Ochratoxin A biodegradation by Agaricus campestris and statistical optimization of cultural variables.

The goal of this study is to identify the optimum conditions for ochratoxin A (OTA) biodegradation by the supernatant of Agaricus campestris strain. The Plackett-Burman and Box-Behnken methods were used to determine optimum OTA degradation conditions of Agaricus campestris under various incubation conditions. The Plackett-Burman method was planned through 16 varied experiments with 15 variants. The three most potent variants, sucrose, yeast extract and wheat bran, were selected using the Box-Behnken methodology. Ochratoxin A biodegradation ratio of 46.67% has been specified in only 1 h under ideal growing conditions. This is the first report on the optimization of OTA biodegradation by Agaricus campestris. When compared to previously published articles, it can be asserted that Agaricus campestris has promise based on its OTA biodegradation ratio in only 1 h of reaction time.

Optimization and reactor-scale production of plant growth regulators by Pleurotus eryngii.

The aims of the this study are to select the best cultivation type for plant growth regulator (PGR) production, to optimize PGR production with statistical experimental design, and to calculate bioprocess parameters and yield factors during PGR production by P. eryngii in flask and reactor scales. Submerged fermentation was the best cultivation type with 4438.67 ± 37.14, 436.95 ± 27.31, and 54.32 ± 3.21 mg/L of GA3, ABA, and IAA production values, respectively. The Plackett-Burman and Box-Behnken designs were used to determine effective culture parameters and interactive effects of the selected culture parameters on PGR production by Pleurotus eryngii under submerged fermentation. The statistical model is valid for predicting PGR production by P. eryngii. After these studies, maximum PGR production (7926.17 ± 334.09, 634.92 ± 12.15, and 55.41 ± 4.38 mg/L for GA3, ABA, and IAA, respectively) was reached on the 18th day of fermentation under optimized conditions. The optimum formula was 50 g/L fructose, 3 g/L NaNO3, and 1.5 g/L KH2PO4, 1 mg/L thiamine, incubation temperature 25 °C, initial medium pH 7.0, and an agitation speed of 150 rpm. The kinetics of PGR production was investigated in batch cultivation under 3-L stirred tank reactor conditions. Concentrations of GA3, ABA, and IAA of 10,545.00 ± 527.25, 872.32 ± 21.81, and 60.48 ± 3.48 mg/L were obtained at the reactor scale which were 4.1, 3.4, and 2.3 times higher than the initial screening values. The specific growth rate (µ), the volumetric (rp) and specific (Qp) PGR production rates, 486.11 mg/L/day and 107.43 mg/g biomass/day for GA3, confirmed the successful transfer of optimized conditions to the reactor scale. In the presented study, PGR production of P. eryngii is reported for the first time.

Flask and reactor scale production of plant growth regulators by Inonotus hispidus: optimization, immobilization and kinetic parameters.

The aims of the presented study are to compare submerged, static, and solid-state fermentation in the production of gibberellic acid (GA3), indole acetic acid (IAA), and abscisic acid (ABA) by Inonotus hispidus, to optimize with a statistical approach, and to determine the kinetic parameters under flask and reactor conditions. The maximum concentrations of GA3, (2478.85 ± 68.53 mg/L), ABA, (273.26 ± 6.17 mg/L) and IAA (30.67 ± 0.19 mg/L) were obtained in submerged conditions. After optimization, these values reached 2998.85 ± 28.85, 339.47 ± 5.50, and 34.56 ± 0.25 mg/L, respectively. Immobilization of fungal cells on synthetic fiber, polyurethane foam, and alginate beads resulted in an increase in plant growth regulators (PGR) production by 5.53%- 5.79% under optimized conditions. At the reactor scale, a significant increase was observed for GA3 concentration, 5441.54 mg/L, which was 2.14 and 1.45 times higher than non-optimized and optimized conditions in the flask scale, respectively. The maximum values for ABA and IAA were 390.39 and 44.79 mg/L, respectively. Although the specific growth rate (µ) decreases relatively from non-optimized flask conditions to optimized reactor conditions, it was observed that the PGR amounts produced per liter medium (rp) and per gram biomass (Qp) increased significantly. This is the first report on the synthesis of PGR by Inonotus hispidus which could be crucial for sustainable agriculture.

