Assessment of postviral qualitative olfactory dysfunction using the short SSParoT in patients with and without parosmia.

PURPOSE: To examine if the short formed Sniffin Sticks Parosmia Test (SSParoT), a test for parosmia can distinguish cases with parosmia from cases without parosmia. METHODS: In this study, 63 patients with postviral olfactory dysfunction were investigated including both COVID and non-COVID cases. The age, symptom duration, degree of parosmia/phantosmia was collected. For olfactory function, the Sniffin Sticks olfactory score was obtained including scores for odor threshold, discrimination and identification. For assessment of parosmic changes, the short SSParoT was adopted and both hedonic range (HedRang) and direction (HedDir) was calculated. RESULTS: The mean HedRang of patients with parosmia (2.35, standard deviation, SD = 1.40) and without parosmia (2.78, SD = 1.09) was smaller than that in controls (4.5, SD = 2.15). However, the mean HedDir of both parosmia (- 0.32, SD = 0.98) and non-parosmia patients (0.04, SD = 1.07) was similar to controls (- 0.1, SD = 1.55). When considering that the 10th percentile of the distribution of SSParoT score should distinguish between patients with and without parosmia, the sensitivity of the HedRang was 29% and specificity was 67%. For HedDir, the sensitivity was 6% and specificity was 100%. Only the odor identification score (r = 0.34, p = 0.01) discriminated parosmia and non-parosmia while other measures including HedRang and HedDir did not. CONCLUSION: The present study showed that the short SSParoT score could not distinguish patients with parosmia from patients without parosmia. Although the SSParoT represents an innovative approach to assess parosmia, and could be useful in the tracking of parosmic changes, the development of measures to diagnose parosmia in an objective way remains a challenge.

Intranasal trigeminal sensitivity to mechanical stimuli is associated with the perception of nasal patency.

PURPOSE: The aim of this prospective study was to examine the characteristics of a clinical test for the assessment of nasal trigeminal sensitivity to mechanical stimuli and its association with the perception of nasal patency. METHODS: Thirty-two normosmic healthy subjects participated (17 women and 15 men; age = 26 ± 3 years). Precisely defined air puffs were used with a flow rate of 2L/min for mechanical stimulation. They were presented to the nasal vestibule, nasal septum, and inferior turbinate with various stimulus durations. Thresholds were measured by single-staircase stimuli with changes in stimulus duration in steps of 10 ms. Trigeminal suprathreshold intensity was rated by subjects for stimulus durations of 200, 300, 400, and 500 ms. Test-retest reliability was examined by intraclass correlations (ICCs) and Bland-Altman plot with limits of agreement. Pearson's correlations were calculated between self-rated nasal patency and nasal trigeminal sensitivity. RESULTS: As indicated by trigeminal threshold and suprathreshold intensities, the nasal vestibule is the most sensitive area among the three locations, followed by the nasal septum and the inferior turbinate (p < 0.001). Coefficients of correlations between test and retest were 0.76 for thresholds, and 0.56 suprathreshold intensities (p < 0.001). The Bland-Altman analysis showed a good agreement between test-retest values. In addition, significant positive associations between trigeminal suprathreshold intensities and self-rated nasal obstruction were found at the inferior turbinate (r = 0.4, p < 0.05). CONCLUSION: Reliable assessment of nasal trigeminal sensitivity for air puffs appears to be possible. Nasal trigeminal suprathreshold sensitivity to mechanical stimuli is associated with the perception of nasal patency at the inferior turbinate. This opens a window into the assessment of the perception of nasal airflow in various clinical purposes, especially for patients with sinonasal diseases.

Parosmia as a predictor of a better olfactory function in COVID-19: a multicentric longitudinal study for upper respiratory tract infections.

