Search results for: human care

Authors: Rachel Goh, Alexander McNab, Brent Alsop, David O'Hare

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In a busy airport, the decision whether to take passengers aside and search their luggage for dangerous items can have important consequences. If an officer fails to search and stop a bag containing a dangerous object, a life-threatening incident might occur. But stopping a bag unnecessarily means that the officer might lose time searching the bag and face an angry passenger. Passengers’ bags, however, are often cluttered with personal belongings of varying shapes and sizes. It can be difficult to determine what is dangerous or not, especially if the decisions must be made quickly in cases of busy flight schedules. Additionally, the decision to search bags is often made with input from the surrounding officers on duty. This scenario raises several questions: 1) Past findings suggest that humans are more reliant on an automated aid when under time pressure in a visual search task, but does this translate to human-human reliance? 2) Are humans more likely to agree with another person if the person is assumed to be an expert or a novice in these ambiguous situations? In the present study, forty-one participants performed a simulated luggage-screening task. They were partnered with an advisor of two different statuses (expert vs. novice), but of equal accuracy (90% correct). Participants made two choices each trial: their first choice with no advisor input, and their second choice after advisor input. The second choice was made within either 2 seconds or 8 seconds; failure to do so resulted in a long time-out period. Under the 2-second time pressure, participants were more likely to disagree with their own first choice and agree with the expert advisor, regardless of whether the expert was right or wrong, but especially when the expert suggested that the bag was safe. The findings indicate a tendency for people to assume less responsibility for their decisions and defer to their partner, especially when a quick decision is required. This over-reliance on others’ opinions might have negative consequences in real life, particularly when relying on fallible human judgments. More awareness is needed regarding how a stressful environment may influence reliance on other’s opinions, and how better techniques are needed to make the best decisions under high stress and time pressure.

Keywords: advisors, decision-making, time pressure, trust

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Authors: Spencer Rutherford, Shadi Saleh

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War and conflict negatively impact all facets of a health system; services cease to function, resources become depleted, and any semblance of governance is lost. Following cessation of conflict, the rebuilding process includes a wide array of international and local actors. During this period, stakeholders must contend with various trade-offs, including balancing sustainable outcomes with immediate health needs, introducing health reform measures while also increasing local capacity, and reconciling external assistance with local legitimacy. Compounding these factors are additional challenges, including coordination amongst stakeholders, the re-occurrence of conflict, and ulterior motives from donors and governments, to name a few. Therefore, the present paper evaluated health system development in three post-conflict countries over a 12-year timeline. Specifically, health policies, health inputs (such infrastructure and human resources), and measures of governance, from the post-conflict periods of Afghanistan, Cambodia, and Mozambique, were assessed against health outputs and other measures. All post-conflict countries experienced similar challenges when rebuilding the health sector, including; division and competition between donors, NGOs, and local institutions; urban and rural health inequalities; and the re-occurrence of conflict. However, countries also employed unique and effective mechanisms for reconstructing their health systems, including; government engagement of the NGO and private sector; integration of competing factions into the same workforce; and collaborative planning for health policy. Based on these findings, best-practice development strategies were determined and compiled into a 12-year framework. Briefly, during the initial stage of the post-conflict period, primary stakeholders should work quickly to draft a national health strategy in collaboration with the government, and focus on managing and coordinating NGOs through performance-based partnership agreements. With this scaffolding in place, the development community can then prioritize the reconstruction of primary health care centers, increasing and retaining health workers, and horizontal integration of immunization services. The final stages should then concentrate on transferring ownership of the health system national institutions, implementing sustainable financing mechanisms, and phasing-out NGO services. Overall, these findings contribute post-conflict health system development by evaluating the process holistically and along a timeline and can be of further use by healthcare managers, policy-makers, and other health professionals.

Keywords: Afghanistan, Cambodia, health system development, health system reconstruction, Mozambique, post-conflict, state-building

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Authors: Rakesh Mishra, Mukunda Upadhyay, Rajni Singh

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This paper attempts to link remittances sent by internal as well as international out-migrants and its domestic preferences of usage in three different dimension of Household level development in India and its states. Investment of remittances in these sectors reveals for mixed choices of preferential among the states from where people have out-migrated. The multivariate analysis implies that among all three indicators of human development, health (Investment in Food and Health) is the one that attracts the major investment followed by capital formation and least on Education. Usage of the remittances has been found to be varying across all the states in India as far as usage in health, capital formation and education are concerned. Orissa, Nagaland, Madhya Pradesh, Jharkhand, Gujarat, D & H Haweli are some of the states and union territory that contributes highest of its international remittances on health, while most of the usage of the internal remittances has second or third preferences of investment on the health except for Uttar Pradesh, D & H Haweli, Arunachal Pradesh and A & N Is. This paper tries to access usage of international remittances as well as internal remittances on the flow of remittances at the micro level and its implications across three basic determinants of Human Development that is Health, Capital formation and Education coupled with the preferences of usage in presence of Several Socio economic and Demographic variable.

Keywords: multivariate analysis, household development, remittances, internal and international migration

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Authors: Laura Frydel

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Chloroxylenol is a common ingredient in disinfectants. Due to the use of this compound in large amounts, it is more and more often detected in rivers, sewage, and also in human body fluids. In recent years, there have been concerns about the potentially harmful effects of chloroxylenol on human health and the environment. This paper presents the synthesis, a brief characterization and the use of a halloysite-carbon adsorbent for the removal of chloroxylenol from water. The template in the halloysite-carbon adsorbent was acid treated bleached halloysite, and the carbon precursor was cellulose dissolved in zinc (II) chloride, which was dissolved in 37% hydrochloric acid. The FTIR spectra before and after the adsorption process allowed to determine the presence of functional groups, bonds in the halloysite-carbon composite, and the binding mechanism of the adsorbent and adsorbate. The morphology of the bleached halloysite sample and the sample of the halloysite-carbon adsorbent were characterized by scanning electron microscopy (SEM) with surface analysis by X-ray dispersion spectrometry (EDS). The specific surface area, total pore volume and mesopore and micropore volume were determined using the ASAP 2020 volumetric adsorption analyzer. Total carbon and total organic carbon were determined for the halloysite-carbon adsorbent. The halloysite-carbon adsorbent was used to remove chloroxylenol from water. The degree of removal of chloroxylenol from water using the halloysite-carbon adsorbent was about 90%. Adsorption studies show that the halloysite-carbon composite can be used as an effective adsorbent for removing chloroxylenol from water.

