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Background and Objective: Polio is still endemic in Pakistan and Afghanistan. In Pakistan, transmission of polio virus is high due to poor political environment and internal security threats especially in war against terrorism in Swat and FATA. Meanwhile, some groups tried to create misconception about polio vaccine. The objective of the study was to describe the reasons underpinning the refusals to polio vaccine in District Multan. Methods:- This descriptive, cross sectional study was conducted in a District Multan. A closed ended pre- tested questionnaire in Urdu language was used to collect data from 34 parents of under five year children, who refused polio vaccaniation during polio compaign. Results:- Out of 34 polio vaccine refusal parents, 15 did not respond or either locked the doors as researcher tried to interview them. About 29% refusing parents mentioned religious reasons, about 42% have apprehensions on polio vaccine contents. One third reported that it was a western world conspricy against mullims. 45% states that government vaccine supply is of poor quality, as the main factor for refusal. Conclusion: Majority of refusing parents were uncomfortable in responding to the survey or either they were never counseled for Polio and now they are habitual refusals or may be perception about polio vaccine is negative. In District Multan, religious reasons and misconception that vaccine causes sterility in male children were main reasons of polio vaccine refusal. Efforts will be required in changing the perception of parents.

Introduction: Tobacco use has become quite common in school students worldwide and Pakistan is one of those countries massively affected. Data about implementation of tobacco control policies in schools of Peshawar city are scanty, with consequences for the health of students and school staff. Objectives: To evaluate the implementation of tobacco control policies in schools, and the effect these policies have on tobacco use among students. Material & Methods: A cross sectional study was conducted among 3 private and 3 public schools of Peshawar city. Self-structured Questionnaires were used to collect data from school administration and the students. Schools were selected through simple random sampling. Classes 8, 9 and 10 were selected from each school and one section was selected from each class randomly. Students were selected through systematic sampling in which every third student was selected from each row. The age group of study subjects ranged from 12 to 18 years. Results: Out of the 230 students that participated in the study, 51.3% were from the age group 15-18 years and 48.7% students were in the age group 12-14 years. Amongst these, 6.52% of students reported using tobacco products. Of 6 schools included in the study, 4 were unaware of the latest tobacco control policy developed by Khyber Pakhtunkhwa (KP) government for schools. Of the remaining 2 schools, only one was effectively implementing the policy, in which 8.10% students were regular users of tobacco compared to 5.4% of students from schools not following the tobacco policy. The schools unaware of tobacco policies had 6.4% students using tobacco. Conclusion: Two-thirds of the schools were unaware of any Tobacco Policy. An almost total lack of policy implementation was observed in the schools studied, even among the schools aware of the policy.

The study investigates the association of employees’ internal locus of control, employees’ contextual and task performance. Survey questionnaires were gathered from middle-level managers from the banking sector of Pakistan. Regressions analysis was utilized to inspect the impacts of internal locus of control on two dimensions of employees’ performance. Results demonstrate that middle-level managers internal locus of control emphatically impact task performance; internal locus of control uncovers a negative impact on employees’ contextual performance. Besides, a person possessing an internal locus of control may experience a higher positive impact on employee task performance.

Tubercles are small protuberances or bumps on the leading edge of humpback whale's pectoral fin. To examine the effects of leading-edge tubercles on the aerodynamic performance of a flapping wing, lift, drag, and power coefficients are obtained from numerical simulations. A revolving wing (one-degree-of-freedom azimuth rotation; rotation in a horizontal plane after an initial acceleration) with leading-edge tubercles at an angle of attack of 40° and Reynolds number of 400 is used in the present study. The reason for choosing azimuth rotation is that it resembles downstroke and upstroke of flapping motion of an insect. A rigid rectangular wing with six different combinations of wavelengths ( λ = 10% and 50% of the chord length) and amplitudes ( A = 2.5%, 5%, and 10% of the chord length) are chosen for this study. These parameters are inspired by the tubercles present at the leading edge of humpback whales' pectoral fin. It was observed that generally, tubercles degraded the aerodynamic performance of the wings in terms of lift, drag, and power coefficients. Although some of the tubercle leading-edge wings showed lower drag (2.20% lower) and lower power coefficient (2.12% lower) values than the baseline wing, none of the tubercle wing performed better than the baseline wing in terms of aerodynamic performance parameters; aerodynamic efficiency ([Formula: see text]) and power economy ([Formula: see text]). Hence, it was concluded that the tubercles are not advantageous over the straight leading-edge wing for azimuth rotating hovering insect-like motion and further investigation is required to explore its potential benefits.

