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Background: Peyronie’s disease (PD) is a localized fibrosis of tunica albuginea, which causes the anatomical and functional changes to the penis. Corporoplasty with grafting is indicated in severe (>60°) and complex curvature. Buccal mucosa is the most favored autologous graft material nowadays. The ventrolateral aspect of lingual mucosa has similar histological features to the rest of the oral cavity. Methods: This study aimed to test the efficacy, safety, durability, and reproducibility of corporoplasty with lingual mucosal graft (LMG) in the surgical treatment of PD in terms of surgical outcome, sexual function, and donor site complications. This prospective study included 19 patients of PD with severe and complex curvature, who underwent corporoplasty with LMG. Surgical and functional outcomes were assessed at follow-up planned at 2 weeks, 3 months, 6 months, 1 year, and 2 years. Results: The mean operative time was 126.31 ± 21.45 min. Additional Nesbit’s plication to correct the residual deformity was required in 26% (5 / 19) of patients. Straightening of the penis (curvature 1 cm) postoperatively was achieved in 63% (12 / 19) of patients and a shortening of penis occurred in 5% (1 / 19) of patients. Newer onset erectile dysfunction developed in 11% (2 / 19) of patients, and patient and partner satisfaction rates were 89% (17 / 19) and 84% (16 / 19), respectively, in a mean follow-up of 20.66 ± 5.37 months. Donor site complications were minimal and no patient had any salivary changes or speech disturbances. Conclusion: LMG provided excellent short-term results in terms of deformity correction, improved sexual function, and minimal donor site morbidity. The method is simple and reproducible, and multicenter studies with larger number of cases with longer follow-up are required to confirm these favorable results.

Floods in urban areas have become a common problem globally. Extensive research has been done to understand the changes in urban areas that are resulting in floods, such as Land Use Land Cover changes and insufficient subsurface sewer systems. However, many of these studies have concentrated on the city-level changes causing increased flood events. Hence, this paper explores the impact of temporal changes in Land Use Land Cover (LULC) at the geographic unit (meso) level on the flood response for inland cities. LULC changes for two watersheds, Ulsoor and Bellandur in Bengaluru, are assessed using Remote Sensing data and GIS, and flood metrics are calculated using the Hydrologic Engineering Center Hydrologic Modeling System (HEC HMS) between the years 2003 and 2021. Changes in LULC classes are correlated with the changes in flood metrics. Results indicate that the LULC changes were similar in the two watersheds but with varying rates of change. While changes in built-up areas impacted flood metrics in the Ulsoor watershed, vegetation and open land changes impacted the Bellandur watershed.

Abstract Including sea-level rise (SLR) projections in planning and implementing coastal adaptation is crucial. Here we analyze the first global survey on the use of SLR projections for 2050 and 2100. Two-hundred and fifty-three coastal practitioners engaged in adaptation/planning from 49 countries provided complete answers to the survey which was distributed in nine languages – Arabic, Chinese, English, French, Hebrew, Japanese, Korean, Portuguese and Spanish. While recognition of the threat of SLR is almost universal, only 72% of respondents currently utilize SLR projections. Generally, developing countries have lower levels of utilization. There is no global standard in the use of SLR projections: for locations using a standard data structure, 53% are planning using a single projection, while the remainder are using multiple projections, with 13% considering a low-probability high-end scenario. Countries with histories of adaptation and consistent national support show greater assimilation of SLR projections into adaptation decisions. This research provides new insights about current planning practices and can inform important ongoing efforts on the application of the science that is essential to the promotion of effective adaptation.

It is essential to identify consumer purchase behavior to establish and implement effective marketing strategies by Western food chains in Pakistan. By identifying motives, firms can offer extra-value products to their current and potential clients. Thus, this study seeks to understand what drives Pakistani consumers to buy imported Western food. This quantitative study uses A standardized structured questionnaire to collect data from 375 Karachi residents. The researchers use a convenient sampling strategy and analyze the data using PLS-SEM modeling through Smart-PLS 4.0. The findings of this research demonstrate that subjective norms, religiosity, product attributes, brand trust, customer satisfaction, and lifestyle significantly and positively influence consumer purchase intention. The findings also show that consumer purchase intention, lifestyle, and subjective norms significantly and positively correlate with purchase behavior. Finally, the study concludes that purchase intention significantly and positively mediates between exogenous and endogenous variables (purchase behavior). This research has significant theoretical and managerial implications. Local and international marketing professionals who wish to investigate the expanding consumer market in Pakistan can find the study's findings extremely useful. In addition, the outcomes of this research enrich the existing body of consumer behavior literature, which is helpful for future researchers.