Keywords: adsorption, cellulose, chloroxylenol, halloysite

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Authors: H. Yousefnia, S. Zolghadri, A. Golabi Dezfuli

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Tris (1,10-phenanthroline) lanthanum(III)] trithiocyanate is a new compound that has shown to stop DNA synthesis in CCRF-CEM and Ehrlich ascites cells leading to a cell cycle arrest in G0/G1. One other important property of the phenanthroline nucleus is its ability to act as a triplet-state photosensitizer especially in complexes with lanthanides. In Nowadays, the radiation dose assessment resource (RADAR) method is known as the most common method for absorbed dose calculation. 177Lu was produced by irradiation of a natural Lu2O3 target at a thermal neutron flux of approximately 4 × 1013 n/cm2•s. 177Lu-PL3 was prepared in the optimized condition. The radiochemical yield was checked by ITLC method. The biodistribution of the complex was investigated by intravenously injection to wild-type rats via their tail veins. In this study, the absorbed dose of 177Lu-PL3 to human organs was estimated by RADAR method. 177Lu was prepared with a specific activity of 2.6-3 GBq.mg-1 and radionuclide purity of 99.98 %. The 177Lu-PL3 complex can prepare with high radiochemical yield (> 99 %) at optimized conditions. The results show that liver and spleen have received the highest absorbed dose of 1.051 and 0.441 mSv/MBq, respectivley. The absorbed dose values for these two dose-limiting tissues suggest more biological studies special in tumor-bearing animals.

Keywords: internal dosimetry, Lutetium-177, radar, animals

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Authors: Dilruba Showkat, Cindy Grimm

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As robots become more ubiquitous, it is significant for us to understand how different groups of people respond to possible ways of interacting with the robot. In this study, we focused on gender differences while users were tele-operating a humanoid robot that was physically co-located with them. We investigated three factors during the human-robot interaction (1) information processing strategy (2) self-efficacy and (3) tinkering or exploratory behavior. The experimental results show that the information on how to use the robot was processed comprehensively by the female participants whereas males processed them selectively (p < 0.001). Males were more confident when using the robot than females (p = 0.0002). Males tinkered more with the robot than females (p = 0.0021). We found that tinkering was positively correlated (p = 0.0068) with task success and negatively correlated (p = 0.0032) with task completion time. Tinkering might have resulted in greater task success and lower task completion time for males. Findings from this research can be used for making design decisions for robots and open new research directions. Our results show the importance of accounting for gender differences when developing interfaces for interacting with robots and open new research directions.

Keywords: humanoid robots, tele-operation, gender differences, human-robot interaction

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Authors: Haile Berihulay, Chenglong Luo

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Avian influenza, commonly known as bird flu, is a highly contagious viral disease primarily affecting poultry and wild birds, with significant implications for both animal health and public safety. The influenza virus (IV) is notorious for its ability to mutate and infect multiple species, including humans, leading to severe consequences. Avian influenza poses considerable pandemic risks due to the potential evolution of low pathogenic avian influenza (LPAI) into highly pathogenic avian influenza (HPAI), which can cause rapid outbreaks in domestic flocks. While AVI viruses typically do not replicate well in humans, strains such as H5N1 and H7N9 have crossed the species barrier, raising alarm over human infections. The recent documentation of human transmission of the H5N8 strain from birds underscores the ongoing threat posed by avian influenza. This review necessitates a thorough discussion about the genetic foundation of viral pathogens, identifying key candidate genes linked to disease resilience, and discussing powerful tools. This review can help researchers to comprehensively overview the disease severity and combat related to AIV, which causes significant economic impact and set effective control strategies to mitigate the risks associated with avian influenza outbreaks.

Keywords: Avian, candidate genes, chicken, molecular, pathogen, virus

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Authors: Ana Claudia de Souza Costa, Beatriz de Cássia Pinheiro Goulart, Karine de Cássia Cavalari, Henrique Ceretta Oliveira, Edineis de Brito Guirardello

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Background: During the COVID-19 pandemic, nursing represents the largest category of health professionals who were on the front line. Thus, investigating the practice environment and the job satisfaction of nursing professionals during the pandemic becomes fundamental since it reflects on the quality of care and the safety climate. The aim of this study was to evaluate and compare the nursing professionals' perception of the work environment, job satisfaction, and safety climate of the different hospitals and work shifts during the COVID-19 pandemic. Method: This is a cross-sectional survey with 130 nursing professionals from public, private and mixed hospitals in Brazil. For data collection, was used an electronic form containing the personal and occupational variables, work environment, job satisfaction, and safety climate. The data were analyzed using descriptive statistics and ANOVA or Kruskal-Wallis tests according to the data distribution. The distribution was evaluated by means of the Shapiro-Wilk test. The analysis was done in the SPSS 23 software, and it was considered a significance level of 5%. Results: The mean age of the participants was 35 years (±9.8), with a mean time of 6.4 years (±6.7) of working experience in the institution. Overall, the nursing professionals evaluated the work environment as favorable; they were dissatisfied with their job in terms of pay, promotion, benefits, contingent rewards, operating procedures and satisfied with coworkers, nature of work, supervision, and communication, and had a negative perception of the safety climate. When comparing the hospitals, it was found that they did not differ in their perception of the work environment and safety climate. However, they differed with regard to job satisfaction, demonstrating that nursing professionals from public hospitals were more dissatisfied with their work with regard to promotion when compared to professionals from private (p=0.02) and mixed hospitals (p< 0.01) and nursing professionals from mixed hospitals were more satisfied than those from private hospitals (p= 0.04) with regard to supervision. Participants working in night shifts had the worst perception of the work environment related to nurse participation in hospital affairs (p= 0.02), nursing foundations for quality care (p= 0.01), nurse manager ability, leadership and support (p= 0.02), safety climate (p< 0.01), job satisfaction related to contingent rewards (p= 0.04), nature of work (p= 0.03) and supervision (p< 0.01). Conclusion: The nursing professionals had a favorable perception of the environment and safety climate but differed among hospitals regarding job satisfaction for the promotion and supervision domains. There was also a difference between the participants regarding the work shifts, being the night shifts, those with the lowest scores, except for satisfaction with operational conditions.

