Ethnomedicinal and Ethnobotanical Survey in the Aosta Valley Side of the Gran Paradiso National Park (Western Alps, Italy)

Most of traditional knowledge about plants and their uses is fast disappearing because of socio-economic and land use changes. This trend is also occurring in bio-cultural refugia, such as mountain areas. New data on Traditional Ethnobotanical Knowledge (TEK) of Italian alpine regions were collected relating to three valleys (Cogne, Valsavarenche, Rhêmes) of the Gran Paradiso National Park. Extensive dialogues and semi-structured interviews with 68 native informants (30 men, 38 women; mean age 70) were carried out between 2017 and 2019. A total of 3918 reports were collected, concerning 217 taxa (including 10 mushrooms, 1 lichen) mainly used for medicinal (42%) and food (33%) purposes. Minor uses were related to liquor making (7%), domestic (7%), veterinary (5%), forage (4%), cosmetic (1%) and other (2%). Medicinal plants were used to treat 14 ailment categories, of which the most important were respiratory (22%), digestive (19%), skin (13%), musculoskeletal (10%) and genitourinary (10%) diseases. Data were also evaluated by quantitative ethnobotanical indexes. The results show a rich and alive traditional knowledge concerning plants uses in the Gran Paradiso National Park. Plants resources may provide new opportunities from the scientific point of view, for the valorization of local products for health community and for sustainable land management.


Introduction
The traditional uses of plants express the resilient relationship between human communities and their environment. This cultural heritage, cumulated and evolved living in close contact with nature is fast disappearing owing to socio-economic and land use changes [1]. In areas historically exposed to very few external influences and centered around a subsistence economy, such as islands and alpine regions, this trend is less noticeable. Therefore, these areas represent important BioRefugia for the conservation of the biodiversity of plants and animals as well as for the cultural differences [2][3][4].
In recent years, several ethnobotanical investigations have been focused on different North Italian alpine regions, such as Piedmont [5][6][7], Lombardy, including the Stelvio National Park, [8][9][10][11][12] and Western Liguria [13]. The ethnobotanical traditions of Valle Orco, located in the Piedmont side of Gran Paradiso National Park, was previously investigated [14]. Regarding the Aosta Valley, previous ethnobotanical studies are limited and dated (e.g., the scientific studies done by Binel (1972) [15] on the traditional use of some local species and by Chimenti Signorini and Fumagalli (1983) [16] on the medicinal plants used in Valtournanche). However, several informative books concerning the same topic are known [17][18][19][20][21]. The final database included 3918 reports concerning 231 taxa. The most representative uses were medicinal (42%) and food (33%) followed by other categories, as reported in Figure 1. The general importance of the useful plants in the investigated area was evaluated calculating EI and EPI indices. According to Vitalini et al. (2013) [9], the Ethnobotanicity Index (EI) was calculated as the ratio between the number of the wild taxa cited in the medicinal, cosmetic, veterinary, and food (alimentary and liquoristic) sectors and the estimated number of taxa in the wild flora of the area. The resulting value of EI (12.8%) falls above the range of values (5.37-10.75%) reported by Guarrera et al. (2008) [25] for different Italian regions and above those referred in different Italian Alpine areas (e.g., 6.2% for Val San Giacomo [9], 9.7% for Stelvio National Park [10], 11% for North-Western Ligurian Alps [13] and 12% for South Tyrol [26]).
The richness of popular knowledge about the wild species was verified by the Ethnophytonomic Index (EPI), higher (EPI 0.11) than the EPI value previously reported in Italy and for another alpine areas (EPI 0.06) [9]. Nevertheless, this value shows an erosion of the linguistic heritage associated with plants, suggesting that only 11% of the wild taxa have a vernacular name.
The local importance of each species was calculated by using the Relative Frequency of Citation (RFC). In Table 3 the species that obtained an RFC > 0.50 were reported.   Al: [5,10,13] Med: [5,7,10,11,13]  Med: infusion to drink as carminative, digestive and against gastric pains (dig). Vet: seeds placed in a butter ball and given to cows against difficulty in ruminating and swelling.
Al: [5,13] Med: [11]    Al: flavouring in several dishes (e.g., meat, game, repùta, vin brulé, cheeses). Dom/Hand: branches fumigations to disinfect environments; large branches used to build the stick (moudòn, moudèire) used to turn the polenta, releasing an aromatic flavor. Liq: flavouring in liqueur and grappa as digestive. Med: fresh berries, or berry infusion or decoction (in water or wine) against stomach ache, digestive problems, indigestion; berry jam (called tsénèvrà) used to treat digestive (dig), respiratory (resp), circulatory (circ), urinary problems (uri), against osteoarthritis and osteoporosis (skel), and in case of tooth pain (dent), against headache (nerv) and menstrual pain (gen). Vet: berries added to balls of fat or butter, or in form of decoction given to animals with rumen problems and against swelling.
Al: [10,11] Med: [10] 0 Med: dried and powdered (to ingest) or as infusion or decoction for weak bones, against osteoporosis, arthritis, arthrosis, in case of rheumatism, kidney or urinary problems, to regularize the menstrual cycle, as invigorator and reinforcer (skel) (enm) (gen-uri). Others: segments were used by children as a game, because once separated they reassemble to each other.

