Freeze-dried products based on walnuts: Interaction between fat fraction and dietary fiber

Walnuts are appreciated all around the world by consumers and food industries because of their different and positive properties including flavouring, texturizing and nutritional qualities. Walnut paste production and use are commonly associated to confectionery or traditional products but may find space in different innovative foods, as fat replacer and functional component. The aim of this work was to increase the nutritional value of walnut paste and, at the same time, limit its oxidative degradation by developing a freeze-drying process with addition of polysaccharide matrices including dietary fiber. The effects of different formulations and technological treatments on product stability were evaluated. Shelled walnuts were roasted at 165 °C for 15 minutes, grinded, and refined; the obtained walnut paste was mixed with betaglucan, inulin and pectin, singly or combined with tragacanth gum and DE12 maltodextrin. The different formulations were added to water, emulsified and dehydrated by freeze-drying. Lyophilized samples were finally stored at 60 °C for 15 days. Walnut paste, samples just after lyophilization, and lyophilized samples after storage were evaluated in terms of moisture, peroxide number, acidity and pH, conjugated dienes and trienes, total phenols and tocopherols. Further analyses (color, 410 and 420 nm absorption, and total phenols content after ethanol precipitation) were carried out on freeze dried samples before and after storage. The results showed that the freeze-drying process affected the nutritional profile of the walnuts, limiting the onset of oxidative phenomena. After storage the content of total phenols and tocopherols was significantly higher already in the freshly lyophilized walnut paste, compared to the untreated one. The addition of polysaccharide compounds aided to preserve total phenols. However, when betaglucan, inulin, or pectin were individually included, a significant depletion of tocopherols was observed. Maltodextrin and tragacanth gum played a fundamental role in maintaining high levels of both total phenols and tocopherols. Nevertheless, formulations including also dietary fiber were slightly more oxidized. Among them, the inclusion of betaglucan provided the overall best results

An integrative review of the factors influencing older nurses’ timing of retirement

Aims: To summarise the international empirical literature to provide a comprehensive understanding of older nurses’ decision making surrounding the timing of their retirement. Background: The global nursing shortage is increasing. Amongst some countries it has become an economic imperative to consider raising the state pension age and to extend working lives. Design: An integrative literature review using an integrated design. Data sources: MEDLINE, CINAHL and Business Source Premier databases were searched for studies between January 2007 ‐ October 2019. Review Methods: Quality appraisal of the studies were conducted. Findings were summarised, grouped into categories and themes extracted. Two models were developed for data representation. Results: 132 studies were identified by the search strategy. Of these, 27 articles were included for appraisal and synthesis. 16 papers were quantitative, seven qualitative and four mixed methods. The research took place in 13 different geographical locations. Most studies were of a questionnaire design, followed by interviews and focus groups. The total participant sample was 35,460. Through a synthesis of the studies, four themes were identified: Health, Well‐being and Family factors; Employer factors; Professional factors; Financial factors. Conclusion: This review revealed the heterogeneity of studies on this subject and confirmed previous findings but also established a ranking of criteria that influences nurses’ decision making: age, followed by personal and organisational factors. Four extracted themes of push and pull factors map onto these factors. No ‘one‐size‐fits‐all’ strategy exists to ensure the extension of older nurses’ working lives. Organisations need to foster an environment where older nurses feel respected and heard and where personal and professional needs are addressed

Sonographic endometrial thickness : a useful test to predict atrophy in patients with postmenopausal bleeding. An Italian multicenter study

Eighteen centers took part in this prospective study into which 930 eligible patients were recruited. The selection criteria for admission were atypical bleeding after at least 6 months of postmenopansal amenorrhea, and absence of hormonal therapies for at least 6 months. The sonographic measurement of the maximum bi-endometrial thickness was made in a longitudinal plane. Sonographic measurements were always performed within 3 days prior to histological evaluation. In these patients the mean number of years from menopause (25-75th centile) was 6 (range 2-16). The prevalence of endometrial carcinoma was 11.5% and the prevalence of atrophy was 49.2%. The area under the receiver operator characteristic curves generated by sonographic thickness measurements reached the level of 85%, both for cancer and atrophy. The likelihood ratio for cancer, yielded by an endometrial thickness of 64 4.0 mm, was 0.05, and for atrophy it was 7.1. This cut-off of > 4.0 mm yielded a sensitivity for the detection of cancer of 98% and a negative predictive value of 99%. The overall sensitivity and positive predictive value for atrophy achieved by this cut-off were 57.2% and 87.3%, respectively. A multivariate logistic model showed that age and body mass index were independent variables associated with a significantly higher risk of endometrial cancer. The post-test probabilities for cancer and atrophy were recalculated on the basis of the integration of age, body mass index and endometrial thickness. The estimated reduction of invasive procedures on the basis of this integration was 31%. Transvaginal sonographic measurement of endometrial thickness, integrated with individual risk factors, can help in the management of postmenopausal patients with atypical bleeding, with regard to either the need for histological evaluation in high risk cases, or the choice of possible expectant management. We have shown that an endometrial thickness of 64 4.0 mm safely predicts endometrial atrophy and justifies expectant management when the patient understands the need for proper follow up. This could be achieved with a reduction in the use of invasive procedures without unwonted delay in cancer diagnosis

A new method for free testosterone assay: clinical evaluation.

The Authors propose a new direct method for the determination of free Testosterone (F. Te). Our study was made following this method: 1) on a control group composed of 12 healthy men and 21 healthy women, and 2) on a group of 29 patients suffering from Polycystic Ovary Syndrome (PCOS) with clinical signs of hyperandrogenism. This pathological group presented acne and hirsutism in 95% of the cases. The Authors demonstrate how the determination of F

A new method for free testosterone assay: clinical evaluation.

The Authors propose a new direct method for the determination of free Testosterone (F.Te). Our study was made following this method: 1) on a control group composed of 12 healthy men and 21 healthy women, and 2) on a group of 29 patients suffering from Polycystic Ovary Syndrome (PCOS) with clinical signs of hyperandrogenism. This pathological group presented acne and hirsutism in 95% of the cases. The Authors demonstrate how the determination of F.Te permits a 93.1% correct endocrinological diagnosis of hyperandrogenism

Treatment of hypothalamic infertility with pulsatile GN-RH administration.

In this study the Authors have obtained an ovulatory response using intravenous Gn-RH treatment in four patients with hypothalamic hypogonadotropic amenorrhea. The Gn-RH was administered in a pulsatile manner with a small portable autoinfusion pump (Autosyringe, Inc., Hooksett). The ovarian follicular maturation, as it appears from the pelvic echography, was perfectly similar to that observed in a spontaneous ovulatory cycle

The effect of HRT on uterine arterial blood flow in postmenopausal women assessed by transvaginal color doppler sonography (TVDS)

HRT has been suggested to have neither a metabolic nor a direct vascular effect on arterial tone. PI and RI are indicators of resistance to flow: the higher the value of these indices, the greater the resistance to flow. The TVDS measurements of uterine blood flow in postmenopausal women (pmw) show a mean uterine artery PI of 3.3+/-1.04 and a mean RI of 0.93+/-0.1. The aim of our study was to determine whether HRT had any positive effect on uterine arterial blood flow