Keywords: health facility environment, job satisfaction, patient safety, nursing

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Authors: Niyi Awofeso, Yunes Gaber, Moyosola Bamidele

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Since most social media platforms are accessible anytime and anywhere where Internet connections and smartphones are available, the invisibility of the reader raises questions about accuracy, appropriateness and comprehensibility of social media communication. Furthermore, the identity and motives of individuals and organizations who post articles on social media sites are not always transparent. In the health sector, through socially networked platforms constitute a common source of health-related information, given their purported wealth of information. Nevertheless, fake blogs and sponsored postings for marketing 'natural cures' pervade most commonly used social media platforms, thus complicating readers’ abilities to access and understand trustworthy health-related information. This purposive sampling study of 120 participants aged 18-35 year in UAE was conducted between September and December 2017, and explored commonly used social media platforms, frequency of use of social media for accessing health related information, and approaches for assessing the trustworthiness of health information on social media platforms. Results indicate that WhatsApp (95%), Instagram (87%) and Youtube (82%) were the most commonly used social media platforms among respondents. Majority of respondents (81%) indicated that they regularly access social media to get health-associated information. More than half of respondents (55%) with non-chronic health status relied on unsolicited messages to obtain health-related information. Doctors’ health blogs (21%) and social media sites of international healthcare organizations (20%) constitute the most trusted source of health information among respondents, with UAE government health agencies’ social media accounts trusted by 15% of respondents. Cardiovascular diseases, diabetes, and hypertension were the most commonly searched topics on social media (29%), followed by nutrition (20%) and skin care (16%). Majority of respondents (41%) rely on reliability of hits on Google search engines, 22% check for health information only from 'reliable' social media sites, while 8% utilize 'logic' to ascertain reliability of health information. As social media has rapidly become an integral part of the health landscape, it is important that health care policy makers, healthcare providers and social media companies collaborate to promote the positive aspects of social media for young people, whilst mitigating the potential negatives. Utilizing popular social media platforms for posting reader-friendly health information will achieve high coverage. Improving youth digital literacy will facilitate easier access to trustworthy information on the internet.

Keywords: social media, United Arab Emirates, youth engagement, digital literacy

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Authors: Soumaya Gharssallah Falhi, Houda Kohli Kallel

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This article explores the emergence of prehistoric art within the Homo Sapiens species, highlighting their innovative and pioneering characteristics. It investigates the cultural, artistic, and technological advancements that define this era, aiming to understand the importance of prehistoric art in illuminating the nature of early Homo Sapiens as cultural pioneers. The study employs a qualitative approach, analyzing the connection between prehistoric art and tribal cultures to gain insights into ancient societies. By examining various theories and perspectives on art creation during this period, the research underscores the transformative impact of artistic expression on societal development. Findings reveal that prehistoric art played a significant role in portraying Homo Sapiens as innovative beings, showcasing advancements in cultural, artistic, and technological domains. It emphasizes the enduring legacy of ancient art forms in shaping modern societal norms and values. Through data gathered from archaeological findings, literary sources, and expert opinions, the study contributes to the theoretical understanding of prehistoric art as a reflection of early human societies' mindset and way of life. Overall, this research highlights the pivotal role of prehistoric art in cultural evolution and emphasizes its relevance in contemporary understandings of human creativity and progress.

Keywords: Homo sapiens, prehistoric art, cave art, the old stone age (paleolithic era)

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Authors: Uzoma Emmanuel Igboji

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This paper examines the influence of public debts (external and internal) on economic growth and development in Nigeria from (1980-2015). The study uses aggregate GDP as a proxy for economic growth, per capital income as a proxy for standard of living and Government expenditure on health as a proxy for human capital development, while Foreign Direct Investment, Unemployment rate, and Oil revenue were used as control variables. The study made use of ex-post facto research design with the data extracted from the Central Bank of Nigeria (CBN) Statistical Bulletin and the World Bank database. It adopted a multiple regression analysis of the ordinary least square (OLS) method with the help of E-View version 3.0. The results revealed that external debt has a negative and insignificant effect on GDP, per capital income and human capital development. The study concluded that external debts were being channeled to meet the recurrent expenditures of the nation’s economy at the expense of productive investment that could stimulate growth and poverty alleviation. It, however, recommended that government should ensure that the bulk of the total borrowings are mostly sourced from within the domestic economy so that the repayment of the principal and interest will serve as a crowd in-effect rather that crowd out-effect which in turn further accelerates the country’s economic growth and development.

Keywords: economic growth, external debt, internal debt, Nigeria

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Authors: Linda Frost, Lindsay Anderson, Jana Borras, Ariel Dysangco, Vimabayi Makwaira

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The academic environment in which nursing students are immersed in comes with many demands and expectations. Course load, clinical placements, and financial expenses are examples of the pressures facing students each semester. These pressures contribute to student stress and impact their overall well-being and mental fitness. Students' ability to cope with stress and bounce back from adversity is enhanced when we build their mental fitness. Building mental fitness has the benefit of improving physical health, relationships, self-esteem, resilience, work productivity, and overall contentment, happiness and life satisfaction. While self-care is encouraged to avoid burnout, there is a gap in literature on programs to help build nursing students’ mental health and ability to engage in self-care. There is an opportunity and a need to design programs and implement actions aimed at reducing stress and its adverse effects on nursing students. Nursing students require the support of people who understand the complexities of the nursing profession, multifaceted work environments in which they operate, and the impact these environments have on their mental fitness. Nursing academia is in the best position to ensure that tools are in place to support the next generation of nurses who face a career with significant emotional and physical demands. This is a mixed-method study using an embedded design. We utilized a pretest-posttest design to compare the difference in psychological capital (PsyCap) and burnout in students who have received the Mastering My Mental Fitness-Nurses™ (MMMF-N™) workshops (n=8) and the control group (n=9) who have not. Semi structured interviews were conducted with the eight nursing students in the intervention group, along with data from feedback forms to explore the impact of the workshops on student’s burnout and PsyCap and determine how to improve the workshops for future students. The quantitative and qualitative data will be merged using a side-by-side comparison. This will be in a discussion format that allows for the comparison of the results from both phases. The findings will be available January 2025. We anticipate that students in the control and intervention group will report similar levels of burnout. As well, students in the intervention group will indicate the benefits of the MMMF-N™ workshops through qualitative interviews and workshop feedback forms.

