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This Article explores the tax law challenges associated with the taxation of cryptocurrencies and offers proposals to address such challenges. The Article addresses the proper tax treatment of different cryptocurrency transactions and activities. It examines various aspects associated with the taxation of cryptocurrency through its life cycle, starting from earning cryptocurrency, through its disposal or exchange. The Article also examines the tax treatment of two special crypto events, hard forks and airdrops. Specifically, this Article describes a proposal to tax cryptocurrencies based on their unique features. It argues that various ways of earning or receiving crypto tokens (for example, mining in proof-of-work (PoW) protocols like Bitcoin and staking in proof-of-stake (PoS) protocols like Ether) generate taxable income. The Article argues that the U.S. framework for taxing cryptocurrency is unadministrable and ignores the defining feature that distinguishes crypto from other assets: its volatility. Because of its volatility, crypto should not be taxed until tokens are exchanged for real-world items like fiat currency or goods and services. Finally, the Article argues that when crypto tokens are exchanged for fiat currencies or goods and services, they should be treated as foreign currency if held for less than one year., Table of Contents I. Introduction 3 II. General--The World of Cryptocurrencies 5 A. General--What is Cryptocurrency? 6 B. Blockchain C. Bitcoin D. Emergence of New Cryptocurrencies after Bitcoin 8 III. [...]

Abstract Background Prescription opioids are widely used for pain control and palliative care but have been associated with a variety of untoward effects, including opioid use disorder, addiction, and increased mortality. Patterns of opioid use in Israel are to date poorly described. Methods Using a community-based database, the authors performed a retrospective analysis of filled opioid prescriptions of Israeli HMO members 18 years of age or older during the years of 2010–2020 that filled at least one opioid prescription. Morphine milligram equivalent (MME) calculations were stratified by presence or absence of oncology diagnosis and by specific opioid medication. Results The percentage of HMO members who filled at least one opioid prescription increased every year from 2.1% in 2010 to 4.2% in 2020. There was an increase in the MME per prescription (44.2%), daily MME per capita (142.1%) and MME per prescription-filling patient (39%) from 2010 to 2020. Increased prescription opioid use is driven by a small group of non-oncological patients, which is less than 1.5% of opioid-prescribed patients and 0.1% of the adult population, primarily owing to fentanyl use. Conclusion Supervision and control of opioid prescriptions in Israel should be a focused effort directed at patients prescribed uniquely high dosages rather than a population-wide strategy that focuses on all patients prescribed opioids. This should be complemented by improved physician training and access to non-opioid therapies, as well as improved data collection and analysis.

Abstract Background Right middle lobe (RML) syndrome is a recurrent or chronic obstruction of the RML causing atelectasis of the right middle lobe due to mechanical and nonmechanical etiologies. The consequences of untreated RML syndrome range from chronic cough to post‐obstructive pneumonia and bronchiectasis. We report here our bronchoscopy experience in patients with RML syndrome. Methods We conducted a retrospective study of adult patients who underwent bronchoscopy for RML syndrome at Rabin Medical Center from 2008 through 2022. Demographic data and medical history, bronchoscopy findings and procedures, and follow‐up results were collected. Results A total of 66 patients (57.6% male, mean age 63 ± 13 years) underwent bronchoscopy for RML syndrome during the study period. Bronchoscopy revealed a mechanical etiology in 49 (74.2%) cases, including endobronchial mass (21, 31.8%) and external compression (7, 10.6%). Malignancy was identified in 20 (30.3%) cases. In 62 patients (93.9%), the bronchoscopy resulted in partial or complete reopening of the RML bronchus. The therapeutic bronchoscopic procedures were balloon dilatation (19), laser ablation (17), mechanical debridement (12), endobronchial stent insertion (11), and cryoablation (6). Conclusions Malignancy was identified as the etiology of RML syndrome in approximately 25% of cases, suggesting bronchoscopy should be performed in every case of RML atelectasis. To our knowledge, this is the first reported series of endobronchial stenting of the RML bronchus in the context of RML syndrome.