0.09
Linaceae Linum usitatissimum L. Lino Gran de lin C Seeds (fresh or dried) Med: infusion, decoction, seeds macerated overnight in water or linen oil (to ingest) as an anti-inflammatory: against digestive problems, as a laxative but also antidiarrheal (dig) (enm), against respiratory problems, cough, cold, phlegm (also used as a chest pack) (resp); seed decoction used for bath against hemorrhoids (circ); seed decoction or water macerate (to drink) as a pre-birth emollient treatment (pcp). Vet: seeds decoction or macerate given to cows as a pre-birth emollient treatment.
Dom/Hand: [11] Med: [9,16] 0.37  Dom/Hand: wood used in house building, particularly for roofs; to make containers (used for the preparation of repùta and salted meat) and mangers; wood unsuitable to make boards for resting cheese as it releases color and smell; pine needles scattered on the ground to dry the bottom of animal litter; pine needles used as house insulator between interior and exterior walls. Liq: immature cones flavouring in liqueur. Med: immature cones used to make an antitussive syrup, resin infusion against respiratory system diseases (resp) (*); resin (sometimes cooked in oil or butter) to spread on wounds, cracks, and chilblains, due to its antibacterial and healing properties; resin on hematomas, fractures, sprains, and areas affected by gout; dried vascular cambium placed on wounds (skin) (musc-skel). Vet: resin, heated in butter, to spread on sick hooves, wounds, limb problems and sprains.

Psillio
Gran de natùs (C) P Seeds (fresh or dried) Med: used as a remedy for internal hematomas, to dilute the blood: seed ingestion, or seed maceration overnight in water to drink, or wrap with boiled seeds on the hematoma (circ) (musc); In case of eye problems and inflammations put a seed inside the eye to release mucilage (eye). Al: ingredient in soups and omelet (boiled). Med: leaves placed on wounds, thorns, burns, infected pimples and insect bites (skin); on traumas and hematomas (musc); as compress on tooth abscesses (dent); decoction or infusion (to drink) against internal inflammation and abdominal pain (dig); against cystitis and urinary tract problems (uri); disinfectant (cip) and anti-inflammatory (gen); infusion as cough remedy (resp). Others: floral stems used to build small chairs as toys for children. Vet: leaf rubbed on horsefly stings.

0.02
Secale cereale L. Segale Bréla (C) C Seeds (fresh or dried) Al: seeds grounded as flour, to make bread. For: to feed and fatten animals.

0.29
Triticum sp. Frumento Frùmen (C) C Seeds (fresh or dried) Al: seeds grounded as flour, to make bread. For/Vet: to feed and fatten animals and as galactogogue; given to cows before calving.

Insect galls Coutonettes
Med: galls on Rosa canina and Berberis vulgaris placed and rubbed on wounds as haemostatic (skin).

Ibex marrow
Med: spread on hematomas (musc); smeared on the chest or ingested to remove phlegm (resp).

Breast milk
Med: to treat ears diseases (ear).

Mud
Paciòqque Med: to treat skin problems (e.g., gadfly bites) (skin) raw wool Med: bedtime in case of high fever or pneumonia (resp); against arthritis and musculoskeletal pain (musc). The general importance of the useful plants in the investigated area was evaluated calculating EI and EPI indices. According to Vitalini et al. (2013) [9], the Ethnobotanicity Index (EI) was calculated as the ratio between the number of the wild taxa cited in the medicinal, cosmetic, veterinary, and food (alimentary and liquoristic) sectors and the estimated number of taxa in the wild flora of the area. The resulting value of EI (12.8%) falls above the range of values (5.37-10.75%) reported by Guarrera et al. (2008) [25] for different Italian regions and above those referred in different Italian Alpine areas (e.g., 6.2% for Val San Giacomo [9], 9.7% for Stelvio National Park [10], 11% for North-Western Ligurian Alps [13] and 12% for South Tyrol [26]).
The richness of popular knowledge about the wild species was verified by the Ethnophytonomic Index (EPI), higher (EPI 0.11) than the EPI value previously reported in Italy and for another alpine areas (EPI 0.06) [9]. Nevertheless, this value shows an erosion of the linguistic heritage associated with plants, suggesting that only 11% of the wild taxa have a vernacular name.
The local importance of each species was calculated by using the Relative Frequency of Citation (RFC). In Table 3 the species that obtained an RFC > 0.50 were reported. Peucedanum ostruthium showed the highest RFC value (0.97), being reported by almost all informants (233 citations). Imperatoria, called agrù, is considered a panacea to cure all diseases and is mainly used to treat different medicinal and veterinary problems. Thanks to its antiseptic and anti-inflammatory properties, it is used to treat external and internal diseases. Different parts of the plant (flowers, leaves, roots) and different herbal preparations (infusion, decoction, compress) are used. Imperatoria is also used for liquoristic and for domestic purposes; roots fumigations are also reported to disinfect the stables, a practice mainly important during calving.
Urtica dioica (0.91), Blitum bonus-henricus (0.90) and Bistorta officinalis (0.87) are reported by most informants, especially for alimentary uses. Stinging nettle is included in seven categories of use, being reported as food and medicine for humans and animals, as cosmetic and for domestic and other purposes.
Another important plant used is Juniperus communis (RFC 0.88), that is reported as seasoning, for its medicinal and veterinary applications and for domestic and handcraft uses.

