Search results for: open treatment of carpal tunnel syndrome

Authors: Milda A. Cruz-Huaranga, Natalí Carbo-Bustinza, Javier Linkolk López-Gonzales, K. Depaz, Gina M. Tito T., Soledad Torres-Calderón

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The objective of this study was to improve water quality in the “La Mansión” pond in order to irrigate green spaces on the Peruvian Union University campus (Lima, Peru) using the aquatic species Eichhornia Crassipes. Furthermore, tree trimming and cleaning activities were performed that reduced water pollution caused by organic deposits and feathers from wild birds. The impaired waterbody is located on the campus of the Peruvian Union University, 580 meters above sea level, with a volume of 6,405.336 m3, an area of 3,050.16 m2, 256.81 m perimeter, and 0.12 m3/s input flow. Seven 1.8 m2 floating systems were implemented, with 12 common water hyacinth plants in each system. Before implementing this system, a water quality analysis was performed to analyse the physical-chemical, microbiological, and organoleptic parameters. The pre-analysis revealed the pond’s critical condition, with electrical conductivity: 556 mg/l; phosphate: < 0.5; pH: 7.06; total solids: 412 mg/l; arsenic: <0.01; lead: 0.115; BOD5: 14; COD: 16.94; dissolved oxygen: 13; total coliforms: 24000 MCL/100 ml; and thermo-tolerant coliforms: 11000 MCL/100 ml. After implementing the system, the following results were obtained: EC: 495 mg/l; DO:9.2 mg/l; TS: 235 mg/l; BOD5: 7.7; COD: 8.47; Pb: 0.001 mg/l; TC: 460 MCL/100 ml; FC: 240 MCL/100 ml. Thus, we confirmed that the system is 78.79% efficient regarding the Peruvian ECA (Environmental Quality Standards) established for water according to DS #015-2015-MINAM. Therefore, the water is suitable for plant irrigation. Finally, we concluded that treating wastewater with the species Eichhornia Crassipes is efficient since an improvement was achieved in the impaired waterbody.

Keywords: Eichhornia crassipes, plantlets, cleaning, impaired waterbody, pond

Procedia PDF Downloads 140

Authors: Mrunalini Sonne

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Aquaculture uses a variety of broad spectrum antibiotics to manage and prevent a variety of diseases without understanding their mechanisms of action. This has led to water pollution in the modern world. The necessity for alternate control measures against bacterial illnesses in the aquaculture sector is highlighted by issues brought on by antibiotic-resistant bacteria and the dearth of effective control strategies. Bacteriophages (phages) have shown promise as therapeutic agents for the efficient management of bacterial infections in aquaculture. In the current study, a variety of investigations were conducted to determine if utilizing lytic phages to reduce Aeromonas spp. infection in fish aquaculture was appropriate. Motile Aeromonas septicaemia is a fish disease that has caused financial harm to the aquaculture sector. Currently, the production of aquaculture depends significantly on antibiotics, which adds to the worldwide problem of the rise of bacteria that are resistant to medicines and resistance genes. To decrease the usage of antibiotics in aquaculture systems, it is crucial to create efficient antibiotic substitutes. Bacteriophages are capable of acting as a natural antagonist, mostly because of their great specificity, capacity for self-replication, and ability to quickly eradicate dangerous bacteria. There is a need for research that goes beyond just isolating and characterising lytic bacteriophages to examine their morphology, stability, and efficacy in various environmental conditions. Bacteriophage (or phage) therapy is a promising technique to control dangerous microbes in farmed fish. More phage therapy research in aquaculture is required in order to effectively employ phage treatment to lessen infection in fish brought on by Aeromonas.

Keywords: aquaculture, bacteriophages, fish, freshwater

Procedia PDF Downloads 105

Authors: Pei-Fan Mu

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Background: Lung cancer is the most common cancer with the highest mortality rate. Patients with lung cancer under chemotherapy treatment experience life-threatening uncertainty. This study was based on the broaden-and-build theory using intentionality reflection of the body and internalization of positive prioritization strategies to enhance positive emotions of patients with lung cancer. Purpose: The purpose of this study was to use a quasi-experimental research design to examine the effectiveness of the enhancing positive emotion program. Method: Data were collected from a medical center in Taiwan. Fifty-four participants with lung cancer were recruited. Thirty participants were in the experiential group receiving the two weeks program. The content of the program includes awareness and understanding of the symptom experience, co-existing with illness and establishing self-identity, cognitive-emotion adjustment and establishing a new body schema, and symptom management to reach spiritual well-being. Twenty-four participants were in the control group receiving regular nursing care. Baseline, one month later and two months later, programmed measurements of symptoms of distress, positive emotion, and psychological well-being. Results: These two weeks of enhancing the positive emotion program resulted in a significantly improved positive emotion score for the experimental group compared to the control group. The findings of this study indicated that the positive emotion had significant differences between the two groups. There were no differences in symptom distress between the two groups. Discussion: The findings indicated that the enhancing positive emotion program could help patients enhance their life-threatening facing conditions.

Keywords: positive emotion, lung cancer, experimental design, symptom distress

Procedia PDF Downloads 99

Authors: Anissa Mary Thomas Thattil, Nancy Angeline Gnanaselvam, B. Ramakrishna Goud

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Faecal sludge management (FSM) is an unorganized sector, and in India, there is an absence of regulations regarding the collection, transport, treatment, and disposal of faecal sludge. FSM has a high degree of occupational hazards that need to be thoroughly understood in order to shape effective solutions. On-field observations of five FSM operations were conducted in Anekal Taluk of southern Karnataka. All five of the FSM operations were privately owned and snowball method of sampling was employed. Two types of FS operations observed were: mechanical emptying involving direct human contact with faecal sludge and mechanical emptying without direct human contact with faecal sludge. Each operation was manned by 3-4 faecal sludge operators (FSOs). None of the observed FSOs used personal protective equipment. According to the WHO semi-quantitative risk assessment, the very high risk occupational hazards identified were dermal contact with faecal sludge, inhalation of toxic gases, and social stigma. The high risk hazards identified were trips and falls, injuries, ergonomic hazards, substance abuse, and mental health problems. In all five FSM operations, the collected faecal sludge was discharged untreated onto abandoned land. FSM in India is fraught with occupational and environmental hazards which need to be urgently addressed. This includes formalizing the institution of FSM, contextualized behaviour change communication, capacity building of local bodies, awareness programmes among agriculturists and FSOs, and designation of sites for the safe harnessing of faecal sludge as soil nutrient.

