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This study evaluated the association between HIV risk perception and sociodemographic and behavioral characteristics among cisgender female sex workers in the five regions of Brazil. A cross-sectional, multicenter study using respondent-driven sampling was used. Sex workers over 18 years of age and who reported commercial sex in the past four months were included. All participants completed a questionnaire with sociodemographic and behavioral factors. In addition, the participants were offered a rapid HIV antibody test. Unweighted bivariate analyses and multivariable logistic regression models were used to evaluate the association of sociodemographic and behavioral factors. Overall, 794 HIV-negative participants were included (mean age = 34.44 years [SD = 6.49]). Most participants were brown/pardo (59.47%), from social class D-E (82.24%), and with medium education (57.12%). Most women perceived themselves to be at low to moderate risk (68.26%), 7.56% at no risk, and 24.18% at high risk for HIV infection. Those who frequently or always had sexual intercourse under the influence of alcohol had a 2.36 times higher probability of having a high HIV risk perception compared to those who never had sexual intercourse under the influence of alcohol. The data from this study aid in a better understanding of HIV risk perception and its impact on sexual behaviors among female sex workers. Although the majority considered themselves to be at low to moderate risk for HIV, some higher vulnerability behaviors were prevalent., Competing Interests: Declarations. Conflict of interest: The authors have no relevant financial interests to disclose. Ethical approval: This research was approved by the Moinhos de Vento Hospital human subjects research board (Approval No. 2.837.840). Informed consent: Informed consent was obtained from all participants., (© 2025. The Author(s).)

Background: This paper aims to instigate discussion and publication of methodologies applied to enhance quality management through comprehensive scientific reports. It provides a detailed description of the design, implementation, and results of the quality control program employed in the SMESH study., Methods: Cross-sectional, multicenter, national study designed to assess the prevalence of human papillomavirus in sex workers and in men who have sex with men (MSM). Respondent-driven sampling recruitment was used. An online system was developed for the study and checkpoints were defined for data entry. The system checked the quality of biological samples and performed a retest with part of the sample., Results: A total of 1.598 participants (442 sex workers and 1.156 MSM) were included. Fifty-four health professionals were trained for face-to-face data collection. The retest showed Kappa values ranging between 0.3030 and 0.7663., Conclusion: The retest data were mostly classified as indicating a strong association. The data generated by the checkpoints showed the successful implementation of the quality control program., (© 2024. The Author(s).)

Attentional bias (AB) to food after bariatric surgery might be a cognitive marker for weight regain. The visual probe task (VPT) is commonly used to capture AB at automatic, pre-conscious, and conscious orientation of attention. The aim of this study was to investigate how the preoperative BMI of patients submitted to Roux-en-Y gastric bypass (RYGB) impacts AB to food. We assessed patients who had preoperative BMI>50 (n = 28) or preoperative BMI<50 (n = 31) months after the RYGB procedure. Participants underwent clinical, psychological, and VPT evaluations. In VPT, pairs of food and matching non-food images were shown for 100 ms, 500 ms or 2000 ms and AB for food was assessed for each exposure time. A significant AB to food was observed at 2000 ms for all patients in this study, suggesting that the overall sample were consciously orienting their attention toward food cues after surgery, a finding that might be relevant for understanding weight control. When groups with preoperative BMI higher and lower than 50 kg/m 2 were compared, a significant difference on AB to food stimuli at 500 ms was observed, controlling for excess weight lost since surgery and postoperative time. Subjects with preoperative BMI>50 had a positive and reliable AB to food while subjects with preoperative BMI<50 had a negative AB. This suggests that food stimuli have a higher incentive salience even after surgery for those with BMI>50, which might explain why subjects with higher preoperative weight have higher risks for weight regain. These results may indicate that RYGB can impact incentive salience for food cues in a differential manner, increasing conscious AB in all patients and decreasing pre-conscious AB only in those with BMI<50 kg/m 2 ., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The present study aimed to evaluate the association of genital and oral HPV infection among different sexual practices in both sexes. In total, 6388 unvaccinated men and women aged 16-25 years from all state capitals of Brazil were enrolled in through primary care services between September 2016 and November 2017. Genital and oral HPV genotyping was performed using the Roche Linear Array. Poisson regression analysis with robust variance was conducted to examine factors associated with overall HPV infection. A higher prevalence of genital HPV was found in women who practiced oral sex (57.85%) and in men who practiced all types of sex (65.87%). However, having more sexual partners and being younger were more important than the type of sex practiced. HPV 6 (7.1%) and 16 (10.5%) were significantly more prevalent in women who practiced oral sex, while HPV 6 (23.96%) and 11 (21.49%) were more prevalent in men who practiced anal sex. The type of sex was not associated with oral HPV prevalence. Genital and oral HPV infection were not associated by different sexual practices in the studied population., (© 2022. The Author(s).)

Background: Several studies have investigated if bariatric surgery candidates with binge eating disorder (BED) are at risk for suboptimal postoperative weight loss. The aim of this systematic review with meta-analysis was to evaluate the association between binge eating diagnosed preoperatively and weight loss after bariatric surgery., Methods: MEDLINE, EMBASE, CENTRAL, LILACS, and other specialized databases were searched on August 2020. Clinical trials and observational studies including individuals who had undergone any type of bariatric surgical treatment with preoperative evaluation of BED and at least one postoperative measure of weight were initially selected. Four reviewers independently screened for eligibility. The mean difference was calculated using the random-effects model., Results: Nineteen studies, comprising 3223 participants (80.25% women; median age 41 years), met the inclusion criteria for meta-analysis. At 6 months postoperative, the percentage of total weight loss (%TWL) was not significantly different between BED and non-BED groups [6 studies, 914 participants: - 0.75% (95% CI, - 2.79 to 1.29; I 2  = 0%)], even when analyzing only those three studies that included gold standard assessment tools. No significant differences were found at 12, 24, 36, or 60 months., Conclusions: Pre-bariatric BED seems to have little or no influence on weight loss after surgery. However, many questions remain unanswered because of the use of different measures across studies. The heterogeneity among studies emphasizes the importance of investigators using the same assessment measures.

Background: The credibility of a study and its internal and external validity depend crucially on the quality of the data produced. An in-depth knowledge of quality control processes is essential as large and integrative epidemiological studies are increasingly prioritized., Objective: This study aimed to describe the stages of quality control in the POP-Brazil study and to present an analysis of the quality indicators., Methods: Quality assurance and control were initiated with the planning of this nationwide, multicentric study and continued through the development of the project. All quality control protocol strategies, such as training, protocol implementation, audits, and inspection, were discussed one by one. We highlight the importance of conducting a pilot study that provides the researcher the opportunity to refine or modify the research methodology and validating the results through double data entry, test-retest, and analysis of nonresponse rates., Results: This cross-sectional, nationwide, multicentric study recruited 8628 sexually active young adults (16-25 years old) in 119 public health units between September 2016 and November 2017. The Human Research Ethics Committee of the Moinhos de Vento Hospital approved this project., Conclusions: Quality control processes are a continuum, not restricted to a single event, and are fundamental to the success of data integrity and the minimization of bias in epidemiological studies. The quality control steps described can be used as a guide to implement evidence-based, valid, reliable, and useful procedures in most observational studies to ensure data integrity., International Registered Report Identifier (irrid): RR1-10.2196/31365., (©Jaqueline Driemeyer Correia Horvath, Marina Bessel, Natália Luiza Kops, Flávia Moreno Alves Souza, Gerson Mendes Pereira, Eliana Marcia Wendland. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 05.01.2022.)

