Displaying publications 21 - 40 of 43 in total

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  1. Lim CK, Bay HH, Aris A, Abdul Majid Z, Ibrahim Z
    Environ Sci Pollut Res Int, 2013 Jul;20(7):5056-66.
    PMID: 23334551 DOI: 10.1007/s11356-013-1476-5
    Reactive dyes account for one of the major sources of dye wastes in textile effluent. In this study, decolorization of the monoazo dye, Acid Orange 7 (AO7) by the Enterococcus faecalis strain ZL that isolated from a palm oil mill effluent treatment plant has been investigated. Decolorization efficiency of azo dye is greatly affected by the types of nutrients and the size of inoculum used. In this work, one-factor-at-a-time (method and response surface methodology (RSM) was applied to optimize these operational factors and also to study the combined interaction between them. Analysis of AO7 decolorization was done using Fourier transform infrared (FTIR) spectroscopy, desorption study, UV-Vis spectral analysis, field emission scanning electron microscopy (FESEM), and high performance liquid chromatography (HPLC). The optimum condition via RSM for the color removal of AO7 was found to be as follows: yeast extract, 0.1% w/v, glycerol concentration of 0.1% v/v, and inoculum density of 2.5% v/v at initial dye concentration of 100 mg/L at 37 °C. Decolorization efficiency of 98% was achieved in only 5 h. The kinetic of AO7 decolorization was found to be first order with respect to dye concentration with a k value of 0.87/h. FTIR, desorption study, UV-Vis spectral analysis, FESEM, and HPLC findings indicated that the decolorization of AO7 was mainly due to the biosorption as well as biodegradation of the bacterial cells. In addition, HPLC analyses also showed the formation of sulfanilic acid as a possible degradation product of AO7 under facultative anaerobic condition. This study explored the ability of E. faecalis strain ZL in decolorizing AO7 by biosorption as well as biodegradation process.
  2. Ina-Salwany MY, Al-Saari N, Mohamad A, Mursidi FA, Mohd-Aris A, Amal MNA, et al.
    J Aquat Anim Health, 2019 03;31(1):3-22.
    PMID: 30246889 DOI: 10.1002/aah.10045
    Current growth in aquaculture production is parallel with the increasing number of disease outbreaks, which negatively affect the production, profitability, and sustainability of the global aquaculture industry. Vibriosis is among the most common diseases leading to massive mortality of cultured shrimp, fish, and shellfish in Asia. High incidence of vibriosis can occur in hatchery and grow-out facilities, but juveniles are more susceptible to the disease. Various factors, particularly the source of fish, environmental factors (including water quality and farm management), and the virulence factors of Vibrio, influence the occurrence of the disease. Affected fish show weariness, with necrosis of skin and appendages, leading to body malformation, slow growth, internal organ liquefaction, blindness, muscle opacity, and mortality. A combination of control measures, particularly a disease-free source of fish, biosecurity of the farm, improved water quality, and other preventive measures (e.g., vaccination) might be able to control the infection. Although some control measures are expensive and less practical, vaccination is effective, relatively cheap, and easily implemented. In this review, the latest knowledge on the pathogenesis and control of vibriosis, including vaccination, is discussed.
  3. Ibrahim Z, Amin MF, Yahya A, Aris A, Umor NA, Muda K, et al.
    Water Sci Technol, 2009;60(3):683-8.
    PMID: 19657163 DOI: 10.2166/wst.2009.440
    Microbial flocs formed from raw textile wastewater in a prototype Aerobic Biofilm Reactor (ABR) system were characterised and studied for their potential use in the treatment of textile wastewater. After 90-100 days of operation, microbial flocs of loose irregular structures were obtained from the reactor with good settling velocity of 33 m/h and sludge volume index (SVI) of 48.2 mL/g. Molecular analysis of the flocs using PCR-amplified 16S rDNA sequence showed 98% homology to those of Bacillus sp, Paenibacillus sp and Acromobacter sp. Detection of Ca(2+)(131 mg/g) and Fe(2+)(131 mg/g) using atomic absorption spectrometer might be implicated with the flocs formation. In addition, presence of Co(2+) and Ni(2+) were indicative of the flocs ability to accumulate at least a fraction of the metals' present in the wastewater. When the flocs were used for the treatment of raw textile wastewater, they showed good removal of COD and colour about 55% and 70% respectively, indicating their potential application.
