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Open Access June 25, 2025

Performance and Validity of Knee Function Assessment Tools After Total Knee Arthroplasty: A Systematic Review

Abstract 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. [...] Read more.
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.
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Systematic Review
Open Access April 29, 2024

Floristic composition of vascular epiphytes in a disturbed forest of the Douala- Edea National Park (Cameroon)

Abstract The Douala-Edea National Park is a coastal protected area that opens to the Atlantic Ocean, and contains an abundant wildlife which finds a privilege habitat there, and certain taxa such as epiphytes, which are of particular interest for conservation. In many tropical forests, vascular epiphytes are one of the richest taxa, with major impacts on the nutrient and hydrological cycles. The aim of this research was to study the effect of the disturbance of habitat on the floristic composition of vascular epiphytes in the Douala-Edea National Park. This study was carried out between January - April 2021 in three types of disturbed habitats at the northern part of the park. Three plots of 100 m × 100 m dimensions were laid out across three ecosystems along the Sanaga river. The sampling method consisted in the direct observation of five adjacent transects of 100 m x 20 m dimensions inside each plot. Epiphytes species were evaluated on all trees of DBH ≥10 cm. Epiphytes' life-forms and the position on the host trees occupied by the epiphytes were also recorded. A total of 18 species belonging to 16 genera and 13 families were identified. Culcasia sp. was the most common species with a relative frequency of 30.27%. Biological indicators were represented by Ferns, with four species, and Orchidaceae, with one species. [...] Read more.
The Douala-Edea National Park is a coastal protected area that opens to the Atlantic Ocean, and contains an abundant wildlife which finds a privilege habitat there, and certain taxa such as epiphytes, which are of particular interest for conservation. In many tropical forests, vascular epiphytes are one of the richest taxa, with major impacts on the nutrient and hydrological cycles. The aim of this research was to study the effect of the disturbance of habitat on the floristic composition of vascular epiphytes in the Douala-Edea National Park. This study was carried out between January - April 2021 in three types of disturbed habitats at the northern part of the park. Three plots of 100 m × 100 m dimensions were laid out across three ecosystems along the Sanaga river. The sampling method consisted in the direct observation of five adjacent transects of 100 m x 20 m dimensions inside each plot. Epiphytes species were evaluated on all trees of DBH ≥10 cm. Epiphytes' life-forms and the position on the host trees occupied by the epiphytes were also recorded. A total of 18 species belonging to 16 genera and 13 families were identified. Culcasia sp. was the most common species with a relative frequency of 30.27%. Biological indicators were represented by Ferns, with four species, and Orchidaceae, with one species. The epiphytes species richness was highest in the low disturbed habitat (13 species), and lowest in the highly disturbed habitat (8 species). Strict epiphytes were highly recorded in the low disturbed habitat (6 species), and were absent in the highly disturbed habitat. Hemi-epiphytes were the commonest life-form (12 species) in the highly disturbed habitat, and have been defined as indicators of the perturbation of the habitat. Canopy was mostly sollicitated by epiphytes in the low disturbed habitat (66.25%) than the moderate disturbed habitat (49.85%), and highly disturbed habitat (30.66%). It has been found that the different forest sites have an influence on the typology of epiphytic species, and therefore, epiphytic flora should be managed for the conservation of the biodiversity in tropical forests.
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Open Access November 24, 2022

Contribution to the Ethnobotanical Knowledge of Serre Calabre (Southern Italy)

Abstract This work presents the results of an ethnobotanical research carried out in the territory of Serre Calabre, province of Vibo Valentia (Calabria, southern Italy). In this territory, the bond between the residents and the rural environment is still strong, because the small urban centers are placed in a predominantly agricultural and forestry environment still managed in a traditional way. The [...] Read more.
This work presents the results of an ethnobotanical research carried out in the territory of Serre Calabre, province of Vibo Valentia (Calabria, southern Italy). In this territory, the bond between the residents and the rural environment is still strong, because the small urban centers are placed in a predominantly agricultural and forestry environment still managed in a traditional way. The survey took place between January 2019 and July 2021. Data were collected through semi-structured interviews with locals. As many as 17 informants were interviewed and a total of 185 interviews were recorded. Plant specimens were collected under the indication of the informants and then deposited at the herbarium of the Mediterranean University of Reggio Calabria (REGGIO). The data were stored on a digital database and then statistically analyzed some synthetic indexes have also been calculated, such as Relative Frequency of Citation (RFC) and the Cultural Importance Index (CI). The investigation allowed to identify 84 taxa belonging to 39 different families, among which the most represented are Lamiaceae (23 interviews, 9 taxa), Asteraceae (22 interviews, 12 taxa). The identified taxa were prevalently cited for alimentary (46 interviews, 32 taxa) and healing (55, 27) uses. The results obtained show how the traditional knowledge about plants in the Serre Calabre area is still alive, however it is exclusive heritage of elderly people and often only in one or just a few informants. In fact, many practices are no longer in use and will not be transferred to the new generations.
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Open Access September 29, 2022