Keywords: faecal sludge, faecal sludge management, FSM, occupational hazards, sanitation

Procedia PDF Downloads 180

Authors: Yu-Chuan Huang

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Introduction: There is a higher mortality rate for unplanned transfer to intensive care units. It also needs a longer length of stay and makes the intensive care unit beds cannot be effectively used. It affects the immediate medical treatment of critically ill patients, resulting in a drop in the quality of medical care. Purpose: The purpose of this study was using SOFA and APACHEII score to analyze the mortality rate of the cases transferred from ED to ICU. According to the score that should be provide an appropriate care as early as possible. Methods: This study was a descriptive experimental design. The sample size was estimated at 220 to reach a power of 0.8 for detecting a medium effect size of 0.30, with a 0.05 significance level, using G-power. Considering an estimated follow-up loss, the required sample size was estimated as 242 participants. Data were calculated by medical system of SOFA and APACHEII score that cases transferred from ED to ICU in 2016. Results: There were 233 participants meet the study. The medical records showed 33 participants’ mortality. Age and sex with QSOFA , SOFA and sex with APACHEII showed p>0.05. Age with APCHHII in ED and ICU showed r=0.150, 0,268 (p < 0.001**). The score with mortality risk showed: ED QSOFA is r=0.235 (p < 0.001**), exp(B)=1.685(p = 0.007); ICU SOFA 0.78 (p < 0.001**), exp(B)=1.205(p < 0.001). APACHII in ED and ICU showed r= 0.253, 0.286 (p < 0.001**), exp(B) = 1.041,1.073(p = 0.017,0.001). For SOFA, a cutoff score of above 15 points was identified as a predictor of the 95% mortality risk. Conclusions: The SOFA and APACHE II were calculated based on initial laboratory data in the Emergency Department, and during the first 24 hours of ICU admission. In conclusion, the SOFA and APACHII score is significantly associated with mortality and strongly predicting mortality. Early predictors of morbidity and mortality, which we can according the predicting score, and provide patients with a detail assessment and proper care, thereby reducing mortality and length of stay.

Keywords: SOFA, APACHEII, mortality, ICU

Procedia PDF Downloads 147

Authors: H. Aldewachi, M. Hines, M. McCulloch, N. Woodroofe, P. Gardiner

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DPP-IV is an enzyme whose expression is affected in a variety of diseases, therefore, has been identified as possible diagnostic or prognostic marker for various tumours, immunological, inflammatory, neuroendocrine, and viral diseases. Recently, DPP-IV enzyme has been identified as a novel target for type II diabetes treatment where the enzyme is involved. There is, therefore, a need to develop sensitive and specific methods that can be easily deployed for the screening of the enzyme either as a tool for drug screening or disease marker in biological samples. A variety of assays have been introduced for the determination of DPP-IV enzyme activity using chromogenic and fluorogenic substrates, nevertheless these assays either lack the required sensitivity especially in inhibited enzyme samples or displays low water solubility implying difficulty for use in vivo samples in addition to labour and time-consuming sample preparation. In this study, novel strategies based on exploiting the high extinction coefficient of gold nanoparticles (GNPs) are investigated in order to develop fast, specific and reliable enzymatic assay by investigating synthetic peptide sequences containing a DPP IV cleavage site and coupling them to GNPs. The DPP IV could be detected by colorimetric response of peptide capped GNPs (P-GNPS) that could be monitored by a UV-visible spectrophotometer or even naked eyes, and the detection limit could reach 0.01 unit/ml. The P-GNPs, when subjected to DPP IV, showed excellent selectivity compared to other proteins (thrombin and human serum albumin) , which led to prominent colour change. This provided a simple and effective colorimetric sensor for on-site and real-time detection of DPP IV.

Keywords: gold nanoparticles, synthetic peptides, colorimetric detection, DPP-IV enzyme

Procedia PDF Downloads 303

Authors: Laura E. Monroe

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As more non-native English-speaking students enroll in English-medium universities, even more faculty will instruct students who are unprepared for the rigors of post-secondary academic writing in English. Many faculty members lack training and knowledge regarding the assessment of non-native English-speaking students’ writing, as well as the ability to provide effective feedback. This quantitative study investigated the possible attitudinal factors, including demographics, which might affect faculty preparedness and grading practices for both native and non-native English-speaking students’ academic writing and plagiarism, as well as the reasons faculty do not deduct points from both populations’ writing errors. Structural equation modeling and SPSS Statistics were employed to analyze the results of a faculty questionnaire disseminated to individuals who had taught non-native English-speaking students in academic subject courses. The findings from this study illustrated that faculty’s native language, years taught, and institution type were significant factors in not deducting points for academic writing errors and plagiarism, and the major reasons for not deducting points for errors were that faculty had too many students to grade, not enough training in assessing student written errors and plagiarism and that the errors and plagiarism would have taken too long to explain. The practical implications gleaned from these results can be applied to most departments in English-medium post-secondary institutions regarding faculty preparedness and training in student academic writing errors and plagiarism, and recommendations for future research are given for similar types of preparation and guidance for post-secondary faculty, regardless of degree path or academic subject.

Keywords: assessment, faculty, non-native English-speaking students, writing

Procedia PDF Downloads 149

Authors: M. Afzal, Salem Safer Alghamdi, Awais Ahmad

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Limited amount of irrigation water is an alarming threat to arid and semiarid agriculture. However, genotypic response differences to water deficit conditions within species have been reported frequently. Present study was conducted in order to measure the genotypic differences among faba bean accessions under Regular Deficit Irrigation (RDI). Five seeds from each accession were sown in 135 silt filled pots (30 x 24 cm). Experiment was planned under split plot arrangement and replicated thrice. Treatments consisted of three RDI levels (100% (control), 60% and 40% of the field capacity) and fifteen faba bean accessions (two local accessions as reference while thirteen from different sources around the world). Irrigation treatment was started from the very first day of sowing. Plant height, shoot dry weight, stomatal conductance and total chlorophyll contents (SPAD reading) were measured one month after germination. Irrigation, faba bean accessions and the all possible interactions has stood significantly high for all studied parameters. Regular deficient irrigation has hampered the plant growth and associated parameters in decreasing order (100% < 60% < 40%). Accessions have responded differently under regular deficient irrigation and some of them are even better than local accession. A highly significant correlation among all parameters has also been observed. It was concluded from results that above parameters could be used as markers to identify the genotypic differences for water deficit stress response. This outcome encouraged the use of superior faba bean genotypes in breeding programs for improved varieties to enhance water use efficiency under stress conditions.

