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26 pages, 8630 KB  
Article
Experimental Evaluation and Performance Analysis of 5G NSA Networks
by Vasileios D. Batsios, Spiridoula V. Margariti, Constantinos T. Angelis and Eleftherios Stergiou
Future Internet 2026, 18(6), 320; https://doi.org/10.3390/fi18060320 - 12 Jun 2026
Viewed by 184
Abstract
5G technology was introduced in 2019 with the aim of transforming digital connectivity, enabling a new generation of communication capabilities, such as significantly faster mobile broadband, highly reliable low-latency links, and the capacity to support vast IoT deployments. However, the expected improvements promised [...] Read more.
5G technology was introduced in 2019 with the aim of transforming digital connectivity, enabling a new generation of communication capabilities, such as significantly faster mobile broadband, highly reliable low-latency links, and the capacity to support vast IoT deployments. However, the expected improvements promised by 5G technology do not seem to be reflected in actual usage. This study aims to address the issue of the real-world usage of 5G telecommunications networks and compare it with the theoretical specifications of the network as officially published by 3GPP. Specifically, the focus will be on the evaluation of the implementation of the 5G network in northwestern Greece, which operates in Non-Standalone (NSA) mode as of the date of this study’s completion. 5G Standalone (SA) networks were not available for public testing in this region during the data collection period. The analysis focuses on key performance indicators, including throughput, latency, stability, and coverage, to assess how effectively current deployments meet the expectations set by 5G standards. Results show that while 5G delivers notable improvements in peak data rates and latency, several practical limitations persist. NSA deployments remain constrained by their dependence on 4G infrastructure, resource sharing between LTE and 5G components affects performance under high-load conditions, and inconsistent coverage leads to significant variability in user experience. These findings highlight the gap between theoretical capabilities and operational performance, offering insights that can guide future network optimization and inform the transition toward 5G Standalone (SA) architectures. Full article
(This article belongs to the Special Issue 5G/6G and Beyond: The Future of Wireless Communications Systems)
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37 pages, 5047 KB  
Article
Digital Infrastructure, Green Total Factor Productivity, and Sustainable Development in the Yangtze River Economic Belt: Evidence from the Broadband China Pilot Policy
by Zihan Zhou, Dong Feiran and Yanwei Hao
Sustainability 2026, 18(12), 5974; https://doi.org/10.3390/su18125974 - 11 Jun 2026
Viewed by 75
Abstract
This study examines whether digital infrastructure contributes to sustainable development by improving green total factor productivity (GTFP)—a comprehensive measure that jointly evaluates economic output and environmental performance—in the Yangtze River Economic Belt. We exploit the staggered implementation of the “Broadband China” pilot policy [...] Read more.
This study examines whether digital infrastructure contributes to sustainable development by improving green total factor productivity (GTFP)—a comprehensive measure that jointly evaluates economic output and environmental performance—in the Yangtze River Economic Belt. We exploit the staggered implementation of the “Broadband China” pilot policy as a quasi-natural experiment and estimate its effects using panel data for 107 prefecture-level cities from 2010 to 2022. The empirical strategy combines a staggered difference-in-differences design with an event study framework. The baseline results show that the average treatment effect for the full sample is positive but not statistically significant at conventional levels under standard TWFE estimation; however, the Sun–Abraham interaction-weighted estimator confirms a significant positive effect (ATT = 0.080, p < 0.05), and the Goodman-Bacon decomposition shows that the TWFE estimate is driven primarily by clean comparisons (91% weight, 0% negative weights). Further analysis reveals substantial regional heterogeneity. The estimated effect is significantly positive in the central region (0.171, p < 0.05), positive but not significant in the eastern region (0.097), and negligible in the western region (−0.042). A similar pattern emerges across income groups: digital infrastructure generates significant gains in GTFP in high- and middle-income cities, whereas the effect is not identifiable in low-income cities. These results remain robust to propensity score matching, placebo tests, alternative specifications, and alternative measures. Exploratory mechanism analysis provides limited evidence that technological innovation and industrial upgrading mediate the effect of digital