Objective: To identify and evaluate the main functional assessment tools applied in the postoperative monitoring of patients undergoing total knee arthroplasty (TKA), and to synthesize the functional outcomes reported through these instruments in the current scientific literature. Methodology: A structured review was conducted following PRISMA 2020 guidelines. Thirty-one peer-reviewed studies were selected through a targeted manual search based on predefined eligibility criteria. Included studies evaluated functional recovery following TKA using validated outcome measures such as the WOMAC, KSS, KOOS, IKDC, SF-36, and SANE. Data extraction focused on the instruments used, patient population characteristics, and reported outcomes. A descriptive synthesis was compiled in Table 1. Additionally, 15 studies with quantitative data were analyzed using a forest plot to illustrate risk ratios (RR) and 95% confidence intervals (CI) for functional improvement. Risk of bias was assessed qualitatively based on methodological rigor, clarity of reporting, and validation of the outcome tools. Results: All included studies reported improvements in functional status following TKA. Most risk ratios ranged from 0.66 to 0.85, indicating a consistent reduction in the risk of postoperative functional limitation. High-quality studies demonstrated more precise effect estimates and greater internal validity. The SANE scale emerged as a valid and practical tool with high responsiveness, including in its culturally adapted Brazilian version. Despite heterogeneity in study design, the direction of effect remained consistent across all included studies. Conclusion: Validated functional assessment tools are essential for monitoring recovery after total knee arthroplasty. Instruments such as WOMAC and SANE demonstrate strong clinical utility and psychometric validity. Their systematic use enhances outcome comparability, supports individualized rehabilitation planning, and improves decision-making in orthopedic care.

The Mambaka watershed is extends between latitudes 1 3°45'E and 14°15'E and longitudes 7°16'N and 6°45'N. The geology, various tectonic and structural events that have affected the Adamawa Plateau in Cameroon make it rich in multi-substance mining. The objective of this study is to map rare earth (REE) geochemical anomalies in the sediments of the watershed streams west of Mambaka, and to trace their origins and geochemical processes. Predictive maps from inverse distance interpolations (IDW), factor analysis (F1) or principal component analysis (PCA) and hierarchical bottom-up classification maps provided a better understanding of the central tendency, distribution and dispersion of REE in the samples and in the study area, based on standard deviation and variance values that generated two factors F1 (Ho-Tm-Er-Yb-Lu-Dy-Tb-Gd-Eu-Sm) and F2 (Pr-Nd-Ce-La-Sm) representing 92.44% of the total cumulative variance. The ratios Ce/Ce* > 0.78 and Eu/Eu* > 1 demonstrate positive anomalies in Ce and Eu, and clear differentiation. The normalized concentrations used to calculate fractionation ratios show that the values for LaN/YbN (0.58 to 1.34), LaN/SmN (0.61 to 0.88) and LaN/LuN (0.62 to 1.43) suggest higher fractionation in SS09 and lower fractionation in SS01. Similarly, the ratios La/Lu (61.71 to 143.46), La/Yb (9.00 to 20.72), La/Sm (4.02 to 5.83) and La/ Lu (61.71 to 143.46) confirm these higher ratios in SS09 and lower in SS01. The REE in the study area comes from hydrothermal processes based on high lineament densities at sampling points in igneous rocks with a mean ∑REE value of between 174-219 ppm.

Background: Peripartum cardiomyopathy (PPCM) is a life-threatening heart muscle disease of unknown aetiology that affects women during the peripartum period, particularly in sub-Saharan Africa. While many studies have observed normal blood pressure (BP) in PPCM patients, none have explored whether their BP is appropriate for their body size. This study investigated the correlation between body anthropometric parameters and BP in PPCM patients, comparing the findings with those of age-matched normal peripartum controls. Methods: A cohort of 105 women, each from PPCM and matched normal peripartum control groups, were recruited from three healthcare facilities in Sokoto. Blood pressure (BP) parameters were assessed in relation to their anthropometric measurements, and the findings were compared between the two groups. Results: The PPCM patients were significantly smaller in body weight (57.0 ±11.6 Kg vs 66.8 ±13.8 Kg, P <.0001), body mass index (BMI) (21.9 ±4.1 Kg/m2 vs 25.4 ±5.4 Kg/m2, P <.0001, body surface area (BSA) (1.3 ±0.7 m2 vs 1.7 ±0.2 m2, P <.0001), Lean body mass (LBM) (45.3 ±7.0 Kg vs 49.4 ±4.1 Kg, P <.0001) and Percentage body fat (BF) (23.5 ±10.9 % vs 31.2 ±6.9 %, P <.0001). Similarly, PPCM patients had significantly higher systolic BP (SBP), Pulse pressure (PP) and Mean arterial blood pressure (MABP) compared to the normal peripartum PPCM control. Further, linear regression analysis showed that there was higher slope of the relationship between anthropometric indices and SBP and PP in the PPCM cohort, compared to the normal peripartum control group. A similar trend of the slope was seen in the Pearson’s coefficient of the relationship of the anthropometries and BP parameters. Conclusions: This study found that women with peripartum cardiomyopathy (PPCM) exhibited disproportionately higher systolic blood pressure (SBP) and pulse pressure (PP) for each unit increase in anthropometric measurements compared to normal peripartum controls. Notably, PPCM patients had significantly lower anthropometric measures, potentially attributable to poverty and chronic undernutrition. Additionally, the effects of poor antenatal care, lack of immunization and recurrent infection should be considered. These findings suggest an abnormal relationship between anthropometry and blood pressure in PPCM patients, which may have detrimental effects on their cardiovascular health. This abnormal relationship may contribute to the development of heart failure (HF) in PPCM patients and potentially increase the risk in women susceptible to PPCM. Even-though our assumption, yet to be proven. To address this concerning trend in vulnerable populations, improvements in nutritional status, socioeconomic determinants health, adequate antenatal care (ANC), immunization, and infection prevention should be considered.

