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Godfrey L Sambayi,1,* George M Bwire,2,3,* Mary Spicar Kilapilo,3 David T Myemba,4 Idda H Mosha,5 Manase Kilonzi,6 Renatus B Magati,7 Maryam Amour,8 Rogers Mwakalukwa,1 Ally Nassoro Mangara,9 Muhammad Bakari,10 Christopher R Sudfeld,11 Mecky IN Matee,12 Raphael Z Sangeda,3 Lisa V Adams,13 Japhet Killewo14 1Department of Pharmacognosy, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, 65013, Tanzania; 2Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research Clinical and Epidemiological Virology, Institute for the Future, KU Leuven, Leuven, 3000, Belgium; 3Department of Pharmaceutical Microbiology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, 65013, Tanzania; 4Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, 65013, Tanzania; 5Department of Behavioural Sciences, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, 65015, Tanzania; 6Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, 65013, Tanzania; 7Department of Clinical Nursing, Catholic University of Health and Allied Sciences, Mwanza, P.O. Box 1464, Tanzania; 8Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, 65015, Tanzania; 9Dar Es Salaam Urban Cohort Study, Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, Dar es Salaam, 65013, Tanzania; 10Department of Internal Medicine, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, P.O. Box 65001, Tanzania; 11Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA; 12Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, 65013, Tanzania; 13Department of Medicine, Center for Global Health Equity, Geisel School of Medicine at Dartmouth, Hanover, NH, USA; 14Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, 65015, Tanzania*These authors contributed equally to this workCorrespondence: Godfrey L Sambayi, Department of Pharmacognosy, Sciences, School of Pharmacy, Muhimbili University of Health and Allied, Dar es Salaam, P. O. Box 65013, Tanzania, Email godfreysambayi08@gmail.comPurpose: To explore the enabling factors, barriers, and strategies to improve retention in HIV care and adherence to antiretroviral therapy (ART) among adults (18 years and above) living with HIV in Dar es Salaam, Tanzania.Methods: We conducted a descriptive qualitative study to better understand and explore enablers, barriers, and strategies to improve retention in HIV care and adherence to antiretroviral therapy (ART) among PLHIV in Dar es Salaam, Tanzania. Focus group discussions (FGD) were conducted with a semi-structured discussion guide between December 2021 and June 2022. A non-random purposive sampling technique was used to select PLHIV and people involved in provision of healthcare and socioeconomic support to PLHIV. Thematic analysis was used to identify and interpret the themes.Results: Three major themes with 10 sub-themes emerged. Participants indicated that family and partner support, peer-support group/adherence clubs, and healthcare provider counselling on medication adherence facilitated retention and adherence to ART. In contrast, stigma and discrimination, financial constraints, disease outbreaks such as the COVID-19 pandemic, myths and misconceptions about HIV, and side effects of antiretrovirals were mentioned as barriers. Strengthening community and patient education about HIV and ART through peer support groups and financial support for poor PLHIV were the proposed mitigation.Conclusion: Addressing the challenges to ART adherence may require a more holistic approach. We recommend the implementation of peer support groups and financial support through small microfinance groups as interventions to increase retention in HIV care and adherence to ART in the study area.Keywords: people living with HIV, peer support group, stigma, SDG 3.3

