Public Telemedicine Policy in Brazilian Unified Health System: An Impact Analysis.

There are several difficulties in evaluating interventions seeking to promote public health policies. In this article, we analyzed the promotion of the use of telemedicine during COVID-19 in Brazil. Using the random promotion method with instrumental variables, we showed that the policy of promoting telemedicine was adequate, with intense use of this type of care. Our results showed that telemedicine works if it is encouraged in the population. We contributed to the discussion of public health policies and their impact on the population's health in times of health crisis, such as during the COVID-19 pandemic.

The Influence of Behavioral Sciences on Adherence to Physical Activity and Weight Loss in Overweight and Obese Patients: A Systematic Review of Randomized Controlled Trials.

In recent years, weight gain and reduced physical activity in the general population have contributed to the development of obesity and other health problems; on the other hand, studies in behavioral sciences have been used to modify behaviors for a healthier life, so the objective of this study was to identify the evidence of interventions in behavioral sciences on adherence to physical activity and weight loss in obese patients. This systematic review study is based on a search of the electronic databases PubMed, Web of Science, Scopus, and Cochrane. Studies assessed the evidence from intervention studies that assessed the influence of intervention studies of behavioral sciences on public health. The articles were published between 2013 and 2023. The systematic search of the databases identified 2951 articles. The review analyzed 10 studies. Behavioral science interventions presented evidence through strategies such as multicomponent interventions, lottery and financial incentives, message framing, message framing with financial incentive and physical activity, and psychological satisfaction, demonstrating results in weight loss and maintenance and increased physical activity. This study presents scientific evidence through healthy behavior change methodologies, and future studies can explore these strategies in conjunction with public health technologies in the search for public-private partnerships to promote physical activity in adults.

The Intersection of Health Literacy and Public Health: A Machine Learning-Enhanced Bibliometric Investigation.

In recent decades, health literacy has garnered increasing attention alongside a variety of public health topics. This study aims to explore trends in this area through a bibliometric analysis. A Random Forest Model was utilized to identify keywords and other metadata that predict average citations in the field. To supplement this machine learning analysis, we have also implemented a bibliometric review of the corpus. Our findings reveal significant positive coefficients for the keywords "COVID-19" and "Male", underscoring the influence of the pandemic and potential gender-related factors in the literature. On the other hand, the keyword "Female" showed a negative coefficient, hinting at possible disparities that warrant further investigation. Additionally, evolving themes such as COVID-19, mental health, and social media were discovered. A significant change was observed in the main publishing journals, while the major contributing authors remained the same. The results hint at the influence of the COVID-19 pandemic and a significant association between gender-related keywords on citation likelihood, as well as changing publication strategies, despite the fact that the main researchers remain those who have been studying health literacy since its creation.

Analysis of the Effectiveness of Public Health Measures on COVID-19 Transmission.

In this study, we investigate the COVID-19 epidemics in Brazilian cities, using early-time approximations of the SIR model in networks and combining the VAR (vector autoregressive) model with machine learning techniques. Different from other works, the underlying network was constructed by inputting real-world data on local COVID-19 cases reported by Brazilian cities into a regularized VAR model. This model estimates directional COVID-19 transmission channels (connections or links between nodes) of each pair of cities (vertices or nodes) using spectral network analysis. Despite the simple epidemiological model, our predictions align well with the real COVID-19 dynamics across Brazilian municipalities, using data only up until May 2020. Given the rising number of infectious people in Brazil-a possible indicator of a second wave-these early-time approximations could be valuable in gauging the magnitude of the next contagion peak. We further examine the effect of public health policies, including social isolation and mask usage, by creating counterfactual scenarios to quantify the human impact of these public health measures in reducing peak COVID-19 cases. We discover that the effectiveness of social isolation and mask usage varies significantly across cities. We hope our study will support the development of future public health measures.

Robotic Surgery for Pediatric Choledochal Cysts: An American Case Series and Literature Review.

