Implementation of a 3-phase grid-coupled solar electricity and back-up system at Mulanje Mission Hospital, Malawi.

In this report we describe the implementation of a new electricity supply system at Mulanje Mission Hospital, Malawi, which integrates the use of grid electricity, solar-generated electricity and battery back-up. To realize the system, suppliers from several countries had to be used and external expertise and funding were vital. The completed system provides reliable and good quality electricity to all departments in the hospital, prioritizing essential equipment when needed. Implementation of the system has reduced cost of electricity bills by 60%, ended black-outs and extended longevity of electrical equipment. We describe our approach, the materials used and results with challenges and recommendations to governments, donors interested in hospital infrastructure and other health facilities operating in similar circumstances. Others in similar settings can benefit from the experiences documented.

Factors influencing the material footprint in the USA.

Using novel approaches, namely Fourier autoregressive distributive lag (F-ADL) cointegration and nonlinear autoregressive distributed lag (N-ARDL), this article analyzes how infrastructure investment and environmental R&D affected the material footprint from 1995Q1 to 2019Q4 in the USA while controlling financial development and economic growth. The outcomes reveal that (i) a reduction in the material footprint can be achieved through increasing environmentally related R&D; (ii) by increasing the environmental R&D, material consumption can be used more effectively; (iii) an increase in financial development leads to an increase in the material footprint; and (iv) the slowdown of the economy contributes to efficient material consumption. Integr Environ Assess Manag 2024;00:1-8. © 2024 SETAC.

Systematic review, evaluation and comparison of different approaches for the implementation of road network safety analysis.

Introduction: Road safety is still a major issue all around the world. The capability to analyze the road network and identify high risk sections is crucial in road safety management. Therefore, it is essential for road administrations, practitioners, and researcher to have a clear and practical framework of the available road network safety analysis procedures. The aim of this study is to provide such a framework by carrying out an exhaustive analysis of the main procedures available all around the world. Method: The proposed literature review has started considering a web search on Web of Science (WoS). Then, a systematic review of each publication has been carried out using the Bibliometrix software, to identify the main characteristics of the publications within the specific topic. Then, the most relevant and widespread safety analysis procedures have been considered and the following aspects have been analyzed: the type of approach (crash analysis, crash prediction models procedures, based on road safety inspections, etc.), which and how many data are required (crashes, traffic, visual inspections, geometrical data, etc.), which is the effectiveness of the procedure, and which are the segmentation criteria used (fixed length, variable length based on geometry, traffic, etc.). Results: Ten different procedures for road network safety analysis have been considered for detailed analysis. The research findings highlight that each procedure has its own pros and cons. Conclusions: The choice of the best procedure to use is highly related to the characteristics of the road network that need to be analyzed, to the availability of data, and to the main elements the Road Authorities (RA) wants to give priority to. Practical applications: This collection and review of different procedures will be of great interest for RAs, practitioners, and researchers in the process of selecting the most useful procedure to use to carry out a road network safety analysis.

Topography-based modulation of environmental factors as a mechanism for intertidal microhabitat formation: A basis for marine ecological design.

Topographic complexity is often considered to be closely associated with habitat complexity and niche diversity; however, complex topography per se does not imply habitat suitability. Rather, ecologically suitable habitats may emerge if topographic features interact with environmental factors and thereby alter their surrounding microenvironment to the benefit of local organisms (e.g., resource provisioning, stress mitigation). Topography may thus act as a key modulator of abiotic stressors and biotic pressures, particularly in environmentally challenging intertidal systems. Here, we review how topography can alter microhabitat conditions with respect to four resources required by intertidal organisms: a source of energy (light, suspended food particles, prey, detritus), water (hydration, buffering of light, temperature and hydrodynamics), shelter (temperature, wave exposure, predation), and habitat space (substratum area, propagule settlement, movement). We synthesize mechanisms and quantitative findings of how environmental factors can be altered through topography and suggest an organism-centered 'form-follows-ecological-function' approach to designing multifunctional marine infrastructure.

Exploring optimal deep tunnel sewer systems to enhance urban pluvial flood resilience in the gangnam region, South Korea.

