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Abstract We aimed to assess the weight loss trend following Roux en Y Gastric Bypass (RYGB), One Anastomosis Gastric Bypass (OAGB), and Sleeve Gastrectomy (SG), utilizing a change-point analysis. A retrospective cohort study was conducted on 8640 patients, from 2009 to 2023. The follow-up period extended to 7 years, with a median follow-up of 3 years (interquartile range: 1.4–5). Following metabolic bariatric surgery, four weight loss phases (three change points) were observed. The primary, secondary, and tertiary phases, transitioned at 12.64–13.73 days, 4.2–4.8 months, and 11.3–13.1 months post-operation, respectively, varying based on the type of procedure. The weight loss rate decreased following each phase and plateaued after the tertiary phase. The nadir weight was achieved 11.3–13.1 months post-procedure. There was no significant difference in the %TWL between males and females, however, males achieved their nadir weight significantly earlier. Half of the maximum %TWL was achieved within the first 5 months, with the greatest reduction rate in the first 2 weeks. Our findings inform healthcare providers of the optimal timing for maximum weight loss following each surgical method and underscore the importance of close patient monitoring in the early postoperative period.

Abstract Background Mitochondria dysfunction is one of the major causes of insulin resistance, and other countless complications of obesity. PGC-1α, and UCP-2 play key roles in energy expenditure regulation in the mitochondrial thermogenesis. However, the effects of bariatric surgery on the level of PGC-1α and UCP-2 and their relationships are unclear. Objective This study aimed to investigate the effect of bariatric surgery on key pathways in energy, and to assess the potential predictive role of body composition and metabolic parameters in this regard. Settings Hazrat-e Rasool General Hospital, Center of Excellence of International Federation for Surgery of Obesity. Methods This prospective cohort study was carried out on 45 patients with morbid obesity who underwent Roux-en-Y gastric bypass surgery. The patients have evaluated three-time points at baseline, three, and six months after the surgery. Body composition components, the levels of PGC-1α, UCP-2, and metabolic parameters were measured three times during this study. Results Significant changes in TWL%, EBMIL%, and metabolic lab tests were observed at three- and six months post-surgery (P

Abstract Background Patients with class I obesity may need metabolic and bariatric surgery (MBS) in the presence of obesity-associated medical problems, but MBS in this class of obesity is under debate. This study aimed to investigate the efficacy and safety of MBS in patients with class I obesity. Methods and materials This study was a historical cohort carried out on 112 patients with class I obesity with body mass index (BMI) of 30–35 kg/m2 with a 24-month follow-up underwent MBS at Rasoul-e-Akram Hospital. The required data were extracted through the Iran National Obesity Surgery Database. The data required for the study consisted of demographic information such as age, gender, and obesity-associated medical problems like type-2 diabetes mellitus (T2DM), hypertension, obstructive sleep apnea, and dyslipidemia before surgery, 6, 12, and 24 months after surgery. Results Mean age of the patients was 38.10 ± 10.04 years; mean BMI was 32.96 ± 1.35 kg/m2 and 83.9% (n = 94) of patients were female. Out of 18 patients with T2DM, 11 patients (61.11%) had complete remission and seven patients (38.88%) had partial remission. Obstructive sleep apnea, hypertension, dyslipidemia, and gastroesophageal reflux disease were observed in 18 (16.07%), 23 (20.53%), 43 (38.39%), and 13 patients (11.60%) before surgery and resolved at 24-month follow-up. Post-operative complications during the 24-month follow-up were checked to assess safety and there were no De novo gastroesophageal reflux disease, intolerance, leakage, pulmonary thromboembolism, deep vein thrombosis, incisional hernia, hypoalbuminemia (Albumin

Abstract Background Being obese can lead to various complications during pregnancy, such as Gestational Diabetes Mellitus (GDM), pregnancy induced hypertension (PIH), Pre-Eclampsia (PE), and Large Gestational Age (LGA). Although bariatric surgery is an effective way to treat obesity, it can also result in complications and may be linked to having small for gestational age (SGA) babies. This cohort study protocol aims to compare the maternal and fetal/neonatal outcomes of two groups of Iranian pregnant women: those who have undergone bariatric surgery and those who are obese but have not had bariatric surgery. Methods In this study Pregnant women (

