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Semei Christopher Mukama,1 Jane Senyondo Nakawesi,1 Dedrix Stephenson Bindeeba,1 Simon Ezajobo,1 Andrew Mugisa,1 Catherine Senyimba,1 Eve Namitala,1 Robert Onzima DDM Anguyo,2 Simon Peter Katongole,3 Barbara Mukasa1 1Mildmay Uganda, Kampala, Uganda; 2Department of International Public Health, Liverpool School of Tropical Medicine (LSTM), Kampala, Uganda; 3Department of Public Health, Gudie University Project, Kampala, UgandaCorrespondence: Simon Peter Katongole, Email spkatongole@gmail.comBackground: This study evaluated the effectiveness and responsiveness of differentiated Human Immunodeficiency Virus (HIV)/Acquired Immuno-Deficiency Syndrome (AIDS) service delivery models (DSDMs) implemented to enhance antiretroviral therapy (ART) access and outcomes for patients while addressing Tuberculosis (TB)-HIV integration, focusing on four of the five DSDMs currently implemented in Uganda.Methodology: A descriptive cross-sectional survey was conducted in eight districts of central Uganda using Lot Quality Assurance Sampling approach from 7th to 23rd March 2023. We randomly sampled 2668 patients who have been on ART for at least 1 year in a Facility-Based Individual Management (FBIM) model or in a non-FBIM DSDM for at least one year. Data were collected through patient interviews and review of records in ART and DSDM registers as well as ART cards. We analyzed the data in proportions, comparing the selected ART outcome and responsiveness indicators between Community Client Led ART Distribution (CCLAD), Community Drugs Distribution Point (CDDP) and Fast-Track Drug Refill (FTDR) DSDMs with the standard care (FBIM) model. The ART outcome variables include patients retained in the 1st line of the ART regimen, patients in World Health Organization clinical stage 1 during the last facility visit, patients who had no CD4 request during the past 12 months, viral load suppression, ART adherence, and patients who reported that they did not experience HIV/AIDS-related symptoms in the past 6 months. The variables on TB care include screening for TB using the intensified case finding form and patients tested positive for TB. Responsiveness variables include the perceived; travel time for ART refill, travel distance for ART refill, convenience and flexibility during ART refill, cost of travel for ART refill, fear of being seen at ART refill point, waiting time before service, adequacy of service time, crowding and risk of infections, social support, ability to address ART treatment challenges, HIV status disclosure and barriers to access. Non-overlap in 95% confidence interval in indicator proportion between non-FBIM DSDM and FBIM means a statistically significant difference in proportion, or otherwise non-significant.Results: Higher proportions of ART patients in the CCLAD and CDDP DSDMs adhered to ART, had suppressed viral load, and a lower TB prevalence than those in FBIM model. Additionally, more CCLAD and CDDP clients reported shorter travel time and distance to access ART than their counterparts in the FBIM model. Compared to FBIM model, higher proportions of those in CCLAD and CDDP also reported flexibility in ART refill scheduling, reduced transport costs, fewer privacy concerns, less HIV/AIDS-related stigma, shorter waiting times, more efficient services, decreased congestion at ART pickup sites, enhanced peer support, improved problem-solving assistance, and increased HIV status disclosure. The FTDR model outperformed FBIM in proportions with fewer requests for CD4 testing, viral load suppression, as well as proportions of clients who reported; shorter travel time, lower transportation cost, decreased privacy concerns, shorter waiting time, and efficient service provision. Compared to both CDDP and FTDR, the FBIM had a higher proportion of clients remain on the first-line ART regimen.Conclusion: Community-based DSDMs show responsiveness to clients’ needs without compromising the effectiveness of ART care for patients. Although FTDR also demonstrates high effectiveness and responsiveness for clients on ART, there is potential for further improvement. Planners and implementers of ART programs should consider both demand- and supply-side innovations to sustain the continuation of DSDMs.Keywords: HIV/AIDS, TB-HIV, DSDM, LQAS

Abstract This study focuses on meeting end‐users’ demand for cassava (Manihot esculenta Crantz) varieties with low cyanogenic potential (hydrogen cyanide potential [HCN]) by using near‐infrared spectrometry (NIRS). This technology provides a fast, accurate, and reliable way to determine sample constituents with minimal sample preparation. The study aims to evaluate the effectiveness of machine learning (ML) algorithms such as logistic regression (LR), support vector machine (SVM), and partial least squares discriminant analysis (PLS‐DA) in distinguishing between low and high HCN accessions. Low HCN accessions averagely scored 1–5.9, while high HCN accessions scored 6–9 on a 1–9 categorical scale. The researchers used 1164 root samples to test different NIRS prediction models and six spectral pretreatments. The wavelengths 961, 1165, 1403–1505, 1913–1981, and 2491 nm were influential in discrimination of low and high HCN accessions. Using selected wavelengths, LR achieved 100% classification accuracy and PLS‐DA achieved 99% classification accuracy. Using the full spectrum, the best model for discriminating low and high HCN accessions was the PLS‐DA combined with standard normal variate with second derivative, which produced an accuracy of 99.6%. The SVM and LR had moderate classification accuracies of 75% and 74%, respectively. This study demonstrates that NIRS coupled with ML algorithms can be used to identify low and high HCN accessions, which can help cassava breeding programs to select for low HCN accessions.