infrastructure on GTFP within the sample period, though the causal interpretation of mediation is constrained by the sequential ignorability assumption. The findings suggest that the environmental returns to digital infrastructure depend on local complementary conditions, especially human capital, institutional capacity, and industrial foundations. These results imply that digital infrastructure policy should be differentiated across regions rather than implemented uniformly. By demonstrating that the environmental returns to digital infrastructure are conditional on local complementary conditions, this study contributes to the sustainability literature by providing a framework for quantifying and monitoring the sustainability impacts of digital infrastructure policies, with implications for sustainable development strategies in developing economies. Full article
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32 pages, 2087 KB  
Article
Digital Infrastructure and Green Innovation for Urban Sustainability: Evidence from the Perspective of Innovation Structure
by Yichen Dai and Zhaojuan Meng
Sustainability 2026, 18(11), 5546; https://doi.org/10.3390/su18115546 - 1 Jun 2026
Viewed by 158
Abstract
Digital infrastructure is increasingly regarded as a key enabler of economic modernization and urban sustainability, but its sustainability implications depend on whether digitalization guides innovation activities toward greener technological directions. Against the backdrop of China’s “dual carbon” goals and the deepening of low-carbon [...] Read more.
Digital infrastructure is increasingly regarded as a key enabler of economic modernization and urban sustainability, but its sustainability implications depend on whether digitalization guides innovation activities toward greener technological directions. Against the backdrop of China’s “dual carbon” goals and the deepening of low-carbon transformation, this study examines the relationship between digital infrastructure development and the green orientation of urban innovation from the perspective of innovation structure. Using panel data for 284 prefecture-level cities in China from 2011 to 2023, we measure the share of green innovation by the proportion of green invention patents in total granted patents, and use broadband Internet access users per 100 residents, denoted as InternetRate, as a proxy for digital infrastructure development. A two-way fixed effects model is employed to investigate the empirical relationship between the two. The results show that digital infrastructure development is significantly negatively associated with the relative share of green innovation within total innovation. This finding remains robust to alternative functional-form specifications, extreme-value treatment, alternative measures of digital infrastructure, and alternative measures of green innovation structure, and remains directionally consistent in a supplementary instrumental-variable test. Decomposition of scale effects indicates that this negative association reflects the relatively faster expansion of non-green innovation rather than an absolute contraction in green innovation, suggesting a structural reallocation pattern within urban innovation activities. Heterogeneity analysis shows that the negative association is mainly concentrated in cities with lower levels of economic development and higher text-based environmental governance attention, and is more pronounced in cities with a lower degree of industrial servitization. Moderation analysis further shows that this negative association becomes weaker in cities with stronger local green fiscal support. Spatial analysis indicates that the share of green innovation exhibits significant spatial dependence; however, the association between digital infrastructure development and innovation structure is mainly localized, with no significant spatial spillover detected. These findings contribute to sustainability research by showing that digital infrastructure does not automatically improve the green composition of innovation and that sustainable digital transformation requires complementary green fiscal support, environmental governance, and industrial upgrading policies. Full article
(This article belongs to the Section Economic and Business Aspects of Sustainability)
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32 pages, 3147 KB  
Article
Bridging the Map, Widening the Gap: Digital Infrastructure and Income Inequality
by Huangxin Chen, Li Lin, Zenghui Li, Yi Shi and Su Lin
Systems 2026, 14(6), 625; https://doi.org/10.3390/systems14060625 - 1 Jun 2026
Viewed by 229
Abstract
Income inequality remains a central impediment to inclusive growth, yet whether government-led digital infrastructure programs mitigate or exacerbate distributional disparities is empirically contested. Exploiting the staggered rollout of China’s “Broadband China” (BBC) demonstration cities as a quasi-natural experiment, this study employs a multi-period [...] Read more.
