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OBJECTIVE: This scoping review aims to contribute a descriptive analysis of the craniomaxillofacial trauma (CMF trauma) literature in low- and middle-income countries (LMICs) to identify knowledge gaps, direct future research, and inform policy. DATA SOURCES: PubMed/MEDLINE, Cochrane Review, EMBASE, ClinicalTrials.gov, and Google Scholar from January 1, 2012 to December 10, 2023. REVIEW METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guided reporting, and the PRISMA flowchart documented database searches. Specific, predefined search terms and inclusion criteria were used for screening, and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was used for quality assessment. The search yielded 54 articles, with 13 meeting the inclusion criteria. Key findings were summarized and divided into 7 categories. RESULTS: There were 10,420 patients (7739 [74.3%] male, 2681 [25.7%] female) with a male-to-female ratio of 2.9:1. The mean peak age of incidence of CMF trauma was 30.8 years, ranging from 20 to 40 years. Road traffic accidents were the leading cause (60.4%), followed by assault (27.2%) and falls (12.2%). The most common injuries were soft tissue injury (31.7%), isolated mandibular fracture (22.8%), and isolated middle-third of mandible fracture (18.1%). The most common treatments were closed reduction and immobilization (29.5%), conservative management (27.6%), and open reduction and internal fixation (19.6%). Most patients (77.8%) experienced a treatment delay due to a lack of fixation materials (54.8%) or surgeon unavailability (35.7%). CONCLUSION: CMF trauma remains a significant cause of global morbidity, yet there remains a lack of high-quality, CMF trauma-specific data in LMICs. Country-specific investigations are required to enhance knowledge and inform novel interventions. Implementing policy change must be community-specific and account for unique cultural barriers, attitudes, and behaviors to maximize patient care outcomes.

We performed a secondary analysis of the National Institutes of Health-sponsored Adaptive COVID-19 Treatment Trial (ACTT-2) randomized controlled trial and found that baricitinib was associated with a 50% reduction in secondary infections after controlling for baseline and postrandomization patient characteristics. This finding provides a novel mechanism of benefit for baricitinib and supports the safety profile of this immunomodulator for the treatment of coronavirus disease 2019.

Background: Chronic suppurative otitis media (CSOM) is a common paediatric ear disease in developing countries, typically resulting from an acute otitis media (AOM) that is not promptly diagnosed or treated. Home remedies using herbal medicine in rural villages may contribute to treatment delays and complications. Methods: A cross-sectional study of children from three rural schools was conducted. Children between 6 and 14 years of age were randomly selected and screened by the lead author for CSOM between January and February 2015 by history and physical examination, including otoscopy. Parents of children diagnosed with CSOM were asked additional questions regarding their understanding of this clinical entity. Results: A total of 461 children with a mean age of 9.8 years were screened and 17 were diagnosed with CSOM (3.6%). The majority (n = 10/17, 59%) of parents reported no understanding of the aetiology of their children’s ear symptoms and the remainder (n = 7, 41%) reported other incorrect aetiologies. Traditional home remedies such as instilling fruit juice are still common in this community. Most parents confirmed to have previously used traditional remedies at least once to treat their children for CSOM. Conclusion: Approximately one in 25 school-aged children in rural Rwanda had CSOM at the time of this study. Parental knowledge about the causes, treatments and complications of CSOM is limited. Contribution: This study provided insights into the prevalence of CSOM in school-aged children in the Rwandan district of Bugesera and explored current beliefs and practices among parents of children with CSOM.

Abstract Objective This scoping review aims to contribute a descriptive analysis of the craniomaxillofacial trauma (CMF trauma) literature in low‐ and middle‐income countries (LMICs) to identify knowledge gaps, direct future research, and inform policy. Data Sources PubMed/MEDLINE, Cochrane Review, EMBASE, ClinicalTrials.gov, and Google Scholar from January 1, 2012 to December 10, 2023. Review Methods The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Scoping Reviews (PRISMA‐ScR) guided reporting, and the PRISMA flowchart documented database searches. Specific, predefined search terms and inclusion criteria were used for screening, and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was used for quality assessment. The search yielded 54 articles, with 13 meeting the inclusion criteria. Key findings were summarized and divided into 7 categories. Results There were 10,420 patients (7739 [74.3%] male, 2681 [25.7%] female) with a male‐to‐female ratio of 2.9:1. The mean peak age of incidence of CMF trauma was 30.8 years, ranging from 20 to 40 years. Road traffic accidents were the leading cause (60.4%), followed by assault (27.2%) and falls (12.2%). The most common injuries were soft tissue injury (31.7%), isolated mandibular fracture (22.8%), and isolated middle‐third of mandible fracture (18.1%). The most common treatments were closed reduction and immobilization (29.5%), conservative management (27.6%), and open reduction and internal fixation (19.6%). Most patients (77.8%) experienced a treatment delay due to a lack of fixation materials (54.8%) or surgeon unavailability (35.7%). Conclusion CMF trauma remains a significant cause of global morbidity, yet there remains a lack of high‐quality, CMF trauma‐specific data in LMICs. Country‐specific investigations are required to enhance knowledge and inform novel interventions. Implementing policy change must be community‐specific and account for unique cultural barriers, attitudes, and behaviors to maximize patient care outcomes.

