Ensuring “stability of the real estate legal situation” in the Iranian land recording system

The topic of recording real estate transactions and the documentation of the rights of all parties is a controversial topic under the Iranian recording system. One of the functions of the recording system is “assuring security” regarding the stability of real estate property transactions, which can affect the rights of third parties as well. “Security” in transactions requires establishing priority for recorded transactions and observing rights concerning unrecorded ones. This means that the developed form of the recording system must move from “static security” to “dynamic security” in order to protect public interests instead of private ones. In reviewing the Iranian legal system, the bases of “Dynamic Security” can identified in various laws related to the recording of real estate transactions that legally recognize formal deeds and recorded rights. However, since these bases have not been theorized yet, there is not enough sanction to guarantee the enforcement of this theory. In addition, judicial procedure has issued a lot of sentences implying the acceptance of “Static Security”, so that private interests are considered much more important than public interests. The lack of any formal and legal “Dynamic Security” theory has even led legislators to adopt rules against this theory by granting the authority to judges to give effect to informal documents as well. All this has resulted in a lack of security and stability in the recording system, which has led to a lack of trust by all parties in trusting the information and the content of a registration book, because any kind of transaction can be nullified by a judicial decision. In applying a qualitative method and content analysis, it can be concluded that “Dynamic Security” can provide very useful tools for guaranteeing the security and stability of real estate transactions. Consequently, it is essential to theorize this security and consider it in the law and practical procedures relating to it

The effects of cholesterol lowering drugs on vitamin D status in familial hypercholesterolemia patients

Background: Familial high blood cholesterol (hypercholesterolemia) is a common disease that involves many complications for patients. The aim of this study is to investigate the effects of cholesterol-lowering drugs (Gemfibrozil and Atorvastatin) on the level of serum Vitamin D.Materials and methods: In this study, the 25-hydroxy vitamin D levels were evaluated in 65 women between 30-55 years of age. After receiving drug information of patients, cholesterol-lowering medication; Gemfibrozil and Atorvastatin were prescribed by a specialist, then vitamin D and cholesterol levels were measured following 9 month treatment. Also 30 patients consumed vitamin D supplements plus medicine regularly.Results: In the first stage, vitamin D levels in subjects are quite normal but their cholesterol levels were higher than normal. In the second stage, vitamin D levels were measured after 9 months use of Gemfibrozil and Atorvastatin. Accordingly, cholesterol levels decreased significantly due to the use of blood cholesterol-lowering drugs (p=0.021). Also, in this stage the level of vitamin D showed a severe and significant reduction (p=0.041). However, there were no significant reductions in vitamin D in 30 women who consumed vitamin D supplements plus medicine (p=0.073).Conclusion: It seems that taking cholesterol-lowering medicines have reduced the amount of vitamin D. With long-term use of medications, bone diseases such as osteoporosis can be predicted in these individuals. Therefore, taking supplements and food rich in vitamin D during the use of these drugs is recommended

Iran's Health System Transformation Plan: A SWOT analysis

Background: Societies are characterized by evolving health needs, which become more challenging throughout time, to which health system should respond. As such, a constant monitoring and a periodic review and reformation of healthcare systems are of fundamental importance to increase the efficiency and effectiveness of healthcare services delivery, equity, and sustainable funding. The establishment of President Rouhani's government in Iran, on May 5, 2014, the settlement of the new Ministry of Health and Medical Education administration (MoHME) and the need for change in the provision of healthcare services has led to the "Health System Transformation Plan" (HSTP). The aim of the current investigation was to critically evaluate the health transformation plan in Iran. Methods: Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis enables to identify and assess the strengths and weaknesses within an organization or program, as well as the threats and opportunities outside the given organization or program. To identify SWOT of the HSTP in Iran, all articles concerning this program published in scholarly databases as well as in the gray literature were systematically searched. Subsequently, all factors identified at the first round were thematically classified into four categories and for reaching consensus on this classification, the list of points and factors was sent to 40 experts - policy- and decisionmakers, professors and academicians, health department workers, health activists, journalists. Results: Thirty-four subjects expressed comments on classification. Incorporating their suggestions, the SWOT analysis of Iran's HSTP was revised, finalized and then performed. Conclusion: HSTP in Iran, like many of the initiatives that have been recently introduced and not fully implemented, have various challenges, difficulties and pitfalls that health policymakers need to pay attention to. Interacting with criticisms, taking into account public opinion and strengthening the plan can make the project more effective, and it can be anticipated that in the future, better conditions in the health sector will be achieved

