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This study focused on vaccine hesitancy and decision regret about the COVID-19 vaccine among nursing students (BScN and MScN) and Registered Nurses (RNs) in Italy. The primary aim was to describe decision regret and vaccine hesitancy among these groups and to understand what influences vaccine hesitancy. Data were collected through an e-survey conducted from March to June 2024. The Decision Regret Scale and the Adult Vaccine Hesitancy Scale were employed to assess regret and hesitancy levels, assessing trust, concerns, and compliance regarding vaccination. Among the participants, 8.64% were not vaccinated. The results indicated moderate to high levels of decision regret and diverse levels of trust, concerns, and compliance with COVID-19 vaccination. Structural equation modeling revealed that decision regret significantly predicted Trust (R2 = 31.3%) and Concerns (R2 = 26.9%), with lower regret associated with higher trust and lower concerns about vaccine safety. The number of COVID-19 vaccine boosters was a significant predictor of Trust and Concerns, with more boosters associated with higher trust and lower concerns. MScN students exhibited higher Compliance compared to RNs (R2 = 2.9%), highlighting the role of advanced education. These findings suggest that addressing decision regret and providing comprehensive vaccine information could enhance trust and compliance.

Objectives There are no data regarding the prevalence of comorbidity (ie, additional conditions in reference to an index disease) and multimorbidity (ie, co-occurrence of multiple diseases in which no one holds priority) in patients with liver cirrhosis. We sought to determine the rate and differences between comorbidity and multimorbidity depending on the aetiology of cirrhosis.Design This is a subanalysis of the San MAtteo Complexity (SMAC) study. We have analysed demographic, clinical characteristics and rate of comorbidity/multimorbidity of patients with liver cirrhosis depending on the aetiology—alcoholic, infectious and non-alcoholic fatty liver disease (NAFLD). A multivariable analysis for factors associated with multimorbidity was fitted.Setting Single-centre, cross-sectional study conducted in a tertiary referral, academic, internal medicine ward in northern Italy (November 2017–November 2019).Participants Data from 1433 patients previously enrolled in the SMAC study were assessed; only those with liver cirrhosis were eventually included.Results Of the 1433 patients, 172 (median age 79 years, IQR 67–84; 83 females) had liver cirrhosis. Patients with cirrhosis displayed higher median Cumulative Illness Rating Scale (CIRS) comorbidity (4, IQR 3–5; p=0.01) and severity (1.85, IQR 16.–2.0; p3 (OR 2.81, 95% CI 1.14 to 6.93, p=0.024) and admission related to cirrhosis (OR 0.19, 95% CI 0.07 to 0.54, p=0.002) were the only significant associations.Conclusions Comorbidity is more common in alcohol cirrhosis compared with other aetiologies in a hospital, internal medicine setting.

Food waste presents a continuous challenge for the food industry, leading to environmental pollution and economic issues. A substantial amount of waste, including by-products from fruits and vegetables, non-edible food items, and other waste materials, is produced throughout the food supply chain, from production to consumption. Recycling and valorizing waste from perishable goods is emerging as a key multidisciplinary approach within the circular bio-economy framework. This waste, rich in raw by-products, can be repurposed as a natural source of ingredients. Researchers increasingly focus on biomass valorization to extract and use components that add significant value. Traditional methods for extracting these bio-compounds typically require the use of solvents and are time-consuming, underscoring the need for innovative techniques like ultrasound (US) extraction. Wastes from the processing of fruits and vegetables in the food industry can be used to develop functional foods and edible coatings, offering protection against various environmental factors. This comprehensive review paper discusses the valorization of waste from perishable items like fruits and vegetables using US technology, not only to extract valuable components from waste but also to treat wastewater in the beverage industry. It also covers the application of biomolecules recovered from this process in the development of functional foods and packaging.