Transformers are one of the most important and expensive equipments in industries whose optimal performance has been influenced by various parameters such as weather conditions (temperature, humidity, etc.) and consumption patterns of the region. Transformer oils are one of the most vital materials used in this equipment. The oil of the transformer coils has been controlled by two factors: First, it acts as an electrical insulator between the coils and the body. Second, the heat created in the parts and the core of the transformer is transferred to the outside. In the electrical industry, many problems may be caused by transformers. Most of these cases have been affected by the performance of oils. In case of improper operation of the oil, it will cause disruption in electricity distribution and even damage and destruction. The oil should perform both tasks of cooling the transformer and insulating the body with electricity at the ideal level. However, due to the low thermal conductivity of such mineral oils, transformers cannot provide optimal performance. In this research by the simulation study, sufficient and acceptable information has been obtained to create the most optimal nano-oil in the operational range with comprehensive library reviews. On the other hand, according to the theoretical analysis, it has been presented that metal oxide nanoparticles, such as CuO, TiO2, Al2O3, SiO2, and MWCNT as hybrid NMs, have been used so far. The most important result of this study, in addition to the type of hybrid nanoparticles, is to find the best combination to increase thermal conductivity and the principles of electrical conductivity and standard indicators of transformer industries. To start the experimental design, the best and most optimal instruction is simulating the function of the transformer using different nano-oils by a computer. Then, in the next step, this simulation has been done by COMSOL software. So, first of all, precise prioritization for using different nanoparticles can be obtained.

Abstract Religious fasting in Ramadan the 9th month of the lunar year is one of five pillars in Islam and is practiced for a full month every year. There may be risks with fasting in patients with a history of metabolic/bariatric surgery (MBS). There is little published evidence on the possible complications during fasting and needs stronger recommendations and guidance to minimize them. An international survey was sent to surgeons to study the types of complications occurring during religious fasting in patients with history of MBS to evaluate the risk factors to manage and prepare more evidence-based recommendations. In total, 21 centers from 11 countries participated in this survey and reported a total of 132 patients with complications occurring during religious fasting after MBS. The mean age of patients with complications was 36.65 ± 3.48 years and mean BMI was 43.12 ± 6.86 kg/m2. Mean timing of complication occurring during fasting after MBS was 14.18 months. The most common complications were upper GI (gastrointestinal) symptoms including [gastroesophageal reflux disease (GERD), abdominal pain, and dyspepsia], marginal ulcers and dumping syndrome in 24% (32/132), 8.3% (11/132) and 23% (31/132) patients respectively. Surgical management was necessary in 4.5% of patients presenting with complications (6/132) patients due to perforated marginal or peptic ulcer in Single Anastomosis Duodenoileostomy with Sleeve gastrectomy (SADI-S), one anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG), obstruction at Jejunojenostomy after Roux-en-Y gastric bypass (RYGB) (1/6) and acute cholecystitis (1/6). Patients after MBS should be advised about the risks while fasting including abdominal pain, dehydration, and peptic ulcer disease exacerbation, and a thorough review of their medications is warranted to minimize complications.

Abstract Background The COVID-19 pandemic has significantly impacted healthcare services worldwide, including bariatric surgery. There is a concern that the pandemic-induced stay-at-home orders and social restrictions may negatively affect weight reduction outcomes post-bariatric surgery. This study aimed to examine the impact of the COVID-19 on weight loss up to six months after three types of bariatric surgeries including One-Anastomosis Gastric Bypass (OAGB), RY Gastric Bypass (RYGB), and Sleeve Gastrectomy (SG) before and two time periods during the COVID-19 pandemic. Methods We conducted a retrospective study using data from a comprehensive database of bariatric surgery patients in Iran. We recruited 882 patients who underwent bariatric surgery from the initiation of COVID-19 to 6 months before public vaccination (Time period 3); among them, 311 patients underwent surgery in the first six months of the pandemic (Time period 2). These patients were compared with 1368 ones in the control group who completed their 6 months follow-up before the pandemic. The study compared the BMI reduction, excess weight loss (EWL), and total weight loss (TWL) outcomes between these groups using Generalized Estimating Equations (GEE) with gamma distribution to adjust for factors that were unevenly distributed across the groups. Results The age of participants in time periods 2 and 3 had a mean (standard deviation) of 38.97 (10.99) and 38.84 (10.71), respectively. In all groups, the majority of patients were females, accounting for 76.02%, 71.06%, and 75.74% for the control group and time periods 2 and 3, respectively. There was no significant difference between the groups in terms of weight reduction, as measured by BMI reduction, EWL, and TWL (related P values: 0.283, 0.465 and 0.169). Regression analysis indicated that higher baseline BMI values were associated with greater BMI reduction (0.04, 95% CI: 0.03–0.05), but this did not translate to higher EWL or TWL. Males showed greater BMI reduction (0.33, 95% CI: 0.18–0.49) and EWL (1.58, 95% CI: 0.79–2.37) than females, while females achieved higher TWL compared to males. Among different types of surgery, the OAGB resulted in more weight reduction among patients in the study. Conclusion In conclusion, our study reveals that bariatric surgery remains effective for weight reduction during the first 6 months of the pandemic in Iran. Implementation of pandemic protocols ensures comparable efficacy to non-pandemic times. However, caution is needed in generalizing results beyond our specific context due to study limitations. Further research is essential to comprehensively assess the pandemic's broader impact on bariatric surgery outcomes under varying conditions.

