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Ensuring microbiological safety in fruit juices while maintaining their nutritional and sensory qualities remains a significant challenge in food processing. Traditional thermal methods, although effective against vegetative pathogens, can degrade important nutrients and are less effective at inactivating bacterial spores. High-pressure carbon dioxide (HPCD) technology has emerged as a promising non-thermal alternative, using CO 2 under high pressure to inactivate spores and enzymes. More importantly, HPCD has shown great potential in preserving the quality of fruit juices. This review assesses recent studies on the use of HPCD in fruit juices, focusing on its effectiveness in reducing spore counts and inactivating enzymes like polyphenol oxidase (PPO) and pectin methylesterase (PME). The impact of HPCD on the physicochemical, nutritional, and sensory attributes of fruit juices, such as vitamin retention, color, and cloudiness, is also examined. Despite HPCD's advantages, challenges remain in optimizing process parameters for consistent microbial inactivation, with variations depending on juice composition and microbial strain. Additionally, while initial costs are high, the long-term economic viability of HPCD is favorable due to lower energy consumption and CO 2 recyclability. Future research should focus on optimizing equipment design and scaling HPCD technology for industrial applications., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Given his role as EIC (Anderson S. Sant'Ana) had no involvement in the peer review of this article and had no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to Dr. Tian Ding., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Gelatin, a versatile protein derived from collagen, is widely used in the food, pharmaceutical and medical sectors. However, bacterial contamination by spore-forming bacteria during gelatin processing represents a significant concern for product safety and quality. In this study, an investigation was carried out to explore the heat and chemical resistance, as well as the identification and characterization of spore-forming bacteria isolated from gelatin processing. The methodologies involved chemical resistance tests with drastic pH in microplates and thermal resistance tests in capillary tubes of various isolates obtained at different processing stages. In addition, phenotypic and genotypic analyses were carried out to characterize the most resistant isolates of spore-forming bacteria. The findings of this study revealed the presence of several species, including Bacillus cereus, Bacillus licheniformis, Bacillus sonorensis, Bacillus subtilis, Geobacillus stearothermophilus, and Clostridium sporogenes, with some isolates exhibiting remarkable chemical and heat resistances. In addition, a significant proportion of the most resistant isolates showed gelatinase activity (n = 19/21; 90.5 %) and the presence of heat resistance (n = 5/21; 23.8 %), and virulence genes (n = 11/21; 52.4 %). The results of this study suggest that interventions should be done in quality control practices and that process parameter adjustments and effective contamination reduction strategies should be implemented through gelatin processing., 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., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Inflammation may contribute to cognitive difficulties in patients with breast cancer. We tested 2 hypotheses: inflammation is elevated in patients with breast cancer vs noncancer control participants and inflammation in patients is associated with worse attention and processing speed over the course of chemotherapy., Methods: Serum cytokines (interleukin [IL]-4, 6, 8, 10; tumor necrosis factor [TNF]-α) and soluble receptors [sTNFRI, II]) were measured in 519 females with breast cancer before and after chemotherapy and 338 females without cancer serving as control participants. Attention and processing speed were measured by Rapid Visual Processing (RVP), Backward Counting (BCT), and Trail Making-A (TMT-A) tests. Linear regression models examined patient vs control cytokines and receptor levels, adjusting for covariates. Linear regression models also examined relationships between patient cytokines and receptor levels and test performance, adjusting for age, body mass index, anxiety, depression, cognitive reserve, and chemotherapy duration. Statistical tests were 2-sided (α = .05)., Results: sTNFRI and sTNFRII increased over time in patients relative to controls, whereas