Keywords: accessions, stomatal conductance, total chlorophyll contents, RDI, regular deficient irrigation

Procedia PDF Downloads 297

Authors: Najmeh Jafari, Sona Rostampour Yasouri

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Crimean-Congo hemorrhagic fever (CCHF) is an acute hemorrhagic disease. This disease is one of the common diseases between humans and animals, transmitted through tick bites or contact with the blood and secretions or carcasses of infected animals and humans. CCHF is more common in people who work with livestock, such as ranchers, butchers, farmers, slaughterhouse workers, healthcare workers, etc. Its hospital prevalence is also very high. Considering that CCHF can be transmitted through the consumption of food such as beef and sheep meat, this study aims to quickly identify and diagnose the Crimean-Congo fever virus in suspected patients through real-time PCR technique. In the summer of 1402, 20 blood samples were collected separately from Ahvaz and Gilan hospitals. An extraction kit was used to extract the virus RNA. Primers and probes were designed based on the S genomic region, the conserved region in CCHFV. Then, a real-time PCR technique was performed with specific primers and probes. It should be noted that the mentioned technique was repeated several times. The number of 4 samples from the examined samples was determined positive by real-time PCR. This technique has high sensitivity and specificity and the possibility of rapid detection of CCHFV. Therefore, the above method is a good candidate for quick disease diagnosis. By diagnosing the disease, the treatment process can be done faster, and the best prevention methods can be used to control the disease and prevent the death of patients.

Keywords: ahvaz, crimean-congo hemorrhagic fever, gilan, real time PCR

Procedia PDF Downloads 74

Authors: Mohammad Jamal

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Non-alcoholic fatty liver disease (NAFLD) has become one of the most chronic liver diseases, prevalent among people with morbid obesity. NAFLD does not develop clinically significant liver disease, however cirrhosis and liver cancer develop in subset and currently there are no approved therapies for the treatment of NAFLD. The study is aimed to understand the various key genes involved in the mechanism of NAFLD which can be valuable for developing diagnostic and predictive biomarkers based on their histologic stage of liver. The study was conducted on 16 male Sprague Dawley rats. The animals were divided in two groups: control group (n=8) fed on ad libitum normal chow and regular water and the cafeteria group (CAF)) (n=8) fed on high fatty/ carbohydrate diet. The animals received their respective diet from 4 weeks onwards from D.O.B until 25 weeks. Liver was extracted and RT² Profiler PCR Array was used to assess the NAFLD related genes. Histological evaluation was performed using H&E stain in liver tissue sections. Our PCR array results showed that genes involved in anti-inflammatory activity (Ifng, IL10), fatty acid uptake/oxidation (Fabp5), apoptosis (Fas), lipogenesis (Gck and Srebf1), Insulin signalling (Igfbp1) and metabolic pathway (pdk4) were upregulated in the liver of cafeteria fed obese rats. Bloated hepatocytes, displaced nucleus and higher lipid content were seen in the liver of cafeteria fed obese rats. Although Liver biopsies remain the gold standard in evaluating NAFLD, however an approach towards non-invasive markers could be used in understanding the physiology, therapeutic potential, and the targets to combat NAFLD.

Keywords: biomarkers, cafeteria diet, obesity, NAFLD

Procedia PDF Downloads 143

Authors: Hsiu-Chuan Hsueh, Kuei-Feng Shen Jr., Chia-Ling Chao, Hui-Chuan Pan

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This article described a 75 years old woman who has suffered from intestinal perforation and accepted surgery with temporary enterostomy, the operation makes her depressed, refused relatives and friend's care, facing low willingness to participate in various activities due to fear of changing body appearance caused by surgery and leave enterostomy. The author collected information through observation talks, physical evaluation, and medical records during the period of care from November 14 to November 30, 2016, we used the four aspects of physiology, psychology, society and spirituality as a whole sexual assessment to establish the nursing problems of patient, included of acute pain, disturbance of body image,coping ineffective individual. For patient care issues, to encouraged case to express their inner feelings and take part in self-care programs through providing good therapeutic interpersonal relationships with their families. However, it provided clear information about the disease and follow-up treatment plan, give compliments in a timely manner, enhanced self-confidence of individual cases and their motivation to participate in self-care of stoma, further face the disease in a positive manner. At the same time, cross-section team care model and individual care measures were developed to enhance the care skills after returning home and at the same time assist the individual in facing the psychological impact caused by stoma. Hope to provide this experience, as a reference for the future care of the disease.

Keywords: enterostomy, intestinal perforation, nursing experience, ostomy

Procedia PDF Downloads 139

Authors: Azza A. Ali, Hebatalla I. Ahmed, Asmaa Abdelaty

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Background: Manganese (Mn) is a naturally occurring element. Exposure to high levels of Mn causes neurotoxic effects and represents an environmental risk factor. Mn neurotoxicity is poorly understood but changing of AChE activity, monoamines and oxidative stress has been established. Bisphenol A (BPA) is a synthetic compound widely used in the production of polycarbonate plastics. There is considerable debate about whether its exposure represents an environmental risk. Caffeine is one of the major contributors to the dietary antioxidants which prevent oxidative damage and may reduce the risk of chronic neurodegenerative diseases. Epigallocatechin-3-gallate is another major component of green tea and has known interactions with caffeine. It also has health-promoting effects in CNS. Objective: To evaluate the potential protective effects of Caffeine and/or EGCG against Mn-induced neurotoxicity either alone or in the presence of BPA in rats. Methods: Seven groups of rats were used and received daily for 5 weeks MnCl2.4H2O (10 mg/kg, IP) except the control group which received saline, corn oil and distilled H2O. Mn was injected either alone or in combination with each of the following: BPA (50 mg/kg, PO), caffeine (10 mg/kg, PO), EGCG (5 mg/kg, IP), caffeine + EGCG and BPA +caffeine +EGCG. All rats were examined in five behavioral tests (grid, bar, swimming, open field and Y- maze tests). Biochemical changes in monoamines, caspase-3, PGE2, GSK-3B, glutamate, acetyl cholinesterase and oxidative parameters, as well as histopathological changes in the brain, were also evaluated for all groups. Results: Mn significantly increased MDA and nitrite content as well as caspase-3, GSK-3B, PGE2 and glutamate levels while significantly decreased TAC and SOD as well as cholinesterase in the striatum. It also decreased DA, NE and 5-HT levels in the striatum and frontal cortex. BPA together with Mn enhanced oxidative stress generation induced by Mn while increased monoamine content that was decreased by Mn in rat striatum. BPA abolished neuronal degeneration induced by Mn in the hippocampus but not in the substantia nigra, striatum and cerebral cortex. Behavioral examinations showed that caffeine and EGCG co-administration had more pronounced protective effect against Mn-induced neurotoxicity than each one alone. EGCG alone or in combination with caffeine prevented neuronal degeneration in the substantia nigra, striatum, hippocampus and cerebral cortex induced by Mn while caffeine alone prevented neuronal degeneration in the substantia nigra and striatum but still showed some nuclear pyknosis in cerebral cortex and hippocampus. The marked protection of caffeine and EGCG co-administration also confirmed by the significant increase in TAC, SOD, ACHE, DA, NE and 5-HT as well as the decrease in MDA, nitrite, caspase-3, PGE2, GSK-3B, the glutamic acid in the striatum. Conclusion: Neuronal degeneration induced by Mn showed some inhibition with BPA exposure despite the enhancement in oxidative stress generation. Co-administration of EGCG and caffeine can protect against neuronal degeneration induced by Mn and improve behavioral deficits associated with its neurotoxicity. The protective effect of EGCG was more pronounced than that of caffeine even with BPA co-exposure.