BACKGROUND: In many regions of the world, little is known about meal structures, meal patterns, and nutrient intake because the collection of quantitative dietary intake is expensive and labor-intensive. OBJECTIVES: We describe the development and field feasibility of a tablet-based Tanzania 24-h recall tool (TZ-24hr-DR) and dietary intakes collected from adults and children in rural and urban settings. METHODS: Using the Tanzanian food-composition table, the TZ-24hr-DR tool was developed on an Android platform using the Open Data Kit. The module provides food lists, meal lists, ingredient lists, quantity and amount consumed, breastfeeding frequency, and a recipe feature. Similar to the USDA Automated Multiple Pass Method, this TZ-24hr-DR contains review features such as time in-between meals, a summary of meals, and portion sizes. RESULTS: Dietary intake using TZ-24hr-DR was collected among 1) 845 children 0-18 mo of age enrolled in the Engaging Fathers for Effective Child Nutrition and Development in Tanzania (EFFECTS) trial (ClinicalTrials.gov identifier: NCT03759821) in Mara, Tanzania, and 2) 312 adult families from the Diet, Environment, and Choices of positive living (DECIDE) observational study in peri-urban Dar es Salaam. Interviewers were trained on paper-based methods with food models and tablet-based collection. Conversion to nutrient intake was readily linked and accessible, enabling rapid review and analysis. Overall, 2158 and 8197 dietary meal records were collected from the DECIDE study and EFFECTS trial, respectively. Among adults, 63% of men and 92% of women reported eating at home, and there were differences in protein, fat, and zinc. Food consumed outside the home typically occurs for the first 2 meals. Childrens intake of nutrients increased with age; however, median micronutrient intakes for calcium, iron, zinc, and vitamin A remained below recommended nutrient intakes. CONCLUSIONS: The TZ-24hr-DR is a field- and user-friendly tool that can collect large samples of dietary intakes. Further validation is needed. The tool is available freely for research purposes and can be further adapted to other contexts in East Africa.

This research aims to analyze the contextual teaching and learning (CTL) model on students' creative thinking skills on the reaction rate topic. This quantitative research used true experimental design of pretest-posttest control. The samples used in this study were from 11th grade at SMA Negeri 1 Pinolosian. The experimental class sample was given treatment of the CTL learning model while the control class used conventional learning, respectively, were 31 and 30 students of 93 populations. Based on a questionnaire, students' creative thinking skills were obtained through observation during the learning process. The data analysis of the test instrument was carried out through a validity test using the product-moment correlation technique (significant level = 0.05), Lilliefors normality test, homogeneity of variance test and ttest. The CTL implementation questionnaire and instrument test data were converted into percentages and categorized. The results showed that the application of the CTL model had a positive effect on students' creative thinking abilities, evidenced by the average score of students in the experimental class before and after treatment increased from 14.55 to 74.84. Otherwise, in the control class, the scores were 30.59 to 33.56. The percentage of students' achievement in creative thinking aspects in the experimental class was good (61%-80%) while the control class was less good (21%-40%). The creative thinking abilities of both classes are very different, which is also reflected in the learning outcomes. The value of tcount (2.240) was greater than ttable (2.042) at the significant level = 0.05, and the hypothesis of H0 was rejected, or H1 was accepted. The application of the CTL learning model positively influenced students' creative thinking skills on the reaction rate material. Students' low originality abilities compared to fluency, flexibility, and elaboration abilities were also discussed.

Highlights: • Hemangioma of the hand is a challenging case due to the need to maximize eradication of the mass while minimizing damage to the healthy tissue to preserve the physiologic function of the hand. • The reconstruction of the defect also needs to be taken into account to maintain the cosmetical appearance. • Collaborative multidisciplinary work is essential to achieve these demands and maintain the patient’s quality of life. Abstract: Hemangiomas are known for their typical involution with age. However, around 40% of cases require intervention. Hemangioma in hand is challenging because the hand function and the aesthetic appearance need to be preserved. Hereby we reported a 21-year-old woman with a recurrent hemangioma on the left hand in Abdul Wahab Sjahranie Hospital, Samarinda, Indonesia. The patient’s previous surgery was ineffective since the mass reappeared in the same area. We performed surgical excision and reconstruction with an abdominal flap. One-month and one-year postoperative follow-up indicated good flap viability and preserved hand functions without the need for amputation. This report also emphasizes the importance of collaboration from multiple surgical and medical fields to allow favorable outcomes in this case.

Introduction. Occipital neuralgia (ON) is a well-known cause of headache that affecting the posterior head at the occipital nerve(s) distribution. It is a multiple-factor clinical condition resulting from the pathology of the greater, lesser or third occipital nerve. Interventional therapy, such as occipital nerve block (ONB), is one of the various modalities that could be normally considered when the conservative wasn’t satisfying. Besides as effective treatment, ONB also used as an important diagnostic procedure for occipital neuralgia. Content. Currently, there is no a complete consensus among practitioners regarding the optimal therapy for occipital neuralgia although many modalities offered. ONB traditionally performed with blinded approach relying on anatomic landmarks create the higher risks of injection in the occipital artery and/or block failure. Therefore, ONB with ultrasound guidance becomes solution to improve the safety and efficacy of therapy especially in occipital neuralgia cases. Conclusion. Occipital nerve block with ultrasound guidance is recommended as primary interventional therapy for occipital neuralgia cases.