IL-4, IL-6, and IL-10 decreased. Prechemotherapy, higher IL-8 associated with worse BCT (β = 0.610, SE = 0.241, P = .01); higher IL-4 (β = -1.098, SE = 0.516, P = .03) and IL-10 (β = -0.835, SE = 0.414, P = .04) associated with better TMT-A. Postchemotherapy, higher IL-8 (β = 0.841, SE = 0.260, P = .001), sTNFRI (β = 6.638, SE = 2.208, P = .003), and sTNFRII (β = 0.913, SE = 0.455, P = .045) associated with worse BCT; higher sTNFRII also associated with worse RVP (β = -1.316, SE = 0.587, P = .03). At prechemotherapy, higher IL-4 predicted RVP improvement over time (β = 0.820, SE = 0.336, P = .02); higher sTNFRI predicted worse BCT over time (β = 5.566, SE = 2.367, P = .02). Longitudinally, increases in IL-4 associated with BCT improvement (β = -0.564, SE = 0.253, P = .03)., Conclusions: Generally, worse attention and processing speed were associated with higher inflammatory cytokines and receptors and lower anti-inflammatory cytokines in patients; future confirmatory studies are needed., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

The aim of this study was to investigate the combined effect of carvacrol, thymol and nisin against Staphylococcus aureus and the combined effect of carvacrol and thymol against Salmonella Enteritidis. Minimum inhibitory concentrations (MIC) of carvacrol, thymol, and nisin for S. aureus were 200, 150 and 30 µg/mL, respectively. MIC of carvacrol and thymol for Salmonella Enteritidis was 200 µg/mL. A factorial method of independent variables was then used to study the combined effect of antimicrobials. Results showed that combinations of carvacrol-thymol-nisin (reduction of 1.2 log CFU/mL for MIC and 4.98 log CFU/mL for 2MIC), carvacrol-thymol (reduction of 1.33 log CFU/mL for 2MIC), nisin-thymol (reduction of 3.52 log CFU/mL for 2MIC) and nisin-carvacrol (reduction of 3.41 log CFU/mL for 2MIC) attained a significant inhibition of S. aureus. Similarly, there was significant reduction of Salmonella Enteritidis due to combined effect of thymol-carvacrol (reduction of 4.5 log CFU/mL for MIC and inhibition below detection limit for 2MIC). Therefore, the combinations of natural antimicrobials described in this work showed potential to be used as an additional barrier for food safety.

Background: Cancer-related fatigue is a significant problem and is associated with poor quality of life. Behavioral interventions include exercise and cognitive-behavioral therapy, which survivors may be unwilling or unable to adopt. Pharmacologic interventions (e.g., selective serotonin reuptake inhibitors) have been disappointing. One potential therapy is the antidepressant bupropion, a norepinephrine-dopamine reuptake inhibitor that targets both inflammation and the hypothalamic-pituitary-adrenal axis. The current study is intended to provide a rigorous test of the efficacy and tolerability of bupropion for cancer-related fatigue., Methods: A randomized, double-blind, placebo-controlled trial will examine the effects of bupropion on cancer-related fatigue. The trial will be conducted nationwide through the University of Rochester Medical Center (URMC) National Cancer Institute Community Oncology Research Program (NCORP). Disease-free breast cancer survivors (n = 422) who completed chemotherapy and/or radiotherapy 12-60 months previously and report significant fatigue will be randomized 1:1 to receive bupropion (300 mg/day) or placebo. Outcomes will be assessed at baseline and the 12-week follow-up. The primary outcome, fatigue, will be measured with the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F). Secondary outcomes include quality of life, depression, and drug tolerability. Exploratory outcomes include cognition and symptomatology. Potential biological mechanisms and genetic moderators of cancer-related fatigue will also be explored., Discussion: This study is the first placebo-controlled trial to our knowledge to evaluate bupropion for cancer-related fatigue. Positive results could revolutionize the treatment of cancer-related fatigue, as bupropion is safe, inexpensive, widely-available, and may be more tolerable and acceptable for many patients than current, limited treatment options., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: Nearly 80% of cancer patients struggle with insomnia, which is associated with decreased heart rate variability (HRV) and quality of life (QOL). The aim of this secondary analysis was to evaluate the possible effects of Brief Behavioral Therapy for Cancer-Related Insomnia (BBT-CI), delivered during chemotherapy visits, on QOL and