Urban pluvial flooding is becoming a global concern, exacerbated by urbanization and climate change, especially in rapidly developing areas where existing sewer systems lag behind growth. In order to minimize a system's functional failures during extreme rainfalls, localized engineering solutions are required for urban areas chronically suffering from pluvial floods. This study critically evaluates the Deep Tunnel Sewer System (DTSS) as a robust grey infrastructure solution for enhancing urban flood resilience, with a case study in the Gangnam region of Seoul, South Korea. To do so, we integrated a one-dimensional sewer model with a rapid flood spreading model to identify optimal routes and conduit diameters for the DTSS, focusing on four flood-related metrics: the total flood volume, the flood duration, the peak flooding rate, and the number of flooded nodes. Results indicate that, had the DTSS been in place, it could have reduced historical flood volumes over the last decade by 50.1-99.3%, depending on the DTSS route. Regarding the conduit diameter, an 8 m diameter was found to be optimal for minimizing all flood-related metrics. Our research also developed the Intensity-Duration-Frequency (IDF) surfaces in three dimensions, providing a correlation between simulated flood-related metrics and design rainfall characteristics to distinguish the effect of DTSS on flood risk reduction. Our findings demonstrate how highly engineered solutions can enhance urban flood resilience, but they may still face challenges during extreme heavy rainfalls with a 80-year frequency or above. This study contributes to rational decision-making and emergency management in the face of increasing urban pluvial flood risks.

Unlocking the genomic landscape: Results of the Beyond 1 Million Genomes (B1MG) pilot in Belgium towards Genomic Data Infrastructure (GDI).

Genomic medicine has great potential to offer insights into how humans' genetic variation can affect their health, prevention options and treatment responses. The Beyond 1 Million Genomes (B1MG) project was kicked off in 2020 with the aim of building a federated network of genomic data in Europe, in which Belgium took part as a piloting country. B1MG developed a framework to enable all interested countries to self-evaluate the level of maturity of national genomic medicine practices following a common matrix, called Maturity Level Model (MLM), that contained 49 indicators across eight domains: I. Governance and strategy; II. Investment and economic model; III. Ethics, legislation and policy; IV. Public awareness and acceptance; V. Workforce skills and organisation; VI. Clinical organisation, infrastructure and tools; VII. Clinical genomics guidelines and infrastructure; and VIII. Data management, standards and infrastructure. The ongoing Genomic Data Infrastructure (GDI) project aims to capitalise on the experience of B1MG piloting countries and their MLM results. In this paper, we present the qualitative and quantitative outcomes of B1MG MLM assessment in Belgium and discuss their relevance to GDI. The insights gained from this study can be helpful for steering future policy directions and interventions on genomics in Belgium and beyond.

The emergence of telemedicine in a low-middle-income country: challenges and opportunities.

The quality of cancer care delivery varies across different regions of Ghana, highlighting the need for improved access to quality healthcare services. Telemedicine has emerged as a promising solution to address this disparity, as it can reduce costs and improve access to healthcare services for cancer patients in remote areas. Despite the widely reported benefits of telemedicine, its adoption in low-resource settings has been slow due to several challenges. This study explores strategies for incorporating telemedicine into the current healthcare system in Ghana for the benefit of all patients especially those diagnosed with cancer. The study also highlights the current challenges and opportunities associated with the implementation and utilisation of telemedicine in Ghana. This research was a cross-sectional study conducted in Accra, Ghana that adopted a mixed-methods approach. Participants were selected through multi-stage probability sampling. Quantitative data were collected via a survey whereas qualitative data were obtained by means of in-depth interviews and focus group discussions among healthcare professionals, patients and key stakeholders in the telemedicine industry. The Statistical Program for the Social Sciences (version 21) was used to assemble, analyse and display the research data. The major challenges discussed centered on high initial investment costs, privacy and security concerns, poor internet connectivity, insufficient infrastructure and training of healthcare providers as well as the resistance to change among healthcare professionals. The study contributes to the understanding of telemedicine adoption in Ghana with findings underscoring the potential to address healthcare challenges while highlighting the need to overcome implementation obstacles. The study findings also provide valuable insights for policymakers, healthcare institutions and stakeholders to enhance telemedicine adoption in Ghana.

Specific and Non-specific Aspects and Future Challenges of ICU Care Among COVID-19 Patients with Obesity: A Narrative Review.

