Search results for: Rare vascular phenomenon

Authors: B. Waked Najar

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Since the spread of Covid- 19, Israel and other countries suffer from lockdowns and social distance, which impose different kinds of restrictions. On the one side, many organization closed and unemployment increased, bringing about economic problems and distress. On the other side, family ties were damaged due to inability to sustain close relations with some family members and too frequent interactions with others. Unfortunately, conflicts within families, controlling behavior and domestic violence appear more often. Purpose: to examine the phenomenon of domestic violence and its expansion during the Covid-19 crisis, to propose and classify strategies of dealing with it, including encouragement of public systems providing more information and support to domestic violence victims. Methodology: the author strives to reveal methods of supporting domestic violence victims through public and private treatment organizations. The author interviewed battered women and families who experienced violence during the Covid-19 crisis. Findings: victims of domestic violence often feel isolated and helpless. It is a real challenge to track and support them, especially in the traditional minorities’ communities. Research limitations: Many families refused to be interviewed because they did not want to be exposed to the community, especially religious families. Originality: research is aimed to examine a phenomenon of domestic violence during the Covid-19 crisis and methods of help and support the victims, which is not a common theme of research during the pandemic.

Keywords: violence, coronavirus, domestic violence, influence

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Authors: Ian Campbell, Gillian Mitchell, Paul James, Na Li, Ella Thompson

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The genetic cause of the majority of multiple-case breast cancer families remains unresolved. Next generation sequencing has emerged as an efficient strategy for identifying predisposing mutations in individuals with inherited cancer. We are conducting whole exome sequence analysis of germ line DNA from multiple affected relatives from breast cancer families, with the aim of identifying rare protein truncating and non-synonymous variants that are likely to include novel cancer predisposing mutations. Data from more than 200 exomes show that on average each individual carries 30-50 protein truncating mutations and 300-400 rare non-synonymous variants. Heterogeneity among our exome data strongly suggest that numerous moderate penetrance genes remain to be discovered, with each gene individually accounting for only a small fraction of families (~0.5%). This scenario marks validation of candidate breast cancer predisposing genes in large case-control studies as the rate-limiting step in resolving the missing heritability of breast cancer. The aim of this study is to screen genes that are recurrently mutated among our exome data in a larger cohort of cases and controls to assess the prevalence of inactivating mutations that may be associated with breast cancer risk. We are using the Agilent HaloPlex Target Enrichment System to screen the coding regions of 168 genes in 1,000 BRCA1/2 mutation-negative familial breast cancer cases and 1,000 cancer-naive controls. To date, our interim analysis has identified 21 genes which carry an excess of truncating mutations in multiple breast cancer families versus controls. Established breast cancer susceptibility gene PALB2 is the most frequently mutated gene (13/998 cases versus 0/1009 controls), but other interesting candidates include NPSR1, GSN, POLD2, and TOX3. These and other genes are being validated in a second cohort of 1,000 cases and controls. Our experience demonstrates that beyond PALB2, the prevalence of mutations in the remaining breast cancer predisposition genes is likely to be very low making definitive validation exceptionally challenging.

Keywords: predisposition, familial, exome sequencing, breast cancer

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Authors: Yvonne Dedzo

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Social media has become a powerful tool in bridging the distance between individuals regardless of their location. It has become a convenient platform for public discussion and, consequently, generated the phenomenon of citizen journalists who have become both proactive and reactive participants in the dissemination of news, information and other epochal and historical events. This phenomenon has fueled the growth of niche authorities who deliver exceptional democratically consequential information online. This study, therefore, investigates how some selected niche authorities maintain their status on social media. Using the selective processes theory, the study further interrogates the information shared by niche authorities and further analyses the extent to which a public interest-altruistic motive or personal interest-self-serving motive drives their agenda of new sharing and usage. Through cyber-ethnography and, qualitative content analysis and semi-structured interviews, data was gathered and analysed from the posts of two purposely selected niche authorities on Facebook and Twitter. The findings indicate that niche authorities maintain their status by being consistent, prompt, informative, resourceful and interactive in their postings on the social media platform. The study also discovered that even though niche authorities are motivated by both public interest-altruism and interest-self-serving, the latter had a higher of motivation than the former.

Keywords: social medida, citizen journalist, niche authorities, selective processes theory

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Authors: Paula C. Ferreira, Ana Margarida Veiga Simão, Nádia Pereira, Aristides Ferreira, Alexandra Marques Pinto, Alexandra Barros, Vitor Martinho

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Cyberbullying is a phenomenon of worldwide concern regarding children and adolescents’ mental health and risk behavior. Bystanders of this phenomenon can help diminish the incidence of this phenomenon if they engage in pro-social behavior. However, different social-cognitive and affective bystander reactions may surface because of the lack of contextual information and emotional cues in cyberbullying situations. Hence, this study investigated how cyberbullying bystanders’ unpleasant emotions could be related to their personal moral beliefs and their behavioral intentions to cyberbully or defend the victim. It also proposed to investigate how their normative beliefs of perceived severity about cyberbullying behavior could be related to their personal moral beliefs and their behavioral intentions. Three groups of adolescents participated in this study, namely a first of group 402 students (5th – 12th graders; Mage = 13.12; SD = 2.19; 55.7% girls) to compute explorative factorial analyses of the instruments used; a second group of 676 students (5th – 12th graders; Mage = 14.10; SD = 2.74; 55.5% were boys) to run confirmatory factor analyses; and a third group (N = 397; 5th – 12th graders; Mage = 13.88 years; SD = 1.45; 55.5% girls) to perform the main analyses to test the research hypotheses. Self-report measures were used, such as the Personal moral beliefs about cyberbullying behavior questionnaire, the Normative beliefs of perceived severity about cyberbullying behavior questionnaire, the Unpleasant emotions about cyberbullying incidents questionnaires, and the Bystanders’ behavioral intentions in cyberbullying situations questionnaires. Path analysis results revealed that unpleasant emotions were mediators of the relationship between adolescent cyberbullying bystanders’ personal moral beliefs and their intentions to help the victims in cyberbullying situations. Moreover, adolescent cyberbullying bystanders’ normative beliefs of gravity were mediators of the relationship between their personal moral beliefs and their intentions to cyberbully others. These findings provide insights for the development of prevention and intervention programs that promote social and emotional learning strategies as a means to prevent and intervene in cyberbullying.

