Search results for: case – II waters

Authors: Álvaro Ramírez Vidal, Martín Muñoz Morales, Francisco Jesús Fernández Morales, Luis Rodríguez Romero, José Villaseñor Camacho, Javier Llanos López

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In recent times, environmental problems have led to the extensive use of biological systems to solve them. Among the different types of biological systems, the use of plants such as aquatic macrophytes in constructed wetlands and terrestrial plant species for treating polluted soils and sludge has gained importance. Though the use of constructed wetlands for wastewater treatment is a well-researched domain, the slowness of pollutant degradation and high biomass production pose some challenges. Plants used in CW participate in different mechanisms for the capture and degradation of pollutants that also can retain some pharmaceutical and personal care products (PPCPs) that are very persistent in the environment. Thus, these systems present advantages in line with the guidelines published for the transition towards friendly and ecological procedures as they are environmentally friendly systems, consume low energy, or capture atmospheric CO₂. However, the use of CW presents some drawbacks, as the slowness of pollutant degradation or the production of important amounts of plant biomass, which need to be harvested and managed periodically. Taking this opportunity in mind, it is important to highlight that this residual biomass (of lignocellulosic nature) could be used as the feedstock for the generation of carbonaceous materials using thermochemical transformations such as slow pyrolysis or hydrothermal carbonization to produce high-value biomass-derived carbons through sustainable processes as adsorbents, catalysts…, thereby improving the circular carbon economy. Thus, this work carried out the analysis of some PPCPs commonly found in urban wastewater, as salicylic acid or ibuprofen, to evaluate the remediation carried out for the Phragmites Australis. Then, after the harvesting, this biomass can be used to synthesize electrodes through hydrothermal carbonization (HTC) and produce high-value biomass-derived carbons with electrocatalytic activity to remove heavy metals and persistent pollutants, promoting circular economy concepts. To do this, it was chosen biomass derived from the natural environment in high environmental risk as the Daimiel Wetlands National Park in the center of Spain, and the rest of the biomass developed in a CW specifically designed to remove pollutants. The research emphasizes the impact of the composition of the biomass waste and the synthetic parameters applied during HTC on the electrocatalytic activity. Additionally, this parameter can be related to the physicochemical properties, as porosity, surface functionalization, conductivity, and mass transfer of the electrodes lytic inks. Data revealed that carbon materials synthesized have good surface properties (good conductivities and high specific surface area) that enhance the electro-oxidants generated and promote the removal of PPCPs and the chemical oxygen demand of polluted waters.

Keywords: constructed wetlands, carbon materials, heavy metals, pharmaceutical and personal care products, hydrothermal carbonization

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Authors: Brigitta Szabo, Miklosi Monika

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Background/Aims: In early childhood, the context of development is the caregiver-child relationship. Maternal attachment style plays a major role in the intergenerational transmission of psychopathology. The aim of this study was to explore the relationship between the mothers’ attachment style, mindful parenting, and perception of the child. Method: Data was collected from 144 non-clinical mothers who have a child below the age of 3 years. Mothers completed self-report questionnaires, including the following scales: a demographic questionnaire, Attachment Style Questionnaire (ASQ), Interpersonal Mindfulness in Parenting Scale (IMP), and the Mothers’ Object Relations Scale (MORS-SF). K-means cluster analysis was used to identify the mothers’ attachment styles. Mediation analyses with Mothers’ Object Relations Scale (MORS-SF) positive emotions and dominance subscales as dependent variables, mothers’ attachment style (ASQ) as an independent variable, and mindful parenting (IMP) as a mediator were conducted. Results: Four attachment styles (secure, preoccupied, fearful, dismissing) were identified. The relationship between mothers’ attachment style and mindful parenting was significant (R2 = .51; F(4,139) = 36.60; p < .001). Compared to the secure attachment style as a reference group, both preoccupied and dismissing styles were related to lower levels of mindful parenting; however, this relationship was the strongest in case of fearful style. In mediation analysis the direct effects of mothers’ attachment style on the perception of the child were not significant (MORS positive emotions: R2= .29; F(5,138) = 11.22; p < .001; MORS dominance: R2= .39 F(5,138) = 17.54, p < .001). However, indirect effects through mindful parenting were significant; higher levels of mindful parenting were associated with higher levels of MORS positive emotions and lower levels of MORS dominance. Conclusions: These findings suggest that attachment styles are related to the perception of the child through mindful parenting. Mindfulness-based parenting training might be useful in case of attachment-related problems to improve the parent-child relationship.

Keywords: mindfulness, mindful parenting, attachement, perception

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Authors: Wei-Chieh Yeh, Yung-Tang Shen

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The concept of community building started in 1994 in Taiwan. After years of development, it fostered the notion of active local resident participation in community issues as co-operators, instead of minions. Participatory design gives participants more control in the decision-making process, helps to reduce the friction caused by arguments and assists in bringing different parties to consensus. This results in an increase in the efficiency of projects run in the community. Therefore, the participation of local residents is key to the success of community building. This study applied participatory design to develop plans for the reuse of deserted spaces in the community from the first stage of brainstorming for design ideas, making creative models to be employed later, through to the final stage of construction. After conducting a series of participatory designed activities, it aimed to integrate the different opinions of residents, develop a sense of belonging and reach a consensus. Besides this, it also aimed at building the residents’ awareness of their responsibilities for the environment and related issues of sustainable development. By reviewing relevant literature and understanding the history of related studies, the study formulated a theory. It took the “2012-2014 Changhua County Community Planner Counseling Program” as a case study to investigate the implementation process of participatory design. Research data are collected by document analysis, participants’ observation and in-depth interviews. After examining the three elements of “Design Participation”, “Construction Participation”, and” Follow–up Maintenance Participation” in the case, the study emerged with a promising conclusion: Maintenance works were carried out better compared to common public works. Besides this, maintenance costs were lower. Moreover, the works that residents were involved in were more creative. Most importantly, the community characteristics could be easy be recognized.

