Search results for: emergence delirium

Authors: Jenny Ringblom, Marie Proczkowska, Laura Korhonen, Ingrid Wåhlin

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Background: Emergence delirium is a well-known behaviour of perceptual disturbances that may occur after general anaesthesia in children. Children with emergence delirium are often confused; they cry, are involuntarily physically active and are almost impossible to console. The prevalence varies considerably between about 13% and 53%. Research has mainly focused on how different medication accents affect the incidence of emergence delirium, but less is known about parents’ experiences of emergence delirium during the recovery process. Aim: The aim of this study was to describe parents’ experiences and reflections during their child's emergence delirium behaviour when recovering from anaesthesia. Method: The study has a qualitative design, and the data has been analyzed using thematic analysis. A total of 16 parents were interviewed at two county hospitals in Sweden. Results: When the parents reunited with their child at the recovering unit, they felt as if they were encountering an incomprehensible scenario. When watching their child demonstrating emergence delirium, they experienced fear and insecurity and had feelings of powerlessness and guilt. Information and previous experience turned out to offer relief and being seen by the healthcare staff when they, in their vulnerability, failed to reach or console their child gave hope and energy. Conclusion: Emergence delirium must be extensively considered in children undergoing general anaesthesia. Healthcare staff needs to be aware of the parental difficulties it may cause. There is also important to know what parents experience as relieving, such as receiving information and when staff members are being available, responsive and supportive during the wake-up period.

Keywords: emergence delirium, experiences, pediatrics, parents, postoperative care

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Authors: Paul M. H. J. Roekaerts

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In recent years, it became clear that much intensive care (ICU) survivors develop a post-intensive care syndrome (PICS) consisting of psychiatric, cognitive and physical problems for a prolonged period after their ICU stay. Physical inactivity and delirium during the ICU stay are the main determinants of the post-ICU PICS. This presentation will focus on delirium, its epidemiology, prevalence, effect on outcome, risk factors and the current standard of care for managing delirium. Because ICU delirium is a predictor of prolonged length-of-stay in the ICU and of death, the use of a delirium prevention bundle (DPB) becomes mandatory in every ICU. In this presentation, a DPB bundle will be discussed consisting of six components: pain, sedation, sleep, sensory and intellectual stimulation, early mobilization, and hydration. For every of the six components, what to do and what not to do will be discussed. The author will present his own institutional policy on pharmacological and non-pharmacological interventions in the management of delirium. The component ‘early mobilization’ will be discussed more in detail, as this component is extremely important in the prevention of delirium as well as in the prevention of the PICS. The author will conclude his presentation with the remaining areas of uncertainties/work and research to be done.

Keywords: delirium, delirium prevention bundle, early mobilisation in intensive care (ICU), post-intensive care syndrome (PICS)

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Authors: S. Öcal, A. Erakgün, E. Yüksel, M. N. Deniz, E. Erhan, A. Çertuğ

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Background: Emergence agitation (EA) is defined as a dissociated state of consciousness during the early post-anesthesia period in which the child is inconsolable, irritable, uncompromising or uncooperative, typically thrashing, crying, moaning, or incoherent, and not recognizing or identifying familiar and known objects or people. Some studies found preoperative parental anxiety to be a predictor of EA. Methods: Seventy-four children, between the ages of 3-12 undergoing adenoidectomy/tonsillectomy at Ege University Hospital, were studied. Anesthesia was induced and maintained using 2% sevoflurane in 50% oxygen and 50% air following a premedicative dose of 0.5mg/kg oral midazolam. After the children were taken into the operating theater, the mothers were given the State-Trait Anxiety Inventory (STAI) questionnaire. To evaluate EA, Post Anesthetic Emergence Delirium (PAED) score of the children were noted every 10min during the first 30min of the postoperative period. EA was defined with a highest PAED score of ≥ 10, and non-EA with a highest PAED score of ≤ 9. Results: In this study, the incidence of postoperative EA was 31% (34% under the age of 6 and 19% over). Mothers of children with EA were found not to be significantly more anxious on STAI compared to mothers of non-EA children. Conclusions: Contrary to some earlier studies, we were unable to find an association between preoperative parental anxiety and postoperative EA.

Keywords: parental anxiety, emergence agittion, Post Anesthetic Emergence Delirium, anesthesia

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Authors: Rupesh K. Chaudhary, Narinder P. Jain, Rajesh Mahajan, Rajat Manchanda

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Introduction: Delirium is a complex, multifactorial neuropsychiatric syndrome comprising a broad range of cognitive and neurobehavioral symptoms. In critically ill patients, it may develop secondary to multiple predisposing factors. Although it can be transient and irreversible but if left untreated may lead to long term cognitive dysfunction. Early identification and assessment of risk factors usually help in appropriate management of delirium which in turn leads to decreased hospital stay, cost of therapy and mortality. Aim and Objective: Aim of the present study was to estimate the incidence of delirium using a validated scale in medical ICU patients and to determine the associated risk factors and outcomes. Material and Method: A prospective study in an 18-bed medical-intensive care unit (ICU) was undertaken. A total of 357 consecutive patients admitted to ICU for more than 24 hours were assessed. These patients were screened with the help of Confusion Assessment Method for Intensive Care Unit -CAM-ICU, Richmond Agitation and Sedation Scale, Screening Checklist for delirium and APACHE II. Appropiate statistical analysis was done to evaluate the risk factors influencing mortality in delirium. Results: Delirium occurred in 54.6% of 194 patients. Risk of delirium was independently associated with a history of hypertension, diabetes but not with severity of illness APACHE II score. Delirium was linked to longer ICU stay 13.08 ± 9.6 ver 7.07 ± 4.98 days, higher ICU mortality (35.8% % vs. 17.0%). Conclusion: Our study concluded that delirium poses a great risk factor in the outcome of the patient and carries high mortality, so a timely intervention helps in addressing these issues.