Keywords: cyberbullying, normative beliefs of perceived severity, personal moral beliefs, unpleasant emotions

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Authors: Hai-Hong Gu, Yan-Jun Ai, Zheng Zhou

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Vanadium and titanium are rare metals with superior properties and are important resources in aerospace, aviation, and military. The vanadium/titanium magnetite are mostly ultra-lean ores, and a large number of tailings has been produced in the exploitation process. The tailings are characterized by loose structure, poor nutrient, complex composition and high trace metal contents. Returning green manure has been shown to not only increase plant biomass and soil nutrients but also change the bioavailability of trace metals and the microbial community structure. Fungi play an important role in decomposing organic matter and increasing soil fertility, and the application of organic matter also affects the community structure of fungi. The effects of green manure plants, alfalfa (Medicago sativa L.), returned to the tailings in situ on community structure of fungi, nutrients and bioavailability of trace metals in vanadium/titanium magnetite tailings were investigated in a pot experiment. The results showed that the fungal community diversity and richness were increase after alfalfa green manure returned in situ. The dominant phyla of the fungal community were Ascomycota, Basidiomycota and Ciliophora, especially, the phyla Ciliophora was rare in ordinary soil, but had been found to be the dominant phyla in tailings. Meanwhile, the nutrient properties and various trace metals may shape the microbial communities by affecting the abundance of fungi. It was found that the plant growth was stimulated and the available N and organic C were significantly improved in the vanadium/titanium magnetite tailing with the long-term returning of alfalfa green manure. Moreover, the DTPA-TEA extractable Cd and Zn concentrations in the vanadium/titanium magnetite tailing were reduced by 7.72%~23.8% and 8.02%~24.4%, respectively, compared with those in the non-returning treatment. The above results suggest that the returning of alfalfa green manure could be a potential approach to improve fungal community structure and restore mine tailing ecosystem.

Keywords: fungal community, green manure returning, vanadium/titanium magnet tailings, trace metals

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Authors: Muhammad Yayat Afianto, Darmawan, Agung Putra Utama, Hari Kushardanto

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Fish Forever, Rare’s innovative coastal fisheries program, combined community-based conservation management approach with spatial management to restore and protect Indonesia’s small-scale fisheries by establishing Fishing Managed Access Area. A ‘TURF-Reserve’ is a fishery management approach that positions fishers at the center of fisheries management, empowering them to take care of and make decisions about the future of their fishery. After two years of the program, social marketing campaigns succeeded in changing their behavior by adopting the new conservation behavior. The Pride-TURF-R campaigns developed an overarching hypothesis of impact that captured the knowledge, attitude and behavior changes needed to reduce threats and achieve conservation results. Rare help Batu Belah fishers to develop their group, developed with their roles, sustainable fisheries plan, and the budget plan. On 12th February 2017, the Head of Loka Kawasan Konservasi Perairan Nasional (LKKPN) which is a Technical Implementation Unit for National Marine Conservation Areas directly responsible to the Directorate General for Marine Spatial Management in the Ministry of Marine Affairs and Fisheries had signed a Partnership Agreement with the Head of Batu Belah Village to manage a TURF+Reserve area as wide as 909 hectares. The fishers group have been collecting the catch and submitting the report monthly, initiated the installation of the buoy markers for the No Take Zone, and formed the Pokmaswas (community-based surveillance group). Prior to this behavior adoption, they don’t have any fisheries data, no group of fishers, and they have still fishing inside the No Take Zone. This is really a new behavior adoption for them. This paper will show the process and success story of the social marketing campaign to conserve marine habitat in Anambas through Pride-TURF-R program.

Keywords: behavior adoption, community participation, no take zone, pride-TURF-R

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Authors: Joe Kallas

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It is now widely accepted that the preservation of cultural heritage must go beyond simple restoration and renovation actions. While some historic monuments have been preserved for millennia, many of them, less important or simply neglected because of lack of money, have disappeared. As a result, the adaptation of monuments and archaeological sites to new functions allow them to 'survive'. Temporary activities or 'ephemeral' re-use, are increasingly recognized as a means of vitalization of deprived areas and enhancement of historic sites that became obsolete. They have the potential to increase economic and cultural value while making the best use of existing resources. However, there are often conservation and preservation issues related to the implementation of this type of re-use, which can also threaten the integrity and authenticity of archaeological sites and monuments if they have not been properly managed. This paper aims to get a better knowledge of the ephemeral re-use of heritage, and more specifically the subject of the incorporation of the festival phenomenon within the monuments and archaeological sites in Lebanon, a topic that is not yet studied enough. This paper tried to determine the elements that compose it, in order to analyze this phenomenon and to trace its good practices, by comparing international study cases to important national cases: the International Festival of Baalbek, the International Festival of Byblos and the International Festival of Beiteddine. Various factors have been studied and analyzed in order to best respond to the main problematic of this paper: 'How can we preserve the integrity of sites and monuments after the integration of an ephemeral function? And what are the preventive conservation measures to be taken when holding festivals in archaeological sites with fragile structures?' The impacts of the technical problems were first analyzed using various data and more particularly the effects of mass tourism, the integration of temporary installations, sound vibrations, the effects of unstudied lighting, until the mystification of heritage. Unfortunately, the DGA (General Direction of Antiquities in Lebanon) does not specify any frequency limit for the sound vibrations emitted by the speakers during musical festivals. In addition, there is no requirement from its part regarding the installations of the lighting systems in the historic monuments and no monitoring is done in situ, due to the lack of awareness of the impact that could be generated by such interventions, and due to the lack of materials and tools needed for the monitoring process. The study and analysis of the various data mentioned above led us to the elaboration of the main objective of this paper, which is the establishment of a list of recommendations. This list enables to define various preventive conservation measures to be taken during the holding of the festivals within the cultural heritage sites in Lebanon. We strongly hope that this paper will be an awareness document to start taking into consideration several factors previously neglected, in order to improve the conservation practices in the archaeological sites and monuments during the incorporation of the festival phenomenon.