Objectives: To investigate the pattern of multiple human papillomavirus (HPV) infections and associated factors in young women who access the Brazilian public health care system to better understand the characteristics of multiple HPV infections, a critical issue in this era of multivalent vaccines., Methods: This was a cross-sectional, multicenter study with sexually active unvaccinated women (16-25 years old) from 119 primary Brazilian healthcare centers between September 2016 and November 2017. Cervical samples were collected by trained health professionals, and HPV detection was performed in a central laboratory by Linear Array., Results: Of the 5268 women, 33.00% (95% CI 31.07-34.92) had multiple infections. At least one type of high-risk HPV was present in 85.50% of all multiple infections. All HPV types were detected more frequently in association with other types than alone. Young individuals who were single or in a casual relationship and those who had more than one sexual partner in the past year were more likely to have multiple infections., Conclusions: In this work, a high rate of multiple HPV infections among unvaccinated young adults tended to increase due to certain risk factors. Such data can provide insight for decision makers in the development of public policies regarding HPV prevention., (© 2021. The Author(s).)

Objectives: This study aimed to report the national prevalence of oral HPV infection among unvaccinated women and men aged 16-25 years who utilized the public primary care services., Methods: POP-Brazil is a cross-sectional, multicentric, nationwide survey conducted between September 2016 and November 2017. Recruitment was based in 119 public primary care practices in 26 state capitals and the Federal District of Brazil. Trained health professionals conducted face-to-face interviews. Oral samples were collected with mouthwash and gargle cycles. Genotyping was performed using the Roche PCR-based linear array genotyping test. Sampling weights by sex and age were applied., Results: Valid oral HPV samples were collected from 5071 (96.88%) participants; 4005 women and 1066 men. Mean participant age was 21.63 years. Overall HPV prevalence was 1.69% (n = 73, 95% CI 1.05-2.32). Thirty individuals presented at least one high-risk HPV type [0.57% (95% CI, 0.29-0.85)]. There were no associations between age, sex, sociodemographic characteristics, drug use or sexual behavior and oral HPV prevalence., Conclusion: The prevalence of oral HPV infection in Brazilian teenagers and young adults is low, with no sociodemographic or behavioral correlates., (Copyright © 2021. Published by Elsevier Ltd.)

Background: Uncoupling protein 2 (UCP2) plays an important role in energy expenditure regulation. Previous studies have associated the common -866G/A (rs659366) and Ins/Del polymorphisms in the UCP2 gene with metabolic and obesity-related phenotypes. However, it is still unclear whether these polymorphisms influence weight loss after bariatric surgery., Objectives: To investigate whether UCP2 -866G/A and Ins/Del polymorphisms are associated with weight loss outcomes after bariatric surgery., Setting: Longitudinal study in a university hospital., Methods: We retrospectively evaluated 186 patients who underwent Roux-en-Y gastric bypass (RYGB) surgery for clinical and laboratory characteristics in the preoperative period, 6, 12, and 18 months after RYGB. The -866G/A (rs659366) polymorphism was genotyped using real-time PCR, while the Ins/Del polymorphism was genotyped by direct separation of PCR products in 2.5% agarose gels., Results: Patients with the -866A/A genotype showed higher body mass index (BMI) after 6, 12, and 18 months of surgery and excess body weight after 6 and 12 months compared with G/G patients. They also showed lower excess weight loss (EWL%) after 6 and 12 months of surgery. Ins allele carriers (Ins/Ins + Ins/Del) had lower delta (Δ) BMI 12 months after surgery compared with Del/Del patients. Accordingly, patients carrying haplotypes with ≥2 risk alleles of these polymorphisms had higher BMI and excess weight and lower EWL% during follow-up., Conclusion: UCP2 -866A/A genotype is associated with higher BMI and excess weight and lower EWL% during an 18-month follow-up of patients who underwent RYGB, while the Ins allele seems to be associated with lower ΔBMI 12 months after surgery. Further studies are needed to confirm the associations of the -866G/A and Ins/Del polymorphisms with weight loss after bariatric surgery., (Copyright © 2021 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

We examined human papillomavirus (HPV) vaccine effectiveness in a nationwide sample of women aged 16 to 25 years who utilized the public health system in Brazil. This was a cross-sectional, multicentric survey conducted between September 2016 and November 2017 (POP-Brazil Study). A total of 5,945 young adult women were recruited from 119 public primary care units from all 27 federative units of Brazil by trained health professionals. The participants participated in a face-to-face interview and provided biological samples for genital HPV analysis. HPV genotyping was performed using a Linear Array HPV genotyping test in a central laboratory. Sampling weights were applied to the data. Overall, 11.92% (95% CI 10.65, 13.20) of the participants reported having been vaccinated. The frequency of vaccination was highest in 16- to 17-year-old women, with a decreasing vaccination rate with increasing age, and vaccinated women were more likely to belong to the high socioeconomic status group. The use of a quadrivalent vaccine decreased the HPV types 6, 11, 16, and 18 by 56.78%, from 15.64% in unvaccinated women to 6.76% in vaccinated women (P < 0.01), even after adjustment for age. Those who received the vaccine had lower HPV 16 (2.34% in vaccinated vs 8.91% in unvaccinated, P < 0.01) and 6 rates (2.06% vs 5.77%, P < 0.01). Additionally, a higher rate of high-risk HPV types other than HPV 16 and 18 (40.47% in vaccinated vs 32.63% in unvaccinated, P < 0.01) was observed. In conclusion, the results of this study support the effectiveness of HPV vaccination in Brazil. Continuous surveillance must be assured to monitor the HPV infection rate in the vaccination era., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Dr. Villa is an occasional consultant and speaker for HPV vaccines at Merck, Sharp & Dohme and an occasional consultant for HPV tests at BD, Roche and Qiagen. All other authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The aim of this study is to evaluate genital human papillomavirus (HPV) infection according to socioeconomic categories in Brazil. This cross-sectional, nationwide study included 7,694 sexually active women and men aged 16-25 years. Individuals of all socioeconomic groups in all 26 Brazilian capitals and the Federal District were enrolled through public primary care units between September 2016 and November 2017. All participants answered a standardized interview administered by trained primary care health professionals. Socioeconomic class was analyzed using a pricing classification system for the Brazilian public that divides the market exclusively in terms of economic class based on the ownership of assets and the education level. Cervical samples were obtained using a Digene® HC2 DNA Collection, and penile/scrotum samples were obtained using a wet Dacron swab. HPV typing (overall and high-risk) was performed in a central lab. Of the 7,694 participants (47.85% women), 17.92% belonged to class A-B, 56.08% to class C, and 26.00% to class D-E. The prevalence of overall HPV was similar among the social classes: 51.16% for classes A-B, 53.39% for class C, and 55.47% for classes D-E ( P  = 0.479). Similar results were found for high-risk HPV. After adjustments, the presence of HPV in individuals with a brown skin color belonging to classes A-B was 57.00% higher [prevalence ratio 1.57 (95%: 1.23, 2.01)] than that in whites and had no impact on the other social classes. In conclusion, HPV infection affects all socioeconomic classes in Brazil, evidencing the importance of offering the HPV vaccine to the entire population., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Authors.)

Background: External genital lesions (EGL) are the most common sexually transmitted infections (STIs). We aimed to evaluate the prevalence, determinants and sex differences in EGL among young adults from Brazil., Methods: Overall, 7694 participants (aged 16 to 25 years) underwent an interview, genital examination and sampling for HPV genotyping., Results: The prevalence of EGL was 4.08% (234) and is more frequent in men (5.72%) than women (2.31%) (p <  0.001). Genital lesions were significantly associated with male sex, infection by high-risk and multiple HPV types, having more than two sexual partners in the last year, smoking status and the presence of other STI. While alcohol use was associated with a higher prevalence of EGL in women, same-sex sexual relationship increase the prevalence in men. In the EGL group, 67.79% (p = 0.032) were positive for HPV infection and the types HPV6 and HPV11 were the most prevalent ones., Conclusion: The prevalence of EGL in young adults was consistently high, and most cases were associated with genital HPV infection and STIs. Although men have a higher prevalence, both sexes share most genital lesion determinants. The promotion of sexual education and vaccination especially focus in young men, who are usually outside the targets of primary health care programmes, can prevent EGL in Brazilian young adults.

