Among six pluripotency regulators examined only NANOG and

Among six pluripotency regulators examined, only NANOG and POU5F1 were downregulated by 2days of LY364947 treatment, which impaired DE competence. NANOG is a direct target of Nodal/Activin signaling, and the maintenance of its expression requires active Nodal/Activin signaling (Xu et al., 2008; Chambers et al., 2007; Vallier et al., 2009; Yu et al., 2011). Furthermore, NANOG is essential to maintain DE competence in hESCs, because the knockdown of NANOG expression by RNAi compromises the ability of hESCs to become DE in response to enhanced Nodal/Activin signaling (Vallier et al., 2009). Nonetheless, the loss of the DE competence by LY364947 treatment is unlikely caused by downregulation of NANOG for the following two reasons. First, either 1day or 2days of LY364947 treatment caused substantial downregulation of NANOG, while only 2days of treatment abrogated DE competence. Second, the expression of NANOG was almost immediately restored by Activin A treatment even after 2days of LY364947 treatment. Thus, downregulation of NANOG does not always correlate with the loss of DE competence. On the other hand, however, the downregulation of POU5F1 correlates with the abrogation of DE competence. Specifically, both the level of POU5F1 and the DE competence were significantly reduced only after 2days, but not 1day, of LY364947 treatment. In addition, the expression of POU5F1 remained low after 2days of LY364947 treatment even when Nodal/Activin signaling was activated afterward with Activin A. Repression of POU5F1 in human and mouse ESCs results in differentiation to trophectoderm (Nichols et al., 1998; Matin et al., 2004; Zaehres et al., 2005; Babaie et al., 2007), while overexpression of POU5F1 causes expression of mesendoderm genes, including Sox17, Hex, and T (Niwa et al., 2000; Stefanovic et al., 2009). Recent studies with mouse ESCs and P19 embryonal carcinoma naloxone hydrochloride suggested that Pou5f1 is also required for mesendoderm differentiation, as knockdown of Pou5f1 impaired the upregulation of Brachyury in response to Wnt/β-catenin signaling activation (Thomson et al., 2011; naloxone hydrochloride Marikawa et al., 2011). Thus, downregulation of POU5F1 may be contributing to the loss of DE competence, although other factors may also be involved. Future studies should be designed to identify molecular alterations at the transcriptional, protein, and epigenetic levels that occur in response to 2days, but not 1day, of Nodal/Activin signaling inhibition, which lead to a loss of competence to the DE lineage.

Materials and methods

Author contributions

Conflict of interest

This work was supported by grants from the George F. Straub Trust Fund of the Hawaii Community Foundation Medical Research Grant (11ADVC-49271) and Johns Hopkins Center for Alternatives to Animal Testing Grant (#2012-11) to Y.M. FACS analysis was conducted at the Institute for Biogenesis Research FACS Core Facility, which was supported by the COBRE grants from the National Center for Research Resources (5P20RR024206-05) and the National Institute of General Medical Sciences (8P20GM103457-05) from the National Institutes of Health. The authors thank Dr. Phillip Davy and Natsumi Takahashi for their assistance with our FACS analysis. The authors also thank Dr. Vernadeth B. Alarcon and Dana Ann A. Tamashiro at the Institute for Biogenesis Research for technical assistance and encouragement throughout the study. K.L.J. thanks the Cell and Molecular Biology Graduate Program at the University of Hawaii for support.

Gene expression signatures have yielded a wealth of information for benchmarking stem cell phenotypes (for example, (Muller et al., 2008, 2011; Pelekanos et al., 2012)), identifying core signalling networks (Novershtern et al., 2011) and mining novel gene products with roles in the maintenance and differentiation of various stem cell lines. It is increasingly common for researchers to include gene expression profiling as a metric of cell quality, particularly in the derivation of iPSC from various tissues or disease cohorts (Bock et al., 2011; Nayler et al., 2012). As a result, a large number of gene expression datasets generated on various stem cell models, using microarray or sequencing platforms, are publicly available, in gene expression repositories such as ArrayExpress (Parkinson et al., 2011) or GEO (Barrett et al., 2011). However, assessment of gene expression patterns across different stem cell datasets remains difficult, and as such, there is a demand for tools that allow researchers to determine the reproducibility of genes and gene signatures that correlate with particular stem cell phenotypes.