Keywords: archaeology, authenticity, conservation, cultural heritage, festival, historic sites, integrity, monuments, tourism

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Authors: Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem

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Objective: To determine incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Design and setting: Retrospective cohort study in trauma patients during anesthesia for emergency surgery at a university hospital in northern Thailand country. Patients and methods: This study was permitted by the medical ethical committee, Faculty of Medicine at Maharaj Nakorn Chiang Mai Hospital, Thailand. We clarified data of 19,683 trauma patients receiving anesthesia within a decade between January 2007 to March 2016. The data analyzed patient characteristics, traumas surgery procedures, anesthesia information such as ASA physical status classification, anesthesia techniques, anesthetic drugs, location of anesthesia performed, and cardiac arrest outcomes. This study excluded the data of trauma patients who had received local anesthesia by surgeons or monitoring anesthesia care (MAC) and the patient which missing more information. The factor associated with perioperative cardiac arrest was identified with univariate analyses. Multiple regressions model for risk ratio (RR) and 95% confidence intervals (CI) were used to conduct factors correlated with perioperative cardiac arrest. The multicollinearity of all variables was examined by bivariate correlation matrix. A stepwise algorithm was chosen at a p-value less than 0.02 was selected to further multivariate analysis. A P-value of less than 0.05 was concluded as statistically significant. Measurements and results: The occurrence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were age being more than 65 years (RR=1.41, CI=1.02–1.96, p=0.039), ASA physical status 3 or higher (RR=4.19–21.58, p < 0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each p < 0.001), cardiopulmonary comorbidities (RR=1.55, CI=1.10–2.17, p < 0.012), hemodynamic instability with shock prior to receiving anesthesia (RR=1.60, CI=1.21–2.11, p < 0.001) , special techniques for surgery such as cardiopulmonary bypass (CPB) and hypotensive techniques (RR=5.55, CI=2.01–15.36, p=0.001; RR=6.24, CI=2.21–17.58, p=0.001, respectively), and patients who had a history of being alcoholic (RR=5.27, CI=4.09–6.79, p < 0.001). Conclusion: Incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with many factors, especially age of patient and cardiopulmonary comorbidities, patient having a history of alcoholic addiction, increasing ASA physical status, preoperative shock, special techniques for surgery, and sites of surgery including brain, thorax, abdomen, and major vascular region. Anesthesiologists and multidisciplinary teams in pre- and perioperative periods should remain alert for warning signs of pre-cardiac arrest and be quick to manage the high-risk group of surgical trauma patients. Furthermore, a healthcare policy should be promoted for protecting against accidents in high-risk groups of the population as well.

Keywords: perioperative cardiac arrest, trauma patients, emergency surgery, anesthesia, factors risk, incidence

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Authors: Nihan Nugay, Nur Cicek Kekec, Kalman Toth, Turgut Nugay, Joseph P. Kennedy

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In recent years, polyurethane structures are paving the way for elastomer usage in biology, human medicine, and biomedical application areas. Polyurethanes having a combination of high oxidative and hydrolytic stability and excellent mechanical properties are focused due to enhancing the usage of PUs especially for implantable medical device application such as cardiac-assist. Currently, unique polyurethanes consisting of polyisobutylenes as soft segments and conventional hard segments, named as PIB-based PUs, are developed with precise NCO/OH stoichiometry (∽1.05) for obtaining PIB-based PUs with enhanced properties (i.e., tensile stress increased from ∽11 to ∽26 MPa and elongation from ∽350 to ∽500%). Static and dynamic mechanical properties were optimized by examining stress-strain graphs, self-organization and crystallinity (XRD) traces, rheological (DMA, creep) profiles and thermal (TGA, DSC) responses. Annealing procedure was applied for PIB-based PUs. Annealed PIB-based PU shows ∽26 MPa tensile strength, ∽500% elongation, and ∽77 Microshore hardness with excellent hydrolytic and oxidative stability. The surface characters of them were examined with AFM and contact angle measurements. Annealed PIB-based PU exhibits the higher segregation of individual segments and surface hydrophobicity thus annealing significantly enhances hydrolytic and oxidative stability by shielding carbamate bonds by inert PIB chains. According to improved surface and microstructure characters, greater efforts are focused on analyzing protein adsorption and calcification profiles. In biomedical applications especially for cardiological implantations, protein adsorption inclination on polymeric heart valves is undesirable hence protein adsorption from blood serum is followed by platelet adhesion and subsequent thrombus formation. The protein adsorption character of PIB-based PU examines by applying Bradford assay in fibrinogen and bovine serum albumin solutions. Like protein adsorption, calcium deposition on heart valves is very harmful because vascular calcification has been proposed activation of osteogenic mechanism in the vascular wall, loss of inhibitory factors, enhance bone turnover and irregularities in mineral metabolism. The calcium deposition on films are characterized by incubating samples in simulated body fluid solution and examining SEM images and XPS profiles. PIB-based PUs are significantly more resistant to hydrolytic-oxidative degradation, protein adsorption and calcium deposition than ElastEonTM E2A, a commercially available PDMS-based PU, widely used for biomedical applications.

Keywords: biomedical application, calcification, polyisobutylene, polyurethane, protein adsorption

