Vascular Access Management for Haemodialysis: A Value-Based Approach from NephroCare Experience

A good functioning vascular access (VA) is a prerequisite to obtain a successful dialysis treatment. This chapter reviews VA management in advanced chronic kidney disease (CKD) patients drawn from the experience of a large network dialysis care provider with the following sections: overview on VA management in advanced CKD that follows patient pathway and patient profile, current practice patterns in line with best clinical practices; VA creation addressing crucial themes: when and what type of VA to construct, how to assess patient pre-emptively, how to proceed for the construction and monitoring to prevent early failures and complications; VA management with particular focus on clinical monitoring, surveillance and interventional procedures required to preserve patency and functionality of VA; the often-forgotten patient perspective is VA usage. What information to share, how to proceed for preventing pain, and fears related with VA needling? What should patients know about their VA and how to manage in daily life? Competences, skills and responsibilities of nursing staff when using and managing VA; and future of VA in terms of innovative concept for creating and maintaining VA conduits in dialysis patients

Truck drivers' perceptions on wearable devices and health promotion:A qualitative study

Professional truck drivers, as other shift workers, have been identified as a high-risk group for various health conditions including cardiovascular disease, obesity, diabetes, sleep apnoea and stress. Mobile health technologies can potentially improve the health and wellbeing of people with a sedentary lifestyle such as truck drivers. Yet, only a few studies on health promotion interventions related to mobile health technologies for truck drivers have been conducted. We aimed to explore professional truck drivers views on health promotion delivered via mobile health technologies such as wearable devices.We conducted a phenomenological qualitative study, consisting of four semi-structured focus groups with 34 full-time professional truck drivers in the UK. The focus groups were audio-taped, transcribed verbatim and analysed using thematic content analysis. We discussed drivers perceptions of their health, lifestyle and work environment, and their past experience and expectations from mobile health technologies.The participants viewed their lifestyle as unhealthy and were aware of possible consequences. They expressed the need and wish to change their lifestyle, yet perceived it as an inherent, unavoidable outcome of their occupation. Current health improvement initiatives were not always aligned with their working conditions. The participants were generally willing to use mobile health technologies such as wearable devices, as a preventive measure to avoid prospect morbidity, particularly cardiovascular diseases. They were ambivalent about privacy and the risk of their employers monitoring their clinical data.Wearable devices may offer new possibilities for improving the health and wellbeing of truck drivers. Drivers were aware of their unhealthy lifestyle. They were interested in changing their lifestyle and health. Drivers raised concerns regarding being continuously monitored by their employer. Health improvement initiatives should be aligned with the unique working conditions of truck drivers. Future research is needed to examine the impact of wearable devices on improving the health and wellbeing of professional drivers

Scalar potentials for light in a cavity

The nonequilibrium dynamics of light in a coherently driven nonlinear cavity resembles the equilibrium dynamics of a Brownian particle in a scalar potential. This resemblance has been known for decades, but the correspondence between the two systems has never been properly assessed. Here we demonstrate that this correspondence can be exact, be approximate, or break down, depending on the driving conditions. For vanishing nonlinearity and on-resonance driving, the correspondence is exact: The cavity dissipation and driving amplitude define a scalar potential, and light follows the equilibrium Boltzmann distribution with an effective temperature defined by the noise variance and cavity dissipation. The scalar potential pertaining to linear on-resonance dynamics fails dramatically in nonlinear and/or off-resonance regimes. However, we introduce a distinct scalar potential enabling an effective equilibrium description of light. Our potential gives a reasonably accurate description in limited nonlinear regimes of bistability, but fails deep in the bistability where nonconservative forces dominate the dynamics. Consequently, the correspondence to Brownian motion in a scalar potential breaks down. This breakdown is accompanied by a qualitative change in the spectrum of small intracavity field fluctuations, reminiscent of an exceptional point of a non-Hermitian Hamiltonian. Our results lay the foundations for an effective thermodynamic description of coherently driven cavities, and suggest that fundamental results for overdamped Langevin dynamics can help to assess the energetics and information processing of resonant optical technologies

Stochastic Thermodynamics of a Linear Optical Cavity Driven On Resonance

We present a complete framework of stochastic thermodynamics for a single-mode linear optical cavity driven on resonance. We first show that the steady-state intracavity field follows the equilibrium Boltzmann distribution. The effective temperature is given by the noise variance, and the equilibration rate is the dissipation rate. Next, we derive expressions for internal energy, work, heat, and free energy of light in a cavity and formulate the first and second laws of thermodynamics for this system. We then analyze fluctuations in work and heat and show that they obey universal statistical relations known as fluctuation theorems. Finite time corrections to the fluctuation theorems are also discussed. Additionally, we show that work fluctuations obey Crooks’ fluctuation theorem which is a paradigm for understanding emergent phenomena and estimating free energy differences. The significance of our results is twofold. On one hand, our work positions optical cavities as a unique platform for fundamental studies of stochastic thermodynamics. On the other hand, our work paves the way for improving the energy efficiency and information processing capabilities of laser-driven optical resonators using a thermodynamics based prescription

Fano Lineshapes and Rabi Splittings: Can They Be Artificially Generated or Obscured by the Numerical Aperture?

Fano resonances and Rabi splittings are routinely reported in the scientific literature. Asymmetric resonance lineshapes are usually associated with Fano resonances, and two split peaks in the spectrum are often attributed to a Rabi splitting. True Fano resonances and Rabi splittings are unequivocal signatures of coherent coupling between subsystems. However, can the same spectral lineshapes characterizing Fano resonances and Rabi splittings arise from a purely incoherent sum of intensities? Here we answer this question through experiments with a tunable Fabry-Pérot cavity containing a CsPbBr3 perovskite crystal. By measuring the transmission and photoluminescence of this system using microscope objectives with different numerical aperture (NA), we find that even a modest NA = 0.4 can artificially generate Fano resonances and Rabi splittings. We furthermore show that this modest NA can obscure the anticrossing of a bona fide strongly coupled light–matter system. Through transfer matrix calculations we confirm that these spectral artifacts are due to the incoherent sum of transmitted intensities at different angles captured by the NA. Our results are relevant to the wide nanophotonics community, characterizing dispersive optical systems with high numerical aperture microscope objectives. We conclude with general guidelines to avoid pitfalls in the characterization of such optical systems

Rotterdam als filmset. Welke factoren zijn van invloed op de aantrekkelijkheid van Rotterdam als filmlocatie?

De stad Rotterdam heeft zich ontwikkelt als filmlocatie, steeds meer series en films worden hier opgenomen. De factoren die van invloed kunnen zijn op de aantrekkelijkheid van Rotterdam als filmlocatie zijn op verschillende terreinen te vinden. De stad, het beleid, de mensen, de films zelf. Wat doet Rotterdam aan de promotie van de stad als filmlocatie? Welke randvoorwaarden zijn van invloed op de aantrekkelijkheid van Rotterdam als filmlocatie? Wat is er in Rotterdam gefilmd? Welke beelden van Rotterdam worden gebruikt tijdens de opnames? Wat vinden de filmmakers van Rotterdam als filmlocatie