Cancers of the lung, colon, liver, stomach, and breast are common worldwide and have significant fatality rates. Cachexia caused by cancer is the major cause of death in cancer patients, and malnutrition and metabolic illnesses have become more widespread in recent years. To combat these health conditions, proper nutrition is essential. Chickpeas include a variety of bioactive components, including antioxidants, phytochemicals, and bioactive peptides, all of which have preventative and protective health effects. This review summarizes the evidence-based studies on chickpeas’ ability to serve as a valuable source of bioactive chemicals that can help protect against many types of cancer. Chickpeas include secondary metabolites including quercetin and myricetin, as well as phenolic acids and vitamins A, B, and E, which may protect the body from free radicals. Chickpeas have the highest total phenolic content and essential amino acid concentration of any germinated seed. Chickpea storage proteins, such as globulins, glutelins, albumins, and prolamins, are high in protein and can help with cachexia. These proteins contain angiotensin-converting enzyme inhibitory and anti-proliferative capabilities, making them useful in the treatment of a wide range of cancers. As a result, this article provides advice to consumers on improving their eating habits to protect against and fight cancer and may serve as a foundation for future clinical studies.

Introduction Decision regret refers to feelings of remorse or dissatisfaction with a decision made regarding the treatment. Mapping the meaningful aspects of decision regret in patients with non-communicable diseases (NCDs) is necessary to provide a comprehensive understanding of the phenomenon and inform the development of effective interventions to address it. For this reason, this protocol aimed to describe the methodological aspects of a scoping review focused on mapping all the meaningful aspects of decision regret in patients with NCDs and provide a conceptual and comprehensive framework of the phenomenon.Methods and analysis The study described in this protocol will be performed following the Joanna Briggs Institute (JBI) methodology for scoping reviews. The anticipated starting time is July/August 2023 and the anticipated end of the review is June 2024. This scoping review will include quantitative, qualitative, primary and secondary literature, as well as grey literature on decision regret in patients with NCDs. The systematic search will be performed by consulting PubMed, Embase, Scopus, CINAHL, the Cochrane Library and Google Scholar. English-language articles from any context will be eligible for inclusion. Two independent reviewers will take part in an iterative process of evaluating literature, choosing papers and extracting data. Disagreements among reviewers will be solved through consensus meetings. Results will be presented in relation to the review question by employing tables, figures and narrative summaries.Ethics and dissemination This scoping review did not require ethical approval since it involves a literature review and does not include new data collection from human participants. The results of the review will provide a summary of the available literature on decision regret experienced by patients with NCDs, which is crucial for developing preventive educational interventions in situations where multiple therapeutic options are available.

Abstract Background Little is known about resilience in an internal medicine setting. We aimed to assess the relationship between resilience and frailty and other clinical and sociodemographic characteristics in a cohort of prospectively enrolled hospitalised patients. Methods In 2017–2019, we consecutively enrolled patients in our internal medicine wards. We selected all patients who filled in the 25-item Connor-Davidson resilience scale (CD-RISC). Mean resilience was evaluated according to baseline demographic (i.e., age, sex, marital and socioeconomic status) and clinical (i.e., Cumulative Illness Rating Scale [CIRS], Edmonton Frail Scale [EFS], Barthel index, Short Blessed test, length of stay [LOS]) data. A multivariable analysis for assessing factors affecting resilience was fitted. Results Overall, 143 patients (median age 69 years, interquartile range 52–79, 74 females) were included. Resilience was significantly lower in frail (p = 0.010), elderly (p = 0.021), dependent (p = 0.032), and more clinically (p = 0.028) and cognitively compromised patients (p = 0.028), and in those with a low educational status (p = 0.032). No relation between resilience and LOS was noticed (p = 0.597). Frail patients were significantly older (p

