608 research outputs found
Phosphodiesterase-5 inhibitors in management of pulmonary hypertension: safety, tolerability, and efficacy
Pulmonary arterial hypertension (PAH) is a progressive disease that causes severe disability and has no cure. Over the past 20 years, a variety of treatment options have evolved for the management of PAH. With an expanded therapeutic armamentarium come more complex decisions regarding treatment options. Agent selection depends upon several factors including efficacy, side effect profile, and cost, as well as convenience of administration. We have undertaken a review of phosphodiesterase-5 (PDE-5) inhibitors in PAH with a focus on efficacy and safety. A literature search was conducted using the Medline and Cochrane Central Register of Controlled Trials databases (1966âFebruary 2010) for relevant randomized clinical studies. Overall, 10 studies met our inclusion criteria. Sildenafil was the most commonly studied agent, followed by tadalafil and vardenafil. Most trials found that the PDE-5 inhibitors significantly improved exercise capacity and lowered pulmonary pressures. However, there were conflicting results regarding these agentsâ impact on improving cardiac function and functional class. Overall, these medications were effective and well tolerated with a relatively benign side effect profile. The PDE-5 inhibitors are an important option in treating PAH. While most of the published clinical data involved sildenafil, the other PDE-5 inhibitors show promise as well. Further studies are needed to determine the optimal doses of this therapeutic drug class, as well as its effects as adjunctive therapy with other agents in PAH
Leaf segmentation and tracking using probabilistic parametric active contours
Active contours or snakes are widely used for segmentation and tracking. These techniques require the minimization of an energy function, which is generally a linear combination of a data fit term and a regularization term. This energy function can be adjusted to exploit the intrinsic object and image features. This can be done by changing the weighting parameters of the data fit and regularization term. There is, however, no rule to set these parameters optimally for a given application. This results in trial and error parameter estimation. In this paper, we propose a new active contour framework defined using probability theory. With this new technique there is no need for ad hoc parameter setting, since it uses probability distributions, which can be learned from a given training dataset
Direct subthalamic nucleus stimulation influences speech and voice quality in Parkinson's disease patients
BACKGROUND
DBS of the subthalamic nucleus (STN) considerably ameliorates cardinal motor symptoms in PD. Reported STN-DBS effects on secondary dysarthric (speech) and dysphonic symptoms (voice), as originating from vocal tract motor dysfunctions, are however inconsistent with rather deleterious outcomes based on post-surgical assessments.
OBJECTIVE
To parametrically and intra-operatively investigate the effects of deep brain stimulation (DBS) on perceptual and acoustic speech and voice quality in Parkinson's disease (PD) patients.
METHODS
We performed an assessment of instantaneous intra-operative speech and voice quality changes in PD patients (n = 38) elicited by direct STN stimulations with variations of central stimulation features (depth, laterality, and intensity), separately for each hemisphere.
RESULTS
First, perceptual assessments across several raters revealed that certain speech and voice symptoms could be improved with STN-DBS, but this seems largely restricted to right STN-DBS. Second, computer-based acoustic analyses of speech and voice features revealed that both left and right STN-DBS could improve dysarthric speech symptoms, but only right STN-DBS can considerably improve dysphonic symptoms, with left STN-DBS being restricted to only affect voice intensity features. Third, several subareas according to stimulation depth and laterality could be identified in the motoric STN proper and close to the associative STN with optimal (and partly suboptimal) stimulation outcomes. Fourth, low-to-medium stimulation intensities showed the most optimal and balanced effects compared to high intensities.
CONCLUSIONS
STN-DBS can considerably improve both speech and voice quality based on a carefully arranged stimulation regimen along central stimulation features
Direct subthalamic nucleus stimulation influences speech and voice quality in Parkinson's disease patients
Background
DBS of the subthalamic nucleus (STN) considerably ameliorates cardinal motor symptoms in PD. Reported STN-DBS effects on secondary dysarthric (speech) and dysphonic symptoms (voice), as originating from vocal tract motor dysfunctions, are however inconsistent with rather deleterious outcomes based on post-surgical assessments.
Objective
To parametrically and intra-operatively investigate the effects of deep brain stimulation (DBS) on perceptual and acoustic speech and voice quality in Parkinson's disease (PD) patients.
Methods
We performed an assessment of instantaneous intra-operative speech and voice quality changes in PD patients (n = 38) elicited by direct STN stimulations with variations of central stimulation features (depth, laterality, and intensity), separately for each hemisphere.
Results
First, perceptual assessments across several raters revealed that certain speech and voice symptoms could be improved with STN-DBS, but this seems largely restricted to right STN-DBS. Second, computer-based acoustic analyses of speech and voice features revealed that both left and right STN-DBS could improve dysarthric speech symptoms, but only right STN-DBS can considerably improve dysphonic symptoms, with left STN-DBS being restricted to only affect voice intensity features. Third, several subareas according to stimulation depth and laterality could be identified in the motoric STN proper and close to the associative STN with optimal (and partly suboptimal) stimulation outcomes. Fourth, low-to-medium stimulation intensities showed the most optimal and balanced effects compared to high intensities.
Conclusions
STN-DBS can considerably improve both speech and voice quality based on a carefully arranged stimulation regimen along central stimulation features
Relationship between quantum decoherence times and solvation dynamics in condensed phase chemical systems
A relationship between the time scales of quantum coherence loss and
short-time solvent response for a solute/bath system is derived for a Gaussian
wave packet approximation for the bath. Decoherence and solvent response times
are shown to be directly proportional to each other, with the proportionality
coefficient given by the ratio of the thermal energy fluctuations to the
fluctuations in the system-bath coupling. The relationship allows the
prediction of decoherence times for condensed phase chemical systems from well
developed experimental methods.Comment: 10 pages, no figures, late
Does the Constitution Provide More Ballot Access Protection for Presidential Elections Than for U.S. House Elections?
Both the U.S. Constitution and The Federalist Papers suggest that voters ought to have more freedom to vote for the candidate of their choice for the U.S. House of Representatives than they do for the President or the U.S. Senate. Yet, strangely, for the last thirty-three years, the U.S. Supreme Court and lower courts have ruled that the Constitution gives voters more freedom to vote for the candidate of their choice in presidential elections than in congressional elections. Also, state legislatures, which have been writing ballot access laws since 1888, have passed laws that make it easier for minor-party and independent candidates to get on the ballot for President than for the U.S. House. As a result, voters in virtually every state invariably have far more choices on their general election ballots for the President than they do for the House. This Article argues that the right of a voter to vote for someone other than a Democrat or a Republican for the House is just as important as a voterâs right to do so for President, and that courts should grant more ballot access protection to minor-party and independent candidates for the House
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