Umbria Region Research Articles

Challenges in the use of natural flavorings and labeling compliance in meat preparations in the Umbria region (central Italy)

Challenges in the use of natural flavorings and labeling compliance in meat preparations in the Umbria region (central Italy)

Incidence and clinical characteristics of cardiac amyloidosis in Tuscany and Umbria

Abstract Background Recent advances in imaging and increased disease awareness have led to a significant rise in newly diagnosed cases of cardiac amyloidosis (CA) over the past decade. However, there remains a lack of epidemiological data regarding the true incidence of the disease. Purpose To determine the incidence and clinical characteristics of newly diagnosed cases of CA in a large Italian population. Methods Subjects with suspected CA underwent diagnostic work-up in 20 Centers in Tuscany and Umbria regions within the Cardiac Amyloidosis RegistRY (CARRY), between January 1st 2022 and December 31st 2022. Results A total of 551 subjects were enrolled in the registry, with complete data on the final diagnosis available for 448 individuals. CA was diagnosed in 179 patients (40%), with 28 (16%) classified as light chain CA (AL-CA), 114 (64%) wild-type transthyretin CA (ATTR-CA), 12 (7%) variant ATTR-CA, and 25 (13%) undetermined CA. Considering a reference population in Tuscany and Umbria in 2022 (4,518,388, according to the Italian National Institute of Statistics), this yields an estimated cumulative incidence of 39.6 cases per million inhabitants per year. Alternative diagnoses in the remaining patients mostly included hypertensive heart disease (n=157, 58%), hypertrophic cardiomyopathy (n=25, 9%), moderate-to-severe valvular heart disease (n=11, 4%), or a mixed phenotype (n=72, 27%). The primary referral pathway for the suspicion of CA was cardiological (n=345, 77%), followed by incidental finding during screening visits (n=58, 13%), and haematology referral (n=33, 7%). Patients with confirmed CA were older (81 [75-85] vs. 77 [72-83] years, p<0.001), and more frequently reported musculoskeletal red flags of CA, such as carpal tunnel syndrome (85 [48%] vs. 53 [20%] years, p<0.001), and spontaneous tendon rupture (39 [22%] vs. 18 [7%] years, p<0.001). Median time to diagnosis from clinical suspicion was 73 (37-140) days for CA and 84 (36-156) days for alternative diagnoses (p=0.564). Conclusions The diagnosis of CA is on the rise globally, with an estimated incidence of 39.6 new cases per million inhabitants per year in two large regions of Italy. These findings should inform policymakers in redefining the status of CA as a rare disease, potentially influencing patient care and treatment costs.

Survey on the occurrence of Aspergillus section Nigri species in grapes cultivated in Umbria (central Italy) and influence of several factors on their distribution

AbstractSecondary bunch rots caused by Aspergillus species belonging to the section Nigri, commonly called black aspergilli, pose a serious threat to grapes yield and quality. Due to their ability to produce ochratoxin A (OTA), they are considered the primary source of contamination of this mycotoxin in grapes. In this study, a three-year survey was realized to assess the occurrence of black aspergilli in grapes harvested in the Umbria region, a very important grapevine cultivation area in central Italy, by fungal isolation and phylogenetic analysis. In addition, the influence of growing season, vineyard location, farming system and grapes growth stages on black aspergilli distribution was examined. Phylogenetic analysis of the 208 obtained isolates showed the presence of three black aspergilli species: Aspergillus tubingensis, Aspergillus welwitschiae and Aspergillus uvarum. Interestingly, A. carbonarius, one of the most important OTA producers, was not detected in the surveyed years. A. tubingensis, whose ability to produce OTA is controversial, was always the most isolated species followed by A. welwistichiae (OTA producer). The species A. uvarum (unable to produce OTA) was detected only in one surveyed year with a low incidence. A. tubingensis was always the species with the highest incidence, regardless of location, and farming system. Growth stage appeared to influence the incidence of the three species, that, in the case of A tubingensis, was lower during setting in comparison to berries pea-size and berries harvest-ripe. Finally, in the setting and berries pea-size stages, a stereomicroscope analysis, showed that flower debris was the substrate from which black aspergilli mainly developed prior to colonizing berries and bunches.

