Background: Simulation has been recognized as a shift in healthcare education that can improve skills and patient safety and outcomes. High-fidelity simulation of critical medical situations can be a source of stress among participants that can interfere with students' abilities leading to unexpected emotional responses. The aim of this study is to determine if two simulation methods, high-fidelity (HF) and procedural simulation (PS), may be associated with stress responses at a self-perceived and biological level (salivary cortisol variations), and to compare stress levels of the two different simulation method. We also wanted to find independent variables associated with cortisol total hormonal output. Methods: A quasi-experimental before-after study was used including the administration of questionnaires, and biomarkers evaluation by salivary cortisol samples before and after simulation. A total of 148 students were eligible and agreed to participate in the study. We used paired T-test for mean comparison regarding State-trait anxiety for both HF and PT simulations. For NASA-TLX we performed a T-test mean comparison between groups. We used paired T-test mean comparison for cortisol analysis. Multivariable linear regression has been used to assess variables associated with AUC_g values and perceived stress. Results: values of STAI-Y scores were relatively higher at the end of the HF and PS sessions. NASA-TLX was significantly higher at baseline for the HF simulations, with respect to the PS simulation. Cortisol fold increase was significantly different in the two groups. Linear regression showed that cortisol AUCg was related to the STAI-Y score in both groups. Conclusion: Participating students developed a stress response both after in the HF and PS training, testified by psychological and biological outputs. According to our results, stress levels were increased for simply being in a simulation scenario than to the intrinsic complexity of the task required. More studies are needed to confirm this trend and to clarify the role of simulated stress response in a long-term learning scenario.

Prostate cancer (PCa) is a common cancer among men, and it has a multifactorial etiology. Cadmium (Cd), a toxic heavy metal classified as a carcinogen by the IARC, can cause various acute and chronic effects. This systematic review and meta-analysis aims to update previous findings on the association between Cd exposure and PCa. We carried out a literature search in PubMed, Web of Science, and Scopus up to May 2024, identifying eight new articles. The effect size from the highest and lowest exposure categories were extracted and analyzed using a random-effects model. Heterogeneity was assessed with the I² test, and publication bias was evaluated using funnel plot asymmetry. Overall, the effect size for PCa associated with Cd exposure, combining previous and new articles, was 1.11 (95% CI 0.85–1.45). Heterogeneity was high, but no significant publication bias was detected. For studies from Europe, the effect size was 1.47 (95% CI 1.00–2.17). Notably, 11 articles from the previous systematic review and meta-analysis highlighted that higher Cd exposure is significantly associated with more aggressive histopathological types of PCa (OR 1.50, 95% CI 1.08–2.07). These findings suggest a potential public health concern, indicating the need for further research to clarify the risk associated with Cd exposure.

Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) are serious health challenges. Point prevalence surveys (PPSs) are valuable tools for monitoring HAIs and AMR. To describe results of the ECDC PPS 2022 dealing with the prevalence of HAIs, antimicrobial consumption, and associated factors, in acute care hospitals. The survey was performed in November 2022 in 14 hospitals according to the protocol proposed by the European Centre for Disease Prevention and Control. Multilevel logistic regression was performed using geographical area/hospital type as cluster variable to evaluate the factors independently associated with HAIs and antibiotics. The point prevalence of HAIs was 7.43%. Patients hospitalized for longer periods were more likely to have an HAI as well as those aged 15-44 years, with a rapidly fatal disease, intubated, and with one or two devices. Antibiotics prevalence was 47.30%. Males, unknown McCabe scores, minimally invasive/non-National Healthcare Safety Network (NHSN) surgery, patients with HAIs, hospitals with a higher alcohol hand-rub consumption, hospitals with a greater number of IPC personnel, geriatric wards, and hospitals with 300-600 beds were more likely to be under antimicrobial therapy. This PPS provided valuable information on the prevalence of HAIs and antimicrobial consumption and variables associated. The high prevalence of HAIs highlights the need for improved infection control measures.

