eHEALS as a predictive factor of digital health information seeking behavior among Brazilian undergraduate students.

This study aimed to perform the cross-cultural adaptation and validation of the eHealth Literacy Scale (eHEALS) for Brazilian Portuguese. The cross-cultural adaptation was conducted through conceptual equivalence, verbatim translation, semantic, item and operational equivalence, and back-translation. Subsequently, 521 undergraduate students answered the adapted version of the eHEALS, the General Perceived Self-Efficacy Scale (GSES), the Oral Health Impact Profile-14 (OHIP-14) and sociodemographic and health-related questions. Statistical analysis was performed to determine the dimensionality, internal consistency, stability and concurrent/convergent/discriminant/predictive validities of the eHEALS (p < 0.05). The adequacy of sample size was confirmed by a non-identity correlation matrix (Bartlett's test of sphericity, p < 0.001), without influence of multicollinearity (determinant = 0.026). The confirmatory factor analysis identified four factors in agreement to the constructs namely as online searching self-efficacy, awareness of available sources, information usage ability, and critical analysis of useful information. The eHEALS displayed an excellent internal consistency (Cronbach's alpha = 0.88), a good stability (ICC = 0.71, 95% CI: 0.49-0.84), and it was significantly correlated with GSES (concurrent validity). Higher eHEALS scores were identified among (i) white and (ii) younger students, (iii) from health sciences courses, (iv) with more years of graduation, (v) who their fathers were working in specialized functions (discriminant validity), and (vi) among those who were frequently interested in digital health information (convergent validity). The students with higher eHealth literacy levels were more likely to seek health information in the last 24 h (predictive validity). In conclusion, the eHEALS demonstrated adequate psychometric properties to be applied for the Brazilian population.

The eHealth Literacy Scale (eHEALS) is a self-fulfilling tool designed to determine individuals' levels of electronic health literacy. It helps to determine how people deal with electronic health-related information, being useful to identify potential difficulties of accessing, evaluating and using online health information, with potential to support the planning of educational interventions. This study aimed to adapt and validate the eHealth Literacy Scale (eHEALS) for being applied to Brazilian Portuguese native speakers. Five hundred twenty-one undergraduate students answered the adapted version of the eHEALS, the General Perceived Self-Efficacy Scale (GSES), the Oral Health Impact Profile-14 (OHIP-14), and sociodemographic and health-related questions. The tool showed sufficient consistency and stability, with the detection of higher eHEALS scores among white and younger people who reported a frequent interest for seeking digital health information, students from health sciences courses, those with more years of graduation, and who their fathers were working in specialized functions. Also, the students with higher eHealth literacy scores were more likely to seek health information in the last 24 h. In conclusion, the eHEALS demonstrated being adequate to be applied for the Brazilian population.

Acceptability and feasibility of fecal microBIOME and serum metabolite sample collection in people with end-stage kidney disease and pain being treated with HemoDialysis: A pilot study (BIOME-HDp).

Pain is known to reduce hemodialysis treatment adherence, reduce quality of life, and increase mortality. The absence of effective strategies to treat pain without medications has contributed to poor health outcomes for people with end-stage kidney disease (ESKD) on hemodialysis. It is now recognized that symbiotic microbiota in the gut play a critical role in health and disease, and new evidence sheds light on the role of the microbiome in chronic pain. The pilot study protocol presented here (BIOME-HDp) employs a longitudinal repeated measures design to interrogate the effects of a nonpharmacological pain intervention on the composition and function of the gut microbiome and circulating metabolites. This pilot study is an ancillary study of the HOPE Consortium Trial to reduce pain and opioid use in hemodialysis, which is part of the NIH's Helping to End Addiction Long-term (HEAL) initiative. The BIOME-HDp pilot study will establish clinical microbiome research methods and determine the acceptability and feasibility of fecal microbiome and serum metabolite sample collection.

Retention of zirconia crowns to Ti-base abutments: effect of luting protocol, abutment treatment and autoclave sterilization.

PURPOSE: To evaluate the influence of resin cement type, surface pretreatment and autoclave sterilization on the retention of Y-TZP crowns to Ti-base abutments. METHODS: Y-TZP crowns were designed and milled to fit Ti-base abutments. Crowns were cemented using either a conventional resin cement (conventional) with a universal adhesive or a self-adhesive resin cement (self-adhesive), both following no surface pretreatment (No) or Ti-base abutment sandblasting (SB) (n=20/group). Half of the cemented samples were subjected to in-office autoclave sterilization. Pullout testing was performed in a universal testing machine at a speed of 1 mm/min until crown displacement. Data were statistically evaluated through a linear mixed model following post hoc comparisons by LSD test. RESULTS: Pullout data as a function of cement type demonstrated higher retention for conventional relative to self-adhesive cement (p < 0.001). Ti-base sandblasting (SB) favored crown retentiveness over No pretreatment (p < 0.001). Sterilized crowns exhibited higher pullout values than non-sterile (p=0.036). All the two- and three-factor interaction analyses corroborated with the superior adhesive strength of conventional compared to self-adhesive cement (all, p < 0.011), as well as, SB relative to No pretreatment (all, p < 0.024). While autoclave sterilization maximized bond strength when self-adhesive cement (data collapsed over surface pretreatment, p < 0.050) and No pretreatment were evaluated (data collapsed over surface pretreatment, p < 0.013), no significant difference was observed for conventional resin cement (p=0.280) and SB (p=0.878) groups. CONCLUSIONS: Conventional resin cement and/or Ti-base sandblasting increased Y-TZP crown retentiveness, with no significant influence of autoclave sterilization. Autoclaving increased retentiveness when self-adhesive cement and/or no Ti-base pretreatment were used.