br Geological setting and sample characteristics From South to

Geological setting and sample characteristics
From South to North, the Tibetan Plateau mainly comprises the Himalaya, Lhasa, Qiangtang, and Songpan-Ganzi Blocks (Yin and Harrison, 2000; Chung et al., 2005) (Fig. 1a). The Himalayan Block lies between the Indian shield to the south and the Indus-Yalu suture to the north, and consists mainly of Precambrian–Mesozoic sedimentary and metasedimentary rocks with some DMH-1 to Early Ordovician and Eocene–Miocene granites (Yin and Harrison, 2000; Zeng et al., 2011; Hou et al., 2012). The Songpan-Ganzi Block is bounded by the Jinshajiang suture to the south, and the Anyimaqen–Kunlun–Muztagh suture to the north (Yin and Harrison, 2000; Zeng et al., 2011; Hou et al., 2012; Guo and Wilson, 2012). The exposed Songpan-Ganzi Block consists mainly of Triassic and younger strata with some Early Mesozoic granites and Miocene–Quaternary volcanic lavas (Yin and Harrison, 2000; Weislogel et al., 2006; Ding et al., 2013; Zhang et al., 2014; Wang et al., 2005, 2011, 2012).
In this study, rock samples were collected from the Cuonadong Miocene (∼16.7 Ma) tourmaline-bearing two-mica granites in the Himalayan Block (Yunnan, 2004) and ∼3.0 Ma Hudongliang tourmaline-bearing two-mica rhyolites in the northern Hoh Xil area of the central Songpan-Gangzi Block (Wang et al., 2012), respectively (Fig. 1a–c). The Hudongliang tourmaline-bearing two mica rhyolites are located near Taiyang Lake (Fig. 1c), and contain potassium feldspar, albite, biotite, quartz, muscovite, and tourmaline phenocrysts, and similar microlitic minerals in the groundmass along with cryptocrystalline-glassy materials (Fig. 2a and b). The Cuonadong tourmaline-bearing two-mica granites are geographically located to the south of Nariyongcuo Lake (Fig. 1b), and consist of potassium feldspar, albite, biotite, quartz, muscovite, and tourmaline (Fig. 2c and d) and minor zircon and apatite. In the Cuonadong granites, tourmaline grains are in direct contact with potassium feldspar, plagioclase, and quartz (Fig. 2c and d), indicating that these four minerals most likely crystallized contemporaneously. All tourmaline grains, which are similar to the primitive tourmalines found in the crust-derived strongly peraluminous granites (London et al., 1996), occur as disseminated grains in both rhyolites and granites (Fig. 2a–d) in the studied areas, indicating that they crystallized directly from granitic magmas. Backscattered electronic images (Fig. 2e and f) indicate that tourmalines from both the rhyolites and granites have no compositional zoning and relatively homogeneous textures.

Analytical methods
Tourmaline grains of 0.1–1 mm in size were separated for each ca. 1 kg sample using standard density separation techniques. Tourmaline grains were handpicked and mounted in an epoxy resin disc, and then polished. Microscopic and backscattered electron images were taken at the State Key Laboratory of Isotope Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences (SKLaBIG GIG CAS) with a JEOL JXA-8100 Superprobe for inspecting internal morphology of individual tourmalines. Before B isotope analyses, the analyses for the compositions of the tourmaline grains were carried out at the SKLaBIG GIG CAS with a JEOL JXA-8100 Superprobe. Operating conditions were as the follows: 15 kV accelerating voltage, 20 nA beam current, 1–2 μm beam diameter, 10 s counting DMH-1 time and ZAF correction procedure for data reduction. The analytical procedures were described in detail in Huang et al. (2007). The mineral composition data are listed in Table 1.
Tourmaline in situ B isotope analyses were conducted on a Neptune Plus multicollector inductively coupled plasma mass spectrometer (MC-ICP-MS) and a matching RESOlution M-50 laser ablation system, at the SKLaBIG GIG CAS. The MC-ICPMS is fitted with a collector block containing 9 variable position Faraday cups and 8 Ion Counters (compact discrete dynamic multiplier, CDD or SEM). Detailed operating conditions (Table 2) for the laser ablation system and the MC-ICP-MS instrument and data reduction were approximately similar to those described by Hou et al. (2010), Míková et al. (2014), Guo et al. (2014) and Martin et al. (2015). The laser ablation system generated an ultraviolet laser of 193 nm. After laser homogenization, the energy was focused on the surfaces of samples with the laser output frequency of 5 Hz, and with an ablation diameter of 45 μm. During the analysis, both B isotope signals (L3: 10B; H3: 11B) were collected simultaneously by Faraday cups. The cup positions were adjusted and the masses were calibrated by using a 2 μg/mL H3BO3 solution (a product of Alfa Company) before connecting to the laser ablation system. The aerosol produced by laser ablation was blown out with He as the carrier gas, and after passing a T-cock, it was mixed with Ar gas and the mixture was injected into the plasma of the MC-ICP-MS for ionization. Before the analysis of samples, the instrumental parameters were optimized with IAEA B4 (a certified tourmaline reference for B isotopes from the International Atomic Energy Agency (Tonarini et al., 2003a)).

Peptone cost Both the active and passive moisture sensors HIH

Both the active and passive moisture sensors (HIH4031 and HCZ-D5) showed reliable and repeatable performance during experiments with and without the applied bandage. The active sensor showed a faster response as compared to that of the passive sensor. Moreover, it does not require any additional interface electronics for its operation except for an excitation voltage signal. However, the thickness (3.5mm) of this sensor may be of concern during its use in a Peptone cost bandage on a wound. Although this problem can be mitigated by placing the sensor distal to the wound site, it may still cause residual pain if not used with care.
The passive moisture sensor has the advantage of smaller size (10mm×5mm×0.5mm) and therefore can be placed anywhere under the bandage. However, it gave a slower response to moisture within the bandage. It also required an additional interface circuit for its normal operation, which increased the size of the sensing system, though with minimal effect on power consumption.
The prototype sensing system has also been studied for power consumption and data transmission range. With one temperature sensor, two active or passive moisture sensors, and one pressure sensor interfaced, the average current consumption of the transmitter was 20mA (measured using the Digitech Q M1535 multimeter) at maximum transmitter output power (i.e. 3.5dBm). The current consumption rose to a maximum of 24mA only when the pressure sensor was pressed to its full range, while the other sensors had a minimum effect on current consumption during their normal and peak operation. The transmission range depended on the effective transmitter power, antenna parameters, and RF matching network. With the maximum transmitter power selected and using the recommended matching RF network, a transmission range of 4–5m was achieved in an unobstructed environment. With all other factors remaining constant, the transmission range decreased when the transmitter and receiver were not facing each other, or when there was an obstacle between them. However, considering the clinical environment, the range of 4–5m was deemed Peptone cost reasonable for reliable observations.