Can Geographical Indications foster local development? Evidence from Montefalco Sagrantino DOCG

One of the main goals in the establishment of Geographical Indications (GIs) for European agri-food products was to help fostering development in rural communities. Given the cultural and economic importance of wine production in Italy, this paper aims to understand how a wine GI in the Umbria region may have influenced local socio-economic development and, if so, what is its perceived magnitude among local stakeholders. By conducting semi-structured interviews and carrying out a qualitative analysis through the grounded theory model, results indicate a mirroring ascent, during the last three decades, in the pursuit of a unique identity, for both the territory and the wine product.

Contribution to the floristic knowledge of Mount Pennino massif (Umbria-Marche Apennines, central Italy)

The inventory of the taxa collected in 2021 during the annual field trip of the Working Group for Floristics, Systematics, and Evolution of the Italian Botanical Society is reported. The field trip was held in the Mount Pennino massif, between Umbria and Marche administrative regions (central Italy). The flora documented for the study area amounts to 413 specific and subspecific taxa (including one hybrid), belonging to 234 genera and 64 families. Thirty-seven taxa are endemic to Italy; 42 are included in the IUCN Red List of the Italian Flora. Only three alien taxa were found. Ten taxa and one hybrid are considered floristic novelties because either new or confirmed for the regional flora of Umbria and/or Marche. Particularly, 6 taxa are new and 4 are confirmed for Umbria; one taxon and one hybrid are new for Marche.

Perfluoroalkyl substances: a risk for the aquatifc environment? A 1-year case study in river waters of central Italy.

Perfluoroalkyl substances (PFASs) are a large class of persistent emerging pollutants, ubiquitous in different environmental compartments. In this study, twenty-one PFASs were determined in seventy-eight water samples collected from six different rivers in the Umbria region (central Italy) during a 13-month monitoring campaign. The sum of the twenty-one target analytes (Σ21PFASs) ranged from 2.0 to 68.5ng L-1, with a mean value of 22.0ng L-1. The highest concentrations of Σ21PFASs were recorded in the warmest months (from June to September) due to reduced river streamflow caused by low rainfall and high temperatures. PFASs with a number of carbon atoms between four and nine prevail over C10-C18 congeners due to their higher water solubility and to their increased use in industry. PFBA, followed by PFPeA, PFHxA, and PFOA, was the most abundant congeners detected in the analyzed river water samples. Finally, the calculation of risk quotients (∑RQs) has allowed to assess the risk for three aquatic organisms (fish, algae, and daphnid) deriving from the exposure to PFASs. The survey showed that the risk for the three aquatic organisms during the four seasons and throughout the year was always negligible. The only exception was a low risk for fish and daphnid in GEN river considering the annual exposure.

A Fully Connected Neural Network (FCNN) Model to Simulate Karst Spring Flowrates in the Umbria Region (Central Italy)

In the last decades, climate change has led to increasingly frequent drought events within the Mediterranean area, creating an urgent need of a more sustainable management of groundwater resources exploited for drinking and agricultural purposes. One of the most challenging issues is to provide reliable simulations and forecasts of karst spring discharges, whose reduced information, as well as the hydrological processes involving their feeding aquifers, is often a big issue for water service managers and researchers. In order to plan a sustainable water resource exploitation that could face future shortages, the groundwater availability should be assessed by continuously monitoring spring discharge during the hydrological year, using collected data to better understand the past behaviour and, possibly, forecast the future one in case of severe droughts. The aim of this paper is to understand the factors that govern different spring discharge patterns according to rainfall inputs and to present a model, based on artificial neural network (ANN) data training and cross-correlation analyses, to evaluate the discharge of some karst spring in the Umbria region (Central Italy). The model used is a fully connected neural network (FCNN) and has been used both for filling gaps in the spring discharge time series and for simulating the response of six springs to rainfall seasonal patterns from a 20-year continuous daily record, collected and provided by the Regional Environmental Protection Agency (ARPA) of the Umbria region.

