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Political polarization has become a growing concern in democratic societies, as it drives tribal alignments and erodes civic deliberation among citizens. Given its prevalence across different countries, previous research has sought to understand under which conditions people tend to endorse extreme opinions. However, in polarized contexts, citizens not only adopt more extreme views but also become correlated across issues that are, a priori, seemingly unrelated. This phenomenon, known as "ideological sorting", has been receiving greater attention in recent years but the micro-level mechanisms underlying its emergence remain poorly understood. Here, we study the conditions under which a social dynamic system is expected to become ideologically sorted as a function of the mechanisms of interaction between its individuals. To this end, we developed and analyzed a multidimensional agent-based model that incorporates two mechanisms: homophily (where people tend to interact with those holding similar opinions) and pairwise-coherence favoritism (where people tend to interact with ingroups holding politically coherent opinions). We numerically integrated the model's master equations that perfectly describe the system's dynamics and found that ideological sorting only emerges in models that include pairwise-coherence favoritism. We then compared the model's outcomes with empirical data from 24,035 opinions across 67 topics and found that pairwise-coherence favoritism is significantly present in datasets that measure political attitudes but absent across topics not considered related to politics. Overall, this work combines theoretical approaches from system dynamics with model-based analyses of empirical data to uncover a potential mechanism underlying the pervasiveness of ideological sorting.

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INTRODUCTION: Reasons for using and stopping the use of e-cigarettes and their associations with transitions in nicotine product use are relatively unknown in countries with e-cigarette bans, such as Mexico. METHODS: Data comes from an open cohort of people who smoke in Mexico, surveyed every 4 months from November 2018 to November 2021. Those who smoked and used e-cigarettes at time t (n=904 individuals, 1653 observations) were categorised at 4-month follow-up (t+1): (1) continued 'dual use', (2) exclusive smoking, (3) exclusive use of e-cigarettes or neither product. For people who formerly used e-cigarettes at time t (n=332 individuals, 372 observations), follow-up categories were: (1) continued exclusive smoking; (2) re-initiated e-cigarette use. Multinomial and logistic models regressed follow-up status (ref=status at time t) on reasons for using or stopping e-cigarette use, respectively, at time t, adjusting for covariates. RESULTS: The most prevalent reasons for current e-cigarette use were 'they were less harmful to others' (40.5%) and 'enjoyable' (39.0%). Those who reported using e-cigarettes because they were less harmful to others (Adjusted Relative Risk Ratio (ARRR)=0.67), more enjoyable (ARRR=0.52), could help them to quit smoking (ARRR=0.65), or to control weight (ARRR=0.46) were less likely to return to exclusively smoking. Among people who formerly used e-cigarettes, lack of satisfaction was the primary reason for stopping e-cigarette use (32%) and those who reported this were less likely to start using e-cigarettes again at follow-up (Adjusted Odds Ratio (AOR)=0.58). CONCLUSIONS: Specific reasons for using and stopping e-cigarettes predict changes in smoking and e-cigarette use, and targeting these beliefs could promote desired behaviour changes.

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Background: The use of artificial intelligence (AI) in medicine has been a trending subject in the past few years. Although not frequently used in daily practice yet, it brings along many expectations, doubts, and fears for physicians. Surveys can be used to help understand this situation. Objective: This study aimed to explore the degree of knowledge, expectations, and fears on possible AI use by physicians in daily practice, according to sex and time since graduation. Methods: An electronic survey was sent to physicians of a large hospital in Brazil, from August to September 2022. Results: A total of 164 physicians responded to our survey. Overall, 54.3% (89/164) of physicians considered themselves to have an intermediate knowledge of AI, and 78.5% (128/163) believed that AI should be regulated by a governmental agency. If AI solutions were reliable, fast, and available, 77.9% (127/163) intended to frequently or always use AI for diagnosis (143/164, 87.2%), management (140/164, 85.4%), or exams interpretation (150/164, 91.5%), but their approvals for AI when used by other health professionals (85/163, 52.1%) or directly by patients (82/162, 50.6%) were not as high. The main benefit would be increasing the speed for diagnosis and management (106/163, 61.3%), and the worst issue would be to over rely on AI and lose medical skills (118/163, 72.4%). Physicians believed that AI would be useful (106/163, 65%), facilitate their work (140/153, 91.5%), not alter the number of appointments (80/162, 49.4%), not interfere in their financial gain (94/162, 58%), and not replace their jobs but be an additional source of information (104/162, 64.2%). In case of disagreement between AI and physicians, most (108/159, 67.9%) answered that a third opinion should be requested. Physicians with ≤10 years since graduation would adopt AI solutions more frequently than those with >20 years since graduation (P=.04), and female physicians were more receptive to other hospital staff using AI than male physicians (P=.008). Conclusions: Physicians were shown to have good expectations regarding the use of AI in medicine when they apply it themselves, but not when used by others. They also intend to use it, as long as it was approved by a regulatory agency. Although there was hope for a beneficial impact of AI on health care, it also brings specific concerns.