Keywords: delirium, risk factors, outcome, intervention

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Authors: Niyada Naksuk, Thoetchai Peeraphatdit, Vitaly Herasevich, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham

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Introduction: Little is known about the safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. Methods: Pre-study Confusion Assessment Method-Intensive Care Unit (CAM–ICU) criteria were implemented in screening consecutive patients admitted to Mayo Clinic, Rochester, the USA from 2004 through 2013. Death status was prospectively ascertained. Results: Of 11,079 study patients, the incidence of delirium was 8.3% (n=925). Delirium was associated with an increased risk of in-hospital mortality (adjusted OR 1.49; 95% CI, 1.08-2.08; P=.02) and one-year mortality among patients who survived from CCU admission (adjusted HR 1.46; 95% CI, 1.12-1.87; P=.005). A total of 792 doses of haloperidol (5 IQR [3-10] mg/day) or quetiapine (25 IQR [13-50] mg/day) were given to 244 patients with delirium. The clinical characteristics of patients with delirium who did and did not receive antipsychotic therapy were not different (baseline corrected QT [QTc] interval 460±61 ms vs. 457±58 ms, respectively; P = 0.57). In comparison to baseline, mean QTc intervals after the first and third doses of the antipsychotics were not significantly prolonged in haloperidol (448±56, 458±57, and 450±50 ms, respectively) or quetiapine groups (459±54, 467±68, and 462±46 ms, respectively) (P > 0.05 for all). Additionally, in-hospital mortality (adjusted OR 0.67; 95% CI, 0.42-1.04; P=.07), ventricular arrhythmia (adjusted OR 0.87; 95% CI, 0.17-3.62; P=.85) and one-year mortality among the hospital survivors (adjusted HR 0.86; 95% CI 0.62-1.17; P = 0.34) were not different in patients with delirium irrespective of whether or not they received antipsychotics. Conclusions: In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.

Keywords: arrhythmias, haloperidol, mortality, qtc interval, quetiapine

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Authors: Shammael Selorfia

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The Quality improvement project aimed to improve junior doctors and nurses’ knowledge and confidence in diagnosing and managing delirium on inpatient surgical wards in a tertiary hospital. The study aimed to develop a standardised assessment and management checklist for all staff working with patients who were presenting with signs of delirium. The aim of the study was to increase confidence of staff at dealing with delirium and improve the quality of referrals that were being sent to the Mental Health Liaison team over a 6-month period. A significant proportion of time was being spent by the Mental Health Liaison triage nurses on referrals for delirium. Data showed 28% of all delirium referrals from surgical teams were being closed at triage reflecting a poor standard of quality of those referrals. A qualitative survey of junior doctors in 6 surgical specialties in a UK tertiary hospital was conducted. These specialties include general surgery, vascular, plastic, urology, neurosurgery, and orthopaedics. The standardised checklist was distributed to all surgical wards. A comparison was made between the Mental health team caseload of delirium before intervention was compared and after. A Qualitative survey at end of 3-month cycle and compare overall caseload on Mental Health Liaison team to pre-QIP data with aim to improve quality of referrals and reduce workload on Mental Health Liaison team. At the end of the project cycle, we demonstrated an improvement in the quality of referrals with a decrease in the percentage of referrals being closed at triage by 8%. Our surveys also indicated an increase in the knowledge of official trust delirium guidelines and confidence at managing the patients. This project highlights that a new approach to delirium using multi-component interventions is needed, where the diagnosis of delirium is shared amongst medical and nursing staff, and everyone plays role in management. The key is improving awareness of delirium and encouraging the use of recognized diagnostic tools and official guidelines. Recommendations were made to the trust on how to implement a long-lasting change.

Keywords: delirium, surgery, quality, improvement

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Authors: Yi Shan Cheng, Ya Hui Yeh, Hsiao Wen Hsu

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Delirium is an acute state of confusion, which is mainly the result of the interaction of many factors, including: age>65 years, comorbidity, cognitive function and visual/auditory impairment, dehydration, pain, sleep disorder, pipeline retention, general anesthesia and major surgery… etc. Researches show the prevalence of delirium in hospitalized elderly patients over 50%. If it doesn't improve in time, may cause cognitive decline or impairment, not only prolong the length of hospital stay but also increase mortality. Some studies have shown that multiple nonpharmacological interventions are the most effective and common strategies, which are reorientation, early mobility, promoting sleep and nutritional support (including water intake), could improve or prevent delirium in the hospitalized elderly. In Taiwan, only one research to compare the delirium incidence of the older patients who have received orthopedic surgery between multi-nonpharmacological interventions and general routine care. Therefore, the purpose of this study is to address the prevention or improvement of delirium incidence density in medical hospitalized elderly, provide clinical nurses as a reference for clinical implementation, and develop follow-up related research. This study is a quasi-experimental design using purposive sampling. Samples are from two wards: the geriatric ward and the general medicine ward at a medical center in central Taiwan. The sample size estimated at least 100, and then the data will be collected through a self-administered structured questionnaire, including: demographic and professional evaluation items. Case recruiting from 5/13/2023. The research results will be analyzed by SPSS for Windows 22.0 software, including descriptive statistics and inferential statistics: logistic regression、Generalized Estimating Equation(GEE)、multivariate analysis of variance(MANOVA).