  4. Ibrahim Z, Amin MF, Yahya A, Aris A, Muda K
    Water Sci Technol, 2010;61(5):1279-88.
    PMID: 20220250 DOI: 10.2166/wst.2010.021
    Textile wastewater, one of the most polluted industrial effluents, generally contains substantial amount of dyes and chemicals that will cause increase in the COD, colour and toxicity of receiving water bodies if not properly treated. Current treatment methods include chemical and biological processes; the efficiency of the biological treatment method however, remains uncertain since the discharged effluent is still highly coloured. In this study, granules consisting mixed culture of decolourising bacteria were developed and the physical and morphological characteristics were determined. After the sixth week of development, the granules were 3-10 mm in diameter, having good settling property with settling velocity of 70 m/h, sludge volume index (SVI) of 90 to 130 mL/g, integrity coefficient of 3.7, and density of 66 g/l. Their abilities to treat sterilised raw textile wastewater were evaluated based on the removal efficiencies of COD (initial ranging from 200 to 3,000 mg/L), colour (initial ranging from 450 to 2000 ADMI) of sterilised raw textile wastewater with pH from 6.8 to 9.4. Using a sequential anaerobic-aerobic treatment cycle with hydraulic retention time (HRT) of 24 h, maximum removal of colour and COD achieved was 90% and 80%, respectively.
  5. How SW, Lim SY, Lim PB, Aris AM, Ngoh GC, Curtis TP, et al.
    Water Sci Technol, 2018 May;77(9-10):2274-2283.
    PMID: 29757179 DOI: 10.2166/wst.2018.143
    Intensive aeration for nitrification is a major energy consumer in sewage treatment plants (STPs). Low-dissolved-oxygen (low-DO) nitrification has the potential to lower the aeration demand. However, the applicability of low-DO nitrification in the tropical climate is not well-understood. In this study, the potential of low-DO nitrification in tropical setting was first examined using batch kinetic experiments. Subsequently, the performance of low-DO nitrification was investigated in a laboratory-scale sequential batch reactor (SBR) for 42 days using real tropical sewage. The batch kinetic experiments showed that the seed sludge has a relatively high oxygen affinity. Thus, the rate of nitrification was not significantly reduced at low DO concentrations (0.5 mg/L). During the operation of the low-DO nitrification SBR, 90% of NH4-N was removed. The active low-DO nitrification was mainly attributed to the limited biodegradable organics in the sewage. Fluorescence in-situ hybridisation and 16S rRNA amplicon sequencing revealed the nitrifiers were related to Nitrospira genus and Nitrosomonadaceae family. Phylogenetic analysis suggests 47% of the operational taxonomic units in Nitrospira genus are closely related to a comammox bacteria. This study has demonstrated active low-DO nitrification in tropical setting, which is a more sustainable process that could significantly reduce the energy footprint of STPs.
  6. How SW, Sin JH, Wong SYY, Lim PB, Mohd Aris A, Ngoh GC, et al.
    Water Sci Technol, 2020 Jan;81(1):71-80.
    PMID: 32293590 DOI: 10.2166/wst.2020.077
    Many developing countries, mostly situated in the tropical region, have incorporated a biological nitrogen removal process into their wastewater treatment plants (WWTPs). Existing wastewater characteristic data suggested that the soluble chemical oxygen demand (COD) in tropical wastewater is not sufficient for denitrification. Warm wastewater temperature (30 °C) in the tropical region may accelerate the hydrolysis of particulate settleable solids (PSS) to provide slowly-biodegradable COD (sbCOD) for denitrification. This study aimed to characterize the different fractions of COD in several sources of low COD-to-nitrogen (COD/N) tropical wastewater. We characterized the wastewater samples from six WWTPs in Malaysia for 22 months. We determined the fractions of COD in the wastewater by nitrate uptake rate experiments. The PSS hydrolysis kinetic coefficients were determined at tropical temperature using an oxygen uptake rate experiment. The wastewater samples were low in readily-biodegradable COD (rbCOD), which made up 3-40% of total COD (TCOD). Most of the biodegradable organics were in the form of sbCOD (15-60% of TCOD), which was sufficient for complete denitrification. The PSS hydrolysis rate was two times higher than that at 20 °C. The high PSS hydrolysis rate may provide sufficient sbCOD to achieve effective biological nitrogen removal at WWTPs in the tropical region.