It is well known that experiences of extreme adversity strongly impact caregiving and family dynamics. In this study, we explore how caregiving is shaped by experiences of war and displacement among a community experiencing protracted, ongoing conflict and displacement, namely, Congolese Banyamulenge refugee families in Rwanda. The findings are based on six months of ethnographic team research with Banyamulenge refugee families living in semi-urban southern Rwanda. Among the caregivers, including people who arrived several years ago and others who have lived in Rwanda for over two decades, we found a strong longing for home and past cattle-herding life. We also found that caregivers emphasized the transmission of “survival tactics” as well as Banyamulenge identity and culture. We argue that these caregiving objectives and practices speak to the community’s experiences of material and existential losses in the past, as well as those anticipated in the unknown future. Second, parental caregiving efforts appear to lead to increased intergenerational dissonance, with children wishing to integrate into their host community. While this finding appears in line with much of the migration literature about intergenerational family relationships and conflict, we find that children’s orientation is not only informed by the host environment but also stems from a desire to relieve their parents’ suffering from loss and help them invest in more optimistic futures. Finally, while our findings suggest profound changes in social and cultural reproduction in the long term, we argue for caution, as ongoing changes in war dynamics in DR Congo may inform shifts in ideas on belonging among the children. The findings provide new insights for understanding how caregiving may be affected by war and displacement while effecting change in war-affected, displaced communities.

This research evaluated the effects of Clay Pot Irrigation System (CPIS) on water saving and water productivity compared with Drip Irrigation System (DIS) as micro-irrigation systems in cabbage production in Rwanda. This research was conducted at the Rwanda Polytechnic/Integrated Polytechnic Regional College Huye (RP/IPRC Huye) farm (2[degrees]35'48' S and 29[degrees]44'21' E, Elevation of 1769 m above sea level), in Huye district of Rwanda. The experimental designed was a Randomized Complete Block Design (RCBD) with three treatments and three replications. The experimental treatments were Clay pot irrigation system, Drip irrigation system, and the control treatment (No irrigation). The soil type was a sand clay loam. The clay pots used were manufactured by mixing clay and sand at the ratio of 4:1 and dried with burning dry grass. Pots were buried under the soil up to their necks, with about 2 cm of their top above the surface of the surrounding. The crop variety used for the study was Zawadi F1 of cabbage produced by the East African Co. Seed, which is adaptable under the agroclimatic conditions of the Huye district of Rwanda. Crop water requirement and irrigation scheduling were estimated by using CROPWAT 8.0 software. Organic manure (20 tons [ha.sup.-1]) was applied for whole trial during tillage, Nitrogen-Phosphorous-Potassium/ NPK 17-17-17 (300 kg [ha.sup.-1]) was uniformly applied around the seedling (ring application) and Urea (300 kg [ha.sup.-1]) was split applied, first after three weeks of transplanting, and the second application was five weeks after transplanting. The water productivity of CPIS was 36.17 kg [m.sup.-3] for DIS was 25.4 kg [m.sup.-3], while the control was 31.1 kg [m.sup.-3]. The results of this research show that CPIS increases water productivity and water saving. Water saved is 40.23% when CPIS is compared with DIS. Clay pot irrigation system can be a viable option for water scarce areas, particularly for small-scale farmers looking to improve their productivity with their small holdings of land in sandy and drier environments. Key words: CPIS, DIS, Water saving, Water productivity, Clay pots, CROPWAT, Rwanda, INTRODUCTION Agriculture irrigation accounts for 70-80% of water use worldwide [1, 2]. Water is becoming a scarce economic resource in many areas of the world, especially in arid and semi-arid [...]