Background & Aims: To compare groups of bariatric patients with preoperative scores of Binge Eating Scale (BES) above and below the clinical cut off value on weight outcomes up to 60 months following surgery., Methods: This is a prospective observational study involving 108 Brazilian patients (follow-up rate: 48.1%) operated by Roux-en-Y gastric bypass. In the preoperative period, they were clinically evaluated, and BES was applied. Based on the scores, patients were categorized as high or low according to established cut off 17 for binge eaters. Follow-up weight loss was obtained (3, 6, 12, 24, 36, 48, and 60 months) using data from medical records. The percentage of total weight loss (%TWL) was examined by generalized linear model., Results: 41.7% of patients had BES scores higher than 17 at baseline. Weight loss was significant up to 12 months. The greatest weight loss was at 24 months of follow-up, ranging from 2.7 to 110.4 kg (mean 42.9 ± 17.8 kg). In the short postoperative period (3, 24, and 36 months), %TWL was significantly different between groups. At 24 months, patients with higher scores lost more %TWL than those with lower scores (35.1 ± 0.8% vs 31.6 ± 0.7%, p = 0.029). However, this difference was not fount at 60 months postoperatively (mean 28.9 ± 9.6%). In a multivariate analysis, the presence of depression, age, and BES score were not associated with %TWL at 24 and 60 months., Conclusions: The results suggest that preoperative BES scores point to a similar weight loss after bariatric surgery. Further studies with long-term follow-up are necessary to evaluate this finding., Competing Interests: Declaration of competing interest The authors declared no conflict of interest., (Copyright © 2020 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Objectives: This study aimed to estimate the prevalence of genital, anal and oral HPV infection in Brazil through systematic review and meta-analysis., Methods: We searched EMBASE, LILACS, MEDLINE, Web of Science and SciELO from inception to December 2018. Original research articles that assessed the prevalence of genital (i.e., cervical, penile), anal and oral HPV infection in Brazil were selected in pairs by independent authors. No sex, age, HPV vaccination, language or date restrictions were applied. HPV prevalence was estimated and stratified according to risk factors population and by geographic area throughout the country. The study prevalence was pooled using a random effects model. Analysis was performed using R (version 3.5.2), packages meta version 4.9-4 and metaphor 2.0-0. This review is registered on PROSPERO under protocol number CRD42016032751., Results: We identified 3,351 references. After the screening process, 139 of them were eligible for this systematic review (57,513 total participants). Prevalence of cervical HPV was 25.41% (95% CI 22.71-28.32). Additionally, prevalence was 36.21% (95% CI 23.40, 51.33) in the penile region, 25.68% (95%CI 14.64, 41.04) in the anal region, and 11.89% (95%CI 6.26, 21.43) in the oral region. Subgroup analysis showed prevalence in each anatomic site was higher in high-risk populations., Conclusion: The prevalence of HPV is high in the Brazilian population and varies by population risk and anatomic body site, with lower rates in the oral cavity compared to that in the cervical, penile and anal region. Studies on HPV have primarily been developed to evaluate infection and cancer in the cervical region. There is a profound lack of HPV data in many geographic regions of Brazil and for different anatomic sites., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Human papillomavirus (HPV) is the most common sexually transmitted infection and is associated with several types of cancer. The number of cases of HPV-associated head and neck squamous cell carcinomas (HNSCCs), especially oropharyngeal carcinomas, has increased significantly in recent years despite decreased tobacco smoking rates. Currently, no data concerning the risk factors and prevalence of HPV in HNSCC patients in all regions of Brazil are available, making it difficult to promote advances in this field of public health. Therefore, our goal is to determine the impact of infection by HPV, including HPVs with different genotypes, on head and neck cancer and the risk factors associated with the development of head and neck cancer in all regions of Brazil., Methods and Analysis: This is a case-control study that will include 622 patients and 622 controls from all regions of Brazil. A questionnaire will be applied to gather information on sociodemographic, behavioural and health factors. Oral, cervical or penile/scrotal, and anal specimens and serum samples will be collected from all participants. Formalin-fixed paraffin-embedded tissue from tumour biopsies will be analysed only in the case group. Molecular and serological analyses will be performed to evaluate the presence and role of HPV in the development of head and neck cancer., Ethics and Dissemination: This project was approved by the research ethical committee of the proposing institution (Hospital Moinhos de Vento, number 2.852.060). Ethical approval from the collaborators is currently under evaluation and is not yet complete. The results of this study will be presented at meetings with the Brazilian Ministry of Health through technical reports and to the scientific community at national and international events, with subsequent publication of scientific articles., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Human papillomavirus (HPV) infection is transmitted through skin-to-skin contact, and vaginal and anal sex are the most common transmission routes. Sex workers and men who have sex with men (MSM) are more exposed to the virus, and therefore, a higher frequency of this infection would be expected. The prevalence of HPV infection types and the forms and factors of transmission must be investigated to control infection-related outcomes. This protocol study will be the first nationwide study with a uniform methodology to evaluate HPV prevalence of and infection types among sex workers and MSM in Brazil., Methods and Analysis: This multicentre cross-sectional study will be conducted with a respondent-driven sampling method to recruit 1174 sex workers and 1198 MSM from all regions of Brazil. The study will consist of preliminary interviews to verify the eligibility criteria and characterise the network size as well as a second questionnaire to obtain sociodemographic, behavioural and sexual information. Specimens from the oral cavity and anal and cervical or penile/scrotal sites will be collected. All HPV samples will be processed in a certified central laboratory. Other sexually transmitted infections will be evaluated by interview and by rapid testing for HIV and syphilis. Strict quality control will be conducted using different procedures, including the training and certification of the health professionals responsible for acquiring data and monitoring visits., Ethics and Dissemination: The project was approved by the research ethics committee of the main institution and the corresponding ethics committees of the recruitment sites. Due to the literature gap on the sexual health of sex workers and MSM and the intense stigma surrounding these populations, a critical analysis of the study results will contribute to epidemiological knowledge and will be useful for the development of strategies against virus morbidities., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: to describe the perception of data collection performed by primary health care professionals as collaborators of the national POP-Brasil survey - Epidemiological Study of National Prevalence of HPV Infection., Methods: in all, 217 professionals from 119 primary care units participated in the POP-Brasil Study conducted in the 26 Brazilian capitals and the Federal District., Results: the professionals were trained and certified locally for collecting data and biological material from 8,580 participants; participation in the study allowed professionals to recognize the importance of their work., Conclusion: the successful experience confirms how important it is to do research as part of work practice, as long as professionals are trained and have adequate support, given that their work routine is compatible with the execution of the research protocol.

