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Atmospheric pollutants PM2.5 and CO2 share similar sources and impact mechanisms. Green innovations and urban greening significantly reduce these pollutants while promoting economic growth. However, the synergies and trade-offs between carbon reduction, pollution control, green expansion, and economic growth remain understudied. This paper examines 110 cities in the Yangtze River Economic Belt (YREB), China's premier green development site, as a unified system. Using fractional-order synthesis analysis, this paper constructs an assessment indicator system and measures synergy with a coupled coordination degree model. The driving factors are explored using a system-generalized method of moments estimation. The findings indicate that most cities in the YREB are at an intermediate coordination stage. The coupling of greening with carbon reduction, pollution control, and growth has a low degree, highlighting an urgent need to strengthen greening efforts. Key drivers include the digital economy, advanced industrial structure, innovative talent aggregation, infrastructure construction, financial investment, and marketization. The digital economy significantly influences all regions of the Yangtze River. Notable heterogeneity exists in the impact of other drivers across different regions. These results offer valuable policy insights for managing carbon emissions and pollutants, contributing to sustainable urban development.

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This study innovatively evaluated ecological civilization in China from the perspective of environment and health. A Composite Environmental Health Index (CEHI) was constructed based on the Driving force-Pressure-State-Impact-Response (DPSIR) and Coupling Coordination Degree (CCD) models. Results showed that significant and sustained improvements were observed in the ecological environment after ecological civilization, while economic development continued to progress at a steady pace. However, the advancement in population health (impact subsystem), exhibited comparatively modest progress, potentially linked to issues such as demographic aging and the enduring consequences of past exposure to environmental pollutants. At the provincial level, the regional development was uneven. The CEHI performance was highest in the eastern regions, followed by the central regions, with the western regions showing the least progress. Beijing, Guangdong, Jiangsu, Shanghai, and Zhejiang emerged as top performers with higher CEHI scores, which can be attributed to their favorable geographical positioning and the response subsystem. Conversely, northeastern regions (Heilongjiang, Jilin, and Liaoning) and northwestern regions (Shanxi, Gansu, Ningxia, and Qinghai) experienced limited advancements in post-ecological civilization implementation. For these underperforming regions, there is a pressing need to intensify efforts aimed at enhancing their response subsystems. In summary, China's pursuit of ecological civilization has yielded significant successes, potentially offering valuable insights for other nations striving for sustainable development. The ecological civilization model's integration of ecological environmental protection into economic, political, cultural, and social constructs may serve as a meaningful reference for the sustainable development of other countries.

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The non-coordination between the socio-economic systems and ecosystems of a region is a crucial obstacle to sustainable development. To reveal the relationships between complex urban systems and achieve the goal of sustainable and coordinated urban development, we constructed a coupling coordination degree model (CCDM) and coupling angle model (CAM) and analyzed the degree of coupling coordination and evolution process among the population, water resources, economy, and ecology (PWEE) system of the Tuha region for 2005-2020. The results indicated that: (1) During 2005-2020, the comprehensive development index (CDI) of the population, water resources and economy subsystems was 0.21-0.65, with the three subsystems portraying an overall increase; the average values of the RSEI at five-year intervals were 0.29, 0.28, 0.28, and 0.26, indicating a downward trend in the environmental quality. (2) The coupling coordination effect of the PWEE system portrayed a low level; the coupling coordination degree (CCD) values were 0.28-0.58, portraying a fluctuating upward trend. The level of CCD increased from low disorder to marginal coordination. (3) The PWEE system's scissor difference reflects large evolutionary characteristics. The ecological support capacity was not observed until the late stage. We conclude that the PWEE composite system of the region is in a stage of disordered development. These findings significantly bolster the theoretical underpinnings of sustainable development studies, offering essential scientific theories and methodological frameworks for crafting sustainable development policies tailored to urban systems in the Tuha region.

