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Objective. To evaluate different concentrations of solvents (tetrahydrofuran (THF) and dimethyl sulfoxide (DMSO) and monomers on the degree of conversion, microtensile bond strength, and mechanical properties of experimental resin infiltrants. Materials and Methods. Resin infiltrants were formulated and divided into eleven groups: (1) Icon, (2) 75% TEGDMA (T) +25% UDMA (U), (3) T +25% BIS-EMA (B), (4) T + U +0.5%DMSO, (5) T + U +5% DMSO, (6) T + U +0.5% THF, (7) T + U +5% THF, (8) T + B +0.5% DMSO, (9) T + B +5% DMSO, (10) T + B +0.5% THF, and (11) T + B +5% THF. One hundred and ten bovine mandibular incisors were sectioned, treated, and destined to the degree of conversion, tensile cohesive strength, microtensile bond strength, flexural strength, and elastic modulus. Data were submitted to one-way ANOVA and Tukey’s test ( α = 0.05 ). Results. The degree of conversion was lowest for T + B +5%THF (41.9%) and highest for T + U +5%THF (62.1%). In flexural strength and E-modulus, the T + B (96.5 MPa and 0.49 GPa) obtained the highest values and the lowest for T + U +5% DMSO (18.5 MPa and 9.7 GPa). Icon showed the highest bond strength (19.3 MPa) and cohesive strength (62.2 MPa), while T + U +5%DMSO (9.7 MPa) and T + B +5% DMSO (9.8 MPa) the lowest values and T + B +0.5% DMSO (12.3 MPa) the lowest cohesive strength. Conclusions. The addition of lower concentrations of DMSO or THF (0.5%) did not impair bond strength or significantly affect monomer conversion, but reduced the mechanical properties of resin infiltration.

Objectives The primary objective of the presented study is to analyze the respiratory and functional effects of a rehabilitation program in patients affected by hospitalization in Intensive Care Unit (ICU) due to COVID-19, in comparison with the group treated with standard of care, at discharge endpoint. The secondary objectives of the presented study are to evaluate different outcomes of the rehabilitation program in comparison to standard of care regarding: functional performance at 4-week and 12-week post- discharge mark; health-related quality of life, the impact on the health services (namely days of hospitalization), the cost-effectiveness of the intervention proposed. Trial design This is a randomized, controlled, double-blind, double-arm clinical trial of treatment, with an allocation ratio 1:1 and framework of superiority. Participants The study will be conducted at Centro Hospitalar Entre Douro e Vouga, Santa Maria da Feira, Portugal. Potential participants will be adult patients (≥18 years old) hospitalized in ICU with respiratory insufficiency due to COVID-19, who are referred to respiratory and functional rehabilitation. Only patients approved by physical rehabilitation doctors to perform respiratory and functional rehabilitation will be considered potential participants. To be eligible for inclusion participants must have been independent in their activities of daily living before the onset of critical illness (verbal statement by their proxy) and have to meet the safety criteria defined by the Portuguese Society of Physical Rehabilitation Medicine. Intervention and comparator Both groups will receive usual medical and nursing care in the ICU, which involves assessment and treatment of the respiratory system and may include positioning, hyperinflation techniques and suctioning. The physical function of the patient is assessed, and active bed exercises and mobility are encouraged as soon as possible and may include sitting out of bed. The intervention group will receive a functional and respiratory multidisciplinary rehabilitation protocol (that includes medical, nursing, physiotherapy and occupational therapy interventions) during their entire hospital stay. After reassurance that the patients fulfil the safety criteria, they will initiate the rehabilitation protocol, individualized to each patient based on the clinical status. The rehabilitation interventions and exercises implemented will be consistent with recommendations from the Portuguese Society of Physical Rehabilitation Medicine. The intervention will occur 6 days per week (Monday to Saturday), fifteen minutes, twice per day for each participant. Throughout all activities, progression will be increased successively, depending on the individual’s tolerance and stability. After discharge, the intervention group will continue with rehabilitation exercises, prescribed by physical rehabilitation doctors. These exercises are designed for the patient to do at home, and then report their execution to rehabilitation nurses through teleconsultation, until 12 weeks after ICU discharge. Main outcomes Baseline descriptive data collection will include age, sex, comorbidities and date of admission to ICU. The need of mechanical ventilation and length of use, as well as the need for oxygen therapy, length of ICU stay (days/hours), incidence of ICU readmission, discharge destination and survival will also be recorded. Prior to intervention, every two days and at discharge, participants will be evaluated using the following scales: Glasgow Coma Scale, Richmond Agitation Sedation Scale, Chelsea Critical Care Physical Assessment, 5 standardized questions for cooperation, Medical Research Council Sum-Score, Handgrip strength test and Medical Research Council dyspnea scale. At discharge, Borg Rating of Perceived Exertion will be evaluated. The primary outcome measure will be functional capacity using the 6-Minute Walk Test, and it will be measured at discharge and at the 4-week and 12-week mark. Medical Research Council Sum-Score, Handgrip strength test, Medical Research Council dyspnea scale and Borg Rating of Perceived Exertion will also be re-evaluated at the 4-week and 12-week mark. The health related quality of life will also be used as an outcome measure, using the 12-Item Short Form Survey, at 12 weeks of follow-up. Randomisation Participants will be divided into two groups, standard care and intervention, by means of balanced randomization at a 1:1 ratio using blocks of 10 participants. The randomization sequence is going to be created using a free software (http://www.randomized.org/). In order to ensure the confidentiality of the randomisation sequence, this process will be conducted by an assessor external to the study. Blinding (masking) The evaluators in the study will be blinded during the entire process. The evaluators will be unaware of the study objectives and the randomized distribution of patients to study groups and will not have access to the randomization sequence. Although blinding for patients will not be possible to achieve completely, subjects will be unaware of other treatment modalities, and they will not know if they belong to the intervention or standard group. As for the treating physiotherapists and ICU staff, blinding will not be possible to achieve, but they will not be responsible for assessing outcomes. Numbers to be randomised (sample size) We plan to randomise 40 participants to each group. 80 participants in total. Trial Status This is the second and definitive protocol version, dated from 26th February 2021. Recruitment started on 8th March 2021. Participants will be recruited between March 8, 2021, and June 8, 2021. Study completion is expected to be October 2021. Trial registration ReBEC RBR-7rvhpq9. Registry name: The effect of rehabilitation in hospitalized COVID-19 patients. Registered on 17 March 2021.Retrospectively registered. Full protocol “The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol”.