Medicinal Uses
Medicinal plants represent the most important category of use, with a total of 1639 citations concerning 124 taxa, including 122 plants belonging to 51 families, one lichen (Parmeliaceae) and one fungus (Agaricaceae). Asteraceae (20 species), Lamiaceae (eight), Rosaceae (eight), Pinaceae (five), Plantaginaceae (five), Gentianaceae (four) and Apiaceae (four) are the families with the highest number of species.
Human disorders were classified into 14 categories based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10) by the World Health Organization [27]. Used subcategories concern diseases of the: respiratory tract; digestive system; subcutaneous tissues; genitourinary tract; musculoskeletal system and connective tissue; circulatory system; nervous system; eye and adnexa; ear and mastoid process (sensory system); infections and parasitosis; pregnancy, childbirth and puerperium; symptoms and signs not elsewhere classified; dental and oral; endocrine, nutritional and metabolic.
As reported for other alpine areas [9,13], also in the PNGP, the most frequent treatments were those of the respiratory, digestive, and integumentary systems, showing the highest citations (352, 315 and 219, respectively), followed by those of the genitourinary tract, musculoskeletal system and connective tissue (169 and 156 citations, respectively) ( Table 4).  Table 3). For the treatment of dental and circulatory problems, for the treatment of problems related to pregnancy, for infectious and parasitic diseases and nervous problems a greater choice of medicinal plants has been reported (Fic from 0.69 to 0.75).
Considering the use of plants in relation to specific disease categories, we calculated the Fidelity Level (FL) and selected the species with a FL > 70% and with at least 10 citations in the disease category for which the highest FL has been obtained. In Table 5 we reported these species with the related disease category and their main bioactive compounds involved in the specific therapeutic effects based on pharmacological investigations. Sesquiterpenes, triterpenoids, flavonoids, phenolic acids, chromones and its derivatives, alkaloids with anti-inflammatory and anti-microbial activities [38] Allium sativum 85.70% 20 21 Infections and parasitosis Sulfur-containing phytoconstituents and flavonoids with antibacterial, antiviral, antifungal, antiprotozoal, antioxidant and anti-inflammatory activities [39] Plantago major 84.60% 13 13 Skin and subcutaneous tissues Polysaccharides responsible of wound healing effects [40] Gentiana punctata 82.80% 22 29 Digestive system Polyphenol such as flavones and their glycosides with gastroprotective activity [41] Plantago media 78.40% 24 37 Skin and subcutaneous tissues Polysaccharides and flavonoids with wound healing and anti-inflammatory effects [42] Arnica montana 76.40% 53 72 Musculoskeletal system and connective tissue Sesquiterpene lactones of helenalin and dihidrohelenalin type, essential oil, flavonoids, phenolic acids [43] with anti-inflammatory activity [44,45] Juniperus communis 72.50% 50 80 Digestive system Flavonoids, essential oil and coumarins with hepatoprotective, anti-inflammatory and antimicrobial activities [46], as well as digestive properties [47] Some of the most important medicinal plants are depicted in Figure 2A-G. Peucedanum ostruthium (Figure 2A) is not included among species with high FL, because it is used to treat several categories of diseases, including respiratory, digestive, muscular, skin and genitourinary problems.
For the respiratory tract, the species with the highest FL value (100%) were Cetraria islandica together with Tussilago farfara (91.7%) ( Figure 2B) and Viola calcarata (98.3%) ( Figure 2C), used to treat phlegm, bronchitis and colds. Other species used for the same purpose are Artemisia umbelliformis, Gymnadenia nigra, Teucrium chamaedrys, Thymus pulegioides, Salvia officinalis and Artemisia genipi. In addition, different Pinaceae such as Pinus sylvestris L. (Figure 2D), Pinus cembra ( Figure 2E), Pinus mugo and Picea abies were widely used for the treatment of respiratory diseases: young resinous cones or buds were macerated with sugar in a glass jar and exposed to the sun to obtain a syrup. For the digestive system high FL value were found for Carum carvi, Gentiana punctata and Juniperus communis ( Figure 2F). For the diseases of the skin and subcutaneous tissues, leaves of Calendula officinalis, Plantago spp., Hilotelephium maximum were widely used, while latex of Chelidonium majus and Euphorbia seguieriana were indicated to treat warts. For the diseases of the genitourinary tract, Arctostaphylos uva-ursi was the most quoted plant followed by Vaccinium vitis-idaea and Polygonum aviculare. Among the species referred for the treatment of musculoskeletal system, Arnica montana ( Figure 2G) was used to treat blows and external hematomas, while Equisetum arvense in form of decoction to strengthen bones and against osteoporosis. For the diseases of the sensory system (eye and adnexa), the most important taxa were Rosa sp., Euphrasia officinalis subsp rostkoviana and Matricaria discoidaea. Infections and parasitosis were commonly treated with flowers of Tanacetum vulgare and bulbs of Allium sativum. For pregnancy, childbirth and the puerperium Linum usitatissimum, Malva neglecta were used as emollients, while Carduus defloratus L. was reported as a galactogogue. For the respiratory tract, the species with the highest FL value (100%) were Cetraria islandica together with Tussilago farfara (91.7%) ( Figure 2B) and Viola calcarata (98.3%) (Figure 2C), used to treat phlegm, bronchitis and colds. Other species used for the same purpose are Artemisia umbelliformis, Gymnadenia nigra, Teucrium chamaedrys, Thymus pulegioides, Salvia officinalis and Artemisia genipi. In addition, different Pinaceae such as Pinus sylvestris L. (Figure 2D), Pinus cembra ( Figure 2E), Pinus mugo and Picea abies were widely used for the treatment of respiratory diseases: young resinous cones or buds were macerated with sugar in a glass jar and exposed to the sun to obtain a syrup. For the digestive

Liquoristic Uses
Different liqueurs consisting of herbal macerates in alcohol were considered traditional preparations with also medicinal properties. In the studied area, 35 different taxa (35 plants and 1 fungus) were reported in liqueur making.
Digestive liqueurs and grappas were prepared with artisanal systems (Figure 3A,B). The roots of Gentiana punctata ( Figure 3C) and G. lutea, as well as the flowers of G. acaulis and G. verna ( Figure 3D) were reported for this purpose. The aerial parts of different species such as Achillea erba-rotta ( Figure 3E) and A. moschata were added in the Fernet liqueur; Artemisia genipi ( Figure 3F), A. glacialis, A. umbelliformis in the Genepì liqueur. The Kummel liqueur was made by using the seeds of C. carvi, while the Arquébùse using the leaves of T. vulgare. In addition, several species belonging to the Pinaceae were quoted to flavor grappas and liqueurs (e.g., Larix decidua, Picea abies, Pinus cembra, P. mugo and P. sylvestris). Even wild berries were used to flavor grappas (e.g., Rubus idaeus, Vaccinium myrtillus and Rosa canina). In the Cogne valley, a traditional beer recipe obtained by macerating in water the seeds of Hordeum vulgare L., the fruits of Berberis vulgaris, and the roots of Polypodium vulgare, was referred. Lastly, several informants reported the old use of the fungus Fomitopsis officinalis (Figure 3G), added in liqueur for its bitter properties. tissimum, Malva neglecta were used as emollients, while Carduus defloratus L. was reported as a galactogogue.