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Authors: Sena Park

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Background: The concurrent presentation with colorectal cancer in the inguinal hernia has been extremely rare. Due to its rarity, its presentation may lead to diagnostic and therapeutic dilemmas. We aim to review all the reported cases on colorectal cancer incarcerated in the inguinal hernia in the last 20 years, and discuss the operative approaches. Methods: We identified all case reports on colorectal cancer within inguinal hernia using PUBMED (2002-2022) and MEDLINE (2002-2022). The search strategy included the following keywords: colorectal cancer (title/abstract) AND inguinal hernia (title/abstract) OR incarceration (title/abstract). The search did not include letters, book chapters, systemic reviews, meta-analysis and editorials. Results: In the last 20 years, a total of 19 cases on colorectal cancer within the inguinal hernia were identified. The age of the patients ranged between 48 and 89. Majority of the patients were male (95%). Most commonly involved part of the large intestine was sigmoid colon (79%). Of all the cases, 79 percent of patients received open procedure and 21 percent had laparoscopic procedure. Discussion: Inguinal hernias are common with an incidence of approximately 1.7 percent. Colorectal cancer is the one of the leading causes of cancer-related mortality worldwide. However, their concurrent presentation has been extremely rare. In the last 20 years, 19 cases on concurrent presentation of colorectal cancer and inguinal hernia have been reported. Most patients who had open procedures had two incisions of groin incision and a midline laparotomy. There were 4 cases where the oncological resection was performed laparoscopically. The advantages of laparoscopic resection include reduced blood lost, reduced post-operative pain, reduced length of hospital stay and similar number of lymph nodes taken. From the review of the cases in the last 20 years, both open and laparoscopic approaches seemed to be safe and achieve adequate oncological resections. Conclusion: This is a brief overview of reported cases of colorectal cancer presenting with inguinal hernia concurrently. Due to its rarity, there are no current guidelines on operative approach in clinical practice. The experience in the last 20 years supports both open and laparoscopic approach.

Keywords: colorectal cancer, inguinal hernia, incarceration, operative approach

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Authors: Vipin Kumar, Girish S. Setlur

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Graphene has been recognized as a promising 2D material with many new properties. However, pristine graphene is gapless which hinders its direct application towards graphene-based semiconducting devices. Graphene is a zero-gapp and linearly dispersing semiconductor. Massless charge carriers (quasi-particles) in graphene obey the relativistic Dirac equation. These Dirac fermions show very unusual physical properties such as electronic, optical and transport. Graphene is analogous to two-level atomic systems and conventional semiconductors. We may expect that graphene-based systems will also exhibit phenomena that are well-known in two-level atomic systems and in conventional semiconductors. Rabi oscillation is a nonlinear optical phenomenon well-known in the context of two-level atomic systems and also in conventional semiconductors. It is the periodic exchange of energy between the system of interest and the electromagnetic field. The present work describes the phenomenon of Rabi oscillations in graphene based systems. Rabi oscillations have already been described theoretically and experimentally in the extensive literature available on this topic. To describe Rabi oscillations they use an approximation known as rotating wave approximation (RWA) well-known in studies of two-level systems. RWA is valid only near conventional resonance (small detuning)- when the frequency of the external field is nearly equal to the particle-hole excitation frequency. The Rabi frequency goes through a minimum close to conventional resonance as a function of detuning. Far from conventional resonance, the RWA becomes rather less useful and we need some other technique to describe the phenomenon of Rabi oscillation. In conventional systems, there is no second minimum - the only minimum is at conventional resonance. But in graphene we find anomalous Rabi oscillations far from conventional resonance where the Rabi frequency goes through a minimum that is much smaller than the conventional Rabi frequency. This is known as anomalous Rabi frequency and is unique to graphene systems. We have shown that this is attributable to the pseudo-spin degree of freedom in graphene systems. A new technique, which is an alternative to RWA called asymptotic RWA (ARWA), has been invoked by our group to discuss the phenomenon of Rabi oscillation. Experimentally accessible current density shows different types of threshold behaviour in frequency domain close to the anomalous Rabi frequency depending on the system chosen. For single layer graphene, the exponent at threshold is equal to 1/2 while in case of bilayer graphene, it is computed to be equal to 1. Bilayer graphene shows harmonic (anomalous) resonances absent in single layer graphene. The effect of asymmetry and trigonal warping (a weak direct inter-layer hopping in bilayer graphene) on these oscillations is also studied in graphene systems. Asymmetry has a remarkable effect only on anomalous Rabi oscillations whereas the Rabi frequency near conventional resonance is not significantly affected by the asymmetry parameter. In presence of asymmetry, these graphene systems show Rabi-like oscillations (offset oscillations) even for vanishingly small applied field strengths (less than the gap parameter). The frequency of offset oscillations may be identified with the asymmetry parameter.

Keywords: graphene, Bilayer graphene, Rabi oscillations, Dirac fermion systems

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Authors: Damian Winczewski

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Carl von Clausewitz’s political theory of war was criticized in the 20th century in several ways. It was also the source of many disagreements over readings of its most popular theses. Among them, the reflections of thinkers categorized as part of the broader postmodern current stand out, such as Michael Foucault and his successors, who presented a nuanced and critical approach to strategy theory. Foucault viewed it as part of a broader political–legal discourse of sovereignty rooted in the Middle Ages, which underlies modern biopower. Clausewitz’s theory of strategy underpinned a new humanist discourse rationalizing the phenomenon of war while, in a methodological sense, becoming an epistemic model of how Foucault conceived power strategy. Foucault’s contemporary commentators try to develop his position by arguing the analogy between the discourse prevailing in Clausewitz’s time and the contemporary neoliberal discourse and technological revolution on the battlefield, which create a new order of power. Meanwhile, they recognize that the modern development of strategy was to make Clausewitz’s understanding of war obsolete. However, postmodernists focusing on showy stylistics in their assessments rely on a mythologized narrative about Clausewitz, reducing his theories to a discourse of war as a way for nation-states to conduct foreign policy. In this article, Clausewitz shows that his theory goes much deeper and provides a critical perspective on the relationship between war and politics. The dialectical structure makes it possible to understand war as a historically variable but constantly policy-dependent phenomenon.

Keywords: Clausewitz, Foucault, Virilio, postmodernism, war and politics, power

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Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.

Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis

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Authors: R. Maher, D. Marchant, F. Fazel

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The initial aim of the study was to capitalize on the depth of athletes’ and coaches’ knowledge pertaining to the phenomenon of choking in basketball, free-throw shooting in particular, from an ‘insiders’ perspective. The findings of this study have developed a deeper understanding of how basketball players and coaches deal with choking and potentially contribute new knowledge relevant to designing useful interventions for alleviating choking. A key element was thus, knowledge, transfer, and exchange (KTE). KTE is the process of acquiring, developing, sharing and applying knowledge. Semi-structured interviews were conducted employing a composed sample of eight elite basketball players and four elite coaches who have been experiencing the choking episode previously. All interviews have been digitally recorded and later transcribed verbatim. Then the interviews have been content analyzed. Participants of the present study have provided useful information regarding the underlying mechanisms and antecedents of choking and also suggested applicable antidotes to conquer the phenomenon of choking. According to the results of the present study, self-confidence, mental and physical preparation, and coping styles should be considered as influential factors in athletes’ performance under pressure. Moreover, using all noteworthy information and preventative strategies suggested by participants of the present study, an effective multi-modal intervention has been introduced that should be taken into account by sports psychologists, coaches and athletes.

