Protective effects of hyperbaric oxygen therapy (HBO2) in cardiac care--A proposal to conduct a study into the effects of hyperbaric pre-conditioning in elective coronary artery bypass graft surgery (CABG).

We review and report on accumulated data showing the benefits offered by hyperbaric oxygen (HBO2) therapy as an adjunct in the treatment of coronary artery bypass graft (CABG) patients. It has been shown that ischemia-reperfusion injury is deleterious to the myocardium, causing left ventricular dysfunction, structural damage to the myocytes and endothelial cells, myocardial stunning, reperfusion arrhythmias and potentially irreversible injury. There is a substantial body of evidence pointing to the role of HBO2 in mitigating the harmful effects of ischemia-reperfusion injury. Specifically, we review evidence from a number of studies which clearly point to both clinical and cost benefits HBO2 offers when used to precondition non-emergent patients having on-pump coronary arterial bypass graft surgery. Study data show that adding adjunctive HBO2 into the plan of care leads to improved myocardial function, reduces length of stay in the ICU, and limits post-surgical complications. Further, it has only minimal impact on the presurgical preparation, i.e., time must be allowed for the hyperbaric treatment(s), and no role in the surgery or post-surgical care of the patient. The studies pointing to clinical and cost benefit of preconditioning have been conducted outside the United States. Given the pressure on costs in all areas of health care, it seems that a therapeutic approach, which has been shown to be of benefit in both animal and human trials over the course of many years, should attract funding for a properly structured study designed to test whether significant and simultaneous improvements in clinical outcomes and cost reductions can be achieved within the framework of a U.S. healthcare facility.

Hyperbaric oxygen therapy (HBO2) as an adjunct in the treatment of idiopathic sudden sensorineural hearing loss (ISSHL)--a case report on two patients.

We report on two cases of idiopathic sensorineural sudden hearing loss (ISSHL) successfully treated at our center. The patients were referred to us by a neurotologist for adjunctive hyperbaric oxygen therapy and were treated using a standard 2.4 atmospheres absolute (atm abs) 90-minute protocol with two five- minute air breaks. During this period the referring physician administered injections of steroids at his offices. The outcome in both cases was positive and produced significantly improved scores in both speech reception and speech discrimination. In October 2011, the UHMS added ISSHL to its list of approved indications. Despite this and an increasing body of literature that supports the use of hyperbaric oxygen therapy as an adjunct in the treatment of ISSHL, it has not yet been accepted for reimbursement by CMS and, in our experience, commercial carriers. We believe it would be beneficial in developing the case for reimbursement in this indication if all facilities record and submit their results to a national database perhaps organized and managed by the UHMS.

Valores humanos e escolha do consumidor na Austrália e Brasil / Human Values and Consumer Choice in Australia and Brazil

O presente estudo teve o objetivo de observar quais implicações as diferenças culturais têm para o comportamento do consumidor. Um total de 793 participantes (brasileiros e australianos) foi exposto à Escala de Valores, Escala de Significado e Julgamento, e medidas de atributos de carros e comportamento de consumo. Observou-se o efeito de país sobre padrões culturais, de modo que australianos apresentaram escores mais altos para individualismo do que para coletivismo. Australianos preferiram um julgamento passo-a-passo e colocaram maior importância em atributos tangíveis, enquanto que brasileiros preferiram um julgamento afetivo. Conforme predito, a rota direta foi mais forte para brasileiros, enquanto que a rota indireta foi a preferida por australianos. Os resultados são discutidos em termos da validade ética do modelo para indivíduos que endossam valores culturais não individualistas.(AU)

The present study aimed to determine the effect of cultural differences on consumer behavior. A total of 793 participants (both Brazilians and Australians) were exposed to the Values Scale, the Meaning and Judgment Scale, and measures of car attributes and consumer behavior. There was a main effect of country on cultural patterns such that Australians scored higher on individualism than on collectivism. Australians preferred piecemeal judgment and placed more importance on the product's tangible attributes, whereas Brazilians preferred affective judgment. As predicted, the direct route was stronger for Brazilians than for Australians, who preferred the indirect route. Results are discussed in terms of the ethic validity of the model for individuals who endorse cultural values other than individualism.(AU)