This study focused on vaccine hesitancy and decision regret about the COVID-19 vaccine among nursing students (BScN and MScN) and Registered Nurses (RNs) in Italy. The primary aim was to describe decision regret and vaccine hesitancy among these groups and to understand what influences vaccine hesitancy. Data were collected through an e-survey conducted from March to June 2024. The Decision Regret Scale and the Adult Vaccine Hesitancy Scale were employed to assess regret and hesitancy levels, assessing trust, concerns, and compliance regarding vaccination. Among the participants, 8.64% were not vaccinated. The results indicated moderate to high levels of decision regret and diverse levels of trust, concerns, and compliance with COVID-19 vaccination. Structural equation modeling revealed that decision regret significantly predicted Trust (R2 = 31.3%) and Concerns (R2 = 26.9%), with lower regret associated with higher trust and lower concerns about vaccine safety. The number of COVID-19 vaccine boosters was a significant predictor of Trust and Concerns, with more boosters associated with higher trust and lower concerns. MScN students exhibited higher Compliance compared to RNs (R2 = 2.9%), highlighting the role of advanced education. These findings suggest that addressing decision regret and providing comprehensive vaccine information could enhance trust and compliance. [ABSTRACT FROM AUTHOR]

Wheat-based products are largely consumed by children worldwide. Deoxynivalenol (DON) is known for its acute and chronic toxicity and is the most common contaminant of cereal grains. Since no legal limits are set for DON in wheat-based products and specific foods intended for children over 3 years on the market, a high risk of overexposure to this contaminant may emerge. The main objective of the study, conducted in 2018–2019, was to produce a wheat flour intended for children over three years, characterized by a high level of safety in terms of DON content, to be used to produce wheat-derived products. The dedicated flour was produced by adopting tailored procedures like the selection of wheat suppliers, the predetermination of the safe contamination of DON in the final products, and the evaluation of the transfer rate from the wheat flour to derived products (bread, breadsticks, biscuits, plumcake, and focaccia). The results showed that the daily exposure of children was considered to be safe, in a range between 7% (biscuits) and 67% (bread) of DON tolerable daily intake (TDI) and that only by producing a flour characterized by DON levels much lower than those in force, can “safe” products be marketed.

Sugarcane juice (Saccharum officinarum) is a proven nutritious beverage with high levels of antioxidants, polyphenols, and other beneficial nutrients. It has recently gained consumer interest due to its high nutritional profile and alkaline nature. Still, high polyphenolic and sugar content start the fermentation in juice, resulting in dark coloration. Lately, some novel techniques have been introduced to extend shelf life and improve the nutritional value of sugarcane juice. The introduction of such processing technologies is beneficial over conventional processes and essential for producing chemical-free, high-quality, fresh juices. The synergistic impact of these novel technologies is also advantageous for preserving sugarcane juice. In literature, novel thermal, non-thermal and hurdle technologies have been executed to preserve sugarcane juice. These technologies include high hydrostatic pressure (HHP), ultrasound (US), pulsed electric field (PEF), ultraviolet irradiation (UV), ohmic heating (OH), microwave (MW), microfludization and ozone treatment. This review manifests the impact of novel thermal, non-thermal, and synergistic technologies on sugarcane juice processing and preservation characteristics. Non-thermal techniques have been successfully proved effective and showed better results than novel thermal treatments. Because they reduced microbial load and retained nutritional content, while thermal treatments degraded nutrients and flavor of sugarcane juice. Among non-thermal treatments, HHP is the most efficient technique for the preservation of sugarcane juice while OH is preferable in thermal techniques due to less nutritional loss.

Background: The nursing professional self-efficacy scale (NPSES) is one of the most used self-reporting tools for assessing nursing self-efficacy. Its psychometric structure was described differently in several national contexts. This study aimed to develop and validate version 2 of the NPSES (NPSES2), which is a brief version of the original scale selecting items that contribute to stably detecting attributes of care delivery and professionalism as descriptors of salient aspects of the nursing profession. Methods: Three different and subsequent cross-sectional data collections were employed to reduce the number of items to generate the NPSES2 and validate its new emerging dimensionality. The first (June 2019–January 2020) involved 550 nurses and was used to reduce the number of the original scale items by using a Mokken scale analysis (MSA) to ensure the selection of items consistently with the invariant item ordering properties. The subsequent data collection was performed to conduct an exploratory factor analysis (EFA) involving 309 nurses (September 2020–January 2021), and the last data collection (n = 249) was performed to cross-validate with a confirmatory factor analysis (CFA), the most plausible dimensionality derived from the EFA (June 2021–February 2022). Results: The MSA led to the removal of twelve items and retention of seven items (Hs = 0.407, standard error = 0.023), which showed adequate reliability (rho reliability = 0.817). The EFA showed a two-factor solution as the most plausible structure (factors loading ranged from 0.673 to 0.903; explained variance = 38.2%), which was cross-validated by the CFA that showed adequate fit indices: χ2 (13, N = 249) = 44.521, p < 0.001; CFI = 0.946; TLI = 0.912; RMSEA = 0.069 (90% CI = 0.048–0.084); SRMR = 0.041. The factors were labeled as care delivery (four items) and professionalism (three items). Conclusions: NPSES2 is recommended to allow researchers and educators to assess nursing self-efficacy and inform interventions and policies.