Keywords: anxiety, basketball, choking, free-throw shooting, psychological intervention

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Authors: Muhammad Tariq A. Chaudhary

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Soil-structure interaction (SSI) in bridges under seismic excitation is a complex phenomenon which involves coupling between the non-linear behavior of bridge pier columns and SSI in the soil-foundation part. It is a common practice in the study of SSI to model the bridge piers as linear elastic while treating the soil and foundation with a non-linear or an equivalent linear modeling approach. Consequently, the contribution of soil and foundation to the SSI phenomenon is disproportionately highlighted. The present study considered non-linear behavior of bridge piers in FEM model of a 4-span, pile-supported bridge that was designed for five different soil conditions in a moderate seismic zone. The FEM model of the bridge system was subjected to a suite of 21 actual ground motions representative of three levels of earthquake hazard (i.e. Design Basis Earthquake, Functional Evaluation Earthquake and Maximum Considered Earthquake). Results of the FEM analysis were used to delineate the influence of pier column non-linearity and SSI on critical design parameters of the bridge system. It was found that pier column non-linearity influenced the bridge lateral displacement and base shear more than SSI for majority of the analysis cases for the class of bridge investigated in the study.

Keywords: bridge, FEM model, reinforced concrete pier, pile foundation, seismic loading, soil-structure interaction

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Authors: Ilirian Laçi, Alketa Spahiu

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Modality of treatment in hepatocellular carcinoma (HCC) patients depends on the stage of the disease. The Barcelona Clinic Liver Cancer Classification (BCLC) is the preferred staging system. There are many patients initially present with intermediate-stage disease. For these patients, transarterial chemoembolization (TACE) is the treatment of choice. The differences in individual factors that are not captured by the BCLC framework, such as the tumor growth pattern, degree of hypervascularity, and vascular supply, complicate further evaluation of these patients. Because of these differences, not all patients benefit equally from TACE. Several tools have been devised to aid the decision-making process, which have shown promising initial results but have failed external evaluation and have not been translated to the clinic aspects. Criteria for treatment decisions in daily clinical practice are needed in all stages of the disease.

Keywords: hepatocellular carcinoma, transarterial chemoembolization, TACE, liver

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Authors: Matza Gusto Andika, Malinda Sabrina, Syarie Fatunnisa

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Aerodynamic and aeroelastics studies on the hanger bridge profile are important to analyze the aerodynamic phenomenon and Aeroelastics stability of hanger. Wind tunnel tests were conducted on a model of H-beam profile from hanger bridge. The purpose of this study is to investigate steady aerodynamic characteristics such as lift coefficient (Cl), drag coefficient (Cd), and moment coefficient (Cm) under the different angle of attack for preliminary prediction of aeroelastics stability problems. After investigation the steady aerodynamics characteristics from the model, dynamic testing is also conducted in wind tunnel to know the aeroelastics phenomenon which occurs at the H-beam hanger bridge profile. The studies show that the torsional vortex induced vibration occur when the wind speed is 7.32 m/s until 9.19 m/s with maximum amplitude occur when the wind speed is 8.41 m/s. The result of wind tunnel testing is matching to hanger vibration where occur in the field, so wind tunnel studies has successful to model the problem. In order that the H-beam profile is not good enough for the hanger bridge and need to be modified to minimize the Aeroelastics problem. The modification can be done with structure dynamics modification or aerodynamics modification.

Keywords: aerodynamics, aeroelastic, hanger bridge, h-beam profile, vortex induced vibration, wind tunnel

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Authors: Sabine A. Zauchner-Studnicka

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As the term indicates, reverse-mentoring flips the classical roles of mentoring: In school, students take over the role of mentors for adults, i.e. teachers or parents. Originally reverse-mentoring stems from US enterprises, which implemented this innovative method in order to benefit from the resources of skilled younger employees for the enhancement of IT competences of senior colleagues. However, reverse-mentoring in schools worldwide is rare. Based on empirical studies and theoretical approaches, in this article an implementation model for reverse-mentoring is developed in order to bring the significant potential reverse-mentoring has for education into practice.

Keywords: reverse-mentoring, innovation in education, implementation model, school education

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Authors: Payman Davoodi-Nasab, Ahmad Rahbar-Kelishami, Jaber Safdari, Hossein Abolghasemi

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The high purity rare earth elements (REEs) have been vastly used in the field of chemical engineering, metallurgy, nuclear energy, optical, magnetic, luminescence and laser materials, superconductors, ceramics, alloys, catalysts, and etc. Neodymium is one of the most abundant rare earths. By development of a neodymium–iron–boron (Nd–Fe–B) permanent magnet, the importance of neodymium has dramatically increased. Solvent extraction processes have many operational limitations such as large inventory of extractants, loss of solvent due to the organic solubility in aqueous solutions, volatilization of diluents, etc. One of the promising methods of liquid membrane processes is emulsion liquid membrane (ELM) which offers an alternative method to the solvent extraction processes. In this work, a study on Nd extraction through multi-walled carbon nanotubes (MWCNTs) assisted ELM using response surface methodology (RSM) has been performed. The ELM composed of diisooctylphosphinic acid (CYANEX 272) as carrier, MWCNTs as nanoparticles, Span-85 (sorbitan triooleate) as surfactant, kerosene as organic diluent and nitric acid as internal phase. The effects of important operating variables namely, surfactant concentration, MWCNTs concentration, and treatment ratio were investigated. Results were optimized using a central composite design (CCD) and a regression model for extraction percentage was developed. The 3D response surfaces of Nd(III) extraction efficiency were achieved and significance of three important variables and their interactions on the Nd extraction efficiency were found out. Results indicated that introducing the MWCNTs to the ELM process led to increasing the Nd extraction due to higher stability of membrane and mass transfer enhancement. MWCNTs concentration of 407 ppm, Span-85 concentration of 2.1 (%v/v) and treatment ratio of 10 were achieved as the optimum conditions. At the optimum condition, the extraction of Nd(III) reached the maximum of 99.03%.

