International audienceIn literature on neighbourhood effects and on resources accessibility, number of neighbourhood resources to which residents may have access are often estimated from spatial units whose constant size fails to account for unique ways residents experience their neighbourhoods. To investigate this "constant size neighbourhood trap", we compared numbers of health-care resources included in Constant Size Buffers (CSBs) and in Perceived Neighbourhood Polygons (PNPs) from cognitive neighbourhood data collected among 653 residents of the Paris metropolitan area,. We observed that residents of deprived and peripheral areas had smaller PNPs than their counterparts. Studying residents assessments of the quantity of neighbourhood practitioners, we then assessed the validity of using PNPs rather than CSBs to estimate number of neighbourhood resources. Lastly, resource inequalities across the Paris metropolitan area were found to be far wider when considering PNPs rather than CSBs. Using constant neighbourhood delineation can lead to inaccurately measure individual accessibility to neighbourhood resources and to downplay the extent of inequalities in urban resources

While social scientists have invested a lot of energy in exploring the uneven distribution of social groups in the city, they have surprisingly limited their efforts to investigating social segregation at the place of residence. The present paper investigates social segregation over the 24 hours a day in the Paris region, taking into account how social groups move within a city throughout the day. From a large and precise daily travel survey carried out in the Paris region (EGT 2010) among 25,500 respondents aged 16 or over, we have computed segregation indices and maps hour by hour from respondents' educational and socioprofessional indicators. We then observed that social segregation within the Paris region decreases during the day and that the most segregated group (the upper class group) during the night remains the most segregated during the day. We also explored how the co-presence between various social groups evolves throughout the day. Finally, we highlighted some large variations in districts' social composition over 24 hours: districts with similar social composition during the night can differ deeply in their social composition during the daytime because of socially selective daily trips. Exploring social segregation around the clock helps in considering more dynamically place effects on individual behavior and targeting areas to implement interventions more connected with the real city rhythm.

Distribution électronique Cairn.info pour Ined Éditions. © Ined Éditions. Tous droits réservés pour tous pays.La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit.

The results suggests that the difficulty of laparoscopic liver surgery is not fully assessed by the available difficulty scoring systems and prompts the development of a new difficulty score that incorporates all factors believed to increase difficulty.

IV, retrospective cohort study.

Traditional measures of spatial accessibility overlook neighbourhood experiences.  Social gradient in resource accessibility vary with neighbourhood definition.  Half-mile buffers mask social variations observed in neighbourhood experiences.  Self-defined neighbourhoods are larger for higher social groups.

Background: Systemic chemotherapy is the treatment of choice for inoperable (advanced or metastatic) cholangiocarcinoma. According to phase II and III trials, regimens combining 5-fluorouracil (5FU) or gemcitabine with a platinum salt have provided an overall response rate of 12–50% with a median overall survival of 5–16 months. Methods: This was a retrospective analysis of 78 consecutive cases of inoperable cholangiocarcinoma treated by palliative chemotherapy from July 2005 to November 2009 in one center. We firstly aimed to evaluate the impact of palliative chemotherapy in terms of survival and secondly to analyze possible related prognostic factors. Results: This cohort included 25 female and 53 male patients, with a mean age of 60.8 ± 11.4 years. Intrahepatic and extrahepatic cholangiocarcinoma were observed in 57 and 21 patients, respectively. First-line chemotherapy regimens were as follows: gemcitabine (n = 7), gemcitabine plus oxaliplatin (with or without cetuximab; n = 62) and 5FU plus cisplatin (n = 9). None of the patients achieved a complete response. The partial response rate was 35.9% (27/78), and the stable disease rate was 26.9% (21/78), giving a disease control rate of 62.8%. At the time of this analysis, with a median follow-up of 18 months, 13 patients were survivors. Median overall survival was 10 months [95% confidence interval (CI) 7–12], and median progression-free survival was 7 months (95% CI 6–8). Upon univariate analysis, only the distribution of the disease was significantly linked with prognosis, with a median overall survival of 10 months (95% CI 10–24) for solitary tumors versus 7 months (95% CI 6–11) in the case of infiltrative or multifocal tumors (p = 0.039). Conclusion: The disease control rate, overall survival and progression free-survival in this single-center retrospective study were in agreement with earlier reports. Specific features of this cohort were a large proportion of cholangiocarcinoma with associated cirrhosis (n = 30/78, 38.5%), mostly intrahepatic (n = 25/30, 83.5%). This confirms the increasing incidence of intrahepatic localization and the epidemiological link recently reported between intrahepatic biliary tract carcinoma and cirrhosis.

No abstract