Keywords: burnout, mental fitness, nursing students, psychological capital

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Authors: Pei-Chih Wu, Hsin-Chih Lai, Yung-Lung Lee, Yun-Yao Chi, Ching-Yi Horng, Hsien-Chang Wang

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The impact of climate change to health has always been well documented. Amongst them, water-borne infectious diseases, chronic adverse effects or cancer risks due to chemical contamination in flooding or drought events are especially important in river basin. This study therefore utilizes GIS and different models to integrate demographic, land use, disaster prevention, social-economic factors, and human health assessment in the Erren River basin. Therefore, through the collecting of climatic, demographic, health surveillance, water quality and other water monitoring data, potential risks associated with the Erren River Basin are established and to understand human exposure and vulnerability in response to climate extremes. This study assesses the temporal and spatial patterns of melioidosis (2000-2015) and various cancer incidents in Tainan and Kaohsiung cities. The next step is to analyze the spatial association between diseases incidences, climatic factors, land uses, and other demographic factors by using ArcMap and GeoDa. The study results show that amongst all melioidosis cases in Taiwan, 24% cases (115) residence occurred in the Erren River basin. The relationship between the cases and in Tainan and Kaohsiung cities are associated with population density, aging indicator, and residence in Erren River basin. Risks from flooding due to heavy rainfall and fish farms in spatial lag regression are also related. Through liver cancer, the preliminary analysis in temporal and spatial pattern shows an increases pattern in annual incidence without clusters in Erren River basin. Further analysis of potential cancers connected to heavy metal contamination from water pollution in Erren River is established. The final step is to develop an assessment tool for human exposure from water contamination and vulnerability in response to climate extremes for the second year.

Keywords: climate change, health impact, health adaptation, Erren River Basin

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Authors: Osman Yildiz

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As it is predicted 2559 years before there is nothing permanent except change. In our turbulent World, Organizations will always be faced with the challenge of determining the path that will always keep them on balance en route that will bring success. That means from top to bottom, every organisation is exposed to fight to stay afloat and compete while they face the continuous prospect of change in an increasingly competitive and globalized World. Otherwise, they would fail to realize their goals and targets, and ultimately would disappear. But the organizations that will celebrate success five or ten years from now will be the winners of the fight by having recognizing that planning the change was only the first step in the journey and put sufficient efforts into the task of leading change. Increasingly unpredictable and competitive organizational environments have put pressure on leaders across all industries to better manage the change. The key of establishing effective change and transformation in organisations lies on the steps taken before the change happens depending to the quality of the human sources; readiness for change, acknowledgement by management, prepared leaders, motivated employees, overcoming the resistance to change and ultimately adapting change into the organization. Due to these factors, leaders managing the organisational development can ensure organizations and employees to meet new performance targets, motivation and skills rapidly and effectively. Finally, this article will provide some tools for leaders, and discuss how to catch organisational development and manage the innovations in effective ways.

Keywords: managing the change, organizational change, human factor, leaders, globalization, organisational development

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Authors: Doreen Mekunda

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This paper is built on the premise that the current socio-political crisis in the two restive regions of Cameroon, though enveloped with destructive and devastating trends (effects) on both property and human lives, is not without its strengths and merits. It is incontestable that many cultures, to a greater extent, are going to be destroyed as people forcibly move from war-stricken habitats to non-violent places. Many cultural potentials, traditional shrines, artifacts, art, and crafts, etc., are unknowingly or knowingly disfigured, and many other ugly things will, by the end of the crisis, affect the cultures of these two regions under siege and of the receiving population. A plethora of other problems like the persecution of Internally Displaced Persons (IDPs) for being displaced and blamed for increased crime rates and the existence of cultural and ethnic differences that produce both inter-tribal and interpersonal conflicts and conflicts between communities will abound. However, there is the emergence of rapid literature, and other forms of cultural productions, whether written or oral, is visible, thereby precipitating a rich cultural diversity due to the coming together of a variety of cultures of both the IDPs and the receiving populations, rapid urbanization, improvement of health-related issues, the rebirth of indigenous cultural practices, the development of social and lingua-cultural competences, dependence on alternative religions, faith and spirituality. Even financial and economic dependence, though a burden to others by IDPs, has its own merits as it improves the living standards of the IDPs. To be able to obtain plausible results, cultural materialism, which is a literary theory that hinges on the empirical study of socio-cultural systems within a materialist infrastructure-super-structure framework, is employed together with the postcolonial theory. Postcolonial theory because the study deals with postcolonial experiences/tenets of migration, hybridity, ethnicity, indignity, language, double consciousness, migration, center/margin binaries, and identity, amongst others. The study reveals that the involuntary movement of persons from their habitual homes brings about movement in cultures, thus, the emergence of new cultures. The movement of people who hold fast to their cultural heritage can only influence new forms of literature, the development of new communication competences, the rise of alternative religion, faith and spirituality, the re-emergence of customary and traditional legal systems that might have been abandoned for the new judicial systems, and above all the revitalization of traditional health care systems.

Keywords: alternative religion, emergence, socio-political crisis, spirituality, lingua-cultural competences

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Authors: Christoph Ostermair

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We deal with the effect of correlation between prospects on human decision making under uncertainty as proposed by the comparatively new and promising model of “salience theory of choice under risk”. In this regard, we show that the theory entails the prediction that the inconsistency of choices, known as the Allais paradox, should not be an issue in the context of “real-life decision making”, which typically corresponds to situations of subjective uncertainty. The Allais paradox, probably the best-known anomaly regarding expected utility theory, would then essentially have no practical relevance. If, however, empiricism contradicts this prediction, salience theory might suffer a serious setback. Explanations of the model for variable human choice behavior are mostly the result of a particular mechanism that does not come to play under perfect correlation. Hence, if it turns out that correlation between prospects – as typically found in real-world applications – does not influence human decision making in the expected way, this might to a large extent cost the theory its explanatory power. The empirical literature regarding the Allais paradox under subjective uncertainty is so far rather moderate. Beyond that, the results are hard to maintain as an argument, as the presentation formats commonly employed, supposably have generated so-called event-splitting effects, thereby distorting subjects’ choice behavior. In our own incentivized experimental study, we control for such effects by means of two different choice settings. We find significant event-splitting effects in both settings, thereby supporting the suspicion that the so far existing empirical results related to Allais paradoxes under subjective uncertainty may not be able to answer the question at hand. Nevertheless, we find that the basic tendency behind the Allais paradox, which is a particular switch of the preference relation due to a modified common consequence, shared by two prospects, is still existent both under an event-splitting and a coalesced presentation format. Yet, the modal choice pattern is in line with the prediction of salience theory. As a consequence, the effect of correlation, as proposed by the model, might - if anything - only weaken the systematic choice pattern behind the Allais paradox.

