Search Results (303)

The European Health Technology Assessment (HTA) regulation (HTAR) came into effect in January 2025 and impacts the HTA process in all European Member States. Member States must give due consideration to the joint clinical assessment (JCA) report. This may require adaptations at the national level. This paper describes the anticipated changes to the Dutch national HTA process and how the Dutch National Health Care Institute (Zorginstituut Nederland, ZIN) prepared for this, because sharing experience between Member States can be of general interest for future expansion of the EU HTAR. ZIN’s implementation activities were facilitated by a project-governance structure and by a continuous gap analysis of the current national assessment and appraisal process of medicinal products, resulting in a concrete action plan. The implementation of the HTAR has two major implications for ZIN’s HTA process, namely that the scoping phase starts much earlier and that the JCA report is the starting point for the national assessment. Gaps, challenges and issues were identified in the categories: information and knowledge, IT and template, communication and stakeholder engagement, capacity and resources, and financial aspects. Based on a thorough and well-defined implementation plan, ZIN is ready to implement the HTAR in national HTA processes and to take on (co-)assessor roles for JCA of medicinal products in 2025. Full article

Energy storage technologies are becoming increasingly important when it comes to maintaining the balance between electricity generation and consumption, especially with the increasing share of variable renewable energy sources (VRES). Pumped storage hydropower plants (PSHs) are currently the largest form of energy storage at the grid level. The aim of this study is to investigate the importance and prospects of using PSHs as part of the energy transition to decarbonize energy sources. A comparison was made between PSHs and battery energy storage systems (BESSs) in terms of technical, economic, and ecological aspects. To identify the key factors influencing the wider adoption of PSHs, a combined approach using SWOT analysis (which assesses strengths, weaknesses, opportunities, and threats) and the Analytical Hierarchy Process (AHP) as a decision support tool was applied. Regulatory and market uncertainties (13.54%) and financial inequality (12.77%) rank first and belong to the “Threats” group, with energy storage capacity (10.11%) as the most important factor from the “Strengths” group and increased demand for energy storage (9.01%) as the most important factor from the “Opportunities” group. Forecasts up to 2050 show that the capacity of PSHs must be doubled to enable the integration of 80% of VRES into the grids. The study concludes that PSHs play a key role in the energy transition, especially for long-term energy storage and grid stabilization, while BESSs offer complementary benefits for short-term storage and fast frequency regulation. Recommendations to policymakers include the development of clear, accelerated project approval procedures, financial incentives, and support for hybrid PSH systems to accelerate the energy transition and meet decarbonization targets. Full article

The link between ESG and financial performance is still under debate. In this study, we explore which aspects of ESG specifically drive market valuations through both systematic and idiosyncratic risk channels. We analyze the impact of the three core ESG pillars, 10 subcategories, and associated controversies on market valuations in the energy sector. This analysis reveals that the environmental factor has a stronger impact (regression coefficient = 0.05) than the governance factor (regression coefficient = 0.003), emphasizing the need to prioritize environmental performance in ESG strategies. The positive coefficients for environmental resource use (0.005) and innovation (0.008) indicate that investments in efficiency and clean technologies are beneficial, while the negative coefficient for emissions (−0.004) underscores the risks associated with poor emissions management. These findings suggest that environmental risks currently outweigh governance risks for the energy sector, reinforcing the importance of aligning governance practices with environmental goals. To maximize ESG effectiveness, energy firms should focus on measurable improvements in resource efficiency, innovation, and emissions reduction and transparently communicate this progress to stakeholders. The evidence suggests that energy firms approach the ESG landscape differently, with sustainability leaders benefiting from higher valuations, particularly when ESG efforts are aligned with core competencies. However, many energy companies under-invest in value-creating environmental initiatives, focusing instead on emission management, which erodes value. While they excel in emission control, they lag in innovation, missing opportunities to enhance valuations. This underscores the potential for ESG risk analysis to improve portfolio performance, as sustainability can both create value and mitigate risks by factoring into valuation equations as both risks and opportunities. This study uniquely contributes to the ESG–financial performance literature by disentangling the specific ESG dimensions that drive market valuations in the energy sector, revealing that value is created not through emission control but through strategic alignment with eco-innovation, governance, and social responsibility. Full article

The paper presents the financial potential of recycling waste electronic equipment (WEE) in the form of printed circuit boards, hard drives, and lithium-ion batteries. Metal contents in selected types of WEE were presented, as well as their price and importance from an environmental, economic, and geopolitical perspective using indicators of relative supply risk and abiotic depletion potential (ADP). The potential benefits that recycling can bring to the company and the environment were presented. Furthermore, the mass balance and value of recovered metals were estimated for southern Poland, and potential possibilities for the management of the remaining separation products were presented. Finally, verified physical recycling methods for the presented WEE were described. Full article

