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Regional assessment of urban impacts on landcover and open space finds a smart urban growth policy performs little better than business as usual.

ABSTRACT: Assessment of landscape change is critical for attainment of regional sustainability goals. Urban growth assessments are needed because over half the global population now lives in cities, which impact biodiversity, ecosystem structure and ecological processes. Open space protection is needed to preserve these attributes, and provide the resources humans need. The San Francisco Bay Area, California, is challenged to accommodate a population increase of 3.07 million while maintaining the region's ecosystems and biodiversity. Our analysis of 9275 km² in the Bay Area links historic trends for three measures: urban growth, protected open space, and landcover types over the last 70 years to future 2050 projections of urban growth and open space. Protected open space totaled 348 km² (3.7% of the area) in 1940, and expanded to 2221 km² (20.2%) currently. An additional 1038 km² of protected open space is targeted (35.1%). Urban area historically increased from 396.5 km² to 2239 km² (24.1% of the area). Urban growth during this time mostly occurred at the expense of agricultural landscapes (62.9%) rather than natural vegetation. Smart Growth development has been advanced as a preferred alternative in many planning circles, but we found that it conserved only marginally more open space than Business-as-usual when using an urban growth model to portray policies for future urban growth. Scenarios to 2050 suggest urban development on non-urban lands of 1091, 956, or 179 km², under Business-as-usual, Smart Growth and Infill policy growth scenarios, respectively. The Smart Growth policy converts 88% of natural lands and agriculture used by Business-as-usual, while Infill used only 40% of those lands. Given the historic rate of urban growth, 0.25%/year, and limited space available, the Infill scenario is recommended. While the data may differ, the use of an historic and future framework to track these three variables can be easily applied to other metropolitan areas.

SUBMITTER: Thorne JH

PROVIDER: S-EPMC3673918 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundPeripheral arterial disease (PAD) is a common and highly morbid disease. Although there have been recent advancements in the endovascular modalities to treat PAD, comparisons of these strategies, especially in the popliteal region, remain underinvestigated. The objective of this study was to compare midterm outcomes in patients with PAD undergoing treatment with both novel and SS compared with drug-coated balloon (DCB) angioplasty.MethodsAll patients at a multi-institution health system treated for PAD in the popliteal region from 2011 to 2019 were identified. Presenting features, operative details, and outcomes were included in the analysis. Patients who underwent popliteal revascularization with stents were compared with DCB. SS were compared separately with novel dedicated stents. Two-year primary patency was the primary outcome.ResultsWe included 408 patients (72.7 ± 11.8 years old; 57.1% men) in the analysis. There were 221 (54.7%) patients who underwent popliteal stenting and 187 (45.3%) who underwent popliteal DCB. There were high rates of tissue loss in both groups (57.9% vs 50.8%; P = .14). Stented patients had longer lesions (112.4 ± 3.2 vs 100.2 ± 5.8 mm; P = .03) and higher rates of concomitant superficial femoral artery treatment (88.2% vs 39.6%; P < .01). Chronic total occlusions accounted for the majority of lesions treated (stent 62.4%, DCB 64.2%). Perioperative complications were similar between groups. Primary patency for the stented group was higher at two years than the DCB group (61.0% vs 46.1%; P = .03). When evaluating stented patients only, SS had higher 2-year patency than novel stents in the popliteal segment (69.6% vs 51.4%; P = .04). On multivariable analysis, stenosis, as opposed to chronic total occlusion, was associated with improved patency (hazard ratio, 0.49; 95% confidence interval, 0.25-0.96; P = .04), whereas novel stents were associated with worse primary patency (hazard ratio, 2.01; 95% confidence interval, 1.09-3.73; P = .03).ConclusionsIn a population of patients with severe vascular disease, stents do not have inferior patency and limb salvage rates compared with DCB angioplasty when treating the popliteal region. For patients with advanced vascular disease, and especially tissue loss, stents and DCB are both beneficial when treating popliteal lesions.

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Regional assessment of urban impacts on landcover and open space finds a smart urban growth policy performs little better than business as usual.

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