Introduction With obesity reaching pandemic proportions, its detrimental influence on many health-related conditions has recently become a focus of research. Musculoskeletal (MSK) pain is one of several disorders associated with obesity. Materials and methods This study was designed to identify MSK pain in individuals with severe obesity, recruited from a specialized obesity clinic, and to evaluate the correlation between the MSK symptoms and some individual criteria. Results In 466 patients (342 females and 124 males), with a mean BMI of 42,77 ± 5.64 kg/m², 90,3% reported MSK pain. Severe pain was reported by 57,8% of female vs 26,6% of male patients. Female patients showed higher mean pain level when compared with males. Body sites with a higher prevalence of pain were: knee (63.5%), lumbar region (46.8%), hip (29%) and ankle (23%), with a predominance of severe pain. BMI have shown a positive correlation to numeric rating scale score in female participants in three body regions: shoulder (P = 0.010), knee (P = 0.042) and ankle (P = 0.024). Body sites with higher pain prevalence were especially in areas of increased mechanical load. Conclusions Understanding the relationship between obesity and pain may provide insights into preventive measures and therapeutic strategies for MSK pain. Persistent MSK pain is a significant problem in obese patients that can have a negative relationship with quality of life and function. This fact highlights the importance that patients with obesity may have access to interdisciplinary care, for the prevention and rehabilitation of MSK disorders. To further understand this association, more robust studies are needed.

Anatomy is an essential subject of the medical curriculum. Despite its relevance, the curricular time and logistical resources devoted to teaching anatomy are in decline, favoring the introduction of new pedagogical approaches based on computer-assisted learning (CAL). This new pedagogical approach provides an insight into students' learning profiles and features, which are correlated with knowledge acquisition. The aim of this study was to understand how training with CAL platforms can influence medical students' anatomy performance. A total of 611 medical students attending Musculoskeletal Anatomy (MA) and Cardiovascular Anatomy (CA) courses were allocated to one of three groups (MA Group, CA Group, and MA + CA Group). An association between the performance in these anatomy courses and the number of CAL training sessions was detected. In the MA Group (r = 0.761, P < 0.001) and the MA + CA Group (r = 0.786, P < 0.001), a large positive correlation was observed between musculoskeletal anatomy performance and the number of CAL training sessions. Similarly, in the CA Group (r = 0.670, P < 0.001) and the MA + CA Group (r = 0.772, P < 0.001), a large positive correlation was observed between cardiovascular anatomy performance and the number of CAL training sessions. Multiple linear regression models were performed, considering either musculoskeletal or cardiovascular anatomy performance as the dependent variable. The results suggest that using CAL platforms to study has a positive dose-dependent effect on anatomy performance. Understanding students' individual features and academic background may contribute to the optimization of the learning process.

Background The employment rates of people with disabilities (PWDs) are lower than the general population in many countries because of several factors, including prejudices about labour production and absenteeism of these workers. Objective The objective of the research was to evaluate the absenteeism of PWDs in the construction industry in the metropolitan area of Recife, Pernambuco, Brazil. Methods Study participants were workers with disabilities that performed jobs at the work sites in the construction industry. Participants were interviewed and they answered the Work Limitation Questionnaire (WLQ). In order to compare the absenteeism of people with disabilities and without disabilities, the companies provided real absenteeism data. Results Twenty-five workers with disabilities participated in the study, of which 32% were laborers and 72% had physical disabilities. The companies made accommodations for 56% of PWDs and all of them were the organizational type. The WLQ summed score of the PWDs was 3.16. The mean absenteeism of the PWDs was 19.00% ±1.22 standard deviation (SD) (p = 0.238) higher in relation to workers without disabilities. Conclusions Most of the workers with disabilities had lower absenteeism than those without disability, however, the mean absenteeism of PWDs was higher in relation to workers without disabilities. In addition, workers higher educational level, the laborer of auxiliary warehouse, the workers for whom the companies have not made accommodations to the workplace and the higher WLQ summed score lower statistically significantly absenteeism in relation to workers without disabilities.

AIM The purpose of this study was to evaluate the influence of widening the apical root canal preparation (RCP) on the efficiency of different ethylenediaminetetraacetic acid (EDTA) agitation protocols on smear layer removal: EDTA; EDTA + Easy Clean in rotary movement (ECROT); EDTA + Easy Clean in reciprocating movement (ECREC); and EDTA + Passive ultrasonic irrigation (PUI). MATERIALS AND METHODS A total of 80 mandibular premolars had their crowns sectioned and then were divided into two groups according to widening: size 25 or 40, 0.08 taper. Sequentially they were once again allocated to subgroups according to the agitation protocol performing eight experimental groups (n = 10). Ten additional teeth were prepared for controls (C+/C-). The specimens were then submitted to the cleaning protocols and thereafter cleaved and microphotographed by variable pressure scanning electron microscopy (SEM) at previously determined points along their root thirds (750*). Scores were attributed to the images, and data were analyzed by the Kruskal-Wallis, Student-Newman-Keuls and Friedman tests. RESULTS A higher widening was observed to have a positive influence on cleaning efficiency offering significant differences in global and apical third evaluations (p < 0.05). Relative to the agitation, significant differences were observed mainly in the apical third, with PUI and ECROT providing the best results (p < 0.05); no difference for C+ was observed when higher widening was employed. CONCLUSION A greater widening of the apical third provided a significant improvement in the action of the agitation/activation protocols. Moreover, the PUI and ECROT activation methods were shown to be superior to the use of EDTA solely, particularly in the apical third. CLINICAL SIGNIFICANCE The findings of this study reinforce the need for clinical use of additional methods to complement cleaning. Therefore, it is important for professionals to have knowledge and command of these protocols to obtain more satisfactory results.

