Healthy cities initiative in China: Progress, challenges, and the way forward

Article discusses how China implemented the first phase of its National Healthy Cities pilot program from 2016-20. Authors recommend aligning the Healthy Cities initiative in China with strategic national and global level agendas such as Healthy China 2030 and the Sustainable Development Goals (SDGs) by providing an integrative governance framework to facilitate a coherent intersectoral program to systemically improve population health

Efficacy of Danlou Tablet in Patients with Non-ST Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: Results from a Multicentre, Placebo-Controlled, Randomized Trial

This study seeks to investigate potential cardioprotection of Danlou Tablets in patients undergoing PCI with non-ST elevation acute coronary syndrome (NSTE-ACS). 219 patients with NSTE-ACS were randomised to Danlou Tablet pretreatment (n=109) or placebo (n=110). No patients received statins prior to PCI and all patients were given atorvastatin (10 mg/day) after procedure. The main endpoint was the composite incidence of major adverse cardiac events (MACEs) within 30 days after PCI. The proportion of patients with elevated levels of cTn I>5 × 99% of upper reference limit was significantly lower in the Danlou Tablet group at 8 h (22.0% versus 34.5%, p=0.04) and 24 h (23.9% versus 38.2%, p=0.02) after PCI. The 30-day MACEs occurred in 22.0% of the Danlou Tablet group and 33.6% in the placebo group (p=0.06). The incidence of MACE at 90-day follow-up was significantly decreased in the Danlou Tablet group compared to the placebo group (23.9% versus 37.3%, p=0.03). The difference between the groups at 90 days was the incidence of nonfatal myocardial infarction (22% versus 34.5%, p=0.04). These findings might support that treatment with Danlou Tablet could reduce the incidence of periprocedural myocardial infarction in patients with ACS undergoing PCI

Randomized, Double-Blinded, Multicenter, Placebo-Controlled Trial of Shenfu Injection for Treatment of Patients with Chronic Heart Failure during the Acute Phase of Symptom Aggravation (Yang and Qi Deficiency Syndrome)

Background. Shenfu injection (SFI) has shown a remarkable therapeutic effect in patients with chronic heart failure (CHF) during the acute phase of symptom aggravation since it became commercially available in 1987. However, the therapeutic effect of SFI has not been validated in a standard clinical study. As a pilot clinical trial, this study aimed to evaluate the safety and efficacy of SFI for treatment of CHF patients during the acute phase. Methods. A total of 160 patients experiencing acute phase CHF were enrolled in this study and randomly assigned to receive the placebo (placebo group, 150 ml glucose (GS)) or SFI (SFI group, 50 ml SFI + 100 ml GS) in addition to their standard medications for CHF treatment. The treatment lasted for 7 ± 1 days, and the follow-up continued for 28 ± 3 days after treatment. The primary endpoints were New York Heart Association (NYHA) classification and Traditional Chinese Medicine (TCM) syndrome scores. Results. After 7±1 days of treatment, the efficacy of SFI according to improvements in NYHA and TCM syndrome scores in the SFI group (78.38% and 89.19%, respectively) was significantly higher than that in the placebo group (61.43% and 60.00%, respectively; P<0.05). The SFI group had a longer increase in amplitude than the placebo group (113.00 m versus 82.99 m, P<0.05). The incidence of adverse events and other safety indices showed no significant differences between the two groups. Conclusion. SFI combined with conventional therapy for treatment of CHF during acute symptom aggravation ameliorated the cardiac dysfunction and clinical symptoms and improved the patients’ quality of life without any significant AEs compared with the conventional therapy alone

Mapping global urban boundaries from the global artificial impervious area (GAIA) data

Urban boundaries, an essential property of cities, are widely used in many urban studies. However, extracting urban boundaries from satellite images is still a great challenge, especially at a global scale and a fine resolution. In this study, we developed an automatic delineation framework to generate a multi-temporal dataset of global urban boundaries (GUB) using 30 m global artificial impervious area (GAIA) data. First, we delineated an initial urban boundary by filling inner non-urban areas of each city. A kernel density estimation approach and cellular-automata based urban growth modeling were jointly used in this step. Second, we improved the initial urban boundaries around urban fringe areas, using a morphological approach by dilating and eroding the derived urban extent. We implemented this delineation on the Google Earth Engine platform and generated a 30 m resolution global urban boundary dataset in seven representative years (i.e. 1990, 1995, 2000, 2005, 2010, 2015, and 2018). Our extracted urban boundaries show a good agreement with results derived from nighttime light data and human interpretation, and they can well delineate the urban extent of cities when compared with high-resolution Google Earth images. The total area of 65 582 GUBs, each of which exceeds 1 km ^2 , is 809 664 km ^2 in 2018. The impervious surface areas account for approximately 60% of the total. From 1990 to 2018, the proportion of impervious areas in delineated boundaries increased from 53% to 60%, suggesting a compact urban growth over the past decades. We found that the United States has the highest per capita urban area (i.e. more than 900 m ^2 ) among the top 10 most urbanized nations in 2018. This dataset provides a physical boundary of urban areas that can be used to study the impact of urbanization on food security, biodiversity, climate change, and urban health. The GUB dataset can be accessed from http://data.ess.tsinghua.edu.cn