PURPOSE OF REVIEW: Since the end of 2019, the coronavirus disease 2019 (COVID-19) pandemic has infected nearly 800 million people and caused almost seven million deaths. Obesity was quickly identified as a risk factor for severe COVID-19, ICU admission, acute respiratory distress syndrome, organ support including mechanical ventilation and prolonged length of stay. The relationship among obesity; COVID-19; and respiratory, thrombotic, and renal complications upon admission to the ICU is unclear. RECENT FINDINGS: The predominant effect of a hyperinflammatory status or a cytokine storm has been suggested in patients with obesity, but more recent studies have challenged this hypothesis. Numerous studies have also shown increased mortality among critically ill patients with obesity and COVID-19, casting doubt on the obesity paradox, with survival advantages with overweight and mild obesity being reported in other ICU syndromes. Finally, it is now clear that the increase in the global prevalence of overweight and obesity is a major public health issue that must be accompanied by a transformation of our ICUs, both in terms of equipment and human resources. Research must also focus more on these patients to improve their care. In this review, we focused on the central role of obesity in critically ill patients during this pandemic, highlighting its specificities during their stay in the ICU, identifying the lessons we have learned, and identifying areas for future research as well as the future challenges for ICU activity.

'Nowhere and no one is safe': spatial analysis of damage to critical civilian infrastructure in the Gaza Strip during the first phase of the Israeli military campaign, 7 October to 22 November 2023.

BACKGROUND: Since the Hamas attacks in Israel on 7 October 2023, the Israeli military has launched an assault in the Gaza Strip, which included over 12,000 targets struck and over 25,000 tons of incendiary munitions used by 2 November 2023. The objectives of this study include: (1) the descriptive and inferential spatial analysis of damage to critical civilian infrastructure (health, education, and water facilities) across the Gaza Strip during the first phase of the military campaign, defined as 7 October to 22 November 2023 and (2) the analysis of damage clustering around critical civilian infrastructure to explore broader questions about Israel's adherence to International Humanitarian Law (IHL). METHODS: We applied multi-temporal coherent change detection on Copernicus Sentinel 1-A Synthetic Aperture Radar (SAR) imagery to detect signals indicative of damage to the built environment through 22 November 2023. Specific locations of health, education, and water facilities were delineated using open-source building footprint and cross-checked with geocoded data from OCHA, OpenStreetMap, and Humanitarian OpenStreetMap Team. We then assessed the retrieval of damage at and with close proximity to sites of health, education, and water infrastructure in addition to designated evacuation corridors and civilian protection zones. The Global Moran's I autocorrelation inference statistic was used to determine whether health, education, and water facility infrastructure damage was spatially random or clustered. RESULTS: During the period under investigation, in the entire Gaza Strip, 60.8% (n = 59) of health, 68.2% (n = 324) of education, and 42.1% (n = 64) of water facilities sustained infrastructure damage. Furthermore, 35.1% (n = 34) of health, 40.2% (n = 191) of education, and 36.8% (n = 56) of water facilities were functionally destroyed. Applying the Global Moran's I spatial inference statistic to facilities demonstrated a high degree of damage clustering for all three types of critical civilian infrastructure, with Z-scores indicating < 1% likelihood of cluster damage occurring by random chance. CONCLUSION: Spatial statistical analysis suggests widespread damage to critical civilian infrastructure that should have been provided protection under IHL. These findings raise serious allegations about the violation of IHL, especially in light of Israeli officials' statements explicitly inciting violence and displacement and multiple widely reported acts of collective punishment.

Indonesian air medical evacuation: Analyzing readiness and proposing an integrated standard procedure.

Indonesia still faces challenges in providing healthcare services, and it is crucial to develop an air medical evacuation services system for at least two reasons. Firstly, Indonesia is an archipelagic country and a popular tourist destination. Secondly, there are still significant disparities in the number and types of healthcare facilities and health workers nationwide. To respond to the current situation, the healthcare providers and government have made some efforts regarding air medical evacuation but are showing an unintegrated system. This qualitative study aimed to explore the current implementation of air medical evacuation in Indonesia and to propose an integrated standard procedure that all related stakeholders can adopt at the national and regional levels. The study used a multi-case design analysis, collecting both primary and secondary data. Secondary data was gathered through desk studies to learn related policies and previous studies. Primary data was collected through observation and in-depth interviews with relevant stakeholders, including regulators, service providers, practitioners, and non-governmental organizations. The study found that there is currently a regulatory gap for the implementation of air medical evacuation services in Indonesia. The readiness of the Health Human Resources (HHR) is limited in terms of qualification and competency, and the definitive infrastructure of air medical evacuation requires improvement since the providers continue to use the airport for civil transportation. Besides, the interaction pattern between stakeholders needs to be integrated into standardized procedures. Therefore, the study recommends proposing an integrated standard procedure and actionable recommendations to advocate for all stakeholders.

A quantitative review of nature-based solutions for urban sustainability (2016-2022): From science to implementation.

Nature-based solutions (NBS) have great potential for achieving urban sustainability. While several reviews have comprehensively examined NBS, few have focused on its role in addressing urban sustainability challenges. Here we present a systematic review of 142 case studies selected from English papers published in SCI journals (i.e., indexed by Web of Science) during 2016-2022, whose titles, abstracts or keywords contain both urban-related terms and NBS-related terms. Using multiple methods, including statistical analysis, deductive content analysis, and inductive content analysis, we found that: (1) NBS have primarily been utilized to address urban flooding (43 %) and heat stress (21 %), with green roofs (24 %) and urban forests (16 %) being the most extensively studied NBS for tackling these challenges. (2) The ecosystem services (ES) capacity of NBS has been heavily researched (57 %), while studies addressing ES flows (7 %) and ES demand (18 %) are limited. (3) Most studies involved at least one NBS implementation process (83 %), but primarily focused on selecting and assessing NBS and related actions (66 %), with fewer studies on designing and implementing NBS and transferring & upscale NBS. We suggest that future research should contribute to the establishment of a checklist to assist in identifying which NBS types are effective in addressing specific urban sustainability challenges in varying contexts. Integrating the science and practice of NBS for urban sustainability is also crucial for advancing this field.

How does the development of the digital economy influence carbon productivity? The moderating effect of environmental regulation.

Improving carbon productivity is of great significance to China's "30 · 60" carbon target, while the development of the digital economy is a driving force for green transformation. However, few studies discuss the relationship between the digital economy and carbon productivity. We investigate the influence of digital economic development on carbon productivity using panel data from 30 Chinese provinces from 2011 to 2020. Spatial econometric and moderating effects are considered. The results show that (i) digital economy has a positive direct and negative spatial spillover effect on carbon productivity, and this conclusion is still valid after the robustness test and endogeneity test; (ii) digital infrastructure has a greater impact on carbon productivity than digital industrialization and industrial digitalization; (iii) the mechanism analysis shows that environmental regulation negatively moderates the relationship between the digital economy and carbon productivity; (iv) heterogeneity analysis shows that the effect of the digital economy on carbon productivity is more obvious in the central region compared to the western region, while it is not significant in the eastern region. Overall, this paper not only provides a new analytical perspective for understanding the improvement of carbon productivity in the digital economy but also provides policy inspiration for promoting carbon peak and carbon neutrality goals.

Planned expansion of transportation infrastructure in Brazil has implications for the pattern of agricultural production and carbon emissions.

High transportation costs have been a barrier to the expansion of agriculture in the interior of Brazil. To reduce transportation costs, Brazil launched the National Logistics Plan, aiming to expand its railway network by up to 91 % by 2035. Such a large-scale infrastructure investment raises concerns about its economic and environmental consequences. By combining geospatial estimation of transportation cost with a grid-resolving, multi-scale economic model that bridges fine-scale crop production with its trade and demand from national and global perspectives, we explore impacts of transportation infrastructure expansion on agricultural production, land use changes, and carbon emissions both locally and nationally in Brazil. We find that globally, the impacts on output and land use changes are small. However, within Brazil, the plan's primary impacts are impressive. PNL2035 results in the reduction of transportation costs by 8-23 % across states (depending on expansion's extent) in the interior Cerrado biome. This results in cropland expansion and increases in terrestrial carbon emissions in the Cerrado region. However, the increase in terrestrial carbon emissions in the Cerrado is offset by spillover effects elsewhere in Brazil, as crop production shifts away from the Southeast-South regions and accompanying change in the mix of transportation mode for farm products from roadway to more emission-efficient railway. Furthermore, we argue that the transportation infrastructure's impact on the enhanced mobility of labor and other agricultural inputs would further accentuate the regional shift in agricultural production and contribute to carbon emission mitigation. Upon its completion, PNL2035 is expected to result in the reduction of net national emissions by 1.8-30.7 million metric ton of CO2-equivalent, depending on the impacts on labor and purchased input mobility. We conclude that the omission of spillover effects due to infrastructure expansion can lead to misleading assessments of transport policies.

Impacts of noise pollution from high-speed rail and road on bird diversity: a case study in a protected area of Italy.

The disturbance of infrastructures may affect biological communities that are exposed to them. This study assesses the impact of high-speed (highway and railway) infrastructures in a protected study site, the Natural Reserve Fontanili di Corte Valle Re (Emilia-Romagna, Italy). We compared bird diversity with sound intensity and frequency in three sampling areas, increasingly distant from the infrastructures at the border with the reserve, during the last 4 years (2019-2022), monitoring sedentary, nesting, and migratory bird species. We hypothesize a decreasing diversity closer to the source of disturbance, which is mostly attributable to noise pollution. Our findings confirmed this trend, and we show that, in particular, disturbance seems to influence species richness more than the total abundance of birds. We also discovered that highway disturbance was much higher than railway in terms of frequency and duration. In light of these results, we suggest that some species, which have a behavioral ecology strongly based on singing to communicate with each other for their reproductive and defensive strategies, may suffer more from constant acoustic disturbance. The installation of effective noise barriers to shield the sound produced by the highways should be considered a mandatory request not only in proximity to houses but also in the vicinity of protected areas.

Automated Lane Centering: An Off-the-Shelf Computer Vision Product vs. Infrastructure-Based Chip-Enabled Raised Pavement Markers.

Safe autonomous vehicle (AV) operations depend on an accurate perception of the driving environment, which necessitates the use of a variety of sensors. Computational algorithms must then process all of this sensor data, which typically results in a high on-vehicle computational load. For example, existing lane markings are designed for human drivers, can fade over time, and can be contradictory in construction zones, which require specialized sensing and computational processing in an AV. But, this standard process can be avoided if the lane information is simply transmitted directly to the AV. High definition maps and road side units (RSUs) can be used for direct data transmission to the AV, but can be prohibitively expensive to establish and maintain. Additionally, to ensure robust and safe AV operations, more redundancy is beneficial. A cost-effective and passive solution is essential to address this need effectively. In this research, we propose a new infrastructure information source (IIS), chip-enabled raised pavement markers (CERPMs), which provide environmental data to the AV while also decreasing the AV compute load and the associated increase in vehicle energy use. CERPMs are installed in place of traditional ubiquitous raised pavement markers along road lane lines to transmit geospatial information along with the speed limit using long range wide area network (LoRaWAN) protocol directly to nearby vehicles. This information is then compared to the Mobileye commercial off-the-shelf traditional system that uses computer vision processing of lane markings. Our perception subsystem processes the raw data from both CEPRMs and Mobileye to generate a viable path required for a lane centering (LC) application. To evaluate the detection performance of both systems, we consider three test routes with varying conditions. Our results show that the Mobileye system failed to detect lane markings when the road curvature exceeded ±0.016 m-1. For the steep curvature test scenario, it could only detect lane markings on both sides of the road for just 6.7% of the given test route. On the other hand, the CERPMs transmit the programmed geospatial information to the perception subsystem on the vehicle to generate a reference trajectory required for vehicle control. The CERPMs successfully generated the reference trajectory for vehicle control in all test scenarios. Moreover, the CERPMs can be detected up to 340 m from the vehicle's position. Our overall conclusion is that CERPM technology is viable and that it has the potential to address the operational robustness and energy efficiency concerns plaguing the current generation of AVs.

Extended Kalman Filter-Based Vehicle Tracking Using Uniform Planar Array for Vehicle Platoon Systems.

We develop an extended Kalman filter-based vehicle tracking algorithm, specifically designed for uniform planar array layouts and vehicle platoon scenarios. We first propose an antenna placement strategy to design the optimal antenna array configuration for precise vehicle tracking in vehicle-to-infrastructure networks. Furthermore, a vehicle tracking algorithm is proposed to improve the position estimation performance by specifically considering the characteristics of the state evolution model for vehicles in the platoon. The proposed algorithm enables the sharing of corrected error transition vectors among platoon vehicles, for the purpose of enhancing the tracking performance for vehicles in unfavorable positions. Lastly, we propose an array partitioning algorithm that effectively divides the entire antenna array into sub-arrays for vehicles in the platoon, aiming to maximize the average tracking performance. Numerical studies verify that the proposed tracking and array partitioning algorithms improve the position estimation performance.

Assessing the functionality of a water-vending kiosk network with high-frequency instrumentation in Freetown, Sierra Leone.