Background and Aim: Aflatoxins are metabolites of molds that exert potentially toxic effect on animals and humans. This study aimed to investigate the occurrence of aflatoxin M1 (AFM1) in raw cow milk collected during 1 year (2016-2017) from different regions of Algeria and risk factors associated with the contamination. Materials and Methods: During the survey period, 84 samples of raw milk were collected in three regions of Algeria (northeast, north center, and northwest) during four seasons. AFM1 levels were analyzed by competitive enzyme-linked immunosorbent assay. Results: AFM1 was detected in 39 (46.43%) samples (total mean concentration, 71.92 ng/L; range, 95.59-557.22 ng/L). However, the AFM1 levels exceeded the maximum tolerance limit set by the Food and Drug Administration in the USA (500 ng/L) in only 1 sample (1.19%). Statistical analysis revealed significant differences (p

Fruit juices are popular beverages that provide various health benefits due to their rich nutritional profile, but they are prone to microbial spoilage and quality deterioration. Thermal pasteurization is the conventional method to preserve fruit juices, but it causes undesirable changes in the physicochemical and nutritional value of the juices. Therefore, there is a need to develop alternative methods to ensure the microbial safety and quality of fruit juices. The aim of this study was to investigate the impact of thermal (95-100°C for 4 min), ultrasonication (US) (25 kHz for 5 and 10 min), and thermosonication (TS) (25 kHz at 40 and 50°C) processes on the quality profile of watermelon-beetroot juice blend, a novel juice formulation with enhanced nutritional and functional properties with 50 : 50 formulation. The samples were analysed for physicochemical (colour, pH, total soluble solids, and titratable acidity), bioactive (phenolic, flavonoid, antioxidant, and ascorbic acid contents), and microbiological (total plate count and yeast/molds) properties. The results showed that all the processed samples retained high total phenolic (756.33-842.33 μg GAE/g), total flavonoid (435.33-512.67 μg CE/g), and ascorbic acid (45.23-50.34 mg/100 mL) contents along with a high antioxidant potential (total antioxidant capacity (274.14-305.33 μg AAE/g) and DPPH radical scavenging activity (33.05-42.18%)) while preserving the normal physicochemical characteristics and decreasing the microbial counts of all the processed blend juices. In conclusion, the US treatment (10 min) produced the juice blends with the best quality. The findings of this research suggest that thermal, US, and TS processes are promising technologies for the preservation of fruit juices and that watermelon-beetroot juice blend is a novel juice formulation with high nutritional and functional value. The results of this research might be useful to the processed fruit juice industry and the consumers who are looking for healthy and safe fruit juices. [ABSTRACT FROM AUTHOR]

Fresh fruits and vegetables, being the source of important vitamins, minerals, and other plant chemicals, are of boundless importance these days. Although in agriculture, the green revolution was a milestone, it was accompanied by the intensive utilization of chemical pesticides. However, chemical pesticides have hazardous effects on human health and the environment. Therefore, increasingly stimulating toward more eco-friendly and safer alternatives to prevent postharvest losses and lead to improving the shelf life of fresh fruits and vegetables. Proposed alternatives, natural plant extracts, are very promising due to their high efficacy. The plant-based extract is from a natural source and has no or few health concerns. Many researchers have elaborated on the harmful effects of synthetic chemicals on human life. People are now much more aware of safety and health concerns than ever before. In the present review, we discussed the latest research on natural alternatives for chemical synthetic pesticides. Considering that the use of plant-based extracts from aloe vera, lemongrass, or neem is non-chemical by-products of the fruits and vegetable industry, they are proved safe for human health and may be integrated with economic strategies. Such natural plant extracts can be a good alternative to chemical pesticides and preservatives.

