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We determined the cause of renal deterioration after augmentation cystoplasty (AC). Twenty-nine adult patients with refractory bladder dysfunction and who underwent ileocystoplasty from 2004 to 2015 were studied. Patients with a decline in glomerular filtration rate (GFR) after augmentation were reviewed. The primary outcome was to determine the factors that might lead to deterioration of estimated GFR. Median follow-up was 7.0 ± 2.6 years. Significant bladder capacity, end filling pressure, and bladder compliance were achieved from median 114 ± 53.6 to 342.1 ± 68.3 ml (p = .0001), 68.5 ± 19.9 to 28.2 ± 6.9 cm H2O (p = .0001), and 3.0 ± 2.1 to 12.8 ± 3.9 (p = .0001), respectively. Renal function remained stable and improved in 22 (76%) patients from median eGFR 135 ± 81.98 to 142.82 ± 94.4 ml/min/1.73 m2 (p = .160). Significant deterioration was found in 7 (24%) patients from median eGFR 68.25 ± 42 to 36.57 ± 35.33 (p = .001). The causes of renal deterioration were noncompliance to self-catheterization (2 patients), posterior urethral valve/dysplastic kidneys (2 patients), and reflux/infection (2 patients). On multivariate analysis, recurrent pyelonephritis (OR 3.87, p = 0.0155) and noncompliance (OR 30.78, p = 0.0156) were significant. We concluded that AC is not the cause of progression to end-stage renal disease in patients with renal insufficiency.

Wireless sensor networks (WSNs) play a huge part in arising innovations like smart applications, the Internet of Things, and numerous self-designed, independent applications. Energy exhaustion and efficient energy consumption are principal issues in wireless sensor networks. Energy is a significant and valuable asset of sensor nodes; early energy depletion ultimately leads to a shorter network lifetime and the replacement of sensor nodes. This research proposes a novel Power-Efficient Cluster-based Routing (PECR) algorithm. It takes in clustering using K-Means, the arrangement of Cluster Heads (CHs) and a Main Cluster Head (MCH), the optimal route choice, communication in light of the energy utilization model, cluster heads, and main cluster head alternation based on residual energy and relative location. PECR decreases traffic overburden, restricts energy usage, and at last, expands the network lifetime. Sensor nodes sense the information and transmit traffic to a Base Station (BS) through a legitimate channel. The results confirm it decreases the traffic overhead and effectively utilizes the energy assets. The simulation results show that PECR’s performance is 44% more improved than LEACH, EC, EECRP, and EECA algorithms. It is suitable for networks that require a stretched life.

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The purpose of the present study was to assess the relationship among fear of negative evaluation, loneliness and life orientation among never married men and women. It was hypothesized that there would be a significant relationship among these variables and there would be gender differences among the participants. Correlational research design was used. The sample size of the study was 200 including 100 males and 100 females selected using purposive sampling. Correlation, regression, independent sample t test and mediation analysis were used. Findings showed that fear of negative evaluation is significantly and positively related with loneliness and negatively related with optimistic life orientation. In addition, loneliness significantly predicted optimistic and pessimistic life orientation. There were also significant gender differences among participants on loneliness and optimistic life orientation. In addition, it was found that loneliness significantly mediated the relationship between fear of negative evaluation and life orientation.