Evidence-based monitoring of chronic wounds, such as venous leg ulcers and diabetic foot ulcers, has drawn substantial attention because of soaring costs of their treatment. In current clinical practice, clinicians and nurses rely on their subjective judgement when applying or changing dressings on chronic wounds. Quite often, these dressings are changed unnecessarily without any scientific evidence about the state of wound. On the other hand, there is no objective mechanism to apply correct sub-bandage pressure on the wound site. These activities not only consume nursing time, but also create an unnecessary burden on healthcare budget. There is an opportunity to utilize modern sensors, biosensors, and wireless transmission technology to report to the patients and clinicians on the status of wound parameters from within bandages or dressings. Sensors play a vital role in extracting accurate information of wound parameters. In this paper, we have proposed and implemented calibration and characterization methods for carefully-selected temperature, moisture, and pressure sensors for reliable and accurate information acquisition of wound parameters. The calibration curves and mathematical expressions were obtained for each sensor using commercially-available software and measurement instrumentation. The performance of the sensors was validated by placing them on a mannequin limb with a compression bandage wrapped around them. We also designed a prototype wireless flexible sensing system, and a matched receiver to demonstrate the real-time performance of the calibrated sensors. The received data can be visualized on a computer screen. The average current consumption of the sensing system was measured as 20mA, with all the sensors interfaced simultaneously. The system reliably works within a range of 4–5m in an open environment.

purchase Aprotinin Recently due to the unique physicochemical properties

Recently, due to the unique physicochemical properties, excellent biocompatibility and biodegradability, polydopamine nanoparticles (PDA NPs) have attracted much attention and been extensively investigated for various applications including surface modification, bio-inspired hydrogel generation, biosensor fabrication, metal deposition and drug delivery [21,18,20,31,13,32,30,26,22,14]. Especially, it was found that the fluorescence quenching capacity of PDA NPs was equivalent to that of graphene oxide [23]. For instance, PDA NP-based FRET assay has been used to detect DNA and thrombin [18,20,23]. The PDA NP-based FRET assay is fast, simple and homogeneous, and could be used for in vivo fluorescence imaging.

Experimental section

Results and discussion


Conflict of interest

The authors would like to thank the National Natural Science Foundation of China (Grant No. 21127010) and Jilin Provincial Science and Technology Department (Grant No. 20100701) for financial supports.

In the early 1990’s the introduction of the concept of the micro Total Analysis Systems (μTAS) and the development of micro-electro-mechanical technologies led to the development of Lab-on-Chip (LoC) systems as a powerful tool for complex chemical or bio-chemical analysis. A variety of recent technological breakthroughs in the fabrication of thin film physical and optical sensors have made possible the development of LoC systems where several functional modules are integrated onto a single substrate [1–3].
Each module has a specific function in the sample-treatment chain, such as: sample handling performed by a microfluidic system [4,5]; detection and quantification of biomolecules by using specific sensors [6].
Microfluidic devices are capable to handle fluid volume smaller than pico-liter scale through purchase Aprotinin with dimensions of a few microns, but they often need macro-to-micro interconnections between micro-channels and external pumps. On the other hand, the electrowetting-on-dielectric (EWOD) technique leads to fluidic operations varying the shape of an electrically conductive liquid droplet by means on an external electric field [7–9], and may be an effective alternative to microchannels.
Detection modules rely often on thin film devices [10–13]. In particular hydrogenated amorphous silicon (a-Si:H) based devices, which can be utilized as physical [14], electronic [15] and optical devices [16], have received a lot of attention by different research groups, for optical biomolecule detection, both in labeled [17–19] and label-free [20]; [21] techniques, such as stimulated fluorescence detection [22,23], optical absorption measurements [24] and chemiluminescence detection [25–27].
In this paper we present a solution for this drawback integrating, on a single glass substrate, amorphous silicon photodiodes with a fluid handling system performed by an electrowetting-on-dielectric (EWOD) module and a capillary-driven microfluidic channel, for achieving a technological demonstrator of a compact, stand-alone LoC system. In this way we avoid the use external pumps and/or syringes for movement as well as the use of external detectors and external optics to focus the emitted light, achieving a ‘true’ Lab-on-Chip system [28], where the only external component in our system is the front-end electronics that provides signal readout, driving voltages as well as power supply using a single USB connection of a laptop or PDA. In particular, Section 2 reports the description and the operation of the integrated system; Section 3 presents the design of the microfluidic system and of the a-Si:H photosensors; Section 4 reports the structure of the electronic board that controls and interfaces the microfluidic system with a computer in order to achieve the droplet movement in the EWOD system; Section 5 describes the steps sequence of the fabrication process of the LoC on a glass substrate, taking into account the compatibility of all the techniques used to fabricate the EWOD electrodes, the a:Si:H photosensors and the capillary-driven microchannels; Section 6 demonstrates the functionality and successful integration of the different fabrication processes. Finally, conclusions are drawn.