The interaction between muscle tension, posture, and vocal use is very complex as clinical research suggests that abnormal laryngeal posture can be associated with muscle adaptive changes, although specific evidence concerning body posture and voice disorders has been lacking. Thus, the aim of this study was to verify if there were differences in posture, muscle tension and voice between teachers with and without voice complaints.Cross-sectional study.Twenty-four teachers, 6 males and 18 females, were submitted to photogrammetry, muscle tension assessed trough palpation and algometry assessment. Aerodynamic assessment of voice, acoustic and auditory-perceptual analysis of voice were done. Participants were divided into without voice complaints group (WVCG; n = 11) and voice complaints group (VCG; n = 13) based on Sociodemographic and Clinical Questionnaire completion.For auditory-perceptual analysis, VCG showed a significant higher values on GRBASH subscales Grade (p0.001) and Roughness (p = 0.011). The VCG showed statistically significant higher values on muscle tension of suprahyoids (p = 0.001), thyrohyoids (P = 0009) and cricothyroids muscles (p = 0.040) and statistically significant lower values on algometry of the cricothyroid (p = 0.023 left and p = 0.026 right), suprahyoids (p = 0.017 leftp = 0.018 right), thyrohyoids (p = 0.006 left and p = 0.007 right) and pharyngolaryngeal (p = 0.016 left and p = 0.021 right) muscles of both sides. Concerning the aerodynamic assessment of voice and acoustic analysis of voice, no statistically significant differences between the groups were found.Findings indicated statistically significant differences in muscle tension in laryngeal intrinsic muscles and auditory-perceptual analysis between teachers with and without voice complaints.

This study aimed to analyze the chemical-physical properties, including pH, volumetric change, radiopacity, and apatite-forming ability in simulated body fluid, of a new tricalcium silicate material (MTA Flow; Ultradent Products Inc, South Jordan, UT).MTA Flow was tested in comparison with MTA Angelus (Angelus, Londrina, PR, Brazil). The pH of soaking water was tested up to 168 hours in deionized water. In the solubility test, the root-end fillings of 20 acrylic teeth were scanned twice by micro-computed tomographic imaging before and after immersion in ultrapure water for 168 hours. In addition, using an aluminum step wedge, the radiopacity of each material was evaluated as recommended by international standards. The mean gray values of the test materials were measured using ImageJ software (National Institutes of Health, Bethesda, MD). The morphologic and chemical analyses of the material surface were performed using scanning electron microscopic energy-dispersive X-ray spectroscopic analysis after 28 days in Hank's balanced salt solution (HBSS). The data were analyzed using 2-way analysis of variance with the Student-Newman-Keuls test (P .05).MTA Flow showed similar alkalizing activity to that of MTA Angelus. In the solubility test, both materials presented lower values without statistical differences. Both materials showed a marked alkalinizing activity within 3 hours, which continued for 168 hours. MTA Angelus showed statistically higher radiopacity values (P .05). All materials showed the ability to nucleate calcium phosphate on their surface after 28 days in HBSS.MTA Flow showed remarkable alkalinizing capability, low solubility, good radiopacity, and the ability to form calcium phosphate deposits after being soaked in simulated body fluid, showing values similar to those of MTA Angelus.

The time, material, and staff-consuming nature of anatomy's traditional pen-and-paper assessment system, the increase in the number of students enrolling in medical schools and the ever-escalating workload of academic staff have made the use of computer-based assessment (CBA) an attractive proposition. To understand the impact of such shift in the assessment method, an experimental study evaluating its effect on students' performance was designed. Additionally, students' opinions toward CBA were gathered. Second-year medical students attending a Clinical Anatomy course were randomized by clusters in two groups. The pen-and-paper group attended two sessions, each consisting of a traditional sectional anatomy steeplechase followed by a theoretical examination, while the computer group was involved in two similar sessions conducted in a computerized environment. At the end of each of the computer sessions, students in this group filled an anonymous questionnaire. In the first session, pen-and-paper group students scored significantly better than computer-group students in both the steeplechase (mean ± standard deviation: 66.00 ± 14.15% vs. 43.50 ± 19.10%; P

N/a.

Made available in DSpace on 2019-10-06T17:02:46Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-01-01. Added 1 bitstream(s) on 2019-10-09T18:35:45Z : No. of bitstreams: 1 S1806-83242019000100208.pdf: 882996 bytes, checksum: c123fd6f2497206fb010c04c10f8bd50 (MD5) We assessed the effect of a new coating material based on resin-modified glass-ionomer with calcium (Ca) in inhibiting the demineralization of underlying and adjacent areas surrounding caries-like lesions in enamel. The measures used were surface hardness (SH) and cross-sectional hardness (CSH). Thirty-six bovine enamel specimens (3 × 6 × 2 mm) were randomly allocated into three groups (n = 12): No treatment (NT); resin-modified glass-ionomer with Ca (Clinpro XT Varnish, 3M ESPE) (CL), and fluoride varnish (Duraphat, Colgate) (DU). The specimens were subjected to alternated immersions in demineralizing (6 h) and remineralizing solutions (18 h) for 7 days. SH measurements were conducted at standard distances of 150, 300, and 450 μm from the treatment area. CSH evaluated the mean hardness profile over the depth of the enamel surface and at standard distances from the materials. The energy-dispersive X-ray spectroscopy analysis was conducted to evaluate the demineralization bands created on the sublayer by % of calcium (Ca), phosphorus (P), and fluoride (F). Ca/P weight ratio was also calculated. Based on SH and CSH measurements, there was no difference between groups at the distances 150 μm (p = 0.882), 300 μm (p = 0.995), and 450 μm (p = 0.998). Up to 50 μm depth (at 150 μm from the treatment area), CL showed better performance than DU ( p< 0.05). NT presented higher loss of Ca and P than CL and DU (p < 0.05). There was no significant difference in the % of F ion among the three groups. The new coating material was similar to F varnish in attenuating enamel demineralization. Universidade de São Paulo - USP Bauru School of Dentistry Department of Operative Dentistry Endodontics and Dental Materials Universidade Estadual Paulista - Unesp Faculty of Science Department of Mathematics Universidade Estadual Paulista - Unesp Faculty of Science Department of Mathematics

