[Development and validation of Russian olfactory test]. / Otechestvennyi obonyatel'nyi test: razrabotka i validizatsiya.

Olfactory disorders is one of the first symptoms of diseases from various departments of medicine (otorhinolaryngology, psychology, neurology, etc.). Based on international clinical recommendations, olfactory tests are the gold standard for the diagnosis of olfactory disorders. There are many different psychophysical tests: UPSIT (USA, Pennsylvania), Sniffin' Sticks test (Germany), BAST-24 (Spain), etc. Currently, there is an acute shortage of olfactory tests available for clinical practice In Russia. This problem is related to the fact that there are no olfactory tests registered as medical devices on the territory of the Russian Federation. Also, a significant limitation is the unrecognizability of odors by the population of our country, which include foreign analogues (licorice, anise, turpentine, etc.). OBJECTIVE: To develop and validate the national olfactory test on healthy volunteers. MATERIAL AND METHODS: The development and validation of the olfactory test included several stages. First, the development of an olfactory test was carried out, the selection of aromas to assess the threshold and identification ability of olfaction. 25 dilutions of n-butanol were used for the assessment of the threshold olfactory ability. For the stage of assessing the identification ability of the sense of smell, in our previous study, an assessment of the recognition of odor names in the territory of the Russian Federation was carried out. A total of 3.000 people from 8 federal districts of the Russian Federation were interviewed. During the development of the test, 20 names of flavors with the highest rating were used. By the 8th, the selection of monocomponent substances was carried out. Commercially available certified food and perfume flavorings have been used for fragrances whose equivalent in the test cannot be a monocomponent substance. A group of 25 healthy volunteers selected a flavor or a monocomponent for each of the 20 positions. To carry out the identification stage of testing, a booklet was developed with answer options for each fragrance, including 80 images associated with the smell. A methodology for conducting diagnostics has been created. Next, the validation of the developed olfactory test was carried out on 150 healthy volunteers. The study included an assessment of the threshold and identification ability of the sense of smell using the developed test and conducting a comparative analysis with a set of flavors and descriptors corresponding to the Sniffin' Sticks test. RESULTS: The developed test includes: 2 panels - panel 1 to assess the threshold ability of smell, panel 2 to assess the identification ability of smell, a booklet with 80 images and captions to them. The norms of threshold and identification olfactory abilities were also determined in the developed test. The domestic test was validated against the relative foreign Sniffin' Sticks test. Spearman's correlation between the accuracy values of the domestic test (17-20; 85.00-100.00%) and the values of the foreign test (11-16; 68.75-100.00%) did not reveal statistically significant differences (rs=0.065, p=0.432), which confirms the equally effective assessment of olfactory ability by the domestic olfactory test in comparison with its foreign counterpart. CONCLUSION: In this work, a methodology for the use of Russian olfactory test was developed and validated on healthy volunteers. The features of the developed test are an assessment of the threshold and identification ability of smell, an adapted set of odors for the Russian population, the use of paper blotters when applying flavor and visual images of descriptors. Despite the wide variety of psychophysical tests, this problem requires further study and comparative analysis of olfactory tests available In Russia and foreign analogues in order to obtain a universal and effective diagnostic method for the populations of our country.This work was supported by the Russian Foundation for Basic Research (Project No. 24-25-00415).

Additional measures of macular function beyond visual acuity.

PURPOSE: Visual function is a complex process in which external visual stimuli are interpreted. Patients with retinal diseases and prolonged follow-up times may experience changes in their visual function that are not detected by the standard visual acuity measure, as they are a result of other alterations in visual function. With the advancement of different methods to evaluate visual function, additional measurements have become available, and further standardization suggests that some methods may be promising for use in clinical trials or routine clinical practice. The objectives of this article are to review these additional measurements and to provide guidance on their application. METHODS: The Vision Academy's membership of international retinal disease experts reviewed the literature and developed consensus recommendations for the application of additional measures of visual function in routine clinical practice or clinical trials. RESULTS: Measures such as low-luminance visual acuity, contrast sensitivity, retinal fixation and microperimetry, and reading performance are measures which can complement visual acuity measurements to provide an assessment of overall visual function, including impact on patients' quality of life. Measures such as dark adaptation, color vision testing, binocular vision testing, visual recognition testing, and shape discrimination require further optimization and validation before they can be implemented in everyday clinical practice. CONCLUSION: Additional measurements of visual function may help identify patients who could benefit from earlier diagnosis, detection of disease progression, and therapeutic intervention. New and additional functional clinical trial endpoints are required to fully understand the early stages of macular disease, its progression, and the response to treatment.