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ABSTRACT Objective: This study aimed to assess the frequency with which orthodontic patients decided to shift to another type of orthodontic appliance, among conventional metal brackets, ceramic brackets, lingual brackets and clear aligner, based on their personal experiences of pain, ulcers, bad breath, hygiene issues and social difficulties. Material and Methods: This study comprises of patients seeking orthodontic treatment. The sample (n = 500; age group = 19-25 years) was divided equally into four groups based on the treatment modality: conventional metal brackets, ceramic brackets, lingual brackets and clear aligner. Patients rated the questionnaire using a visual analogue scale, to assess variables (such as pain, ulcer etc) that impact various treatment modalities. Subsequently, patients from all groups provided feedback regarding their treatment experiences, and expressed their preference for an alternative modality. Intergroup comparison among the four groups was done using one-way analysis of variance with Tukey's HSD post-hoc test (p ≤ 0.05). Results: Patients who received lingual brackets reported higher levels of pain and ulceration, as compared to those who received clear aligners. All four groups showed statistically significant differences for ulcers during treatment (p ≤ 0.05). Of the 125 patients who received conventional metal brackets, 28% expressed a preference for clear aligner therapy, while 20% preferred ceramic brackets. In the lingual group, 56% of 125 patients preferred clear aligner therapy, and 8% preferred ceramic brackets to complete their treatment. In the ceramic group, 83% did not want to switch, whereas 17% desired to switch to clear aligner, while in aligner group no patient desired to switch. Conclusions: A higher percentage of patients from lingual brackets group chose to shift to clear aligners, followed by conventional metal brackets group and by ceramic brackets group, in this descending order. The clear aligner group demonstrated fewer issues than the other treatment modalities.

RESUMO Objetivo: Este estudo teve como objetivo avaliar a frequência com que pacientes ortodônticos decidiram mudar para outro tipo de aparelho ortodôntico, entre braquetes convencionais de metal, braquetes cerâmicos, braquetes linguais e alinhadores transparentes, com base em suas experiências pessoais de dor, aftas, mau hálito, problemas de higiene e dificuldades sociais. Material e Métodos: Esse estudo foi composto por pacientes que procuram tratamento ortodôntico. A amostra (n = 500; faixa etária = 19-25 anos) foi dividida igualmente em quatro grupos, com base na modalidade de tratamento: braquetes metálicos convencionais, braquetes cerâmicos, braquetes linguais e alinhadores transparentes. Os pacientes responderam a um questionário, usando uma escala visual analógica, para avaliar variáveis como dor e aftas, que impactam diferentes modalidades de tratamento. Posteriormente, os pacientes de todos os grupos forneceram feedback sobre suas experiências de tratamento e expressaram sua preferência por uma modalidade alternativa. A comparação intergrupos entre os quatro grupos foi feita usando análise de variância unidirecional com teste post-hoc HSD de Tukey (p ≤ 0,05). Resultados: Os pacientes que usaram braquetes linguais relataram níveis mais elevados de dor e aftas, em comparação com aqueles que usaram alinhadores transparentes. Todos os quatro grupos apresentaram diferenças estatisticamente significativas para aftas durante o tratamento (p ≤ 0,05). Dos 125 pacientes que usaram braquetes metálicos convencionais, 28% expressaram preferência pelo tratamento com alinhadores transparentes, enquanto 20% preferiram braquetes cerâmicos. No grupo com braquetes linguais, 56% dos 125 pacientes preferiram o tratamento com alinhadores transparentes e 8% preferiram braquetes cerâmicos para completar o tratamento. No grupo com braquetes cerâmicos, 83% não queriam trocar de tratamento, enquanto 17% desejavam mudar para os alinhadores transparentes; enquanto no grupo de alinhadores nenhum paciente desejou mudar. Conclusões: Uma porcentagem maior de pacientes do grupo com braquetes linguais optou pela mudança para alinhadores transparentes, seguido pelo grupo com braquetes metálicos convencionais e pelo grupo com braquetes cerâmicos, em ordem decrescente. O grupo de alinhadores transparentes demonstrou menos problemas do que as outras modalidades de tratamento.

