Administrative Units Research Articles

Investigating the patterns of air pollution exposure on major cardiovascular events by cluster analysis. Insights from the EP-PARTICLES study on a Polish smog cohort

Abstract Introduction Exposure to air pollution (AP) is a modifiable risk factor for cardiovascular diseases. Aim To analyse the short-term effects of AP on the occurrence of acute coronary syndromes (ACS). Methods The EP-PARTICLES study consists of a retrospective nationwide cohort of Eastern Poland residents (N= 8,077,671). The area is characterized by a specific type of pollution - Polish smog, featuring high concentrations of particulate matter (PM), benzo(a)pyrenes (BaP) and favourable atmospheric conditions of formation. Medical data were collected from the National Health Fund and the Central Statistical Office. The records included sex and age and the causes of hospitalization. The analysis utilized air quality modeling data from the GEM-AQ system, which allowed to provide daily pollution concentration at the level of each LAU (ie. local administrative units, at municipality level), throughout the observation period. We estimated LAU specific associations of AP concentration using quasi-Poisson generalized additive models. We controlled our models for long-term trends and weather conditions. In the second stage, we pooled LAU-specific estimates with a random-effects meta-analysis. The results are presented as % risk ratio (RR), and 95% confidence intervals (95% CIs) for the two-day moving average of AP concentration on the present day and the day after exposure (ie. LAG0-1). Cluster analysis was performed on LAU levels from 19 variables using the k-mens clustering using the Ward minimum variance method. The set of variables included demographic, ecological, socioeconomic, environmental conditions. Results Over the years 2011-20, we noted 2,141,213 hospitalizations due to CVD, including 139,697 ACS cases (45.2% STEMI). The main triggers for ACS were PM2.5 (RRLAG0-1 1.04 95%CI 1.028-1.053), BaP (RRLAG0-1 1.021 95%CI 1.01-1.032). We identified three distinct clusters: Cluster 1 was characterized by high population density and GPD per capita and highest prevalence of atrial fibrillation. Cluster 2 (40% of the entire population) exhibited significantly high variability, characterized by low population density and GPD per capita, the highest prevalence of heart failure, people drinking alcohol and smoking tobacco. Cluster 3 (7% of the entire population) was in the middle but showed the highest prevalence of hypertension, diabetes and renal failure. Cluster 2 inhabited areas with low concentrations of PMs and BaP and demonstrated increased vulnerability to the effects of PM2.5 and BaP from 3% to 5.2% (P<0.001). For details see Figure 1. Conclusions PM and BaP are important factors associated with the occurrence of MACE. AP exposure should be considered in CVD prevention models. Cluster classification helps in risk stratification and prognosis. Adverse effects of AP can be mitigated by attention to improving socio-economic status and hazardous habits.Associations between AP exposure and ACS

Analysis of the national structure of care provided to older people in Slovenia

Ageing in place has for many years been at the forefront of political goals for care provision for older people in Europe. The organization of care in terms of the national governing structure must therefore be continually observed to better understand the care actually offered and then used by older people. In this study, we examined the organization of social home care and institutional care across municipalities and administrative units in terms of what is offered to older people as formal care. Variation across municipalities and administrative units is observed with explorative cluster analysis and analysis of means of key dependent variables across clusters to better understand the variability in the care offered to older people in those municipalities and administrative units. The results show that while social home care is temporally available across several clusters of municipalities, and the affordability of social home care is also stable across clusters of municipalities, there are still municipalities where social home care has a limited time availability and municipalities where the out-of-pocket contribution to social home care delivery is nearly the twice the average of such contributions. In terms of institutional care, one can find administrative units with either a deficit or a surplus of placements of such care available.