Artificial Immune Systems (AIS) are bio-inspired computational frameworks that emulate the adaptive mechanisms of the human immune system, such as self/non-self discrimination, clonal selection, and immune memory. These systems have demonstrated significant potential in addressing complex challenges across optimization, anomaly detection, and adaptive system control. This paper provides a comprehensive exploration of AIS applications in domains such as cybersecurity, resource allocation, and autonomous systems, highlighting the growing importance of hybrid AIS models. Recent advancements, including integrations with machine learning, quantum computing, and bioinformatics, are discussed as solutions to scalability, high-dimensional data processing, and efficiency challenges. Core algorithms, such as the Negative Selection Algorithm (NSA) and Clonal Selection Algorithm (CSA), are examined, along with limitations in interpretability and compatibility with emerging AI paradigms. The paper concludes by proposing future research directions, emphasizing scalable hybrid frameworks, quantum-inspired approaches, and real-time adaptive systems, underscoring AIS's transformative potential across diverse computational fields.

This study aimed to assess the knowledge level of street food vendors on hygiene in the Tamale metropolis in the Northern Region of Ghana. The study employed the health belief model as the theoretical basis. Quantitatively, the study employed a descriptive cross-sectional study design to examine the microbial load of street-cut fruits and assess the knowledge and practice of vendors of cut fruits on personal and food hygiene in the study setting. The population consists of cut and vented pawpaw, watermelon, and street fruit vendors registered with the health directorate in the Tamale Metropolis. A convenient sampling technique was used to select 113 respondents for the study. The Yamane formula was used to determine the sample size to select one hundred and thirteen participants (113) out of one hundred and fifty-eight street fruit vendors in the Tamale Metropolis. The main instrument for data collection was a questionnaire. A questionnaire had close-ended questions which were developed using a 'Yes' and 'No' response, and a four-point Likert-type scale ranging from 1=Strongly Disagree (SD), 2=Disagree (D), 3=Agree (A) and 4= Strongly Agree (SA). The data were analysed using descriptive statistics (frequency, percentages, means and standard deviation). The findings revealed that the overall knowledge level of respondents is low. The findings also indicate that vendors do not control the rate at which their customers touch their vended fruits. It is recommended that Street fruit vendors and handlers be educated on fruit hygiene practices through engagement by the Health Directorate Unit of Tamale Metropolis and the Ministry of Health. To keep consumers safe, the Tamale Metropolitan Assembly must strictly enforce compliance with regulations on operation permits and health clearance certificates. Metropolitan sanitation officers must regularly monitor fruit vendors to ensure compliance with goods.

The Internationalization of higher education has plummeted since the 2010 tightening of migration policies. This study aims to examine the retention and graduation rates of international students at Northern Arizona University (NAU). Using a quantitative analysis approach, the study utilized secondary data from the Center for International Admission and Recruitment Office at NAU to examine the university’s recruitment, graduation, and retention strategies. The aim was to evaluate the impact of internationalization strategies on application and enrolment numbers. The study sample consisted over 2000 international students from fourteen countries, including China, India, Vietnam, Kuwait, Nepal, Ghana, Nigeria, United Kingdom, Spain, Germany, Canada, Mexico, France, and Iran in four cultural groups (Asia, Europe, Africa, and North America). A random sampling technique was used to select these countries partly because of their highest applications, enrolment numbers, as well as their adoption of recruitment strategies like those used by higher education institutions in the United States. A descriptive graphic representation, focusing on full-time undergraduate students during fall semesters, specifically freshmen international students, is illustrated. To facilitate a cross-country comparison of international students, this study presents an analysis of retention and graduation data across different countries spanning the past five years, from 2016 to 2020.

