Factors associated with, and echocardiographic findings of heart failure among HIV infected patients at a tertiary health care facility in Dar es Salaam, Tanzania

Abstract: Cardiovascular diseases, including heart failure are a known complication of Human Immunodeficiency Virus (HIV) infection globally. The objective of this study was to describe factors associated with, and echocardiographic findings of heart failure among HIV infected patients at a tertiary health care facility in Dar es Salaam, Tanzania. Clinical, laboratory and echocardiographic assessment was performed in all HIV-infected patients presenting with cardiac complaints at the medical department, Muhimbili National Hospital between September 2009 and April 2010. HF was diagnosed clinically and confirmed by echocardiography. Of the 102 HIV-infected patients with cardiac complaints 50 (49%) were in HF. Commonest causes of HF were hypertensive heart disease, pulmonary hypertension and dilated cardiomyopathy. In multivariate analysis male gender (OR 4.03), low education (OR 4.91), previous history of tuberculosis (OR 3.01), and low haemoglobin (OR 0.83), were independently associated with the diagnosis of HF (p<0.05 for all). In conclusion, heart failure is common in HIV-infected patients with cardiac complaints, and is associated with both modifiable and non-modifiable factors

Towards Guidelines for Assessing Qualities of Machine Learning Systems

Nowadays, systems containing components based on machine learning (ML) methods are becoming more widespread. In order to ensure the intended behavior of a software system, there are standards that define necessary quality aspects of the system and its components (such as ISO/IEC 25010). Due to the different nature of ML, we have to adjust quality aspects or add additional ones (such as trustworthiness) and be very precise about which aspect is really relevant for which object of interest (such as completeness of training data), and how to objectively assess adherence to quality requirements. In this article, we present the construction of a quality model (i.e., evaluation objects, quality aspects, and metrics) for an ML system based on an industrial use case. This quality model enables practitioners to specify and assess quality requirements for such kinds of ML systems objectively. In the future, we want to learn how the term quality differs between different types of ML systems and come up with general guidelines for specifying and assessing qualities of ML systems.Comment: Has been accepted at the 13th International Conference on the Quality of Information and Communications Technology QUATIC2020 (https://2020.quatic.org/). QUATIC 2020 proceedings will be included in a volume of Springer CCIS Series (Communications in Computer and Information Science

High prevalence of ST-elevation, early repolarization, and left ventricular hypertrophy during the eligibility assessment for an HIV vaccine trial in young, healthy Tanzanians

BACKGROUND: Vaccinia based immunizations have caused myo/pericarditis and vaccine study volunteers are monitored by ECG. We report ECG outcome obtained during the screening period for an HIV vaccine trial. METHODS: ECG was performed in healthy Tanzanian volunteers. ECG abnormalities and findings interfering with the interpretation of myo/pericarditis were subject to study ineligibility. We determined the prevalence of left ventricular hypertrophy (LVH) defined by the Sokolow-Lyon (SL) or the Cornell index, ST-elevations and early repolarization (ERP) in association with gender, age, BMI and body height by regression analysis adjusted for gender and age. RESULTS: In 257 volunteers (median age 23 years, 63% males) overall positivity for LVH defined by SL or Cornell criteria was seen in 20.6% and 3.5%, ST-elevations ≥ 0.1 mV or ≥ 0.2 mV in 77.8% and 38.1%, and ERP in 23.4%. Positive SL criteria were associated with male gender (PR 7.84, p < 0.001) and lower age (PR 0.70, p = 0.002), and associated with increased body height and lower BMI in univariate analysis. Positive Cornell criteria were only associated with lower age (PR 0.44, p = 0.010). ST-elevations ≥ 0.2 mV were associated with male gender (PR 8.05, p < 0.001) and lower age (PR 0.81, p = 0.003), and ERP with male gender (PR 2.86, p < 0.001). Vaccine study ineligibility due to ECG findings was concluded in 22.1% of the screening population. CONCLUSIONS: High prevalence of LVH according to SL in association with ST-elevation and ERP is especially found in young and male Africans. ECG variations need to be considered for eligibility criteria in studies investigating potential cardiotoxic agents in Africa

Integration of security standards in DevOps pipelines: An industry case study

In the last decade, companies adopted DevOps as a fast path to deliver software products according to customer expectations, with well aligned teams and in continuous cycles. As a basic practice, DevOps relies on pipelines that simulate factory swim-lanes. The more automation in the pipeline, the shorter a lead time is supposed to be. However, applying DevOps is challenging, particularly for industrial control systems (ICS) that support critical infrastructures and that must obey to rigorous requirements from security regulations and standards. Current research on security compliant DevOps presents open gaps for this particular domain and in general for systematic application of security standards. In this paper, we present a systematic approach to integrate standard-based security activities into DevOps pipelines and highlight their automation potential. Our intention is to share our experiences and help practitioners to overcome the trade-off between adding security activities into the development process and keeping a short lead time. We conducted an evaluation of our approach at a large industrial company considering the IEC 62443-4-1 security standard that regulates ICS. The results strengthen our confidence in the usefulness of our approach and artefacts, and in that they can support practitioners to achieve security compliance while preserving agility including short lead times.info:eu-repo/semantics/acceptedVersio