In this study we have employed mouse NSCs rather than

In this study, we have employed mouse NSCs rather than human NSCs to explore the effects of PA. In view of this, further study would be desirable to ascertain if comparable effects of PA occur in human NSCs. In addition, elevated FFA level is intimately associated with oxidative stress and high level of ROS. Therefore, the roles of oxidative stress in the activation and regulation of JNK and its specific effect on downstream associated transcription factors are worth pursuing in PA-induced apoptosis of NSCs. It is also desirable to extend the study in vivo such as to feed the mice with high fat diet for further exploration of the possible association between elevation of FFAs and Calcium Ionophore I disorders.
In summary, this study has demonstrated that PA can induce apoptosis of NSCs that is mediated via JNK signaling. It is speculated that this might be one of possible mechanisms contributing to the increased incidence of neurological disorders caused by elevation of FFAs. In light of this, lowering plasma FFA level to normal level, through adjustment of diets and/or application of some potential drugs, may be beneficial to avoid unnecessary neuropsychopathic symptoms and brain abnormalities.
The following are the supplementary data related to this article.

HMGA2 is a non-histone chromosomal high-mobility group A (HMGA) family protein that binds to the minor groove of AT-rich DNA sequences (Fusco and Fedele, 2007; Grosschedl et al., 1994). The HMGA2 protein does not have direct transcriptional activity but rather transforms the chromatin structure through its DNA binding (Thanos and Maniatis, 1992); these changes in chromatin architecture can alter the local transcription. In general, HMGA2 is highly expressed during embryogenesis and is nearly undetectable in adult tissues (Chiappetta et al., 1996). In many cases, HMGA2 is up-regulated in tumor cells in adult tissues (Fedele et al., 2010; Young and Narita, 2007); overexpression studies have generally shown that HMGA2 induces oncogenesis (Fedele et al., 2010). However, there are some exceptions, particularly in adult stem cells. Recent studies have proposed the possibility that HMGA2 is intimately involved in the regulation of adult stem cells. HMGA2 was highly expressed in neural stem cells (NSCs) and regulated the stemness of NSCs in young mice (Nishino et al., 2008). In humans, normal CD34-positive hematopoietic stem cells (HSCs) express HMGA2, and the proliferation and differentiation of HSCs are governed by HMGA2 (Rommel et al., 1997). These data suggest that HMGA2 may have critical roles in regulating stemness in NSCs or HSCs and also in hUCBSCs. Our previous study showed that the expression of HMGA2, p16INK4A, p21CIP1/WAF1 and p27KIP1 was strongly affected by the aging of hUCBSCs (Lee et al., 2011). These results indicate that HMGA2 has crucial roles in adult stem cells, especially hUCBSCs, and can regulate stem cell aging in addition to proliferation and differentiation.
Phosphatidylinositol 3-kinases (PI3Ks) are lipid kinases that are involved in the control of stem cell proliferation (Welham et al., 2011). Previously, we reported that the PI3K signaling pathway determines the proliferation and differentiation potential of hUCBSCs (Yu et al., 2012). PI3K is one component of an intracellular signaling cascade that also involves AKT and mammalian target of rapamycin (mTOR). The PI3K/AKT/mTOR pathway regulates several cellular functions, such as proliferation, growth, survival, mobility and tumorigenesis, and several studies have investigated the PI3K/AKT/mTOR pathway within the context of adult stem cell regulation (Mantovani et al., 1998; Martelli et al., 2011). However, the interactions between PI3K/AKT/mTOR and HMGA2 in adult stem cells remain uncharacterized.
p16Ink4a and p19Arf, also known as cyclin-dependent kinase inhibitors, are well-known tumor suppressor genes. There is considerable evidence that p16Ink4a and p19Arf promote cellular aging (Bennecke et al., 2010; Collado et al., 2007), and previous studies have shown that HMGA2 modulates stemness and aging by reducing p16Ink4a and p19Arf expression in adult stem cells (Nishino et al., 2008). However, it remains unknown whether HMGA2 regulates p16Ink4a and p19Arf directly or indirectly in adult stem cells. In this study, we elucidate the mechanistic relationship among p16Ink4a, p19Arf and HMGA2 within the context of the PI3K/AKT/mTOR/p70S6K pathway. Moreover, our results confirm that HMGA2 regulates the proliferation and aging of hUCBSCs.

