Investigations into β-ketoacyl-ACP Synthase III and enoyl-ACP reductase of plant fatty acid synthase

An antisense transgenic approach was taken in order to assess the importance of P-ketoacyl-ACP- Synthase III (KAS III) in regulation and initiation of de novo fatty acid synthesis in planta. The transgenic plants were generated in order to show whether alternative pathways exist to initiate fatty acid synthesis if the most direct route is lost. In order to develop such a study, a KAS III cDNA clone of 1622bp was isolated from a Brassica napus embryo library. This clone was used to generate an antisense construct containing a strong double 35S promoter and a CaMV poly A tail. The antisense vector was transformed into both Brassica napus and Arabidopsis thaliana. Sixty-three antisense KAS III lines were generated in Brassica napus, along with 10 transgenic KAS III Arabidopsis thaliana lines. The open reading frame of the KAS III cDNA clone was overexpressed in E.coli to yield a novel protein of 45kDa. It was subsequently purified and used to raise KAS III polyclonal and sera. This provided an immunological tool that could detect KAS III in leaf and seed extracts in wild type Brassica napus. To analyse whether KAS III caused any pleiotropic effects on other FAS components such as down regulation of other FAS enzymes, a quantitative ELISA assay was developed to Enoyl- ACP-Reductase (ENR). This was the first such assay for the detection of ENR in plants and its development has required careful consideration of sample preparation. Levels of KAS III, ENR and (3-Keto-ACP-Reductase (BKR) were assessed in developing leaf of wild type cultivars, along with total fatty acid levels in the growing leaf. Analysis of transgenic KAS III lines was performed in conjunction with the analysis of transgenic sense and antisense ENR Brassica napus that had become available during the study. Transgenic KAS III lines were seen to be slower growing, but were still able to grow to maturity, flower and set seed. This suggests that the KAS FU down regulation may lead to the use of alternative pathways in the synthesis of the initial condensation product acetoacetyl-ACP. Down regulation of ENR in some antisense KAS III lines suggest that a pleiotropic effect may have been exerted as a result of the lowering of KAS III levels. The analysis of the Tl generations for both KAS III and ENR during this study showed that certain lines possessed a phenotype which is characterised by a slower growing plant, where a change of seed morphology was observed along with a change in testa colour and a decrease in overall fatty acid levels in the seed

Facilitating shared decision-making with breast augmentation patients: Acceptability of the PEGASUS intervention

© 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons Background PEGASUS is an intervention to facilitate shared decision-making by helping prospective patients consider their expectations of surgery, so that surgeons have a clear understanding of their individual goals. To date, shared decision-making interventions within aesthetic surgery are lacking. The present mixed methods study therefore explored the acceptability of implementing PEGASUS into routine private practice with breast augmentation patients and aesthetic providers. Method Seventeen women presenting for breast augmentation surgery from three practices received the PEGASUS intervention pre-operatively and completed a process evaluation post-operatively. Semi-structured interviews exploring 3 aesthetic providers’ experiences of using PEGASUS were subjected to a thematic analysis, whilst a content analysis was conducted on the 77 goals identified by patients. Results The majority of patients reported that the PEGASUS intervention was relevant, helpful and useful, and they felt comfortable during it. Qualitatively, patients and aesthetic providers found that PEGASUS enabled them to reflect on and discuss about their expectations from surgery. Aesthetic providers discussed some of the issues and barriers associated with implementing PEGASUS in routine private practice, factors that must be considered prior to further evaluation. Conclusion This study provides preliminary support for the acceptability of PEGASUS to breast augmentation patients and to aesthetic providers working in the private sector

In the Era of Systematic Reviews, Does the Size of an Individual Trial Still Matter?

Background to the debate: Systematic reviews that combine high-quality evidence from several trials are now widely considered to be at the top of the hierarchy of clinical evidence. Given the primacy of systematic reviews—and the fact that individual clinical trials rarely provide definitive answers to a clinical research question—some commentators question whether the sample size calculation for an individual trial still matters. Others point out that small trials can still be potentially misleading

Salience and valence of appearance in a population with a visible difference of appearance: Direct and moderated relationships with self-consciousness, anxiety and depression

Psychometric measures of appearance salience and valence, CARSAL and CARVAL, have been previously demonstrated to be key factors underpinning appearance related self-consciousness and negative affect in the general population. However, the extent to which the scales are appropriate for people with a visibly different appearance has not previously been reported. Neither has the moderating effect of appearance salience (CARSAL) on the relationship between appearance valence (CARVAL) and appearance self-consciousness, previously shown in a general population sample, been replicated with people who are visibly different. Twelve hundred and sixty five participants with a visible difference in either secondary care (n = 651) or the community (n = 614) provided data. Analysis confirmed the psychometric qualities of both CARSAL and CARVAL, and the conceptual independence of each scale. The scales also demonstrated independent and interdependent relationships with social anxiety and avoidance in relation to appearance, depression and anxiety. Appearance salience moderated the relationship with valence on these psychosocial measures. In summary, this paper corroborates the use of CARSAL and CARVAL with both visibly different and general adult populations for the measurement of appearance salience and valence. © 2014 Moss et al

The acceptability of PEGASUS: An intervention to facilitate shared decision-making with women contemplating breast reconstruction

© 2015 The Author(s). Published by Taylor & Francis. Good practice guidelines recommend that women who undergo mastectomy are offered reconstructive surgery. However, many who choose this option report a degree of decisional regret and dissatisfaction because their pre-surgical expectations were not met. This paper reports an acceptability study of a new intervention (PEGASUS) that aims to support shared decision-making by eliciting womens pre-surgical expectations and setting patient-centred goals. Eighteen women contemplating breast reconstruction completed the PEGASUS intervention. Semi-structured interviews were conducted with 12 women and 3 health professionals to explore their experiences of using PEGASUS. Interview transcripts were subjected to a thematic analysis, and a content analysis was conducted on 79 goals that the 18 women identified. Feedback was extremely positive - women found that completing PEGASUS alongside a discussion with a specially trained health professional helped them prepare for the surgical consultation and increased their trust in their surgeon. Staff reported that PEGASUS facilitated patient-centred discussions and informed the decisions made about potential surgery. This preliminary study suggests that this novel intervention is acceptable to patients and health professionals alike. Further work is needed to evaluate its efficacy and then its effectiveness with a larger sample of women, and its potential use with other patient groups