Keywords: manganese, bisphenol a, caffeine, epigallocatechin-3-gallate, neurotoxicity, behavioral tests, rats

Procedia PDF Downloads 228

Authors: Adebowale T. Odeyemi, Oluwafemi A. Ajenifuja

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The leachate samples collected from Erifun dumpsite along Federal Polythenic road, Ado-Ekiti, Ekiti State, were subjected to bacteriological and mineral analyses. The bacteriological estimation and isolation were done using serial dilution and pour plating techniques. Antibiotic susceptibility test was done using agar disc diffusion technique. Atomic Absorption Spectophotometry method was used to analyze the heavy metal contents in the leachate samples. The bacterial and coliform counts ranged from 4.2 × 105 CFU/ml to 2.97 × 106 CFU/ml and 5.0 × 104 CFU/ml to 2.45 x 106 CFU/ml, respectively. The isolated bacteria and percentage of occurrence include Bacillus cereus (22%), Enterobacter aerogenes (18%), Staphylococcus aureus (16%), Proteus vulgaris (14%), Escherichia coli (14%), Bacillus licheniformis (12%) and Klebsiella aerogenes (4%). The mineral value ranged as follow; iron (21.30mg/L - 25.60mg/L), zinc (1.80mg/L - 5.60mg/L), copper (1.00mg/L - 2.60mg/L), chromium (0.50mg/L - 1.30mg/L), candium (0.20mg/L - 1.30mg/L), nickel (0.20mg/L - 0.80mg/L), lead (0.05mg/L-0.30mg/L), cobalt (0.03mg/L - 0.30mg/L) and in all samples manganese was not detected. The entire organisms isolated exhibited a high level of resistance to most of the antibiotics used. There is an urgent need for awareness to be created about the present situation of the leachate in Erifun, on the need for treatment of the nearby stream and other water sources before they can be used for drinking and other domestic use. In conclusion, a good method of waste disposal is required in those communities to prevent leachate formation, percolation, and runoff into water bodies during the raining season.

Keywords: antibiotic susceptibility, dumpsite, bacteriological analysis, heavy metal

Procedia PDF Downloads 142

Authors: Nicole Cervenka

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On the question of norms in international politics, scholars are divided over whether norms are a tool for power politics or a genuine reflection of an emergent international society. The line is drawn between rationalism and idealism, but this dialectical relationship needs to be broken down if we hope to come to a comprehensive understanding of how norms play out in international society. The concept of an elusive international society is a simplification of a more pluralistic, cosmopolitan, and diverse collection of international societies. The English School effectively overcomes realist-idealist dichotomies and provides a pluralistic, comprehensive explanation and description of international societies through its application to two distinct areas: human rights as well as security and war. We argue that international norms have always been present in human rights, war, and international security, forming international societies that can be complimentary or oppositional, beneficial or problematic. Power politics are present, but they can only be regarded as partially explanatory of the role of norms in international politics, which must also include history, international law, the media, NGOs, and others to fully represent the normative influences in international societies. A side-by-side comparison of international norms of war/security and human rights show how much international societies converge. World War II was a turning point in terms of international law, these forces of international society have deeper historical roots. Norms of human rights and war/security are often norms of restraint, guiding appropriate treatment of individuals. This can at times give primacy to the individual over the sovereign state. However, state power politics and hegemony are still intact. It cannot be said that there is an emergent international society—international societies are part of broader historical backdrops. Furthermore, states and, more generally, power politics, are important components in international societies, but international norms are far from mere tools of power politics. They define a more diverse, complicated, and ever-present conception of international societies.

Keywords: English school, international societies, norms, pluralism

Procedia PDF Downloads 384

Authors: Jesús Horacio, Alfredo Ollero, Víctor Bouzas-Blanco, Augusto Pérez-Alberti

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Rivers have traditionally been classified, assessed and managed in terms of hydrological, chemical and / or biological criteria. Geomorphological classifications had in the past a secondary role, although proposals like River Styles Framework, Catchment Baseline Survey or Stroud Rural Sustainable Drainage Project did incorporate geomorphology for management decision-making. In recent years many studies have been attracted to the geomorphological component. The geomorphological processes and their associated forms determine the structure of a river system. Understanding these processes and forms is a critical component of the sustainable rehabilitation of aquatic ecosystems. The fluvial auto-classification approach suggests that a river is a self-built natural system, with processes and forms designed to effectively preserve their ecological function (hydrologic, sedimentological and biological regime). Fluvial systems are formed by a wide range of elements with multiple non-linear interactions on different spatial and temporal scales. Besides, the fluvial auto-classification concept is built using data from the river itself, so that each classification developed is peculiar to the river studied. The variables used in the classification are specific stream power and mean grain size. A discriminant analysis showed that these variables are the best characterized processes and forms. The statistical technique applied allows to get an individual discriminant equation for each geomorphological type. The geomorphological classification was developed using sites with high naturalness. Each site is a control point of high ecological and geomorphological quality. The changes in the conditions of the control points will be quickly recognizable, and easy to apply a right management measures to recover the geomorphological type. The study focused on Galicia (NW Spain) and the mapping was made analyzing 122 control points (sites) distributed over eight river basins. In sum, this study provides a method for fluvial geomorphological classification that works as an open and flexible tool underlying the fluvial auto-classification concept. The hydrographic mapping is the visual expression of the results, such that each river has a particular map according to its geomorphological characteristics. Each geomorphological type is represented by a particular type of hydraulic geometry (channel width, width-depth ratio, hydraulic radius, etc.). An alteration of this geometry is indicative of a geomorphological disturbance (whether natural or anthropogenic). Hydrographic mapping is also dynamic because its meaning changes if there is a modification in the specific stream power and/or the mean grain size, that is, in the value of their equations. The researcher has to check annually some of the control points. This procedure allows to monitor the geomorphology quality of the rivers and to see if there are any alterations. The maps are useful to researchers and managers, especially for conservation work and river restoration.