INTRODUCTION: Choledochal cysts are rare congenital biliary cystic dilations. The US incidence rate varies between 5 and 15 cases per 1,000,000 people. In contrast, Asians, which are a large subset of the population of Hawaii, have an incidence of approximately one in every 1000 births. We report our experience with robot-assisted laparoscopic surgical management with biliary reconstruction of choledochal cysts which to date is the largest American case series to be reported. MATERIALS AND METHODS: From 2006 to 2021, patients diagnosed with a choledochal cyst(s) at a tertiary children's hospital were retrospectively reviewed. Perioperative analysis was performed. Complications were defined as immediate, early, or late. The data underwent simple descriptive statistics. RESULTS: Nineteen patients underwent choledochal cystectomy and hepaticoduodenostomy. Thirteen underwent a robotic approach while the rest were planned laparoscopic. Eighteen of 19 were female with 15/19 of Asian descent. The ages ranged from 5 mo to 21 y. Presenting diagnoses included jaundice, primary abdominal pain, pancreatitis, and cholangitis. Sixty eight percent had type 1 fusiform cysts while the rest were type 4a. Operative time and length of stay for robotic versus laparoscopic were 321 versus 267 min and 8.2 versus 17.3 d, respectively. For the robotic group, there was one immediate complication due to peritonitis. One-year follow-up revealed two patients requiring endoscopic retrograde cholangiopancreatography with dilation/stenting for an anastomotic stricture. There were no anastomotic leaks. CONCLUSIONS: Robot-assisted laparoscopic choledochal cystectomy with hepaticoduodenostomy is associated with overall good outcomes with the most common long-term complication being anastomotic stenosis.

Null results of oxytocin and vasopressin administration on mentalizing in a large fMRI sample: evidence from a randomized controlled trial.

BACKGROUND: Although potential links between oxytocin (OT), vasopressin (AVP), and social cognition are well-grounded theoretically, most studies have included all male samples, and few have demonstrated consistent effects of either neuropeptide on mentalizing (i.e. understanding the mental states of others). To understand the potential of either neuropeptide as a pharmacological treatment for individuals with impairments in social cognition, it is important to demonstrate the beneficial effects of OT and AVP on mentalizing in healthy individuals. METHODS: In the present randomized, double-blind, placebo-controlled study (n = 186) of healthy individuals, we examined the effects of OT and AVP administration on behavioral responses and neural activity in response to a mentalizing task. RESULTS: Relative to placebo, neither drug showed an effect on task reaction time or accuracy, nor on whole-brain neural activation or functional connectivity observed within brain networks associated with mentalizing. Exploratory analyses included several variables previously shown to moderate OT's effects on social processes (e.g., self-reported empathy, alexithymia) but resulted in no significant interaction effects. CONCLUSIONS: Results add to a growing literature demonstrating that intranasal administration of OT and AVP may have a more limited effect on social cognition, at both the behavioral and neural level, than initially assumed. Randomized controlled trial registrations: ClinicalTrials.gov; NCT02393443; NCT02393456; NCT02394054.

Efficacy of Telehealth in Preoperative Pediatric Surgery Consultations.

INTRODUCTION: The Coronavirus disease 2019 pandemic created a sudden need to transition outpatient pediatric surgical care to a telehealth platform, allotting little time to study the efficacy of these changes. In particular, the accuracy of telehealth preoperative assessment remains unclear. Therefore, we sought to study the prevalence of errors in diagnosis and procedure cancellations between preoperative in-person evaluations and telehealth evaluations. METHODS: We conducted a single institution, retrospective chart review of perioperative medical records at a tertiary children's hospital over a 2-year period. Data included patient demographics (age, sex, county, primary language, and insurance), preoperative diagnosis, postoperative diagnosis, and surgical cancellation rates. Data were analyzed using Fisher's exact and chi-square tests. Alpha was set at 0.05. RESULTS: A total of 523 patients were analyzed, with 445 in-person visits and 78 telehealth visits. There were no demographic differences between the in-person and telehealth cohorts. The frequency of changes from the preoperative to the postoperative diagnosis was not significantly different between in-person preoperative visits and telehealth preoperative visits (0.99% versus 1.41%, P = 0.557). The frequency of case cancellations between the two consultation modalities was not significantly different (9.44% versus 8.97%, P = 0.899). CONCLUSIONS: Our results demonstrate that preoperative pediatric surgical consultations held via telehealth were neither associated with a decrease in the accuracy of preoperative diagnosis, nor an increased rate of surgery cancellations, compared to those held in-person. Further study is needed to better determine the advantages, disadvantages, and limitations of telehealth in the delivery of pediatric surgical care.