Por otra parte el estudio revel que el programa no

4) Por otra parte, el estudio reveló que el programa no está contribuyendo congo red asegurar a las mujeres indígenas y de sus comunidades el derecho incondicional al acceso a servicios de atención de su salud de calidad y culturalmente adaptados, por diferentes razones: en primer lugar, porque los precarios servicios de salud con los que contaban las comunidades indígenas antes de la implementación de este programa se han visto disminuidos debido a que el personal médico destina gran cantidad de su tiempo y atención a la operación del programa. Si bien la afiliación al mismo ha implicado también afiliación al Seguro Popular, queda sujeto a decisiones de carácter discrecional del personal médico la atención o no de ciertos padecimientos o urgencias, así como la emisión de orden de remisión al hospital regional más cercano o a atención especializada, incluso en materia de salud reproductiva y atención de embarazos complicados y partos. La discrecionalidad se extiende incluso a la justificación o no de faltas o retrasos en la hora de llegada de las mujeres titulares y de sus familias a las pláticas y talleres. Estos factores están ocasionando serios obstáculos al acceso a servicios de salud para las mujeres y demás miembros de las comunidades, y aumenta la necesidad de acudir a servicios privados en ciudades cercanas o a clínicas y hospitales foráneos, lo cual no es posible para muchas personas. Si algunas lo logran, hacerlo las aleja de la posibilidad de recibir atención en su lengua y de que se tome en cuenta su cultura y sus tradiciones.
El estudio concluye con recomendaciones dirigidas a las dependencias gubernamentales responsables del programa, entre las cuales se encuentran: la revisión del mismo para que se respeten los derechos colectivos de los pueblos indígenas y se incorpore la perspectiva de género; el diálogo con la instituciones representativas de las comunidades indígenas que tienda a llegar a acuerdos sobre la implementación del programa en su contexto cultural; y separar el componente de salud de la infraestructura instalada para brindar atención de salud a la población indígena, adoptando las medidas que se requieren para evitar que la aplicación del programa esté sujeto a discrecionalidades que, como se pudo constatar, están vulnerando seriamente los derechos de las mujeres indígenas titulares, de sus familias y de sus comunidades. En general, se recomienda que dicha revisión incorpore las perspectivas de derechos humanos, de género e indígena.
Tales recomendaciones son acordes con la reforma al artículo 1° de la Constitución que por fin otorga rango constitucional a amniote egg los derechos reconocidos por el Estado mexicano en los tratados internacionales, así como con la también reciente reforma a la Ley de Planeación que establece, entre otras cosas, que la planeación debe basarse entre otros principios: en el de igualdad de derechos entre mujeres y hombres, la atención de las necesidades básicas de la población y la mejoría de todos los aspectos de la calidad de vida; así como de la perspectiva de género para garantizar la igualdad de oportunidades entre mujeres y hombres, y promover el adelanto de las mujeres mediante el acceso equitativo a los bienes, recursos y beneficios del desarrollo (artículo 2); ordena que las dependencias de la administración pública centralizada deberán planear y conducir sus actividades con perspectiva de género y con sujeción a los objetivos y congo red prioridades de la planeación nacional de desarrollo (artículo 9); y que la Secretaría de Hacienda y Crédito Público deberá elaborar el Plan Nacional de Desarrollo, tomando en cuenta también los planteamientos que se formulen por los grupos sociales y por los pueblos y comunidades indígenas interesados, así como la perspectiva de género (artículo 14).
La reforma constitucional que incorpora los derechos reconocidos en los tratados internacionales y la reforma a la Ley de Planeación referida crean el escenario propicio para que en la normatividad y en los instrumentos que rigen el diseño y la aplicación del programa Oportunidades se implementen los cambios que requiere el mismo para que a la brevedad se haga compatible con las obligaciones del Estado en materia de derechos individuales y colectivos de las mujeres y de los pueblos indígenas, atendiendo en particular las recomendaciones que al respecto hace el estudio de referencia, así como las derivadas de la Evaluación externa del programa Oportunidades 2008, a diez años de intervención en zonas rurales (1997–2007). Esta última es de particular importancia debido a que es la única evaluación solicitada por la propia coordinación del programa que observa su impacto en comunidades indígenas y formula recomendaciones que contribuirían a disminuir los impactos negativos que en la actualidad están viviendo estas.