Keywords: participatory design, deserted space, community building, reuse

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Authors: Lukasz Grabowski, Marcin Szlachetka, Tytus Tulwin

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The main task of the engine cooling system is to maintain its average operating temperatures within strictly defined limits. Too high or too low average temperatures result in accelerated wear or even damage to the engine or its individual components. In order to avoid local overheating or significant temperature gradients, leading to high stresses in the component, the aim is to ensure an even flow of air. In the case of analyses related to heat exchange, one of the main problems is the comparison of temperature fields because standard measuring instruments such as thermocouples or thermistors only provide information about the course of temperature at a given point. Thermal imaging tests can be helpful in this case. With appropriate camera settings and taking into account environmental conditions, we are able to obtain accurate temperature fields in the form of thermograms. Emission of heat from the engine to the engine compartment is an important issue when designing a cooling system. Also, in the case of liquid cooling, the main sources of heat in the form of emissions from the engine block, cylinders, etc. should be identified. It is important to redesign the engine compartment ventilation system. Ensuring proper cooling of aircraft reciprocating engine is difficult not only because of variable operating range but mainly because of different cooling conditions related to the change of speed or altitude of flight. Engine temperature also has a direct and significant impact on the properties of engine oil, which under the influence of this parameter changes, in particular, its viscosity. Too low or too high, its value can be a result of fast wear of engine parts. One of the ways to determine the temperatures occurring on individual parts of the engine is the use of thermal imaging measurements. The article presents the results of preliminary thermal imaging tests of aircraft piston diesel engine with a maximum power of about 100 HP. In order to perform the heat emission tests of the tested engine, the ThermaCAM S65 thermovision monitoring system from FLIR (Forward-Looking Infrared) together with the ThermaCAM Researcher Professional software was used. The measurements were carried out after the engine warm up. The engine speed was 5300 rpm The measurements were taken for the following environmental parameters: air temperature: 17 °C, ambient pressure: 1004 hPa, relative humidity: 38%. The temperatures distribution on the engine cylinder and on the exhaust manifold were analysed. Thermal imaging tests made it possible to relate the results of simulation tests to the real object by measuring the rib temperature of the cylinders. The results obtained are necessary to develop a CFD (Computational Fluid Dynamics) model of heat emission from the engine bay. The project/research was financed in the framework of the project Lublin University of Technology-Regional Excellence Initiative, funded by the Polish Ministry of Science and Higher Education (contract no. 030/RID/2018/19).

Keywords: aircraft, piston engine, heat, emission

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Authors: Mariam Begadze

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Separation of Powers (SOP) has often been the most frequently posed objection against the judicial enforcement of socio-economic rights. Although a lot has been written to refute those, very rarely has it been assessed what effect the current practice of social rights adjudication has had on the construction of SOP doctrine in specific jurisdictions. Colombia is an appropriate case-study on this question. The notion of collaborative SOP in the 1991 Constitution has affected the court’s conception of its role. On the other hand, the trends in the jurisprudence have further shaped the collaborative notion of SOP. Other institutional characteristics of the Colombian constitutional law have played its share role as well. Tutela action, particularly flexible and fast judicial action for individuals has placed the judiciary in a more confrontational relation vis-à-vis the political branches. Later interventions through abstract review of austerity measures further contributed to that development. Logically, the court’s activism in this sphere has attracted attacks from political branches, which have turned out to be unsuccessful precisely due to court’s outreach to the middle-class, whose direct reliance on the court has turned into its direct democratic legitimacy. Only later have the structural judgments attempted to revive the collaborative notion behind SOP doctrine. However, the court-supervised monitoring process of implementation has itself manifested fluctuations in the mode of collaboration, moving into more managerial supervision recently. This is not surprising considering the highly dysfunctional political system in Colombia, where distrust seems to be the default starting point in the interaction of the branches. The paper aims to answer the question, what the appropriate judicial tools are to realize the collaborative notion of SOP in a context where the court has to strike a balance between the strong executive and the weak and largely dysfunctional legislative branch. If the recurrent abuse lies in the indifference and inaction of legislative branches to engage with political issues seriously, what are the tools in the court’s hands to activate the political process? The answer to this question partly lies in the court’s other strand of jurisprudence, in which it combines substantive objections with procedural ones concerning the operation of the legislative branch. The primary example is the decision on value-added tax on basic goods, in which the court invalidated the law based on the absence of sufficient deliberation in Congress on the question of the bills’ implications on the equity and progressiveness of the entire taxing system. The decision led to Congressional rejection of an identical bill based on the arguments put forward by the court. The case perhaps is the best illustration of the collaborative notion of SOP, in which the court refrains from categorical pronouncements, while does its bit for activating political process. This also legitimizes the court’s activism based on its role to counter the most perilous abuse in the Colombian context – failure of the political system to seriously engage with serious political questions.

Keywords: Colombian constitutional court, judicial review, separation of powers, social rights

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Authors: Hasan Muslemani, Jeffrey Wilson, Xi Liang, Francisco Ascui, Katharina Kaesehage

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This paper aims to examine consumer behaviour towards, and the willingness to adopt, green steel use in the automotive sector, in order to identify potential barriers and opportunities for its widespread adoption. Semi-structured interviews were held with experts from global, regional and country-specific industry associations and automakers. The analysis shows there is a new shift towards lifecycle thinking in the sector, although these efforts have been voluntary and driven by customer and employee pressures rather than regulation. The paper further appraises possible demand for green steel within different vehicle types (based on size and powertrain), and shows that manufacturers of electric heavy-duty vehicles are most likely to adopt green steel in the first instance, given the amount of incorporated steel in the vehicles and the fact that lifecycle emissions lie predominantly in their manufacturing phase. A case for green advanced higher-strength steels (AHSS) can also be made in light-duty passenger vehicles, which may mitigate competition from light-weight alternative materials in terms of cost and greenness (depending on source and utilisation zones). This work builds on a wide sustainability-related literature in the automotive sector and highlights areas in need of urgent action if the sector as a whole were to meet its Paris Agreement climate targets, in particular a need to revisit current CO2 performance regulations to include Scope 1 and Scope 2 emissions, engage in educational green marketing campaigns, and explore innovative market-based mechanisms to bridge the gap between relatively-low carbon abatement costs of steelmaking and high abatement costs of vehicle manufacturing.