Transregional Cooperation of German Federal States with Eastern Regions and Countries (Late 20th — 21st Century)

This study examines the formation and development of transregional relations between the federal states of Germany (Bundesländer) and Eastern countries and regions. It presents the findings of a normative-legal analysis of the foundations of international and foreign policy activities of German federal states, based on national legislation. The focus is on the institutional framework for cross-border interactions between individual administrative units of the Federal Republic of Germany and their foreign partners. The research explores partnerships with both neighboring Middle Eastern territories and more distant Eastern regions. The findings indicate that the international and foreign economic activities of the German states are extensive, aligning with the opportunities outlined in Germany’s constitutional documents, and are significantly broader and more diverse compared to similar activities in the regions of France and Italy. It has been identified that German states engage in a system of “horizontal partnerships” primarily with provinces of the People’s Republic of China. Additionally, it is reported that a principle of “network cooperation” is applied to most other Eastern countries, encompassing not only economic but also scientific, cultural, and humanitarian ties. The study demonstrates that among the examined EU countries at the regional level, German federal states lead in establishing the most successful and effective partnerships with regions in Eastern countries.

The Attitudes of Households for Disaster Risk Management in Fogera, Estie and Ebenat Woredas

The underlining disaster risk management practice translates the combination of knowledge, attitude, and action to maximize the effectiveness of responses against disasters. While knowledge and disaster risk management activities move along simultaneously, attitudes are inherent to individuals posing challenges to easily identify issues and then taking extended time to change. Lack of scientific wisdom on the perception of individuals towards disaster management, and the limited understanding of different factors that influence attitudes, complicates the endeavor in response to the increasingly uncertain future. This study assesses the attitudes of households for disaster risk management in the nine kebeles, the lowest administrative unit in Ethiopia, and 32 villages in Fogera, Ebenat and Estie districts (Woredas, the main administrative unit similar to county). Cross-sectional quantitative method was employed, and attitudinal survey was conducted among 412 households selected through probability simple random sampling. Purposive nonprobability sampling technique was used to identify research kebeles based on disaster prevalence, and to collect supplementary attitudinal data from 64 participants representing academia and local stakeholders. Descriptive statistics and parametric test of variance and covariance have been conducted to determine the attitude levels and to assess major factors influencing households’ attitude for disaster risk management. Results indicated that most of the households (53%) have a fairly positive attitude. Households with negative (27%) and extremely negative (20%) perception are concentrated in rural kebeles that are highly affected by recurrent disasters. Therefore, households in disaster affected areas have negative and unconstructive perception for disaster risk management. This is mainly associated with lack of active community participation and ineffective risk management activities. Households’ attitude is also significantly affected by age (p = 0.0001), and within different age groups (p = 0.001), location by kebeles (p = 0.0237), education levels (p = 0.0016), education status (p = 0.004) and experience in indigenous risk management practices (p = 0.00001). In addition, this study revealed a linear relationship within all the identified factors and households’ attitude levels. Considering the situation in Ethiopia where individual perceptions are deeply rooted, coupled with the results of this study that revealed highly negative attitude among disaster affected households, it is recommended to consolidate efforts and influence attitude through maximizing community participation and enhancing the effectiveness of disaster management.

The spatial-temporal evolution patterns of landslide-oriented resilience in mountainous city: A case study of Chongqing, China

Cities, as complex systems with multi-interconnected subsystems, face significant challenges from both rapid urbanization and climate change. Ensuring high resilience in urban areas is essential for managing these dynamic risks effectively. This study introduces an innovative, data-driven approach to quantitatively analyze the spatial-temporal evolution patterns of urban resilience, validated through a case study of Chongqing, a representative mountainous city in China. Based on historical landslide data from Chongqing (2010–2020), which includes 4464 events, along with indicator data from the Chongqing Statistical Yearbook, we developed a comprehensive assessment framework. This framework incorporates 33 variables, covering indicators of physical-environmental resilience (PER) and socio-economic resilience (SER). The model integrates the Random Forest (RF) algorithm, Analytic Hierarchy Process (AHP), and Coupling Coordination Degree (CCD) model. Key findings include: (1) Social development in mountainous cities like Chongqing follows a point-to-area pattern. Although there is an overall increase in SER, the CCD in more developed areas (Chongqing urban circle) was generally higher than in less developed areas (northeastern and southeastern Chongqing) (2) The PER model demonstrated exceptional performance (AUC values consistently above 0.95). Spatiotemporal evolution models reveal that Chongqing maintains a high overall PER. Notably, from 2019 to 2020, the proportion of administrative units classified as highly resilient peaked at 24.5%, marking a historical high. (3) Multi-year average rainfall primarily impacts PER (ranked first), while Gross Domestic Product (GDP) significantly affect SER. The development of multi-dimensional recovery indicators provides a robust framework for assessing resilience against landslides in mountainous cities. The CCD model illustrates the importance of regional dynamic coordinated development in resilience trajectories. This study provides a detailed blueprint for the scientific development of resilient mountainous cities, emphasizing the need for a spatial-temporal perspective on resilience and the benefits of coordinated regional development.