  7. Hasan ZAE, Mohd Zainudin NAI, Aris A, Ibrahim MH, Yusof MT
    J Appl Microbiol, 2020 Oct;129(4):991-1003.
    PMID: 32324939 DOI: 10.1111/jam.14674
    AIMS: Agro-based wastes were evaluated as a medium for mass micropropagule production and optimal efficacy of Trichoderma asperellum B1092 in controlling Fusarium oxysporum f. sp. lycopersici and promoting tomato growth. This study focused on biological control because pathogen persistence in the soil makes the disease difficult to control.

    METHODS AND RESULTS: Rice bran, biochar, empty fruit bunches, coconut fibres, compost, top soil and mixed soil were evaluated as media for mass multiplication of T. asperellum, which is effective in controlling plant pathogens. Yielding the most colony forming units (CFU) among the media, coconut fibre was deemed most suitable for promoting sporulation. After 120 days on the medium, T. asperellum B1902 produced 9·053 × 105  CFU per gram coconut fibre; oil palm empty fruit bunches was second highest (7·406 × 105  CFU per gram). In field tests of T. asperellum B1092 against F. oxysporum f. sp lycopersici (causing Fusarium wilt of cherry tomato), B1092 significantly promoted plant growth compared to the control. The efficacy of this formulation resulted in increased growth of roots and shoots tomato plants and total lycopene, sugar, K, N, Ca, P and Mg content after 120 days.

    CONCLUSIONS: Trichoderma asperellum B1092 showed great field potential for improving productivity and quality of tomatoes and in controlling Fusarium wilt of cherry tomato.

    SIGNIFICANCE AND IMPACT OF THE STUDY: This innovative approach using a cheap agro-waste to control the persistent soil-borne Fusarium pathogen of cherry tomato should increase soil survival rate of Trichoderma and has potential for upscaling in the field for other crops.

  8. Hadibarata T, Yusoff AR, Aris A, Kristanti RA
    J Environ Sci (China), 2012;24(4):728-32.
    PMID: 22894109
    Armillaria sp. F022, a white rot fungus isolated from tropical rain forest (Samarinda, Indonesia) was used to biodegrade naphthalene in cultured medium. Transformation of naphthalene by Armillaria sp. F022 which is able to use naphthalene, a two ring-polycyclic aromatic hydrocarbon (PAH) as a source of carbon and energy was investigated. The metabolic pathway was elucidated by identifying metabolites, biotransformation studies and monitoring enzyme activities in cell-free extracts. The identification of metabolites suggests that Armillaria sp. F022 initiates its attack on naphthalene by dioxygenation at its C-1 and C-4 positions to give 1,4-naphthoquinone. The intermediate 2-hydroxybenzaldehyde and salicylic acid, and the characteristic of the meta-cleavage of the resulting diol were identified in the long-term incubation. A part from typical metabolites of naphthalene degradation known from mesophiles, benzoic acid was identified as the next intermediate for the naphthalene pathway of this Armillaria sp. F022. Neither phthalic acid, catechol and cis,cis-muconic acid metabolites were detected in culture extracts. Several enzymes (manganese peroxidase, lignin peroxidase, laccase, 1,2-dioxygenase and 2,3-dioxygenase) produced by Armillaria sp. F022 were detected during the incubation.
  9. Fulazzaky MA, Nuid M, Aris A, Muda K
    Environ Technol, 2018 Sep;39(17):2151-2161.
    PMID: 28675960 DOI: 10.1080/09593330.2017.1351494
    Understanding of mass transfer kinetics is important for biosorption of nitrogen compounds from palm oil mill effluent (POME) to gain a mechanistic insight into future biological processes for the treatment of high organic loading wastewater. In this study, the rates of global and sequential mass transfer were determined using the modified mass transfer factor equations for the experiments to remove nitrogen by aerobic granular sludge accumulation in a sequencing batch reactor (SBR). The maximum efficiencies as high as 97% for the experiment run at [kLa]g value of 1421.8 h-1 and 96% for the experiment run at [kLa]g value of 9.6 × 1037 h-1 were verified before and after the addition of Serratia marcescens SA30, respectively. The resistance of mass transfer could be dependent on external mass transfer that controls the transport of nitrogen molecule along the experimental period of 256 days. The increase in [kLa]g value leading to increased performance of the SBR was verified to contribute to the future applications of the SBR because this phenomenon provides new insight into the dynamic response of biological processes to treat POME.