Keywords: fluvial auto-classification concept, mapping, geomorphology, river

Procedia PDF Downloads 367

Authors: Jae-Yong Lee, Gyu-Hyun Bae, Yun-Soo Chung, Dae-Sub Kim, Jae-Sung Bae

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In general, fabric is heat-treated using a stenter machine in order to dry and fix its shape. It is important to shape before the heat treatment because it is difficult to revert back once the fabric is formed. To produce the product of right shape, camera type weft straightener has been applied recently to capture and process fabric images quickly. It is more powerful in determining the final textile quality rather than photo-sensor. Positioning in front of a stenter machine, weft straightener helps to spread fabric evenly and control the angle between warp and weft constantly as right angle by handling skew and bow rollers. To process this tricky procedure, the structural analysis should be carried out in advance, based on which, its control technology can be drawn. A structural analysis is to figure out the specific contact/slippage characteristics between fabric and roller. We already examined the applicability of camera type weft straightener to plain weave fabric and found its possibility and the specific working condition of machine and rollers. In this research, we aimed to explore another applicability of camera type weft straightener. Namely, we tried to figure out camera type weft straightener can be used for fabrics. To find out the optimum condition, we increased the number of rollers. The analysis is done by ANSYS software using Finite Element Analysis method. The control function is demonstrated by experiment. In conclusion, the structural analysis of weft straightener is done to identify a specific characteristic between roller and fabrics. The control of skew and bow roller is done to decrease the error of the angle between warp and weft. Finally, it is proved that camera type straightener can also be used for the special fabrics.

Keywords: camera type weft straightener, structure analysis, control, skew and bow roller

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Authors: Alazar Nebyou, Sujata Pandit

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Lactic acid bacteria (LAB) are essential ingredients in probiotic foods, intestinal microflora, and dairy products that are capable of coping up with harsh gastrointestinal tract conditions and are available in a variety of environments. The objective of this study is to evaluate the probiotic property of LAB isolated from bovine milk. Milk samples were collected from local dairy farms. Samples were obtained using sterile test tubes and transported to a laboratory in the icebox for further biochemical characterization. Preliminary physiological and biochemical identification of LAB isolates was conducted by growing on MRS agar after ten-fold serial dilution. Seven of the best isolates were selected for the evaluation of the probiotic property. The LAB isolates were checked for resistance to antibiotics and their antimicrobial activity by disc diffusion assay and agar well diffusion assay respectively. Bile salt hydrolase activity of isolates was studied by growing isolates in a BSH medium with bile salt. Cell surface property of isolates was assayed by studying their autoaggregation and coaggregation percentage with S. aerues. All isolates were found BSH positive. In addition, BCM2 and BGM1 were susceptible to all antibiotic disks except BBM1 which was resistant to all antibiotic disks. BCM1 and BGM1 had the highest autoaggregation and coaggregation potential respectively. Since all LAB isolates showed gastrointestinal tolerance and good cell surface property they could be considered as good potential probiotic candidates for treatment and probiotic starter culture preparation.

Keywords: probiotic, aggregation, lactic acid bacteria, antimicrobial activity

Procedia PDF Downloads 215

Authors: Khaleel Alyahya, Faizah Alotaibi

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The coronavirus disease 19 (COVID-19) pandemic has caused an increase in general fear and anxiety around the globe. With the public health measures, including lockdown and travel restrictions, the COVID-19 period further resulted in a sudden increase in the vulnerability of people too ill mental health. This becomes greater among individuals who have a history of mental illness or are undergoing treatment and do not have easy access to medication and medical consultations. The study aims to measure the impact of COVID-19 and the degree of distress with the DASS scale on the mental health of residents living in Saudi Arabia. The study is a quantitative, observational, and cross-sectional conducted in Saudi Arabia to measure the impact of COVID-19 on the mental health of both citizens and residents of Saudi Arabia during pandemics. The study ran from February 2021 to June 2021, and a validated questionnaire was used. The targeted population of the study was Saudi citizens and non-Saudi residents. A sample size of 800 participants was calculated with a single proportion formula at 95% level of significance and 5% allowable error. The result revealed that participants who were always doing exercise experienced the lowest level of depression, anxiety, and stress. The highest prevalence of severe and extremely severe depression was among participants who sometimes do exercise at 53.2% for each. Similar results were obtained for anxiety and stress, where the extremely severe form was reported by those who sometimes did exercise at 54.8% and 72.2%, respectively. There was an inverse association between physical activity levels and levels of depression, anxiety, and stress during the COVID-19. Similarly, the levels of depression, anxiety, and stress differed significantly according to the exercise frequency during COVID-19.

