City Region Research Articles

Molecular and serological detection of Leishmania infantum (Trypanosomatida: Trypanosomatidae) in domestic dogs in Manaus city, Amazonas, Brazil.

Leishmaniasis are zoonosis widely spread in Brazil, caused by the protozoan of the genus Leishmania, which includes several species. The disease manifests itself in the visceral or tegumentary form, and the main reservoir is the dogs. Manaus is the largest city in the Brazilian Amazon region, and despite the importance of the municipality, practically nothing is known about leishmaniosis in humans and animals. The objective of this study was to evaluate the occurrence and risk factors associated with the presence of Leishmania infantum in domiciliated dogs from Manaus. Molecular (polymerase chain reaction) and serological (immunofluorescent antibody test) methods were used as an indication of the circulation of the parasite. Blood samples for 154 domiciled dogs were obtained, and prevalence ratio and analysis of the variables were performed. Serum antibodies anti-Leishmania spp. were detected in 20.8% (95% CI: 14.4%-27.2%). Access to the street and zone of residence (P < 0.01) were associated with higher seropositivity. Molecular diagnosis for L. infantum detected positivity in 60 (39%) of the 154 (95% CI: 31.3%-46.7%) animals, and the variables street access, contact with dogs, and zone of residence were associated with higher frequencies of positivity (P < 0.05). Both serology and molecular diagnosis detected positive dogs in the municipality. This is the first description of the circulation of L. infantum infecting dogs in Manaus. As the municipality is classified as nonendemic, studies of isolation and characterization of the isolate must be done urgently.

Official Turnover and Embodied Carbon Emissions: Evidence From Industrial Linkages in China's Prefecture‐Level Cities

ABSTRACTCarbon emission is the most critical environmental pollution issue today. However, regional trade and industrial linkages have changed the traditional carbon emission pattern. As a public product with strong negative externalities, carbon emissions inevitably lead to severe consequences if the market is allowed to adjust itself. Therefore, public policies made by government officials have an important role in environmental governance and emission reduction. This paper uses China's Multi‐regional Input‐Output (MRIO) table and official turnover data of 269 prefecture‐level cities in China for the empirical test. The results show that official turnover has a significant positive impact on embodied carbon emissions between regions. Heterogeneity analysis shows that the inter‐provincial turnover of officials and the turnover between regional central cities results in more significant embodied carbon emissions. Further research finds that the longer the officials stay in their previous positions or as new local government leaders, the greater the embodied carbon emissions caused by their turnover. In addition, the turnover of officials affects interregional embodied carbon emissions by promoting regional entrepreneurship, venture capital and structure transformation of industries. The findings of this paper provide essential enlightenment for optimizing Chinese local government governance and promoting the transformation of the economic development mode.

Heuristic Optimal Scheduling for Road Traffic Incident Detection Under Computational Constraints

The intelligent monitoring of road surveillance videos is a crucial tool for detecting and predicting traffic anomalies, swiftly identifying road safety risks, rapidly addressing potential hazards, and preventing accidents or secondary incidents. With the vast number of surveillance cameras in operation, conducting traditional real-time video analysis across all cameras at once requires substantial computational resources. Alternatively, methods that employ periodic camera patrol analysis frequently overlook a significant number of anomalous traffic events, thereby hindering the effectiveness of traffic event detection. To overcome these challenges, this paper introduces a heuristic optimal scheduling approach designed to enhance traffic event detection efficiency while operating within limited computational resources. This method leverages historical data and prior knowledge to compute a weighted event feature value for each camera, providing a quantitative measure of its detection efficiency. To optimize resource allocation, a cyclic elimination mechanism is implemented to exclude low-performing cameras, enabling the dynamic reallocation of resources to higher-performing cameras, thereby enhancing overall detection performance. Finally, the effectiveness of the proposed method is validated through a case study conducted in a representative region of a major metropolitan city in China. The results revealed a substantial improvement in traffic event detection efficiency, with increases of 40%, 28%, 17%, and 28% across different time periods when compared to the pre-optimized state. Furthermore, the proposed method outperformed existing resource scheduling algorithms in terms of average load degree, load balance degree, and higher computational resource utilization. By avoiding the common issues of resource wastage and insufficiency often found in static allocation models, this approach offers greater flexibility and adaptability in computational resource scheduling, thereby effectively addressing the practical demands of traffic anomaly detection and early warning systems.