Keywords: Allais paradox, common consequence effect, models of decision making under risk and uncertainty, salience theory

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Authors: Mohammed Eltayeb Salih Elamin

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This study discusses the concept of the artificial heart using engineering concepts, of the fluid mechanics and the characteristics of the non-Newtonian fluid. For the purpose to serve heart patients and improve aspects of their lives and since the Statistics review according to world health organization (WHO) says that heart disease and blood vessels are the first cause of death in the world. Statistics shows that 30% of the death cases in the world by the heart disease, so simply we can consider it as the number one leading cause of death in the entire world is heart failure. And since the heart implantation become a very difficult and not always available, the idea of the artificial heart become very essential. So it’s important that we participate in the developing this idea by searching and finding the weakness point in the earlier designs and hoping for improving it for the best of humanity. In this study a pump was designed in order to pump blood to the human body and taking into account all the factors that allows it to replace the human heart, in order to work at the same characteristics and the efficiency of the human heart. The pump was designed on the idea of the diaphragm pump. Three models of blood obtained from the blood real characteristics and all of these models were simulated in order to study the effect of the pumping work on the fluid. After that, we study the properties of this pump by using Ansys15 software to simulate blood flow inside the pump and the amount of stress that it will go under. The 3D geometries modeling was done using SOLID WORKS and the geometries then imported to Ansys design modeler which is used during the pre-processing procedure. The solver used throughout the study is Ansys FLUENT. This is a tool used to analysis the fluid flow troubles and the general well-known term used for this branch of science is known as Computational Fluid Dynamics (CFD). Basically, Design Modeler used during the pre-processing procedure which is a crucial step before the start of the fluid flow problem. Some of the key operations are the geometry creations which specify the domain of the fluid flow problem. Next is mesh generation which means discretization of the domain to solve governing equations at each cell and later, specify the boundary zones to apply boundary conditions for the problem. Finally, the pre–processed work will be saved at the Ansys workbench for future work continuation.

Keywords: Artificial heart, computational fluid dynamic heart chamber, design, pump

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Authors: Waganesh Zeleke, Abebaw Minaye

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This study examined the act, means, and purpose of human trafficking in the case of Ethiopian migrant returnees from the Middle East and South Africa. Using a questionnaire survey data was gathered from 1078 returnees. Twelve focus group discussions were used to solicit detailed experience of returnee about the process of their 'unsafe' immigration. Both quantitative and qualitative analysis results revealed that against the mainstream thinking of human trafficking means such as forcing, coercing, abducting or threatening, traffickers used 'victims’ free will' means by providing false promises to and capitalizing on the vulnerability of migrants. The migrants’ living condition including unemployment, ambitious view to change their life, and low level of risk perception were found to be risk factors which made them vulnerable and target of the brokers and smugglers who served as a catalyst in the process of their 'unsafe' migration. Equal to the traffickers/brokers/agency, the migrants’ family, friends and Ethiopian embassies contributed to the deplorable situation of migrant workers. 64.4% of the returnees reported that their migration is self-initiated, and 20% reported peer pressure and 13.8 percent reported family pressure, and it is only 1.8% who reported having been pushed by brokers. The findings revealed that 69.5% of the returnees do not know about the lifestyle and culture of the host community before their leave. In a similar vein, 50.9% of the returnees reported that they do not know about the nature of the work they are to do and their responsibilities. Further, 81% of the returnees indicated that the pre-migration training they received was not enough in equipping them with the required skill. Despite the returnees experiences of various forms of abuse and exploitation in the journey and at the destination they still have a positive attitude for migration (t=9.7 mean of 18.85 with a test value of 15). The returnees evaluated the support provided by sending agencies and Ethiopian embassies in the destination to be poor. 51.8% of the migrants do not know the details of the contract they signed during migration. Close to 70% of the returnees expressed that they had not got any legal support from stakeholders when they faced problems. What is more is that despite all these 27.9% of the returnees indicated re-immigrating as their plan. Based on these findings on the context and experience of Ethiopian migrant returnees, implications for training, policy, research, and intervention are discussed.

Keywords: trafficking, migrant, returnee, Ethiopia, experience, reconceptualizing

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Authors: T. Suleiman, C. Mchugh, H. Ranu

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Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.

Keywords: asthma, nurse specialist, clinical audit, quality improvement

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Authors: Y. B. Sharma, K. B. Biswas

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This research project examines a 5000 cal yr BP sediment core record to reveal the consequences of human impact and climate variability on the tropical dry forests of the Mahi river basin, western India. To date there has been little research to assess the impact of climate variability and human impact on the vegetation dynamics of this region. There has also been little work to link changes in vegetation cover to documented changes in the basin hydrology over the past 100 years – although it is assumed that the two are closely linked. The key objective of this research project therefore is to understand the driving mechanisms responsible for the abrupt changes in the Mahi river basin as detailed in historical documentation and its impact on water resource management. The Mahi river basin is located in western India (22° 11’-24° 35’ N 72° 46’-74° 52’ E). Mahi river arises in the Malwa Plateau, Madhya Pradesh near Moripara and flows through the uplands and alluvial plain of Rajasthan and Gujarat provinces before draining into the Gulf of Cambay. Palaeoecological procedures (sedimentology, geochemical analysis, C&N isotopes and fossil pollen evidences) have been applied on sedimentary sequences collected from lakes in the Mahi basin. These techniques then facilitate to reconstruct the soil erosion, nutrient cycling, vegetation changes and climatic variability over the last 5000 years. Historical documentation detailing changes in demography, climate and landscape use over the past 100 years in this region will also be collated to compare with the most recent palaeoecological records. The results of the research work provide a detailed record of vegetation change, soil erosion, changes in aridity, and rainfall patterns in the region over the past 5000 years. This research therefore aims to determine the drivers of change and natural variability in the basin. Such information is essential for its current and future management including restoration.