Background: Xanthogranulomatous pyelonephritis (XGP) is chronic pyelonephritis subtype where in renal parenchymal destruction occurs and therefore results in progressive loss of kidney functions. Although middle age group is the predominant age group affected but it can be seen at any age. There is accumulation of macrophages (lipid-laden) leading to renal parenchymal destruction and fibrosis. In this study, we present our data of 15 patients who had undergone nephrectomy and were biopsy proven XGP. Aims and Objectives: The aim of the study was to describe the clinical and radiological features of XGP in adults. Materials and Methods: XGP constituted 4.31% of the 348 nephrectomies done for infective causes over a period of 7 years. All our patients had undergone unilateral total nephrectomy. Demographic and clinical records were analyzed after consent from all the patients. Results: The age range in our study was 18–65 years with mean 42.93±15.66 years. Nine of our patients, that is, 60% were females. Diabetes was present in 53.3% of our patients. Three patients had imaging suggestive of pyonephrosis, three patients had perinephric collection and 9 patients (60%) had concomitant nephrolithiasis. All the kidneys were grossly enlarged and were non-functional on renal scintigraphy. Conclusion: XGP is a form of chronic pyelonephritis which although being less common but is devastating given the destruction of renal parenchyma it does and associated morbidity. Clinicoradiologic correlation cannot be overemphasized. The definitive diagnosis is established after histopathologic examination.

Vehicle electrification is a critical application of lithium-ion batteries (LIBs), and it is essential to develop LIBs that can operate at sub-ambient temperatures with satisfying performance. Conventional LIBs have performance deficits at low temperatures which hinder their use in extreme environments. One approach to address this problem is to rationally engineer the electrode/electrolyte interface with electrolyte additives to improve the electrochemical kinetics at sub-ambient temperatures. In this work, silicic acid (SiAc) is incorporated into standard LIB electrolyte as an additive to enhance the capacity and energy density of LIBs at temperatures down to −20 °C. Full-cell impedance analysis and X-ray photoelectron spectroscopy of cycled electrodes point towards an additive-induced change in surface chemistry which alters the charge transfer process. It is proposed that the SiAc additive participated in the formation of solid electrolyte interphase (SEI) and lowered the activation energy of the interface impedance, assisting lithium ion transport across the interface at lower temperatures.

Dengue fever is a viral infection caused by the dengue virus and is a growing concern for public health worldwide, particularly in tropical and subtropical regions. This study aimed to assess the diagnostic accuracy of a commercially available NS1 ELISA kit for dengue fever in Pakistan using multiplex qRT-PCR as the gold standard. The study recruited 1236 suspected cases of dengue fever admitted to public sector hospitals in Lahore, Pakistan. Of the suspected cases, 610 (49.3%) were confirmed positive for DENV infection through qRT-PCR, with all four serotypes detected. DENV-2 was the most prevalent serotype, detected in 95.7% of cases. The NS1 ELISA kit detected 71.1% of the positive cases. However, the diagnostic accuracy of the NS1 ELISA kit was found to be only 64.89%. Of the 610 confirmed cases, 68% were male and 32% were female, with a median age of 30 years. Dengue fever was diagnosed in 91.8% of cases, while 8.2% were diagnosed with dengue hemorrhagic fever (DHF). DHF patients had a higher prevalence of abdominal pain, hemorrhagic manifestations, and thrombocytopenia. The cocirculation of all four DENV serotypes in Lahore is concerning and could lead to more severe forms of the disease, such as DHF or dengue shock syndrome, in the future. The study highlights the low diagnostic accuracy of commercially available NS1 ELISA kits and emphasizes the importance of using molecular methods to confirm acute dengue infections. Given the increasing prevalence of dengue fever in developing countries like Pakistan, more accurate and reliable diagnostic tools are needed for effective disease management and control.