HRV in patients with breast cancer (BC)., Method: QOL and HRV data were obtained during a pilot clinical trial assessing the feasibility and effects of BBT-CI on insomnia. A total of 71 BC patients (mean age = 52.5 years) were randomly assigned to either BBT-CI or a healthy-eating control intervention (HEAL). BBT-CI and HEAL were delivered over 6 weeks (2 face-to-face sessions plus 4 phone calls) by trained staff at 4 National Cancer Institute-funded Community Oncology Research Program clinics. QOL was measured with the Functional Assessment of Cancer Therapy (FACT-G) and HRV with the Firstbeat device at baseline and after intervention., Results: There were significant improvements in QOL after intervention for BBT-CI (FACT-G, p = .009; FACT-B, p = .016; ANCOVA) and 5-min supine HRV measures (SDNN, p = .005; rMSSD, p = .004; HF, p = .009; ANCOVA) compared with HEAL., Conclusions: Patients randomized to BBT-CI showed improvements in QOL and HRV, providing support for BBT-CI's possible benefit when delivered in the community oncology setting by trained staff. A more definitive efficacy trial of BBT-CI is currently being planned with sufficient statistical power to evaluate the intervention's clinical utility. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Background: This phase II RCT was conducted to determine the feasibility and acceptability of brief behavioral therapy for cancer-related insomnia (BBT-CI) in breast cancer patients undergoing chemotherapy. We also assessed the preliminary effects of BBT-CI on insomnia and circadian rhythm in comparison to a Healthy Eating Education Learning control condition (HEAL)., Methods: Of the 71 participants recruited, 34 were randomised to receive BBT-CI and 37 to receive HEAL. Oncology staff was trained to deliver the intervention in four community clinics affiliated with the NCI. Insomnia was assessed with the Insomnia Severity Index (ISI), and circadian rhythm was assessed using a wrist-worn actiwatch., Results: Community staff interveners delivered 72% of the intervention components, with a recruitment rate of 77% and an adherence rate of 73%, meeting acceptability and feasibility benchmarks. Those randomised to BBT-CI improved their ISI scores by 6.3 points compared to a 2.5-point improvement in those randomised to HEAL (P = 0.041). Actigraphy data indicated that circadian functioning improved in the BBT-CI arm as compared to the HEAL arm at post-intervention (all P-values <0.05)., Conclusions: BBT-CI is an acceptable and feasible intervention that can be delivered directly in the community oncology setting by trained staff. The BBT-CI arm experienced significant improvements in insomnia and circadian rhythm as compared to the control condition.

Background: Older adults receiving cancer therapy have heightened risk for treatment-related toxicity. Geriatric assessment (GA) can identify impairments, which may contribute to vulnerability and adverse outcomes. GA management interventions can address these impairments and have the potential to improve outcomes when implemented., Methods: We conducted a randomized pilot study comparing GA with management interventions versus usual care in patients with stage III/IV solid tumor malignancies (N = 71). In all patients, a trained coordinator conducted and scored a baseline GA with pre-determined cutoffs for impairment. For patients randomized to the intervention arm, an algorithm was used to identify GA management recommendations based upon identified impairments. Recommendations were relayed to the primary oncologist for implementation. GA was repeated at 3 months. The primary outcome was grade 3-5 chemotherapy toxicity. Secondary outcomes included feasibility, hospitalizations, dose reductions, dose delays, and early treatment discontinuation., Results: The mean participant age was 76 (70-89). The total number of GA management recommendations relayed was 409, of which 35.4% were implemented by the primary oncologist. Incidence of grade 3-5 chemotherapy toxicity did not differ between the two groups. Prevalence of hospitalization, dose reductions, dose delays, and early treatment discontinuation also did not differ between the two groups., Conclusions: An algorithm can be used to guide GA management recommendations in older adults with cancer. However, reliance upon the primary oncologist for execution resulted in a low prevalence of implementation. Future work should aim to understand barriers to implementation and explore alternate models of implementing geriatric-focused care for older adults with cancer.