PROBLEMS OF POST-WAR DEVELOPMENT OF REGIONAL HEALTHCARE (based on materials from the administrative department of Gorky Regional Committee of the All-Union Communist Party (Bolsheviks))

The article reveals health problems in the City of Gorky and Gorky Region in the period of 1945 – early 1950s. Topicality of the study is connected, first of all, with the insufficient development of this topic in historiography. On the other hand, the secrecy of a number of archival funds and the gradual work on declassifying socially significant documents require their timely involvement in scientific circulation. The source base is the materials of the State Socio-Political Archive of Nizhny Novgorod Region and the Central Archive of Nizhny Novgorod Region. The City of Gorky and the regional centres of Gorky Region, especially Dzerzhinsk, were important industrial centres in the post-war period. Gorky was also one of the major transport hubs. The article notes that these factors directly influenced the development of regional medicine. With the outbreak of the Cold War, medical documentation became closed. The author focuses on the analysis of medical documents of the administrative department of Gorky Regional Committee of the All-Union Communist Party of Bolsheviks. Data on the state of health care in the region is just at the moment being introduced into scientific circulation. The research is based on the principles of historicism, scientific objectivity, and determinism. Methods of analysis, synthesis, comparative historicism, chronology were used. The novelty of the research lies in obtaining new knowledge about the conditions of the state, functioning and reform of the health care system of Gorky Region, as well as about the organisation of fighting social diseases, such as venereal ones and tuberculosis, in the post-war period. The author highlights the main problems of regional medicine of the period under study and the proposals of Party bodies to resolve socially significant issues.

Open Data for Transparency of Government Tenders: A State Analysis in Croatian Agriculture Land Lease

State-owned agricultural land is an asset that the state must manage in a responsible and transparent manner. Agricultural land is extremely important for farmers as it enables them to carry out agricultural activities. Due to its importance to farmers, it is often the subject of debate as stakeholders are often dissatisfied with the allocation and management of state-owned agricultural land. Qualitative research of the process of state agricultural land lease and the associated legislation in the Republic of Croatia enabled the analysis of the existing business model, with the results pointing to shortcomings in the Initial and Evaluation phases of the process. A steady rise in the number of tenders published in 2015–2022 was recorded. Local administrative units in the Continental region scored higher than those in the Adriatic region (both cities and municipalities) in terms of transparency. Unfortunately, the response rate from the local authorities was below 50% across both region and unit, further indicating low transparency. Based on the findings, a proposal of changes in the tendering process was made utilizing a digital platform as an environment for all stakeholders, which provides functionalities essential for the transparent implementation of tenders for the agricultural land lease in Croatia.

Unbound hukou and rebound innovation in urban China

The Chinese authorities issued the “Guiding Opinions on Further Deepening the Reform of the Household Registration System” in 2014. This policy maintained strict controls on urban hukou in megacities, while slightly less stringent controls were applied in large cities. However, the restrictions on obtaining urban hukou were significantly relaxed in medium-sized cities and completely lifted in small cities. This study examines the causal effects and underlying mechanisms of hukou reform on urban innovation in cities of different sizes, using DID method based on a quasi-natural experiment by the 2014 hukou reform in China. The findings suggest that the hukou reform can significantly promote urban innovation, with particularly strong positive effects observed in large cities in the eastern region, small- and medium-sized cities in the central and western regions, as well as cities with favourable conditions for innovation. The primary mechanisms in which hukou reform influences urban innovation involve enhancing both the quantity and quality of urban labor force, as well as creating a better environment for innovation in cities.

