Urologic surgery and COVID-19: How the pandemic is changing the way we operate

The coronavirus disease 2019 (COVID-19) pandemic has had a global impact on all aspects of healthcare, including surgical procedures. For urologists, it has affected and will continue to influence how we approach the care of patients pre-operatively, intra-operatively, and post-operatively. A risk-benefit assessment of each patient undergoing surgery should be performed during the COVID-19 pandemic based on the urgency of the surgery and the risk of viral illness and transmission. Patients with advanced age and comorbidities have a higher incidence of mortality. Routine preoperative testing and symptom screening is recommended to identify those with COVID-19. Adequate personal protective equipment (PPE) for the surgical team is essential to protect healthcare workers and ensure an adequate workforce. For COVID-19 positive or suspected patients, the use of N95 respirators is recommended if available. The anesthesia method chosen should attempt to minimize aerosolization of the virus. Negative pressure rooms are strongly preferred for intubation/extubation and other aerosolizing procedures. Although transmission has not yet been shown during laparoscopic and robotic procedures, efforts should be made to minimize the risk of aerosolization. Ultra low particulate air filters are recommended for use during minimally invasive procedures to decrease the risk of viral transmission. Thorough cleaning and sterilization should be performed post-operatively with adequate time allowed for the operating room air to be cycled after procedures. COVID-19 patients should be separated from non-infected patients at all levels of care including recovery to decrease the risk of infection. Future directions will be guided by outcomes and infection rates as social distancing guidelines are relaxed and more surgical procedures are reintroduced. Recommendations should be adapted to the local environment and will continue to evolve as more data becomes available, the shortage of testing and PPE is resolved, and a vaccine and therapeutics for COVID-19 are developed

Cooldown of Cryogenic Transfer Lines an Experimental Report

Pressure, temperature, and flow during cooldown of cryogenic transfer line

People should be allowed to do what they like’: Autistic adults’ views and experiences of stimming

This is the final version. Available from the publisher via the DOI in this record.Data from participants who consented will be deposited in the UK Data Service, in 2019.‘Stereotyped or repetitive motor movements’ are characterised as core features in the diagnosis of autism, yet many autistic adults (and the neurodiversity movement) have reclaimed them as ‘stimming’. Supported by a growing body of scientific research, autistic adults argue that these behaviours may serve as useful coping mechanisms, yet little research has examined stimming from the perspective of autistic adults. Through interviews and focus groups, we asked 32 autistic adults to share their perceptions and experiences of stimming, including the reasons they stim, any value doing so may hold for them and their perceptions of others’ reactions to stimming. Using thematic analysis, we identified two themes: stimming as (1) a self-regulatory mechanism and (2) lacking in social acceptance, but can become accepted through understanding. Autistic adults highlighted the importance of stimming as an adaptive mechanism that helps them to soothe or communicate intense emotions or thoughts and thus objected to treatment that aims to eliminate the behaviour.Wellcome TrustLeverhulme Trus

MANAJEMEN SUMBER DAYA MANUSIA INOVATIF DAN KREATIF PEMBELAJARAN SENI BUDAYA STUDI KASUS: PENTAS SENI SISWA KELAS XII SMA NEGERI 1 TOMOHON 2023

Penelitian ini betujuan untuk memperoleh deskripsi  tentang bagaimana pengelolaan pembelajaran Seni Budaya sebagai manajemen Manajemen Sumber Daya Manusia Inovatif dan Kreatif bidang pendidikan. Pembelajaran tersebut menghasilkan sebuah karya seni pertunjukan, disebut Pentas Seni.  Kegiatan ini sebagai pembelajaran ujian praktik mata pelajaran Seni Budaya bagi siswa kelas XII  SMA Negeri 1 Tomohon. Ini menarik untuk dikaji mengingat Manajemen Sumber Daya Manusia Inovatif dan Kreatif  dibutuhkan dalam lingkungan pendidikan sekolah dalam rangka menjawab perkembangan inovasi pembelajaran. Pengumpulan data diperoleh melalui metode penelitian kualitatif deskriptif dan dirancang sebagai studi kasus. Metode ini menggunakan teknik observasi, wawancara, dan studi dokumen. Selanjutnya hasil data  yang dianalisis dideskripsikan sebagai bentuk Manajemen Sumber Daya Manusia Inovatif dan Kreatif pembelajaran melalui Pentas seni. Faktor-faktor penunjang dan kendalanya  dipaparkan pada bagian hasil dan pembahasan. Pentas seni merupakan implementasi Manajemen Sumber Daya Manusia Inovatif dan Kreatif pembelajaran Seni Budaya. Melalui pentas seni kreatif dan inovatif memberi dampak pembelajaran yang sangat berguna bagi siswa. Siswa menyalurkan minat dan bakatnya yang luar biasa. Siswa juga dilatih kepemimpinan, kemandirian dan  langkah-langkah manajemen melalui berbagai pekerjaan sebagai pembelajaran yang harus dilakukan untuk mensukseskan acara tersebut. Konsep acara dan teknis pelaksanaannya berbeda dengan yang dilakukan oleh sekolah sebelumnya. Oleh sebab itu, pentas seni 2023 ini merupakan Manajemen Sumber Daya Manusia Inovatif dan Kreatif. Sumber Daya Manusia Inovatif dan Kreatif pendidikan ini bermuara pada keunggulan atau mutu satuan Pendidikan  sekolah