PURPOSE: This study aimed to evaluate the course of olfactory dysfunction [OD] due to upper respiratory tract infections [URTI] especially for COVID-19 [C19] in a multicentric design and to investigate possible predictors for the outcome. METHODS: In a multicentric study, patients (n = 147, of which 96 were women) with OD due to URTI, including C19 and non-C19 were evaluated at two visits with a standardized medical history and "Sniffin' Sticks" extended psychophysical testing to examine the course and possible predictors for improvement of olfactory function. RESULTS: C19 patients showed better overall olfactory function (p < 0.001) compared to non-C19. Olfactory function (p < 0.001) improved over 3.5 ± 1.2 months in a comparable fashion for C19 and non-C19 comparable over time (p = 0.20) except for a more pronounced improvement of odour threshold (p = 0.03) in C19. C19 patients with parosmia exhibited a higher probability of clinically relevant improvement of odour threshold, a better threshold in the second visit, and tended to have a better TDI-score at the second visit. Further possible predictors for an improving olfactory function were younger age, female gender, and had lower scores in olfactory tests at the first visit. CONCLUSIONS: Patients with C19 and non-C19 URTI exhibit a similar improvement over 3-4 months except for the odour threshold, with a better TDI in both visits for C19. For C19 a better prognosis in terms of olfactory recovery was found for younger patients with parosmia and lower olfactory scores at the first visit. Still, for many patients with olfactory loss, an improvement that is experienced as complete may only occur over months and possibly years.

Surgical Approaches for Possible Positions of an Olfactory Implant to Stimulate the Olfactory Bulb.

INTRODUCTION: Current scientific developments seem to allow for an "olfactory implant" in analogy to cochlear implants. However, the position and surgical approaches for electrical stimulation of the olfactory system are unclear. METHODS: In a human anatomic cadaver study, we investigated different endoscopic approaches to electrically stimulate the olfactory bulb (OB) based on the following considerations: (1) the stimulating electrode should be close to the OB. (2) The surgical procedure should be as non-invasive and safe as possible and (3) as easy as possible for an experienced ENT surgeon. RESULTS: In summary, the endoscopic intracranial positioning of the electrode via a widened ostium of the fila olfactoria or a frontal sinus surgery like a Draf IIb procedure is a good option in terms of patients' risk, degree of difficulty for ENT surgeons, and position to the OB. Endoscopic intranasal positioning appeared to be the best option in terms of patient risk and the degree of difficulty for ENT surgeons. Although a bigger approach to the OB using a drill and the combined intranasal endoscopic and external approach enabled a close placement of the electrode to the OB, they do not seem relevant in practice due to their higher invasiveness. CONCLUSION: The study suggested that an intranasal positioning of a stimulating electrode is possible, with placements beneath the cribriform plate, extra- or intracranially, applying elegant surgical techniques with low or medium risk to the patient and a close placement to OB.

[Public mental health and patient autonomy-an area of conflict?] / Public Mental Health und Patientenautonomie ­ ein Spannungsfeld?

Public mental health (PMH) interventions aim to promote and improve the well-being of members of a society. PMH is based on a normative understanding of what well-being is and what factors contribute to it. Without necessarily disclosing it, measures of a PMH program may affect the autonomy of individuals if their personal perceptions regarding their own individual well-being differ from PMH's prescriptions for well-being oriented toward societal goals. In this paper, we discuss this potential tension between the possible goals of PMH and those of the addressees.

[Inpatient equivalent home-treatment: an overview]. / Stationsäquivalente Behandlung: Ein Überblick zum Status quo.

Inpatient equivalent home-treatment (IEHT) was implemented in Germany in 2018. Persons with a mental disorder can be admitted to acute multiprofessional IEHT to avoid or shorten inpatient hospital treatment. Exclusion criteria are amongst others lack of consent of cohabitants or endangerment of self and others. Advantages of IEHT include normalization and reduction of stigma. Nevertheless, administrative requirements are high. While there is international evidence for home treatment and crisis resolution teams, there is still a lack of evidence for the concept of IEHT, although specific studies are currently being carried out (e.g. AktiV study financed by the Innovation Fund). Overall, IEHT is important for mental health services and should be further developed.

[Is the role of mental illness in suicide overestimated?] / Wird die Rolle von psychischen Erkrankungen beim Suizid überbewertet?

In the scientific literature, it is often said that 90% of all suicides are the consequences of a mental illness. Nevertheless, recent reports and comments cast doubt on this view and point out that such a limitation might hamper effective suicide prevention. In this overview we will outline and discuss important results on how often suicides are the consequence of mental illnesses and whether the association between mental illnesses and suicide might be overestimated.Mental illnesses and especially affective disorders increase the risk of suicide by 30 to 50 times. Nevertheless, they explain only a certain percentage of all suicides. Observational and treatment studies indicate that mental illness is only one factor of several that lead to suicide. Among other factors are relationship problems, drug abuse, severe somatic illnesses, job problems, financial worries or juridical threats.Suicidal behaviour is an indicator of deep unhappiness but not necessarily caused by a mental illness. Many persons with mental illnesses do not show suicidal behaviour. On the other hand, not all people who take their own lives have a mental illness. This has significant consequences for universal and indicated prevention of suicide.