A Study on the Cooling Impact of the River Yamuna and its Surrounding LULC: A Case Study of New Delhi, India

Abstract. The unplanned growth of urban cities has adversely affected the thermal conditions. The Land Use and Land Cover (LULC) present in urban areas significantly impacts the thermal conditions of the surrounding environment. This study investigated the cooling effect of river in dense urban environments. It is conducted on the Yamuna river that flows through New Delhi, the capital city of India. The River Cooling Intensity (RCI) and River Cooling Range (RCR) assessment has been done for the summer season of May 2023 with the help of Landsat 8 images. The RCI ranged from 3.58°C to 1.16°C while the RCR varied from 1320 m to 360 m. It is observed that the river cooling effect is higher in the built-up class while the vegetation class weakens the effect of river cooling intensity and range. Zonal mean temperature varies from 32.02°C to 34.82°C according to the LULC distribution. This study provides valuable insights into the relationship between river cooling and temperature regulation according to the LULC classes. It also establishes the presence of an urban cool island inside the city region due to the river, as the mean temperature of the river surrounding (33.83°C) was lower than that of the city (35.73°C).

Spatiotemporal differentiation and influencing factors of the degree of resilience coupling coordination in the Beijing–Tianjin–Hebei region, China

Urban agglomeration system resilience involves multiple subsystems that are interconnected and interactive, and exploring the relationships among subsystems can elucidate and increase urban agglomeration resilience. This study constructed a social-economic-built environment resilience model and proposed a social-economic-built environment resilience index system. Using the entropy weight method, the coupling coordination degree (CCD) model, GeoDetector, spatial autocorrelation analysis and the autoregressive integrated moving average model (ARIMA) model, the resilience development level of the Beijing‒Tianjin‒Hebei (BTH) region from 2000 to 2020 was evaluated, the main influencing factors for the spatiotemporal differentiation pattern were identified, and the development levels in 2030 and 2050 were predicted. The results show that (1) high-resilience and high-CCD regions are concentrated in the region of Beijing and Tianjin in the centre, and low-value regions are concentrated in the districts and counties in the west and south; (2) economic elements, especially the economic aggregate status of a region as a whole, are the main factors contributing to the differences in resilience levels between regions, but their influence gradually decreases; and (3) the gap between the CCDs of Beijing, Tianjin and cities in Hebei increased from 2000 to 2020, but this gap is expected to narrow by 2030 and 2050. On this basis, five categories of future development guidelines for cities in the BTH region are proposed.

Blue space resilient urban planning to enhance severely distressed thermal environment

Water resilience is a vital aspect of current smart city planning. Maintaining the quality and volume of urban blue spaces can benefit local ecology, environment, and social well-being. The application of geospatial techniques provides an opportunity to achieve such goals in a spatially and temporally effective manner. While researchers often highlight city-level environmental problems, location-based solutions are insufficient, particularly for the rapidly sprawling Asian cities—the current work aimed to examine the water-resilient urban planning scopes for an Indian tropical megacity. The work assessed a major environmental hazard, i.e., urban heat island, which appeared to cover 9.6 % to 17.4 % of the area of the city region during the summer months. The importance of blue spaces in mitigating heat islands was quantified using data from nearly 150 waterbodies, including a river, a vast wetland, and multiple lakes and urban tanks. Linear and logarithmic models established how the cooling effect increases with larger water bodies. Blue space ranging between 1.8 km2 and 2.3 km2 was recommended as the smallest yet effective size for future recreational zones. Incorporating ambient wind patterns further aided in deciding the locations of blue wedges that can be key for heat island mitigation. Moreover, to substantially amplify the blue resource recharge rate in a cost-effective manner, a multi-parameter decision analysis was carried out. Overlay of five surface characteristics contributed to planning sites for surface infiltration systems. The entire framework of the work was built to achieve sustainable development goals.

UBER IN EXURBIA: Peripheral Platformization, Post‐Suburbanization and the Public–Private Ridehail Partnership in the Toronto City Region

AbstractAfter their widespread legalization, ridehailing companies Uber and Lyft soon embarked on a new stage of their respective business models: the initiation of a wave of strategic partnerships with local and regional transit agencies across the North American continent. This article accounts for this trend by putting forward the concept of the public–private ridehail partnership (PPRP). It aims to render visible the PPRP as a variously contradictory attempt to splice Uber and Lyft's platform‐based business models with the existing social and physical realities of North American post‐suburban space. While conceived as a strategic response to pressing sub‐ and exurban problems such as low physical densities, widespread car centrism and extensive transit undersupply, the PPRP, as I argue, is neither able to adequately address these dilemmas nor to ultimately resolve them. Rather, the PPRP latches onto old—and sets in motion new—powerful dynamics of heightened uneven development and continued urban entrepreneurialism. Each of these two dynamics is explored through empirical analyses of two recent PPRPs in the Toronto city region: the Lyft–Metrolinx pilot carried out between July and December 2019; and Uber's ongoing partnership with the town of Innisfil, located about 80 km north of downtown Toronto.

Impact of Transparency on Public Trust in a Government Charity and Gaming Office as Mediated by Corporate Social Responsibility

Purpose: This study investigated the mediating role of corporate social responsibility (CSR) on the relationship between transparency and public trust in a government and charity gaming office in Davao City. Materials and Methods: Using a quantitative, mediating design, samples of 300 clients were selected using stratified sampling surveyed through standardized modified instruments. The gathered data was analyzed using Mean, Pearson r, Regression and Medgraph using Sobel z-test. The pertinent results were presented appropriately in tables. Findings: The findings revealed an overall high level of transparency within the organization. Furthermore, the results demonstrated a very high level of public trust, as well as a very high level of CSR. The test of relationship revealed significant correlation among the variables. The mediation analysis revealed that CSR significantly mediated the relationship between transparency and public trust in the organization. The relationships between the variables are all significant; therefore, there is only partial mediation of CSR on the relationship between transparency and public trust. Partial mediation suggests that not only is there a significant relationship between the mediator and the dependent variable but that there is also direct relationship between the independent and dependent variable. Implications to Theory, Practice and Policy: The study has uncovered significant implications for practice, theory, and policy regarding the relationships between transparency, public trust, and corporate social responsibility (CSR). It was found that transparency is closely linked to public trust and CSR. Specifically, a strong correlation was observed between transparency and public trust and between transparency and CSR. Additionally, a significant relationship was established between CSR and public trust. Given the overall high level of transparency observed, the researcher suggests that the PCSO branch in Davao City should maintain this level in this domain and focus on enhancing transparency across other indicators, particularly in terms of secrecy. To address this, it is recommended that the organization improve its information dissemination practices to clients. Moreover, future researchers must delve deeper into the relationships among transparency, public trust, and CSR, particularly within the context of Davao City or other regions of the country. More empirical studies on these variables need to be conducted in these specific contexts. Thus, further research could provide valuable insights for both academia and policymaking.

Impact of COVID-19 on health-related quality of life in patients with cardiovascular disease: A cross-sectional study.

The COVID-19 pandemic disrupted healthcare access for cardiovascular patients, potentially worsening their health outcomes and quality of life through both medical and psychological impacts. This cross-sectional study was conducted to assess the quality of life of patients with cardiovascular disease before and after the COVID-19 pandemic. The work was conducted from January 9 to April 28, 2023, in Almaty city and the Almaty region. 3026 outpatients with cardiovascular pathology participated in the survey using a standardised European Quality of Life Questionnaire. The study utilized cluster, frequency analysis, and discrete statistics to analyze the impact of COVID-19 on quality of life parameters, revealing significant changes in anxiety and depression among cardiovascular patients, resulting in reduced quality of life (from 0.3% to 5.5% and 0.4; to 7.5% in the categories of extremely severe and severe manifestations, respectively). An analysis of the nosological structure of cardiovascular diseases in the study group was performed and revealed that coronary heart disease occurred in 51.6% of cases, arterial hypertension in 88%, and diabetes mellitus in 34.6%. The availability of both outpatient and inpatient medical services in Almaty region and Almaty city was also assessed, and their comparative analysis was conducted, during which it was found that the need for these services in the district settlements is 10% and 12% higher, respectively, than in the city, which is particularly important for understanding the effectiveness of the public health system in the context of the COVID-19 pandemic, both at the regional and republican levels. This study is of practical importance for health care workers, as it allows assessing the impact of the COVID-19 pandemic on the quality of life of patients with cardiovascular diseases, which provides an opportunity to develop effective rehabilitation protocols and psychological support for this vulnerable category.

The Effect of Murottal Al-Qur'an on the Anxiety of Pregnant Women in the Third Trimester in the Independent Practice of Midwives in the Bandung City Region

Background: Anxiety is still widespread among pregnant women in Indonesia, and the frequency of this condition is relatively significant. During the third trimester of pregnancy, pregnant women experience a higher level of anxiety compared to the previous trimester. This is because they are more concerned about the labor and delivery procedure that they will go through as well as the pain that they will face during the birth process—taking in the murottal of the Al-Qur'an, which has the potential to induce a soothing effect. Purpose: The aim of this study is to investigate how murottal Al-Qur'an influences third trimester pregnant women's anxiety level. Methode: The study design was a quasi-experiment with a control design that was used before and after the experiment. The study sample was made up of 60 pregnant women from Bandung who were in their third trimester and were between 28 and 36 weeks along. There were 30 expecting women in each of the two groups: the control group and the intervention group. Anxiety observation sheets were used to gather information. The results were looked at with the Mann Whitney test. Result: The intervention group was found to have a mean difference of 9.27, while the control group had a mean difference of 1.17. The Mann-Whitney test results, which were obtained by comparing the posttest results of the intervention group and the control group, indicated that murottal Al-Qur'an had a significant impact on the reduction of anxiety in third-trimester expectant women (p value = 0.017 &lt; 0.05). Conclusion: Murottal al-Qur'an affects anxiety of third-trimester pregnant women.. Suggestion: It is hoped that future researchers will carry out further research by adding variables that can influence the anxiety of pregnant women in the third trimester and a larger number of respondents studied.

Bridging the Disparity: An Optimization Model for Equitable Allocation of Urban and Rural Educational Resources in Western China

The persistent disparity in educational resources between urban and rural areas in western China remains a critical barrier to achieving educational equity. This study addresses the critical issue by developing an innovative optimization model. The model aims to allocate financial, human, and physical resources effectively to minimize the educational quality gap between these regions. Using information from the China Education Panel Survey (CEPS) and concentrating on Xinjiang as a representative instance, our design integrates budget constraints, minimum resource requirements, and a unique regional prioritization factor. The goal of the objective function is to reduce the squared disparity in educational quality between city and rural regions. It thinks about variables such as Teacher-Student Ratio (TSR), Per Capita Investment (PCI), and Teaching Equipment Perfection (TEP). Our searchings for show that strategic resource distribution can considerably lessen educational inequalities in between metropolitan and country setups, especially by focusing on underdeveloped rural regions. Sensitivity analysis shows that customizing the local prioritization specification makes it possible for versatile policy strategies, ranging from equitable distribution to plainly sustaining rural regions. This study presents a pragmatic structure for boosting resource allotment in education. It supplies vital understandings for policymakers aiming to promote an extra equitable educational environment in Western China.

Prevecardio: a single-visit population screening model for detection and prevention of 10-year cardiovascular risk

Abstract Introduction Cardiovascular diseases (CVDs) are a major contributor to global mortality. The early detection of cardiovascular risk factors, coupled with timely intervention strategies, is essential for CVD prevention. PreveCardio was developed as an innovative, single-visit population screening model designed to facilitate the early identification and management of cardiovascular risk factors within a population of 1 million in a European capital city region totaling 6 million inhabitants. Purpose This study aimed to ascertain the prevalence of cardiovascular risk factors within the general population and to evaluate the effectiveness of the PreveCardio model in estimating 10-year cardiovascular risks and promoting preventive interventions. Methods In this cross-sectional prevalence study, individuals aged 50 to 75 from a health network were randomly selected and invited to participate in a comprehensive health check. The 30-minute screening consisted of lifestyle evaluations, anthropometric measurements, and blood tests for lipid profiles and glycated haemoglobin. The methodology was designed to provide participants with immediate feedback on their results, cardiovascular health and practical guidance for risk management. Results From the 8,492 individuals solicited, 3,546 took part in the screening: 56,83% were female, mean age 61,17 ± 7,33 y.o. Picture 1 shows the population's percentages with various modifiable cardiovascular risk factors, including 20% with active smoking, 30% with sedentarism, 16% with risky alcohol consumption, 49% with non-adherence to the Mediterranean diet, 40% with overweight, and 30% with obesity. The screening revealed new diagnoses of LDL-hypercholesterolemia in 47% participants, high levels of blood pressure in hypertension range in 49%, prediabetes in 30% and diabetes in 2% (Picture 2). After use SCORE2 and SCORE-OP risk prediction algorithms, PreveCardio is estimated to potentially prevent between 39 to 202 fatal and non-fatal cardiovascular events over 10 years. Predictive modelling based on PreveCardio data projected that expanding the screening across the capital region could prevent at least 26,260 cardiovascular events over 10 years. Conclusion(s) PreveCardio has established itself as a viable and effective model for the early detection of cardiovascular risk factors in a general population. It holds significant promise for public health impact by potentially reducing the incidence of CVD through comprehensive screening and proactive intervention.

Traffic injury as a medical and sanitary consequence of an emergency of man-made nature in Ukraine. Report four: analysis and characterization of the array of victims depending on the volume of damage

Background. Road traffic injuries always remain a significant medical and social problem for all mankind, and in Ukraine even during the full-scale invasion of the Russian Federation. The purpose of the study: to determine the clinical and nosological characteristics of victims of road traffic accidents according to the extent of damage in road users. Materials and methods. This article is a continuation of the cycle of publications that were previously published in the journal “Emergency Medicine”, that is, it is a component of a comprehensive study. The actual material of the study were 1,696 cases of road traffic injuries formed by the method of irreversible randomization. The resulting array was formed from victims who were injured in the conditions of a metropolis, a regional city, and a rural area. Results. The conducted analysis found that in the total body of the study, 78.25 % of victims of traffic accidents had damage of up to three anatomical and functional areas (AFAs). Greater damage (4–6 AFAs) occurs in 21.75 % of patients. In the array of those who survived, 79.71 % had damage to 4–6 AFAs, in the array of the dead — 34.68 %. The highest mortality rate is 27.78 % when six AFAs are damaged, and the lowest — with one injured AFA (2.37 %). It was also found that among the “drivers” traffic participants, victims with damage to two (31.56 %) and three AFAs (25.58 %) have the highest specific weight. Among the “passengers” traffic participants, victims with damage to two (33.73 %) and one AFA (26.56 %) have the highest specific weight. Among the “pedestrians” traffic participants, victims with damage to two (29.74 %) and three AFAs (25.15 %) have the highest percentage. Conclusions. 1. It was found that a large amount of damage in general causes a greater threat to the life of a victim of traffic accidents, but the trend is non-linear, that is, the survival is affected by other risk-creating factors. 2. All traffic participants in general have a relatively smaller injury (damage to 1–3 anatomical and functional areas). At the same time, the highest specific weight of such trauma is observed among drivers, and the lowest one among pedestrians. 3. There was a significant influence of the sign of participation in traffic and the extent of damage on the outcome of traumatic process in victims of traffic accidents.

