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The Prisoner's Dilemma (PD) is one of the most popular concepts amongst the scientific literature. The task is used in order to study different types of social interactions by giving participants the choice to defect or cooperate in a specific social setting/dilemma. This review focuses on the technical characteristics of the PD task as it is used in medical literature and describes how the different PD settings could influence the players' behaviour. We identify all the studies that have used the PD task in medical research with human participants and distinguish, following a heuristic approach, seven parameters that can differentiate a PD task, namely (a) the opponent parties' composition; (b) the type of the opponent as perceived by the players; (c) the interaction flow of the game; (d) the number of rounds; (e) the instructions narrative and options that are given to players; (f) the strategy and (g) the reward matrix and payoffs of the game. We describe how each parameter could influence the final outcome of the PD task and highlight the great variability concerning the settings of these parameters in medical research. Our aim is to point out the heterogeneity of such methods in the past literature and to assist future researchers with their methodology design. Copyright © 2022 Mantas et al.

Background: Several theories in autism posit that common aspects of the autism phenotype may be manifestations of an underlying differentiation in predictive abilities. The present study investigates this hypothesis in the context of strategic decision making in autistic participants compared to a control group. Method: Autistic individuals (43 adults, 35 male) and a comparison group (42 adults, 35 male) of age and gender matched individuals, played a modified version of the prisoner’s dilemma (PD) task where they were asked, if capable, to predict their opponents’ move. The predictive performance of the two groups was assessed. Results: Overall, participants in the autism group had a significantly lower number of correct predictions. Moreover, autistic participants stated, significantly more frequently than the comparison group, that they were unable to make a prediction. When attempting a prediction however, the success ratio did not differ between the two groups. Conclusions: These findings indicate that there is a difference in prediction performance between the two groups. Although our task design does not allow us to identify whether this difference is due to difficulty to form a prediction or a reluctance in registering one, these findings could justify a role for prediction in strategic decision making during the PD task. Copyright 2022 Mantas et al.

Parenting a child with autism can be particularly stressful and challenging, especially during periods of crises. This study focuses on parenting children with autism during the COVID-19 pandemic in comparison to the economic crisis, six years ago. We administered the same set of questionnaires (CES-D, F-COPES, PSI-SF, and WHOQoL-BREF), along with a demographic characteristic and a COVID-19-related questionnaire to the same group of parents of children with autism as we did six years ago. Results indicated that during the COVID-19 crisis, the level of parenting stress and the distress due to personal factors related to demands of parenting, were significantly lower compared to the economic crisis, while the environment facet of quality of life was significantly higher. The depressive symptomatology was elevated during both periods. Finally, when addressing the pandemic crisis, parents were more likely to passively accept problematic issues, less able to obtain social support, and less able to acquire and accept help from others. In our sample, findings differentiate the genre of crises through the parents’ responses regarding the sense of competence in their parental role, their quality of life, and the coping strategies they implemented. The study implies that each crisis must be confronted with particular responses to particular needs. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Background: Prisoner's dilemma is one of the most popular concepts among scientific literature. In medical literature the majority of prisoner's dilemma experiments with human participants implement computerized means. Despite this, there is no shared validated tool for prisoner's dilemma tasks. Methods: The application is developed in Javascript programming language and makes use of the pixijs library for WebGL rendering. To create a custom trial, a set of variables have to be set. These refer to the linguistics, user controls, available choices, computer strategy, interaction flow (simultaneous or sequential), opponent's choice prediction requirement, noise induction, human opponent behavior simulation, the way resulted data will be handled and more. Results are in JSON format and include time interval data. Results: We have developed an application which, given the various parameters experimenter can modify, is able to simulate a large number of single player prisoner's dilemma versions. It is open source with no installation requirement, executable by any modern internet browser remotely or locally with the ability to post data results either locally or remotely. Experimenter only has to modify certain starting values in order to create his design of choice. Two examples are included, with initial settings and results, to demonstrate the use and validity of the application. Conclusions: Our aim is to assist future researchers in their methodological designs. In this scope, our application, has the minimum requirements, can be served either locally or remotely, has a wide range of modifiable parameters and takes care of the resulted data. In the long term, a shared and validated tool would contribute to increasing methodologies’ credibility and mitigating cross-validation discrepancies. © 2022

Aging is associated with the development of chronic low-grade systemic inflammation (LGSI) characterized by increased circulating levels of proinflammatory cytokines and acute phase proteins such as C-reactive protein (CRP). Collective evidence suggests that elevated levels of inflammatory mediators such as CRP, interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) are correlated with deteriorated skeletal muscle mass and function, though the molecular footprint of this observation in the aged human skeletal muscle remains obscure. Based on animal models showing impaired protein synthesis and enhanced degradation in response to LGSI, we compared here the response of proteolysis- A nd protein synthesis-related signaling proteins as well as the satellite cell and amino acid transporter protein content between healthy older adults with increased versus physiological blood hs-CRP levels in the fasted (basal) state and after an anabolic stimulus comprised of acute resistance exercise (RE) and protein feeding. Our main findings indicate that older adults with increased hs-CRP levels demonstrate (i) increased proteasome activity, accompanied by increased protein carbonylation and IKKα/β phosphorylation; (ii) reduced Pax7+ satellite cells; (iii) increased insulin resistance, at the basal state; and (iv) impaired S6 ribosomal protein phosphorylation accompanied by hyperinsulinemia following an acute RE bout combined with protein ingestion. Collectively, these data provide support to the concept that age-related chronic LGSI may upregulate proteasome activity via induction of the NF-κB signaling and protein oxidation and impair the insulin-dependent anabolic potential of human skeletal muscle. © 2021 Dimitrios Draganidis et al.

The original English language Empathy Quotient (EQ) is a self-reporting questionnaire that measures the construct of empathy in adults of normal intelligence. The EQ is sensitive to gender, and neurodevelopmental disorders. The EQ has been translated to many languages all over the world. The EQ - Greek version may be available through open access from www.autismresearchcentre.com. Aim of the present study was to validate the EQ- Greek version.The study took place in the 1st and 2nd Departments of Psychiatry of the National and Kapodistrian University of Athens (NKUA), "Eginition" and "Attikon" Hospitals respectively, and in the Korydallos Prison Psychiatric Clinic in Athens. Two groups completed the original 60 items version. One group consisted of general population and volunteer students from post graduate training programs (normal control group, N= 127) and the other group of patients recruited from the Adult Neurodevelopmental Disorders Unit of the 1st Department of Psychiatry of NKUA, the outpatients' clinic of the 2nd Department of Psychiatry of NKUA and the Korydallos Prison Psychiatric Clinic (patient group, N=196). Three versions of the EQ were examined: the EQ-40, EQ-28 and EQ-15. All versions showed very good internal validity: Cronbach's a value was 0.902, 0.892 and 0.793 respectively. They all showed good test-retest variability: the Intraclass Correlation Coefficient was 0.928, 0.924 and 0.855 respectively. Concurrent validity examined by the correlation analysis with the Interpersonal Reactivity Index (IRI) showed non-significant correlations between the EQ and the IRI. Exploratory Factor Analysis (EFA) indicated a one-factor structure for the three versions. Confirmatory Factor Analysis (CFA) for the one-factor structure showed a good fit for all the three versions. CFA for the three-factor structures (Cognitive Empathy, Emotional Empathy, Social Skills) showed also a good fit for EQ-28 and the EQ-15. When the EQ-40 was used as a measure of empathy in a single dimension in adults, the EQ discriminated the normal control group from the patients' group. The mean EQ score for the total sample was 35.84 with the lowest scoring being among Autism Spectrum Disorder (ASD) patients. As expected, females scored higher than males (p

This study assessed the co-occurrence of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in newly diagnosed adults of normal intelligence and the contribution of trait-based dimensions deriving from the Barkley Adult ADHD Rating Scale-IV (BAARS-IV), the Autism-Spectrum Quotient (AQ), and the Empathy Quotient (EQ) to the differentiation of patients with ADHD, ASD, and ADHD/ASD. A total of 16.1% of patients with ADHD received a co-occurring ASD diagnosis, while 33.3% of patients with ASD received an ADHD diagnosis. Subjects with ADHD or ADHD/ASD had higher scores in all ADHD traits compared to ASD subjects. Compared to the ADHD group, the ASD group had AQ scores that were significantly greater, except for attention to detail. ADHD/ASD co-occurrence significantly increased the score of attention to detail. The total EQ score was greater in the ADHD group. In the stepwise logistic regression analyses, past hyperactivity, current inattention and impulsivity, attention switching, communication, imagination, and total EQ score discriminated ADHD patients from ASD patients. Attention to detail, imagination, and total EQ score discriminated ADHD cases from ADHD/ASD cases, while past hyperactivity and current impulsivity discriminated ASD subjects from ADHD/ASD subjects. Our findings highlight the importance of particular trait-based dimensions when discriminating adults with ADHD, ASD, and co-occurring ADHD/ASD. © 2020 by the authors. Li-censee MDPI, Basel, Switzerland.