Antimicrobial activity of thymol, carvacrol and thymol/carvacrol liposomes (TCL) was evaluated against two bacterial pools, each one consisting of four strains of Staphylococcus aureus or Salmonella enterica. TCL were prepared using thin-film hydration, showing 270.20nm average diameter (polydispersity index of 0.33) and zeta potential of +39.99mV. Minimum inhibitory concentration (MIC) of thymol, carvacrol and TCL against S. aureus pool was 0.662mg/ml, while MIC for Salmonella pool was 0.331mg/ml for thymol and carvacrol, and for TCL was 0.662mg/ml. Bacterial pools (8.0logCFU/ml), allowed in contact on stainless steel AISI 304 coupons in UHT skim milk for 15min, resulted in adhered populations of 5.6-6.1logCFU/cm 2 . Adhered S. aureus (±6.1logCFU/cm 2 ) were inhibited after 1-min and 10-min treatments using thymol or carvacrol at MIC and 2.0 MIC. Reductions of 1.47-1.76logCFU/cm 2 and 1.87-2.04logCFU/cm 2 were obtained using 0.5 MIC of thymol and carvacrol, respectively. A 10-min contact with free (MIC and 2.0 MIC) and encapsulated (MIC) antimicrobials inhibited attached Salmonella (±6.0logCFU/cm 2 ); however, after 1-min of contact, 2.0 MIC of thymol and carvacrol were not able to inactivate adhered Salmonella MIC of TCL inactivated S. aureus and Salmonella after 10min; however, after 1-min contact, adhered S. aureus and Salmonella populations were decreased in 1.62logCFU/cm 2 and 2.01logCFU/cm 2 , respectively. Considering antimicrobial concentrations and contact times, thymol, carvacrol, and TCL could be employed in food-contact surfaces to prevent biofilm formation at early stages of bacterial attachment. Further investigations should be performed considering long-term antibacterial effects of TCL., (Copyright © 2017. Published by Elsevier B.V.)

Importance: Cancer-related fatigue (CRF) remains one of the most prevalent and troublesome adverse events experienced by patients with cancer during and after therapy., Objective: To perform a meta-analysis to establish and compare the mean weighted effect sizes (WESs) of the 4 most commonly recommended treatments for CRF-exercise, psychological, combined exercise and psychological, and pharmaceutical-and to identify independent variables associated with treatment effectiveness., Data Sources: PubMed, PsycINFO, CINAHL, EMBASE, and the Cochrane Library were searched from the inception of each database to May 31, 2016., Study Selection: Randomized clinical trials in adults with cancer were selected. Inclusion criteria consisted of CRF severity as an outcome and testing of exercise, psychological, exercise plus psychological, or pharmaceutical interventions., Data Extraction and Synthesis: Studies were independently reviewed by 12 raters in 3 groups using a systematic and blinded process for reconciling disagreement. Effect sizes (Cohen d) were calculated and inversely weighted by SE., Main Outcomes and Measures: Severity of CRF was the primary outcome. Study quality was assessed using a modified 12-item version of the Physiotherapy Evidence-Based Database scale (range, 0-12, with 12 indicating best quality)., Results: From 17 033 references, 113 unique studies articles (11 525 unique participants; 78% female; mean age, 54 [range, 35-72] years) published from January 1, 1999, through May 31, 2016, had sufficient data. Studies were of good quality (mean Physiotherapy Evidence-Based Database scale score, 8.2; range, 5-12) with no evidence of publication bias. Exercise (WES, 0.30; 95% CI, 0.25-0.36; P < .001), psychological (WES, 0.27; 95% CI, 0.21-0.33; P < .001), and exercise plus psychological interventions (WES, 0.26; 95% CI, 0.13-0.38; P < .001) improved CRF during and after primary treatment, whereas pharmaceutical interventions did not (WES, 0.09; 95% CI, 0.00-0.19; P = .05). Results also suggest that CRF treatment effectiveness was associated with cancer stage, baseline treatment status, experimental treatment format, experimental treatment delivery mode, psychological mode, type of control condition, use of intention-to-treat analysis, and fatigue measures (WES range, -0.91 to 0.99). Results suggest that the effectiveness of behavioral interventions, specifically exercise and psychological interventions, is not attributable to time, attention, and education, and specific intervention modes may be more effective for treating CRF at different points in the cancer treatment trajectory (WES range, 0.09-0.22)., Conclusions and Relevance: Exercise and psychological interventions are effective for reducing CRF during and after cancer treatment, and they are significantly better than the available pharmaceutical options. Clinicians should prescribe exercise or psychological interventions as first-line treatments for CRF.