Introduction and importanceGastrointestinal (GI) symptoms are the most common extrapulmonary presentation of coronavirus disease 2019 (COVID-19) infection. GI perforation may be an unusual manifestation of COVID-19 infection.Case presentationWe report a 45-year-old man who presented with acute abdominal pain without any respiratory symptoms to our emergency department. Investigations revealed retroperitoneal duodenal perforation and fibrotic changes in lung bases. Laboratory findings demonstrated a positive polymerase chain reaction (PCR) test for COVID-19 and mild leukocytosis.Clinical discussionCOVID-19 related perforation of the retroperitoneal part of the duodenum is extremely rare, and to the best of our knowledge, this is the first reported case. With increasing COVID-19 infection, we might see more cases of GI perforation. In the era of COVID-19 pandemic, any abdominal signs and symptoms should alert the clinicians to consider COVID-19 diagnosis in the differential.ConclusionConservative management with close monitoring, antibiotic therapy and serial examinations were completely successful. The patient's general condition improved, and he was discharged on day 7 of hospitalization.

Nanostructured additives have been widely used in various industries especially power industry in order to decrease both specific fuel consumption (fuel consumption per unit of electricity production, SFC) and pollutants emission. The most important fuel properties are fuel density, kinematic viscosity, flash point, cetane number, and calorific value. Calorific value of a fuel is the thermal energy released per unit quantity of fuel when the fuel is burned completely and the products of combustion are cooled back to the initial temperature of the combustible mixture. It measures the energy content in a fuel. The calorific value of a fuel can be measured in a bomb calorimeter. The most frequently used fuel additives for diesel engines are oxygenated additives, antioxidants, cold flow improvers, lubricity improvers, cetane improvers, metal-based additives, and nanomaterials. In recent years, various nanomaterials, acting as diesel engine fuel additives, gained substantial attention. According to investigation results obtained so far, these additives look to be extremely promising. This follows from the wide range of options they offer in influencing practically all important engine characteristics by affecting many processes from fuel combustion to exhaust treatment. In this study, hybrid nanoparticles were dispersed in mazut and diesel fuels as hybrid nanofuels and the physico-chemical properties of manufactured nanofuels were evaluated. Dispersion of the nanoparticles were carried out in two stages. They were weighed and mixed to surfactants and added to fuel. Then the mixture was dispersed by using an ultrasonic device.The results indicated that the rate of calorific values of mazut-based nanofuels and diesel-based nanofuels were improved to 13.41% and 14.02%, respectively, in proportion to pure mazut and pure diesel fuels. Therefore, metal oxide nanoparticles and multi-walled carbon nanotubes had a remarkable impact on combustion properties of fuels. The final price of nanofuel was up to 20-30% more than pure fuels which can be reduced when nanofules are produced in large scale. It can be concluded that the optimized samples of mazut-based and diesel-based nanofuels had all properties of an ideal fuel for using in a combustion process and could be considered as suitable alternatives to pure mazut and pure diesel fuels.

There are approximately 7,000 miles of inland waterways in the UK, many of them built during the 18th and 19th centuries principally to transport bulk materials. These waterways provide numerous benefits to society and the economy. However, they have untapped potential for freight transport which could be released to provide more efficient solutions compared to other modes of transport. In addition to providing solutions to reduce emissions from land or air transportation, inland waterways also bring environmental and public health benefits to local communities. Therefore, these blue-green spaces should play a central role in government and local authority planning. This article explores some of the issues which prevent full use of inland waterways transportation from being achieved from the hydrodynamics point of view. Specifically, the concepts and ideas underpinning vessel operation are reviewed and discussed in detail in this article. It is shown how hydrodynamic concepts can inform public policy to maximise the efficiency of transportation from inland waterways.