In recent years, Pakistan's computer software market has experienced steady growth. Agile is the iterative approach in software industry. Innovation by employees is one of the best ways to enhance innovation and organizational success. The customer wants new and innovative products. This required an effective innovative behavior. New ideas affect the performance of projects positively or negatively and became the reason of project success or project failure. Based on 223 responses collected from the software industry in Pakistan. To test descriptive analysis and correlation Cronbach alpha and SPSS was used. The study found that Idea Exploration was significantly related to agile project performance. Idea Generation also was significantly related to agile project performance. Idea Championing also was significantly related to agile project performance. Idea Implementation also was significantly related to agile project performance. The findings of this study help the project managers to implement better strategies and plan for agile project management success. The study has implications for both theoretical and practical professionals working in software industry of Pakistan.

OBJECTIVE The growth characteristics of vestibular schwannomas (VSs) under surveillance can be studied using a Bayesian method of growth risk stratification by time after surveillance onset, allowing dynamic evaluations of growth risks. There is no consensus on the optimum surveillance strategy in terms of frequency and duration, particularly for long-term growth risks. In this study, the long-term conditional probability of new VS growth was reported for patients after 5 years of demonstrated nongrowth. This allowed modeling of long-term VS growth risks, the creation of an evidence-based surveillance protocol, and the proposal of a cost-benefit analysis decision aid. METHODS The authors performed an international multicenter retrospective analysis of prospectively collected databases from five tertiary care referral skull base units. Patients diagnosed with sporadic unilateral VS between 1990 and 2010 who had a minimum of 10 years of surveillance MRI showing VS nongrowth in the first 5 years of follow-up were included in the analysis. Conditional probabilities of growth were calculated according to Bayes’ theorem, and nonlinear regression analyses allowed modeling of growth. A cost-benefit analysis was also performed. RESULTS A total of 354 patients were included in the study. Across the surveillance period from 6 to 10 years postdiagnosis, a total of 12 tumors were seen to grow (3.4%). There was no significant difference in long-term growth risk for intracanalicular versus extracanalicular VSs (p = 0.41). At 6 years, the residual conditional probability of growth from this point onward was seen to be 2.28% (95% CI 0.70%–5.44%); at 7 years, 1.35% (95% CI 0.25%–4.10%); at 8 years, 0.80% (95% CI 0.07%–3.25%); at 9 years, 0.47% (95% CI 0.01%–2.71%); and at 10 years, 0.28% (95% CI 0.00%–2.37%). Modeling determined that the remaining lifetime risk of growth would be less than 1% at 7 years 7 months, less than 0.5% at 8 years 11 months, and less than 0.25% at 10 years 4 months. CONCLUSIONS This multicenter study evaluates the conditional probability of VS growth in patients with long-term VS surveillance (6–10 years). On the basis of these growth risks, the authors posited a surveillance protocol with imaging at 6 months (t = 0.5), annually for 3 years (t = 1.5, 2.5, 3.5), twice at 2-year intervals (t = 5.5, 7.5), and a final scan after 3 years (t = 10.5). This can be used to better inform patients of their risk of growth at particular points along their surveillance timeline, balancing the risk of missing late growth with the costs of repeated imaging. A cost-benefit analysis decision aid was also proposed to allow units to make their own decisions regarding the cessation of surveillance.

Information technology governance (ITG) is recognized as a vital organizational ability to exploit opportunities for innovation and enhance organizational performance. However, the potential of ITG for public sector innovation and performance has not been fully grasped in Pakistani public sector organizations (PakPSOs). This study has presented an explanatory model to investigate the mediating effect of innovation in the relationship between ITG and organizational performance in PakPSOs. Partial least squares structural equation modeling (PLS-SEM)–based hierarchical component modeling approach has applied to analyze the model by taking sample data from 97 PakPSOs. The results revealed that ITG positively affected innovation and organizational performance. Innovation positively affected organizational performance. Innovation partially mediated the relationship between ITG and organizational performance. The study corroborates the strategic use of information technology (IT) to enhance innovation and organizational performance in this context. The study contributes to the existing knowledge base through a new theoretical model and promotes academic rigor. The results are also significant for the practice as they can help to achieve organizational performance in terms of operational efficiency, transparency in costs and results, planning and decision making, performance monitoring and control, and collaboration and synergy. The other countries operating in a similar environment can also take the benefit of this study.