Green innovation is an essential and burning topic for environmental and organizational performance. Therefore, this research aims to examine the effect of green innovation on environmental performance, which leads to organizational performance. Another objective is to measure the impact of two dimensions of green innovation, such as green process & green product measures, on green innovation. The second prime aim of this research is to evaluate the moderation of management commitment & human resource practices in an association between green innovation and organizational & environmental performance. A total of 320 employees provided their perspectives on a self-administrated questionnaire from the textile industry of Pakistan. We have employed SEM-based multivariate modeling to examine the data. This research has measured the reflective indicators measurement model through confirmatory factor analysis, an obvious choice of structural equation modeling to examine observed and unobserved variables and indicators using PLS-SEM (partial least square-structural equation modeling). The research findings reveal a positive & significant effect of product & process innovation on green innovation. Further, green innovation significantly impacts environmental and organizational performance. A two-way interaction (moderation) of human resource practices & green innovation does not have a cogent moderating effect on organizational & environmental performance. However, management commitment has a significant moderation between green innovation & organizational performance. A three-way interaction (moderated moderation) model finds a substantial effect on organizational attainment but an insignificant impact on environmental performance. The research outcomes significantly contribute and suggest that practitioners and policymakers must institutionalize green innovation practices in their organizations to enhance their organizational and environmental performance. HR practitioners play a vibrant role in creating green norms and organizational culture. The study findings also suggest that management commitment to green innovation advocates organization-level transformations toward adopting green practices.

IgG4 Related disease (IgG4 RD) is a rapidly evolving clinical entity, involving multiple organs, manifesting clinically as tumefactive lesions, histopathologically characterized by an IgG4 predominant, dense lymphoplasmacytic tissue infiltrate. It might mimic malignancy, infection as well as various other inflammatory disorders. First described in literature in 2003, in the pancreas, it has been subsequently seen to involve a wide range of organs like salivary glands, paranasal sinuses, thyroid gland, retroperitoneum, lung and kidney. Rarely, it may present as a skull base osteomyelitis (SBO). Diagnosing IgG4 RD in such patients is a herculean challenge in view of absence of systemic symptoms, difficulty in obtaining adequate tissue specimens in view of densely fibrotic cranial base lesions, as well as the close proximity of the lesions to critical neurovascular structures. The standard of care, in such cases is medical, and comprises of steroids and rituximab. Herein, we discuss one such case of IgG4 RD, who presented as multiple lower cranial nerve palsies and headache, with imaging evidence of SBO, which was diagnosed as a case of IgG4RD on histopathology, and who despite receiving the standard of care, had a poor outcome. The purpose of presenting this case is to stress upon a high index of suspicion and an aggressive management approach while treating such cases.

Due to stability issue of isoquinolone’s their N-methylation is a challenging task, achieved the synthesis of N-methylated 2-methylisoquinoline-1,5,8(2H)-trione using readily available precursor 2-(2,5-dimethoxyphenyl)ethanamine via multistep strategy, finally oxidation of 5,8-dimethoxy-2-methyl-3,4-dihydroisoquinolin-1(2H)-one with ceric ammonium nitrate (CAN) lead to target isoquinolone in good yield, further oxidation conditions in final step were optimized using different catalyst ratio, reaction time and temperature conditions. DOI: http://dx.doi.org/10.17807/orbital.v12i1.143

Introduction: We share our experience of managing 15 cases of forgotten double-J (DJ) stent in our tertiary care center. Methods: This is a retrospective analysis of cases with forgotten DJ stent for a period of 2 years spanning from January 2017 to January 2019. The details included sex, age, literacy, socioeconomic status, stenting indication, duration of indwelling stent, presenting complaints, type of encrustations, various treatments given, intraoperative complications, and their management and eventual outcome. Results: The male-to-female ratio was 2:1, and the mean age was 39.5 years (17–65). The mean indwelling time was 31.7 months. The majority of patients had an education score of 1 out of 7 and belonged to lower socioeconomic class according to the modified Kuppuswamy scale. The most common presentation was irritative voiding symptom. The complicated and heavily encrusted stents were managed by combination of endourological procedures, and procedures were staged whenever deemed necessary. Majority of the stents were removed with simple retrograde cystoscopic removal. There was no mortality in our study. Conclusions: A forgotten DJ stent affects population having low education score and belonging to the lower end of the socioeconomic class. Endourological procedures are quite successful in managing a forgotten DJ stent, provided the treatment options are selected judiciously and meticulously. We also suggest some protocols to be followed in our study in order to prevent a forgotten DJ stent.