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BACKGROUND: In this study we proposed a new strategy to measure cost-effectiveness of second opinion program on spine surgery, using as measure of effectiveness the minimal important change (MIC) in the quality of life reported by patients, including the satisfaction questionnaire regarding the treatment and direct medical costs. METHODS: Retrospective analysis of patients with prior indication for spine surgery included in a second opinion program during May 2011 to May 2019. Treatment costs and outcomes were compared considering each patients' recommended treatment before and after the second opinion. Costs were measured under the perspective of the hospital, including hospital stay, surgical room, physician and staff fees and other costs related to hospitalization when surgery was performed and physiotherapy or injection costs when a conservative treatment was recommended. Reoperation costs were also included. For comparison analysis, we used data based on our clinical practice, using data from patients who underwent the same type of surgical procedure as recommended by the first referral. The measure of effectiveness was the percentage of patients who achieved the MIC in quality of life measured by the EQ-5D-3 L 2 years after starting treatment. An incremental cost-effectiveness ratio (ICER) was calculated. RESULTS: Based upon the assessment of 1,088 patients that completed the entire second opinion process, conservative management was recommended for 662 (60.8%) patients; 49 (4.5%) were recommended to injection and 377 (34.7%) to surgery. Complex spine surgery, as arthrodesis, was recommended by second opinion in only 3.7% of cases. The program resulted in financial savings of -$6,705 per patient associated with appropriate treatment indication, with an incremental effectiveness of 0.077 patients achieving MIC when compared to the first referral, resulting in an ICER of $-87,066 per additional patient achieving the MIC, ranging between $-273,016 and $-41,832. CONCLUSION: After 2 years of treatment, the second opinion program demonstrated the potential for cost-offsets associated with improved quality of life.

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This study sought to analyze whether an accurate diagnosis of the type and subtype of hepatic Glycogen Storage Diseases (GSDs) could be performed based on general clinical and biochemical aspects via comparing the proposed diagnostic hypotheses with the molecular results. Twelve physicians with experience in hepatic GSDs reviewed 45 real cases comprising a standardized summary of clinical and laboratory data. There was no relation between the hit rate and the time since graduation, the time of experience in GSD, and the number of patients treated during their careers. The average assertiveness was 47%, with GSD Ia and Ib being the best-identified types, while no expert correctly identified GSD IXc. Underage investigation for later manifestations, incomplete clinical description, and complementary analysis, the overvaluation of a specific clinical finding ("false positive") or the discarding of the diagnosis in the absence of it ("false negative"), as well as the lack of knowledge of the rarest GSD types, may have impacted the accuracy of the assessment. This study emphasized that characteristics considered as determinants in identifying the specific types or subtypes of GSD are not exclusive, thus becoming factors that may have induced the evaluators to misdiagnose.

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How much do citizens value democracy? How willing are they to sacrifice their liberties and voting rights for growth, equality, or other social outcomes? We design a conjoint experiment in nationally representative surveys in Brazil, France, and the United States in which respondents choose between different societies that randomly vary in their economic outcomes (country income, income inequality, social mobility), political outcomes (democracy, public health insurance), and the level of personal income for each respondent. Our research allows us to estimate the respondents' willingness to trade off democracy for individual income (as well as other societal attributes). We find that, on average, individuals are strongly attached to democracy and a robust welfare state. They prefer to live in a country without free democratic elections only if their individual income multiplies by at least three times and in a country without public health insurance only if their individual income more than doubles. After estimating these preferences at the individual level for all respondents, we show that, although there is an authoritarian minority in all three countries, forming a nondemocratic majority (by offering more income and/or other goods to respondents) is very unlikely. Our findings imply that, contrary to a growing discussion about the crisis of democracy, liberal democratic values remain substantially robust in high and middle income democracies.