Keywords: multiple nonpharmacological interventions, hospitalized elderly, delirium incidence, delirium

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Authors: Pei Yi Lin

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Objective: The objective of this study is to use machine learning methods to build an early prediction classifier model for acute delirium to improve the quality of medical care for intensive care patients. Background: Delirium is a common acute and sudden disturbance of consciousness in critically ill patients. After the occurrence, it is easy to prolong the length of hospital stay and increase medical costs and mortality. In 2021, the incidence of delirium in the intensive care unit of internal medicine was as high as 59.78%, which indirectly prolonged the average length of hospital stay by 8.28 days, and the mortality rate is about 2.22% in the past three years. Therefore, it is expected to build a delirium prediction classifier through big data analysis and machine learning methods to detect delirium early. Method: This study is a retrospective study, using the artificial intelligence big data database to extract the characteristic factors related to delirium in intensive care unit patients and let the machine learn. The study included patients aged over 20 years old who were admitted to the intensive care unit between May 1, 2022, and December 31, 2022, excluding GCS assessment <4 points, admission to ICU for less than 24 hours, and CAM-ICU evaluation. The CAMICU delirium assessment results every 8 hours within 30 days of hospitalization are regarded as an event, and the cumulative data from ICU admission to the prediction time point are extracted to predict the possibility of delirium occurring in the next 8 hours, and collect a total of 63,754 research case data, extract 12 feature selections to train the model, including age, sex, average ICU stay hours, visual and auditory abnormalities, RASS assessment score, APACHE-II Score score, number of invasive catheters indwelling, restraint and sedative and hypnotic drugs. Through feature data cleaning, processing and KNN interpolation method supplementation, a total of 54595 research case events were extracted to provide machine learning model analysis, using the research events from May 01 to November 30, 2022, as the model training data, 80% of which is the training set for model training, and 20% for the internal verification of the verification set, and then from December 01 to December 2022 The CU research event on the 31st is an external verification set data, and finally the model inference and performance evaluation are performed, and then the model has trained again by adjusting the model parameters. Results: In this study, XG Boost, Random Forest, Logistic Regression, and Decision Tree were used to analyze and compare four machine learning models. The average accuracy rate of internal verification was highest in Random Forest (AUC=0.86), and the average accuracy rate of external verification was in Random Forest and XG Boost was the highest, AUC was 0.86, and the average accuracy of cross-validation was the highest in Random Forest (ACC=0.77). Conclusion: Clinically, medical staff usually conduct CAM-ICU assessments at the bedside of critically ill patients in clinical practice, but there is a lack of machine learning classification methods to assist ICU patients in real-time assessment, resulting in the inability to provide more objective and continuous monitoring data to assist Clinical staff can more accurately identify and predict the occurrence of delirium in patients. It is hoped that the development and construction of predictive models through machine learning can predict delirium early and immediately, make clinical decisions at the best time, and cooperate with PADIS delirium care measures to provide individualized non-drug interventional care measures to maintain patient safety, and then Improve the quality of care.

Keywords: critically ill patients, machine learning methods, delirium prediction, classifier model

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Authors: Laurie Prange-Martin, Romeo Turcan, Norman Fraser

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The aim of this study is to identify the conditions required and describe the process of emergence for a new economic sector created from new or established businesses. A systematic literature review of English-language studies published from 1983 to 2016 was conducted using the following databases: ABI/INFORM Complete; Business Source Premiere; Google Scholar; Scopus; and Web of Science. The two main terms of business sector and emergence were used in the systematic literature search, along with another seventeen synonyms for each these main terms. From the search results, 65 publications met the requirements of an empirical study discussing and reporting the conditions of new sector emergence. A meta-analysis of the literature examined suggest that there are six favourable conditions and five key individuals or groups required for new sector emergence. In addition, the results from the meta-analysis showed that there are eighteen theories used in the literature to explain the phenomenon of new sector emergence, which can be grouped in three study disciplines. With such diversity in theoretical frameworks used in the 65 empirical studies, the authors of this paper propose the development of a new theory of sector emergence.

Keywords: economic geography, new sector emergence, economic diversification, regional economies

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Authors: V. R. Kakulte, K. N. Gaikwad

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The emergence pattern of different types of cercariae form three snail hosts Melania tuberculata, Lymnea auricularia Viviparous bengalensis has been studied in detail. In natural emerging method the snails (2 to 3 at a time) were kept in separate test tube. This was constant source of living cercariae naturally emerging from the snails. The sunlight and artificial light play an important positive role in stimulating the emergence of cercariae has been observed. The effect of light and dark on the emission pattern of cercariae has been studied.

Keywords: cercariae, snail host, emergence pattern, gastropoda

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Authors: Sukhee Park, Gaab Soo Kim

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Purpose: We aimed to evaluate the adequacy of second-generation laryngeal mask airway use during prolonged abdominal surgery in respect of ventilation, oxygenation, postoperative pulmonary complications (PPC), and postoperative non-pulmonary complications on living donor kidney transplant (LDKT) surgery. Methods: In total, 257 recipients who underwent LDKT using either laryngeal mask airway-ProSeal (LMA-P) or endotracheal tube (ETT) were retrospectively analyzed. Arterial partial pressure of carbon dioxide (PaCO2 and ratio of arterial partial pressure of oxygen to fractional inspired oxygen (PFR) during surgery were compared between two groups. In addition, PPC including pulmonary aspiration and postoperative non-pulmonary complications including nausea, vomiting, hoarseness, vocal cord palsy, delirium, and atrial fibrillation were also compared. Results: PaCO2 and PFR during surgery were not significantly different between the two groups. PPC was also not significantly different between the two groups. Interestingly, the incidence of delirium was significantly lower in the LMA-P group than the ETT group (3.0% vs. 10.3%, P = 0.029). Conclusions: During prolonged abdominal surgery such as LDKT, second-generation laryngeal mask airway offers adequate ventilation and oxygenation and can be considered a suitable alternative to ETT.