Liquoristic Uses
Different liqueurs consisting of herbal macerates in alcohol were considered traditional preparations with also medicinal properties. In the studied area, 35 different taxa (35 plants and 1 fungus) were reported in liqueur making.
Digestive liqueurs and grappas were prepared with artisanal systems (Figure 3A,B). The roots of Gentiana punctata ( Figure 3C) and G. lutea, as well as the flowers of G. acaulis and G. verna ( Figure 3D) were reported for this purpose. The aerial parts of different species such as Achillea erba-rotta ( Figure 3E) and A. moschata were added in the Fernet liqueur; Artemisia genipi ( Figure 3F), A. glacialis, A. umbelliformis in the Genepì liqueur. The Kummel liqueur was made by using the seeds of C. carvi, while the Arquébùse using the leaves of T. vulgare. In addition, several species belonging to the Pinaceae were quoted to flavor grappas and liqueurs (e.g., Larix decidua, Picea abies, Pinus cembra, P. mugo and P. sylvestris). Even wild berries were used to flavor grappas (e.g., Rubus idaeus, Vaccinium myrtillus and Rosa canina). In the Cogne valley, a traditional beer recipe obtained by macerating in water the seeds of Hordeum vulgare L., the fruits of Berberis vulgaris, and the roots of Polypodium vulgare, was referred. Lastly, several informants reported the old use of the fungus Fomitopsis officinalis ( Figure 3G), added in liqueur for its bitter properties.

Food Plants and Edible Fungi
Alimentary plants represent the second most important category of uses, with a total of 1302 citations concerning 103 edible species belonging to 40 families. Rosaceae (10 species), Asteraceae (eight), Lamiaceae (six), Fabaceae (six), Poaceae (six), Ericaceae and Grossulariaceae (five) are the most represented families. Data about nine edible fungi belonging to five families were also collected; Agaricaceae, Boletaceae and Suillaceae represent the most quoted families.
The leaves of Bistorta officinalis, Blitum bonus-henricus, Urtica dioica ( Figure 4A,B) and Taraxacum officinale were used as ingredient in soups, in omelets or stir-fried with butter and eaten as a side dish. The young leaves of Taraxacum officinale were also often consumed raw in salad, with boiled eggs, potatoes and walnut oil. Other wild species less frequently reported as ingredients for soups were Silene vulgaris, Tragopogon pratensis, Primula veris, Phyteuma spp. and Rumex acetosa. Botrychium lunaria ( Figure 4C) is a very valued fern used in summer's soups, especially in the mountain pastures.
The leaves of Bistorta officinalis, Blitum bonus-henricus, Urtica dioica ( Figure 4A,B) and Taraxacum officinale were used as ingredient in soups, in omelets or stir-fried with butter and eaten as a side dish. The young leaves of Taraxacum officinale were also often consumed raw in salad, with boiled eggs, potatoes and walnut oil. Other wild species less frequently reported as ingredients for soups were Silene vulgaris, Tragopogon pratensis, Primula veris, Phyteuma spp. and Rumex acetosa. Botrychium lunaria ( Figure 4C) is a very valued fern used in summer's soups, especially in the mountain pastures. Several species were mainly eaten in the past as a snack. For example, the leaves of Rumex acetosella and the stems of T. pratensis for their refreshing properties; the root of P. vulgare for its sweet taste of licorice, while bulbs of Bunium bulbocastanum ( Figure 4D) for their chestnut flavor. Edible flowers cited by informants included P. veris, Viola calcarata and Trifolium pratense.
Various wild or cultivated fruits were eaten fresh or used for jelly, jams or syrups. The most quoted included Fragaria vesca, Ribes nigrum and R. rubrum, Rubus idaeus and Vaccinium myrtillus, followed by Amelanchier ovalis (Figure 4E), Berberis vulgaris, Hippophae rhamnoides, R. canina ( Figure 4F), Arctous alpina, Ribes uva-crispa and R. petraeum, Rubus saxatilis, Sambucus nigra, Vaccinium uliginosum and V. vitis-idaea. Several species were mainly eaten in the past as a snack. For example, the leaves of Rumex acetosella and the stems of T. pratensis for their refreshing properties; the root of P. vulgare for its sweet taste of licorice, while bulbs of Bunium bulbocastanum ( Figure 4D) for their chestnut flavor. Edible flowers cited by informants included P. veris, Viola calcarata and Trifolium pratense.
Among the aromatic plants, some are purchased form valley floor such as Laurus nobilis, Salvia rosmarinus and S. officinalis, while others are wild local species such as T. pulegioides and Juniperus communis, used for seasoning meat (e.g., in the mocetta and in the 'suede in civet' recipes). In addition, some exotic species were also used as spices (e.g., Myristica fragrans and Syzygium aromaticum). All these aromatic plants, with the addition of C. carvi fruits, were used in the past for seasoning the repùta, a typical recipe for storing some cultivated vegetables (Allium ampeloprasum, Brassica rapa, Brassica oleracea, Daucus carota and Beta vulgaris). Hordeum vulgare, Secale cereale and Triticum sp.pl. were widely cultivated in the past to make flour for baking. Solanum tuberosum is also today an important cultivated plant, playing an important role in human nutrition in the mountain areas. The most common vegetable rennet used in the past in cheesemaking were Ranunculus sp.pl., Galium sp.pl., Lotus corniculatus, Urtica dioica, Bistorta officinalis and A. genipi. Roasted roots of Taraxacum officinale and Cychorium intybus and roasted seeds of Hordeum vulgare were used as coffee substitutes until the second postwar period.