Background: Paranasal sinus osteoma in association with intracranial mucocele is a rare entity while intradural extension is even rarer. Our aim of presenting this case is to highlight the diagnostic pitfalls and reiterate the importance of prompt treatment of expected complications. Case Description: A 35-year-old known epileptic, for the past 5 years, presented with altered sensorium for the past 2 days. Computed tomography (CT) of the brain plain showed ventriculomegaly and cystic lesion in the left frontal lobe adjacent to a calvarial osteoma. A ventriculoperitoneal (VP) shunt was done which resulted in tension pneumocephalus and led us to discover the origin of osteoma from the left frontal sinus on CT functional endoscopic sinus surgery (FESS) protocol. He underwent left frontal craniotomy. The osteoma and mucocele were excised completely and watertight primary dural closure was done. Postoperative meningitis was treated with antibiotics according to the culture report. Conclusion: Intracranial extension of mucocele led to meningitic hydrocephalus, prompting us for VP shunt. Resulting tension pneumocephalus revealed what was missed on preop CT, a small pocket of air adjacent to osteoma intracranially. Therefore, this case underscores the importance of obtaining a preoperative CT FESS to elaborate the origin of osteoma, thus planning approach differently.

The COVID-19 outbreak has prevented students from contributing towards the economic growth of Pakistan. It first disrupted the education system in China and later entered Pakistan to close all levels of educational institutions/sectors since the middle of March 2020. This study aims to highlight the COVID-19 outbreak's effects on educational sector in Pakistan. Pakistan's overall public sector expenditure as a percentage of GDP before the pandemic was already low as compared to regional level, but due to the pandemic, it has dropped down significantly. This study seeks to answer two important questions: (1) What are the impacts of COVID-19 outbreak on Pakistan? (2) Will the closure of educational institutions impact the economic growth of Pakistan? According to empirical and theoretical findings, the results show that the lack of school education for a long period of time will contribute towards unskilled human capital. The COVID-19 outbreak has impacted student learning activities, which may increase the dropout rates, loss of mental health, and consequently, may impact the economic growth of Pakistan later.

Clival chordomas are rare tumours with a notochordal origin that are classically multilocular gelatinous lesions. Due to their location, endoscopic endonasal resection is an option to optimize extent of resection whilst also balancing risk to critical neurovascular structures. Nonetheless, patients may be at high risk of recurrence therefore the potential for adjuvant treatment with radiotherapy or proton beam therapy should always be considered.

The purpose of this study is to empirically test the impact of employee empowerment on organizational commitment through the mediating role of job satisfaction. The non-probability random sampling technique and time lag was used to collect data from 307 employees working at four and five Stars Hotels in two cities Rawalpindi, Islamabad of Pakistan. Smart Partial least squares-structural equation modeling (Smart PLS SEM v.3.2.8) was used to test the hypotheses. The result indicates that employee empowerment has a significant and positive impact on organizational commitment. Also, job satisfaction is considered as a potential mediator between employee empowerment and organizational commitment. Furthermore, to sup-port the results current study used the social exchange theory. Finally, some theoretical and practical contributions to employee empowerment and organizational commitment literature, and research limitations and future directions are presented.

Centrifugal pumps are being widely used in various industries for moving fluids that carry solids through pipelines where the need of head and flow rate is not high. Slurry erosion and cavitation are an extremely complex and not yet fully understood phenomenon that occur in centrifugal pumps; however, these undesirable phenomena can be reduced to a certain extent. Appropriate design and development of experiments is required to reasonably predict slurry erosion and cavitation. However, CFD methodology complements analytical solutions and experiments whenever testing of equipment has limitations. The current paper highlights the various slurry erosion and cavitation reduction techniques utilized by different researchers. Economic analysis conducted for a case study relevant to centrifugal pump (CP) usage in Pakistan shows that an 8% enhancement in pump efficiency can reduce the life cycle cost to about 17.6%, which could save up to USD 4281 for a single pump annually in Pakistan.