Keywords: human impact, climate variability, vegetation cover, hydrology, water resource management, Mahi river basin, sedimentology, geochemistry, fossil pollen, nutrient cycling, vegetation changes, palaeoecology, aridity, rainfall, drivers of change

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Authors: Mohammed Gamil Montasser, Angelo Battaglia

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Entrepreneurship is mostly related to the beginning of organization. In growing business organizations, entrepreneurship expands its conceptualization. It reveals itself through new business creation in the active organization, through renewal, change, innovation, creation and development of current organization, through breaking and changing of established rules inside or outside the organization and becomes more flexible, adaptive and competitive, also improving effectiveness of organization activity. Therefore, the topic of entrepreneurship, relates the creation of firms to personal / individual characteristics of the entrepreneurs and their social context. This paper is an empirical study, which aims to address these two gaps in the literature. For this endeavor, we use the latest available data from the Global Entrepreneurship Monitor (GEM) project. This data set is widely regarded as a unique source of information about entrepreneurial activity, as well as the aspirations and attitudes of individuals across a wide number of countries and territories worldwide. This paper tries to contribute to fill this gap, by exploring the key drivers of innovative entrepreneurship in the tourism sector. Our findings are consistent with the existing literature in terms of the individual characteristics of entrepreneurs, but quite surprisingly we find an inverted U-shape relation between human development and innovative entrepreneurship in tourism sector. It has been revealed that tourism entrepreneurs are less likely to have innovative products, compared with entrepreneurs in medium developed countries.

Keywords: GEM, human development, innovative entrepreneurship, occupational choice, tourism

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Authors: David A. Swanson, Lucky M. Tedrow

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Taylor’s Law is a widely observed empirical pattern that relates variances to means in sets of non-negative measurements via an approximate power function, which has found application to human mortality. This study adds to this research by showing that Taylor’s Law leads to a model that reasonably describes the relationship between life expectancy at birth (e0, which also is equal to mean age at death in a life table) and variance at age of death in seven World Bank regional life tables measured at two points in time, 1970 and 2000. Using as a benchmark a non-random sample of four Japanese female life tables covering the period from 1950 to 2004, the study finds that the simple linear model provides reasonably accurate estimates of variance in age at death in a life table from e0, where the latter range from 60.9 to 85.59 years. Employing 2017 life tables from the Human Mortality Database, the simple linear model is used to provide estimates of variance at age in death for six countries, three of which have high e0 values and three of which have lower e0 values. The paper provides a substantive interpretation of Taylor’s Law relative to e0 and concludes by arguing that reasonably accurate estimates of variance in age at death in a period life table can be calculated using this approach, which also can be used where e0 itself is estimated rather than generated through the construction of a life table, a useful feature of the model.

Keywords: empirical pattern, mean age at death in a life table, mean age of a stationary population, stationary population

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Authors: Filip Jaroš

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The Swiss scholar Adolf Portmann (1897-1982) was an outstanding figure in the history of biology and the philosophy of the life sciences. Portmann’s biological theory is primarily focused on the problem of animal form (Gestalt), and it poses a significant counterpart to neo-Darwinian theories about the explanatory primacy of a genetic level over the outer appearance of animals. Besides that, Portmann’s morphological studies related to species-specific ontogeny and the influence of environmental surroundings can be classified as the antecedents of contemporary synthetic approaches such as “eco-evo-devo, “extended synthesis or biosemiotics. The most influential of Portmann’s concepts up to the present is his thesis of a social womb (Soziale Mutterschos): human children are born physiologically premature in comparison with other primates, and they find a second womb in a social environment nurturing their healthy development. It is during the first year of extra-uterine life when a specific human nature is formed, characterized by the strong tie between an individual and a broader historical, cultural whole. In my paper, I will closely analyze: a) the historical coordinates of Portmann’s philosophy of the life sciences (e.g., the philosophical anthropology of A. Gehlen, H. Plessner, and their concept of humans as beings “open to the world”), b) the relation of Portmann’s concept of the social womb to contemporary theories of infant birth evolution.

Keywords: adolf portmann, extended synthesis, philosophical anthropology, social womb

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Authors: Osama H. Elsayed, Mohsen M. S. Asker, Mahmoud A. Swelim, Ibrahim H. Abbas, Aziza I. Attwa, Mohamed E. El Awady

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Hydroxy marilone C is a bioactive metabolite was produced from the culture broth of Streptomyces badius isolated from Egyptian soil. hydroxy marilone C was purified and fractionated by silica gel column with a gradient mobile phase dicloromethane (DCM) : Methanol then Sephadex LH-20 column using methanol as a mobile phase. It was subjected to many instruments as Infrared (IR), nuclear magnetic resonance (NMR), Mass spectroscopy (MS) and UV spectroscopy to the elucidation of its structure. It was evaluated for antioxidant, cytotoxicity against human alveolar basal epithelial cell line (A-549) and human breast adenocarcinoma cell line (MCF-7) and antiviral activities; showed that the maximum antioxidant activity was 78.8 % at 3000 µg/ml after 90 min. and the IC50 value against DPPH radical found about 1500 µg/ml after 60 min. By Using MTT assay the effect of the pure compound on the proliferation of A-549 cells and MCF-7 cells were 443 µg/ml and 147.9 µg/ml, respectively. While for detection of antiviral activity using Madin-Darby canine kidney (MDCK) cells the maximum cytotoxicity was at 27.9% and IC50 was 128.1µg/ml. The maximum concentration required for protecting 50% of the virus-infected cells against H1N1 viral cytopathogenicity (EC50) was 33.25% for 80 µg/ml. This results indicated that the hydroxy marilone C has a potential antitumor and antiviral activities.

