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Aim: There is limited research on Out-of-hospital cardiac arrest (OHCA) in the Gulf Cooperation Council (GCC) and especially in Bahrain. This is the first study to describe the incidence, characteristics, and outcomes of OHCA in Bahrain. Methods: This was a retrospective national observational study on OHCA patients in Bahrain using the Utstein framework for resuscitation. Data was collected between 1st July 2022 to 30th June 2023 from the electronic medical records of the only three governmental hospitals emergency departments (EDs) and National Ambulance (NA). Results: The annual incidence of OHCA attended by (Emergency Medical Services) EMS was nearly 21 per 100,000 population. The majority were males (n = 228, 68.8 %) with median age of 65 years (IQR=49–78). Most OHCA cases were witnessed (n = 265, 81 %), with (n = 247, 76 %) happened at home/residence. Rates for bystander CPR was low (n = 122, 36.8 %) and bystander automated external defibrillator (AED) was not performed in any of the cases. The OHCA cases transported by the NA was (n = 314, 94.8 %), with median response time of 9 min (IQR=7–12). However, only (n = 20, 6.0 %) were witnessed by EMS, and (n = 7, 2.1 %) received EMS defibrillation for shockable rhythms. First monitored rhythms included shockable rhythm in (n = 28, 8.5 %) versus non-shockable rhythm in (n = 303, 91.5 %). In the EDs, return of spontaneous circulation was achieved in (n = 60, 18.1 %) cases. But survival rate to hospital discharge at 30-day was (n = 4, 1.2 %) and survival rate to hospital discharge with good neurological outcomes was (n = 0, 0 %). Conclusion: In Bahrain the estimated annual incidence of OHCA is 21 individuals per 100,000 population, with a very low survival rate. Solutions should focus on community-level CPR and AED training, evaluating OHCA care provided by EMS, and establishing OHCA registry.

Sustainable consumption is increasingly considered critical for the sustainable growth of developing countries. Consequently, these countries exert significant efforts to foster sustainable consumption behaviors among the consumer public to maximize their sustainability outcomes. This research, while making appeals to the sustainable consumption theory and the stakeholder theory, aims to determine the role of a few critical antecedents, namely the attitude of consumers towards sustainable consumption, their overall satisfaction with the consumption of sustainable products/services, consumers' environmental knowledge and sustainable consumption promotions together with social media influence in engendering sustainable consumption behaviors among consumer publics, along with the role of governments' sustainable consumption policies in enabling such effects. After performing PLS-based structural equation modeling on 500 data points, we found a significant positive role in the consumers' attitude towards sustainable consumption, their sustainable consumption promotions, the impact of social media, and the environmental knowledge possessed by the consumers in inducing sustainable consumption behaviors. In addition, the mediating effects of sustainable consumption promotions and the instrumental role of the government's sustainable consumption policy have also been empirically substantiated. Besides contributing to advancing the body of knowledge encompassing sustainable consumption and sustainable growth/development, the study puts forward several practical implications for the consumers, practitioners, and public policymakers to transmogrify sustainable consumption behaviors by influencing consumers' attitudes, enhancing their environmental knowledge and social media enabled discourse enkindled by an efficacious sustainable consumption policy put in place by the government.

Due to the influx of advancements in technology and the increased simplicity of communication through emails, there has been a severe threat to the global economy and security due to upsurge in volume of unsolicited During the training of models, high-dimensional and redundant datasets may reduce the classification results of the model due to high memory costs and high computation. An important data processing technique is feature selection which helps in selecting relevant features and subsets of information from the dataset. Therefore, choosing efficient feature selection techniques is very important for the best performance of classification of a model. Moreover, most of the research has been performed using traditional machine learning techniques, which are not enough to deal with the huge amount of data and its variations. Also, spammers are becoming smarter with technological advancement. Therefore, there is a need for hybrid techniques consisting of deep learning and conventional algorithms to cope with these problems. We have proposed a novel scheme in this paper for email spam detection, which will result in an improved feature selection approach from the original dataset and increase the accuracy of the classifier as well. The literature has been studied to explore the efficient machine learning models that have been applied by different researchers for email spam detection and feature selection to acquire the best results. Our method, GWO-BERT, has given remarkable results with deep learning techniques such as CNN, biLSTM and LSTM. We have compared our models with RF and LSTM and used dataset: “Lingspam,” which is a publicly available dataset. With different experiments, our technique, GWO-BERT, obtained 99.14% accuracy, which is almost equal to 100 percent.