Valores humanos e escolha do consumidor na Austrália e Brasil / Human Values and Consumer Choice in Australia and Brazil

O presente estudo teve o objetivo de observar quais implicações as diferenças culturais têm para o comportamento do consumidor. Um total de 793 participantes (brasileiros e australianos) foi exposto à Escala de Valores, Escala de Significado e Julgamento, e medidas de atributos de carros e comportamento de consumo. Observou-se o efeito de país sobre padrões culturais, de modo que australianos apresentaram escores mais altos para individualismo do que para coletivismo. Australianos preferiram um julgamento passo-a-passo e colocaram maior importância em atributos tangíveis, enquanto que brasileiros preferiram um julgamento afetivo. Conforme predito, a rota direta foi mais forte para brasileiros, enquanto que a rota indireta foi a preferida por australianos. Os resultados são discutidos em termos da validade ética do modelo para indivíduos que endossam valores culturais não individualistas.

The present study aimed to determine the effect of cultural differences on consumer behavior. A total of 793 participants (both Brazilians and Australians) were exposed to the Values Scale, the Meaning and Judgment Scale, and measures of car attributes and consumer behavior. There was a main effect of country on cultural patterns such that Australians scored higher on individualism than on collectivism. Australians preferred piecemeal judgment and placed more importance on the product's tangible attributes, whereas Brazilians preferred affective judgment. As predicted, the direct route was stronger for Brazilians than for Australians, who preferred the indirect route. Results are discussed in terms of the ethic validity of the model for individuals who endorse cultural values other than individualism.

Metallo-phthalocyanine near-IR fluorophores: oligonucleotide conjugates and their applications in PCR assays.

Water soluble, metallo-pthalocyanine (MPc) near-IR fluorophores were designed, synthesized, and evaluated as highly stable and sensitive reporters for fluorescence assays. Their conjugation to oligonucleotides was achieved via succinimidyl ester-amino coupling chemistry with the conditions for conjugation extensively examined and optimized. In addition, various conjugate purification and isolation techniques were evaluated as well. Results showed that under proper conditions and following purification using reverse-phase ion-pair chromatography, labeling efficiencies near 80% could be achieved using ZnPc (Zn phthalocyanine) as the labeling fluorophore. Absorption and fluorescence spectra accumulated for the conjugates indicated that the intrinsic fluorescence properties of the MPc's were not significantly altered by covalent attachment to oligonucleotides. As an example of the utility of MPc reporters, we used the MPc-oligonucleotide conjugates as primers for PCR (polymerase chain reaction) amplifications with the products sorted via electrophoresis and detected using near-IR fluorescence (lambda ex = 680 nm). The MPc dyes were found to be more chemically stable under typical thermal cycling conditions used for PCR compared to the carbocyanine-based near-IR reporter systems typically used and produced single and narrow bands in the electrophoretic traces, indicative of producing a single PCR product during amplification.

Water soluble metallo-phthalocyanines: the role of the functional groups on the spectral and photophysical properties.

Strategies are reported that produce symmetrical metal-free and metallo-phthalocyanine dyes, Pc and MPc, respectively, containing various numbers of water solubilizing carboxylic acid groups on their periphery that provide a dual role by also serving as functional groups to covalently link primary amine-containing targets to these dyes. In order to induce water compatibility and to minimize the degree of aggregation, the periphery of the macrocycle was decorated with various numbers of water-solubilizing groups and/or altering the identity of the metal center. The influence of the number of solubilizing groups and metal center on the spectral and photophysical properties were evaluated. MPc dyes containing 4, 8, or 16 carboxylic acid groups exhibited similar absorption and emission maxima (677 and 686 nm, respectively) with the molar absorptivity of the Q-band approximately 10(5) M(-1) cm(-1). Results indicated that the fluorescence lifetimes and quantum yields varied as a function of the metal center; the degree of carboxylation did not significantly alter these properties in DMSO, but did mediate the solubility and aggregation states when placed in aqueous solvents. The water solubilizing groups could also serve as labeling moieties for targets bearing primary amines. Results showed that the conjugate, produced by covalently linking an MPc to streptavidin through one of its carboxylate groups, generated a red-shift in the emission maximum with a fluorescence lifetime shorter than that of the native MPc dye.