[When does StäB (not) Work? A Qualitative, Multi-Perspective Survey on Factors that can Affect the Outcome of Inpatient-Equivalent Home Treatment (IEHT)]. / Wann funktioniert StäB (nicht)? Eine qualitative, multiperspektivische Erhebung zu Faktoren, die den Erfolg einer stationsäquivalenten Behandlung (StäB) beeinträchtigen können.

OBJECTIVE: There are always cases in which an already started inpatient equivalent home treatment is terminated. Aim of our study was to reach a better understanding of the circumstances leading to a termination of IEHT that has already begun. METHODS: 17 qualitative interviews were conducted with patients, relatives as well as practitioners and therapists. Data analysis was performed by means of qualitative content analysis. RESULTS: Our data shows, that there are further factors, besides the formal exclusion criteria for IEHT, that can complicate or prevent an inpatient equivalent home treatment or lead to its termination. CONCLUSION: IEHT offers many patients the possibility of an intensive treatment in their own home. However, there our various constellations that can lead to a complication or termination of an inpatient equivalent home treatment.

Forming social capital--does participatory planning foster trust in institutions?

Participatory planning that includes interest groups and municipal representatives has been presented as a means to deal with the increasing difficulty to reach arrangements due to progressively scarce land resources. Under dispute is whether collaborative forms of planning augment social capital or whether they might actually cause the destruction of such a valuable social commodity. In this paper we focus on trust in institution as a specific dimension of social capital because we argue that this is one of the effects the convenors of such participatory planning procedures are most interested in. We pursue a pre-post design and survey advisory group members of five on-going river-related planning processes in Switzerland. Controlling for generalised trust, we investigate how trust in institutions is affected over time by the quality of such processes and the degree of participation they offer. We find that generalised trust is highly correlated with initial levels of trust and so is process quality. Particularly the latter finding challenges the usually assumed direction of causality according to which process quality influences trust building. Additionally, we find a positive (non-significant) effect of process quality on changes in trust, while a higher degree of participation rather seems to hinder trust building. We suppose this indicates that under the conditions of limited time and resources more attention should be paid to how to improve the quality of participatory processes than putting much effort in increasing the degree of participation.

Characterization of human oxidoreductases involved in aldehyde odorant metabolism.

Oxidoreductases are major enzymes of xenobiotic metabolism. Consequently, they are essential in the chemoprotection of the human body. Many xenobiotic metabolism enzymes have been shown to be involved in chemosensory tissue protection. Among them, some were additionally shown to be involved in chemosensory perception, acting in signal termination as well as in the generation of metabolites that change the activation pattern of chemosensory receptors. Oxidoreductases, especially aldehyde dehydrogenases and aldo-keto reductases, are the first barrier against aldehyde compounds, which include numerous odorants. Using a mass spectrometry approach, we characterized the most highly expressed members of these families in the human nasal mucus sampled in the olfactory vicinity. Their expression was also demonstrated using immunohistochemistry in human epitheliums sampled in the olfactory vicinity. Recombinant enzymes corresponding to three highly expressed human oxidoreductases (ALDH1A1, ALDH3A1, AKR1B10) were used to demonstrate the high enzymatic activity of these enzymes toward aldehyde odorants. The structure‒function relationship set based on the enzymatic parameters characterization of a series of aldehyde odorant compounds was supported by the X-ray structure resolution of human ALDH3A1 in complex with octanal.

Well-being in patients with olfactory dysfunction.

