Massively collaborative crowdsourced research on COVID19 and the chemical senses: Insights and outcomes

In March 2020, the Global Consortium of Chemosensory Research (GCCR) was founded by chemosensory researchers to address emerging reports of unusual smell and taste dysfunction arising from the SARS-CoV-2 pandemic. Over the next year, the GCCR used a highly collaborative model, along with contemporary Open Science practices, to produce multiple high impact publications on chemosensation and COVID19. This invited manuscript describes the founding of the GCCR, the tools and approaches it used, and a summary of findings to date. These findings are contextualized within a summary of some of the broader insights about chemosensation (smell, taste, and chemesthesis) and COVID19 gained over the last 18 months, including potential mechanisms of loss. Also, it includes a detailed discussion of some current Open Science approaches and practices used by the GCCR to increase transparency, rigor, and reproducibility.

The Adaptive Olfactory Measure of Threshold (ArOMa-T): A rapid test of olfactory function.

Many widely used psychophysical olfactory tests have limitations that can create barriers to adoption. For example, tests that measure the ability to identify odors may confound sensory performance with memory recall, verbal ability, and prior experience with the odor. Conversely, classic threshold-based tests avoid these issues, but are labor intensive. Additionally, many commercially available tests are slow and may require a trained administrator, making them impractical for use in situations where time is at a premium or self-administration is required. We tested the performance of the Adaptive Olfactory Measure of Threshold (ArOMa-T) - a novel odor detection threshold test that employs an adaptive Bayesian algorithm paired with a disposable odorant delivery card - in a non-clinical sample of individuals (n=534) at the 2021 Twins Day Festival in Twinsburg, OH. Participants successfully completed the test in under 3 min with a false alarm rate of 7.5% and a test-retest reliability of 0.61. Odor detection thresholds differed by sex (~3.2-fold lower for females) and age (~8.7-fold lower for the youngest versus the oldest age group), consistent with prior studies. In an exploratory analysis, we failed to observe evidence of detection threshold differences between participants who reported a history of COVID-19 and matched controls who did not. We also found evidence for broad-sense heritability of odor detection thresholds. Together, this study suggests the ArOMa-T can determine odor detection thresholds. Additional validation studies are needed to confirm the value of ArOMa-T in clinical or field settings where rapid and portable assessment of olfactory function is needed.

Clinical outcomes of low-pressure pneumoperitoneum in minimally invasive urological surgery.

The adoption of minimally invasive laparoscopic techniques has revolutionised urological practice. This necessitates a pneumoperitoneum (PNP) and the impact the PNP pressure has on post-operative outcomes is uncertain. During the current COVID-19 era guidance has suggested the utilisation of lower PNP pressures to mitigate the risk of intra-operative viral transmission. Review the current literature regarding the impact of pneumoperitoneum pressure, within the field of urology, on post-operative outcomes. A search of the PubMed, Medline and EMBASE databases was undertaken to identify studies that met the inclusion criteria. The Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines were adhered to. Ten studies, that included both randomised controlled trials and retrospective case series reviews, were identified that met the inclusion criteria. The effect of PNP pressure on outcomes following prostatectomy, live donor nephrectomy, partial nephrectomy and a variety of benign upper tract procedures were discussed. Low pressure PNP appears safe when compared to high pressure PNP, potentially reducing post-operative pain and rates of ileus. When compared to general surgery, there is a lack of quality evidence investigating the impact of PNP pressures on outcomes within urology. Low pressure PNP appears non-inferior to high pressure PNP. More research is required to validate this finding, particularly post-cystectomy and nephrectomy.

Self-Reported Olfactory Dysfunction and Diet Quality: Findings from the 2011-2014 National Health and Nutrition Examination Survey (NHANES).

We identified associations between self-reported olfactory dysfunction (OD) and dietary attributes in participants aged ≥40 years (n = 6,356) from the nationally representative 2011-2014 National Health and Nutrition Examination Survey (NHANES). The chemosensory questionnaire and 24-h dietary recalls were administered by trained interviewers. OD was defined as self-report of either smell problems in the last year, worse smell relative to age 25, or perceiving phantom odors. Dietary outcomes included Healthy Eating Index 2015 score (HEI) with adequacy and moderation components (higher scores indicated higher diet quality), dietary diversity, energy density, and intake of major food groups. Survey-weighted linear regression models estimated OD-diet associations, adjusting for socio-demographic, lifestyle, and clinical factors. Adjusted mean difference (95% CI) between those with versus without OD, showed that adults with OD had significantly lower HEI moderation score (-0.67 (-1.22, -0.11)) and diets higher in energy density (0.06 (0.00, 0.11)), and percent energy from saturated fat (0.47 (0.12, 0.81)), total fat (0.96 (0.22, 1.70)), and added sugar (1.00 (0.33, 1.66)). Age and sex-stratified analyses showed that younger females (40-64 years) primarily accounted for the associations with diet quality and total/saturated fat intake. These findings inform dietary screening and recommendations for adults who report OD, including those experiencing transient or persistent smell loss with COVID-19.