Background: Androgen deprivation therapy (ADT) can decrease the physical performance (PP) of older men with prostate cancer (PC)., Methods: We conducted a three-arm randomized pilot study (n=19) comparing a home-based walking and resistance intervention (EXCAP) and a technology-mediated walking and resistance intervention using Wii-Fit to a usual-care arm in men ≥70 years with PC receiving ADT. The intervention lasted for 6 weeks, with follow-up at 12 weeks. The primary pre-specified outcome was change in Short Physical Performance Battery (SPPB) score. Mixed effects regression models were used to assess change in outcomes over time., Results: Mean participant age was 70 years (range: 67-93). Eight patients were randomized to the Wii-Fit arm, 6 to the EXCAP arm, and 5 to the usual-care arm. SPPB scores remained nearly constant in the usual-care arm (β=-0.12; p=0.79), while individuals in the EXCAP arm had on average a 1.2 point increase at each follow-up (β=1.20; 95% CI: 0.36, 2.06). The Wii-fit arm had a non-significant increase in SPPB score over time relative to usual-care (β=0.32; 95% CI -0.43, 1.06; p=0.46). Individuals in the EXCAP arm had an increase in steps per day over time compared to the usual-care arm (p-value=0.006); the EXCAP arm had an increase of 2720 steps (95% CI: 1313, 4128) while the usual-care arm had an increase of 97 steps (95% CI: -1140, 1333). Participants in the Wii-Fit arm had an increase of 1020 steps (95% CI: -474, 1238, p=0.710). Other outcomes (i.e., handgrip strength, lean muscle mass, and chest press repetitions) were not statistically significant., Conclusions: A home-based aerobic and resistance exercise program, EXCAP, shows promise for improving PP in older men with PC on ADT., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Purpose: Studies have found disparities in psychological distress between lesbian and gay cancer survivors and their heterosexual counterparts. Exercise and partner support are shown to reduce distress. However, exercise interventions haven't been delivered to lesbian and gay survivors with support by caregivers included., Methods: In this pilot randomized controlled trial (RCT), ten lesbian and gay and twelve heterosexual survivors and their caregivers were randomized as dyads to: Arm 1, a survivor-only, 6-week, home-based, aerobic and resistance training program (EXCAP ©® ); or Arm 2, a dyadic version of the same exercise program involving both the survivor and caregiver. Psychological distress, partner support, and exercise adherence, were measured at baseline and post-intervention (6 weeks later). We used t-tests to examine group differences between lesbian/gay and heterosexual survivors and between those randomized to survivor-only or dyadic exercise., Results: Twenty of the twenty-two recruited survivors were retained post-intervention. At baseline, lesbian and gay survivors reported significantly higher depressive symptoms (P = .03) and fewer average steps walked (P = .01) than heterosexual survivors. Post-intervention, these disparities were reduced and we detected no significant differences between lesbian/gay and heterosexual survivors. Participation in dyadic exercise resulted in a significantly greater reduction in depressive symptoms than participation in survivor-only exercise for all survivors (P = .03). No statistically significant differences emerged when looking across arm (survivor-only vs. dyadic) by subgroup (lesbian/gay vs. heterosexual)., Conclusion: Exercise may be efficacious in ameliorating disparities in psychological distress among lesbian and gay cancer survivors, and dyadic exercise may be efficacious for survivors of diverse sexual orientations. Larger trials are needed to replicate these findings.

Purpose: Up to 38% of prostate cancer survivors experience significant psychological distress; 6-16% are diagnosed with depression or anxiety disorders. Support from a relationship partner can ameliorate psychological distress, but many studies treat relationship status as a dichotomous predictor without accounting for level of support provided by the partner., Methods: The current study is a secondary analysis of a sample of 292 prostate cancer survivors recruited by nine Community Clinical Oncology Program (CCOP) sites around the USA to a larger randomized controlled trial. Self-reported distress was measured at a baseline visit using the Profile of Mood States (POMS) and partner support was measured using the Social Network and Support Assessment (SNSA). Post hoc groups consisting of unmarried survivors, married survivors with low partner support (SNSA scores below the median), and married survivors with high partner support (SNSA scores above the median) were compared on distress using univariate and analysis of covariance (ANCOVA) analyses., Results: Married prostate cancer survivors with high partner support reported significantly lower levels of psychological distress than the other two groups on the total distress scale (16.20-19.19 points lower, p < 0.001). After adjusting for multiple comparisons, this pattern was also seen for subscales of distress., Conclusions: This study highlights the importance of assessing both partner support and marital status when evaluating a survivor's psychosocial functioning and support network., Implications for Cancer Survivors: Assessing support could improve understanding of the association between partner support and prostate cancer survivors' psychological distress and could lead to interventions to bolster support and reduce distress.