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OBJECT: To analyze the trend of the coupling and coordination of the supply and demand of healthcare resources between the elderly population and healthcare resources in China during the period of 2012-2022, to reveal the impact of the growth of the elderly population on the relationship between the supply and demand of healthcare resources, and to put forward suggestions to improve the coupling and coordination between the supply and demand of healthcare resources and the elderly population, in order to cope with the challenges of an aging society. METHODS: By obtaining relevant data from authoritative data sources such as China Statistical Yearbook, Health and Health Statistics Yearbook, and the Chinese government website from 2012 to 2022, we constructed a comprehensive measurement index for the three systems of elderly population, healthcare resource supply, and healthcare resource demand; Using the entropy value method to assign weights to the indicators, combined with the coupling coordination degree model, to reveal the changes of the elderly population change and the supply and demand of medical and health resources; using ArcGIS technology, to study the spatial characteristics of the elderly population change and the supply and demand of medical and health resources. RESULTS: From 2012 to 2022, the supply and demand of healthcare resources and the variation of the elderly population in China show a continuous growth trend, and the comprehensive development level of the system gradually climbs from a low level to a high level. The fluctuation of coupling degree and coordination degree rises, although the coordination degree has always been lower than the coupling degree, but the distance between the coordination degree and the coupling degree gradually narrows with the passage of time. The coordination degree between population aging and medical and health resources development shows spatial heterogeneity in China, with the eastern region significantly higher than the western region/. CONCLUSIONS: The coupling degree between population aging and healthcare resource supply and demand in China from 2012 to 2022 shows a general upward trend from low coupling to medium-high coupling, but it is worth noting that even though the degree of coupling increases, the degree of coordination is still relatively lagging behind, suggesting that the government and relevant departments need to pay more attention to coordinated allocation and management of healthcare resources. At the same time, the spatial differences in the degree of coordination among provinces suggest that future policymakers should take regional differences into full consideration in policymaking and sustainable development.

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BACKGROUND: With the intensification of China's aging population, the demand for elderly care services has become increasingly prominent. At the same time, rapid development of internet technology provides more convenience and possibilities for the elderly. However, the coordinated development between the internet and elderly care services still faces challenges. This study aims to measure the level of coupling and coordinated development between the internet and elderly care services in China, and analyze the influencing factors, in order to provide reference for promoting elderly care services. METHODS: In this paper, the entropy method and coupling coordination degree model were used to measure the coupling coordination development index of the internet and elderly care services in China from 2012 to 2021. In addition, considering that the coordinated development between the two is affected by many factors, the Tobit model was used to analyze the main factors affecting the integration of the internet and elderly care services. RESULTS: (1) The coupling and coordination of the Internet and senior care services is in its infancy, but the coupling and coordination of the two is on the rise, and there is still a lot of room for development in the future. (2) In terms of time scale, the coupling coordination development level between the internet and elderly care services in China has gone through three stages of "disorder recession-transition coordination-coordinated development". (3) In terms of influencing factors, government management ability has a more positive impact on the development of the integration of the Internet and senior care services, financial support, scientific and technological investment and the level of innovation play a mild pulling role, while the level of informatization to a certain extent restricts the level of integration of the Internet and senior care services. CONCLUSION: In order to promote the coordinated development of China's Internet and senior care services, it is necessary to comprehensively understand the current situation and development space of China's Internet and senior care services coupling coordination degree, accurately grasp the dynamic trend of China's Internet and senior care services coupling and coordinated development, promote the stage of leapfrogging, and fully consider the influencing factors, so as to realize the optimal allocation of policies and resources. These measures will help to promote a more coordinated and sustainable development of the internet and elderly care services in China.

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Based on the panel data of 30 provinces in China from 2010 to 2020, this study uses the coupling coordination degree model (CCDM), spatial autocorrelation analysis, and the panel vector autoregression (PVAR) model to quantitatively examine the dynamic coordination and interactive response of green finance (GF) and green total factor productivity (GTFP). The results show that the coupling coordination degree (CCD) between GF and GTFP during the study period shows an overall increasing trend and significant regional differentiation and remains at the medium level, indicating large room for improvement. The CCDs of provinces fluctuate between the low and high types. The distribution gradually shifts from a "high in the south and low in the north" pattern to a "high in the east and low in the west" configuration. The spatial difference of coupling development continues to expand and presents a significant spatial positive correlation. In addition, GF and GTFP in China exhibit significant self-reinforcing characteristics, but the reinforcing effect gradually decreases. There is only a unidirectional interaction relationship between GF and GTFP, which is GF actively fosters the advancement of GTFP, while the influence of GTFP on GF appears less pronounced. This research provides comprehensive insights into the dynamic interaction between GF and GTFP.