As disasters and climate change risks, particularly droughts and floods, continue to affect food security globally, most governments, including South Africa, have resorted to the use of technology to incorporate climate change adaptation and disaster risk reduction to address FS issues. This is because most institutions and policies that address climate change adaptation, disaster risk reduction, and food security operate in parallel, which usually leads to the polarisation of interventions and conflicting objectives, thus leaving the issue of FS unresolved. The study aimed to investigate how food security projects are incorporating climate change adaptation and disaster risk reduction using technology. A qualitative research design was applied, whereby in-depth interviews were conducted with ten project participants from two projects, while 24 key informants were purposively selected from government and research institutions. The study's main findings revealed that both projects incorporate climate change adaptation and disaster risk reduction measures in most of their food value chains. Although the projects are different, they still face similar challenges, such as a lack of expertise, resources, and funding, and an inadequate regulatory environment to improve their farming practices. The study brings in the practical side of addressing the coherence between food security, climate change adaptation, and disaster risk reduction through technology. [ABSTRACT FROM AUTHOR]

Off-campus housing remains a major issue related to studentification in African cities. This study analyses the perspectives of landlords and students on off-campus housing supply and utilization in Chinhoyi, Zimbabwe. The study was qualitative and adopted a case study research design. Interviews were conducted with purposively selected key informants, while textual and content analysis was used. We argue that studentification is a potential catalyst for housing development in Chinhoyi, yet the municipality fails to formulate relevant housing policies. The study contributes to studies on student housing in African university towns by highlighting the perceptions of the different stakeholders towards off-campus housing. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) merupakan penyakit degeneratif sendi yang paling umum terjadi di negara berkembang, termasuk Indonesia. Angka kejadiannya mencapai 15.5% pada laki-laki dan 12.7% pada wanita. Walaupun OA dapat menyerang seluruh sendi, namun sendi lutut merupakan sendi yang paling sering terkena. Tingginya angka prevalensi OA disebabkan karena peningkatan angka harapan hidup dan prevalensi dari obesitas, yang memicu disabilitas kronik serta peningkatan beban sosial dan ekonomi pada negara berkembang. Penanganan OA lutut merupakan suatu tantangan karena sendi lutut memiliki kemampuan regeneratif dan pemulihan yang rendah. Terapi konservatif seperti asetaminofen, obat anti inflamasi non-steroid, dan opioid hanya efektif dalam menangani nyeri dan mengurangi inflamasi. Salah satu terapi regeneratif yang sedang berkembang dalam menangani OA lutut adalah injeksi platelet-rich plasma (PRP), dimana merupakan produk darah autolog dengan konsentrasi platelet, faktor pertumbuhan, dan sitokin yang tinggi. Penggunaan PRP dapat menjadi alternatif karena tidak hanya mengurangi inflamasi, namun memiliki kemampuan untuk memulai dan meregenerasi jaringan yang rusak. Namun, walau PRP dapat dipertimbangakan sebagai terapi yang aman untuk penanganan OA lutut, masih terdapat pro dan kontra terkait teknik yang digunakan serta variasi komposisi dari PRP yang digunakan. Artikel ini akan memaparkan informasi terkini mengenai mekanisme dan efektifitas dari PRP dalam penanganan OA lutut.

