Global maps of travel time to healthcare facilities.

Access to healthcare is a requirement for human well-being that is constrained, in part, by the allocation of healthcare resources relative to the geographically dispersed human population1-3. Quantifying access to care globally is challenging due to the absence of a comprehensive database of healthcare facilities. We harness major data collection efforts underway by OpenStreetMap, Google Maps and academic researchers to compile the most complete collection of facility locations to date. Leveraging the geographically variable strengths of our facility datasets, we use an established methodology4 to characterize travel time to healthcare facilities in unprecedented detail. We produce maps of travel time with and without access to motorized transport, thus characterizing travel time to healthcare for populations distributed across the wealth spectrum. We find that just 8.9% of the global population (646 million people) cannot reach healthcare within one hour if they have access to motorized transport, and that 43.3% (3.16 billion people) cannot reach a healthcare facility by foot within one hour. Our maps highlight an additional vulnerability faced by poorer individuals in remote areas and can help to estimate whether individuals will seek healthcare when it is needed, as well as providing an evidence base for efficiently distributing limited healthcare and transportation resources to underserved populations both now and in the future.

A global map of travel time to cities to assess inequalities in accessibility in 2015.

The economic and man-made resources that sustain human wellbeing are not distributed evenly across the world, but are instead heavily concentrated in cities. Poor access to opportunities and services offered by urban centres (a function of distance, transport infrastructure, and the spatial distribution of cities) is a major barrier to improved livelihoods and overall development. Advancing accessibility worldwide underpins the equity agenda of 'leaving no one behind' established by the Sustainable Development Goals of the United Nations. This has renewed international efforts to accurately measure accessibility and generate a metric that can inform the design and implementation of development policies. The only previous attempt to reliably map accessibility worldwide, which was published nearly a decade ago, predated the baseline for the Sustainable Development Goals and excluded the recent expansion in infrastructure networks, particularly in lower-resource settings. In parallel, new data sources provided by Open Street Map and Google now capture transportation networks with unprecedented detail and precision. Here we develop and validate a map that quantifies travel time to cities for 2015 at a spatial resolution of approximately one by one kilometre by integrating ten global-scale surfaces that characterize factors affecting human movement rates and 13,840 high-density urban centres within an established geospatial-modelling framework. Our results highlight disparities in accessibility relative to wealth as 50.9% of individuals living in low-income settings (concentrated in sub-Saharan Africa) reside within an hour of a city compared to 90.7% of individuals in high-income settings. By further triangulating this map against socioeconomic datasets, we demonstrate how access to urban centres stratifies the economic, educational, and health status of humanity.

Mathematical modelling of the heat resistance of Listeria monocytogenes.

The heat resistance of Listeria monocytogenes phagovar 2389/2425/3274/2671/47/108/340 (1992 French outbreak strain) in broth was studied at 55, 60 and 65 degrees C. Experiments were carried out on bacterial cultures in three different physiological states: cultures at the end of the log phase, cultures heat-shocked at 42 degrees C for 1 h, and subcultures of cells resistant to prolonged heating. Survivor curves were better fitted using a sigmoidal equation than the classical log-linear model. This approach was justified by the existence of heat resistance distributions within the bacterial populations. Peaks (log10 of heating time) of heat resistance distributions of untreated, heat-shocked, and selected cultures at 55, 60 and 65 degrees C were 0.34, -0.90 and -1.84 min, 0.74, -0.51 and -1.24 min, and 0.17, -0.94 and -1.45 min, respectively. The widths of the distributions are proportional to 0.29, 0.36 and 0.41 min0.5, 0.26, 0.36 and 0.41 min0.5, and 0.34, 0.44 and 0.41 min0.5. An increase in the thermal tolerance could then be induced by sublethal heat shock or by selection of heat resistant cells.

Diagnosis of puerperal ovarian vein thrombophlebitis by computed tomography.

A case of puerperal ovarian vein thrombophlebitis diagnosed by computed tomography is presented. Resolution after treatment with antibiotics and anticoagulation is demonstrated. The obstetrician must be aware of the role of computed tomography in making a prompt and accurate diagnosis in such cases.

[Biofeedback of blood pressure information in man: changes in the electroencephalographic power spectrum]. / Biorétro-action de l'information "pression artérielle" chez l'homme: modifications des spectres de puissance de l'électroencéphalogramme.