Background: Hypovitaminosis D is common, before and after gastric bypass surgery. The prevalence of hypovitaminosis D in a large group of candidates for bariatric surgery in Brazil and South America has not been studied., Objective: To evaluate the prevalence of hypovitaminosis D and associated factors in patients undergoing bariatric surgery in Southern Brazil., Materials and Methods: Cross-sectional study involving all patients presenting for bariatric surgery at Hospital de Clínicas de Porto Alegre, from January 2013 to June 2018. Data were extracted from the patients' electronic medical records. Patients who were taking multivitamin supplements or vitamin D supplements, who had renal insufficiency, or had missing data for 25(OH) vitamin D [25(OH)D] levels were excluded., Results: A total of 291 patients were included. Mean subjects' age was 44.9 (SD 10.7) years, and BMI 49.3 (SD 8.3) kg/m 2 ; 76.6% of the study patients were women, and 87.3% were white. More than half the patients (55.3%) were vitamin D deficient (serum 25(OH)D ≤ 19.9 ng/ml), and 37.1% had insufficient levels (20-29.9 ng/mL). Mean vitamin D level was 19.2 ng/mL (SD 7.6). An inverse correlation was found between 25(OH)D levels and BMI. Vitamin D deficiency was more prevalent in patients with higher BMI [PR 1.02; CI 95% (1.00-1.03)], higher fasting glucose [PR 1.01; CI 95% (1.00-1.01)], in nonwhite patients [PR 1.58; CI 95% (1.30-1.92)] and during autumn/winter season [PR 1.41; CI 95% (1.14-1.75)]., Conclusions: Prevalence of vitamin D insufficiency and deficiency is very high among patients presenting for bariatric surgery in Southern Brazil, and the known associated factors are confirmed in this population.

The aim of this study was to evaluate self-reported syphilis and associated factors in sexually active young adults (16-25 years old) in the Public Health System in Brazil. This was a cross-sectional study with 8071 participants recruited from 119 primary care units. Of these, 224 (2.86%, 95% CI 2.29-3.43%) reported having the disease. Age, lower socio-economic class, being a smoker, not using a condom at first sexual intercourse, and ever had a same-sex sexual experience were associated with syphilis. The results reinforce the importance of implementing strategies focused on socio-economic class and early sexual education that encourage condom use from the beginning of sexual activity., (Copyright © 2019 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. All rights reserved.)

Objectives: To analyse factors associated with genital human papillomavirus (HPV) and other self-reported sexually transmitted infection (STI) coinfections among women and men aged 16-25 years from Brazil., Design: A cross-sectional, nationwide, multicentre study., Setting: 119 primary healthcare centres between September 2016 and November 2017., Participants: 6388 sexually active young adults were enrolled by trained health professionals., Primary Outcome Measure: Genital HPV and other self-reported STI coinfections., Results: Of 3512 participants with valid data for genital HPV and (STI)-positive status, 276 (9.60%, 95% CI 7.82% to 11.36%) had HPV/STI coinfection. Among men, HPV/STI coinfection was more prevalent than HPV infection alone. Among HPV-positive participants, the percentage of subjects who reported having another STI was highest for gonorrhoea at 4.24% (95% CI 2.67% to 5.81%), followed by syphilis, herpes and HIV. Smoking, drug use and ever having a same-sex sexual experience were risk factors that were uniquely associated with HPV/STI coinfection compared with HPV infection alone., Conclusions: The results identified a low prevalence of self-reported STIs, but in participants with at least one STI, the prevalence of HPV was high. These results reinforce the importance of implementing strategies to prevent risky behaviours among Brazilian young adults., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background & Aims: A better understanding of the factors that affect self-perception of body characteristics may play an important role in weight control practices. The objective of this study was to analyze body weight perception and body image satisfaction in low-income adult women in Southern Brazil., Methods: This was a cross-sectional survey study in a cohort of women recruited from areas of social vulnerability in the city of Porto Alegre, RS. A random sample (n = 218) of women was interviewed, and socioeconomic and lifestyle factors, body image perception using the Stunkard Scale, body weight estimation, weight concern and duplicate anthropometric measurements were obtained., Results: The average age of the low-income women was 56.3 ± 9.5 years. The prevalences of overweight and obese individuals were 34.1% and 52.5%, respectively. Among all women, 83.0% were dissatisfied with their body image, and 68.9% of the women estimated their body weight correctly. In addition to BMI (body mass index), the proportions of women with a higher income (p = 0.05), smoking history (p < 0.01) and history of hypertension (p = 0.04) were significantly different between groups according to body image satisfaction. Multivariate analyses using Poisson regression showed that black/mixed race, higher income, and underweight and obese women were more likely to be dissatisfied with their body image., Conclusions: The majority of women know their body weight and have body image dissatisfaction. Skin color, higher income and BMI were significantly associated with dissatisfaction. In addition, these women consider the "healthiest" body image to be thinner than the "ideal" body image, and the "ideal" image is one of normal weight and not too thin., (Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background: In addition to screening by Pap smears, vaccination against human papillomavirus (HPV) can dramatically reduce cervical cancers caused by the virus. The acceptance of HPV vaccination is directly related to HPV knowledge. This research aimed to evaluate knowledge about HPV and vaccination among men and women aged 16-25 years who use the public health system in Brazil., Methods: This was a cross-sectional, multicenter study of sexually active young adults recruited from 119 primary care units between 2016 and 2017. All participants answered a face-to-face standardized questionnaire., Results: Of 8581 participants, the mean percentage of correct answers about HPV and vaccination was 51.79% (95% CI 50.90-52.67), but 75.91% (95% CI 74.13-77.69) had awareness of the HPV vaccination. Women answered a higher proportion of questions correctly than men did (p = 0.0003). Lower education level was the variable that most interfered with knowledge. The best information sources for knowledge were both health professionals and the media (1.33%, 95% CI 1.03-1.70)., Conclusions: The results emphasize the importance of educational programs about HPV and vaccination among young adults, especially in socially disadvantaged populations. These findings can help to increase the vaccination rate in the country and to stimulate public health policies., (Copyright © 2019. Published by Elsevier B.V.)

Purpose: The purpose of this paper is to identify and describe hospital quality indicators, classifying them according to Donabedian's structure, process and outcome model and in specific domains (quality, safety, infection and mortality) in two care divisions: inpatient and emergency services., Design/methodology/approach: A systematic review identified hospital clinical indicators. Two independent investigators evaluated 70 articles/documents located in electronic databases and nine documents from the grey literature, 35 were included in the systematic review., Findings: In total, 248 hospital-based indicators were classified as infection, safety, quality and mortality domains. Only 10.2 percent were identified in more than one article/document and 47 percent showed how they were calculated/obtained. Although there are scientific papers on developing, validating and hospital indicator assessment, most indicators were obtained from technical reports, government publications or health professional associations., Research Limitations/implications: This review identified several hospital structure, process and outcome quality indicators, which are used by different national and international groups in both research and clinical practice. Comparing performance between healthcare organizations was difficult. Common clinical care standard indicators used by different networks, programs and institutions are essential to hospital quality benchmarking., Originality/value: To the authors' knowledge, this is the first systematic review to identify and describe hospital quality indicators after a comprehensive search in MEDLINE/PubMed, etc., and the grey literature, aiming to identify as many indicators as possible. Few studies evaluate the indicators, and most are found only in the grey literature, and have been published mostly by government agencies. Documents published in scientific journals usually refer to a specific indicator or to constructing an indicator. However, indicators most commonly found are not supported by reliability or validity studies.