Introduction: Mortality decrease following bariatric surgery. We explored the extent of the reduction and whether or not it reaches the general population level in a large cohort of patients with obesity. Compare all-cause mortality between patients with obesity who undergo bariatric surgery and those who do not, with the general Iranian population during the same period. Method: Data from Iran's National Obesity Surgery Database was used to establish a large cohort of patients registered between 2009 and 2019. The current vital status of the patients was determined by utilizing post-surgery follow-up data for those who underwent the operation. For patients without a surgery record, a predefined checklist was filled out through telephone interviews. Death data from the National General Registrar's office was obtained for all cohort members. Results: Of 13313 cohort members, 12915 were eligible for analysis. The median age at the first visit was 38 years, and 78% were women. 6190 patients (47.9%) underwent bariatric surgery, and 6725 patients (52.1%) were not yet operated on at the time of analysis. We observed 139 deaths during 53,880 person-years (PY) follow-ups. The median follow-up for operated-on and not-operated-on groups were 4 and 4.8 years. The mortality rates among non-operated patients were 2.89 times higher (SMR=2.89, 95% CI: 2.36-3.53) than those in the general population, while in operated patients, the mortality rate decreased to 1.82 as high (SMR=1.82, 95% CI: 1.34-2.46). Conclusion: The risk of death has been diminished in the operated-on group. It still remains considerably higher than the risk in the general population.

Purpose: Insufficient angiogenesis is associated with serious diabetic complications. Recently, adipose-derived mesenchymal stem cells (ADScs) are known to be a promising tool causing therapeutic neovascularization. However, the overall therapeutic efficacy of these cells is impaired by diabetes. This study aims to investigate whether in vitro pharmacological priming with deferoxamine, a hypoxia mimetic agent, could restore the angiogenic potential of diabetic human ADSCs. Methods: Diabetic human ADSCs were treated with deferoxamine and compared to normal and nontreated diabetic ADSCs for the expression of hypoxia inducible factor 1-alpha (HIF-1α), vascular endothelial growth factor (VEGF), fibroblast growth factor-2 (FGF-2) and stromal cell-derived factor-1α (SDF-1α), at mRNA and protein levels, using qRT-PCR, western blotting and ELISA assay. Activities of matrix metalloproteinases (MMPs)-2 and -9 were measured using a gelatin zymography assay. Angiogenic potentials of conditioned media derived from normal, Deferoxamine treated, and non-treated ADSCs were determined by in vitro scratch assay and also three-dimensional tube formation assay. Results: It is demonstrated that deferoxamine (150 and 300 μM) stabilized HIF-1α in primed diabetic ADSCs. At the concentrations used, deferoxamine did not show any cytotoxic effects. In deferoxamine treated ADSCs, expression of VEGF, SDF-1α, FGF-2 and the activity of MMP-2 and MMP-9 were significantly increased compared to nontreated ADSCs. Moreover, deferoxamine increased the paracrine effects of diabetic ADSCs in promoting endothelial cell migration and tube formation. Conclusion: Deferoxamine might be an effective drug for pharmacological priming of diabetic ADSCs to enhance the expression of proangiogenic factors noted via HIF-1α accumulation. In addition, impaired angiogenic potential of conditioned medium derived from diabetic ADSCs was restored by deferoxamine.

Abstract Application of cost-effective pretreatment of wheat straw is an important stage for massive bioethanol production. A new approach is aimed to enhance the pretreatment of wheat straw by using low-cost ionic liquid [TEA][HSO4] coupled with ultrasound irradiation. The pretreatment was conducted both at room temperature and at 130 °C with a high biomass loading rate of 20% and 20% wt water assisted by ultrasound at 100 W-24 kHz for 15 and 30 min. Wheat straw pretreated at 130 °C for 15 and 30 min had high delignification rates of 67.8% and 74.9%, respectively, and hemicellulose removal rates of 47.0% and 52.2%. Moreover, this pretreatment resulted in producing total reducing sugars of 24.5 and 32.1 mg/mL in enzymatic saccharification, respectively, which corresponds to saccharification yields of 67.7% and 79.8% with commercial cellulase enzyme CelluMax for 72 h. The ethanol generation rates of 38.9 and 42.0 g/L were attained for pretreated samples for 15 and 30 min, equivalent to the yields of 76.1% and 82.2% of the maximum theoretical yield following 48 h of fermentation. This demonstration provided a cheap and promising pretreatment technology in terms of efficiency and shortening the pretreatment time based on applying low-cost ionic liquid and efficient ultrasound pretreatment techniques, which facilitated the feasibility of this approach and could further develop the future of biorefinery.