Usher syndrome is a genetic, clinically heterogeneous condition characterized by sensorineural hearing loss, progressive retinal degeneration, and vestibular dysfunction. There are three phenotypically recognizable types of Usher syndrome. Individuals with Usher syndrome type 1 have no vestibular function and profound sensorineural hearing loss. Individuals with Usher syndrome type 2 have normal vestibular function and mild-to-severe hearing loss with visual impairment that is presented later in life. People with Usher syndrome type III experience hearing and vision loss beginning later in life. In this case report, we are reporting a 7-year-old boy consulted for progressive hearing loss and bilateral vision impairment, and fundus exam revealed mild bilateral retinal vessel attenuation and bone spicule deposits in both eyes. A molecular genetic test done by next-generation sequencing identified a homozygous pathogenic variant in the CDH23 gene (NM_022124.5:c.2255del variant coordinate with amino acid change of p.(Gly752Valfs*13)), confirming the diagnosis of autosomal recessive Usher syndrome type ID (USH1D). The patient had a remarkable improvement with visual and optical aids. Genetic counseling, including reproductive counseling, was provided to the parents. Clinical evaluation, visual hearing tests, and genetic workup confirmed Usher syndrome, which is a rare but dangerous cause of hearing loss and visual impairment that needs to be thoroughly evaluated by a multi-disciplinary team approach.

Abstract Fractures of the craniomaxillofacial (CMF) skeleton cause significant morbidity and mortality in low‐ and middle‐income countries (LMICs). Despite this, quality CMF trauma care is lacking for the majority of the world's population. There is a paucity of literature describing the costs of standard‐of‐care open reduction internal fixation (ORIF) for CMF fractures in LMICs. We consider the cost of a six‐hole plate with six screws (SHPS), standard materials used in ORIF for CMF fractures, as a percentage of gross domestic product (GDP) per capita to ascertain the cost burden to patients. Hospital pricing catalog data at 14 LMIC institutions were queried. On average, the SHPS cost represented 10.2% of the GDP per capita in sampled LMICs. We highlight manufacturing costs, import taxes, and lack of subsidized health care as factors contributing to the significant cost burden of ORIF in these areas. Future work should characterize additional financial and socioeconomic barriers to optimal CMF care.

ABSTRACT Fosfomycin, approved in the United States only for cystitis, is an attractive alternative for oral treatment of outpatient complicated urinary tract infections (cUTIs) as it has antimicrobial activity against most common uropathogens. The study was a multicenter, randomized, open-label pragmatic superiority clinical trial evaluating the efficacy of oral fosfomycin versus oral levofloxacin strategies in cUTIs (FOCUS study). The trial compared two strategies for initial or step-down oral therapy of cUTI without bacteremia after 0–48 hours of parenteral antibiotic therapy. Subjects were assigned to 3 g of fosfomycin or 750 mg (or dose adjusted for kidney function) of levofloxacin daily for 5–7 days. Clinical and microbiological cures were assessed at the end of therapy (EOT) and test of cure (TOC) (approximately 21 days from the start of antibiotics). The trial did not meet accrual goals; thus, the results were descriptive. Only 51 subjects were included in the microbiological intention-to-treat population. The subjects were mainly females (76%), with a mean age of 46.7 years (standard deviation [SD] = 20.8) and acute pyelonephritis (88%). At the end of therapy, clinical cure remained similar (69% and 68% for fosfomycin and levofloxacin strategies, respectively), and microbiological success was 100% for both strategies. At the test of cure, clinical cure was similar (84% and 86% in the fosfomycin and levofloxacin strategies, respectively); however, a numerically lower microbiological success was observed for fosfomycin (69% compared to 84% for levofloxacin). These limited data suggest that fosfomycin could be an oral alternative as a step-down therapy for the treatment of cUTIs (registry number NCT 03697993). IMPORTANCE Concerns over resistance and safety have been identified in the current treatment regimen for complicated urinary tract infections. Fosfomycin is a drug that is routinely used for the treatment of uncomplicated cystitis. This study shows that fosfomycin could be an oral alternative as step-down therapy for the treatment of complicated urinary tract infections, with a clinical cure rate comparable to levofloxacin but a lower microbiological success rate 3 weeks from start of antibiotics.

INTRODUCTION: While Beckwith-Wiedemann syndrome is among rare genomic imprinting disorders, its diagnosis still presents challenges in clinical settings. Therefore, the aim of this work is to present different phenotypic features of this syndrome. CASE PRESENTATION: We reviewed two-month-old patient referred to the genetic unit at Rwanda military hospital, Kigali, Rwanda. Physical examinations indicated severe larger birth length (macrosomia), Overgrowth of the right side of lower limbs (hemihypertrophy/hemihyperplasia), larger tongue (macroglossia) and bigger abdomen. We performed karyotype and revealed a normal male chromosomal formula: 46,XY. CONCLUSION: Based on the phenotypic clinical features, the patient was diagnosed with Beckwith-Wiedemann Syndrome. However, cytogenetic tests performed were not advanced and should not rule out epigenetic abnormalities that should account for phenotypic features of this syndrome in our patient.

