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This research aims to understand the nonlinear relationship between financial inclusion and Islamic banking stability, as well as the moderating effect of corporate social responsibility on this relationship. To do so, we use a sample of 27 Islamic banks operating in the GCC countries (Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) over the period 2012–2020. We used the two-step system generalized method of moments (SGMM). This method accounts for the dynamic nature of the dependent variable and potential endogeneity. The results indicate that there is an inverted U-shaped relationship between financial inclusion and Islamic banking stability. Moreover, they show that CSR moderates the relationship between financial inclusion and Islamic banking stability. It is imperative that policymakers and the leaders of Islamic banking institutions adopt a thoughtful financial inclusion strategy that carefully balances its advantages, such as promoting equity and financial justice, reducing funding costs and improving financial stability, with its potential disadvantages, such as the risks associated with excessive leverage. Moreover, the trade-off between financial inclusion and CSR is drastic to avoid default risks and optimize the effect of financial inclusion on Islamic banking stability.

National cancer control planning is crucial for countries in the WHO Eastern Mediterranean region. This region is challenged with an increase in cancer incidence leading to substantial disease burden, premature deaths, and increasing health-care costs in most countries. Huge inequity in cancer control planning and implementation exists between and within the countries. Over half of the countries (12 [55%] of 22) have standalone comprehensive National Cancer Control Plans and six (27%) have non-communicable disease plans that include cancer. The implementation of cancer plans has common challenges related to weak governance structure, few coordination mechanisms within countries, and inadequate human and financial resources. In most countries, the plan is not costed. Yet, the majority of countries (20 [91%]) reported having fully or partially funded plans. Additionally, political instability and conflicts affecting over half of the countries in the Eastern Mediterranean region have enormously affected cancer planning and implementation, both among the affected countries and those that host large numbers of refugees. In this Policy Review, we used the WHO regional framework for action on cancer to systematically analyse the status of cancer control planning and implementation across the six domains of cancer control, from prevention to palliation. We highlight the gaps, and the opportunities for bridging these gaps, to achieve scale-up on implementation of cancer control programmes in the Eastern Mediterranean region.

ObjectivesTo evaluate progress in the implementation of the WHO Eastern Mediterranean Regional Office (EMRO) Regional Framework for Action on Diabetes Prevention and Control, identify implementation barriers and facilitators, and provide recommendations for accelerating progress, with a particular focus on fragile, conflict-affected and vulnerable settings (FCVs).DesignMixed-methods study combining secondary analysis of quantitative data from WHO datasets with qualitative synthesis of inputs from WHO consultative meetings with EMR member states.Setting22 countries of the WHO EMR, including 10 classified as FCV and 12 as non-FCV according to World Bank and WHO classifications.ParticipantsQuantitative data were drawn from the 2021 WHO Country Capacity Survey targeting all EMR countries and other WHO sources. Qualitative data were based on insights from 16 country representatives during a regional WHO EMRO webinar, including non-communicable diseases programme managers, policy leads and WHO country office staff.ResultsAmong the 22 countries analysed, only 10% (1/10) of FCVs had a national diabetes action plan compared with 67% (8/12) of non-FCVs. A sugar-sweetened beverage tax was implemented in 75% (9/12) of non-FCVs but in just 10% (1/10) of FCVs. For diabetes management, detailed national guidelines were available in 30% (3/10) of FCVs compared with 83% (10/12) of non-FCVs; insulin was available in primary care in 50% (5/10) of FCVs compared with 83% (10/12) of non-FCVs. Surveillance systems were less robust in FCVs: while 70% (7/10) collected data on diabetes status, only 30% (3/10) had a national diabetes registry, compared with 83% (10/12) of non-FCVs.ConclusionsAddressing diabetes in the EMR requires strategic collaboration and tailored approaches for FCVs, including strengthened governance, preparedness, integrated care, medication access and surveillance. Prioritising primary healthcare and embedding diabetes prevention and control in universal health coverage and emergency response frameworks is critical to reducing inequities and improving health outcomes in fragile contexts.

The Eastern Mediterranean region covers a population of more than 700 million individuals and 22 countries and territories, sharing histories, culture, and languages. The countries and territories of this region also have large differences in demographics and human development. Population ageing and growth is predicted to more than double the number of new cancer cases in the region over the next few decades, from 782 000 in 2022 to close to 1·8 million by the year 2050. At the same time, cancer control capacity is low, with large inequalities between and within countries, further aggravated by political instability and conflicts. From 2013, the International Agency for Research on Cancer and the WHO Regional Office for the Eastern Mediterranean have been working together to strengthen cancer surveillance to inform regional and national cancer control. Based on an exposition of the cancer patterns, this Policy Review summarises remaining opportunities and barriers in ensuring high-quality cancer surveillance in all WHO Eastern Mediterranean countries and territories.