  10. Daud SM, Noor ZZ, Mutamim NSA, Baharuddin NH, Aris A
    Environ Sci Pollut Res Int, 2023 Aug;30(40):91636-91648.
    PMID: 37518846 DOI: 10.1007/s11356-023-28975-y
    A conventional activated sludge (CAS) system has traditionally been used for secondary treatment in wastewater treatment plants. Due to the high cost of aeration and the problem of sludge treatment, researchers are developing alternatives to the CAS system. A membrane bioreactor (MBR) is a technology with higher solid-liquid separation efficiency. However, the use of MBR is limited due to inevitable membrane fouling and high energy consumption. Membrane fouling requires frequent cleaning, and MBR components must be replaced, which reduces membrane lifetime and operating costs. To overcome the limitations of the MBR system, a microbial fuel cell-membrane bioreactor (MFC-MBR) coupling system has attracted the interest of researchers. The design of the novel bioelectrochemical membrane reactor (BEMR) can effectively couple microbial degradation in the microbial electrochemical system (MES) and generate a microelectric field to reduce and alleviate membrane fouling in the MBR system. In addition, the coupling system combining an MES and an MBR can improve the efficiency of COD and ammonium removal while generating electricity to balance the energy consumption of the system. However, several obstacles must be overcome before the MFC-MBR coupling system can be commercialised. The aim of this study is to provide critical studies of the MBR, MES and MFC-MBR coupling system for wastewater treatment. This paper begins with a critical discussion of the unresolved MBR fouling problem. There are detailed past and current studies of the MES-MBR coupling system with comparison of performances of the system. Finally, the challenges faced in developing the coupling system on a large scale were discussed.
  11. Darwish M, Aris A, Puteh MH, Jusoh MNH, Abdul Kadir A
    J Environ Manage, 2017 Dec 01;203(Pt 2):861-866.
    PMID: 26935149 DOI: 10.1016/j.jenvman.2016.02.033
    Struvite precipitation has been widely applied for the removal of ammonium-nitrogen (NH4-N) from wastewater. Due to the high cost of phosphorus (P) reagents, the current research trend was directed to find alternative sources of P, in order to maintain a sustainable NH4-N removal process. The current study investigated waste bones ashes as alternative sources of P. Different types of bones' ashes were characterized, in which the ash produced from waste fish bones was the highest in P content (17%wt.). The optimization of the factors affecting P extraction from ash by acidic leaching showed that applying 2M H2SO4 and 1.25 kg H2SO4/kg ash achieved the highest P recovery (95%). Thereafter, the recovered P was successfully used in struvite precipitation, which achieved more than 90% NH4-N removal and high purity struvite.
  12. Chen CX, Aris A, Yong EL, Noor ZZ
    Environ Sci Pollut Res Int, 2022 Jan;29(4):4787-4802.
    PMID: 34775565 DOI: 10.1007/s11356-021-17365-x
    Many advanced technologies have shown encouraging results in removing antibiotics from domestic wastewater. However, as activated sludge treatment is the most common sewage treatment system employed worldwide, improving its effect on antibiotic removal would be more desirable. Understanding the removal mechanisms, kinetics and factors that affect antibiotic removal in the activated sludge process is important as it would allow us to improve the treatment performance. Although these have been discussed in various literature covering different types of antibiotics and wastewater, a specific review on antibiotics and domestic wastewater is clearly missing. This review paper collates, discusses and analyses the removal of antibiotics from sewage in the activated sludge process along with the removal mechanisms and kinetics. The antibiotics are categorised into six classes: β-lactam, dihydrofolate reductase inhibitor, fluoroquinolone, macrolide, sulfonamides and tetracycline. Furthermore, the factors affecting the system performance with regard to antibiotic removal are examined.
  13. Aziz MA, Norman S, Mohamed Zaid S, Simarani K, Sulaiman R, Mohd Aris A, et al.
    Arch Microbiol, 2023 Jan 28;205(2):76.