Veterinary Uses and Forage
Species of veterinary interest account for 5% of the total uses, with 229 citations, while the plants used as fodder account for 4% with 123 citations. Altogether, data for about 61 species belonging to 29 families were collected. The most represented families were Asteraceae (eight species), Fabaceae (seven) and Poaceae (seven), followed by Apiaceae, Rosaceae and Polygonaceae (four species).
The daily cows feeding was made up of hay, consisting of Festuca sp. added with some cultivated plants such as Onobrychis viciifolia and Medicago sativa. In addition, the mash given to fatten animals and increase milk production included Brassica rapa, Solanum tuberosum, Triticum sp., Zea mays and Avena sativa; Hordeum vulgare is also added for its anti-inflammatory properties.
Several wild plants, common at lower altitude pastures, were referred as good fodder for cows (e.g., Bistorta officinalis, Alchemilla vulgaris, Taraxacum officinale, Trifolium pratense and T. repens). In the higher altitude pastures, other plants increased the milk production and its quality (e.g., Trifolium alpinum and Viola calcarata).
Several remedies are reported in case of cow pregnancy. First, 15 days before the calve birth, some emollient plants were given in form of decoction such as Linum usitatissimum and Malva neglecta or M. sylvestris L. Even the pods of Vicia faba and Phaseolus vulgaris were reported for their emollient properties. The decoction prepared with Achillea millefolium was given to the pregnant cow as an anti-inflammatory, while the flowers of Carduus defloratus and Carlina acaulis were added to the mash to increase the milk production.
Several plants were used to treat different animal diseases (e.g., for the digestive system problems, the roots of Gentiana punctata or G. lutea or the berries of J. communis were added in the fodder mixture). Arnica montana and P. ostruthium were reported to treat musculoskeletal problems; Imperatoria was also used to treat skin problems such as infected wounds and hoofing problems. Mentha sp. was reported in case of cow mastitis.
The leaves of Taraxacum officinale, Trifolium pratense and Urtica dioica were also reported as a good fodder for rabbits and hens. During the winter nettle was added dried in the fodder to increase eggs production.
As repellents for noxious insects, leaves of Levisticum officinale and Veratrum album were indicated.

Domestic and Handcraft
In this study, 340 citations were related to plants used for domestic and handcraft purposes, including 39 species belonging to 28 families. Among these, Apiaceae, Lamiaceae, Pinaceae and Salicaceae are the most represented with three species.
Several species were used for the manufacture of small tools and as construction wood. Larix decidua and Picea abies were used for construction purpose such as to build roofs and perimeter walls, respectively. On the contrary, thanks to its durable wood, Fraxinus excelsior L. was used to make blades and pickaxes ( Figure 5A). Pinus cembra was considered the most valuable wood for building furniture, because of his resinous smell and his mothproof power. Juniperus communis was used for building the stick to turn the polenta, to which confers its typical aroma. Brooms made by branches of Betula pendula Roth and B. vulgaris were used to clean the stables and to remove the wheat chaff from the barn floor. The branches of Sambucus nigra, Viburnum lantana, Corylus avellane, Clematis vitalba, Salix caprea and S. purpurea were used for making baskets such as the traditional gerle ( Figure 5B). In the past, the cortex of Betula pendula was used to build handcrafted snuffboxes with artistic inlaid designs ( Figure 5C). Domestic uses of plants for Valeriana celtica and Lavandula angustifolia put in the closets against moths were also referred. lenta, to which confers its typical aroma. Brooms made by branches of Betula pendula Roth and B. vulgaris were used to clean the stables and to remove the wheat chaff from the barn floor. The branches of Sambucus nigra, Viburnum lantana, Corylus avellane, Clematis vitalba, Salix caprea and S. purpurea were used for making baskets such as the traditional gerle (Figure 5B). In the past, the cortex of Betula pendula was used to build handcrafted snuffboxes with artistic inlaid designs ( Figure 5C). Domestic uses of plants for Valeriana celtica and Lavandula angustifolia put in the closets against moths were also referred.

Others Uses
During the interviews, several other uses and traditional practices related to the local flora were collected. The aqueous macerate of Urtica dioica was widely used as fertilizer and as insecticide in home gardens. Moreover, Carlina acaulis and Stipa pennata. ( Figure  5D) were used as timepiece plants, hanged on the houses for weather forecast. Flowers of Leontopodium alpinum Cass. ( Figure 5E) were collected, dried and used as bookmarkers. Some plants were used in the past for ludic activities (e.g., the flowers of Arctium lappa were thrown on clothes by children; whistles were made by using the hollow stems of