The aim of this randomized controlled study was to evaluate the accuracy of Root ZX, iPex and YS-RZ-A apex locators in tooth with incomplete apices. Material and methods: Thirty human mandibular pre-molars without dental caries, fracture and with 1-3mm apical diameter and ¾ of root development stage were used. After coronal access, tooth length was determined with the visualization of a K-file, compatible with the root canal diameter, at the apex. To determine the root canal length using electronic methods, the teeth were included in alginate. The 30 teeth were measured with the three apex locators until achieving the apex foramen. During the measurement, the canals were inundated with 1% sodium hypochlorite. Statistical analysis was performed using Qui-square test (p < 0.05).Results: The Root ZX apex locator showed the higher accuracy (53.3%), with statistical difference in relation to iPex apex locator (33.3%) and YS-RZ-A apex locator (26.7%) (p < 0.05). Regarding the security limit of ±1 mm, the Root ZX apex locator did not show statistical difference in comparison with iPex apex locator (p > 0.05), but both were statistically different in relation to YS-RZ-A apex locator (p < 0.05). Conclusion:The results showed that all the studied apex locators were efficient in determining the root canal length in tooth with incomplete apex, considering the tolerance of ±1 mm. The Root ZX apex locator showed the highest accuracy with 100% of agreement.

Accidental sodium hypochlorite extrusion can occur during endodontic irrigation procedures. The symptoms appear immediately and include severe pain, swelling, and probable tissue necrosis adjacent to the root of the treated tooth. Treatment of sodium hypochlorite extrusion involves immediate and copious saline irrigation to neutralize the area and prescription of analgesic, anti-inflammatory, and antibiotic medications. Low-level laser therapy (LLLT) might be useful as an adjuvant treatment for damaged soft tissues to improve healing. This case report describes the treatment of accidental extrusion of 1% sodium hypochlorite through a root canal perforation in a mandibular incisor during endodontic treatment. The extrusion caused minor swelling within the mentolabial sulcus and a large area of necrosis in the gingivolabial mucosa and right edentulous premolar area. Conventional treatment was performed in association with LLLT. Clinical and radiographic examinations after 6 months showed complete healing of the necrotic area without paresthesia and the repair of apical tissues.

Made available in DSpace on 2018-12-11T17:20:55Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-08-01 Objectives: To evaluate the effect of desensitizing agent containing calcium phosphate nanoparticles on the bond strength of etch-and-rinse adhesive system (Scotchbond Multi-Purpose), presence of precipitate, dentinal tubule obliteration and hybrid layer formation in dentin in comparison with potassium nitrate plus sodium fluoride or strontium chloride compounds. Methods: 150 bovine incisors were treated with (n = 10): G1, Desensibilize Nano P (Ca3(PO4)2+5%KNO3+0.9%NaF); G2, Desensibilize (10%SrCl2+5%KNO3); G3, Desensibilize KF2% (5%KNO3+0.2%NaF); G4, Ultra EZ (3%KNO3+0.25%NaF) and G5, no treated (control). Scanning electron microscopy was used to assess the incidence of precipitates (500×) and obliterated dentinal tubule counts (1.000×). The adhesive system was used after all desensitization treatments. The bond strength (n = 40) and the fracture pattern were evaluated. Confocal laser microscopy was used to quantify the hybrid layer formation in dentin. Results: G1 and G2 presented higher adhesive system bond strength (MPa) than G4 and G5, however no significant differences were observed in comparison with G3. Cohesive fracture was frequently found: G1 (58.5%), G2 (51.3%) and G3 (43.8%). G1 showed the highest incidence of precipitates and the highest number of blocked dentinal tubules. G1 and G2 presented similar hybrid layer formation and the highest hybrid layer formation values. Conclusions: Desensibilize Nano P (G1) favored the bond strength of the adhesive system to dentin, increased the precipitation of residues, obliteration of dentinal tubules, and hybrid layer formation in comparison with other agents. Clinical relevance: Desensitizers promote dentin obliteration, however, may affect dentin bonding. Restorative Dentistry Department Araraquara Dental School São Paulo State University (Unesp) Dentistry Endodontic and Dental Materials Department Bauru Dental School São Paulo University Restorative Dentistry Department Ribeirão Preto Dental School São Paulo University Restorative Dentistry Department Araraquara Dental School São Paulo State University (Unesp)

The aim of this study was to compare the efficacy of passive ultrasonic irrigation and EasyClean for removing residual filling material in retreatment. Twenty-two maxillary lateral incisors with apical curvature were instrumented with ProTaper files and filled with Endofill using the lateral compactation technique. Removal of filling material was performed with Reciproc, Mtwo and ProDesign Logic 50/.01 files. The teeth were inserted in a silicone mould, which was placed in a metal muffle, and split to visualize the residual filling material. The samples were divided into two groups (n = 11) according to the irrigation protocol: Passive ultrasonic irrigation (PUI group) with 3 activations of 20 seconds and EasyClean (Easy Equipamentos Odontológicos, Belo Horizonte, Brazil) (EC group) used in continuous rotation with 3 activations of 20 seconds, both using NaOCl and EDTA. Environmental scanning electron microscopic images of the apical, middle, and cervical thirds were taken before and after the irrigant activation. The Kappa test was used to determine interexaminer agreement. Statistical analysis was performed using Kruskal–Wallis, Mann–Whitney, and Wilcoxon tests (p < 0.05). PUI and EC improved the removal of remnant filling material in all root canal thirds (p < 0.05). PUI and EC presented similar performance in the final step of retreatment (p > 0.05). No significant difference was observed in the removal of filling material in the apical, middle, and cervical thirds in both groups (p > 0.05). EasyClean in continuous rotary motion is useful in retreatment and was shown to be as effective as ultrasonic activation in the removal of remnant filling material.