A dual-process model of the influence of human values on consumer choice

A dual-process model for how consumer values influence product choice is proposed. Recent theoretical developments regarding what products mean to consumers, how they are judged, and what motives they satisfy suggest two processes. First, when consumers evaluate a product’s utilitarian meaning, use a piecemeal judgment, and the product satisfies an instrumental motivation, the human values they endorse determine which tangible attributes are important; they compare the product’s actual tangible attributes to their preferred tangible attributes, and choose the product that comes closest. In contrast, when consumers evaluate a product’s symbolic meaning, use an affective judgment, and the product satisfies an expressive motivation, their values may influence product choice directly. In particular, individuals compare the cultural values symbolized by the product to the human values they endorse, choosing the product with the most congruency. Current and future directions of the dual-process model are discussed.(AU)

Um processo dualístico sobre como os valores dos consumidores influenciam a sua escolha por produtos é proposto. Desenvolvimentos teóricos recentes sobre o que os produtos significam para os consumidores, como eles são julgados e os quais motivos eles satisfazem segerem a existencia de dois processos. Primeiro, quando os consumidores avaliam um sentido utilitarista do produto, use um julgamento passo-a-passo, e se o produto satisfaz uma motivação instrumental, os valores humanos endossados por esses consumidores determinam quais atributos tangíveis são importantes; eles compararam o produto real aos seus atributos tangíveis preferidos por eles, e escolher o produto que mais se aproxime. Em contrapartida, quando os consumidores avaliam um significado simbólico do produto, usam um julgamento afetivo, e se o produto satisfaz uma expressiva motivação, os seus valores podem influenciar a escolha do produto diretamente. Em particular, os indivíduos comparam os valores culturais simbolizado pelo produto para os valores humanos que subscrevo, escolhendo o produto com a maior congruência. Atuais e futuras orientações do modelo de processo dualístico foi discutidos.

Consumo no Brasil: um teste etic da relação entre valores humanos, significado do produto e preferência de consumo em culturas coletivas / Consumption in Brazil: an etic test of the relationship between human values, product meaning and consumer choice in collectivist cultures

Quando se avalia o significado simbólico de um objeto, verifica-se que indivíduos prestam atenção aos valores que ele expressa, e esses valores devem relacionar-se com seus próprios valores. Alguns autores afirmam que a carne vermelha simboliza hierarquia em culturas que têm esse tipo de relação. Este estudo investiga o significado da carne no Brasil, explorando os valores endossados por compradores e como esses valores influenciam sua escolha. Participantes brasileiros preencheram escalas de valores, significado e julgamento, bem como de medida de comportamento relativa ao consumo de carne. Resultados indicaram que consumidores brasileiros usam seus valores verticais (hierarquia e iniqüidade) simbolizados pela carne vermelha para sua escolha. Sugere-se que a extensão dos valores humanos tem impacto na escolha de itens de alimentação.(AU)

When evaluating the symbolic meaning of an object, individuals pay attention to the values expressed by the object, whether these values match the human values most endorsed by them. Authors proposed is that read meat symbolizes hierarchy in cultures that have hierarchical relations. The present study investigated the symbolic meaning of meat in Brazil, by exploring the values endorsed by meat buyers and how these values influence food choice. Brazilian participants completed values, Meaning and Judgment, and Consumption Behavior scales. Results indicated that Brazilian consumers use their vertical values to evaluate the hierarchy and inequality values symbolized by red meat. It is suggested that examination of the extent to which human values have an impact on consumption of food items.(AU)

Conformational substates of calmodulin revealed by single-pair fluorescence resonance energy transfer: influence of solution conditions and oxidative modification.

