bluuebunny/crossref_metadata_2025 huggingface dataset:
Feminist Jurisprudence in India with Reference to Individual Freedom of Women vis-a-vis State's Duty to Protect Them
Authors: Gupta Pallavi
Published: December 2014

In the history of mankind ‘equality' and ‘freedom' evaded women in comparison to men. Women always suffered subordinate status and were assigned a purely functional role in every society or civilisation of the world. Over the period this unequal status of women being offensive to human dignity and human rights steered to develop feminist jurisprudence. This research paper reflects the perspective of feminist jurisprudence with reference to individual freedom of women, its expansion under other various issues and State's / employer's duty to protect women's individual freedom and to empower them. This research paper exclusively deals with that feminist jurisprudence which has been developed by judicial decisions in India.
Postpandemic influenza A/H1N1pdm09 is still causing severe perinatal complications
Authors: Bogers Hein , Bos Dominique , Schoenmakers Sam , Duvekot Johannes J
Published: December 2014

Although influenza A/H1N1pdm09 is not causing a pandemic anymore, we recently observed two critically ill pregnant women infected by this virus. We present these cases to illustrate the possible severe complications of an – at that moment – seasonal influenza in pregnancy. We discuss the epidemiological differences between the pandemic and postpandemic phase and try to explain the high virulence of H1N1-infections in pregnancy by discussing insights in immunology during pregnancy. We conclude that although the influenza A/H1N1pdm09 is in the postpandemic phase, infection by this influenza virus still needs to be considered in pregnant women with progressive respiratory dysfunction.
Genetic Characterization of Echinococcus granulosus from a Large Number of Formalin-Fixed, Paraffin-Embedded Tissue Samples of Human Isolates in Iran
Authors: Rostami Sima , Shariat Torbaghan Shams , Dabiri Shahriar , Babaei Zahra , Ali Mohammadi Mohammad , Sharbatkhori Mitra , Fasihi Harandi Majid
Published: December 2014

Cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus, presents an important medical and veterinary problem globally, including that in Iran. Different genotypes of E. granulosus have been reported from human isolates worldwide. This study identifies the genotype of the parasite responsible for human hydatidosis in three provinces of Iran using formalin-fixed paraffin-embedded tissue samples. In this study, 200 formalin-fixed paraffin-embedded tissue samples from human CE cases were collected from Alborz, Tehran, and Kerman provinces. Polymerase chain reaction amplification and sequencing of the partial mitochondrial cytochrome c oxidase subunit 1 gene were performed for genetic characterization of the samples. Phylogenetic analysis of the isolates from this study and reference sequences of different genotypes was done using a maximum likelihood method. In total, 54.4%, 0.8%, 1%, and 40.8% of the samples were identified as the G1, G2, G3, and G6 genotypes, respectively. The findings of the current study confirm the G1 genotype (sheep strain) to be the most prevalent genotype involved in human CE cases in Iran and indicates the high prevalence of the G6 genotype with a high infectivity for humans. Furthermore, this study illustrates the first documented human CE case in Iran infected with the G2 genotype.
A Linguagem Gerencial Analisada à Luz da Teoria dos Atos de Fala de J. L. Austin: estudo do pensamento de Peter Drucker
Authors: Stefani Dorival De , Azevêdo Ariston
Published: December 2014

Neste texto, analisa-se a dimensão linguística da ação administrativa em sua vertente gerencial à luz da Teoria dos Atos de Fala de John Austin. Tal análise toma como objeto a obra de um autor clássico da literatura administrativa sobre o assunto, Peter Drucker, selecionando, do conjunto de seus escritos, livros que contribuíram significativamente para o desenvolvimento da teoria e da prática gerencial. Dessas obras, procurou-se identificar formas simbólicas caracterizadoras da prática linguística do gerente. Conclui-se que Drucker confina e dirige a linguagem e a comunicação do administrador para a esfera dos objetivos da empresa, com o fim de obter aquiescência nos empregados
Hygroscopic properties of NaCl and NaNO3 mixture particles as reacted inorganic sea-salt aerosol surrogates
Authors: Gupta D. , Kim H. , Park G. , Li X. , Eom H.-J. , Ro C.-U.
Published: December 2014