Others Uses
During the interviews, several other uses and traditional practices related to the local flora were collected. The aqueous macerate of Urtica dioica was widely used as fertilizer and as insecticide in home gardens. Moreover, Carlina acaulis and Stipa pennata. ( Figure 5D) were used as timepiece plants, hanged on the houses for weather forecast. Flowers of Leontopodium alpinum Cass. ( Figure 5E) were collected, dried and used as bookmarkers. Some plants were used in the past for ludic activities (e.g., the flowers of Arctium lappa were thrown on clothes by children; whistles were made by using the hollow stems of Heracleum spondhylium and Angelica silvestris). Several plants were also reported as tobacco substitutes (e.g., the leaves of Arnica montana and the needles of Pinus spp).
Several plants were traded until the second postwar period as a source of income: the aerial parts of Artemisia genipi, A. absinthium, Achillea erba-rotta and A. millefolium; the roots of Gentiana lutea and G. punctata; the thallus of Fomitopsis officinalis.
During the interviews, some traditional magico-spiritual practices, were documented: in the Epinèl village, in the Cogne Valley, during St John fest (24 June), a bunch of wildflowers was collected at dawn, still covered in dew, and placed on the house doors in sign of protection. Similar practice was found in the Rhêmes valley, where the flowers of Paradisea liliastrum ( Figure 5F) were used to build a cross with flowers protruding at the ends that was placed on the doors against the misfortune.
Other uses not related to plants were recorded in the studied area. In particular, the marmot fat and the ibex marrox were indicated to treat respiratory and musculoskeletal diseases. In these valleys, the presence of local healers called Rabeilleurs showing therapeutic ability in massage in case of musculoskeletal problems, were also documented. In addition, in Aosta valley still persists the practice of Sécrèts, consisting of the treatment of several diseases (e.g., warts, worms, burns, pains and others) by using prayers and rituals. The healing formulas were kept secret and handed down mainly orally, usually within the family or the village [48].

Discussion
The present results are consistent with ethnobotanical data from other Italian alpine areas [5][6][7][8][9][10][11][12][13]15,16]. The high EI value obtained in our study indicates that the knowledge of useful plants is still well consolidated in the studied area. The impervious territory and the climate, characterized by severe and long winters, forced the population to collect abundant supplies of food, medicinal herbs and firewood suitable for survival. As food reserve, in addition to cultivated cereals and potatoes, other vegetables such as cabbages, carrots, turnips and leeks were cultivated in home gardens. Elderly people remember a typical dish, called repùta, that was prepared with these fermented vegetables in the Cogne valley. Nowadays, in home gardens, in addition to food plants, several aromatic and medicinal plants were also commonly cultivated (e.g., Calendula officinalis, Levisticum officinale, Cyanus segetum, Tanacetum vulgare and Rosa × alba). These species were dried and stored or used fresh to prepare traditional remedies such as infusions, liqueurs and syrups.
An important source of food and medicine also came from wild plants and fungi. According to data from other Italian alpine regions, many small edible fruits and berries such as different Vaccinium and Ribes species are still today collected [5][6][7][8][9][10][11][12][13]15,16]. However, in the studied area, our informants also cited the use of other fruits: Arctous alpina and Rubus saxatilis. As regard to edible wild plants, used raw in salads or boiled, besides the most common species collected in the alpine areas, data concerning the Pteridophyte B. lunaria, used to prepare tasty soups, were also recorded. Curiously, this fern was also reported in the neighboring Waldesian valleys of Piedmont for the treatment of skin diseases [7].
Many wild plants were also quoted for their medicinal properties, used alone or in association to treat several diseases. Traditional remedies were used for the treatment of respiratory diseases, very frequents among the local population. Among species quoted for the treatment of cough, cold and flu, in addition to some Viola species, reported also in other alpine zones, the use of V. calcarata, was recorded. Lamaison et al. (1991) [36] found in this species different bioactive compounds such as flavonoids, rutin and mucilages, that could be related to its activity against airway problems. Indeed, the effectiveness of quercetin-type flavonols such as rutin against viral low respiratory tract infections has been recently demonstrated [49]. The traditional use of the lichen C. islandica for the treatment of respiratory diseases is probably due to the presence of polysaccharides with antiviral [28] and anti-inflammatory properties [29]. For the same purposes, also several Artemisia species are used. In this regard, Vouillamoz et al. (2015) [50], suggested that Artemisia bioactive compounds (sesquiterpene lactones) could be involved in the activation of bitter receptors, stimulating ciliary motion and relaxation of bronchial tissues. By this way, these compounds prevent infections and improve ventilation; the absorption path of these volatile compounds explains the use of inhalations in addition to herbal tea, the main preparation traditionally used.
Digestive diseases are also very common in the studied area, probably related to a diet rich in animal fats. In agreement with other investigation on the traditional medicine of Alpine areas [5][6][7][8][9][10][11][12][13]15,16], the digestive use of different species of Gentiana (mainly G. punctata), Achillea and Artemisia, as well as of J. communis and C. carvi, were recorded. Artemisia spp., representing iconic plants of the Alpine region, were commonly called génépi and they were widely used for infusions and liqueurs making with thermogenic and digestive effects [50].
Skin and musculoskeletal problems often affected the population involved in manual and field work and consequently several plants were cited for this purpose. The use of Arnica montana for musculoskeletal diseases was related to the presence of helenalin and dihidrohelenalin-type sesquiterpene lactones, flavonoids and phenolic acids with antiinflammatory activity [43][44][45]. On the contrary, Plantago spp. were widely used being rich in polysaccharides and flavonoids with anti-inflammatory effects for treatment of wounds and other skin problems [40]. Some species were also indicated to treat infections and parasitosis such as Allium sativum and Tanacetum vulgare. A. sativum with sulfur-containing phytoconstituents and flavonoids showed antibacterial, antiviral, antifungal, antiprotozoal, antioxidant and anti-inflammatory properties [39], whereas T. vulgare, rich in β-thujone, was responsible for the anthelmintic activity [33].
Regarding the medicinal and veterinary properties, P. ostruthium deserves a special mention, representing the core of the cultural ethnobotanical heritage of the investigated area, as showed by RFC value. The rhizome has a long tradition of medicinal use and the plant has been known as 'Divinum remedium' since the eighteenth century [51]. The phytochemical profile of the rhizomes of P. ostruthium showed the main bioactive compounds such as coumarins, oxypeucedanin hydrate, oxypeucedanin, ostruthol, imperatorin, osthole, isoimperatorin and ostruthin [52]. In Aosta valley, the plant is considered a panacea for all ailments. Moreover, in our survey, information concerned traditional uses not only of root/rhizome but also of leaves and the flowers, used both as external and internal remedies. Similar uses of these aerial portions are only rarely referred for other alpine areas such as Swiss Alps [53], South Tyrol [26] and Austria [54].
Given the considerable economic importance of pastoralism in these valleys, several plants were quoted to increase milk production and quality. Data on some species typical of alpine pastures such as T. alpinum and V. calcarata, rarely reported in previous studies, were recorded [5][6][7][8][9][10][11][12][13]15,16]. Our informants also reported the past use of different species of Galium as rennet, in agreement with similar data reported by Biella and Pieroni (2015) for Piedmont. In addition, other species were cited for the same purpose in the studied area such as L. corniculatus, U. dioica, Ranunculus spp. and Bistorta officinalis.
Quantitative analysis of the data collected showed the most cited species (RFC values), representing the heart of the ethnobotanical culture of the investigated area. In addition, Fic and FL gives us useful indications about medicinal species worthy of being further studied from the phytochemical and pharmacological point of view.
The general importance of the useful plants in the study area was showed by a very high EI value, compared with those obtained by studies on other Italian alpine areas and such as another protected area, Stelvio National Park [10]. Similarly, EPI value obtained in our survey was higher than that referred for Stelvio National Park, showing a good popular knowledge concerning local names of the wild species in PNGP. Although in the Aosta Valley the patois dialect is very widespread, several differences in the plant dialectal names among the three valleys indagated, were found. Moreover, the documented dialect names used in Aosta Valley were similar to those used in Lower and Central Valais (Switzerland) (e.g., J. communis called tsénèvro in Aosta Valley and dzenièvro in Switzerland, Artemisia vulgaris reported as porta rusò and porta-rozò and V. vitis-idea known as gravelòn and gravèlong, respectively) [53]. This knowledge is fast disappearing because of the linguistic homologation that characterizes modern societies. Therefore, the documentation of these local names is crucial also to preserve TEK handed down orally from one generation to the next.