A calmodulin (CaM) mutant (T34,110C-CaM) doubly labeled with fluorescence probes AlexaFluor 488 and Texas Red in opposing domains (CaM-DA) has been used to examine conformational heterogeneity in CaM by single-pair fluorescence resonance energy transfer (spFRET). Burst-integrated FRET efficiencies of freely diffusing CaM-DA single molecules yielded distributions of distance between domains of CaM-DA. We recently reported distinct conformational substates of Ca(2+)-CaM-DA and apoCaM-DA, with peaks in the distance distributions centered at approximately 28 A, 34-38 A, and 55 A [Slaughter et al. (2004) J. Phys. Chem. B 108, 10388-10397]. In the present study, shifts in the amplitudes and center distances of the conformational substates were detected with variation in solution conditions. The amplitude of an extended conformation was observed to change as a function of Ca(2+) over a free Ca(2+) range that is consistent with binding to the high affinity, C-terminal Ca(2+) binding sites, suggesting the existence of communication between lobes of CaM. Lowering pH shifted the relative amplitudes of the conformations, with a marked increase in the presence of the compact conformations and an almost complete absence of the extended conformation. In addition, the single-molecule distance distribution of apoCaM-DA at reduced ionic strength was shifted to longer distance and showed evidence of an increase in conformational heterogeneity relative to apoCaM-DA at physiological ionic strength. Oxidation of methionine residues in CaM-DA produced a substantial increase in the amplitude of the extended conformation relative to the more compact conformation. The results are considered in light of a hypothesis that suggests that electrostatic interactions between charged amino acid side chains play an important role in determining the most stable CaM conformation under varying solution conditions.

Single-molecule fluorescence spectroscopy: new probes of protein function and dynamics.

Single-molecule fluorescence methods provide new tools for the study of biological systems. Single-pair fluorescence resonance energy transfer has provided detailed information about dynamics and structure of the Ca2+-signaling protein calmodulin. Single-molecule polarization modulation spectroscopy has probed the mechanism by which calmodulin activates the plasma membrane Ca2+ pump.

Hyperbaric oxygen in the treatment of patients with cerebral stroke, brain trauma, and neurologic disease.

Hyperbaric oxygen (HBO) therapy has been used to treat patients with numerous disorders, including stroke. This treatment has been shown to decrease cerebral edema, normalize water content in the brain, decrease the severity of brain infarction, and maintain blood-brain barrier integrity. In addition, HBO therapy attenuates motor deficits, decreases the risks of sequelae, and prevents recurrent cerebral circulatory disorders, thereby leading to improved outcomes and survival. Hyperbaric oxygen also accelerates the regression of atherosclerotic lesions, promotes antioxidant defenses, and suppresses the proliferation of macrophages and foam cells in atherosclerotic lesions. Although no medical treatment is available for patients with cerebral palsy, in some studies, HBO therapy has improved the function of damaged cells, attenuated the effects of hypoxia on the neonatal brain, enhanced gross motor function and fine motor control, and alleviated spasticity. In the treatment of patients with migraine, HBO therapy has been shown to reduce intracranial pressure significantly and abort acute attacks of migraine, reduce migraine headache pain, and prevent cluster headache. In studies that investigated the effects of HBO therapy on the damaged brain, the treatment was found to inhibit neuronal death, arrest the progression of radiation-induced neurologic necrosis, improve blood flow in regions affected by chronic neurologic disease as well as aerobic metabolism in brain injury, and accelerate the resolution of clinical symptoms. Hyperbaric oxygen has also been reported to accelerate neurologic recovery after spinal cord injury by ameliorating mitochondrial dysfunction in the motor cortex and spinal cord, arresting the spread of hemorrhage, reversing hypoxia, and reducing edema. HBO has enhanced wound healing in patients with chronic osteomyelitis. The results of HBO therapy in the treatment of patients with stroke, atherosclerosis, cerebral palsy, intracranial pressure, headache, and brain and spinal cord injury are promising and warrant further investigation.

Changes in psychosocial well-being during stages of gay identity development.

The current study evaluated the stage theory of Homosexual Identity Formation (HIF) developed by Cass (1979), in terms of the relationship between stage of gay identity development and psychosocial well-being. Four hundred twenty-five males (12 to 64 years, M = 29.2) reporting sexual attraction to other men provided demographic information and completed psychosocial measures: the Happiness-Sadness Scale (McGreal & Joseph, 1993), the Satisfaction with Life Scale (Diener, Emmons, Larsen & Griffin, 1985), the UCLA Loneliness Scale (Russell, Peplau & Ferguson, 1978), the Index of Self-Esteem (Hudson, 1982), and the Gay Identity Questionnaire (Brady & Busse, 1994). Correlation analysis and ANCOVAs controlling for age and nationality demonstrated that the 6 sequential stages of HIF were associated with a U-shaped function for the psychosocial variables. Well-being was high during the initial Confusion and Comparison stages of HIF, was reduced during the middle Tolerance and Acceptance stages, and was again high in the later Pride and Synthesis stages. Each of the psychosocial variables was significantly different according to stage of development (p <.001). Qualitative analysis of subjects' comments also revealed support for the U-shaped pattern.

