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Hospital in the Home (HITH) programs are emerging as a key pillar of smart city healthcare infrastructure, leveraging technology to extend care beyond traditional hospital walls. The global healthcare sector has been conceptualizing the notion of a care without walls hospital, also called HITH, where virtual care takes precedence to address the multifaceted needs of an increasingly aging population grappling with a substantial burden of chronic disease. HITH programs have the potential to significantly reduce hospital bed occupancy, enabling hospitals to better manage the ever-increasing demand for inpatient care. Although many health providers and hospitals have established their own HITH programs, there is a lack of research that provides healthcare executives and HITH program managers with management models and frameworks for such initiatives. There is also a lack of research that provides strategies for improving HITH management in the health sector. To fill this gap, the current study ran a systematic literature review to explore state-of-the-art with regard to this topic. Out of 2631 articles in the pool of this systematic review, 20 articles were deemed to meet the eligibility criteria for the study. After analyzing these studies, nine management models were extracted, which were then categorized into three categories, namely, governance models, general models, and virtual models. Moreover, this study found 23 strategies and categorized them into five groups, namely, referral support, external support, care model support, technical support, and clinical team support. Finally, implications of findings for practitioners are carefully provided. These findings provide healthcare executives and HITH managers with practical frameworks for selecting appropriate management models and implementing evidence-based strategies to optimize program effectiveness, reduce costs, and improve patient outcomes while addressing the growing demand for home-based care. Full article

Urban sustainability challenges demand integrated frameworks capable of addressing the dynamic, non-linear nature of cities. This study explores how the principles of the circular economy and complexity theory intersect to support systemic transformation in sustainable urban planning. Through a systematic literature review of 71 peer-reviewed articles published between 2015 and 2025, we analyze conceptual, methodological, and practical articulations across multiple thematic axes, including circular governance, urban metabolism, regenerative design, adaptive planning, digital integration, and environmental justice. Bibliometric and content analyses were conducted using Scopus metadata, VOSviewer for thematic clustering, and the StArt software (Version 3.4) to structure article selection. The findings reveal that circular economy provides practical tools for resource efficiency and regeneration, while complexity theory offers an adaptive framework to navigate uncertainty, emergent behaviors, and feedback dynamics. The synthesis suggests that their integration enables a more holistic and resilient approach to urban transformation. However, gaps remain in social inclusivity, long-term assessment, and the operationalization of complexity-informed planning. This study contributes to advancing a transdisciplinary agenda for circular and adaptive urban futures, offering insights for scholars, planners, and policymakers aiming to reconfigure cities within planetary boundaries. Full article

Payments for Watershed services (PWSs) have been emerging as a critical tool for environmental governance in watershed, yet their comparative effectiveness across implementation models has remained poorly understood. Based on a comparative analysis of Eco-Compensation (EC) and Payments for Ecosystem Services (PESs) frameworks, examining both theoretical foundations and implementation practices, this study aims to quantitatively assess and compare the effectiveness of two dominant PWSs models—the EC-like model (Phase I: October 2008–April 2017) and the PESs-like model (Phase II: 2017–December 2021). Using the Liaohe River in China as a case study, utilizing ecosystem service value (ESV) as an indicator and employing the corrected unit-value transfer method, we compare the effectiveness of different PWSs models from October 2008 to December 2021. The results reveal the following: (1) Policy Efficiency: The PESs-like model demonstrated significantly greater effectiveness than the EC-like model, with annual average increases in ESV of 3.23 billion CNY (491 million USD) and 1.79 billion CNY (272 million USD). (2) Functional Drivers: Water regulation (45.1% of total ESV growth) and climate regulation (24.3%) were dominant services, with PESs-like interventions enhancing multifunctionality. (3) Stakeholder Impact: In the PESs-like model, the cities implementing inter-county direct payment showed higher growth efficiency than those without it. The operational efficiency of PWSs increases with the number of participating stakeholders, which explains why the PESs-like model demonstrates higher effectiveness than the EC-like model. Our findings offer empirical evidence and actionable policy implications for designing effective PWSs models across global watershed ecosystems. Full article