Massively collaborative crowdsourced research on COVID19 and the chemical senses: Insights and outcomes.

In March 2020, the Global Consortium of Chemosensory Research (GCCR) was founded by chemosensory researchers to address emerging reports of unusual smell and taste dysfunction arising from the SARS-CoV-2 pandemic. Over the next year, the GCCR used a highly collaborative model, along with contemporary Open Science practices, to produce multiple high impact publications on chemosensation and COVID19. This invited manuscript describes the founding of the GCCR, the tools and approaches it used, and a summary of findings to date. These findings are contextualized within a summary of some of the broader insights about chemosensation (smell, taste, and chemesthesis) and COVID19 gained over the last 18 months, including potential mechanisms of loss. Also, it includes a detailed discussion of some current Open Science approaches and practices used by the GCCR to increase transparency, rigor, and reproducibility.

Differences in preferred fat level, sweetener type, and amount of added sugar in chocolate milk in a choice task relate to physical activity and orthorexia.

Fluid dairy milk consumption has decreased over the last 4 decades, and this drop has accelerated with the introduction of many competing beverage alternatives, such as plant-based milks and bottled water. Conversely, flavored milk sales remain strong, but many adults avoid flavored milk because of concerns about added sugar and calories and/or excessive sweetness. Here we used two discrete choice experiments to assess interest for a dark chocolate milk drink in adults, and explored whether there might be a consumer segment who prefers a more bitter, lower sugar chocolate milk. Adults were recruited from the Mid-Atlantic region of the United States for two conjoint analysis studies. In a general population cohort (n = 735), type of sweetener was the most important attribute (24%), followed by milk fat (19%), grams of added sugar (16%), front of pack messaging (15%), package type (12%), carton size (8%), and protein content (6%). Attribute importance was relatively consistent in a second study with a younger, more physically active cohort (n = 1017). Product choices in the active cohort were related to orthorexia and physically activity scores, indicating revealed preferences in a choice task are reflective of personal lifestyle and eating behavior. In both cohorts, three consistent consumer segments were identified and characterized: the calorie conscious, the average consumer, and the natural eaters. These data can help uncover lifestyle differences between adult consumers that impact their food product choices.

Building a Successful, Socially-Distanced Family Medicine Clerkship in the COVID Crisis.

INTRODUCTION: In the wake of the COVID-19 pandemic, many family medicine clerkships across the United States are scrambling to provide meaningful medical education in a new clinical environment. Most medical schools have paused or severely limited the direct patient care that has been the core educational requirement of the clinical clerkships. The aim of this study was to develop and evaluate a curricular model that meets the family medicine clerkship learning objectives via telemedicine clinical instruction. METHODS: We created a clerkship where all clinical encounters took place by phone or video visits. Students were required to have telemedicine encounters with at least 20 patients over a 4-week clerkship. We also created a telemedicine illness script-writing assignment to prepare students and faculty for these encounters. We evaluated our curriculum by surveying participating students and faculty members. RESULTS: Student surveys revealed that all learning objectives were met during the telemedicine clerkship experience. Students felt they made a difference during the COVID-19 pandemic. Faculty felt that the medical students were helpful and that they were able to provide meaningful clinical instruction. CONCLUSION: Our study reveals that a family medicine clerkship can be successfully delivered using telemedicine and remote learning techniques. Senior medical students are a valuable resource and can have a meaningful clinical impact while learning more about family medicine. If social distancing precautions continue, this model can be used by other clerkships to continue medical education and provide medical care.

Smell and taste changes are early indicators of the COVID-19 pandemic and political decision effectiveness.

In response to the COVID-19 pandemic, many governments have taken drastic measures to avoid an overflow of intensive care units. Accurate metrics of disease spread are critical for the reopening strategies. Here, we show that self-reports of smell/taste changes are more closely associated with hospital overload and are earlier markers of the spread of infection of SARS-CoV-2 than current governmental indicators. We also report a decrease in self-reports of new onset smell/taste changes as early as 5 days after lockdown enforcement. Cross-country comparisons demonstrate that countries that adopted the most stringent lockdown measures had faster declines in new reports of smell/taste changes following lockdown than a country that adopted less stringent lockdown measures. We propose that an increase in the incidence of sudden smell and taste change in the general population may be used as an indicator of COVID-19 spread in the population.