Objective: To examine whether company compliance with RS-17 influences the characterization of the casual nexus in physical therapists' expert reports of cumulative trauma disorders in the labor court of Pernambuco, Brazil. Method: The sample was composed of seven physical therapists who provided expert testimony regarding cumulative trauma disorder cases in the labor court of Pernambuco, Brazil. Data collection was performed across two stages. In the first stage, the experts answered a sociodemographic survey and requested the identification numbers of recent cases where expert testimony was provided to characterize the causal nexus. In the second stage, the researchers went to the labor court to collect expert testimony data. These experts indicated that of 75 total cases, 31% (N=23) of the companies fulfilled RS-17, whereas 69% (N=52) did not comply with the law. Results: Among the organizations that complied with legislation, 30% of the analyzed expert testimonies showed a positive causal nexus. However, of the companies that did not comply with RS-17, 71% of the expert testimonies revealed a causal nexus. These results indicate that the breach of the law increases the probability that a causal nexus will be determined by 54.8%. Conclusion: The results showed that failure to comply with RS-17 significantly increases the probability that a causal nexus will be determined in physical therapists' expert testimony of cumulative trauma disorders.

This study aimed to analyze the influence of two different vehicles for MTA manipulation on color alteration, chemical characteristics, and radiopacity after immersion in blood or distilled water (DW). In addition, some physical-chemical properties, volumetric solubility and bioactivity of new brands of calcium silicate cements such as MTA Repair HP, MTA Vitalcem and MTA Flow were compared with MTA Angelus. MTA Angelus mixed with 100% Distilled Water (DW) or 80% DW/20% propylene glycol (PG) as vehicles were placed into rubber rings and incubated at 37°C and 100% relative humidity. Color assessment and scanning electron microscopy/energy-dispersive spectroscopy (SEM/EDX) analysis were performed after setting and repeated after 7, 15, and 30 days after immersion in blood and DW. The data were analyzed by using Kruskal-Wallis followed by the Dunn test. The association of 80% DW/20% PG used as vehicle presented significantly lower color alterations compared with 100% DW, when immersed in blood (p < 0.05). All samples surfaces displayed loss of bismuth after immersion in both media and consequently a decrease in radiopacity was observed with significant results after 30 days. This study showed that ratio of 80% DW/20% PG as a vehicle for MTA Angelus results in a lower color alteration when in contact with blood. The physical-chemical properties such as radiopacity, calcium release, the pH change, solubility, water sorption, porosity, surface morphology, and bioactivity of MTA Repair HP and MTA Vitalcem were compared with MTA Angelus. Water absorption, interconnected pores and apparent porosity were measured after 24h-immersion in DW at 37ºC. Calcium and pH were tested up to 28d in DW. Morphological and chemical analyses of the material surfaces were performed by using ESEM-EDX after 28d in HBSS. All the materials showed good bioactivity after 28d in HBSS. The data were analyzed by using two-way ANOVA followed by the RM Student-Newman-Keuls test (p

There are few studies that use integrated evaluation instruments for the design, preparation and adaptation of orthoses that reflect very specifically the physical conditions of the patients. Therefore, the present study aimed the application of integrated instrumentation for the development of assistive technology products for patients of the Psychiatry Institute of Santa Catarina (IPq-SC). As instruments we used infrared thermography, surface electromyography, manual dynamometry and motion capture by inertial sensors, along with a collection protocol established by the team through observation and audiovisual recordings of the activities. As a result, we obtained data suitable for the diagnosis of the physical condition of the patient, requiring some adjustments into the collection process in order to respect the physical and cognitive limitations of the patients. In addition, the collection and the use of data should take into account the appropriate instruments of analysis and the factors that may influence the results.

Due to scientific and technological development, Medical Education has been readjusting its focus and strategies. Medical curriculum has been adopting a vertical integration model, in which basic and clinical sciences coexist during medical instruction. This context favours the introduction of new complementary technology-based pedagogical approaches. Thus, even traditional core sciences of medical curriculum, like Anatomy, are refocusing their teaching/learning paradigm.We performed a bibliographic review aiming to reflect on Medical Education's current pedagogical trend, by analysing the advantages of the introduction and diversification of pedagogical approaches in Anatomy Education.Anatomy Education's status quo is characterized by: less available teaching time, increasing demands from radiology and endoscopy imaging and other invasive and non-invasive medical techniques, increasing number of medical students and other logistical restrains exposed by the current Medical Education scenario. The traditional learning approach, mainly based on cadaveric dissection, is drifting to complementary newer technologies - such as 3D models or 2D/3D digital imaging - to examine the anatomy of the human body. Also, knowledge transfer is taking different channels, as learning management systems, social networks and computer-assisted learning and assessment are assuming relevant roles.The future holds promising approaches for education models. The development of Artificial Intelligence, Virtual Reality and Learning Analytics could provide analytic tools towards a real-time and personalized learning process.A reflection on Anatomy Education, as a comprehensive model, allows us to understand Medical Education's complexity. Therefore, the present Medical Education context favours a blended learning approach, in which multi-modality pedagogical strategies may become the landmark.Introdução: A Educação Médica, face ao desenvolvimento científico e tecnológico, reajustou o enfoque. Progressivamente, o programa curricular em Medicina tem adotado o modelo vertical. Neste modelo, ciências básicas e clínicas coexistem ao longo da formação médica. Este contexto favorece a introdução de novas abordagens pedagógicas de base tecnológica. De facto, áreas de conhecimento tradicionais, como Anatomia, igualmente refocalizaram o seu paradigma de ensino. Material e Métodos: Nesse sentido, realizamos uma revisão bibliográfica com objetivo de refletir a tendência pedagógica atual da Educação Médica, analisando as vantagens da introdução/diversificação de abordagens pedagógicas em Anatomia. Resultados: O status quo da Anatomia é caracterizado por menor tempo disponível para o ensino, pela expansão da imagiologia radiológica e endoscópica, bem como, de outras técnicas médicas invasivas/não-invasivas, pelo aumento do número de estudantes e por restrições logísticas inerentes ao presente contexto da Educação Médica. A abordagem pedagógica tradicional, alicerçada na disseção cadavérica, vem sendo complementada por novas tecnologias auxiliares (modelos 3D ou imagiologia digital 2D/3D) ao estudo anatómico. Também, a transmissão de conhecimento vem adotando diferentes vias. Assim, os Sistemas Gestores de Aprendizagem, redes sociais ou plataformas de aprendizagem/avaliação virtuais assumem papéis relevantes. Discussão: O futuro reserva metodologias educativas promissoras. O desenvolvimento de Inteligência Artificial, da Realidade Virtual e a aplicação dos princípios de Learning Analytics favorece a disponibilização de ferramentas analíticas ao processo de aprendizagem em tempo-real, personalizando-o. Conclusão: A reflexão sobre a Educação em Anatomia, como modelo compreensivo, permite perceber a complexidade da Educação Médica. Assim, o presente contexto favorece a perspectiva de blended learning, sustentada em estratégias pedagógicas multimodais.