ABSTRACT: Streptococcus pyogenes is an important human pathogen, commonly spread by airborne droplets but also by ingestion of contaminated food. Apart from causing infection, this pathogen produces 13 distinct types of streptococcal pyrogenic exotoxins (SPE). The current method for detection cannot distinguish between the biologically active form of SPE that has been reported to cause foodborne outbreaks and the inactivated toxin that poses no health risk. To measure the biological activity of SPE type C (SPE-C), one such toxin that was linked to foodborne outbreaks associated with milk and milk products, we developed a cell-based assay that can discern between biologically active and inactive SPE-C. To the best of our knowledge, this is the first showing that SPE-C activates T-cells expressing Vβ8. With this finding, we used a T-cell line natively expressing Vβ8 that was genetically engineered to also express the luciferase reporter gene under the regulation of nuclear factor of activated T-cells response element in combination with a B-cell line to present the recombinant SPE-C (rSPE-C) toxin via major histocompatibility complex (MHC) class II to the Vβ8 T-cell receptor (TCR) in an assay to detect and to discern between biologically active and inactive rSPE-C. By using this system, we demonstrated that SPE-C induced significant IL-2 secretion after 72 h and visible light emission after only 5 h, doubling by 24 h. We utilize this finding to assess the specificity of the assay and the effect of pasteurization on SPE-C activity. We observed no cross-reactivity with SPE-B and significant loss of SPE-C biological activity in spiked phosphate-buffered saline while SPE-C spiked into milk is heat stable. Once SPE-C has formed, it is infeasible to eliminate it from milk by thermal treatment.

Asynclitism, a misalignment of the fetal head with respect to the plane of passage through the birth canal, represents a significant obstetric challenge. High degrees of asynclitism are associated with labor dystocia, difficult operative delivery, and cesarean delivery. Despite its clinical relevance, the diagnosis of asynclitism and its influence on the outcome of labor remain matters of debate. This study analyzes the role of the degree of asynclitism (AD) in assessing labor progress and predicting labor outcome, focusing on its ability to predict intrapartum cesarean delivery (ICD) versus non-cesarean delivery. The study also aims to assess the performance of the AIDA (Artificial Intelligence Dystocia Algorithm) algorithm in integrating AD with other ultrasound parameters for predicting labor outcome. This retrospective study involved 135 full-term nulliparous patients with singleton fetuses in cephalic presentation undergoing neuraxial analgesia. Data were collected at three Italian hospitals between January 2014 and December 2020. In addition to routine digital vaginal examination, all patients underwent intrapartum ultrasound (IU) during protracted second stage of labor (greater than three hours). Four geometric parameters were measured using standard 3.5 MHz transabdominal ultrasound probes: head-to-symphysis distance (HSD), degree of asynclitism (AD), angle of progression (AoP), and midline angle (MLA). The AIDA algorithm, a machine learning-based decision support system, was used to classify patients into five classes (from 0 to 4) based on the values of the four geometric parameters and to predict labor outcome (ICD or non-ICD). Six machine learning algorithms were used: MLP (multi-layer perceptron), RF (random forest), SVM (support vector machine), XGBoost, LR (logistic regression), and DT (decision tree). Pearson’s correlation was used to investigate the relationship between AD and the other parameters. A degree of asynclitism greater than 70 mm was found to be significantly associated with an increased rate of cesarean deliveries. Pearson’s correlation analysis showed a weak to very weak correlation between AD and AoP (PC = 0.36, p < 0.001), AD and HSD (PC = 0.18, p < 0.05), and AD and MLA (PC = 0.14). The AIDA algorithm demonstrated high accuracy in predicting labor outcome, particularly for AIDA classes 0 and 4, with 100% agreement with physician-practiced labor outcome in two cases (RF and SVM algorithms) and slightly lower agreement with MLP. For AIDA class 3, the RF algorithm performed best, with an accuracy of 92%. AD, in combination with HSD, MLA, and AoP, plays a significant role in predicting labor dystocia and labor outcome. The AIDA algorithm, based on these four geometric parameters, has proven to be a promising decision support tool for predicting labor outcome and may help reduce the need for unnecessary cesarean deliveries, while improving maternal-fetal outcomes. Future studies with larger cohorts are needed to further validate these findings and refine the cut-off thresholds for AD and other parameters in the AIDA algorithm.

This study presents the development and application of a prototype decision support system (DSS) for tree selection specifically for Punjab, India, a region facing challenges of low forest cover and an increasing demand for sustainable land use practices. The DSS developed using the R Shiny framework integrates ecological, social, and agro-commercial criteria to facilitate scientific knowledge decision making in tree plantation. The modules in this DSS include a tree selection tool based on comprehensive species attributes, a GIS-based tree suitability map module utilizing an Analytical Hierarchical Process (AHP), and a silviculture practice information module sourced from authoritative databases. Combining sophisticated statistical and spatial analysis, such as NMDS and AHP-GIS, this DSS mitigates data redundancy in SDM while incorporating extensive bibliographic research in dataset processing. The study highlights the necessity of fundamental niche-based suitability in comparison to realized niche suitability. It emphasizes on the importance of addressing ecosystem services, agro-commercial aspects, and enhancing silvicultural knowledge. Additionally, the study underscores the significance of local stakeholder engagement in tree selection, particularly involving farmers and other growers, to ensure community involvement and support. The DSS supports agroforestry initiatives and finds applications in urban tree management and governmental programs, emphasizing the use of scientific literature at each step, in contrast to relying solely on local knowledge.