Abstract. NaCl in fresh sea-salt aerosol (SSA) particles can partially or fully react with atmospheric NOx / HNO3, so internally mixed NaCl and NaNO3 aerosol particles can co-exist over a wide range of mixing ratios. Laboratory-generated, micrometer-sized NaCl and NaNO3 mixture particles at ten mixing ratios (mole fractions of NaCl (XNaCl) = 0.1 to 0.9) were examined systematically to observe their hygroscopic behavior, derive experimental phase diagrams for deliquescence and efflorescence, and understand the efflorescence mechanism. During the humidifying process, aerosol particles with the eutonic composition (XNaCl = 0.38) showed only one phase transition at their mutual deliquescence relative humidity (MDRH) of 67.9(± 0.5)%. On the other hand, particles with other mixing ratios showed two distinct deliquescence transitions, i.e., the eutonic component dissolved at MDRH and the remainder in the solid phase dissolved completely at their DRHs depending on the mixing ratios, resulting in a phase diagram composed of four different phases, as predicted thermodynamically. During the dehydration process, NaCl-rich particles (XNaCl > 0.38) showed two-stage efflorescence transitions: the first stage was purely driven by the homogeneous nucleation of NaCl and the second stage at the mutual efflorescence RH (MERH) of the eutonic components, with values in the range of 30.0–35.5%. Interestingly, aerosol particles with the eutonic composition (XNaCl = 0.38) also showed two-stage efflorescence with NaCl crystallizing first followed by heterogeneous nucleation of the remaining NaNO3 on the NaCl seeds. NaNO3-rich particles XNaCl ≤ 0.3) underwent single-stage efflorescence transitions at ERHs progressively lower than the MERH, because of the homogeneous nucleation of NaCl and the almost simultaneous heterogeneous nucleation of NaNO3 on the NaCl seeds. SEM/EDX elemental mapping indicated that the effloresced NaCl-NaNO3 particles at all mixing ratios were composed of a homogeneously crystallized NaCl moiety in the center, surrounded either by the eutonic component (for XNaCl > 0.38) or NaNO3 (for XNaCl ≤ 0.38). During the humidifying or dehydration process, the amount of eutonic composed part drives particle/droplet growth or shrinkage at the MDRH or MERH (second ERH), respectively, and the amount of remnant pure salts (NaCl or NaNO3 in NaCl- or NaNO3-rich particles, respectively) drives the second DRHs or first ERHs, respectively. Therefore, their behavior can be a precursor to the optical properties and direct radiative forcing for these atmospherically relevant mixture particles representing the coarse, reacted inorganic SSAs. In addition, the NaCl-NaNO3 mixture aerosol particles can maintain an aqueous phase over a wider RH range than the genuine SSA surrogate (i.e., pure NaCl particles), making their heterogeneous chemistry more probable.
Assessing the prospective resource base for enhanced geothermal systems in Europe
Authors: Limberger J. , Calcagno P. , Manzella A. , Trumpy E. , Boxem T. , Pluymaekers M. P. D. , van Wees J.-D.
Published: December 2014

Abstract. In this study the resource base for EGS (enhanced geothermal systems) in Europe was quantified and economically constrained, applying a discounted cash-flow model to different techno-economic scenarios for future EGS in 2020, 2030, and 2050. Temperature is a critical parameter that controls the amount of thermal energy available in the subsurface. Therefore, the first step in assessing the European resource base for EGS is the construction of a subsurface temperature model of onshore Europe. Subsurface temperatures were computed to a depth of 10 km below ground level for a regular 3-D hexahedral grid with a horizontal resolution of 10 km and a vertical resolution of 250 m. Vertical conductive heat transport was considered as the main heat transfer mechanism. Surface temperature and basal heat flow were used as boundary conditions for the top and bottom of the model, respectively. If publicly available, the most recent and comprehensive regional temperature models, based on data from wells, were incorporated.

 With the modeled subsurface temperatures and future technical and economic scenarios, the technical potential and minimum levelized cost of energy (LCOE) were calculated for each grid cell of the temperature model. Calculations for a typical EGS scenario yield costs of EUR 215 MWh−1 in 2020, EUR 127 MWh−1 in 2030, and EUR 70 MWh−1 in 2050. Cutoff values of EUR 200 MWh−1 in 2020, EUR 150 MWh−1 in 2030, and EUR 100 MWh−1 in 2050 are imposed to the calculated LCOE values in each grid cell to limit the technical potential, resulting in an economic potential for Europe of 19 GWe in 2020, 22 GWe in 2030, and 522 GWe in 2050. The results of our approach do not only provide an indication of prospective areas for future EGS in Europe, but also show a more realistic cost determined and depth-dependent distribution of the technical potential by applying different well cost models for 2020, 2030, and 2050.
Processing and Analysis of Hyperspectral Fingerprints to Characterise Haematite of Singbhum Iron Ore Belt, Orissa, India
Authors: Magendran T. , Sanjeevi S.
Published: December 2014