The banana (Musa spp.) is a tropical fruit with excellent sensory characteristics in terms of aroma, flavor and texture, consumed worldwide and exploited in most tropical countries. Green banana flour is rich in flavonoids, which protect the gastric mucosa, has a high content of resistant starch, which acts in the body as a dietary fiber and thus has health benefits, and is an alternative option for bakery products, reducing waste of both the peel and the pulp. The aim of this study was to develop bread formulations with partial substitution of wheat flour with green banana flour (FBV), thus increasing the nutritional, technological and sensory value. 4 formulations, (A), standard sample; (B), bread with 10% FBV; (C), bread with 15% FBV and (D), bread with 20% FBV. Physico-chemical quality was assessed in terms of moisture content by drying at 105ºC, ash by incineration, fat by the Soxhlet method, protein by the biuret method, carbohydrates by difference calculation and calorific value by sum calculation and sensory analysis by affective methods. The data was evaluated using the RStudio 4.2.1 DCC statistical package. There were no significant differences in moisture content, lipids and calorific value. Differences were evident in the ash and protein content. Sensory acceptance of the standard formulation was 82.22%. The results obtained show that green banana flour can be used as a partial substitute for wheat flour to produce breads with functional properties.

The pulmonary characteristics of Staphylococcus aureus (S. aureus) co-infection with respiratory viruses, such as SARS-CoV-2 and influenza virus, are still unclear. Case series: Two patients with methicillin-susceptible S. aureus (MSSA) infection in the lungs co-infected with either SARS-CoV-2 or influenza virus are reported. Case 1 was a 66-year-old woman who was admitted with SARS-CoV-2 infection. Her chest X-ray and computed tomography (CT) showed multiple cavity formations with infiltration shadows, and MSSA was detected from her sputum and blood, suggesting COVID-19-related bacterial pneumonia and pulmonary embolism. No catheters had been used, but she had skin eruptions and a history of SARS-CoV-2 vaccination. Ampicillin/sulbactam (ABPC/SBT) was administered, and she finally improved. Case 2 was an 87-year-old man with a history of atopic dermatitis who was admitted with moderate pneumonia, and influenza virus co-infection was found. He showed multiple cavitary shadows, and MSSA was isolated from both his sputum and blood. He was diagnosed with influenza-related bacterial pulmonary embolism. No catheters had been used, but he had a history of influenza vaccination. He was also treated by ABPC/SBT and finally improved. Conclusions: These cases suggest that MSSA showed affinity to the lungs when co-infected with either SARS-CoV-2 or influenza virus, and it presented as septic emboli without catheter use. We should consider MSSA infection when patients have SARS-CoV-2 or influenza virus co-infection, and multiple cavity formation and skin disorders are seen, even though they were vaccinated and no catheters were used.

A regular menstrual cycle is important to maintain a woman’s fertility. This cycle has been linked to optimal function of the thyroid gland in the production of its hormones. Disturbance of thyroid gland functions could result to female infertility due to changes in menstrual patterns. Aim of this research was to determine the correlation between thyroid gland functions and menstrual patterns amongst infertile and fertile women attending a tertiary care hospital in North-Central Nigeria. This comparative, cross-sectional study recruited 106 women who visited the hospital's Gynecology Clinic and Family Planning Clinic. 53 of the 106 patients were women with a history suggestive of either primary or secondary infertility and the remaining 53 women with no history of infertility served as the control. A well-structured questionnaire was used to obtain data on the patients’ menstrual patterns. Anthropometric data were measured and obtained. Collected blood samples were analyzed using Enzyme-Linked Immunosorbent Assay (ELISA) technique to determine the serum levels of thyroid hormones. All obtained data was analyzed, and the level of significance was set at p<0.05, at a 95% confidence interval. 33 patients had menstrual anomalies (78.8% infertile women; 21.2% fertile women who served as control, p=0.012). The incidence of menstrual anomalies in the infertile women group and control group was 7.5% versus 0.0% for amenorrhea; 20.8% versus 5.7% for menorrhagia; 9.4% versus 7.5% for oligomenorrhea; 7.5% versus 0.0% for hypomenorrhea; nil polymenorrhea for both groups; and 50.9% versus 86.8% for normal menstrual patterns. Ten (9.43%) patients were diagnosed with thyroid dysfunctions (80% in infertile group; 20% in control group, p=0.046). Six (18.2%) out of 33 women with menstrual anomalies were diagnosed with thyroid dysfunction. Five (83.3%) out of these 6 women with both menstrual anomalies and diagnosed thyroid dysfunction were infertile while only one (16.7%) was fertile. Thyroid gland dysfunction correlates strongly with abnormal menstrual patterns, which implies that it is vital to evaluate thyroid hormone levels in blood serum in the course of treating menstrual irregularities and female infertility. Early detection of thyroid dysfunction is important in achieving a positive treatment outcome for female infertility.