Background: Mental health has been identified by the World Health Organization as an integral component of the COVID-19 response. Aims: This study aimed to estimate the impact of COVID-19 pandemic on mental, neurological and substance use disorders (MNS) services in the Eastern Mediterranean Region. Methods: The assessment was conducted through a web-based survey that was completed by national mental health focal persons and was analysed between June and August 2020. Results: School and workplace mental health services were wholly or partially disrupted in more than 70% of reporting countries. Fewer than 20% of the countries in the Region reported full operations of mental health services for children and adolescents or for older adults. The main reasons were travel restrictions, decreases in inpatient volumes due to the cancellation of elective care, decreases in outpatient volumes due to patients not presenting, and health authority directives for the closure of outpatient services. The majority (85%) of countries responded by establishing MNS helplines using telemedicine/teletherapy and digital psychological interventions. The fragile and conflict-affected states relied mostly on implementing infection prevention and control measures at MNS service facilities. Gaps were identified in the areas of addictive behaviours, substance use and neurology research related to the pandemic. Conclusion: The assessment highlights the need to strengthen capacities for monitoring changes in service delivery and utilization, and documents evidence on what works in different settings during the different phases of the pandemic to facilitate informed decisions related to the nature and timing of adaptations to service delivery.

The urbanization of cities, the corroding of green areas, and the increasing demand for electric energy lead to the formation of heat islands in cities and the appearance of the global climate change phenomenon. Therefore, it was necessary to resort to the use of renewable energy sources, such as geothermal energy, to be used in different applications, as it can be used to cool buildings in cities during the summer. This research deals with the benefits of using geothermal energy systems, their different types, and the possibility of their application in Egypt. Also discussing the effectiveness of the vertical closed geothermal system in residential buildings in Alexandria Governorate in Egypt to reach an answer to a question. The effectiveness of the geothermal energy system in residential buildings is to reduce the problem of rising temperatures, energy consumption for cooling, and carbon emissions and thus reduce the problem of the formation of heat islands in cities and the appearance of the global climate change phenomenon and reaching a sustainable, environmentally friendly building that achieves thermal comfort for humans through the use of a simulation program called TRNSYS-17, through which the current situation of the building was compared and the addition of a vertical closed geothermal system was assumed, the extent of its effectiveness was compared in the whole building, and the cost of a vertical closed geothermal system and a traditional air conditioning system (HVAC) in a building was compared (case study). Hence, the efficiency of the vertical closed geothermal system appeared to reduce electric energy consumption and carbon emissions in the whole building at Alexandria in Egypt, especially the ground floor, which reached thermal comfort for humans and worked to reduce electricity consumption and carbon emissions by up to 22.93% in the building as a whole.

ObjectiveChildren are vulnerable to secondhand smoke (SHS) exposure because of limited control over their indoor environment. Homes remain the major place where children may be exposed to SHS. Our study examines the magnitude, patterns and determinants of SHS exposure in the home among children in 21 countries (19 low-income and middle-income countries and 2 high-income countries).MethodsGlobal Adult Tobacco Survey (GATS) data, a household survey of people 15 years of age or older. Data collected during 2009–2013 were analysed to estimate the proportion of children exposed to SHS in the home. GATS estimates and 2012 United Nations population projections for 2015 were also used to estimate the number of children exposed to SHS in the home.ResultsThe proportion of children younger than 15 years of age exposed to SHS in the home ranged from 4.5% (Panama) to 79.0% (Indonesia). Of the approximately one billion children younger than 15 years of age living in the 21 countries under study, an estimated 507.74 million were exposed to SHS in the home. China, India, Bangladesh, Indonesia and the Philippines accounted for almost 84.6% of the children exposed to SHS. The prevalence of SHS exposure was higher in countries with higher adult smoking rates and was also higher in rural areas than in urban areas, in most countries.ConclusionsA large number of children were exposed to SHS in the home. Encouraging of voluntary smoke-free rules in homes and cessation in adults has the potential to reduce SHS exposure among children and prevent SHS-related diseases and deaths.