Evaluation of moral intelligence of healthcare professionals via the "Survey for Measuring Moral Intelligence in the Provision of Healthcare Services" / Evaluación de la inteligencia moral de profesionales de la salud a través de la "Encuesta para medir la inteligencia moral en la prestación de servicios de salud" / Avaliação da inteligência moral de professionais de saúde via "Levantamento para Medir a Inteligência Moral na Provisão de Serviços de Cuidados à Saúde"

Abstract: Moral intelligence -through which an individual makes mental evaluation before taking action about a decision- is important in individual-centered healthcare. Using Lawshe Method, we designed the "Survey for Measuring Moral Intelligence in the Provision of Healthcare Services" with "equality", "empathy", "moral intelligence", "justice", "tolerance", "self-control", and "politeness" dimensions (α=.966). Age of the population (physicians and nurses) was 36.44±9.52, consisting 517 (65.5%) women, 538 married participants, 653 employed in public hospitals, and 352 had work experience of 8 hours/day. Using dimensions of this survey as skills is expected to ensure due diligence about rights and dignity in healthcare services.

Resumen: La inteligencia moral, mediante la cual un individuo realiza una evaluación mental antes de tomar medidas sobre una decisión, es importante en la atención médica centrada en el individuo. Usando el método Lawshe, diseñamos la "Encuesta para medir la inteligencia moral en la provisión de servicios de salud" con dimensiones de "igualdad", "empatía", "inteligencia moral", "justicia", "tolerancia", "autocontrol" y "cortesía" (α=.966). La edad de la población (médicos y enfermeras) era de 36.44±9.52, que consistía en 517 (65,5%) mujeres, 538 participantes casados, 653 empleados en hospitales públicos y 352 tenían una experiencia laboral de 8 horas/día. Se espera que el uso de las dimensiones de esta encuesta como habilidades garantice la debida diligencia sobre los derechos y la dignidad en los servicios de atención médica.

Resumo: Inteligência moral -através da qual um individuo faz uma avaliação mental antes de agir frente a uma decisão- é importante em cuidados à saúde centrados na pessoa. Usando o Método Lawshe, nós elaboramos o "Levantamento para Medir a Inteligência Moral na Provisão de Serviços de Cuidados à Saúde" com as dimensões "igualdade", "empatia", "inteligência moral", "justiça", "tolerância", "autocontrole" e "polidez (α=.966). A idade da população (médicos e enfermeiras) foi 36.44±9.52 anos, consistindo de 517 (65.5%) mulheres, 538 participantes casados, 653 empregados em hospitais públicos e 352 tinham experiência de trabalho 8 horas/dia. Usando dimensões deste levantamento como habilidades, espera-se que garanta a devida presteza sobre direitos e dignidade em serviços de cuidados à saúde.

Statistical optimization of cultural variables for enzymatic degradation of aflatoxin B1 by Panus neostrigosus.

The aim of this study is to determine the best aflatoxin B1 degradation conditions which was optimized using a combination of the Plackett-Burman and Box-Behnken methods with Panus neostrigosus culture filtrate. Panus neostrigosus was grown in a modified Kirk Broth medium to determine optimal degradation conditions. As a result, aflatoxin B1 was degraded under varying culture conditions. The Plackett-Burman method was designed after sixteen different experiments with fifteen variables. The three most effective variables (Sucrose, yeast extract, wheat bran) were chosen for the Box-Behnken methodology. The aflatoxin B1 degradation rate was 49% in just 1 h exposure to culture filtrate which was obtained under optimal growth conditions; (g-ml/L) sucrose 10, yeast extract 3, wheat bran 3, soytone 5, KH2PO4 2, MgSO4.7H2O 0.5, CaCl2.H2O 0.1, ammonium tartrate 2, trace element solution 10; 28 °C of incubation temperature, medium pH 5, 7.5% inoculum rate, 125 rpm of agitation speed, and a twelve-day incubation period. The SDS-PAGE studies show that the enzyme responsible for AFB1 degradation has 38 kDa molecular weight and has no laccase or MnP activity. To the best of our knowledge, this is the first report for AFB1 degradation by Panus neostrigosus.

New concept in clinical care: proposal of a moral intelligence scale / Nuevo concepto en atención clínica: propuesta de una escala de inteligencia moral / Novo conceito em atenção clínica: proposta de uma escala de inteligência moral