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Climate change has become an unavoidable problem in achieving sustainable development. As one of the major industries worldwide, tourism can make a significant contribution to mitigating climate change. The main objective of the paper is to assess the development level of low-carbon tourism from multi-aspect, using the Yellow River Basin as an example. Firstly, this study quantified tourism carbon dioxide emissions and tourism economy, and analyzed their evolution characteristics. The interaction and coordination degree between tourism carbon dioxide emissions and tourism economy were then analyzed using the improved coupling coordination degree model. Finally, this study analyzed the change in total factor productivity of low-carbon tourism by calculating the Malmquist-Luenberger productivity index. The results showed that: (1) the tourism industry in the Yellow River Basin has the characteristics of the initial environmental Kuznets curve. (2) There was a strong interaction between tourism carbon dioxide emissions and tourism economy, which was manifested as mutual promotion. (3) The total factor productivity of low-carbon tourism was increasing. Based on the above results, it could be concluded that the development level of low-carbon tourism in the Yellow River Basin has been continuously improved from 2000 to 2019, but it is still in the early development stage with the continuous growth of carbon dioxide emissions.

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Under the western development strategy of China, the urbanization process of Chengdu-Chongqing economic circle (CCEC) develops rapidly, but also brings a series of ecological and environmental problems. Understanding the coordination mechanism that links urbanization and the ecological environment (UE) is crucial for promoting environmental conservation and sustainable development. Using the comprehensive nighttime light index (CNLI) and the remote sensing ecological index (RSEI), this study objectively evaluated the urbanization level and ecological environment quality and used the modified coupling coordination degree model to quantify the coupling coordination of UE for the two indexes. The results show that (1) the urbanization level of each city in the CCEC presents an increasing trend year by year, showing a circle distribution pattern with the twin cities as the core. (2) The overall eco-environmental quality presents a fluctuating upward trend, and in recent years, it has been significantly improved, showing a spatial pattern of higher in the surrounding areas and lower in the middle. (3) The overall coupling coordination of the study area is developing, and the upward trend is larger in recent years. The spatial distribution is centered on the "double nucleus," and the distribution of circles is characterized by a gradual decrease from the inside to the outside; the coupling coordination of cities in the northwest and east of the CCEC is decreasing, and that of cities in the northeast and southwest is increasing. During the study period, a total of 5 cities have reached the level of coordinated development, while most other cities are in the stage of uncoordinated development, mainly due to the lagging development of urbanization. CCEC still needs to strengthen the construction of urbanization, in order to improve the degree of coordination between economic development and ecological environment.

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Grappling with the global ecological concern of the Aral Sea disaster, Uzbekistan exemplifies the urgent necessity of unravelling and addressing the complex Water-Energy-Food-Ecology (WEFE) nexus conflicts in arid regions, a critical task yet largely uncharted. Through the strategic process of 'Indicator Articulation - Weight Calibration - Nexus Coordination Quantification - Correlational Analysis', this work has developed a tailored framework that integrates a novel, context-specific indicator system, enabling an illumination of the intricate dynamics within the WEFE nexus in arid regions. During 2000-2018, the WEFE Nexus in Uzbekistan showed low-level coordination, indicating systemic imbalances. The Aral Sea crisis was the central disruptor, resulting in a moderately disordered ecological subsystem. Concurrently, disorder was observed in water resources, signaling inadequate management and potential overutilization. Furthermore, Coordination for energy and food were barely coordinated and under primary coordination respectively, underlining critical challenges in energy efficiency and food security. Over the last two decades, the WEFE Nexus has evolved towards a tighter interlinkage, yet the stability of this coupling coordination has experienced increased fluctuations, indicating that Uzbekistan's policies in the WEFE subsystems have been less stable in the last two decades and are in need of further adjustment and improvement. To address the challenges, we recommend a comprehensive approach that integrates technological, infrastructure, and policy solutions is needed. Specifically, promoting water-saving irrigation technology, renewing and maintaining outdated energy facilities, and raising public awareness of ecological protection are part of the essential measures. Furthermore, alleviating the contradiction between economic growth and ecological conservation remains a major challenge. Collectively, our constructed WEFE Nexus framework, with its extendable and context-specific indicators, holds significant potential for broad application in the analysis of multi-sectoral sustainability, particularly within arid regions globally, and forms a solid foundation for the formulation of effective, targeted policies and sustainable development strategies.