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We study the Galam majority rule dynamics with contrarian behavior and an oscillating external propaganda in a population of agents that can adopt one of two possible opinions. In an iteration step, a random agent interacts with three other random agents and takes the majority opinion among the agents with probability p(t) (majority behavior) or the opposite opinion with probability 1-p(t) (contrarian behavior). The probability of following the majority rule p(t) varies with the temperature T and is coupled to a time-dependent oscillating field that mimics a mass media propaganda, in a way that agents are more likely to adopt the majority opinion when it is aligned with the sign of the field. We investigate the dynamics of this model on a complete graph and find various regimes as T is varied. A transition temperature Tc separates a bimodal oscillatory regime for TTc in which m oscillates around zero. These regimes are characterized by the distribution of residence times that exhibit a unique peak for a resonance temperature T*, where the response of the system is maximum. An insight into these results is given by a mean-field approach, which also shows that T* and Tc are closely related.

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Deaths attributable to unhealthful eating underscore the need to improve dietary patterns through upstream, policy-led solutions. The approval and successful implementation of food policies is partly determined by their public acceptance. Little is known about public support for food policies in Mexico. We aimed to investigate the level of public support for 30 food policies, grouped into 5 domains, and their associated characteristics among Mexican adults. Data are from the 2017-2021 International Food Policy Study (IFPS), a cross-sectional web-based survey of adults. Differences in public support across years were estimated using linear regression models. The association between demographic characteristics and policy support was analyzed using multivariate logistic regression models. The highest mean support was for the subsidies and benefits domain, followed by the labelling and reformulation domain. The level of support varied across years and policy domains. Support was higher in 2019 compared to 2017 and 2018, and subsequently lower in 2020 and 2021 compared to previous years. Older age was associated with greater support across all domains (OR ranged from 0.002 to 0.004, p < 0.01). Female participants and those selfidentifying as indigenous showed greater support for certain policy domains, whereas higher income adequacy was associated with lower support for other policy domains. In Mexico, support for food policies varies across subpopulations. Our findings may serve as a guide to the development and promotion of food policies in Mexico, as well as to improve their feasibility and success.

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Background: Effective scale-up of multisectoral strategies aimed to prevent and treat childhood obesity has been a challenge in Brazil, the largest country in Latin America. Implementation Science methods, such as Net-Map, can identify key actors and opinion leaders (OLs) to advance the implementation and promote sustainability. Objectives: This study aimed to analyze power relations between key actors and OLs who influence the scale-up of Brazilian strategies for childhood obesity at the federal and state/municipal (local) levels. Methods: A mixed method study, applying the Net-Map method, collected data through virtual workshops with federal and local level stakeholders. The Net-Map included key actors mapping, power mapping, and identification of OLs. Four domains of power were analyzed: command, funding, technical assistance, and dissemination. Network cohesion and centrality measures were calculated. A qualitative analysis was conducted to qualify power relations according to ∗ gears for a successful scale-up (i.e., coordination, goals, and monitoring; advocacy; political will; legislation and policy; funding and resources; training; program delivery; communication; and research and technical cooperation). Results: A total of 121 federal key actors and 63 local key actors were identified across networks, of which 62 and 28 were identified as OLs, respectively. Whereas the command domain of power had the highest number of key actors, the funding domain had the least. The health sector executive branch emerged as an OL across all domains of power. Conclusions: Barriers that threatened successful scale-up include the lack of coordination between domains of power, missing leadership within key actors, and lack of mechanisms to manage conflict of interest. Governance strategies to enhance multisectoral coordination and communication are needed to effectively scale-up and sustain childhood obesity strategies in Brazil.

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Resumen Antecedentes: El misoprostol es un medicamento de fácil acceso con el que se puede tener un aborto seguro. Objetivo: Explorar los conocimientos sobre la situación legal del aborto en el Estado de Aguascalientes, en donde el aborto está penalizado, así como los conocimientos y opiniones sobre el misoprostol. Método: Se aplicó un cuestionario en línea a 208 adultos. Resultados: La mayoría de las participantes no conocía la situación legal del aborto ni del Estado de Aguascalientes ni del país. Cerca de la mitad conocía el misoprostol, y sus principales fuentes de información fueron Internet y redes sociales. Aproximadamente la mitad de estos participantes no supo qué complicaciones puede ocasionar que requieran atención médica. Conclusión: El conocimiento sobre la situación legal del aborto y sobre el uso del misoprostol como método abortivo es limitado. Existe consciencia de la importancia de la supervisión médica cuando se usa, aunque esta se dificulta debido a la ilegalidad del aborto en Aguascalientes.