Objective: This study aims to adapt a questionnaire about the knowledge, beliefs and behaviors regarding HPV and related subjects into Brazilian Portuguese., Study Design: National Survey., Methods: The instrument was translated into Portuguese and retranslated into English separately. Experts assessed the validity of the content and cross-cultural adaptation of the instrument. The instrument was administered to 8580 male and female Brazilian adolescents and young adults (aged between 16 and 25 years) who participated in the National Survey of Human Papillomavirus Prevalence (POP-Brazil). This large-scale survey enrolled participants from 26 Brazilian capitals and the Federal District., Results: The full questionnaire is composed of 30 questions, with a good absolute agreement between its two halves (61.16 ± 9.97). The preventive behavior section showed the lowest agreement. Men and women showed a difference concerning their knowledge about HPV (score for men 0.48 (± 8.93) vs. women 0.55 (± 4.51), p < 0.001)., Conclusion: The proposed questionnaire is the first instrument able to describe the knowledge, beliefs and behaviors regarding HPV and related subjects in Brazilian women and men. This questionnaire appears to be adequate for use in future studies that may produce evidence and knowledge on these specific topics., (Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Current studies have shown that fast weight gain may be more important than body mass index on the incidence of breast cancer. The aim of this study was to evaluate the association between body weight and breast cancer., Patients and Methods: This was a case-control study nested in a cohort of a breast cancer mammography screening program in Southern Brazil. A trained investigator administered a standardized interview to collect sociodemographic and clinical data, and body weight history (weight at menarche, at marriage, at first and last pregnancy, and at menopause). Current anthropometric measurements were also made., Results: Fifty-seven women with cancer (66.7% postmenopausal) and 159 controls were included. Current age (60.3 ± 10.4 vs. 55.8 ± 8.4 years, P < .01), marital status (49.1% vs. 64.8% with a partner, P = .03), and physical activity (48.2% vs. 32.3% sedentary, P = .01) were significantly different between cases and controls, respectively. Odds ratio showed that age and current waist circumference were associated with postmenopausal cancer. No difference was found in relation to body weight at different stages of life., Conclusion: Women with social vulnerability recruited at a mammography screening program in Southern Brazil showed a large weight gain during life, but no significant differences were found in body weight between women with or without breast cancer., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Purpose: Differences in weight loss outcomes after bariatric surgery may be related to individual preoperative characteristics. The aim of this study was to evaluate the potential effect of fatty acid binding protein-2 (rs1799883), leptin receptor (LEP223, rs1137101 and LEP656, rs1805094), and fat mass and obesity-related (rs9939609) genotypes on weight loss 2 years after bariatric surgery in Brazilian patients., Materials and Methods: Prospective observational study involving 105 patients (lost to follow-up, 25.7%). In the preoperative period, patients were clinically evaluated and a fasting blood sample for genetic analysis (by real-time DNA amplification technique) was collected. From the patient's medical records, follow-up weight loss (3, 6, 12, 24 months) was obtained. Percentage of excess weight loss (%EWL) was examined by pairwise comparison across the polymorphisms., Results: At baseline, the mean weight was 127.5 (23.3) kg and age 43.1 (10.9) years old. The %EWL was significant over time (p < 0.01). Only the LEP223 genotype showed association (p < 0.01). Up to 6 months after surgery, no differences were observed. At 12 months, a significant difference (p = 0.03) between AA (n = 19) and GG (n = 34) groups was observed, with 76.5% EWL versus 52.0%, respectively. This difference remained at 24 months. Other genotypes did not present any significant association., Conclusions: There is a different evolution of weight loss in carriers of the LEP223 after bariatric surgery. The AA genotype seems to be associated with a higher weight loss. However, this pattern was evident only at 12 months after surgery.

The sexual behaviors of 15- to 24-year-olds increase the risk of this population to acquire sexually transmitted infections (STIs). The present study aimed to describe the sexual behavior in the transition to adulthood Brazilian population and its association with STI history.We analyzed cross-sectional data collected from 8562 sexually active women and men who participated in the National Survey of Human Papillomavirus Prevalence (POP-Brazil). This large-scale survey enrolled participants from 26 Brazilian capitals and the Federal District. Professionals from primary care facilities were trained to collect data utilizing a standardized questionnaire with questions on sociodemographic, sexual behavior, and drug use. We constructed a Poisson model with robust variance for both crude and adjusted analysis to investigate the associations between the variables. To adjust the distribution of the sample to the study population, we weighted the measures by the population size in each city and by gender.There were differences in several aspects from sexual behavior between genders. The majority of men reported an early sexual initiation, more sexual partners, and a different practice in sexual positions when compared with women. Women reported use of contraception more frequently than men (P < .001). The use of alcohol and drugs and the use of drugs before sexual intercourse impact in STIs equally between the genders. Exclusive for women, the presence of any STI was associated with the practice of vaginal sex and other types of intercourse (adjusted prevalence ratio [APR] 1.43, 95% CI 1.08-1.88). For men, the number of sexual partners in the last year (APR 1.02, 95% CI 1.01-1.04), not having vaginal sex (APR 3.25, 95% CI 1.78-5.92) and sexual experience with someone of the same sex (APR 4.05, 95% CI, 2.88-5.70) were associated with a higher presence of STIs.This is the first report regarding sexual behavior in a nationally representative population sample in Brazil. This study provides more valid estimates of sexual behavior and associated STIs, identifying important differences in sexual behavior and identifying predictors for referred STIs among females and males.

Purpose: The aim of this study is to assess potential risk factors for breast cancer in a population in Southern Brazil and build a multivariate logistic model using these factors for breast cancer risk prediction., Methods: A total of 4242 women between 40 and 69 years of age without a history of breast cancer were selected at primary healthcare facilities in Porto Alegre and submitted to mammographic screening. They were evaluated for potential risk factors., Results: In all, 73 participants among the 4242 women had a breast cancer diagnosis during the follow-up of the project (10 years). The multivariate analysis considering all the patients aged 40-69 years showed that older age (OR 1.08, 95% CI 1.04-1.12), higher height (OR 1.04, 95% CI 1.01-1.09), and history of previous breast biopsy (OR 2.66, 95% CI 1.38-5.13) were associated with the development of breast cancer. Conversely, the number of pregnancies (OR 0.87, 95% CI 0.78-0.98) and use of hormone replacement therapy (OR 0.39, 95% CI 0.20-0.75) were considered a protective factor. Additionally, we performed an analysis separating the participants into groups of 40-49 and 50-69 years old, since a risk factor could have a specific behavior in these age groups. No additional risk factors were identified within these age brackets, and some factors lost statistical significance., Conclusion: The risk prediction model indicates that the following variables should be assessed in this specific population: age, height, having had previous breast biopsies, number of pregnancies, and use of hormone replacement therapy. These findings may help to better understand the causal model of breast cancer in Southern Brazil.