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Urbanisation can cause a variety of environmental and health issues, which has prompted experts to evaluate degraded areas and develop management strategies aimed at promoting urban sustainability and reducing carbon emissions. In low-carbon cities, sustainable urban areas have low carbon emission and prioritised carbon reduction by implementing sustainable transportation, green infrastructure, and energy-efficient buildings. On the other hand, unsustainable urban areas tend to lack these priorities and rely heavily on non-renewable energy sources and have high carbon emission. Therefore, this study aims to identify the most sustainable and unsustainable regions in the Abha-Khamis Mushayet Twin City region of Saudi Arabia in respect to urbanisation and carbon emission during the period between 1990 and 2020. To do so, we used Landsat datasets to create land use land cover (LULC) maps and then calculated carbon storage, emission, and absorption using InVest software. Additionally, the study examined micro-climatic conditions by calculating the urban heat island (UHI) effect, which allowed determining sustainable and unsustainable regions by comparing the UHI model and carbon similarity and mismatch model using coupling coordination degree model (CCDM). The study found that during the last three decades, the LULC pattern of the region underwent significant alterations, resulting in a substantial decline in carbon storage from 710,425 Mg C/hm2 in 1990 to approximately 527,012.9 Mg C/hm2 in 2020. Conversely, carbon emissions were observed to be very high in areas with high built-up density, with emission levels exceeding 20 tons per annum. Whilst the areas of excess carbon have decreased significantly, the areas of excess carbon emission have increased over time, resulting in the UHI effect due to high greenhouse gases. By comparing the UHI and carbon similarity and mismatch model, the researchers found that over 280 km2 of the study area is unsustainable and has increased since 1990. In contrast, only about 410 km2 of the study area is currently sustainable. To promote sustainability, the study recommends several strategies such as carbon capture, utilisation, and storage; green infrastructure; and the use of renewable energy to manage carbon emissions.

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The expansion of built-up area is the most noticeable form of urbanization-induced land use/land cover (LULC) change. In the global cities of south, the urban sprawl is increasing rapidly with even higher probabilities of future built-up expansion. These cities are witnessing unsustainable urban growth with no consideration of eco-friendly environmental condition and quality of life due to rapid expansion in built-up area. Indian cities too have been witnessing rapid urban growth and built-up expansion especially in the large metropolitan cities like Delhi. Therefore, the main objective of this study is to model the built-up expansion probabilities in Delhi National Capital Region (Delhi NCR) using remote sensing datasets and an integrated fuzzy logic and coupling coordination degree model (CCDM). For this, initially, the LULC classification was done using random forest (RF) classifier to extract the built-up area. Further, analytical hierarchy process (AHP) integrated fuzzy sets were applied using the extracted built-up area along with a set of economic, demographic, proximity parameters, topographic, and utility services. Five zones of built-up expansion probabilities were made namely very high, high, medium, low and very low. The result shows that the probability of built-up expansion in Delhi NCR is maximum under very high and high probability zones, whereas minimum expansion probabilities come in the very low probability zone for both base year i.e., 2018 and future years. Moreover, between base year and future years, the probability of built-up expansion has increased maximum (5.72%) under the very high zone while it declined by 14.06% in low probability zone. The validation of built-up probability using CCDM shows that the AHP integrated fuzzy logic-based probability model is robust while predicting built-up probability. The results of this study may provide useful insights for the urban planning department and policy makers to mitigate the adverse impacts of built-up expansion. Similar approach may be utilized in the analyzing the built-up urban expansion of other major cities of the world similar geographical conditions.