Income inequality remains a central impediment to inclusive growth, yet whether government-led digital infrastructure programs mitigate or exacerbate distributional disparities is empirically contested. Exploiting the staggered rollout of China’s “Broadband China” (BBC) demonstration cities as a quasi-natural experiment, this study employs a multi-period difference-in-differences (DID) framework on a panel of 281 prefecture-level cities spanning 2009–2022 to estimate the designation effects of national digital infrastructure policy under the DID identifying assumptions. After parallel-trends validation, permutation-based placebo tests, and propensity score matching, the baseline estimates indicate a dual distributional pattern: BBC designation is associated with a wider urban-rural income gap and lower within-prefecture nighttime-light-based spatial income inequality. Candidate-channel analysis provides evidence consistent with financial deepening and factor mobility as plausible pathways: expanded financial coverage and cross-regional labor reallocation are associated with spatial convergence, whereas asymmetric usage depth and selective labor mobility reinforce urban-rural divergence. Exploratory heterogeneity analysis across four institutional dimensions, officials’ political promotion incentives, local fiscal capacity, traditional infrastructure endowments, and urban hierarchy, further shows that this distributional pattern varies across local contexts. Furthermore, this study extends the analytical lens to the spatial dimension by employing a spatial DID framework. The results identify significant cross-border externalities characterized by cross-prefecture spillovers associated with lower within-prefecture nighttime-light-based spatial income inequality in neighboring cities. These findings provide an integrated policy-evaluation framework that disentangles the complex, multidimensional distributional consequences of digital infrastructure investment, offering actionable insights for designing more equitable digital public policies in developing economies. Full article
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36 pages, 2295 KB  
Review
The Evolution of FTTH Networks in Europe and South Korea—Regulatory Power
by Jorge Duarte, Carlos Serôdio, Sílvia de Castro Pereira, Fernando Santos, António Valente, Sérgio Ramos and Sérgio Leitão
Telecom 2026, 7(3), 59; https://doi.org/10.3390/telecom7030059 - 26 May 2026
Viewed by 347
Abstract
Regulations of next-generation networks (NGNs) have played a central role in the transition from copper networks to broadband networks in Fiber to The Home (FTTH), also allowing for a reduction in asymmetries between incumbent operators and their competitors. Despite common European Union directives, [...] Read more.
Regulations of next-generation networks (NGNs) have played a central role in the transition from copper networks to broadband networks in Fiber to The Home (FTTH), also allowing for a reduction in asymmetries between incumbent operators and their competitors. Despite common European Union directives, telecom infrastructure development varies across countries due to differences in regulation, investment models, legacy networks, operators’ behavior, and public policies. This study analyzes the evolution of Very High-Capacity Networks (VHCNs), focusing on the implementation of FTTH in four European countries (Portugal, Spain, France, and Germany), and in South Korea. The latter was included as a benchmark in government-driven broadband development. The analysis considers key factors influencing FTTH development, including infrastructure regulation, fiber investment incentives, incumbent strategies, infrastructure sharing and co-investment, rural coverage plans, and demographic differences of each country. The results show that regulatory measures directly influence the pace of FTTH installation; but its effectiveness also depends on investment incentives, market competition, and demand factors. Portugal, Spain, and France have high FTTH coverage despite different regulatory and investment models. In contrast, Germany relied on xDSL over copper networks for a long time, causing significant delays, with an FTTH coverage rate of 42.5% and a penetration rate of only 12.3%, putting the European Union’s 2030 goal of universal 1 Gbps coverage at risk. South Korea shows that long-term public policies, demand-side incentives, and high digital adoption accelerate mass FTTH adoption and turn telecommunications infrastructure into a key driver of economic and technological development. Full article
(This article belongs to the Topic Electronic Communications, IOT and Big Data, 2nd Volume)
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25 pages, 1696 KB  
Article
Rural Income Growth Through Digital Infrastructure: Evidence from China’s Yellow River Basin
by Ruomeng Zhou, Yunsheng Zhang and Ruyu Yang
Agriculture 2026, 16(11), 1154; https://doi.org/10.3390/agriculture16111154 - 24 May 2026
Viewed by 386
Abstract
The digital economy has changed the way agricultural production is organized and how rural households access markets, jobs, and information. Yet it remains unclear whether these changes translate into higher income for rural residents, especially in major agricultural regions. This study examines the [...] Read more.