This study delineates a 1000 Megawatt (MW) very large scale Photovoltaic (PV) system designed in three phases, from which 100 MW has functional and the remaining two phases of 300MW, 600 MW has yet to be functional at Quaid-eAzam solar park (QSP) in Cholistan desert near Bahawalpur City of Pakistan. This study describes the opportunities and risks in the construction of solar PV plant (QSP), which is constructed through public-private partnership (3P).This study uses the case study as a part of research methodology. Firstly it explains about 3Ps, their various types and necessity. Secondly, explores the critical factors in the construction of QSP PV Plant through PESTLE (political, economic, social, technological, legal, environmental) analysis. Thirdly outlines the effect of RE projects on the socioeconomic status of the periphery which is ignored in previous studies. The recommendations will guide the policymakers how they can embed social acceptance in RE projects.

The Southeast Asian speciesMus (Mus) cookiiRyley 1914 has been previously reported from southern China, Nepal, northeastern and peninsular India, Myanmar, north and central Thailand and Vietnam. A cytochromeb(Cytb) gene analysis revealed the presence ofM. cookiiwhich significantly expands the known western range of this species. However, it is unclear whether theM. cookiipopulation in the Pothwar region represents a historical or recent westward range expansion or, on the contrary, a relictual source population that further experienced an historic eastward range expansion into Southeast Asia.

In recent years, Public Private Partnerships (PPPs) has been developed as one of the best approaches in many nations (like Australia, UK etc.) for delivering social infrastructure projects. PPPs are those risk sharing investment plans stipulated for public goods and services seen by governments as a mean to launch investment plans which would not have been imaginable within the existing public sector budget inside rational time. The multi objectives of PPP’s including to support infrastructure development, increasing construction and operational efficiencies, developed local economy, reducing costs, improving the service quality in embedding the private sector skills, knowledge expertise and funds have drawn growing interest from policy makers, industry practitioners and scholars. Whereas role of efficaciously implemented PPP projects seems to be very confined in emerging markets from South Asia. This paper offers pragmatic implications for investors in various types of infrastructure projects of emerging markets of south Asian countries like transportation, energy, communication, water supply, water sewage, education, health etc. This study uses SPSS for analysis of data through Run test, Kolmogorov Smirnov test & Mann Whitney-U test. This article identifies the critical risks and meta-analysis of risk factors criticality through questionnaire which was based on 20 years Meta review of literature on PPP projects, case studies, interviews from public/private sector, academicians and established ten most critical common risk factors in two countries (Bangladesh, Pakistan). The first most critical factor is the unsoundness of political government. The second important factor is the engagement level and consistent policies of governments regardless of change in political regime. The third critical factor is the financial attraction in project for investors. The fourth important critical factor is the obtainability of finance.

Leader’s personality considerably influences the behavior of employees and is perhaps one of the most important predictor of their job performance. The purpose of the study was to evaluate the personality-performance paradigm in the context of emerging economies. Personality was assessed through big five traits, namely openness to experience, conscientiousness, extraversion, agreeableness and neuroticism. While task performance attribute of job performance was considered as dependent variable. Stratified sampling technique was deployed to gather data from 149 SMEs belonging to diversified business sectors operating in the industrial city of Gujranwala, Pakistan. Cronbach’s alpha test endorsed the consistency of survey questionnaire, and multiple regression analysis was used to test hypotheses. All of the personality traits, with the exception of neuroticism, are found to be valid predictors of employee job performance, though the degree and significance of correlation varies. The study contributes to the enhanced understanding of the personality-performance relationship and highlights the desirable personality inventories of potential leaders and entrepreneurs. Broader practical implications and recommendations for future research bring the discussion to the close.

Extremophiles organisms are defined by the environmental conditions in which they can survive and grow maintaining the metabolic pathway in dynamic process. Extremophilic microorganisms developed defense strategies to survive under extreme pressure (piezophilic), temperature (psychrophilic, thermophilic, or hyperthermophilic), salinity (halophilic), dryness (xerophilic), pH (acidophilic or alkaliphilic), low nutrient (oligotrophic), or even within rock or within pores of mineral grains (endolithic), leading to the biosynthesis of biomolecules with diverse biological activities. In general, microorganisms can be considered a chemical factory, and extremophiles are an interesting source for innovative products in biotechnology due to their ability to produce different kinds of several biomolecules with prospective application in the pharmaceutical, medical, and agricultural fields. The study of aspects of life in extreme environments is an exciting area of research and despite the latest advances and engagement of researchers around the world, the fact is that the knowledge in this field is still incipient considering the hugeness of microorganisms’ life context and diversity. This chapter aims specifically to highlight the relevance of extremophiles as a rich source for biomolecules with biotechnological potential. Recent discoveries and biotechnological applications of biomolecules produced by extremophiles microorganisms highlighting the importance of bacteria, archaea, and fungi for biotechnology are described. The knowledge in microorganisms’ strategies for surviving can certainly offer benefits for humanity, mainly with regard to aiding us to understand what form life takes on other planetary bodies in our own solar system and beyond.