Exploring the Effect of Road Network Structure on Inter-Regional Accessibility in a Diverse Road Network

Abstract. Accessibility analyses quantify the level of access to certain areas or opportunities, such as employment and healthcare facilities. Since public data is often aggregated at the level of regions, such as administrative units, it is useful to quantify accessibility between regions. Many factors influence inter-regional accessibility, most notably the accessibility metric used, and the way in which regions are chosen. This paper investigates the effects of road network structure on accessibility, using a previously developed inter-regional accessibility model that bases its accessibility metric on travel distance via the road network. This paper considers an area within the City of Tshwane municipality in South Africa. We investigate the effects of road structure in two ways. Firstly, regions are chosen based on the road network structure, which is done by extending a previously developed road network clustering algorithm for this novel use. Different spatial scales of regionalisation are considered, and the accessibility between these regions is compared to the accessibility between administrative units within the study area. Secondly, the effect of road network homogeneity on accessibility is investigated, where homogeneity corresponds to a uniform concentration of roads across a region. The results show that although road network homogeneity does not significantly correlate with accessibility, the way in which regions are chosen and their spatial scale has a strong effect on the results of the accessibility model. Our novel method of obtaining regions thus provides fresh insights into road-based accessibility within the City of Tshwane.

A harmonized data set of ruminant livestock presence and grazing data for the European Union and neighbouring countries

Improving the sustainability of the European livestock sector requires recent data at high spatial resolutions. Only then can we analyse potential negative impacts of livestock related to ecosystem degradation, and positive ones such as preserving cultural landscapes through grazing. Data on livestock numbers in Europe are provided by the European statistical office but at a coarse spatial resolution aggregated to statistical regions like NUTS2 or even coarser. While data on a more detailed level, such as local administrative areas, are available from individual national statistical offices, a collection of harmonized data has not been available until now, limiting the use of livestock data in environmental and agricultural studies. We collected data from all European Union Member States and neighbouring countries, resulting in the most up to date and spatially explicit dataset on livestock numbers publicly available to all researchers. We provide data on livestock numbers for more than 70,000 administrative units in 43 countries and territories. In addition, we provide data on the share of cattle that are grazing.

Study on Regional Economic Effect of "West-East Power Transmission"

There is a certain mismatch between China's energy distribution and economic development. In this regard, the "West-East Power Transmission" project has optimized the allocation of China's power resources by exploiting the energy potential of the west. Based on the relevant economic data of 31 provincial administrative units in China from 1995 to 2018, combined with theoretical mechanism analysis, this paper hopes to explore the regional economic effect of "west point to East transmission" by designing a dynamic two-way fixed effect DID model divided into input and output areas. It is found that the policy of "power transmission from west to East" has no significant promoting effect on the whole, but has significant promoting effect on the economy of the import area in the medium and long term. In the input area, it mainly improves the output value of the tertiary industry and promotes the optimization of industrial structure. In addition, the heterogeneity robust estimators of de Chaisemartin and D 'Haultfoeuille were also used to estimate the policy effect at the input site, and the results were similar to those of dynamic TWFE.