(1) Background: This article aims to understand the forms and elements through which the inhabitants of the city of Medellin have configured their subjectivity in the context of the application of neoliberal policies in the last two decades. In this way, we can approach the frameworks of understanding that constitute a fundamental part of the individuation processes in which the incorporation of their subjectivities is evidenced in neoliberal contexts that, in the historical process, have been converging with authoritarian, antidemocratic and neoconservative elements. (2) Method: A qualitative approach with a hermeneutic-interpretative paradigm was used. In-depth semi-structured interviews were conducted with 41 inhabitants of Medellín who were politically identified with right-wing or center-right positions. Data analysis included thematic coding to identify patterns of thought and points of view. (3) Results: Participants associate success with individual effort and see state intervention as an obstacle to development. They reject redistributive policies, arguing that they generate dependency. In addition, they justify authoritarian models of government in the name of security and progress, from a moral superiority, which is related to a negative and stigmatizing perception of progressive sectors and a negative view of the social rule of law and public policies with social sense. (4) Conclusions: The naturalization of merit as a guiding principle, the perception of themselves as morally superior based on religious values that grant a subjective place of certainty and goodness; the criminalization of expressions of political leftism, mobilizations and redistributive reforms and support for policies that establish authoritarianism and perpetuate exclusion and structural inequalities, closes roads to a participatory democracy that enables social and economic transformations. Full article

Studying the impact of digital economy development on marine environmental quality has important theoretical and practical significance for achieving a win–win situation between high-quality economic development and high-level ecological environment protection. This article selects the marine environment of coastal provinces and cities in China from 2011 to 2022 as the research object and uses the entropy method to comprehensively evaluate the quality of marine environment and the level of digital economy. Also, we construct intermediary and threshold effect models to deeply explore the impact mechanism of digital economy development on marine environmental quality. We find that digital economy and marine environmental quality both show a wave-like rising trend, but the comprehensive level is relatively low. The development of the digital economy can effectively improve the level of marine environmental quality, and the digital economy promotes the improvement of marine environmental quality by improving the level of marine economy. The level of economic development and industrial scale has created a threshold effect in the process of promoting the development of marine environmental quality through the digital economy. Therefore, strengthening the digital governance of the marine environment and promoting the industrialization of marine ecology and the ecologicalization of marine industries will help promote the integrated development of the digital economy and marine environment. Full article

With the rapid pace of urbanization, cities are increasingly facing severe challenges related to environmental pollution, ecological degradation, and climate change. Extreme climate events—such as heatwaves, droughts, heavy rainfall, and wildfires—have intensified public concern about sustainability, environmental protection, and low-carbon development. Ensuring environmental preservation while maintaining residents’ quality of life has become a central focus of urban governance. In this context, evaluating green indicators and predicting urban greenness is both necessary and urgent. This study incorporates international frameworks such as the EU Green City Index, the European Green Capital Award, and the United Nations Sustainable Development Goals to assess urban sustainability. The Extreme Gradient Boosting (XGBoost) algorithm is employed to predict the green level of cities and to develop multiple optimized models. Comparative analysis with traditional models demonstrates that XGBoost achieves superior performance, with an accuracy of 0.84 and an F1-score of 0.81. Case study findings identify “Greenhouse Gas Emissions per Person” and “Per Capita Emissions from Transport” as the most critical indicators. These results provide practical guidance for policymakers, suggesting that targeted regulations based on these key factors can effectively support emission reduction and urban sustainability goals. Full article

Strengthening climate resilience constitutes a foundational approach through which cities adapt to climate change and mitigate associated environmental risks. However, research on the influence of economic policy environments on climate resilience remains limited. Guided by institutional theory and dynamic capability theory, this study employs a panel dataset comprising 272 Chinese cities at the prefecture level and above, covering the period from 2009 to 2023. It constructs a composite index framework for evaluating the green business environment (GBE) and urban climate resilience (UCR) using the entropy weight method. Employing a two-way fixed-effect regression model, it examined the impact of GBE optimization on UCR empirically and also explored the underlying mechanisms. The results show that improvements in the GBE significantly enhance UCR, with green innovation (GI) in technology functioning as an intermediary mechanism within this relationship. Moreover, climate policy uncertainty (CPU) exerts a moderating effect along this transmission pathway: on the one hand, it amplifies the beneficial effect of the GBE on GI; on the other hand, it hampers the transformation of GI into improved GBEs. The former effect dominates, indicating that optimizing the GBE becomes particularly critical for enhancing UCR under high CPU. To eliminate potential endogenous issues, this paper adopts a two-stage regression model based on the instrumental variable method (2SLS). The above conclusion still holds after undergoing a series of robustness tests. This study reveals the mechanism by which a GBE enhances its growth through GI. By incorporating CPU as a heterogeneous factor, the findings suggest that governments should balance policy incentives with environmental regulations in climate resilience governance. Furthermore, maintaining awareness of the risks stemming from climate policy volatility is of critical importance. By providing a stable and supportive institutional environment, governments can foster steady progress in green innovation and comprehensively improve urban adaptive capacity to climate change. Full article