Taste Dysfunction in Children-A Clinical Perspective and Review of Assessment Methods.

Taste dysfunction has been associated with aging and is therefore thought to be less common in children. However, children can face medical conditions influencing their taste function. Measuring and understanding taste dysfunction in children may foster the development of treatments/interventions mitigating the detrimental effects of taste dysfunction on children's appetite and quality of life. But measuring loss of taste function requires adequate tools. This review was conducted to 1) provide an overview of etiologies (i.e., disease and iatrogenic) associated with taste dysfunction in a pediatric population; 2) to investigate which tools (psychophysical tests and questionnaires) are available to assess taste function in children; and 3) to identify what tools can be and are actually used in clinical practice. It is concluded that only a minority of available tools to assess taste function in children are readily suitable for a pediatric clinical setting. Considering the profound impact of taste dysfunction in the pediatric setting, developing, and implementing a standard taste test that is sensitive, simple, and practical to use with children is pertinent.

Psychophysical evaluation of chemosensory functions 5 weeks after olfactory loss due to COVID-19: a prospective cohort study on 72 patients.

PURPOSE: To evaluate the evolution of chemosensation via extended psychophysical testing in patients who suffered from sudden chemosensory loss due to coronavirus disease 2019 (COVID-19). Additionally, this study sought to determine whether odor threshold testing provided additional information on olfactory loss due to COVID-19 compared to the more common odor identification testing. METHODS: Prospective cohort study of patients with sudden chemosensory loss since February 2020 and confirmed COVID-19 infection via RT-PCR or serology testing. Olfactory function was tested extensively using the "Sniffin Sticks" test battery. In addition, we screened gustatory perception and nasal cooling sensations using psychophysical tests. RESULTS: Seventy-two patients completed the study. After a mean of 37 days, 37% of patients showed olfactory dysfunction, 7% were dysgeusic, and 48% showed signs of low sensitivity for cooling sensation. A longer duration of anosmia before smell improvement was correlated with lower olfactory function at 5 weeks. Odor threshold detection was more affected by COVID-19 compared to odor identification. CONCLUSION: Five weeks after developing sudden chemosensory loss due to COVID-19, a high proportion of patients were dysosmic and showed signs of low nasal cooling sensitivity, whereas most of them had normal taste function. SARS-CoV-2 affected mainly odor thresholds, possibly suggesting that the major cause of loss of smell lies at the level of the olfactory neuroepithelium, rather than in the central nervous system.

A New Tactile Transfer Cell Using Magnetorheological Materials for Robot-Assisted Minimally Invasive Surgery.

This paper proposes a new type of tactile transfer cell which can be effectively applied to robot-assisted minimally invasive surgery (RMIS). The proposed tactile device is manufactured from two smart materials, a magnetorheological fluid (MRF) and a magnetorheological elastomer (MRE), whose viscoelastic properties are controllable by an external magnetic field. Thus, it can produce field-dependent repulsive forces which are equivalent to several human organs (or tissues) such as a heart. As a first step, an appropriate tactile sample is made using both MRF and MRE associated with porous foam. Then, the microstructures of these materials taken from Scanning Electron Microscope (SEM) images are presented, showing the particle distribution with and without the magnetic field. Subsequently, the field-dependent repulsive force of the sample, which is equivalent to the stress relaxation property of viscoelastic materials, are measured at several compressive deformation depths. Then, the measured values are compared with the calculated values obtained from Young's modulus of human tissue data via the finite element method. It is identified from this comparison that the proposed tactile transfer cell can mimic the repulsive force (or hardness) of several human organs. This directly indicates that the proposed MR materials-based tactile transfer cell (MRTTC in short) can be effectively applied to RMIS in which the surgeon can feel the strength or softness of the human organ by just changing the magnetic field intensity. In this work, to reflect a more practical feasibility, a psychophysical test is also carried out using 20 volunteers, and the results are analyzed, presenting the standard deviation.