This paper traces the tenuous relationship of prestige television, the culture industry and blackness. The opening section aims to get a hold on what is meant by prestige television. We review literature that introduces and problematizes the intuitive arguments of prestige television’s elevated status as high art and ultimately conclude with a sociopolitical argument that minimises the distinction between form and content in order to emphasise and show the hierarchy inherent in the culture industry based on legitimacy. The second section introduces the idea of blackness to the conversation of prestige television by analysing the final scene of The Sopranos – a cut to the black screen – as not merely the event that officially inaugurates prestige television, but as an event that also announces the possible escape from its parameters of legitimacy. To do the latter we reflect upon “Black Bieber” as a figure of illegitimate blackness in Donald Glover’s Atlanta. In the third and concluding sections of the paper, we continue our elaboration of the uniqueness of blackness by putting into conversation Fred Moten’s conception of fugitive blackness with Theodor Adorno’s aesthetic theory. In the conclusion, we show how blackness challenges the totalizing aspect of the culture industry, totalizing aspect of the culture industry, pointing us towards something altogether new, after black(ness).

Breeding for low-hydrogen-cyanide (HCN) varieties is a major objective of programs targeting boiled cassava food products. To enhance the breeding of low-HCN varieties, knowledge of genetic variation and trait heritability is essential. In this study, 64 cassava clones were established across four locations and evaluated for HCN using three HCN assessment methods: one with a 1 to 9 scale, on with a 0 ppm to 800 ppm scale, and a quantitative assay based on spectrophotometer readings (HCN_Spec). Data were also collected on the weather variables precipitation, relative humidity, and temperature. Highly significant differences were observed among clones (p < 0.001) and locations (p < 0.001). There was also significant clone–environment interactions, varying from p < 0.05 to p < 0.001. Locations Arua and Serere showed higher HCN scores among clones and were associated with significantly higher (p < 0.001) mean daily temperatures (K) and lower relative humidity values (%) across 12 h and 18 h intervals. Within locations, HCN broad sense heritability estimates ranged from 0.22 to 0.64, while combined location heritability estimates ranged from 0.14 to 0.32. Relationships between the methods were positive and strong (r = 0.75–0.92). The 1 to 9 scale is more accurate and more reproducible than either the 0 to 800 ppm scale or spectrophotometric methods. It is expected that the information herein will accelerate efforts towards breeding for low-HCN cassava varieties.

David Kavuma,1,2 Juliet Ndibazza,1 Venantius Bbaale Kirwana,3 Hussein Mukasa Kafeero,1 Simon Peter Katongole,1 Joseph Baruch Baluku2 1Faculty of Health Sciences, Uganda Martyrs University-Nkozi, Kampala, Uganda; 2Directorate of Medical Services, Mildmay Uganda, Kampala, Uganda; 3Monitoring, Evaluation and Learning, Sexual Reproductive Health and Rights Alliance, Kampala, UgandaCorrespondence: David Kavuma, Tel +2560772839416, Email davikavu@gmail.comIntroduction: Evidence is lacking about condom use among out-of-school young people (OS-YP) on anti-retroviral therapy (ART). This study aimed to understand the factors associated with consistent condom use among OS-YP aged 15– 24 years old on ART in Central Uganda.Methods: This was a quantitative descriptive cross-sectional study conducted among 357 OS-YP on ART from seven districts of Central Uganda. Interviewer-administered questionnaire was used to collect data on consistent condom use in the past 12 months from OS-YP, aged 15– 24 years, who did not intend to have children in that period. Consistent condom use by participants was considered to be the routine (always) use of condoms during sexual intercourse in the past 12 months. Frequencies and percentages were used for univariate analysis, while Pearson’s Chi-square was used to determine bivariate association and logistic regression analysis for multivariable association with consistent condom use, at 95% confidence level.Results: Of the 357 sexually active OS-YP on ART, 73% were females. The age range of study participants was between 15 and 24 years old (with a mean ± standard deviation of 20± 3 years) where 55% were aged 20 to 24 years, while their sexual partners were aged ≥ 25 years, and 49% of respondents did not use condoms. Primary school education level, being employed, rural residence, and receiving ART from health facilities with a perceived adequate number of health workers were strongly associated with consistent condom use with the adjusted odds ratio (AOR) of 0.2 (95% CI 0.07– 0.69) level of education; 2.12 (95% CI 1.06– 4.26) employment status; 2.46 (95% CI 1.19– 5.10) residence and 6.08 (95% CI 1.05– 35.22) perceived level of staffing at the health facility, respectively.Conclusion: Efforts to increase consistent condom use should focus on recruiting more providers in health facilities to intensify condom use sensitization among sexually active young people on ART in the context of HIV epidemic control.Keywords: out-of-school young people, antiretroviral therapy, consistent condom use