The digital economy has changed the way agricultural production is organized and how rural households access markets, jobs, and information. Yet it remains unclear whether these changes translate into higher income for rural residents, especially in major agricultural regions. This study examines the income effect of digital infrastructure development by using the rollout of the Broadband China policy as a quasi-natural experiment. The analysis draws on panel data for 77 prefecture-level administrative units in the Yellow River Basin, one of China’s major agricultural regions, from 2009 to 2021. A staggered difference in differences model is used to estimate the policy effect. The results show that digital infrastructure development significantly increases rural residents’ income. Under the log income specification, the baseline coefficient indicates an average income increase of about 8.33%. The mechanism analysis shows that innovation capacity and nonfarm employment both serve as positive partial transmission channels, with innovation capacity explaining a larger share of the total effect. The heterogeneity results suggest that the income effect is stronger in regions with higher GDP and larger population size. These findings indicate that digital infrastructure can support rural income growth when it is linked with local innovation capacity, employment opportunities outside agriculture, and rural development policies suited to local conditions. Full article
(This article belongs to the Section Agricultural Economics, Policies and Rural Management)
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26 pages, 680 KB  
Article
Can Public Data Openness Improve Carbon Emission Efficiency? A Quasi-Natural Experiment Analysis Based on the Launch of Public Data Platforms
by Yufan Dong, Shuangling Sun, Hongli Jiang and Na Lu
Sustainability 2026, 18(10), 5188; https://doi.org/10.3390/su18105188 - 21 May 2026
Viewed by 406
Abstract
Public data openness (PDO) is critical for advancing digital government initiatives and sustainable development. This study investigates the impact and underlying mechanisms of PDO on carbon emission efficiency (CEE) using a staggered difference-in-differences (DID) approach. The results reveal that the PDO significantly improves [...] Read more.
Public data openness (PDO) is critical for advancing digital government initiatives and sustainable development. This study investigates the impact and underlying mechanisms of PDO on carbon emission efficiency (CEE) using a staggered difference-in-differences (DID) approach. The results reveal that the PDO significantly improves CEE. Mechanism analysis demonstrates that PDO enhances CEE by facilitating digital technology innovation, improving capacity utilization, and fostering industrial structure upgrading. The positive effect of PDO on CEE exhibits heterogeneity across the dimensions of data themes, human capital, green finance development, and land marketization. Furthermore, the Broadband China Strategy (BCS) and the New Energy Demonstration City (NEDC) policy amplify PDO’s positive effect on CEE. This study quantitatively evaluates the economic and environmental effects of data resource openness and sharing, offering insights into deepening data infrastructure development and unleashing data’s potential to promote sustainable development. Full article
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27 pages, 2093 KB  
Article
Wires, Patents and Growth: An Explainable Machine Learning Approach for What Drives Digital Competitiveness in the European Union
by Rareș Mihai Nițu, Raluca Iuliana Georgescu, Dumitru Alexandru Bodislav, Loredana Maria Popescu, Cristina Voicu and Andrei Josan
Electronics 2026, 15(10), 2190; https://doi.org/10.3390/electronics15102190 - 19 May 2026
Viewed by 284
Abstract
This study investigates the predictive contribution of digital infrastructure to GDP per capita growth across 27 European Union Member States over the period 1995–2024, using a balanced panel of 810 country–year observations and an explainable machine learning framework. An XGBoost model trained on [...] Read more.