INTRODUCTION: Recurrent spontaneous abortion (RSA) is defined as three or more consecutive pregnancy losses before the 20th week of gestation. RSA is often idiopathic, but structural chromosomal abnormality is an important cause. An unbalanced karyotype in the conceptus of a couple when one partner has a structural chromosomal abnormality may result in failure to implant, miscarriage, or pregnancy of a fetus with an unbalanced karyotype. CASE PRESENTATION: We report a rare case of RSA associated with balanced translocation of chromosomes. a woman who had four spontaneous abortions, all pregnancy loss happened before 12 weeks of gestation, no other known chronic diseases reported to the family nor medications taken during pregnancy. The karyotype was 46.XX, t(13p,21p) The abnormal karyotype was not found in any other chromosomes. Further spectral karyotyping was performed to rule out the involvement of any other chromosomal aberrations present in the genome.The cytogenetic analysis of the husband revealed a normal karyotype 46.XY. CONCLUSION: Couples with more than three miscarriages should be referred to the genetist for chromosomal analysis for possible hereditary etiology and chromosomal abnormalities responsible for miscarriages to plan prenatal diagnostics and genetic counseling for subsequent pregnancies.

INTRODUCTION: Neurofibromatosis Type 1 (NF1) or Von Recklinghausen’s disease, is a rare genetic disease characterized by multiple benign tumors of nerves and skin (neurofibromas), and skin decorations. However, it is multisystem and can affect each organ in the body, leading to debilitating effects. CLINICAL CASE: We present a case of an 18-year-old girl with NF1. The disease onset started in childhood at the age of 3 years with the appearance of hyperpigmented skin macules. Her mother also presented with multiple nodules on the face and trunk, and her little brother was reported to have disseminated macules. She had poor performance at school and delayed menses. The diagnosis of NF-1 was made, and a multidisciplinary team was involved in management of the patient CONCLUSION: Although genetic testing and confirmation are available, NF1 remains a clinical diagnosis and requires management by multidisciplinary team

INTRODUCTION: Although Treacher-Collins syndrome has to be considered a differential diagnosis in congenital craniofacial abnormalities, the clinical diagnosis and research related to it still present a gap, especially in African regions. Thus, this work aims at highlighting this syndrome's clinical features for raising medical awareness. CLINICAL CASE: We reviewed a 1-year-old patient referred to our clinical genetic unit at Rwanda military hospital, Kigali, Rwanda. Physical examinations indicated severe craniofacial abnormalities, including downward-sloping eyes, slight notching of the lower lids, small and underdeveloped eyebrow bones, vision problems, small outer ears, small and underdeveloped cheekbones, and jaw. Within the limits of the techniques used in our laboratory, the cytogenetic analysis revealed a normal karyotype, 46, XY. CONCLUSION: The patient was diagnosed with Treacher-Collins syndrome based on clinical manifestations of craniofacial features. Nevertheless, laboratory tests performed were limited to karyotyping and should not detect any gene defect. Long-term follow-up of the patient and his family was recommended. Further molecular analyses should be performed to identify causing genetic mutation mainly in the TCOF1, POLR1C, or POLR1D genes.

INTRODUCTION: Disorders of sex development (DSDs) are genetic abnormalities characterized by discordance between phenotypic, gonadal, and genetic sex. They are grouped into two categories based on karyotype: 46, XX DSD and 46, XY DSD. CASES: We reviewed two patients referred to the Rwanda Military Hospital genetic unit. The first patient was a 3-year-old toddler who was referred for confusing sex organs. Physical examination showed ambiguous genital organs with hypospadias and micropenis. Pelvic examination showed a swelling solid mass hat leading to a suspicion of ovary or undescended testes or combined ovary and testes (ovotestes). The second patient was a 17 years old teenager who presented with primary amenorrhea and lack of female secondary sexual characteristics at her age. The karyotype test was performed to investigate the genotypic sex of the patients and results revealed the karyotype formula of 46, XX/XY indicating the presence of two cell lines in the patient for the toddler and 46XYinv9 (p11q13) indicating the mismatch between the genotype and phenotype of the patients for the teenager. CONCLUSION: Patients were diagnosed with Disorder of Sex Development with 46, XX/XY and 46, XY genotypes respectively. A multidisciplinary team of a geneticist, urologist, endocrinologist and a psychologist reviewed the patient for the effective management.

Abstract Background The practice of Pharmacists has changed worldwide over the past years. Today, health promotion is better known as an important part of modern pharmacy practice. Involving Community Pharmacists in health promotion is thus considered a valuable option in addressing public health issues. However, the literature on this practice remains unsubstantiated in African countries. In Rwanda, Community Pharmacists are believed to be solely involved in dispensing and very little has been studied about their role in health promotion. Thus, this study aimed to evaluate attitudes, perceptions, and barriers of Community Pharmacists in Rwanda towards their involvement in health promotion. Methods A cross-sectional study was conducted among 236 licensed Community Pharmacists in Rwanda from 23rd January to 23rd June, 2021. A list of all respondents was obtained from Rwanda Food and Drugs Authority. All participants were randomly enrolled. Each community pharmacy was represented by one Pharmacist. We collected data from community pharmacy settings using a self-administered questionnaire made of close and open-ended questions. Statistical analyses were performed using Statistical Packages for Social Sciences (SPSS) version 25. Results Of the 236 respondents, (n = 149, 63.1%) were male and (n = 87,37%) were female. The average age was 38.1 years (SD = 4.3). More than half confirmed that professional curriculum is adequate for offering health promotion services (n = 152, 64.4%).Majority responded that health promotion is part of their responsibility, and they are willing to provide health promotion services (n = 233,98.7%).The statement that “Pharmacists should not be involved in public health activities “was opposed by many (n=174,73.7%).The most sought-after service provided was education to drug misuse (n=211, 89.4%).Three major barriers to provision of health promotion were: lack of coordination with other healthcare professionals(n=106,69%),structure of healthcare system (n=157,67%),and lack of equipment (n=144,61%).Most Pharmacists disagreed with the statement that “patients are not interested in getting health promotion services”(n = 134,57%). Conclusion Though Community Pharmacists faced several challenges that hindered their participation in health promotion, they had positive attitudes towards promoting public health messages. There are several barriers like lack of structure to provide health promotion services that need to be addressed to boost more active participation of Pharmacists in health promotion.

INTRODUCTION: Turner syndrome is a frequent chromosome disorder characterized by short stature, gonadal dysgenesis and multisystem diseases associated with high morbidity and reduced life expectancy CASE: We reviewed an 18 month old patient who presented to the genetics unit at Rwanda Military Hospital (RMH), a tertiary healthcare facility, with a chief complaint of poor weight gain. She was born with a birth weight of 1.76kg and in the neonatal period, paediatricians had noticed dysmorphic features. At the first consultation at the RMH genetics unit, he weighed 5.2kg and was 64 cm tall. Physical examinations revealed some dysmorphic features, including hypertelorism, absent philtrum, short and webbed neck and large low set ears. Cytogenetic analysis showed the chromosomal formula of 45, X0. CONCLUSION: ThepatientwasdiagnosedwithTurnersyndromebasedonthecytogeneticanalysis and managed with physiotherapy of stimulation and re-education that led to improvements.

The use of Unmanned Aerial Vehicles (UAVs) in data transport has attracted a lot of attention and applications, as a modern traffic engineering technique used in data sensing, transport, and delivery to where infrastructure is available for its interpretation. Due to UAVs’ constraints such as limited power lifetime, it has been necessary to assist them with ground sensors to gather local data, which has to be transferred to UAVs upon visiting the sensors. The management of such ground sensor communication together with a team of flying UAVs constitutes an interesting data muling problem, which still deserves to be addressed and investigated. This paper revisits the issue of traffic engineering in Internet-of-Things (IoT) settings, to assess the relevance of using UAVs for the persistent collection of sensor readings from the sensor nodes located in an environment and their delivery to base stations where further processing is performed. We propose a persistent path planning and UAV allocation model, where a team of heterogeneous UAVs coming from various base stations are used to collect data from ground sensors and deliver the collected information to their closest base stations. This problem is mathematically formalised as a real-time constrained optimisation model, and proven to be NP-hard. The paper proposes a heuristic solution to the problem and evaluates its relative efficiency through performing experiments on both artificial and real sensors networks, using various scenarios of UAVs settings.

INTRODUCTION: Although Treacher-Collins syndrome has to be considered a differential diagnosis in congenital craniofacial abnormalities, the clinical diagnosis and research related to it still present a gap, especially in African regions. Thus, this work aims at highlighting this syndrome's clinical features for raising medical awareness. CLINICAL CASE: We reviewed a 1-year-old patient referred to our clinical genetic unit at Rwanda military hospital, Kigali, Rwanda. Physical examinations indicated severe craniofacial abnormalities, including downward-sloping eyes, slight notching of the lower lids, small and underdeveloped eyebrow bones, vision problems, small outer ears, small and underdeveloped cheekbones, and jaw. Within the limits of the techniques used in our laboratory, the cytogenetic analysis revealed a normal karyotype, 46, XY. CONCLUSION: The patient was diagnosed with Treacher-Collins syndrome based on clinical manifestations of craniofacial features. Nevertheless, laboratory tests performed were limited to karyotyping and should not detect any gene defect. Long-term follow-up of the patient and his family was recommended. Further molecular analyses should be performed to identify causing genetic mutation mainly in the TCOF1, POLR1C, or POLR1D genes.