Jean Mukasa,1 Michael Otim,2 Beatrice Monaco,1 Amina Al Marzouqi,2 Priya Breitener,1 Lalitha Jawahar1 1Fatima College of Health Science, Institute of Technology, Ajman, United Arab Emirates; 2College of Health Sciences, University of Sharjah, Sharjah, United Arab EmiratesCorrespondence: Michael OtimCollege of Health Sciences, University of Sharjah, PO Box 27272, Sharjah, United Arab EmiratesTel +971 6 505 7527Email motim@sharjah.ac.aeIntroduction: The 2020 COVID-19 crisis affected all sectors, including education. This study explored the experiences and challenges faced by tertiary students in the United Arab Emirates when they were suddenly required to transition from traditional classroom learning to E-learning following the outbreak of COVID-19.Methods: This cross-sectional study used mixed methods to collect and analyse qualitative and quantitative data. The participants were Nursing students involved in clinical training.Results: Most students (87%) reported inexperience with studying via E-learning. Challenges encountered included the lack of privacy, Internet connection issues, problems with the teaching platform and communication difficulties. Some students also reported that instructors were slow at responding to their needs. The lack of robust internet coverage was a major overarching issue that affected communication, students’ engagement, preparedness for E-learning, and other challenges.Discussion: This study is significant because it highlights the challenges experienced by Nursing Students during the rapid transition from traditional education to e-learning. It enables the faculty to understand and support students during the time of crisis. Communication with students needs to be streamlined for successful E-learning. Authorities should provide more essential infrastructure such as reliable and stable Internet connectivity to strengthen the E-learning approach.Keywords: E-learning, independent-learning, tertiary, COVID-19, coronavirus, online-learning, nursing student, traditional education

Michael E Otim,1,2 Desmond Kabuya Demaya,2 Amina Al Marzouqi,1 Jean Mukasa3 1College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; 2School of Graduate Studies and Research, Nexus International University, Kampala, Uganda; 3Fatima College of Health Science, Institute of Technology, Ajman, United Arab EmiratesCorrespondence: Michael E OtimCollege of Health Sciences, University of Sharjah, P.O. Box 27272, Sharjah, United Arab EmiratesTel +971 6 505 7527Email motim@sharjah.ac.aePurpose: Antibiotic resistance is spreading at an alarming rate globally, mainly because of antibiotics misuse. The World Health Organization developed guidelines for the rational use of antibiotics to prevent antibiotic misuse and reduce the potential development of antibiotic resistance. Although many countries adhere to these guidelines and have contextualized them to their needs, data on antibiotics use are limited in African countries, particularly in South Sudan. This study explored prescription patterns and use of antibiotics at Juba Teaching Hospital (JTH) to clarify the potential for antibiotic resistance in South Sudan.Materials and Methods: We conducted a retrospective, cross-sectional study of archived patient data from 2016 to determine the prevalence of inappropriate antibiotics use at JTH. We used methodology developed in a previous study to assess the appropriate use of antibiotics. The study sample comprised 384 files. After reviewing and cleaning the files, 316 files were included in our analyses. This study was approved by the South Sudan Ministry of Health Ethics Review Board (approval number: MoH/ERB 51/2018) and all procedures were consistent with the Declaration of Helsinki.Results: Antibiotics use was highest in the medical ward (75.4%). Most antibiotics prescriptions were for infectious diseases (23.7%), followed by ailments affecting the digestive system (19.9%). Commonly prescribed antibiotics were ceftriaxone (21.2%) and metronidazole (20.0%). The mean number of antibiotics prescribed per patient encounter was 2.09 (95% confidence interval: 1.98– 2.19). Most files (n=233, 70.57%) demonstrated incorrect use of antibiotics with 78.8% (n=249) of prescriptions being inappropriate (misuse).Conclusion: This study revealed a high level of inappropriate antibiotics use at JTH despite the existence of local guidelines, which suggested there was an increased risk for antibiotic resistance. Therefore, it is necessary to introduce antibiotic stewardship activity, along with continuous national surveillance. Enforcement of guidelines to reduce irrational antibiotics use may reduce the risk for antibiotic resistance.Keywords: antibiotics, low-income countries, clinical guidelines, policy implications, antimicrobial resistance, AMR, antibiotic use, antibiotic dispensing

Potatoes are prone to attack by multiple viruses, which contribute greatly to yield and quality decline depending on the cultivar and the virus involved. This study investigated the effect of co-infection involving Potato virus Y (potyvirus) and Potato leafroll Virus (pelero virus) on productivity of five potato cultivars in Uganda and the nature of virus interaction during co-infection process. Variety response to virus infection by PVY, PLRV and co-infection (PVY + PLRV) varied across different varieties. The plants that were infected with PLRV had leaf rolling, stuntedness, leaf distortion, reduction in leaf size and mottling and light yellow mosaics, and in some cases, purple or red margins were observed, while single infection of PVY induced necrosis, leaf rugosity, crinkling, stunting, interveinal necrosis, blotching of the margins, leaf distortion and mottling. When the two viruses were combined during co-infection with PVY + PLRV, the symptoms were characterized by bright blotching and necrotic leaf margins with purpling of the leaf tips and leaf margins, stuntedness and leaf distortions. The virus disease severity was higher under mixed infected plants than single infected plants. The high disease severity culminated in a significant effect on yield, marketable tuber number per plant, plant growth height and plant vigor, which were different across the varieties. Co-infection involving PVY and PLRV caused a reduction in the marketable yield of 95.2% (Kinigi), 94% (Victoria), 89.5 (Rwagume), 45.3% (Royal) and 23.7% (Sifra). Single infection by PLRV caused a reduction in a marketable yield in Victoria (91.8%), Kinigi (84.8%), Rwagume (73.3%), Royal (47.2%) and Sifra 22.1%, while PVY caused a marketable yield reduction in Victoria (87.2%), Rwagume (85.9.7%), Kinigi (85.1%), Royal (37.4%) and Sifra (14.1%). The effects associated with the co-infection of PVY and PLRV were lower than the combined value of the single infections, suggesting that the two viruses were interacting to affect the potato productivity. The high yield loss suggested that effective resistance strategy targeting PVY, PLRV and their combination was required to save the potato industry in Uganda.

