Veneto Region Research Articles

Occurrence and phase distribution of benzothiazoles in untreated highway stormwater runoff and road dust.

The study about how tyre-derived particles can potentially worsen the water quality and how traffic pollution markers can affect the environment is crucial for environmental management. Road emissions are known to contribute to pollution in various environments, and benzothiazoles and their derivates can be used to trace pollutant inputs related to surface runoff in the aquatic system. A total of eight benzothiazoles were determined in highway stormwater runoff and road dust collected from February to August 2022 near Venice (Casale sul Sile, Veneto Region, Italy). A new analytical method was validated, by using an UHPLC system coupled to a mass spectrometer (triple quadrupole). The target compounds were determined in both dissolved phase and suspended particulate matter of runoff, and the road dust samples were divided into seven fractions depending on particle diameters to understand the fraction partitioning. The results indicate that 2-SO3H-BTH was the most concentrated benzothiazole in all the analysed substrates, suggesting tyre debris as the main source because it is usually used in the vulcanization process. 2-SO3H-BTH reached a mean concentration of 115 ± 59µg L-1, 4 ± 3µg L-1, and 411 ± 441µg Kg-1 for dissolved phase, suspended particulate matter, and road dust, respectively, while 2-OH-BTH and BTH showed values about an order of magnitude lower. The size distribution of most BTHs suggests that they are distributed in the finest fraction of road dust. An exception was given by 2-SCNMeS-BTH being present only in particles with a diameter > 1mm.

Acceptability of deferring the start of cervical cancer screening to age 30 for women vaccinated against human papillomavirus

HPV vaccination of girls younger than 15 is very effective in reducing their risk of cervical cancer. In Italy, for vaccinated women, the starting age for cervical cancer screening is set to change from 25 to 30. Adherence to a protocol change is crucial to assure efficacy. The aim of our study was to monitor women’s reaction to the change and learn about their attitudes.In September 2022, an anonymous online questionnaire was proposed to 3122 women born in 1997, fully vaccinated before 15 years of age and afferent to an organized cervical cancer screening programme in the Veneto region (North-East Italy). The questionnaire included 30 items on knowledge of HPV infection and preventive measures for cervical cancer, gynaecological check-ups and reactions to the deferment of the start of screening.Overall, 147 questionnaires were completed (4.7% participation rate). Almost all women had some information on HPV and HPV vaccination, while one third were unaware of the existence of the screening programme. Over 66% expressed agreement with the rationale for the deferment of screening initiation, but 62% would have preferred to start screening at 25. There was a significant association between having had one or more Pap tests and the willingness to undergo additional testing outside the screening programme before the age of 30. Continued efforts are required to improve the effectiveness of communication to women, especially when implementing existing protocols, together with strategies to promote correct approaches.

(Re)constructing identity following acquired brain injury: The complex journey of recovery after stroke.

People with poststroke acquired brain injury (ABI) face a complex and often troubled identity reconstruction journey. The literature is rich with studies related to the psychological and neuropsychological components involved in rehabilitation, but it is lacking with respect to the investigation of the existential dimensions and the challenges associated with finding new senses and meanings for one's identity and future perspectives, body and interpersonal relationships. The aim of this study is to investigate the narrative processes of identity reconstruction after brain damage. Through a qualitative approach, 30 autobiographical narratives about self, body and the relationships with others were collected and analyzed. Semistructured interviews were used for the data collection. Narrative and positioning analysis were applied. Four main positionings emerged: sanctioning a radical break with one's previous life; assuming a sense of salvation and compulsory as well as irreversible adaptation to the limitations associated with one's condition; feeling different and disabled; and considering new possibilities and active constructions of self-being in relationship with others. These results underline the narrative processes of construction of the injury and the identity and delineate possible resources and instruments to improve the clinical practice for health practitioners. They are also valuable for other professionals who deal with neurological services and rehabilitation, such as psychological counselling and support for persons who have experienced ABI and their families. This work resulted from a close collaboration between two universities and a hospital neurological rehabilitation department in the Veneto Region (Northern Italy). Three associations of people with stroke and their families living in the same area contributed to designing the research on the basis of the needs expressed by their members with the aim to identify strategies and devices to be implemented in the public service to improve the care pathway. They also participated in the interpretation of the data.