Background: Three global reports published by the World Health Organization (WHO) report trends in the prevalence of tobacco smoking from 2000 to 2025 based on data from national surveys. Aims: The is study aimed to: (i) compare current and projected prevalence rates of tobacco smoking presented in these reports for males ≥ 15 years in countries of the Eastern Mediterranean Region; and (ii) assess changes in the prevalence rates in the context of changes in tobacco monitoring and control policies in these countries. Methods: Regional and country-level data on tobacco smoking were extracted from the trend reports. Percentage point differences between the estimated prevalence of tobacco smoking in 2010 and the projected prevalence in 2025 were calculated for countries with available data. Data on implementation of national surveys and policies on tobacco use were obtained from relevant WHO reports. Results: In the latest trend report (2019), the prevalence of male current tobacco smoking is projected to decrease by less than 2 percentage points in the Region (from 33.1% in 2010 to 31.2% in 2025). The projections for male tobacco smoking for 2025 in the 2019 report are more encouraging than in the 2015 report in seven of the eight countries of the Region. For five of these seven countries, implementation of tobacco monitoring and tobacco control policies improved over the same period. Conclusions: Countries of the Region need to conduct additional national tobacco-use surveys to improve the accuracy of prevalence estimates and projections. Such data can help guide policy-makers to implement policies to control tobacco smoking.

Background Noncommunicable diseases (NCDs) are the leading causes of mortality and morbidity among Palestinians, accounting for 71.8% of all deaths in 2023. Following the initial STEPS survey conducted in 2010/2011 and in accordance with WHO recommendations, a second STEPS survey was carried out for the occupied Palestinian territory (oPt) between August and October 2022. Methods The target population for the survey included all Palestinian individuals between 18 and 69 years of age residing in the West Bank and Gaza. A three-stage stratified cluster sampling method was used to randomly select a sample of 5,775 adults from 525 enumeration areas, comprising 3,135 individuals from the West Bank and 2,640 from the Gaza Strip. Of the target sample, 5503 adults participated in the survey. Results The prevalence of smoking, obesity, and insufficient physical activity among Palestinians was notably high, with rates of 33.5%, 31.6%, and 21.1%. The prevalence of smoking among men in the West Bank was alarmingly high and was the highest in the world. In terms of diet, 84.3% of the participants reported an insufficient intake of fruits and vegetables, and 26.5% always or often added salt to their food before eating. Among the Palestinian population aged 18–69 years, 7.6% had raised fasting blood glucose (≥ 126 mg/dl) or were currently on medication for raised blood glucose; and 17.1% of adults between the ages of 40–69 years had a 10-year cardiovascular disease risk (CVD) risk ≥ 20% or had existing CVD. More than 55% of men and women aged 45–69 had three or more risk factors for NCDs. Conclusions The prevalence of risk factors for NCDs was notably high in oPt. These results underscore the urgent need for interventions to reduce the imminent burden of NCDs within this vulnerable population. The worsening crisis in Gaza demands immediate action. Unified and decisive global efforts are essential to halt the war in Gaza, secure a permanent ceasefire, and ensure access to humanitarian aid. While rebuilding the healthcare system will be a long-term undertaking, empowering local professionals, investing in essential infrastructure, and providing sustained support can offer renewed hope to patients with NCDs.

Purpose To compare changes of vertical palpebral fissure height after bilateral lateral rectus (BLR) recessions versus unilateral lateral rectus (LR) recession and medial rectus (MR) muscle scleral plication, for treatment of intermittent exotropia. Methods This prospective, comparative, randomized study included 40 patients with intermittent exotropia who were divided into two groups: 20 patients who underwent BLR recessions (BLR recession group) and 20 patients who underwent unilateral LR recession and MR muscle scleral plication (recession-plication group). Eyelid evaluation included measurement of margin reflex distance 1 (MRD1) and margin reflex distance 2 (MRD2) at 1 week, 6 weeks, and 3 months postoperatively. Angle of deviation and any incomitance were also recorded at each visit. Results There was no significant statistical difference in eyelid measurements after the surgery between both groups (P = 1.00). There was no significant statistical difference in ocular alignment after the surgery between both groups (P = 1.00). Also, there was no significant statistical difference in lateral incomitance after the surgery between both groups (P = 1.00). Conclusions Both the unilateral recession and plication of horizontal rectus muscles technique and bilateral recession provide comparable surgical results for correction of exotropia without significant palpebral fissures changes or lateral incomitance. [J Pediatr Ophthalmol Strabismus. 2025;62(3):182–189.]