Kohelet: A Map to Eden--An Intertextual Journey (Maggid Books, 2023), by David Curwin. 254 pp. Reviewed by Reuven Chaim Klein. This work is a highly enjoyable and refreshingly original exploration [...]

Summary: Background: We compared the effect of perioperative COVID-19, before and after vaccination, on 30-day mortality after cardiac surgery. Methods: Data was extracted from several national registries. The study period was March 1st, 2020–March 31st, 2022. Results: 2594 adult patients underwent cardiac surgery before the availability of a universal COVID-19 vaccine. 33 patients were diagnosed with COVID-19 prior to surgery (mean age 58.3±10.0, mean length of time 73.6±60.1 days) and 7 patients were diagnosed with COVID-19 0–14 days after surgery (age 66.4±7.6). These were compared to 4426 patients who underwent cardiac surgery after the availability of a universal vaccine: 469 patients were diagnosed with COVID-19 prior to surgery (age 62.1±10.1, length of time 175.8±158.2) and 32 patients diagnosed with COVID-19 0–14 days after surgery (age 60.8±14.5). In patients diagnosed with COVID-19 prior to surgery, there was no excess 30-day mortality either before or after vaccination (1 (3.0%) vs. 57 (2.2%), respectively, P

In this article we study the social dynamic of temporal partitioning congestion games (TPGs), in which participants must coordinate an optimal time-partitioning for using a limited resource. The challenge in TPGs lies in determining whether users can optimally self-organize their usage patterns. Reaching an optimal solution may be undermined, however, by a collectively destructive meta-reasoning pattern, trapping users in a socially vicious oscillatory behavior. TPGs constitute a dilemma for both human and animal communities. We developed a model capturing the dynamics of these games and ran simulations to assess its behavior, based on a 2×2 framework that distinguishes between the players' knowledge of other players' choices and whether they use a learning mechanism. We found that the only way in which an oscillatory dynamic can be thwarted is by adding learning, which leads to weak convergence in the no-information condition and to strong convergence in the with-information condition. We corroborated the validity of our model using real data from a study of bats' behaviour in an environment of water scarcity. We conclude by examining the merits of a complexity-based, agent-based modelling approach over a game-theoretic one, contending that it offers superior insights into the temporal dynamics of TPGs. We also briefly discuss the policy implications of our findings.

Background. DISH is a systemic condition characterized by ligamentous ossification of at least four contiguous thoracic vertebrae. Prior studies have shown an association between DISH and cardiovascular morbidity. Objective. To investigate the association between DISH, cardiovascular risk factors, and MACE (myocardial infarction, ischemic stroke, and CV mortality) in patients who underwent coronary angiography between 5/2014 and 4/2015 in Ha’Emek Medical Center through 7 years of retrospective follow-up. Methods. Two cohorts were studied retrospectively and were defined according to the status of the coronary artery as diagnosed in angiography at enrolment (obstructive vs. nonobstructive coronary heart disease). For the retrospective analysis, we added the status of DISH (according to Resnick’s criteria) and defined four cohorts as follows: CHD and DISH (group 1), CHD and no DISH (group 2), no CHD and DISH (group 3), and no CHD and no DISH (group 4). The four groups were followed up retrospectively for a median period of 7 years. Association between DISH and cardiovascular outcomes was studied. Results. 198 patients were included in the study. 100 of them had CHD, and 98 were without significant CHD. At enrolment, DISH was present in 44 patients of CHD group and in 35 of non-CHD (p=0.28 age and sex adjusted). Through the follow-up period, the presence of DISH was not found to be associated with death from any cause, cardiovascular death, ischemic stroke, and MACE. Within the group of non-CHD, there were two additional MI events in DISH (group 3) which was found to be statistically significant. Conclusion. Among patients with high burden of cardiovascular risk factors undergoing coronary angiography, the presence of DISH was not associated with an increased incidence of MACE.

Reversed halo sign (RHS) is a radiological feature described as a focal, rounded area of ground-glass opacity surrounded by a ring of consolidation. In this report we describe two unique radiological cases demonstrating diffuse bilateral infiltrates with multiple RHSs in chest CT scans. Both patients were ultimately diagnosed as having tuberculosis (TB) and had been exposed to silica in the past. This report presents for the first time an association between silica exposure and RHS on CT scans among TB patients. It highlights the importance of having a high index of suspicion for TB in similar scenarios.