This cross-sectional, retrospective study aimed to investigate the differences in well-being among patients with olfactory disorder (OD) with quantitative and/or qualitative olfactory dysfunctions, and to identify factors associated with well-being (WB). We included 470 OD patients. WB (WHO-5 questionnaire), quantitative olfactory function (Sniffin' Sticks) and qualitative dysfunction were assessed. Overall, 35% of the OD patients reported a poor WB, higher than 22% of the normative data in general population. For quantitative function, anosmia patients showed lower WB scores than hyposmia and normosmia patients (all p's < 0.03). For qualitative dysfunction, patients with severe parosmia showed lower WB scores than patients without and with less severe parosmia (p's < 0.01). Regarding OD causes in hyposmic patients, post-infectious patients showed poorer WB than idiopathic patients (p = 0.01); sinonasal patients had lower WB than post-traumatic and idiopathic patients (all p's < 0.04). There was a weak but significant positive correlation between WB score and Threshold test score (r = 0.11, p = 0.02). Hierarchical regression analyses showed that women gender, Threshold and overall Sniffin' Sticks scores (TDI) significantly predicted WB score in OD patients. Our results implied that quantitative and qualitative dysfunction is associated with WB. However, only patients with severe dysfunction showed significantly lower WB. While this needs to be better understood, in order to improve well-being, in these patients it appears to be highly important to improve olfactory function, and here especially olfactory sensitivity.

Differences between suicide note leavers and other suicides: A German psychological autopsy study.

INTRODUCTION: Suicide notes are not only the last personal message from the suicide victim to the bereaved, but are also a valuable source for research in preventing suicides. However, not all suicide victims leave a suicide note and it is unclear whether note leavers are representative of the general population of suicide victims. METHODS: The aim of our study was to compare suicide victims who leave a suicide note compared to those who do not. Therefore, data from the Allgäu Suicide Study, which comprised detailed information on N = 626 suicides, were analysed using multiple regression analyses. RESULTS: Of N = 612 cases with complete data, n = 255(42%) left a suicide note and n = 357 (58%) did not. Persons who wrote suicide notes before they killed themselves were more often female, less often married, found themselves more often in a financial or partnership crisis, and were more likely to suffer from a medical illness. They tended to poison themselves more often and were less likely to have a history of alcohol abuse disorder. CONCLUSION: Suicide notes are one source to better understand the motives, which lie behind suicides and therefore may help to further develop and improve suicide prevention programs. Keeping in mind that suicide has heterogeneous reasons, the group of "note writers" might be one, which might especially have benefitted from psychosocial and psychotherapeutic interventions, as interpersonal relationships obviously played an important role even shortly before suicide.

Lipidomic profile of human nasal mucosa and associations with circulating fatty acids and olfactory deficiency.

The nasal mucosa (NM) contains olfactory mucosa which contributes to the detection of odorant molecules and the transmission of olfactory information to the brain. To date, the lipid composition of the human NM has not been adequately characterized. Using gas chromatography, liquid chromatography coupled to mass spectrometry and thin layer chromatography, we analyzed the fatty acids and the phospholipid and ceramide molecular species in adult human nasal and blood biopsies. Saturated and polyunsaturated fatty acids (PUFAs) accounted for 45% and 29% of the nasal total fatty acids, respectively. Fatty acids of the n-6 family were predominant in the PUFA subgroup. Linoleic acid and arachidonic acid (AA) were incorporated in the main nasal phospholipid classes. Correlation analysis revealed that the nasal AA level might be positively associated with olfactory deficiency. In addition, a strong positive association between the AA levels in the NM and in plasma cholesteryl esters suggested that this blood fraction might be used as an indicator of the nasal AA level. The most abundant species of ceramides and their glycosylated derivatives detected in NM contained palmitic acid and long-chain fatty acids. Overall, this study provides new insight into lipid species that potentially contribute to the maintenance of NM homeostasis and demonstrates that circulating biomarkers might be used to predict nasal fatty acid content.

Topic Specificity and Antecedents for Preservice Biology Teachers' Anticipated Enjoyment for Teaching About Socioscientific Issues: Investigating Universal Values and Psychological Distance.