Abstract: Effective communication, especially of those health professionals in management positions, contributes to the entire process of treating patients and can transform the quality of service into the processes of diagnosis, treatment and care. Managers with moral intelligence are able to distinguish right from wrong and can facilitate the relationship between health professionals and patients. The purpose of this study is to develop a scale to measure moral intelligence. The measurement tool created by the Lawshe method was applied to 789 health professionals. Following the calculations of the Content Validity Ratio and the Content Validity Index, the scale included 77 items. After applying it, with the subsequent exploratory and confirmatory factor analysis, the scale received its final form with 47 items. The Cα value of the scale is 0.966. The scale has seven dimensions, and they have been defined as "equality", "empathy", "moral intelligence", "justice", "tolerance", "self-control" and "kindness". The Cα values for these dimensions are determined respectively as 0.922, 0.910, 0.874, 0.859, 0.799, 0.840 and 0.772; demonstrating that the scale allows to study the moral intelligence of nurses and doctors. The scale developed had high Cronbach alpha values for each component and element, indicating that the scale provides a survey with high validity to measure the moral intelligence of doctors and nurses. Factor analysis shows a statistically valid distribution of items and components. Taking into account the moral intelligence parameters in the provision of health services will contribute to accurately diagnose disorders, reduce patient anxiety, ensure a shorter hospital stay, reduce the number of patients transferred to other health centers, to prevent negligence, save time and achieve better workforce planning.

Resumen: La comunicación efectiva, especialmente de aquellos profesionales de la salud en puestos directivos, contribuye a todo el proceso de tratamiento de los pacientes y puede transformar la calidad del servicio en los procesos de diagnóstico, tratamiento y atención. Los gerentes con inteligencia moral son capaces de distinguir lo correcto de lo incorrecto y pueden facilitar la relación entre los profesionales de la salud y los pacientes. El propósito de este estudio es desarrollar una escala para medir la inteligencia moral. La herramienta de medición creada por el método Lawshe se aplicó a 789 profesionales de la salud. Siguiendo los cálculos de la Relación de Validez del Contenido y el Índice de Validez del Contenido, la escala incluyó 77 ítems. Después de aplicarlo, con el posterior análisis factorial exploratorio y confirmatorio, la escala recibió su forma final con 47 ítems. El valor Cα de la escala es 0,966. La escala tiene siete dimensiones, y se han definido como "igualdad", "empatía", "inteligencia moral", "justicia", "tolerancia", "autocontrol" y "amabilidad". Los valores de Cα para estas dimensiones se determinan respectivamente como 0.922, 0.910, 0.874, 0.859, 0.799, 0.840 y 0.772; demostrando que la escala permite estudiar la inteligencia moral de enfermeras y médicos. La escala desarrollada tenía altos valores alfa de Cronbach para cada componente y elemento, lo que indica que la escala proporciona una encuesta con alta validez para medir la inteligencia moral de médicos y enfermeras. El análisis factorial muestra una distribución estadísticamente válida de ítems y componentes. Tomar en cuenta los parámetros de inteligencia moral en la provisión de servicios de salud contribuirá a diagnosticar trastornos con precisión, reducir la ansiedad de los pacientes, garantizar una estadía más corta en el hospital, reducir el número de pacientes transferidos a otros centros de salud, prevenir la negligencia, ahorrar tiempo y lograr una mejor planificación de la fuerza laboral.

Resumo: A comunicação efetiva, especialmente dos profissionais da saúde em cargos diretivos, contribui com todo o processo de tratamento dos pacientes e pode transformar a qualidade do serviço nos processos de diagnóstico, tratamento e atenção. Os gerentes com inteligência moral são capazes de distinguir o certo do errado e podem facilitar a relação entre os profissionais da saúde e os pacientes. O propósito deste estudo é desenvolver uma escala para medir a inteligência moral. A ferramenta de mensuração criada pelo Método Lawshe foi aplicada a 789 profissionais da saúde. Seguindo os cálculos da Relação de Validade de Conteúdo e o Índice de Validade de Conteúdo, a escala incluiu 77 itens. Depois de aplica-la, com a análise fatorial exploratória e confirmatória posterior, a escala recebeu sua forma final com 47 itens. O valor C! da escala é 0,966. A escala tem sete dimensões que foram definidas como "igualdade", "empatia", "inteligência moral", "justiça", tolerância", "autocontrole" e "amabilidade". Os valores de C! para estas dimensões foram, respectivamente, determinados como 0,922, 0,910, 0,874, 0,859, 0,799, 0,840 e 0,772, demonstrando que a escala permite estudar a inteligência moral de enfermeiras e médicos. A escala desenvolvida tinha altos valores de alfa de Cronbach para cada componente e elemento, o que indica que proporciona uma pesquisa com alta validade para medir a inteligência moral de médicos e enfermeiras. A análise fatorial mostra uma distribuição estatisticamente válida de itens e componentes. Ter em conta os parâmetros de inteligência moral na provisão de serviços de saúde contribuirá para diagnosticar transtornos com precisão, reduzir a ansiedade dos pacientes, garantir uma permanência mais curta no hospital, reduzir o número de pacientes transferidos para outros centros de saúde, prevenir a negligência, salvar tempo e lograr um melhor planejamento da força de trabalho.