Endoscopic, radiological, and symptom correlation of olfactory dysfunction in pre- and postsurgical patients of chronic rhinosinusitis.

The aim of the present study was to correlate olfactory dysfunction determined with psychophysical testing with nasal endoscopy, computed tomography (CT) scan, and patient's self-assessed olfactory deficit in patients of chronic rhinosinusitis (CRS) before and after sinus surgery. It was a prospective cohort study comprising of a total of 40 consecutive patients of CRS. All of them were given Connecticut Chemosensory Clinical Research Center Test for olfactory evaluation, nasal endoscopy, CT scan, and a graded questionnaire for perceived olfactory ability preoperatively on the same day after failing maximal medical management for 3 weeks. All investigations except CT scan were repeated 3 months postsinus surgery. For metrics, Visual Analog Scale (VAS) score, Lund Kennedy nasal endoscopy score, and Lund MacKay CT score were used. Spearman's correlation coefficients were determined between olfactory scores and endoscopic, CT, and VAS scores. Significant positive correlation was found between subjective VAS scores and composite odor scores both preoperatively (r = 0.89, P < 0.001) and 3 months postoperatively (r = 0.54, P < 0.001). Significant negative correlation was established between olfactory scores and CT (r = -0.71, P < 0.001). With nasal endoscopy also, the correlation results of odor scores were significant (r = -0.39, P = 0.01 in preoperative period and r = -0.47, P = 0.002 in postoperative period). Hence, it could be concluded that severity of olfactory disturbance determined by olfactory tests correlates well with nasal endoscopic findings, presence of CT opacification, and the patient's self-perceived olfactory insufficiency in CRS both before and after sinus surgery and can guide us well to determining the olfactory burden.

Gray and White Matter Changes Associated with Psychophysical Functions Induced by Diabolo Training in Young Men.

Learning a skill has been demonstrated to relate to neural plasticity in both animal and human brains. Performing diabolo consists of different tricks and may cause brain structural changes associated with psychophysical functions. Therefore, the purpose of this study was to investigate gray matter (GM) and white matter (WM) changes associated with psychophysical functions induced by diabolo training in healthy subjects. Fourteen healthy right-handed male subjects were enrolled to receive the diabolo training. Whole brain T1-weighted images and diffusion tensor imaging (DTI) data were acquired from all subjects on a 3.0 T magnetic resonance scanner before and after the training. Voxel-based morphometry (VBM), surface-based morphometry (SBM), and voxel-wise DTI analysis were carried out to detect the GM volume, cortical thickness, and WM diffusion changes using T1-weighted image and DTI data, respectively. In addition, two-arm coordination and mirror-drawing tests were performed to evaluate their psychophysical functions before and after 2, 4, 6 and 8 weeks of training. Analysis of variance was performed to understand whether the psychophysical functions changed over time after the training. The results showed that the psychophysical functions were significantly changed over time during the training. The VBM and SBM analyses revealed that the GM volume and cortical thickness were significantly increased in the brain areas associated with visual, motor, sensory, and spatial cognition functions. The voxel-wise DTI analysis further demonstrated that the mean diffusivity was significantly reduced in the genu of corpus callosum. Moreover, significant correlations were revealed between the increase rate of GM volume and the improvement rate of psychophysical functions in the left angular gyrus. The results suggest that the diabolo training may induce increased GM volume associated with improved psychophysical function in the brain region involved in spatial cognition and attention. Therefore, we conclude that the diabolo training may improve psychophysical function which might be reflected by the increased GM volume in the angular gyrus.

Relationship Between the Ability to Detect Frequency Changes or Temporal Gaps and Speech Perception Performance in Post-lingual Cochlear Implant Users.