Background: Several socioeconomic conditions may influence subjects’ adherence to healthy eating habits. Food consumption may be influenced by external stress during crisis periods; however, the effects of these events on food habits are difficult to predict. Also, a pandemic crisis like the recent COVID-19 pandemic may have influenced dietary habits and food consumption. The objective of this study was to compare the dietary habits of Italian people before the COVID-19 pandemic with those belonging to the year 2020 in a nationwide population sample. Materials and methods: Information on dietary habits has been obtained from the multi-purpose survey on families’ “Aspects of daily life”, carried out in Italy by the Italian National Statistics Institute (ISTAT). We analyzed data coming from 2016 and 2020 editions of the survey (43,000 subjects each year). We used population attributable fraction (PAF) adjusted for age, defined as the proportional reduction in unhealthy diet that would occur if all participants had had a higher education, assuming higher educated individuals as more socially advantaged. Prevalence association for each dietary exposition has been calculated through logistic regression. Results: Looking at aggregated data from 2016 and 2020 both men and women showed a high prevalence of unhealthy dietary habits. Regarding men, excessive consumption of eggs, pork meat, and bovine meat was characterized by a PAF attributable to socioeconomic conditions to an extent greater than 30%. Women showed the same trend. Focusing on different years of investigation, in 2020, during the COVID-19 pandemic, men and women increased their consumption of eggs, cooked fats, snacks, and sweets, and reduced consumption of fruits and vegetables. Additionally, women increased the assumption of dietary products and meat. Both sexes registered an increase in overweight and obese subjects in 2020. Conclusions: To our knowledge, this study was the first in our country to use a yearly, nationwide sample to analyze dietary habits by examining specific types of various foods on a nationwide scale and establishing a correlation between these habits and the COVID-19 pandemic. Our results showed unbalanced dietary habits of the Italian population with an excess of consumption of several foods like eggs, cooked fats snacks, and sweets with low consumption of fruits and vegetables. Socioeconomic differences influence food choices but in a complex way since they seemed to affect some wrong dietary habits but not others, especially regarding fruits and vegetables assumption where differences were less evident among social classes. Outside stressors like a crisis period such as the COVID-19 pandemic seem to have an important role in both men and women regarding the assumption of so-called “junk food”.

Plastic pollution is a growing concern. It can form smaller particles called microplastics (<5 mm). Microplastics can break down into even smaller pieces called nanoplastics (<1 μm). These minute particles can infiltrate human cells and tissues, with their health impacts still largely undetermined. On average, a liter of bottled water includes about 240,000 tiny pieces of plastic. The purpose of this study was to evaluate the association between the use of bottled plastic water (BW) and several health outcomes. Utilizing data from the Italian National Institute of Statistics’ “Aspects of Daily Life” survey (N = 45,597), we employed logistic regression to explore the correlation between BW consumption and the prevalence of various chronic diseases, including hypertension, gastric/duodenal ulcers, and kidney stones. Adjustments were made for covariates such as education, age, gender, and economic resources. Our analysis indicated a statistically significant association between BW consumption and increased risk of hypertension (Odds ratio [OR] = 1.05, 95% confidence interval [CI] 1.00–1.11), diabetes (OR = 1.09, 95% CI 1.01–1.18), gastric/duodenal ulcers (OR = 1.21, 95% CI 1.07–1.38), and kidney stones (OR = 1.17, 95% CI 1.03–1.32). The consumption of BW is associated with heightened risk for certain health conditions. Policymakers and healthcare providers should consider implementing targeted prevention strategies and awareness campaigns.

Background: Lung cancer (LC) is the leading cause of cancer deaths worldwide among both men and women, and represents a major public health challenge. DNA methylation (DNAm) has shown potential in identifying individuals at higher risk of LC, but the overall evidence has not been systematically evaluated. This review and meta-analysis aims to evaluate and summarize existing research on the association between blood DNAm levels and LC risk. Methods: Searches were conducted in PubMed, Web of Science, and Scopus for studies published until February 2024, following PRISMA and MOOSE guidelines. Eleven studies met the eligibility criteria. Results: Using a random effects model, our pooled analysis showed a significant association between increased DNAm levels and LC risk (OR 1.24, 95% CI 1.10–1.39; I² = 93.90%, p = 0.0001). Stratifying the results by study design showed a stronger association in two prospective cohort studies (OR 1.61; 95% CI 1.36–1.90; I² = 14.42%, p = 0.32), while case–control studies showed a weaker association (OR 1.05; 95% CI 0.99–1.11; I² = 70.57%, p = 0.0001). Sensitivity analyses indicated that omitting individual studies did not significantly alter the LC risk estimates. Conclusions: These findings suggest that higher blood DNAm levels are associated with an increased risk of LC, especially in long-term cohort studies. Further research is recommended to explore the potential of DNAm as a screening biomarker for LC and to clarify the role of other influencing factors.