Deducting the Cost of Sex Reassignment Surgery: How O’Donnabhain v. Commissioner Can Help Us Make Sense of the Medical Expense Deduction

In February 2010, the Tax Court held that a taxpayer’s expenses incurred for hormone therapy and sex reassignment surgery were deductible as medical expenses under § 213 because they treated the disease of gender identity disorder. The court, however, was deeply divided in its determination of whether sex reassignment surgery qualifies as nondeductible cosmetic surgery under § 213(d)(9). In 1990, Congress amended § 213 to exclude cosmetic surgery from the definition of deductible medical care. Since then, the Tax Court and the I.R.S. have rarely addressed the meaning and extent of that exclusion. The judges’ divergent opinions in O’Donnabhain make it clear that a thorough examination of the statutory meaning of cosmetic surgery is timely. This Note considers what should qualify as cosmetic surgery within the context of the medical expense deduction. It argues that a medical procedure that improves physical appearance should be deductible under § 213 when it is physician-prescribed treatment for a specific disease, and consistent with generally accepted medical practice. This analysis is grounded in the statutory language of § 213, and is supported by broader principles that bear on the policy debate surrounding the medical expense deduction more generally

Are Groups more Rational than Individuals? A Review of Interactive Decision Making in Groups

Many decisions are interactive; the outcome of one party depends not only on its decisions or on acts of nature but also on the decisions of others. In the present article, we review the literature on decision making made by groups of the past 25 years. Researchers have compared the strategic behavior of groups and individuals in many games: prisoner’s dilemma, dictator, ultimatum, trust, centipede and principal-agent games, among others. Our review suggests that results are quite consistent in revealing that groups behave closer to the game-theoretical assumption of rationality and selfishness than individuals. We conclude by discussing future research avenues in this area.group decision making, interactive decision making, rationality, discontinuity effect

GUIDE: Graphical User Interfaced Development Environment

GUIDE is an interactive graphical system for designing and generating graphical user interfaces. It provides flexibility to the system designer while minimizing the amount of code which the designer must write. The GUIDE methodology includes the notions of tool, task, and context. GUIDE encourages designers to tailor their systems to individual users by inclusion of user profiles, allowing different control paths based on the user\u27s characteristics. GUIDE also provides a method for invoking application routines with parameters. Parameters may be based on user inputs and are computed at invocation time. Help messages are created along with the objects to which they refer. GUIDE handles the overhead required to display help messages

Obstetric vesico-vaginal fistulae seen in the Northern Democratic Republic of Congo: a descriptive study

Background: The Democratic Republic of Congo (DRC) is a developing country with poor obstetric indicators. Despite ongoing efforts to improve care, women continue to suffer multiple complications of child birth including vesico-vaginal fistulae (VVF).Objective: To describe socio-demographic and clinical characteristics of VVF patients in Northern DRC.Methods: Women presenting at two VVF mobile surgical campaign missions in the province of Equateur in Northern DRC in August 2012 and October 2013 were examined and treated for VVF. We collected socio-demographic data, including marital status, education, and accompaniment by husbands for treatment, as a proxy for marital support, and clinical data related to characteristics of VVF in patients, duration of illness, and the outcome of treatment surgery.Results: Out of 163 VVF patients, 100 (61.3%) were less than 35 years old, 102 had no formal education ( 62.6%), and 100 were married ( 61.3%). The mean duration of illness before surgery was 8.4 years. Successful surgery rate for VVF was 87.1% (142/163). A majority of patients who were married, were accompanied to the hospital by their husbands for treatment (56/100; 56.00%). Association analysis revealed age was the only variable that maintained significant association with duration of illness after multivariate analysis (p-value <0.0001). Marital status was the only variable associated with surgical outcome (0.334, 95% CI 0.125- 0.847, p-value = 0.021).Conclusion: We found that most VVF patients were young adults, not educated, and married. Marital status and age may have important roles in outcome of VVF surgery and duration of illness, respectively.Keywords: Obstetric vesico-vaginal fistulae, Northern Democratic Republic of Cong

Ovarian reserve and anti-Mullerian hormone (AMH) in mothers of dizygotic twins

This study aimed to explore if natural dizygotic (DZ) twinning is associated with earlier menopause and lower anti-Mullerian hormone (AMH) values. We investigated if advanced biological reproductive aging, which can be responsible for the multiple follicle growth in familial twinning, is similar to mechanisms that occur in normal ovarian aging, reflected by earlier menopause in mothers of DZ twins and lower levels of AMH. A total of 16 mothers of DZ twins enrolled with the Netherlands Twin Register (average age at first assessment: 35.9 +/- 3.0 years) and 14 control mothers (35.1 +/- 3 years) took part in a prospective study. Fifteen years after entry into the study, which included follicle-stimulating hormone (FSH) assessment, AMH was measured in stored serum samples and menopause status was evaluated. Average AMH levels were not significantly different between DZ twin mothers and controls (2.1 +/- 2.4 mu g/L vs. 1.9 +/- 1.9 mu g/L). Among the 16 mothers of twins, 7 had an elevated (FSH) value over 10 U/L at first assessment. Their AMH levels were lower than the nine twin mothers with normal FSH values: 0.6 +/- 0.4 versus 3.4 +/- 2.6 mu g/L (p = .01). Of the mothers of twins, eight mothers had entered menopause at the second assessment compared with only one control mother (p = .07). Thus, slightly more DZ mothers were in menopause than the control mothers, although this difference was not significant. The subgroup of DZ twin mothers who had an increased FSH concentration 15 years ago had a limited ovarian reserve as reflected by lower AMH levels. These data indicate that advanced ovarian aging can be a feature in familial DZ twinning, particularly with elevated early follicular phase FSH

