MicroRNAs (miRNAs) are a class of short non-coding RNAs involved in the regulation of gene expression and the control of several cellular processes at physiological and pathological levels. Furthermore, extracellular vesicles (EV), which are small membrane-bound vesicles secreted by cells in the extracellular environment, contain functional miRNAs. The remarkable deregulation of many miRNAs has been demonstrated in respiratory diseases. Among them, miR-206, miR-133a-5p, and miR-133a-3p are striated muscle-specific miRNAs (myo-miRNA), related to skeletal muscle dysfunction, one of the commonest systemic manifestations in patients with chronic obstructive pulmonary disease (COPD). Nevertheless, their circulating expression in COPD patients is not demonstrated. For these reasons, we performed a pilot study to analyze the expression profiles of myo-miRNAs in plasma-derived EV from patients with COPD. We analyzed the expression profiles of selected myo-miRNAs in plasma-derived EV from COPD. Receiver operating characteristic analyses were carried out to evaluate whether selected plasma miRNAs were able to discriminate between different groups of COPD patients. We found EV-embedded myo-miRNAs in the bloodstream of COPD patients. Specifically, miR-206, miR-133a-5p and miR-133a-3p were significantly upregulated in group B patients. Receiver operating characteristic analyses of the combination of these selected miRNAs showed their high capacity to discriminate group B from other COPD patients. Our data provide evidence that myo-miRNA are present in EV in the plasma of COPD patients and their expression (miR-206, miR-133a-5p, and miR-133a-3p) can discriminate group B from group C patients. The future analysis of a larger number of patients should allow us to obtain more refined correlations.

Background: Nowadays, wearable sensors are widely used to quantify physical and motor activity during daily life, and they also represent innovative solutions for healthcare. In the clinical framework, the assessment of motor behaviour is entrusted to clinical scales, but they are dependent on operator experience. Thanks to their intrinsic objectivity, sensor data are extremely useful to provide support to clinicians. Moreover, wearable sensors are user-friendly and compliant to be used in an ecological environment (i.e., at home). This paper aims to propose an innovative approach useful to predict clinical assessment scores of infants’ motor activity. Materials and methods: Starting from data acquired by accelerometers placed on infants’ wrists and trunk during playtime, we exploit the method of functional data analysis to implement new models combining quantitative data and clinical scales. In particular, acceleration data, transformed into activity indexes and combined with baseline clinical data, represent the input dataset for functional linear models. Conclusions: Despite the small number of data samples available, results show correlation between clinical outcome and quantitative predictors, indicating that functional linear models could be able to predict the clinical evaluation. Future works will focus on a more refined and robust application of the proposed method, based on the acquisition of more data for validating the presented models. Trial registration number: ClincalTrials.gov; NCT03211533. Registered: July, 7th 2017. ClincalTrials.gov; NCT03234959. Registered: August, 1st 2017.

Background: Guidelines recommend limiting melanoma screening in a population with known risk factors, but none indicates methods for efficient recruitment. The purpose of this study is to compare three different methods of recruiting subjects to be screened for melanoma to detect which, if any, is the most efficient. Methods: From 2010 to 2019, subjects were recruited as follows: (1) regular skin examinations (RS), mainly conducted through the Associazione Contro il Melanoma network; (2) occasional melanoma screening (OS), during annual public campaigns; (3) and selective screening (SS), where people were invited to undergo a skin check after filling in a risk evaluation questionnaire, in cases where the assigned outcome was intermediate/high risk. Melanoma risk factors were compared across different screening methods. Generalized Linear Mixed Models were used for multivariable analysis. Results: A total of 2238 subjects (62.7% women) were recruited, median age 44 years (2–85), and 1094 (48.9 %) records were collected through RS, 826 (36.9 %) through OS, and 318 (14.2 %) through SS. A total of 131 suspicious non-melanoma skin cancers were clinically diagnosed, 20 pathologically confirmed, and 2 melanomas detected. SS performed significantly better at selecting subjects with a family history of melanoma and I-II phototypes compared to OS. Conclusions: Prior evaluation of melanoma known risk factors allowed for effective selection of a population to screen at higher risk of developing a melanoma.

Considering the variability and heterogeneity of motor impairment in children with Movement Disorders (MDs), the assessment of postural control becomes essential. For its assessment, only a few tools objectively quantify and recognize the difference among children with MDs. In this study, we use the Virtual Reality Rehabilitation System (VRRS) for assessing the postural control in children with MD. Furthermore, 16 children (mean age 10.68 ± 3.62 years, range 4.29–18.22 years) were tested with VRRS by using a stabilometric balance platform. Postural parameters, related to the movements of the Centre of Pressure (COP), were collected and analyzed. Three different MD groups were identified according to the prevalent MD: dystonia, chorea and chorea–dystonia. Statistical analyses tested the differences among MD groups in the VRRS-derived COP variables. The mean distance, root mean square, excursion, velocity and frequency values of the dystonia group showed significant differences (p < 0.05) between the chorea group and the chorea–dystonia group. Technology provides quantitative data to support clinical assessment: in this case, the VRRS detected differences among the MD patterns, identifying specific group features. This tool could be useful also for monitoring the longitudinal trajectories and detecting post-treatment changes.