Study Area
The investigated area included the three valleys, namely Cogne, Valsavarenche, Rhêmes, of the Gran Paradiso National Park (PNGP) in Aosta Valley, Western Alps, Northern Italy (Figure 6). In addition, the land use and vegetation map of the PNGP is added as supplementary material ( Figure S1). [55] zerland) (e.g., J. communis called tsénèvro in Aosta Valley and dzenièvro in Switzerland, Artemisia vulgaris reported as porta rusò and porta-rozò and V. vitis-idea known as gravelòn and gravèlong, respectively) [53]. This knowledge is fast disappearing because of the linguistic homologation that characterizes modern societies. Therefore, the documentation of these local names is crucial also to preserve TEK handed down orally from one generation to the next.

Study Area
The investigated area included the three valleys, namely Cogne, Valsavarenche, Rhêmes, of the Gran Paradiso National Park (PNGP) in Aosta Valley, Western Alps, Northern Italy ( Figure 6). In addition, the land use and vegetation map of the PNGP is added as supplementary material ( Figure S1). [55]  The PNGP, previously a royal hunting reserve ceded to the state at the beginning of the twentieth century by the King Vittorio Emanuele III of Savoy, is a protected area established in 1922. It is the Italy's first National Park established to preserve fauna, flora and the natural beauty of the landscape. The PNGP covers 71.044 ha between Aosta Valley (52%) and Piedmont (48%) and includes five valleys (Cogne, Valsavarenche, Rhêmes, Orco, Soana) surrounding the Gran Paradiso peak (4061 m). The current geomorphological set-up is the result of the action of the glaciers that led to the formation of large valleys, while currently, the main modeling agent of the landscape is river engravings. The cliffs are mostly of siliceous origin, although there are some areas of calcareous and limestone, especially on the Aosta Valley side. The lithology, geomorphological and climatic features strongly influence the vegetation. The great biodiversity of the park is due-in addition The PNGP, previously a royal hunting reserve ceded to the state at the beginning of the twentieth century by the King Vittorio Emanuele III of Savoy, is a protected area established in 1922. It is the Italy's first National Park established to preserve fauna, flora and the natural beauty of the landscape. The PNGP covers 71.044 ha between Aosta Valley (52%) and Piedmont (48%) and includes five valleys (Cogne, Valsavarenche, Rhêmes, Orco, Soana) surrounding the Gran Paradiso peak (4061 m). The current geomorphological set-up is the result of the action of the glaciers that led to the formation of large valleys, while currently, the main modeling agent of the landscape is river engravings. The cliffs are mostly of siliceous origin, although there are some areas of calcareous and limestone, especially on the Aosta Valley side. The lithology, geomorphological and climatic features strongly influence the vegetation. The great biodiversity of the park is due-in addition to the considerable extension of its territories-to the presence of two slopes, the Aosta Valley and the Piedmont ones, very different in lithology and climatic characteristics. Furthermore, the landscape is characterized by several micro-environments due to the significant differences in altitude (from 800 m to 4061 m a.s.l.). The protected area has an average altitude of about 2400 m and the subalpine, alpine and snowy vegetation types are the most represented natural environments. Forest formation mainly consists of Larix decidua and Picea abies, with Pinus cembra at the higher altitudes; in alpine grasslands Festuca sp., Carex curvula and Sesleria caerulea are the most represented species. The flora of prairies and pastures is mainly composed of acidophilous species, due to the wide dominance of the siliceous substrates; however, in calcareous outcrops also basophilous species are present.
Until today, about 1160 taxa [56], including Lycopods, Horsetails, Pteridophytes, Gymnosperms and Angiosperms, have been listed within the PNGP, 82 of which are endemic to the Alps. Native species account for 99% of the total (1127 species). Due to the high degree of plant biodiversity and to the high number of rare species, the entire territory of the park has been declared Site of Community Importance (ZSC IT 1201000). Collection of plants within the National Park is subject to the regulation-excerpt of the PNGP [57]. The gathering of plants is currently prohibited unless specific authorization. However, only for residents, a few edible and medicinal species with a strong cultural value are excluded.
In the 13 Municipalities of the Park, including 6 municipalities in Piedmont and 7 in Aosta Valley, live about 8300 people. Our research was focused on the municipalities of Cogne (1370 inhabitants), Valsavarenche (169 inhabitants) and Rhêmes (251 inhabitants), representing the Aosta Valley area belonging to the PNGP. The dialectal language commonly used by all the residents of the three valleys is called patois.