America the Beautiful: Meeting “30 × 30” Conservation Goals Through Connected Protected Areas

Protected areas are a primary instrument for biodiversity conservation, and area-based targets have become a hallmark of global efforts with the 2022 Kunming-Montreal Global Biological Framework recommending at least 30 percent of land and water be protected by 2030. In parallel, the United States has implemented “America the Beautiful,” a call for local, state, and regionally led efforts to conserve, connect, and restore 30 percent of U.S. lands and waters by 2030. Achieving these goals is complicated, however, by the multiple policy scales at which conservation decisions are made and governed and the limited guidance provided on how gains to protected and connected areas should be evaluated. We assess the connectedness of U.S. protected areas at multiple scales and find that less than 3 percent of the United States is protected and connected. Connectedness increases when the area under investigation is partitioned into smaller policy units (e.g., counties), a product of the modifiable areal unit problem. Similarly, connectedness values increase by an order of magnitude when assessed relative to the protected area network rather than considering all land area. Both findings support the need for standardized reporting frameworks and highlight the challenges in coordinating conservation goals across administrative units.

Hobli wise hydro geomorphological evaluation of the groundwater prospects mapping

ABSTRACT Numerous studies highlight the urgent issue of groundwater depletion due to overexploitation. The United Nations’ World Water Development Report (2023) warns that if current extraction rates persist, many regions could face severe groundwater shortages in the coming decades. A 2021 study in Nature reports that about one-third of the world’s largest groundwater basins are depleting faster than they are replenished, escalating the risk of critical shortages. In Chickballapur District, excessive agricultural activity has led to an imbalance between groundwater loss and recharge. To address this challenge, a weighted overlay analysis of spatial layers in QGIS was employed to identify potential groundwater zones. This methodical approach involved mapping topographic features and integrating six spatial layers: slope, geomorphology, lithology, drainage, lineament and land use/cover. Each subcategory was ranked and scored based on expert opinion and existing literature. The Central Ground Water Board data was used to validate the resulting groundwater prospect map. The study further included an assessment of groundwater prospects across administrative units by superimposing the administrative boundaries on the final map. Calculating the percentage of land within each groundwater prospect category is crucial for effective groundwater management at the administrative level.

Varying size and shape of spatial units

When an analysis over a specific geographic area is performed, the way that area is divided into regions can affect the outcome of the analysis. Results obtained based on different geographic units can be conflicting. This issue is known as the Modifiable Areal Unit Problem (MAUP). The objective of this paper is to understand the extent to which the regional setting influences the results of an analysis with spatially aggregated variables, with a focus on agglomeration effects, in the case of Germany. Relying on a sample of manufacturing firms over 7 years we estimate a fixed effects model to explain the firm-specific total factor productivity in dependence of region-based agglomeration variables. We simulate 1000 regional settings of Germany on three scales and overtake thereby some characteristics of the administrative units, which are used as the baseline. We infer that the spatial scale and shape matter in the case of Germany.

Analysis of demand for managerial and teaching staff (with knowledge of the Russian language) in the economy of the United Republic of Tanzania

The analysis and economic evaluation of the prerequisites of demand for Russian language teachers in the education system in Tanzania show the Russian and Tanzanian interstate projects growth, which require not only political and legal, but also educational support. The activities of domestic structures (Rossotrudnichestvo, Ministry of Education of the Russian Federation, and business structures) in Tanzania create economic prerequisites for demand for the Russian language in the country’s economy. Considering the increased level of interstate relations between the two states, due to the changes in Russia’s foreign policy course, it is possible to predict increasing demand for specialists in the field of Russian language, as well as knowledge of the language as a competitive advantage in Tanzania’s labor market. As a result of the analysis of the presence or planned presence of the structures associated with Russia, it is advisable to open centers for Russian language teachers training in the administrative districts of Tanzania, such as Zanzibar, Kigoma, Pemba, Rukwa, Mbeya, Arusha, and Mwanza. In these administrative units the interaction between the two countries is carried out or is planned, which will lead to an increase in demand for specialists speaking the Russian language, whose training is carried out as part of the main professional activity by Russian language teachers from among locally trained specialists.