Objectives Craniomaxillofacial (CMF) trauma represents a significant proportion of global surgical disease burden, disproportionally affecting low- and middle-income countries where care is often delayed. We investigated risk factors for delays to care for patients with CMF trauma presenting to the highest-volume trauma hospital in Rwanda and the impact on complication rates. Study Design This prospective cohort study comprised all patients with CMF trauma presenting to the University Teaching Hospital of Kigali, Rwanda, between June 1 and October 1, 2020. Setting Urban referral center in resource-limited setting. Methods Epidemiologic data were collected, and logistic regression analysis was undertaken to explore risk factors for delays in care and complications. Results Fifty-four patients (94.4% men) met criteria for inclusion. The mean age was 30 years. A majority of patients presented from a rural setting (n = 34, 63%); the most common cause of trauma was motor vehicle accident (n = 18, 33%); and the most common injury was mandibular fracture (n = 28, 35%). An overall 78% of patients had delayed treatment of the fracture after arrival to the hospital, and 81% of these patients experienced a complication (n = 34, P = .03). Delay in treatment was associated with 4-times greater likelihood of complication (odds ratio, 4.25 [95% CI, 1.08-16.70]; P = .038). Conclusion Delay in treatment of CMF traumatic injuries correlates with higher rates of complications. Delays most commonly resulted from a lack of surgeon and/or operating room availability or were related to transfers from rural districts. Expansion of the CMF trauma surgical workforce, increased operative capacity, and coordinated transfer care efforts may improve trauma care.

Detecting tax fraud is a top objective for practically all tax agencies in order to maximize revenues and maintain a high level of compliance. Data mining, machine learning, and other approaches such as traditional random auditing have been used in many studies to deal with tax fraud. The goal of this study is to use Artificial Neural Networks to identify factors of tax fraud in income tax data. The results show that Artificial Neural Networks perform well in identifying tax fraud with an accuracy of 92%, a precision of 85%, a recall score of 99%, and an AUC-ROC of 95%. All businesses, either cross-border or domestic, the period of the business, small businesses, and corporate businesses, are among the factors identified by the model to be more relevant to income tax fraud detection. This study is consistent with the previous closely related work in terms of features related to tax fraud where it covered all tax types together using different machine learning models. To the best of our knowledge, this study is the first to use Artificial Neural Networks to detect income tax fraud in Rwanda by comparing different parameters such as layers, batch size, and epochs and choosing the optimal ones that give better accuracy than others. For this study, a simple model with no hidden layers, softsign activation function performs better. The evidence from this study will help auditors in understanding the factors that contribute to income tax fraud which will reduce the audit time and cost, as well as recover money foregone in income tax fraud.

Due to the multi-technology advancements, internet of things (IoT) applications are in high demand to create smarter environments. Smart objects communicate by exchanging many messages, and this creates interference on receivers. Collection tree algorithms are applied to only reduce the nodes/paths’ interference but cannot fully handle the interference across the underlying IoT. This paper models and analyzes the interference spread in the IoT setting, where the collection tree routing algorithm is adopted. Node interference is treated as a real-life contamination of a disease, where individuals can migrate across compartments such as susceptible, attacked and replaced. The assumed typical collection tree routing model is the least interference beaconing algorithm (LIBA), and the dynamics of the interference spread is studied. The underlying network’s nodes are partitioned into groups of nodes which can affect each other and based on the partition property, the susceptible–attacked–replaced (SAR) model is proposed. To analyze the model, the system stability is studied, and the compartmental based trends are experimented in static, stochastic and predictive systems. The results shows that the dynamics of the system are dependent groups and all have points of convergence for static, stochastic and predictive systems.

Wireless Sensor Networks (WSNs) continue to provide essential services for various applications such as surveillance, data gathering, and data transmission from hazardous environments to safer destinations. This has been enhanced by the energy-efficient routing protocols that are mostly designed for such purposes. Gateway-based Energy-Aware Multi-hop Routing protocol (MGEAR) is one of the homogenous routing schemes that was recently designed to more efficiently reduce the energy consumption of distant nodes. However, it has been found that the protocol has a high energy consumption rate, lower stability period, and poorer data transmission to the Base station (BS) when it was deployed for a longer period of time. In this paper, an enhanced Heterogeneous Gateway-based Energy-Aware multi-hop routing protocol (HMGEAR) is proposed. The proposed routing scheme is based on the introduction of heterogeneous nodes in the existing scheme, selection of the head based on the residual energy, introduction of multi-hop communication strategy in all the regions of the network, and implementation of energy hole elimination technique. All these strategies are aiming at reducing energy consumption and extend the life of the network. Results show that the proposed routing scheme outperforms two existing ones in terms of stability period, throughputs, residual energy, and the lifetime of the network.