Keywords: Green steel, Consumer behaviour, Automotive industry, Environmental sustainability

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Authors: A. Pietro Rimoldi, B. Anilkumar Gopinath, C. Minimol Korulla

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Coastal engineering structure is conventionally designed for a shorter planning horizon usually 20 years. These structures are subjected to different offshore climatic externalities like waves, tides, tsunamis etc. during the design life period. The probability of occurrence of these different offshore climatic externalities varies. The impact frequently caused by these externalities on the structures is of concern because it has a significant bearing on the capital /operating cost of the project. There can also be repeated short time occurrence of these externalities in the assumed planning horizon which can cause heavy damage to the conventional coastal structure which are mainly made of rock. A replacement of the damaged portion to prevent complete collapse is time consuming and expensive when dealing with hard rock structures. But if coastal structures are made of Geo-synthetic containment systems such replacement is quickly possible in the time period between two successive occurrences. In order to have a better knowledge and to enhance the predictive capacity of these occurrences, this study estimates risk of encounter within the design life period of various externalities based on the concept of exponential distribution. This gives an idea of the frequency of occurrences which in turn gives an indication of whether replacement is necessary and if so at what time interval such replacements have to be effected. To validate this theoretical finding, a pilot project has been taken up in the field so that the impact of the externalities can be studied both for a hard rock and a Geosynthetic tube structure. The paper brings out the salient feature of a case study which pertains to a project in which Geosynthetic tubes have been used for reformation of a seawall adjacent to a conventional rock structure in Alappuzha coast, Kerala, India. The effectiveness of the Geosystem in combatting the impact of the short-term externalities has been brought out.

Keywords: climatic externalities, exponential distribution, geosystems, planning horizon

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Authors: Jiří Vágner, Dana Fialová

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The Covid-19 pandemic and its effects have triggered significant changes in travel behavior. On the contrary to a deep decline in international tourism, domestic tourism has recovered. It has not fully replaced the total volume of national tourism so far. However, from a regional point of view, and especially according to the type of destinations, regional targeting has changed significantly compared to the previous period. Urban destinations, which used to be the domain of foreign tourists, have been relatively orphaned, in contrast to destinations tied to natural attractions, which have seen seasonal increases. Even here, at a lower hierarchical geographic level, we can observe the differentiation resulting from the existing localization and infrastructure. The case study is focused on the three largest water reservoirs of the Vltava Cascade in Czechia– Lipno, Orlík, and Slapy. Based on a detailed field survey, in the periods before and during the pandemic, as well as available statistical data (Tourdata; Czech Statistical Office, Czech Cadaster and Ordnance Survey), different trends in the exploitation of these destinations with regard to existing or planned infrastructure are documented, analyzed and explained. This gives us the opportunity to discuss on concrete examples of generally known phenomena that are usually neglected in tourism: slum, brownfield, greenfield. Changes in travel behavior – especially the focus on spending leisure time individually in naturally attractive destinations – can affect the use of sites, which can be defined as a tourist or recreational slum, brownfield, but also as a tourist greenfield development. Sociocultural changes and perception of destinations by tourists and other actors represent, besides environmental changes, major trends in current tourism.

Keywords: Covid-19 pandemic, czechia, sociocultural and environmental impacts, tourist infrastructure, travel behavior, the Vltava Cascade water reservoirs

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Authors: Jessy Rugeyo, William Donner

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This research delves into the resilience of Rwanda's public health infrastructure amidst natural disasters, a critical issue given that the Northern Province alone has witnessed no fewer than 1500 cases of disaster ranging from floods and landslides in the last five years, with more than 200 people killed and thousands of homes destroyed, according to MINEMA. In an era where climate change escalates the frequency and intensity of such disasters, fortifying the resilience of public health systems is paramount. This study offers a comprehensive analysis of the existing state of Rwanda's public health infrastructure and its ability to manage such crises. Employing a mix of literature review, case studies, and policy analysis, the study discerns key vulnerabilities and brings to light the intricacies of disaster management in Rwanda. Case studies centered around past natural disasters in Rwanda provide critical insights into the strengths and weaknesses of the existing disaster response mechanisms. A thorough critique of related disaster management and public health infrastructure policies reveals areas of commendable practice, along with gaps calling for policy enhancements. Findings guide the proposition of targeted strategies to bolster the resilience of Rwanda's public health infrastructure. This research serves as a significant contribution to the domains of disaster studies and public health, offering valuable insights for policymakers, public health and disaster management professionals in Rwanda and similar contexts. It presents actionable recommendations for improvement, underscoring the potential for enhancing Rwanda's disaster management capacity. By advocating for the strengthening of public health infrastructure resilience, the research highlights the potential for improved public health outcomes following natural disasters, thereby showcasing significant implications for public health and disaster management in the country, particularly in the face of a changing climate.

Keywords: public health infrastructure, disaster resilience, natural disaster, disaster management, emergency preparedness, health policy

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Authors: Naufal Ahmed, Michael Lwin

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Background: MPFL reconstructions are ideally performed with au-tografts like gracilis semitendinosus tendon, which may be associated with donor site morbidity and complications. In this case series, we have tried to use fiber tape, which avoids the above complications and also keeps the graft virgin. This kind of synthetic graft has been used successfully in rotator cuffs and ACJ reconstructions with good results. Materials and methods: It was a retrospective data analysis of 45 patients who underwent this procedure from 2014-2020 under a single consultant in a DGH . These patiens have been followed up at 6 weeks, 6 months, 1 year, and 1 ½ years with clinical assessment and KOOS scores. We compared the results with the NJR and also with the Belgium report and was found to be satisfactory and comparable with them. Surgical technique : We used Arthrex fiber tape for the reconstruction of MPFL . Initially, two parallel holes drilled over sup aspect of the patella with help of an image intensifier, and then fiber wire passed through them from the medial to the lateral side and back to the medial side. The fiber wire was attached to the schottle point on the femoral side, giving a good extra articular internal brac-ing to the MPFL. All patients were scoped before the procedure, and the final tightening over the femoral side was done directly under vision to see the position of the patella. Results: We had 45 MPFL reconstructions along with 4 additional procedures 1 ACLR, 2 ACL REPAIR, 1 TTT advancement ( revision MPFL ). There were 14 males and 31 females, and their average age was 25 (13-55 ). We did not have any donor site morbidity, no infection, no fractures, no recurrent dislocations, no reoperations yet. Conclusion: Fiber tape is a feasible and appropriate option for MPFL reconstruction. We haven’t seen any re -operation in our 5 year follow up. This technique avoids the use of autograft, which can be used in the future if needed for revision surgeries. We don’t lose anything by following this simple novel technique.

