0, 95% confidence interval 3.81 to 59.0, p  less then  0.001). Plaque erosion was associated with greater physical activity at the onset. This finding may help to further clarify the pathogenesis of ACS Impact of physical exertion on the incidence of plaque erosion. NSTE-ACS, non ST-segment elevation acute coronary syndrome.Sunscreen use is an important aspect of sun protective behavior. Previous studies revealed deficits in sunscreen use. Our aim was to quantify sunscreen use in a nationwide representative study in Germany as well as to develop and test an item battery on reasons for none use of sunscreen.  https://www.selleckchem.com/products/l-alpha-phosphatidylcholine.html  We analyzed data of the National Cancer Aid Monitoring (NCAM; wave 4; n = 3000, aged 14-45). To describe those who only use sunscreen rarely or never, we used chi2 statistics and logistic regression analysis. In addition, we utilized a newly developed item battery on barriers to sunscreen use. Here, we used Cronbach's alpha to investigate reliability. In total, 20.7% reported using sunscreen rarely or never. Infrequent or none use of sunscreen was associated with male sex, immigrant background, none or rare sunbathing in summer, and current or past use of sunbeds. Participants with higher skin cancer risk (e.g., pale skin) were less likely to use sunscreen infrequently or never. The major reasons for not using sunscreen were inconvenience and no perceived need for applying sunscreen. Overall, internal consistency of the item battery on potential barriers to sunscreen use was very good (Cronbach's alpha = 0.865). We found deficits in sunscreen use especially in sunbed users, men, and individuals with immigrant background. Our results give important implications for future prevention and health promotion campaigns on sunscreen use.BACKGROUND Spinal muscular atrophy (SMA) is a rare disorder, estimated to affect 1 per 10,000 live births. Patients affected with SMA often require intensive, chronic healthcare, which represents great social and economic costs. OBJECTIVE This study aimed to evaluate the direct medical costs of SMA, from the National Health System perspective in Catalonia, and provide regional data for the development of optimal disease management protocols and resource allocation decisions at the regional level. METHODS A retrospective, population-based study was designed based on admission records from primary care centres, hospitals and specialised care settings (inpatient and outpatient care), emergency services and extended care facilities obtained from a regional governmental claims database. RESULTS A total of 396 patients met the inclusion criteria. Annual direct medical costs summed €58,606 per patient, taking into account the use of healthcare resources at all levels of care and excluding the cost of prescription medication. Specialised care represented 81% of the expenses that were mostly associated with respiratory manifestations of SMA. In the year 2016, 71.26% of patients with SMA had four or more systems affected by a chronic condition, versus 23.50% in the general population, which had an impact on healthcare use. CONCLUSIONS Inpatient extended care and the increased presence of multimorbid chronic conditions in patients with SMA must be taken into account in order to develop multidisciplinary treatment protocols that reflect the complexity of SMA. Forthcoming resource allocation decisions should reflect the intensive use of specialised care registered in patients with SMA.BACKGROUND AND OBJECTIVES The efficacy of direct oral anticoagulants (DOACs) in the management of left ventricular (LV) thrombi remains to be determined, especially in patients with ischemic cardiomyopathy. This retrospective study sought to compare the efficacy of vitamin K antagonists (VKAs) and DOACs in patients with LV thrombi and evaluate the rate of LV thrombus resolution after adjusting anticoagulation. METHODS This observational retrospective study included patients admitted to our institution for LV thrombus between January 2010 and August 2019. The rate of LV thrombus resolution was compared between VKAs and DOACs. Patients without thrombus resolution with DOAC treatment were switched to VKA agents in order to obtain an international normalized ratio (INR) of 3-4. RESULTS Between January 2010 and August 2019, 59 consecutive patients with LV thrombi detected by transthoracic echocardiography were included in the study. The mean age was 62 ± 14 years and 16.9% were women. The circumstances of LV thromare as it is possible to control INR levels (3-4) with them.Sperm morphology, as an indicator of fertility, is a critical tool in semen analysis. In this study, a smartphone-based hybrid system that fully automates the sperm morphological analysis is introduced with the aim of eliminating unwanted human factors. Proposed hybrid system consists of two progressive steps automatic segmentation of possible sperm shapes and classification of normal/ab-normal sperms. In the segmentation step, clustering techniques with/without group sparsity approach were tested to extract region of interests from the images. Subsequently, a novel publicly available morphological sperm image data set, whose labels were identified by experts as non-sperm, normal and abnormal sperm, was created as the ground truths of classification step. In the classification step, conventional and ensemble machine learning methods were applied to domain-specific features that were extracted by using wavelet transform and descriptors. Additionally, as an alternative to conventional features, three deep neural network architectures, which can extract high-level features from raw images after using statistical learning, were employed to increase the proposed method's performance. The results show that, for the conventional features, the highest classification accuracies were achieved as 80.5% and 83.8% by using the wavelet- and descriptor-based features that were fed to the Support Vector Machines respectively. On the other hand, the Mobile-Net, which is a very convenient network for smartphones, achieved 87% accuracy. In the light of obtained results, it is seen that a fully automatic hybrid system, which uses the group sparsity to enhance segmentation performance and the Mobile-Net to obtain high-level robust features, can be an effective mobile solution for the sperm morphology analysis problem. A fully automated hybrid human sperm detection and classification system based on mobile-net.