This study investigates the predictive contribution of digital infrastructure to GDP per capita growth across 27 European Union Member States over the period 1995–2024, using a balanced panel of 810 country–year observations and an explainable machine learning framework. An XGBoost model trained on six World Bank indicators—fixed broadband subscriptions, internet users, mobile subscriptions, patent applications, R&D expenditure, and secure internet servers—achieves a training R2 of 0.804 and a test R2 of 0.430 under temporal out-of-sample validation spanning the COVID-19 structural break. TreeSHAP decomposition identifies fixed broadband as the strongest predictor of model-estimated GDP per capita growth (mean |SHAP| = 0.948; bootstrap rank 1 in 78% of 50 resamples; Friedman Chi-square (5) = 168.16, p < 0.001), providing predictive support for Hypothesis H1. Innovation indicators, represented by patent applications and R&D expenditure, exceed the pre-specified materiality threshold, providing predictive support for H2, while SHAP dependence plots reveal pronounced non-linear threshold patterns consistent with S-curve diffusion theory, supporting H3. Temporal SHAP decomposition identifies three structural phases: broadband dominance (1995–2007), crisis-induced reconfiguration (2008–2013), and quality convergence (2014–2024). The framework reconciles contradictory findings from prior literature by visualizing the complete functional form of the broadband–growth relationship without imposing a parametric specification. Full article
(This article belongs to the Section Artificial Intelligence)
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28 pages, 1040 KB  
Article
Drivers and Barriers to Artificial Intelligence Adoption in Agriculture: A Socio-Technical Analysis of Midwestern United States Farmers
by Abeer F. Alkhwaldi, Cherie Noteboom and Amir A. Abdulmuhsin
Sustainability 2026, 18(10), 4996; https://doi.org/10.3390/su18104996 - 15 May 2026
Viewed by 439
Abstract
The agricultural industry is at a critical juncture, experiencing global pressures in the form of climate volatility, a shortage of labor, and an increase in production costs. Although artificial intelligence (AI) has the potential for revolution due to its predictive analytics and self-controlled [...] Read more.
The agricultural industry is at a critical juncture, experiencing global pressures in the form of climate volatility, a shortage of labor, and an increase in production costs. Although artificial intelligence (AI) has the potential for revolution due to its predictive analytics and self-controlled machinery, it has not achieved widespread and even distribution for use, especially among small-to-medium-sized farms in the Midwestern United States. This study formulates and empirically examines a comprehensive socio-technical model to determine the drivers and barriers to the adoption of AI in this agricultural region. Based on a synthesized framework of the “Unified Theory of Acceptance and Use of Technology” (UTAUT) and “Task–Technology Fit” (TTF), the study incorporates agriculture-specific contextual factors such as “environmental risk, access to broadband, economic constraints, and policy support”. The analyses of the 489 farmers in the U.S. Midwest were conducted through the “partial least squares structural equation modeling” (PLS-SEM) “SmartPLS v.3.9”. The findings provide full empirical evidence of the proposed model, which supports 11 hypothesized relationships. The key results show that the strongest positive predictors of adoption intention are “performance expectancy, effort expectancy, and trust”. On the other hand, data security concerns and financial restrictions are strong deterrents. The paper also outlines the significant facilitating functions of the broadband infrastructure and policy support in building farmer perceptions of technology’s ease-of-use and facilitating conditions. These lessons can provide policymakers, ag-tech developers, and extension agencies with a roadmap on how to create more equitable and contextual interventions that overcome the rural digital divide and create resilient data-driven farming systems. Full article
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21 pages, 5637 KB  
Article
The Economic Dimension of Cybercrime in the Digital Era: A Systems Perspective on Structural Inequalities and Regional Dynamics of Computer Fraud in Spain
by Carlos J. Mármol, Aurelio Luna and Isabel Legaz
Systems 2026, 14(5), 538; https://doi.org/10.3390/systems14050538 - 9 May 2026
Viewed by 220
Abstract
Computer fraud has become a rapidly expanding form of cybercrime linked to the growth of digital infrastructures and socioeconomic development. This study adopts a socio-technical systems perspective to examine the temporal evolution, regional disparities, structural determinants, and future trends of computer fraud in [...] Read more.