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Collaborative reduction of carbon and air pollutants can more efficiently achieve green technological change, industrial low-carbon transition, and high-quality economic and social development. As a typical environmental policy in China, the pilot carbon Emission Trading Scheme (ETS) has obvious advantages in achieving the collaborative reduction of carbon and air pollutants. Therefore, an evaluation of China's pilot carbon ETS from the perspective of collaborative reduction of carbon and air pollutants is performed in this paper. Compared with previous studies, first, this study innovatively uses the coupled coordination degree (CCD) model to measure the collaborative reduction level of carbon and air pollutants under different scenarios based on the panel data of China's 30 provincial-level regions during 2004-2018. Second, this study uses the DID method to evaluate the impact of China's pilot carbon ETS on the collaborative reduction of carbon and air pollutants and conducts some robustness checks and regional heterogeneity regressions. Third, this study uses the synthetic control method (SCM) further to examine the policy outcomes of the pilot carbon ETS. Scenario analysis shows that attaching importance to reducing air pollution will improve the collaborative reduction effect of carbon and air pollutants. Furthermore, the implementation of China's pilot carbon ETS exerts an effect of roughly 24.7% on reducing carbon, roughly 10.1% on reducing air pollutants, and roughly 22.0% on the collaborative reduction of carbon and air pollutants, ceteris paribus. Regional heterogeneity analysis shows that the impacts of the pilot carbon ETS are significant in all regions, except that the impact on reducing air pollutants in the central region is not significant. In addition, results from SCM indicate that the impacts of the pilot carbon ETS on the collaborative reduction of carbon and air pollutants are significantly efficient in Beijing, Tianjin, Shanghai, Hubei, and Chongqing, while not much efficient in Guangdong and Fujian. The main policy implications include strengthening the top-level design of the ETS in the collaborative reduction of carbon and air pollutants, attaching importance to the governance of air pollution, making the regional governance more targeted, and improving energy efficiency.

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Urban development in developing regions increases ecological and environmental pressures. Few annual ecological studies have been conducted on tourist-oriented cities. Guilin is famous as an international tourist destination in Chine. Analyzing its coupling coordination between urbanization and ecology is vital for subsequent sustainable development. This paper constructed a night-time light index (NTLI) based on DMSP/OLS, NPP/VIIRS night-time light data in response to these problems. The remote sensing ecological index (RSEI) model was established in this study by using four indexes: greenness, wetness, dryness and heat. The coupling coordination degree model (CCDM) was built. From the dynamic time-series changes of CCDM, the urban development and ecological environment of the urban area of Guilin, from 2000 to 2020, were analyzed. The results showed that the urban area of Guilin's urbanization had developed rapidly over the past 20 years. NTLI in 2020 was 7.72 times higher than in 2000. The overall ecological quality of the main urban area of Guilin has improved significantly, while local ecological pressure in Lingui District has increased. CCDM has shifted from low to high coupling coordination, and the relationship between urban development and the ecological environment has improved. The method of annual spatial-temporal analysis of urban ecology in this paper can be applied in similar studies on other cities, and the results obtained for Guilin have reference value for future urban planning and environmental protection work.

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With the rapid development of urbanization, problems such as the degradation of water ecological environment have emerged. How to improve the water ecological environment in the process of urbanization has become one of the urgent problems facing policy makers. This paper studies the coupling coordination relationship between new-type urbanization and water ecological environment, with the purpose of using insights gained from the study to help improve the quality of water ecological environment and promote sustainable development of water ecological environment. We take 11 cities in China's Jiangxi Province as the research object, and construct the coupling coordination evaluation indicator system of new-type urbanization and water ecological environment, then using the coupling coordination degree model to examine the state of coupling coordination between new-type urbanization and water ecological environment from 2009 to 2019. We further explore its driving factors employing random effect panel Tobit model. The results show that: (1) The level of new-type urbanization in Jiangxi Province shows a steady upward trend, and the water ecological environment level tends to rise steadily and slowly, although the comprehensive score of water ecological environment in most cities is lower than 0.1, indicating that the situation of water ecological environment is not optimal yet and there is room for improvement. (2) In 2009, 2014 and 2019, the coupling coordination development level between new-type urbanization and water ecological environment in Jiangxi Province showed an upward trend, from moderate maladjustment recession to mild maladjustment recession, and from low coupling coordination to moderate coupling coordination, although the overall coupling coordination degree was low. (3) The investment in scientific and technological innovation, degree of opening-up and government capacity are positively correlated with the coupling coordination degree, while economic development level, resource agglomeration ability, education level and industrialization level are negatively correlated with the coupling coordination degree. These results can provide insights to support new-type urbanization and water ecological environment in the future, and hold great significance for urban sustainable development.

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Territorial space is a multi-functional complex. The coordinated production-living-ecological space (PLES) effectively coordinates the man-land relationship, promotes regional sustainable development, and maximizes territorial space. How to build a high-quality national spatial layout and support system for development has become a hot topic of concern in all sectors of society. However, few studies have explored the coupling coordination considering the various production-living-ecological functions of land use type and its influencing factors of PLES at the county scale in China. To address the gap, based on the connotation of PLES theory, this study established a classification and evaluation system for PLES and analyzed the spatio-temporal characteristics, coupling coordination degree, spatial autocorrelation, and influencing factors of PLES in China from 2000 to 2020. The results are as follows: (1) The production space index and living space index in China showed a continuous increase tendency, while the ecological space index decreased continuously during the study period. The production space and living space were concentrated in the east of Hu Line, and the ecological space indexes in mountainous areas were significantly higher than those in plain areas during the study period. (2) The gravity centers of PLES all migrated to the west of China to different degrees during the study period. (3) From 2000 to 2020, the basically balanced category was the main coupling coordination type, and the number of seriously unbalanced categories accounted for the least. In the west of the Hu Line, the seriously unbalanced category was dominant, while in the east of the Hu Line were the moderately unbalanced categories and above. (4) During the study period, the low-low type was the main relationship type, widely distributed in western China, followed by the high-high type, mainly situated in the North China Plain, Yangtze River Delta, Pearl River Delta, Jianghan Plain, Chengdu Plain, Northeast China Plain, and some provincial capital cities. (5) Regression results showed that natural factors were the main reason restricting the coordinated development of PLES, and socioeconomic factors could effectively promote the coordinated development of PLES. Landscape pattern also significantly influenced the coordinated development of PLES, but varied greatly. The findings of this study can provide a scientific reference for the optimization of territorial space layout and the promotion of high-quality development of territorial space.

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Previous Studies, such as the evaluation of the supply of and demand for regional medical resources and carrying capacity assessments, require further development. This paper aims to evaluate the carrying capacity and spatial distribution of medical resources in Shenzhen from the perspective of supply and demand, and to conduct a time-series variation of the coupling coordination degree from 1986 to 2019. The two-step floating catchment area method was employed to quantify the carrying capacity and coupling coordination degree method and spatial autocorrelation analysis were applied to analyze spatial distribution between supply and demand. The results were as follows. (1) The carrying capacity index in more than 50% of the districts was classified as low-grade. The percentage of regions with good grades was 8.27%. The regions with a high carrying capacity were distributed in the central and southeastern areas. (2) The coupling coordination continued to rise, increasing from 0.03397 in 1986 to 0.33627 in 2019. (3) The level of supply and demand for medical resources in Shenzhen increased from 1986 to 2019, and the highest degree of compatibility between the supply and the population size was largely concentrated in the western and eastern regions. This research can provide a theoretical reference for Shenzhen to rationally plan medical resources and improve the carrying capacity of medical resources.

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The Yangtze River Economic Belt (YREB) is the core region for the security of mineral resources in China and is a strategic water source containing rich water resources. Coordinating the security of mineral resources and water resources in the YREB is a key problem. Establishing and optimizing the water ecological environment (WEE) is crucial for addressing this problem in mining cities, which are the main bases for the supply of mineral resources. This study applies the cloud model, CV-TOPSIS, the standard deviation ellipse, and the coupling coordination degree model to evaluate the WEE and the coordinated development state, and to optimize the WEE. The results show that: (1) the WEE of mining cities in the YREB is generally good; (2) the protection of WEE in most mining cities has achieved significant results recently, and the results in the downstream are more remarkable than those in the mid-upstream; (3) the coordinated development of WEE in regenerative mining cities is better than that of mature and declining cities; and (4) most mining cities still belong to the lagging type of water environment (heavy metal pollution has been better treated and the threat of water ecological security caused by heavy metal pollution is low). This study suggests improvements to the sewer system, promotes WEE management in the mid-upstream, and propels the transformational development of mature and declining mining cities in advance.