Made available in DSpace on 2018-12-11T16:46:57Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-06-01 Introduction The aim of the study was to investigate the addition of variable amounts of zinc oxide to inhibit dental discoloration caused by mineral trioxide aggregate (MTA) Angelus. Methods MTA Angelus and MTA with additions of 5%, 15%, and 45% zinc oxide (ZnO) in weight were tested. The set cements were characterized by using a combination of scanning electron microscopy, energy dispersive spectroscopy, and x-ray diffraction. Radiopacity and setting time were analyzed according to American National Standards Institute/American Dental Association (57/2012) and American Society for Testing and Materials (C266-08). Volume change was evaluated by using micro–computed tomography analysis. The pH and calcium ion release were measured after 3 hours, 24 hours, and 28 days. Dental discoloration in contact with the cements was measured after 24 hours, 28 days, and 90 days. Biocompatibility to subcutaneous implantation in rats was verified after 30 and 60 days. Results Addition of ZnO did not alter significantly the radiopacity, setting time, volume change, pH, and biocompatibility compared with MTA Angelus (P >.05). Calcium ion release increased with addition of ZnO (P

This study analyzed the quality of obturation and physical properties of MTA Fillapex and AH Plus sealer. A sample of 30 human maxillary central incisors were instrumented with Protaper until a F5 (50/05) file. Both sealers were mixed with Rhodamine-B dye to allow visualization on a confocal laser-scanning microscope (CLSM). Next, the canals were filled using the single cone technique. After setting, all samples were sectioned at 2, 4, and 6 mm from the apex. CLSM was used to analyze the gaps and sealer penetration into the dentinal tubules. All samples were scanned 10 mu m below the dentin surface and images were recorded at 100x magnification using the fluorescent mode. Additionally, the solubility, flowability and setting time of the sealers were evaluated. All the measured quantities of the examined materials were evaluated for significant differences by means of statistical analysis. The CLSM analysis of the MTA Fillapex showed the highest percentage of gaps at all sections (P = 0.0001). Physical tests revealed adequate properties for both sealers except for a higher solubility of the MTA Fillapex (P = 0.0001). The MTA Fillapex presented flowability and intratubular penetration similar to the AH Plus. Nevertheless, the MTA Fillapex sealer presented a higher solubility and considerable quantity of gaps between the sealer/dentin interface in relation to the AH Plus sealer. Clinicians must take into consideration, the quality of endodontic sealers as it is essential in the outcome of the root canal filling. Microsc. Res. Tech. 77:1031-1036, 2014. (c) 2014 Wiley Periodicals, Inc.

Aim To evaluate the effect of individual and combined use of sodium hypochlorite (NaOCl), etidronate (HEDP) and ethylenediaminetetraacetic acid (EDTA) in tissue dissolution. Methodology Sixty fragments of bovine muscle tissue were prepared and their weights determined on a precision scale. The samples were then distributed in the following groups (n = 10): G1 – saline solution (control); G2 – 17% EDTA; G3 – 18% HEDP; G4 – 2.5% NaOCl; G5 – mixture of 5% NaOCl + 17% EDTA; and G6 – mixture of 5% NaOCl + 18% HEDP. The specimens in each group were immersed in the solutions for 5, 10 and 15 min and reweighted at each time period. Analysis of variance (anova) and Tukey's multiple-comparison tests (α G5 = G3 = G2 = G1 after 5 min of immersion and G4 > G6 > G5 = G3 = G2 = G1 after 10 and 15 min of immersion. Conclusion The only solution capable of dissolving organic matter was NaOCl. In the mixtures analysed, this ability was arrested by EDTA; however, it was minimally affected by the HEDP, proving that this combination, if used during the biomechanical preparation, is able to dissolve of organic matter.

Objectives: To investigate if there is a relation between the increase of bismuth oxide and the decrease of pH levels and an intensification of toxicity in the Portland cement. Material and Methods: White Portland cement (WPC) was mixed with 0, 15, 20, 30 and 50% bismuth oxide, in weight. For the pH level test, polyethylene tubes were filled with the cements and immersed in Milli-Q water for 15, 30 and 60 days. After each period, the increase of the pH level was assessed. For the biocompatibility, two polyethylene tubes filled with the cements were implanted in ninety albino rats (n=6). The analysis of the intensity of the inflammatory infiltrate was performed after 15, 30 and 60 days. The statistical analysis was performed using the Kruskal-Wallis, Dunn and Friedman tests for the pH level and the Kruskal-Wallis and Dunn tests for the biological analysis (p0.05). For the inflammatory infiltrates, no significant statistical differences were found among the groups in each period (p>0.05). The 15% WPC showed a significant decrease of the inflammatory infiltrate from 15 to 30 and 60 days (p