A global dataset of 7 billion individuals with socio-economic characteristics

In global impact modeling, there is a need to address the heterogeneous characteristics of households and individuals that drive different behavioral responses to, for example, environmental risk, socio-economic policy changes and spread of diseases. In this research, we present GLOPOP-S, the first global synthetic population dataset with 1,999,227,130 households and 7,335,881,094 individuals for the year 2015, consistent with population statistics at an administrative unit 1 level. GLOPOS-S contains the following attributes: age, education, gender, income/wealth, settlement type (urban/rural), household size, household type, and for selected countries in the Global South, ownership of agricultural land and dwelling characteristics. To generate GLOPOP-S, we use microdata from the Luxembourg Income Study (LIS) and Demographic and Health Surveys (DHS) and apply synthetic reconstruction techniques to fit national survey data to regional statistics, thereby accounting for spatial differences within and across countries. Additionally, we have developed methods to generate data for countries without available microdata. The dataset can be downloaded per region or country. GLOPOP-S is open source and can be extended with other attributes.

Impact of coupled input data source-resolution and aggregation on contributions of high-yielding traits to simulated wheat yield

High-yielding traits can potentially improve yield performance under climate change. However, data for these traits are limited to specific field sites. Despite this limitation, field-scale calibrated crop models for high-yielding traits are being applied over large scales using gridded weather and soil datasets. This study investigates the implications of this practice. The SIMPLACE modeling platform was applied using field, 1 km, 25 km, and 50 km input data resolution and sources, with 1881 combinations of three traits [radiation use efficiency (RUE), light extinction coefficient (K), and fruiting efficiency (FE)] for the period 2001–2010 across Germany. Simulations at the grid level were aggregated to the administrative units, enabling the quantification of the aggregation effect. The simulated yield increased by between 1.4 and 3.1 t ha− 1 with a maximum RUE trait value, compared to a control cultivar. No significant yield improvement (< 0.4 t ha− 1) was observed with increases in K and FE alone. Utilizing field-scale input data showed the greatest yield improvement per unit increment in RUE. Resolution of water related inputs (soil characteristics and precipitation) had a notably higher impact on simulated yield than of temperature. However, it did not alter the effects of high-yielding traits on yield. Simulated yields were only slightly affected by data aggregation for the different trait combinations. Warm-dry conditions diminished the benefits of high-yielding traits, suggesting that benefits from high-yielding traits depend on environments. The current findings emphasize the critical role of input data resolution and source in quantifying a large-scale impact of high-yielding traits.

Finiq riverscape | Green and blue infrastructures among the Finiq municipality rivers

The Municipality of Finiq is part of the District of Vlora. It is located 20 km from the city of Saranda, 7 km from the city of Delvina, 8 km from the shores of the Ionian Sea, and it shares a border with Greece. It consists of 5 ad- ministrative units: Livadhja, Finiq, Dhivri, Mesopotamia and Aliko. It has 58 villages under its administration among which the most important ones are the cen- ters of the administrative units with the same name. According to municipal reg- isters, the population of the municipality is 35,518 inhabitants or 10,103 families while according to the 2011 census, the population reaches 11,862 inhabitants.1 From the ethnographic or anthropogeo- graphic point of view, the Municipality of Finiq consists of three communities: Vurgu, consisting of plain villages; Rëza, consisting of mountain villages; and the intermediate hilly area consisting of vil- lages like Sirakat, Livinë, Llazat, Gravë, Karroq.2 The history of these areas is “written in the stones” of the old settle- ments of Phoeniciae, Butrint and in the religious buildings of Dhrovjan. These historical evidences speak of a glorious past of these areas, but today they are in a state of constant shrinkage3. All of it concentrates in a territory of 441.2 km2. Finiq Municipality spreads between two mountain ranges, one in the west dividing it from the Ionian Sea with an elevation of 100 – 600 meters above sea level, the other one on the west dividing it from Dropull Municipality with an elevation of 800 – 1400 meters above sea level. Both mountain ranges are directed north- west. The terrain of the municipality is composed of 44% plain, located in the middle, 34% mountains and 22% hills. In this environmental complexity, the natural area spreads in 71% of the territory, especially in the east part of the municipality, agriculture area spreads in 24% of the territory, concentrating in the west part of the municipality. Agriculture and nature make up the predominant use of the territory of Finiq. On the other hand, the settlements spread only on 3% of the territory, but they are scattered in the whole municipality. Water and infrastructure make up only 1% of the territory each and connect the various settlements of the municipality together.4 The District of Vlora faces a number of environmental issues that are also a reality for the Municipality of Finiq5. The District of Vlora faces a high pressure from urbanization and new development of touristic structures, which is especially true for the coastal ecosystem but not only. The settlements, with an emphasis on villages, are characterized by the absence of a wastewater management system and solid waste management system, which are important sources of pollution for the land and also for the water. The shrinkage of protected areas is another relevant environmental issue not only for Vlora District but also for Finiq Municipality. The area of protected areas is changing to accommodate strategic public investments. In the case of the Butrint protected area (a Ramsar area6 and also a UNESCO-protected area7), it is shrinking to accommodate the construction of a national airport. In the natural landscape deforestation is a very relevant issue since in the Finiq Municipality on 25% of the original forest remains8. For the rivers, the main threat is the illegal exploitation of the riverbeds but also the mismanagement of the river deltas.

