Optical properties of femtosecond laser-treated diamond

A laser-induced periodic surface structure (LIPSS) has been fabricated on polycrystalline diamond by an ultrashort Ti:Sapphire pulsed laser source (λ = 800 nm, P = 3 mJ, 100 fs) in a high vacuum chamber (<10−7 mbar) in order to increase diamond absorption in the visible and infrared wavelength ranges. A horizontally polarized laser beam had been focussed perpendicularly to the diamond surface and diamond target had been moved by an automated X–Y translational stage along the two directions orthogonal to the optical axis. Scanning electron microscopy of samples reveals an LIPSS with a ripple period of about 170 nm, shorter than the laser wavelength. Raman spectra of processed sample do not point out any evident sp 2 content, and diamond peak presents a right shift, indicating a compressive stress. The investigation of optical properties of fs-laser surface textured diamond is reported. Spectral photometry in the range 200/2,000 nm wavelength shows a significant increase of visible and infrared absorption (more than 80 %) compared to untreated specimens (less than 40 %). The analysis of optical characterization data highlights a close relationship between fabricated LIPSS and absorption properties, confirming the optical effectiveness of such a treatment as a light-trapping structure for diamond: these properties, reported for the first time, open the path for new applications of CVD diamond

Surface nanotexturing of boron-doped diamond films by ultrashort laser pulses

Polycrystalline boron-doped diamond (BDD) films were surface nanotextured by femtosecond pulsed laser irradiation (100 fs duration, 800 nm wavelength, 1.44 J/cm² single pulse fluence) to analyse the evolution of induced alterations on the surface morphology and structural properties. The aim was to identify the occurrence of laser-induced periodic surface structures (LIPSS) as a function of the number of pulses released on the unit area. Micro-Raman spectroscopy pointed out an increase in the graphite surface content of the films following the laser irradiation due to the formation of ordered carbon sites with respect to the pristine sample. SEM and AFM surface morphology studies allowed the determination of two different types of surface patterning: narrow but highly irregular ripples without a definite spatial periodicity or long-range order for irradiations with relatively low accumulated fluences (&lt;14.4 J/cm²) and coarse but highly regular LIPSS with a spatial periodicity of approximately 630 nm ± 30 nm for higher fluences up to 230.4 J/cm²

The Role of Tissue Factor in Atherothrombosis and Coronary Artery Disease : Insights into Platelet Tissue Factor

The contribution of vessel wall-derived tissue factor (TF) to atherothrombosis is well established, whereas the pathophysiological relevance of the blood-borne TF is still a matter of debate, and controversies on the presence of platelet-associated TF still exist. In the past 15 years, several studies have documented the presence of TF in human platelets, the capacity of human platelets to use TF mRNA to make de novo protein synthesis, and the increase in the percentage of TF positive platelets in pathological conditions such as coronary artery disease (CAD). The exposure of vessel wall-derived TF at the site of vascular injury would play its main role in the initiation phase, whereas the blood-borne TF carried by platelets would be involved in the propagation phase of thrombus formation. More recent data indicate that megakaryocytes are committed to release into the bloodstream a well-defined number of TF-carrying platelets, which represents only a fraction of the whole platelet population. These findings are in line with the evidence that platelets are heterogeneous in their functions and only a subset of them is involved in the hemostatic process. In this review we summarize the existing knowledge on platelet associated TF and speculate on its relevance to physiology and to atherothrombosis and CAD

Antithrombotic therapy in patients with acute coronary syndrome complicated by cardiogenic shock or out-of-hospital cardiac arrest: a Joint Position Paper from the European Society of Cardiology (ESC) Working Group on Thrombosis, in association with the Acute Cardiovascular Care Association (ACCA) and European Association of Percutaneous Cardiovascular Interventions (EAPCI)

© The Author 2020. This is a pre-copyedited, author-produced version of an article accepted for publication in European Heart Journal - Cardiovascular Pharmacotherapy following peer review. The version of record [Gorog et al., Antithrombotic therapy in patients with acute coronary syndrome complicated by cardiogenic shock or out-of-hospital cardiac arrest: a Joint Position Paper from the European Society of Cardiology (ESC) Working Group on Thrombosis, in association with the Acute Cardiovascular Care Association (ACCA) and European Association of Percutaneous Cardiovascular Interventions (EAPCI), European Heart Journal - Cardiovascular Pharmacotherapy, pvaa009] is available online at: https://doi.org/10.1093/ehjcvp/pvaa009.Peer reviewedFinal Accepted Versio

Differences between cardiogenic shock related to acute decompensated heart failure and acute myocardial infarction

