Background and objectivesSeveral clinical practice guidelines noted the potential benefits of urate-lowering therapy on cardiovascular disease and CKD progression; however, the effect of this regimen remains uncertain. In this systematic review, we aimed to evaluate the efficacy of urate-lowering therapy on major adverse cardiovascular events, all-cause mortality, kidney failure events, BP, and GFR.Design, setting, participants, & measurementsWe systematically searched MEDLINE, Embase, and the Cochrane databases for trials published through July 2020. We included prospective, randomized, controlled trials assessing the effects of urate-lowering therapy for at least 6 months on cardiovascular or kidney outcomes. Relevant information was extracted into a spreadsheet by two authors independently. Treatment effects were summarized using random effects meta-analysis.ResultsWe identified 28 trials including a total of 6458 participants with 506 major adverse cardiovascular events and 266 kidney failure events. Overall urate-lowering therapy did not show benefits on major adverse cardiovascular events (risk ratio, 0.93; 95% confidence interval, 0.74 to 1.18) and all-cause mortality (risk ratio, 1.04; 95% confidence interval, 0.78 to 1.39) or kidney failure (risk ratio, 0.97; 95% confidence interval, 0.61 to 1.54). Nevertheless, urate-lowering therapy attenuated the decline in the slope of GFR (weighted mean difference, 1.18 ml/min per 1.73 m2 per year; 95% confidence interval, 0.44 to 1.91) and lowered the mean BP (systolic BP: weighted mean difference, −3.45 mm Hg; 95% confidence interval, −6.10 to −0.80; diastolic BP: weighted mean difference, −2.02 mm Hg; 95% confidence interval, −3.25 to −0.78). There was no significant difference (risk ratio, 1.01; 95% confidence interval, 0.94 to 1.08) in the risk of adverse events between the participants receiving urate-lowering therapy and the control group.ConclusionsUrate-lowering therapy did not produce benefits on the clinical outcomes, including major adverse cardiovascular events, all-cause mortality, and kidney failure. Thus, there is insufficient evidence to support urate lowering in patients to improve kidney and cardiovascular outcomes.

Abstract:Object-based change detection (OBCD) has recently been receiving increasing attention as a result of rapid improvements in the resolution of remote sensing data. However, some OBCD issues relating to the segmentation of high-resolution images remain to be explored. For example, segmentation units derived using different segmentation strategies, segmentation scales, feature space, and change detection methods have rarely been assessed. In this study, we have tested four common unsupervised change detection methods using different segmentation strategies and a series of segmentation scale parameters on two WorldView-2 images of urban areas. We have also evaluated the effect of adding extra textural and Normalized Difference Vegetation Index (NDVI) information instead of using only spectral information. Our results indicated that change detection methods performed better at a medium scale than at a fine scale where close to the pixel size. Multivariate Alteration Detection (MAD) always outperformed the other methods tested, at the same confidence level. The overall accuracy appeared to benefit from using a two-date segmentation strategy rather than single-date segmentation. Adding textural and NDVI information appeared to reduce detection accuracy, but the magnitude of this reduction was not consistent across the different unsupervised methods and segmentation strategies. We conclude that a two-date segmentation strategy is useful for change detection in high-resolution imagery, but that the optimization of thresholds is critical for unsupervised change detection methods. Advanced methods need be explored that can take advantage of additional textural or other parameters.

This study aims to support sustainable urban and environmental planning by using urban growth simulation models, in which environmental quality is employed as one of the inputs. We proposed an extended SLEUTH urban growth model (UGM) for the regions threatened by environmental quality degradation caused by uncontrolled urban expansion. In this model, habitat quality is assessed by the InVEST model and is used to represent environmental quality, which is utilized in urban growth simulation. The habitat quality map is used to replace the slope layer as input for the SLEUTH model's urban growth simulation for cities where relatively flat topography makes this layer of minimal explanatory value. The extended SLEUTH UGM was calibrated using data for Changzhou city, China in 1990, 2000, 2010, and 2014. The best value of the Optimal SLEUTH Metric (OSM) was calculated for both the standard SLEUTH UGM and the extended SLEUTH UGM independently. The OSM value for the latter model was much higher than that of the former model, which indicated that the extended model provided a better explanation of urban growth in the study area. The calibrated extended SLEUTH UGM was applied to predict growth in Changzhou city from 2014 to 2030. The result showed that the urban area is expected to expand about 626 km by 2030. Comparison with the prediction result by using standard SLEUTH UGM showed that the area with high habitat quality could be reserved and the urban expansion could be limited by using our model. The findings demonstrate that the extended SLEUTH UGM could be a valuable tool for sustainable urban and environmental planning and management in developing regions where environmental protection should be considered as one of the major land-use objectives in their rapid urbanization process.

This synopsis was not peer reviewed.Since China initiated economic reforms and an open-door policy in 1978, rural China has made remarkable achievements during the past three decades. The GDP of rural China increased from 2.8 trillion yuan (1 U.S. dollar = 6.7 yuan) in 1996 to 8.8 trillion yuan in 2008, with the annual growth rate at around 10%, and the average annual income per capita in rural China reached 4,761 yuan in 2008, with the growth rate of 8%. However, there are still many biophysical, socio-economic, and political problems or constraints that need to be solved or taken into account for sustainable development in rural China. Among them, rural land issue has always been a concern of the Chinese government and people (Long et al. 2010). RURAL CHINA LAND-USE ISSUESA shortage of cultivated land resources is the most significant challenge facing rural China's development and the drastic loss of valuable cultivated land has caught the attention of the central government (Lin and Ho 2003). Concomitant to the annual GDP growth averaged at about 10% during the past three decades, China's cultivated land has been decreasing continuously. According to statistical data released by the Ministry of Land and Resources of China (MLRC), total cultivated land decreased approximately by 8.35 million ha between 1996 and 2008. It is widely accepted by many researchers that when cultivated land per capita is less than 0.17 ha, food security will be threatened. However, China's per capita cultivated land in 2008 was a mere 0.09 ha, which was lower than the world average of 0.236 ha by more than 50%. Urban-related industrialization is well known to be one of the most important driving forces of the decreasing cultivated land (Xu 2004).The fragmentation of cultivated land can be observed due to construction on land of the country, which often results in problems of increased labor time, land loss, restrictions to irrigation access, and such operational difficulties as those associated with pest control and land supervision. In addition, intensive agriculture, and the overuse of fertilizer and pesticide has resulted in serious environmental problems such as water pollution, degradation of soil quality, and a decrease in the number of wild animals and plants. The environmental impact of cultivated land changes will threaten the sustainability of food production. Studies have shown that food production capacity has continuously been reduced by the degradation of land quality (Yang and Li 2000).While most attention has been paid to cultivated land in China, few people have noticed the changes in rural settlement. In fact, rural settlements are most representative to depict China's rural development. Between 1996 and 2008, the rural population decreased by approximately 129 million, while the increment of the rural settlements was 100,000 ha, and the rural settlement per capita increased from 193 to 230 m 2 . This accounted for 51.84% of China's total construction land in 2008. These new increased rural settlements have two char...