Access to safe, reliable, and equitable water services in urban settings of low- and middle-income countries remains a critical challenge toward achieving Sustainable Development Goal 6.1, but progress has either slowed or stagnated in recent years. A pilot water kiosk network funded by the United States Millennium Challenge Corporation was implemented by the Sierra Leone Millennium Challenge Coordinating Unit into the intermittent piped water distribution network of Freetown, Sierra Leone, as a private-public partnership to improve water service provision for households without reliable piped water connections and to reduce non-revenue water. This study employs the use of high-frequency instrumentation to monitor, model, and assess the functionality of this water kiosk network over 2,947 kiosk-days. Functionality was defined via functionality levels on a daily basis through monitored stored water levels and modeled water withdrawals. The functionality levels across the kiosk network were found to be 34% operational, 30% offline, and 35% empty. Statistically significant (p<0.001) determinants of functionality were found for several predictors across the defined thresholds. Finally, modeling of water supply, water demand and withdrawal capacity, and water storage was conducted to further explain findings and provide additionally externally relevant support for kiosk operations.

Challenges in capacity building of national immunization programs and emergency or pandemic vaccination responses in the Global Health Security Agenda member countries.

The Immunization Action Package aims to increase the vaccination rate for vaccine-preventable diseases to save lives. To achieve this, member countries of the Global Health Security Agenda (GHSA) must have the capacity to implement sustainable national immunization programs (NIPs) and to respond to emergency vaccination scenarios. This article focuses on 4 major areas of NIP capacity, including in emergency situations: infrastructure capacity, sustainable financing capacity, vaccine access and equity, and vaccination hesitancy. Countries require resilient infrastructure to achieve high vaccination rates and develop preparedness for public health emergencies. Financial sustainability is crucial in achieving high vaccination coverage to best implement initiatives and national programs. Furthermore, challenges to NIPs include vaccine access and equity, as inequitable distribution and access to vaccines for coronavirus disease 2019 accelerated the impact of the pandemic. Lastly, the correlation between low acceptance and successful implementation of national initiatives suggests that vaccination hesitancy is another challenge to NIPs. In an attempt to overcome these challenges, the Expert Forum of the GHSA Seventh Ministerial Meeting was held to provide sessions allowing countries to share their national case studies and discuss strategies for capacity building of country-level NIPs, including for emergency responses.

A comprehensive review of the environmental benefits of urban green spaces.

This detailed analysis highlights the numerous environmental benefits provided by urban green spaces, emphasizing their critical role in improving urban life quality and advancing sustainable development. The review delves into critical themes such as the impact of urban green spaces on human health, the complex interplay between urban ecology and sustainability, and the evaluation of ecosystem services using a comprehensive review of existing literature. The investigation thoroughly examines various aspects of green infrastructure, shedding light on its contributions to social cohesion, human well-being, and environmental sustainability in general. The analysis summarizes the study's findings and demonstrates the critical role of urban green spaces in urban ecology, which significantly mitigates environmental challenges. The intricate links between these green spaces and human health are thoroughly investigated, with benefits ranging from enhanced mental and physical well-being to comprehensive mental health. Furthermore, the analysis emphasizes how green spaces benefit urban development by increasing property values, boosting tourism, and creating job opportunities. The discussion also considers possible futures, emphasizing the integration of technology, the advancement of natural solutions, and the critical importance of prioritizing health and well-being in the design of urban green spaces. To ensure that urban green spaces are developed and maintained as essential components of resilient and sustainable urban environments, the assessment concludes with practical recommendations for communities, urban planners, and legislators.

Ecosystem services potential is declining across European capital metropolitan areas.

Ecosystem services (ES) are essential to sustainable development at multiple spatial scales. Monitoring ES potential (ESP) at the metropolitan level is imperative to sustainable cities. We developed a procedure for long-term monitoring of metropolitan ESP dynamics, utilizing open-source land use land cover (LULC) data and the expert matrix method. We compared the ESP results of 38 European Capital Metropolitan Areas (ECMA) regarding biodiversity integrity, drinking water provision, flood protection, air quality, water purification, and recreation & tourism. Our results show significant declines in ESP across ECMA due to LULC alteration between 2006, 2012, and 2018. We found that ECMA in post-socialist European countries like Poland (Warszawa) have experienced high rates of land use transformation with a remarkable impact on ESP. Surprisingly, we found that Fennoscandinan ECMA, like Helsinki, Stockholm, and Oslo which lead the cumulative ESP ranking, faced the ESP reduction of the highest impact in recent years. The correlation analysis of ESP dynamics to urban expansion and population growth rates suggests that inattentive urbanization processes impact ESP more than population growth. We unveil the implications of our results to the EU and global level agendas like the European Nature Conservation Law and the Sustainable Development Goals.