Keywords: mental, COVID-19, pandemic, lockdown, depression, anxiety, stress

Procedia PDF Downloads 103

Authors: Jennifer E Simpson

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Background and purpose: The ubiquitous use of the Internet and social media by children and young people has had a dual effect. The first is to open a world of possibilities and promise that is characterized by the ability to consume and create content, connect with friends, explore and experiment. The second relates to risks such as unsolicited requests, sexual exploitation, cyberbullying and commercial exploitation. This duality poses significant difficulties for a generation of foster carers and social workers who have no childhood experience to draw on in terms of growing up using the Internet, social media and digital devices. This presentation is concerned with the findings of a small qualitative study about the use of digital devices and the Internet by care-experienced young people to stay in touch with their families and the way this was managed by foster carers and social workers using specific parental mediation strategies. The findings highlight that restrictive strategies were used by foster carers and endorsed by social workers. An argument is made for an approach that develops a series of balanced solutions that move foster carers from such restrictive approaches to those that are grounded in co-use and are interpretive in nature. Methods: Using a purposive sampling strategy, 12 triads consisting of care-experienced young people (aged 13-18 years), their foster carers and allocated social workers were recruited. All respondents undertook a semi-structured interview, with the young people detailing what social media apps and other devices they used to contact their families via an Ecomap. The foster carers and social workers shared details of the methods and approaches they used to manage digital devices and the Internet in general. Data analysis was performed using a Framework analytic method to explore the various attitudes, as well as complementary and contradictory perspectives of the young people, their foster carers and allocated social workers. Findings: The majority of foster carers made use of parental mediation strategies that erred on the side of typologies that included setting rules and regulations (restrictive), ad-hoc checking of a young person’s behavior and device (monitoring), and software used to limit or block access to inappropriate websites (technical). It was noted that minimal use was made by foster carers of parental mediation strategies that included talking about content (active/interpretive) or sharing Internet activities (co-use). Amongst the majority of the social workers, they also had a strong preference for restrictive approaches. Conclusions and implications: Trepidations on the part of both foster carers and social workers about the use of digital devices and the Internet meant that the parental strategies used were weighted more towards restriction, with little use made of approaches such as co-use and interpretative. This lack of balance calls for solutions that are grounded in co-use and an interpretive approach, both of which can be achieved through training and support, as well as wider policy change.

Keywords: parental mediation strategies, risk, children in state care, online safety

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Authors: Anil Bhandari, Imran Khan Pathan, Peeyush K. Sharma, Rakesh K. Patel, Suresh Purohit

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The purpose of this study was to prepare time and pH dependent release tablets of Ayurvedic Churna formulation and evaluate their advantages as colon targeted drug delivery system. The Vidangadi Churna was selected for this study which contains Embelin and Gallic acid. Embelin is used in Helminthiasis as therapeutic agent. Embelin is insoluble in water and unstable in gastric environment so it was formulated in time and pH dependent tablets coated with combination of two polymers Eudragit L100 and ethyl cellulose. The 150mg of core tablet of dried extract and lactose were prepared by wet granulation method. The compression coating was used in the polymer concentration of 150mg for both the layer as upper and lower coating tablet was investigated. The results showed that no release was found in 0.1 N HCl and pH 6.8 phosphate buffers for initial 5 hours and about 98.97% of the drug was released in pH 7.4 phosphate buffer in total 17 hours. The in vitro release profiles of drug from the formulation could be best expressed first order kinetics as highest linearity (r2= 0.9943). The results of the present study have demonstrated that the time and pH dependent tablets system is a promising vehicle for preventing rapid hydrolysis in gastric environment and improving oral bioavailability of Embelin and Gallic acid for treatment of Helminthiasis.

Keywords: embelin, gallic acid, Vidangadi Churna, colon targeted drug delivery

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Authors: Qiaofeng Guo

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Aims: Obesity is often accompanied by insulin resistance (IR) and whole-body inflammation. Aerobic exercise is an effective treatment to improve insulin resistance and inflammation. However, the anti-inflammatory mechanisms of exercise on epididymal and subcutaneous adipose remain to be elucidated. Here, we compared the macrophage polarization between epididymal and subcutaneous adipose after aerobic exercise. Methods: Male C57BL/6 mice were fed a normal diet group or a high-fat diet group for 12 weeks and performed aerobic training on a treadmill at 55%~65% VO₂ max for eight weeks. Food intake, body weight, and fasting blood glucose levels were monitored weekly. The intraperitoneal glucose tolerance test was to evaluate the insulin resistance model. Fat mass, blood lipid profile, serum IL-1β, TNF-α levels, and CD31/CD206 rates were analysed after the intervention. Results: FBG (P<0.01), AUCIPGTT (P<0.01), and HOMA-IR (P<0.01) increased significantly for a high-fat diet and decreased significantly after the exercise. Eight weeks of aerobic exercise attenuated HFD-induced weight gain and glucose intolerance and improved insulin sensitivity. Serum IL-1β, TNF-α, CD11C/CD206 expression in subcutaneous adipose tissue were not changed before and after exercise, but not in epididymal adipose tissue (P<0.01). Conclusion: Insulin resistance is not accompanied by chronic inflammation and M1 polarization of subcutaneous adipose tissue macrophages in high-fat diet mice. Aerobic exercise effectively improved lipid metabolism and insulin sensitivity, which may be closely associated with reduced M1 polarization of epididymal adipose macrophages.

Keywords: aerobic exercise, insulin resistance, chronic inflammation, adipose, macrophage polarization

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Authors: Anela Lupuwana

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The main objective of this paper is to develop an ethnobotanical survey that documents medicinal plants used to treat diarrhea among infants in the Eastern Cape province of South Africa. In South Africa’s pluralistic healthcare system, medicinal plants are an integral part of healing and treating an array of diseases. This is also the case in rural areas of South Africa, where healthcare facilities are hard to access. There is a lack of literature on the use of medicinal plants to cure ailments common to children, and this paper fills this gap. A total of 18 participants were interviewed using semi-structured interviews. A purposive approach was used to sample the study cohorts. A total of 28 medicinal plants representing 19 different families were recorded, with the family Asteraceae (11%) having the most medicinal plants. The remaining plants (82%) were distributed equally among the following families: Rubiaceae, Canellaceae, Aloaceae, Rutaceae, Thymeleaceae, Myrinaceae, Olinaceae, Iradeceae, Zingiberaceae, Capparaceae, Aizoaceae, Fabaceae, Geraniaceae, Cornaceae, Monimiaceae, Talinaceae, Chrysobalanaceae, and Icacinaceae. Oral administration was the most common mode of administration, with 82% of plants taken orally. Healing was proven to be holistic; it was more than just treating physical ailments as such; infants were protected from evil spirits that made them vulnerable to illnesses. There was also evidence of the assimilation of Dutch medicine and animal products into traditional healing methods. In order to mitigate the prevalence of disease and illness in South Africa, I recommend that diversity in healing practices should be acknowledged and appreciated.

