Exercise and Coronary Atherosclerosis: Observations, Explanations, Relevance, and Clinical Management.

Physical activity and exercise training are effective strategies for reducing the risk of cardiovascular events, but multiple studies have reported an increased prevalence of coronary atherosclerosis, usually measured as coronary artery calcification, among athletes who are middle-aged and older. Our review of the medical literature demonstrates that the prevalence of coronary artery calcification and atherosclerotic plaques, which are strong predictors for future cardiovascular morbidity and mortality, was higher in athletes compared with controls, and was higher in the most active athletes compared with less active athletes. However, analysis of plaque morphology revealed fewer mixed plaques and more often only calcified plaques among athletes, suggesting a more benign composition of atherosclerotic plaques. This review describes the effects of physical activity and exercise training on coronary atherosclerosis in athletes who are middle-aged and older and aims to contribute to the understanding of the potential adverse effects of the highest doses of exercise training on the coronary arteries. For this purpose, we will review the association between exercise and coronary atherosclerosis measured using computed tomography, discuss the potential underlying mechanisms for exercise-induced coronary atherosclerosis, determine the clinical relevance of coronary atherosclerosis in middle-aged athletes and describe strategies for the clinical management of athletes with coronary atherosclerosis to guide physicians in clinical decision making and treatment of athletes with elevated coronary artery calcification scores

Time Scales in Spectator Fragmentation

Proton-proton correlations and correlations of p-alpha, d-alpha, and t-alpha from spectator decays following Au + Au collisions at 1000 AMeV have been measured with an highly efficient detector hodoscope. The constructed correlation functions indicate a moderate expansion and low breakup densities similar to assumptions made in statistical multifragmentation models. In agreement with a volume breakup rather short time scales were deduced employing directional cuts in proton-proton correlations. PACS numbers: 25.70.Pq, 21.65.+f, 25.70.MnComment: 8 pages, with 5 included figures; To appear in the proceedings of the CRIS 2000 conference; Also available from http://www-kp3.gsi.de/www/kp3/aladin_publications.htm

Thermal and Chemical Freeze-out in Spectator Fragmentation

Isotope temperatures from double ratios of hydrogen, helium, lithium, beryllium, and carbon isotopic yields, and excited-state temperatures from yield ratios of particle-unstable resonances in 4He, 5Li, and 8Be, were determined for spectator fragmentation, following collisions of 197Au with targets ranging from C to Au at incident energies of 600 and 1000 MeV per nucleon. A deviation of the isotopic from the excited-state temperatures is observed which coincides with the transition from residue formation to multi-fragment production, suggesting a chemical freeze-out prior to thermal freeze-out in bulk disintegrations.Comment: 14 pages, 10 figures, submitted to Phys. Rev. C, small changes as suggested by the editors and referee

Breakup Density in Spectator Fragmentation

Proton-proton correlations and correlations of protons, deuterons and tritons with alpha particles from spectator decays following 197Au + 197Au collisions at 1000 MeV per nucleon have been measured with two highly efficient detector hodoscopes. The constructed correlation functions, interpreted within the approximation of a simultaneous volume decay, indicate a moderate expansion and low breakup densities, similar to assumptions made in statistical multifragmentation models. PACS numbers: 25.70.Pq, 21.65.+f, 25.70.Mn, 25.75.GzComment: 11 pages, LaTeX with 3 included figures; Also available from http://www-kp3.gsi.de/www/kp3/aladin_publications.htm

"Mushroom cloud": a giant left ventricular pseudoaneurysm after a myocardial infarction due to myocardial bridging – a case report

Left ventricular pseudoaneurysm is an uncommon complication after transmural myocardial infarction, occurring when a free wall rupture is contained by adhesions of the overlying pericardium preventing acute tamponade. In this report, an unusual case of a 61 year-old male with a giant apical left ventricular pseudoaneurysm after an unnoticed myocardial infarction is presented. On coronary angiogram myocardial bridging of the distal left anterior descending artery was judged to be the infarct related lesion. The echocardiographic diagnosis allowed for a timely surgical intervention which resulted in the patient's full recovery

Transient integral boundary layer method to calculate the translesional pressure drop and the fractional flow reserve in myocardial bridges