Background: Piriformis syndrome (PS) is a neuromuscular condition caused by the entrapment of the sciatic nerve at the level of the piriformis muscle (PM). Diagnosing PS remains challenging despite recent invasive and non-invasive diagnostic methods. Response to invasive nerve block is still one of the most reliable diagnostic modalities because there is no gold standard test for PS. As early diagnosis may prevent delayed diagnosis that results in chronic somatic dysfunction and muscle weakness, a screening test with high sensitivity could guide clinicians in performing the next appropriate step in diagnosing PS.Aim: The purpose of this study is to determine the sensitivity, specificity, and best cut-off point of ultrasound-guided PM thickness in PS.Method: This case-control study was conducted in a general hospital in Tangerang during a 3-month period. We recruited 58 patients clinically diagnosed with PS and 58 healthy patients (without a history of hip and buttock pain) during their visits to the outpatient clinic. All patients underwent ultrasound assessment to measure bilateral PM thickness. Sex, age, body mass index, history of micro-/macro-trauma, and prolonged sitting duration were recorded. Statistical analyses were performed using the Statistical Package for the Social Sciences version 25.Result: The PS and control groups predominantly comprised female subjects, with mean ages of 51.79 ± 14.10 and 50.09 ± 13.26 years on PS and healthy subjects, respectively. The mean ultrasound-guided PM thickness was higher in PS subjects compared to healthy subjects with mean thicknesses of 1.16 ± 0.13 and 0.85 ± 0.11 cm, respectively (p < 0.05). The area under the receiver operating characteristic curve of the PM was 0.970 (95% confidence interval 0.943–0.998, p < 0.05). The best cut-off point defined by Youden's J index was 0.9950 cm for all PS subjects.Conclusion: We propose 0.9950 cm as the cut-off point for diagnosing PS by ultrasound, which has the sensitivity and specificity of 94.8 and 87.9%, respectively.

Introduction: This study aims to analyze how the existence of branchless banking in rural areas affects the economic behavior of the micro and small business households, and vice versa. Background Problem: Within the framework at inclusive finance program, Indonesia has implemented the branchless banking model. However, the impact of the branchless banking system to micro and small business household has not discussed yet. Research Method: The research was conducted in Bogor District, with many remote villages adjacent to Jakarta, a capital city of Indonesia. A total of 97 samples of micro and small business households were selected from 13 sub-districts. The estimation was conducted using 2SLS method. The model describes the existing condition that explains the uniqueness of the economic behavior of the micro and small business households in a branchless banking system. Novelty: Studies related to branchless banking generally analyzed from the perspective of banking institutions. However, this study focusses on supply side, namely it analyzDe the household economic behavior using simultaneously equation model. Findings: The results show that the presence of branchless banking agents, as measured by the value of the transactions conducted by the households, have little effect on the economic behavior of the micro and small business households. On the other hand, the economic behavior variables which are expected to affect the value of the transactions do not occur. The results explain that the utilization of the banking services provided through agents in the branchless banking system is in the form of payment transactions. In addition, the presence of branchless banking in rural areas has not affected production activities and vice versa. Conclusion: This study suggests a further study to find out the factors that make business actors unwilling to perform financial transactions related to their production activities through branchless banking agents.

Background: Piriformis syndrome is a neuromuscular condition characterized by hip and gluteal pain caused by abnormality of piriformis muscle. In clinical practice, this syndrome is usually misdiagnosed with other spinal disorders. There is no specific test in diagnosing piriformis syndrome, therefore by understanding the characteristics and predisposing factors, clinicians may be more aware in diagnosing this syndrome. Objective: To investigate the characteristics and predisposing factors of piriformis syndrome. Methods: A descriptive study was conducted on patients with gluteal pain in a referral hospital. Diagnosis was established by block injection on piriformis muscle and showed clinical improvement afterwards. Demographic characteristics, predisposing factors, and physical examination were analyzed. The data is collected and processed by SPSS 20.0. Results: The total of 65 patients were evaluated, with a male to female ratio 1:3. As much as 47.7% of patients were > 60 years old. Average weight was 60 kg and BMI (Body Mass Index) was within normal range (58.9%). Most subjects were housewives (55.4%) and the majority of subjects had history of microtrauma such as sitting on rigid surfaces (36.9%), walking or running long distances (18.5%), and cross-legged sitting (10.8%). Average sitting per day was approximately 5 hours. In 56.9% of subjects, exercises were conducted. There was no history of back pain in 81.5% of subjects. Conclusion: Our study showed age and housewives characteristics differ with other studies. The most predisposing factors were history of microtrauma, female, age, and normal BMI.