Plant roots and biochar amendment cause changes in soil structure and hydraulic properties; however, their interactive influences are still inadequately understood. A six-year field study was conducted on hillslope farmland in the Sichuan basin, China, to evaluate how honeysuckle planting and biochar application affect soil structure and hydraulic properties. Various parameters related to soil structure (soil organic matter (SOM), soil aggregate stability, bulk density were obtained in the laboratory) and hydraulic (hydraulic conductivity, and soil water retention characteristics by single porosity of van Genuchten 1980 and dual porosity bi-exponential model) properties were determined. The results showed that honeysuckle planting alone increased (SOM) content, honeysuckle planting following biochar amendment could not only enhance SOM content to a greater magnitude in top 20 cm soil but also markedly increase the SOM content in deeper soil layers (20–30 and 30–40 cm), while the application of biochar alone enhanced the SOM content in top 20 cm soil. The combination of honeysuckle planting and biochar amendment could increase soil aggregate stability. Furthermore, It was found that soil pores with size r > 125 µm were the dominant macropores in all treatments. Honeysuckle planting increased saturated soil hydraulic conductivity (Ks) significantly (p < 0.05). Biochar amendment also significantly increased Ks directly or indirectly through enhancement of SOM content. Results also showed that honeysuckle planting and biochar amendment could lead to a greater increase in saturated soil water content than saturated soil hydraulic conductivity. However, SOM showed lower value in bare land plots suggesting that both honeysuckle planting and biochar could increase SOM in soil, hence improving soil quality. Therefore, our field study demonstrated that the practice of honeysuckle planting and biochar amendment jointly in sloping farmland of purple soil could effectively strengthen soil structure and improve soil water retention.

We are in the era where various processes need to be online. However, data from digital learning platforms are still underutilised in higher education, yet, they contain student learning patterns, whose awareness would contribute to educational development. Furthermore, the knowledge of student progress would inform educators whether they would mitigate teaching conditions for critically performing students. Less knowledge of performance patterns limits the development of adaptive teaching and learning mechanisms. In this paper, a model for data exploitation to dynamically study students progress is proposed. Variables to determine current students progress are defined and are used to group students into different clusters. A model for dynamic clustering is proposed and related cluster migration is analysed to isolate poorer or higher performing students. K-means clustering is performed on real data consisting of students from a South African tertiary institution. The proposed model for cluster migration analysis is applied and the corresponding learning patterns are revealed.

INTRODUCTION: Antimicrobial Resistance (AR) is on a rise as one of the major global public health threats. It is therefore important to assess contributory factors to the rise in the cases of resistance reported. The main objective of this study was to assess the nself-medication practices with antibiotics among the University of Rwanda students in Huye Campus. METHODS: a sample of 570 students from all levels and colleges of the University of Rwanda in Huye Campus were selected using a simple random sampling to participate in this study. A questionnaire was administered to be answered individually by the consented respondents where the self-medication practices with antibiotics in the past 6 months were assessed. The results were statistically analyzed using SPSS v.16. RESULTS: the study showed that 12.1% (n=69) practiced self-medication with antibiotics. The major reason for self medication with antibiotics was illness not serious to have a consultation (50.72%). The main diseases being treated were common cold/fever/cough (47.83%). The antibiotic that was mostly used was Amoxicillin capsules (59.42%), while the main source of antibiotics was community pharmacy (72.42%). CONCLUSION: the prevalence of self medication is considerably high among university students. Regarding the main reasons of self-medication with antibiotics, diseases being treated, and the antibiotics used, it was found that all these may be related to the students' lack of knowledge about the need for rational use of antibiotics and a study was needed to confirm it.

This paper considers a case where an Unmanned Aerial Vehicle (UAV) is used to monitor an area of interest. The UAV is assisted by a Sensor Network (SN), which is deployed in the area such as a smart city or smart village. The area being monitored has a reasonable size and hence may contain many sensors for efficient and accurate data collection. In this case, it would be expensive for one UAV to visit all the sensors; hence the need to partition the ground network into an optimum number of clusters with the objective of having the UAV visit only cluster heads (fewer sensors). In such a setting, the sensor readings (sensor data) would be sent to cluster heads where they are collected by the UAV upon its arrival. This paper proposes a clustering scheme that optimizes not only the sensor network energy usage, but also the energy used by the UAV to cover the area of interest. The computation of the number of optimal clusters in a dense and uniformly-distributed sensor network is proposed to complement the k-means clustering algorithm when used as a network engineering technique in hybrid UAV/terrestrial networks. Furthermore, for general networks, an efficient clustering model that caters for both orphan nodes and multi-layer optimization is proposed and analyzed through simulations using the city of Cape Town in South Africa as a smart city hybrid network engineering use-case.