Previous studies, using modulation stimuli, on the relative effects of frequency resolution and time resolution on CI users' speech perception failed to reach a consistent conclusion. In this study, frequency change detection and temporal gap detection were used to investigate the frequency resolution and time resolution of CI users, respectively. Psychophysical and neurophysiological methods were used to simultaneously investigate the effects of frequency and time resolution on speech perception in post-lingual cochlear implant (CI) users. We investigated the effects of psychophysical results [frequency change detection threshold (FCDT), gap detection threshold (GDT)], and acoustic change complex (ACC) responses (evoked threshold, latency, or amplitude of ACC induced by frequency change or temporal gap) on speech perception [recognition rate of monosyllabic words, disyllabic words, sentences in quiet, and sentence recognition threshold (SRT) in noise]. Thirty-one adult post-lingual CI users of Mandarin Chinese were enrolled in the study. The stimuli used to induce ACCs to frequency changes were 800-ms pure tones (fundamental frequency was 1,000 Hz); the frequency change occurred at the midpoint of the tones, with six percentages of frequency changes (0, 2, 5, 10, 20, and 50%). Temporal silences with different durations (0, 5, 10, 20, 50, and 100 ms) were inserted in the middle of the 800-ms white noise to induce ACCs evoked by temporal gaps. The FCDT and GDT were obtained by two 2-alternative forced-choice procedures. The results showed no significant correlation between the CI hearing threshold and speech perception in the study participants. In the multiple regression analysis of the influence of simultaneous psychophysical measures and ACC responses on speech perception, GDT significantly predicted every speech perception index, and the ACC amplitude evoked by the temporal gap significantly predicted the recognition of disyllabic words in quiet and SRT in noise. We conclude that when the ability to detect frequency changes and the temporal gap is considered simultaneously, the ability to detect frequency changes may have no significant effect on speech perception, but the ability to detect temporal gaps could significantly predict speech perception.

A Point-of-Use Quality Assurance Tool for Digital Pathology Remote Working.

Pathology services are facing pressures due to the COVID-19 pandemic. Digital pathology has the capability to meet some of these unprecedented challenges by allowing remote diagnoses to be made at home, during periods of social distancing or self-isolation. However, while digital pathology allows diagnoses to be made on standard computer screens, unregulated home environments may not be conducive for optimal viewing conditions. There is also a paucity of experimental evidence available to support the minimum display requirements for digital pathology. This study presents a Point-of-Use Quality Assurance (POUQA) tool for remote assessment of viewing conditions for reporting digital pathology slides. The tool is a psychophysical test combining previous work from successfully implemented quality assurance tools in both pathology and radiology to provide a minimally intrusive display screen validation task, before viewing digital slides. The test is specific to pathology assessment in that it requires visual discrimination between colors derived from hematoxylin and eosin staining, with a perceptual difference of ±1 delta E (dE). This tool evaluates the transfer of a 1 dE signal through the digital image display chain, including the observers' contrast and color responses within the test color range. The web-based system has been rapidly developed and deployed as a response to the COVID-19 pandemic and may be used by anyone in the world to help optimize flexible working conditions at: http://www. virtualpathology.leeds.ac.uk/res earch/systems/pouqa/.

A Tactile Device Generating Repulsive Forces of Various Human Tissues Fabricated from Magnetic-Responsive Fluid in Porous Polyurethane.

In this study, a controllable tactile device capable of realizing repulsive forces from soft human tissues was proposed, and its effectiveness was verified through experimental tests. The device was fabricated using both porous polyurethane foam (PPF) and smart magnetorheological fluid (MRF). As a first step, the microstructural behavior of MRF particle chains that depended on the magnetic field was examined via scanning electron microscopy (SEM). The test samples were then fabricated after analyzing the magnetic field distribution, which was crucial for the formation of the particle chains under the squeeze mode operation. In the fabrication of the samples, MRF was immersed into the porous polyurethane foam and encapsulated by adhesive tape to avoid leakage. To verify the effectiveness of the proposed tactile device for appropriate stiffness of soft human tissues such as liver, the repulsive force and relaxation stress were measured and discussed as a function of the magnetic field intensity. In addition, the effectiveness and practical applicability of the proposed tactile device have been validated through the psychophysical test.

Olfactory exploration: State of the art.

Olfactory disorders are fairly common in the general population. Exploration, on the other hand, is seldom performed by ENT specialists, even in reference centers. There may be three reasons for this: this particular sensory modality may seem unimportant to patients and/or physicians; available treatments may be underestimated, although admittedly much yet remains to be done; and olfactory exploration is not covered by the national health insurance scheme in France. Advances in research in recent decades have shed light on olfactory system functioning. At the same time, several techniques have been developed to allow maximally objective olfactory assessment, as olfactory disorder is sometimes the first sign of neurodegenerative pathology. Moreover, objective olfactory assessment may be needed in a medico-legal context. The present paper updates the techniques currently available for olfactory exploration.