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The renewable energy transition of oil- and gas-producing countries has specific peculiarities due to the ambivalent position of these countries in the global energy market, both as producers and consumers of energy resources. This task becomes even more challenging when the share of oil and gas in the country’s GDP is very high. These circumstances pose serious challenges for long-term energy policy development and require compromising decisions to better align the existing and newly created energy policies of the country. The scale, scope, and pace of changes in the transition process must be well balanced, considering the increasing pressure of economic and environmental factors. The objective of this paper is to develop models that allow the selection of the most appropriate scenario for renewable energy transition in an oil- and gas-producing country. The distinguishing feature of the proposed model is that alternatives in the decision matrix are presented as scenarios, composed of a set of energy resources and the level of their use. Linguistic descriptions of the alternative scenarios are formalized in the form of fuzzy statements. For the problem solution, four different Multiple-Criteria Decision-Making (MCDM) methods were used: the fuzzy simple additive weighting (F-SAW) method, the distance-based fuzzy TOPSIS method (Technique of Order Preference Similarity to the Ideal Solution), the ratio-analysis-based fuzzy MOORA method (Multi-Objective Optimization Model Based on the Ratio Analysis), and the fuzzy multi-criteria optimization and compromise solution method VIKOR (Serbian: VIekriterijumsko Kompromisno Rangiranje). This approach is illustrated using the example of the energy sector of Azerbaijan. The recommended solution for the country involves increasing natural gas (NG) moderately, maintaining hydro, and increasing solar notably and wind moderately.

Management of nonobstetric pain in the pregnant patient presents unique challenges related to transplacental fetal exposure to opioids and the subsequent risk of neonatal withdrawal syndrome. We present the case of a pregnant patient suffering from the pain of a progressively enlarging thoracoabdominal sarcoma. Epidural analgesia (using local anesthetics with minimal opioid) was utilized over a span of weeks to manage oncologic pain, limiting fetal opioid exposure and culminating in the birth of a healthy infant. While nonobstetric abdominal pain during pregnancy is not that uncommon, neoplastic abdominal pain does appear to be rare. Combined local anesthetic and opioid continuous epidural infusion should be considered a viable option in the pain management approach to obstetric patients with nonobstetric pain associated with malignancy. [ABSTRACT FROM AUTHOR]

The present study was carried to determine the prevalence of Hepatitis A virus (HAV) IgM antibody among general population in Hyderabad since January 2002 to December 2011. A total of 4571 subjects were selected and divided into groups on the basis of age. The serum samples were screened for the presence of HAV IgM antibodies (anti-HAV IgM) using a commercially available enzyme linked immunosorbent assay (ELISA) kit. Of the 4571 serum samples, 4257 were negative and 314 (6.87%) were positive for the HAV IgM assay. The disease predominance was more in males (212) with 67.51% compared to females (102) with 32.48%. Anti-HAV seroprevalence was measured for the following age groups: Early (≤20 years), Middle (21-40 years) and Late (≥41 years). Average age-wise IgM-anti-HAV positivity from 2002-2011 was 234 of 314 in ≤20 years, 74.52%), 73 of 314 (21-40 years, 23.24%), and 7 of 314 (≥41 years, 2.22%). The present study will provide insights to the recent epidemiologic features of HAV infection in South India.

Background Choledochal cyst is a congenital cystic dilatation of the biliary tree. Various aspects of pathophysiology are unclear, particularly with reference to intracholedochal cystic pressure (ICCP) and liver histopathology. This study aimed to determine the relationship among cystic volume, ICCP, and histopathological changes in the liver in patients with choledochal cysts. Methods This cross-sectional study was carried out among 21 patients diagnosed with choledochal cysts, who attended the Department of Pediatric Surgery at Bangabandhu Sheikh Mujib Medical University (BSMMU) from April 2021 to August 2022. Cystic volume was measured pre-operatively using ultrasonography, while ICCP was measured per-operatively with a pressure gauge. Liver histology was assessed through an intraoperative liver biopsy and graded using the meta-analysis of histological data in viral hepatitis (METAVIR) scoring system. The data were analyzed using SPSS version 25.0 (IBM Corporation, Armonk, New York). Frequency and percentages were calculated to present categorical variables, and for quantitative variables, mean, standard deviation (SD), median, and interquartile range (IQR) were calculated. Fisher's exact tests were performed to determine the association between cystic volume, ICCP, and the grading of hepatic fibrosis. A p-value of <0.05 was considered statistically significant. Results The age of the patients ranged from 1 to 12 years, with a mean of 5.0±3.4 years. The male-to-female ratio was 1:4.3. Type I cysts were the most prevalent (71.4%). The median and IQR for cystic volume were 3.4 ml and 1.1-8.2 ml, respectively. The median and IQR for ICCP were 7.46 mmHg and 4.67-9.33 mmHg, respectively. The most frequent grade of fibrosis was F1 (38.1%), followed by F2 (23.8%) and F3 (23.8%). A negative relationship between cystic volume and ICCP was observed, which was statistically significant (p=0.008). A positive relationship was also observed between ICCP and the grading of liver fibrosis, which was statistically significant (p=0.002). Although a negative correlation between cystic volume and grading of liver fibrosis was noted, it was not statistically significant (p=0.198). Conclusions This study reveals significant associations between cystic volume, ICCP, and the grading of liver fibrosis in patients with choledochal cysts. Smaller volume cysts may exhibit higher ICCP, resulting in more pronounced fibrotic changes in the liver., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Jannat et al.)

