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Objectives to assess the levels of anxiety, depression, stress and fear of COVID-19 in non-syndromic cleft lip and/or palate (NSCL/P) children parents and caregivers. Materials and Methods Cross-sectional case-control study conducted at a Craniofacial Anomalies Rehabilitation Center, Brazil. Non-probabilistic convenience sampling was used and data were collected between October 2021 and November 2022. Variables were assessed by Depression, Anxiety and Stress Scale (DASS-21) and Fear of COVID-19 Scale (FC-19S). Pearson's chi-square test and multivariate binary logistic regression model have been performed. Results Data were obtained of 80 NSCL/P parents group and 130 by control group. Severe symptoms were higher in NSCL/P parents indicated by rates (8.8% vs 69% to anxiety; 12.5% vs 8.5% to depression and 17.5% vs 10.0% to stress). As for the predilection in case group there was an association (p 95%CI 1.28–13.06). Control group caregivers were more fear of COVID-19 (43.8% vs 28.7% p

To evaluate the surgical rehabilitation of cleft lip and/or palate by the Brazilian public health system.Retrospective, analytical and comparative ecological study, with information on hospital procedures performed on individuals with cleft lip and/or palate in Centers authorized by the Brazilian public health system, between the years 2008 and 2020. The information was collected in databases Ministry of Health data.Between 2008 and 2020, there was an increase of 8 (36.4%) qualified Centers in Brazil, currently having 30 Centers in 100% of the geographic regions. The surgical procedures performed totaled 68,716; with multiple surgeries being the most frequent. Complete cleft lip and palate was the most frequent type in hospital admissions. The public financial resources invested in the surgical rehabilitation of cleft lip and palate in the qualified Lip and Palate Malformation Treatment Centers were US$ 39,693 million, making an average value per procedure of US$ 577.64.In Brazil, public health system performed and financed, over the years 2008 and 2020, an important volume of surgical procedures for cleft lip and/or palate, which presented a polarization in the Southeast region but with a slight tendency expansion to other regions of the country. The most performed surgical procedures were multiple surgeries and mostly for individuals with cleft lip and palate. The amounts paid showed a heretogeneous distribution in the national territory.Level 5: Report containing program evaluation data.

— In recent years there is a growing number of attacks in the computer networks. Therefore, the use of a prevention mechanism is an inevitable need for security admins. Although firewalls are preferred as the first layer of protection, it is not sufficient for preventing lots of the attacks, especially from the insider attacks. Intrusion Detection Systems (IDSs) have emerged as an effective solution to these types of attacks. For increasing the efficiency of the IDS system, a dynamic solution, which can adapt itself and can detect new types of intrusions with a dynamic structure by the use of learning algorithms is mostly preferred. In previous years, some machine learning approaches are implemented in lots of IDSs. In the current position of artificial intelligence, most of the learning systems are transferred with the use of Deep Learning approaches due to its flexibility and the use of Big Data with high accuracy. In this paper, we propose a clustered approach to detect the intrusions in a network. Firstly, the system is trained with Deep Neural Network on a Big Data set by accelerating its performance with the use of CUDA architecture. Experimental results show that the proposed system has a very good accuracy rate and low runtime duration with the use of this parallel computation architecture. Additionally, the proposed system needs a relatively small duration for training the system

Background Fracture diagnosis in the austere environment where radiographic tests are not available can be a challenge. In the past, a diagnostic technique has been described using a tuning fork and stethoscope to assess decreased sound conduction in the fractured extremity. In this study, we evaluate the use of a cellular phone's vibrate function and a stethoscope to limit equipment carried by expeditionary practitioners. Objective The purpose of this study was to evaluate the accuracy of fracture diagnosis using a cellular phone and stethoscope. Methods This is a pilot study to assess the usefulness of the above technique before clinical implementation. In 3 cadavers, we created fractures of the humerus and femur. Twenty-seven emergency medicine residents and an attending physician performed the diagnostic technique. Results Overall, the use of the cellular phone and stethoscope resulted in a sensitivity of 73% (95% confidence interval [CI]: 0.64 to 0.81) and a specificity of 83% (95% CI: 0.77 to 0.88), with a positive predicted value of 68% (95% CI: 0.59 to 0.77) and a negative predicted value of 86% (95% CI: 0.81 to 0.90). Positive likelihood ratio was 4.3, and negative likelihood ratio was 0.32. Conclusions The use of a cellular phone and stethoscope may be a useful tool for the diagnosis of fractures in the austere environment. However, further study is needed to validate these findings in the clinical environment.

To describe the main characteristics, including stage of disease and local treatment of patients admitted to two reference services for the treatment of breast cancer in the North of Minas Gerais.We conducted a cross-sectional descriptive study. We evaluated medical records of 288 female patients with breast cancer admitted between January 2006 and December 2009, referred from a public hospital and a private clinic. Variables were analyzed using the chi-square test and multinomial logistic regression.68.1% of patients were referred from the public hospital. There was a predominance of patients over 50 years old (54.5%), married (59%) and with children (87.8%). The mean age of the population studied was 63 years old. Time between suspected cancer and confirmation of diagnosis was over six months in 42.7% of patients. Cancer diagnosis was late (stage III and IV) in 47.6% of patients. Family history of breast cancer was present in 20.1%, 20.8% of them had performed self-breast examination, and 41% had been submitted to a mammogram.There was a higher prevalence of stage III/IV patients from the public service when compared to the private sector. We found that the major factors associated with the late diagnosis of breast cancer were the delay between suspected and confirmed diagnosis, the absence of family history of breast cancer and not having a mammogram.

Location matters for immunosuppression In the gut, food antigens and resident microbes can trigger unwanted immune responses. Immunosuppressive cell types in the gut, such as regulatory T cells (T regs ) and intraepithelial T lymphocytes (IELs), help to keep these responses at bay. Sujino et al. report that the specific anatomical location within the gut shapes the properties of the suppressive T cell populations that reside there (see the Perspective by Colonna and Cervantes-Barragan). Using mice, they find that T regs primarily reside in the lamina propria. T regs migrate to the intestinal epithelium, where they convert to IELs in a process that depends on the microbiota and the loss of a specific transcription factor. T regs and IELs also play distinct but complementary roles in suppressing intestinal inflammation. Science , this issue p. 1581 ; see also p. 1515