Single-molecule assays of calmodulin target binding detected with a calmodulin energy-transfer construct.

We have detected single-molecule binding interactions of a target peptide with the calcium-signaling protein calmodulin (CaM) immobilized in an agarose gel, and we have demonstrated the application of a single-molecule binding assay to measure the binding strength of CaM with the CaM-binding domain of calmodulin-dependent protein kinase II (CaMKII). The results demonstrate the potential for ultrasensitive assays of CaM-target interactions and the measurement of a picomolar dissociation constant. To detect single-molecule protein interactions, single-molecule assays require that the analyte molecule be confined to the focal spot of the objective for the time scale of the measurement. We demonstrate the deleterious effect of surface immobilization on CaM. As an alternative to surface immobilization, we have constructed a CaM/maltose binding protein fusion protein, which renders CaM translationally immobile in a low weight percent agarose gel. The target binding functionality of CaM assayed in agarose gels is in good agreement with solution assays. The utility of the construct for detecting interactions with CaM targets was demonstrated in a single-molecule assay of binding interactions of MBP-CaM with the CaMKII CaM-binding domain peptide. A value of 103 +/- 35 pM for the dissociation constant of this interaction was determined by simple counting of fluorescent molecules.

Fluorescence labeling, purification, and immobilization of a double cysteine mutant calmodulin fusion protein for single-molecule experiments.

We present a method of labeling and immobilizing a low-molecular-weight protein, calmodulin (CaM), by fusion to a larger protein, maltose binding protein (MBP), for single-molecule fluorescence experiments. Immobilization in an agarose gel matrix eliminates potential interactions of the protein and the fluorophore(s) with a glass surface and allows prolonged monitoring of protein dynamics. The small size of CaM hinders its immobilization in low-weight-percentage agarose gels; however, fusion of CaM to MBP via a flexible linker provides sufficient restriction of translational mobility in 1% agarose gels. Cysteine residues were engineered into MBP.CaM (MBP-T34C,T110C-CaM) and labeled with donor and acceptor fluorescent probes yielding a construct (MBP.CaM-DA) which can be used for single-molecule single-pair fluorescence resonance energy transfer (spFRET) experiments. Mass spectrometry was used to verify the mass of MBP.CaM-DA. Assays measuring the activity of CaM reveal minimal activity differences between wild-type CaM and MBP.CaM-DA. Single-molecule fluorescence images of the donor and acceptor dyes were fit to a two-dimensional Gaussian function to demonstrate colocalization of donor and acceptor dyes. FRET is demonstrated both in bulk fluorescence spectra and in fluorescence trajectories of single MBP.CaM-DA molecules. The extension of this method to other biomolecules is also proposed.

Manipulating the symbolic meaning of meat to encourage greater acceptance of fruits and vegetables and less proclivity for red and white meat.

The present study tested the extent to which dietary preferences are altered by making aspects of the symbolic meaning of meat salient to participants. Individuals in the treatment group were informed of a previous scientific study which found that people who endorse social hierarchy and human dominance over nature consume more red and white meat, and that people who reject hierarchy and dominance eat more fruits and vegetables. The results showed that, compared to a control group, individuals in the treatment group who reject hierarchy and dominance (most participants) perceived red and white meat less favourably, decreased their liking of red and white meat, decreased their object identification with red and white meat, anticipated that they would eat more fruits and vegetables in the subsequent three days, and indeed consumed more fruits and vegetables in a follow-up study three weeks later. Moreover, the salience manipulation's ability to induce a negative response toward red and white meat and greater acceptance of fruits and vegetables was strongest for individuals in the treatment group for whom the salience manipulation made sense, individuals with less confidence in their diet choices, those who had previously considered reducing their meat consumption, and low/normal weight persons. These findings have implications for health promotion and for theories of food choice.