Statistical optimization of lovastatin production by Omphalotus olearius (DC.) singer in submerged fermentation.

In this study, culture conditions were optimized to improve lovastatin production by Omphalotus olearius, isolate OBCC 2002, using statistical experimental designs. The Plackett-Burman design was used to select important variables affecting lovastatin production. Accordingly, glucose, peptone, and agitation speed were determined as the variables that have influence on lovastatin production. In a further experiment, these variables were optimized with a Box-Behnken design and applied in a submerged process; this resulted in 12.51 mg/L lovastatin production on a medium containing glucose (10 g/L), peptone (5 g/L), thiamine (1 mg/L), and NaCl (0.4 g/L) under static conditions. This level of lovastatin production is eight times higher than that produced under unoptimized media and growth conditions by Omphalotus olearius. To the best of our knowledge, this is the first attempt to optimize submerged fermentation process for lovastatin production by Omphalotus olearius.

Enhanced production of lovastatin by Omphalotus olearius (DC.) Singer in solid state fermentation.

BACKGROUND: Although lovastatin production has been reported for different microorganism species, there is limited information about lovastatin production by basidiomycetes. AIMS: The optimization of culture parameters that enhances lovastatin production by Omphalotus olearius OBCC 2002 was investigated, using statistically based experimental designs under solid state fermentation. METHODS: The Plackett Burman design was used in the first step to test the relative importance of the variables affecting production of lovastatin. Amount and particle size of barley were identified as efficient variables. In the latter step, the interactive effects of selected efficient variables were studied with a full factorial design. RESULTS: A maximum lovastatin yield of 139.47mg/g substrate was achieved by the fermentation of 5g of barley, 1-2mm particle diam., at 28°C. CONCLUSIONS: This study showed that O. olearius OBCC 2002 has a high capacity for lovastatin production which could be enhanced by using solid state fermentation with novel and cost-effective substrates, such as barley.

Optimization of submerged fermentation conditions for lovastatin production by the culinary-medicinal oyster mushroom, Pleurotus ostreatus (Higher Basidiomycetes).

Statistical experimental designs were used to optimize lovastatin production by culinary-medicinal oyster mushroom Pleurotus ostreatus OBCC 1031 under submerged fermentation. The Plackett-Burman design was used to determine effective culture parameters, glucose, lactose, maltose, glycerol, peptone, yeast extract, NH4SO2, NaCl, thiamine, and agitation speed. Statistical analyses of data from the Plackett-Burman design show that glucose, yeast extract, and agitation speed are significant parameters. The interactive effects of these culture parameters on lovastatin production by P. ostreatus OBCC 1031 were further studied by a Box-Behnken design. Maximum lovastatin production (114.82 mg/L) was reached after 6 days of fermentation in optimized culture conditions (30 g/L glucose, 10 g/L yeast extract, 200 rpm, 28°C, and pH 6). This amount was found to be 50 times higher than that produced under unoptimized conditions in submerged fermentation by P. ostreatus.

The impact of nurses' motivation to work, job satisfaction, and sociodemographic characteristics on intention to quit their current job: an empirical study in Turkey.

This study investigated the effects of motivation to work, job satisfaction, and sociodemographic characteristics on nurses' intention to quit. The questionnaire used was designed to focus on 23 job satisfaction items, 4 sociodemographic items, and 4 motivation to work questions. Nine hundred thirty-six completed questionnaires were used for analyses. An ordinal regression model was proposed to explore the impact of the factors on nurses' intention to quit. Two motivation to work and 8 job satisfaction items were proven to be significant predictors of nurses' intention to quit. Clinicians and clinic researchers can be guided by suggestions and insights from this study that organizational, motivation, and sociodemographic factors contribute to nurses' intention to quit.

[The Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) Scale: a validity and reliability study]. / Kardiyovasküler Hastaliklar Risk Faktörleri Bilgi Düzeyi (KARRIF-BD) Olçegi'nin geçerlik ve güvenirligi.