BACKGROUND: The pressure drop – flow relations in myocardial bridges and the assessment of vascular heart disease via fractional flow reserve (FFR) have motivated many researchers the last decades. The aim of this study is to simulate several clinical conditions present in myocardial bridges to determine the flow reserve and consequently the clinical relevance of the disease. From a fluid mechanical point of view the pathophysiological situation in myocardial bridges involves fluid flow in a time dependent flow geometry, caused by contracting cardiac muscles overlying an intramural segment of the coronary artery. These flows mostly involve flow separation and secondary motions, which are difficult to calculate and analyse. METHODS: Because a three dimensional simulation of the haemodynamic conditions in myocardial bridges in a network of coronary arteries is time-consuming, we present a boundary layer model for the calculation of the pressure drop and flow separation. The approach is based on the assumption that the flow can be sufficiently well described by the interaction of an inviscid core and a viscous boundary layer. Under the assumption that the idealised flow through a constriction is given by near-equilibrium velocity profiles of the Falkner-Skan-Cooke (FSC) family, the evolution of the boundary layer is obtained by the simultaneous solution of the Falkner-Skan equation and the transient von-Kármán integral momentum equation. RESULTS: The model was used to investigate the relative importance of several physical parameters present in myocardial bridges. Results have been obtained for steady and unsteady flow through vessels with 0 – 85% diameter stenosis. We compare two clinical relevant cases of a myocardial bridge in the middle segment of the left anterior descending coronary artery (LAD). The pressure derived FFR of fixed and dynamic lesions has shown that the flow is less affected in the dynamic case, because the distal pressure partially recovers during re-opening of the vessel in diastole. We have further calculated the wall shear stress (WSS) distributions in addition to the location and length of the flow reversal zones in dependence on the severity of the disease. CONCLUSION: The described boundary layer method can be used to simulate frictional forces and wall shear stresses in the entrance region of vessels. Earlier models are supplemented by the viscous effects in a quasi three-dimensional vessel geometry with a prescribed wall motion. The results indicate that the translesional pressure drop and the mean FFR compares favourably to clinical findings in the literature. We have further shown that the mean FFR under the assumption of Hagen-Poiseuille flow is overestimated in developing flow conditions

Breakup Temperature of Target Spectators in Au + Au Collisions at E/A = 1000 MeV

Breakup temperatures were deduced from double ratios of isotope yields for target spectators produced in the reaction Au + Au at 1000 MeV per nucleon. Pairs of $^{3,4}$He and $^{6,7}$Li isotopes and pairs of $^{3,4}$He and H isotopes (p, d and d, t) yield consistent temperatures after feeding corrections, based on the quantum statistical model, are applied. The temperatures rise with decreasing impact parameter from 4 MeV for peripheral to about 10 MeV for the most central collisions. The good agreement with the breakup temperatures measured previously for projectile spectators at an incident energy of 600 MeV per nucleon confirms the observed universality of the spectator decay at relativistic bombarding energies. The measured temperatures also agree with the breakup temperatures predicted by the statistical multifragmentation model. For these calculations a relation between the initial excitation energy and mass was derived which gives good simultaneous agreement for the fragment charge correlations. The energy spectra of light charged particles, measured at $\theta_{lab}$ = 150$^{\circ}$, exhibit Maxwellian shapes with inverse slope parameters much higher than the breakup temperatures. The statistical multifragmentation model, because Coulomb repulsion and sequential decay processes are included, yields light-particle spectra with inverse slope parameters higher than the breakup temperatures but considerably below the measured values. The systematic behavior of the differences suggests that they are caused by light-charged-particle emission prior to the final breakup stage. PACS numbers: 25.70.Mn, 25.70.Pq, 25.75.-qComment: 29 pages, TeX with 11 included figures; Revised version accepted for publication in Z. Phys. A Two additional figure

Temperatures of Exploding Nuclei

Breakup temperatures in central collisions of 197Au + 197Au at bombarding energies E/A = 50 to 200 MeV were determined with two methods. Isotope temperatures, deduced from double ratios of hydrogen, helium, and lithium isotopic yields, increase monotonically with bombarding energy from 5 MeV to 12 MeV, in qualitative agreement with a scenario of chemical freeze-out after adiabatic expansion. Excited-state temperatures, derived from yield ratios of states in 4He, 5Li, 6Li, and 8Be, are about 5 MeV, independent of the projectile energy, and seem to reflect the internal temperature of fragments at their final separation from the system. PACS numbers: 25.70.Mn, 25.70.Pq, 25.75.-qComment: 10 pages, RevTeX with 4 included figures; Also available from http://www-kp3.gsi.de/www/kp3/aladin_publications.htm

Finding Plastic Patches in Coastal Waters using Optical Satellite Data

Satellites collecting optical data offer a unique perspective from which to observe the problem of plastic litter in the marine environment, but few studies have successfully demonstrated their use for this purpose. For the first time, we show that patches of floating macroplastics are detectable in optical data acquired by the European Space Agency (ESA) Sentinel-2 satellites and, furthermore, are distinguishable from naturally occurring materials such as seaweed. We present case studies from four countries where suspected macroplastics were detected in Sentinel-2 Earth Observation data. Patches of materials on the ocean surface were highlighted using a novel Floating Debris Index (FDI) developed for the Sentinel-2 Multi-Spectral Instrument (MSI). In all cases, floating aggregations were detectable on sub-pixel scales, and appeared to be composed of a mix of seaweed, sea foam, and macroplastics. Building first steps toward a future monitoring system, we leveraged spectral shape to identify macroplastics, and a Naïve Bayes algorithm to classify mixed materials. Suspected plastics were successfully classified as plastics with an accuracy of 86