Objective: The aim of this study was to evaluate the anthropometric and lipid profiles of individuals being considered for bariatric surgery, taking into account the presence of the Thr54 allele of the fatty acid-binding protein-2 (FABP-2) gene (rs1799883), and dietary intake., Methods: In a cross-sectional study, 120 participants being evaluated for bariatric surgery were asked to keep 24-h dietary records (R24 h) for 3 d, and to collect a 24-h urine sample for measurement of urea (as an assessment of the adequacy of food records) during day 3 of the diet record; a fasting blood sample for laboratory and genetic evaluations was collected., Results: When considering the whole sample, no significant differences were found; however, those who complied with the R24 h (n = 43) had more years of schooling and higher saturated fat intake, but lower weight and body mass index (BMI). When analyzing only the completers, the Thr54 allele carriers showed higher body weight (P = 0.02), BMI (P = 0.03), hip circumference (P = 0.02), basal metabolic rate (P = 0.02), and homeostatic model assessment-β (P = 0.04) compared with those who were homozygous for Ala54., Conclusion: When the participants complied with the R24 h, Thr54 carriers were shown to have higher anthropometric parameters and higher homeostatic model assessment-β values than those with the wild genotype, but the lipid profile resulted similar in both carriers and noncarriers., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Introduction: Multiple factors are related to lower weight loss after bariatric surgery. This review and meta-analysis evaluates the influence of several mental and behavioral factors on weight loss., Method: Six electronic databases were searched. Percentage excess weight loss (%EWL) was calculated for all moderator and non-moderator groups of the variables: symptoms of depression, anxiety and binge eating, compliance, physical activity, quality of life, and body image. All moderators, surgery types, and follow-up moments were analyzed separately., Results: In total, 75 articles were included in the review; 12 meta-analyses were conducted. Higher postoperative compliance to follow-up was associated with 6.86%-13.68% higher EWL. Preoperative binge eating was related to more weight loss at 24- and 36-month follow-up (7.97% and 11.79%EWL, respectively). Patients with postoperative binge eating symptoms had an 11.92% lower EWL. Patients with preoperative depressive symptoms lost equal weight compared to patients without symptoms., Conclusion: Despite the high heterogeneity between studies, a trend emerges suggesting that the presence of postoperative binge eating symptoms and lower postoperative compliance may be associated with less weight loss after bariatric-metabolic surgery. Additionally, preoperative depressive symptoms and binge eating do not seem to significantly impact weight loss., (© 2024 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Purpose: To evaluate the awareness and existing knowledge of a portion of the Greek population about prevention, screening, and HPV vaccination., Methods: A questionnaire designed in Google forms has been distributed through social media between June 2021 and December 2021 in men and women aged > 16 years old. Statistical analysis was performed using the SPSS 20.0 program. Inferential analysis was performed to evaluate differences in responses among men and women., Results: We enrolled 2685 participants. Of those, 2285 were women, 386 were men, while 14 respondents chose not to respond to this question. Various age groups were detected with those aged between 26 and 30 years old being the predominant one. Participants with a higher education constituted 36.5% of the population. Most respondents were married (59.8%). In socioeconomic terms 75.5% of participants were employed whereas, monthly income ranged between 1000 and 1500 euros in the predominant group (36.8%). Only 40% of females and 3.9% of males were vaccinated against HPV. Adolescent immunization, acceptability rates reached 92.7% among female and 82.1% among male responders. Although, only a small proportion of the participants were not aware of the existence of HPV, 24.1% of males and 23.4% of females had the impression that condom use may provide absolute immunity to HPV and only 51.6% of males and 60.4% of females were aware about the high prevalence of HPV in the general population. Logistic regression analysis indicated that male participants as well as those aged > 50 years and those choosing to reject vaccination had decreased knowledge of the basic pathophysiology of HPV infection, as well as knowledge related to the existence and use of HPV DNA as a screening tool and the existence and efficacy of HPV vaccination., Conclusion: Our results indicate that although awareness of the existence of HPV infection is high in Greek general population, the actual perception of the pathophysiology of transmission and importance of HPV testing and vaccination is low. Targeting specific population groups is essential to help increase HPV coverage and screening., (© 2024. The Author(s).)

Introduction: The prevalence of Binge Eating Disorder (BED) is high in obese patients referred to bariatric surgery. Although the total energy intake is increased, the risk of nutritional deficiencies in these patients is unknown. This study proposes to evaluate and compare the intakes of candidate patients for bariatric surgery with and without BED, using for this purpose the Dietary Reference Intakes., Methods: 116 patients referred for bariatric surgery were submitted to nutritional, laboratory and psychological assessments., Results: Among the patients, 46.6% had BED, of these, 25.9% had the severe form. The patients with current depression (31.9%) were more compulsive than those without depression (p < 0.001). The mean age was significantly higher in patients without BED (46.94 ± 12.05 vs 42.32 ± 10.60, p = 0.030). The only difference in anthropometric parameters individuals with and without BED was the mid-upper arm circumference (P = 0.047). The percentage of energy from carbohydrates was higher in patients with BED (53.78%) than without BED (48.88%) (U = 1222, P = 0.018, r = − 0.22). The percentage from total fat (13.63% versus 12.89%, U = 1201.0, P = 0.019, r = − 0.22) and from saturated fat (9.04% versus 8.15%, U = 1074.0, P = 0.023, r = − 0.21), was higher in patients without BED. When adjusted for the body weight of patients, these differences were not significant., Conclusion: Patients with BED eat more carbohydrates and have larger mid-upper arm circumference in the face of similar body weight, suggesting a higher percentage of fat mass.

Human papillomavirus (HPV), a common sexually transmitted infection, includes over 200 types, some linked to genital warts and various cancers, including cervical, anal, penile, and oropharyngeal cancers. In Saudi Arabia, an estimated 10.7 million women aged 15 years and older are at risk of HPV-related cervical cancer. This study assessed HPV prevalence, genotype distribution, awareness, and health behaviors among females in Jeddah, Saudi Arabia. Pap smear samples were collected from 106 women attending gynecology clinics at King Abdulaziz University Hospital and were analyzed using nested PCR and Sanger sequencing. Results showed a 15.1% HPV positivity rate, with genotypes of HPV 16, 6, and 58 identified. HPV 16 was the most prevalent (43.75%), particularly among women aged 35–44. In addition, over 60% of the participants were unaware of the link between HPV and cervical cancer, or the availability of vaccines, indicating significant knowledge gaps in the population. These findings underscore the urgent need for comprehensive HPV surveillance and targeted public health interventions in Saudi Arabia. This study emphasizes the importance of HPV vaccination programs, increased screening, and educational campaigns to address the high prevalence of high-risk genotypes, particularly HPV 16. Tailored strategies are crucial to reducing HPV-related health risks, especially for high-risk age groups and under-informed populations. The data provide a foundation for improving HPV prevention and reducing the burden of related diseases in the Saudi population. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus (HPV) is the cause of genital tract infections. This virus can cause diverse diseases, such as warts and anogenital cancers. Despite the WHO recommendations for HPV vaccination, there is no public HPV vaccination plan in Iran. Therefore, the prevalence of HPV infection in Iran is greater than that in countries with vaccination programs. Objectives: We aimed to evaluate the prevalence of various HPV genotypes in genital specimens from patients with clinical symptoms in western Iran. Methods: Between 2015 and 2023, 818 vaginal swabs and 26 genital wart samples from females and 28 genital wart samples from males were transferred to the Pars Pathobiology Laboratory (Kermanshah Province) for HPV evaluation. HPV genotyping was performed with two real-time PCR kits and one reverse hybridization kit during the study. Results: Generally, 38.9% (340/872) of the participants were HPV positive. The prevalence rates of HPV in female vaginal swabs and genital wart samples were 37.4% (306/818) and 61.5% (16/26), respectively; however, the prevalence for males was 64.3% (18/28). The most common high-risk genotype was HPV50 (51, 52, 53, 56, 58, and 59) (26.5%), and among the low-risk genotype was HPV6 (62.9%). Conclusions: The prevalence of HPV-positive patients was greater than that in some neighboring countries and other regions of Iran. This high prevalence may be due to a lack of public vaccination. Therefore, we should conduct regular screenings for all age groups of females. Males can act as carriers for the virus, and informing men about this infection is essential. [ABSTRACT FROM AUTHOR]

Background: Human Papillomavirus (HPV) is the most common sexually transmitted lower genital tract infection worldwide and the main etiological factor of cervical cancer (CC). Since 2006, vaccines have been implemented to reduce CC-related morbidity and mortality. This systematic review and meta-analysis aimed to evaluate the prevalence of cervical infections by non-vaccine high-risk HPV (HR-HPV) types in women vaccinated against types 16 and 18. Method: This systematic review and meta-analysis used independent electronic databases – Lilacs, WHO, BDENF, State Department of Health SP, Health Information Locator, IRIS, Coleciona Sistema Único de Saúde, BINACIS, IBECS, CUMED and SciELO, on July 14, 2023. Observational studies that evaluated vaccinated and unvaccinated women against HR-HPV and the prevalence of cervical infection by types of HR-HPV were included. Intervention effects were expressed as prevalence ratios (PR). Forest plots were used to visualize vaccination effects. The study protocol was previously registered in PROSPERO, under code CRD42023440610. Results: Of the 7,051 studies, 31 met the analysis criteria. A total of 59,035 women were eligible for this systematic review. The results showed a high prevalence of non-vaccine HR-HPV types, regardless of vaccination status. For HPV 31/33/45 (PR = 0.60 [0.40–0.91]), HPV31 (PR = 0.47 [0.31–0.72]), and HPV 45 (PR = 0.38 [0.22–0.69]), a positive random effect was found. Conclusion: The prevalence of non-vaccine HR-HPV cervical infection was high in women, regardless of vaccination status. For HPV types 31 and 45 and 31/33/45, the prevalence was lower in vaccinated women, suggesting a cross-protective effect of vaccines for these viral types. [ABSTRACT FROM AUTHOR]