i Educaci n En t rminos de

i). Educación
En términos de gasto público, diversos indicadores ayudan guanabenz entender el papel del gobierno como proveedor de educación. La proporción del pib y del presupuesto total no es el único indicador relevante; la composición de los gastos también tiene gran importancia.
En México, el presupuesto que se adjudica a la educación básica es el doble del que se adjudica, de forma agregada, a los niveles de bachillerato, vocacional, licenciatura y posgrado (). En ese sentido, se debe señalar que la población objetivo de estudiantes que asisten al nivel básico es de un tamaño similar al de la población objetivo de los otros niveles educativos en su conjunto. Sin embargo, la cobertura efectiva es muy diferente: en educación básica es superior a 80%, ligeramente superior a 50% para bachillerato (o equivalente) e inferior a 30% para educación universitaria (o equivalente). Más aún, la inasistencia está muy correlacionada con hogares de bajos ingresos. Por lo tanto, incrementar el gasto público en los niveles escolares más altos puede ser una medida razonable, pero también es muy posible que resulte regresiva en términos de incidencia fiscal. Ello implica la necesidad de diseñar políticas públicas, incluyendo algunas con implicaciones fiscales (becas, por ejemplo), dirigidas a personas de bajos ingresos para que puedan tener acceso a los niveles de educación superior.
ii). Seguridad social
Como ha argumentado Deaton (2013), la seguridad social constituye el centro de la agenda de política social, y de hecho también económica, de los gobiernos modernos. La seguridad social es un recurso poderoso para tratar de igualar resultados y para garantizar los derechos de los miembros menos privilegiados de nuestras sociedades. En casi todo el mundo el componente de salud pública de la seguridad social es directamente responsable del incremento de la esperanza de vida. En las economías desarrolladas, las pensiones han sido un elemento clave para incrementar el bienestar de las personas de edad avanzada hasta niveles inesperados e inéditos. En un contexto de bajos ingresos fiscales, surge un dilema de política pública: mantener un Estado pequeño en términos de gasto público, con derechos sociales muy acotados, o buscar fuentes de ingresos que permitan la ampliación de dichos derechos. Ambas opciones implican disciplina fiscal, por lo menos a lithosphere largo plazo.
. Si bien, este tema puede propiciar discusiones en términos éticos, aquí nos referimos a un tipo de injusticia más específico: esquemas de pensiones donde los beneficios son actuarialmente muy elevados con respecto a las contribuciones. Este es un problema frecuente en todo el mundo. En el caso de México es muy agudo porque las pensiones financiadas por contribuciones suelen ser realidad solo en el mercado de trabajo formal, además de que están muy correlacionadas con grupos de mayor ingreso, por lo que el hecho de que el gobierno destine recursos públicos a este tipo de pensiones tiende a ser regresivo.
. La idea es sencilla y directa: se debe garantizar una pensión a toda persona que llegue a cierta edad. Sin embargo, los problemas para lograrlo son obvios y numerosos. Uno es el de incentivar a los trabajadores de ingresos bajos para que participen en los mercados de trabajo formales. Otro, es que incluso los niveles de pensiones mínimos implican recursos fiscales considerables, los cuales pueden no contar con una fuente de ingreso. Dado el incremento de la esperanza de vida y la transición demográfica en México, y en la mayoría de los países de América Latina, toda propuesta de pensión universal mínima debe incluir proyecciones y propuestas sobre esquemas de financiamiento y sobre la manera en la que evolucionarían las erogaciones públicas correspondientes.
. Es bien sabido que la transición demográfica y el mayor número de personas de edad avanzada implican también una transición epidemiológica. Una población muy joven con una gran proporción de niños es propensa a enfermedades infecciosas, pero a medida que aumenta la edad de la población, la propensión cambia a enfermedades crónicas. Sin subestimar la importancia de las enfermedades infecciosas, que son devastadoras para los países de bajos ingresos, sus implicaciones fiscales son muy diferentes a las de las enfermedades crónicas. El tratamiento de estas últimas es mucho más caro, tanto por su costo como por su duración.

El an lisis de la

El análisis de la austeridad desde una perspectiva histórica permite evaluar la orientación cíclica de la política fiscal. De aquí surgen preguntas de investigación adicionales tales como la posible relación causal entre austeridad, por un lado, y ciclos y tendencias económicas, por el otro. Por ejemplo, si los incrementos oxymetazoline hydrochloride los impuestos o los recortes al gasto afectan de manera directa a la demanda y a la producción, es posible que la austeridad conduzca a una desaceleración económica o incluso a una recesión. Esto también dependería de la manera y el momento en que se ejecuten esas medidas fiscales. Una política basada en el déficit puede estimular el crecimiento, y la expansión económica subsiguiente podría propiciar medidas de consolidación fiscal y la reducción del déficit inicial. Para los propósitos de este artículo, partimos de la evolución de los balances fiscal y primario de México para analizar los periodos recientes de austeridad.

El primer periodo de austeridad fiscal en la historia económica de México posterior a la II Guerra Mundial se registró en los años setenta. Durante la primera mitad de esa década el país disfrutó de un alto crecimiento económico, con un incremento anual promedio del pib de 6%. Pero esa bonanza terminó en 1976, ante desequilibrios macroeconómicos asociados a severos choques externos. El incremento del gasto público en más de 10 puntos porcentuales del pib provocó desequilibrios fiscales, los cuales estuvieron lejos de ser compensados con mayores ingresos tributarios. Entre 1971 y 1975 el déficit fiscal primario aumentó de 0.5 a 6.4% del pib, mientras que el déficit del sector público consolidado se disparó de 2.5 a 10% del pib. Cuando el primer choque de la Organización de Países Exportadores de Petróleo (opep) sorprendió a México como un país importador neto de petróleo, la deuda externa se multiplicó casi cuatro veces; la inflación interna se aceleró; el tipo de cambio real se apreció y el déficit de cuenta corriente en la balanza de pagos se incrementó de manera significativa.
En 1976, en plena crisis fiscal y de balanza de pagos, México depreció su tipo de cambio nominal con relación al dólar. Así terminó su régimen de tipo de cambio fijo, el cual había prevalecido durante más de dos décadas. Además, México solicitó formalmente apoyo financiero al Fondo Monetario Internacional (fmi). Se estableció un programa de estabilización convencional y el gasto público que incluye inversión, se recortó de manera drástica. Si bien la crisis fue breve, se desaceleró el crecimiento económico y aumentó la inflación.
Menos de un año después, el panorama económico de México mejoró de manera radical cuando se anunció el descubrimiento de un gigantesco campo petrolero Cantarell. Las reservas probadas de petróleo, que constituyen un activo del gobierno, aumentaron de 6.3 miles de millones en noviembre de 1976 a 40 mil millones un año después. Se reestructuró el perfil de vencimiento de la deuda externa y se lanzó un ambicioso plan de industrialización bajo el supuesto del incremento sostenido y a largo plazo del precio del petróleo. La explotación de los recursos petroleros recién descubiertos y la restructuración de la deuda propiciaron una recuperación económica rápida y firme. Entre 1978 y 1981 el pib creció a una tasa anual promedio cercana a 9%, impulsada por un extraordinario auge en la inversión, en especial del sector público.
Durante ese periodo se implementó una reforma fiscal con el propósito de corregir la fragilidad de México en este campo. El impuesto sobre la renta se ajustó a la inflación y se establecieron nuevos impuestos al valor agregado y al ingreso de las empresas. La base fiscal se amplió a medida que se cerraron diversas lagunas, mientras que se simplificó todo el proceso de administración y cumplimiento tributario. A pesar de lo anterior, los ingresos públicos fueron cada vez más dependientes de los ingresos petroleros.