Computer fraud has become a rapidly expanding form of cybercrime linked to the growth of digital infrastructures and socioeconomic development. This study adopts a socio-technical systems perspective to examine the temporal evolution, regional disparities, structural determinants, and future trends of computer fraud in Spain (2011–2022). Official data from the Spanish Ministry of the Interior were used to calculate incidence rates per 100,000 inhabitants. Temporal trends were analyzed using linear regression, regional patterns using clustering analysis, and structural associations using correlation models. Projections were developed to estimate trends up to 2035. Computer fraud increased sharply from 44.7 to 707.7 cases per 100,000 inhabitants, with the strongest growth observed in card and bank fraud. Higher rates were found in economically developed and highly digitalized regions. Fraud incidence was positively associated with broadband access, mobile connectivity, and income levels, whereas traditional technologies were negatively associated. These findings indicate that computer fraud should be understood as a system-level phenomenon driven by the interplay of digital, economic, and territorial factors. Effective prevention requires integrated strategies that combine technological, regulatory, and educational measures, adapted to regional vulnerability profiles. Full article
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24 pages, 838 KB  
Article
The Impact of Digital Infrastructure Construction on Urban–Rural Consumption Inequality in China: Evidence from Difference-in-Differences and Double Machine Learning
by Yi Luo, Duxuan Zeng, Jian Zhu and Min Chen
Sustainability 2026, 18(10), 4707; https://doi.org/10.3390/su18104707 - 8 May 2026
Viewed by 947
Abstract
Bridging urban–rural consumption inequality (URCI) is crucial for achieving sustainable and inclusive development. Although the welfare implications of digital infrastructure construction (DIC) have attracted increasing attention, evidence on its effect on URCI remains limited. This study exploits the staggered rollout of the “Broadband [...] Read more.
Bridging urban–rural consumption inequality (URCI) is crucial for achieving sustainable and inclusive development. Although the welfare implications of digital infrastructure construction (DIC) have attracted increasing attention, evidence on its effect on URCI remains limited. This study exploits the staggered rollout of the “Broadband China” strategy as a quasi-natural experiment and estimates the effect of DIC on URCI using a city-level panel of 277 prefecture-level and above cities in China from 2012 to 2023. The empirical analysis combines a two-way fixed effects DID frame-work with double machine learning and a series of robustness checks. The results show (a) that DIC significantly reduces URCI, suggesting that digital infrastructure contributes to urban–rural consumption convergence; (b) mechanism analysis provides suggestive evidence consistent with two potential mechanisms: industrial structural transformation, reflected in industrial upgrading and industrial rationalization, and consumption scenario innovation, proxied by the expansion of digitally enabled consumption environments. Nonparametric bootstrap evidence further supports the presence of indirect associations through these mechanisms; (c) heterogeneity analysis shows that the mitigating effect of DIC is more pronounced in the central region, in cities with lower levels of economic development, and in cities with weaker innovation capacity, suggesting higher marginal returns to digital infrastructure in areas with less developed digital and consumption ecosystems. These findings highlight the inclusive role of digital infrastructure in reducing consumption inequality and provide policy-relevant evidence for promoting balanced urban–rural development in China and other developing economies pursuing digital infrastructure expansion. Full article
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40 pages, 4482 KB  
Article
From Connectivity to Commerce: A Multi-Technique Investigation of E-Commerce Drivers in Italy’s Regional Landscape
by Angelo Leogrande, Carlo Drago, Alberto Costantiello and Massimo Arnone
J. Theor. Appl. Electron. Commer. Res. 2026, 21(5), 137; https://doi.org/10.3390/jtaer21050137 - 28 Apr 2026
Viewed by 582
Abstract
The research examines regional disparities in the diffusion of e-commerce among enterprises employing at least 10 people in Italy, using an integrated analytical framework that blends econometric modeling, machine learning, and network analysis. Instrumental Variable (IV) panel models overcome endogeneity arising from digital [...] Read more.