“Geological Wonders of Italy”: The Coveted Privilege of Disseminating Geology and Geomorphology through Science Documentaries in the Marche Region

This paper proposes an unusual method for the dissemination of geological sciences and the promotion of geotourism: a scientific documentary, where a representative itinerary of geological and geomorphological evolution of the Umbria and Marche regions was presented. The considerations that led to the identification of the geological route proposed to the editorial staff of FOCUS TV are presented in detail. At each stop, there was an explanation by academic professors and researchers, mainly from the Geology Division of the University of Camerino (MC), who explained the outcrops in detail. During the episode, insights were also given into the anthropogenic frequentation of the epigean caves in Frasassi (AN), ancient places of frequentation and worship thanks to their suggestiveness and the sense of magnificence that they can elicit. In addition to the illustration of the individual stops, the article offers further insights into the geomorphology of the most important geosites depicted, all of which are in natural parks or protected areas and characterized by a high landscape value. The result was the production of an episode of the television program ‘Geological Wonders of Italy: the Marche and Umbria Regions’, which was broadcast in October 2022 by the Italian national Mediaset group.

Detection of Hepatitis E Virus in Game Meat (Wild Boar) Supply Chain in Umbria Region, Central Italy.

Consumption of raw or undercooked wild boar (WB) meat is considered an important risk factor for hepatitis E virus (HEV) infection in humans. The possibility of HEV contamination during the slaughtering practices may pose an additional risk. Based on these assumptions, we evaluated HEV contamination of WB meat hunted in Umbria (central Italy) during the 2022-2023 hunting season by real-time RT-PCR. Herein, we show that 10.8% of livers from slaughtered WB were positive for HEV RNA, thus providing an estimate of HEV infection in WB in the Umbria region. Then, by evaluating paired liver-muscle samples from both HEV-positive and HEV-negative animals, we found evidence of muscle HEV contamination in 33% and 14% of cases, respectively. This is the first report on the detection of HEV in WB meat in Umbria, an Italian region with diffuse WB hunting and consumption. The evidence of contamination provided by our study underscores the importance of adopting good hygienic practices in the processing stages of hunted WB carcasses to significantly reduce meat contamination and the risk posed for the final consumer.

The role of citizenship in the acceptance and completion of COVID-19 vaccine cycle in the resident population with foreign citizenship registered with the Umbrian Health Care System - An analysis of regional data.

Non-italian citizens experienced less access to anti-COVID-19 vaccination, compared to the native population. Literature has found differences in adherence to anti-COVID-19 vaccination among these groups; however, there are apparently no studies that investigated the role of citizenship. Our objective was to investigate the role of citizenship in vaccine hesitancy toward anti-COVID-19 vaccination and the completion of vaccine cycle, in the non-Italian citizens resident in the Umbria Region. This is a population study, performed on resident population in Umbria. Population data were obtained thanks to a record linkage between the Regional Health Information System and the regional DBCOVID Umbria database. On this dataset, a descriptive and logistic regression analyses were performed. The 19.2% of non-Italian citizens did not take even one dose, 2.1% did not complete it and 40.6% did not take the additional dose. The range of values of which these results are an average, however, is very wide, suggesting important differences in COVID-19 vaccine up taking, among different citizenships. The logistic regression shows that citizenships with the highest probability of non-adherence to vaccination, compared to Philippine, was Romanian (OR=7.8), followed by Macedonian (OR=7.3) and Polish (OR=5.9). The study provides evidence of differences among citizenships that pinpoint the importance of understanding the reasons behind these behaviours, to support decisions around health policies tailored to each citizenship.

Evaluation of the effect of agroclimatic variables on the probability and timing of olive fruit fly attack.