Anthyllis hermanniae L. subsp. brutia Brullo & Giusso (Fabaceae): population survey and conservation tasks

Abstract Anthyllis hermanniae subsp. brutia, is an Italian endemic shrub occurring just in one locality by the Calabrian Ionian coast in southern Italy. Objective of this study is to provide data on population numbers, demography and ecology, as well as to identify the main threats on the long term conservation of the target taxon. The survey has been carried out through field census work, sampling biometric and dendrometric data, and applying simple statistics. The population, counting totally 962 individuals, is divided in two stands concentrated in the central part of the distribution area. It is restricted to a narrow belt on the inland part of the dune slope encompassed between an artificial pine forest at the dune top, and the dune-specialized vegetation on the slope. Some biometric insights, such as stem diameter, plant height and number of annual rings, suggest the role of micro-ecology in individual shaping. The most relevant threating factor for the long term conservation of this rare taxon is the rapidly spreading Pinus halepensis subsp. halepensis. Local population of this invasive alien species, deriving from planted individuals, is now invading the A. hermanniae subsp. brutia [...] Read more.
Anthyllis hermanniae subsp. brutia, is an Italian endemic shrub occurring just in one locality by the Calabrian Ionian coast in southern Italy. Objective of this study is to provide data on population numbers, demography and ecology, as well as to identify the main threats on the long term conservation of the target taxon. The survey has been carried out through field census work, sampling biometric and dendrometric data, and applying simple statistics. The population, counting totally 962 individuals, is divided in two stands concentrated in the central part of the distribution area. It is restricted to a narrow belt on the inland part of the dune slope encompassed between an artificial pine forest at the dune top, and the dune-specialized vegetation on the slope. Some biometric insights, such as stem diameter, plant height and number of annual rings, suggest the role of micro-ecology in individual shaping. The most relevant threating factor for the long term conservation of this rare taxon is the rapidly spreading Pinus halepensis subsp. halepensis. Local population of this invasive alien species, deriving from planted individuals, is now invading the A. hermanniae subsp. brutia habitat. Chorological and ecological data here provided should hopefully steer further population dynamics investigation as well as any urgent environment management actions.
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Open Access June 23, 2022

Priority tree and shrubs for use in Landscape Architecture based on the dynamic states of native vegetation with the highest ecological value in mainland Portugal

Abstract The reduction of the native forests coverage in mainland Portugal increased in the past centuries, leading to a marked decrease in biodiversity in general, especially on typical species of mature forest environments. However, urban biodiversity seems to resist more effectively than rural to disturbances due to the lower incidence of fires, as well as to agriculture expansion. Thus, in this work, [...] Read more.
The reduction of the native forests coverage in mainland Portugal increased in the past centuries, leading to a marked decrease in biodiversity in general, especially on typical species of mature forest environments. However, urban biodiversity seems to resist more effectively than rural to disturbances due to the lower incidence of fires, as well as to agriculture expansion. Thus, in this work, we analyzed the dynamics of the natural vegetation potential in each biogeographic sector, and selected, based on the evolutionary stages of the vegetation, a set of priority taxa for conservation. The criteria used are intended to highlight plants with ornamental value, but at the same time, some of them have high patrimonial value, belonging to the Red List of Vascular Flora of Mainland Portugal or protected by Annexes II, IV and V of the Sectorial Plan of the Natura 2000 Network at the European level. Our analysis resulted in the identification of 62 plants that can be increased in public spaces in order to improve their conservation status. For each biogeographic sector, the plants best adapted to the local edaphoclimatic conditions are presented. Forest habitats can now, through micro-reserves in urban areas, ensure their long-term conservation and greater awareness among the population. An integrated planning, where the socio-ecological strategy is designed for the long term, will benefit the quality of life of citizens in an urban environment. Furthermore, the creation of micro-reserves in urban parks (gardens) can prevent the extinction of many botanical values in the landscapes of the western Mediterranean Basin.
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Open Access December 08, 2022

Directorial Interpretation of the Adventures of Sasa and Esi: An Experimentation of Theatrical Elements