Forensic medicine has increasingly integrated advanced imaging technologies to improve the accuracy and efficiency of investigations. Techniques such as virtual autopsy, multi-detector computed tomography (MDCT), and artificial intelligence (AI)-driven imaging have revolutionized the identification of injuries and causes of death. Despite these advancements, the field faces operational, ethical, and legal challenges that hinder widespread adoption. Objectives: This systematic review aimed to explore the role of emerging imaging technologies in forensic medicine, identify key challenges in their implementation, and provide insights into optimizing their use in forensic practice, with particular attention to cultural, ethical, and interdisciplinary aspects. Methods: A systematic review was conducted following PRISMA guidelines. Literature searches were performed across six databases, including PubMed, Scopus, Web of Science, and others, focusing on studies discussing imaging technologies in forensic contexts. A total of 10 studies were included after applying eligibility criteria. The data were synthesized using narrative synthesis and thematic analysis. Results: Four key themes emerged: (1) advancements in AI and imaging technologies, (2) operational and financial barriers, (3) ethical and legal considerations, and (4) interdisciplinary collaboration and training. Emerging imaging modalities enhance diagnostic precision and facilitate non-invasive examinations, offering culturally sensitive alternatives to traditional autopsies. However, high costs, algorithmic biases, data security risks, and the lack of standardized forensic imaging protocols present significant challenges. The potential for cross-cultural and international forensic collaborations through AI-enabled imaging was also identified as a promising future direction. Conclusions: Advanced imaging technologies hold transformative potential in forensic medicine. Addressing financial, ethical, and operational challenges through interdisciplinary collaboration, standardized guidelines, and culturally sensitive practices is crucial for maximizing their utility and global acceptance Full article

Innovation-driven development is the main driving strategy for promoting high-quality economic development. Technological innovation is the core of innovation-driven development. Financial innovation is an important aspect of promoting financial development. As such, the coupling and coordination of the technological innovation and financial development in developing countries, such as China, is an important issue. The topic has been extensively studied over the last decade in the context of China, and a dominating method has emerged on how to model the technological innovation subsystem and the financial development subsystem, and how to quantitatively determine the degree of coupling and coordination of the two subsystems. A variety of predictors have been proposed to model each subsystem. The coupling degree and the coordination degree are then calculated, and then they are used to analyze the current development status for potential issues. However, we make an effort to validate the calculated degree of coupling and coordination before the results are used for the analysis.Without validation, the outcomes of the analysis not only might not be useful but also could lead to inappropriate governmental policies. That said, it is tremendously challenging to validate the results due to the lack of the ground truth. The goal of this study is to work towards objectively determining the reliability of the degree of coupling and coordination from an engineering perspective. Specifically, we accomplish this task by evaluating the regression performance and projection performance. We demonstrate that the use of a carefully crafted set of predictors for each subsystem is the foundation for deriving the reliable coordination degree of the two subsystems. Full article

The digital economy, as an emerging productive force, has become a critical catalyst for economic sustainable progress. This study examines the regional disparities and origins of the digital economy, as well as its spatial and temporal growth patterns, which are essential for bridging the financial gap among regions and promoting synchronized economic progress. We developed a multidimensional index system to evaluate the level of digital economic development across 30 Chinese provinces, encompassing aspects such as the Internet’s evolution, digital infrastructure, capacity for digital innovation, and the application of digital technologies. The regional imbalances and origins of the digital economy were scrutinized using Dagum Gini coefficient decomposition. Furthermore, the study investigated the spatiotemporal dynamics of digital economy progression in China, employing methods like kernel density estimation, migration models of the gravity center, and an analysis via the standard deviation ellipse. The results reveal the following: (1) Digital economic development is more advanced in Eastern China compared to the western regions, with variations primarily driven by inter-regional differences. (2) The absolute gap in national digital economic development levels is widening, and relative disparities within the eastern region are increasing. Significant polarization is observed in the development of the digital economy across the central and western regions, while disparities in the northeastern region are comparatively minimal. (3) The center of gravity for China’s digital economy has overall shifted southward; the standard deviation ellipse has extended both northward and southward and become more oblate; and the dispersion within China’s digital economy has intensified. Full article