Keywords: emulsion liquid membrane, extraction of neodymium, multi-walled carbon nanotubes, response surface method

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Authors: Li-Ju Chen, Hsiang-Lin Chan, Hsin-Yi Kathy Cheng, Hui-Ju Chen

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Stereotype behavior is one of the maladaptive syndromes of the individuals with autism. Most of the previous researches focused on the stereotype behavior with stimulating type, while less on the stereotype behavior about cognition (This research names it cognitive stereotype behavior; CSB). This research explored CSB and the rationality to explain CSB with imprinting phenomenon. After excluding the samples without CSB described, the data that came from 271 individuals with autism were recruited and analyzed with quantitative and qualitative analyses. This research discovers that : (1) Most of the individuals with autism originally came out CSB at 3 years old and more than a half of them appeared before 4 years old; The average age which firstly came out CSB was 6.10 years old, the average time insisting or ossifying CSB was 31.71 minutes each time and the average longest time which they last was 358.35 minutes (5.97 hours). (2) CSB demonstrates various aspects, this research classified them into 4 fields with 26 categories. They were categorized into sudden CSB or habitual CSB by imprinting performance. (3) Most of the autism commented that their CSBs were not necessary but they could not control them well. One-third of them appeared CSB suddenly and the first occurrence accompanied a strong emotional or behavioral response. (4) Whether respondent is the person with autism himself/herself or not was the critical element: on the awareness of the severity degree, disturbance degree, and the emotional /behavioral intensity at the first-time CSB happened. This study concludes imprinting could reasonably explain the phenomenon CSB forms. There are implications leading the individuals with autism and their family to develop coping strategies to promote individuals with autism having a better learning accomplishment and life quality in their future.

Keywords: autism, cognitive stereotype behavior, constructivism, imprinting, stereotype

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Authors: Samuel Quashie

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Ph.D. Construction Management methodology and mixed methods are organized to guide the researcher to assemble and assess data in the research activities. Construction management research is close to business management and social science research. It also contributes to researching the phenomenon and answering the research question, generating an integrated management system for post-disaster reconstruction in construction and related industries. Research methodology and methods drive the research to achieve the goal or goals, contribute to knowledge, or increase knowledge. This statement means the research methodology, mixed methods, aim, objectives, and processes address the research question, facilitate its achievement and foundation to conduct the study. Mixed methods use project-based case studies, interviews, observations, literature and archival document reviews, research questionnaires, and surveys, and evaluation of integrated systems used in the construction industry and related industries to address the research work. The research mixed methods (qualitative, quantitative) define the research topic and establish a more in-depth study. The research methodology is action research, which involves the collaboration of participants and service users to collect and evaluate data, studying the phenomenon, research question(s) to improve the situation in post-disaster reconstruction phase management.

Keywords: methodology, Ph.D. research, post-disaster reconstruction, mixed-methods qualitative and quantitative

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Authors: Abdul Aziz, Muhammad Qamar Masood, Saadia Sattar, Saira Fatima, Najmul Islam

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Introduction: The most common endocrine tumor is thyroid cancer. Follicular Thyroid Carcinoma (FTC) accounts for 5%–10% of all thyroid cancers. Patients with FTC frequently present with more advanced stage diseases and a higher occurrence of distant metastases because of the propensity of vascular invasion. FTC is mainly treated with surgery, while radioactive iodine therapy is the main adjuvant therapy as per ATA guidelines. In many developing countries, surgical facilities and radioactive iodine are in short supply; therefore, understanding follicular thyroid cancer trends may help developing countries plan and use resources more effectively. Methodology: It was a retrospective observational study of FTC patients of age 18 years and above conducted at Aga Khan University Hospital, Karachi, from 1st January 2010 to 31st December 2019. Results: There were 404 patients with thyroid carcinoma, out of which forty (10.1%) were FTC. 50% of the patients were in the 41-60 years age group, and the female to male ratio was 1.5: 1. Twenty-four patients (60%) presented with complain of neck swelling followed by metastasis (20%) and compressive symptoms (20%). The most common site of metastasis was bone (87.5%), followed by lung (12.5%). The pre-operative thyroglobulin level was done in six out of eight metastatic patients (75%) in which it was elevated. This emphasizes the importance of checking thyroglobulin level in unusual presentation (bone pain, fractures) of a patient having neck swelling also to help in establishing the primary source of tumor. There was no complete documentation of ultrasound features of the thyroid gland in all the patients, which is an important investigation done in the initial evaluation of thyroid nodule. On FNAC, 50% (20 patients) had Bethesda category III-IV nodules, while 10% ( 4 patients ) had Bethesda category II. In sixteen patients, FNAC was not done as they presented with compressive symptoms or metastasis. Fifty percent had a total thyroidectomy and 50% had subtotal followed by completion thyroidectomy, plus ten patients had lymph node dissection, out of which seven had histopathological lymph node involvement. On histopathology, twenty-three patients (57.5%) had minimally invasive, while seventeen (42.5%) had widely invasive follicular thyroid carcinoma. The capsular invasion was present in thirty-three patients (82.5%); one patient had no capsular invasion, but there was a vascular invasion. Six patients' histopathology had no record of capsular invasion. In contrast, the lymphovascular invasion was present in twenty-six patients (65%). In this study, 65 % of the patients had clinical stage 1 disease, while 25% had stage 2 and 10% had clinical stage 4. Seventeen patients (42.5%) had received RAI 30-100 mCi, while ten patients (25%) received more than 100 mCi. Conclusion: FTC demographic and clinicopathological presentation are the same in Pakistan as compared to other countries. Surgery followed by RAI is the mainstay of treatment. Thus understanding the trend of FTC and proper planning and utilization of the resources will help the developing countries in effectively treating the FTC.