New uses of castles owned by municipalities in the province of Alicante (Spain) during the first quarter of the 21st century

The province of Alicante is an administrative unit belonging to the Valencian Community, one of the 17 autonomous communities that make up Spain, and it is located in the southeast of the Iberian Peninsula. Its historical vicissitudes have motivated the existence of many castles. All of them mark the province from north to south and from east to west. After losing their military and/or residential functions, many castles were abandoned and became ruins of reference in their landscape. Their recovery began without a defined use in the second half of the 20th century. However, the tourist development of the province of Alicante, under the Costa Blanca brand, has turned these castles into a first-rate cultural and tourist resource. In this way, many actions have been carried out on their cultural and tourist use to learn about the history of the places where they are. For this reason, the present work is committed to reflect on the new uses of these castles during the first quarter of the 21st century and the remains for their preservation.

Evaluating Spatial Interpolation Maps of the Age Structure of the Population of Thi Qar Governorate Using Geographic Information Systems (GIS) Technologies

The research aims to harness spatial interpolation techniques to produce maps with a high level of perceptual accuracy in representing the population data of the study area. This is achieved after exploring the statistical and spatial nature of the databases used, analyzing them, and determining their distribution using a variety of spatial data exploration tools available within the GIS (Geographic Information Systems) environment. These tools contribute to evaluating the characteristics, distribution, and analysis of data, including testing data distribution, identifying its direction, and uncovering its spatial correlations. This highlights the importance of the study and understanding the distribution pattern of the population data in the study area, thereby facilitating the preparation of future that serve spatial organization by building spatial models for the numerical distribution of the data for age groups: young, middle-aged, and elderly, at the level of administrative units of the study area by relying on the inductive approach and the quantitative analysis approach. This is done using Geostatistical Analysis methods within the concept of spatial interpolation in GIS. The research also seeks to predict the population maps for Thi Qar Governorate by comparing spatial interpolation methods, namely Inverse Distance Weighting (IDW) and Simple Kriging (SK). The study concluded, after verifying the accuracy of the results using the Cross-Validation curve, that the Simple Kriging (SK) method is the most accurate model in spatial prediction of population data for representing the data of the young age group in the study area, as it had the lowest Root Mean Square Error (RMSE) of 10.012. It was followed by the Inverse Distance Weighting (IDW) method for representing the data of the elderly age group with an RMSE of 350.48. This indicates that the use of statistical criteria improves the accuracy of spatial interpolation and that the spatial prediction of the population data for the study area using the Simple Kriging (SK) method was more accurate than the Inverse Distance Weighting (IDW) method based on statistical indicators.

