Epigenetic underpinnings of the autistic mind: Histone modifications and prefrontal excitation/inhibition imbalance.

Autism spectrum disorder (ASD) is complex neurobehavioral condition influenced by several cellular and molecular mechanisms that are often concerned with synaptogenesis and synaptic activity. Based on the excitation/inhibition (E/I) imbalance theory, ASD could be the result of disruption in excitatory and inhibitory synaptic transmission across the brain. The prefrontal cortex (PFC) is the chief regulator of executive function and can be affected by altered neuronal excitation and inhibition in the course of ASD. The molecular mechanisms involved in E/I imbalance are subject to epigenetic regulation. In ASD, altered enrichment and spreading of histone H3 and H4 modifications such as the activation-linked H3K4me2/3, H3K9ac, and H3K27ac, and repression-linked H3K9me2, H3K27me3, and H4K20me2 in the PFC result in dysregulation of molecules mediating synaptic excitation (ARC, EGR1, mGluR2, mGluR3, GluN2A, and GluN2B) and synaptic inhibition (BSN, EphA7, SLC6A1). Histone modifications are a dynamic component of the epigenetic regulatory elements with a pronounced effect on patterns of gene expression with regards to any biological process. The excitation/inhibition imbalance associated with ASD is based on the excitatory and inhibitory synaptic activity in different regions of the brain, including the PFC, the ultimate outcome of which is highly influenced by transcriptional activity of relevant genes.

COVID-19 related stigma among the general population in Iran.

BACKGROUND: COVID-19 related stigma has been identified as a critical issue since the beginning of the pandemic. We developed a valid and reliable questionnaire to measure COVID-19 related enacted stigma, inflicted by the non-infected general population. We applied the questionnaire to measure COVID-19 related enacted stigma among Tehran citizens from 27 to 30 September 2020. METHODS: A preliminary questionnaire with 18 items was developed. The total score ranged from 18 to 54; a higher score indicated a higher level of COVID-19 related stigma. An expert panel assessed the face and content validity. Of 1637 randomly recruited Tehran citizens without a history of COVID-19 infection, 1064 participants consented and were interviewed by trained interviewers by phone. RESULTS: Item content validity index (I-CVI), Item content validity ratio (I-CVR), and Item face validity index (I-FVI) were higher than 0.78 for all 18 items. The content and face validity were established with a scale content validity index (S-CVI) of 0.90 and a scale face validity index (S-CVI) of 93.9%, respectively. Internal consistency of the questionnaire with 18 items was confirmed with Cronbach's alpha of 0.625. Exploratory factor analysis revealed five latent variables, including "blaming", "social discrimination", "dishonor label", "interpersonal contact", and "retribution and requital attitude". The median of the stigma score was 24 [25th percentile: 22, 75the percentile: 28]. A large majority (86.8%) of participants reported a low level of stigma with a score below 31. None of the participants showed a high level of stigma with a score above 43. We found that the higher the educational level the lower the participant's stigma score. CONCLUSION: We found a low level of stigmatizing thoughts and behavior among the non-infected general population in Tehran, which may be due to the social desirability effect, to the widespread nature of COVID-19, or to the adaptation to sociocultural diversity of the large city.

Translation and psychometric properties of the Persian version of the Health of the Nation Outcome Scales for Elderly People (HoNOS65+).

OBJECTIVES: This study aimed to evaluate the validity and reliability of the Persian version of Health of the Nation Outcome Scales for Elderly People (HoNOS65+) in Iran's elderly population. METHODS: The scale English version translated to Persian using a forward and backward translation method. The scale was filled for two elderly population groups (inpatient and outpatients) (N = 300). Simultaneously with HoNOS+65, the Clinical Global Impressions Scale (CGI) was completed. Two separate therapists were filled HoNOS+65 for thirty-one patients (inter-rater reliability test). In general, content validity, consistency, confirmatory factor analyses (CFA), convergent validity, and criterion validity were examined. RESULTS: Using exploratory factor analysis, three factors were extracted. Inter-rater reliability in some items has a slight agreement. Content validity ratio (0.75) and index (0.90) were calculated for each item. Cronbach's alpha total score was 0.82. According to the largest modification indices, CFA showed satisfactory fit indices. The convergent validity between HoNOS +65 and CGI was (r = 0/71, sig = 0.000). Finally, the optimal cut-off point was achieved 13. Sensitivity and specificity for the HoNOS +65 were 88.89% and 81.16%, respectively, with the Youden index of 0.7005. CONCLUSION: The Persian version of HoNOS65+ has high reliability, validity, specificity, and sensitivity in multidimensional assessment of Iranian geriatric mental health.

The association between sleep quality, health status and disability due to breathlessness in chronic obstructive pulmonary disease patients.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) increases susceptibility to sleep disturbances. This study aimed to evaluate the association between COPD severity criteria with sleep quality. METHODS: One hundred fifty-eight patients in Rasul Akram Hospital of Iran University of Medical Sciences, Tehran, Iran, from April 2019 to March 2021 diagnosed with COPD were examined using the Pittsburgh Sleep Quality Index (PSQI), COPD Assessment Test (CAT), modified Medical Research Council (mMRC) dyspnoea scale, spirometry and pulse oximetry. RESULTS: Of 158 subjects, 125 patients were male (79%), and 33 were female (21%). The mean subject's age and FEV1/FVC ratio were 62.6 ± 11.5 and 65.6 ± 14.9%, respectively. The mean CAT scoring and Spo2 saturation reported 16.2 ± 7 and 91.5 ± 10.8%, respectively. The mean PSQI score was 8.2 ± 3.8. The association between PSQI score with FEV1 and FEV1/FVC ratio was not statistically significant (p = 0.64 and 0.58, respectively), whereas the association between PSQI scores with CAT score (p Ë‚ 0.0001, r2  = 0.51) and dyspnoea severity (p Ë‚ 0.0001, r2  = 0.29) were statistically significant. The patients with higher CAT score demonstrated poor sleep quality, particularly in longer sleep latency (p = 0.001, r2  = 0.056), bad subjective sleep quality (p Ë‚ 0.0001, r2  = 0.286), lower sleep efficiency (p = 0.002, r2  = 0.077), higher sleep disturbance (p Ë‚ 0.0001, r2  = 0.225), daytime dysfunction (p Ë‚ 0.0001, r2  = 0.259) and sleep medication intake times a week (p = 0.01, r2  = 0.069). Dyspnoea severity was attributed to bad subjective sleep quality (p Ë‚ 0.0001, r2  = 0.069), higher sleep disturbances (p = 0.005, r2  = 0.08), and daytime dysfunction (p Ë‚ 0.0001, r2  = 0.108). CONCLUSION: The PSQI has a significant association with the CAT and mMRC for COPD patients and is linked to the disease's severity.

Development and Validation of the Knowledge and Attitude Scale Toward COVID-19 Pandemic Breaking Transmission Chain (KA-C) Among Iranian Population.

Objectives: We aimed to develop a scale and evaluate this scale's validity and reliability to measure factors affecting people's knowledge and attitudes toward the pandemic breaking transmission chain. Methods: This exploratory mixed-method study was carried out in two phases: (1) item generation using literature reviews and interviews and, (2) item reduction by psychometric assessments of the developed scale. The face, content, construct (exploratory and confirmatory factor analysis), convergent, and discriminant validity of the scale were assessed in the Iranian population (n = 500) from March to June 2020. The Composite Reliability (CR) and the internal consistency correlation coefficient were estimated. Results: The Knowledge and Attitude Scale Toward COVID-19 Pandemic Breaking Transmission Chain (KA-C) among the Iranian population included 18 items. Two factors with a whole variance of 66.05% were identified by exploratory factor analysis. Factors were labeled as "health literacy" and "home health empowerment." The confirmatory factor analysis showed the goodness of fit. The CR of the scale for first and second factors were 0.965 and 0.833 receptively. The scale's internal consistency correlation coefficient was acceptable (Cronbach's alpha = 0.960 and 0.823, average interitem correlation = 0.643 and 0.635, McDonald's omega = 0.963 and 0.829, for the first and second factor, receptively). Conclusion: The KA-C scale can be exerted to screen the people's knowledge and attitude about the COVID-19 pandemic breaking the transmission chain as a valid and reliable scale for further policymaking, health care providers, and for a multi-dimensional psychosocial assessment of the pandemic period.