Background: Expertise in scientific and grant writing are essential in health science research and practice. Quality scientific and grant writing are uncommon in Uganda which is partly responsible for the low quality and quantity of research outputs. To address this, the Makerere University Walter Reed Project (MUWRP)implemented Strengthening Institutional Capacity for Research Administration in Uganda (SICRA). Methods: SICRA conducted 3-day face-to-face and virtual training workshops in scientific and grant writing targeting early-career scientists (ECS) at institutions involved in health research and graduate training in Uganda. Mentorship and follow-up were by phone call, email and face-to-face meetings as required. To determine the effect of SICRA interventions, we conducted a quasi-experimental impact assessment among trainees using a semi-structured questionnaire. Results: 245 ECS attended SICRA workshops on grant writing (37.2%), scientific writing (33.3%), or both(28.2%). Seventy-eight trainees (32%) participated in the impact assessment. A majority of respondents (60.3%) had a master's degree; 83% were full-time employees at a research or academic institution and 97.4% were involved in health research. Before SICRA, only 34.6%of respondents had written a manuscript, 19.2% had submitted at least one manuscript for institutional internal review and 25.6% had been published. After SICRA, 66.7% had written a manuscript (p<0.001), 51.3% had submitted a manuscript for internal review (p<0.001) and 38.5% were published (p=0.064). Before SICRA, only 37.2% had submitted a grant proposal, 24.4% had won a grant and 43.6% had participated in grant writing teams. After SICRA, 64.1% had submitted a grant proposal (p<0.001), 42.3% had received funding (p=0.011), and 62.8% were participating in grant writing teams (p=0.02). Conclusions: SICRA improved ECS scientific and grant writing which led to increased research output. The 3-day training approach is appropriate for Uganda and similar LMICs.

BackgroundAnthrax is a zoonotic disease that can be transmitted to humans from infected animals. During May-June 2017, three persons with probable cutaneous anthrax were reported in Arua District, Uganda; one died. All had recently handled carcasses of livestock that died suddenly and a skin lesion from a deceased person tested positive by PCR for Bacillus anthracis. During July, a bull in the same community died suddenly and the blood sample tested positive by PCR for Bacillus anthracis. The aim of this investigation was to establish the scope of the problem, identify exposures associated with illness, and recommend evidence-based control measures.MethodsA probable case was defined as acute onset of a papulo-vesicular skin lesion subsequently forming an eschar in a resident of Arua District during January 2015-August 2017. A confirmed case was a probable case with a skin sample testing positive by polymerase chain reaction (PCR) for B. anthracis. Cases were identified by medical record review and active community search. In a case-control study, exposures between case-patients and frequency- and village-matched asymptomatic controls were compared. Key animal health staff were interviewed to learn about livestock deaths.ResultsThere were 68 case-patients (67 probable, 1 confirmed), and 2 deaths identified. Cases occurred throughout the three-year period, peaking during dry seasons. All cases occurred following sudden livestock deaths in the villages. Case-patients came from two neighboring sub-counties: Rigbo (attack rate (AR) = 21.9/10,000 population) and Rhino Camp (AR = 1.9/10,000). Males (AR = 24.9/10,000) were more affected than females (AR = 0.7/10,000). Persons aged 30-39 years (AR = 40.1/10,000 population) were most affected. Among all cases and 136 controls, skinning (ORM-H = 5.0, 95%CI: 2.3-11), butchering (ORM-H = 22, 95%CI: 5.5-89), and carrying the carcass of livestock that died suddenly (ORM-H = 6.9, 95%CI: 3.0-16) were associated with illness.ConclusionsExposure to carcasses of animals that died suddenly was a likely risk factor for cutaneous anthrax in Arua District during 2015-2017. The recommendations are investigation of anthrax burden in livestock, prevention of animal infections through vaccinations, safe disposal of the carcasses, public education on risk factors for infection and prompt treatment of illness following exposure to animals that died suddenly.