The role of Teff crop in Ethiopian life: consumption and contribution to rural livelihoods

Teff (Eragrostis tef) is believed to be the smallest grain in the world. It is the most important crop in Ethiopia in terms of production and consumption. Smallholder farmers produce Teff, and it is the main source of income for farmers in comparison to other cereal crops. Teff is the daily staple food for over 50 million Ethiopians. There is a need for information on agricultural consumption, disaggregated at district level, to support evidence-based decision-making at local level. The objective of this paper is to understand the consumption of Teff among rural smallholder producers at district level and assess the position of Teff among cereals in the lives of Ethiopian rural farmers. The study employed a multistage sampling technique to select the top Teff producing regions, districts, and kebeles (small administrative units) and collected primary data through focus group discussions (FGDs), key informants, and questionnaire respondents. The survey collected qualitative and quantitative data from 357 households. FGD, key informant interview (KII) participants and survey respondents were drawn from the same areas where the survey was conducted. The quantitative and qualitative data were subjected to statistical and content analysis respectively. The study findings revealed that on average households consume 26.92% of their Teff production per year. Moreover, there is a shift in the consumption of Teff which might be due to improved standards of living among the farmers, a health-conscious community, and improved income from Teff sales. Although Teff is a staple grain in Ethiopia, there is a statistically significant variation in Teff consumption among districts.

The Role of Public Administration Expenditures in Tourism Development – a Comparative Analysis of Two Valuable Geoheritage Areas

This study examines the relationship between public administration expenditure and the development of the tourism sector in four Administrative Territorial Units (ATUs) with high natural potential between 2000 and 2018. It first analyzes the public expenditures of the ATUs, classifying them by function and calculating the share of each expenditure in the total. Next, the study assesses local economies using the Classification of National Economic Activities (NACE) to determine the contribution of tourism. Finally, the two databases are correlated to explore the impact of public spending on tourism growth. The findings provide a foundation for developing new methodologies to assess public investment in tourism and raise awareness of its importance. Keywords: tourism, revenues, expenditures, public administration, local economy

Efficiency and safety of high-dose undiluted intravenous push levetiracetam loading doses compared to intravenous infusion in seizing patients: A retrospective cohort study.

Intravenous (IV) push (IVP) is an alternative administration method for levetiracetam, but evidence evaluating it compared to IV piggyback (IVPB) for loading doses in acutely seizing patients is limited, particularly in patients with status epilepticus (SE). This study aimed to compare the efficiency and safety of IVP versus IVPB levetiracetam loading doses. This was a single-center sequential retrospective study conducted in adult (≥18 years) patients who received an IV levetiracetam loading dose (>2000 mg or ≥20 mg/kg) for acute or suspected seizure. The primary outcome was time to administration, compared between doses given as IVP versus IVPB. Secondary outcomes included rates of adverse events (AEs), rescue benzodiazepine or antiseizure medication administration, intubation, and intensive care unit (ICU) admission between groups. A total of 246 patients were included; 116 received IVP and 130 received IVPB loading doses. Median age was 56 years; most patients were male (62%) and White (60%) and had witnessed seizures (67%). Doses were administered for SE in 32 (27.5%) and 46 (35.4%) patients in the IVP and IVPB arms, respectively. Median time to administration was shorter in the IVP group (12 vs. 38 min, p < .001). Bradycardia (1.7% vs. 2.3%, p = .99), hypotension (7.8% vs. 12%, p = .30), sedation (6% vs. 12.3%, p = .09), intubation (10% vs. 8%, p = .37), ICU admission (32% vs. 39%, p = .31), and rescue medication administration (8.6% vs. 14.6% p = .10) were similar between groups. In SE patients, IVP was associated with shorter time to administration (12 vs. 44 min, p = .003) and lower odds of ICU admission after adjustment for age, dose, Status Epilepticus Severity Score, and seizure history (adjusted odds ratio = .23, 95% confidence interval = .06-.81). IVP reduced time to levetiracetam administration versus IVPB and was not associated with more AEs. Rescue agent use, intubation, and ICU admission were similar between arms, but IVP may reduce ICU admissions in SE patients. Prospective studies should assess the effectiveness of IVP versus IVPB.