    PMID: 36708390 DOI: 10.1007/s00203-023-03417-y
    Wastewater monitoring for SARS-CoV-2 has attracted considerable attention worldwide to complement the existing clinical-based surveillance system. In this study, we report our first successful attempt to prove the circulation of SARS-CoV-2 genes in Malaysian urban wastewater. A total of 18 wastewater samples were obtained from a regional sewage treatment plant that received municipal sewage between February 2021 and May 2021. Using the quantitative PCR assay targeting the E and RdRp genes of SARS-CoV-2, we confirmed that both genes were detected in the raw sewage, while no viral RNA was found in the treated sewage. We were also able to show that the trend of COVID-19 cases in Kuala Lumpur and Selangor was related to the changes in SARS-CoV-2 RNA levels in the wastewater samples. Overall, our study highlights that monitoring wastewater for SARS-CoV-2 should help local health professionals to obtain additional information on the rapid and silent circulation of infectious agents in communities at the regional level.
  14. Asadi K, Tehrany PM, Salari A, Ghorbani Vajargah P, Mollaei A, Sarafi M, et al.
    Int Wound J, 2023 Jul 10.
    PMID: 37424390 DOI: 10.1111/iwj.14300
    The goal of this systematic review and meta-analysis is to provide an overview of the prevalence of surgical wound infection and related factors in patients after long bone surgery. A comprehensive, systematic search was conducted in different international electronic databases, such as Scopus, PubMed, Web of Science and Persian electronic databases such as Iranmedex and Scientific Information Database using keywords extracted from Medical Subject Headings such as "Prevalence", "Surgical wound infection", "Surgical site infection" and "Orthopedics" from the earliest to the May 1, 2023. The appraisal tool for cross-sectional studies (AXIS tool) evaluates the quality of the included studies. A total of 71 854 patients undergoing long bone surgery participated in 12 studies. The pooled prevalence of surgical wound infection in patients who underwent long bone surgery reported in the 12 studies was 3.3% (95% CI: 1.5%-7.2%; I2  = 99.39%; p 
  15. Aris AM, Elegbe EO, Krishna R
    Singapore Med J, 1992 Apr;33(2):204-5.
    PMID: 1621133
    Intubation was difficult and traumatic in a 40-year-old patient presented for emergency oesophagoscopy because the diagnosis of stylohyoid ligament calcification was not suspected. High probability of stylohyoid ligament calcification should be suspected when there is difficulty in lifting the epiglottis and fibre-optic laryngoscopy is suggested as the best way to tackle this problem to prevent trauma and possible risk of regurgitation and aspiration especially in emergency situation.
  16. Aris A. Z., Ismail F. A., Ng, H. Y., Praveena, S. M.
    MyJurnal
    This study was conducted using crab shells as a biosorbent to remove Cu and Cd with different initial concentrations of 1, 5, 10, 15, and 20 mg/L in a biosorption treatment process. Crab shells were selected as biosorbents due to their abundance in the environment and ready availability as waste products from the market place. This study aimed to determine the ability of Scylla Serrata shells to remove Cu and Cd in an aqueous solution, as well as to provide a comparison of the removal rate between the two metals. The data were incorporated into hydrochemical software, PHREEQC, to investigate the chemical speciation distribution of each heavy metal. The shells of S. serrata were found to have a significant (p< 0.05) ability to remove Cu and Cd following the treatment. After six hours of treatment, the crab shells had removed 60 to 80% of both metals. However, the highest removal percentage was achieved for Cu with up to 94.7% removal rate in 5 mg/L initial Cu concentration, while 85.1% of Cd was removed in 1 mg/L initial solution, respectively. It can be concluded that the shells of S. serrata could remove Cu and Cd better with significant results (p
  17. Aris A, Sharratt PN
    Environ Technol, 2006 Oct;27(10):1153-61.
    PMID: 17144264
    The effect of initial dissolved oxygen concentration (IDOC) on Fenton's reagent degradation of a dyestuff, Reactive Black 5 was explored in this study. The study was designed, conducted and analysed based on Central Composite Rotatable Design using a 3-1 lab-scale reactor. The participation of O2 in the process was experimentally observed and appears to be affected by the dosage of the reagents used in the study. The IDOC was found to have a significant influence on the process. Reducing the IDOC from 7.5 mg l(-1) to 2.5 mg l(-1) increased the removal of TOC by an average of about 10%. Reduction of IDOC from 10 mg l(-1) to 0 mg l(-1) enhanced the TOC removal by about 30%. The negative influence of IDOC is likely to be caused by the competition between the O2 and the reagents for the organoradicals. A model describing the relationship between initial TOC removal, reagent dosage and IDOC has also been developed.