Nami Suzuki,1 Jaeduk Yoshimura Noh,1 Toshiaki Kameda,1 Ai Yoshihara,1 Hidemi Ohye,1 Miho Suzuki,1 Masako Matsumoto,1 Yo Kunii,1 Kenji Iwaku,1 Natsuko Watanabe,1 Koji Mukasa,1 Ai Kozaki,2 Toshu Inoue,2 Kiminori Sugino,1 Koichi Ito1 1Department of Internal Medicine, Ito Hospital, Tokyo, Japan; 2Department of Ophthalmology, Olympia Eye Hospital, Tokyo, Japan Background: Euthyroid Graves’ disease (EGD) is a rare condition defined as the presence of thyroid-associated ophthalmopathy (TAO) in patients with normal thyroid function. Due to the rarity of this disease, only a limited number of studies and case reports are available for further evaluation of the characteristics of the disease. The aim of this study was to examine the changes in the thyroid function, thyrotropin receptor antibodies (TRAb) and eye symptoms, and then determine whether TRAb is related to TAO in EGD patients. TRAb in this study was defined as including both thyrotropin-binding inhibitory immunoglobulin (TBII) and thyroid-stimulating immunoglobulin (TSAb). Patients and methods: Medical records of patients diagnosed with EGD were reviewed. Ophthalmologists specializing in TAO examined the eyes of all subjects. Results: Of the 58 patients diagnosed with EGD, 24.1% developed hyperthyroidism, while 3.4% developed hypothyroidism. A total of 72.4% of the 58 patients remained euthyroid throughout the entire follow-up period. At the initial presentation, TBII and TSAb were positive in 74.5% and 70.5%, respectively. Ophthalmic treatments were administered to 30 (51.7%) out of the 58 patients. A significant spontaneous improvement of the eye symptoms was found in 28 of the EGD patients who did not require eye treatments. EGD patients exhibited positive rates for both TBII and TSAb, with the number of the TRAb-positive patients gradually decreasing while the eye symptoms spontaneously improved over time. There were no correlations found between TRAb at initial presentation and the eye symptoms. Conclusion: TBII and TSAb were positive in about 70% of EGD patients at their initial visit. Thyroid functions of EGD patients who have been euthyroid for more than 6.7 years may continue to remain euthyroid in the future. Keywords: euthyroid Graves’ orbitopathy, euthyroid Graves’ ophthalmopathy, thyroid-associated ophthalmopathy, TSH receptor antibody, thyroid-stimulating immunoglobulin

INTRODUCTION: Positive HIV results disclosure plays a significant role in the successful prevention and care of HIV infected patients. It provides significant social and health benefits to the individual and the community. Non-disclosure is one of the contextual factors driving the HIV epidemic in Uganda. Study objectives: to determine the frequency of HIV disclosure, associated factors and disclosure outcomes among HIV positive pregnant women at Mbarara Hospital, southwestern Uganda. METHODS: a cross-sectional study using quantitative and qualitative methods among a group of HIV positive pregnant women attending antenatal clinic was done and consecutive sampling conducted. RESULTS: the total participant recruitment was 103, of which 88 (85.4%) had disclosed their serostatus with 57% disclosure to their partners. About 80% had disclosed within less than 2 months of testing HIV positive. Reasons for disclosure included their partners having disclosed to them (27.3%), caring partners (27.3%) and encouragement by health workers (25.0%). Following disclosure, 74%) were comforted and 6.8% were verbally abused. Reasons for non-disclosure were fear of abandonment (33.3%), being beaten (33.3%) and loss of financial and emotional support (13.3%). The factors associated with disclosure were age 26-35 years (OR 3.9, 95% CI 1.03-15.16), primary education (OR 3.53, 95%CI 1.10-11.307) and urban dwelling (OR 4.22, 95% CI 1.27-14.01). CONCLUSION: participants disclosed mainly to their partners and were comforted and many of them were encouraged by the health workers. There is need to optimize disclosure merits to enable increased participation in treatment and support programs.

Background: Expertise in scientific and grant writing are essential in health science research and practice. Quality scientific and grant writing are uncommon in Uganda which is partly responsible for the low quality and quantity of research outputs. To address this, the Makerere University Walter Reed Project (MUWRP) implemented Strengthening Institutional Capacity for Research Administration in Uganda (SICRA). Methods: SICRA conducted 3-day face-to-face and virtual training workshops in scientific and grant writing targeting early-career scientists (ECS) at institutions involved in health research and graduate training in Uganda. Mentorship and follow-up were by phone call, email and face-to-face meetings as required. To determine the effect of SICRA interventions, we conducted a quasi-experimental impact assessment among trainees using a semi-structured questionnaire. Results: 245 ECS attended SICRA workshops on grant writing (37.2%), scientific writing (33.3%), or both (28.2%). Seventy-eight trainees (32%) participated in the impact assessment. A majority of respondents (60.3%) had a master&apos;s degree; 83% were full-time employees at a research or academic institution and 97.4% were involved in health research. Before SICRA, only 34.6% of respondents had written a manuscript, 19.2% had submitted at least one manuscript for institutional internal review and 25.6% had been published. After SICRA, 66.7% had written a manuscript (p Conclusions: SICRA improved ECS scientific and grant writing which led to increased research output. The 3-day training approach is appropriate for Uganda and similar LMICs. Keywords: early-career scientists, scientific/grant writing, research administration, INTRODUCTION Expertise in scientific communication including scholarly and grant writing are quintessential for a successful career in health science practice and research (Guyer et al., 2021; Behzadi & Gajdacs, 2021; [...]

Anthocyanins are an important micro-component that contributes to the quality factors and health benefits of black rice. Anthocyanins concentration and compositions differ among rice seeds depending on the varieties, growth conditions, and maturity level at harvesting. Chemical composition-based seeds inspection on a real-time, non-destructive, and accurate basis is essential to establish industries to optimize the cost and quality of the product. Therefore, this research aimed to evaluate the feasibility of near-infrared hyperspectral imaging (NIR-HSI) to predict the content of anthocyanins in black rice seeds, which will open up the possibility to develop a sorting machine based on rice micro-components. Images of thirty-two samples of black rice seeds, harvested in 2019 and 2020, were captured using the NIR-HSI system with a wavelength of 895–2504 nm. The spectral data extracted from the image were then synchronized with the rice anthocyanins reference value analyzed using high-performance liquid chromatography (HPLC). For comparison, the seed samples were ground into powder, which was also captured using the same NIR-HSI system to obtain the data and was then analyzed using the same method. The model performance of partial least square regression (PLSR) of the seed sample developed based on harvesting time, and mixed data revealed the model consistency with R2 over 0.85 for calibration datasets. The best prediction models for 2019, 2020, and mixed data were obtained by applying standard normal variate (SNV) pre-processing, indicated by the highest coefficient of determination (R2) of 0.85, 0.95, 0.90, and the lowest standard error of prediction (SEP) of 0.11, 0.17, and 0.16 mg/g, respectively. The obtained R2 and SEP values of the seed model were comparable to the result of powder of 0.92–0.95 and 0.09–0.15 mg/g, respectively. Additionally, the obtained beta coefficients from the developed model were used to generate seed chemical images for predicting anthocyanins in rice seed. The root mean square error (RMSE) value for seed prediction evaluation showed an acceptable result of 0.21 mg/g. This result exhibits the potential of NIR-HSI to be applied in a seed sorting machine based on the anthocyanins content.

Almonds are nutrient-rich nuts. Due to their high level of consumption and relatively high price, their production is targeted for illegal practices, with the intention of earning more profit. The most common adulterants are based on superficial matching, and as an adulterant, the apricot kernel is comparatively inexpensive and almost identical in color, texture, odor, and other physicochemical characteristics to almonds. In this study, a near-infrared hyperspectral imaging (NIR-HSI) system in the wavelength range of 900–1700 nm synchronized with a conveyor belt was used for the online detection of added apricot kernels in almonds. A total of 448 samples from different varieties of almonds and apricot kernels (112 × 4) were scanned while the samples moved on the conveyor belt. The spectral data were extracted from each imaged nut and used to develop a partial least square discrimination analysis (PLS-DA) model coupled with different preprocessing techniques. The PLS-DA model displayed over a 97% accuracy for the validation set. Additionally, the beta coefficient obtained from the developed model was used for pixel-based classification. An image processing algorithm was developed for the chemical mapping of almonds and apricot kernels. Consequently, the obtained model was transferred for the online sorting of seeds. The online classification system feedback had an overall accuracy of 85% for the classification of nuts. However, the model presented a relatively low accuracy when evaluated in real-time for online application, which might be due to the rough distribution of samples on the conveyor belt, high speed, delaying time in suction, and lighting variations. Nevertheless, the developed online prototype (NIR-HSI) system combined with multivariate analysis exhibits strong potential for the classification of adulterated almonds, and the results indicate that the system can be effectively used for the high-throughput screening of adulterated almond nuts in an industrial environment.

Opportunities for Ugandan farmers to undertake the production of sweet potato have resulted in certified sweet potato seed (CSS) innovations being pursued in recent times. The CSS and farmer-saved vine sources co-exist with the latter still predominant despite the formers' on-farm superior performance as regards yields, disease reduction and promotions. Information on the evolution process is missing, leading to ambiguous interpretations of its impact on uptake. This study described the evolution stages, emerging delivery structure and actor interactions during the CSS development process in Uganda. A case study design was employed, and data were collected through focus group discussions (FGDs) and key informant interviews (KIIs), and anchored into actor-network theory (ANT) to generate actor actions and interrelationships. Transcripts were analyzed using the thematic analysis approach by Braun and Clarke. Network analysis was done using UCINET6 V6.759 and a Network visualizer (Net Draw 2.179). Results depicted a six-stage evolution process with most actors having multiple roles, business actors involved at utilization stage only and each stage being triggered by an event. During the process, an integrated CSS system emerged with only 35.6% of the potential direct links between actors being present. The major central actors that had closer interactions with farmers and seed growers were largely public sector, with private sector coming in late. Actors were location-specific with those of Mpigi being many, more interactive (average degree of 7.8) compared to Omoro (average degree of 4.5), and high average path lengths (1.7) implying actors are remotely connected with farmers and vine multipliers being most influential. It is envisaged that the involvement of business actors in product innovation stages and imparting entrepreneurial skills to key farmer groups and vine multipliers will spur the CSS system. Future research into CSS systems should focus on building business ecosystems. Key words: Certified sweet potato seed, Evolution process, Delivery structure, Actor interactions, INTRODUCTION This paper provides an analysis of the events during the evolution from informal to formal certified sweet potato seed (CSS) systems in Uganda. It is poised on the changes [...]