Objective: This study was aimed at evaluating the influence of cervical preflaring using LA-Axxes No. 1 bur (SybronEndo, Glendora, USA) or S1 and SX ProTaper files (Dentsply Maillefer, Ballaigues, Switzerland) on the accuracy of the Electronic Apex Locators (EALs): Root ZX mini (J. Morita Corporation, Tokyo, Japan), and Joypex 5 (Denjoy, Changsha, China). Methods: Thirty mandibular incisors were accessed, and the root canal length (RCL) was determined with a K-file #15, with the aid of a stereo microscope. Afterwards, the specimens were divided into 2 groups (n = 15) referring to the cervical preflaring with LA-Axxess or ProTaper files. The teeth were embedded in alginate and the RCL was determined by the EALs before and after preflaring. Data were classified into: accurate, if the difference in RCL measurement were ≤0.05 mm; and inaccurate, if the difference were >0.5 mm or beyond the RCL. Results: McNemar's test (α 0.05) after the cervical preflaring, regardless of the used instrument. Conclusion: The preflaring procedure increased the number of accurate measurements for both EALs, with statistical difference for Joypex 5 when the preflaring was performed with LA-Axxess. However, after the cervical preflaring, the EALs showed similar accuracy, regardless of the used instrument. RESUMO Objetivo: Avaliar a influência do preparo cervical utilizando a broca LA-Axxess nº 1 (SybronEndo, Glendora, EUA) ou os instrumentos ProTaper S1 e SX (Dentsply Maillefer, Ballaigues, Suíça) na precisão dos Localizadores Apicais Eletrônicos (LAEs): Root ZX mini (J. Morita Corporation, Tóquio, Japão) e Joypex 5 (Denjoy, Changsha, China). Métodos: Trinta incisivos inferiores foram acessados e o comprimento do canal radicular (CCR) determinado com uma lima K #15 com o auxílio de um estereomicroscópio. Em seguida, os dentes foram distribuídos em dois grupos (n=15) referentes ao preparo cervical com LA-Axxess ou instrumentos ProTaper. Os dentes foram incluídos em alginato e o CCR determinado pelos LAEs antes e após o preparo cervical. Os dados foram classificados em: precisos, se a diferença na medida do CCR era ≤ 0,05 mm; e imprecisos, se a diferença era >0,5 mm ou estava além do CCR. Resultados: O teste de McNemar (α0,05) após o preparo cervical, indiferente do instrumento utilizado. Conclusão: O preparo cervical aumentou o número de medições precisas dos LAEs, com diferença estatística para Joypex 5 após o uso da LA-Axxess, contudo os aparelhos apresentaram precisão similar após o preparo cervical, indiferente do instrumento utilizado.

Introduction This study aimed to describe the anatomy of the mandibular incisors by using micro–computed tomography. Methods Mandibular incisors (n = 340) were scanned at 19-μm voxel size resolution, and the numbers of canals were classified according to Vertucci classification, as well as the major and minor diameters of the root and root canals, presence of oval canals, and three-dimensional analysis of the apical third were also measured. Data were presented in terms of median and range for each anatomic classification. Results Overall, the specimens had 1 root canal (N = 257). The second most prevalent anatomy was Vertucci type III (N = 56). These anatomies represent 92% of the sample. The medians of the major diameter at the 1-, 2-, and 3-mm level of the most prevalent anatomies were 0.36, 0.39, and 0.47 mm for type I and 0.41, 0.51, and 0.66 mm for type III, respectively. The apical volume appears to be constant among these anatomies (0.63 and 0.59 mm3). Oval canals were found at the 1-mm apical level, with a prevalence of 16.7% for Vertucci type I and 37.5% for Vertucci type III. The presence of oval canals increased at the 3-mm apical level to 32.4% and 76.2% for Vertucci type I and III classifications, respectively. Conclusions Type I and III configurations represent 92% of the mandibular incisors studied. Within these anatomic configurations, oval-shaped canals in the apical third were not uncommon and more prevalent in the type III anatomy.

The aim of this study was to evaluate the physical, chemical, and biological properties of mineral trioxide aggregate (MTA) mixed with 80% distilled water and 20% propylene glycol (PG) compared with MTA mixed with distilled water only.Flowability, film thickness, and solubility were analyzed according to American National Standards Institute/American Dental Association specification 57/2000. Initial and final setting times were assessed according to American Society for Testing and Materials specification C266/08. Porosity was assessed by using mercury intrusion porosimetry after 1 and 28 days of hydration, and the pH and calcium ion release were assessed after 3, 24, 72, and 168 hours. For the tissue reaction, the cements were implanted in 24 albino rats (2 groups, n = 12). An analysis of the inflammatory infiltrate was performed after 15, 30, and 60 days.MTA + PG exhibited lower film thickness and higher final setting time. No differences were verified for flowability (P .05). MTA + PG showed high porosity at 1 day of hydration (P .05). All the test cements demonstrated an alkaline pH. Microscopic analysis of the specimens revealed neoformation of connective tissue in contact with the cements.The introduction of PG as a mixing vehicle alters the physical and chemical properties of MTA and is biologically acceptable.

This article presents the results of a survey carried out on leading periodicals in the areas of Ergonomics, Physiotherapy and Occupational Therapy, the aim of which was to identify scientific publications on the inclusion at work of people with disabilities. The survey of articles published on this topic in the following journals was conducted in December 2010: Applied Ergonomics, Ergonomics, the International Journal of Industrial Ergonomics, Disability and Rehabilitation, and the Journal of Occupational Rehabilitation. The survey covered issues published between 2000 and 2010 and was conducted electronically using the CAPES Periodicals Portal. To collect the articles, it was necessary to check the articles published in each of the issues of each volume of these periodicals. This is how the articles on the topic in question were found. There were 27 articles on the topic of inclusion at work of people with disabilities, of which 13 were published in the Journal of Occupational Rehabilitation and 12 in Disability and Rehabilitation. Thus, it is clear that the issue in question is still a subject that is seldom dealt with in these publications and it is noted that only two articles were published in Ergonomics journals in this period, thus confirming the paucity of scientific publications on this subject.