Background: Globally, cervical cancer is an increasing public health issue, and vaccination against HPV has proven to be an effective strategy to reduce this neoplasia. The purpose of this study was to assess the effectiveness of the quadrivalent vaccine in reducing the prevalence and incidence of HPV infection in women, aged 18 to 24 years old, in the cities of Ouro Preto and Mariana, Minas Gerais, Brazil. Methods: A concurrent cohort study was performed, with an initial follow-up of 12 to 18 months. The selected young women were interviewed and divided into two groups: vaccinated and unvaccinated. Participants underwent a Pap smear and cervical sample collection for HPV detection, genotyping performed by PCR-RFLP, type-specific PCR, and using the PapilloCheck®. The prevalence of HPV infection was analyzed using the compare proportions test. Poisson and Cox multivariate regression models were used to estimate vaccine effectiveness. Results: There was no significant difference in the overall prevalence of HPV infection between vaccinated and unvaccinated groups (23.6% vs. 18.7%; p = 0.364). However, the prevalence of infection by HPV 6/11, 16 and 18 types in vaccinated young women (1.1%) was lower than in unvaccinated ones (7.5%; p = 0.030). Regarding non-vaccine types, a higher prevalence was identified among vaccinated women (22.5% vs. 11.2%; p = 0.018). The overall incidence of HPV infection was 15.75/100 young women/year in non-immunized women compared to 9.12/100 young women/year among those immunized. The effectiveness of the vaccine was 64.0%, regardless of the viral type, and no vaccinated woman was detected with the specific vaccine HPV-type in follow-up. HPV33/45, related to cross-protection, were detected in 12.3% of vaccinated women and 1.2% of unvaccinated ones (p < 0.001) at baseline. These viral types were identified at follow-up in 2.03/100 young women/year of vaccinated participants and 4.24/100 young women/year of unvaccinated ones. Conclusions: The results showed that the quadrivalent HPV vaccine was effective in reducing the prevalence of vaccine-type HPV and the incidence of infection by any HPV type. Public health policies must encourage vaccination to prevent HPV infection. However, surveillance of HPV infection should be continued to assess the prevalence of different genotypes and the impact of the vaccination program. [ABSTRACT FROM AUTHOR]

Introduction: In 2020, 368 million people globally were affected by knee osteoarthritis, and prevalence is projected to increase with 74% by 2050. Relatively high rates of dissatisfactory results after total knee arthroplasty (TKA), as reported by approximately 20% of patients, may be caused by sub-optimal knee alignment and balancing. While mechanical alignment has traditionally been the goal, patient-specific alignment strategies are gaining interest. Robotic assistance could potentially facilitate implementation of these alignment strategies through data-based surgical planning, accurate execution of the surgical plan and validation. The clinical value of surgical assistance in diverging from mechanical alignment remains to be investigated. In the present study, robotic-assisted TKA will be performed to pursue inverse kinematic alignment (iKA) within predefined boundaries, focusing on restoring native tibia joint line. Methods: This randomized controlled trial evaluates clinical effectiveness of robotic-assisted TKA (ROSA® Knee System, Zimmer Biomet, Montreal, Quebec, Canada) aiming for iKA compared to conventional TKA aiming for mechanical alignment. A total of 150 participants will be randomized (1:1) to either treatment to provide an 80% power for a 4.8-point clinically important difference in the primary outcome measure, the Oxford Knee Score (OKS) 12 months after surgery. Allocation was achieved using computer-based randomization. Outcomes will be analyzed using linear mixed models with time and group as main factors and interaction-term. Secondary outcomes include clinical metrics (leg alignment, implant and patient survival), surgical parameters (adverse events, surgery duration, blood loss, hospital stay length, medication use), patient-reported outcomes (symptoms, quality of life, pain), mobility and physical activity measurements, metabolic syndrome, cost-efficacy, and gait and continuous glucose monitoring. Ethics and dissemination: This study has been approved by the Medical Ethical Committee Zuyd and Zuyderland Medical Centre (NL79161.096.21/METCZ20220006), September 2022. Trial registration number: NCT05685693 (clinicaltrials.gov). [ABSTRACT FROM AUTHOR]

Backgrounds: Bing eating disorder (BED) has been associated with a number of health problems. Remarkably little research has been done to measure dietary intake in people who suffer from binge eating disorder. This study aimed to compare the dietary intake and nutrient adequacy ratio (NAR) between BED individuals and those without BED and also to investigate the association between BED and NAR. Methods: In this cross- sectional study, 180 overweight and obese females who aged between 19 and 50 years old and with BMI between 25 and 40 kg/m2 were interviewed. The women were categorized into BED and non- BED groups based on their earned score in Binge Eating Scale (BES) questionnaire. Nutritional adequacy ratio was assessed as Micronutrient adequacy ratio, Macronutrient adequacy ratio and total adequacy ratio (the sum of the previous two) based on last year's dietary intakes collected using a semi-quantitative food frequency questionnaire (FFQ). The odds of binge eating disorder across the nutritional adequacy scores were assessed using multiple logistic regression models. Data were analyzed using SPSS software. Results: About 41.6% (n = 75) of the subjects were diagnosed with BED. Carbohydrate, saturated fats, sugar levels were significantly higher in women with BED compared to non-BED women (P < 0.05). All vitamins, with the exception of Retinol, and all minerals' levels were significantly lower in BED participants (P < 0.05). Micronutrient adequacy score and total adequacy score differed significantly between individuals with and without BED (P < 0.001) and non- BED group were significantly more nutritional adequate. The odds of having BED were lower in micronutrient, macronutrient adequate individuals (OR = 0.87, 95% CI = 0.78–0.98, P = 0.02), (OR = 0.81, 95% CI = 0.66–0.99, P = 0.049) respectively. Conclusion: Overall, the results demonstrate low intake of key micronutrients and high intake of saturated fatty acids and carbohydrates among binge sufferers. Also, the findings indicate that individuals with BED experience a notably lower nutrient adequacy ratio compared to their peers without the disorder, suggesting that the eating behaviors associated with BED such as high consumption of processed foods and diet with low quality may lead to inadequate intake of vital nutrients. [ABSTRACT FROM AUTHOR]

Background: Systematic study on the relationship between vaginal microbiota and high-risk human papillomavirus infection (HR-HPV) is limited. Hence, the aim of this study is to investigate the correlation between vaginal microbiota and HR-HPV infection through a meta-analysis of case-control studies. Methods: Chinese Journal Full-text database, Wanfang database, PubMed database, VIP Chinese Science and Technology Journal database, Web of Science, ScienceDirect, ProQuest, JSTOR, Wiley, and IEEE Xplore were synthetically searched for studies about the correlation between vaginal microbiota and HR-HPV infection. Revman 5.3 software was used to assess the relationship between vaginal microbiota and HPV infection through meta-analysis. Finally, forest map was used to calculate the results and funnel plot was applied to test the publication bias. Results: Fourteen independent studies were admitted in this study, containing a total of 21, 446 women in gynecological outpatients. Compared with HR-HPV negative group, the prevalence of bacterial vaginosis (BV) [odds ratio (OR)=2.45, 95% confidence intervals (CI): 1.83-3.27, P <0.00001], Ureaplasma urealyticum (UU) (OR=1.38, 95% CI: 1.23-1.54, P <0.00001), and Chlamydia trachomatis (CT) (OR=3.53, 95% CI: 2.82-4.41, P <0.00001) increased in HR-HPV positive group through meta-analysis, while, there was no significant difference in the prevalence of trichomonal vaginitis (TV) (OR=1.69, 95% CI: 0.97-2.96, P=0.06) and vulvovaginal candidiasis (VVC) (OR=0.91, 95% CI: 0.54-1.51, P=0.71. Conclusions: Vaginal pathogens are closely related to HR-HPV infection. When BV, UU, and CT are abnormal, the risk of HR-HPV infection is increased. [ABSTRACT FROM AUTHOR]