Prediction of Nitrous oxides (NOx) emission and development in combustion burning devices utilizing numerical simulation is significant now days because of strict legislation about environment impact of contaminated gases. This work managed consolidates approach of Computational Fluid Dynamics (CFD) and Chemical Reactor Networking (CRN) method to analyze the pollutant discharged NOx from gas turbine Ignition chamber. A 2D model was created of the gas turbine combustor utilizing design tool and CFD simulations were done by using FLUENT software and determined the data about the flow field, temperature, velocity insight the combustor by varying the equivalence ratios, using methane gas (CH4) as burning fuel. On the base of CFD data 2 CRN models were made, the first one depended on 5 PSR's CRN reactors which divided the combustor into 5 flame sections that named as primary CRN model and the second one was increased number of CRN reactors with 12 flame sections that contained 12 PSR's reactors named complex CRN model by using ANSYS CHEMKIN Software. The NOx emission prediction was simulated using methane GRI3.0 mechanism. This paper examined the CFD and CRN simulations results comparing with determined temperature and NOx of both CRN models. The predicted NOx discharge at the combustion chamber outlet from CFD and CRN were compared the available experimental values for the results validation. At the Key end determined that complex CRN model predictions of NOx showed better, efficient and accurate results with experimental values than primary CRN model in very less Computation time, even though the primary CRN model consequences showed also reasonable NOx Prediction. The four NOx Formation mechanisms were also executed for NOx creation pathway analysis and for deep understanding about NOx behavior at combustion Chamber.

Autopilots maintain the flight balance of aircraft using aerodynamics forces autonomously. Autopilot system design is divided into two section, inner and outer loop. Inner loop act as a stabilizer while outer loop provide motion control such as altitude, speed and path angle. The aim of this study is to utilize eigenstructure assignment (EA) and Proportional -Integral-Derivative (PID) in multi-loop configuration for altitude and pitch angle control. Aircraft non-linear model is obtained using Euler formulism and trimmed at certain flight conditions to achieve the linear state space model of aircraft which is used in this study. Aircraft longitudinal motion is highly coupled and unstable, EA is implemented in inner loop for stability augmentation and decoupling of system. Two different outer loop controllers are designed for altitude and pitch control of aircraft using PID controller. Designing controllers in such a configuration not only reduced the coupling between different state variables but also accurately control and tracked the altitude and pitch angle. Effectiveness of multi-loop control configuration will be illustrated with the help Matlab/Simulink model and results.

Objective: In critically ill patients’ central venous catheterization is commonly practiced. The aim of this study is to estimate the risk of cardiac arrhythmias associated with CVC (central venous catheterization). Methods: Total 100 patients were included in study who underwent central venous catheterization. 3ml blood was collected from all patients for study of serum sodium, potassium, creatinine and blood urea nitrogen level. Electrocardiography (ECG) was done during and after the procedure. Vitals were monitored before and after catheterization. Results: The rate of arrhythmias as studied by ECG was; 3 AF, 6 VT, 6 PAC and 6 PVC. Previous catheterization, sex and serum electrolytes levels had significant association with the rate of arrythmias in patients. Conclusion: Although central venous catheterization is a small operative procedure but due to its association with cardiac arrhythmias, it must be performed in ICU with proper arrangements to overcome arrhythmias, if occur. Vitals monitoring should also be done before, during and after the procedure. Key Words: arrhythmia, central venous catheterization, Electrocardiography.