The aim of this paper is to present the results of the evaluation of the job of bricklayer in the construction industry to determine the profile of workers with disabilities who could perform this function and what adjustments are needed. The methods and techniques used in the field study were: direct observation of the activities and the environment, interviews with bricklayers on building sites, a video and photographic record of tasks being carried out to analyze the job of bricklayer, software resources were used. This study set out the disabilities most commonly caused by work accidents in the civil construction industry and simulated the conditions of the individuals to determine whether they could perform the activities of this function and what adaptations are needed. It was observed that workers with hearing impairments could perform activities without any change in the workplace and individuals who had had a leg or foot amputated need to use appropriate prostheses to perform the activities of the function. Thus, it was shown that the activity of professionals with experience in Ergonomics is essential since, by the activity of gathering data and analysing the physical, cognitive and organizational requirements of jobs and by collecting data on and analysing the functional capabilities of the worker with a disability, adaptations to jobs can be adequately defined.

The aim of the study was to evaluate the radiopacity, solubility, flow, film thickness, setting time, and adaptation to the root canal walls of 3 epoxy resin-based sealers: AH Plus, Acroseal, and Adseal.Physical tests were performed following American National Standards Institute/American Dental Association's requirements. For interfacial adaptation analysis, 30 maxillary canines were shaped by using ProTaper instruments. The specimens were divided into 3 groups (n = 10): group 1, AH Plus; group 2, Acroseal; and group 3, Adseal. The sealers were mixed with rhodamine B dye, and the canals were filled by using the lateral compaction technique. The percentage of gaps and voids area was calculated at 2, 4, and 6 mm levels from the apex. Statistical evaluation was performed by using analysis of variance for physical analysis and nonparametric Kruskal-Wallis and Dunn tests for interfacial adaptation (P.05).No statistical differences were found for adaptation, percentage of voids, solubility, flow, and film thickness among the sealers (P.05). AH Plus was significantly more radiopaque (P.05). For the setting time, there were statistical differences among all the studied sealers (P.05).AH Plus, Acroseal, and Adseal presented similar root canal adaptation, solubility, flow, and film thickness. Statistical differences were found for radiopacity and setting time (P.05).

Discoloration of mineral trioxide aggregate (MTA) can be exacerbated by the interaction of the cement with body fluids such as blood. This study aimed to analyze the color alteration, chemical characteristics, and radiopacity of MTA manipulated with 2 different vehicles after immersion in blood or distilled water (DW).MTA mixed with 100% DW or 80% DW/20% propylene glycol (PG) as vehicles were placed into rubber rings and incubated at 37°C and 100% relative humidity until set. Color assessment and scanning electron microscopy/energy-dispersive spectroscopy analysis were performed after setting and repeated after 7, 15, and 30 days after immersion in blood and DW. Statistical analysis for color alteration and radiopacity was performed using nonparametric Kruskal-Wallis and Dunn tests (P.05).When 80% DW/20% PG was used as the vehicle, significantly lower color alterations were observed for all time periods compared with 100% DW when immersed in blood (P.05). All surfaces displayed morphologic changes after immersion in both media because of loss of bismuth. A decrease in radiopacity was observed over time in all groups, with a statistically significant difference after 30 days for groups DW immersed in blood and 80% DW/20% immersed in both media (P.05).The ratio of 80% DW/20% PG as a vehicle for MTA results in a lower color alteration when in contact with blood.

This study compared the fluid filtration, adaptation to the root canal walls, and the push-out bond strength of two resin-based sealers and three calcium silicate-based retrograde filling materials. Fifty maxillary canines were shaped using manual instruments and the apical portion was sectioned. Retrograde cavities of 3-mm depth were prepared. The specimens were divided into five groups (n = 10): Sealer 26 (S26); MBPc (experimental); MTA; Portland cement with 20% zirconium oxide (PC/ZO), and Portland cement with 20% calcium tungstate (PC/CT). The fluid filtration was measured at 7 and 15 days. To evaluate the interfacial adaptation, sections of the teeth, 1 and 2 mm from the apex, were prepared and the percentage of gaps was calculated. The push-out bond strength at 2 mm from the apex was evaluated. Statistical analysis was performed using the ANOVA/Tukey’s test (p < 0.05). At 7 and 15 days (p = 0.0048, p = 0.006), the PC/CT group showed higher fluid filtration values when compared to other groups. At 1 mm from the apex, no statistical differences in the adaptation were found among the cements (p = 0.44). At 2 mm from the apex, the PC/ZO group presented statistically lower percentage of gaps than S26, MBPc, and MTA (p = 0.0007). The MBPc group showed higher push-out bond strength than other cements evaluated (p = 0.0008). The fluid filtration and interfacial adaptation of the calcium silicate-based cements were similar to those of the resin-based cements. The resinous cement MBPc showed superior push-out bond strength.

Dental discoloration with use of materials containing bismuth oxide has been reported. It is postulated that the discoloration is a result of chemical interaction of bismuth oxide with dentin. The aim of the study was to analyze dental color alteration and the chemical interaction of bismuth oxide with the main components present in composite (methacrylate) and in dentin (collagen).Fifty bovine teeth were prepared and filled with white mineral trioxide aggregate (MTA) Angelus, Portland cement (PC) with 20% zirconium oxide, or PC with 20% calcium tungstate and then sealed with composite. Triple antibiotic paste and unfilled samples were the positive and negative controls, respectively. The specimens were stored in separate flasks immersed in tap water at 37°C with ambient light blocked out. The color assessment was performed with a spectrophotometer at different intervals, namely before filling and 24 hours, 15 days, and 30 days after filling. The color change and the luminosity were calculated. The statistical analysis was performed by using nonparametric Kruskal-Wallis and Dunn tests (P.05). The interaction of the bismuth oxide, zirconium oxide, and calcium tungstate with collagen and methacrylate was assessed by placing the materials in contact, followed by color assessment.The analysis of color change values showed that all the materials presented color alteration after the evaluated periods. Statistically higher luminosity was verified for PC/20% zirconium oxide in comparison with white MTA Angelus (P.05). The teeth filled with white MTA Angelus demonstrated a grayish discoloration with evident dentin staining. Bismuth oxide exhibited a color change when in contact with collagen.The color of white MTA Angelus was altered in contact with dental structures. Collagen, which is present in dentin matrix, reacted with bismuth oxide, resulting in a grayish discoloration. The use of an alternative radiopacifier to replace bismuth in white MTA is indicated.