Dengue has become endemic in Pakistan with annual recurrence. A sudden increase in the dengue cases was reported from Rawalpindi in 2016, while an outbreak occurred for the first time in Peshawar in 2017. Therefore, a multi-center study was carried out to determine the circulating dengue virus (DENV) serotypes and Chikungunya virus (CHIKV) co-infection in Lahore, Rawalpindi, and Peshawar cities in 2016-18. A hospital-based cross-sectional study was carried out in Lahore and Rawalpindi in 2016-18, while a community-based study was carried out in Peshawar in 2017. The study participants were tested for dengue NS1 antigen using an immunochromatographic device while anti-dengue IgM/IgG antibodies were detected by indirect ELISA. All NS1 positive samples were used for DENV serotyping using multiplex real-time PCR assay. Additionally, dengue samples were tested for CHIKV co-infection using IgM/IgG ELISA. A total of 6291 samples were collected among which 8.11% were NS1 positive while 2.5% were PCR positive. DENV-2 was the most common serotype (75.5%) detected, followed by DENV-1 in 16.1%, DENV-3 in 3.9% and DENV-4 in 0.7% while DENV-1 and DENV-4 concurrent infections were detected in 3.9% samples. DENV-1 was the predominant serotype (62.5%) detected from Lahore and Rawalpindi, while DENV-2 was the only serotype detected from Peshawar. Comorbidities resulted in a significant increase (p-value

Abstract Background Point‐of‐care (POC) International Normalized Ratio (INR) measurement provides efficient monitoring of warfarin therapy; however, its reliability may be affected in patients with anemia, such as those with sickle cell disease (SCD). Objectives To evaluate the correlation of POC‐INR to clinical laboratory INR (CL‐INR) in SCD and use of a correction factor. Patient/Methods In this retrospective study, the accuracy of POC‐INR compared to CL‐INR was evaluated in a cohort of patients with SCD and in a non‐SCD Black cohort. Results Despite the difference in anemia, the SCD cohort showed a similar percentage of in‐range POC‐INR values as observed in the non‐SCD cohort (37% vs 42%). The SCD cohort was randomly divided to form discovery and validation cohorts. In the discovery cohort, 86% of POC‐INRs were in range when the POC‐INRs were ˂4.0, but only 24% were in range if POC‐INRs were ≥4.0. A linear regression of CL‐INR versus POC‐INR for POC‐INR values ≥4.0 yielded a coefficient of 0.72 (95% confidence interval, 0.69‐0.75); Multiplying POC‐INR by this correction factor, rounded to 0.7 for ease of use in clinical practice, improved the proportion of in‐range POC‐INR values ≥4.0 from 24% to 100% in the SCD discovery cohort and from 19% to 95% in the SCD validation cohort. Similar findings applied to analyses of the non‐SCD cohort. Conclusions POC‐INR and CL‐INR in patients with SCD are similar when POC‐INR is

The polymer electrolytes are considered to be an alternative to liquid electrolytes for lithium-ion batteries because of their high thermal stability, flexibility, and wide applications. However, the polymer electrolytes have low ionic conductivity at room temperature due to the interfacial contact issue and the growing of lithium dendrites between the electrolytes/electrodes. In this study, we prepared gel polymer electrolytes (GPEs) through an in situ thermal-induced cationic ring-opening strategy, using LiFSI as an initiator. As-synthesized GPEs were characterized with a series of technologies. The as-synthesized PNDGE 1.5 presented good thermal stability (up to 150 °C), low glass transition temperature (Tg < −40 °C), high ionic conductivity (>10−4 S/cm), and good interfacial contact with the cell components and comparable anodic oxidation voltage (4.0 V). In addition, PNGDE 1.5 exhibited a discharge capacity of 131 mAh/g after 50 cycles at 0.2 C and had a 92% level of coulombic efficiency. Herein, these results can contribute to developing of new polymer electrolytes and offer the possibility of good compatibility through the in situ technique for Li-ion batteries.