Objective: To find out frequency of clinical and laboratory, transient or permanent hypocalcemia following total, subtotal or near total thyroidectomy. Materials and methods: This case series study was conducted at teaching hospital in Lahore, Pakistan from January to October 2017. Sample size was 50 patients who underwent total, subtotal or near total thyroidectomy. Patients who fulfilled the inclusion criteria were randomly selected. These patients were either males or females belonging from 20 to 70 years of age. Patients admitted in postoperative ward in surgical department were included after taking informed written consent. Serum calcium level was performed in all patients enrolled in study population. Results: The mean age of patients was 40.15±4.1 years. Out of 50 patients, 46 (92%) were females and 4 (8%) were males. 15 patients (30%) had post-thyroidectomy hypocalcemia, out of which 13(86.67%) had transient hypocalcemia while remaining 2 (13.33%) had permanent hypocalcemia. 70%(35) patients had simple or multinodular goiter. Subtotal thyroidectomy was performed on 68% (34) patients. Conclusion: Post-thyroidectomy transient hypocalcemia is commonly seen in patients undergoing thyroidectomy, however permanent hypocalcemia is rarely associated with thyroidectomy. Majority of patients underwent subtotal thyroidectomy. Key Words: hypocalcemia, thyroidectomy, transient, permanent.

An iterative learning control method is better to control the high-order nonlinear strong coupling and external disturbances in the permanent magnet synchronous motor position servo system. This paper proposes a second-order P.D. type iterative learning control strategy, which can effectively achieve the optimal tracking control algorithm. By using the generalization of the Young inequality of convolution, the Lebesgue-p norm is obtained under the adequate condition that the tracking error converges monotonously. Furthermore, the convergence rate of second-order iterative learning control is compared, and it is proved by the mathematical knowledge that second-order iterative learning control is much better than a first-order iterative learning control under satisfactory conditions. Simulation results show that the effectiveness of the proposed algorithm is better than that of the traditional method, and the error of the iterative learning control strategy is smaller but with higher accuracy.

Objectives/Hypothesis Head and neck squamous cell carcinomas of unknown primary (HNSCCUP) accounts for up to 10% of presenting head and neck squamous cell carcinomas. Identification of the primary site allows for directed therapy. Where initial investigations have failed to locate the primary site, 18-fludeoxyglucose positron emission tomography-computed tomography (PET/CT) has emerged as a useful tool with improved sensitivity over positron emission tomography alone. Following PET/CT scan, the role of subsequent panendoscopy ± biopsy has not been fully assessed. We aim to evaluate and quantify the role of PET/CT and subsequent panendoscopy in HNSCCUP. Study Design Retrospective cohort study. Methods Patients with HNSCCUP presenting between January 2005 and December 2010 at a regional oncology referral center were studied. All patients who presented with a metastatic neck node and unknown primary who had undergone PET/CT prior to panendoscopy were included. The accuracy of PET/CT was calculated and compared with panendoscopy and histopathological findings. Results Fifty-two patients were included. Twenty-seven PET/CT scans suggested a primary site. Calculated diagnostic parameters were 83% sensitivity, 87% specificity, positive predictive value 89%, and negative predictive value 80%. Three false-positive PET/CT scans were noted after panendoscopy and normal histology. Importantly, three confirmed tongue base tumors were found on panendoscopy, which were undetected on PET/CT. Conclusions PET/CT is a valuable resource for locating tumors in HNSCCUP. It helps direct biopsy and aids in the detection of local and distant metastases along with synchronous primary tumors. Importantly, due to both false-positive and false-negative PET/CT rates, panendoscopy and biopsy remains an essential adjunct investigation irrespective of PET/CT results. Level of Evidence 4 Laryngoscope, 2015

Contemporary urbanization appears as a conundrum especially in developing nations. This study will act as an accelerator to spill out snags caused by urbanization with a new approach in the development of sustainable infrastructure through Public–Private Partnerships (3Ps). This study first explains the complications generated by rapid urbanization in different infrastructural sectors in South Asian mega cities like Dhaka and Lahore. Second, the findings of the study elaborate on a new mechanism to adapt to Sustainable Development Goal 11 declared by the United Nations with the engagement of different stake holders working in different silos through 3Ps (like BOT, BOOT, BLT, DBF, PFI etc.). This study uses case studies as part of the research mixed methodology. Studies on Dhaka and Lahore including multi projects through 3Ps, and a detailed questionnaire survey based on critical risk factors from the Meta review of 3P literature are presented to establish the current status of sustainable development goals. This paper primarily contributes in two ways. First, by providing a new direction to policy makers to devise policies using a twofold approach i.e., grasp urbanization with sustainable infrastructure delivery by sustainable enactment of 3P projects. Second, bridge the knowledge gap by identifying the risk factors in the sustainable establishment of 3P projects in developing nations.