The Ontology of Intentional Agency in Light of Neurobiological Determinism: Philosophy Meets Folk Psychology

The moot point of the Western philosophical rhetoric about free will consists in examining whether the claim of authorship to intentional, deliberative actions fits into or is undermined by a one-way causal framework of determinism. Philosophers who think that reconciliation between the two is possible are known as metaphysical compatibilists. However, there are philosophers populating the other end of the spectrum, known as the metaphysical libertarians, who maintain that claim to intentional agency cannot be sustained unless it is assumed that indeterministic causal processes pervade the action-implementation apparatus employed by the agent. The metaphysical libertarians differ among themselves on the question of whether the indeterministic causal relation exists between the series of intentional states and processes, both conscious and unconscious, and the action, making claim for what has come to be known as the event-causal view, or between the agent and the action, arguing that a sort of agent causation is at work. In this paper, I have tried to propose that certain features of both event-causal and agent-causal libertarian views need to be combined in order to provide a more defendable compatibilist account accommodating deliberative actions with deterministic causation. The ‘‘agent-executed-eventcausal libertarianism’’, the account of agency I have tried to develop here, integrates certain plausible features of the two competing accounts of libertarianism turning them into a consistent whole. I hope to show in the process that the integration of these two variants of libertarianism does not challenge what some accounts of metaphysical compatibilism propose—that there exists a broader deterministic relation between the web of mental and extra-mental components constituting the agent’s dispositional system—the agent’s beliefs, desires, short-term and long-term goals based on them, the acquired social, cultural and religious beliefs, the general and immediate and situational environment in which the agent is placed, etc. on the one hand and the decisions she makes over her lifetime on the basis of these factors. While in the ‘‘Introduction’’ the philosophically assumed anomaly between deterministic causation and the intentional act of deciding has been briefly surveyed, the second section is devoted to the task of bridging the gap between compatibilism and libertarianism. The next section of the paper turns to an analysis of folk-psychological concepts and intuitions about the effects of neurochemical processes and prior mental events on the freedom of making choices. How philosophical insights can be beneficially informed by taking into consideration folk-psychological intuitions has also been discussed, thus setting up the background for such analysis. It has been suggested in the end that support for the proposed theory of intentional agency can be found in the folk-psychological intuitions, when they are taken in the right perspective

"Life is much more difficult to manage during periods": Autistic experiences of menstruation

Although menarche and menstruation are perceived to be overwhelmingly negative events for women with developmental disabilities, women’s health issues remain under-researched in autism. Here, we conducted a preliminary investigation of the experiences of post-menarcheal autistic (n=123) and non-autistic (n=114) respondents to a brief online survey. Although autistic respondents reported many issues and experiences that overlapped with non-autistic respondents, they also highlighted distinct – and sometimes-distressing – issues relating to menstruation, especially a cyclical amplification of autistic-related challenges, including sensory differences and difficulties with regulating emotion and behavior, which had a significant, negative impact on their lives. These initial findings call for systematic research on the potential causes, correlates and consequences of menstrual-related problems in autistic individuals – across the spectrum, and the lifespan

Coupled Numerical Analysis of Variations in the Capacity of Driven Energy Piles in Clay

Energy piles are an emerging alternative for the reduction of energy consumption to heat and cool buildings. Most of the research to date has focused on thermodynamic properties or axial and radial stress and strain of piles. This paper focuses on the effects of temperature fluctuation on the capacity of driven energy piles in clayey soils. Consolidation of clay surrounding driven piles affects the pile capacity (i.e., set up in clay). The heating and cooling periods of energy piles can create the excess pore-water pressure (EPWP, ue) or relax the existing one (e.g., due to pile driving or previous thermal loads) in clayey soils (due to the contraction and expansion of water) affecting the pile capacity. In the meantime, the thermal expansion and contraction of the pile also generate or relax the EPWP in the soil, which can be computed using the cavity-expansion theory. This paper studies the resulting changes in the pile capacity due to the daily and seasonal thermal cycles. The results show that thermal cycles in an energy pile can cause a decrease in the pile capacity leading to a delay in reaching the capacity after a complete clay set up