Exploring the high-resolution mapping of gender-disaggregated development indicators.

Improved understanding of geographical variation and inequity in health status, wealth and access to resources within countries is increasingly being recognized as central to meeting development goals. Development and health indicators assessed at national or subnational scale can often conceal important inequities, with the rural poor often least well represented. The ability to target limited resources is fundamental, especially in an international context where funding for health and development comes under pressure. This has recently prompted the exploration of the potential of spatial interpolation methods based on geolocated clusters from national household survey data for the high-resolution mapping of features such as population age structures, vaccination coverage and access to sanitation. It remains unclear, however, how predictable these different factors are across different settings, variables and between demographic groups. Here we test the accuracy of spatial interpolation methods in producing gender-disaggregated high-resolution maps of the rates of literacy, stunting and the use of modern contraceptive methods from a combination of geolocated demographic and health surveys cluster data and geospatial covariates. Bayesian geostatistical and machine learning modelling methods were tested across four low-income countries and varying gridded environmental and socio-economic covariate datasets to build 1×1 km spatial resolution maps with uncertainty estimates. Results show the potential of the approach in producing high-resolution maps of key gender-disaggregated socio-economic indicators, with explained variance through cross-validation being as high as 74-75% for female literacy in Nigeria and Kenya, and in the 50-70% range for many other variables. However, substantial variations by both country and variable were seen, with many variables showing poor mapping accuracies in the range of 2-30% explained variance using both geostatistical and machine learning approaches. The analyses offer a robust basis for the construction of timely maps with levels of detail that support geographically stratified decision-making and the monitoring of progress towards development goals. However, the great variability in results between countries and variables highlights the challenges in applying these interpolation methods universally across multiple countries, and the importance of validation and quantifying uncertainty if this is undertaken.

Inspissated bile within the common bile duct simulating cholangiocarcinoma. Case report.

There are a variety of abnormalities that can lead to obstruction of the common bile duct, several of which also can cause dilatation and duct irregularity. The differential diagnosis includes such entities as cholangiocarcinoma and carcinoma of the pancreas invading the common bile duct. We present an unusual case in which inspissated bile caused irregularity and obstruction of the common bile duct that radiographically simulated a cholangiocarcinoma.

Intimal fibromuscular dysplasia and Takayasu arteritis: delayed response to percutaneous transluminal renal angioplasty.

Percutaneous transluminal renal angioplasty has been shown to be an effective technique to dilate renal artery lesions, particularly those due to fibromuscular dysplasia. However, four of 70 patients in this study experienced atypical responses to angioplasty. Their lesions initially resisted dilation and had incomplete dilatation immediately after angioplasty. Long-term follow-up (1 week to 2 years) angiograms, however, demonstrated fully dilated arteries. In cases of focal nonatherosclerotic lesions from intimal or adventitial fibroplasia, initial incomplete dilatation may be satisfactory in the long term whereas repeated inflations may result in undesirable complications.

Antegrade catheterization of the superficial femoral artery.

A simple method of selective catheterization of the superficial femoral artery (SFA) following antegrade puncture of the common femoral artery is described. The method entails using a Cope-type dilator introducer, which directs the guide wire from its side hole into the SFA while the tip is secured in the deep femoral artery.