Keywords: infants, traditional healers, primary care givers, traditional medicine

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Authors: Guanglin Song

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(Objective) Situated within the context of China's tiered medical treatment system, this study aims to analyze spatial causes of urban healthcare access difficulties from the perspective of the configuration of healthcare facilities. (Methods) A social network analysis approach is employed to construct a healthcare demand and supply flow network between major residential clusters and various tiers of hospitals in the city.(Conclusion) The findings reveal that:1.there exists overall maldistribution and over-concentration of healthcare resources in Study Area, characterized by structural imbalance; 2.the low rate of primary care utilization in Study Area is a key factor contributing to congestion at higher-tier hospitals, as excessive reliance on these institutions by neighboring communities exacerbates the problem; 3.gradual optimization of the healthcare facility layout in Study Area, encompassing holistic, local, and individual institutional levels, can enhance systemic efficiency and resource balance.(Prospects) This research proposes a method for evaluating urban healthcare resource distribution structures based on service flows within hierarchical networks. It offers spatially targeted optimization suggestions for promoting the implementation of the tiered healthcare system and alleviating challenges related to accessibility and congestion in seeking medical care. Provide some new ideas for researchers and healthcare managers in countries, cities, and healthcare management around the world with similar challenges.

Keywords: flow of public services, urban networks, healthcare facilities, spatial planning, urban networks

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Authors: Boshra Mozaffar, Iskandar Idris

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Taste change is a common complication after Bariatric surgery (BS). However, the cause of this is still not clear. Since zinc is important fortaste perception, zinc deficiency, which is common after BS, may play an important role for taste change after BS. In this review, we aimto collate evidence relating to taste change and zinc deficiencyin relation to BS; effects of zinc replacement on taste perception in general and thereafter discuss the possible role of zinc deficiency to induce taste change after BS. A literature search was conducted, using four electronic bibliographical databases—EMBASE, PubMed, AMED and MEDLINE. We identified all available and relevant articles published before 30th February 2021.In total, 33 studies were included. The total number of participants analysed was N= 3264. We showed that taste change is a frequent complication after BS, especially after Roux-en-Y gastric bypass RYGBP comparing to other types of procedures. Patients' taste sensitivity differs among studies, but the most important decline in taste preference was observed for sweet food. Twelve studies investigating zinc deficiency following BS showed a significant decrease in zinc levels at six months after surgery. Supplementation with 45–50 mg of zinc sulphate was effective in improving taste, except in cancer patients, who showed no improvement in taste following zinc supplementation. Zinc deficiency appears to be associated with taste change after BS. Supplementation with much higher levels of zinc, at 45–50 mg, was effective in taste change treatment for many cases of taste disorder. The currently recommended levels of zinc replacements currently prescribed to patients following BS were not effective for avoiding zinc deficiency after BS—and thus not effective for averting taste change. It is therefore suggested that taste change following BS is closely related to zinc deficiency induced by the surgery.

Keywords: taste change, taste disorder, bariatric surgery, zinc, zinc sulphate or Zn, deficiency, supplementation, and micro-nutrient deficiencies

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Authors: Shang-Sin Shiu, Shu-I Chin, Hsiu-Ju Chen, Ru-Yu Lien

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The Hospice and Palliative Care Act has undergone three revisions, making it less challenging for terminal patients to withdraw life support systems. However, the adequacy of care before withdraw is a crucial factor in end-of-life medical treatment. The author observed that intensive care unit (ICU) nursing staff often rely on simple flowcharts or word of mouth, leading to inadequate preparation and failure to meet patient needs before withdraw. This results in confusion or hesitation among those executing the process. Therefore, there is a motivation to improve the withdraw of patient care processes, establish standardized procedures, ensure the accuracy of removal execution, enhance end-of-life care self-efficacy for nursing staff, and improve the overall quality of care. The investigation identified key issues: the lack of applicable guidelines for ICU care for withdraw from life-sustaining, insufficient education and training on withdraw and end-of-life care, scattered locations of withdraw-related tools, and inadequate self-efficacy in withdraw from life-sustaining care. Solutions proposed include revising withdraw care processes and guidelines, integrating tools and locations, conducting educational courses, and forming support groups. After the project implementation, the accuracy of removal cognition improved from 78% to 96.5%, self-efficacy in end-of-life care after removal increased from 54.7% to 93.1%, and the correctness of care behavior progressed from 27.7% to 97.8%. It is recommended to regularly conduct courses on removing life support system care and grief consolation to enhance the quality of end-of-life care.

Keywords: the intensive care unit (ICU) patients, nursing staff, withdraw life support systems, self-efficacy

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Authors: Xuemei Yang, Xin Sun, Cheng Fu, Qiong Lan, Chao Han

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Residual stresses, which can be produced during the manufacturing process of plastic bonded explosive (PBX), play an important role in weapon system security and reliability. Residual stresses can and do change in service. This paper mainly studies the influence of vibratory stress relief (VSR) and thermal aging on residual stress of explosives. Firstly, the residual stress relaxation of PBX via different physical condition of VSR, such as vibration time, amplitude and dynamic strain, were studied by drill-hole technique. The result indicated that the vibratory amplitude, time and dynamic strain had a significant influence on the residual stress relief of PBX. The rate of residual stress relief of PBX increases first and then decreases with the increase of dynamic strain, amplitude and time, because the activation energy is too small to make the PBX yield plastic deformation at first. Then the dynamic strain, time and amplitude exceed a certain threshold, the residual stress changes show the same rule and decrease sharply, this sharply drop of residual stress relief rate may have been caused by over vibration. Meanwhile, the comparison between VSR and thermal aging was also studied. The conclusion is that the reduction ratio of residual stress after VSR process with applicable vibratory parameters could be equivalent to 73% of thermal aging with 7 days. In addition, the density attenuation rate, mechanical property, and dimensional stability with 3 months after VSR process was almost the same compared with thermal aging. However, compared with traditional thermal aging, VSR only takes a very short time, which greatly improves the efficiency of aging treatment for explosive materials. Therefore, the VSR could be a potential alternative technique in the industry of residual stress relaxation of PBX explosives.

