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1.
Med Teach ; 37(5): 433-6, 2015 May.
Article in English | MEDLINE | ID: mdl-25109230

ABSTRACT

In an era of increasing scrutiny of the performance of graduates in the workplace, there can be frustrations when decisions about learners with borderline or poor performance in formal assessments are over-turned in appeal processes. This article addresses the approach to reducing the uncertainty about assessment decisions and surviving appeals.


Subject(s)
Education, Medical/methods , Education, Medical/standards , Educational Measurement/methods , Educational Measurement/standards , Clinical Competence , Formative Feedback , Humans , Learning , Policy
4.
J Clin Neurosci ; 9(5): 565-72, 2002 Sep.
Article in English | MEDLINE | ID: mdl-12383417

ABSTRACT

Few studies have characterised apoptosis in a brain injury model that causes a significant degree of diffuse axonal injury. Such characterisation is essential from a clinical viewpoint since diffuse axonal injury is a major component of human head injury. The present study therefore, examines the expression of active and proactive caspase-3, and the bax, bcl-2 and bcl-x members of the bcl-2 family, to characterise the temporal profile of apoptosis in a model of traumatic brain injury in rats that produces significant diffuse axonal injury. Pentobarbital anaesthetised male Sprague-Dawley rats were injured using the 2m impact-acceleration model of diffuse traumatic brain injury. After injury, diffuse trauma resulted in an increased bax expression followed by induction of caspase-3. The increase in caspase-3 was simultaneous with an increase in anti-apoptotic bcl-2 expression. Bcl-x levels were increased after induction of caspase-3 and the increased levels of bcl-x were sustained to the end of the 5-day observation period. Increased active caspase-3 expression was associated with the appearance of TUNEL positive cells. These cells were detected in different brain regions at different times, with some regions showing no apoptotic cells until 3 days after injury. No TUNEL positive cells were detected at 7 and 14 days after injury. DNA electrophoresis confirmed that DNA fragmentation was maximal at 3 days after injury. Increased active caspase-3 levels were also significantly correlated with increased bcl-2 levels (r=0.80; P<0.001) suggesting that the apoptotic cascade after diffuse traumatic brain injury is a carefully controlled cellular homeostatic response. Pharmacological manipulation of this balance may offer a therapeutic approach for preventing cell death and improving outcome after diffuse traumatic brain injury.


Subject(s)
Apoptosis/physiology , Brain Injuries/pathology , Animals , Caspase 3 , Caspases/biosynthesis , DNA Fragmentation , Electrophoresis, Agar Gel , Immunoblotting , Immunohistochemistry , In Situ Nick-End Labeling , Male , Neurons/pathology , Proto-Oncogene Proteins/biosynthesis , Proto-Oncogene Proteins c-bcl-2/biosynthesis , Rats , Rats, Sprague-Dawley , bcl-2-Associated X Protein
5.
Biol Reprod ; 67(5): 1480-7, 2002 Nov.
Article in English | MEDLINE | ID: mdl-12390879

ABSTRACT

The receptors for neurokinin 1 (NK1-R), neurokinin 2 (NK2-R), and neurokinin 3 (NK3-R) are expressed and functionally active in the uterus, promoting strong contractions of the myometrium. Previously, we demonstrated that myometrial contractility activated by the NK-Rs is regulated by estrogen. In the current study, we furthered our investigations of the role of estrogen in the regulation of NK3-R-mediated myometrial contractility. Estrogen promotes both heterologous and homologous desensitization of NK3-R-mediated uterine contractility. In tissue obtained from estrogen-dominated rats (ovariectomized estrogen-treated rats and rats in estrus), the magnitude of uterine contractions decreased in response to consecutive additions of the NK3-R-selective agonist senktide. By addition of the fourth dose of agonist, the contractile response was routinely barely above baseline. In contrast, in tissue obtained from non-estrogen-dominated rats consecutive doses of senktide resulted in contractions of identical magnitude. The homologous desensitization was specific to the NK3-R, and the desensitization of the NK3-R-mediated response did not affect the magnitude or nature of uterine contractions in response to NK1-R or NK2-R activation. Furthermore, heterologous and homologous desensitization of NK3-R-mediated contractility is dependent upon the duration of exposure to estrogen. This complex mechanism appears to be important in intact tissue; capsaicin-mediated release of endogenous neuropeptides resulted in a desensitization of response to subsequent stimulation with senktide in estrogen-dominated uterine tissue.


Subject(s)
Estrogens/physiology , Receptors, Neurokinin-3/metabolism , Substance P/analogs & derivatives , Uterine Contraction/physiology , Acetylcholine/pharmacology , Animals , Capsaicin/pharmacology , Dose-Response Relationship, Drug , Estrogens/pharmacology , Estrus/physiology , Female , In Vitro Techniques , Ovariectomy , Peptide Fragments/pharmacology , Rats , Rats, Sprague-Dawley , Receptors, Neurokinin-1/drug effects , Receptors, Neurokinin-1/metabolism , Receptors, Neurokinin-2/drug effects , Receptors, Neurokinin-2/metabolism , Receptors, Neurokinin-3/agonists , Substance P/pharmacology , Uterine Contraction/drug effects , Uterus/drug effects , Uterus/physiology
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