Abstract. The demand for iron ore has been increasing in the recent years, thereby requiring the adoption of fast and accurate approaches to iron ore exploration and its grade-assessment. It is in this context that hyperspectral sensing is deemed as a potential tool. This paper examines the potential of hyperspectral fingerprints in the visible, NIR and SWIR regions of the EMR to assess the grades of haematite of the western Singhbhum iron ore belt of Orissa, eastern India, in a rapid manner. Certain spectro-radiometric measurements and geochemical analysis were carried out and the results have been presented. From the spectral measurements, it is seen that the strength of reflectance and absorption at definite wavelength regions is controlled by the chemical composit ion of the iron ores. It is observed that the primary spectral characteristics of these haematites lie in the 650–750 nm, 850 to 900 nm and 2130–2230 nm regions. The laboratory based hyperspectral fingerprints and multiple regression analysis of spectral parameters and geochemical parameters (Fe% and Al2O3%) predicted the concentration of iron and alumina content in the haematite. A very strong correlation (R2 = 0.96) between the spectral parameters and Fe% in the haematite with a minimum error of 0.1%, maximum error of 7.4% and average error of 2.6% is observed. Similarly, a very strong correlation (R2 = 0.94) between the spectral parameters and Al2O3% in the iron ores with a minimum error of 0.04%, maximum error of 7.49% and average error of 2.5% is observed. This error is perhaps due to the presence of other components (SiO2, TiO2, P2O etc.) in the samples which can alter the degree of reflectance and hence the spectral parameters. Neural network based multi-layer perception (MLP) analysis of various spectral parameters and geochemical parameters helped to understand the relative importance of the spectral parameters for predictive models. The strong correlations (Iron: R2 = 0.96; Alumina: R2 = 0.94) indicate that the laboratory hyperspectral signatures in the visible, NIR and SWIR regions can give a better estimate of the grades of haematite in a rapid manner.
Estimation of currents using SARAL/AltiKa in the coastal regions of India
Authors: Chaudhary A. , Agarwal N. , Sharma R.
Published: December 2014

Abstract. The present study explores the possibility of deriving the across track currents along the Indian coastal region from SARAL/AltiKa mission. The across track surface geostrophic currents obtained from along track SARAL altimeter data are directly compared (qualitatively) with high frequency (HF) radar observations of surface currents in the Bay of Bengal. The velocity component from HF radar which is perpendicular to the altimeter tracks is considered. Since the ageostrophic velocity contribution is ignored for the moment, the surface geostrophic currents SARAL compare well only under low wind conditions. Due to high along track resolution of SARAL there are large variations in velocity which are not captured by the HF radar observations. In general, the magnitude and variations in surface currents derived from SARAL altimeter are comparable with HF radar observations.
Integrating GIS with AHP and Fuzzy Logic to generate hand, foot and mouth disease hazard zonation (HFMD-HZ) model in Thailand
Authors: Samphutthanon R. , Tripathi N. K. , Ninsawat S. , Duboz R.
Published: December 2014

Abstract. The main objective of this research was the development of an HFMD hazard zonation (HFMD-HZ) model by applying AHP and Fuzzy Logic AHP methodologies for weighting each spatial factor such as disease incidence, socio-economic and physical factors. The outputs of AHP and FAHP were input into a Geographic Information Systems (GIS) process for spatial analysis. 14 criteria were selected for analysis as important factors: disease incidence over 10 years from 2003 to 2012, population density, road density, land use and physical features. The results showed a consistency ratio (CR) value for these main criteria of 0.075427 for AHP, the CR for FAHP results was 0.092436. As both remained below the threshold of 0.1, the CR value were acceptable. After linking to actual geospatial data (disease incidence 2013) through spatial analysis by GIS for validation, the results of the FAHP approach were found to match more accurately than those of the AHP approach. The zones with the highest hazard of HFMD outbreaks were located in two main areas in central Muang Chiang Mai district including suburbs and Muang Chiang Rai district including the vicinity. The produced hazardous maps may be useful for organizing HFMD protection plans.
Modis data acquisition and utilization for forest fire management in india
Authors: Satyanarayana A.N. , Chandrashekara Rao B. , Lalitha D. , Lakshmi B.
Published: December 2014

Abstract. The Moderate Resolution Imaging Spectroradiometer (MODIS) instrument onboard Terra & Aqua Spacecrafts Scans the earth in 36 spectral bands & covers the entire earth in two days. MODIS data has proved to be very useful for ocean & land studies with resolution ranging from 250 m to 1000 meters. The Data Reception system at Shadnagar (Refer to the Block diagram Fig.1), receives the data transmitted in X-band on 8160 MHz carrier SQPSK modulated with a data rate of 15 MBPS from the Aqua satellite. The down converted IF signal is fed to the demodulator & bit-synchronizer unit. The data and clock output signals of bitsynchronizer unit are given to a PC based DAQLB system where real-time telemetry processing is carried out and data is recorded onto hard disk in real time. The effectiveness of the system in supporting the forest fire management during the 2011, 12, 13 & 14 is also presented in the paper. Near real-time active fire monitoring, interactive fire visualization, fire database and statistical analysis functions also presented. Preliminary results of the upgrading satellite receiving system and in expanding the utilization of satellite data for multi-disciplinary resources management will also be presented and discussed.
Assessment of HICO data for Coastal Studies
Authors: Singh R. B. , Chauhan P.
Published: December 2014