Clinical Report Multiple Cutaneous Inverted Papilloma in a German shepherd Dog

Abstract Case Description-In this clinical report, occurrence of a rare case of canine cutaneous inverted papilloma was discussed. A 4-year-old, intact, male German shepherd dog was presented with multiple skin lesions, located on the inguinal region near the root of penis, which have been progressively growing since two months ago. In close examination of the lesions multiple, firm, painful, and cup-shaped nodules in different sizes with a central pore filled with keratin were observed. Treatment and Outcome-Surgical excision and histological evaluation was done. Histologically this tumor was characterized by endophytic projections of the epidermis extending into dermis.Cytopathic effects included ballooning degeneration of keratinocytes, koilocytosis, irregularity of keratohyalin granules, and margination of nuclear chromatin. Numerous eosinophilic intranuclear inclusions were present within keratinocytes of endophytic lesion. Immunohistochemically, the tumor cells were intensely positive for pancytokeratin. On the basis of histopathological and clinical findings, the tumor was diagnosed as multiple cutaneous inverted papilloma. There was no recurrence or any other complications in post operative monitoring. Clinical Relevance-Inverted papillomas are relatively uncommon in dogs; whereas, the incidence of this tumor in the inguinal region is uncommon. Treatment of inverted papilloma was completed by surgical excision in ablating the tumor masses and preventing re-growth. 92 Case Description A 4-year-old, intact, male German shepherd dog was presented for treatment of multiple skin lesions, located on the inguinal region near the root of penis. The owner declared that the masses have been growing up rapidly through two months prior to presentation. On clinical examination; all vital signs (heart Rate, respiratory rate and rectal temperature) were in the normal range. On dermatological examination, multiple, firm, painful, and cup-shaped nodules in different sizes with a central pore filled with keratin were observed and the masses had well-demarcated border Treatment and Outcome Based on the clinical examination, cutaneous neoplasia was suspected and complete surgical excision of the masses was recommended. The dog was premedicated with 0/05 mg/kg acepromazine (KELA Laboratoria) intramusculary and anesthesia intravenously was induced with 10 mg/kg thiopental sodium (Sandoz) and was maintained with halothane 2% (Halothane BP, Nicholas Piramal). An elliptical incision was made in the skin around the lesion and the masses were dissected from subcutaneous tissues. The skin was sutured with Nylon (Monofil Polyamid, Supa) USP: 2/0 in interrupted suture pattern. Postoperative care included Cefazoline (Exir Pharmaceutrical Co.) at 20 mg/kg intramuscularly, every 12 hours for 3 days. The removed masses were fixed in 10% neutral buffered formalin, processed routinely, embedded in paraffin, sectioned at 5 µm thickness, stained with hematoxylin and eosin, and studied with a routine light microscope. Immunohistochemistry of additional section was performed with Avidin-Biotin complex method by using monoclonal antibodies for pancytokeratin antibody (1/500). Microscopic examination at the nodules revealed cupshaped epidermal proliferation with centripetal papillary projections into dermi

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Ubiquitous spin freezing in the superconducting state of UTe2

UTe2 receives significant attention as it may be an example of a spin-triplet superconductor but many features of this material are still to be fully understood. Here, the authors use muon spin rotation to investigate the existence of low-temperature magnetic clusters in single crystals of UTe2 and discuss the potential relationship with the temperature dependent behaviour of the specific heat

Age–sex differences in the global burden of lower respiratory infections and risk factors, 1990–2019: results from the Global Burden of Disease Study 2019