Testicular tuberculosis presenting with metastatic intracranial tuberculomas only: a case report

<p>Abstract</p> <p>Introduction</p> <p>Intracranial tuberculomas are a rare complication of tuberculosis occurring through hematogenous spread from an extracranial source, most often of pulmonary origin. Testicular tuberculosis with only intracranial spread is an even rarer finding and to the best of our knowledge, has not been reported in the literature. Clinical suspicion or recognition and prompt diagnosis are important because early treatment can prevent patient deterioration and lead to clinical improvement.</p> <p>Case presentation</p> <p>We present the case of a 51-year-old African man with testicular tuberculosis and multiple intracranial tuberculomas who was initially managed for testicular cancer with intracranial metastasis. He had undergone left radical orchidectomy, but subsequently developed hemiparesis and lost consciousness. Following histopathological confirmation of the postoperative sample as chronic granulomatous infection due to tuberculosis, he sustained significant clinical improvement with antituberculous therapy, recovered fully and was discharged at two weeks post-treatment.</p> <p>Conclusion</p> <p>The clinical presentation of intracranial tuberculomas from an extracranial source is protean, and delayed diagnosis could have devastating consequences. The need to have a high index of suspicion is important, since neuroimaging features may not be pathognomonic.</p

Development, Implementation, and Scale Up of the National Furaha Yangu Campaign to Promote HIV Test and Treat Services Uptake Among Men in Tanzania

Evidence has demonstrated that immediate HIV treatment initiation upon a positive HIV test, referred to as Test and Treat, can help people living with HIV live longer, healthier lives and prevent HIV transmission. Although Tanzania adopted the evidence-based Test and Treat strategy since 2016, men were not being adequately reached for HIV services. A national campaign was launched to promote the new HIV services with a focus on men. To inform the development and implementation of the campaign, we conducted formative audience insights-gathering (AIG) sessions to assess facilitators and barriers to accessing HIV Test and Treat services and inform the concepts and materials for the campaign. Qualitative AIG interviews and focus group discussions were conducted with 54 people who were unaware or aware of their HIV status and currently or not currently on treatment, as well as health workers. Facilitators and barriers included a fear of testing positive, the desire to belong, control their narratives, and reinvent themselves to achieve their dreams and live a happy life. The campaign played off a My Happiness! creative concept to position antiretroviral therapy (ART) as a solution to fears around what life would be like after a positive HIV diagnosis. The development and implementation of the campaign were informed by the AIG sessions and national stakeholders, leading to strong partners? buy-in that supported the scale-up of the ongoing campaign from 12 to 26 regions via the collaborative efforts of government, donors, and implementing partners

Electrocardiographic and echocardiographic characteristics in HIV-1 and non-HIV-1 infected children at Muhimbili National Hospital, Dar es Salaam, Tanzania

Objective: The objective of the study was to describe the electrocardiographic and echocardiographic characteristics of HIV–1 infected children. aged 18 months to 7years.at Muhimbili National Hospital. Methods: A cross sectional comparative study was carried out between April 2001 and January 2002. All consecutive children aged between 18 months to 7 years admitted in the paediatric wards and those attending the out patient department between April 2001 and January2002 were enrolled for the study. Children who tested HIV-1 positive comprised the study group and those who tested HIV-1 negative formed the comparative group. Results: The study population consisted of 280 children, 160 males and 120 females. The overall prevalence of cardiovascular disorders was (83/280) 29.6%.The prevalence of cardiovascular disorders was significantly higher in HIV infected than non-HIV infected children,(46.2% versus 23.3%, p< 0.0001).The common cardiac disorders strongly associated with HIV infection were pericardial effusion, (26.9%) (p< 0.0002), Left ventricular dysfunction (LVD) 24.7% (p< 0.0004),Dilated cardiomyopathy (DCM) 24.4% (p< 0.0001), and sinus tarchycardia 20.5% (p< 0.0001). Endocarditis was not detected. Conclusion: Cardiac diseases are common in HIV infected children. ECG detectable sinus tachycardia prompts further investigation by Echocardiogram to detect the cardiac abnormalities in HIV-1 infected children. Tanzania Medical Journal Vol. 19 (1) 200

Towards Customer-Centric Software Development: A Multiple-Case Study

Customer involvement in software development is essential for building successful software products. Incremental improvements and enhancements of software require an in-depth and continuous understanding of customer needs. Also, mechanisms for managing customer feedback data need to be in place. However, previous research shows that the feedback loops from customers are slow and the process for obtaining timely feedback is challenging. In this study, we investigate customer feedback mechanisms and the ways in which customer data can be used to inform continuous improvement of software products. The contribution of this paper is twofold. First, we present a multiple-case study conducted in five Finnish software companies, where we identify how customer feedback data is collected and used in different product development activities. Second, we provide an explanatory \u27customer touch point\u27 (CTP) model which provides an overall understanding of customer feedback data collection and the related challenges in the case companies during software development