Abstract. Coastal waters, in particular, are the regions of high productivity and biodiversity. Detailed investigations of the variability within them can aid in understanding many biogeochemical processes. With the advent of hyperspectral remote sensing having large number of closely spaced channels and highly improved signal-to-noise ratio (SNR), the coastal applications are expected to increase and improve. In India, very less work is done in the field of coastal studies, let alone using hyperspectral remote sensing. HICO, onboard ISS, is the most recent addition to this family of instruments. So, a pilot study was conducted to assess HICO data for coastal studies especially in deriving the shallow water bathymetry estimates. The methodology for deriving bathymetry estimates is based on the different responses of shallow-water reflectance on depth and substrate type because with decreasing water depth in case 2 waters, the spectral contributions arriving from pure water reduce while from other OCAs increase. This variability is typically higher in the wavelength range 480 to 610 nm. Using this wavelength range, bathymetric estimates were made at pixel level. Bathymetry estimates were found to vary from 1 m to >12 m. Spectral variability is clearly observed in the continuum removed spectral plots from waters of different depths and is reported in this paper.
Reduction of livelihood risk for river bank erosion affected villagers
Authors: Sen Majumder S. , Fox D. M. , Chakrabari S. , Bhandari G.
Published: December 2014

Abstract. Bank erosion process of the Ganga River created a serious livelihood risk for the villagers situated on left bank of the river in Malda district of the State of West Bengal, India since last four decades. Due to the erosion of agriculture land by the river, most of the villagers having agriculture as their only means of livelihood became jobless suddenly. Presently they are living in a miserable condition. One of the main objectives of this paper is to find out an alternative means of livelihood for the victims to improve their miserable socio-economic condition. It has been found from field survey that some erosion affected villagers have started to live and practice agriculture temporarily on the riverine islands (large and stable since thirteen years) as these islands have very fertile soil. If the re-emerged land plots can again be demarcated on the newly formed islands and distributed among the landless people to practice agriculture over there, then it will be a useful alternative livelihood strategy for the victims. The demarcation of re-emerged plots can be achieved by georeferencing the cadastral maps and then overlaying the plots on the present river course. In the present study area geo-referencing process of the cadastral maps became a serious issue as the study area has been very dynamic in terms of land cover and land use. Most of the villages were lost into the river course. Thus the common permanent features, required for geo-referencing, shown in the cadastral maps (surveyed during 1954–1962) were not found in the present satellite images. The second important objective of the present study is to develop a proper methodology for geo-referencing the cadastral maps of this area. The Spatial Adjustment Transformation and Automatic Digitization tools of Arc GIS were used to prepare geo-referenced plot maps. In Projective Transformation method the geometrically corrected block maps having village boundaries were used as source file. Then the georeferenced plot maps were overlaid on the present river course and the plots covered by islands or lands were extracted. For e.g., Gopalpur village contains nearly 29% of its total area as riverine island and 36% of total plots are covered by this island area. These plots can be distributed to the land less people so that they can utilize it and reduce their livelihood risk in future.
Precipitation Trend Analysis over Eastern Region of India Using Cmip5 Based Climatic Models
Authors: Kundu A. , Dwivedi S. , Chandra V.
Published: December 2014

Abstract. Climate science is a complex field as climate is governed by processes that interact and operate on a vast array of time and space scales. The processes involving radiative transfer, chemistry and phase changes of water are most easily described at atomic and molecular scales; the influence of ice sheets, continents and planetary scale circulations controlling the basic energy balance of the planet operate at continental scales; even planetary orbital and solar variations operating at millennial time scales cannot be ignored. Global as well as regional climate has changed due to human activities like land use changes, production of industrial effluents and other activities due to the development of the society. The consequences of these changes have a massive impact on atmospheric events like precipitation, temperature etc. So, present and future information of precipitation is required to develop adaptation and mitigation strategies at national and international levels. Precipitation is one of the major phenomena of the atmosphere. So, its prediction and the trend are very necessary to realize the change of climate. The study attempted some model based analysis to assess prediction of rainfall trend using MK test and the Sen’s slope estimator.
Road Traffic Accident Analysis of Ajmer City Using Remote Sensing and GIS Technology
Authors: Bhalla P. , Tripathi S. , Palria S.
Published: December 2014

Abstract. With advancement in technology, new and sophisticated models of vehicle are available and their numbers are increasing day by day. A traffic accident has multi-facet characteristics associated with it. In India 93% of crashes occur due to Human induced factor (wholly or partly). For proper traffic accident analysis use of GIS technology has become an inevitable tool. The traditional accident database is a summary spreadsheet format using codes and mileposts to denote location, type and severity of accidents. Geo-referenced accident database is location-referenced. It incorporates a GIS graphical interface with the accident information to allow for query searches on various accident attributes. Ajmer city, headquarter of Ajmer district, Rajasthan has been selected as the study area. According to Police records, 1531 accidents occur during 2009–2013. Maximum accident occurs in 2009 and the maximum death in 2013. Cars, jeeps, auto, pickup and tempo are mostly responsible for accidents and that the occurrence of accidents is mostly concentrated between 4PM to 10PM. GIS has proved to be a good tool for analyzing multifaceted nature of accidents. While road safety is a critical issue, yet it is handled in an adhoc manner. This Study is a demonstration of application of GIS for developing an efficient database on road accidents taking Ajmer City as a study. If such type of database is developed for other cities, a proper analysis of accidents can be undertaken and suitable management strategies for traffic regulation can be successfully proposed.
Site Suitability Analysis of Water Harvesting Structures Using Remote Sensing and GIS – A Case Study of Pisangan Watershed, Ajmer District, Rajasthan
Authors: Prasad H. C. , Bhalla P. , Palria S.
Published: December 2014