Keywords: laryngeal mask airway, prolonged abdominal surgery, kidney transplantation, postoperative pulmonary complication

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Authors: Yan Cheng, Yijun Shao, James Rudolph, Charlene R. Weir, Beth Sahlmann, Qing Zeng-Treitler

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Supervised predictive models require labeled data for training purposes. Complete and accurate labeled data, i.e., a ‘gold standard’, is not always available, and imperfectly labeled data may need to serve as an alternative. An important question is if the accuracy of the labeled data creates a performance ceiling for the trained model. In this study, we trained several models to recognize the presence of delirium in clinical documents using data with annotations that are not completely accurate (i.e., weakly-supervised learning). In the external evaluation, the support vector machine model with a linear kernel performed best, achieving an area under the curve of 89.3% and accuracy of 88%, surpassing the 80% accuracy of the training sample. We then generated a set of simulated data and carried out a series of experiments which demonstrated that models trained on imperfect data can (but do not always) outperform the accuracy of the training data, e.g., the area under the curve for some models is higher than 80% when trained on the data with an error rate of 40%. Our experiments also showed that the error resistance of linear modeling is associated with larger sample size, error type, and linearity of the data (all p-values < 0.001). In conclusion, this study sheds light on the usefulness of imperfect data in clinical research via weakly-supervised learning.

Keywords: weakly-supervised learning, support vector machine, prediction, delirium, simulation

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Authors: Halilu Babaji, Adamu Buba

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Illicit arms and the emergence of armed groups have witnessed unprecedented situations of political uncertainties in Nigeria, and the twenty-first century globalisation has established the process that has benefited a good number of militia groups and thereby boosting both illicit arms movement and the thriving of terrorist groups, which are largely responsible for the longstanding threat to the national security and stability of the country. This has unleashed unforeseen consequences on the entire Sub-region, following an inflow of weapons and armed fighter which are motivated by weak governance, insecurity and poverty. The social, economic and political environments make it a fertile breeding ground for the penetration and development of terrorist groups in Sub-Saharan Africa.

Keywords: arms, emergence, insecurity, groups

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Authors: Nurvadi Albekov

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Communicative situation is a basis, which designates potential models of ‘constructed forms’, a motivated basis of a text, for a text can be assumed as a product of the communicative situation. It is within the field of emergence the models of text, that can be potentially prognosticated in a certain communicative situation, are designated. Every text can be assumed as conceptual system structured on the base of certain communicative situation. However in the process of ‘structuring’ of a certain model of ‘conceptual system’ consciousness of a recipient is able act only within the border of the field of emergence for going out of this border indicates misunderstanding of the communicative situation. On the base of communicative situation we can witness the increment of meaning where the synergizing of the informative model of communication, formed by using of the invariant units of a language system, is a result of verbalization of the communicative situation. The potential of the models of a text, prognosticated within the field of emergence, also depends on the communicative situation. The conception ‘the field of emergence’ is interpreted as a unit of the language system, having poly-directed universal structure, implying the presence of the core, the center and the periphery, including different levels of means of a functioning system of language, both in terms of linguistic resources, and in terms of extra linguistic factors interaction of which results increment of a text. The conception ‘field of emergence’ is considered as the most promising in the analysis of texts: oral, written, printed and electronic. As a unit of the language system field of emergence has several properties that predict its use during the study of a text in different levels. This work is an attempt analysis of entropy in a text in the aspect of lingua-cultural code, prognosticated within the model of the field of emergence. The article describes the problem of entropy in the field of emergence, caused by influence of the extra-linguistic factors. The increasing of entropy is caused not only by the fact of intrusion of the language resources but by influence of the alien culture in a whole, and by appearance of non-typical for this very culture symbols in the field of emergence. The borrowing of alien lingua-cultural symbols into the lingua-culture of the author is a reason of increasing the entropy when constructing a text both in meaning and in structuring level. It is nothing but artificial formatting of lexical units that violate stylistic unity of a phrase. It is marked that one of the important characteristics descending the entropy in the field of emergence is a typical similarity of lexical and semantic resources of the different lingua-cultures in aspects of extra linguistic factors.

Keywords: communicative situation, field of emergence, lingua-culture, entropy

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Authors: Shailendra Kumar, Lokesh Kashyap, Puneet Khanna, Nishant Patel, Rakesh Kumar, Arshad Ayub, Kelika Prakash, Yudhyavir Singh, Krithikabrindha V.

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Introduction: Spinal anesthesia is considered a standard anesthesia technique for caesarean delivery. The incidence of spinal hypotension during caesarean delivery is 70 -80%. Spinal hypotension may cause cerebral hypoperfusion in the mother, but physiologically cerebral autoregulatory mechanisms accordingly prevent cerebral hypoxia. Cerebral blood flow remains constant in the 50-150 mmHg of Cerebral Perfusion Pressure (CPP) range. Near-infrared spectroscopy (NIRS) is a non-invasive technology that is used to detect Cerebral Desaturation Events (CDEs) immediately compared to other conventional intraoperative monitoring techniques. Objective: The primary aim of the study is to correlate the change in cerebral oxygen saturation using NIRS with respect to a fall in mean blood pressure after spinal anaesthesia and to find out the effects of spinal hypotension on neonatal APGAR score, neonatal acid-base variations, and presence of Postoperative Delirium (POD). Methodology: NIRS sensors were attached to the forehead of all the patients, and their baseline readings of cerebral oxygenation on the right and left frontal regions and mean blood pressure were noted. Subarachnoid block was given with hyperbaric 0.5% bupivacaine plus fentanyl, the dose being determined by the individual anaesthesiologist. Co-loading of IV crystalloid solutions was given to the patient. Blood pressure reading and cerebral saturation were recorded every 1 minute till 30min. Hypotension was a fall in MAP less than 20% of the baseline values. Patients going for hypotension were treated with an IV Bolus of phenylephrine/ephedrine. Umbilical cord blood samples were taken for blood gas analysis, and neonatal APGAR was noted by a neonatologist. Study design: A prospective observational study conducted in a population of Thirty ASA 2 and 3 parturients scheduled for lower segment caesarean section (LSCS). Results: Mean fall in regional cerebral saturation is 28.48 ± 14.7% with respect to the mean fall in blood pressure 38.92 ± 8.44 mm Hg. The correlation coefficient between fall in saturation and fall in mean blood pressure is 0.057, and p-value {0.7} after subarachnoid block. A fall in regional cerebral saturation occurred 2±1 min before a fall in mean blood pressure. Twenty-nine out of thirty patients required vasopressors during hypotension. The first dose of vasopressor requirement is needed at 6.02±2 min after the block. The mean APGAR score was 7.86 and 9.74 at 1 and 5 min of birth, respectively, and the mean umbilical arterial pH of 7.3±0.1. According to DRS-98 (Delirium Rating Scale), the mean delirium rating score on postoperative day 1 and day 2 were 0.1 and 0.7, respectively. Discussion: There was a fall in regional cerebral oxygen saturation, which started before with respect to a significant fall in mean blood pressure readings but was statistically not significant. Maximal fall in blood pressure requiring vasopressors occurs within 10 min of SAB. Neonatal APGAR scores and acid-base variations were in the normal range with maternal hypotension, and there was no incidence of postoperative delirium in patients with post-spinal hypotension.