Background: Individuals with a higher level of awareness and knowledge of HPV are more likely to dispel misconceptions about HPV and reduce their likelihood of engaging in risky sexual behavior. Behavioural change can be achieved through interventions such as participatory action research (PAR), which has been applied in various contexts. Few studies have reported on the use of PAR in Nigeria. This study aims to utilise PAR as an intervention to increase HPV awareness, improve knowledge of HPV infection, and promote behavioural change for HPV prevention among young adolescents in Benue State, Nigeria. Methods: The study design uses a school-based, pre-post intervention approach with a cross-sectional component. Study participants are young adolescents aged 10–19 years in selected co-educational secondary schools in three local government areas (LGAs) spread across the three senatorial zones in Benue State, Nigeria. Two-stage sampling was used to select the LGAs and schools, and the sample size was computed using the before and after implementation with some prior information from a previous study. Data on sociodemographic characteristics, HPV awareness and knowledge of infection and prevention, prevention practices, and willingness for HPV vaccination were obtained with a self-administered semi-structured questionnaire adapted from the Vaccination and HPV Knowledge (THinK) survey. The HPV Knowledge survey (New Zealand) was utilized to collect information from students at baseline and post-implementation after PAR intervention. The Wilcoxon Signed Test (WST) was used to investigate the significance of the median differences before and after the intervention. A p-value less than 0.05 or 0.001 was considered significant. Results: A total of 548 adolescents were sampled before the intervention. After the intervention, the sample size decreased to 503, reflecting an 8% attrition rate. PAR effectively increased HPV awareness among the participants from 80.9% before the intervention to 99.8% afterward. The PAR led to a significant change in knowledge of HPV infection and primary prevention and an increase in perception of HPV primary prevention. decrease in misconceptions and risky sexual behaviours, increase in HIV screening tests, and increase in the willingness of participants to uptake the HPV vaccine. Among the measures of risky sexual behaviours was a decreased perception that having more than one sexual partner is not a risk factor for HPV after the PAR intervention. The number of participants in sexual relationships decreased from 84 (16.7%) at baseline to 37 (7.4%) post-implementation. The PAR also led to a decrease in the number of participants who reported having STDs. The Wilcoxon Signed test was further disaggregated based on sex (male and female), school funding type (public and private), and school class level (junior and senior). Conclusions: PAR led to a significant increase in awareness and knowledge of HPV, knowledge of different aspects of HPV infection, and willingness to uptake the HPV vaccine. Additionally, the study has provided evidence that PAR interventions can be a viable tool in delaying sexual initiation and reducing sexual behavioural tendencies, especially in high-risk groups. [ABSTRACT FROM AUTHOR]

Introduction: Body image issues among adolescents are rising in India. The grade of body image has alarming influence on functions in all perspectives of life. Outcome like academic absenteeism are connected with one's body perception. There is a need to review the perception of self-esteem and body image of medical undergraduates along with their impacts on academic behavior of undergraduates. Methodology: The study involved medical undergraduates and cross-sectional design was used. Questionnaire consisted of Socio demographic profile and 3 scales which includes Rosenberg Self-Esteem Scale, Szuch's scale and Measurement of Academic Behavior (MAB). Data was collected and analyzed using SPSS version 27. Results: 540 MBBS students participated in the study. Positive correlation seen amid self-esteem and body image perception with r=0.5 (p=<0.001). Significant positive correlation was observed among academic behavior and self-esteem as r = 0.0.473 (p=<0.001). Body image dissatisfaction was observed in underweight and overweight undergraduates. (p <0.001). Conclusion: The results concluded that the undergraduates with poor body image satisfaction and low self-esteem were found to be having low level of academic behavior. [ABSTRACT FROM AUTHOR]

Background: Human Papillomavirus (HPV) DNA screening was a crucial element in the fight against cervical cancer and had been adopted in many countries, including China. However, the onset of the COVID-19 pandemic in March 2020 disrupted this program significantly. Methods: The aim of this study is to investigate the prevalence and distribution of HPV genotypes among the population undergoing cervical cancer screening during the pandemic period. From January 2017 to December 2022, Peking Union Medical College Hospital gathered 45,496 cervical swabs from individuals undergoing cervical cancer screening. These samples were analyzed to detect fifteen high-risk HPV (HR-HPV) DNA types and a combination of two low-risk HPV (LR-HPV) types. Results: The study revealed an overall infection rate of 11.24% (5,114/45,496), with 11.06% (5,032/45,496) of individuals infected with HR-HPV. The number of HPV screening patients and the infection rates of HPV, HR-HPV, LR-HPV, multiple genotype HPV (M-HPV), and single genotype HPV (S-HPV) during the pandemic were lower than those observed before the pandemic. Moreover, the age group with the highest percentage of infected individuals was under 45–49 years, with HPV52, HPV58, HPV16, and HPV51 being the most prevalent genotypes. Notably, HPV66 emerged as the fifth most commonly detected genotype during the pandemic. Additionally, among the eleven age groups examined, women under 25 exhibited the highest detection rate, with HPV52 and HPV16 infection rates exceeding those observed in the pre-pandemic period. Conclusions: The findings of this study offer significant insights for shaping HPV prevention strategies and enhancing cervical cancer screening initiatives in China following the epidemic. [ABSTRACT FROM AUTHOR]

Background: High-risk genotypes of Human Papillomavirus are responsible for 90% of cases of cervical cancer worldwide. Inflammation of squamous cells is mainly linked to HPV. In Gabon, HPV is endemic and circulates among the female population. The study aimed to determine the prevalence of HR-HPV genotypes and to investigate the correlation between squamous cell inflammation and HPV viral load in infected women in Gabon. Methods: The cross-sectional study was conducted at Libreville University Hospital Center (UHC) and National Public Health Laboratory from March to May 2024 among 399 women. Two cervical smears were taken. Genotype detection was carried out by multiplex fluorescence real-time PCR in the NPHL virology unit. Cytology was carried out in UHC's anatomic-pathology laboratory. Data were analyzed by SPSS software. Graphs were plotted using Microsoft Excel 2016. Results: The prevalence of Human Papillomavirus was 26.1% (95% CI: 22-30.6). The prevalence of HR-HPV genotypes was 24.8%. The most common HR-HPV genotypes were HPV-16/52/18/35/56/58/53/68. The rate of multiple HPV infections was 29.8% and 95.2% for the HR-HPV infection rate. Viral load was significantly correlated with squamous cell inflammation (r = 0.977 and P = 0.001). Conclusion: HR-HPV infection remains a concern in women, however early screening is necessary for optimal monitoring and management. HR-HPV viral load is a predictive marker of squamous cell inflammation. [ABSTRACT FROM AUTHOR]

Persistent human papillomavirus (HPV) infection is associated with the grading of cervical intraepithelial neoplasia (CIN), high-risk HPV infection, multiple HPV infections, high HPV load, HPV infection of surgical margin, and age in CIN after conization. The immune mechanism is complex and is primarily related to vaginal microecology disorders, immune escape, immune response impairment, and the release of regulatory cytokines. Currently, the treatment methods for postoperative persistent HPV infection include surgical treatment, antiviral treatment, vaccination, and other approaches. [ABSTRACT FROM AUTHOR]