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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

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 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 (

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.

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.

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.

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.

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.