Cementation Protocol for Bonding Zirconia Crowns to Titanium Base CAD/CAM Abutments.

PURPOSE: To establish the most effective cementation protocol for bonding zirconia crowns to Ti-Base CAD/CAM abutments in terms of abutment height, cement type, and surface pretreatment. MATERIALS AND METHODS: Zirconia crowns were designed to fit abutments of 2.5-mm (short) and 4.0-mm (tall) height. The retention of conventional resin cement with a universal adhesive (RelyX Ultimate, 3M ESPE) was compared to self-adhesive resin cement (RelyX U200, 3M ESPE) following different surface pretreatments (n = 10/group): (1) no treatment (NT); (2) Ti-Base abutment surface blasting with alumina particles (SB); (3) zirconia crown tribochemical surface blasting with silica-coated alumina particles (TBS); and (4) a combination of SB + TBS. Pull-out testing was performed in a universal testing machine. Data were statistically evaluated using a linear mixed model following least significant difference post hoc test. RESULTS: Pull-out data as a function of Ti-Base height demonstrated higher retention for tall compared to short abutments (P < .001). Ultimate outperformed U200 cement (data collapsed over height and pretreatment) (P < .001). Analysis of pretreatment depicted higher retention for SB + TBS, followed by SB, TBS, and NT (P < .04). The interaction between Ti-Base height and cement type highlighted the superior adhesive strength of Ultimate compared to U200 for both heights (P < .001). Irrespective of type of pretreatment, surface pretreatment improved the retention for U200 cement and short Ti-Base (P < .03 compared to NT). In contrast, higher retention was demonstrated for SB + TBS, followed by SB, TBS, and NT, for Ultimate cement combined with tall Ti-Base (P < .02) (data collapsed over height and cement, respectively). CONCLUSION: There was a direct relationship among Ti-Base height, micromechanical and/or chemical pretreatment, and conventional adhesive bonding in improving the retention of zirconia crowns.

Sarcina Organisms in the Upper Gastrointestinal Tract: A Report of 3 Cases With Varying Presentations.

Sarcina species are anaerobic gram-positive cocci rarely seen in the upper gastrointestinal tract and associated with delayed gastric emptying. We present 3 cases of Sarcina infection with varying clinical presentations including the first reported case of Sarcina in a patient with eosinophilic esophagitis. Although the pathogenesis of Sarcina is unclear, awareness of the bacteria is important as they can usually only be detected on histopathologic examination of upper gastrointestinal biopsies. Treatment in symptomatic patients may prevent severe complications such as emphysematous gastritis and gastric perforation.

Analysis of the prevalence of injuries and associated factors in brazilian climbers / Análise da prevalência de lesões e fatores associados em escaladores brasileiros / Análisis de la prevalencia de lesiones y factores asociados en escaladores brasileños

ABSTRACT Introduction Many Brazilians became climbing enthusiasts in the 20th century, and the activity was recently included as an Olympic sport at the Tokyo 2020 Olympic Games. With the increase in the number of climbers seeking to beat personal and/or competitive records, the number of injuries has also increased. Objectives To verify the prevalence of injuries in Brazilian climbers, as well as their association with sociodemographic characteristics and sport performance. Methods A cross-sectional, descriptive and analytic observational study was conducted from March 2018 to May 2018 with the application of a virtual questionnaire for 266 Brazilian climbers. The statistical analysis was performed subsequently. Results The prevalence of injuries in Brazilian climbers was 71.8%. The main characteristics of the injuries that merited special attention were musculotendinous site (50.8%), sport climbing (22.0%), upper limb (50.3%) and mechanism of abrupt movement (20.4%). The most popular treatment was medical in combination with physiotherapy (34.5%), and time off was generally more than 30 days (50.3%). There was a significant association (p <0.05) of the injuries with age, gender, region of the country, BMI, level of education and involvement in other sports, as well as athletic and recreational category, climbing time, basic course certificate, warming up, monthly rock climbing and weekly indoor climbing frequency, and the climbing grade. Conclusion Due to the increase in the popularity of the sport and the high prevalence of climbers with a history of injuries, multiprofessional follow-up is needed to procure risk reduction programs and to enhance climbers' awareness of the factors associated with these injuries. Level of Evidence III; Study of nonconsecutive patients, without consistently applied ''gold'' reference standard.