Abstract The Adventures of Sasa and Esi is a dance theatre that takes its story reference from two short Ghanaian folktale stories the Adventures of Sasa and Esi, and the Witch of the Forest [...] Read more.
The Adventures of Sasa and Esi is a dance theatre that takes its story reference from two short Ghanaian folktale stories the Adventures of Sasa and Esi, and the Witch of the Forest which were written by Martin Otchere Owusu and directed by Johnson Kwaku Edu and Latipher Amma Osei. The production was staged at the Amu Theatre of the Department of Theatre Arts, University of Education (UEW), Winneba from the 3rd to the 6th of November, 2016. Though the play was written for children it appeals to adults due to the lessons embedded in it. Both plays were adapted by the authors to include Ghanaian folk and popular contemporary choreographed dances and theatrical special effects make-up as key theatrical elements to drive the production and to project the element of spectacle. The style of presentation was naturalism and realism. The production also served as a learning platform for the cast and crew who were students in the Department of Theatre Arts, UEW as they participated in it. Through experimentation, experiences, and concept development, the directors’ style and professional background in technical theatre and creative dance heightened the element of naturalism and realism to underscore the theme of the play, understanding, and interpretation of the play.
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Case Report
Open Access November 25, 2022

Knowledge for a Better Conservation: Syntaxonomic Review of Caribbean Pine Forests (Cuba, Hispaniola)

Abstract A phytosociological review is carried out of the pine forest formations on the islands of Cuba and Hispaniola (Caribbean), due to the diversity of soils and environments. We collected 10 plant associations belonging to the class Byrsonimo-Pinetea caribaea growing on siliceous, calcareous and sandy substrates and 21 associations on special, serpentine and ophite substrates and on ultramafic rocks belonging to the class Caseario crassinervis-Pinetea cubensis, exclusive to Cuba; while the association of pine forests on serpentines in Hispaniola is included in the class Phyllantho orbicularis-Neobracetea valenzuelanae with a Caribbean distribution. The comparative phytosociological and statistical study reveals phytosociological anomalies in the inclusion of various syntaxa, and in the description of other syntaxa according to the International Code of Phytosociological Nomenclature (ICPN). We therefore propose a change in status for several of the subassociations described: subass. ilicetosum repandae: syn. var. con Ilex repanda; subass. schmidtottietosum shaferi: syn. var. with Schmidtottia shaferi; subass. acrosynanthetosum trachyphylli: syn. var. with Acrosynanthus trachyphyllus; subass. psychotrietosum grandis: var. con Psychotria grandis; subass. notodonetosum roigii: syn. var. with Notodon roigii. We also propose a nomen novum: jaquinietosum oxhyphyllae Reyes & Acosta 2012 ex Cano et al. hoc loco [...] Read more.
A phytosociological review is carried out of the pine forest formations on the islands of Cuba and Hispaniola (Caribbean), due to the diversity of soils and environments. We collected 10 plant associations belonging to the class Byrsonimo-Pinetea caribaea growing on siliceous, calcareous and sandy substrates and 21 associations on special, serpentine and ophite substrates and on ultramafic rocks belonging to the class Caseario crassinervis-Pinetea cubensis, exclusive to Cuba; while the association of pine forests on serpentines in Hispaniola is included in the class Phyllantho orbicularis-Neobracetea valenzuelanae with a Caribbean distribution. The comparative phytosociological and statistical study reveals phytosociological anomalies in the inclusion of various syntaxa, and in the description of other syntaxa according to the International Code of Phytosociological Nomenclature (ICPN). We therefore propose a change in status for several of the subassociations described: subass. ilicetosum repandae: syn. var. con Ilex repanda; subass. schmidtottietosum shaferi: syn. var. with Schmidtottia shaferi; subass. acrosynanthetosum trachyphylli: syn. var. with Acrosynanthus trachyphyllus; subass. psychotrietosum grandis: var. con Psychotria grandis; subass. notodonetosum roigii: syn. var. with Notodon roigii. We also propose a nomen novum: jaquinietosum oxhyphyllae Reyes & Acosta 2012 ex Cano et al. hoc loco.
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Review Article
Open Access March 25, 2022

Floristic Composition and Structure in the Undergrowth of Agroforests in Neems in the Far North Region (Cameroon)