Abstract. Rajasthan is a region with very limited water resources. Water is the most crucial for maintaining an environment and ecosystem conducive to sustaining all forms of life. The principle of watershed management is the proper management of all the precipitation by the way of collection, storage and efficient utilization of runoff water and to recharge the ground water. The present study aim's to identify suitable zones for water harvesting structures in Pisangan watershed of Ajmer district, Rajasthan by using Geographic Information System (GIS) and Multi Criteria Evaluation (MSE). Multi criteria evaluation is carried out in Geographic Information system to help the decision makers in determining suitable zones for water harvesting structures based on the physical characteristics of the watershed. Different layers which were taken into account for multi criteria evaluation are; Soil texture, slope, rainfall data (2000–2012), land use/cover, geomorphology, lithology, lineaments, drainage network. The soil conservation service model was used to estimate the runoff depth of the study area Analytical Hierarchy Processes (AHP) is used to find suitable water harvesting structures on the basis of rainfall. Produced suitability map will help in the selection of harvesting structures such as percolation tanks, storage tank, check dams and stop dams.
International Charter Support during Major Flood Disasters in India
Authors: Srinivasa Rao G. , Bhatt C. M. , Diwaker P. G.
Published: December 2014

Abstract. Earth observation (EO) satellites provide near real time, comprehensive, synoptic and multi-temporal coverage of inaccessible areas at frequent intervals, which is required support for a quick response and planning of emergency operations. Owing to their merits, satellite images have become an integral part of disaster management and are being extensively used globally for mapping, monitoring and damage assessment of extreme disaster events. During major disaster, information derived from satellite observation is not only highly useful, it may at times be indispensable because of the unfavourable weather conditions, collapse of communication systems and inaccessibility to the area. Satellite images help in identifying the location of the disaster, its severity and the extent. The International Charter "Space and Major Disasters" has been the major sources of satellite data, in times of catastrophic disasters, due to availability of data from large number of sensors (with 15 organisations as signatories), which can be planned with the required temporal frequency and spectral range to cover a disaster event. During last three years, International Charter has been activated regularly, during major disasters in India. Satellite data from different sensors is obtained and was used for improving the frequency of observations, and extracting detailed information. This is used during floods in Assam (2012), floods in Uttarakhand (2013), cyclone Phailin (2013) and floods in Jammu and Kashmir (2014). The present paper discusses the role of International Charter in effective flood disaster management in India during recent past.
Understanding Soil as an Open System and Fertility as an Emergent Property of the Soil System
Authors: Nicolodi Margarete , Gianello Clesio
Published: December 2014

The application of the principles of thermodynamics and General Systems Theory is responsible for important progress in the study of soil and its fertility, and this application can even improve our understanding of the processes that govern the functioning of soil and determine the magnitude of soil fertility. Consequently, we can improve the evaluation and practices recommended for preserving or improving the soil and its fertility, contributing to sustainable food production. Recalling how the concept and human perception of soil have evolved is fundamental to improve our understanding. Thus, this article aims to encourage people to reflect on the application of the principles of thermodynamics of non-equilibrium and General Systems Theory in studying the soil and its fertility and to participate in constructing a new notion of soil fertility, able to express what is perceived by plants. Several authors in the last century have considered the soil to be an open system; however, this approach is a recent in Brazil. Fertility can be coherently understood as one of the emergent properties of the soil system by applying the principles of thermodynamics of non-equilibrium and General Systems Theory to the study of soil.
Cost‑effectiveness analysis of apixaban versus other NOACs for the prevention of stroke in Italian atrial fibrillation patients
Authors: Pradelli Lorenzo , Calandriello Mario , Di Virgilio Roberto , Bellone Marco , Tubaro Marco
Published: December 2014