Evaluating Scientific Potential in Kazakhstan: A Regional Index Assessment Approach

The role of human resources in increasing competitiveness is enormous, including people with higher education, a certain status or academic degree, as well as knowledgeable human resources. The objective is to identify the scientific potential across Kazakhstan’s regions using the index assessment method and to analyze the differences between regions. Thus, the authors determine the scientific potential in the regions by the method of index assessment, using factors such as the proportion of people working in the field of science in the region and the amount of spending on science in that region. Conducting a regional analysis provides important information in the management of the state. According to this rating, the cities of Abay region (0.27), Almaty (0.58) and Astana (0.44) were in the lead, and Turkestan (0.02), Atyrau (0.02) and Ulytau (0.001) were in the last place.After all, since most of the scientific research organizations and universities are located in Astana and Almaty, the funds allocated from the Center for science and the number of people engaged in science are concentrated in these cities. This article also revealed the correlation of factors affecting the number of people involved in science in the country’s regions. As a result of the study, it was found that the number of people engaged in science in the regions is directly affected by the internal costs of research work in the regions. At the end of the article, recommendations were given on increasing scientific and high intellectual potential. These recommendations can be used by persons and organizations interested in the development of Science in the regions and applied to the teaching aids of higher educational institutions.

Quality of Life and Health Awareness Among Patients With Hypertension in Urban and Rural Regions of Riyadh City, Saudi Arabia

Quality of Life and Health Awareness Among Patients With Hypertension in Urban and Rural Regions of Riyadh City, Saudi Arabia

Digital Economy and Urban Carbon Emissions: A Quasi-Natural Experiment of the National Big Data Comprehensive Pilot Zone in China

In this study, we assess the impact of digital economy development on urban carbon emissions using a difference-in-differences (DID) approach based on the quasi-natural experiment of the national big data comprehensive pilot zone (NBDCPZ) policy and panel data from 168 prefecture-level cities in China from 2006 to 2019. We find that the establishment of NBDCPZ has a significant carbon emission reduction effect. This finding is robust to various sensitivity tests. Further mechanism validation illustrates that the construction of NBDCPZ promotes the regional digital development level and reduces urban carbon emissions through three channels: improving energy efficiency to optimize energy consumption, increasing green total factor productivity, and promoting the clustering of high-tech industries. The heterogeneity analysis concludes that the carbon emission reduction effect of NBDCPZ policy varies with different regional locations and different city characteristics. Moreover, using spatial models, we find that the positive impact is characterized by spatial spillover effect. The findings provide detailed empirical evidence to formulate urban development strategies for enabling carbon reduction of the digital economy. JEL Classification: O30, Q53, Q55, Q58, R10

Current status analysis of the prevalence and regional disparities of robot-assisted laparoscopic prostatectomy in Japan using diagnosis procedure combination data

The introduction of the “da Vinci S HD Surgical System” marked a significant shift towards robotic surgeries in Japan. However, initial high costs and lack of efficacy data posed barriers to its widespread adoption. By 2023, more than 570 da Vinci units were operational in Japan, highlighting the growing acceptance of robotic surgery despite these challenges. This study aimed to investigate the prevalence and regional disparities in the adoption of robot-assisted laparoscopic prostatectomy (RALP) across Japan using diagnosis procedure combination data. This retrospective observational study analyzed data from 2857 urban and 4184 regional hospitals across 47 prefectures in Japan. The study focused on the number of RALP procedures, da Vinci systems, and certified urological surgery proctors. Multiple regression analysis was performed to identify significant factors influencing RALP adoption. Urban areas demonstrated a higher prevalence of RALP procedures and more da Vinci systems compared to regional areas, with urban hospitals performing an average of 937 RALP procedures compared to 195.5 in regional hospitals. The number of certified urological surgeons also showed significant urban-regional disparities, contributing to the overall imbalance. Our findings highlight substantial regional disparities in access to robot-assisted surgery in Japan, with urban areas benefiting from better access to advanced medical technologies and specialist training. Addressing these disparities will require targeted policies to improve the dissemination of robotic surgery systems and enhance training opportunities in regional cities.