AbstractWe fabricated a pH-sensitive device on a glass substrate based on properties of carbon nanotubes. Nanotubes were immobilized specifically on chemically modified areas on a substrate followed by deposition of metallic source and drain electrodes on the area. Some nanotubes connected the source and drain electrodes. A top gate electrode was fabricated on an insulating layer of silane coupling agent on the nanotube. The device showed properties of ann-type field effect transistor when a potential was applied to the nanotube from the top gate electrode. Before fabrication of the insulating layer, the device showed that thep-type field effect transistor and the current through the source and drain electrodes depend on the buffer pH. The current increases with decreasing pH of the CNT solution. This device, which can detect pH, is applicable for use as a biosensor through modification of the CNT surface.

Wearable sensors hold great potential in empowering personalized health monitoring, predictive analytics, and timely intervention toward personalized healthcare. Advances in flexible electronics, materials science, and electrochemistry have spurred the development of wearable sweat sensors that enable the continuous and noninvasive screening of analytes indicative of health status. Existing major challenges in wearable sensors include: improving the sweat extraction and sweat sensing capabilities, improving the form factor of the wearable device for minimal discomfort and reliable measurements when worn, and understanding the clinical value of sweat analytes toward biomarker discovery. This review provides a comprehensive review of wearable sweat sensors and outlines state-of-the-art technologies and research that strive to bridge these gaps. The physiology of sweat, materials, biosensing mechanisms and advances, and approaches for sweat induction and sampling are introduced. Additionally, design considerations for the system-level development of wearable sweat sensing devices, spanning from strategies for prolonged sweat extraction to efficient powering of wearables, are discussed. Furthermore, the applications, data analytics, commercialization efforts, challenges, and prospects of wearable sweat sensors for precision medicine are discussed.

INTRODUCTION: Pelvic organ prolapse (POP) is associated with negative physical, social, psychological, and sexual experiences. There is paucity of data in low and middle income countries like Uganda. The purpose of this study was to describe clinical characteristics and outcomes of patients undergoing surgery for POP from 2007 to 2016. METHODS: The study was conducted at Mulago National Referral Hospital from 2014 to 2016. We conducted a retrospective review of the urogynecology surgical records using a standardized medical record abstraction form. Data of 222 POP patients were abstracted and managed using REDCap. Analysis was performed using Stata statistical software, v14. RESULTS: The mean participant age and parity was 57 years and 7 respectively. Ninety four percent of participants presented with a mass protruding from the vagina, 38% with uterine prolapse and 32% with cystocoele. Anaemia and hypertension were common comorbidities. Women underwent a variety of surgery types, and 35% experienced persistent pain post-operatively. At hospital discharge, 83% had achieved either complete resolution or improvement in their condition. CONCLUSIONS: Measures encouraging presentation for care as soon as symptoms are experienced and reduction of total fertility rate will be beneficial. Patients with POP should be routinely screened for anaemia and hypertension.

OBJECTIVES: To quantify the main reasons for referral of infants and children from first-level health facilities to referral hospitals in sub-Saharan Africa and to determine what further supplies, equipment, and legal empowerment might be needed to manage such children when referral is difficult. METHODS: In an observational study at first-level health facilities in Uganda, the United Republic of Tanzania, and Niger, over 3-5 months, we prospectively documented the diagnoses and severity of diseases in children using the standardized Integrated Management of Childhood Illness (IMCI) guidelines. We reviewed the facilities for supplies and equipment and examined the legal constraints of health personnel working at these facilities. FINDINGS: We studied 7195 children aged 2-59 months, of whom 691 (9.6%) were classified under a severe IMCI classification that required urgent referral to a hospital. Overall, 226 children had general danger signs, 292 had severe pneumonia or very severe disease, 104 were severely dehydrated, 31 had severe persistent diarrhoea, 207 were severely malnourished, and 98 had severe anaemia. Considerably more ill were 415 young infants aged one week to two months: nearly three-quarters of these required referral. Legal constraints and a lack of simple equipment (suction pumps, nebulizers, and oxygen concentrators) and supplies (nasogastric tubes and 50% glucose) could prevent health workers from dealing more appropriately with sick children when referral was not possible. CONCLUSION: When referral is difficult or impossible, some additional supplies and equipment, as well as provision of simple guidelines, may improve management of seriously ill infants and children.

Globally, tuberculosis (TB) is the 13th leading cause of death and a leading infectious killer, second to COVID-19 (1,2). In 2021, TB affected 10.6 million persons and caused 1.6 million [...]