Physical exercise has been proposed as an adjunct in addiction treatment, including tobacco cigarette smoking. The physiological and biochemical mechanisms that could be affected by physical exercise in smokers and that could help quit smoking have not been investigated yet. Objective: To investigate whether the effects of acute exercise on smoking behavior and HPA axis activation in smokers are intensity-dependent. Methods: Healthy, non-systematically exercising individuals [25 smokers (age: 33±1.4 years) and 10 non-smokers (age: 34±2.1 years)] underwent three trials [moderate intensity (MI), high intensity (HI) exercise, control (C)] in a counterbalanced order, after an overnight fast and smoking abstinence, separated by at least six days. MI involved cycling at 50–60% of Heart Rate Reserve (HRR) for 30 min, HI involved cycling at 65–75% HRR for 30 min, while in C participants rested for 30 min. Time till the first cigarette following each trial was recorded. Smoking urge was evaluated and blood samples, [analyzed for β-endorphin (β-E), adrenocorticotropic hormone (ACTH), cortisol and catecholamines], were obtained prior to and immediately after each trial. Results: β-E, ACTH, catecholamines and cortisol responses to exercise were intensity-dependent and differed in smokers and non-smokers. Resting β-E levels were 2–2.5 times lower in smokers compared to non-smokers. HI resulted in increased β-E levels in both groups, with smokers exhibiting similar levels to that observed in non-smokers. Although smoking urge did not change post-exercise in smokers, time till first cigarette increased following both MI (64.6%) and HI (77.9%) compared to C. Conclusions: HPA axis activation in response to exercise may differ between smokers and non-smokers. Smokers have lower resting levels of β-E compared to non-smokers and, since HI exercise increases β-E to similar levels to those of non-smokers and delays smoking, this may be used as an adjunct in smoking cessation. © 2020 Elsevier Inc.

Background: Co-occurring psychiatric disorders in adults with Attention Deficit Hyperactivity Disorder (ADHD) and/or Autism Spectrum Disorder (ASD) contribute to the burden of the healthcare and possibly to the delay of diagnosis. Aim of the study was to clinically assess the prevalence and compare lifetime co-occurring psychopathology in a sample of newly diagnosed ADHD and/or ASD adults and discuss the diagnostic challenges they pose. Methods: The lifetime prevalence rates of ten of the most frequently co-occurring psychiatric diagnoses was registered in 336 adults of normal intelligence who underwent a thorough clinical evaluation for the diagnosis of ADHD and/or ASD for the first time in their lives. Four study groups were formed: the ADHD (n = 151), the ASD (n = 58), the ADHD+ASD (n = 28) and the nonADHD/nonASD (NN) (n = 88) group. Results: At least one co-occurring psychopathology was found in 72.8% of the ADHD group, in 50% of the ASD group, in 72.4% of the ADHD+ASD group and in 76.1% of the NN group (p = 0.004). In all groups the most frequent psychiatric disorder was depressive disorder. The only significant difference regarding the patterns of psychiatric co-occurrence between the ADHD and the nonADHD groups (ASD and NN groups) was found for SUD (p = 0.001). Also, the proportion of subjects with Bipolar Disorder was significantly greater in the NN group as compared to those with ASD (p = 0.025). Conclusions: Our results support the high prevalence of co-occurring psychiatric disorders in adults with ADHD and/or ASD with the ASD group presenting the lowest rate. The most marked difference between the ADHD and the nonADHD groups was found for SUD. Moreover, our findings highlight the need for a thorough clinical assessment of all referred patients both in the presence and absence of ADHD and/or ASD. © 2020 The Author(s).