Field Study and Data Collection
Ethnobotanical data were collected during summer over three consecutive years (2017-2019), through extensive dialogues and semi-structured interviews with 68 inhabitants aged between 36-92 years (mean age 70 years). Informants were native or longtime residents in the area and had strong links with the traditional human activities of the territory. We selected informants using snowball techniques and we tried to ensure that all key informants were interviewed. We obtained the oral prior informed consent from all informants, according to the ISE (International Society of Ethnobiology) Code of Ethics. During the individually or in groups interviews, we tried to build a relationship of confidence with informants, to facilitate the dialogue. The age, gender, origin, level of education and occupation of all informants were recorded.
The questions were aimed at documenting the use of plants as food and medicine for humans and animals. In addition, also liquoristic, domestic, cosmetic and others uses were documented. The informants were asked to provide local name, parts used, period of gathering, association with other plants, preparation and use, related recipes and further indications. We reported the plant uses derived from the oral tradition in the local community. During the interviews we collect several fresh plants and dried samples representative of the local officinal flora. The nomenclature of plants follows "Plants of the world" [58] and the corresponding synonymous were added, according to "Flora d'Italia" [59,60]. "Index fungorum" [61] was used for the nomenclature of fungal species. Voucher specimens of the wild cited plant species were prepared and deposited at the Ethnobotanical Herbarium of the PNGP in the Paradisia Alpine Botanic Garden (Valnontey, Cogne).

Data Analysis and Quantitative Indices
All the ethnobotanical data were added and organized in spreadsheets of Microsoft Excel, in order to process the survey results.
Data were evaluated by quantitative parameters such as ethnobotanicity and ethnophytonomic indices, relative frequency of citation, factor informant consensus and fidelity level.

Ethnobotanicity Index
Ethnobotanicity Index (EI) [62] allows to estimate the importance of the useful plants in a defined area. It is the ratio, expressed as percentage (%), between the number of used wild plants and the number of species making up the flora of the considered territory.

Ethnophytonomic Index
Ethnophytonomic Index (EPI) [63] allows to estimate the wealth of the people's knowledge about the local plant species. It is the ratio between the number of plants with vernacular name and the total number of species belonging to the studied area. The local importance of each species was calculated by using the Relative Frequency of Citation (RFC) [64]: RFC = FC/N (1) where FC is the number of informants, who mentioned the use of the species and N is the total number of informants (68 in this study).

Factor Informant Consensus (Fic)
Factor informant consensus (Fic) [65] is used to identify the main categories of diseases and to consider the agreement among the respondents on the use of plants. It was calculated according to the following formula: where Nur refers to the number of use citations in each category and Nt to the number of species used in the same category. The values of Fic ranging from 0 to 1. A high value is obtained when one or few plant species are used by a large proportion of informants to treat a given disease category, while a low value indicates that the informants are in disagree about the taxa to be used in the treatment of a certain ailment.

Fidelity Level
The Fidelity Level Index (FL) [66,67] was also considered to indicate the informants' choice for a potential plant species to treat a given disease. It was calculated by the following formula: FL = (Np/N) × 100 (3) where Np is the number of use reports for a given species reported to be used for a particular ailment category and N is the total number of use reports cited for any given species.

Conclusions
Our survey provided an exhaustive prospect of the Ethnobotanical Traditional Knowledge (TEK) in the territory of the Gran Paradiso National Park, located in the Aosta Valley, an area so far scarcely studied from the perspective of plant folk traditions. Data collected confirmed that this knowledge mainly remains in the memories of the eldest population and enhanced the important role of the mountain areas as biocultural refugia. However, TEK is fast disappearing among the new generations and, therefore, documenting and preserving such information is crucial to reduce the loss of biocultural diversity. The results of our study contribute to the goal of Article 8(j) of the Convention on Biological Diversity (CBD) that recognizes the importance of preserving the traditional knowledge of indigenous peoples to conserve biological diversity and to ensure the sustainable use of its components. We observed that the uses of food wild plants to prepare typical dishes and liqueurs, as well as the use of medicinal plants to cure the most common diseases of human and livestock, are still well preserved by local population. Some of these species need further investigation (e.g., B. lunaria for its nutritional properties). In regard to medicinal plants, inhabitants give a great healing value to all the portions of P. ostruthium used in these valleys for the treatment of several diseases. Further studies are in progress to better characterize the phytochemical profile and the biological activity of these plants. As a future perspective, it would be useful to complete the ethnobotanical investigation also in the Piedmont side of the PNGP. It would also be useful to select some medicinal species and evaluate the possibility of local production of phytotherapeutics based on traditional remedies. The Park would play a key role in optimizing the ecosystem services of the flora, in a context of greater involvement of local populations. Informed Consent Statement: Informed consent was obtained from all subjects involved in the study.

Data Availability Statement:
The data presented in this study are available in this article; databases are held at Distav (University of Genoa) and at PNGP (Aosta).