Hypospadias is a developmental defect of male urethra characterized by absence of meatal opening at the tip of glans but is present at the ventral surface of penis anywhere along the shaft, even in the perineum. Usually this defect is associated with ventrally curved penis. Surgery is the single option to correct this birth defect. More than 300 techniques have been developed but none is universally acceptable as because, surgery is usually associated with fistula. Rate of fistula formation varies from technique to technique. Now a day, Snodgrass technique is widely practiced because of its low rate of fistula formation. Many factors are responsible for this post-operative complication. Most important one is developmentally defective ventral penile skin where some local factors like vascular and collagen tissues are insufficient. This observational study was performed to evaluate the role of dorsal vascular flap over the neourethra following urethroplasty by Snodgrass technique in terms of post-operative fistula formation in the Department of Paediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2018 to March 2020. A total of 39 patients with distal penile hypospadias were included in this study. All underwent Snodgrass urethroplasty with additional dorsal vascular flap over the neourethra to support this ventrally deficient local factor. The outcome in terms of post operative urethrocutaneous fistula was evaluated. Only two patients (5.15%) developed urethrocutaneous fistula. In conclusion, addition of dorsal vascular flap over the neourethra by Snodgrass technique reduces the rate of the fistula formation.

Cytosolic phospholipase A2α (cPLA2α) is the rate-limiting enzyme in releasing arachidonic acid and biosynthesis of its derivative eicosanoids. Thus, the catalytic activity of cPLA2α plays an important role in cellular metabolism in healthy as well as cancer cells. There is mounting evidence suggesting that cPLA2α is an interesting target for cancer treatment; however, it is unclear which cancers are most relevant for further investigation. Here we report the relative expression of cPLA2α in a variety of cancers and cancer cell lines using publicly available datasets. The profiling of a panel of cancer cell lines representing different tissue origins suggests that hematological malignancies are particularly sensitive to the growth inhibitory effect of cPLA2α inhibition. Several hematological cancers and cancer cell lines overexpressed cPLA2α, including multiple myeloma. Multiple myeloma is an incurable hematological cancer of plasma cells in the bone marrow with an emerging requirement of therapeutic approaches. We show here that two cPLA2α inhibitors AVX420 and AVX002, significantly and dose-dependently reduced the viability of multiple myeloma cells and induced apoptosis in vitro. Our findings implicate cPLA2α activity in the survival of multiple myeloma cells and support further studies into cPLA2α as a potential target for treating hematological cancers, including multiple myeloma.

As a regulator of cellular inflammation and proliferation, cytosolic phospholipase A 2 α (cPLA 2 α) is a promising therapeutic target for psoriasis; indeed, the cPLA 2 α inhibitor AVX001 has shown efficacy against plaque psoriasis in a phase I/IIa clinical trial. To improve our understanding of the anti-psoriatic properties of AVX001, we sought to determine how the compound modulates inflammation and keratinocyte hyperproliferation, key characteristics of the psoriatic epidermis. We measured eicosanoid release from human peripheral blood mononuclear cells (PBMC) and immortalized keratinocytes (HaCaT) and studied proliferation in HaCaT grown as monolayers and stratified cultures. We demonstrated that inhibition of cPLA 2 α using AVX001 produced a balanced reduction of prostaglandins and leukotrienes; significantly limited prostaglandin E 2 (PGE 2 ) release from both PBMC and HaCaT in response to pro-inflammatory stimuli; attenuated growth factor-induced arachidonic acid and PGE 2 release from HaCaT; and inhibited keratinocyte proliferation in the absence and presence of exogenous growth factors, as well as in stratified cultures. These data suggest that the anti-psoriatic properties of AVX001 could result from a combination of anti-inflammatory and anti-proliferative effects, probably due to reduced local eicosanoid availability.