Table presents the distribution of amputation in patients receiving conservative

Table 3 presents the distribution of amputation in patients receiving conservative and revascularization treatment. The 256 revascularization patients underwent a total of 346 procedures during the study period. The most frequently performed surgical intervention was vessel bypass grafting [51.56% (132/256 patients); p < 0.001], followed by endarterectomy (19.92%) and angioplasty (18.36%). Approximately 10% of patients had more than two types of surgical interventions. The patients who received bypass grafts and combination intervention were younger than patients receiving angioplasty and endarterectomy [p < 0.001, based on analysis of variance (ANOVA) test]. The crude total amputation rate was 5.32% (328 of 6162 patients) for the conservative group and 16.08% (41 of 256 patients) for the revascularization group. Compared to patients who underwent in-between revascularizations, patients who underwent combined surgery and endarterectomy had a higher total amputation rate than patients who underwent angioplasty and bypass grafting [38.46% (combined), 21.57% (endarterectomy), 12.77% (angioplasty), and 10.61% (bypass grafting), p = 0.0027, based on the Chi-square test]. Table 4 shows the Cox proportional hazard regressions of the crude and adjusted hazard ratios for amputation during the follow-up monensin by the cohorts of the total sample. Age ranges of 50–59 years, 60–69 years, and >70 years had an increased amputation risk of 1.683-fold [95% confidence interval (CI), 1.107–2.559], 1.962-fold (95% CI, 1.328–2.900), and 2.142-fold (95% CI, 1.462–3.137), respectively, in comparison to the amputation risk in patients < 50 years. Gender was also a risk factor for amputation. The adjusted hazard ratio was 0.711 (95% CI, 0.574–0.881) for females. A comorbid cardiovascular disorder posed a 3.472-fold hazard ratio (95% CI, 2.691–4.480) for amputation. Concurrent renal disorders moreover presented a 2.801 times higher risk for amputation (95% CI, 2.804–3.764). During the follow-up period, the cumulated mortality rate for diabetic CLI patients in Taiwan was 18.62%. As Table 5 monensin shows, 59.25% of patients who were >70 years had the highest mortality. A gender discrepancy existed between the two sexes in survival and mortality rates. In regard to patient mortality, 54.64% of the patients were male and 45.36% of the patients were female (p = 0.0017). Patients who died had more concurrent cardiovascular, neurological, pulmonary, renal, hepatic, and gastrointestinal diseases, compared to patients who survived.
After adjusting for age, gender, and comorbid diseases as confounding factors, higher hazard ratios were determined for mortality, old age (50–59 years, 60–69 years, and >70 years), male gender, and all selected comorbidities (except rheumatologic disease; Table 6). For patients >70 years, the hazard ratio was 4.501 (95% CI, 3.553-5.701) higher than for patients < 50 years. A comorbid renal disease posed an especially high hazard ratio of 2.013 (95% CI, 1.681-2.409) and cardiovascular disease posed a hazard of a 1.823-fold (95% CI = 1.560–2.130) increase in mortality, compared to diabetic patients with CLI but without renal disease. Concurrent neurological, pulmonary, and gastrointestinal-hepatic diseases also increased the hazard of mortality for diabetic CLI patients.
In this study, we found that the incidence of CLI in diabetic patients rose gradually with aging. This finding was consistent with previous studies that reported a positive association between old age and CLI in Caucasians and in Hispanics. Old age and diabetes mellitus may predispose patients to distal atherosclerotic disease. However, we did not find a significant gender discrepancy in CLI in diabetic patients in Taiwan. This was different from results in other studies in the medical literature that report that men with diabetes are at a higher risk for CLI. In the Framingham study, the age-adjusted incidence of limb ischemia was 50% greater in men with diabetes than in women with diabetes. However, as indicated in the present study, a recent survey by a teaching hospital in Taiwan also reported no significant gender difference in the prevalence of diabetic peripheral artery obstructive disease. We suspected that racial or ethnic differences may contribute to such different results. In the present study, a significant gender discrepancy was nevertheless noted in patients who needed revascularization intervention. Chen et al in their most recent report—which used 14,241 patients with peripheral artery disease from a 1997–2004 longitudinal database in Taiwan—similarly demonstrated that significantly more males received revascularization therapy than females.

Accurate diagnoses for cyst like lesions are crucial for subsequent

Accurate diagnoses for cyst-like lesions are crucial for subsequent medical and surgical planning by clinicians. Brain CT accurately diagnoses 38% of cystic meningiomas, and the accuracy has increased to 80% with the application of multiplanar MRI. However, a diagnosis on the basis of CT and MRI findings can be unreliable because the image characteristics of pilocytic astrocytomas and hemangioblastomas are similar to cystic meningiomas. The features of common cystic meningiomas on MRI are dura tail, extra axial mass lesion, and mural nodule enhancement. However, the patient in this case presented with an intra-axial mass lesion without dura tail and cystic wall enhancement. Although magnetic resonance spectrometry is a useful tool for distinguishing between tumors, necrosis, infections, and healthy brain, limitations exist in tumor identification. Therefore, image-based diagnoses are less reliable than permanent pathology reports, regardless of improved imaging technologies and knowledge of cystic meningiomas. The image characteristics and common features of cystic AN-2728 neoplasms are listed in Table 1.
Although pathology is a crucial contributor to the final diagnosis, differential diagnoses alter the treatment plan and prognosis (Table 1). For hemangioblastomas associated with peritumoral cysts, the tumors should be removed and the cysts should be drained. Complete removal of the tumor is warranted for cystic meningioma, and cystic component removal depends on the classification provided by Nauta et al. As the mechanism of cystic wall formation varies, the removal is indicated in Type I and Type II classifications provided by Nauta et al, but not in Type III and Type IV. Surgery is not recommended for neuroblastoma because of chemoradiosensitive tumors. Surgery is warranted for pilocytic astrocytoma and metastatic tumor if the region is anatomically favorable.
In the present case, because of a preoperative diagnosis of hemangioblastoma and an intraoperative absence of tumor around the cystic wall, the cystic wall was not resected. The final diagnosis of meningothelial meningioma resulted in re-evaluation of patient diagnosis. The presented case had a Type III tumor, according to the classification provided by Nauta et al, and a peritumoral cystic meningioma, according to the classification provided by Rengachary et al. The preoperative diagnosis of hemangioblastoma was misleading, and removal of only the tumor and not the cystic component was the appropriate surgical management.

Accidents resulting in blunt chest trauma incidences are increasingly common and can potentially result in death if diagnosis is incorrect or if treatment is delayed. Traffic-related accidents are the most common causes of blunt chest trauma. Traumatic asphyxia, first mentioned by Ollivier in 1837, is a rare, blunt chest trauma-related condition and an indicator of severe injury, including subconjunctival hemorrhage, facial edema, cyanosis, and petechiae on the upper chest and face, with compression of the chest or upper abdomen being the causal factor. Associated injuries, such as pulmonary contusion, rib fractures, hemopneumothorax, diaphragmatic rupture, and myocardial injury, have also been described.

Case Report
A healthy 25-year-old Vietnamese man working at an electronics factory was involved in an accident while cleaning the factory conveyor belts. This resulted in the compression of his thorax and limbs. He was extricated from the machine and was conscious and alert. The Glasgow Coma Scale (GCS) score upon AN-2728 arrival to hospital was 15 (E4M6V5). His vital signs were as follows: blood pressure, 151/94 mmHg; heart rate, 167 beats/min; respiratory rate, 18 breaths/min; and body temperature, 36.6°C. Physical appearance was characterized by facial cyanosis with bilateral subconjunctival hemorrhage, multiple abrasive wounds from the left chest to the left arm, and deformity of the left upper arm and thigh (Figure 1). Chest X-ray revealed a fracture in the left ribs (third to eighth ribs to be precise) with bilateral pulmonary hemorrhages (Figure 2). Additional X-rays showed a midshaft left humerus fracture, a midshaft left femur fracture, and proximal left tibia and fibula fractures. Chest-to-pelvis computed tomography (CT) revealed multiple rib fractures, left hemothorax, right pneumothorax, and pulmonary contusion (Figure 3). After 20 minutes, a sudden decline of O2 saturation from 98% to 88% was observed, and an endotracheal tube intubation with mechanical ventilator support was arranged. Tube thoracostomy was performed because of decreased respiration on the left side, and the patient was admitted to the intensive care unit. After 2 days, the patient developed a change in consciousness and underwent a follow-up brain CT. There was no obvious hemorrhage or ischemic change. An electrolyte level analysis revealed an elevated serum creatine kinase concentration. Massive hydration with 3 L of isotonic saline/d and mannitol was administered. Because no change in the GCS score was observed, brain magnetic resonance imaging (MRI) was performed and extensive microhemorrhaging in the brain stem, basal ganglia, internal capsules, and the genu and splenium of the corpus callosum was observed (Figure 4). Therefore, a diffuse axonal injury was diagnosed. The patient\’s consciousness progressively improved after approximately 27 days of hospitalization, and he was transferred to the ward.