Komunikasi Interpersonal Guru Pembimbing Akademis dengan Siswa dalam Meningkatkan Prestasi di Man 1 Pekanbaru

Achievements can be achieved because of the role of a teacher. Students will find it difficult to attain achievement in the absence of a teacher who nurtures, teaches and improves the student's abilities. From the established communication can also be known hobbies and interests and talents of students / I so that even academic tutors can have a solution to channel the student / hobby so as to improve student achievement. This research was conducted to know the interpersonal communication of academic tutors in improving achievement in Madrasah Aliyah Negeri 1 Pekanbaru. The result of the research shows that the interpersonal communication done by the teacher and the students run well. Openness done between teacher and student resulted in the exchange of information so that found learning method according to student character. The empathetic attitude done by the teacher in the form of verbal speech and non verbal action. Supportive attitudes performed between teachers and students include motivating students and praising the results of what they do. Positive behavior is done between teachers and students by always thinking positive when there is a problem with students. The attitude of equality between teachers and students by way of teachers behave as if people who are not too smart so that students do not feel inferior when being in communication with the teacher. Interpersonal communication that is done by academic supervisor teacher give positive impact that is increase of student achievement in MAN 1 Pekanbaru

Seniority zero pair coupled cluster doubles theory

Coupled clusterﾠtheoryﾠwith single and doubleﾠexcitationsﾠaccurately describes weak electronﾠcorrelationﾠbut is known to fail in cases of strong staticﾠcorrelation.ﾠFascinatingly, however, pairﾠcoupled clusterﾠdoubles (p-CCD), a simplified version of theﾠtheoryﾠlimited to pairﾠexcitationsﾠthat preserve the seniority of the reference determinant (i.e.,ﾠthe number of unpaired electrons), hasﾠmean fieldﾠcomputational cost and is an excellent approximation to the full configuration interaction (FCI) of the paired space provided that the orbital basis defining the pairing scheme is adequately optimized. In previous work, we have shown that optimization of the pairing scheme in the seniority zero FCI leads to a very accurate description of staticﾠcorrelation.ﾠThe same conclusion extends to p-CCD if the orbitals are optimized to make the p-CCD energy stationary. We here demonstrate these results with numerous examples. We also explore the contributions of different seniority sectors to theﾠcoupled clusterﾠdoublesﾠ(CCD)ﾠcorrelationﾠenergy using different orbital bases. We consider both Hartree-Fock and Brueckner orbitals, and the role of orbital localization. We show how one can pair the orbitals so that the role of the Brueckner orbitals at theﾠCCDﾠlevel is retained at the p-CCD level. Moreover, we explore ways of extendingﾠCCDﾠto accurately describe strongly correlated systems

Exploration Ground Data Systems (xGDS) Overview

xGDS supports rapid scientific decision making by synchronizing the time and mapped location of observation notes, instrument data, photos, video, samples and other data. xGDS is a suite of web tools, developed at NASA Ames Research Center to support remote science operations in analog missions and prototype new ideas for planetary exploration. During operations, xGDS displays science data in real-time with geographic context, supporting key decisions (e.g. sample site selection). Post-operations, xGDS enables efficient analysis of data by correlating data products in time and on the map. xGDS has been developed in close collaboration with science teams since 2009, and used enthusiastically by upwards of 100 scientists to support scientific field research and data analysis

Mutation in Fas Ligand Impairs Maturation of Thymocytes Bearing Moderate Affinity T Cell Receptors

Fas ligand, best known as a death-inducer, is also a costimulatory molecule required for maximal proliferation of mature antigen-specific CD4+ and CD8+ T cells. We now extend the role of Fas ligand by showing that it can also influence thymocyte development. T cell maturation in some, but not all, strains of TCR transgenic mice is severely impaired in thymocytes expressing mutant Fas ligand incapable of interacting with Fas. Mutant Fas ligand inhibits neither negative selection nor death by neglect. Instead, it appears to modulate positive selection of thymocytes expressing both class I– and class II–restricted T cell receptors of moderate affinity for their positively selecting ligands. Fas ligand is therefore an inducer of death, a costimulator of peripheral T cell activation, and an accessory molecule in positive selection