High Rates of Pediatric Venous Thromboembolism After Elective Laparoscopic Splenectomy Suggest Need for Perioperative Prophylaxis.

INTRODUCTION: In adult populations, postoperative venous thromboembolism (VTE) is a reported complication of up to 8% of elective laparoscopic splenectomy (LS) cases. VTE is a rare event in the pediatric population, affecting less than 1% of all pediatric surgical patients. We hypothesized that pediatric patients are at a higher risk of postoperative VTE after undergoing elective LS relative to other laparoscopic procedures and may warrant prophylactic treatment. MATERIALS AND METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database from 2012 to 2020. Patients were identified using the Current Procedural Terminology code 38120 and only elective cases were analyzed. RESULTS: The incidence of VTE in all pediatric patients undergoing surgery in the American College of Surgeons NSQIP-P database was 0.13%. The incidence of VTE in pediatric patients undergoing elective laparoscopic abdominopelvic procedures was 0.17%. There were seven total cases of VTE (0.41%) in pediatric patients undergoing elective LS, more than twice the rate of the general population (P = 0.001). Eighty percent of pediatric patients undergoing elective LS had an underlying hematological disorder. CONCLUSIONS: By analyzing the NSQIP-P database, we evaluated the largest cohort of pediatric patients undergoing elective LS to date. We identified a higher incidence of VTE following this procedure relative to the rate of VTE in the overall population in the NSQIP-P database, as well as those undergoing elective laparoscopic abdominopelvic operations. The relatively higher incidence of VTE after elective LS is likely due to the presence of underlying hematological conditions. Given the low incidence of complications associated with pharmacologic VTE prophylaxis, the results of this study suggest that further research is warranted to establish the efficacy of perioperative pharmacological VTE prophylaxis in pediatric patients undergoing elective LS.

Initial evidence for a relation between behaviorally assessed empathic accuracy and affect sharing for people and music.

Are people who are better able to understand or feel the emotions of others also better at understanding or feeling emotions conveyed through music? Although evolutionary theories have proposed that both empathy and music help to foster social connection, few studies to date have examined the relation between behavioral assessments of empathic processes for people and music. We examined this question using 2 independent samples: a laboratory sample of undergraduates (n = 236) and a larger online direct replication with participants across the United States (n = 596). Across both samples, linear mixed effects models showed positive associations between empathic accuracy and affect sharing for people telling personal stories and for musical expression, and results were maintained when including relevant individual differences as covariates. These findings provide initial evidence of a relation between behaviorally assessed empathic processes across social and musical domains. Future research is needed to build upon this evidence by investigating whether active, socially engaged music listening may have a beneficial effect on social cognition. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Advances in human oxytocin measurement: challenges and proposed solutions.

Oxytocin, a neuropeptide known for its role in reproduction and socioemotional processes, may hold promise as a therapeutic agent in treating social impairments in patient populations. However, research has yet to uncover precisely how to manipulate this system for clinical benefit. Moreover, inconsistent use of standardized and validated oxytocin measurement methodologies-including the design and study of hormone secretion and biochemical assays-present unresolved challenges. Human studies measuring peripheral (i.e., in plasma, saliva, or urine) or central (i.e., in cerebrospinal fluid) oxytocin concentrations have involved very diverse methods, including the use of different assay techniques, further compounding this problem. In the present review, we describe the scientific value in measuring human endogenous oxytocin concentrations, common issues in biochemical analysis and study design that researchers face when doing so, and our recommendations for improving studies using valid and reliable methodologies.

Oxytocin reactivity to a lab-based stressor predicts support seeking after stress in daily life: Implications for the Tend-and-Befriend theory.

Social relationships play an important role in mental and physical health, particularly during times of stress. However, little is known about the biological mechanisms underlying the tendency to seek support following stress. The Tend-and-Befriend theory suggests that oxytocin (OT) may enhance the desire for social contact in response to stress. Yet, no studies in humans have provided empirical support for the connection between stress-induced changes in endogenous OT and increased support seeking after stress. In the present study, 94 participants performed a standardized laboratory stressor and then completed two weeks of daily assessments of support seeking after stress. In line with preregistered hypotheses, stress-induced plasma OT reactivity to the laboratory stressor was associated with more frequent support seeking behaviors following stress in daily life (i.e., outside of the laboratory). Additional results suggested that attachment anxiety (but not avoidance) strengthened this association. Our findings implicate the OT system in affiliative behaviors following stress, providing empirical support for the Tend-and-Befriend theory.

