Friuli Venezia Giulia Region Research Articles

First data on the reproduction of the Vagrant Emperor Anax ephippiger in North-Eastern Italy, Friuli-Venezia Giulia Region (Odonata aeshnidae)

The Vagrant Emperor, Anax ephippiger (burmeister, 1839), is a migrant dragonfly species from africa and Middle East; in Europe only summer generation are known, without evidence of overwintering larvae. In august 2010 a reproductive breeding site for this species was found in the in Friuli-Venezia Giulia Region (north-eastern Italy). This discovery represents the first proof of reproduction for the species in north-eastern Italy. With the aim of increasing the knowledge on the species requirements, a study to delineate the emerging habitat was conducted: dragonfly community (adult and exuviae), vegetation, chemical and physical water parameters were sampled. This yielded data about larval tolerance toward salinity. This new data proves a northward move for the species, which may also have been facilitated by global warming.

Epidemiology of amyotrophic lateral sclerosis in Friuli-Venezia Giulia, North-Eastern Italy, 2002–2014: a retrospective population-based study

Objectives: To describe the epidemiology of Amyotrophic Lateral Sclerosis (ALS) in Friuli-Venezia Giulia (FVG) region, Italy, over a 13-year period (2002–2014), estimating ALS (a) incidence, prevalence, and clinical features; (b) mortality, also comparing Udine municipality to the rest of FVG.Methods: We conducted a retrospective population-based study. ALS incident cases were ascertained using multiple sources and validated through expert review. We calculated crude and standardized incidence rate (IR), point prevalence and mortality rate (MR), each with 95% confidence interval. Standardized incidence (SIR) and mortality (SMR) ratio were calculated to compare Udine to FVG.Results: Among 444 incident cases (50.0% men, median age 68.5 years), onset was bulbar in 30.2%, spinal in 59.9%, mixed in 9.9%; 3.6% had familial ALS. Crude and 2000 European population standardized IR was respectively 2.81 (2.56–3.09) and 2.09 (1.89–2.29) per 100,000 person-years. Standardized male-to-female incidence ratio was 1.05. IR peaked at age 65–74 years (men: 9.93, 8.04–12.32; women: 7.74, 6.18–9.67) and decreased thereafter. Prevalence was 8.36 (6.74–9.97) cases per 100,000 inhabitants on 30 June 2009 and 7.98 (6.40–9.56) on 30 June 2014. SIR was 1.20 and SMR 1.11.Conclusions: When assessed over a long period, incidence of ALS was in the range of Italian and European population-based registries and showed a consistent pattern by age and sex. IR and MR were only slightly higher in Udine vs. FVG.

Providing patients visiting emergency departments with useful information using public real time data: A case study based on Italian data.

Many hospitals provide some type of real time publicly available information about the crowding of the emergency departments (EDs). For example, at the time of writing, the number of patients waiting and in treatment is publicly available for EDs that cover more than half of the Italian population. However, usually, these data do not provide the key information that low-priority patients are seeking, which is the time they might expect to wait before being seen by a doctor. In this paper, we reanalyze the prospectively collected public data from the two major EDs of the Friuli Venezia Giulia Italian region, which maintains a web page that provides a real time estimate of the average waiting time of current ED patients. The paper discusses the usefulness of the estimate from the patients' prospective. We point out a flow of the methodology used on web page of the Friuli Venezia Giulia region, and further show that the waiting time of current patients reflects poorly the expected time to treatment of new patients. The results suggest that available data should be used to develop and validate ED-specific waiting time prediction models of low-priority patients. The same data could also be used to estimate quantities that might be of interest for EDs resource management.

Discontinuation of antidepressants in suicides findings from the Friuli Venezia Giulia Region, Italy, 2005‐2014

Although continued use of antidepressants (AD) has been found to be associated with a lower risk of suicide, AD discontinuation is reported repeatedly. The aim of this case-control study, thus, was to assess whether discontinuation to AD was associated with an increased risk of suicide, according to different genders and age groups. The Social and Health Information System of Friuli Venezia Giulia Region, Italy, was used to collect data on suicides, diagnoses and AD use from 2005 to 2014. We selected, as cases, all suicides that had at least one prescription of AD in the 730days before death (N=876), and we matched with regard to age and sex each case with five controls from the general population. Conditional logistic regression analyses were used to assess the association between suicide and modifications of AD treatment. We found that 70% of suicides and controls from the general population discontinued AD in the 2years before the index date. In two-thirds of them, discontinuations were two or more. Discontinuation of AD, however, did not represent a significant risk factor for suicide. More appropriate care of depression, particularly by primary care physicians who widely prescribe AD, should be fostered in order to prevent suicide. However, more research is needed to assess to which extent AD discontinuation can affect suicidal risk.