Keywords: arthroscopy, fibertape, MPFL reconstruction, recurrent patella dislocation

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Authors: Alison Brown

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Through stories, children make sense of their world, see themselves through the eyes of another, and process emotions and lived experiences in a non-threatening and indirect manner. Building on research around the use of narrative techniques with adults and families, this research looked directly at the use of narratives as a therapeutic technique with children in counseling. Based on individual therapy sessions with children over a six-year period, this work of collective case studies tells the story of a practice incorporating children’s narratives, of children’s experiences in writing and sharing their narratives, and of the clinical impact of the use of narratives with children. Not all stories were narratives of success or happiness. Children documented their fears and anger as well as their achievements and hope for the future. What emerged through this study was an awareness of recurring themes in the way children responded to the narrative process and in the benefits and limitations of story writing with children. Consistent with previous studies focusing on narrative work with adults and families, the use of narratives with children provided opportunities for healing, acceptance, developing greater understanding, externalizing, and re-authoring a preferred future. In terms of the children’s experiences in writing and sharing their narratives, consistent themes emerged again, with many children finding the experience cathartic and liberating, empowering and hopeful, but most importantly, an opportunity that allowed them to feel and understand that they were not alone. Whilst a small collection of case studies tells the stories of a limited number of children, it is hoped that this research provides both a model and inspiration for others to explore similar uses of narratives with children. As a greater number of children’s narratives are created, the potential to share and benefit from the many rich stories and experiences of other children becomes more of a reality. Across cultures, economic and social settings, rural and urban environments, and varying family structures, it is important that we hear the voices of our children – ‘In their own words’.

Keywords: narrative therapy children counselling, social, emotional, zone of proximal development, scaffolding

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Authors: Liwiusz Wojciechowski

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Research background: The current knowledge does not give a clear answer to the question of the impact of FDI on productivity. Results of the empirical studies are still inconclusive, no matter how extensive and diverse in terms of research approaches or groups of countries analyzed they are. It should also take into account the possibility that FDI and productivity are linked and that there is a bidirectional relationship between them. This issue is particularly important because on one hand FDI can contribute to changes in productivity in the host country, but on the other hand its level and dynamics may imply that FDI should be undertaken in a given country. As already mentioned, a two-way relationship between the presence of foreign capital and productivity in the host country should be assumed, taking into consideration the endogenous nature of FDI. Purpose of the article: The overall objective of this study is to determine the causality between foreign direct investment and total factor productivity in host county in terms of different relative absorptive capacity across countries. In the classic sense causality among variables is not always obvious and requires for testing, which would facilitate proper specification of FDI models. The aim of this article is to study endogeneity of selected macroeconomic variables commonly being used in FDI models in case of Visegrad countries: main recipients of FDI in CEE. The findings may be helpful in determining the structure of the actual relationship between variables, in appropriate models estimation and in forecasting as well as economic policymaking. Methodology/methods: Panel and time-series data techniques including GMM estimator, VEC models and causality tests were utilized in this study. Findings & Value added: The obtained results allow to confirm the hypothesis states the bi-directional causality between FDI and total factor productivity. Although results differ from among countries and data level of aggregation implications may be useful for policymakers in case of providing foreign capital attracting policy.

Keywords: endogeneity, foreign direct investment, multi-equation models, total factor productivity

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Authors: Kevin Soubly, Kaysara Khatun

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This study applies the existing Middle-Out Perspective (MOP) as a complementing analytical alternative to the customary dichotomous options of top-down vs. bottom-up strategies of international development and commons governance. It expands the framework by applying it to a new context of land management and environmental change, enabling fresh understandings of decision making around land use. Using a case study approach in Central Kalimantan, Indonesia among a village of indigenous Dayak, this study explores influences from both internal and external middle actors, utilizing qualitative empirical evidence and incorporating responses across 25 village households and 11 key stakeholders. Applying the factors of 'agency' and 'capacity' specific to the MOP, this study demonstrates middle actors’ unique capabilities and criticality to change due to their influence across various levels of decision-making. Study results indicate that middle actors play a large role, both passively and actively, both directly and indirectly, across various levels of decision-making, perception-shaping, and commons governance. In addition, the prominence of novel 'passive' middle actors, such as the internet, can provide communities themselves with a level of agency beyond that provided by other middle actors such as NGOs and palm oil industry entities – which often operate at the behest of the 'top' or out of self-interest. Further, the study posits that existing development and decision-making frameworks may misidentify the 'bottom' as the 'middle,' raising questions about traditional development and livelihood discourse, strategies, and support, from agricultural production to forest management. In conclusion, this study provides recommendations including that current policy preconceptions be reevaluated to engage middle actors in locally-adapted, integrative manners in order to improve governance and rural development efforts more broadly.

Keywords: environmental management, governance, Indonesia, land use, middle actors, middle-out perspective

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Authors: Sarah M. Schoellhammer, Stephen Gibb

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Bureaucracy, in particular, its core element, a formal and stable hierarchy of authority, is proving less and less appropriate under the conditions of today’s knowledge economy. Centralization and formalization were consistently found to hinder innovation, undermining cross-functional collaboration, personal responsibility, and flexibility. With its focus on systematical planning, controlling and monitoring the development of new or improved solutions for customers, even innovation management as a discipline is to a significant extent based on a mechanistic understanding of organizations. The most important drivers of innovation, human creativity, and initiative, however, can be more hindered than supported by central elements of classic innovation management, such as predefined innovation strategies, rigid stage gate processes, and decisions made in management gate meetings. Heterarchy, as an alternative network form of organization, is essentially characterized by its dynamic influence structures, whereby the biggest influence is allocated by the collective to the persons perceived the most competent in a certain issue. Theoretical arguments that the non-hierarchical concept better supports innovation than bureaucracy have been supported by empirical research. These prior studies either focus on the structure and general functioning of non-hierarchical organizations or on their innovativeness, that means innovation as an outcome. Complementing classic innovation management approaches, this work aims to shed light on how innovations are initiated and realized in heterarchies in order to identify alternative solutions practiced under conditions of the post-bureaucratic organization. Through an initial individual case study, which is part of a multiple-case project, the innovation practices of an innovative and highly heterarchical medium-sized company in the German fire engineering industry are investigated. In a pragmatic mixed methods approach media resonance, company documents, and workspace architecture are analyzed, in addition to qualitative interviews with the CEO and employees of the case company, as well as a quantitative survey aiming to characterize the company along five scaled dimensions of a heterarchy spectrum. The analysis reveals some similarities and striking differences to approaches suggested by classic innovation management. The studied heterarchy has no predefined innovation strategy guiding new product and service development. Instead, strategic direction is provided by the CEO, described as visionary and creative. Procedures for innovation are hardly formalized, with new product ideas being evaluated on the basis of gut feeling and flexible, rather general criteria. Employees still being hesitant to take responsibility and make decisions, hierarchical influence is still prominent. Described as open-minded and collaborative, culture and leadership were found largely congruent with definitions of innovation culture. Overall, innovation efforts at the case company tend to be coordinated more through cultural than through formal organizational mechanisms. To better enable innovation in mainstream organizations, responsible practitioners are recommended not to limit changes to reducing the central elements of the bureaucratic organization, formalization, and centralization. The freedoms this entails need to be sustained through cultural coordination mechanisms, with personal initiative and responsibility by employees as well as common innovation-supportive norms and values. These allow to integrate diverse competencies, opinions, and activities and, thus, to guide innovation efforts.