Education and training of Quantity Surveyors (QSs) has been a topical subject amongst academics, the industry, and professional institutions, often leading to a discussion about education versus training, in which case, the industry sometimes argues that QSs are often ill-prepared for work. The current study investigated strategies for improving QSs' education training in Uganda, with a focus on devising ways of engendering better graduates that are fit for the industry. A semi-structured online questionnaire was used to collect data. The research population included QSs practicing in the Ugandan Construction Industry. The majority of respondents agreed to a great extent that QSs, and thus their training, are still relevant in the current construction industry. Majority of respondents desired the teaching curriculum to include more practical aspects that expose students to real challenges in practice. It was suggested that early exposure of students to real field practice was paramount to students' training. Engagements such as industrial training and internship placements in Quantity Surveying firms were highly encouraged. The curriculum also needs to be responsive to recent advances in industry practices, such as Building Information Modelling (BIM). Meanwhile, the University should intensify action research with the industry, and forge collaborations with all the key players in the construction sector to streamline the training. The findings of this study, if implemented, could potentially improve the quality of Quantity Surveying programmes at institutions of higher learning in similar developing countries. This would hopefully produce graduates who are industrially relevant and with a sound academic background.

Wearable non-invasive biosensors for the continuous monitoring of metabolites in sweat can detect a few analytes at sufficiently high concentrations, typically during vigorous exercise so as to generate sufficient quantity of the biofluid. Here we report the design and performance of a wearable electrochemical biosensor for the continuous analysis, in sweat during physical exercise and at rest, of trace levels of multiple metabolites and nutrients, including all essential amino acids and vitamins. The biosensor consists of graphene electrodes that can be repeatedly regenerated in situ, functionalized with metabolite-specific antibody-like molecularly imprinted polymers and redox-active reporter nanoparticles, and integrated with modules for iontophoresis-based sweat induction, microfluidic sweat sampling, signal processing and calibration, and wireless communication. In volunteers, the biosensor enabled the real-time monitoring of the intake of amino acids and their levels during physical exercise, as well as the assessment of the risk of metabolic syndrome (by correlating amino acid levels in serum and sweat). The monitoring of metabolites for the early identification of abnormal health conditions could facilitate applications in precision nutrition.

Background: Institutions of higher learning are persistently struggling with issues of academic dishonesty such as plagiarism, despite the availability of university policies and guidelines for upholding academic integrity. Methodology: This was a descriptive qualitative study conducted on 37 students of a Healthcare Ethics course at an Australian tertiary institution from February 2016 to October 2018. The purpose of the study was to explore the reasons for plagiarism detected the Turnitin® plagiarism checking software and extensive review of manuscripts. The interviews were conducted in private rooms and in strict confidence. Thematic analysis was manually done. Results: Four major themes namely, lack of interest; pressure of time with competing priorities; lack of understanding of the policy on academic honesty, and "the determined students" were identified. Sub themes under lack of interest were lack of preparation and effort, low self-efficacy, poor studying techniques, and convenience of internet sources. Under pressure of time, the subthemes were, misplaced priorities, procrastination, high workloads, poor planning, competing interests, and the perception of availability of time at the start of the semester. Regarding lack of understanding of the policy on academic honesty, the subthemes identified were, lake of awareness of plagiarism, lack of awareness of acceptable similarity, conflicting messages from tutors and confusion with high school learning. The determined students were those that either made all effort to reduce plagiarism but still remained high, used the another language at home other than English, had poor paraphrasing techniques or lacked resources for English language editing. Conclusion: There are varied and diverse reasons for plagiarism. There is a need to systematically reinforce and educate students on issues pertaining to academic dishonesty and their associated implications.

INTRODUCTION Antiretroviral therapy (ART) has significantly improved disease outcomes and quality of life among people living with HIV [1, 2]. Globally, about 75% of people living with HIV receive ART; [...], : Introduction: Habits are a common strategy for successfully countering medication non‐adherence, yet existing interventions do not support participants during the long habit formation period, resulting in high attrition. We test a novel intervention combining text messages and incentives with anchoring to support antiretroviral therapy (ART) pill‐taking habits. Methods: In a randomized, parallel controlled trial, a sample of 155 participants 18 years and older who initiated ART within 3 months were recruited at Mildmay Uganda between October 2021 and April 2022. All participants were educated on the anchoring strategy and chose an anchor, that is existing routines, to pair with pill‐taking. Participants were randomized to either usual care (C = 49), daily text message reminders to follow their anchoring plan (Messages group; T1 = 49) or messages and incentives conditional on pill‐taking in line with their anchor (Incentives group; T2 = 57). Assessments occurred at baseline, month 3 (end of intervention) and month 9 (end of observation period). The primary outcomes are electronically measured mean adherence and pill‐taking consistent with participants’ anchor time. Results: The primary outcome of pill‐taking in line with the anchoring plan was higher in the Incentives group during the 3‐month intervention (12.2 p.p. [95% CI: 2.2 22.2; p =.02]), and remained significantly higher after the incentives were withdrawn (months 4−6 (14.2 p.p. [95% CI 1.1 27.2; p =.03]); months 7−9 (14.1 p.p. [95% CI −0.2 28.5; p =.05])). Mean adherence was higher in both treatment groups relative to the control group during the intervention (T1 vs. C, p =.06; T2 vs. C, p =.06) but not post‐intervention. Conclusions: The promising approach of using incentives to support habit formation among ART treatment initiators needs to be evaluated in a fully powered study to further our understanding of the habit formation process and to evaluate its cost‐effectiveness.