This study investigates the relationship between sub-national institutional contingencies and corporate social responsibility performance (CSRP). Sub-national institutional contingencies (SNICs) play a moderating role in the link between CSRP and corporate financial performance (CFP). Using data from all A-share Chinese companies listed on the Shenzhen and Shanghai exchanges for the period 2010 to 2015, ordinary least square (OLS) regression was used as a baseline methodology to draw inferences from the data. The study uses propensity score matching (PSM) to confirm the robustness and to tackle the possible issue of endogeneity. We find reliable evidence that SNICs have a positive and significant effect on CSRP. This positive relationship is more pronounced in cross-listed companies as compared to state-owned enterprises (SOEs) and in companies located in the more developed region. Moreover, SNICs moderate the positive relationship between CSRP and CFP. The relationship is stronger in firms that are non-SOEs, are non-cross-listed, and are from less-developed regions as compared to their counterparts. The findings provide implications for regulators and individual companies. Investment in corporate social responsibility (CSR) helps companies to achieve their primary objective (i.e., financial performance). With respect to practical implications, the study indicates that policymakers, executives, and managers should refrain from &ldquo, one size fits all&rdquo, CSR policies. Instead, they need to simultaneously evaluate the effects of regional development, cross-listing, and ownership characteristics. Considering weak social performance by firms that are from less developed regions, are non-cross-listed, and that are non-SOEs, policymakers and the government should improve information transparency and the regulatory framework, and provide these firms with incentives. This study also provides insights for other emerging economies, especially those going through extraordinary government interventions.

Background: Tetanus still remains a major public health problem in Pakistan like in most other developing countries, with ahigh morbidity and mortality. Objectives: To study the demographic profile the clinical profile, the outcome of the tetanus patients andeffectiveness of tetanus immunization coverage in district Faisalabad. Design: Retrospective record based study. Place and Duration:Surgical unit-5 DHQ Hospital, Faisalabad from January 2010 to December 2012. Subjects and Methods: All data of 198 patients oftetanus of any age and sex, diagnosed clinically was collected, compiled and analyzed from the Medical Records Department of theHospital. Results: Out of 198 patients of tetanus,138(69.7%) were males and 60(30.3%) were females. Their ages ranged from 1 to 85years with a mean and a standard deviation respectively of 29.36 and 17.48 years.162 (81.8%) were from rural and36(18.2%) were fromurban areas. 47(23.7%) patients were having prior immunization and151(76.3%) were not immunized. The most common presentingsymptoms were trismus (47.5%), body stiffness(24.2%),fits(19.2%) and respiratory distress(9.1%). 23(11.6%) patients were havingmild disease,71(35.9%) patients were having moderate disease,71(35.9%) patients were having severe disease and 33(16.7%) werehaving very severe disease. Overall mortality rate was 41.4%. Respiratory failure was the most common cause of death and there wasstatistically significant association between mortality and increasing grades of disease. Conclusions: By making expanded programmeof immunization(EPI) more effective and removing flaws from out-dated vaccination through incomplete vaccination. By improvingawareness in public and complete vaccination through EPI program, we can reduce the incidence of tetanus.

The snow leopard (Panthera uncia) inhabits the high, remote mountains of Pakistan from where very little information is available on prey use of this species. Our study describes the food habits of the snow leopard in the Himalayas and Karakoram mountain ranges in Baltistan, Pakistan. Ninety-five putrid snow leopard scats were collected from four sites in Baltistan. Of these, 49 scats were genetically confirmed to have originated from snow leopards. The consumed prey was identified on the basis of morphological characteristics of hairs recovered from the scats. It was found that most of the biomass consumed (70%) was due to domestic livestock viz. sheep (23%), goat (16%), cattle (10%), yak (7%), and cattle-yak hybrids (14%). Only 30% of the biomass was due to wild species, namely Siberian ibex (21%), markhor (7%), and birds (2%). Heavy predation on domestic livestock appeared to be the likely cause of conflict with the local inhabitants. Conser- vation initiatives should focus on mitigating this conflict by minimizing livestock losses.