Keywords: bureaucracy, heterarchy, innovation management, values

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Authors: Y. P. Raghavendra Babu

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Electrocution is a common cause of morbidity and mortality as electricity is an indispensible part of today’s World. Deaths due to electrocution which are witnessed do not pose a problem at the manner and cause of death. However un-witnessed deaths can raise suspicion of manner of death. A case of fatal electrocution is reported here which was diagnosed to be accidental in manner with the help of reconstruction of events by proper investigation.

Keywords: electrocution, manner of death, reconstruction of events, health information

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Authors: Praniil Nagaraj

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This paper proposes a method to collect homeless data using crowdsourcing and presents an approach to analyze the data, demonstrating its potential to strengthen existing and future policies aimed at promoting socio-economic equilibrium. The 2022 Annual Homeless Assessment Report (AHAR) to Congress highlighted alarming statistics, emphasizing the need for effective decision-making and budget allocation within local planning bodies known as Continuums of Care (CoC). This paper's contributions can be categorized into three main areas. Firstly, a unique method for collecting homeless data is introduced, utilizing a user-friendly smartphone app (currently available for Android). The app enables the general public to quickly record information about homeless individuals, including the number of people and details about their living conditions. The collected data, including date, time, and location, is anonymized and securely transmitted to the cloud. It is anticipated that an increasing number of users motivated to contribute to society will adopt the app, thus expanding the data collection efforts. Duplicate data is addressed through simple classification methods, and historical data is utilized to fill in missing information. The second contribution of this paper is the description of data analysis techniques applied to the collected data. By combining this new data with existing information, statistical regression analysis is employed to gain insights into various aspects, such as distinguishing between unsheltered and sheltered homeless populations, as well as examining their correlation with factors like unemployment rates, housing affordability, and labor demand. Initial data is collected in San Francisco, while pre-existing information is drawn from three cities: San Francisco, New York City, and Washington D.C., facilitating the conduction of simulations. The third contribution focuses on demonstrating the practical implications of the data processing results. The challenges faced by key stakeholders, including charitable organizations and local city governments, are taken into consideration. Two case studies are presented as examples. The first case study explores improving the efficiency of food and necessities distribution, as well as medical assistance, driven by charitable organizations. The second case study examines the correlation between micro-geographic budget expenditure by local city governments and homeless information to justify budget allocation and expenditures. The ultimate objective of this endeavor is to enable the continuous enhancement of the quality of life for the underprivileged. It is hoped that through increased crowdsourcing of data from the public, the Generosity Curve and the Need Curve will intersect, leading to a better world for all.

Keywords: crowdsourcing, homelessness, socio-economic policies, statistical analysis

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Authors: Christine Ysabelle G. Roman, Pauline Torres

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Background: Hypertrophic cardiomyopathy is a disease of marked heterogeneity. It is a genetically determined heart disease characterized by significant myocardium hypertrophy that results in diastolic dysfunction, left ventricular outflow tract obstruction, and an increased risk of arrhythmias. The primary treatment in patients with such conditions is negative inotropic drugs, such as beta-blockers, calcium channel antagonists, and disopyramide. However, for those who remain symptomatic and need septal reduction therapy, surgical septal myectomy or alcohol septal ablation are options. Case Summary: A 19 – year old female presented in the authors’ institution with easy fatigability. The consult was done a year prior, and 2D echocardiography was requested which showed concentric left ventricular hypertrophy, asymmetrically hypertrophied interventricular septum (IVS) with the largest diameter of 3.3cm & subaortic dynamic obstruction with a maximum gradient of 47 mmHg. A repeat echo a year later showed asymmetric septal hypertrophy (IVS measuring at 3cm) with the systolic anterior motion of anterior mitral valve leaflet and left ventricular outflow tract obstruction (peak gradient of 50mmHg). The patient then underwent alcohol septal ablation and was discharged stable after four days of admission. Conclusion: Hypertrophic obstructive cardiomyopathy, a cardiovascular genetic disease, results in various patterns of left ventricular hypertrophy and abnormality of mitral valve apparatus. The patient is managed medically initially. However, despite optimal drug therapy and significant left ventricular outflow tract obstruction, significant heart failure symptoms or syncope require invasive treatment.

Keywords: hypertrophic obstructive cardiomyopathy, left ventricular outflow tract obstruction, alcohol septal ablation, alcohol

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Authors: Nida Iftikhar, Jamaluddin Thaheem, Bilal Iftikhar

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In the construction industry, adequate and effective decision-making can mean the difference between success and failure. Bidding is the most important element of the construction business since it is a mean by which contractors obtain work. This is probably the only option for any contractor firm to sustain in the market and achieve its objective of earning the profits by winning tenders. The capability to select most appropriate ventures not only defines the success and wellbeing of contractor firms but also their survival and sustainability in the industry. The construction practitioners are usually on their own when it comes to deciding on bidding for a project or not. Usually, experience-based solutions are offered where a lot of subjectivity is involved. This research has been opted considering the local construction industry of Pakistan in order to examine the critical success factors from contractors’ perspective while making bidding decisions, listing and evaluating critical factors in order of their importance, categorization of these factors into decision support & decision oppose groups and to develop a framework to help contractors in the decision-making process. Literature review, questionnaires, and structured interviews are used for identification and quantification of factors affecting bid/no bid decision-making. Statistical methods of ranking analysis and analytical hierarchy process of multi-criteria decision-making method are used for analysis. It is found that profitability, need for work and financial health of client are the most decisive factors in bid/no bid decision-making while project size, project type, fulfilling the tender conditions imposed by the client and relationship, identity & reputation of the client are least impact factors in bid/no bid decision-making. Further, to verify the developed framework, case studies have been conducted to evaluate the bid/no bid decision-making in building procurement. This is the first of its nature study in the context of the local construction industry and recommends using a holistic decision-making framework for such business-critical deliberations.