Revisiting the association between self-reported empathy and behavioral assessments of social cognition.

Previous research has shown a weak association between self-reported empathy and performance on behavioral assessments of social cognition. However, previous studies have often overlooked important distinctions within these multifaceted constructs (e.g., differences among the subcomponents of self-reported empathy, distinctions in tasks assessing lower- vs. high-level social cognition, and potential covariates that represent competing predictors). Using data from three separate studies (total N = 2,376), we tested whether the tendency to take the perspective of others (i.e., perspective-taking), and the tendency to catch the emotions of others (i.e., emotional contagion for positive and negative emotions), were associated with performance on tasks assessing lower- to higher-level social-cognitive ability (i.e., emotion recognition, theory of mind, and empathic accuracy) and affect sharing. Results showed little evidence of an association between any of the self-reported empathy measures and either social-cognitive ability or affect sharing. Using several large samples, our findings add additional evidence to previous work showing that self-report measures of empathy are not valid proxies of behaviorally assessed social cognition. Moreover, we find that the ease with which individuals recognize and understand their own emotions (i.e., alexithymia) is more related to social-cognitive abilities and affect sharing, than their tendency to take the perspective of others, or to vicariously experience the emotions of others. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Social anxiety and behavioral assessments of social cognition: A systematic review.

BACKGROUND: Social anxiety is highly prevalent and has increased in young adults during the COVID-19 pandemic. Since social anxiety negatively impacts interpersonal functioning, identifying aspects of social cognition that may be impaired can increase our understanding of the development and maintenance of social anxiety disorder. However, to date, studies examining associations between social anxiety and social cognition have resulted in mixed findings. METHODS: The aim of this systematic review was to summarize the literature on the association between social anxiety and social cognition, while also considering several potential moderators and covariates that may influence findings. RESULTS: A systematic search identified 52 studies. Results showed mixed evidence for the association between social anxiety and lower-level social cognitive processes (emotion recognition and affect sharing) and a trend for a negative association with higher-level social cognitive processes (theory of mind and empathic accuracy). Most studies examining valence-specific effects found a significant negative association for positive and neutral stimuli. LIMITATIONS: Not all aspects of social cognition were included (e.g., attributional bias) and we focused on adults and not children, limiting the scope of the review. CONCLUSIONS: Future studies would benefit from the inclusion of relevant moderators and covariates, multiple well-validated measures within the same domain of social cognition, and assessments of interpersonal functioning outside of the laboratory. Additional research examining the moderating role of attention or interpretation biases on social cognitive performance, and the potential benefit of social cognitive skills training for social anxiety, could inform and improve existing cognitive behavioral interventions.

Analysis of connectivity between the world's banking markets: The COVID-19 global pandemic shock.

We contribute to the literature on financial networks by presenting empirical evidence that the global shock of the COVID-19 pandemic caused changes in the forms and intensity of banking sector connections between different countries. These changes include providing the highest level of connectivity observed in the timeline initiated in 2005. We used a comprehensive set of information containing data from 35 countries (developed and emerging economies) and showed the change in the classification of transmitting and receiving spillover during the COVID-19 crisis. Our results provide relevant insights into systemic integration between countries' banking markets, especially during difficult times. Our results are significant to Central Banks, banking sector investors, and governments seeking assistance from banks in the solutions for the resumption of the economy in the face of the COVID-19 shock.

The pandemic should catalyze research on social pain: Examining oxytocin administration studies.

For decades, researchers have tried to identify drugs that can decrease the painful feelings associated with social loss, rejection, or isolation. One effort has been to investigate whether the neuropeptide oxytocin reduces social pain. In this commentary, I examine intranasal oxytocin's effects on experimentally induced social exclusion. Future recommendations are presented with the goal of spurring new research efforts to elucidate the neurobiological mechanisms underlying the experience of social pain.

Social anxiety is associated with greater peripheral oxytocin reactivity to psychosocial stress.