Abstract Background: Misoprostol is an easily accessible medication with which to have a safe abortion. Objective: To explore knowledge about the legal situation of abortion in the state of Aguascalientes, where abortion is criminalized, as well as knowledge and opinions about misoprostol. Method: An online questionnaire was administered to 208 adults. Results: Most of the participants did not know the legal situation of abortion neither in the state of Aguascalientes nor in the country. Almost half of them knew about misoprostol, and their main sources of information were the Internet and social networks. About half of these participants did not know which are the complications that misoprostol may cause that require medical attention. Conclusion: Knowledge about the legal situation of abortion and about the use of misoprostol as an abortion method is limited. There is awareness of the importance of medical supervision when misoprostol is used, but obtaining this supervision is difficult due to the illegality of abortion in Aguascalientes.

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An analytical observational study was conducted to investigate the association between knowledge of COVID-19 in the general population of Mexico and sociodemographic variables of interest. A total of 758 adults between 18 and 74 years old (M = 37.3 SD = 12.6), of which 88.9% had higher education and 33.2% were health care workers, participated in an online questionnaire assessing disease knowledge and the COVID-5 item Fear Scale, which was adapted by the research team. The proportion of individuals with high knowledge about COVID-19 was found to be 41.0%. Participants with higher education and healthcare professionals demonstrated higher knowledge scores in comparison to those with primary and secondary education, as well as non-healthcare professionals (PR=1.25, 95%CI 1.05-1.48). In conclusion, that people with higher education and healthcare workers exhibited better knowledge scores regarding the disease, while high knowledge about COVID-19 was only associated with being a health professional.

Se realizó un estudio observacional analítico con el objetivo de explorar la asociación entre el conocimiento que tiene la población general de México sobre COVID-19 y las variables sociodemográficas de interés. Un total de 758 adultos entre 18 y 74 años (M=37,3 DE=12,6), 88,9% con educación superior y 33,2% trabajadores de la salud, diligenciaron un cuestionario en línea sobre conocimientos la enfermedad y la Escala de Temor a COVID-5, adaptada por el equipo de investigación. La proporción de conocimientos altos sobre COVID-19 fue del 41,0%. Las personas con educación superior y los profesionales de la salud presentaron puntajes de conocimientos altos en comparación con los que tenían primaria y secundaria y con los que no pertenecían al gremio de la salud RP = 1,25 IC 95% (1,05 - 1,48). Se concluye que las personas con escolaridad superior y los profesionales de la salud tienen mejores puntajes de conocimientos sobre la enfermedad, mientras que el conocimiento alto sobre COVID-19 solo se asoció con ser profesional de la salud.

Foi realizado um estudo observacional analítico com o objetivo de explorar a associação entre o conhecimento que tem a população geral de México sobre COVID-19 e as variáveis sociodemográficas de interesse. Um total de 758 adultos entre 18 e 74 anos (M=37,3 DE=12,6), 88,9% com ensino superior e 33,2% trabalhadores da saúde, responderam um questionário on-line sobre conhecimentos a doença e a Escala de Temor a COVID-5, adaptada pela equipe de pesquisa. A proporção de conhecimentos altos sobre COVID-19 foi do 41,0%. As pessoas com educação superior e os profissionais da saúde apresentaram pontuação de conhecimentos altos em comparação com os que tinham ensino básico e ensino médio e com os que não pertenciam aos profissionais da saúde RP = 1,25 IC 95% (1,05 - 1,48). Concluise que as pessoas com educação superior e os profissionais da saúde têm melhor pontuação de conhecimentos sobre a doença, enquanto que o conhecimento alto sobre COVID-19 só se associou com ser professional da saúde.