Keywords: hydroxy marilone C, production, bioactive compound, Streptomyces badius

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Authors: Simona Perga, Chiara Beltramo, Floriana Fruscione, Isabella Martini, Federica Cavallo, Federica Riccardo, Paolo Buracco, Selina Iussich, Elisabetta Razzuoli, Katia Varello, Lorella Maniscalco, Elena Bozzetta, Angelo Ferrari, Paola Modesto

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Introduction: Human and canine melanoma have common clinical, histologic characteristics making dogs a good model for comparative oncology. The identification of specific genes and a better understanding of the genetic landscape, signaling pathways, and tumor–microenvironmental interactions involved in the cancer onset and progression is essential for the development of therapeutic strategies against this tumor in both species. In the present study, the differential expression of genes in spontaneously occurring canine melanoma and in paired normal tissue was investigated by targeted RNAseq. Material and Methods: Total RNA was extracted from 17 canine malignant melanoma (CMM) samples and from five paired normal tissues stored in RNA-later. In order to capture the greater genetic variability, gene expression analysis was carried out using two panels (Qiagen): Human Immuno-Oncology (HIO) and Mouse-Immuno-Oncology (MIO) and the miSeq platform (Illumina). These kits allow the detection of the expression profile of 990 genes involved in the immune response against tumors in humans and mice. The data were analyzed through the CLCbio Genomics Workbench (Qiagen) software using the Canis lupus familiaris genome as a reference. Data analysis were carried out both comparing the biologic group (tumoral vs. healthy tissues) and comparing neoplastic tissue vs. paired healthy tissue; a Fold Change greater than two and a p-value less than 0.05 were set as the threshold to select interesting genes. Results and Discussion: Using HIO 63, down-regulated genes were detected; 13 of those were also down-regulated comparing neoplastic sample vs. paired healthy tissue. Eighteen genes were up-regulated, 14 of those were also down-regulated comparing neoplastic sample vs. paired healthy tissue. Using the MIO, 35 down regulated-genes were detected; only four of these were down-regulated, also comparing neoplastic sample vs. paired healthy tissue. Twelve genes were up-regulated in both types of analysis. Considering the two kits, the greatest variation in Fold Change was in up-regulated genes. Dogs displayed a greater genetic homology with humans than mice; moreover, the results have shown that the two kits are able to detect different genes. Most of these genes have specific cellular functions or belong to some enzymatic categories; some have already been described to be correlated to human melanoma and confirm the validity of the dog as a model for the study of molecular aspects of human melanoma.

Keywords: animal model, canine melanoma, gene expression, spontaneous tumors, targeted RNAseq

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Authors: Andrea Knezevic, Padmini Pai, Julaine Allan, Katarzyna Olcoń, Louisa Smith

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Healthcare staff are on the frontline during times of disaster and are required to support the health and wellbeing of communities despite any personal adversity and trauma they are experiencing as a result of the disaster. This study explored the experiences of healthcare staff trained as ‘Wellness Warriors’ following the 2019-2020 Australian bushfires. The findings indicated that healthcare staff developed interpersonal skills around deep listening and connecting with others which allowed them to feel differently about work and restored their faith in healthcare leadership.

Keywords: Australian bushfires, burnout, health care providers, mental health, occupational trauma, post-disaster, wellbeing, workplace wellness

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Authors: Souhila Terfi, Fatma Hassaine-Sadi

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In the present study, wet digestion with HCl and HNO3 mixture was used to extract the heavy metals (copper (Cu), chromium (Cr), zinc (Zn), lead (Pb) and cadmium (Cd)) from the leaves, the stems and the roots of Malva sylvestris L., which were subsequently analyzed by AAS. The samples (soil and parts of species) were collected from different sites: the industrial area (IA) (Rouiba), the rubbish dump area (RDA) (Boudouaou), the residential area (RA) with large open fields and construction activities (Blida), the Montaigne area (MA) (Chrea) and the high plateau area (HPA) (Berouaguia). The study showed differences in metal concentrations according to the analysed parts and the different sampling locations. In the contaminated site of the industrial area (IA), high content of the toxic heavy metals (Cd: 3.18 µg/g DW and Pb: 34.48 µg/g DW) were found in the leaves of Malva sylvestris L. This finding suggests that the consumers of this species could be exposed to a risk associated with this higher level of these toxic metals. It was found that Malva sylvestris L. is rich by Zn and Cu in some sites, which are considered to be the essential elements for the human health. The obtained results with the control site (Montaigne area) suggest that this species can be applicable in both the health and food, feasible alternatives as medicinal plant without any risk.

Keywords: Malva sylvestris L., toxic heavy metal, medicinal plant, impact on human health

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Authors: Matthew Sedgwick

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Introduction: Social media continues to grow in popularity and Instagram is one of the largest platforms available. It provides an invaluable method of communication between health care professionals and patients. Both patients and dentists can benefit from seeing clinical cases posted by other members of the profession. It can prompt discussion about how the outcome was achieved and showcases what is possible with the right techniques and planning. This study aimed to identify what people were posting about the topic ‘veneers’ and inform health care professionals as to what content had the most engagement and make recommendations as to how to improve the quality of social media posts. Design: 150 consecutive posts for the search term ‘veneers’ were analyzed retrospectively between 21st October 2021 to 31st October 2021. Non-English language posts duplicated posts, and posts not about dental veneers were excluded. After exclusions were applied, 80 posts were included in the study for analysis. The content of the posts was analyzed and coded and the main themes were identified. The number of comments, likes and views were also recorded for each post. Results: The themes were: before and after treatment, cost, dental training courses, treatment process and trial smiles. Dentists were the most common posters of content (82.5%) and it was interesting to note that there were no patients who posted about treatment in this sample. The main type of media was photographs (93.75%) compared to video (6.25%). Videos had an average of 45,541 views and more comments and likes than the average for photographs. The average number of comments and likes per post were 20.88 and 761.58, respectively. Conclusion: Before and after photographs were the most common finding as this is how dentists showcase their work. The study showed that videos showing the treatment process had more engagement than photographs. Dentists should consider making video posts showing the patient journey, including before and after veneer treatment, as this can result in more potential patients and colleagues viewing the content. Video content could help dentists distinguish their posts from others as it can also be used across other platforms such as TikTok or Facebook reaching a wider audience. More informative posts about how the result has shown are achieved required, including potential costs. This will help increase transparency regarding this treatment method, including the financial and potential biological cost to teeth. As a result, this will improve patient understanding and become an invaluable adjunct in informed consent.