OBJECTIVES: The study evaluated the cost‑effectiveness of apixaban in preventing thromboembolic events in non‑valvular atrial fibrillation (NVAF) patients, as compared to other three available novel oral anticoagulant agents (NOACs), from the Italian Health System (SSN) perspective.METHODS: A previously published lifetime Markov model was adapted for the Italian context. Baseline clinical risks were assigned based on the demographic and clinical features of the patients; effectiveness and safety parameters derived from adjusted indirect comparison using warfarin as link. The main clinical events considered in the model are ischemic and hemorrhagic stroke, systemic thromboembolism, bleeds (both major and clinically relevant minor) and cardiovascular hospitalizations, besides treatment discontinuations. Expected survival was projected beyond trial duration using national mortality data adjusted for clinical risks and weighted by published utilities. Unit costs were collected from published Italian sources and actualized to 2013. Costs and health gains occurring after the first year were discounted at an annual 3.5% rate. The primary outcome measure of the economic evaluation was the incremental cost effectiveness ratio (ICER), where effectiveness is measured in terms of life‑years and quality adjusted life‑years gained. Deterministic and probabilistic sensitivity analyses (DSA&PSA) were carried out.RESULTS: In the short to medium term, apixaban was associated with marginal LYs and QALYs gains and slight savings, as compared to other NOACs. However, as apixaban extended expected survival versus dabigatran (110mg), dabigatran (150mg) and rivaroxaban (0.13, 0.08, and 0.06 LYs or 0.11, 0.07, and 0.05 QALYs), expected total lifetime costs exceeded those of these comparators (€ 319, € 282, and € 16). Corresponding ICERs were estimated in € 2,911, € 3,882 and € 327 per QALY gained. The most influential parameter according to DSA was daily costs of NOACs, but the corresponding ICERs remained well below commonly accepted WTP values. In PSA, the probabilities of apixaban being cost effective with a WTP threshold of 20,000 €/QALY gained were 99%, 92% and 93% for the same comparisons.CONCLUSIONS: Apixaban is expected to be more effective than dabigatran and rivaroxaban in Italian NVAF population, and marginally more costly due to consume healthcare resources for a longer period of time. The ICERs have a high likelihood of being below conventional thresholds of WTP for health benefits of the SSN and suggest that apixaban is cost‑effective compared with other three available NOACs.
Quantifying the effect of intervertebral cartilage on neutral posture in the necks of sauropod dinosaurs
Authors: Taylor Michael P.
Published: December 2014

Attempts to reconstruct the neutral neck posture of sauropod dinosaurs, or indeed any tetrapod, are doomed to failure when based only on the geometry of the bony cervical vertebrae. The thickness of the articular cartilage between the centra of adjacent vertebrae affects posture. It extends (raises) the neck by an amount roughly proportional to the thickness of the cartilage. It is possible to quantify the angle of extension at an intervertebral joint: it is roughly equal, in radians, to the cartilage thickness divided by the height of the zygapophyseal facets over the centre of rotation. Applying this formula to published measurements of well-known sauropod specimens suggests that if the thickness of cartilage were equal to 4.5%, 10% or 18% of centrum length, the neutral pose of theApatosaurus louisaeholotype CM 3018 would be extended by an average of 5.5, 11.8 or 21.2 degrees, respectively, at each intervertebral joint. For theDiplodocus carnegiiholotype CM 84, the corresponding angles of additional extension are even greater: 8.4, 18.6 or 33.3 degrees. The cartilaginous neutral postures (CNPs) calculated for 10% cartilage—the most reasonable estimate—appear outlandish. But it must be remembered that these would not have been the habitual life postures, because tetrapods habitually extend the base of their neck and flex the anterior part, yielding the distinctive S-curve most easily seen in birds.
Assertive Community Treatment (ACT) in a Rural Canadian Community: Client Characteristics, Client Satisfaction, and Service Effectiveness
Authors: Pope Leslie M. , Harris Gregory E.
Published: December 2014

This study describes an assertive community treatment (ACT) model in a rural Canadian location and examines characteristics of ACT service users, their degree of satisfaction with ACT, and whether their engagement with ACT resulted in reduced reliance on acute psychiatric services and hospital emergency room use. Chart audits were used to collect demographic and clinical participant data, including days of psychiatric admission and emergency room (ER) visits. Twenty-nine ACT clients agreed to participate. The majority of participants (82.8%) were male and had been diagnosed with schizophrenia or a schizoaffective disorder (65.5%). There was a high rate of concurrent substance abuse (75.9%). The average number of readmission days was reduced from 14 to 0 (p < 0.05) following engagement with ACT, and the average number of visits to ER s was reduced from 3 to 1 (p < 0.05). Participants reported overall high satisfaction with ACT services. Study implications for policy and practice are discussed along with future research recommendations.
Impact of pharmacists in mental health over the past decade
Authors: Thomas Jennifer E. , Caballero Joshua
Published: December 2014

Purpose: As healthcare moves towards an interdisciplinary approach to improve clinical outcomes, it has become increasingly important for health care providers to collaboratively work together. Pharmacists have been working with psychiatrists for several decades to improve patient outcomes. However, their utility in psychiatry has not been recently elucidated. The purpose of this article is to describe and evaluate the impact of pharmacists in psychiatric settings over the past ten years.

Methods: A literature search was conducted using PubMed and CINAHL Plus with Full Text. Studies published between 2002 and 2011 were included. Additional studies were identified through references contained within the studies. Case reports and case series were excluded.

Results: Seventeen studies met the inclusion criteria: 15 studies in outpatient settings, two in inpatient settings. Outcomes measured included: patient symptoms, economic outcomes, medication adherence, and patient satisfaction. The majority of studies found improvements (e.g., resolution of symptoms, cost savings). However, controlled trials found no significant difference in clinical improvement from pharmacists' interventions.