This article explores the current state of collaboration between higher education institutions (HEIs) and small and medium-sized enterprises (SMEs), focusing on advancing the achievements of SDG 9. Using two bibliometric analyses, in Scopus and Web of the Science, this study examines resilient infrastructure, innovation, information and communication technology, and financial services as fundamental concepts within SDG 9’s targets to investigate how SMEs can contribute to meeting SDG 9 and what can be expected from higher education institutions to generate knowledge that supports SMEs’ efforts. The bibliometric analysis revealed trends and patterns that shape the state of the art regarding HEIs-SMEs collaboration for SDG 9. There is a subtle yet significant partnership between higher education institutions and SMEs centered around the key aspect of innovation within SDG 9. Even more significant is the insight into various mechanisms for strengthening knowledge transfer from higher education institutions to SMEs, as they substantially enhance the capabilities and skills of their workforce to innovate primarily through information and communication technologies. This suggests that higher education institutions emerge as strategic partners for SMEs to progress toward, if not all, some of the targets of SDG 9, which is essential for their sustainable future readiness. Full article

Background: Sustainability in healthcare has gained increasing importance due to its impact on environmental, financial, and social strategies, as well as on public health, and therefore, relevant policies and actions can also play a significant role in telemedicine services. The establishment of a sustainable telemedicine network at a country level is important to improve access to healthcare, reduce costs, increase convenience, and ensure the continuity of service delivery. However, there are significant environmental, social, technological, human, and governance challenges to meet the sustainability conditions for these networks. Methods: Thus, a narrative literature review was conducted to investigate the telemedicine implementation aspects and the sustainability dimensions in a unified approach and integrated strategy in order to develop a more resilient and equitable healthcare solution, ensuring its long-term integration into healthcare systems. Results: This paper aims to identify critical factors related to the proposed governance model for the National Telemedicine Network in Greece (EDIT) that influence sustainability requirements and interdisciplinary strategies to address relevant challenges. Conclusions: By examining these factors, the paper seeks to propose the fundamental pillars of a sustainable telemedicine framework and the methodology for developing a sustainability plan that will enhance EDIT’s capacities toward a sustainable and resilient operation of telemedicine as a standard practice within the Greek healthcare system. Full article

The transition to 100% renewable energy systems is critical for achieving global sustainability and reducing dependence on fossil fuels. Island power systems, due to their geographical isolation, limited interconnectivity, and reliance on imported fuels, face unique challenges in this transition. These systems’ vulnerability to supply–demand imbalances, voltage instability, and frequency deviations necessitates tailored strategies for achieving grid stability. This study conducts a systematic review of the technical and operational challenges associated with transitioning island energy systems to fully renewable generation, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Out of 991 identified studies, 81 high-quality articles were selected, focusing on key aspects such as grid stability, energy storage technologies, and advanced control strategies. The review highlights the importance of energy storage solutions like battery energy storage systems, hydrogen storage, pumped hydro storage, and flywheels in enhancing grid resilience and supporting frequency and voltage regulation. Advanced control strategies, including grid-forming and grid-following inverters, as well as digital twins and predictive analytics, emerged as effective in maintaining grid efficiency. Real-world case studies from islands such as El Hierro, Hawai’i, and Nusa Penida illustrate successful strategies and best practices, emphasizing the role of supportive policies and community engagement. While the findings demonstrate that fully renewable island systems are technically and economically feasible, challenges remain, including regulatory, financial, and policy barriers. Full article

Financial technology (FinTech) rapidly transforms financial landscapes across ASEAN-4 countries by enhancing financial inclusion and digital service accessibility. However, the key factors driving FinTech development in these economies remain ambiguous. While existing studies highlight the economic and technological aspects of FinTech adoption, limited research distinguishes the unique conditions shaping FinTech’s evolution in developing ASEAN markets. This study bridges this gap by identifying economic and non-economic determinants and exploring their mediating effects. This research aims to investigate the primary drivers of FinTech development in ASEAN-4, emphasizing the roles of financial access and technological readiness as mediators in fostering a sustainable FinTech ecosystem. Utilizing structural equation modeling (SEM) with SmartPLS3, this study analyzes secondary data from 2008 to 2018, evaluating macroeconomic indicators, banking conditions, internet penetration, innovation levels, population dynamics, and human development factors. General banking conditions, access to finance, and technological readiness significantly impact FinTech development. Additionally, financial accessibility and technological infrastructure mediate the influence of economic stability, innovation, and digital penetration on FinTech growth. This study underscores policymakers’ and stakeholders’ need to enhance digital infrastructure and financial accessibility to accelerate FinTech growth. Strengthening financial ecosystems will drive digital transformation and economic resilience in emerging ASEAN economies. Full article