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Baseando-se nos conceitos de "desordens informativas" propostos por Claire Wardle e Hossein Derakhshan, este trabalho propõe-se a observar o fenômeno de hesitação vacinal e a opinião pública em relação à vacina CoronaVac contra a covid-19, a partir da análise de falas públicas do presidente Jair Bolsonaro sobre esse imunizante produzido pelo Instituto Butantan em parceria com a biofarmacêutica chinesa Sinovac. As falas em questão foram proferidas no período de julho de 2020 a janeiro de 2021. Através de uma pesquisa de abordagem qualitativa, com finalidades exploratórias e descritivas, o trabalho analisou o conteúdo de dez pronunciamentos do então presidente sobre as vacinas no contexto do primeiro ano da pandemia de covid-19 no Brasil e observou desordens informativas dos seguintes tipos: má informação (17,6%), informação incorreta (47,1%) e desinformação (35,3%) em todas as falas. As desordens informativas propagadas contribuíram para os sentimentos de desconfiança e as posturas coletivas de hesitação vacinal relacionadas à covid-19, principalmente em relação à CoronaVac

Using the concepts of "informational disorder" proposed by Claire Wardle and Hossein Derakhshan, this paper observes the phenomenon of vaccine hesitancy and the public opinion towards the CoronaVac vaccine against covid-19, from the analysis of public speeches by President Jair Bolsonaro about this immunizer produced by Instituto Butantan in partnership with the Chinese biopharmaceutical company Sinovac. The speeches in question were delivered in the period from July 2020 to January 2021. Through a qualitative approach research, with exploratory and descriptive purposes, the work analyzed the content of ten pronouncements of the president about vaccines in the context of the first year of the covid-19 pandemic in Brazil and observed informational disorders of the following types: bad information (17.6%), incorrect information (47.1%) and misinformation (35.3%) in all speeches. The propagated informational disorders contributed to feelings of distrust and collective postures of vaccine hesitancy related to covid-19, especially in relation to CoronaVac

Utilizando los conceptos de "desórdenes informativos" propuestos por Claire Wardle y Hossein Derakhshan, este trabajo observa el fenómeno de la vacilación a la vacunación y la opinión pública hacia la vacuna CoronaVac contra el covid-19, a partir del análisis de los discursos públicos del presidente Jair Bolsonaro sobre este inmunizante producido por el Instituto Butantan en asociación con la biofarmacéutica china Sinovac. Los discursos en cuestión se pronunciaron en el periodo comprendido entre julio de 2020 y enero de 2021. A través de una investigación de abordaje cualitativo, con fines exploratorios y descriptivos, el trabajo analizó el contenido de diez pronunciamientos del presidente sobre vacunas en el contexto del primer año de la pandemia de covid-19 en Brasil y observó trastornos informativos de los siguientes tipos: mala información (17,6%), información incorrecta (47,1%) y desinformación (35,3%) en todos los discursos. Los trastornos informativos propagados contribuyeron a los sentimientos de desconfianza y a las posturas colectivas de indecisión vacunal relacionadas con el covid-19, especialmente en relación con CoronaVac

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The 2019 social outburst in Chile marked a significant turning point for the nation's politics and society, with widespread reports of human rights violations committed by the armed forces and the Police during demonstrations and riots. Despite the attention given to these events, few studies have systematically analyzed perceptions of human rights violations in such contentious contexts. To investigate the factors influencing perceptions of human rights violations during the 2019 Chilean social outburst, we conducted ordered logistic regressions using data from a nationally representative survey fielded during the unrest. Our findings reveal that participation in demonstrations, use of social media for political information, fear of crime, and proximity to violent protests are correlated with the perception that security forces frequently violated human rights during the outburst. These results contribute to the understanding of public perceptions of human rights violations in the context of the 2019 Chilean social outburst and provide insights for future research on the role of individual and contextual factors in shaping these perceptions.

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Disaster corruption is a vexing problem, damaging state legitimacy and exacerbating human suffering. Mexico has a history of both major disasters and persistently high levels of corruption. A magnitude 7.1 earthquake in 2017 provided an opportunity to study change over time in expectations and tolerance of corruption in disaster relief. Twenty years earlier, Mexico City residents expected, on average, essentially three out of 10 hypothetical trucks loaded with humanitarian assistance to be lost to corruption but expressed near zero tolerance of such conduct. By 2018-19, Mexico City residents expected more than one-half of all relief, six out of 10 trucks, to be stolen, and could tolerate three out of 10 trucks being pilfered. Similar results were found at the national level. Hence, Mexicans appear to be giving up on the state. Addressing corruption in disaster risk reduction and humanitarian relief specifically might provide a template for improving public trust across other state institutions.