Abstract This study took place in the Far North region of Cameroon. The general objective was to assess the floristic diversity of the undergrowth of Agrosystems in Azadirachta indica. The data were collected in 100 m long by 20 m wide transects surveyed in plantations of different ages. In total, 5 transects were carried out, ie a total area of 1 ha per site. The sampling bands were established using the compass, decameter, GPS and wires. The experimental set-up used was a 5-repetition split plot. A total of 7689 individuals divided into 9 families, 13 genera and 16 species have been identified. Guiera senegalensis and Piliostigma thonningii are the most common in terms of relative abundance. The analysis of the Family Importance Index (VIF) shows overall that the Combretaceae, and Mimosaceae are the most important in ecological terms. While those of the species show that Guiera senegalensis, Combretum micranthum and Acacia nilotica [...] Read more.
This study took place in the Far North region of Cameroon. The general objective was to assess the floristic diversity of the undergrowth of Agrosystems in Azadirachta indica. The data were collected in 100 m long by 20 m wide transects surveyed in plantations of different ages. In total, 5 transects were carried out, ie a total area of 1 ha per site. The sampling bands were established using the compass, decameter, GPS and wires. The experimental set-up used was a 5-repetition split plot. A total of 7689 individuals divided into 9 families, 13 genera and 16 species have been identified. Guiera senegalensis and Piliostigma thonningii are the most common in terms of relative abundance. The analysis of the Family Importance Index (VIF) shows overall that the Combretaceae, and Mimosaceae are the most important in ecological terms. While those of the species show that Guiera senegalensis, Combretum micranthum and Acacia nilotica finally for the genera, it is Acacia, Guiera and Combretum which contains the most important ecological indices. The overall density of species within the plots varies between 129 and 105 ind / ha. The basal area varies from 2.02 to 3.88 m² / ha. The Importance Value Index (IVI) is of the order of 300 in the different plots. The floristic diversity of the undergrowth of Agrosystems (average ISH> 2) shows homogeneity and an even distribution between the different plots. Plots with similarity indices of less than 50% do not meet floristic affinity while similarity indices are high in plots with floristic affinities greater than or equal to 50%. The diameter structure showed a predominance of young individuals. This information drawn from the conclusion of the present study shows that they constitute an important argumentation of the advantages so that the services of agricultural development should be interested in the conservation and valuation of such an agroforestry system for the protection of the environment against the climate change mitigation and sustainable development of local communities.
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Open Access October 24, 2021

Cultivation Trial of an Edible and Medicinal Mushroom Species, Pleurotus Tuber-regium (Rumph. ex Fr.) Singer 1951 (strain 190212) on Various Lignocellulosic Substrates

Abstract In Central Africa, mushrooms are critically important non-timber forest products (NTFPs), both nutritionally and economically. A strain of edible and medicinal lignicolous fungus, Pleurotus tuber-regium (Rumph. ex Fr.) Singer 1951 (strain 190212), isolated from tissue (sclerotia), on PDA medium, was tested on corn grain and sawdust seedling substrates and on palm oil male inflorescence (Elaeis guineensis Jacq.), ground corn (Zea mays L) stalks and grass (Paspalum notatum L) soaked for 24 hrs then drained for 24 hours, and unsoaked ground corn (Zea mays L) stalks. The highest mycelial growth rate recorded was about 0.9 cm on the PDA medium; 5.97 cm on the corn-based seedling medium and 11.95 cm on the sawdust-based seedling medium. Total mycelial invasion on the PDA medium was observed on day 10, day 14 on the corn-based seedling medium, and day 24 on the sawdust-based seedling medium. The onset of mycelial invasion was noticeable on day 3 of seeding for all treatments T0 (control), T1 (Final substrate based on soaked ground corn stalks), T2 (Final substrate based on unsoaked ground corn stalks), and T3 (Final substrate based on turf). Total invasion of mycelium was obtained at day 15 of incubation for treatments T1 and T2, at day 18 for treatment T3 and at day 24 for treatment T0. The results obtained on treatments T1 and T2 respectively (14.95±3.12% and 15.65±1.06%) of the maize stalk substrate, lead us to believe that the strain 190212 of Pleurotus tuber-regium [...] Read more.
In Central Africa, mushrooms are critically important non-timber forest products (NTFPs), both nutritionally and economically. A strain of edible and medicinal lignicolous fungus, Pleurotus tuber-regium (Rumph. ex Fr.) Singer 1951 (strain 190212), isolated from tissue (sclerotia), on PDA medium, was tested on corn grain and sawdust seedling substrates and on palm oil male inflorescence (Elaeis guineensis Jacq.), ground corn (Zea mays L) stalks and grass (Paspalum notatum L) soaked for 24 hrs then drained for 24 hours, and unsoaked ground corn (Zea mays L) stalks. The highest mycelial growth rate recorded was about 0.9 cm on the PDA medium; 5.97 cm on the corn-based seedling medium and 11.95 cm on the sawdust-based seedling medium. Total mycelial invasion on the PDA medium was observed on day 10, day 14 on the corn-based seedling medium, and day 24 on the sawdust-based seedling medium. The onset of mycelial invasion was noticeable on day 3 of seeding for all treatments T0 (control), T1 (Final substrate based on soaked ground corn stalks), T2 (Final substrate based on unsoaked ground corn stalks), and T3 (Final substrate based on turf). Total invasion of mycelium was obtained at day 15 of incubation for treatments T1 and T2, at day 18 for treatment T3 and at day 24 for treatment T0. The results obtained on treatments T1 and T2 respectively (14.95±3.12% and 15.65±1.06%) of the maize stalk substrate, lead us to believe that the strain 190212 of Pleurotus tuber-regium species used has adapted and requires an improvement of the medium with nitrogen-rich additives such as soybean meal. This could achieve the theoretical yield of 20% or more, according to which a substrate can be considered better in producing sporophores.
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