Conclusion: Although the majority of studies suggest pharmacists provide positive outcomes, the trials vary widely in quality and measured outcomes. Additional controlled trials with more standardized methods are recommended to support the role of pharmacists in psychiatric settings.
Dosing of valproate in an elderly population with dementia: Evaluation of discontinuations and dose reductions
Authors: Leung Jonathan G. , Mullen Sandra
Published: December 2014

It is estimated that more than half of elderly patients with dementia will develop some degree of behavioral and psychological symptoms of dementia (BPSD). BPSD is associated with significant morbidity, rapid functional decline, and psychiatric hospitalization, and there are currently no medications approved by the Food and Drug Administration (FDA) for its treatment. One treatment option that has been evaluated is the antiepileptic drug valproate. This retrospective medical record review evaluated the tolerability of valproate in elderly patients with dementia. A total of 62 patients met inclusion criteria for this review, which sought to determine whether there was an association either between the initial valproate dose and discontinuation or dose reduction (DCDR) or the maximum valproate dose achieved and DCDR. Both the total daily dose and total daily dose in mg/kg were assessed. For both the maximum daily dose (OR 1.0; 95% CI 0.99, 1.01) and maximum daily mg/kg dose (OR =1.15; 95% CI 0.92, 1.49) there was also no association with DCDR. There was no associated risk of DCDR when evaluating initial daily doses (OR: 1.0; 95% CI: 0.99 – 1.01). However, an association between DCDR and initial daily mg/kg dose was found (OR: 1.92; 95% CI: 1.11–4.02). For both the initial dose and initial mg/kg dose model, African Americans were associated with the need for DCDR (OR 20.75; 95% CI: 1.77–660). Results from this study suggest that higher initial starting doses based on weight may lead to higher rates of side effects necessitating a discontinuation or dose reduction; however, large trials are needed to confirm these results.
Antipsychotics in the treatment of neuropsychiatric symptoms in dementia
Authors: Thomas Christopher
Published: December 2014

The use of antipsychotics in the treatment of neuropsychiatric symptoms (NPS) in the geropsychiatric population is a controversial topic. Clinicians must be aware of current guidelines and best practices regarding antipsychotic use in long term care populations due to an associated risk of mortality. This article discusses and compares the guidelines regarding treatment of NPS published by the American College of Neuropsychopharmacology and the World Federation of Societies of Biological Psychiatry, and reviews the guidelines regarding gradual dose reduction in this population.
Lowering the seizure threshold associated with antidepressants, stimulants, antipsychotics, and others
Authors: Oh Caleb Y. , Bainbridge Jacquelyn
Published: December 2014

While seizures are commonly associated with epilepsy, seizures can also be provoked by many other causes, including trauma, stroke, fever, and medications. The seizure threshold refers to the patient's susceptibility to seizures. This article reviews common psychiatric medications which may alter the seizure threshold.
Recognizing and referring at-risk youth
Authors: Dopheide Julie A.
Published: December 2014

Nearly 20% of children and adolescents in the US have at least one mental health condition yet less than half of these youth are engaged in treatment. Violent acts such as school shootings, suicide and even bullying have been attributed in part to inadequate mental health awareness, screening and follow-up care in youth. Children and adolescents with persistent behavioral problems, low academic functioning and high rates of psychosocial adversity are ideal candidates for mental health screening in schools and the community. School-based screening offers easier access and less stigma while community care offers the opportunity for more specialized psychiatric evaluation and treatment. There are simple validated screening tools for the most common mental health problems in youth such as anxiety, depression, substance abuse, autistic spectrum disorder, attention-deficit hyperactivity disorder and suicidality. This paper provides an overview of the prevalence of psychiatric disorders in children and adolescents and recommends screening tools to facilitate recognition and referral for additional evaluation and therapeutic intervention.
Favorable pregnancy outcomes following continual intramuscular lorazepam use in late pregnancy
Authors: Moeller Karen E.
Published: December 2014

Use of benzodiazepines during pregnancy is controversial due to conflicting studies in the literature. Furthermore, few published reports on continual use of parenteral benzodiazepines during the third trimester of pregnancy have been published. This case report evaluates the use of high-dose intramuscular lorazepam in a pregnant patient during her last three weeks of gestation.
Differentiating serotonin syndrome and neuroleptic malignant syndrome
Authors: Kateon Hayley
Published: December 2014

Serotonin syndrome (SS) and neuroleptic malignant syndrome (NMS) are two rare, but serious adverse reactions associated with psychotropic medications. While the disorders may share certain features, there are differences in how they are managed and treated. This article reviews the risk factors, clinical presentation, and treatment of SS and NMS.
Adderall XR® and Vyvanse™
Authors: Allen Shari N.
Published: December 2014