Keywords: explosives, residual stresses, thermal aging, vibratory stress relief, VSR

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Authors: Manal Suleiman, George Abu-Aqil, Uraib Sharaha, Klaris Riesenberg, Itshak Lapidot, Ahmad Salman, Mahmoud Huleihel

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Klebsiella pneumoniae is one of the most aggressive multidrug-resistant bacteria associated with human infections resulting in high mortality and morbidity. Thus, for an effective treatment, it is important to diagnose both the species of infecting bacteria and their susceptibility to antibiotics. Current used methods for diagnosing the bacterial susceptibility to antibiotics are time-consuming (about 24h following the first culture). Thus, there is a clear need for rapid methods to determine the bacterial susceptibility to antibiotics. Infrared spectroscopy is a well-known method that is known as sensitive and simple which is able to detect minor biomolecular changes in biological samples associated with developing abnormalities. The main goal of this study is to evaluate the potential of infrared spectroscopy in tandem with Random Forest and XGBoost machine learning algorithms to diagnose the susceptibility of Klebsiella pneumoniae to antibiotics within approximately 20 minutes following the first culture. In this study, 1190 Klebsiella pneumoniae isolates were obtained from different patients with urinary tract infections. The isolates were measured by the infrared spectrometer, and the spectra were analyzed by machine learning algorithms Random Forest and XGBoost to determine their susceptibility regarding nine specific antibiotics. Our results confirm that it was possible to classify the isolates into sensitive and resistant to specific antibiotics with a success rate range of 80%-85% for the different tested antibiotics. These results prove the promising potential of infrared spectroscopy as a powerful diagnostic method for determining the Klebsiella pneumoniae susceptibility to antibiotics.

Keywords: urinary tract infection (UTI), Klebsiella pneumoniae, bacterial susceptibility, infrared spectroscopy, machine learning

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Authors: B. Chandar, M. K. Ramasamy, P. Madasamy

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The discovery and development of newer antibiotics are limited with the increase in resistance of such multi-drug resistant bacteria creating the need for alternative new therapeutic agents. The recently discovered New Delhi Metallo-betalactamase-1 (NDM-1), which confers antibiotic resistance to most of the currently available β-lactams, except colistin and tigecycline, is a global concern. Several antibacterial drugs approved are natural products or their semisynthetic derivatives, but plant extracts remain to be explored to find molecules that are effective against NDM-1 bacteria. Therefore, it is necessary to explore the possibility of finding new and effective antibacterial compounds against NDM-1 bacteria. In the present study, we have screened a diverse set South Indian plant species, and report most plant species as a potential source for antimicrobial compounds against NDM-1 bacteria. Ethanol extracts from the leaves of taxonomically diverse South Indian medicinal plants were screened for antibacterial activity against NDM-1 E. coli using streak plate method. Among the plant screened against NDM-1 E. coli, the ethanol extracts from many plant extracts showed minimum bactericidal concentration between 5 and 15 mg /ml and MIC between 2.54 and 5.12 mg/ml. These extracts also showed a potent synergistic effect when combined with antibiotics colistin and tetracycline. Combretum albidum that was effective was taken for further analysis. At 5mg/L concentration, these extracts inhibited the NDM-1 enzyme in vitro, and residual activity for Combretum albidum was 33.09%. Treatment of NDM-1 E. coli with the extracts disrupted the cell wall integrity and caused 89.7% cell death. The plant extract of Combretum albidum that was effective was subjected to fractionation and the fraction was further subjected to HPLC, LC-MS for identification of antibacterial compound.

Keywords: antibacterial activity, combretum albidum, Escherichia coli, NDM-1

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Authors: Tiera Tanksley, Amanda M. McLeroy

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The advent of technology and social media has ushered in a new era of communication, providing platforms for news dissemination and cause advocacy. However, this digital landscape has also exposed a distressing phenomenon termed "Black death," or trauma porn. This paper delves into the profound effects of repeated exposure to traumatic content on Black youth via social media, exploring the psychological impacts and potential reinforcing of stereotypes. Employing Critical Race Technology Theory (CRTT), the study sheds light on algorithmic anti-blackness and its influence on Black youth's lives and educational experiences. Through ethnographic content analysis, the research investigates common manifestations of Black death encountered online by Black adolescents. Findings unveil distressing viral videos, traumatic images, racial slurs, and hate speech, perpetuating stereotypes. However, amidst the distress, the study identifies narratives of activism and social justice on social media platforms, empowering Black youth to engage in positive change. Coping mechanisms and community support emerge as significant factors in navigating the digital landscape. The study underscores the need for comprehensive interventions and policies informed by evidence-based research. By addressing algorithmic anti-blackness and promoting digital resilience, the paper advocates for a more empathetic and inclusive online environment. Understanding coping mechanisms and community support becomes imperative for fostering mental well-being among Black adolescents navigating social media. In education, the implications are substantial. Acknowledging the impact of Black death content, educators play a pivotal role in promoting media literacy and digital resilience. Creating inclusive and safe online spaces, educators can mitigate negative effects and encourage open discussions about traumatic content. The application of CRTT in educational technology emphasizes dismantling systemic biases and promoting equity. In conclusion, this study calls for educators to be cognizant of the impact of Black death content on social media. By prioritizing media literacy, fostering digital resilience, and advocating for unbiased technologies, educators contribute to an inclusive and just educational environment for all students, irrespective of their race or background. Addressing challenges related to Black death content proactively ensures the well-being and mental health of Black adolescents, fostering an empathetic and inclusive digital space.

Keywords: algorithmic anti-Blackness, digital resilience, media literacy, traumatic content

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Authors: Zanib Nafees, Amir Razaghizad, Ibtisam Mahmoud, Abhinav Sharma, Renzo Cecere

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More than one million surgeries are performed each year in Canada, resulting in more than 100,000 associated serious adverse events (SAEs) per year. These are defined as unintended injuries or complications that adversely affect the well-being of patients. In recent years, there has been a proliferation of digital health interventions that have the potential to assist, monitor, and educate patients—facilitating self-care following post-operative discharge. Among digital health, interventions are interactive-voice response technologies (IVRs), which have been shown to be highly effective in certain medical settings. Although numerous IVR-based interventions have been developed, their effectiveness and utility remain unclear, notably in post-operative settings. To the best of our knowledge, no systematic or scoping reviews have evaluated this topic to date. Thus, the objective of this scoping review protocol is to systematically map and explore the literature and evidence describing and examining IVR tools, implementation, evaluation, outcome, and experience for post-operative patients. The focus will be primarily on the evaluation of baseline performance status, clinical assessment, treatment outcomes, and patient management, including self-management and self-monitoring. The objective of this scoping review is to assess the extent of the literature to direct future research efforts by identifying gaps and limitations in the literature and to highlight relevant determinants of positive outcomes in the emerging field of IVR monitoring for health outcomes in post-operative patients.

Keywords: digital healthcare technologies, post-surgery, interactive voice technology, interactive voice response

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