Introduction Rehabilitation after stroke often employs Robots and Allied Digital Technologies (RADTs). However, evidence of their effectiveness remains inconclusive due to study heterogeneity and limited sample sizes. Here, we describe a protocol for a multicentre randomized controlled pragmatic trial aimed at comprehensively and accurately assessing the effectiveness and sustainability of RADT-mediated rehabilitation, compared to traditional rehabilitation. Methods and analysis This is a pragmatic multicentre, multimodal, randomised, controlled, parallel-group (1:1) interventional study with blinded assessors. The trial will recruit 596 adult post-stroke patients in the subacute phase (less than 6 months post-stroke). Patients will be recruited from thirteen rehabilitation centres participating in a national research initiative, encompassing both outpatient and inpatient clinical settings. Participants will be randomized into either the experimental group, or the control group. The experimental group will receive rehabilitation using RADTs within a new organizational model, where two physical therapists supervise four to six patients; patients will undergo a comprehensive rehabilitation treatment, targeting the following domains: a) upper limb sensorimotor abilities; b) lower limb sensorimotor abilities and gait; c) balance; d) cognitive abilities. In the control group, patients will undergo individual traditional rehabilitation, maintaining a 1:1 patient-to-therapist ratio, targeting the same domains. Patients will undergo a total of 25 sessions, each lasting 45 minutes, with a frequency of 5 times a week, for inpatients; and 3 times a week, for outpatients. The primary endpoint is to demonstrate non-inferiority in the recovery of the activities of daily living as measured by the modified Barthel Index. If non-inferiority is established, the study will then evaluate the superiority of RADTs in the recovery of the activities of daily living. Secondary endpoints include improvements in upper and lower limb function, balance, cognitive function, and, according to the ICF, in the body functions, activities, and participation domains. Additional analyses will cover neurophysiological assessments of neural plasticity, as well as biochemical, and genetic evaluations. Upper limb dexterity and gait recovery rates during treatment will be monitored. The study will also evaluate daily activities and quality of life during a six-month follow-up period post-treatment. Acceptability and usability of integrated RADTs-based rehabilitation for patients, families, and healthcare providers, along with economic and organizational sustainability for patients, payers, and society, will also be assessed. Outcomes will be measured and analysed by blinded assessors. Ethics and dissemination This study was reviewed and approved by National Ethics Committee for clinical trials of Public Research Bodies (EPR) and other National Public Institutions (CEN). The results will be disseminated through scientific articles in peer-reviewed journals and presentations at both national and international conferences. Trial registration number NCT06547827 • The effectiveness of robotics and allied technologies will be evaluated using a novel approach involving a multimodal intervention. This approach addresses all impaired functions to holistically enhance activities of daily living, which represent the patient’s most important needs. • In addition to clinical scales, neurophysiological and biochemical data will be considered for a deeper understanding of the mechanisms underlying motor recovery. • Detailed patient profiling will enable the creation of predictive models to identify subjects who may respond better to treatment integrated with robotics and allied technologies. • The economic analysis will allow us to assess the sustainability of a new organizational model based on the use of robotics and allied technologies, where two physiotherapists supervise a group of patients simultaneously. • A study limitation is the use of different technologies across research centres. However, this reflects real-world conditions. To address the inevitable variability, we clearly defined the functional domains for treatment with robotic or technological systems, focusing on the lower limbs, balance, upper limb segments, and cognitive functions. Moreover, to manage other possible sources of variability due to the number of centres involved, a consensus was reached about clear protocols for clinical evaluation and therapy administration to be shared in clinical practice by all the participating centres.

This article discusses the use of statistical methods for systematising 96 archaeological ship finds, mainly from the southern and south-eastern coast of Norway. It draws on an article published in 2009 by Jan Bill, where he did a similar investigation of material from the Danish area. The method of multiple correspondence analysis (MCA) provides a way to summarise categorical data in a reduced number of dimensions. The results are presented in a geographical space, a plot, that can be used for making interpretations and assumptions of cohesions and divergences in the material. It is a way of analysing continuity and change in boatbuilding techniques that avoids using arbitrary and ambiguous concepts of historical (ship) types. Instead, the building techniques, the ways of ‘doing things’, make the premises for classification. The results in this article can be considered preliminary, its primary function being a discussion on methodology.