Mathematical Simulation and Validation of a Wastewater Treatment Plant in Northern Italy

Abstract The aim of this study was to calibrate and validate activated sludge model No. 3 (ASM3) for an Italian municipal wastewater treatment plant (WWTP) located in Friuli Venezia Giulia region. ...

VISUALIZATION AND ANALYSIS OF CELLULAR & TWITTER DATA USING QGIS

Abstract. The study is to understand individual presence and movement in Friuli Venezia Giulia region. It is important for tourism planning, hazard management, business marketing, implementing government lifetime policies and benefit. The aim of this study is achieved by advanced web 2.0 applications. We need real time and geo-located data to monitor the inflow of tourist and to come up with effective promoting and benefiting plans for tourism, the evacuation and mitigation strategies during hazards to protect social life and environment with less infrastructure damage, marketing plans for advertising or selling of products. Despite wide spread success in predicting specific aspects of human behavior by social media information, a little attention is given to twitter and cell phone data. Accessibility to detailed human movements with fine spatial and temporal granularity is challenging due to confidentiality and safety reasons. With rapid development of web 2.0 applications people can post about events, share opinion and emotions online. Using twitter data, how short term travelers, such as tourists, can be recognized and how their travel pattern can be analyzed. Study of finding tourist dynamics such as arriving and outgoing of tourist, sum of trips, sum of days and night spent, number of unique visitors, country of residence, main destination, secondary destination, transits pass through, repeat visits are achieved using CDR (call detail records) and DDR (data detail records).

A Population-Based Program Improving Diabetes Care

Objective: The aim of this study was to evaluate whether implementation of an integrated regional program can be effective in producing improvement in diabetes care. Methods: Friuli Venezia Giulia is an Italian region accounting for about 1,250,000 population. A diabetic patients register based on administrative databases merging accounted in 2015 for a morbidity prevalence rate of 6.7%. Guidelines on diabetes integrated care were approved by the regional government. They were disseminated through a multifaceted intervention based on training, incentives to family physicians, primary care reorganization, modeling and proactive medicine. The program was assessed through the before-after intervention measure of process indicators. Analysis excluded gestational patients, those who didn’t consent for privacy reasons and those not included in the same family physician administrative list over the study period. Results: Regionally, significant improvement in 2016 vs. 2015 was observed for all measures. Analysis included 54593 patients. The percentage of patients who received one ore more: A1C test arose from 73.8% in 2015 to 79.1% in 2016 (+7.2%), Microalbuminuria test arose from 44.7% in 2015 to 56.3 in 2016 (+26.0%), Blood Creatinine test arose from 70.7% in 2015 to 76.2% in 2016 (+7.8%), Lipid profile arose from 69.6% in 2015 to 72.6% in 2016 (+4.3%). Those who received at least one Fundus Oculi arose from 42.1% in 2014-2015 to 47.9% in 2015-2016 (+13.8%). Hospital specific diabetes patients admission rate decreased from 342/1000 in 2015 to 328/1000 in 2016 (-4.2%). However, there was significant regional variation among all measures. Conclusions: The evidence based introduction of an integrated professional and organizational intervention improved adherence to diabetes specific process measures in 2016 compared with 2015 baseline for patients assisted in Friuli Venezia Giulia region. A better integration with hospital care and a partial revision of IT system are needed. Disclosure A. Mariotto: None. A. De Monte: None.

Cancer incidence in a cohort of asbestos-exposed workers undergoing health surveillance.

To compare a local cohort of 2488 men occupationally exposed to asbestos and enrolled in a public health surveillance program with the 1995-2009 cancer incidence of the general population of Friuli Venezia Giulia (FVG) region, Northeast Italy, we conducted a historical cohort study. Standardized incidence ratios (SIRs), with 95% confidence interval (95% CI), for specific cancer sites were estimated in the cohort and in subgroups of workers employed in shipbuilding between 1974 and 1994. For internal comparisons, we calculated incidence rate ratios (IRRs) for all cancers, lung cancer and mesothelioma, by level of exposure to asbestos and sector of employment adjusted for smoking habits and age at start of follow-up. Among cohort members the SIR was 8.82 (95% CI 5.95-12.61) for mesothelioma and 1.61 (95% CI 1.26-2.04) for lung cancer. In subgroup analyses, the SIR for lung cancer in subjects hired in shipbuilding between 1974 and 1984 was 2.09 (95% CI 1.32-3.13). In the overall cohort, a borderline increased incidence was also found for stomach cancer (SIR = 1.53 95% CI 0.96-2.31). Internal comparisons within the cohort show that among men with high asbestos exposure level the relative risk was almost threefold for lung cancer (IRR = 2.94 95% CI 1.01-8.57). This cohort experienced an excess in the incidence of both mesothelioma and lung cancer, showing increasing incidence rates at higher level of asbestos exposure. For lung cancer, the relative incidence was highest among workers hired in shipbuilding between 1974 and 1984.

Chemical characterization of atmospheric particulate matter in Friuli Venezia Giulia (NE Italy) by exploratory data analysis with multisite and multivariate approach.

The chemical composition of atmospheric particulate (PM10) in the Friuli Venezia Giulia (FVG) region (NE Italy) has been characterized for the first time with the help of exploratory data analysis (EDA) techniques (uni-, bi-, and multivariated, i.e., principal components analysis), molecular and elemental diagnostic ratios, and seasonal trends. Despite that the available analytical data was limited to the parameters routinely analyzed on PM10 by ARPA FVG (11 elements and 16 PAH congeners), the large number of samples and of measured chemical parameters, together with the applied techniques of data analysis, allowed us to extract useful latent information from the dataset, resulting in a greater knowledge of both regional and local features. Specifically, we succeeded in matching data patterns to the known pollution sources of some sampling stations, both industrial (two secondary fusion steelworks and one coke oven) and urban (traffic and domestic heating), and in defining the mainly urban or mainly industrial feature of some questionable sampling stations. This is of paramount importance to check for possible industrial inputs in urban stations, allowing policymakers to implement the most appropriate response.

Accuracy of lung cancer ICD-9-CM codes in Umbria, Napoli 3 Sud and Friuli Venezia Giulia administrative healthcare databases: a diagnostic accuracy study

ObjectivesTo assess the accuracy of International Classification of Diseases 9th Revision–Clinical Modification (ICD-9-CM) codes in identifying subjects with lung cancer.DesignA cross-sectional diagnostic accuracy study comparing ICD-9-CM 162.x code (index test)...

Risk of Fractures in Youths with Celiac Disease—A Population-Based Study

To assess the risk of any fracture requiring hospital care in a cohort of individuals with celiac disease diagnosed in childhood/adolescence compared with reference individuals matched by age and sex. Our study cohort consisted of 213 635 people born and residing in Friuli-Venezia Giulia Region, Italy, in 1989-2011. We selected, through pathology reports, hospital discharge records, or co-payment exemptions, 1233 individuals with celiac disease (aged 0-17 years at diagnosis) and compared them with 6167 reference individuals matched by sex and year of birth. Fractures were identified through hospital discharge records. We calculated hazard ratios (HRs) for any fracture after celiac disease diagnosis (or index date for reference individuals) with Cox regression and ORs for any fracture before celiac disease diagnosis with conditional logistic regression. During the follow-up period (maximum 23 years), 22 individuals with celiac disease (9394 person-years) and 128 reference individuals (47 308 person-years) experienced a fracture, giving an overall HR of 0.87 (95% CI 0.55-1.37). The risk was not modified by sex, age at diagnosis, or calendar period of diagnosis. We obtained similar HRs when excluding fractures occurring after the age of 18 years and adjusting for maternal education or vitamin D supplementation. The odds of previous fracture also did not differ between subjects with celiac disease and reference individuals (22 and 96 cases, respectively: OR 1.15; 95% CI 0.72-1.84). We did not find any evidence of an increased risk of fractures during childhood and youth among patients with celiac disease.

Land subsidence in the Friuli Venezia Giulia coastal plain, Italy: 1992–2010 results from SAR-based interferometry

Land subsidence is a concern in many coastal plains worldwide, particularly in the low-lying areas already facing sea level rise due to climate change, and much still needs to be done, with respect to both mapping land subsidence and gaining a comprehensive understanding of the relevant cause-effect relationships. Land subsidence of the northern coastal plain encompassing the Friuli Venezia Giulia (FVG) region in Italy, remains, to the authors' knowledge, poorly investigated. This coastland includes low-lying agricultural and urban areas and highly valuable lagoon environments, archaeological and touristic sites, and industrial zones.Here, we resolve land subsidence in the coastal plain between the Tagliamento River delta and the Isonzo River mouth over the period 1992–2010 using Envisat ASAR and ERS1/2 interferometric datasets. We identify a large variability of the land subsidence and a spatial gradient that ranges from less than 1mm/year in the high southwestern plain toward the littoral to more than 5mm/year close to the Tagliamento River delta. A comparison between the 2003–2010 and 1992–2000 sinking rates depicts quite similar behaviors of the process over the two time spans. The analysis indicates unclear correlations between ground movements and the typical driving mechanisms acting in the north Adriatic coastal plains, such as the variability of the morphological setting, the subsoil characteristics and the land use. We reason that multi-component mechanisms contribute to the observed image of the subsidence in the FVG coastland. Specifically, anthropogenic activities, e.g., groundwater exploitations, hydraulic reclamations and the development of newly built-up areas, are superposed to natural mechanisms related to the spatial variability of the subsoil characteristics, typical of transitional coastal environments.

The epidemiology of Parkinson's disease in the Italian region Friuli Venezia Giulia: a population-based study with administrative data.

Parkinson's disease is known to pose a relevant burden to society in industrialized countries. However, not much research has been conducted on the epidemiology of this disease in Italy. Our aim was to estimate the incidence rate and prevalence of Parkinson's disease in the Italian Friuli Venezia Giulia region using administrative health-related databases. Five regional administrative databases (hospitalizations, exemptions from medical charges, drug prescriptions, nursing homes, and home visits) were individually linked with one another through an anonymous stochastic univocal key. Using a pre-defined algorithm, incident and prevalent cases of Parkinson's disease were identified for the year 2016. The estimated regional incidence rate was 0.28 new cases/1000 person-years; prevalence was 3.89/1000 inhabitants. Both increased with increasing age and were higher among males than among females. A considerable proportion of prevalent cases was admitted to the hospital or nursing home in 2016, whereas only a few received home visits by health professionals. The incidence and prevalence of the disease were considerable, especially in the older population, indicating the need to develop multidisciplinary models to care for patients living in the region.

Cancer estimates up to 2015 in Friuli Venezia Giulia.

This analysis intended to estimate the incidence, mortality and prevalence time trends for the major cancer sites up to 2015 in the Friuli Venezia Giulia region, northeastern Italy, where a population-based cancer registry has been covering the whole area since 1995. The MIAMOD method, a statistical back-calculation approach, was applied to estimate incidence, mortality and prevalence figures, in the period 1970-2015, using mortality data from the Italian National Institute of Statistics and relative survival data from Italian cancer registries. We estimated that the cancer sites with the highest incidence rates in the forthcoming years will be breast in women (with an age-standardized incidence rate of 130 per 100,000 in 2015), prostate in men (97 per 100,000) and colon-rectum in both sexes (85 and 42 per 100,000 in men and women, respectively). The incidence rates for lung cancer will continue to decrease only in men (down to 43 per 100,000 in 2015). Although the decline in the mortality rates of lung, breast and colorectal cancers is likely to persist, these tumors will remain the big killers in the near future. The number of people living in Friuli Venezia Giulia after a cancer diagnosis is expected to continue to rise in particular for breast cancer (with a crude prevalence of 3,000 per 100,000 women in 2015), prostate cancer (1,700 per 100,000 men) and colorectal cancer (1,100 and 800 per 100,000 in men and women, respectively). These estimates confirmed the epidemiological patterns in time trends of major cancer sites recorded in Friuli Venezia Giulia. They highlighted in particular the increasing number of people living after a cancer diagnosis as a result of population aging, earlier diagnosis and better prognosis, which warrants adequate public health policies.

Agricultural Health and Safety Survey in Friuli Venezia Giulia

The work in the agricultural sector has taken on a fundamental role in the last decades, due to the still too high rate of fatal injuries, workplace accidents, and dangerous occurrences reported each year. The average old age of agricultural machinery is one of the main issues at stake in Italy. Numerous safety problems stem from that; therefore, two surveys were conducted in two different periods, on current levels of work safety in agriculture in relation to agricultural machinery’s age and efficiency, and to show the levels of actual implementation of the Italian legislation on safety and health at work in the agricultural sector. The surveys were carried out, considering a sample of 161 farms located in the region Friuli Venezia Giulia (North-East of Italy). The research highlights the most significant difficulties the sample of farms considered have in enforcing the law. One hand, sanitary surveillance and workers’ information and training represent the main deficiencies and weakest points in family farms. Moreover, family farms do not generally provide the proper documentation concerning health and safety at workplaces, when they award the contract to other companies. On the other hand, lack of maintenance program for machinery and equipment, and of emergency plans and participation of workers’ health and safety representative, are the most common issues in farms with employees. Several difficulties are also evident in planning workers’ training programs. Furthermore, the company physician’s task is often limited to medical controls, so that he is not involved in risk assessment and training. Interviews in heterogeneous samples of farms have shown meaningful outcomes, which have subsequently been used to implement new databases and guidelines for Health and Safety Experts and courses in the field of Work Safety in agriculture. In conclusion, although the legislation making training courses for tractor operators and tractor inspections compulsory dates back to the years 2012 and 2015, deadlines have been prorogued, and the law is not yet fully applied, so that non-upgraded unfit old agricultural machinery is still being used by many workers, putting their health and their own lives at risk.

Tools to Upgrade Facilities for All: How to Improve Business Dealing with Tourism.

Providing quality services to any traveller requires constant efforts to ensure that tourist destinations, products, and services are accessible to all people, regardless of their health condition, physical limitations, gender, origin, age. This entails a collaborative process among all the interested parties: administrators, tourist agencies, tour operators, and end users, who expressing their points of view can objectively contribute to reach shared and effective solutions. A single visit destination can involve many factors, including access to information: the project A Region for All, promoted by Promoturismo FVG in collaboration with CRAD FVG and the University of Trieste, focused on this issue. Promoturismo FVG is a semi-public destination management organization. Its mission is to develop the regional tourism system collaborating with all the active subjects to improve the promotion and to optimize the resources by concentrating the efforts. The organization pursues its objectives by planning and organizing the offer through specific tourism products. In 2016 a mapping process has been started to investigate the usability of the relevant services to tourists / visitors with special needs along the itinerary of eight tourist centers of the Friuli Venezia Giulia region. To date, more than 200 facilities (bars, restaurants, pharmacies, cash machines…) have been detected. The paper will present the development of the work conducted by TrIAL - Trieste Inclusion & Accessibility Lab at Department of Engineering and Architecture within the University of Trieste for the management of the mapping process. On the strength of the mapping experience developed during the previous project LabAc (Laboratory of Accessibility) for the Province of Trieste and the project Trieste for All for the Municipality of Trieste (from 2013 to 2016), the research group has adopted and set a series of digital tools, has identified specific indicators and has focused on an efficient return of data to Promoturismo FVG. The overall project is still ongoing: collected data have not yet been published by the organization. Overall monitoring and evaluation activities are still lacking and will be part of a future phase of research.

The last Doge's groom: How the Villa Manin stable became a regional institute and library for Friuli-Venezia Giulia cultural heritage

The 1976 earthquake that devastated much of the Friuli region of Italy also marked the rebirth of the Villa Manin as a centre for cataloguing and restoration. This essay charts how this Venetian villa transformed into an important centre for restoring and conserving the cultural heritage of the Friuli-Venezia Giulia region.

Characterization of the expected seismic damage for a critical infrastructure: the case of the oil pipeline in Friuli Venezia Giulia (NE Italy)

Seismic codes using the performance-based approach for seismic design of critical and important structures generally refer to seismic hazard which takes into account a lower exceedance probability than that used for ordinary buildings. In the present study, the seismic hazard for an oil pipeline, located in the Friuli Venezia Giulia region (NE Italy), has been calculated in terms of PGA and PGV with a 2475-year return period, and compared with estimates calculated with the standard 475-year return period used for ordinary buildings. The results, referring to three soil types (rock, stiff soil, and soft soil), have been combined through GIS technology in a single map (soil seismic hazard map) on the basis of the local lithological characterization. The major earthquakes considered in the study have been associated with the linear sources found in the database of Italian seismic sources, considering the characteristic earthquake model. The regional seismogenic zonation has been added to the linear sources in order to consider minor seismicity as described by the Gutenberg–Richter model. Quaternary faults in the broader Trieste area, long enough to justify, at least, a characteristic magnitude of 6, have been added in the source model to take into account unlikely but possible unknown sources. The Transalpine Oil Pipeline, which connects Trieste (Italy) to Ingolstadt (Germany), is the crude-oil distribution system considered in the present study. It consists of a storage tank, compressor stations, and buried pipeline. For the characterization of the expected damage to the infrastructure in case of an earthquake, we have used underground pipeline seismic vulnerability curves that relate a performance indicator, such as the reparation rate (number of ruptures per kilometre), with a representative ground motion parameter (e.g., PGA or PGV). In this study, we have considered as performance indicator the consequences of a rupture in the pipeline caused by a seismic event.

Epidemiological and clinical features of imported malaria at the three main hospitals of the Friuli-Venezia Giulia Region, Italy.

Imported malaria cases continue to occur in non-endemic regions among travellers returning from tropical and subtropical countries. At particular risk of acquiring malaria is the group of travellers identified as immigrants who return to their home country with the specific intent of visiting friends or relatives (VFRs) and who commonly believe they are immune to malaria and fail to seek pre-travel advice. Our aim was to review the current trends of imported malaria in the three main hospitals of the Friuli-Venezia Giulia region (FVG), North Eastern Italy, focusing in particular on patient characteristics and laboratory findings. In this retrospective study, we examined all malaria cases among patients admitted from January 2010 through December 2014 to the emergency department of the three main hospitals located in FVG. During the 5-year study period from 2010 to 2014, there were a total of 140 patients with a diagnosis of suspected malaria and who received microscopic confirmation of malaria. The most common species identified was P. falciparum, in 96 of 140 cases (69%), followed by P. vivax (13%), P. ovale (4%), P. malariae (4%), and mixed infection (4%). The most common reason for travel was VFRs (54%), followed by work (17%), and recent immigration (15%). Moreover, 78% of all patients took no chemoprophylaxis, 80 (79%) of whom were foreigners. Notably, the percentage of Italian travellers who took chemoprophylaxis was only 20% (8 of 39 Italian cases), and the regimen was appropriate in only four cases. Parasitaemia greater than 5% was observed in 11 cases (10%), all due to P. falciparum infection. We highlight that VFRs have the highest proportion of malaria morbidity and the importance of improving patient management in this category. These data are useful for establishing appropriate malaria prevention measures and recommendations for international travellers.

Does diabetes mellitus comorbidity affect in-hospital mortality and length of stay? Analysis of administrative data in an Italian Academic Hospital.

Hospitalized patients with comorbid diabetes mellitus may have worse outcomes than the others. We conducted a study to assess whether comorbid diabetes affects in-hospital mortality and length of stay. For this population-based study, we analyzed the administrative databases of the Regional Health Information System of the Region Friuli Venezia Giulia, where the Hospital of Udine is located. Hospital discharge data were linked at the individual patient level with the regional Diabetes Mellitus Registry to identify diabetic patients. For each 3-digit ICD-9-CM discharge diagnosis code, we assessed the difference in length of stay and in-hospital mortality between diabetic and non-diabetic patients. We conducted both univariate and multivariate analyses, adjusted for age, sex, Charlson's comorbidity score, and urgency of hospitalization, through linear and logistic regression models. After adjusting for potential confounders, diabetes significantly increased the risk of in-hospital death among patients hospitalized for bacterial pneumonia (OR=1.94) and intestinal obstruction (OR=4.23) and length of stay among those admitted for several diagnoses, including acute myocardial infarction and acute renal failure. Admission glucose blood level was associated with in-hospital death in patients with pneumonia and intestinal obstruction, and increased length of stay for several conditions. Patients with diabetes mellitus who are hospitalized for other health problems may have increased risk of in-hospital death and longer hospital stay. For this reason, diabetes should be promptly recognized upon admission and properly managed.