ISCHEMIC STROKE AND MAJOR BLEEDING WHILE ON DIRECT ORAL ANTICOAGULANTS IN NAÏVE PATIENTS WITH ATRIAL FIBRILLATION: IMPACT OF RESUMPTION OR DISCONTINUATION OF ANTICOAGULANT TREATMENT. A population-based study.

AimsWe assessed the cumulative incidence of recurrent stroke, major bleeding and all-cause mortality associated with restarting antithrombotic treatment, in patients experiencing an anticoagulation-related event (stroke or major bleeding), occurred during anticoagulation therapy for AF.Methods and Results.We performed a retrospective population-based analysis on linked claims data of patients resident in the Veneto Region, treated with DOACs for AF and discharged (2013−2020) from the hospital for stroke, intracranial haemorrhage (ICH), and major bleeding. To adjust for competing risk of death and reduce confounding, we started the follow up after a 120-days blanking period, counting events in patients resuming oral anticoagulation versus those that did not. Risks of all-cause mortality, ischemic stroke (IS)intracranial haemorrhage (ICH), and other major bleeding events (MB) were estimated with multivariable Cox proportional hazard models and propensity score to adjust for differences in baseline characteristics. Overall, 1029 patients (mean age 77 years) were included in the final cohort: 23% experienced an IS, 18% an ICH, and 59% MB. Of these, 77% resumed anticoagulation. The cumulative incidence of events was significantly lower in patients resuming therapy. In the multivariable analysis considering age, sex and propensity score as covariates, resumption of anticoagulation significantly reduced the risk of a cumulative event (HR 0.45, 95%CI 0.35–0.57, p < 0.01). Stratifying for the index event, among patients with IS (92% resumed therapy), we observed a risk reduction of 81%; in patients with ICH (64% resumed therapy), we observed a risk reduction of 64% and for patients with MB (76% resuming therapy), we observed a risk reduction of 49%. ConclusionsIn patients with AF who experienced an anticoagulation-related event, resuming oral anticoagulation was associated with better outcomes for all-cause mortality and subsequent events as compared with patients who did not resume treatment.

Spatio-temporal variations of growth, chemical composition, and gene expression in Mediterranean mussels (Mytilus galloprovincialis): A two-year study in the Venice lagoon under anthropogenic and climate changing scenarios

The Mediterranean mussel Mytilus galloprovincialis represents one of the most important aquaculture species in the Mediterranean Sea. The Venice lagoon is an historically important mussels farming area, contributing 25% of the total mussel production of the Veneto region. This area represents a vulnerable ecosystem, subject to significant spatio-temporal variations due to climate change and anthropogenic interventions as for the recent commissioning of MoSE (Experimental Electromechanical Module), a system of mobile barriers aimed at protecting Venice from high tides. In this study, we monitored for two consecutive production cycles three mussels farming sites located in Chioggia at different distance from the southern Venice lagoon inlet. During each season of the two productive cycles, mussels were collected in the three farming sites and site- and seasonal-specific variations of growth, chemical composition and fatty acid profile were investigated. In addition, we also characterized whole gene expression profiles of mussels grown in two investigated farming sites. Biometric traits and gene expression results highlighted narrow differences between rearing sites, inconsistent between the two production cycles. Conversely, seasonality led to important changes in mussel transcriptional profiles, fatty acid composition and condition index due to mussel reproductive cycle and seasonal conditions of the Venice lagoon (e.g. temperature, food availability).Fatty acid differences were primarily linked to dietary changes, rather than stress-related or physiological differences. Regardless of the rearing site, the lowest condition index was observed in October, probably due to intensified metabolic expenditure and depletion of energy reserves to cope with summer stressful environmental conditions. This hypothesis is corroborated by gene expression profiling and by the reduction in the mussel lipid content observed between July and October.The differences between mussels farmed in different sites were mainly related to the hydrodynamics which influences water physico-chemical parameters and feed availability for mussels. Overall biometric traits (i.e. growth) were more favourable in mussels farmed in the most external site characterized by higher hydrodynamics and more favourable water conditions compared to the other two sites. The most favourable condition of mussels farmed close to Chioggia inlet was also measured by gene expression profiles suggesting stressful conditions in inner site at the end of the second production cycle. Despite comparisons between farming sites at transcriptional level showed different results between production cycles, mussels exhibited comparable growth patterns during corresponding months or seasons, suggesting limited and not yet noticeable effects of MoSE commissioning in mussel production.

Comparative study showed that children faced a 78% higher risk of new-onset conditions after they had COVID-19.

Children have largely been unaffected by severe COVID-19 compared to adults, but data suggest that they may have experienced new conditions after developing the disease. We compared outcomes in children who had experienced COVID-19 and healthy controls. A retrospective nested cohort study assessed the incidence rate of new-onset conditions after COVID-19 in children aged 0-14 years. Data were retrieved from an Italian paediatric primary care database linked to Veneto Region registries. Exposed children with a positive nasopharyngeal swab were matched 1:1 with unexposed children who had tested negative. Conditional Cox regression was fitted to estimate the adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for the exposure and outcome associations after adjusting for covariates. We compared 1656 exposed and 1656 unexposed children from 1 February 2020 to 30 November 2021. The overall excess risk for new-onset conditions after COVID-19 was 78% higher in the exposed than unexposed children. We found significantly higher risks for some new conditions in exposed children, including mental health issues (aHR 1.8, 95% CI 1.1-3.0) and neurological problems (aHR 2.4, 95% CI 1.4-4.1). Exposed children had a 78% higher risk of developing new conditions of interest after COVID-19 than unexposed children.

A Strategic Interpretation of Landscape through Interaction between Natural, Built and Virtual Environments: The Case Study of Piazzola sul Brenta

The need to digitize data as an analysis tool is increasingly a topical issue, also because it is a tool of common interest for several disciplines. This new research merges with the iNEST project (Interconnected Nord-Est Innovation Ecosystem), referring in particular to Spoke 4: city, architecture and sustainable design, which aims at extending the beneficial effects of digitalization to the areas of “Nord-Est” Italy. The project started in August 2022 and will end in August 2025. Knowing that the trend of urbanization, metropolis living, and climate change is related to psychologically stressful situations as a result of environmental stressors, this research aims to analyze if living in a place surrounded by natural and valuable artificial elements (i.e., historical architecture, art) is crucial in generating health and psychophysical well-being. This paper presents the case study of Piazzola sul Brenta, a small town in the Veneto region on which a territorial analysis was carried out to understand the existing dynamics between the natural and artificial environment, using the literature and historical maps. Since this research began recently, with only preliminary and partial results so far, this paper focuses on the interdisciplinary discussion developed around this topic, showing the first part of a research that aims to create models of urban and landscape contexts that enable in-depth analysis and the prefiguration of strategies for regeneration.

Risk of SARS-CoV-2 transmission in the close contacts in a small rural area in the Veneto Region (NE-Italy): past evidence for future scenarios.

During the first pandemic phase of COVID-19, an epidemiological study, named First survey, was conducted on the population of a small rural area in northern Italy. In spring 2020, the results showed how a prolonged lockdown slowed down the spread of the virus. After contacting positive First Survey subjects and their families, those who decided to join voluntarily underwent a blood test to assess the presence of qualitative lgG about 2 months after the previous one. This was to determine if IgG persisted in individuals who tested positive in the First Survey as well as to assess the antibody status of their close family members, to determine if they were unintentionally infected. Based on serological analysis, 35.1% of the samples contained blood IgG. In subjects who tested positive during the First Survey, 62.5% remained IgG positive more than 2 months later. Among family members who were exposed to a positive relative, 23.7% were infected. Linear regression analysis showed that the presence of an infected person within a household resulted in the infection spreading to the others, but not excessively. Induced isolation extinguished the infection regardless of the extent of the contagion (intra-family or extra-family). Micro-outbreaks of SARS-Cov-2 infection which arose in the same household from extra-familial infections played a decisive role on the statistical significance of IgG-positive subjects (p < 0.001). The study reveal 52.6% of the IgG-positive subjects in the Second Survey came from the First Survey and 47.4% were family members previously in contact with positive subjects. Data suggest that there have been undiagnosed patients feeding the spread of the virus since the beginning of the pandemic. In conclusion, for future pandemics, it will be necessary: i) to ensure the rapid isolation of symptomatic patients and the early identification of their close contacts, ii) to carry out the maximum number of tests in the shortest possible time, both on symptomatic and asymptomatic subjects, and iii) to implement information campaigns to make people aware of their risks, and implement clear, non-conflicting communication.

Telemonitoring patients with chronic heart failure. Results from a pilot study in the Veneto Region, Italy

Remote monitoring of patients with chronic heart failure (HF) can prevent acute episodes of HF, optimize treatment, reduce emergency room (ER) visits and hospitalizations, and improve quality of life of patients and caregivers. In current clinical practice, however, the most appropriate model is still under debate. We aimed to evaluate the impact of a new remote telemonitoring (TM) system in the clinical management of HF patients on the reduction of hospitalizations and ER admissions and on possible related-economic benefits. A working group participated by primary care and family practitioners, cardiologists, home care nurses of the 8th Local Health Unit of the Veneto Region, Italy, has established a new operating procedure for TM chronic HF patients, identifying the clinical profiles and the inclusion/exclusion criteria of enrollment, the clinical parameters to be monitored, the input/output modalities of the information to/from the call center, the alarm criteria and the response procedures. Patients were profiled into three risk categories based on age, clinical characteristics, prognosis assessment, and social needs and provided with appropriate devices for remote measurement and transmission of blood pressure, heart rate, peripheral oxygen saturation (SpO2) and body weight. Clinical data, self-measured at home according to a predetermined schedule based on the patient's risk profile, were automatically transmitted to the operating center, generating, if above the threshold, a grading of alarms (green/cyan, yellow, red) and the consequent activation of the most appropriate response (returned phone calls to check patient's status, reporting to primary physician/family practitioner for clinical evaluation, notification to the HF outpatient clinic for an early follow-up visit, alerting medical emergency services). The number of hospitalizations and ER visits during the TM period was compared with the pre-TM equivalent for each individual patient. Overall, 22 patients with chronic HF were enrolled (mean age 82.3 ± 8.6 years, 17 males). The average duration of TM was 18.7 ± 8.8 months. Overall, 62 108 home measurements were performed and transmitted. The alarms received by the operating center were 4120 (6.6% of all measurements): 62% cyan, 30% yellow, 8% red. Most of the data above the threshold concerned weight gain (42.0%) and SpO2 variations (28.0%). During the observation period (TM period and pre-TM equivalent interval calculated for each individual patient), a total of 127 hospitalizations and 181 ED visits were recorded. Compared to the pre-TM period, there was a 66% reduction in hospitalizations for all causes (95 vs 32, p<0.001) and a 68% decrease in ED visits (137 vs 44, p<0.001). Similarly, hospitalizations and ED visits due to HF were reduced by 82% (p<0.001) and 66% (p<0.001), respectively, with a decrease in days of HF-related hospitalization from 211 to 48. Despite a higher cost for TM of € 6911.15, a total saving of € 64 103.87 was obtained for the reduction of expenses from € 8665.45 to € 2664.00 for ED visits and from € 71 627.93 to € 13 525.51 for HF hospitalizations. This pilot experience on remote monitoring HF patients proved to be effective in determining a significant reduction in ED visits and hospitalizations with a consequent significant economic benefit. Larger studies are needed to confirm this favorable outcome.

Spatio-temporal modeling of groundwater quality deterioration and resource depletion

In Hydrogeology, the analysis of groundwater features is based on multiple data related to correlated variables recorded over a spatio-temporal domain. Thus, multivariate geostatistical tools are fundamental for assessment of the data variability in space and time, as well as for parametric and nonparametric modeling. In this work, three key hydrological indicators of the quality of groundwater—sodium adsorption ratio, chloride and electrical conductivity—as well as the phreatic level, in the unconfined aquifer of the central area of Veneto Region (Italy) are investigated and modeled for prediction purposes. By using a new geostatistical approach, probability maps of groundwater resource deterioration are computed, and some areas where the aquifer needs strong attention are identified in the north-east part of the study region. The proposed analytical methodology and the findings can support policy makers in planning actions aimed at sustainable water management, which should enable better monitoring of groundwater used for drinking and also ensure high quality of water for irrigation purposes.

Projecting cancer prevalence by phase of care: a methodological approach for health service planning.

In most developed countries, the number of cancer survivors is expected to increase in the coming decades because of rising incidence and survival rates and an aging population. These patients are heterogeneous in terms of health service demands: from recently diagnosed patients requiring first-course therapy to patients with extensive care needs and severe disabilities to long-term survivors who only need minimal care. Therefore, in terms of providing healthcare planners and policymakers with useful indicators for addressing policies according to health service demands, it is worth supplying updated measures of prevalence for groups of patients based on the level of care they require. The aim of this paper is to illustrate a new method for estimating short-term projections of cancer prevalence by phase of care that applies to areas covered by cancer registration. The proposed method combines linear regression models to project limited duration prevalence derived from cancer registry data and a session of the freely available software COMPREV to estimate the projected complete prevalence into three distinct clinically relevant phases of care: initial, continuing, and final. The method is illustrated and validated using data from the Veneto region in Italy for breast, colorectal, and lung cancers. Prevalence is expected to increase in 2015-2026 for all considered cancer sites and sexes, with average annual variations spanning from 2.6% for women with lung cancer to 0.5% for men with colorectal cancer. The only exception is lung cancer prevalence in men, which shows an average annual decrease of 1.9%. The majority of patients are in the continuing phase of care, followed by the initial and final phases, except for lung cancer, where the final phase of care prevails over the initial one. The paper proposes a method for estimating (short-term) future cancer healthcare needs that is based on user-friendly and freely available software and linear regression models. Validation results confirm the applicability of our method to the most frequent cancer types, provided that cancer registry data with at least 15 years of registration are available. Evidence from this method is addressed to policymakers for planning future cancer care, thus improving the cancer survivorship experience for patients and caregivers.

Multi-Risk Assessment in the Veneto Region: An Approach to Rank Seismic and Flood Risk

Effective disaster risk management in a given area relies on the analysis of all relevant risks potentially affecting it. A proper multi-risk evaluation requires the ranking of analyzed risks and the estimation of overall expected impacts, considering possible hazards (and vulnerabilities) interactions as well. Due to their complex and challenging modelling, such interactions are usually neglected, and the analysis of risks derived from different sources are commonly performed through independent analysis. However, often the assessment procedures adopted for the analysis as well as the metrics used to express various risks are different, making results of single risk analyses hardly comparable. To overcome this issue, an approach that allows for comparing and ranking risks is presented in this study. The approach is demonstrated through an application for an Italian region. Earthquakes and floods are the investigated hazards. First, in order to select the case study area, the municipalities within the Veneto region where both risks could be highest are identified by adopting an index-based approach. Then, the harmonization of seismic and flood risk assessment procedure is performed. Sub-municipal areas are selected as scale of analysis and direct economic losses are chosen as common impact metrics. The results of the single risk analyses are compared using risk curves as standardization tool. The EAL (expected annual losses) are estimated through risk curves and the ratios between EAL due to floods and earthquakes are mapped, showing in which area risk is significantly higher than the other.

Indicators of clinical performance in monitoring soft tissue sarcoma management: a population-based perspective.

Soft tissue sarcomas (STS) are rare malignancies which prognosis varies significantly by primary site, histological subtype, and tumor stage. Their low incidence, and the complexity of their clinico-pathological characteristics demand standardized, cancer-tailored diagnostics and therapies managed at high-volume, multidisciplinary care centers. This study evaluates the quality of STS management in north-east Italy (Veneto Region) through a list of ad hoc defined clinical indicators. This population-based study concerns all incident cases of STS in 2018 (214 cases) recorded in the adult population censored by the Veneto's regional Cancer Registry. Based on the international literature, a multidisciplinary working group of experts identified a set of indicators for monitoring the quality of diagnostic, therapeutic, and end-of-life clinical interventions. The quality of care was assessed by comparing the reference thresholds with the indicators' values achieved in clinical practice. Diagnostic procedures showed poor adherence to the thresholds, with a low percentage of histological diagnoses validated by a second opinion. The indicators relating to the surgical treatment of superficial, small, low-grade STS, or of medium, high-grade STS of the head-neck, trunk, or limbs were consistent with the thresholds, while for intermediate, high-grade (large-sized, deep) and retroperitoneal STS they fell significantly below the thresholds. A critical evaluation of the clinical indicators allowed to uncover the procedures needing corrective action. Monitoring clinical care indicators improves cancer care, confirms the importance of managing rare cancers at highly specialized, high-volume centers, and promotes the ethical sustainability of the healthcare system.

Promoting an integrated planning for a sustainable upscale of renewable energy. A regional GIS-based comparison between ecosystem services tradeoff and policy constraints

The upscale of renewable energy production on a regional scale implies possible negative impacts on the environment, economies and societies. To ensure the sustainability of renewable energy production on a regional scale, the lens of ecosystem services can support sustainable energy assessments. This paper proposes a GIS-based methodology to spatially analyze the integration of renewable energy with other ecosystem services in order to identify trade-offs. The work focuses on solar farms and agricultural biomass from leftovers and considers five other ecosystem services that are fundamental to agricultural landscapes. The proposed assessment methodology relates land cover types to land suitability for renewable energy production, building on the literature on ecosystem service tradeoffs. The methodology was tested on a case study. The case study is the Veneto Region, whose renewable energy policy constraints are also analyzed. The assessment methodology shows that the land cover of fruit crops has a high level of tradeoff. The results of the case study highlight the discrepancy between the two separate analyses: the policy constraints analysis favours solar agriculture, while the tradeoff analysis favours energy production from agricultural biomass. Finally, the study paves the way for further investigation in the field of ES-RES and provides policy recommendations.

Estimated Direct Costs of Renal Cancer by Stage of Disease at Diagnosis and Phase of Its Management: A Whole-Disease Model.

Renal cell carcinoma (RCC) is the seventh most common neoplasm in high-income countries. New clinical pathways have been developed to deal with this tumor, which includes costly drugs that pose an economic threat to the sustainability of healthcare services. This study provides an estimate of the direct costs of care for patients with RCC by stage of disease (early vs. advanced) at diagnosis, and disease management phase along the pathway recommended by local and international guidelines. Considering the clinical pathway for RCC adopted in the Veneto region (north-east Italy) and the latest guidelines, we developed a very detailed "whole-disease" model that covers the probabilities of all potentially necessary diagnostic and therapeutic actions involved in the management of RCC. Based on the cost of each procedure according to the Veneto Regional Authority's official reimbursement tariffs, we estimated the total and average per-patient costs by stage of disease (early or advanced) and phase of its management. In the first year after diagnosis, the mean expected cost of a patient with RCC is €12,991 if it is localized or locally-advanced and reaches €40,586 if it is advanced. For early disease, the main cost is incurred by surgery, whereas medical therapy (first and second line) and supportive care become increasingly important for metastatic disease. It is crucially important to examine the direct costs of care for RCC, and to predict the burden on healthcare services of new oncological therapies and treatments, as the findings could be useful for policy-makers planning the allocation of resources.

Probabilistic network analysis of social-ecological relationships emerging from EU LIFE projects for nature and biodiversity: An application of ERGM models in the case study of the Veneto region (Italy)

Considering social-ecological relationships in managing protected areas is fundamental to ensuring effective biodiversity conservation and restoration governance. Network analysis offers valuable methods to disentangle intangible relations between and within the social and ecological systems. In this way, it could be possible to identify and integrate multiple social and ecological variables that inevitably affect collaborative environmental governance's effectiveness. Nevertheless, this research area is still nascent, with few methodologies and concrete applications reported in the scientific literature. With this study, we aim to propose a robust novel application of a network methodology to enrich the evaluation of the effectiveness of collaborative environmental governance for nature and biodiversity, which has been applied through the analysis of social-ecological relationships that emerged from EU-cofounded LIFE-NAT projects. Specifically, we focus on LIFE-NAT projects implemented in the Veneto Region (Italy) financed in the last programming period (2014–2020). Through formulating four research hypotheses to be tested through Exponential Random Graph Models, we analyze 13 LIFE-NAT projects involving 83 social actors and 29 Natura 2000 (N2000) sites composed of 57 protected habitats. Results show that LIFE-NAT projects in Veneto Region stimulate polycentric governance. Nevertheless, they still need to concretize a multi-actor and multilevel governance. Furthermore, the analysis highlights that selected LIFE-NAT projects implement activities in N2000 sites able to support ecological connectivity and synergies across marine, freshwater, and land habitats through the bridging role of forests, especially in estuarine and coastal areas.

Multivariate Modeling for Spatio-Temporal Radon Flux Predictions.

Nowadays, various fields in environmental sciences require the availability of appropriate techniques to exploit the information given by multivariate spatial or spatio-temporal observations. In particular, radon flux data which are of high interest to monitor greenhouse gas emissions and to assess human exposure to indoor radon are determined by the deposit of uranium and radio (precursor elements). Furthermore, they are also affected by various atmospheric variables, such as humidity, temperature, precipitation and evapotranspiration. To this aim, a significant role can be recognized to the tools of multivariate geostatistics which supports the modeling and prediction of variables under study. In this paper, the spatio-temporal distribution of radon flux densities over the Veneto Region (Italy) and its estimation at unsampled points in space and time are discussed. In particular, the spatio-temporal linear coregionalization model is identified on the basis of the joint diagonalization of the empirical covariance matrices evaluated at different spatio-temporal lags and is used to produce predicted radon flux maps for different months. Probability maps, that the radon flux density in the upcoming months is greater than three historical statistics, are then built. This might be of interest especially in summer months when the risk of radon exhalation is higher. Moreover, a comparison with respect to alternative models in the univariate and multivariate context is provided.

New insights into the distribution and spreading of the Asian walnut moth, Garellamusculana (Erschov, 1874) (Lepidoptera, Nolidae) in Europe with a focus on the Italian range.

The Asian walnut moth, Garellamusculana (Erschov, 1874) (Lepidoptera, Nolidae) is an alien pest originating from Central Asia and is now spreading in Europe, attacking walnut trees. In this study, we updated the current distribution of G.musculana, focusing on the Italian range, where it was reported for the first time in 2021. Field surveys showed an extensive distribution of G.musculana in northern Italy, particularly in the Veneto Region. In this area, the Asian walnut moth developed on English and black walnut, attacking almost exclusively tree shoots. Based on current distribution data, further investigations are required in the nearby regions as well as in those that were less surveyed. Lastly, it is imperative to conduct more studies on insect biology and the impact on walnut production.

Pediatric Injury Surveillance From Uncoded Emergency Department Admission Records in Italy: Machine Learning-Based Text-Mining Approach.

Unintentional injury is the leading cause of death in young children. Emergency department (ED) diagnoses are a useful source of information for injury epidemiological surveillance purposes. However, ED data collection systems often use free-text fields to report patient diagnoses. Machine learning techniques (MLTs) are powerful tools for automatic text classification. The MLT system is useful to improve injury surveillance by speeding up the manual free-text coding tasks of ED diagnoses. This research aims to develop a tool for automatic free-text classification of ED diagnoses to automatically identify injury cases. The automatic classification system also serves for epidemiological purposes to identify the burden of pediatric injuries in Padua, a large province in the Veneto region in the Northeast Italy. The study includes 283,468 pediatric admissions between 2007 and 2018 to the Padova University Hospital ED, a large referral center in Northern Italy. Each record reports a diagnosis by free text. The records are standard tools for reporting patient diagnoses. An expert pediatrician manually classified a randomly extracted sample of approximately 40,000 diagnoses. This study sample served as the gold standard to train an MLT classifier. After preprocessing, a document-term matrix was created. The machine learning classifiers, including decision tree, random forest, gradient boosting method (GBM), and support vector machine (SVM), were tuned by 4-fold cross-validation. The injury diagnoses were classified into 3 hierarchical classification tasks, as follows: injury versus noninjury (task A), intentional versus unintentional injury (task B), and type of unintentional injury (task C), according to the World Health Organization classification of injuries. The SVM classifier achieved the highest performance accuracy (94.14%) in classifying injury versus noninjury cases (task A). The GBM method produced the best results (92% accuracy) for the unintentional and intentional injury classification task (task B). The highest accuracy for the unintentional injury subclassification (task C) was achieved by the SVM classifier. The SVM, random forest, and GBM algorithms performed similarly against the gold standard across different tasks. This study shows that MLTs are promising techniques for improving epidemiological surveillance, allowing for the automatic classification of pediatric ED free-text diagnoses. The MLTs revealed a suitable classification performance, especially for general injuries and intentional injury classification. This automatic classification could facilitate the epidemiological surveillance of pediatric injuries by also reducing the health professionals' efforts in manually classifying diagnoses for research purposes.

Migrant status disparities in blood pressure: a multiple mediation analysis of modifiable factors

BackgroundWe examined differences in blood pressure (BP) levels between first-generation immigrants and natives in adult residents in Northeast Italy, and investigated the role of lifestyle behaviors, body mass index (BMI), and education as potentially modifiable mediating factors.MethodsWe included 20–69-year-old participants from the Health Surveillance Program of the Veneto Region (n = 37,710). Immigrants born in a high migratory pressure country (HMPC) were further grouped into geographical macro-areas. The outcomes were systolic BP (SBP) and hypertension. Multiple mediation analyses were performed to determine the contribution of each mediator of the SBP/migrant status association.ResultsOf the 37,380 subjects included, 8.7% were born in an HMPC. BMI, education, alcohol, sweets and meat consumption were included as potential mediators. A small advantage in SBP was seen for immigrants compared to natives (β = – 0.71,95%CI – 1.30; – 0.10). The direct effect (net of the covariates) of immigrant status on SBP was a reduction of 1.62 mmHg (95%CI – 2.25; – 0.98). BMI played the highest suppressive role (β = 1.14,95%CI 0.99; 1.35), followed by education. Alcohol consumption amplified the health advantage of immigrants. The suppressing effect of BMI was particularly evident among women and North Africans compared to natives. Similar results were seen for hypertension rates.ConclusionsAlthough causation cannot be proven given the cross-sectional design, our findings identify BMI as the most effective target to preserve the health advantage of immigrants with respect to BP levels.