Social network analysis (SNA) is widely used to analyze social interactions in asynchronous discussions. A well established model that represents a clear picture of the knowledge-building processes occurring in online discussions is the Community of Inquiry. SNA has recently emerged as an analytical tool for exploring the development of a Community of Inquiry in online learning. However, the application of SNA has been limited and lacks appropriate pedagogical grounding. In this paper, we investigate a) the relationship between social networks and community learning as well as b) the impact of gamification, based on social network metrics, on community learning. According to the results, strong relationships have been revealed mainly between SNA metrics and the social presence, as well as the exploration phase of the cognitive presence of a Community of Inquiry. The evidence also highlights the potential of gamification for empowering the evolution of a Community of Inquiry. © Springer Nature Switzerland AG 2020.

This article proposes the use of gamification techniques to motivate students and cultivate the sense of a Community of Inquiry (CoI) through asynchronous discussions. Prior research is being examined to identify essential factors in relation to Communities of Inquiry. These factors provide key insights for the development of a CoI through the asynchronous discussions and thus, they guide the selection of learning analytic tools and gamification mechanisms within the course. In this article it is proposed that measuring and exploring the aforementioned factors by the instructors through learning analytics for rewarding good social practice through gamification, promotes cognitive presence. This process is relevant to educators interested in developing critical thinking skills and may serve to support them redesign the course or teaching interventions. © Springer Nature Switzerland AG 2020.

This paper presents a case study in which student-teachers practiced microteaching in the form of peer-teaching. They collaboratively developed a learning design, implemented it as a micro-lesson i.e. as a simulated teaching session and later they participated in a structured peer review activity. In particular, students initially used the Integrated Learning Design Environment to organize their task and its integrated WebCollage editor for authoring the learning design. Then these particular designs were implemented as a micro-lesson during which the authors of the design “taught” their peers who played the role of the students. After each micro-lesson, the Ld-Feedback application was used so that the student-teachers who practiced the microteaching got feedback from their peers regarding both the design and the implementation. This paper focuses on the first phase of the peer review activity explaining the use of the Ld-Feedback App and investigating the added value of involving student-teachers in creating feedback forms to evaluate their learning designs. © 2020, Springer Nature Switzerland AG.

This study proposes a rewarding system for blended learning courses delivered through the Moodle platform. The proposed rewarding system consists of two types of rewards, those that are automatically provided by Moodle and those that are provided manually by the tutor. The specific rewarding system follows the principles of the Gamified e-Learning Model, focusing on the way students should be rewarded in order to become engaged in the course and form a Community of Inquiry. An empirical study in which the proposed rewarding system was implemented in a blended learning course on educational technology, is described. The rewards provided by the teacher are based on analysis of the Moodle log files and data collected for each student using a learning analytics tool. The results of the study provide evidence about students’ appreciation of the various types of rewards rewarding individual and collaborative effort. © Springer Nature Switzerland AG 2019.

The development of chronic, low-grade systemic inflammation in the elderly (inflammaging) has been associated with increased incidence of chronic diseases, geriatric syndromes, and functional impairments. The aim of this study was to examine differences in habitual physical activity (PA), dietary intake patterns, and musculoskeletal performance among community-dwelling elderly men with low and elevated systemic inflammation. Nonsarcopenic older men free of chronic diseases were grouped as ‘low’ (LSI: n = 17; 68.2 ± 2.6 years; hs-CRP: 1 mg/L) systemic inflammation according to their serum levels of high-sensitivity CRP (hs-CRP). All participants were assessed for body composition via Dual Emission X-ray Absorptiometry (DEXA), physical performance using the Short Physical Performance Battery (SPPB) and handgrip strength, daily PA using accelerometry, and daily macro- and micronutrient intake. ESI was characterized by a 2-fold greater hs-CRP value than LSI (p < 0.01). The two groups were comparable in terms of body composition, but LSI displayed higher physical performance (p < 0.05), daily PA (step count/day and time at moderate-to-vigorous PA (MVPA) were greater by 30% and 42%, respectively, p < 0.05), and daily intake of the antioxidant vitamins A (6590.7 vs. 4701.8 IU/day, p < 0.05), C (120.0 vs. 77.3 mg/day, p < 0.05), and E (10.0 vs. 7.5 mg/day, p < 0.05) compared to ESI. Moreover, daily intake of vitamin A was inversely correlated with levels of hs-CRP (r = −0.39, p = 0.035). These results provide evidence that elderly men characterized by low levels of systemic inflammation are more physically active, spend more time in MVPA, and receive higher amounts of antioxidant vitamins compared to those with increased systemic inflammation. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.