Background: The global burden of lower respiratory infections (LRI) and corresponding risk factors in children older than five years and adults has not been studied as comprehensively as in children under five years old. We assessed the burden and trends of LRI and risk factors across all age groups by sex for 204 countries and territories. Methods: We used clinician-diagnosed pneumonia or bronchiolitis as our case definition for lower respiratory infections. We included ICD9 codes 073.0-073.6, 079.82, 466-469, 480-489, 513.0, and 770.0 and ICD10 codes A48.1, J09-J22, J85.1, P23-P23.9, and U04. We used the Cause of Death Ensemble modelling strategy to analyse 23,109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age-sex-specific incidence and prevalence data identified via systematic review, population-based surveys, and claims and inpatient data. Additionally, we estimated age-sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors.Results: Globally, we estimated LRI episodes of 257 million (95% UI 240–275) for males and 232 million (217–248) for females in 2019. In the same year, LRI accounted for 1.3 million (1.2–1.4) deaths among males and 1.2 million (1.1–1.3) deaths among females. Age-standardised incidence and mortality rates were 1.2 times and 1.3 times greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups while an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older experiencing the highest increase in LRI episodes (126.0% [121.4–131.1]) and deaths (100.0% [83.4–115.9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for mortality among males under the age of five (70.7% [61.8–77.3]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths among males and females younger than five years were attributable to child wasting, and more than a quarter of LRI deaths among those aged 5–14 years were attributable to household air pollution in 2019. For males aged 15–49, 50–69, and 70 years and older, 20.4 (15.4-25.2), 30.5% (24.1–36.9), and 21.9% (16.8–27.3), respectively, of estimated LRI deaths were attributable to smoking in the same year. For females aged 15–49 and 50–69 years, 21.1% (14.5–27.9) and 7.9% (5.5–10.5) of estimated LRI deaths were attributable to household air pollution in 2019. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11.7% (8.2–15.8) of LRI deaths in the same year.Interpretation: The patterns and progress in reducing the burden of LRI and key risk factors varied across age groups and sexes.. The progress seen in under five children was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to achieving multiple Sustainable Development Goals targets, including promoting well-being at all ages and reducing inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would mean preventable deaths and millions of lives saved, as well as reduced health disparities

Age–sex differences in the global burden of lower respiratory infections and risk factors, 1990–2019: results from the Global Burden of Disease Study 2019

Summary Background The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories. Methods In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466–469, 470.0, 480–482.8, 483.0–483.9, 484.1–484.2, 484.6–484.7, and 487–489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4–B97.6, J09–J15.8, J16–J16.9, J20–J21.9, J91.0, P23.0–P23.4, and U04–U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23 109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age–sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and claims and inpatient data. Additionally, we estimated age–sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors. Findings Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240–275) LRI incident episodes in males and 232 million (217–248) in females. In the same year, LRIs accounted for 1·30 million (95% UI 1·18–1·42) male deaths and 1·20 million (1·07–1·33) female deaths. Age-standardised incidence and mortality rates were 1·17 times (95% UI 1·16–1·18) and 1·31 times (95% UI 1·23–1·41) greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126·0% [95% UI 121·4–131·1]) and deaths (100·0% [83·4–115·9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for LRI deaths in males younger than 5 years (–70·7% [–77·2 to –61·8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53·0% [95% UI 37·7–61·8] in males and 56·4% [40·7–65·1] in females), and more than a quarter of LRI deaths among those aged 5–14 years were attributable to household air pollution (PAF 26·0% [95% UI 16·6–35·5] for males and PAF 25·8% [16·3–35·4] for females). PAFs of male LRI deaths attributed to smoking were 20·4% (95% UI 15·4–25·2) in those aged 15–49 years, 30·5% (24·1–36·9) in those aged 50–69 years, and 21·9% (16·8–27·3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21·1% (95% UI 14·5–27·9) in those aged 15–49 years and 18·2% (12·5–24·5) in those aged 50–69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11·7% (95% UI 8·2–15·8) of LRI deaths. Interpretation The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children younger than 5 years was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, including promoting wellbeing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities