The mini clinical evaluation exercise (mini-CEX) for assessing clinical performance of international medical graduates

Objective: To evaluate the feasibility, reliability and acceptability of the mini clinical evaluation exercise (mini-CEX) for performance assessment among international medical graduates (IMGs). Design, setting and participants: Observational study of 209 patient encounters involving 28 IMGs and 35 examiners at three metropolitan teaching hospitals in New South Wales, Victoria and Queensland, September-December 2006. Main outcome measures: The reliability of the mini-CEX was estimated using generatisability (G) analysis, and its acceptability was evaluated by a written survey of the examiners and IMGs. Results: The G coefficient for eight encounters was 0.88, suggesting that the reliability of the mini-CEX was 0.90 for 10 encounters. Almost half of the IMGs (7/16) and most examiners (14/18) were satisfied with the mini-CEX as a learning tool. Most of the IMGs and examiners enjoyed the immediate feedback, which is a strong component of the tool. Conclusion: The mini-CEX is a reliable tool for performance assessment of IMGs, and is acceptable to and well received by both learners and supervisors.

Quantum Space-Time and Noncommutative Gauge Field Theories

Arguments arising from quantum mechanics and gravitation theory as well as from string theory, indicate that the description of space-time as a continuous manifold is not adequate at very short distances. An important candidate for the description of space-time at such scales is provided by noncommutative space-time where the coordinates are promoted to noncommuting operators. Thus, the study of quantum field theory in noncommutative space-time provides an interesting interface where ordinary field theoretic tools can be used to study the properties of quantum spacetime. The three original publications in this thesis encompass various aspects in the still developing area of noncommutative quantum field theory, ranging from fundamental concepts to model building. One of the key features of noncommutative space-time is the apparent loss of Lorentz invariance that has been addressed in different ways in the literature. One recently developed approach is to eliminate the Lorentz violating effects by integrating over the parameter of noncommutativity. Fundamental properties of such theories are investigated in this thesis. Another issue addressed is model building, which is difficult in the noncommutative setting due to severe restrictions on the possible gauge symmetries imposed by the noncommutativity of the space-time. Possible ways to relieve these restrictions are investigated and applied and a noncommutative version of the Minimal Supersymmetric Standard Model is presented. While putting the results obtained in the three original publications into their proper context, the introductory part of this thesis aims to provide an overview of the present situation in the field.

Aspects of Inflationary Models at Low Energy Scales

Cosmological inflation is the dominant paradigm in explaining the origin of structure in the universe. According to the inflationary scenario, there has been a period of nearly exponential expansion in the very early universe, long before the nucleosynthesis. Inflation is commonly considered as a consequence of some scalar field or fields whose energy density starts to dominate the universe. The inflationary expansion converts the quantum fluctuations of the fields into classical perturbations on superhorizon scales and these primordial perturbations are the seeds of the structure in the universe. Moreover, inflation also naturally explains the high degree of homogeneity and spatial flatness of the early universe. The real challenge of the inflationary cosmology lies in trying to establish a connection between the fields driving inflation and theories of particle physics. In this thesis we concentrate on inflationary models at scales well below the Planck scale. The low scale allows us to seek for candidates for the inflationary matter within extensions of the Standard Model but typically also implies fine-tuning problems. We discuss a low scale model where inflation is driven by a flat direction of the Minimally Supersymmetric Standard Model. The relation between the potential along the flat direction and the underlying supergravity model is studied. The low inflationary scale requires an extremely flat potential but we find that in this particular model the associated fine-tuning problems can be solved in a rather natural fashion in a class of supergravity models. For this class of models, the flatness is a consequence of the structure of the supergravity model and is insensitive to the vacuum expectation values of the fields that break supersymmetry. Another low scale model considered in the thesis is the curvaton scenario where the primordial perturbations originate from quantum fluctuations of a curvaton field, which is different from the fields driving inflation. The curvaton gives a negligible contribution to the total energy density during inflation but its perturbations become significant in the post-inflationary epoch. The separation between the fields driving inflation and the fields giving rise to primordial perturbations opens up new possibilities to lower the inflationary scale without introducing fine-tuning problems. The curvaton model typically gives rise to relatively large level of non-gaussian features in the statistics of primordial perturbations. We find that the level of non-gaussian effects is heavily dependent on the form of the curvaton potential. Future observations that provide more accurate information of the non-gaussian statistics can therefore place constraining bounds on the curvaton interactions.

Array-based gene expression, CGH and tissue data defines a 12q24 gain in neuroblastic tumors with prognostic implication

Neuroblastoma has successfully served as a model system for the identification of neuroectoderm-derived oncogenes. However, in spite of various efforts, only a few clinically useful prognostic markers have been found. Here, we present a framework, which integrates DNA, RNA and tissue data to identify and prioritize genetic events that represent clinically relevant new therapeutic targets and prognostic biomarkers for neuroblastoma.

Integrative functional genomics analysis of sustained polyploidy phenotypes in breast cancer cells identifies an oncogenic profile for GINS2

Aneuploidy is among the most obvious differences between normal and cancer cells. However, mechanisms contributing to development and maintenance of aneuploid cell growth are diverse and incompletely understood. Functional genomics analyses have shown that aneuploidy in cancer cells is correlated with diffuse gene expression signatures and that aneuploidy can arise by a variety of mechanisms, including cytokinesis failures, DNA endoreplication and possibly through polyploid intermediate states. Here, we used a novel cell spot microarray technique to identify genes with a loss-of-function effect inducing polyploidy and/or allowing maintenance of polyploid cell growth of breast cancer cells. Integrative genomics profiling of candidate genes highlighted GINS2 as a potential oncogene frequently overexpressed in clinical breast cancers as well as in several other cancer types. Multivariate analysis indicated GINS2 to be an independent prognostic factor for breast cancer outcome (p = 0.001). Suppression of GINS2 expression effectively inhibited breast cancer cell growth and induced polyploidy. In addition, protein level detection of nuclear GINS2 accurately distinguished actively proliferating cancer cells suggesting potential use as an operational biomarker.

Nuorten mäntyjen ulkoisen laadun kehitykseen vaikuttavat tekijät

Männyn laatuun vaikuttavista tekijöistä tässä tutkimuksessa selvitettiin, mitkä tekijät aiheuttavat nuorissa männyissä oksikkuutta, mutkaisuutta käsittäen myös lenkouden ja haaraisuutta. Jokaiselle laatuvialle laadittiin kolme eritasoista mallia. Eniten keskityttiin tutkimaan oksikkuutta aiheuttavia tekijöitä, koska oksikkuus vaikuttaa männyn sisäiseen oksaisuuteen, joka on yleisin sahatavarakappaleen laatuluokan määräävä ominaisuus. Lisäksi mutkaisuus ja erityisesti haaraisuus osoittautuivat melko sattumanvaraisesti esiintyviksi laatuvioiksi, minkä takia niiden kehittymiseen vaikuttavia tekijöitä on vaikea määritellä. Tutkimuksessa käytettiin Metsäntutkimuslaitoksen taimikoiden inventointikokeiden (TINKA-kokeet) aineiston ensimmäisen ja kolmannen mittauskerran tuloksia. Näiden mittauskertojen väli oli 15 vuotta. Tutkimuksen perustuminen useampaan kuin yhteen mittauskertaan erottaa tämän tutkimuksen monista muista mäntyjen laatua käsittelevistä tutkimuksista, jotka ovat perustuneet yhden mittauskerran poikkileikkausaineistoon. Laadittujen kolmen eritasoisen mallin perusteella voidaan todeta, että oksikkuuden ja mutkaisuuden kehittymistä mäntyihin pystytään arvioimaan kohtalaisesti jo metsikön perustietojen (syntytapa, kasvupaikka, lämpösumma) avulla, jotka metsänomistajalla on tiedossaan jo taimikkoa perustaessaan. Puutason mittauksilla pystytään selvästi tarkentamaan arviota siitä, tuleeko männystä oksikas vai ei. Sitä vastoin puutason mittaukset parantavat vain vähän arviota mutkaisuuden kehittymisestä. Haaraisuuden esiintymistä luotettavasti ennustavaa mallia ei pystytty tekemään. Oksikkuutta lisääviä tekijöitä mallien mukaan olivat mm. männyn suuri läpimitan kasvu, suuri suhteellinen pituus saman metsikön muihin puihin verrattuna, alhainen kasvatustiheys männyntaimikon alkukehitysvaiheessa ja taimikonhoidon tekemättä jättäminen. Mutkaisuutta lisääviä tekijöitä olivat mm. suuri lämpösumma eli männikön sijainti Etelä-Suomessa, männyn suuri läpimitan kasvu, pieni suhteellinen pituus, alhainen kasvatustiheys männyntaimikon alkukehitysvaiheessa ja taimikonhoidon tekemättä jättäminen. Eri uudistamistavoista kylvö osoittautui parhaimmaksi laadun kannalta sekä oksikkuutta että mutkaisuutta tarkasteltaessa. Haaraisuutta lisääviä tekijöitä olivat mm. pieni lämpösumma eli männikön sijainti Pohjois-Suomessa, männyn suuri läpimitan kasvu ja alhainen kasvatustiheys männyntaimikon alkukehitysvaiheessa.

Anthranilic acid oxidase system of Tecomastans—III.: Studies on the conversion of o-aminophenol to catechol

The terminal step in the oxidation of anthranilic acid to catechol by anthranilic acid oxidase system from Tecoma stans, which converts o-aminophenol to catechol has been studied in detail. The reaction catalyses the conversion of one molecule of o-aminophenol to one molecule each of ammonia and catechol. The partially purified enzyme has a pH optimum of 6·2 in citrate-phosphate buffer and a temperature optimum of 45°. The metal ions, Mg2+, Co2+ and Fe3+ were inhibitory to the reaction. Metal chelating agents like 8-hydroxyquinoline, o-phenanthroline, and diethyldithiocarbamate, caused a high degree of inhibition. A sulfhydryl requirement for the reaction was inferred from the inhibition of the reaction by p-chloromercuribenzoate and its reversal with GSH. Atebrin inhibition was reversed by addition of FAD to the reaction mixture.

Conversion of isophenoxazine to catechol in Tecoma stans

Isophenoxazine, formed by the condensation of two molecules of o-aminophenol, is reduced by an enzyme system from Tecoma stans leaves to two molecules of catechol. The reaction proceeds well under anaerobic conditions; a 1–2 mole stoichiometry between the substrate disappeared and the product formed was maintained. The enzyme showed maximum activity at pH 5. The substrate at high concentrations caused a diminution in the activity and the optimum concentration of substrate was at 6 × 10−4 Image . The enzyme preparation was able to convert cinnabarinic acid and diphenylene dioxide 2,3-quinone into the corresponding catechol substances. The diphenylene dioxide 2,3-quinone at the same concentration was three times more susceptible to enzymic cleavage than isophenoxazine. Cinnabarinic acid inhibited the enzymic cleavage of isophenoxazine competitively. None of the known electron donors was found to activate the reaction. Inhibition studies suggested that intact sulfhydryl groups are necessary for enzyme activity. Heavy metal ions like Hg++, Ag+, Co++, Fe++, Ni++, and Fe3++ inhibited the reaction. Metal chelating agents did not have any effect on the enzyme.

Anthranilic acid oxidase system of Tecoma stans—II. : Studies on the properties of a purified anthranilic acid oxidase system and its separation into different enzymic components

An enzyme system which catalysed the conversion of anthranilic acid to catechol has been purified 20-fold from a cell-free leaf extract of Tecoma stans. The optimum substrate concentration was 10−3 M and optimum temperature for the reaction was 45°. The presence of a multi-enzyme system was inferred from inhibition studies. The formation of catechol was inhibited by Mg2+, Zn2+, and Co2+ ions, whereas anthranilic acid disappearance was not affected to the same extent. The effect of metal chelating agents like EDTA, cyanide and pyrophosphate showed a similar trend. PCMB inhibited catechol formation but had no effect on anthranilic acid disappearance. The reaction was not inhibited by catalase, nor was it activated by peroxide-donating systems. This ruled out the possibility of peroxidative type of reaction. The overall reaction is markedly activated by NADPH and THFA. This multi-enzyme was separated into three different components, by fractionation with Alumina Cγ and calcium phosphate gels. The overall reaction catalysed by these components can be represented as anthranilic acid→3-hydroxy anthranilic acid→o-aminophenol→catechol.

The conversion of 3-hydroxyanthranilic acid to cinnabarinic acid by the nuclear fraction of rat liver

Although several authors have implicated 3-hydroxyanthranilic acid (3-OHA) as an intermediate in tryptophaniacin pathway in animals (Kaplan, 1961), alternative pathways of metabolism of this compound have not been fully explored. Madhusudanan Nair obtained an enzyme from spinach leaves which could convert 3-OHA to cinnabarinic acid (private communication). Viollier and Süllmann (1950) reported the conversion of 3-OHA to an unidentified red compound by rat liver homogenates. The present investigation describes the identification of this product as cinnabarinic acid (2-amino-3-H-isophenoxazine-3-one-1,9-dicarboxylic acid). Cinnabarinic acid is known to occur in nature along with cinnabarin is olated from the fungus Polystictus sanguineus (Gripenberg et al., 1957; Gripenberg, 1958).

