Understanding the impacts of urbanization requires accurate and updatable urban extent maps. Here we present an algorithm for mapping urban extent at global scale using Landsat data. An innovative hierarchical object-based texture (HOTex) classification approach was designed to overcome spectral confusion between urban and nonurban land cover types. VIIRS nightlights data and MODIS vegetation index datasets are integrated as high-level features under an object-based framework. We applied the HOTex method to the GLS-2010 Landsat images to produce a global map of human built-up and settlement extent. As shown by visual assessments, our method could effectively map urban extent and generate consistent results using images with inconsistent acquisition time and vegetation phenology. Using scene-level cross validation for results in Europe, we assessed the performance of HOTex and achieved a kappa coefficient of 0.91, compared to 0.74 from a baseline method using per-pixel classification using spectral information.

Understanding and monitoring the environmental impacts of global urbanization requires better urban datasets. Continuous field impervious surface change (ISC) mapping using Landsat data is an effective way to quantify spatiotemporal dynamics of urbanization. It is well acknowledged that Landsat-based estimation of impervious surface is subject to seasonal and phenological variations. The overall goal of this paper is to map 2000-2010 ISC for India using Global Land Survey datasets and training data only available for 2010. To this end, a method was developed that could transfer the regression tree model developed for mapping 2010 impervious surface to 2000 using an iterative training and prediction (ITP) approachAn independent validation dataset was also developed using Google Earth™ imagery. Based on the reference ISC from the validation dataset, the RMSE of predicted ISC was estimated to be 18.4%. At 95% confidence, the total estimated ISC for India between 2000 and 2010 is 2274.62 ± 7.84 km 2 .

Background Several stroke outcome and quality control projects have demonstrated the success in stroke care quality improvement through structured process. However, Chinese health-care systems are challenged with its overwhelming numbers of patients, limited resources, and large regional disparities. Aim To improve quality of stroke care to address regional disparities through process improvement. Method and design The Shanghai Stroke Service System (4S) is established as a regional network for stroke care quality improvement in the Shanghai metropolitan area. The 4S registry uses a web-based database that automatically extracts data from structured electronic medical records. Site-specific education and training program will be designed and administrated according to their baseline characteristics. Both acute reperfusion therapies including thrombectomy and thrombolysis in the acute phase and subsequent care were measured and monitored with feedback. Primary outcome is to evaluate the differences in quality metrics between baseline characteristics (including rate of thrombolysis in acute stroke and key performance indicators in secondary prevention) and post-intervention. Conclusions The 4S system is a regional stroke network that monitors the ongoing stroke care quality in Shanghai. This project will provide the opportunity to evaluate the spectrum of acute stroke care and design quality improvement processes for better stroke care. A regional stroke network model for quality improvement will be explored and might be expanded to other large cities in China. Clinical Trial Registration-URL http://www.clinicaltrials.gov . Unique identifier: NCT02735226.

Armed conflict and geopolitics are a driving force of Land Use and Land Cover Change (LULCC), but with considerable variation in deforestation trends between broader and finer scales of analysis. Remotely-sensed annual deforestation rates from 1989 to 2018 are presented at the national and (sub-) regional scales for Kachin State in the north of Myanmar and in Kayin State and Tanintharyi Region in the southeast. We pair our multiscaled remote sensing analysis with our multisited political ecology approach where we conducted field-based interviews in study sites between 2018 and 2020. Our integrated analysis identified three common periods of deforestation spikes at the national and state/region level, but with some notable disparities between regions as well as across and within townships and village tracts. We found the rate and geography of deforestation were most influenced by the territorial jurisdictions of armed authorities, national political economic reforms and timber regulations, and proximity to national borders and their respective geopolitical relations. The absence or presence of ceasefires in the north and southeast did not solely explain deforestation patterns. Rather than consider ceasefire or war as a singular explanatory variable effecting forest cover change, we demonstrate the need to analyze armed conflict as a dynamic multisited and diffuse phenomenon, which is simultaneously integrated into broader political economy and geopolitical forces.

This study aimed to analyze the changes in the 10 major categories of women’s healthcare services (WHSs) in Shanghai (SH) and New York City (NYC) from 1978 to 2017, and examine the relationship between these changes and maternal mortality ratio (MMR). Content analysis of available public policy documents concerning women’s health was conducted. Two indicators were designed to represent the delivery of WHSs: The essential women’s healthcare service coverage rate (ESCR) and the assessable essential healthcare service coverage rate (AESCR). Spearman correlation was used to analyze the relationship between the two indicators and MMR. In SH, the ESCR increased from 10% to 90%, AESCR increased from 0% to 90%, and MMR decreased from 24.0/100,000 to 1.01/100,000. In NYC, the ESCR increased from 0% to 80%, the AESCR increased from 0% to 60%, and the MMR decreased from 24.7/100,000 to 21.4/100,000. The MMR significantly decreased as both indicators increased (p < 0.01). Major advances have been made in women’s healthcare in both cities, with SH having a better improvement effect. A common shortcoming for both was the lack of menopausal health service provision. The promotion of women’s health still needs to receive continuous attention from governments of SH and NYC. The experiences of the two cities showed that placing WHSs among policy priorities is effective in improving service status.