A land-use decision approach integrating thermal regulation, stormwater management, and economic benefits based on urbanization stage identification.

Driven by global climate change and urbanization, urban heat island (UHI) and urban storm flood (USF) have become the most frequent and influential hazards in recent decades. Land-use optimization can effectively cope with these hazards. However, the trade-offs between multi-hazard mitigation and economic development impose many limitations in practice. Furthermore, current region-based optimization methods no longer meet the precise management demand, and both subdivision and spatial heterogeneity identification have the potential for wider applicability. Hence, a systematic integration of climate adaptation and urban construction through land-use planning is urgently required. This paper proposes a new land-use decision approach for improving climate adaptability of urbanization. This approach involves multi-objective optimization, spatial subdivision, and urbanization stage identification, which enable the simultaneous achievement of environmental and economic benefits. Taking Xiamen as case study, the results showed that excessive pursuit of land economic output (LEO) limits the chance of mitigating UHI and USF. Improving the LEO per unit area of construction land could disrupt the link between land exploitation and the increasing side effects of climate hazards. Future urbanization hotspots in Xiamen will likely emerge at the urban fringe in Tong'an District and Xiang'an District. Within each developing unit, the upper limit of construction land was 81.06 hm2 and the green space was recommended to be 7.29-21.94 hm2. Construction land and bare land contributed most to UHI and USF, while forest and grassland were highly efficient in heat and runoff mitigation. The developed approach proved to be effective and practicable, especially for reducing the impacts of extreme UHI and USF.

Socioeconomic disparity in the diet quality of pregnant women in Northwest China.

BACKGROUND AND OBJECTIVES: Few studies have described the socioeconomic disparity of dietary quality in Northwest China. The present study aimed to evaluate the diet quality of pregnant women in Shaanxi province of Northwest China by using the Diet Balance Index for Pregnancy (DBI-P) and explored the relationships with socioeconomic status (SES). METHODS AND STUDY DESIGN: A cross-sectional analysis of data from 7,630 women who were pregnant during 2012-2013 was performed. Dietary intake during the whole pregnancy was assessed by FFQ within 12 months (median, 3 months; 10th-90th percentile, 0-7 months) after delivery. Diet quality evaluated by the DBI-P was related to socioeconomic factors. RESULTS: Most women had insufficient consumption of vegetables (72.27%), dairy (89.58%), meat (82.07%), fish and shrimp (92.23%), eggs (62.54%), and dietary variety (97.92%). 67.76% of women had excessive intake of grains, and 87.77% and 69.79% of participants had surplus consumption of edible oil and salt respectively. Women with higher education, occupation and household wealth index (HWI) consumed more vegetables, fruit, dairy, soybean and nuts, meat, fish and shrimp, eggs, edible oil, alcohol and dietary variety but less grains and salt. After adjusting for confounders, education, occupation and HWI were negatively associated with the level of inadequate dietary intake. Conversely, individuals with medium HWI had higher level of excessive dietary intake compared to low HWI groups. CONCLUSIONS: The diet quality of pregnant women in Northwest China was associated with SES. Socioeconomic disparities in diet quality should be considered when planning nutrition interventions for pregnant women.

Socioeconomic inequalities and determinants of maternal health services in Shaanxi Province, Western China.

