A Realist Evaluation of the Sustainability of Disease Surveillance Intervention Outcomes in Sub-Saharan Africa

In recent years, the use of Information and Communication Technologies (ICTs) and to improve disease surveillance has been on the increase. This is in line with the notion that ICTs improve timeliness, availability and quality of public health data. Sub-Saharan Africa (SSA) is burdened with increasing health challenges and poor health infrastructure. Thus, an explosion of ICT-based health surveillance interventions to curb these challenges. However, despite the implementation of these interventions, important questions around the effectiveness and sustainability still remain. This study proposes a realist evaluation of disease surveillance intervention outcomes from a sustainability perspective to uncover what works, for whom, under what conditions and why? We also discuss how the complex adaptive systems theory and affordance theory provide a lens for investigating this phenomenon. The results of this study will contribute to the evidence based movement for Information Systems (IS) research and practice in SSA

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Ultra sensitive biosensor based on impedance spectroscopy at microwave frequencies for cell scale analysis

International audienceThis paper presents an original approach for biological cell discrimination using impedance spectroscopy analysis at microwave frequencies. The proposed method allows label-free analysis at the cell scale using high frequency electromagnetic waves as a non-invasive probe to analyze the intracellular medium. In the present case, the biosensor design takes advantage of classical planar microwave filter topology, where coupling zones present high sensitivity to tiny dielectric perturbations. With proper design, these specific areas can be used as an electromagnetic (EM) detector. In the present work, biosensor sensitivity allows reaching selective biological sample detection and bio-impedance measurements down to single-cell analysis. As presented in this paper, this concept has been experimentally validated with characterisations conducted on biological cancerous stem cells (cells considered at a low differentiation degree) and U87 glial cells (differentiated cells); both coming from human nervous system. Stem cells are almost similar in shape and size as differentiated cells. They are therefore quite difficult to identify using a microscope, and studies focusing on their differentiation mechanisms are very challenging. Cell chemical labeling would have been suitable if we would have been sure that used label will not induce an unwanted cell differentiation. To the contrary, EM impedance measurements show a significant difference between stem and differentiated cells dielectric permittivity. Therefore, such measurements can be an efficient approach to determine cell differentiation degree in a non-invasive way. As a label-free approach, the high frequency impedance spectroscopy could be very interesting for accurate discrimination of un-differentiated cells. Indeed, stem cells are currently the subject of a large research effort in the biologist community; especially in case of cancers, where cancerous stem cells are suspected to be the origin of most of tumor recurrences. Hence, based on this identification technique, a new diagnostic analysis could be developed for early cancer recurrence prevention

MANAGEMENT OF A CHRONIC NECROTIZING WOUND IN A DOG USING NATURAL HONEY THERAPY

Infected skin wounds are common in pet animals. Following an infected severe bite wound in a dog with marked necrotic aftermath, natural honey was successfully used alongside systemic antibiotic therapy to hasten healing. The condition improved with speed and regeneration of skin tissue, avoiding sloughing. The wound took 168 days to heal and to form a scar. Natural honey can be considered as a wound management tool, as it is both highly effective, can render a low cost therapy and less managemental expenditure compared to other specialized therapies and techniques