Abstract Background Several studies on various bariatric surgeries involving patients with type 2 diabetes mellitus (T2DM) showed an overall rate of remission of hyperglycemia. However, there is little known about predictive factors on remission after different types of surgeries. The aim of this study was to identify the T2DM remission rate and to determine the effects of preoperative factors characteristics of remission of type 2 diabetes in Iran. Methods We conducted a retrospective analysis of 1351 patients with T2DM operated by three different types of surgeries (Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and One Anastomosis Gastric Bypass (OAGB)). Diabetes remission was defined according to the American Diabetes Association (ADA) criteria. Binary logistic regression analyses were employed. Results A total of 1351 patients, 675 patients (50.0%) undergoing OAGB, 475 (35.2%) RYGB, and 201 (14.9%) SG. 80.6%, 84.2% of OAGB, 81.7%, 82.6% of RYGB, and 77.1%, 81.5% of SG participants were in T2DM remission after 1 and 3 years, respectively. 1- and 3-year remission were associated with preoperative age, duration of T2DM, FBS and HbA1c, BMI, insulin therapy, and a family history of obesity (p

Refineries are amongst the most energy-intensive and polluting industries in the world. Biotechnology may serve as an alternative low-cost and environmental-friendly tool to the current costly, toxic and hazardous refining processes. In this study, the compositional redistribution of a heavy hydrocarbon cut is investigated under biological conversion using native microbial consortia. The native consortia were obtained by batch enrichment method applied on oil-polluted soil samples from oil refineries of Iran. The bioconversion experiments were conducted with 20% and 40% (v/v) of the heavy cut as the sole carbon source and 10% (v/v) of the consortia broth in 250 ml flasks containing a mineral medium. The samples kept at 30°C stirring at 120 rpm for one week. The biotreated hydrocarbons were then separated and analyzed for determination of saturate, aromatic and resin fractions using column chromatography and gravimetric measurements. The results showed that the amounts of saturates increased by 6% to 92% while the resins decreased by 10% to 70% in most cases, compared to the blank. The GC-Mass analysis of the saturate fractions also revealed an increase in the cyclic and branched alkanes and a decrease in the S-containing and N-containing compounds.

Abstract Background Historically, Roux-en-Y gastric bypass (RYGB) has been considered the gold standard of bariatric surgery (BS). This procedure acts as a mixed restrictive and malabsorptive operation. Methods This retrospective cohort study included 410 morbidly obese patients (BMI > 40 kg/m2 or BMI > 35 kg/m2 along with at least one major comorbidity) who underwent primary laparoscopic RYGB surgery from 2009 to 2015 by a single surgery team. The patients were 18 years and older with at least 12 months of follow-up. Total weight loss (%TWL) and comorbidity resolution were compared in short-term (12 months) and mid-term (12–60 months) follow-ups. The primary and secondary outcomes were evaluating the effect of Roux-en-Y on weight loss and control of comorbidities, respectively. Results The mean ± SD age, weight, and BMI at surgery were 40.1 ± 10.58 years, 123.32 ± 19.88 kg, and 45.78 ± 5.54 kg/m2, respectively, and 329 (80%) were female, and 62 (15%) had T2DM. %TWL was significantly higher in T2DM patients 9 months postoperatively and after that. Patients with lower BMI (