Enjoyment for teaching represents one of the most frequently reported teaching emotions and positively affects student outcomes. Therefore, researchers and teacher educators need to understand its nature and underlying appraisal processes to prepare motivated teachers as part of initial teacher education. Using cross-sectional questionnaire data from 189 German biology preservice teachers (73.5% female, meanage = 23.45 years, SD age = 3.71 years), we empirically tested the topic-specific structure and antecedents of participants' anticipated enjoyment for teaching. We adapted the established Teacher Emotion Scale to measure preservice teachers' trait-based enjoyment for teaching by reframing the items with the environmental socioscientific issues of the return of wild wolves and climate change and the health socioscientific issue of preimplantation genetic diagnosis. Confirmatory factor analysis confirmed the best fit of a topic-specific model. We also found different correlations for the anticipated enjoyment for teaching about the issues, but no significant differences in means. Concerning further topic-specific antecedents, the environmentally oriented basic value of universalism predicted the anticipated enjoyment for teaching about the return of wolves, and the socially oriented universal value of benevolence predicted the anticipated enjoyment for teaching about preimplantation genetic diagnosis. Both values inconsistently predicted the anticipated enjoyment for teaching about climate change. While this is in line with the complex nature of this socioscientific issue, psychological distance was a predictor for the anticipated enjoyment for teaching about every topic. While these effects remained stable when controlling for demographic variables, male participants showed a higher anticipated enjoyment for teaching about wolves and about climate change, and female preservice teachers for teaching about preimplantation genetic diagnosis. Further studies are needed to investigate if the results can be transferred to in-service teachers or to other teaching emotions. Furthermore, future studies could examine effects on other factors relevant to teaching emotions such as reactions to student behavior, which have been described as central for the causation of teaching emotions in prior studies (i.e., "reciprocal model of teaching emotions"). The present study stimulates such new studies and adds important knowledge to the understanding of topic specificity and topic-specific antecedents of anticipated enjoyment for teaching, which are relevant for teacher education and professional development.

Biology Teachers' Worldviews on the Global Distribution and Loss of Biodiversity: A GIS-Based Mental-Mapping Approach.

This paper explores (1) student teachers' mental maps of the global distribution and loss of biodiversity and (2) their perception of threatened biodiversity at the national, transnational and global levels. Data was collected from a questionnaire study of student biology teachers from Germany (n = 868) and Costa Rica (n = 284). Student teachers' mental maps matched quite well with the scientific view. Nevertheless, they clearly showed a "brazilisation bias," meaning that the first and foremost country associated with high and threatened biodiversity was Brazil. Industrialized countries were often misconceived to have a particularly threatened biodiversity. Except for Brazil (and Costa Rica in the Costa Rican sample), most students neglected a connection between a country's high biodiversity and its high threat as proposed by the biodiversity hotspots concept. Despite this common ground, major ethnocentric distortions merged in the composite mental maps for each sample: German students had a more global perspective on biodiversity and its loss, whereas Costa Ricans students had a more localized view. Student teachers from both countries have largely overestimated the percentage of threatened plant species on a national, transnational and global level ("overestimation bias"). In addition, the estimated percentage of threatened plant species have correspondingly increased with a greater distance from the students' home country ("spatial optimism bias"). Results will be discussed in terms of educational implications.

Can a Like Save the Planet? Comparing Antecedents of and Correlations Between Environmental Liking on Social Media, Money Donation, and Volunteering.

Due to the societal dissemination of digital technology, people are increasingly experiencing environmental topics through digital media channels such as social networks. Several researchers therefore have proposed these channels as a possibility to strengthen sustainable development based on their cost-efficient nature. But while prior studies have investigated isolated factors for understanding environmental social media behavior, there is still scarce understanding of the relevant underlying motivational factors and possible connections with more traditional environmental behaviors. Therefore, the present study applied the established socio-psychological model of goal-directed behavior and compared the desires for liking as a fundamental form of digital social media behavior with the desires for two traditional environmental behaviors (money donation and volunteering) in a cross-sectional research design. Within the biodiversity conservation case of the Andean bear (Tremarctos ornatus) in Ecuador, we compared the antecedents for the desires for the corresponding environmental behaviors (RQ1) as well as their connections between each other (RQ2). Within a sample of 407 Ecuadorian students (M age = 20.94 years, SD = 2.25, 61.2% female), we found the marginal effect of perceived behavioral control on the desires for liking on social media as the main difference concerning the antecedents of the behaviors because money donation and volunteering largely depended on personal resources such as time or money. Furthermore, gender emerged as the second main difference between the behaviors due to it only being predictive for the liking motivation. Enjoyment was the only variable that coherently predicted all three behaviors. Finally, desires for liking on social media predicted both other behaviors in robust regression analyses, but were only predictive for volunteering in corresponding path models. The results illustrate how cost-efficient digital environmental behaviors such as liking may be suitable for sparking low-level environmental action, which may entail more pronounced forms of environmental activism, at least when they involve feasible personal costs. Overall, the findings are in line with prior research regarding the less demanding nature of liking, but further elaborate on the importance of gender for digital environmental behavior and correlates between digital and classical environmental behaviors.