Agroclimatic variables may affect insect and plant phenology, with unpredictable effects on pest populations and crop losses. Bactrocera oleae Rossi (Diptera: Tephritidae) is a specific pest of Olea europaea plants that can cause annual economic losses of more than one billion US dollars in the Mediterranean region. In this study, we aimed at understanding the effect of olive tree phenology and other agroclimatic variables on B. oleae infestation dynamics in the Umbria region (Central Italy). Analyses were carried out on B. oleae infestation data collected in 79 olive groves during a 7-year period (from 2015 to 2021). In July-August, B. oleae infestation (1% attack) was negatively affected by altitude and spring mean daily temperatures and positively by higher winter mean daily temperatures and olive tree cumulative degree days. In September-October, infestation was negatively affected by a positive soil water balance and high spring temperatures. High altitude and cumulative plant degree days were related to delayed attacks. In contrast, high winter and spring temperatures accelerated them. Our results could be helpful for the development of predictive models and for increasing the reliability of decision support systems currently used in olive orchards.

Monitoring and protection of local genetic resources of sweet chestnut (Castanea sativa Mill.) by integrated analysis of cultivated and wild populations: case study of Umbria and Lombardy regions (Italy)

Monitoring and protection of local genetic resources of sweet chestnut (<i>Castanea sativa</i> Mill.) by integrated analysis of cultivated and wild populations: case study of Umbria and Lombardy regions (Italy)

Phytosanitary problems in elephant garlic (Allium ampeloprasum var. holmense) in the “Val di Chiana” area (Central Italy), and evaluation of potential control strategies

Allium ampeloprasum var. holmense (elephant garlic) is traditionally cultivated in “Val di Chiana”, an area between Umbria and Tuscany regions of Central Italy, under the name “Aglione della Valdichiana”. This product has recently increased in importance, becoming a key economic resource for local farmers. In 2019, phytosanitary problems of elephant garlic cloves ready for transplanting emerged in this cultivation area. Symptom/sign observations and fungal isolations were performed for cloves divided into four components (tunic, basal plate, reserve tissue and shoot) from six farms in the “Val di Chiana” area. Isolates obtained were identified, using partial β-tubulin (BenA) and calmodulin (CaM) or translation elongation factor 1α (tef1α) genes sequences, as belonging to Penicillium [P. allii (95%), P. citrinum (4%), P. brevicompactum (1%)] or Fusarium [F. oxysporum (81%), F. proliferatum (19%)]. Fusarium spp. were mainly associated with clove tunics and basal plates, while Penicillium spp. with basal plates, reserve tissues and shoots. Fungi often also developed from asymptomatic components, but a correlation was found between isolated pathogens and disease symptoms. Pathogenicity and virulence towards elephant garlic cloves were verified for a representative isolate of each identified species, and Penicillium allii was the most virulent. Strategies to control Fusarium and Penicillium spp. on cloves were assessed, including chemicals, a biocontrol agent, surface sterilization and heat treatment. Among these, treatments with Patriot Gold® (active ingredient [a.i.] Trichoderma asperellum TV1, approved in organic farming on crops similar to elephant garlic), or Signum® (a.i. boscalid + pyraclostrobin, approved for Integrated Pest Management systems on crops similar to elephant garlic), were effective in simultaneous reduction of Penicillium spp. and Fusarium spp. Transplanting of asymptomatic cloves combined with the use of the above treatments showed promising effects for pathogens control, and to assist elephant garlic crop establishment.

Combatting Climate Change within the EU Green Deal in Contemporary Forestry Administrative Systems: A Case Study of the Umbria Region

The integration of digital technologies into forest management is crucial for the European Union’s Green Deal, the Forestry Strategy 2030, and Italy’s national forestry strategy, aiming to enhance governance and efficiency. However, sustainable forest management’s administrative aspects are often overlooked, despite the potential for digital tools to significantly improve environmental performance. Through a Life Cycle Assessment (LCA) for a case study in the Umbria region, the research quantifies CO2 emissions associated with over-threshold forestry administrative procedures under both current and future digitalisation scenarios. Data were collected from legislative documents, interviews with forestry professionals, and emissions calculated according to ISO standards. The findings reveal a considerable reduction in CO2 emissions through digitalisation, from 75.07 kgCO2 to 38.14 kgCO2, with the implementation of the LIFE FOLIAGE project’s digital platform. This underscores digitalisation’s role in climate change mitigation, highlighting the significant, albeit modest per procedure, of the cumulative national impact. The main findings support further digitalisation in forest management as a method of increasing resource efficiency and reducing greenhouse gas emissions, thus contributing to the Green Deal’s and Italy’s forest sustainability goals.

Incidence and Risk Factors Epilepsy in Patients with Dementia: A Population-Based Study Using Regional Healthcare Databases in Umbria.

Dementia is prevalent among the elderly, also representing a risk for seizures/epilepsy. Estimations of epilepsy risk in dementia patients are not widely available. Our research aims to ascertain the incidence of epilepsy and its associated risk factors in subjects with dementia in the Umbria region, based on data from healthcare databases. In this retrospective study based on the healthcare administrative database of Umbria, we identified all patients diagnosed with dementia from 2013 to 2017, based on ICD-9-CM codes. For epilepsy ascertainment, we used a validated algorithm that required an EEG and the prescription of one or more anti-seizure medications post-dementia diagnosis. A case-control analysis was conducted, matching five non-dementia subjects by gender and age to each dementia patient. Cox proportional hazards models were then utilized in the analysis. We identified 7,314 dementia cases, also including 35,280 age- and sex-matched control subjects. Out of patients with dementia, 148 individuals (2.02%) were diagnosed with epilepsy. We observed a progressive increase in the cumulative incidence of seizures over time, registering 1.45% in the first year following the diagnosis, and rising to 1.96% after three years. Analysis using Cox regression revealed a significant association between the development of epilepsy and dementia (HR = 4.58, 95% CI = 3.67-5.72). Additional risk factors were male gender (HR = 1.35, 95% CI = 1.07-1.69) and a younger age at dementia onset (HR = 1.03, 95% CI=1.02-1.04). Dementia increases epilepsy risk, especially with early onset and male gender. Clinicians should have a low threshold to suspect seizures in dementia cases.

Salmonella in Wild Boar Meat: Prevalence and Risk Assessment in Central Italy (Umbria and Marche Region).

A survey was conducted from 2018 to 2023 to assess the presence of Salmonella in 280 hunted wild boar (carcasses after evisceration and skinning, N = 226; liver, N = 258; and fecal samples, N = 174). The overall prevalence was 2.86% (confidence interval 95%, 1.45-5.45%) with five positive samples detected in carcasses, three in the liver, and one in a fecal sample. This prevalence was in line with those found in nearby areas denoting a low number of positive samples. Positive animals were over 24 months of age and weighed, before skinning, 59.00 ± 9.11 Kg and no difference was detected in microbial loads between samples positive and negative for Salmonella (aerobic colony count of 4.59 and 4.66 log CFU/400 cm2, and Enterobacteriaceae count of 2.89 and 2.73 log CFU/400 cm2 (mean values) in positive and negative subjects, respectively). Salmonella Stanleyville was the most frequently isolated serotype. A semiquantitative risk assessment was conducted for the first time in game meat considering two products, meat cuts intended for cooking and fermented dry sausages. Only proper cooking can reduce the risk of ingestion of Salmonella to the minimum for consumers, whereas ready-to-eat dry sausages constitute risk products in terms of foodborne Salmonellosis (risk score of 64 out of 100).

A New Empirical Formulation of the Areal Reduction Factor for Design Rainfalls Applied to the Umbria Region in Central Italy

A New Empirical Formulation of the Areal Reduction Factor for Design Rainfalls Applied to the Umbria Region in Central Italy

Use of antidepressant and antipsychotic drugs in subjects with hemophilia of the Umbria Region in the period 2011-2022.

Chronic diseases, such as hemophilia, can evoke psychological sequelae and be associated with a higher risk of mental health disorders. The utilization of antidepressant and antipsychotic drugs in subjects with hemophilia is not completely understood and few data are available. The aim of this analysis is to describe use of antidepressant and antipsychotic drugs in subjects with hemophilia of the Umbria Region in the period 2011-2022. A descriptive, cross-sectional, and retrospective analysis based on data on filled prescriptions for antidepressants and antipsychotics has been carried out. The overall and annual prevalence of drugs use and consumption were calculated based on pharmaceutical prescriptions charged to the National Health Service in subjects with hemophilia and matched controls from general population. In the study period 170 subjects with hemophilia were identified; about 80% were male. About 20% and 8.2% received antidepressants and antipsychotics, respectively. A higher percentage of users and consumption were found in subjects with hemophilia compared to matched controls, although no statistically significant differences were observed. Our analysis suggests that depression and psychosis are important comorbidities in subjects with hemophilia. Further larger studies are needed in order to confirm these data and better define the burden of mental health disorders in subjects with hemophilia.

The role of SRF in achieving the EU landfill targets in the Umbria Region, Italy

In December 2015, the European Commission published the circular economy package “Closing the loop - An European action plan for the Circular Economy” with four quantitative objectives: long-term recycling targets for municipal waste (55% in 2025, 60% in 2030 and 65% in 2035) and landfill target of 10% by 2030. In Umbria (Italy) 43% of waste are landfilled in 2020, so the region is far from the European target. Hence, it is significant to analyse different strategies to improve the waste management in the region. In particular, the main issue is how to reduce waste landfill in the most efficient way. The SRF and waste-to-energy approaches are the most interesting to study as a substitute for landfilling. In the communication “The role of waste-to-energy in the circular economy”, the European Commission clarifies the position covered by the different energy processes in the waste hierarchy and identifying the technologies with the highest potential in terms of efficient management of resources and environmental impact. Among the most efficient waste-to-energy technologies, the document mentions the gasification of recovered solid fuel (SRF) and co-incineration of the resulting synthesis gases in the combustion plant to replace fossil fuels in the production of electricity and heat and co-incineration in the cement production. The European Commission recognizes the important role of energy recovery in the transition to the circular economy, if this does not stop the improvement in recycling rates. In this paper, MSW management policy in Umbria (Italy) and possible solutions are discussed. The paper considers three scenarios in the management of MSW: i) direct combustion of residual waste in waste-to-energy plants; ii) combustion of SRF in waste-to-energy plants; iii) combustion of F-SRF in dedicated plants (cement plant). All three scenarios may be able to match the 10% landfill EU target.

Potentially inappropriate drug use in myasthenia gravis: a real-world population-based cohort study in Italy.

To evaluate the use of pyridostigmine in presence of contraindications, and the use of concomitant potentially contraindicated drugs in a cohort of patients affected by Myasthenia Gravis (MG) in the Italian Regions of Lazio, Tuscany, and Umbria. This is a retrospective cohort study. A multivariate logistic regression model was used to evaluate the determinants of pyridostigmine and of potentially contraindicated drugs use in MG patients. Among 591 incident pyridostigmine users affected by MG, 91 (15.4%) had at least one of the contraindications considered at the first prescription of pyridostigmine. Patients prescribed with pyridostigmine in presence of contraindications were more frequently affected by diabetes, obesity, and renal diseases. Age 75+ years (odds ratio, OR 4.94, 95% confidence interval, CI 1.60-15.22 for Latium; OR 3.78, 95%CI: 1.26-11.34 for Tuscany; OR 5.83, 95%CI 1.19-28.52 for Umbria), the presence of at least one specific comorbidity (OR 3.93; 95%CI 1.68-9.17 for Latium), and polytherapy (6+ drugs, OR 4.90, 95%CI: 1.35-17.85 for Tuscany) were found to be significantly associated with pyridostigmine use in presence of contraindications. Among patients affected by MG, 1,483 (62.6%) were treated with potentially contraindicated drugs in the first year of follow-up (67.06.9% in Latium; 59% in Tuscany; 57.6% in Umbria). Patients aged 75+ years, those with at least one specific complication or comorbidity, and those exposed to polytherapy were more likely to be treated with a potential contraindicated drug. Among incident users of pyridostigmine, more than 15% of patients have at least one of the contraindications considered, and among patients diagnosed with MG, in the first year of follow-up >60% of subjects were treated with potentially contraindicated drugs.