RESUMO Introdução No século 20, a escalada passou a ganhar muitos adeptos brasileiros e, recentemente, foi incluída como esporte olímpico nos Jogos Olímpicos Tóquio 2020. Com o aumento no número de praticantes que buscam superações pessoais e/ou competitivas, tem-se aumentado também o número de lesões. Objetivo Verificar a prevalência de lesões em escaladores brasileiros, bem como sua associação com as características sociodemográficas e desempenho esportivo. Métodos Estudo observacional descritivo-analítico do tipo transversal, com aplicação de questionário virtual para 266 escaladores brasileiros, realizado de março de 2018 a maio de 2018. Posteriormente, foi realizada a análise estatística. Resultados A prevalência de lesões nos escaladores brasileiros foi de 71,8%. Dentre as principais características das lesões, destacaram-se as musculotendinosas (50,8%), a modalidade escalada esportiva (22,0%), o membro superior (50,3%) e o mecanismo de movimento brusco (20,4%). O tratamento mais procurado foi o médico associado ao fisioterapêutico (34,5%), e o tempo de afastamento em geral foi de mais de 30 dias (50,3%). Verificou-se associação significativa (p < 0,05) das lesões com idade, sexo, região do país, índice de massa corporal, nível de escolaridade e prática de outros esportes, bem como categoria atleta e recreativo, tempo de escalada, certificado de curso básico, realização de aquecimento, frequência mensal da escalada em rocha e semanal da escalada indoor, e dos graus de dificuldade escalados. Conclusão Com o aumento da popularidade do esporte e a alta prevalência de escaladores com histórico de lesões, faz-se necessário o acompanhamento multiprofissional, em busca de programas de redução de riscos e maior conscientização dos escaladores quanto aos fatores associados a essas lesões. Nível de Evidência III; Estudo de pacientes não consecutivos; sem padrão de referência "ouro" aplicado uniformemente.

RESUMEN Introducción En el siglo XX la escalada comenzó a ganar muchos adeptos brasileños y recientemente fue incluida como deporte olímpico en los Juegos Olímpicos de Tokio 2020. Con el aumento en el número de practicantes, que buscan superaciones personales y/o competitivas, ha aumentado también el número de lesiones. Objetivo Verificar la prevalencia de lesiones en escaladores brasileños, así como su asociación con las características sociodemográficas y el desempeño deportivo. Métodos Se realizó un estudio observacional descriptivo-analítico del tipo transversal, con aplicación de cuestionario virtual para 266 escaladores brasileños, de marzo de 2018 a mayo de 2018. Posteriormente se realizó el análisis estadístico. Resultados La prevalencia de lesiones en los escaladores brasileños fue del 71,8%. Entre las principales características de las lesiones se destacaron las músculo-tendinosas (50,8%), la modalidad escalada deportiva (22,0%), el miembro superior (50,3%) y el mecanismo de movimiento brusco (20,4%). El tratamiento más buscado fue el médico asociado al fisioterapéutico (34,5%) y el tiempo de alejamiento de la práctica fue de más de 30 días (50,3%). Se verificó una asociación significativa (p <0,05) de las lesiones con la edad, sexo, región del país, índice de masa corporal (IMC), nivel de escolaridad y práctica de otros deportes, así como categoría atleta y recreativa, tiempo de escalada, certificado de curso básico, realización de calentamiento, frecuencia mensual de la escalada en roca y semanal de la escalada indoor, y de los grados de dificultad escalados. Conclusión Con el aumento de la popularidad del deporte y la alta prevalencia de escaladores con historial de lesiones, se hace necesario un acompañamiento multiprofesional en busca de programas de reducción de riesgos y mayor concientización de los escaladores en cuanto a los factores asociados a estas lesiones. Nivel de evidencia III; Estudio de pacientes no consecutivos, sin patrón de referencia "oro" aplicado uniformemente.

Overview of ultrasound usage trends in orthopedic and sports physiotherapy.

BACKGROUND: The purpose of this study is to examine current beliefs about the use, the clinical importance, the theoretical fundamentals and the utilization criteria of therapeutic ultrasound (TUS) among physical therapists on the clinical practice in orthopedic and sports physiotherapy in Brazil. METHODS: A brief survey was developed based on previous studies and was sent to 55 physical therapists with advanced competency in orthopedics and sports physiotherapy. The questions addressed general topics about the professional profile and ultrasound usage and dosage. RESULTS: Our data show the wide availability and frequent use of TUS in this sample of physical therapists. TUS is used in distinct musculoskeletal injuries and/or disorders in both acute and chronic conditions. Muscles, tendons and ligaments represented the major structures where TUS is used. Questions on the basic theory of TUS demonstrated a lack of knowledge of the ultrasound physiological effects as well as its interaction with biological tissues and TUS absolute contraindication. CONCLUSION: A Brazilian profile about the US usage and dosage in orthopedic and sports physiotherapy is presented and highlights the need for a continuous upgrading process and further research into its effects.