Modifications of attention in cardiovascular field with the aim of a perceptive activity focused on a vegetative feature may include in man: a specific arousal component linked to significant visual information (blood pressure); an unspecific attention component (P300), obvious in modifications of averaged visual response in the same time to a background unsignificant stimulation.

[Antimicrobial effects of nitrates in meat products]. / Les effets antimicrobiens des nitrites dans les produits carnés.

In a review of the subject, the authors show that nitrite play an important role upon stability and safety of cured meat products. In non heated cured meat, they have a synergistic effect together with pH, NaCl concentration and storage temperature, in such a way that 150 ppm seem to be necessary. Usefullness of nitrite is also advocated in heated systems, though it seems difficult to establish quantitative requirements. In any way, there is a general agreement on the fact that curing without nitrite would enhance food poisoning risks, especially where botulism is concerned.

Lactose intolerance in adults in Senegal. / L'intolérance au lactose chez l'adulte au Sénégal.

The isolated malabsorption of the lactose in the adult is an hereditary feature while is not found often in the white people but is spread out in black Africa. In Senegal, a ratio of about 29% is verified, changing according to the ethnic composition. Only the Peuhls, of semitic origin, show a full tolerance to lactose.

[Radiological techniques for locating intrauterine device (author's transl)]. / Techniques radiologiques de localisation d'un dispositif intra-utérin.

PIP: A radiological method for the localization of intrauterine devices is suggested. The 1st step consists of taking a picture without any preparation, of the pelvic cavity. If there is no IUD is this area, one will obtain a picture of the whole abdomen. If the IUD is located in the pelvis, a traction on the cervix will most often allow to determine the intrauterine location of the device. In some cases, one has to perform a fractionated hysterography. The method gives the most reliable results. It is a very simple procedure which in most cases only necessitates 2 pictures and generally allows to avoid an hysterography. The echotomography is a more sophisticated procedure which generally allows the localization of the IUD. Other techniques include the double contrast hysterography and the pneumo-hysterography; these procedures however are rarely used.^ieng

Genital malignancy in pregnancy.

The clinical problems associated with the presence of genital malignancies occurring during pregnancy are presented. This report represents the clinical experience at one medical institution over a 20 year period. Eighty cases of cervical neoplasm, four cases of ovarian carcinoma, five vulva carcinomas, and one vaginal carcinoma are presented. The diagnostic and therapeutic approaches to malignant neoplasia of each area are discussed separately.

[The normal reaction of sinocarotidian origin in the rabbit]. / La réaction d'éveil d'origine sino-carotidienne chez le lapin

Spontaneous changes of respiratory rate and blood pressure in the slightly anesthetized rabbit, contemporaneous with hippocampal synchronization, might be related with abrupt changes of the alertness. Registration of arousal reaction in hippocampal, thalamic and cortical leads, elicited by Hering nerve stimulation, shows that baro- and chemosensitive afferences may induce activation of areas which are usually involved in conditioning process.

Use of progestational agents in endometrial adenocarcinoma.

PIP: Since 1963 there have been 266 patients with cancer of the uterine fundus at the Medical University of South Carolina. Progestational agents were used to treat 54 but 10 received the drugs for less than 1 month. This report relates to the remaining 44. 34 were treated with Depo-Provera (medroxyprogesterone acetate), 9 with Colprone (megestrone acetate), and 1 with Megace (megestrol acetate). Of the 34 patients treated with Depo-Provera 13 showed regression of the tumor; 3 of the 9 treated with Colprone showed regression. In an additional 11 (25%) of cases growth of the tumors was arrested. 7 of these were later found to have abdominal metastases; however, 3 were free of symptoms for over 43 months. A patient on Depo-Provera with lung metastases had recurrence after 62 months when treatment was reduced to every other week but when Colprone was then given, regression again occurred and has continued for almost 10 years. Another patient not responding to Depo-Provera did respond to Colprone. Average duration of regression was 27.7 months, of survival 31.1 months. Arrest of growth was 25 months in some; survival averaged 23.4 months. (The 1 Megace case was in this group.)y Those having progression of tumors lived an average of 9 months with the longest survival 24 months. Of the responders 8 lived from 44 to 111 months and 5 remain alive, 4 now showing no evidence of the cancer. Tumors with well-differentiated, slow-growing lesions were most likely to respond. Site of recurrence did not seem to influence the response. No contraindications were found to use of progestational agents in this type of cancer. Local reactions to the injections were few. Subjective response was frequent even though progression was taking place.^ieng