Keywords: cerebral oxygenation, LSCS, NIRS, spinal hypotension

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Authors: S. Ahmet Bagci, Hayati Akman

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This study was conducted at the research laboratory and greenhouse conditions to determine the effect on germination and emergency values of long-term stored seed (7 years) and non-stored seed (control) of nine durum wheat varieties. Three replicates of 20 seeds were germinated between double layered rolled germination papers in the Petri plates. Seeds were allowed to germinate at 20±1°C in the dark for 8 days. The seeds were counted on the 8th day as per ISTA rules and calculated in percent to determine germination capacity. Seedling emergency values were determined by testing 20 seeds placed into the sands with three replications of pots. Plants were counted on the 7th day and 12th day to determined seedling emergency rate and capacity, respectively. According to results, there are significant differences among the varieties in terms of germination capacity, seedling emergency rate and capacity of long-term stored and non-stored seeds. Germination capacity values declined from 100% to 93,3% of non-stored seeds whereas they were from 96,7% to 71,7% of long-term stored seeds. Percentage of seedling emergency capacity varied from 65,0% to 93,3% for non-stored seeds, however, the percentage of it was between 11,7 and 86,7% for long-term stored seeds. Results indicate that germination and emergence values responses to long-term stored condition varied significantly among durum wheat cultivars. Research results showed that the long-term-storage resulted in significant decrease with 13.5 % for germination, 36.4 % for emergence on the seventh day and 32.4 % for emergence on the twelfth day. Germination values ranged from 93.3 to 100.0 % for control and 71.7 to 96.7 % for storage. Emergence values in seventh day varied between 51.7 % and 90.0 % for control and 75.0 % and 10.0 % for storage, however values in twelfth day were between 93.3 % and 65.0 % for control and 86.7 % and 11.7 % for storage. According to research results, germination and emergence responses to long-term storage condition varied significantly among durum wheat cultivars.

Keywords: germination, emergence, long-term-storage, durum wheat

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Authors: Subhash Nerella, Ziyuan Guan, Azra Bihorac, Parisa Rashidi

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Intensive care units (ICUs) provide care to critically ill patients in severe and life-threatening conditions. However, patient monitoring in the ICU is limited by the time and resource constraints imposed on healthcare providers. Many critical care indices such as mobility are still manually assessed, which can be subjective, prone to human errors, and lack granularity. Other important aspects, such as environmental factors, are not monitored at all. For example, critically ill patients often experience circadian disruptions due to the absence of effective environmental “timekeepers” such as the light/dark cycle and the systemic effect of acute illness on chronobiologic markers. Although the occurrence of delirium is associated with circadian disruption risk factors, these factors are not routinely monitored in the ICU. Hence, there is a critical unmet need to develop systems for precise and real-time assessment through novel enabling technologies. We have developed the mobility and circadian disruption quantification system (Mobi-DiQ) by augmenting biomarker and clinical data with pervasive sensing data to generate mobility and circadian cues related to mobility, nightly disruptions, and light and noise exposure. We hypothesize that Mobi-DiQ can provide accurate mobility and circadian cues that correlate with bedside clinical mobility assessments and circadian biomarkers, ultimately important for delirium risk assessment and prevention. The collected multimodal dataset consists of depth images, Electromyography (EMG) data, patient extremity movement captured by accelerometers, ambient light levels, Sound Pressure Level (SPL), and indoor air quality measured by volatile organic compounds, and the equivalent CO₂ concentration. For delirium risk assessment, the system recognizes mobility cues (axial body movement features and body key points) and circadian cues, including nightly disruptions, ambient SPL, and light intensity, as well as other environmental factors such as indoor air quality. The Mobi-DiQ system consists of three major components: the pervasive sensing system, a data storage and analysis server, and a data annotation system. For data collection, six local pervasive sensing systems were deployed, including a local computer and sensors. A video recording tool with graphical user interface (GUI) developed in python was used to capture depth image frames for analyzing patient mobility. All sensor data is encrypted, then automatically uploaded to the Mobi-DiQ server through a secured VPN connection. Several data pipelines are developed to automate the data transfer, curation, and data preparation for annotation and model training. The data curation and post-processing are performed on the server. A custom secure annotation tool with GUI was developed to annotate depth activity data. The annotation tool is linked to the MongoDB database to record the data annotation and to provide summarization. Docker containers are also utilized to manage services and pipelines running on the server in an isolated manner. The processed clinical data and annotations are used to train and develop real-time pervasive sensing systems to augment clinical decision-making and promote targeted interventions. In the future, we intend to evaluate our system as a clinical implementation trial, as well as to refine and validate it by using other data sources, including neurological data obtained through continuous electroencephalography (EEG).

Keywords: deep learning, delirium, healthcare, pervasive sensing

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Authors: Faezeh Zaefarian1, Sajedeh Golmohammadzadeh, Mohammad Rezvani

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Weed management decisions for weed species can be derived from knowledge of seed germination biology. Experiments were conducted in laboratory and greenhouse to determine the effects of light, temperature, salt and water stress, seed burial depth on seed germination and seedling emergence of Papaver rhoeas and P.dubium and to assay the response of these species to commonly available POST herbicides. Germination of the Papaver seeds was influenced by the tested temperatures (day/night temperatures of 20 and 25 °C) and light. The concentrations of sodium chloride, ranging from 0 to 80 mM, influence germination of seeds. The osmotic potential required for 50% inhibition of maximum germination of P. rhoeas was -0.27 MPa and for P. dubium species was 0.25 MPa. Seedling emergence was greatest for the seeds placed at 1 cm and emergence declined with increased burial depth in the soil. No seedlings emerged from a burial depth of 6 cm. The herbicide 2,4-D at 400 g ai ha-1 provided excellent control of both species when applied at the four-leaf and six-leaf stages. However, at the six-leaf stage, percent control was reduced. The information gained from this study could contribute to developing components of integrated weed management strategies for Papaver species.

Keywords: germination, papaver species, planting depth, POST herbicides

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Authors: Uditi Dhakad, Baldev Ram, Chaman K. Jadon, R. K. Yadav, D. L. Yadav, Pratap Singh, Shalini Meena

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A field experiment was conducted during Kharif 2021 at Agricultural Research Station, Kota, to evaluate the effect of different post-emergence herbicides applied to soybean [Glycine max (L.) Merrill] on soil enzymes activity viz. dehydrogenase, phosphatase, and urease. The soil of the experimental site was clay loam (vertisols) in texture and slightly alkaline in reaction with 7.7 pH. The soil was low in organic carbon (0.49%), medium in available nitrogen (210 kg/ha), phosphorus (23.5 P2O5 kg/ha), and high in potassium (400 K2O kg/ha) status. The results elucidated that no significant adverse effect on soil dehydrogenase, urease, and phosphatase activity was determined with the application of post-emergence herbicides over the untreated control. Two hands weeding at 20 and 40 DAS registered maximum dehydrogenase enzyme activity (0.329 μgTPF/g soil/d) closely followed by herbicides mixtures and sole herbicide while pre-emergence application of pendimethalin + imazethapyr 960 g a.i./ha and pendimethalin 1.0 kg a.i./ha significantly reduced dehydrogenase enzyme activity compared to control. Urease enzyme activity was not much affected under different weed control treatments and weedy checks. The treatments were found statistically non-significant, and values ranged between 1.16-1.25 μgNH4N/g soil/d. Phosphatase enzyme activity was also not influenced significantly due to various weed control treatments. Though maximum phosphatase enzyme activity (30.17 μgpnp/g soil/hr) was observed under two-hand weeding, followed by fomesafen + fluazifop-p-butyl 220 g a.i./ha. Herbicidal weed control measures did not influence the total bacteria, fungi, and actinomycetes population.

Keywords: dehydrogenase, phosphatase, post-emergence, soil enzymes, urease.

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Authors: Priscilla Omonedo, Paul Bocij

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Since the emergence of e-commerce, the world of business has witnessed a radical shift in the way business activities are conducted. However, the emergence of m-Commerce has further pushed the boundaries of virtual commerce revolution. As a result, there seems to be a growing blur in the distinction between e-Commerce and m-Commerce. In addition, existing definitions for both forms of commerce highlight characteristics (e.g. type of device and activity conducted) that may be applicable to both concepts. The aim of this paper is to identify the characteristics that help define and delineate between e- and m- Commerce. The paper concludes that characteristics of mobility, ubiquity, and immediacy provides a clearer and simpler template to distinguish between e-commerce and m-commerce.

Keywords: e-commerce, m-commerce, mobility, ubiquity

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Authors: Rahamdad Khan, Ijaz Ahmad Khan

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In modern agriculture the herbicides application are considered the most effective and fast in action against all types of weeds. But it’s a fact that the herbicide applicator cannot totally secure the crop plants from the possible herbicide injuries that further leads to several destructive changes in plant biochemistry. For the purpose pots studies were undertaken to test the tolerance order of chickpea against pre- emergence herbicides (Stomp 330 EC- Dual Gold 960 EC) and post- emergence herbicides (Topik 15 WP- Puma Super 75 EW- Isoproturon 500 EW) during 2012-13 and 2013-14. The experimental design was CRD with three replications. Plant height, number of branches plant-1, number of seeds plant-1, nodulation, seed protein contents and other growth related parameters in chickpea were examined during the investigations. The results indicate that all the enquire herbicides gave a significant variation to all recorded parameter of chick pea except nodule fresh and dray weight. Moreover the toxic effect of pre-emergence herbicide on chickpea was found higher as compared to post-emergence herbicides. Minimum chickpea plant height (50.50 cm), number of nodule plant-1 (17.83) and lowest seed protein (14.13 %) was recorded in Stomp 330 EC. Similarly the outmost seeds plant-1 (29.66) and number of nodule plant-1 (21) were found for Puma Super 75 EW. The results further showed that the highest seed protein content (21.75 and 21.15 %) was recorded for control/ untreated and Puma Super 75EW. Taking under concentration the possible negative impact of the herbicides the chemical application must be minimized up to certain extent at which the crop is mostly secure. However chemical weed control has many advantages so we should train our farmer regarding the proper use of agro chemical to minimize the loses in crops while using herbicides.

Keywords: chickpea, herbicides, protein, stomp 330 EC, weed

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Authors: Marcel Hechler

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Since passion is considered one of the most important motivating factors for entrepreneurship, we examined the influence of the availability of resources and information on the emergence of a harmonious passion for entrepreneurship (HPE). Drawing on self-determination theory and a cross-cultural sample of 1,085 entrepreneurs from seven developing countries, we argue that the availability of resources and information increases an entrepreneur's autonomy and, thus, promotes the emergence of HPE.

Keywords: harmonious passion, access to resources and information, developing and emerging countries, self-determination theory

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Authors: Nadiya Didyk

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This thesis deals with the unique history of the emergence of the Ukrainian feminist movement. Ukrainian feminism is still in its making, so the field is under-investigated in general. Nevertheless, the perspective of political economy and the enabling and constraining effects of capitalist dynamics are almost absent from the research on the emergence and the development of the feminist movement in Ukraine. This research was inspired by Hetland and Goodwin’s approach and an attempt to test their approach on the case of the Ukrainian feminist movement. Hetland and Goodwin claim that many scholars tend to neglect political economy from analysis of feminism as a new social movements, namely because such movement are not about class or materialist concerns, and thus have no discernible connection to capitalism. Both scholars, however, point out that there at least four ways in which capitalism has been of high importance for any social movement. Accordingly, the following issues are analysed in this paper: capitalism as the facilitator of the emergence and development of Ukrainian feminism; the influence of class balance in society on the formation of the Ukrainian feminist movement, and the ways in which class divisions within the movement shape its goals and strategies. This paper also focuses on the role of capitalist institutions and free wage labour expansion in shaping collective feminist identities and solidarities. Specific attention is paid to the representativeness of women in the highest echelons in business and politics under the capitalist systems. This study shows that there is a significant hole in the literature regarding the feminist movement in Ukraine and aims to motivate further detailed research.

Keywords: feminism, hetland, goodwin, new soical movements, political economy

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Authors: Muhammad Anjum Aqueel, Muhammad Jaffar Hussain, Abu Bakar Muhammad Raza

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Diaeretiella rapae (M’Intosh) attack most of the aphid species. However, it is specialized in feeding on crucifer aphid, Brevicoryne brassicae. Biological potential of parasitoid is its density-dependency due to sharing of limited resources in few cases. The present study was carried out to check the biotic potential of D. rapae at its different densities (1, 2, 4, 8 and 10 pairs) on fixed number of B. brassicae (100 in number) as a host. The present study was performed under laboratory conditions (25 ± 2 ºC temperature and 65-70 % R.H.). Different biological parameters for parasitoid (e.g. percent parasitism, adult emergence, adult longevity and per pair parasitism) were evaluated to check its biotic potential. The present findings showed that maximum parasitism (43.09 % ± 0.63) was observed in highest density (10 pairs) and minimum parasitism (16.59 % ± 1.28) in lowest density (1 pair) of the parasitoid. Maximum adult emergence (80.31 % ± 1.33) was observed in highest density (10 pairs) and minimum parasitism (45.99 % ± 1.27) in lowest density (1 pair) of the parasitoid. In the case of adult longevity, highest (8.2 days ± 0.38) and lowest (6 days ± 0.32) longevity were observed in lowest (1 pair) and highest (10 pairs) densities of parasitoids respectively. However, per pair parasitism rate decreased with the increase in parasitoid densities due to intra-specific competition, developed between the parasitoids for parasitism. The positive but close relationship was observed between percent parasitism and adult emergence. The increase in parasitoid densities increased the percent parasitism and adult emergence of the parasitoid. So, we conclude that an inter-specific competition negatively affected the efficacy of parasitoids and may reduce the fitness of the emerging parasitoid.

Keywords: Diaeretiella rapae, Parasitoid densities, Percent parasitism, adult emergence

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Authors: Sibusiso Mnyanda

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Storytelling through motion pictures is a valuable economy. South Africa was one of the first countries in the world to see and hear sound motion pictures With Lingards Waxworks in Durban first showing them in August 1895. This article celebrates and takes a microscopic look into the developments of this industry and its economy, highlighting these fundamentals: Skill levels and talent sets that were displayed in this emergence, the quality of the products that were produced by filmmakers and actors, the level of Administration and quality assurance of production houses and the general infrastructure and resources available to the industry at the time.

Keywords: film, Africa, production economy, history

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Authors: Jessica Morales Perdomo, Daniel Rodriguez Caicedo, Fernando Cantor Rincon

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Tuta absoluta known as the tomato leaf miner, is one of the main pests in tomato crops in South America and the main pest in many European countries. Apanteles gelechiidivoris is a parasitoid of third instar Tuta absoluta larvae. Our studies have demonstrated that this parasitoid can cause up to 80% mortality of T. absoluta larvae in the field. We investigated cold storage of A. gelechiidivoris pupae as a method of mass production of this parasitoid. This storage method does not interfere with biological characteristics of the parasitoid. In this study, we evaluated the effect of different temperatures (4, 8 and 12°C) and different time duration (7, 14, 21 or 28 days) of cold storage on biological parameters of A. gelechiidivoris pupae and adults. The biological parameters of the parasitoid evaluated were: adult emergence time, lifespan, parasitism percentage and sex ratio. We found that the adult emergence time was delayed when the parasitoid pupae were stored at 4°C and 8°C. The shortest adult emergence was recorded when pupae were stored for seven days. The lowest adult emergence was found for pupae stored at 4°C and decreased significantly as the days of storage increased. We found high percentages of adult emergence when pupae were stored at 8°C and 12°C for seven days. Adult lifespan decreased with increasing days of cold storage. Adults emerging from pupae stored at 8°C during seven and 14 days showed the longest lifespan (nine days). The lowest parasitism rate was recorded at 4°C at every time point. The highest percentage of parasitism (80%) was found at 8°C during seven days of storage. The treatments had no effect on adults the sex ratio. The results suggest that A. gelechiidivoris pupae can be stored for up to 14 days at 8°C without affecting the efficacy of the parasitoid in the field.