The research examines regional disparities in the diffusion of e-commerce among enterprises employing at least 10 people in Italy, using an integrated analytical framework that blends econometric modeling, machine learning, and network analysis. Instrumental Variable (IV) panel models overcome endogeneity arising from digital infrastructure, socioeconomic factors, and online business activity, with geographic slope as a suitable instrument for broadband penetration. Machine learning models—regularized regressions, random forests, and boosting—augment causal inference by registering nonlinear effects and sorting variable salience. The results, in all cases, emphasize internet use, household digital connectivity, and the prevalence of remote work as the most important predictors of the diffusion of e-commerce. Cluster analysis identifies regional digital profiles that distinguish northern-central regions from southern-insular regions, characterizing persistently distinct digital divides. The network analysis, in turn, identifies digital inclusion variables—such as internet penetration and ICT infrastructure—that occupy central positions within the entirety of the economic and technological interdependencies’ regime. Innovation and income levels, while practiced, hold peripheral positions, indicating that digital capacity, rather than economic affluence in the singular, drives online business participation. Italy’s case can particularly illustrate this beyond its national borders. Being a high-income economy with significant regional disparities, it reproduces challenges common elsewhere in the world, among which the cases of Spain, Germany, the USA, the Republic of Korea, and Japan come to mind, where regional disparities inhibit inclusive digital development. The Italian case presents, then, a transferable model for the diffusion of digital tools, the reduction in regional disparities, and the encouragement of economic integration. By synthesizing the causal, predictive, and systemic methodologies, the study offers a theoretical and practical response to digital transformation across diverse terrains. Full article
(This article belongs to the Special Issue Emerging Technologies and Innovations in Electronic Commerce)
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27 pages, 827 KB  
Systematic Review
Recent Rural Hospital Closures and Service Disruptions in the United States: A Rapid Systematic Review
by Annabella Bellard, Andrea Otti, Enoc Carbajal, Jaelyn Moore and Cristian Lieneck
Hospitals 2026, 3(2), 11; https://doi.org/10.3390/hospitals3020011 - 22 Apr 2026
Viewed by 2638
Abstract
Rural hospitals are essential access points for healthcare delivery in the United States, yet they continue to experience disproportionate rates of closure and service disruption that threaten community health, economic stability, and equity. This rapid systematic review synthesizes recent peer-reviewed evidence examining rural [...] Read more.
Rural hospitals are essential access points for healthcare delivery in the United States, yet they continue to experience disproportionate rates of closure and service disruption that threaten community health, economic stability, and equity. This rapid systematic review synthesizes recent peer-reviewed evidence examining rural hospital closures and service disruptions, with emphasis on financial, policy, workforce, and performance-related factors and their downstream impacts. Guided by PRISMA methodology, four databases were searched for U.S.-based studies published between January 2024 and June 2025. Following screening and consensus-based review, 59 articles met inclusion criteria. Across studies, financial vulnerability, characterized by revenue instability, low patient volumes, unfavorable payer mix, and reliance on non-operating revenue, emerged as a dominant precursor to closure and service reductions. Policy context, particularly Medicaid expansion status, telehealth and broadband infrastructure, and reimbursement adequacy, strongly shaped hospital sustainability. Closures and service disruptions were consistently associated with increased travel distances, reduced access to maternal, surgical, mental health, and chronic care services, higher prices at surviving hospitals, and increased strain on remaining providers. Workforce shortages further compounded these challenges. Collectively, findings demonstrate that rural hospital closures reflect interconnected structural weaknesses rather than isolated organizational failure. Coordinated policy action, targeted financial stabilization, workforce development, and technology-enabled care models are necessary to mitigate continued erosion of rural healthcare access. Full article
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30 pages, 595 KB  
Article
Digital Infrastructure and Firm Labor Productivity: Evidence from the Implementation of China’s Labor Contract Law
by Qian Hu, Yong Chen and Lu Zhao
Economies 2026, 14(4), 140; https://doi.org/10.3390/economies14040140 - 16 Apr 2026
Viewed by 866
Abstract
This paper utilizes panel data of Chinese A-share listed manufacturing firms from 2006 to 2022 and measures regional digital infrastructure by the number of internet broadband access ports per capita. It systematically examines the moderating role of digital infrastructure in the relationship between [...] Read more.
