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

Unanticipated proximity behavior in ferromagnet-superconductor heterostructures with controlled magnetic noncollinearity

Magnetization noncollinearity in ferromagnet-superconductor (F/S) heterostructures is expected to enhance the superconducting transition temperature (Tc) according to the domain-wall superconductivity theory, or to suppress Tc when spin-triplet Cooper pairs are explicitly considered. We study the proximity effect in F/S structures where the F layer is a Sm-Co/Py exchange-spring bilayer and the S layer is Nb. The exchange-spring contains a single, controllable and quantifiable domain wall in the Py layer. We observe an enhancement of superconductivity that is nonmonotonic as the Py domain wall is increasingly twisted via rotating a magnetic field, different from theoretical predictions. We have excluded magnetic fields and vortex motion as the source of the nonmonotonic behavior. This unanticipated proximity behavior suggests that new physics is yet to be captured in the theoretical treatments of F/S systems containing noncollinear magnetization.Comment: 17 pages, 4 figures. Physical Review Letters in pres

COLOR III: a multicentre randomised clinical trial comparing transanal TME versus laparoscopic TME for mid and low rectal cancer

Total mesorectal excision (TME) is an essential component of surgical management of rectal cancer. Both open and laparoscopic TME have been proven to be oncologically safe. However, it remains a challenge to achieve complete TME with clear circumferential resections margin (CRM) with the conventional transabdominal approach, particularly in mid and low rectal tumours. Transanal TME (TaTME) was developed to improve oncological and functional outcomes of patients with mid and low rectal cancer.An international, multicentre, superiority, randomised trial was designed to compare TaTME and conventional laparoscopic TME as the surgical treatment of mid and low rectal carcinomas. The primary endpoint is involved CRM. Secondary endpoints include completeness of mesorectum, residual mesorectum, morbidity and mortality, local recurrence, disease-free and overall survival, percentage of sphincter-saving procedures, functional outcome and quality of life. A Quality Assurance Protocol including centralised MRI review, histopathology re-evaluation, standardisation of surgical techniques, and monitoring and assessment of surgical quality will be conducted.The difference in involvement of CRM between the two treatment strategies is thought to be in favour of the TaTME. TaTME is therefore expected to be superior to laparoscopic TME in terms of oncological outcomes in case of mid and low rectal carcinomas

Magnetic Structure in Fe/Sm-Co Exchange Spring Bilayers with Intermixed Interfaces

The depth profile of the intrinsic magnetic properties in an Fe/Sm-Co bilayer fabricated under nearly optimal spring-magnet conditions was determined by complementary studies of polarized neutron reflectometry and micromagnetic simulations. We found that at the Fe/Sm-Co interface the magnetic properties change gradually at the length scale of 8 nm. In this intermixed interfacial region, the saturation magnetization and magnetic anisotropy are lower and the exchange stiffness is higher than values estimated from the model based on a mixture of Fe and Sm-Co phases. Therefore, the intermixed interface yields superior exchange coupling between the Fe and Sm-Co layers, but at the cost of average magnetization.Comment: 16 pages, 6 figures and 1 tabl

Magnetically asymmetric interfaces in a (LaMnO3_3)/(SrMnO3_3) superlattice due to structural asymmetries

Polarized neutron reflectivity measurements of a ferromagnetic [(LaMnO$_3$)$_{11.8}$/(SrMnO$_3$)$_{4.4}$]$_6$ superlattice reveal a modulated magnetic structure with an enhanced magnetization at the interfaces where LaMnO$_3$ was deposited on SrMnO$_3$ (LMO/SMO). However, the opposite interfaces (SMO/LMO) are found to have a reduced ferromagnetic moment. The magnetic asymmetry arises from the difference in lateral structural roughness of the two interfaces observed via electron microscopy, with strong ferromagnetism present at the interfaces that are atomically smooth over tens of nanometers. This result demonstrates that atomic-scale roughness can destabilize interfacial phases in complex oxide heterostructures.Comment: 5 pages, 4 figure

Delta Doping of Ferromagnetism in Antiferromagnetic Manganite Superlattices

We demonstrate that delta-doping can be used to create a dimensionally confined region of metallic ferromagnetism in an antiferromagnetic (AF) manganite host, without introducing any explicit disorder due to dopants or frustration of spins. Delta-doped carriers are inserted into a manganite superlattice (SL) by a digital-synthesis technique. Theoretical consideration of these additional carriers show that they cause a local enhancement of ferromagnetic (F) double-exchange with respect to AF superexchange, resulting in local canting of the AF spins. This leads to a highly modulated magnetization, as measured by polarized neutron reflectometry. The spatial modulation of the canting is related to the spreading of charge from the doped layer, and establishes a fundamental length scale for charge transfer, transformation of orbital occupancy and magnetic order in these manganites. Furthermore, we confirm the existence of the canted, AF state as was predicted by de Gennes [P.-G. de Gennes, Phys. Rev. 118, 141 (1960)], but had remained elusive

Test beam Characterizations of 3D Silicon Pixel detectors

3D silicon detectors are characterized by cylindrical electrodes perpendicular to the surface and penetrating into the bulk material in contrast to standard Si detectors with planar electrodes on its top and bottom. This geometry renders them particularly interesting to be used in environments where standard silicon detectors have limitations, such as for example the radiation environment expected in an LHC upgrade. For the first time, several 3D sensors were assembled as hybrid pixel detectors using the ATLAS-pixel front-end chip and readout electronics. Devices with different electrode configurations have been characterized in a 100 GeV pion beam at the CERN SPS. Here we report results on unirradiated devices with three 3D electrodes per 50 x 400 um2 pixel area. Full charge collection is obtained already with comparatively low bias voltages around 10 V. Spatial resolution with binary readout is obtained as expected from the cell dimensions. Efficiencies of 95.9% +- 0.1 % for tracks parallel to the electrodes and of 99.9% +- 0.1 % at 15 degrees are measured. The homogeneity of the efficiency over the pixel area and charge sharing are characterized.Comment: 5 pages, 7 figure