Institutions play a vital role in restricting or encouraging the performance of any economic agent. In this context, fintechs represent a vector of exponential change in the global financial system and its institutions. However, despite the existing relationship between fintechs and institutions, there is a need for more studies exploring the connections between them. Beginning with a framework that integrates aspects of the relation between fintechs and institutions in the financial system, the objective of this article is to empirically demonstrate the interaction between fintechs and financial system institutions in an emerging country. To do so, the chosen research method was an embedded case study, which involved documental analysis and semi-structured interviews conducted with different agents in the Brazilian financial system, belonging to the following categories: technology providers, fintechs, regulatory institutions, financial institutions, and consumers. The findings validate the applicability of the theoretical framework, highlighting that fintechs drive institutional changes across stakeholders with different characteristic traits. Based on these results, we created theoretical propositions that guide future studies on the topic of fintechs and institutions. This study’s contributions provide valuable insights for financial policymakers, regulators, and technology providers, particularly regarding the adaptation of regulatory frameworks and technological infrastructures in emerging economies. For policymakers, this study suggests guidelines to foster financial inclusion through fintech initiatives, while managers are encouraged to develop strategies that reduce operational gaps in digital financial services. Full article

Climate risk is the negative effect of climate change on several aspects of the environment, business, and society. There are two categories of climate risks: physical risks include direct impacts due to extreme events and chronic changes due to climate modifications that have become commonplace; the transition risk arises from the economic and regulatory adjustments required to shift toward reducing greenhouse gas emissions and the transition to renewable energy. The problem, in financial terms, is the correct assessment and quantification of transition risk, as it is not univocal in the literature. This research aims to provide a literature review on transition risk that permits filling this gap and identifying the proxies used for its representation and evaluation. Moreover, the analysis considers the critical aspect of the connection between transition and credit risk, as firms exposed to high transition risks may face challenges in maintaining creditworthiness. Results highlight the most commonly used proxies, including carbon pricing, CO₂ or GHG emissions, and metrics from various databases. However, the findings emphasize the importance of integrating these indicators with broader factors, such as a company’s negative environmental impacts (e.g., waste production and water usage) and delays in technological adaptation from a forward-looking perspective. Full article

There is a trend towards urbanization and thus higher energy consumption in buildings, while decarburization and renewable energy sources (RESs) are becoming top priorities. Building-integrated wind turbines (BIWTs) represent a potential solution, especially in urban areas where space is limited. The aim of this article is to examine the technical, economic, and environmental aspects of the application of BIWTs based on the scientific literature, considering innovations and challenges related to their wider application. The analysis shows that BIWTs have a high capital cost (CapEx) and levelized cost of electricity (LCOE) due to the lower capacity factor, shorter lifetime, and high cost of building integration. However, the application of technologies such as computational fluid dynamics (CFD), additive manufacturing (3D printing), and artificial intelligence (AI) makes it possible to enhance the efficiency of turbines and reduce production and maintenance costs. Esthetically acceptable performance, noise reduction and possible integration with photovoltaic systems further enhance BIWT. In the short term, BIWT will remain a niche market, but policies and legislation mandating greater use of RES in buildings, as well as financial incentives, can significantly boost the growth of BIWT, which is particularly likely in coastal areas with favorable wind conditions. In the long term, BIWT has the potential to make an important contribution to sustainable urban development and the energy transition. Full article

The clustering and collaborative development among cities, as a strategic measure concerning regional inclusivity and sustainable development, is both a current practice and a future trend, as evidenced by numerous successful cases worldwide. Scholarly research has extensively validated, from a macro-level perspective, its positive effects on social and economic aspects. However, relatively little research has examined its impact on the behavior of micro-level enterprises. To bridge this gap, this study leverages China’s urban integration strategy as a natural experimental framework and employs a two-way fixed effects model to conduct an in-depth investigation. The empirical results indicate that coordinated urban agglomeration development significantly enhances the technological complexity of enterprises within the region. The primary mechanism underlying this relationship is that the urban integration strategy facilitates regional financial concentration, fosters industrial collaborative agglomeration, and advances firm specialization, thereby enhancing the innovation capacity of enterprises. Furthermore, the heterogeneity analysis indicates that the findings are particularly pronounced for core cities within urban clusters, cities with lower levels of industrial specialization, and those with higher levels of financial development. Additionally, the effects are more significant for firms that face fewer financing constraints and inherently possess strong innovation capabilities. These findings not only augment the existing research on the micro-level effects of urban cluster development but also provide valuable insights for local governments in crafting policies to further enhance the sustainable innovation capacity of enterprises. Full article