  18. Aris A, Din MF, Salim MR, Yunus S, Abu Bakar WA
    Water Sci Technol, 2002;46(9):255-62.
    PMID: 12448476
    In Malaysia, most colored wastewater from dyeing factories is discharged to the environment causing serious problems. In this paper the influence of several reacting conditions, i.e. H2O2, pH, Ultraviolet (UV) intensity and dye concentration, on the performance of the immobilized system is discussed. The pH of the solution was varied from 3 to 11 while H2O2 concentration tested was from 10(-4) M to 5 x 10(-2) M. UV was tested at 365 nm and 254 nm, while dye concentration ranged from 2.5 x 10(-4) M to 10(-3) M. The influence of the reacting conditions was assessed based on absorbance. Using an OG concentration of 10(-3) M, the degradation increases from 17.8% to 49.7%. Optimum concentration of H2O2 was found to be 5 x 10(-3) M for degradation. Increasing the intensity of the UV light via shorter light wavelength also improves the performance of the system. Increasing the concentration of the dye reduces the overall performance of the system. Using the dye concentration of 2.5 x 10(-4) M (H2O2 = 10(-2) M, lambda = 254 nm, pH = 11), gives a degradation of 93.2%. At dye concentration of 10(-3) M, the performance was reduced to 53.1%.
  19. Aris A, Sulaiman S, Che Hasan MK
    Enferm Clin, 2019 09;29 Suppl 2:16-23.
    PMID: 31208927 DOI: 10.1016/j.enfcli.2019.04.004
    OBJECTIVE: The objective of this study was to investigate whether music therapy affects immediate postoperative well-being among patients who had undergone TKA surgery in the recovery unit.

    METHOD: A randomized controlled trial was conducted recruiting patients from Hospital Melaka, Malaysia. Postoperative TKA patients with good hearing and visual acuity, fully conscious and prescribed with patients controlled analgesia (PCA) were randomized to either intervention or control groups using a sealed envelope. Patients in the intervention group received usual care with additional music therapy during recovery, while patients in the control group received the usual care provided by the hospital. Two factors identified affecting mental well-being were the pain (measured using numerical rating scale) and anxiety (measured using a visual analog scale) at five different minutes' points (0, 10, 20, 30, and 60).

    RESULTS: A total of 56 (control: 28, intervention: 28) postoperative TKA patients consented in the study. There was no difference in baseline characteristics between the two groups (p>0.05). Using Mann-Whitney U tests, patients in music therapy group showed significantly lower numerical pain score at 60min (p=0.045) whereas there was no significant difference between the two groups at all time points for anxiety scores (p>0.05). In the intervention group, Friedman tests showed that there was a significant difference in numerical pain (χ2=36.957, df=4, p<0.001) and anxiety score across times (χ2=18.545, p=0.001).

    CONCLUSIONS: This study found that pain score decreases over time among patients in the music therapy group while no effect is seen for anxiety. It is suggested that music therapy could not affect postoperative TKA patients' mental well-being. Nonetheless, patients reported better pain score despite the small sample.

  20. Aris A, Sulaiman S, Che Hasan MK
    Enferm Clin, 2021 04;31 Suppl 2:S10-S15.
    PMID: 33849138 DOI: 10.1016/j.enfcli.2020.10.006
    This study aimed to investigate the effects of music on physiological outcomes for post-operative TKA patients in the recovery unit. Fifty-six patients from Hospital Melaka were randomized equally into intervention (IG) and control groups (CG). IG received the usual care and listened to selected music for 60min, while the CG received only the usual care. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), respiration rate (RR) and oxygen saturation (SpO2) were measured on arrival and after 10, 20, 30, and 60min in the recovery unit. A significant difference between groups was observed in RR upon arrival (U=276.5, p=0.029) and after 10min (U=291, p=0.45). Meanwhile, there were significant differences in DBP (F=3.158, p=0.032), RR (χ2=15.956, p=0.003) and SpO2 (χ2=14.084, p=0.007) over time in the IG. Overall, listening to music immediately after TKA has an effect on DBP, RR, and SpO2.
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