Unmanned aerial vehicles (UAVs) or drones are increasingly used in cities to provide service tasks that are too dangerous, expensive or difficult for human beings. Drones are also used in cases where a task can be performed more economically and or more efficiently than if done by humans. These include remote sensing tasks where drones can be required to form coalitions by pooling their resources to meet the service requirements at different locations of interest in a city. During such coalition formation, finding the shortest path from a source to a location of interest is key to efficient service delivery. For fixed-wing UAVs, Dubins curves can be applied to find the shortest flight path. When a UAV flies to a location of interest, the angle or orientation of the UAV upon its arrival is often not important. In such a case, a simplified version of the Dubins curve consisting of two instead of three parts can be used. This paper proposes a novel model for UAV coalition and an algorithm derived from basic geometry that generates a path derived from the original Dubins curve for application in remote sensing missions of fixed-wing UAVs. The algorithm is tested by incorporating it into three cooperative coalition formation algorithms. The performance of the model is evaluated by varying the number of types of resources and the sensor ranges of the UAVs to reveal the relevance and practicality of the proposed model.

This research evaluated the effects of Clay Pot Irrigation System (CPIS) on water saving and water productivity compared with Drip Irrigation System (DIS) as microirrigation systems in cabbage production in Rwanda. This research was conducted at the Rwanda Polytechnic/Integrated Polytechnic Regional College Huye (RP/IPRC Huye) farm (2°35'48° S and 29°44'21° E, Elevation of 1769 m above sea level), in Huye district of Rwanda. The experimental designed was a Randomized Complete Block Design (RCBD) with three treatments and three replications. The experimental treatments were Clay pot irrigation system, Drip irrigation system, and the control treatment (No irrigation). The soil type was a sand clay loam. The clay pots used were manufactured by mixing clay and sand at the ratio of 4:1 and dried with burning dry grass. Pots were buried under the soil up to their necks, with about 2 cm of their top above the surface of the surrounding. The crop variety used for the study was Zawadi F1 of cabbage produced by the East African Co. Seed, which is adaptable under the agroclimatic conditions of the Huye district of Rwanda. Crop water requirement and irrigation scheduling were estimated by using CROPWAT 8.0 software. Organic manure (20 tons ha-1) was applied for whole trial during tillage, Nitrogen-Phosphorous-Potassium/NPK 17-17-17 (300 kg ha-1) was uniformly applied around the seedling (ring application) and Urea (300 kg ha-1) was split applied, first after three weeks of transplanting, and the second application was five weeks after transplanting. The water productivity of CPIS was 36.17 kg m-3 for DIS was 25.4 kg m-3, while the control was 31.1 kg m-3. The results of this research show that CPIS increases water productivity and water saving. Water saved is 40.23% when CPIS is compared with DIS. Clay pot irrigation system can be a viable option for water scarce areas, particularly for small-scale farmers looking to improve their productivity with their small holdings of land in sandy and drier environments. [ABSTRACT FROM AUTHOR]

With increased availability of paediatric combination antiretroviral therapy (cART) in resource limited settings, cART outcomes and factors associated with outcomes should be assessed.HIV-infected children -2, immunological success as CD4 cells ≥500/mm3 and ≥25% for respectively children over 5 years and under 5 years, and virological success as a plasma HIV-1 RNA concentration 1000 c/mL). Older age at cART initiation, poor adherence, and exposure to antiretrovirals around birth were associated with virological failure. A third (33%) of children had side effects (by self-report or clinical assessment), but only 9% experienced a severe side effect requiring a cART regimen change.cART in Rwandan HIV-infected children was successful but success might be improved further by initiating cART as early as possible, optimizing adherence and optimizing management of side effects.

• The nexus is conceptualized to understand WEF sectors' co-production in Africa. • A comprehensive assessment is conducted to quantify the model of WEF resources produced in Africa. • WEF resources are produced with very low levels of resource sectors collaboration. • Huge resources are expanded at resource treatment plants due to inadequate technology and infrastructure. In African countries, limited knowledge about the co-production of water, energy, and food (WEF) resources and their sectoral interaction makes it problematic to define sufficient policy options to ensure their efficient and sustainable production. This study proposes a new approach to assess the WEF sectors' co-production in 47 African countries from 2000 to 2020. The study shows low and varied co-production between resource sectors in African countries. At the continental level, the water sector contributes 91.3% of its share to food and energy production and gets 10.5% back from these two sectors. Similarly, the energy sector contributes 17.7% of its share to food and water production and receives 39.1% from these two sectors. The food sector contributes a small percentage of 6.7% to the total production of the water and energy sectors, compared with the 79.5% it receives back from those two sectors. Limited and unsustainable collaboration between resource sectors is a major concern in all African countries, particularly between the food and energy sectors, and seems to be a continuous challenge for WEF security. Applying the co-production approach provides a dynamic pathway capable of helping practitioners identify opportunities and gaps among WEF production and plan investments to achieve their respective SDGs. [ABSTRACT FROM AUTHOR]