Nature Relatedness and Environmental Concern of Young People in Ecuador and Germany.

Today's societies are confronted by a daily biodiversity loss, which will increase in the face of climate change and environmental pollution. Biodiversity loss is a particularly severe problem in so-called biodiversity hotspots. Ecuador is an example of a country that hosts two different biodiversity hotspots. Human behavior - in developing as well as in industrial countries such as Germany - must be considered as one of the most important direct and indirect drivers of this global trend and thus plays a crucial role in environmentalism and biodiversity conservation. Nature relatedness and environmental concern have been identified as important environmental psychological factors related to people's pro-environmental behavior. However, the human-nature relationship depends on a variety of other factors, such as values, gender, nationality, qualities of environmental concern and time spent in nature. This study compared young people from Ecuador and Germany with regard to their nature relatedness and environmental concern. Furthermore, the role of the aforementioned factors was investigated. In total, we surveyed 2,173 high school students from Germany (M age = 14.56 years, SD = 1.45; female: 55.1%) and 451 high school students from Ecuador (M age = 14.63 years, SD = 1.77; female: 55.3%). We found that young Ecuadorians were more related to nature than young people from Germany. Additionally, we found country-specific differences in the structure of environmental concern and in the role of gender in the explanation of biospheric environmental concern and nature relatedness. In both samples, the self-transcendence value cluster was a significant positive predictor for biospheric environmental concern and nature relatedness. Time spent in nature was a significant positive predictor for nature relatedness in both samples. The results are an empirical basis for the assumption of culture-specific differences in human-nature relationships.

Olfactory change detection.

The human olfactory system is characterized by poor temporal and spatial resolution. When determining changes in the environment, humans rather rely on visual than on olfactory information. Against this background, we developed a test in order to investigate the human capacity to detect changes in the olfactory environment and to determine potential modulators of olfactory change detection. Participants consecutively received four odors (2 odor qualities in 2 concentrations each) which were presented via a computer-controlled olfactometer. The participants' task was to react as soon as they perceived a change of the odor. For control purpose, the same paradigm was also presented with visual instead of olfactory stimuli. A total of 83 healthy participants (aged 18-34 years, 50 women) were included; all of them were screened for attention, olfactory function, chemical sensitivity and the subjective importance of the sense of smell. While visual changes were detected above chance by all participants, olfactory changes were reliably detected by only 24% of the participants. Those were characterized by high subjective importance of olfaction and low chemical sensitivity. Across all participants, changes of olfactory quality were detected more frequently than changes of olfactory concentration. These results suggest that olfaction is imprecise in guiding environmental change detection and may help to explain why humans typically rate the importance of vision higher than the importance of olfaction.

Evaluation of the InteraX system technology in a high-throughput screening environment.

The authors have developed a cell-based high-throughput screening (HTS)-compatible assay to measure EGFR dimerization using the InteraX enzyme complementation technology of Applied Biosystems. The cells contain 2 chimeric proteins with complementing deletion mutants of the beta galactosidase enzyme, each fused to the extracellular and transmembrane part of EGFR. On binding of EGF, EGF receptor dimerizes and an active beta galactosidase is built. The authors used this homogeneous 384-well assay to screen about 20,000 diverse compounds. From 2 independent primary screen runs 239 hits were identified. For run 1, a mean S/B ratio of 4.26 and a mean Z' factor of 0.74 were obtained, for run 2 a mean S/B ratio of 3.88 and a mean Z' factor of 0.71 were obtained. After hit confirmation, repeated 4 times, 112 hits remained with a confirmation rate of 48.9%. Thirty of the 112 could be identified as cytotoxic. Fifty-one of the remaining 82 compounds could be shown to be inhibitors of the beta galactosidase enzyme itself. In summary, 31 compounds remained as potential EGFR dimerization or EGF stimulation inhibitors. The authors conclude that the InteraX system technology is HTS capable and can detect small molecule inhibitors capable of inhibiting protein-protein interactions.