Keywords: bidding, bid decision-making, construction procurement, contractor

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Authors: Rafael Santos, Clara Pimenta Do Vale, Barbara Bogoni, Poul Henning Kirkegaard

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In the last decades, the relevance of hand drawing has decreased in the scope of architectural education. However, some schools continue to recognize its decisive role, not only in the architectural design teaching, but in the whole of architectural training. With this paper it is intended to present the results of a research developed on the following problem: the practise of hand drawing as a premier form of representation in architectural design teaching. The research had as its object the educational model of the Faculty of Architecture of the University of Porto (FAUP) and was led by three main objectives: to identify the circumstance that promoted hand drawing as a form of representation in FAUP's model; to characterize the types of hand drawing and their role in that model; to determine the particularities of hand drawing as a premier form of representation in architectural design teaching. Methodologically, the research was conducted according to a qualitative embedded single-case study design. The object – i.e., the educational model – was approached in FAUP case considering its Context and three embedded unities of analysis: the educational Purposes, Principles and Practices. In order to guide the procedures of data collection and analysis, a Matrix for the Characterization (MCC) was developed. As a methodological tool, the MCC allowed to relate the three embedded unities of analysis with the three main sources of evidence where the object manifests itself: the professors, expressing how the model is Assumed; the architectural design classes, expressing how the model is Achieved; and the students, expressing how the model is Acquired. The main research methods used were the naturalistic and participatory observation, in-person-interview and documentary and bibliographic review. The results reveal that the educational model of FAUP – following the model of the former Porto School – was largely due to the methodological foundations created with the hand drawing teaching-learning processes. In the absence of a culture of explicit theoretical elaboration or systematic research, hand drawing was the support for the continuity of the school, an expression of a unified thought about what should be the reflection and practice of architecture. As a form of representation, hand drawing plays a transversal role in the entire educational model, since its purposes are not limited to the conception of architectural design – it is also a means for perception, analysis and synthesis. Regarding the architectural design teaching, there seems to be an understanding of three complementary dimensions of didactics: the instrumental, methodological and propositional dimension. At FAUP, hand drawing is recognized as the common denominator among these dimensions, according to the idea of "globality of drawing". It is expected that the knowledge base developed in this research may have three main contributions: to contribute to the maintenance and valorisation of FAUP’s model; through the precise description of the methodological procedures, to contribute by transferability to similar studies; through the critical and objective framework of the problem underlying the hand drawing in architectural design teaching, to contribute to the broader discussion concerning the contemporary challenges on architectural education.

Keywords: architectural design teaching, architectural education, forms of representation, hand drawing

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Authors: Renu Sisodia

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This paper attempted to explore and explain the local level river water conflicts in the larger context of state - society relations. This study also covered causes of local level river water conflicts in the catchment area of Bandi and Arvari river of Rajasthan. The focus of the study was on the emergence of community driven, decentralised management of river water bodies and strategies used by local communities to protect and manage river water conflicts. The research is conducted through the process of designing a framework based on essential theoretical and practical findings supported by primary and secondary data. Two in depth case study is conducted to understand the phenomenon in depth. The first field site is Bandi River of Pali district, which is about the struggle between textile industries, community and the State government in which water pollution is said to be one of the driving force of the conflict. Finding shows that the state is supporting textile industries in Pali district have not been adherent to the environmental ethics. Present legal infrastructure and local institutions fail to resolve the serious problem of water pollution in Bandi River and its adverse impact on the local community as a result local community resistance against the local administration and the state government. The second case illustrates the plight of Arvari River in Alwar district. Tussle for the ownership of fisheries between local community, the private fish contractor and State government has been the main bone of contestation. To resolve this conflict local community formed conflict management mechanism named as Arvari Parliament. Arvari Parliament has its own principle and rules to resolve water conflicts related to ownership of the river and use of the river water. The research findings also highlight the co-existence between conventional and modern practices in resolving conflicts.

Keywords: water, water pollution, water conflicts, water scarcity, conflict resolution, local community

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Authors: Dmitry Nosik, Nickolay Nosik, Elli Kaplina, Olga Lobach, Marina Chataeva, Lev Rasnetsov

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Background and aims: Human Immunodeficiency Virus (HIV) infection is very often associated with Herpes Simplex Virus (HSV) infection but HIV patients are treated with a cocktail of antiretroviral drugs which are toxic. The use of an antiviral drug which will be active against both viruses like ferrovir found in our previous studies is rather actual. Earlier we had shown that Fullerene poly-amino capronic acid (FPACA) was active in case of monoinfection of HIV-1 or HSV-1. The aim of the study was to analyze the efficiency of FPACA against mixed infection of HIV and HSV. Methods: The peripheral blood lymphocytes, CEM, MT-4 cells were simultaneously infected with HIV-1 and HSV-1. FPACA was added 1 hour before infection. Cells viability was detected by MTT assay, virus antigens detected by ELISA, syncytium formation detected by microscopy. The different multiplicity of HIV-1/HSV-1 ratio was used. Results: The double viral HIV-1/HSV-1 infection was more cytopathic comparing with monoinfections. In mixed infection by the HIV-1/HSV-1 concentration of HIV-1 antigens and syncytium formations increased by 1,7 to 2,3 times in different cells in comparison with the culture infected with HIV-1 alone. The concentration of HSV-1 increased by 1,5-1,7 times, respectively. Administration of FPACA (1 microg/ml) protected cells: HIV-1/HSV-1 (1:1) – 80,1%; HIV-1/HSV-1 (1:4) – 57,2%; HIV-1/HSV-1 (1:8) – 46,3 %; HIV-1/HSV-1 (1:16) – 17,0%. Virus’s antigen levels were also reduced. Syncytium formation was totally inhibited in all cases of mixed infection. Conclusion: FPACA showed antiviral activity in case of mixed viral infection induced by Human Immunodeficiency Virus and Herpes Simplex Virus. The effect of viral inhibition increased with the multiplicity of HIV-1 in the inoculum. The mechanism of FPACA action is connected with the blocking of the virus particles adsorption to the cells and it could be suggested that it can have an antiviral activity against some other viruses too. Now FPACA could be considered as a potential drug for treatment of HIV disease complicated with opportunistic herpes viral infection.