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This work constructs an evaluation index system and quantitatively explores the coupling coordination relationship between the tourism development system and the medical services system in China. Results show that the degree of coupling coordination between the tourism development system and the medical services system showed a good upward trend in China during the period 2012-2019. However, the relationship was barely balanced, with tourism development lagging. The overall layout shows a spatial pattern of "high in the north and low in the south, high in the east and low in the west." The degree of coupling coordination tends to be randomly distributed from clustered distribution, and the cold-hot spots show a spatial development pattern of "cold in the northwest and hot in the southeast" as time passes. The power of government to regulate has always been an important mechanism affecting the degree of coupling coordination. The study aims to provide reference for the rationalization of medical tourism layout and sustainable development.

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Mastering the coupling and coordination relationship and driving mechanism of urbanization and ecosystem service value (ESV) is of great significance to ecological protection and regional sustainable development. In this paper, the coupling coordination model, geographic detector and GWR model are used to analyze the spatio-temporal coupling interaction between urbanization and ESV and the spatial differentiation characteristics of influencing factors from 1995 to 2018. The results of the study are as follows: (1) During the study period, cities in the Yellow River Basin experienced accelerated urban expansion, and the ESV of forests, water and wetlands increased, which offset the reduction in ESV due to the expansion of construction land and farmland and grassland. (2) The degree of coupling and coordination between the two gradually improved, but the overall situation showed a low-level coupling and coordination process. Mild coupling coordination gradually increased, reaching an increase of 38.10%; severe imbalance types tended to disappear, decreasing by 52.38%, and coupling subtypes developed from lagging urbanization to ESV backward types. The high-value areas of the coupling coordination degree are distributed in the high-value areas of ESV in the north of the upper reaches, and the low-value areas are distributed in the cities of Henan and Shandong with high urbanization levels in the downstream and most resource-based cities in the middle reaches. (3) In addition, the spatial intensity of the effect of each dominant factor on the degree of coupling coordination is different. Economic growth, technological development, environmental regulations and the proportion of forest land have positive and belt-shaped alienation characteristics for the coupling and coordination of the two, and infrastructure and temperature show negative driving characteristics. Therefore, the coupling and coordination relationship between ESV and urbanization should be clarified to help future urban planning. On the basis of determining the regional environmental carrying capacity and the adjustment direction of the rational planning of land resources, the impact of urban barriers formed by administrative boundaries and natural geographical conditions on the development of urban agglomerations should be broken to achieve the overall high-quality and coordinated development of the basin.

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In ecologically fragile areas, an uncontrolled increase in urban development intensity (UDI) will erode the ecological carrying capacity (ECC). This study aimed to explore the relationship between UDI and ECC and quantify the impacts of UDI on ECC. The Three Gorges Reservoir Area (Chongqing section) was chosen for the case study. Firstly, the UDI and ECC were comprehensively evaluated. Then, the coupling coordination relationship between the two was analyzed by a coupling coordination degree model. Finally, the influences of UDI on the coordinated development of the two were analyzed by a geographically weighted regression model. The results show that the distributions of UDI and ECC are opposite; UDI and ECC are mutually restricted to some extent. UDI and ECC are moderately coupled and poorly coordinated, and a higher UDI is mostly correlated to a higher coordination degree of UDI and ECC. In areas with higher UDI, an appropriate control on population and economy may benefit the coordinated development. Meanwhile, in areas with lower UDI, the promotion of population aggregation and economic investment would enhance the coordinated development between UDI and ECC. This study could optimize the dimensional control of UDI, which contributes to the long-term sustainability of ecologically fragile areas.

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