Abstract Background The impact of technology and digitalization on health care systems will transform the nursing profession worldwide. Nurses need digital competencies to integrate new technology in their professional activities. Nurse educators play a crucial role in promoting the acquisition of digital competences and therefore need to be digitally competent themselves. Research on digital competencies of nursing educators is scarce but suggests lack of digital knowledge and skills and support needs. Although digitalization is to be seen as a global process, regional contexts need to be taken into account, such as pre-existing competencies, local conditions, and individual needs. Thus, it remains unclear which competencies nurse educators possess and which support needs they have. Aim of this study was to assess nurse educators’ and clinical mentors’ digital competencies and explore their needs and requirements concerning the digital aspects of their pedagogy and teaching activities in Germany. Methods A descriptive exploratory study with a cross-sectional design was conducted. Participants were identified using a convenience sampling approach. Data were collected during July and September 2020 using a standardized self-reported questionnaire that was developed specifically for this study. The questionnaire was provided in a paper and online format and participants could decide which format to use. It contained open- and closed-ended questions. Data were analyzed using descriptive and content analysis. Additionally, explorative subgroup analyses based on job designation, age, and gender were performed. Reporting of this study adhered to the STROBE checklist. Results A total of 169 educating nurses participated in the survey. The respondents considered themselves as digitally competent and showed a positive attitude towards the integration of digital technology in their teaching activities. Their perceived preparedness to integrate digital technology into teaching and training varied. Almost all respondents (98%) declared a need for further training and seemed motivated to participate in corresponding educational events. There were some indications for differences in competencies or needs between subgroups. Conclusions Educating nurses appear to possess basic digital competencies but there is a need to support their professional development in terms of new technologies. Findings can be used as a basis for developing supportive interventions. Further qualitative investigations could inform the design and content of such interventions.

Abstract In patients with BMI ≥ 50 kg/m2, it is difficult to select an appropriate procedure that can lead to optimum results. This study aims to evaluate mid-term weight loss outcomes in patients with BMI ≥ 50 kg/m2 following one anastomosis gastric bypass (OAGB) as a one-stage procedure. A prospective study was conducted on patients with BMI ≥ 50 kg/m2, aged 18 years and above who had undergone primary OAGB from January 2016 to February 2019 with at least two years follow-ups. A total of 197 patients with BMI ≥ 50 kg/m2 had underwent OAGB. The mean age was 38 years and the mean pre-operative BMI was 53.7 kg/m2. Mean EWL% were 63.7%, 67.8% and 66.2% at one, two and five years after OAGB respectively. The highest level of EWL% was 68.4%, which was achieved in the 18th month following OAGB. OAGB can be performed safely in patients with BMI ≥ 50 kg/m2 as a one-stage procedure with acceptable weight loss outcomes and remission of obesity associated medical problems.

Abstract The most accepted procedures as conversion for poor weight changes after sleeve gastrectomy (SG), are malabsorptive surgeries. This study was designed to evaluate the 5-year outcomes of One Anastomosis Gastric Bypass (OAGB) following SG due to weight loss failure and weight regain. From September 2014 to January 2017, totally 23 patients with a history of SG conversion to OAGB in terms of weight loss failure or weight regain who had completed their 5-year follow-ups were studied. Some obesity related co-morbidities containing type-2 diabetes (DM), hypertension (HTN), dyslipidemia, obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) were also investigated at 1, 2, 3 and 5 years after conversional surgery. All cases had remission/improvement in DM, DLP, HTN and OSA 1 year after conversional OAGB. Analysis showed statistically significant (P

A systems-wide analysis of the single-cell green alga Chlamydomonas reinhardti reveals shared and unique responses to moderate and acute high temperatures using multiple-level investigation of transcriptomics, proteomics, cell physiology, photosynthetic parameters, and cellular ultrastructure.

Farabi's Kiitab Alhoroof is the first direct philosophical encounter of a Muslim thinker with Greek philosophical thought. Discussions on the analysis of the concepts of "existence-existent" and " Essence " as the main elements of Aristotle's philosophical thought are among the most important parts of this book. Farabi's purpose in writing this book is to lay the groundwork for a fundamental understanding of Greek philosophical thought in the Islamic world. He begins the discussion with the linguistic analysis of "existent" as a non-derivative word (first example) in Arabic and proposes three meanings (“Categories” and “Truthful” and “Individual external thing by essence) for "existent." He combines three meanings into two meanings and focuses on the third meaning (Individual external thing by essence). Al-Farabi tries to offer a way to justify the multiplicity of beings in the universe by proposing categories for the third meaning of "existence" and "essence" as identifiers of external and mental beings, while emphasizing the external union of "existence" and "essence"; Accordance to the author's view, this way is incoherent without assuming the discussion of the "metaphysical distinction of existence from essence"; Farabi's argument on dividing the existence into rich and poor and designing the concept of (Individual mental thing by essence) in contrast to the concept of "no existence" does not seem understandable except by assuming the metaphysical distinction of existence and essence. His plan paves the way for designing the rules of ontological distinction of "existence" from "essence" are prepared by Ibn Sina.