Keywords: antiviral drug, human immunodeficiency virus (hiv), herpes simplex virus (hsv), mixed viral infection

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Authors: Bill D. Geis

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Suicide wrongful death forensic cases are the fastest rising tort in mental health law. It is estimated that suicide-related cases have accounted for 15% of U.S. malpractice claims since 2006. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from U.S. state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. Research in recent years, however, has indicated that the majority of persons who end their lives do not say they are suicidal at their last medical or psychiatric contact. Near-term risk assessment—that goes beyond verbalized suicide ideation—is needed. Our previous research employed structural equation modeling to predict lethal suicide risk--eight negative thought patterns (feeling like a burden on others, hopelessness, self-hatred, etc.) mediated by nine transdiagnostic clinical factors (mental torment, insomnia, substance abuse, PTSD intrusions, etc.) were combined to predict acute lethal suicide risk. This structural equation model, the Lethal Suicide Risk Pattern (LSRP), Acute model, had excellent goodness-of-fit [χ2(df) = 94.25(47)***, CFI = .98, RMSEA = .05, .90CI = .03-.06, p(RMSEA = .05) = .63. AIC = 340.25, ***p < .001.]. A further SEQ analysis was completed for this paper, adding a measure of Acute Suicide Ideation to the previous SEQ. Acceptable prediction model fit was no longer achieved [χ2(df) = 3.571, CFI > .953, RMSEA = .075, .90% CI = .065-.085, AIC = 529.550].This finding suggests that, in this additional study, immediate verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The LSRP and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training. Without this training, the standard of care for suicide assessment is out of sync with current research—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: forensic evaluation, standard of care, suicide, suicide assessment, wrongful death

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Authors: Cemil Atakara, Hüseyin Eryaman

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The use of glass as an envelope of a building has been increasing in the twentieth century. For more transparency and dematerialization new glass facade types have emerged in the past two decades which depends on point fixed glazing system (PFGS). The aim of this study is to analyze of the PFGS systems which are used on the glass curtain wall according to their types, degree, architectural and structural effects. This new system is desired because it enhances the transparency of the façade and it minimizes the component of the frames or of the profiles. This PFGS led to new structural elements which use cables, rods, trusses when designing a glass building facades, this structural element called the suspended glass system with pre-stressed cable truss (SGSPCT) which has been used for the first time in 1980 in Serres building. The twenty glass buildings which are designed in different systems have been analyzed during this study. After these analyses five selected SGSPCT building analyzed deeply and one skeletal frame building selected from Lefkosa redesigned according to the analysis results. These selected buildings have been included of various cable-truss system typologies and degree. The methodology of this study is building analysis method and literature survey with the help of books, articles, magazines, drawings, internet sources and applied connection details of the glass buildings. The selected five glass buildings and case building have been detailed analyzed with their architectural drawings, photographs and details. A gridshell structure can be compared with a shell structure; it consists of discrete members connecting nodal points. As these nodal points lie on the surface of an imaginary shell, their shapes function almost identically. Difference between shell and gridshell structures can be found in the fact that, due to their free-form and thus, due to the presence of bending forces, gridshells are required to resist loading through their cross-section. This research is divided into parts. A general study about the glass building and cable-glass and grid shell system will be done in the first chapters. Structural analyses and detailed analyses with schematic drawings with the plans, sections of the selected buildings will be explained in the second part. The third part it consists of the advantages and disadvantages of the use of the SGSPCT and Grid Shell in architecture. The study consists of four chapters including the introduction chapter. The general information of the SGSPCT and glazing system has been mentioned in the first chapter. Structural features, typologies, transparency principle and analytical information on systems have been explained of the selected buildings in the second chapter. The detailed analyses of case building have been done according to their schematic drawings with the plans, sections in the third chapter. After third chapter SGSPCT discussed on to the case building and selected buildings. SGSPCT systems have been compared with their advantages and disadvantages to the other systems. Advantages of cable-truss systems and SGSPCT have been concluded that the use of glass substrates in the last chapter.

Keywords: cable truss, glass, grid shell, transparency

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Authors: Sergey Sorokin, Irina Sorokina, Alexander Yazenin

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We present a solution to the Maxmin u/E parameters estimation problem of possibility distributions in m-dimensional case. Our method is based on geometrical approach, where minimal area enclosing ellipsoid is constructed around the sample. Also we demonstrate that one can improve results of well-known algorithms in fuzzy model identification task using Maxmin u/E parameters estimation.

Keywords: possibility distribution, parameters estimation, Maxmin u\E estimator, fuzzy model identification

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Authors: Mahani Razali, Nordin Mamat

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The purpose of this research is to identify the teacher’s role and parent’s participation to develop children`s socio emotion through play activities. This research is based on three main objectives which are to identify children`s socio emotion during play activities, teacher’s role and parent’s participation to develop children`s socio emotion. This qualitative study was carried out among 25 pre-school children, three teachers and three parents as the research sample. On the other hand, parent’s support was obtained from their discussions, supervisions and communication at home. The data collection procedures involved structured observation which was to identify socio emotional development element among pre-school children through play activities; as for semi-structured interviews, it was done to study the perception of the teachers and parents on the acquired socio emotional development among the children. Besides, documentation analysis method was used as to triangulate acquired information with observations and interviews. In this study, the qualitative data analysis was tabulated in descriptive manner with frequency and percentage format. This study primarily focused on five main socio emotional elements among the pre-school children: 1) Cooperation, 2) Confidence and Courage, 3) Ability to communicate, 4) patience, and 5) Tolerance. The findings of this study were presented in the form of case to case manner from the researches sample. Findings revealed that the children showed positive outcomes on the socio emotional development during their play. Both teachers and parents showed positive perceptions towards the acquired socio emotional development during their play activities. In conclusion, this research summarizes that teacher’s role and parent’s support can improve children`s socio emotional development through play activities. As a whole, this research highlighted the significance of play activities as to stimulate socio emotional development among the pre-school children.