BackgroundChristmas and New Year's holidays are risk factors for hospitalization, but the causes of this "holiday effect" are uncertain. In particular, clinical complexity (CC) has never been assessed in this setting. We therefore sought to determine whether patients admitted to the hospital during the December holiday period had greater CC compared to those admitted during a contiguous non-holiday period.MethodsThis is a prospective, longitudinal study conducted in an academic ward of internal medicine in 2017-2019. Overall, 227 consecutive adult patients were enrolled, including 106 cases (mean age 79.4±12.8 years, 55 females; 15 December-15 January) and 121 controls (mean age 74.3±16.6 years, 56 females; 16 January-16 February). Demographic characteristics, CC, length of stay, and early mortality rate were assessed. Logistic regression analyses for the evaluation of independent correlates of being a holiday case were computed.ResultsCases displayed greater CC (17.7±5.5 vs 15.2±5.9; p = 0.001), with greater impact of socioeconomic (3.51±1.7 vs 2.9±1.7; p = 0.012) and behavioral (2.36±1.6 vs 1.9±1.8; p = 0.01) CC components. Cases were also significantly frailer according to the Edmonton Frail Scale (8.0±2.8 vs 6.4±3.1; pConclusionsPatients hospitalized during the December holiday period had worse health outcomes, and this could be attributable to the grater CC, especially related to socioeconomic (social deprivation, low income) and behavioral factors (inappropriate diet). The evaluation of all CC components could potentially represent a useful tool for a more rational resource allocation over this time of the year.

This study presents the exposure scenario to mycotoxins of adult population throughout Europe. The urinary biomarkers values were obtained by modelling data from two European projects. Exposure to AFB1, OTA, CIT, FBs, DON, NIV and T2/HT2 are presented. The main output obtained refers to a concern for public health about AFM1, FBs, T2/HT2 and NIV, and low concern for OTA, DON and CIT. The margin of exposure for AFM1 did not respect the reference value of 10,000 considered of low priority for risk; for Fusarium toxins, FBs and T2/HT2, probable daily intake (PDI) values resulted about ten times higher than their tolerable daily intake and NIV presented the most critical situation with a calculated PDI 30 times higher than the reference TDI value. North and South Europe scenarios were also depicted by clustering biomonitoring data. OTA and DON showed to be prevalent in Northern countries and the opposite was noticed for ZEN, higher in Southern countries. The critical issues of the availability of records feeding the dataset and of the accuracy of excretion rate for some mycotoxins are source of uncertainty for the reliability of the outputs, nevertheless the time is ripe for asking for more concrete HBM values and/or HBM-HBGV which would help in interpreting the burden of mycotoxins in Europe.

This study aimed to evaluate the language of emotions in the Urdu Poetry of Bhabha and Ajami. The study also explicated how meanings were construed through the use of certain linguistic choices pertinent to the representation of emotions. The study was qualitative as the textual data was analyzed qualitatively. The data for the analysis comprised the Urdu Ghazals of Bhabha and Ajami. For analysis, a sample of 25 ghazals of each poet was collected using the technique of purposive sampling. Drawing on Systemic Functional Linguistics, particularly on Appraisal Framework (Martin & White, 2005), an analysis of the sample ghazal was carried out. The results of the study highlighted that linguistic choices made in the Urdu ghazals of both the poets were significant in construal of meanings. It was also revealed that both the poets were significantly different in their use of appraisal resources. Further, the results showed that the differences in the used appraisal resources highlighted the unique meanings construed in the poetry of both poets. [ABSTRACT FROM AUTHOR]