To date, it has been difficult to establish reliable biomarkers associated with specific forms of psychopathology. Social anxiety, for example, is associated with inconsistent biological responses to psychosocial stress on markers including cortisol and salivary alpha-amylase. Thus, it is critical that studies identify more reliable biomarkers that index patterns associated with social anxiety. Two potential candidates are the neuropeptides oxytocin and vasopressin, which have been implicated in stress responsivity across species. Studies have demonstrated a reliable increase in oxytocin, and a surrogate marker for vasopressin, following engagement in the most widely used lab-based psychosocial stress paradigm: the Trier Social Stress Test (TSST). However, no study has examined whether social anxiety moderates peripheral oxytocin or vasopressin reactivity to psychosocial stress. In 101 young adult participants, dimensionally assessed social anxiety was associated with greater plasma oxytocin, but not vasopressin, reactivity to the TSST. Results were maintained following the inclusion of depression as a covariate. Findings suggest that studying changes in peripheral oxytocin concentrations may be a method of differentiating individuals with higher levels of social anxiety.

Propension to customer churn in a financial institution: a machine learning approach.

This paper examines churn prediction of customers in the banking sector using a unique customer-level dataset from a large Brazilian bank. Our main contribution is in exploring this rich dataset, which contains prior client behavior traits that enable us to document new insights into the main determinants predicting future client churn. We conduct a horserace of many supervised machine learning algorithms under the same cross-validation and evaluation setup, enabling a fair comparison across algorithms. We find that the random forests technique outperforms decision trees, k-nearest neighbors, elastic net, logistic regression, and support vector machines models in several metrics. Our investigation reveals that customers with a stronger relationship with the institution, who have more products and services, who borrow more from the bank, are less likely to close their checking accounts. Using a back-of-the-envelope estimation, we find that our model has the potential to forecast potential losses of up to 10% of the operating result reported by the largest Brazilian banks in 2019, suggesting the model has a significant economic impact. Our results corroborate the importance of investing in cross-selling and upselling strategies focused on their current customers. These strategies can have positive side effects on customer retention.

Indirect and direct effects of the subprime crisis on the real sector: labor market migration.

The bursting of the US housing bubble in the second half of 2008 triggered an almost unprecedented systemic crisis in the world economy. The financial collapse quickly overflowed into the real economy and caused, among other effects, a sharp fall in the flow of world trade. Using export data from Brazilian municipalities, we show that the subprime crisis had a more significant effect on production and employment in exporting cities than municipalities more devoted to the domestic economy. We find that the manufacturing and construction sectors of exporting cities were the most affected during the crisis. However, exporting municipalities with a substantial share of services activities were more resilient to the external crisis. This difference is significant and sheds light on the debate on the effects of the crisis on Brazilian regions and cities. Using a unique business management dataset that contains firm-to-firm controls, we also find spillovers in the labor market from exporting to domestic-oriented cities through job reallocation. Our results suggest that workers migrate from exporting municipalities to other non-exporting municipalities within the same firm economic group.

Parsing social motivation: development and validation of a self-report measure of social effort.

BACKGROUND: Reduced efforts to form and maintain social bonds can exist in the context of a sufficient desire for social connection. Thus, social impairment common across many psychiatric conditions may often reflect failures in social effort exertion, despite normative levels of social liking and wanting. Although there are many questionnaires available that assess sociability, desire, or lack thereof for connection and perceived social support, there is no current self-report assessment of the behavioral outputs of social motivation. AIMS: We aimed to develop and validate a measure of the social effort in college students and the general population. METHODS: College students (n = 981) and a broader sample of adults via Amazon's Mechanical Turk (MTurk; n = 506) participated in the study. RESULTS: We identified two factors that represented content related to general social effort and social effort in adherence with social norms; we named the measure the Social Effort and Conscientiousness Scale (SEACS). Results suggest the SEACS is a reliable and valid measure of social effort. CONCLUSIONS: Lower scores on the SEACS were associated with symptoms of depression and anxiety, highlighting the scale's potential utility in clinical populations. We include a discussion of possible applications of the SEACS, including its further use and application in psychopathology research.

Insights from the (in)efficiency of Chinese sectoral indices during COVID-19.

This article evaluates the effects of the crisis caused by the new Coronavirus (COVID-19) on the Chinese sectoral indices. Using the complexity-entropy plane methodology, we find that the COVID-19 crisis caused increased inefficiency in most of China's equity sectors. We also find heterogeneous effects depending on the economic sector. Our results are useful for a better understanding the effect of global shocks on the stock markets and how their effects are distributed across economic sectors.