Keywords: social emotional, children, play activities, stimulating

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Authors: Ma'in Abushaikha

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Memorials are usually a landmark could be either an object, sculpture or a statue. They are built for a specific group or person who has died with historical contribution, or it could refer to an important hub, event or a specific culture, therefore to keep past events alive in the common memory through this kind of physical representation in public areas, or even to satisfy the desire to honour something either it is a person who suffered or died during a conflict or just to honour a group of people or even a whole society in a specific character they used to possess during a specific period of time. The aim behind the research is to look more deeply about the importance of memorials placement and environment for more successful outcomes towards people's psychology, therefore, behavior, manners and characteristics, knowing that in the main, they are usually set for function able purposes so people could be involved meaningfully therefore psychologically more than aesthetically. What contribution either positive or negative does memorialization through its physical/urban elements has towards people? Is it towards locals social reconstruction over time including either their understanding to the current conflicts or is it toward their general behavior, manners and characteristics in terms of psychology? And how important Memorial's placement is for the observer? Moreover, how does that either reduces or increases its value, attractiveness, and its effectiveness? This paper considers taking north Cyprus memorials as the main case study, is good enough as a choice to support the research hypothesis where a comparison between deferent memorials is going to be done as the main approach in trying to address the mentioned questions, by that, the research requires field survey in terms of interviewing both dwellers and general observers as well as library survey by viewing similar studies. As a significant result, this research is about to come up assesses how important memorials placements are, in order to apply its impact to the observers, whereas the most successful placed ones have its more effectiveness on observers psychology by time by introducing several mental reflects by this kind of physical representation.

Keywords: memorials, placement, environment, impact, psychology, characteristics, manners, behavior

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Authors: Luiz F. J. Maia

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This paper presents an approach to fuzzy control, with the use of new pertinence functions, applied in the case of an inverted pendulum. Appropriate definitions of pertinence functions to fuzzy sets make possible the implementation of the controller with only one control rule, resulting in a smooth control surface. The fuzzy control system can be implemented with analog devices, affording a true real-time performance.

Keywords: control surface, fuzzy control, Inverted pendulum, pertinence functions

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Authors: Alokananda Nath

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Land is an important issue anywhere in the world as it is one of the fundamental elements in human settlements. Since the urban areas are considered to be the drivers of economy for any country across the world and the phenomenon of ‘urbanization’ happening everywhere, there is always a greater pressure on urban land and its management. Many states in India have realized the importance of land as a valuable resource and have implemented certain framework for managing and developing land. But in West Bengal no such statutory framework has been formulated till now and a very out dated model of land acquisition for public purpose is practiced. Due to the lop-sided character of urban growth in the entire eastern region of India, the city of Kolkata continues to bear the burden of excessive growth of population and consequent urbanization of the adjoining areas at a rapid pace. This research tries to look into these conflicts with respect to the present pattern of development in the context of Kolkata and suggest a system for land management in order to implement the planning processes. For this purpose, five case study areas were taken up within the Kolkata Metropolitan Area and subsequent analysis of their present land management and development techniques was done. The findings reveal that there is a lack of political will as well as administrative inefficiency on part of both the development authority and the local bodies. Mostly the local bodies lack the financial resources and technical expertise to work out any kind of land management framework or work out any kind of model in order to manage the development that is happening. All these place undue strain on city infrastructure systems and reduce the potential of cities to contribute as engines of economic growth. The focus of reforms, therefore, ought to be on streamlining the urban planning process, judicious and optimal land use, efficient plan implementation mechanisms, improvement of titling and registration processes.

Keywords: urbanization, land management framework, land development, policy reforms, land-use planning processes

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Authors: Abeer N. Alshukairi, Abdulrahman A. Alrajhi, Abdulfattah W. Alamri, Adel F. Alothman

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We described the nosocomial transmission of a pre-XDR or an MDR case of pulmonary tuberculosis in a HIV negative health care worker in an area endemic for MDR & XDR tuberculosis. With inadequate therapy and non-compliance, his strain developed acquired resistance and he presented with extra-pulmonary XDR tuberculosis in the form of multi-focal osteomyelitis and encysted pleural effusion. He was cured after 2 years of therapy with various anti-tuberculous drugs in addition to interferon gamma.

Keywords: osteomyelitis, treatment, XDR tuberculosis, successful treatment

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Authors: Y. Kunitani, Y. Nakashima, S. Yamauchi, Y. Ishigami, K. Naito, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi

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Background: Japanese Spotted Fever (JSF) is one of the Rickettsial infections, caused by Rickettsia japonica, which is transmitted by ticks. JSF is seen in limited area, such as Japan and South Korea. Its clinical triad is rash, eschar and fever. It often shows leukocytopenia, thrombopenia, elevated transaminase and high C-reactive protein (CRP). Sometimes it can be life-threatening due to disseminated intravascular coagulation or multiple organ failure. Study Aim: The aim of this study is to describe the features of JSF, as this unique infection is rapidly growing in Japan. Methods: This is a case series of JSF from 2009 to 2016, in Mie Prefectural Hospital in Japan. We collected JSF cases, which were diagnosed by polymerase chain reaction (PCR) of the skin or blood serum, or the elevation of the antibody titer of paired blood samples. Results: There were 43 JSF patients (19 male, 24 female) with a median age of 71 years [IQR:65-80]. The median body temperature was 38.1°C[IQR: 37.5-39.0]. 95% had a rash, 67% had eschar and 50% had fever. The median WBC count was 6,700 [IQR: 5,750-8,200] and leukocytopenia was observed in only 7%. The median platelet count was 14x104 [IQR10x104-17x104], thrombopenia was observed in 65%. The median aspartate transaminase (AST) was 53 IU/L [IQR: 41-93]; the median alanine aminotransferase (ALT) was 34 IU/L [IQR: 24-54]; the median CRP was 10.4 mg/dL [IQR:7.2-13.9]; the median lactate dehydrogenase (LDH) was 352IU/L [IQR:282-451]. CRP and LDH were elevated in almost all of the patients. Median length of stay in hospital was 8 days [IQR: 6-11]. All patients were treated with tetracycline and quinolone on the day of the presentation. There was no fatality from JSF. Conclusion: The patients with JSF classically presents with eschar, rash and fever. However, in this study, the half of the patients were afebrile. Although JSF is not a common infectious disease worldwide, if the patient had previously visited Japan or South Korea and presented with rash and eschar with or without fever, we should consider JSF as a potential diagnosis.

Keywords: infectious disease, Japanese spotted fever, Rickettsial disease, Rickettsia japonica

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