Prenatal health care interventions are effective ways to improve maternal and neonatal health. There have been few large investigations conducted on the inequalities in maternal health services utilization in Shaanxi Province of west China since the health care reform in 2009. This study examined the inequalities and determinants of maternal health services utilization in Shaanxi Province. A household survey was conducted from August to November in 2013. By using a multistage sampling method, local women aged 15-49 who had given birth in the preceding three years were recruited. Information including social-demographic characteristics and maternal health services utilization was collected through a face-to-face interview. A concentration index approach was used to measure inequalities in maternal health services utilization. A logistic regression model was employed to investigate the determinants of maternal health services utilization. There were 8,488 women from urban areas and 18,724 women from rural areas enrolled in this study. The concentration index for all the indicators of maternal health services utilization showed significance in these two areas. In urban areas, the concentration index of having 5 or more prenatal visits, receiving the first prenatal visit within 12 weeks, delivering at secondary- or higher-level health facilities and delivering by C-section were 0.0356, 0.0166, 0.0177 and 0.0591, respectively, while in rural areas, the corresponding figures were 0.0385, 0.0183, 0.0334 and 0.0566, respectively. The determinants related to maternal health services utilization were women's age at delivery, educational level, employment status, parity, health problems during pregnancy and household income. Inequalities in maternal health services utilization still exist in Shaanxi Province. Providing maternal health services for younger, less educated, unemployed, high parity and poorer women, especially in rural areas, is expected to reduce the inequalities in maternal health services utilization.

Complementary feeding patterns among ethnic groups in rural western China.

OBJECTIVE: This study investigated complementary feeding practices among four ethnic groups (Han, Uygur, Tibetan, and Zhuang) based on a cross-sectional survey in rural western China. METHODS: In 2005, a stratified multistage cluster random sampling method was used to recruit 9712 children (7411 Han, 1032 Uygur, 678 Tibetan, and 591 Zhuang) between 6 and 35 months of age and their mothers from 45 counties in 10 provinces (autonomous regions, municipalities) in western China. RESULTS: The rates of early introduction (before 6 months) of complementary foods in four ethnic groups (Han, Uygur, Tibetan, and Zhuang) were 71.30%, 95.95%, 82.40%, and 72.30%, respectively. The Infant and Child Feeding Index (ICFI) for Uygur and Tibetan children was lower than that for Han children at all age groups. Uygur children were more likely to have unqualified ICFI compared with Han children in a multivariate logistic regression (odds ratio (OR)=5.138, 95% confidence interval (CI): 4.340-6.084). A higher level of maternal education, greater family wealth, and the availability of complementary feeding educational materials decreased the likelihood of an unqualified ICFI. The nutritional status of children (Han, Tibetan, and Zhuang) with qualified ICFI was better than that for children with unqualified ICFI. CONCLUSIONS: Appropriate interventions are required to improve complementary feeding practices in rural western China.

Assessment and modulation of forsythiaside absorption with MDCKII cells and validation with in situ intestinal experiment.

Forsythiaside was characterized by low intestinal absorption by in situ rat experiment and Caco-2 cells. The mechanisms behind this low absorption had not yet been elucidated. The purpose of this study was to investigate the role of efflux transporters in the intestinal absorption of forsythiaside as a potential mechanism for its low small-intestinal absorption following oral administration. Polarized MDCKII cell lines stably transfected with human or murine complementary DNA encoding for various efflux transporters (P-gp/MDR1, MRP2 and Bcrp1) were used to study transepithelial transport of forsythiaside and compare results with the MDCKII-Wild type cells. The transportation inhibitors GF120918, MK571 and Ko143 were used to investigate the transport mechanism. The active transport of forsythiaside was found in MDCKII-WT cells. The MDCKII-MRP2 and MDCKII-Bcrp1 cells significantly increased forsythiaside efflux ratio compared with the parental cells due to the apically directed transport by MRP2 and Bcrp1, respectively. The efflux ratios in MRP2 and Bcrp1 transfected cell lines were greatly decreased in the presence of MK-571 and Ko143, respectively, which indicated that forsythiaside efflux by MRP2 and Bcrp1 were significantly inhibited by their selective inhibitors. MDCKII-MDR1 cells did not exhibit a significant reduction in the forsythiaside efflux compared with the parental cells, indicating that it was not a good substrate for MDR1. And the results were then validated by the in situ experiment. This study presents direct evidence that forsythiaside is effluxed by both MRP2 and Bcrp1, which may contribute to its poor oral bioavailability.