The present analysis from the multicentre prospective Altshock-2 registry aims to better define clinical features, in-hospital course, and management of cardiogenic shock complicating acutely decompensated heart failure (ADHF-CS) as compared with that complicating acute myocardial infarction (AMI-CS). All patients with AMI-CS or ADHF-CS enrolled in the Altshock-2 registry between March 2020 and February 2022 were selected. The primary objective was the characterization of ADHF-CS patients as compared with AMI-CS. In-hospital length of stay and mortality were secondary endpoints. One-hundred-ninety of the 238 CS patients enrolled in the aforementioned period were considered for the present analysis: 101 AMI-CS (80% ST-elevated myocardial infarction and 20% non-ST-elevated myocardial infarction) and 89 ADHF-CS. As compared with AMI-CS, ADHF-CS patients were younger [63 (IQR 59-76) vs. 67 (IQR 54-73) years, P = 0.01], but presented with higher creatinine [1.6 (IQR 1.0-2.6) vs. 1.2 (IQR 1.0-1.4) mg/dL, P < 0.001], bilirubin [1.3 (IQR 0.9-2.3) vs. 0.6 (IQR 0.4-1.1) mg/dL, P = 0.01], and central venous pressure values [14 mmHg (IQR 8-12) vs. 10 mmHg (IQR 7-14),P = 0.01]. Norepinephrine was the most common catecholamine used in AMI-CS (79.3%), whereas epinephrine was used more commonly in ADHF-CS (65.5%); 75.8% vs. 46.6% received a temporary mechanical support in AMI-CS and ADHF-CS, respectively (P < 0.001). Length of hospital stay was longer in the latter [28 (IQR 13-48) vs. 17 (IQR 9-29) days, P = 0.001]. Heart replacement therapies were more frequently used in the ADHF-CS group (heart transplantation 13.5% vs. 0% and left ventricular assist device 11% vs. 2%, P < 0.01 and 0.01, respectively). In-hospital mortality was 41.1% (38.6% AMI-CS vs. 43.8% ADHF-CS, P = 0.5). ADHF-CS is characterized by a higher prevalence of end-organ and biventricular dysfunction at presentation, a longer hospital length of stay, and higher need of heart replacement therapies when compared with AMI-CS. In-hospital mortality was similar between the two aetiologies. Our data warrant development of new management protocols focused on CS aetiology

Gender and contemporary risk of adverse events in atrial fibrillation

Background and Aims: The role of gender in decision-making for oral anticoagulation in patients with atrial fibrillation (AF) remains controversial.Methods: Population cohort study using electronic healthcare records of 16,587,749 patients from UK primary care (2005-2020). Primary (composite of all-cause mortality, ischaemic stroke or arterial thromboembolism) and secondary outcomes were analysed using Cox hazard ratios (HR), adjusted for age, socioeconomic status and comorbidities.Results: 78,852 patients were included with AF, age 40-75 years, no prior stroke and no prescription of oral anticoagulants. 28,590 (36.3%) were women and 50,262 (63.7%) men. Median age was 65.7 years (interquartile range 58.5-70.9) with women being older and other differences in comorbidities. During total follow-up of 431,086 patient-years, women had a lower adjusted primary outcome rate with HR 0.89 vs men (95% CI 0.87-0.92; p&lt;0.001), and HR 0.87 after censoring for oral anticoagulation (95% CI 0.83-0.91; p&lt;0.001). This was driven by lower mortality in women (HR 0.86, 0.83-0.89; p&lt;0.001). No difference was identified between women and men for the secondary outcomes of ischaemic stroke or arterial thromboembolism (adjusted HR 1.00, 0.94-1.07; p=0.87), any stroke or any thromboembolism (1.02, 0.96-1.07; p=0.58), and incident vascular dementia (1.13, 0.97-1.32; p=0.11). Clinical risk scores were only modest predictors of outcomes, with CHA2DS2-VA (ignoring gender) superior to CHA2DS2-VASc for primary outcomes in this population (receiver operator curve area 0.651 vs 0.639; p&lt;0.001), and no interaction with gender (p=0.45).Conclusions: Removal of gender from clinical risk scoring could simplify the approach to which patients with AF should be offered oral anticoagulation.  <br/

Quality indicators for the care and outcomes of adults with atrial fibrillation

Aims To develop quality indicators (QIs) that may be used to evaluate the quality of care and outcomes for adults with atrial fibrillation (AF). Methods and results We followed the ESC methodology for QI development. This methodology involved (i) the identification of the domains of AF care for the diagnosis and management of AF (by a group of experts including members of the ESC Clinical Practice Guidelines Task Force for AF); (ii) the construction of candidate QIs (including a systematic review of the literature); and (iii) the selection of the final set of QIs (using a modified Delphi method). Six domains of care for the diagnosis and management of AF were identified: (i) Patient assessment (baseline and follow-up), (ii) Anticoagulation therapy, (iii) Rate control strategy, (iv) Rhythm control strategy, (v) Risk factor management, and (vi) Outcomes measures, including patient-reported outcome measures (PROMs). In total, 17 main and 17 secondary QIs, which covered all six domains of care for the diagnosis and management of AF, were selected. The outcome domain included measures on the consequences and treatment of AF, as well as PROMs. Conclusion This document defines six domains of AF care (patient assessment, anticoagulation, rate control, rhythm control, risk factor management, and outcomes), and provides 17 main and 17 secondary QIs for the diagnosis and management of AF. It is anticipated that implementation of these QIs will improve the quality of AF care

ESC guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 2-care pathways, treatment, and follow-up

Aims: Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular (CV) disease in association with COVID-19. Methods and results: A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, which was reported previously, focused on the epidemiology, pathophysiology, and diagnosis of CV conditions that may be manifest in patients with COVID-19. This second part addresses the topics of: care pathways and triage systems and management and treatment pathways, both of the most commonly encountered CV conditions and of COVID-19; and information that may be considered useful to help patients with CV disease (CVD) to avoid exposure to COVID-19. Conclusion: This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities