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Recent Submissions

Wetland-use and wetland-cover change and ecological integrity of wetlands around Kibale National Park, Kamwenge District, Western Uganda
(Journal of Freshwater Ecology, 2026-08-14) Ayebazibwe,Francis; Tumusiime,Julius; Yatuha,Jane; Nyakoojo,Clement; Tinka,John; Ainebyona,Peter
Wetlands around Kibale National Park support biodiversity, regulate water quality and sustain livelihoods but face increasing anthropogenic pressures. This study assessed wetland-use and cover change (between 2016 and 2025), macrozoobenthos diversity and physico-chemical water quality in Bigodi, Kahunge and Businge wetland systems within a 5 km buffer of Kibale National Park, Kamwenge District, Uganda. Sentinel imagery was classified to determine cover change. Sampling sites were classified as high quality, medium quality and low quality using the wetland rapid assessment procedure (WRAP). These categories represented a disturbance gradient based on ecological and anthropogenic characteristics of the wetland sites. Macrozoobenthos were sampled in dry ( January 2025) and wet (April 2025) seasons across all quality sites a scoop net, identified to family level and analyzed for diversity indices and average score per Taxon (ASPT). Physico-chemical parameters were measured in situ and in a laboratory. Wetland-use and wetland-cover (WUWC) change varied: Bigodi wetland system gained 1.17% wetland, Kahunge wetland system lost 3.58% and Businge wetland system lost 8.47% with +7.64% grassland increase. Macrozoobenthos abundance was highest in Bigodi (1189 individuals, 22 families), moderate in Kahunge (538, 21 families) and lowest in Businge (216, 21 families). Seasonal effects were significant in Kahunge (diversity p = 0.002) and Businge (diversity p = 0.033, Average Score Per Taxon p = 0.048), while ASPT differences across disturbance gradients were significant only in Businge (p = 0.004). Physico-chemical parameters generally met National Environment Management Authority standards, with minor nitrite exceedance in isolated low-quality sites. A principal component analysis showed system- and season-specific water chemistry: Businge dry-season linked to higher nitrates (mean = 0.413 ± 0.393 mg/L) and hardness (mean = 175 ± 144.3); Bigodi wet-season to higher Total dissolved solids (mean = 142.5 ± 80.6 ppm) and nitrates (mean = 0.675 ± 0.496 mg/L). Despite acceptable water quality, significant wetland loss, especially in Businge, threatens ecological integrity, warranting targeted habitat protection and stricter wetland-use controls.
Maternal inflammation disrupts transplacental antibody transfer in pregnant individuals with and without HIV
(Frontiers in Immunology, 2026-08-28) Bernshtein,Biana; Butler,Audrey; Roberts,Drucilla J.; Atwine,Raymond; Adong,Julian; Alter,Galit; Ngonzi,Joseph; Correia,Katharine F. B.; Bebell,Lisa M.
Introduction: Maternally transferred immunity plays a critical role in protecting infants from pathogens during the vulnerable period before their own immune system matures. Maternal IgG antibodies cross the placenta and circulate in the infant's body for up to six months, providing protection against infection. Despite the importance of transplacental antibody transfer, the mechanisms regulating this process remain poorly understood, including the maternal and placental factors that influence transfer efficiency. Methods: We analyzed maternal and umbilical cord plasma samples from 354 mother-baby dyads in Uganda, of whom 176 were pregnant individuals with HIV taking antiretroviral therapy. We measured IgG antibody levels, antibody binding to Fc receptors, antibody glycosylation, and cytokine levels in both maternal and umbilical cord compartments, and we evaluated placental inflammatory states with placental histology. We used this comprehensive dataset to define correlations between transplacental antibody transfer efficiency, placental inflammation, and cytokine levels in maternal and umbilical cord plasma. Results: We found that antibody transfer efficiency was not impacted by histologic placental inflammation, but that higher maternal plasma levels of the pro-inflammatory cytokines TNF-a and IL-6 correlated with reduced transplacental antibody transfer efficiency. Discussion: Our findings reveal the impact of maternal systemic inflammation on antibody transfer across the placenta and have implications for maternal immunization strategies.
Simulation of a multi-parameter indoor air purification control system using fuzzy logic–PID hybrid control tuned by genetic algorithms
(Scientific Reports, 2026-07-15) Wanzala,Jimmy Nabende; Awamu,Abdallah; Atim,Michael Robson; Mugabe,Robert; Awal,Moses
Indoor Environmental Quality ( IEQ)critically im- pacts human health, comfort, and productivity yet existing air purification systems often rely on single-sensor data, manual monitoring, or cloud-based processing, resulting in limited intelligence, increased latency, and reduced suitability for resource- constrained environments such as Uganda. To address these challenges, this paper presents the design, mathematical modelling, and simulation of a novel multi-parameter indoor air purification control system. The proposed frame work integrates six environmental sensors (dust, smoke, gas, volatile organic compounds (VOC), temperature, and humidity) with a hybrid Fuzzy Logic–Proportional–Integral–Derivative (PID)controller whose parameters are optimally tuned using a Genetic Algorithm (GA).A first-principles mathematical model of the DC motor-driven purifier actuatoris developed to describe the relationship between the input voltage and volume tric air flow. To enhance the physical realism of the simulations, the system model incorporates practical operating factors, including fan inertia, room-air mixing, pollutant transport, filter dynamics, and environmental sensor noise. The complete system is implemented in the MATLAB/Simulink environment using a Mamdani-type fuzzy inferencesystemwith49rulesandaGA-basedmulti- objective fitness function to minimize over shoot, settling time, and steady-state error. Simulation results demonstrate that the proposed GA-tuned Fuzzy-PID controller achieves a stable and well-damped responsewitharisetimeof53.93s, a settling time of 119.99s, and amaximumovershootof2.14%, reflecting the expected dynamics of practical indoor air purification systems. The proposed frame work provides a scalable, low-latency, and network-independent intelligent control solution that establishes a realistic foundation for future prototype development and experimental validation in low-resource environments.
Prevalence, severity and predictors of Antipsychotic-Related Adverse Drug Reactions at the Psychiatry Clinic of a Regional Referral Hospital in Uganda
(PLoS One, 2026-08-13) Tumwebaza,John Martin; Bukke,Sarad Pawar Naik; Narapureddy,Bayapa Reddy; Kabera,Radiana Makuza; Sebisaalu,Joel; Abubakar,Amina; Kitheka,Patrick Muasya; Nimusiima,Godwin; Mohamed,Awad Osman Abdalla; Muwanguzi,Moses; Ashaba,Scholastic; Yadesa,Tadele Mekuriya
Background Adverse drug reactions (ADRs) are associated with hospitalization, increased health¬care cost, morbidity and mortality. This study aimed to investigate the prevalence, severity and associated factors of ADRs among patients taking antipsychotics at Mbarara Regional Referral Hospital (MRRH). Method A cross-sectional study was conducted among patients taking antipsychotics at the psychiatric clinic from March to May 2025. Consecutive sampling was employed whereby all eligible patients attending the psychiatric clinic during the study period were recruited until the required sample size was attained. All patients aged 18 years and above, diagnosed with a psychotic disorder, and who had received an antipsy¬chotic for at least the previous one month were interviewed. STATA version 17 was used for statistical data analysis. Descriptive statistics were presented as mean and standard deviation or median and interquartile ranges. ADRs were analyzed for severity using the modified Hartwig and Siegel scale. We run multivariable logistic regression analysis to determine factors associated with ADRs. Results A total of 415 participants were included in the study with a mean age of 38. Fifteen ADRs were commonly reported among patients taking antipsychotics. More than half of the participants (256/415, 61.70%) experienced at least one ADR, with sedation being the most frequent (31.3%). Of the reported ADRs, 12/15 (80%) were moderate in severity. Separation from spouses (AOR = 2.01, 95% CI [1.08–3.77], p = 0.029), diagnosed with bipolar disorder (AOR = 2.09, 95% CI [1.07–4.07], p = 0.031), and co-administering both IM & oral antipsychotic (AOR = 1.95, 95% CI [1.03–3.70], p = 0.041) were significantly associated with ADRs. Conclusion The current study showed that over 6 in 10 participants taking antipsychotics experi¬enced at least one ADR, the majority of which were moderate in severity. Separation from a spouse, bipolar disorder, concomitant use of oral and intramascular antipsy¬chotics were independently associated with ADRs. These findings highlight the need for strengthen monitoring and preventive strategies, particularly among high-risk patients taking antipsychotics. Integration of clinical pharmacists into the psychiatry care teams may further enhance ADR detection, monitoring and management.
Prevalence and factors associated with hepatitis B surface antigen (HBsAg) positivity in Bugoye Sub-County, Western Uganda
(Discover Public Health, 2026-08-12) Turigye,Brian; Mulogo,Edgar M.; Thompson,Peyton; Camille,Morgan; Goel,Varun; Baguma,Emmanuel; Bhatti,Khadijah; Boyce,Ross M.
Background Hepatitis B virus (HBV) infection is a major cause of global morbidity and mortality. National serosurveys suggest that Uganda has a prevalence of 4.3%of chronic HBV infection. However, there is limited information regarding the potential determinants for infection. Methods Secondary data from a population-based household survey in the Kasese District were used to estimate HBsAg positivity. From these results, two villages were purposefully selected (i.e., low and high prevalence) for a population-representative household survey and a descriptive cross-sectional study. Descriptive analyses were conducted to characterise HBsAg positivity according to demographic, social-behavioural, clinical, and health-system factors, and spatial kernel density analysis and scan statistics were used to detect high-risk areas. Results A total of 2,067 adults were tested for HBV, of whom 93 were HBsAg-positive, giving an overall seroprevalence of 4.5% (95% CI: 3.6–5.5). In the two selected villages, 286 participants were enrolled, including 125 individuals aged ≥ 15 years and 161 children aged < 15 years. HBsAg positivity was detected in 6 of 125 adults (4.8%) and in no children. Descriptive comparisons suggested that HBsAg-positive participants more frequently reported a history of HBV testing, blood transfusion, and receipt of parenteral medications. A significant spatial cluster of elevated HBV risk was identified in the central region of the study area (RR = 5.22, p = 0.0266). Conclusions The prevalence of HBsAg is highly variable between villages in rural western Uganda. Infection was exclusively found in adults, which suggests. This suggests the benefit of hepatitis vaccination among children and could suggest that vertical and early-life transmission may be less of a risk factor. In adults with HBV, we observed a higher frequency of prior healthcare-associated exposures, which merits further investigation into practices intended to prevent transmission of blood-borne pathogens.
Interface-programmed nano energy systems for coupled solar conversion and thermoelectric power: a critical mini-review and translational roadmap
(Frontiers in Energy Research, 2026-07-26) Eze,Val Hyginus Udoka
Nano-enabled solar, thermoelectric, and hybrid photovoltaic–thermoelectric (PV–TEG) systems offer promising routes for improving renewable-energy utilization, yet the field remains fragmented across material classes, device architectures, and isolated performance metrics. This PRISMA-guided critical mini-review synthesizes 74 studies on nanomaterials for solar conversion, thermoelectric generation, and hybrid PV–TEG integration. The review develops an interface-programmed nano-energy framework in which photon absorption, charge-carrier extraction, phonon-mediated heat transport, interfacial thermal resistance, and device stability are treated as coupled design variables rather than separate material functions. The synthesis shows that quantum dots, perovskite nanocrystals, plasmonic nanoparticles, nanowires, superlattices, hierarchical nanocomposites, carbon nanomaterials, and two-dimensional materials enhance energy conversion mainly when their interfaces coordinate optical, electronic, and thermal pathways. For hybrid PV–TEG systems, the review shows that simple device stacking is insufficient because practical net energy gain depends on photovoltaic temperature control, thermal contact resistance, preservation of the thermoelectric temperature gradient, electrical load matching, packaging reliability, and comparison with PV-only and TEG-only references under matched operating conditions. The review further identifies a stability–toxicity–scalability trilemma that limits translation of high-efficiency or high-ZT nanomaterials into deployable energy systems, particularly for Pb-, Cd-, Te-, noble-metal-, and heat-sensitive platforms. To improve transparency and comparability, the review proposes an evidence-summary table, descriptive graphical synthesis, semi-quantitative material scoring, and a reporting checklist covering material identity, synthesis route, device architecture, performance metrics, stability testing, toxicity/sustainability evidence, scalability indicators, and net hybrid gain. Overall, this mini-review argues that future progress in nano-energy systems will depend on mechanism-aware, interface-programmed co-design that integrates efficient solar conversion, useful waste-heat recovery, durable interfaces, safer material chemistry, scalable processing, and validated system-level energy benefit.
Fault–responsive hybrid analytical–simulation framework for electric power transmission performance monitoring
(Scientific Reports, 2026-08-21) Mugabe,Robert; Atim,Michael Robson; Obungoloch,Johnes; Wanzala,Jimmy Nabende
Abstract—Continuous monitoring of electric power transmission systems I essential for maintaining reliable power transfer under increasingly dynamic operating conditions. Although analytical and simulation-based approaches have individually advanced transmission-system analysis, comparatively fewer studies have integrated their complementary strengths within a unified monitoring frame work. This paper proposes a fault-responsive hybrid analytical–simulation framework that combines distributed-parameter transmission-line modelling based on the ABCD parameter formulation with an equivalent π-model implemented in MATLAB/Simulink for continuous assessment of transmission-line performance. The frame work evaluates transmission efficiency, voltage regulation, and voltage-drop index under normal and abnormal operating conditions, including voltage overload low power factor, and balanced and unbalanced faults. Validation is performed against a benchmark distributed-parameter simulation using wave form comparison together with root mean square error (RMSE)and mean absolute error(MAE).The proposed hybrid framework consistently achieved the lowest prediction errors, reducing the average transmission-efficiency MAE from approximately 0.62% fortheanalyticalABCDmodeland0.05%forthe equivalent π-model toapproximately0.01%.Similarly,the average voltage-regulation MAE decreased from approximately 1.05% and0.65%toapproximately0.07%,whileaccurately reproducing transmission-line behavior during fault initiation, fault clearing, and post-fault recovery. These results demonstrate that integrating analytical modelling with dynamic simulation provides a practical, computationally efficient, and scalable frame work for continuous transmission-line performance monitoring and decision support.
Design and simulation of an energy efficient intelligent kitchen HVAC control system using RBFNN–PID and GA
(Discover Applied Sciences, 2026-07-29) Turyashaba,Mellon; Wanzala,Jimmy Nabende; Atim,Michael Robson; Awal,Moses; Mugabe,Robert
Abstract—Heating, Ventilation, and Air Conditioning systems are essential for maintaining thermal comfort, indoor air quality, and occupant health, particularly in energy-intensive environments such as indoor kitchens. However, conventional HVAC control systems often relyon fixed-gain PID controllers that struggle to handle non-linear dynamics, time-varying disturbances, and indoor air pollution, leading to reduced comfort and increased energy consumption. To address these challenges, this study designs and simulates an energy-efficient HVAC control system based on a hybrid Genetic Algorithm, Radial Basis Function Neural Network–PID approach for regulating indoor temperature, humidity, and carbonmonoxide concentration. The genetic algorithm is first employed to obtain optimal baseline PID gains, ensuring fast and stable initial system response, while the RBF neural network adapts these gains online to cope with environmental uncertainties and disturbances. The HVAC plant is modeled as a three-state dynamic system with realistic thermal, moisture, and pollution is turbances. The simulation results indicate accurate tracking of the reference set points across all controlled variables. The temperature regulation achieved a low RMS error of 0.26726 with a co-efficient-of determination of 0.75193, demonstrating good tracking performance. For relative humidity, the RMS errorwascalculatedas1.1548, while the corresponding R² value was 0 .11706, Carbon monoxide regulation exhibitedalowerRMSerrorof0.014568compared to temperature and humidity; andtheassociatedR²value of 0.99539 confirms satisfactory goodness off it and effective disturbance rejection despite intermittent pollutions pikes. The proposed GA–RBFNN–PID control system demonstrated rapid convergence characteristics, where the controlled parameters settled precisely at their respective points within approximately 1–2 minutes with no over shoot and observable steady-state error, thereby ensuring robust and stable indoor kitchen climate regulation.
Incidence of neonatal sepsis among HIV exposed neonates of mothers on integrase strand transfer inhibitors in sub-Saharan Africa: a systematic review and meta-analysis
(BMC Infectious Diseases, 2026-08-12) Pebalo, Francis; Bongomin, Felix; Morgan,Bethan; Pitua,Ivaan; Nantale,Ritah; Omona,Venice; Ngonzi,Joseph; Hamer, Davidson H.
Introduction Human immunodeficiency virus (HIV)-exposed infants face elevated risks of neonatal sepsis, influenced by maternal antiretroviral therapy (ART) regimens. Dolutegravir (DTG), a widely used integrase transfer inhibitor (INSTI), and the preferred first line drugs for management of HIV in pregnancy, has shown potential adverse effects such as hyperglycaemia, which may impact neonatal outcomes including risk of neonatal sepsis. We estimated the pooled incidence of neonatal sepsis among neonates exposed to INSTIs in utero compared to non-INSTIs-based ART regimens. Methods and analysis A systematic review and meta-analysis were conducted following written as per the PRISMA guidelines. Databases including PubMed/MEDLINE, Embase, Cochrane Library, CINAHL, Global Health and Global Index Medicus were searched for studies published between January 2013 and September 2025. Eligible studies included clinical trials and cohort studies comparing INSTI-based ART regimens with non-INSTI regimens among pregnant women living with HIV. Data were extracted using Covidence software, Cochrane risk of bias (RoB) and Newcastle-Ottawa Scale (NOS) were used to assessed for quality of randomised clinical trials and observational studies, respectively. The certainty of the evidence was assessed using the Grading, Recommendation, Assessment, Development and Evaluation (GRADE) framework. Results A total of 714 studies were identified and screened based on their titles and abstracts, of which 63 articles underwent full-text review. Ultimately, four studies, comprising 7,636 participants, met the predefined eligibility criteria and were included in the analysis. The pooled odds ratio (OR) for neonatal sepsis among infants exposed to INSTIs was 0.44 (95% confidence interval [CI]: 0.15–1.30, p = 0.137). The test for subgroup difference was not significant (p = 0.358): the pooled OR for dolutegravir was 0.27 (95% CI 0.06–1.23, p = 0.090) and for the single raltegravir study was 0.73 (95% CI 0.16–3.30, p = 0.681). Conclusion INSTI-based ART was not associated with a significant difference in neonatal sepsis risk compared with non-INSTI regimens. However, the low number of events limited the precision of the estimates, highlighting the need for further research.
Effect of prior TB preventive therapy on all cause mortality during TB treatment among people with HIV/TB in rural eastern Uganda: an observational causal analysis
(BMC Infectious Diseases, 2026) Izudi,Jonathan; Bajunirwe, Francis; Ssentongo, Saadick Mugerwa; Appeli,Saidi; Cattamanchi,Adithya
Background Tuberculosis preventive therapy (TPT) is the cornerstone for preventing TB disease. However, it is uncertain whether prior TPT completion improves survival once TB disease develops in people with human immunodeficiency virus (PWH) while on anti-retroviral therapy (ART). We evaluated the effect of prior TPT completion on all-cause mortality during TB treatment among PWH who developed TB disease while on ART in rural eastern Uganda. Prior TPT completion served as a marker of sustained engagement in HIV care. Methods We applied inverse probability of treatment weighting using propensity scores, a causal inference analysis approach, to mimic a randomized controlled trial using real-world retrospective cohort data. Inverse probability of treatment weighting addresses design flaws in observational studies, such as selection and confounding biases, providing less biased causal effect estimates. Individuals who had completed a full course of TPT before the start of the index TB treatment episode formed the intervention group, while the control group comprised those with no history of TPT before the index TB treatment initiation. Inverse probability of treatment weighting ensured balanced baseline covariates between the exposure groups. We estimated all-cause mortality rates using person-time methods and Kaplan-Meier curves and performed propensity-score weighted Cox proportional hazards analysis for cause effect estimation. We reported adjusted hazard ratios (aHR) with 95% confidence intervals (CI). Results Of 719 participants, 296 (41.2%) had completed a full course of TPT before the start of the index TB treatment episode, and 83 (11.5%) had died. The mortality rate was 7.13 per 10,000 person-days, higher among participants without prior TPT than those with prior TPT completion (18.0% vs. 2.4%, log-rank χ²(1) = 35.3, p < 0.001). Median survival was 277 days (95% CI: 213–689). Prior TPT completion was associated with an 87% lower hazard of all-cause mortality (aHR 0.13, 95% CI: 0.06–0.29). Conclusion Prior TPT completion substantially reduced all-cause mortality among PWH who developed drug susceptible TB disease while on ART. Therefore, there is a need to strengthen TPT completion and engagement in HIV care across HIV programs to lower all-cause mortality among PWH
Comparing technology-enhanced and conventional Van Hiele Phased Instruction in advancing learners through Van Hiele levels in transformation geometry
(Cogent Education, 2026) Ndungo,Issa; Balimuttajjo,Sudi; Akugizibwe, Edwin; Muwonge,Charles Magoba
Developing learners’ geometric reasoning remains a persistent challenge in secondary mathematics education, particularly in transformation geometry, where many learners struggle to progress through the hierarchical Van Hiele levels of geometric thinking. Although technology-enhanced instruction has been associated with improved mathema tics learning, limited evidence exists on how integrating GeoGebra within the phases of Van Hiele instruction influences learners’ progression through these levels. This study compared Technology-Enhanced Van Hiele Phased Instruction (TVHPI) with Conventional Van Hiele Phased Instruction (CVHPI) in promoting learners’ progression through the Van Hiele levels in transformation geometry. Guided by Van Hiele theory and constructivist learning principles, a quasi-experimental design involving 483 Ugandan secondary school learners (TVHPI ¼ 238; CVHPI ¼ 245) was employed. Learners’ progression was assessed using the Van Hiele Geometry Achievement Test and analysed using Wilcoxon signed- rank tests, ordinal logistic regression, and Difference-in-Differences analysis. Both instruc tional approaches significantly improved learners’ geometric reasoning; however, learners receiving TVHPI demonstrated greater progression through the Van Hiele levels than those receiving CVHPI. The findings suggest that integrating GeoGebra within the phases of Van Hiele instruction is associated with higher levels of geometric reasoning and pro vides empirical support for technology-enhanced, competency-based geometry instruc tion that promotes deeper conceptual understanding
Bundibugyo ebolavirus emergence in eastern Democratic Republic of Congo: The critical role of risk communication and community engagement in strengthening health security in fragile and conflict-affected settings
(Journal of Virus Eradication, 2026-08-11) Kihanduka, Elie; Tague,Christian; Nadarajah, Saralees; Rugendabanga,Excellent; Akilimali,Aymar; Muyisa,Beni; Mugenyi,Nathan; Byakika-Kibwika, Pauline
Since mid-May 2026, a rapidly evolving Ebola virus disease (EVD) outbreak caused by the Bundibugyo strain (Orthoebolavirus bundibugyoense) has been spreading in eastern Democratic Republic of Congo (Ituri, North and South Kivu provinces) and Uganda (Kampala and Wakiso areas). Uganda has so far reported 14 imported cases and 5 secondary transmissions according to the World Health Organization (WHO). As of 30 July 2026, 3605 confirmed cases, including 1587 deaths, have been reported in the Democratic Republic of the Congo. Unlike previous Zaire outbreaks, no specific licensed vaccine or antiviral treatment exists for the Bundibugyo strain, making behavioral and community-based interventions the only line of defense. However, armed conflict, chronic insecurity, massive population displacements (>2.1 million), and profound community distrust of health authorities are crippling the response. This article therefore argues that the current threat is a major warning sign for the Great Lakes region, and that investing in Risk Communication and Community Engagement (RCCE) such as involving community health workers, natives, and trusted leaders is the most urgent priority to avoid a regional health catastrophe. Without a humanitarian truce to guarantee access and a coordinated cross-border RCCE strategy, undetected transmission will continue to fuel this outbreak and future zoonotic emergencies.
Bicornuate Uterus with Recurrent Miscarriage Following a Successful Term Pregnancy: A Case Report
(International Journal of Women's Health, 2026-08-10) Olwit,Gerald; Omalla, Ivan Darcy; Kaheru, Sean Arthur; Chris-Uchendu,Hans Chinomso; Nek,Arthur Jonathan; Mugisha,Aime Ishimwe; Ndyomugabe,Michael; Bbosa,Geofrey; Nkoyoyo,Crispus; Okello,Peter; Odongo,Leo; Komagum,Patrick; Turanzomwe,Stuart
Bicornuate uterus is an uncommon congenital Müllerian duct anomaly resulting from incomplete fusion of the para mesonephric ducts and is associated with adverse reproductive outcomes, including recurrent pregnancy loss, preterm birth, and malpresentation. However, some affected women may achieve successful pregnancies before the anomaly becomes clinically apparent, creating diagnostic challenges that can delay recognition and treatment. We report the case of a 28-year-old multiparous woman from rural Southwestern Uganda who presented with recurrent pregnancy loss following a previously uncomplicated term vaginal delivery. Ultrasonographic evaluation revealed a bicornuate unicollis uterus after two consecutive first-trimester miscarriages. Diagnostic uncertainty persisted throughout, as definitive differentiation from a septate uterus was not possible given the imaging limitations in our setting. The diagnosis was complicated by limited access to advanced imaging modalities such as three-dimensional ultrasono graphy, hysteroscopy, and magnetic resonance imaging (MRI), highlighting challenges commonly encountered in low-resource environments. Given her adverse reproductive history, desire for future fertility, and the lack of access to laparoscopic surgical services within our setting, she underwent an open Strassman metroplasty, which was technically successful in restoring a unified uterine cavity. The postoperative course was uneventful, and extensive counseling was provided regarding fertility expectations, contraception, and timing of future conception. At the time of reporting this case, she remained clinically stable at 2 months of follow- up, although reproductive outcomes following surgery could not yet be assessed, and definitive conclusions regarding reproductive benefit cannot be drawn at this stage. This case highlights the paradoxical presentation of bicornuate uterus with an initial successful term pregnancy followed by recurrent miscarriage, underscores the diagnostic and management barriers faced in resource-constrained settings, and emphasizes the importance of considering congenital uterine anomalies in women presenting with secondary recurrent pregnancy loss despite a previously favorable obstetric history.
Baseline Risk of Treatment Abandonment and Survival of Children With Common and Curable Cancers in the Zero Abandonment Cash Transfer Programme—A Multi-Centre Prospective CANCaRe Africa Study
(Pediatric Blood & Cancer, 2026) Molla,Yalew Melkamu; Mezgebu,Esubalew; Atwiine,Barnabas; Mdoka,Cecilia; Wassie,Mulugeta; Branchard,Mushabe; Yimer,Mulugeta Ayalew; Zobeck,Mark; Fufa,Diriba; Israels,Trijn
Background: The WHO Global Initiative for Childhood Cancer (GICC) targets a global survival rate of 60% for childhood cancer, focusing initially on six common and curable cancers. This study assessed the risk of treatment abandonment (TxA) and the impact on survival of five of these cancers in sub-Saharan Africa in preparation for a cash transfer intervention. Methods: This multi-centre, prospective, observational cohort study included newly diagnosed children ( < 16 years) with Burkitt lymphoma (BL), acute lymphoblastic leukaemia (ALL), Wilms tumour (WT), retinoblastoma (RB) or Hodgkin disease (HD), enrolled between January 2022 and April 2024 from hospitals in Ethiopia ( n = 2) and Uganda. Event-free survival (EFS) was estimated using Kaplan–Meier methods, and the cumulative incidence of TxA was estimated using competing risks methods. Results: Of 370 patients enrolled (median age 6 years, 62% boys), ALL was the most common diagnosis (30%, 112/370). Median follow-up was 26 months (range 6–35 months). The overall risk of treatment abandonment was 43%, ranging from 20% in Mbarara, Uganda to 54% in Gondar, Ethiopia. It was highest in patients with WT (48%) and RB (49%). Overall, 2-year EFS was 28% (confidence interval [CI] 24%–34%) with TxA as an event and 59% (53%–66%) when TxA cases were censored. Conclusion: The overall risk of treatment abandonment is high, 43%, in this baseline ‘Zero Abandonment’ study in participating hospitals in Ethiopia and Uganda. Treatment abandonment significantly affects survival, currently 28%, and potentially to increase to 59% if treatment abandonment was completely prevented.
Association of a single prior cesarean delivery with adverse birth outcomes at a tertiary referral hospital in southwestern Uganda: A secondary analysis of four observational studies
(International Journal of Gynecology & Obstetrics, 2026) Tibaijuka,Leevan; Ngonzi,Joseph; Correia,Katharine; Goldstein,Jeffery A.; Wang, James Z.; Walker, Rachel E.; Kumbakumba,Elias; Boatin, Adeline A.; Bebell, Lisa M.
Background: Prior cesarean delivery (CD) is a leading indication for repeat CD and a key driver of rising cesarean rates in Sub- Saharan Africa. Evidence on associations between prior CD and adverse outcomes in low- resource settings remains limited. Objective: We examined the association between one prior CD and adverse maternal and perinatal outcomes and examined current delivery mode as a mediator of this association among women delivering at Mbarara Regional Referral Hospital (MRRH), Uganda. Methods: We conducted a secondary analysis of four prospective studies at MRRH (2014–2024). The exposure was having one prior CD, and outcomes included com posite adverse maternal outcomes (postpartum hemorrhage, infection, blood transfu sion, prolonged hospital stay, and others) and composite adverse perinatal outcomes (stillbirth, neonatal death, preterm birth, low birthweight, low Apgar score, and neo natal intensive care unit admission). We compared the odds of adverse outcomes for women with one prior CD to those with none using multivariable logistic regression. Causal mediation analysis was used to assess whether current CD mediated the effect of prior CD on adverse maternal outcomes. Results: Of 2222 women with at least one prior delivery, 611 (27.5%) had one prior CD. Women with one prior CD more often delivered by cesarean (73.7% vs. 26.4%) and experienced more adverse maternal outcomes (24.5% vs. 15.4%, P 1.69), and low antenatal care (ANC) attendance (aOR: 1.66) independently predicted perinatal outcomes. Conclusion: While prior CD was associated with higher odds of poor maternal out comes due to repeat cesarean, HIV- positive serostatus, facility referral, and low ANC attendance (but not prior CD) independently predicted adverse perinatal outcomes. Individualized delivery planning and improving surgical safety for women with prior CD and strengthened antenatal surveillance are critical to reducing maternal and peri natal morbidity at referral facilities in low- resource settings.
Fire Hawk Optimizer Adjusted Tri-Stage (1+PI)-PI-TID Cascade Controller for Automatic Generation Control of PSI
(IEEE Access, 2025) Awal,Moses; Atim,Michael Robson; Wanzala,Jimmy Nabende; Obungoloch,Johnes; Barakat,Mohamed
This study aims to enhance the performance of automatic generation control (AGC) in power systems interconnection (PSI) by employing the fire hawk optimizer (FHO), a green algorithm, to optimize a novel tri-stage cascade controllers (CCs) configuration: (1+PI)-PI-PID and (1+PI)-PI-TID CCs. The FHO draws inspiration from the foraging behaviors of whistling kites, black kites, and brown falcons, known for their unique prey-catching method involving fire propagation. Evaluation of the proposed FHO: (1+PI)-PI-T/PID scheme is conducted using the integral time multiplied absolute error (ITAE) criteria. The versatility of this technique is demonstrated across four PSI test models, including a two-area non-reheat thermal PSI (NRTPSI) and a multi-unit multi-area (MUMA) system incorporating reheat, hydro, and gas units. Challenges are addressed by initially testing NRTPSI with and without governor dead band (GDB) nonlinearity, showing the superior performance of the proposed method. Next, the HVDC link in MUMA is employed under different scenarios. To assess the robustness of the FHO: (1+PI)-PI-T/PID CCs, real world AGC issues, such as sudden load perturbations and nonlinearities like generation rate constraint, GDB, boiler dynamics, and communication time delay in MUMA, are employed. Also, sensitivity analysis involving a range variation of }40% in PSI model parameters is conducted for validation. The proposed scheme also undergoes evaluation under random step-load perturbations. The results demonstrate significant improvements in the performance of ITAE by 84.3%, 10.7%, 42.1%, and 16.7% for scenario 1 across all four tested models. The FHO: (1+PI)-PI-TID CC significantly improves system performance compared to existing controllers like the HHO: PD-PI CC, FHO: TID, FHO: PID, and the proposed FHO: (1+PI)-PI-PID CCs. This shows that this approach is effective at improving AGC capabilities and can be used in real life. Update each group’s position using their respective equations
The Association Between Neutrophil-to- Lymphocyte and Platelet-to-Lymphocyte Ratios and Anemia in Adults with Hypertension in Southwestern Uganda: A Cross-Sectional Study
(Journal of Blood Medicine, 2026-08-23) Muwanguzi,Enoch; Tumusiime,Jazira; Kalyetsi,Rogers; Bagenda,Charles Nkubi; John,Elizabeth A; Okongo,Benson
Purpose:: This study aimed to determine the association of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with anemia among hypertensive patients in Southwestern Uganda. Patients and Methods: We conducted a secondary analysis of a cross-sectional study involving 386 consecutively enrolled hypertensive patients at Bwizibwera Health Centre IV, Mbarara District, Uganda. Anemia was defined as hemoglobin <12.0 g/dL in women and <13.0 g/dL in men. Data were analyzed using STATA. Categorical variables were compared using chi-square or Fisher’s exact tests, continuous variables with the Mann–Whitney U-test. Logistic regression examined associations of NLR, PLR, and monocyte-to-lymphocyte ratio (MLR) with anemia. Predictive performance was assessed using receiver operating characteristic (ROC) curves. Results: Overall anemia prevalence was 17.1% (95% CI: 13.7–21.2). Prevalence was significantly higher among participants with uncontrolled versus controlled blood pressure (20.8% vs 12.6%; p=0.035). Anemic participants had significantly higher NLR (1.49 vs 1.14; p<0.001), PLR (156.06 vs 118.45; p<0.001), and MLR (0.23 vs 0.20; p=0.006). High NLR and PLR were independently associated with anemia. Participants in the top tertile of NLR had over twice the odds of anemia compared to those in the bottom tertile (aOR=2.29; 95% CI: 1.04–5.07; p=0.040). Similarly, those in the top tertile of PLR had higher odds of anemia (aOR=2.28; 95% CI: 1.05–4.97; p=0.038). Both ratios showed significant predictive ability to distinguish anemic from non-anemic participants: NLR AUC=0.63 (95% CI: 0.56–0.71); PLR AUC=0.64 (95% CI: 0.56–0.72). Conclusion: In hypertensive patients, higher NLR and PLR are independently associated with anemia. These inexpensive, readily available inflammatory hematological ratios may help identify individuals at elevated anemia risk.
Molecular Characterization of Extended- Spectrum Beta-Lactamase-Producing Enterobacterales Among Cancer Patients at the Mbarara Regional Referral Hospital, Southwestern Uganda
(Cureus, 2026-08-18) Zamarano,Henry; Iramiot,Jacob Stanley; Mulogo,Edgar; Natumanya,Debrah; Khakasa,Catherine; Musinguzi,Benson; Mwesigye,Vicent; Mumbere,Iving; Muhwezi,Ivan; Kawuma, Simon; Orikiriza, Patrick
Background and objective Extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) are an important cause of antimicrobial-resistant infections among immunocompromised patients. Cancer patients are vulnerable because of frequent hospital exposure, invasive procedures, chemotherapy-associated immunosuppression, and antibiotic use. This study aimed to determine the molecular characteristics of ESBL-PE among cancer patients at Mbarara Regional Referral Hospital (MRRH), Southwestern Uganda. Methods A laboratory-based cross-sectional study was conducted at the Microbiology and Molecular Laboratory of Mbarara University of Science and Technology (MUST). The study used archived clinical Enterobacterales isolates recovered from clinical specimens collected from inpatient and outpatient cancer patients receiving care at MRRH between June and November 2025. The isolates had been identified using standard microbiological methods, and ESBL-PE were confirmed using the double-disk synergy test (DDST). Molecular detection of ESBL and other antimicrobial resistance-associated genes was performed using conventional polymerase chain reaction (PCR) with gene-specific primers. Target genes included blaCTX-M, blaTEM, blaSHV, blaOXA-1, AmpC-blaCITM, blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48, AAC(6’)-Ib, mcr-1, qnr, FosA, and blaPER. PCR products were separated by agarose gel electrophoresis and visualized under ultraviolet illumination. Data were entered into a database and analyzed using frequencies and percentages to summarize the distribution of resistance genes among isolates. Results A total of 281 isolates were analyzed. Escherichia coli (E. coli) was predominant (155/281, 55.2%), followed by Klebsiella pneumoniae (K. pneumoniae) (85/281, 30.2%). CTX-M was the most frequently detected resistance gene (106/281, 37.7%), followed by TEM (81/281, 28.8%), SHV (26/281, 9.3%), and AAC (24/281, 8.5%). At least one target resistance gene was detected in 170/281 (60.5%) isolates, while 111/281 (39.5%) had no target genes detected within the PCR panel. Multi-gene carriage occurred in 76/281 (27.0%), with TEM + CTX-M as the most common co-carriage pattern (25/281, 8.9%). Carbapenemase-associated genes remained uncommon. Conclusions The findings of this study describe the distribution of ESBL-PE in this population and highlight the importance of continued surveillance of resistant Enterobacterales among patients receiving cancer care.
Exploring Phosphatidylethanol Cutoffs for Self-Reported Unhealthy Alcohol Use: An International Multi-Site Analysis
(Alcohol: Clinical and Experimental Research, 2026) Murnane,Pamela M.; Xia,Fan; Afshar,Majid; Brown,Jennifer L.; Chamie,Gabriel; Cook,Robert L.; Couture,Marie Claude; DiClemente,Ralph J.; Fatch,Robin; Ferguson,Tekeda; Francis,Joel M.; Haberer,Jessica E.; Jacobson,Karen R.; Justice,Amy C.; Kapiga,Saidi; Kim,Theresa W.; Krupitsky,Evgeny; Marcus,Gregory M.; Molina,Patricia E.; Muyindike,Winnie R.; Myers,Bronwyn; Page,Kimberly; Phillips,Shane A.; Piano,Mariann R.; Richards,Veronica L.; So-Armah,Kaku; Stewart,Scott; Sulkowski,Mark S.; Tien,Phyllis C.; Woolf-King,Sarah; Hahn,Judith A.
Background: Unhealthy alcohol use is a preventable cause of morbidity and mortality, yet screening is hampered by inaccurate reporting. Phosphatidylethanol (PEth) is a biomarker that quantifies total drinking over the past 2–4 weeks, but PEth cutoffs for unhealthy drinking have not been well-examined. Methods: We pooled data from 22 studies (11,088 persons globally) that previously collected PEth and self-reported alcohol use. Within a 90% training set, we calculated PEth cutoffs per Youden's J in 1000 bootstrapped samples and explored differences by region, age, sex, race/ethnicity, body mass index (BMI), HIV status, hemoglobin level, and an indirect serum marker of liver fibrosis, FIB-4. For each cutoff, we estimated sensitivity, specificity, and positive and negative predictive values in a 10% validation dataset. We used two definitions for self-reported unhealthy drinking per Alcohol Use Disorders Identification Test Consumption (AUDIT-C) and National Institute on Alcohol Abuse and Alcoholism (NIAAA). Results: Optimal PEth cutoffs using self-reported alcohol use as the reference standard differed substantially by region. The cutoff for AUDIT-C- measured unhealthy alcohol use in studies from the United States (US) was 14.0 ng/mL (95% CI: 12.3–18.6) with 73.0% sensitivity (95% CI: 67.3–79.1) and 77.4% specificity (95% CI: 73.2–81.4); and was 65.7 ng/mL (95% CI 19.3–90.7) in studies from Africa, with 71.7% sensitivity (95% CI: 64.4–78.7) and 65.2% specificity (95% CI: 58.1–72.7). Cutoffs for AUDIT-C did not differ between subgroups in the US, but within Africa, cutoffs were higher for men and lower for those with BMI ≥ 25 kg/m2. Cutoffs for NIAAA defined unhealthy alcohol use were similar to those using the AUDIT-C. Conclusions: Using self-report as the reference standard, PEth cutoffs differed substantially by region and by some other characteristics, which may be attributable to differences in PEth formation, elimination and/or reporting bias. Further work using objective gold-standard measures of alcohol consumption is needed for more definitive conclusions.
The OTELO Survey: The main sequence of low-mass galaxies
(Astronomy & Astrophysics,, 2026) Cedrés,Bernabé; Cepa,Jordi; Padilla–Torres,Carmen P.; Bongiovanni,Ángel; Cerviño,Miguel; Diego,José A. de; Nadolny,Jakub; Danilo,Simon B. De; González–Otero,Mauro; Rodríguez,Monica I.; Gallego,Jesús; Povic,Mirjana; Lara–López,Maritza A.; González–Serrano,J. Ignacio; Sánchez–Portal,Miguel; Pérez–García,Ana María; Pérez–Martínez,Ricardo; Alfaro,Emilio J.
Aims. This paper describes the relationship between the star formation rate and the stellar mass, the so-called main sequence (MS), of low-mass galaxies at three different redshifts from the OTELO survey. In particular, we study H_ at z = 0:38, [O iii] at z = 0:83, and [O ii] at z = 1:43 emission line galaxies (ELGs). This is done to characterise the properties of low-mass ELGs. Methods. We fitted the spectral energy distribution (SED) of each emitter and obtained the stellar masses, the total infrared luminosity, and the star formation rate. We found that 100% of the H_ emitters and about 90% of the [O iii] and [O ii] emitters are low-mass galaxies (<1010M_). We generated a MS for each redshift regime, employing all galaxies and binning them in stellar mass. We obtained the parameters of the fit (turnover mass and slope of the low-mass regime) and compared them to results from the literature. Results. We found that the colour–magnitude method employed to select ELGs leaves out a significant number of them. We also found that the whole sample contains few luminous infrared galaxies and no ultra-luminous infrared galaxies. We also found that the lack of infrared constraints in the input SEDs may generate problems when determining the total infrared luminosity. When comparing the MS obtained for our sample of low-mass ELGs with those from the bibliography, we found, in general, very good agreement. We can consider the MS to be almost the same for the relatively unexplored regime of low-mass galaxies. However, the turnover mass obtained by this work is higher for all redshifts compared with the ones from the literature. We suggest that this is an effect of the different methods and samples used in the generation of the MS compared to those of the bibliography.