This paper utilizes panel data of Chinese A-share listed manufacturing firms from 2006 to 2022 and measures regional digital infrastructure by the number of internet broadband access ports per capita. It systematically examines the moderating role of digital infrastructure in the relationship between labor protection policies and firms’ labor productivity. The findings are as follows: (1) Digital infrastructure exhibits a positive moderating effect on the relationship between the Labor Contract Law and firms’ labor productivity. This conclusion remains generally robust across multiple robustness tests and endogeneity treatments, and the direction of the results remains consistent after applying an instrumental variable approach to alleviate endogeneity concerns. (2) The digital transformation channel exhibits a negative relationship, indicating that compliance pressure associated with the institutional reform generates a short-term “crowding-out effect” on firms’ digital investment; the human capital channel shows a positive relationship, indicating that digital infrastructure strengthens the institutional effect by improving the level of urban human capital. (3) The moderating effect is particularly pronounced in cities with strong digital industry foundations, abundant fiscal resources, and firms that have not received government digital subsidies. These results provide empirical support for optimizing the supporting environment of labor protection policies, accelerating digital infrastructure development, and enhancing enterprise adaptability to institutional changes. Full article
(This article belongs to the Special Issue Macroeconomics of the Labour Market)
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34 pages, 1398 KB  
Article
Digital Government and SDG 9 in the European Union: Institutional Saturation, Digital Co-Investment, and the EU15/EU13 Divide
by Oksana Liashenko, Oleksandr Dluhopolskyi, Olena Mykhailovska, Dariusz Woźniak, Sylwia Skrzypek-Ahmed and Ihor Ruzhytskyi
Sustainability 2026, 18(8), 3921; https://doi.org/10.3390/su18083921 - 15 Apr 2026
Viewed by 426
Abstract
Digital government is widely regarded as a catalyst for sustainable development, yet the mechanisms by which e-government adoption translates into progress on the SDGs remain poorly understood, particularly in high-income contexts where governance is already mature. This study addresses that gap using a [...] Read more.
Digital government is widely regarded as a catalyst for sustainable development, yet the mechanisms by which e-government adoption translates into progress on the SDGs remain poorly understood, particularly in high-income contexts where governance is already mature. This study addresses that gap using a balanced panel of all 27 EU member states over 2015–2023. Applying two-way fixed-effects estimation with formal Baron–Kenny mediation and country-block bootstrap inference, we identify three findings that collectively reframe the relationship between digital government and sustainable development in the European context. First, the widely assumed governance reform pathway is not empirically supported in the EU27: e-government adoption is not associated with measurable improvement in institutional quality, consistent with structural saturation rather than policy failure. Second, the benefits of digital government are unevenly distributed across the EU: old member states (EU15) exhibit significant positive effects on SDG 9: Innovation and Infrastructure, whereas new member states (EU13) do not, challenging the assumption that digital strategies yield symmetric returns across the Union. Third, and most importantly, the EU15 effect appears to be fully channelled through household internet access, consistent with a digital co-investment mechanism in which e-government uptake and broadband infrastructure co-evolve as expressions of a shared national digital transformation strategy. These findings inform the policy debate: the question for EU15 is not whether to invest in e-government, but how to sustain the joint infrastructure investment that makes it effective; for EU13, the priority is to establish the digital and institutional foundations that enable the mechanism to be activated. Full article
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