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This study describes the healthcare resource use and costs associated with anxiety assessing claim database outcomes and expert opinion from the perspective of the Brazilian Private Healthcare System. A retrospective analysis of the Orizon database was conducted, containing claims data of anxiety patients reported in Private Healthcare Systems (2015-2017) according to the ICD-10 code (F40 or F41 and their subtypes). Further, a 3-hour online meeting brought together five anxiety and Health Insurance Companies experts to discuss their perspectives. The total cost of the 18,069 patients identified in the database was BRL 490 million: related to medical appointments (2%), exams (16%), emergency room (5%), and others (77%). The mean number of appointments was 5.1 in a 4-year period, performed by 61% of the patients. Approximately 2,595 visits were made to psychiatrists by 923 patients, and 95% underwent at least one examination (100.6 examinations per patient, on average). The identification of anxiety patients and their corresponding burden is challenging to estimate. The higher impact is related to the frequency of healthcare use before the diagnosis than the treatment itself. These outcomes may help plan and implement adequate healthcare programs for patients with anxiety.

Este estudo descreve o uso de recursos de saúde e os custos relacionados à ansiedade associando resultados de uma base de dados administrativa e opinião de especialistas na perspectiva do Sistema Privado de Saúde Brasileiro. Foi realizada uma análise retrospectiva da base de dados da Orizon de pacientes com ansiedade em atendimento hospitalizar ou ambulatorial no Sistema Privado de Saúde (2015 - 2017) com o código CID-10 (F40 ou F41 e os seus subtipos), adicionalmente promovemos uma reunião online de 3 horas com cinco especialistas em ansiedade e em seguros de saúde para discutir as suas perspectivas. O custo total dos 18.069 pacientes identificados no banco de dados foi de R$ 490 milhões, relacionados a consultas médicas (2%), exames (16%), pronto-socorro (5%) e outros (77%). A média de consultas foi de 5,1 em um período de 4 anos, realizadas por 61% dos pacientes. Aproximadamente 2.595 visitas foram feitas a psiquiatras por 923 pacientes, e 95% realizaram pelo menos um exame (média de 100,6 exames por paciente. É desafiador identificar e estimar o impacto da doença no Sistema Privado de Saúde Brasileiro. O impacto maior está relacionado à frequência de uso de serviços de saúde antes do diagnóstico, em comparação com o próprio tratamento. Esses resultados podem ajudar a planejar e implementar programas de saúde adequados para pacientes com ansiedade.

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Objective: The study aimed to describe the profile and economic burden of patients with depression from the perspective of the Brazilian Private Healthcare System (PHS). Methods: A two-step methodological quantitative-qualitative research design was performed: retrospective descriptive analysis of the Orizon database of patients with at least one claim of depression (F33, F38, or F39) in PHS (2013-2019) and experienced physicians perspective from an expert meeting. Results: 1,802 patients fulfilling the eligibility criteria counted BRL 74,978 million across the 4-year period. Over this period, nearly 60% of patients had a medical appointment (6.6 appointments per patient, on average), 61% had a psychologist, 9.8% had a psychiatrist appointment, and an average of 115.2 exams and 8.7 emergency visits per patient were performed. According to the experts, the economic impact of depression is more significant when considering the indirect costs related to productivity loss and impairment in occupational and interpersonal functioning. Conclusion: Identifying and diagnosing patients with depression and their real burden is challenging; even with significant costs identified in the claim database analyses in the Brazilian PHS, the real impact must be higher if indirect costs are considered. The depressive disorder should be prioritized in the Brazilian PHS to establish more adequate health policies.