Keywords: biological control, cold storage, massive rearing, quality control

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Authors: Jong Yeop Kim, Sung Young Park, Dae Hee Kim, Han Bum Joe, Ji Young Yoo, Jong Bum Choi, Sook Young Lee

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Emergence agitation (EA) is commonly reported adverse events after sevoflurane anesthesia in pediatric patients. The efficacy of prophylactic remifentanil, one of mu opioid agonist, in preventing EA is controversial. This meta-analysis assessed the effectiveness of remifentanil to decrease the incidence of EA from sevoflurane anesthesia in children. We searched for randomized controlled trials comparing sevoflurane alone anesthesia with sevoflurane and remifentanil anesthesia to prevent EA in the Cochrane Library, Embase, Pubmed, and KoreaMed, and included 6 studies with 361 patients. The number of patients of reporting EA was summarized using risk ratio (RR) with 95% confidence interval (CI), with point estimates and 95CIs derived from a random effects Mantel-Haenszel method. Overall incidence of EA was about 41%. Compared with sevoflurane alone anesthesia, intravenous infusion of remifentanil with sevoflurane significantly reduced the incidence of EA (RR 0.53, 95% CI 0.39-0.73, P < 0.0001), (heterogeneity, I2 = 0, P = 0.42). This meta-analysis suggested that continuous infusion of remifentanil could be effective in decreasing the EA of about 47% after sevoflurane anesthesia. However, considering limitations of the included studies, more randomized controlled studies are required to verify our results.

Keywords: emergence agitation, meta-analysis, remifentanil, pediatrics

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Authors: Chia-Lin Tu

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Towards the end of the 20th century, a reductive picture has dominated in philosophy of science and philosophy of mind. Reductive physicalism claims that all entities and properties in this world are eventually able to be reduced to the physical level. It means that all phenomena in the world are able to be explained by laws of physics. However, quantum physics provides another picture. It says that the world is undergoing change and the energy of change is, in fact, the most important part to constitute world phenomena. Quantum physics provides us another point of view to reconsider the reality of the world. Throughout the history of philosophy of mind, reductive physicalism tries to reduce the conscious phenomena to physical particles as well, meaning that the reality of consciousness is composed by physical particles. However, reductive physicalism is unable to explain conscious phenomena and mind-body causation. Conscious phenomena, e.g., qualia, is not composed by physical particles. The current popular theory for consciousness is emergentism. Emergentism is an ambiguous concept which has not had clear idea of how conscious phenomena are emerged by physical particles. In order to understand the emergence of conscious phenomena, it seems that quantum physics is an appropriate analogy. Quantum physics claims that physical particles and processes together construct the most fundamental field of world phenomena, and thus all natural processes, i.e., wave functions, have occurred within. The traditional space-time description of classical physics is overtaken by the wave-function story. If this methodology of quantum physics works well to explain world phenomena, then it is not necessary to describe the world by the idea of physical particles like classical physics did. Conscious phenomena are one kind of world phenomena. Scientists and philosophers have tried to explain the reality of them, but it has not come out any conclusion. Quantum physics tells us that the fundamental field of the natural world is processed metaphysics. The emergence of conscious phenomena is only possible within this process metaphysics and has clearly occurred. By the framework of quantum physics, we are able to take emergence more seriously, and thus we can account for such emergent phenomena as consciousness. By questioning the particle-mechanistic concept of the world, the new metaphysics offers an opportunity to reconsider the reality of conscious phenomena.

Keywords: quantum physics, reduction, emergence, qualia

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Authors: Ali M. Zaid, Muftah Mayouf, Yahya Said Farouj

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The effect of post emergence herbicides on soil micro-flora and nitrogen fixing bacteria was studied in pea field. Pea (Pisum sativum) was grown and treated with one or a mixture of two of several herbicides 2 weeks after sowing. Soil samples were collected 2 weeks after herbicides application. Average number of colony forming units per gram of soil of bacteria, actinomycetes and fungi were determined. Average number of nodules per plant was obtained at the end of the growing season. The results of the study showed MCPB, Bentazon, MCPB+Fluozifop-p-butyl, Bentazon+Fluozifop-p-butyl, Metribuzin, Flouzifop-p-butyl+Metribuzin, Cycloxydin, and Sethoxydin increased the population of soil fungi, with 4 to 10 times compared with the control. The herbicides used showed no significant effects on nitrogen fixing bacteria. The effects of herbicides on soil bacteria and actinomycetes were different. The study showed the use of herbicides could influence the biological balance of soil microflora, which has an important role in soil fertility and microbial ecosystem.

Keywords: herbicides, post emergence, nitrogen fixing bacteria, environmental systems

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Authors: Khalid Alshallash

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Small fragments of the roots of some Rumex species including R. obtusifolius and R. crispus have been found to regenerate readily, contributing to the severity of infestations by these very common, widespread and difficult to control perennial weeds of agricultural crops and grasslands. Their root fragments are usually created during routine agricultural practices. We found that fresh root fragments of both species containing 65-70 % of moisture, progressively lose their moisture content when desiccated under controlled growth room conditions matching summer weather of southeast England, with the greatest reduction occurring in the first 48 hours. Probability of shoot emergence and the time taken for emergence in glasshouse conditions were also reduced significantly by desiccation, with R. obtusifolius least affected up to 48-hour. However, the effects converged after 120 hours. In contrast, R. obtusifolius was significantly slower to emerge after up to 48 hours desiccation, again effects converging after longer periods, R. crispus entirely failed to emerge at 120 hours. The dry weight of emerged shoots was not significantly different between the species, until desiccated for 96 hours when R. obtusifolius was significantly reduced. At 120 hours, R. obtusifolius did not emerge. In outdoor trials, desiccation for 24 or 48 hours had less effect on emergence when planted at the soil surface or up to 10 cm of depth, compared to deeper plantings. In both species, emergence was significantly lower when desiccated fragments were planted at 15 or 20 cm. Time taken for emergence was not significantly different between the species until planted at 15 or 20 cm when R. obtusifolius was slower than R. crispus and reduced further by increasing desiccation. Similar variation in effects of increasing soil depth interacting with increasing desiccation was found in reductions in dry weight, the number of tillers and leaf area, with R obtusifolius generally but not exclusively better able to withstand more extreme trial conditions. Our findings suggest that infestations of these highly troublesome weeds may be partly controlled by appropriate agricultural practices, notably exposing cut fragments to drying environmental conditions followed by deep burial.

Keywords: regeneration, root fragment, rumex crispus, rumex obtusifolius

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