Adderall XR® (MAS XR) and Vyvanse™ (LDX) are both schedule II amphetamine-based central nervous system stimulants indicated for the treatment of attention-deficit/hyperactivity disorder. Differences among the two primarily involve dosage form, pharmacokinetic profiles, and abuse potential. MAS XR and LDX are both long-acting stimulants with an approximate duration of action of 10 hours. The long-acting property of LDX is secondary to its prodrug formulation, whereas MAS XR utilizes bead filled capsules that mimic twice daily dosing upon administration. MAS XR is a substrate of CYP 2D6 while LDX does not utilize the cytochrome P450 enzymes for metabolism. There are few efficacy studies that directly compare LDX and MAS XR. There are no head to head abuse liability studies for MAS XR and LDX; however, the prodrug formulation of LDX is proposed to have lower abuse potential.
Buprenorphine for opioid dependence: Are there really differences between the formulations?
Authors: Graham Rebecca L.
Published: December 2014

Buprenorphine and buprenorphine/naloxone sublingual tablets were approved by the FDA in 2002. In 2010, the buprenorphine/naloxone sublingual film was approved to address concerns of diversion, time for tablet dissolution, and unintentional exposure in children with the tablet. This article will compare the buprenorphine sublingual formulations in terms of pharmacokinetics, safety, diversion and misuse, cost, and patient preference. It will explore current data suggesting advantages or disadvantages of the various formulations since conclusive data are minimally available.
Role in therapy of melatonin for the treatment of insomnia in children and adults
Authors: McGrane Ian R. , Corman Shelby L.
Published: December 2014

Melatonin is an endogenous indolamine produced by the pineal gland which may have a role in the biological regulation of circadian rhythms, sleep, and mood. Melatonin receptor activation in the hypothalamus likely regulates circadian rhythms. In the United States, melatonin is marketed as a dietary supplement. Clinical trials in children and adults have shown modest clinical benefit in the treatment of insomnia. Adverse events reported in patients receiving melatonin were not significantly different in type or occurrence from those reported in patients receiving placebo. Considering the potential for benefit, lack of significant adverse events, and lack of abuse potential, melatonin may be considered a valid therapeutic option for improving outcomes in certain pediatric and adult patients with insomnia.
Management of elevated blood cholesterol in the psychiatric patient: What's new in the guidelines?
Authors: Sebaaly Jamie
Published: December 2014

Compared with the general adult population, patients with schizophrenia and bipolar disorder have a 1.5 to 2.8 fold increase in mortality rates. This increase in mortality is multifactorial, including both natural causes and suicide. Additionally, antipsychotic medications have been associated with several adverse effects, including weight gain, hyperlipidemia, and the onset of diabetes. These adverse effects can place patients at risk for metabolic syndrome and atherosclerotic cardiovascular disease (ASCVD). Regular monitoring and treatment of risk factors for ASCVD, including hyperlipidemia, should be provided in clinical practice. The American College of Cardiology and the American Heart Association recently published updated recommendations for the management of cholesterol to reduce ASCVD. These national guidelines, based on a large body of clinical trials, describe 4 specific patient populations at high risk for ASCVD that should be considered candidates for therapeutic lifestyle changes and pharmacologic treatment. Statin therapy should be considered a first-line treatment option for these patients due to a favorable benefit versus risk profile. Of note, the new guidelines do not recommend a specific LDL target for patients. Instead, either a moderate or high-intensity statin should be recommended based on the patients' comorbidities. Health care providers can have a significant impact on the cardiovascular health of psychiatric patients by appropriately monitoring and treating hyperlipidemia.
Psychotropic-induced sexual dysfunction
Authors: Borg Erik R. , Chavez Benjamin
Published: December 2014

Psychotropic-induced sexual dysfunction is a common and bothersome side effect of psychotropic medications. The majority of information available on the subject primarily pertains to antidepressants, but antipsychotics can also cause significant sexual dysfunction. The mechanisms behind these adverse events are thought to be primarily due to antidepressants' effects on serotonin and to antipsychotics' anti-dopaminergic activity. Sexual dysfunction can have many causes, not just psychotropic medication, therefore this article aims to examine the etiology of sexual dysfunction, as well as discuss differential diagnoses. Treatment for psychotropic-induced sexual dysfunction will be discussed, with more data available for the treatment of antidepressant-induced sexual dysfunction. The paucity of data for antipsychotic-induced sexual dysfunction does make it more difficult to treat.
Review of antidepressants in the treatment of behavioral and psychiatric symptoms in dementia (BPSD)
Authors: Buterbaugh Whitney M. , Jamrose Todd , Lazzara Jonathon , Honaker Lindsay , Thomas Christopher J.
Published: December 2014

Behavioral disturbances are commonplace among patients with dementia. Management of these symptoms has proved difficult.1,2 Currently, there are no FDA approved pharmacologic treatments for the treatment of BPSD.3 Traditionally, atypical antipsychotics have been used to treat behavioral disturbances despite modest efficacy and undesirable adverse effects.34,5 Because of the increase in mortality, there is a continued push to reduce antipsychotic utilization in this population.9,10 Thus, many clinicians are using alternative agents such as antidepressants and mood stabilizers to help treat BPSD, while avoiding using antipsychotics. The goal of this review is to review, analyze, and discuss the current literature available on the use of antidepressants to treat BPSD.