In this article, tin oxide nanoparticles were prepared by hydrothermal method and then deposited on fluorine doped tin oxide (FTO) glass by Dr. Blade method and dye sensitized solar cell (DSSC) was fabricated with tin oxide photoanode. To improve cell efficiency, the prepared photoanode was doped with titanium and the effect of Ti doping on physical properties and performance of DSSCs were investigated. The physical properties of the synthesized nanostructures were investigated by XRD, SEM, BET, and DRS analyses. Finally, DSSC solar cells were constructed from prepared photoanodes and current-voltage analysis was performed. The results showed that Ti doping affects the adsorption-desorption isotherm of the sample and increases the specific surface area significantly. Thus, specific surface area has increased from 36.23 m2/g for the SnO2 sample to 508.13 m2/g for the Ti doped sample. The results showed that the DSSC made with doped photoanode showed much better performance and titanium doping increased both the short circuit current and open circuit voltage. The titanium doped sample showed an increase in efficiency of about 2 times compared to the pure SnO2 photoanode.

Introduction: Mortality decreases following bariatric surgery. We explored the extent of the reduction and whether or not it reaches the general population level in a large cohort of patients with obesity. This study aimed to compare all-cause mortality between patients with obesity who undergo bariatric surgery and those who do not, with the general Iranian population during the same period. Method: Data from Iran's National Obesity Surgery Database were used to establish a large cohort of patients registered between 2009 and 2019. The current vital status of the patients was determined by utilizing post-surgery follow-up data for those who underwent the operation. For patients without a surgery record, a predefined checklist was filled out through telephone interviews. Death data from the National General Registrar's office were obtained for all cohort members. Results: Of 13,313 cohort members, 12,915 were eligible for analysis. The median age at the first visit was 38 years, and 78% were women. 6,190 patients (47.9%) underwent bariatric surgery, and 6,725 patients (52.1%) were not yet operated on at the time of analysis. We observed 139 deaths during 53,880 person-years follow-ups. The median follow-ups for operated-on and not operated-on groups were 4 and 4.8 years. The mortality rates among nonoperated patients were 2.89 times higher (standardized mortality ratio [SMR] = 2.89, 95% CI: 2.36–3.53) than those in the general population, while in operated patients, the mortality rate decreased to 1.82 as high (SMR = 1.82, 95% CI: 1.34–2.46). Conclusion: The risk of death has been diminished in the operated-on group. It still remains considerably higher than the risk in the general population. [ABSTRACT FROM AUTHOR]

Increasingly, the melting of Arctic ice due to global warming has provided opportunities for commercial shipping between Asia and Europe. Given the vulnerability of the Arctic environment, especially due to emissions of short-lived pollutants from shipping activities, a more effective propulsion system with a comprehensive control strategy is required to reduce fuel consumption, thus potentially mitigating the impacts of shipping activities on the northern sea route (NSR). In this paper, a shipboard DC hybrid system powered by a combination of diesel generator sets and batteries is proposed and analysed in terms of its application on a ship in the NSR. The specific fuel consumption and various losses in the power sources were analysed to develop an efficiency-optimisation control strategy for the proposed DC hybrid power system. To evaluate the performance of the hybrid power system with the proposed optimisation control strategy, lab-scale experiments have been conducted in the Shanghai Marine Diesel Engine Research Institute to compare the proposed system with a conventional hybrid system. The experimental results indicate that the proposed DC hybrid power plant with the energy optimisation control contributes a 5.35% fuel saving compared with the DC fixed-speed diesel electric configuration during a scaled-down NSR scenario.

Introduction: Bariatric surgery may lead to unsatisfactory weight loss, weight loss plateau, and even weight regain after various types of surgery. Despite the numerous studies, the mid-term results of surgery, after repetitive weight fluctuations remains a major concern. The aim of the present study was to determine the key time points of weight changes after three types of bariatric procedures, as well as to determine five-year weight loss outcome after surgery. Methods: This is a retrospective cohort study including patients with morbid obesity conducted in the Minimally Invasive Surgery Research Center. The patients underwent one of the three types of bariatric surgeries including laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB), who had been followed up for weight loss trend during five years postoperatively. Results: The mean %EWL and TWL% of 2567 participants with obesity (mean age=39.03, mean BMI=45.67) in the first six months after surgery was independent of the type of surgery (P>0.05). OAGB and RYGB showed significantly higher weight loss compared to LSG in ninth and 24th month after surgery, respectively (P