Societal Attitudes Towards Autism (SATA): Validation of the Greek Version in the General Population.

This study examined the validity of the Greek version of the Societal Attitudes Towards Autism (SATA) scale in a Greek community sample (n = 633) and explored how the demographic variables of the sample modulate knowledge and attitudes regarding people with Autism Spectrum Disorder (ASD). The principal component analysis confirmed the three-dimension model and explained 40.5% of the variance. All Cronbach's alpha values obtained were over 0.70. SATA's subscales were significantly and positively correlated, indicating good internal reliability. Participants presented moderate knowledge about ASD and mediocre positive attitudes towards people with ASD. Gender, age, and educational level significantly affected SATA total scores. Overall, this Greek version of SATA showed acceptable psychometric properties, indicating that can be a reliable scale for use.

A Greek Pediatric Word Recognition Test by Picture Identification.

(1) Background: The study aimed to construct a clinically valuable closet-set WRS test with a picture identification task for young Greek-speaking children. (2) Methods: The test material was meticulously designed based on specific criteria. To determine which parts of speech are used more frequently by preschool children, a spontaneous speech sample (250 words per child) was acquired from three hundred children aged 3 to 6 years (M = 4.56, SD = 0.90). The study involved the development and application of two phonemically balanced 50-word lists suitable for young children, as well as the creation of picture representations for each response set. All testing was accomplished in an audiometric booth that exceeded the audiometric rooms' ambient noise level standards. The speech signal was routed from a laptop computer to a GSI 61 audiometer, and all test items were delivered from the audiometer to the subject. (3) Results: The results indicated that materials for a WRS test for young children are developed with high face validity and are applicable for children as young as three years old. The test satisfies the essential components needed for a WRS test. It consists of two phonemically balanced 50-word lists with low-redundancy bisyllabic words, with each list containing 227 phonemes. (5) Conclusions: This novel closed-set WRS test presents a valuable tool for assessing speech perception skills in young Greek-speaking children. The test results have various applications, including diagnosis, research, and (re)habilitation.

Psychometric Properties of the Greek Version of the Autism Parenting Stress Index (APSI) among Parents of Children with Autism Spectrum Disorder.

(1) Background: This study aimed to validate the Greek version of the Autism Parenting Stress Index (APSI) among parents of children with ASD. (2) Methods: The translated version was administered to 113 parents (Male: 12, Female: 101, 39.24 years old, SD 6.70, age range, 25-58) of children diagnosed with ASD and 127 parents (Male: 24, Female: 103, 41.08 years old, SD 6.22, age range: 27-56) of typically developing children. (3) Results: Significant differences between the APSI total scores and three domains between groups were observed. Although the initial factor structure could not be replicated, the APSI's internal consistency was excellent (a = 0.914), with a high positive item-total correlation (0.900-0.917). The APSI's test-retest reliability was excellent, showing an ICC equal to 0.922 [95%, CI: 0.900-0.940]. The APSI's total score cut-off point was equal to 12.00 (AUC 0.845, p < 0.001) with a sensitivity of 0.839 and 1-specificity of 0.220. A principal component analysis of the 13 items, using varimax rotations, identified three factors, which explained approximately 45.8% of the overall variance. (4) Conclusions: The Greek version of the APSI exhibited discriminant validity for measuring parents of children with ASD. Greek health professionals can use it to assess the stress experienced by parents of children with ASD.

Effects of Transcutaneous Electrical Nervous Stimulation (TENS) on Dysphonic Patients: A Systematic Review Study.