Background: Metastasis is the main cause of cancer-related deaths, but efficient targeted therapies against metastasis are still missing. Major gaps exist in our understanding of the metastatic cascade, as existing methods cannot combine sensitivity, robustness, and practicality to dissect cancer progression. Addressing this issue requires improved strategies to distinguish early metastatic colonization from metastatic outgrowth. Methods: Luciferase-labelled MDA-MB-231, MCF7, and 4T1 breast cancer cells were spiked into samples from tumour-naïve mice to establish the limit of detection for disseminated tumour cells. Luciferase-labelled breast cancer cells (±unlabelled cancer-associated fibroblasts; CAFs) were orthotopically implanted in immunocompromised mice. An ex vivo luciferase assay was used to quantify tumour cell dissemination. Results: In vitro luciferase assay confirmed a linear and positive correlation between cancer cell numbers and the bioluminescence detected at single cell level in blood, brain, lung, liver, and mammary fat pad samples. Remarkably, single luciferase-labelled cancer cells were detectable in all of these sites, as the bioluminescence quantified in the analysed samples was substantially higher than background levels. Ex vivo, circulating tumour cells, metastasis, and tumour self-seeding were detected in all samples from animals implanted with highly metastatic luciferase-labelled MDA-MB-231 cells. In turn, detection of poorly metastatic luciferase-labelled MCF7 cells was scarce but significantly enhanced upon co-implantation with CAFs as early as 20 days after the experiment was initiated. Conclusions: These results demonstrate the feasibility of using an ultrasensitive luciferase-based method to dissect the mechanisms of early metastatic colonization to improving the development of antimetastatic therapies.

Objective: To assess the degree of impact the pandemic had on the Oncology Department regarding patient visits and elective procedures. Study Design: Comparative pre-post analysis study. Place and Duration of Study: Medical Oncology Department of Combined Military Hospital, Lahore Pakistan, from Oct to Dec 2019 before the pandemic, and then 2020 during the pandemic. Methodology: Data was collected from the Department regarding the number of outpatient visits, indoor admissions, new cases diagnosed, chemotherapies administered, blood transfusions, and various procedures like lumbar puncture, ascitic fluid paracentesis, pleural fluid drainage, etc. Results: Our study showed an overall decrease in all the study parameters. The average monthly Outpatient visits fell by 395 patients (55.6%). The new cases decreased by 25 patients (36.2%). The indoor admissions also came down by 17 patients (42.5%). Furthermore, the procedures performed in the Oncology department were also observed to have decreased. Conclusion: Oncology has suffered dramatically in the face of the COVID-19 pandemic, with fewer patients visiting the hospital for their consultations, follow-ups, as well as treatments. This has resulted in a delay in diagnosis and treatment and has had a severe adverse psychological impact on the patients. Keywords: COVID-19, Elective procedures, Pandemic, Oncology.

Online purchasing is increasing because customers are shifting to digital wallets and digital money, as these services are provided by different microfinance and other commercial banking sectors, and different online brands are working in Pakistan to support environmental sustainability. The objective of this study was to demonstrate to what extent low distribution charges and low transit time is contributing to impulsive buying when customers can use digital money in Pakistan. The study was conducted using survey research. Importantly, 650 questionnaires were distributed to the respondents with a received response rate of 40%. The study found that digital money (e-wallet) is positively associated with impulsive buying. Moreover, the moderating role of distribution charges and low transit time has been significant in impulsive buying has been significant. This study concludes that low transit time and load distribution charges must be considered by online businesses and brands working in Pakistan to ensure productivity and capture a larger market share of impulsive buying in Pakistan. Also, the current study contributes a theoretical framework to the knowledge and literature related to impulsive buying. The scope of this study is limited to the online businesses and brands that are working to provide products and services to the Pakistani people with the help of digital money and digital transactions. Significantly, this study provides significant future directions that are important to consider for upcoming studies to focus on and contribute to effectively.

Introduction: Since SARS-CoV2 is a novel virus, not much was previously known about the disease, however recent studies have shown that it is transmitted via droplet infection and mainly affects the respiratory tract, causing symptoms of fever, fatigue and shortness of breath. Comorbidities increase risk of severe disease. Aims & Objectives: Our study aims to determine the predominant manifestations and correlations of COVID-19 in Pakistan. Place and duration of study: The study was carried out at CMH Lahore over ten-day duration from 1st June 2020 to 10th June 2020. Material & Methods: Samples of 107 confirmed cases of COVID-19 was taken. Participants were administered a questionnaire by attending doctor which enquired regarding their symptoms, presence of complications, and comorbidities. Data was analyzed using SPSS 25.0. A p-value of