Keywords: content analysis, dental veneers, Instagram, social media

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Authors: Mazlum Çelik, Burcu Gürkan Ercan, Ahmet Ayaz, Hilal Yakut İpekoğlu, Furkan Baltacı, Mustafa Kurtoğlu, Bilge Kalkavan, Sinem Küçükyılmaz, Hikmet Çağrı Yardımcı, Şeyma Sevgican, Cemile Gökçe Elkovan, Bilal Çayır, Mehmet Emin Düzcan

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The earthquake research literature generally examines emotional, cognitive, and behavioral responses after an earthquake. Studies concerning the behavioral responses to earthquakes reveal that after the earthquake, people either flee in a panic or do not act according to the stereotype that they act irrationally and anti-socially and sometimes give rational and adaptive reactions. However, the rareness of research dealing with human behavior experiencing the earthquake moment makes it necessary to pay particular attention to these behavior patterns. In this direction, this study aims to examine human behavior indoors in case of rising earthquake intensity. In Turkey, located on geography in the earthquake zone, devastating earthquakes took place, such as in "Istanbul" with a magnitude of 7.4 in 1999 and in "Elazığ" with a magnitude of 6.8 in 2020. Occurred recently, the "Kahramanmaraş" earthquake affected 11 provinces, with a magnitude of 7.7 and 7.6 in 2023. In addition, there is expected to be a devastating earthquake in Istanbul, experts warn. For this reason, it is essential to understand human behavior for disaster risk. Management and pre-disaster preparedness to be effective and efficient and to take realistic measures to protect human life. Mazlum Çelik, Burcu Gürkan Ercan, Ahmet Ayaz, Hilal Yakut İpekoğlu, Furkan Baltacı, Mustafa Kurtoğlu, Bilge Kalkavan, Sinem Küçükyılmaz, Hikmet Çağrı Yardımcı, Şeyma Sevgican, Cemile Gökçe Elkovan, Bilal Çayır, Mehmet Emin Düzcan. In this study, which is currently part of a project supported by The Scientific and Technological Council of Turkey (TUBITAK), the indoor recordings during the earthquakes in Elazig on January 24, 2020, and in İzmir on October 30, 2020, are examined, and the people's behavior during the earthquake is analyzed. In this direction, video recordings taken from the YouTube archives of İzmir and Elazığ Disaster and Emergency Management Presidency (AFAD) Directorates and metropolitan municipalities are examined. The researchers have created an observation form in line with the information in the relevant literature to classify people's behavior during an earthquake. It is intended to determine the behavioral patterns by classifying according to the form and video analysis of the people heading toward the door, remaining stable, taking protective measures, turning to people, and engaging in "other" behaviors outside of these behaviors during the earthquake. A total of 60 video analyzes are carried out from Elazığ and İzmir. The descriptive statistic has been used with the SPSS 23.0 package program in the data analysis. It is found that in the event of an increase in the severity of the earthquake, unlike Elazığ, in İzmir, protective action is preferred to the act of remaining stable. In addition, it is observed that with the increase in the earthquake's intensity, women attempt to take more protective action while men head toward the door. In contrast, a rise is observed in the behavior of young people heading toward the door and taking protective actions, while there is a decrease in their behavior directing to people. These findings, unlike the literature, reveal that human behavior during earthquakes cannot be reduced to a single behavior pattern, such as drop-cover-hold-on. The results show that it is necessary to understand the behaviors of individuals during the earthquake and to develop practical policy proposals for combating earthquakes by considering sociocultural, geographical, and demographic variables.

Keywords: descriptive analysis, earthquake, human behaviour, disaster policy.

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Authors: K. Rajarajeswaran, Krishna Prasad

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Introduction: Refractory shock is a typical consequence of sepsis that does not improve with standard vasopressor therapy. A possible adjuvant therapeutic option for treating refractory shock in sepsis is methylene blue. This study looked at the effects of intravenous methylene blue plus norepinephrine given as a single bolus infusion on mortality and hemodynamic improvement in patients suffering from refractory shock. Methodology: This six-month observational prospective study was carried out at an intensive care unit, teaching hospital, and medical college. It involved 112 patients who had been diagnosed with refractory septic shock and needed vasopressor medication. Group B received injection norepinephrine 0.01 µg/kg/min infusion alone, while Group A received injection methylene blue 2 mg/kg iv single bolus (fixed dose) in addition to injection norepinephrine 0.01 µg/kg/min infusion. Both groups' noradrenaline doses were titrated to reach the desired MAP of 60–75 mm Hg. The amount of norepinephrine needed to sustain a MAP of more than 60 mm Hg was the data gathered. Serum lactate, procalcitonin level, C-reactive protein, length of stay in the intensive care unit (ICU), sequential organ failure assessment (SOFA) score, and duration of mechanical ventilation, incidence of acute kidney injury (AKI), and mortality were compared. Results: A total of 112 patients with refractory shock were included in the study. With the use of IV methylene blue, 36 (59.3%) patients showed significant improvement in MAP within 2 hours (77.12 ± 8.90 vs 74.28 ± 21.84, p = 0.005). Responders were 4.009 times more likely to have vasopressor-free time within 24 hours (19.5% vs 6.1%, p = 0.022, odds ratio 5.017, 95% confidence interval, 1.110–14.283). The serum lactate was lower, and urine output was higher in group I than in group II (p <0.05). Group I had a significantly greater reduction in SOFA score in 12 hours than group II. However, there was no significant difference in terms of mortality, length of ICU stay, ventilator free days, and incidence of AKI. In the responder group, there was a significant increase in the MAP and decrease in vasopressor requirement pre- and post-infusion of methylene blue (p < 0.05). Responder had shorter vasopressor-free days as compared with non-responder (5.44 vs 6.99, p = 0.007). Conclusion: When administered as adjuvant therapy, a single-dose bolus infusion of Methylene Blue plus Norepinephrine may aid in meeting early resuscitation goals for the management of patients with septic shock. But the patients' death rate, ICU stay duration, ventilator-free days, or incidence of AKI were unchanged.

Keywords: norepinephrine, methylene blue, shock, vasopressor

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