In the context of global climate governance and the green transition, digital infrastructure serves as a critical enabler of resource allocation in the digital economy, offering strategic value in tackling synergistic pollution and carbon reduction challenges. Using panel data from 280 prefecture-level cities, this study employs a multiperiod difference-in-differences (DID) approach, leveraging smart city pilot policies as a quasinatural experiment, to assess how digital infrastructure affects urban synergistic pollution-carbon mitigation (SPCM). The empirical results show that digital infrastructure increases the urban SPCM index by 1.5%, indicating statistically significant effects. Compared with energy and income effects, digital infrastructure can influence this synergistic effect through indirect channels such as the energy effect, economic agglomeration effect, and income effect, with the economic agglomeration effect accounting for a larger share of the total effect. Additionally, fixed-asset investment has a nonlinear moderating effect on this relationship, with diminishing marginal returns on emission reduction when investment exceeds a threshold. Heterogeneity tests reveal greater impacts in eastern, nonresource-based, and environmentally regulated cities. This study expands the theory of collaborative environmental governance from the perspective of new infrastructure, providing a theoretical foundation for establishing a long-term digital technology-driven mechanism for SPCM. Full article

Urban forests, as a form of green infrastructure, play a vital role in enhancing urban resilience, environmental health, and quality of life. However, users perceive and utilize these spaces in diverse ways. This study aims to identify latent perception types among urban forest visitors and analyze their behavioral, demographic, and policy-related characteristics in Incheon Metropolitan City (Republic of Korea). Using latent class analysis, four distinct visitor types were identified: multipurpose recreationists, balanced relaxation seekers, casual forest users, and passive forest visitors. Multipurpose recreationists preferred active physical use and sports facilities, while balanced relaxation seekers emphasized emotional well-being and cultural experiences. Casual users engaged lightly with forest settings, and passive forest visitors exhibited minimal recreational interest. Satisfaction with forest elements such as vegetation, facilities, and management conditions varied across visitor types and age groups, especially among older adults. These findings highlight the need for perception-based green infrastructure planning. Policy recommendations include expanding accessible neighborhood green spaces for aging populations, promoting community-oriented events, and offering participatory forest programs for youth engagement. By integrating user segmentation into urban forest planning and governance, this study contributes to more inclusive, adaptive, and sustainable management of urban green infrastructure. Full article

Recent years have seen frequent heavy rainfall events in Japan, often linked to Baiu fronts and typhoons. These events are exacerbated by global warming, leading to an increased frequency and intensity. As floods represent a serious threat to sustainable urban development and community resilience, this study contributes to sustainability-focused risk reduction through integrated analysis. This study focuses on the 2 June 2023 heavy rain disaster in Toyohashi City, Japan, which caused extensive damage due to flooding from the Yagyu and Umeda Rivers. Using numerical models, this study accurately reproduces flooding patterns, revealing that high tides amplified the inundation area by 1.5 times at the Yagyu River. A resident questionnaire conducted in collaboration with Toyohashi City identifies key trends in evacuation behavior and disaster information usage. Traditional media such as TV remain dominant, but younger generations leverage electronic devices for disaster updates. These insights emphasize the need for targeted information dissemination and enhanced disaster preparedness strategies, including online materials and flexible training programs. The methods and findings presented in this study can inform local and regional governments in building adaptive disaster management policies, which contribute to a more sustainable society. Full article

Promoting sustainable development requires a clear understanding of how short-term fluctuations in anthropogenic emissions affect urban environmental quality. This is especially relevant for cities experiencing rapid industrial changes or emergency policy interventions. Among key environmental concerns, variations in ambient pollutants like ozone (O₃) are closely tied to both public health and long-term sustainability goals. However, traditional chemical transport models often face challenges in accurately estimating emission changes and providing timely assessments. In contrast, statistical approaches such as the difference-in-differences (DID) model utilize observational data to improve evaluation accuracy and efficiency. This study leverages the synthetic difference-in-differences (SDID) approach, which integrates the strengths of both DID and the synthetic control method (SCM), to provide a more reliable and accurate analysis of the impacts of interventions on city-level air quality. Using Shanghai’s 2022 lockdown as a case study, we compare the deweathered ozone (O₃) concentration in Shanghai to a counterfactual constructed from a weighted average of cities in the Yangtze River Delta (YRD) that did not undergo lockdown. The quasi-natural experiment reveals an average increase of 4.4 μg/m³ (95% CI: 0.24–8.56) in Shanghai’s maximum daily 8 h O₃ concentration attributable to the lockdown. The SDID method reduces reliance on the parallel trends assumption and improves the estimate stability through unit- and time-specific weights. Multiple robustness checks confirm the reliability of these findings, underscoring the efficacy of the SDID approach in quantitatively evaluating the causal impact of emission perturbations on air quality. This study provides credible causal evidence of the environmental impact of short-term policy interventions, highlighting the utility of SDID in informing adaptive air quality management. The findings support the development of timely, evidence-based strategies for sustainable urban governance and environmental policy design. Full article