Objetivo: O estudo teve como objetivo descrever o perfil e a carga econômica de pacientes com depressão na perspectiva do Sistema Único de Saúde (SUS). Métodos: Foi realizado um projeto de pesquisa quantitativo-qualitativo metodológico em duas etapas: análise descritiva retrospectiva do banco de dados Orizon de pacientes com pelo menos uma alegação de depressão (F33, F38 ou F39) no PHS (2013- 2019) e perspectiva de médicos experientes de uma reunião de especialistas. Resultados: 1.802 pacientes que preencheram os critérios de elegibilidade totalizaram R$ 74,978 milhões no período de 4 anos. Nesse período, cerca de 60% dos pacientes tiveram consulta médica (6,6 consultas por paciente, em média), 61% tiveram psicólogo, 9,8% consulta com psiquiatra e foram realizados em média 115,2 exames e 8,7 atendimentos de emergência por paciente . Segundo os especialistas, o impacto econômico da depressão é mais significativo quando considerados os custos indiretos relacionados à perda de produtividade e prejuízo no funcionamento ocupacional e interpessoal. Conclusão: Identificar e diagnosticar pacientes com depressão e sua real carga é desafiador; mesmo com custos significativos identificados nas análises da base de sinistros do SUS brasileiro, o impacto real deve ser maior se considerados os custos indiretos. O transtorno depressivo deve ser priorizado na APS brasileira para o estabelecimento de políticas de saúde mais adequadas.

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Cancer significantly contributes to global mortality, with 9.3 million annual deaths. To alleviate this burden, the utilization of artificial intelligence (AI) applications has been proposed in various domains of oncology. However, the potential applications of AI and the barriers to its widespread adoption remain unclear. This study aimed to address this gap by conducting a cross-sectional, global, web-based survey of over 1000 AI and cancer researchers. The results indicated that most respondents believed AI would positively impact cancer grading and classification, follow-up services, and diagnostic accuracy. Despite these benefits, several limitations were identified, including difficulties incorporating AI into clinical practice and the lack of standardization in cancer health data. These limitations pose significant challenges, particularly regarding testing, validation, certification, and auditing AI algorithms and systems. The results of this study provide valuable insights for informed decision-making for stakeholders involved in AI and cancer research and development, including individual researchers and research funding agencies.

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BACKGROUND: The population's adherence to COVID-19 preventive measures is influenced by their knowledge, attitudes, and practices (KAP) towards the disease, making research into people's awareness of the disease essential. The present survey was designed to assess KAP towards COVID-19 among the population of the state of São Paulo, Brazil. METHODS: An online questionnaire was disseminated via social media between September 14 and October 5, 2020. The intended population was Brazilians over the age of 18, living in the state of São Paulo. RESULTS: A total of 1,111 individuals completed the questionnaire. The majority were women (71.6%), 31.6% were aged 31-40 years old, and 82.8% had higher education. Among the participants, 17.5% reported that they had taken some medication without a medical prescription to prevent COVID-19. The participants showed good knowledge about the transmission and prevention of the disease. The knowledge mean score was lower among participants with complete high school or less, with poor self-perception of their health status, who almost never seek information about COVID-19, and those who are not sure to belong to a risk group for the disease. Only 51.3% of the participants believed that COVID-19 would finally be successfully controlled, and 56.6% were confident that Brazil could win the battle against the virus. CONCLUSIONS: Participants demonstrated good knowledge of COVID-19 but were pessimistic about the pandemic's future. The findings of this study can help in the development of effective health communication strategies to promote better knowledge and a positive attitude about prevention measures.

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A discrete version of opinion dynamics systems, based on the Biswas-Chatterjee-Sen (BChS) model, has been studied on Barabási-Albert networks (BANs). In this model, depending on a pre-defined noise parameter, the mutual affinities can assign either positive or negative values. By employing extensive computer simulations with Monte Carlo algorithms, allied with finite-size scaling hypothesis, second-order phase transitions have been observed. The corresponding critical noise and the usual ratios of the critical exponents have been computed, in the thermodynamic limit, as a function of the average connectivity. The effective dimension of the system, defined through a hyper-scaling relation, is close to one, and it turns out to be connectivity-independent. The results also indicate that the discrete BChS model has a similar behavior on directed Barabási-Albert networks (DBANs), as well as on Erdös-Rènyi random graphs (ERRGs) and directed ERRGs random graphs (DERRGs). However, unlike the model on ERRGs and DERRGs, which has the same critical behavior for the average connectivity going to infinity, the model on BANs is in a different universality class to its DBANs counterpart in the whole range of the studied connectivities.