Background and Objectives: Transcutaneous electrical nerve stimulation (TENS), a pain-alleviating and muscle-relaxing treatment used in physio-therapeutic clinical practice, has recently appeared to be just as effective in dysphonia. This review aimed at clarifying whether TENS can be an effective practice in dysphonia therapy and/or management on its own or combined with other types of interventions and, hence, whether its practice can be a useful, more widespread establishment to speech and language therapy intervention methods. Materials and Methods: A search was conducted on the PubMed database using specific terms based on the PICO search strategy. Eventually, four randomized controlled studies and four clinical trials were included. The methodological quality of the included studies was evaluated using the physiotherapy evidence-based database (PEDro) assessment tool, and this indicated high-quality research with an average score of 8.43. Results: The studies utilized various TENS devices, predominantly the Dualpex 961 device (frequency of 10 Hz, phase of 200 ms). The assessment methods varied, including auditory perception, vocal therapy, electrostimulation, audio and video perceptual assessments, and laryngeal evaluations. The clinical outcomes of TENS showed a reduction in musculoskeletal pain in various areas, while the acoustic analysis results were significant in only one study. TENS was compared to manual laryngeal therapy (LMT), placebo TENS, and vocal therapy in different studies with mixed results. Conclusions: This review supports the idea that a multidimensional approach, incorporating various therapeutic modalities (TENS, LMT, speech therapy, and vocal training) can yield positive outcomes for patients with voice disorders. Further research is needed to explore the specific mechanisms of action and optimal treatment protocols for TENS in voice therapy.

Lawton's Instrumental Activities of Daily Living for Greek-Speaking Adults with Cognitive Impairment: A Psychometric Evaluation Study with Additional Receiver Operating Characteristic Curve Analysis.

One of the components of a dementia diagnosis is the assessment of functional abilities. These abilities are measured via screeners, such as the Instrumental Activities of Daily Living (IADL) scale. The IADL scale is a valid tool that has been adapted in many languages. This study aimed to provide a cut-off point and validate the Greek version of the IADL scale in populations with cognitive impairment. IADL data were collected from 132 individuals: 24 PD patients, 24 Parkinson's disease dementia (PDD) patients, and 24 AD patients. The remaining 60 participants were cognitive healthy adults (CHAs). The CHA group and the PD group served as the cognitively unimpaired group (CUG), while the PDD and AD groups served as the cognitively impaired group (CIG). Additionally, the MMSE, the AMTS, the Clock Drawing Test CDT, the Arizona Battery for Communication Disorders of Dementia (ABCD), the NPI, and the GDS-15 were administered to the participants. Statistically significant differences in the IADL scores were exhibited between all subgroups. The IADL scale showed high internal consistency (Cronbach's alpha = 0.890). A threshold equal to 6.00 (AUC = 0.888, p < 0.001) was estimated between the CUG and the CIG. Significant positive correlations were observed between IADL and MMSE (r = 0.764, p < 0.001), IADL and AMTS (r = 0.724, p < 0.001), IADL and ABCD (r = 0.702, p < 0.001), and IADL and CDT (r = 0.627, p < 0.001) results. Given the obtained results, the IADL scale is a valid tool for clinical use with high reliability and sensitivity. Also, the IADL scale is a valuable instrument for screening functional abilities associated with cognitive impairment.

Speech deficits in multiple sclerosis: a narrative review of the existing literature.

Multiple sclerosis (MS) is a chronic inflammatory and demyelinating autoimmune disease. MS patients deal with motor and sensory impairments, visual disabilities, cognitive disorders, and speech and language deficits. The study aimed to record, enhance, update, and delve into our present comprehension of speech deficits observed in patients with MS and the methodology (assessment tools) studies followed. The method used was a search of the literature through the databases for May 2015 until June 2022. The reviewed studies offer insight into speech impairments most exhibited by MS patients. Patients with MS face numerous communication changes concerning the phonation system (changes observed concerning speech rate, long pause duration) and lower volume. Moreover, the articulation system was affected by the lack of muscle synchronization and inaccurate pronunciations, mainly of vowels. Finally, there are changes regarding prosody (MS patients exhibited monotonous speech). Findings indicated that MS patients experience communication changes across various domains. Based on the reviewed studies, we concluded that the speech system of MS patients is impaired to some extent, and the patients face many changes that impact their conversational ability and the production of slower and inaccurate speech. These changes can affect MS patients' quality of life.

Measuring parental stress, illness perceptions, coping and quality of life in families of children newly diagnosed with autism spectrum disorder.

BACKGROUND: A variety of psychosocial factors have been shown to affect the quality of life of families (FQoL). AIM: This study aimed to assess the impact of mother's demographic characteristics, parental stress, illness perceptions about autism spectrum disorder (ASD), coping strategies, ASD severity and time since diagnosis on FQoL during the initial period following diagnosis (≤6 months). METHOD: Fifty-three mothers of children newly diagnosed with ASD completed the Beach Center Family Quality of Life Scale, the Autism Parenting Stress Index, the Brief Illness Perception Questionnaire and the Brief Coping Orientation to Problems Experienced Inventory. A descriptive analysis was conducted on the demographic characteristics of the family. Eta coefficients and Pearson's analysis were used to determine the associations between the variables and the FQoL dimensions. Hierarchical regression was used to determine whether variables explained a statistically significant family quality of life variance. RESULTS: Pearson's analysis and eta coefficients indicated several correlations. Hierarchical regression analysis showed that higher parental stress related to core autism symptoms was associated with poorer FQoL (95% CI -0.08 to -0.02, P = 0.001), and higher perceived treatment control was associated with better FQoL (95% CI 0.04-0.16, P = 0.001). In addition, stronger perceived personal control was associated with higher physical/material well-being (95% CI 0.01-0.16, P = 0.022) and higher disability-related support (95% CI 0.30-0.61, P = 0.001). Higher family monthly income was associated with better FQoL (95% CI 0.08-0.027, P = 0.000), whereas marital status (divorced mother) was correlated with poorer FQoL (95% CI -0.68 to -0.16, P = 0.002). CONCLUSIONS: Interventions should emphasise managing the disorder's characteristics and implementing psychoeducational and supportive programmes for parents, immediately after the diagnosis, to enhance FQoL.

Validation of the Greek version of the Affiliate Stigma Scale among mothers of children with autism spectrum disorder.

BACKGROUND: Caregivers of children with autism spectrum disorder (ASD) are sensitive to the internalisation of the stigma, known as affiliate stigma, resulting in reduced self-esteem, isolation and poor psychological well-being. AIMS: This study aims to validate the Greek version of the Affiliate Stigma Scale (ASS) among mothers of children with ASD. METHOD: The translated version of ASS in Greek was administered to 53 mothers of children newly diagnosed with ASD in two time periods: 1-6 months from diagnosis (time point 1) and 12 months from the initial assessment (time point 2). The control group consisted of 62 mothers of typically developing children. RESULTS: The ASS total mean score revealed a moderate level of stigma to the ASD group in both assessments. The reliability measures by item showed a satisfactory composite reliability (affective 0.828, cognitive 0.833, behaviour 0.857). Cronbach's alpha revealed that the estimated internal consistency was excellent (α = 0.888), and it found a high positive item-total correlation. Receiver operating characteristic analysis results indicated a statistically significant positive discrimination (area under the curve 0.849, P = 0.000) between the groups. The cut-off point was 31.00, with a sensitivity of 0.849 and a 1 - sensitivity of 0.258. CONCLUSIONS: The proposed version of the ASS has good psychometric properties and is valid and reliable for measuring affiliate stigma among caregivers of children with ASD in Greece. Health professionals can use it to assess and understand the stigma experienced by caregivers of children with ASD, and design appropriate interventions to reduce their affiliate stigma.

A roadmap for the characterization of energy metabolism in human cardiomyocytes derived from induced pluripotent stem cells.

Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM) are an increasingly employed model in cardiac research and drug discovery. As cellular metabolism plays an integral role in determining phenotype, the characterization of the metabolic profile of hiPSC-CM during maturation is crucial for their translational application. In this study we employ a combination of methods including extracellular flux, 13C-glucose enrichment and targeted metabolomics to characterize the metabolic profile of hiPSC-CM during their maturation in culture from 6 weeks, up to 12 weeks. Results show a progressive remodeling of pathways involved in energy metabolism and substrate utilization along with an increase in sarcomere regularity. The oxidative capacity of hiPSC-CM and particularly their ability to utilize fatty acids increased with time. In parallel, relative glucose oxidation was reduced while glutamine oxidation was maintained at similar levels. There was also evidence of increased coupling of glycolysis to mitochondrial respiration, and away from glycolytic branch pathways at later stages of maturation. The rate of glycolysis as assessed by lactate production was maintained at both stages but with significant alterations in proximal glycolytic enzymes such as hexokinase and phosphofructokinase. We observed a progressive maturation of mitochondrial oxidative capacity at comparable levels of mitochondrial content between these time-points with enhancement of mitochondrial network structure. These results show that the metabolic profile of hiPSC-CM is progressively restructured, recapitulating aspects of early post-natal heart development. This would be particularly important to consider when employing these cell model in studies where metabolism plays an important role.

Culturing Human Pluripotent Stem Cells on Micropatterned Silicon Surfaces.

Human pluripotent stem cell culture conditions are constantly being optimized, thus providing insight to the environmental cues that affect cell choices. A wide variety of media, coating materials, and substrates is now available for use, serving different scientific needs. Factors such as material stiffness, roughness, and topography are being recognized to contribute or even direct the acquisition of specific phenotypes. Here, we describe the use of patterned silicon substrates coated with Matrigel for the propagation and differentiation of human pluripotent stem cells.

Embryonic stem cells are devoid of macropinocytosis, a trafficking pathway for activin A in differentiated cells.

Ligand-receptor complexes formed at the plasma membrane are internalised via various endocytic pathways that influence the ultimate signalling output by regulating the selection of interaction partners by the complex along the trafficking route. We report that, in differentiated cells, activin A-receptor complexes are internalised via clathrin-mediated endocytosis (CME) and macropinocytosis (MP), whereas in human embryonic stem cells (hESCs) internalisation occurs via CME. We further show that hESCs are devoid of MP, which becomes functional upon differentiation towards endothelial cells through mesoderm mediators. Our results reveal, for the first time, that MP is an internalisation route for activin A in differentiated cells, and that MP is not active in hESCs and is induced as cells differentiate.

Supporting data on combined transcriptomic and phosphoproteomic analysis of BMP4 signaling in human embryonic stem cells.

Human embryonic stem cells exhibit great potential as a therapeutic tool in regenerative medicine due to their self-renewal and trilineage differentiation capacity. Maintaining this unique cellular state has been shown to rely primarily on the Activin A / TGFß signaling pathway. While most conventional culture media are supplemented with TGFß, in the current study we utilize a modified version of the commercially available mTeSR1, substituting TGFß for Activin A in order to preserve pluripotency. (1) Cells cultured in ActA-mTesR express pluripotency factors NANOG, OCT4 and SOX2 at comparable levels with cells cultured in TGFß-mTeSR. (2) ActA-mTeSR cultured cells retain a physiological karyotype. (3) Cells in ActA-mTeSR maintain their trilineage differentiation capacity as shown in the teratoma formation assay. This system can be used to dissect the role of Activin A, downstream effectors and signaling cascades in human embryonic stem cell responses.

Combined transcriptomic and phosphoproteomic analysis of BMP4 signaling in human embryonic stem cells.

Human embryonic stem cells (hESCs) are an invaluable tool in the fields of embryology and regenerative medicine. Activin A and BMP4 are well-characterised growth factors implicated in pluripotency and differentiation. In the current study, hESCs are cultured in a modified version of mTeSR1, where low concentrations of ActivinA substitute for TGFß. This culture system is further used to investigate the changes induced by BMP4 on hESCs by employing a combination of transcriptomic and phosphoproteomic approaches. Results indicate that in a pluripotent state, hESCs maintain WNT signaling under negative regulation by expressing pathway inhibitors. Initial stages of differentiation are characterized by upregulation of WNT pathway ligands, TGFß pathway inhibitors which have been shown in Xenopus to expand the BMP signaling range essential for embryonic patterning, and mesendodermal transcripts. Moreover, BMP4 enhances the phosphorylation of proteins associated with migration and transcriptional regulation. Results further indicate the vital regulatory role of Activin A and BMP4 in crucial fate decisions in hESCs.

Increased Body Mass Index and Hypertension: An Unbreakable Bond.

BACKGROUND: Adherence with lifestyle recommendations is low among hypertensive patients. The main objective of this study was to assess the prevalence of diagnosed hypertension among the Greek urban population and to examine how lifestyle and sociodemographic characteristics differ between already known hypertensive and the rest of the population. METHODS: In this cross-sectional survey, data were collected from 1,060 participants (mean age 47.1 ± 16.9 (mean ± 1standard deviation), 52.7% females). Sociodemographic characteristics, health risk factors, and medical history were involved. Body mass index (BMI) (kg/m2) was calculated, according to reported height and weight. Parametric tests and multiple logistic regression analysis were applied to identify whether socio-demographic characteristics and health risk factors differed between known hypertensive and the rest of the population. RESULTS: Already known hypertensives were 179 (101 females-78 males). The prevalence of known hypertension was 16.9% (18.1% in females and 15.6% in males). In multivariate analysis, known hypertensives were more likely to have advanced age (P < 0,001, OR = 1.101, 95%CI 1.081-1.121) and increased BMI (P < 0,001, OR = 1.138, 95%CI 1.085-1.194). Moreover, they had a higher probability of suffering from other cardiovascular diseases or sharing other risk factors for cardiovascular diseases. CONCLUSIONS: Among Greek urban population, almost one to six adults knows to suffer from hypertension. In spite the recommendations, patients who were aware of their illness have increased BMI compared with the rest of the population.

Assessment of Health-Related Quality of Life for Caregivers of Alzheimer's Disease Patients.

Background. Alzheimer's disease (AD) dementia is a chronic neurodegenerative disorder that results in total cognitive impairment and functional decline. Family members are the most usual caregivers worldwide, resulting in a subsequent degradation of their quality of life. Methods. During November 2013-March 2014 in Athens, Greece, 155 AD patients' family caregivers' Health-Related Quality of Life and existence of depressive symptomatology were assessed. Results. A strong negative correlation between the dimensions of HRQoL and the scores of the depression scale was revealed. AD patients' caregivers have a lower HRQoL almost in all dimensions compared to the Greek urban general population. The caregivers' social role, the existence of emotional problems, and their mental health status led to this result. Furthermore significantly important differences in caregivers' total HRQoL and depressive symptomatology were indicated in relation to their gender, hypertension existence, patient care frequency, cohabitation with the patient, disease aggravation, and economic status. Conclusions. Caring for relatives with AD strongly correlates with negative caregivers' HRQoL scores and adversely affects their depressive symptomatology. This negative correlation is enhanced in the later stages of the disease, in greater frequency of care, through living with a patient, in poor financial status, and with the existence of a chronic illness.

Psychometrics of the Greek Chronic Liver Disease Questionnaire for Measuring HRQL.

The aim of the present study is to examine psychometric properties such as internal consistency reliability and construct validity of the Greek CLDQ. A sample of 366 eligible patients with chronic liver disease (CLD) self-administered the Greek version of the SF-36 Health Survey, the Chronic Liver Disease Questionnaire (CLDQ), and questions on sociodemographic status and treatment. Child Pugh Score was also collected. Hypothesized scale structure, reliability (Cronbach's alpha), and construct validity (convergent, discriminant, and known groups) were assessed. Multitrait scaling confirmed scale structure of the CLDQ with good item convergence (100%) and discrimination (84.1%) rates. Cronbach's alpha rated >0.70 for all scales. Spearman's correlations between the CLDQ and SF-36 scales assessing similar health-related quality of life dimensions were strong ranging above 0.70 (P < 0.0001). Construct validity was confirmed with satisfactory results for known-group comparisons. Most CLDQ scales discriminated significantly between patients according to disease severity, whereas all CLDQ scales discriminated between treatment receivers and nonreceivers. The overall psychometric results for the Greek version of the CLDQ confirmed it as a reliable and valid questionnaire.

Health-Related Quality of Life of the Roma in Greece: The Role of Socio-Economic Characteristics and Housing Conditions.

The aim was to assess the health-related quality of life (HRQL) of the Roma and further to detect the significant determinants that are associated with their HRQL. The cross-sectional study involved 1068 Roma adults living in settlements (mean age 36). HRQL was measured by the Greek version of SF-36 Health Survey and further socio-demographic characteristics (sex, age, marital status, education, permanent occupation etc.) and housing conditions (stable housing, access to basic amenities such as drinkable water, drainage, electricity which compose material deprivation) were involved. Non parametric tests and multiple linear regression models were applied to identify the factors that have significant association with HRQL. After controlling for socio-demographic characteristics, health status and housing conditions, sex, age, education, chronic diseases, stable housing and material deprivation were found to be significant determinants of the Roma's HRQL. Men reported significantly better health than women as well as those who attended school compared to the illiterate. Chronic diseases were remarkably associated with poor HRQL from 10 units in MH (Mental Health) to 34 units in RP (Role Physical). Material deprivation was related to lower GH (General Health), and VT (Vitality) scores and higher RP (Role Physical) and RE (Role Emotional) scores. Chronic conditions and illiteracy are two key areas that contribute significantly to worse HRQL. Policies should be part of a comprehensive and holistic strategy for the Roma through intervention to education, housing and public health.

Concurrent pleural infiltration by chronic lymphocytic leukemia and adenocarcinoma of unknown primary site diagnosed by effusion cytology.

Synchronous malignancies in a pleural effusion are rare. A case of concurrent pleural infiltration by adenocarcinoma of unknown primary site and chronic lymphocytic leukemia (CLL) is presented in this case study, which was diagnosed by effusion cytology. Pleural effusion is not an uncommon complication in patients with B-CLL. Even in a pleural effusion rich in monoclonal lymphocytes, the presence of a second cancer must be excluded because this can be the main cause of mortality. The role of cytology in such cases is of paramount importance.

Depression, quality of life and primary care: a cross-sectional study.

OBJECTIVE: To estimate the presence of depression and impairment of quality of life in primary care and identify correlations with demographics and chronic diseases. MATERIALS AND METHODS: 500 people (220 men) that visited the Gytheio Health Center, Greece, participated in the study answering a study questionnaire that included demographic and somatometric data, medical history, the Zung self-rating depression scale (SDS-Zung) and the Short Form 12 (SF-12) scale for quality of life evaluation with a mental component scale (MCS) and a physical component scale (PCS). RESULTS: 163 persons (32.6% of the study population) had SDS-Zung scores over 50 indicating depressive symptomatology. Of those 22% of the study population (70% women) had no awareness of their problem and were under no treatment; 80 (16% of the study population) had mild depressive symptoms (SDS-Zung: 53.12±0.6 [95% CI]) and physical impairment: MCS12: 44.32±1.9 (95% CI), PCS: 39.16±2.2 (95% CI) (p<0.005) and 23 (4.6% of study population) had moderate symptoms (SDS-Zung: 63.82±1.34 [95% CI]), with mental and physical impairment: MCS12: 36.99±1.88 (95% CI), PCS: 34.83±5.12 (95% CI) (p<0.005) adjusted for age, sex and co-morbidities. Arthritis and COPD were associated with depressive symptomatology and physical impairment (p<0.05) and coronary heart disease and congestive heart failure with physical impairment (p<0.005). Patients under anti-depressive medication had significant depressive symptomatology and decreased quality of life (p<0.0005). CONCLUSION: The prevalence of both depressive symptomatology and impairment of quality of life is significant and primary care with simple, validated tools can be the setting for identifying and helping such patients.