An indole oxidase isolated from the leaves of Tecoma stans

The presence of an indole oxidase (indole: O2 oxidoreductase) was detected in the leaf extracts of Tecoma stans. The end product of the reaction was identified as anthranil. Formylaminobenzaldehyde, and o- aminobenzaldehyde were detected as intermediates in the overall conversion. Oxygen-uptake studies established that 3 atoms of oxygen were consumed in the formation of anthranil form I molecule of indole. The enzyme showed an absolute requirement for FAD and Cu2+ for maximum activity. FMN was ineffective as a cofactor. The enzyme had an optimum pH of 5.0. Inhibition studies with GSH and p-chloromericuribenzoate showed that a sulfhydrylcupric-ion complex at the active centre is highly essential.

Isophenoxazine synthase

An enzyme which catalyses the oxidation of o-aminophenol to o-quinoneimine and the subsequent condensation of o-aminophenol and o-quinoneime to give isophenoxazine has been isolated from the leaves of Tecoma stans. The reaction had an optimum pH of 6.2 and an optimum temperature of 45°. Heavy-metal ions like Hg2+, Co2+, Mg2+, Fe3+, were inhibitory. Mn2+ activated the reaction to about 40%. The reaction requires intact sulfhydryl groups. A study of the coenzyme requirements showed that isophenoxazine synthase (o-aminophenol: O2 oxidoreductase) is a flavoprotein requiring FAD for maximum activity. Stoichiometric studies showed that 2 moles of o-aminophenol gave 1 mole of isophhenoxazine.

Enzymatic conversion of anthranilic acid to catechol by chloroplast from the leaves of Tecoma stans

An enzyme system which converts anthranilic acid to catechol was detected in the leaves of Tecoma stans, and its properties studied. The system is present exclusively in the chloroplast fraction of the leaves. The optimum pH of the reaction is 5·2 and maximum activity was obtained with citrate-phosphate buffer. There was good stoichiometry between the amounts of anthranilic acid disappeared and the amounts of catechol and ammonia formed. The enzyme system showed an absolute requirement for oxygen and evidence was obtained for the probable participation of NADPH and FAD in the hydroxylation step. The optimum concentration of anthranilic acid was 10−4 M; at higher concentrations the reaction was inhibited to a considerable extent. Cyanide, pyrophosphate, and EDTA also caused inhibition indicating a requirement for metal ions.

A study of the purification and properties of tryptophan synthetase of Bengal gram (Cicer arietinum)

Active preparations of tryptophan synthetase were obtained from Bengal gram (Cicer arietinum) by the following procedure: (1) precipitation of inactive materials by manganous sulfate, (2) Adsorption of impurities on Alumina Cγ, (3) Adsorption of tryptophan synthetase on tricalcium phosphate gel, removal of inert protein from the gel by treatment with phosphate buffer (pH 7.2), and selective elution of the enzyme by 0.15 M phosphate buffer pH 7.2 containing 10% ammonium sulfate and 10−3 M serine. A 220-fold purification of the enzyme with 44% recovery of the activity was achieved. The pH optimum, effect of temperature, and substrate concentration and other properties of the purified enzyme have been studied in detail. Only the Image -isomer of serine takes part in the reaction. The Km values for indole, Image -serine, and Image -serine were calculated to be 0.66, 4.1, and 8.6 × 10−4 M, respectively. A kinetic study of the inhibition of tryptophan synthetase by indole-propionic acid has shown that it is of a competitive type. It has been demonstrated for the first time that 4-nitro-salicylaldehyde can replace pyridoxal phosphate as a coenzyme for the tryptophan synthetase reaction.

A colorimetric method for determination of pyrocatechol and related substances

A colorimetric assay for the quantitative determination of catecholic compounds was developed. The method was based on the observation that a red color was formed when nitrite was added to a solution containing pyrocatechol and sodium tungstate. Aromatic amines interfere with the reaction but this could be overcome by the addition of formaldehyde. When interfering substances are present along with pyrocatechol, it can be readily separated by paper chromatography and estimated after elution from the filter paper.