Health Information and Monitoring of Sexually Transmitted Infections (SIM study): a single-center, parallel, three-arm randomized controlled trial protocol for enhancing adherence to syphilis treatment and follow-up.

BACKGROUND: Syphilis has recently resurfaced as a significant public health problem. Since the 2000s, isolated syphilis outbreaks have increasingly occurred in North America, Europe, and Australia; in Brazil, there have been progressive increases in both congenital and acquired syphilis. There are several possible explanations, such as misdiagnosis of acquired syphilis, which could increase the number of untreated transmitters in the population; failure to initiate or complete treatment; and nontreatment of sexual partners (leading to reinfection). Mobile technologies have been successfully used to promote behavior changes and can positively impact treatment and follow-up adherence in patients with infectious diseases. The purpose of this clinical trial is to evaluate treatment and monitoring methods in patients with syphilis, including follow-up by telephone, via a game in a smartphone app, and at public health centers. METHODS: The SIM study is a single-center, randomized controlled trial with a 12-month follow-up period. The aim is to identify the most effective method of follow-up regarding patient compliance with treatment. The tests will be performed in a mobile unit in easily accessible locations. The goal is to perform 10,000 rapid tests for syphilis. Patients with a confirmed diagnosis according to VDRL tests will be randomized to one of three arms: telephone, smartphone game, or conventional in-person follow-up. All analyses will follow the intention-to-treat principle. CONCLUSION: If we find differences in effectiveness, a major change in the conventional approach for this patient population may be needed, potentially affecting current Brazilian health policy strategies. TRIAL REGISTRATION: NTC04753125 . Version 1 of protocol 1/09/2020.

Economic values of reproductive, growth, feed efficiency and carcass traits in Nellore cattle.

A bioeconomic model was developed to calculate the economic value (ev) of reproductive and growth performance, feed efficiency and carcass traits of a seedstock Nellore herd. Data from a full-cycle cattle operation (1,436 dams) located in the Brazilian Cerrado were assessed. The ev was calculated by the difference in profit before and after one-unit improvement in the trait, with others remaining unchanged. The ev was standardized by the phenotypic standard deviation of each trait. Preweaning average daily gain (ADG) was the most economically important trait evaluated (R$ 58.04/animal/year), followed by age at first calving (R$ 44.35), postweaning ADG (R$ 31.43), weight at 450 days (R$ 25.36), accumulated productivity (R$ 21.43), ribeye area (R$ 21.35), calving interval (R$ 19.97), feed efficiency (R$ 15.24), carcass dressing per cent (R$ 8.27), weight at 120 days (R$ 6.22), weight at 365 days (R$ 6.06), weight at weaning (210 days, R$ 5.82), stayability (R$ 5.70) and the probability of early calving (R$ 0.32). The effects of all traits on profits are evidence that their selection may result in the economic and genetic progress of the herd if there is genetic variability.

Effects of plant extracts from Stryphnodendron adstringens (mart.) coville, Lafoensia pacari a. st.-hil, copaifera spp., and Pterodon emarginatus Vogel on in vitro rumen fermentation.

The effects of doses CTL (0 mg), 30, 300 and 3000 mg/L of extracts from Stryphnodendron adstringens (Mart.) Coville (SA), Lafoensia pacari A. St.-Hil (LP), Copaifera spp. (CO) and Pterodon emarginatus Vogel (PE) on ruminal fermentation were investigated in eight experiments conducted in randomized complete block designs. The in vitro system contained four fermentation vessels. Each treatment was allocated in one vessel in each run. Incubation was run four and five times with diets 50:50 and 10:90 (roughage to concentrate ratio) respectively. Incubation vessel was the experimental unit, and each incubation run was a block. All plant extracts negatively affected DM degradation at 3000 mg/L. In diet 50:50, SA-3000 increased the molar proportion of propionate (p < 0.05), yet it decreased the concentration of fermentation products (p < 0.05); LP-300 reduced ruminal ammonia nitrogen (NH3 -N; 98 vs. 120 mg/dl for LP-300 and average of CTL and LP-30, respectively) and isobutyrate (p < 0.05); CO-300 reduced (p < 0.05) NH3 -N (98 vs. 123 mg/dl for CO-300 and average of CTL and CO-30, respectively); and P. emarginatus had no positive effects on rumen fermentation (p > 0.05). In diet 10:90, SA-300 reduced (p < 0.001) NH3 -N and total volatile fatty acids (VFA); LP-30 increased (p < 0.05) total VFA (85 vs. 63 mM for LP-30 and CTL, respectively), molar proportions of acetate and propionate, and had lower C2 :C3 than CTL (3.6 vs. 4.3, respectively); CO-300 decreased acetate and increased propionate, reducing C2 :C3 (p < 0.001; 2.8 vs. 3.6 for CO-300 and average of other doses, respectively); PE-30 and PE-300 reduced NH3 -N by 14% and increased total VFA by 29% compared with CTL (p < 0.05). Further in vivo investigations may consider L. pacari (LP-30), Copaifera spp. (CO-300) oleoresin and P. emarginatus oleoresin (PE-30 and PE-300) in diets with high inclusion of concentrate.

The impact of socioeconomic status on HPV infection among young Brazilians in a nationwide multicenter study.

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.