Epilepsy is a severe neurological disorder involving 70 million people around the globe. Epilepsy-related neuropsychiatric comorbidities such as depression, which is the most common, is an additional factor that negatively impacts the living quality of epilepsy patients. There are many theories and complexities associated with both epilepsy and associated comorbidities, one of which is the gut-brain-axis influence. The gut microbiome is hypothesized to be linked with many neurological disorders; however, little conclusive evidence is available in this area. Thus, highlighting the role will create interest in researchers to conduct detailed research in comprehending the influence of gut-brain-axis in the manifestation of depressive symptoms in epilepsy. The hypothesis which is explored in this review is that the gut-brain-axis do play an important role in the genesis of epilepsy and associated depression. The correction of this dysbiosis might be beneficial in treating both epilepsy and related depression. This hypothesis is illustrated through extensive literature discussion, proposed experimental models, and its applicability in the field. There is indirect evidence which revealed some specific bacterial strains that might cause depression in epilepsy.

The term survival analysis has been used in a broad sense to describe collection of statistical procedures for data analysis for which the outcome variable of interest is time until an event occurs, the time to failure of an experimental unit might be censored and this can be right, left, interval, and Partly Interval Censored data (PIC). In this paper, the analysis of this model is conducted based on parametric Weibull model via PIC data. Moreover, two imputation techniques are used, which are: left point and right point. The effectiveness of the proposed model is tested through numerical analysis on simulated and secondary data sets.

In the studies that involve competing risks, somehow, masking issues might arise. That is, the cause of failure for some subjects is only known as a subset of possible causes. In this study, a Bayesian analysis is developed to assess the effect of risks factor on the Cumulative Incidence Function (CIF) by adopting the proportional subdistribution hazard model. Simulation is conducted to evaluate the performance of the proposed model and it shows that the model is feasible for the possible applications.

Rechargeable lithium-ion batteries have drawn extensive attention owing to increasing demands in applications from portable electronic devices to energy storage systems. In situ polymerization is considered one of the most promising approaches for enabling interfacial issues and improving compatibility between electrolytes and electrodes in batteries. Herein, we observed in situ thermally induced electrolytes based on an oxetane group with LiFSI as an initiator, and investigated structural characteristics, physicochemical properties, contacting interface, and electrochemical performances of as-prepared SPEs with a variety of technologies, such as FTIR, 1H-NMR, FE-SEM, EIS, LSV, and chronoamperometry. The as-prepared SPEs exhibited good thermal stability (stable up to 210 °C), lower activation energy, and high ionic conductivity (>0.1 mS/cm) at 30 °C. Specifically, SPE-2.5 displayed a comparable ionic conductivity (1.3 mS/cm at 80 °C), better interfacial compatibility, and a high Li-ion transference number. The SPE-2.5 electrolyte had comparable coulombic efficiency with a half-cell configuration at 0.1 C for 50 cycles. Obtained results could provide the possibility of high ionic conductivity and good compatibility through in situ polymerization for the development of Li-ion batteries.

The reactivity of benzyl hypervalent iodine intermediates was explored in congruence with the reductive iodonio-Claisen rearrangement (RICR) to show that there may be an underlying mechanism which expands the reasoning behind the previously known C–C bond-forming reaction. By rationalizing the hypervalent iodine’s metal-like properties it was concluded that a transmetallation mechanism could be occurring with metalloid groups such as silicon and boron. Hypervalent iodine reagents such as Zefirov’s reagent, cyclic iodonium reagents, iodosobenzene/BF3, and PhI(OAc)2/BF3 or triflate-based activators were tested. A desirable facet of the reported reaction is that iodine(I) is incorporated into the product thus providing greater atom economy and a valuable functional group handle for further transformations. The altering of the RICR’s ortho-selectivity to form para-selective products with benzyl hypervalent iodine intermediates suggests a mechanism that involves hypervalent iodine-guided electrophilic substitution (HIGES).

Abstract Pyrido-oxazine derivatives have been synthesized by employing tandem SN2 and SNAr reaction between 2,4,6-tribromo-3-(2-bromoethoxy)pyridine or 2,4,6-tribromo-3-(3-bromopropoxy)pyridine and a variety of primary amines. Moderate to good regioselectivity in favor of cyclization at the 2-position is observed. Pyrido-oxazine products thus generated are converted into biarylated pyrido-oxazine and terpyridine ligands.