OBJECTIVES: We developed a questionnaire to measure the knowledge level of adults about risk factors for cardiovascular diseases (CVD) and assessed its validity and reliability. STUDY DESIGN: We developed the Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) Scale in the light of the literature data. It consisted of 28 items, questioning the features of CVD in the first four items, risk factors in 15 items, and the results of adopting a risk-free attitude in nine items. All the items were based on true/false statements, requiring a response in the form of "Yes", "No" or "Don't know". To determine its validity and reliability, the scale was administered to 200 participants older than 20 years, of whom 144 individuals were involved in test-retest evaluations. Internal consistency was estimated using the Cronbach's alpha. To determine the validity of the scale, individuals with CVD and/or familial history were compared with those without CVD and/or familial history. RESULTS: The rates of true responses varied between 44.5% and 96.5%. The mean score was 19.3+/-3.2 (range 5 to 27), and the median item-total correlation was 0.26 (range 0.13 to 0.51). Internal consistency coefficient (Cronbach's alpha) was 0.768. There was a strong positive correlation between the test and retest total scores (r=0.850; p=0.000). Individuals with CVD and/or familial history had a significantly higher mean score than those without CVD and/or familial history (20.2+/-3.1 vs 19.3+/-3.2; p=0.032). CONCLUSION: In Turkey, CARRF-KL is the first scale developed to measure the knowledge level of individuals about risk factors for CVD, with good indices of validity and reliability.

The relation of sulcus nervi radialis with the fracture line of humerus fracture and radial nerve injury.

PURPOSE: Radial nerve is closely in contact with the bone in sulcus nervi radialis (SNR). Location of SNR shows ethnic differences. Radial nerve is a big problem in humerus fractures and its surgery. In this study, we aimed to examine if humerus fractures of this region increases the probability of radial nerve injury. METHODS: Total length of humerus and the distance of SNR to proximal and distal anatomical points were measured on 57 human dry cadaver bones. The mean values of these data were calculated. The 58 cases of treated humerus fractures in our orthopedics department, whose radiological film techniques were available, were involved in the study and their measurements were made at the same anatomic reference points, retrospectively. Proximal and distal safe zones to total length ratios of both groups were determined. The ratios of the cases were compared with the confidence intervals of dry bones. Location of the fracture line according to SNR and the relationship between radial nerve injury and this location were evaluated. RESULTS: Sulcus nervi radialis region was located at the middle of humerus. Of 24 cases which had radial nerve injury, only nine cases had fracture of SNR region. Of the 34 cases which had no radial nerve injury, 16 had fracture of SNR region. CONCLUSIONS: As a result; radial nerve injury rate was 37.5% for the fractures of SNR region and it was higher compared to other studies. We concluded that the fractures of SNR region do not increase the risk of radial nerve injury.

Telling the truth: Turkish patients' and nurses' views.

The objective of this study was to investigate nurses' communications with patients, particularly regarding getting accurate and truthful information about their medical diagnosis and prognosis. This survey research involved 166 nurses and 435 patients at the Osmangazi University Hospital, Turkey. Although 90% of the nurses said that patients should be informed about their diagnosis, only 66% of the patients said they wanted to be told this information. For those who wanted to be informed, how they should be informed is also discussed.

How do the accounts of the patients on pregnancy and birth process enlighten medical team in terms of narrative ethics?

OBJECTIVE: The aim of this study is to evaluate the relationship between the patient and the physician, midwife and nurse during the process of pregnancy and birth, and to ascertain the importance of communication within this relationship; find out the experiences of patients about the communication process. METHODS: Three hundred eighty-eight people were interviewed about the pregnancy and birth process. Chi square (chi(2)) and t-tests were used for the statistical evaluation of the data. Forty-nine pregnant women, who were participating in any pregnancy training program, were asked to write down their experiences related to the pregnancy and birth process in a notebook. Thirty-two (65.3%) of these notebooks were taken back 3 months after the delivery, and these notebooks were evaluated within the framework of "narrative ethics" and common themes were found out in order to be discussed in this paper. RESULTS: It is found out that communication skills of doctors and midwives/nurses were of primary importance for all the participants. CONCLUSION: Pregnancy and birth are special processes and being informed is of great importance in this process. Every woman has a story to tell about her pregnancy and birth processes. PRACTICE IMPLICATION: These findings may contribute to the development of new hypotheses. Hence, similar research projects should be conducted, and the findings should be compared.

The middle colic artery originating from the coeliac trunk.

A case is reported of an anomalous origin of the middle colic artery. The middle colic artery originated from the coeliac trunk (CT) instead of the superior mesenteric artery, the normal place of origin. The colon receives its blood supply from the superior and inferior mesenteric arteries. Since modern colon surgery requires a more detailed anatomy of blood supply, many articles have been published on the anatomy and variations of the arteries of the colon. However, the incidence of such an anomaly is low and there have been few previous reports. These arterial variations underscore the importance of performing vascular studies prior to major abdominal surgery.