Agenzia Regionale Parchi

Mining cultural landscapes are complex heritage systems shaped by long-term interactions between geological resources, extractive activities and communities. Ensuring their resilience requires integrated approaches that combine scientific knowledge, digital innovation and stakeholder engagement.This contribution presents a transdisciplinary workflow developed at the Archaeological and Mining Park of San Silvestro (Tuscany, Italy), aimed at supporting resilient heritage management through non-invasive investigation and immersive communication. Between 2019 and 2025, the MIMA-SITES project applied cosmic-ray muon radiography (muography) at the Temperino mine to explore subsurface density variations and to improve the understanding of unknown cavities and high-density ore bodies. Muography results were integrated with extensive geomatic surveys (terrestrial and mobile laser scanning, UAV photogrammetry) and three-dimensional geological modelling, producing a comprehensive digital representation of both surface and underground components of the site. These scientific outputs were translated into co-created digital products, including interactive 3D visualisations and video storytelling, and are being further developed into immersive virtual and augmented reality experiences integrated within the park’s museum pathway. Beyond their technical value, these tools contribute to making otherwise invisible subsurface features more accessible, supporting awareness of potential risks and offering new ways for the public to engage with the geological and archaeological evolution of the landscape.The San Silvestro Park exemplifies a dynamic mining cultural landscape where digital technologies can act as a bridge between research, heritage management and community engagement. While the proposed approach is still evolving, it suggests how non-invasive imaging, immersive media and participatory communication may contribute to long-term resilience by improving knowledge transfer, supporting informed decision-making and strengthening the connection between heritage, science and society.

EP3.2, e-Poster Terminal 3, September 3, 2025, 13:05 - 14:00IntroductionIn 2024 immigrants represented 8.9% of the population residing in Italy. They have better overall health conditions compared to the native population. However, the presence of formal and informal barriers often limits their appropriate access to healthcare, which needs to be closely monitored. The objective of this study is to compare the differences in access to emergency care between Italians and immigrants.MethodsThe National Institute for Health, Migration and Poverty (INMP) coordinates a monitoring system for the health status and healthcare of the resident immigrant population, which currently includes 10 regions (Piedmont, Lombardy, Trento and Bolzano Autonomous Provinces, Emilia-Romagna, Tuscany, Umbria, Lazio, Puglia, and Sicily), where 75% of the total residents in Italy and 83% of foreign nationals live.To date, the monitoring system covers the period 2016-2022. Data collected by the regions through different healthcare information systems are summarized in a set of 60 indicators covering hospital care, maternal-child care, and emergency care services.ResultsDuring the observation period (2016-2022), the percentage distribution of emergency department visits by triage code showed a higher proportion of white and green codes among immigrants compared to Italians, with trends remaining fairly stable over time. The 2022 data show the following proportions for foreigners and Italians: 16.3% vs 10.2% for white codes and 68.1% vs 64.2% for green codes, among men; 13.4% vs 9.7% for white codes and 70.5% vs 65.5% for green codes, among women.ConclusionsIt can be hypothesized that the failure to promptly or adequately care for immigrants leads to acute events that require emergency department visits for conditions that could be managed in different care settings, such as primary healthcare and specialist care. Furthermore, the use of emergency services by immigrants for less severe conditions suggests inappropriate use due to difficulties in accessing primary care.

Mesothelioma of the tunica vaginalis testis (MTVT) is an exceedingly rare tumor. We performed a registry-based study on MTVT patient management and survival in Italy. Cases were extracted from the dataset of the Italian National Mesothelioma Registry. A descriptive analysis of patient characteristics, including asbestos exposure, clinical presentation, diagnostic work-up and therapeutic management, was performed. Overall survival was evaluated. We calculated hazard ratios (HR) and 95% confidence intervals (CI) for selected variables by fitting univariate and multivariable Cox models. Overall, 104 patients with MTVT were included. Median age was 72 years (range 17-92). Epithelioid histotype was the most frequent. Previous asbestos exposure was identified in two thirds of cases. Data on diagnostic and therapeutic management were available for 74 patients (71%). The most frequent presentations were scrotal swelling/mass, hydrocele and inguinal pain. All patients underwent surgery, mostly with orchi-funicolectomy. Adjuvant therapy was administered to 15 patients (20%). Overall median survival was 26.2 months (95% CI 22.1-52.1); 3-, 5- and 10-year survival was 49%, 30% and 18%. Older age at diagnosis and presence of distant metastasis (HR 1.91, CI: 0.85-4.26) were negative prognostic factors. Adjuvant therapy was associated with higher mortality (HR 2.54, CI: 1.25-5.15), indicating a more advanced stage at diagnosis. Surgery remains the mainstay of treatment for MTVT; adjuvant therapy in our study did not improve outcome. Data from cancer registries are essential for rare cancers, but they should be integrated routinely with additional diagnostic and therapeutic information.

BACKGROUNDRotavirus is a main gastroenteritis cause in children ≤ 5 years old. In 2017, when few Italian regions had rotavirus vaccination programmes, rotavirus vaccines were included in the National Plan for Preventive Vaccination (PNPV). Although all Italian regions follow the PNPV, they each decide how to implement it, contributing to rotavirus vaccination coverage differences across the country.AIMThe objective was to assess rotavirus vaccination national/regional policies in Italy and, between 2016 and 2023, vaccination coverage trends at national and regional level.METHODSScientific and grey literature was systematically reviewed for reports on Italian national/regional policies or programmes concerning rotavirus vaccination. Their key features and strategies to increase vaccination coverage were recorded. Vaccination coverage data originating from the Ministry of Health, were analysed descriptively, or with linear regression, for national and regional trends.RESULTSAmong 418 policy/programme reports identified, 25 were included. Between 2013 and 2015, Sicilia, Calabria and Puglia had already initiated universal vaccination programmes. The PNPV 2017–19 standardised regions’ offer of rotavirus vaccination. Between 2016 and 2023, vaccination coverage in Italy significantly increased (p = 0.0005) from 10.5% to 70.76%, with a 140% rise in 2019−20. Regional coverage disparities existed. Throughout 2016–23, most central Italian regions had annual coverages below national values. Bolzano annual coverage was consistently < 50%, while in Veneto, coverage reached 85.10% in 2021. In 2023, five regions had > 80% coverage.CONCLUSIONSWhile rotavirus vaccination coverage improved in Italy in 2016−23, regional disparities persist. Addressing these requires overcoming logistical and societal challenges, as well as harmonised policies.

BackgroundMultimorbidity is socially patterned, with lower socioeconomic position (SEP) linked to higher risk. We examined whether a Healthy Lifestyle Index (HLI) mediates the SEP–multimorbidity association and whether pathways differ by sex.MethodsWe used data from 244 886 participants in the European Prospective Investigation into Cancer and Nutrition study. HLI was derived from smoking, alcohol consumption, physical activity, body mass index and diet. SEP was categorised into low, medium and high-SEP based on education. Multimorbidity was defined as the coexistence of at least two diseases among cancer, type 2 diabetes and cardiovascular diseases. Logistic regression assessed SEP-HLI association, Cox regression SEP-multimorbidity and HLI-multimorbidity associations. Counterfactual mediation analysis estimated the natural indirect effect (NIE) and pure direct effect (PDE). Analyses were stratified by sex.ResultsParticipants from lower SEP categories were older with worse health outcomes. Women had a healthier lifestyle than men across all SEP levels. In men, the hazard ratio of developing multimorbidity was 1.40 (95% CI: 1.26 to 1.54) for those with low SEP compared with high SEP, in women 1.74 (95% CI: 1.52 to 2.00). Comparing low versus high SEP, PDE for men was 1.28 (95% CI: 1.15 to 1.41), NIE was 1.09 (95% CI: 1.07 to 1.11) (proportion mediated (PM)=29%). In women, PDE was 1.65 (95% CI: 1.47 to 1.90), NIE 1.05 (95% CI: 1.03 to 1.06) (PM=11%).ConclusionsLifestyle behaviours partly mediated the SEP-multimorbidity association, underscoring the need to integrate considerations of socioeconomic disparities into the planning of lifestyle interventions.

Benign thyroid nodules are common in adults, with incidental detection rates reaching 50-60% in women. While most nodules are asymptomatic and require no treatment, some grow and cause compressive symptoms. This study evaluates the economic impact of various treatment modalities for benign thyroid nodules within the Italian healthcare system, comparing total thyroidectomy, hemithyroidectomy, and minimally invasive thermal ablation. The analysis considers both direct healthcare costs and indirect social costs, such as productivity losses, from the perspective of the Italian National Health Service. A literature review and clinician survey were conducted to collect cost data across treatment phases: pre-hospitalization, procedure, and post-operative care. An Activity-Based Costing approach was used to estimate full treatment costs, including medical expenses, staff involvement, material usage, and indirect costs related to work absences. The findings indicate that total thyroidectomy has the highest overall cost (€ 5,185.36), followed by hemithyroidectomy (€ 4,211.92), and thermal ablation (€ 1,560.06). The analysis also highlighted significant cost savings associated with thermal ablation when compared to surgical options, especially in terms of reduced hospital stay and lower indirect costs. Nevertheless, surgical procedures remain the mainstay treatment due to long-term efficacy and well-established clinical guidelines. Thermal ablation represents a cost-effective alternative to surgery for managing benign thyroid nodules. Treatment selection should be individualized, considering clinical factors, patient preferences, and long-term outcomes. These results underscore the importance of updating management guidelines to incorporate economic considerations, promoting optimized care and efficient resource allocation in the healthcare context.

Background: Asymptomatic congenital cytomegalovirus (acCMV) infections represent 85-90% of all congenital CMV infection. The incidence of late-onset sequelae in these cases significantly contribute to the burden of CMV disease. The timing of maternal infection (TMI) has been identified as the main predictor of late-onset sequelae in acCMV infants, and follow-up programs in Europe are currently calibrated according to the TMI. Our aim was to evaluate neonatal viremia as a possible predictor of the TMI in acCMV infections. Methods: Plasma viral loads (PVLs) were assessed in the first month of life in a population of acCMV-infected newborns delivered by women who suffer a primary CMV infection during pregnancy. TMI was assigned to a trimester of pregnancy according to the maternal serological screening. PVLs were evaluated in relation to the TMI and gestational age (GA) at birth. Results: One hundred and ten newborns were, respectively, assigned to preconceptional (6.4%), 1st (27.3%), 2nd (38.2%), and 3rd (28.2%) trimester infections. Median neonatal PVLs values were significantly different between groups (p < 0.001). First-trimester infections exhibited significantly higher PVLs when compared with third-trimester ones (p < 0.001). Overall, PVLs showed an inverse correlation with GA at birth (p = 0.003). Conclusions: Median neonatal PVLs are significantly higher in 1st trimester infections if compared with 3rd trimester ones, but a wide overlap between PVL values prevent their possible use as a predictor of the TMI. In our population, a significant inverse relationship, mainly dependent on 1st and 2nd trimester infections, is demonstrated between PVLs and GA. Overall, fetal viremia is already decreasing weeks before the term of pregnancy.

ABSTRACT This study examines compound hydrological hazards in a non-stationary context, specifically focusing on the Niger River in Niamey. The hazard results from the confluence of local Sahelian and more remote Guinean tributaries, displaying seasonal floods. The study first investigates whether Niamey’s annual flood hazard is a compound result of Sahelian and Guinean flows, and then assesses the value of a compound hazard approach versus traditional flood analyses in this region. Analysing discharge data from 1950 to 2020, the study disentangles Sahelian and Guinean flow impacts. It compares flood return level estimations from three statistical models of varying complexity. Findings confirm Niamey’s hazard as compound, stressing the need to consider both tributaries separately. Incorporating non-stationarity in statistical modelling is crucial, yet fully integrating the compound nature of hazards does not significantly change the quantitative estimation of the hazard in Niamey.