Classical control laws are still widely used in aviation industry because of their good structural understanding, simplicity, and better tracking control performance. However in recent decades the application of such controllers are getting substantial interest of researchers. This paper addresses controller design method for longitudinal and lateral motion autopilots of F-16. Aircraft complete mathematical model was obtained using Newton-Euler formulism. The non-linear model was linearized around equilibrium points at certain trim conditions to obtain state space model of the system. Comparative analysis of two linear controllers, Proportional-Integral-Derivative (PID) and Linear-Quadratic-Regulator (LQR) is investigated and control algorithm is proposed. Both the control schemes use feedback control laws and a careful selection of tuning parameters for controllers is carried out to track the desired input reference. Effectiveness of both controllers is illustrated with the help Matlab/Simulink figures and results.

Head and neck squamous cell carcinomas of unknown primary (HNSCCUP) accounts for up to 10% of presenting head and neck squamous cell carcinomas. Identification of the primary site allows for directed therapy. Where initial investigations have failed to locate the primary site, 18-fludeoxyglucose positron emission tomography-computed tomography (PET/CT) has emerged as a useful tool with improved sensitivity over positron emission tomography alone. Following PET/CT scan, the role of subsequent panendoscopy ± biopsy has not been fully assessed. We aim to evaluate and quantify the role of PET/CT and subsequent panendoscopy in HNSCCUP.Retrospective cohort study.Patients with HNSCCUP presenting between January 2005 and December 2010 at a regional oncology referral center were studied. All patients who presented with a metastatic neck node and unknown primary who had undergone PET/CT prior to panendoscopy were included. The accuracy of PET/CT was calculated and compared with panendoscopy and histopathological findings.Fifty-two patients were included. Twenty-seven PET/CT scans suggested a primary site. Calculated diagnostic parameters were 83% sensitivity, 87% specificity, positive predictive value 89%, and negative predictive value 80%. Three false-positive PET/CT scans were noted after panendoscopy and normal histology. Importantly, three confirmed tongue base tumors were found on panendoscopy, which were undetected on PET/CT.PET/CT is a valuable resource for locating tumors in HNSCCUP. It helps direct biopsy and aids in the detection of local and distant metastases along with synchronous primary tumors. Importantly, due to both false-positive and false-negative PET/CT rates, panendoscopy and biopsy remains an essential adjunct investigation irrespective of PET/CT results.4 Laryngoscope, 126:1354-1358, 2016.

Schwannomas are peripheral nerve neurogenic tumours and although not common, laryngeal schwannomas can provide a unique challenge in diagnostic and treatment management. There are limited reports in the literature on approaches to management. A 73-year-old lady presented to the otolaryngology department after a MRI scan demonstrated an incidental right supraglottic mass. Further investigations included CT scanning and microlaryngoscopy, which only confirmed the presence of the mass with no histology diagnosis. Excision was undertaken by a laryngofissure approach and tracheostomy. Histology confirmed a benign ancient schwannoma.

Objectives (1) To determine the prevalence of pathology in cervical polyps and whether referring and/or removing them is justified, (2) to assess the frequency of associated endometrial pathology and whether investigating the uterine cavity is warranted, and (3) to estimate the financial costs of processing cervical polyps. Study design Retrospective review of the histopathology database and case notes of women who had cervical polyps examined at the pathology department of Ipswich Hospital, UK, over a seven-year period from 01/01/2002 to 31/12/2008. Results The number of cervical polyps removed from 988 women was 1126. Each case of polyps was considered as a separate episode. The recurrence rate was 15%. All polyps were benign except two (0.2%) symptomatic polyps that showed high grade cervical intraepithelial neoplasia. The cost of referring women with cervical polyps (excluding women aged >45 years with abnormal bleeding and those with abnormal smear) to see a gynaecologist and of examining polyps histologically was estimated to be £94 816.40. Further investigations to assess the cervix and/or uterine cavity which were performed for 133 women (14.3%), because of the cervical polyps and for no other clinical indication, showed no significant pathology at cost of £41 195.54. Conclusion Our data do not justify referring women with asymptomatic cervical polyps to see a gynaecologist. Further, removing these polyps and investigating the uterine cavity is not warranted. A policy of removing polyps from only symptomatic women or those with abnormal smear and limiting histological examination to these polyps would result in significant savings.