Achieving synergies between government-led and market-based policy instruments is critical to advancing Energy–Environmental Productivity and Sustainable Urban Development. This study investigates the effects of China’s dual-pilot energy policies (New Energy Demonstration Cities (NEDCs) and Energy Consumption Permit Trading (ECPT)) on urban environmental productivity (UEP) across 279 prefecture-level cities from 2006 to 2023. Utilizing a Non-Radial Directional Distance Function (NDDF) approach, combined with Difference-in-Differences (DID) estimation and spatial econometric models, the analysis reveals that these synergistic policies significantly enhance both comprehensive and net measures of UEP. Mechanism analysis highlights the roles of industrial restructuring, technological innovation, and energy transition in driving these improvements, while heterogeneity analysis indicates varying effects across different city types. Spatial spillover analysis further demonstrates that policy impacts extend beyond targeted cities, contributing to broader regional gains in UEP. These findings offer important insights for the design of integrated energy and environmental policies and support progress toward key Sustainable Development Goals (SDG 7, SDG 11, and SDG 12). Full article

The integration of artificial intelligence (AI), big data analytics, and blockchain technologies within the digital economy presents transformative opportunities for promoting low-carbon urban development. However, a systematic understanding of how these digital innovations influence urban carbon mitigation remains limited. This study addresses this gap by proposing two research questions (RQs): (1) What are the key success factors for artificial intelligence, big data, and blockchain in urban carbon emission reduction? (2) How do these technologies interact and support the transition to low-carbon cities? To answer these questions, the study employs a hybrid methodological framework combining the decision-making trial and evaluation laboratory (DEMATEL) and interpretive structural modeling (ISM) techniques. The data were collected through structured expert questionnaires, enabling the identification and hierarchical analysis of twelve critical success factors (CSFs). Grounded in sustainability transitions theory and institutional theory, the CSFs are categorized into three dimensions: (1) digital infrastructure and technological applications; (2) digital transformation of industry and economy; (3) sustainable urban governance. The results reveal that e-commerce and sustainable logistics, the adoption of the circular economy, and cross-sector collaboration are the most influential drivers of digital-enabled decarbonization, while foundational elements such as smart energy systems and digital infrastructure act as key enablers. The DEMATEL-ISM approach facilitates a system-level understanding of the causal relationships and strategic priorities among the CSFs, offering actionable insights for urban planners, policymakers, and stakeholders committed to sustainable digital transformation and carbon neutrality. Full article

Urban transport is a key driver of greenhouse gas emissions in Europe, making its decarbonization essential to achieving EU climate neutrality targets. This study examines how European strategies, such as the Green Deal, the Sustainable and Smart Mobility Strategy, and the Fit for 55 package, are reflected in Romania’s transport policies, with a focus on implementation challenges and urban outcomes in Bucharest. By combining policy analysis, stakeholder mapping, and comparative mobility indicators, the paper critically assesses Bucharest’s current reliance on private vehicles, underperforming public transport satisfaction, and limited progress on active mobility. The study develops a context-sensitive reform framework for the Romanian capital, grounded in transferable lessons from Western and Central European cities. It emphasizes coordinated metropolitan governance, public trust-building, phased car-restraint measures, and investment alignment as key levers. Rather than merely cataloguing policy intentions, the paper offers practical recommendations informed by systemic governance barriers and public attitudes. The findings will contribute to academic debates on urban mobility transitions in post-socialist cities and provide actionable insights for policymakers seeking to operationalize EU decarbonization goals at the metropolitan scale. Full article

Improving the green innovation quality (GIQ) of center cities is crucial to achieve sustainable urban agglomeration development. Utilizing data on green patent citations and economic indicators across cities in the Yangtze River Delta urban agglomeration (YRD) from 2003 to 2022, this research examines the influence of center cities’ GIQ on the economic performance of peripheral municipalities. The results show the following: (1) Center cities’ GIQ exerts a significant suppressive effect on peripheral cities’ economic growth overall. Heterogeneity analysis uncovers a distance-dependent duality. GIQ stimulates growth in proximate cities (within 300 km) but suppresses it beyond this threshold. This spatial siphoning effect is notably amplified in national-level center cities. (2) Mechanisms suggest that GIQ accelerates the outflow of skilled labor in peripheral cities through factor agglomeration and industry transfer mechanisms. Concurrently, it impedes the gradient diffusion of urban services, collectively hindering peripheral development. (3) Increased government green attention (GGA) and industry–university–research cooperation (IURC) in centers can mitigate these negative impacts. This paper contributes to the theoretical discourse on center cities’ spatial externalities within agglomerations and offers empirical support and policy insights for the exertion of spillover effects of high-quality green innovation from center cities and the sustainable development of urban agglomeration. Full article