Keywords: thyroid carcinoma, follicular thyroid carcinoma, clinicopathological features, developing countries

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Authors: Christopher Viens, Steve Krase

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Terms such as “riding a hard streak”, “formation push”, and “fighting formation” are commonly used in the directional drilling world to explain BHA behavior that causes unwanted trajectory change. Theories about downhole directional tendencies are commonly speculated from various personal experiences with little merit due to the lack of hard data to reveal the actual mechanisms behind the phenomenon, leaving interpretation of the root cause up to personal perception. Understanding and identifying in real time the lithological factors that influence the BHA to change or hold direction adds tremendous value in terms reducing sliding time and targeting zones for optimal ROP. Utilizing surface drilling parameters and employing downhole measurements of azimuthal gamma, continuous inclination, and bending moment, a direct measure of the rock related directional phenomenon have been captured and quantified. Furthermore, identifying continuous zones of like lithology with consistent bit to rock interaction has value from a reservoir characterization and completions standpoint. The paper will show specific examples of lithology related directional tendencies from the Spraberry and Wolfcamp in the Delaware Basin.

Keywords: Azimuthal gamma imaging, bending moment, continuous inclination, downhole dynamics measurements, high frequency data

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Authors: Augustina Konadu Larbi-Ampofo, Ekemini Umoinwek

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Background: Hypercalcaemia is a common electrolyte imbalance that increases mortality if poorly controlled. Primary hyperparathyroidism often presents like this with a prevalence of 0.1-0.3%. Management due to an ectopic parathyroid adenoma in the mediastinum is challenging, especially in a patient with a pacemaker. Case Presentation: A 79-year-old woman with a history of a previous cardiac arrest, permanent pacemaker, ischaemic heart disease, bilateral renal calculi, rectal polyps, liver cirrhosis, and a family history of hyperthyroidism presented to the emergency department with acute back pain. Management and Outcome: The patient was diagnosed with primary hyperparathyroidism due to her elevated corrected calcium and parathyroid hormone levels. Parathyroid investigations consisting of an NM MIBI scan, SPECT-CT, 4D parathyroid scan, and an ultrasound scan of the neck and thorax confirmed an ectopic parathyroid adenoma in the mediastinum at the level of the aortic arch, along with benign thyroid nodules. The location of the adenoma warranted a thoracoscopic surgical approach; however, the presence of her pacemaker and other cardiovascular conditions predisposed her to a potentially poorer post-operative outcome. Discussion: Mediastinal ectopic parathyroid adenomas are rare and difficult to diagnose and treat, often needing a multimodal imaging approach for accurate localisation. Surgery is a definitive treatment; however, in this patient, long-term medical treatment with cinacalcet was the only next suitable treatment option. The difficulty with this is that cinacalcet tackles the biochemical markers of the disease entity and not the disease itself, leaving room for what happens next if there is refractory/uncontrolled hypercalcaemia in this patient with a pacemaker. Moreover, the coexistence of her multiple conditions raises the suspicion of an underlying multisystemic or multiple endocrine disorder, with multiple endocrine neoplasia coming to mind, necessitating further genetic or autoimmune investigations. Conclusion: Mediastinal ectopic parathyroid adenomas are rare, with diagnostic and management challenges.

Keywords: mediastinal ectopic parathyroid adenoma, hyperparathyroidism, SPECT/CT, nuclear medicine, multimodal imaging

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Authors: Hassan Wajid, Syed T. Ahmed, Syed G. Haider Jr., Razia Latif, Ahsan Ali, Maira Anam

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The phenomenon of Metamorphosis can be associated with any object, organism, or structure gradually and progressively going through the change of systemic or morphological form. This phenomenon can be integrated while teaching drawing to architecture students. In architectural drawings, metamorphosis’s main focus and purpose are not to completely imitate any object. In the process of drawing, the changes in systemic or morphological form happen until the complete process, and the visuals of the complete process change the drawing, opening up possibilities for the imagination of the perceivers. Metamorphosis in architectural drawings begins with an initial form and, through various noticeable stages, ends up final form or manifestation. How much of the initial form is manifested in the final form and progressively among various intermediate stages becomes an indication of the nature of metamorphosis as a phenomenon. It is important at this stage to clarify that the term metamorphosis is presently being coopted from its original domain, usually in life sciences. In this current exercise, the architectural drawings are to act as an operative analog process transforming one image of art and/or architecture in its broadest sense. That composition is claimed to have come from one source (individual work, a cultural artifact, civilizational remain). It dialectically meets, opposes, or confronts some carefully chosen alien opposites from a different domain. As an example, the layers of a detailed drawing of a Turkish prayer rug of 5 x 7 ratio over a detailed architectural plan of a religious, historical complex can be observed such that the two drawings, though at markedly different scales could dialectically converse with one another and through their mutual congruencies. In the final stage, the idea concludes contradictions across the scales to initiate the analogous roles of metamorphosed third reality, which suggests the previous un-acknowledged architectural or artistic identity. The proposed paper explores the trajectory of reproduction by analyzing drawings through detailed drawing stages and analyzes challenges as well as opportunities in the discovered realm of imagination. This description further aims at identifying factors influencing creativity and innovation in producing architectural drawings through the process of observing drawings from inception to the concluding stage.

Keywords: architectural drawings, metamorphosis, perceptions, discovery

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Authors: Ricky Munyaradzi Mukonza

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E-government literature continues to grow as scholars and practitioners endeavour to understand this phenomenon. There are many facets of e-government that have been written about including its definition, adoption, and implementation and so on. However, more still needs to be known particularly in relation to how e-government is being adopted in different contexts. There could be many context specific factors that have a bearing on e-government adoption and in this paper focus is on attitudes and perceptions. Association between usage of e-government services and various perceptions such as ease of use, transparency, security, ease of understanding, communication, reliability, relevancy, perceived usefulness and perceived trust is examined. Within the Zimbabwean context and in particular the country’s local government sphere, such a study has not been done. The main aim of the paper is therefore to establish perceptions and attitudes towards e-government services among residents in Zimbabwe’s two local authorities. In terms of research methodology the paper is based on a Mixed Methods Approach (MMA) to collect and analyse data giving the researcher a holistic picture of the phenomenon being investigated. A sample of 785 residents from the two local authorities was used and these were selected using a combination of cluster and purposive sampling methods. A key finding in this paper is that a majority of respondents who have had the opportunity to use e-government services perceive the services to be easy to use, transparent, secure, easy to understand, reliable, relevant, useful and trustworthy. The paper, therefore, makes an important contribution on the relationship between residents’ perceptions and attitudes and e-government usage within the chosen cases.

Keywords: adoption, attitudes, e-government, perceptions

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Authors: Wahab Ali Shah, Junjia He

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In this work, we performed a large-scale investigation into leader development in a 10 m rod-plane gap under a long front positive impulse. To describe the leader propagation under slow front impulse voltages, we recorded the leader propagation with a high-speed charge coupled device (CCD) camera. It is important to figure out this phenomenon to deepen our understanding of leader discharge. The observation results showed that the leader mechanism is a very complex physical phenomenon; it could be categorized into two types of leader process, namely, continuous and the discontinuous leader streamer-leader propagation. Furthermore, we studied the continuous leader development parameters, including two-dimensional (2-D) leader length, injected charge, and final jump stage, as well as leader velocity for rod–plane configuration. We observed that the discontinuous leader makes an important contribution to the appearance of channel re-illuminations of the positive leader. The comparative study shows better results in terms of standard switch impulse and long front positive impulse. Finally, the results are presented with a view toward improving our understanding of propagation mechanisms related to restrike phenomena, which are rarely reported. To clarify the above doubts under long front cases, we carried out extensive experiments in this study.

Keywords: continuous and discontinuous leader, high-speed photographs, long air gap, positive long front impulse, restrike phenomena

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Authors: R. Mofeed, N. Elgendy

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Cinema constructs mind-spaces that reflect inherent human thoughts and emotions. As a representational art, Cinema would introduce comprehensive images of life phenomena in different ways. The term “represent” suggests verity of meanings; bring into presence, replace or typify. In that sense, Cinema may present a phenomenon through direct embodiment, or introduce a substitute image that replaces the original phenomena, or typify it by relating the produced image to a more general category through a process of abstraction. This research is interested in questioning the type of images that Egyptian Cinema introduces to informal urbanism and how these images were conditioned and reshaped in the last twenty years. The informalities/slums phenomenon first appeared in Egypt and, particularly, Cairo in the early sixties, however, this phenomenon was completely ignored by the state and society until the eighties, and furthermore, its evident representation in Cinema was by the mid-nineties. The Informal City represents the illegal housing developments, and it is a fast growing form of urbanization in Cairo. Yet, this expanding phenomenon is still depicted as the minority, exceptional and marginal through the Cinematic lenses. This paper aims at tracing the forms of representations of the urban informalities in the Egyptian Cinema between 1994 and 2014, and how did that affect the popular mind and its perception of these areas. The paper runs two main lines of inquiry; the first traces the phenomena through a chronological and geographical mapping of the informal urbanism has been portrayed in films. This analysis is based on an academic research work at Cairo University in Fall 2014. The visual tracing through maps and timelines allowed a reading of the phases of ignorance, presence, typifying and repetition in the representation of this huge sector of the city through more than 50 films that has been investigated. The analysis clearly revealed the “portrayed image” of informality by the Cinema through the examined period. However, the second part of the paper explores the “perceived image”. A designed questionnaire is applied to highlight the main features of that image that is perceived by both inhabitants of informalities and other Cairenes based on watching selected films. The questionnaire covers the different images of informalities proposed in the Cinema whether in a comic or a melodramatic background and highlight the descriptive terms used, to see which of them resonate with the mass perceptions and affected their mental images. The two images; “portrayed” and “perceived” are then to be encountered to reflect on issues of repetitions, stereotyping and reality. The formulated stereotype of informal urbanism is finally outlined and justified in relation to both production consumption mechanisms of films and the State official vision of informalities.

Keywords: cinema, informal urbanism, popular mind, representation

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Authors: D. Artamonov, A. Tsibulnikova, I. Samusev, V. Bryukhanov, A. Kozhevnikov

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The synthesis and luminescent properties of Yb₂O₃, Nd₂O₃@Bi₂O₃ complex with upconversion generation are discussed in this work. The obtained samples were measured in the visible region of the spectrum under excitation with a wavelength of 980 nm. The studies showed that the obtained complexes have a high degree of stability and intense luminescence in the wavelength range of 400-750 nm. Consideration of the time dependence of the intensity of the upconversion luminescence allowed us to conclude that the enhancement of the intensity occurs in the time interval from 5 to 30 min, followed by the appearance of a stationary mode.

Keywords: lasers, luminescence, upconversion photonics, rare earth metals

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Authors: Sharon Ost Mor, Yuval Palgi, Ddikla Segel-Karpas

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Solitude and positive solitude (PS) are used in literature interchangeably, yet they have different attributes and effects. While solitude might have devastating outcomes such as depression or health deterioration, PS has beneficial outcomes. Yet, both solitude and PS have no clear unanimous definition. Most researches focus on solitude, while the phenomenon of PS is somewhat neglected. Most research deals with young people and adults, while the current research is interested in PS concepts especially in old age. A qualitative study, with 124 participants was performed in order to understand the essence of PS in different age groups. The findings revealed seven categories related to PS, including: Quietness, religious and spiritual experience, escapism, experience in nature or abroad, controlling stress or thoughts, facilitation achievements and recreation-hobbies-routines. Moreover, three meta-themes emerged: PS is a matter of choice, it is meaningful and enjoyable. One stand alone category was found: PS preconditions. Differences between younger and older adults were found in several categories and in PS preconditions, while the meta-themes were equally mentioned by all participants. Based on the participant's reflections and descriptions a new PS paradigm was built and will be presented as well as a new definition of PS. PS was renamed as 'Soulitude' in order to emphasize its' positive nature. Conclusions: PS serves well most people, yet it has different attributes in different ages. By giving PS a unanimous definition and by understanding its' contribution for the elderly, PS might be addressed as a legitimate, stand alone phenomenon. The paradigm might serve theory as well as clinicians for further PS research.

Keywords: old-old, positive solitude, solitude, soulitude

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