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The interaction of free electrons with intense laser beams in vacuum is studied using a 3D test particle simulation model that solves the relativistic Newton-Lorentz equations of motion in analytically specified laser fields. Recently, a group of solutions was found for very intense laser fields that show interesting and unusual characteristics. In particular, it was found that an electron can be captured within the high-intensity laser region, rather than expelled from it, and the captured electron can be accelerated to GeV energies with acceleration gradients on the order of tens of GeV/cm. This phenomenon is termed the capture and acceleration scenario (CAS) and is studied in detail in this paper. The maximum net energy exchange by the CAS mechanism is found to be approximately proportional to a 2_o, in the regime where a_o > 100, where a_o = eE_o/m_ewc is a dimensionless parameter specifying the magnitude of the laser field. The accelerated GeV electron bunch is a macro-pulse, with duration equal or less than that of the laser pulse, which is composed of many micro-pulses that are periodic at the laser frequency. The energy spectrum of the CAS electron bunch is presented. The dependence of the energy exchange in the CAS on various parameters, e.g., a 2_o (laser intensity), w_o (laser radius at focus), tao (laser pulse duration), b_o (the impact parameter), and theta_i (the injection angle with respect to the laser propagation direction), are explored in detail. A comparison with diverse theoretical models is also presented, including a classical model based on phase velocities and a quantum model based on nonlinear Compton scattering.

The characteristics of electron scattering by intense pulsed laser beams and to determine the dependence of the net energy exchange on various parameters is studied. The interaction of free electrons with intense laser beams in vacuum is studied by using a three-dimensional test particle simulation model.

The interaction of free electrons with intense laser beams in vacuum is studied using a three-dimensional test particle simulation model that solves the relativistic Newton-Lorentz equations of motion in analytically specified laser fields. Recently, a group of solutions was found for very intense laser fields that show interesting and unusual characteristics. In particular, it was found that an electron can be captured within the high-intensity laser region, rather than expelled from it, and the captured electron can be accelerated to GeV energies with acceleration gradients on the order of tens of GeV/cm. This phenomenon is termed the capture and acceleration scenario (CAS) and is studied in detail in this article. The accelerated GeV electron bunch is a macropulse, with duration equal to or less than that of the laser pulse, which is composed of many micropulses that are periodic at the laser frequency. The energy spectrum of the CAS electron bunch is presented. The dependence of the energy exchange in the CAS on various parameters, e.g., α[sub 0] (laser intensity), w[sub 0] (laser radius at focus), τ (laser pulse duration), b[sub 0] (the impact parameter), and θ [sub i] (the injection angle with respect to the laser propagation direction), are explored in detail. A comparison with diverse theoretical models is also presented, including a classical model based on phase velocities and a quantum model based on nonlinear Compton scattering. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) affects approximately 13% of people globally, including 20%-48% with type 2 diabetes (T2D), resulting in significant morbidity, mortality, and healthcare costs. There is an urgent need to increase early screening and intervention for CKD. We are experts in diabetology and nephrology in Central Europe and Israel. Herein, we review evidence supporting the use of sodium-glucose cotransporter-2 (SGLT2) inhibitors for kidney protection and discuss barriers to early CKD diagnosis and treatment, including in our respective countries. SGLT2 inhibitors exert cardiorenal protective effects, demonstrated in the renal outcomes trials (EMPA-KIDNEY, DAPA-CKD, CREDENCE) of empagliflozin, dapagliflozin, and canagliflozin in patients with CKD. EMPA-KIDNEY demonstrated cardiorenal efficacy across the broadest renal range, regardless of T2D status. Renoprotective evidence also comes from large real-world studies. International guidelines recommend first-line SGLT2 inhibitors for patients with T2D and estimated glomerular filtration rate (eGFR) ≥20 mL/min/1.73 m 2 , and that glucagon-like peptide-1 receptor agonists may also be administered if required for additional glucose control. Although these guidelines recommend at least annual eGFR and urine albumin-to-creatinine ratio screening for patients with T2D, observational studies suggest that only half are screened. Diagnosis is hampered by asymptomatic early CKD and under-recognition among patients with T2D and clinicians, including limited knowledge/use of guidelines and resources. Based on our experience and on the literature, we recommend robust screening programmes, potentially with albuminuria self-testing, and SGLT2 inhibitor reimbursement at general practitioner (GP) and specialist levels. High-tech tools (artificial intelligence, smartphone apps, etc.) are providing exciting opportunities to identify high-risk individuals, self-screen, detect abnormalities in images, and assist with prescribing and treatment adherence. Better education is also needed, alongside provision of concise guidelines, enabling GPs to identify who would benefit from early initiation of renoprotective therapy; although, regardless of current renal function, cardiorenal protection is provided by SGLT2 inhibitor therapy., (© 2024 The Author(s). Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)

EMPA-REG OUTCOME is recognised by international guidelines as a landmark study that showed a significant cardioprotective benefit with empagliflozin in patients with type 2 diabetes (T2D) and cardiovascular disease. To assess the impact of empagliflozin in routine clinical practice, the ongoing EMPRISE study is collecting real-world evidence to compare effectiveness, safety and health economic outcomes between empagliflozin and DPP-4 inhibitors. A planned interim analysis of EMPRISE was recently published, confirming a substantial reduction in hospitalisation for heart failure with empagliflozin across a diverse patient population. In this commentary article, we discuss the new data in the context of current evidence and clinical guidelines, as clinicians experienced in managing cardiovascular risk in patients with T2D. We also look forward to what future insights EMPRISE may offer, as evidence is accumulated over the next years to complement the important findings of EMPA-REG OUTCOME.

Background: For patients with type 2 diabetes (T2D), cardiovascular disease (CVD) is the single most common cause of mortality. In 2008 and 2012, the Federal Drug Administration (FDA) and the European Medicines Agency (EMA) respectively mandated cardiovascular outcomes trials (CVOTs) on all new anti-diabetic agents, as prospective trials statistically powered to rule out excess cardiovascular risk in patients with T2D. Unexpectedly, some of these CVOTs have demonstrated not only cardiovascular safety, but also cardioprotective effects, as was first shown for the SGLT2 inhibitor empagliflozin in EMPA-REG OUTCOME., Expert Opinion: To debate newly available CVOT data and to put them into context, we convened as a group of medical experts from the Central and Eastern European Region. Here we describe our discussions, focusing on the conclusions we can draw from EMPA-REG OUTCOME and other SGLT2 inhibitor CVOTs, including when considered alongside real-world evidence., Conclusion: CVOTs investigating SGLT2 inhibitors have suggested benefits beyond glucose lowering that have been confirmed in real-world evidence studies.