Publications by authors named "Paule V Joseph"

46 Publications

Associations of Taste Perception with Tobacco Smoking, Marijuana Use, and Weight Status in the National Health and Nutrition Examination Survey.

Chem Senses 2021 Apr 9. Epub 2021 Apr 9.

Sensory Science & Metabolism Unit, Biobehavioral Branch, Division of Intramural Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD.

Background: Habitual smoking of tobacco and marijuana can lead to weight changes and poor diet quality. These effects may be caused by taste changes related to smoking and marijuana use.

Objectives: This study examined the associations among taste perceptions of a bitterant (quinine) and salt, tobacco and marijuana use, and weight status.

Methods: We conducted a cross-sectional analysis of adults who responded to the National Health and Nutrition Examination Survey in 2013-2014. Participants (n=2808; female=51.7%) were adults ≥ 40 years with an average BMI of 29.6 kg/m 2. Participants completed whole mouth and tongue tip assessments of bitter (quinine) and salty (NaCl) tastes, and questionnaires on demographics, cigarette, tobacco, and drug use. Measured height and weight were used to calculate BMI.

Results: Compared to never smokers, current smokers reported increased bitter ratings. Smoking status was not associated with salty taste intensity ratings after adjustment for demographic variables. Current marijuana users reported lower tongue tip quine ratings than never users. Among current smokers, current marijuana users had lower whole mouth quinine ratings than never users.

Conclusions: Taste perception for salt and quinine for current and former smokers as well as marijuana smokers varied in whole mouth and tongue tip assessment. Changes in taste perception among cigarette smokers and marijuana consumers may be clinically relevant to address to improve diet and weight status.
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http://dx.doi.org/10.1093/chemse/bjab017DOI Listing
April 2021

From loss to recovery: how to effectively assess chemosensory impairments during COVID-19 pandemic.

medRxiv 2021 Mar 26. Epub 2021 Mar 26.

Chemosensory impairments have been established as a specific indicator of COVID-19. They affect most patients and may persist long past the resolution of respiratory symptoms, representing an unprecedented medical challenge. Since the SARS-CoV-2 pandemic started, we now know much more about smell, taste, and chemesthesis loss associated with COVID-19. However, the temporal dynamics and characteristics of recovery are still unknown. Here, capitalizing on data from the Global Consortium for Chemosensory Research (GCCR) crowdsourced survey, we assessed chemosensory abilities after the resolution of respiratory symptoms in participants diagnosed with COVID-19 during the first wave of the pandemic in Italy. This analysis led to the identification of two patterns of chemosensory recovery, limited (partial) and substantial, which were found to be associated with differential age, degrees of chemosensory loss, and regional patterns. Uncovering the self-reported phenomenology of recovery from smell, taste, and chemesthetic disorders is the first, yet essential step, to provide healthcare professionals with the tools to take purposeful and targeted action to address chemosensory disorders and its severe discomfort.
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http://dx.doi.org/10.1101/2021.03.25.21254253DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8010774PMC
March 2021

SeqEnhDL: sequence-based classification of cell type-specific enhancers using deep learning models.

BMC Res Notes 2021 Mar 19;14(1):104. Epub 2021 Mar 19.

Division of Intramural Clinical and Biological Research (DICBR), National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, 20892, USA.

Objective: To address the challenge of computational identification of cell type-specific regulatory elements on a genome-wide scale.

Results: We propose SeqEnhDL, a deep learning framework for classifying cell type-specific enhancers based on sequence features. DNA sequences of "strong enhancer" chromatin states in nine cell types from the ENCODE project were retrieved to build and test enhancer classifiers. For any DNA sequence, positional k-mer (k = 5, 7, 9 and 11) fold changes relative to randomly selected non-coding sequences across each nucleotide position were used as features for deep learning models. Three deep learning models were implemented, including multi-layer perceptron (MLP), Convolutional Neural Network (CNN) and Recurrent Neural Network (RNN). All models in SeqEnhDL outperform state-of-the-art enhancer classifiers (including gkm-SVM and DanQ) in distinguishing cell type-specific enhancers from randomly selected non-coding sequences. Moreover, SeqEnhDL can directly discriminate enhancers from different cell types, which has not been achieved by other enhancer classifiers. Our analysis suggests that both enhancers and their tissue-specificity can be accurately identified based on their sequence features. SeqEnhDL is publicly available at https://github.com/wyp1125/SeqEnhDL .
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http://dx.doi.org/10.1186/s13104-021-05518-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980595PMC
March 2021

Opportunities and challenges presented by recent pedagogical innovations in doctoral nursing education.

J Prof Nurs 2021 Jan-Feb;37(1):228-234. Epub 2020 Sep 2.

NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA 19104, United States of America.

The demand to expand the nurse scientist pipeline over the past decade has generated numerous pedagogical innovations in nursing doctoral education. A PhD nursing education summit was held at the University of Pennsylvania in October 2019 to discuss pedagogical innovations. The main pedagogical innovations discussed by Summit attendees included: 1) the expansion of both 3-year PhD programs and BSN to PhD programs; 2) changes in learning opportunities and curricula content; and 3) the role of postdoctoral fellowships. This overview examines the numerous opportunities and challenges generated by these innovations. Opportunities include producing scholars with research careers that are potentially longer than historically seen in the nursing profession, as well as the emergence of unique educational and mentoring opportunities both during and after doctoral studies. Challenges involve the impact condensed program timelines have had on both the content and delivery of curricula, as well as the research expertise and skillsets of nursing PhD program graduates. There is a need to conduct a national coordinated evaluation of PhD program using shared metrics in order to better evaluate the effect of these pedagogical innovations on the development of nurse scientists, and ultimately, the discipline.
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http://dx.doi.org/10.1016/j.profnurs.2020.09.003DOI Listing
September 2020

PhD programs and the advancement of nursing science.

J Prof Nurs 2021 Jan-Feb;37(1):195-200. Epub 2020 Jul 5.

Biobehavioral Health Sciences Department, School of Nursing, University of Pennsylvania, United States of America. Electronic address:

Nurses are well-positioned to be groundbreaking researchers, scientists, leaders, and innovators to improve the health and well-being of individuals, families, and communities. Nurse scientists are needed to contribute to scientific discoveries that inform effective strategies to improve patient care and outcomes and to inform future policies. Thoughtful consideration is required about the preparation of nurse scientists to ensure they are equipped with the knowledge and skill sets to meet the needs of society. Evolving health needs and priority areas of inquiry along with an ever-increasing array of sophisticated methodologies and centrality of interdisciplinary teams to solve complex problems should drive how we prepare PhD students. This paper reflects a panel and subsequent dialogue with nurse leaders at the PhD summit held at the University of Pennsylvania in October 2019. Three aspects of PhD education and the advancement of nursing science are discussed 1) examining important elements to support nurse scientist development; 2) identifying key gaps in science that the discipline needs to address in educating the next generation of nurse scientists; and 3) preparing nurse scientists for the competitive funding environment.
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http://dx.doi.org/10.1016/j.profnurs.2020.06.011DOI Listing
July 2020

Effect of a plant-based, low-fat diet versus an animal-based, ketogenic diet on ad libitum energy intake.

Nat Med 2021 02 21;27(2):344-353. Epub 2021 Jan 21.

National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA.

The carbohydrate-insulin model of obesity posits that high-carbohydrate diets lead to excess insulin secretion, thereby promoting fat accumulation and increasing energy intake. Thus, low-carbohydrate diets are predicted to reduce ad libitum energy intake as compared to low-fat, high-carbohydrate diets. To test this hypothesis, 20 adults aged 29.9 ± 1.4 (mean ± s.e.m.) years with body mass index of 27.8 ± 1.3 kg m were admitted as inpatients to the National Institutes of Health Clinical Center and randomized to consume ad libitum either a minimally processed, plant-based, low-fat diet (10.3% fat, 75.2% carbohydrate) with high glycemic load (85 g 1,000 kcal) or a minimally processed, animal-based, ketogenic, low-carbohydrate diet (75.8% fat, 10.0% carbohydrate) with low glycemic load (6 g 1,000 kcal) for 2 weeks followed immediately by the alternate diet for 2 weeks. One participant withdrew due to hypoglycemia during the low-carbohydrate diet. The primary outcomes compared mean daily ad libitum energy intake between each 2-week diet period as well as between the final week of each diet. We found that the low-fat diet led to 689 ± 73 kcal d less energy intake than the low-carbohydrate diet over 2 weeks (P < 0.0001) and 544 ± 68 kcal d less over the final week (P < 0.0001). Therefore, the predictions of the carbohydrate-insulin model were inconsistent with our observations. This study was registered on ClinicalTrials.gov as NCT03878108 .
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http://dx.doi.org/10.1038/s41591-020-01209-1DOI Listing
February 2021

Recent Smell Loss Is the Best Predictor of COVID-19 Among Individuals With Recent Respiratory Symptoms.

Chem Senses 2021 01;46

Department of Psychology, Temple University, Philadelphia, PA, USA.

In a preregistered, cross-sectional study, we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n = 4148) or negative (C19-; n = 546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean ± SD, C19+: -82.5 ± 27.2 points; C19-: -59.8 ± 37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC = 0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0-10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4 < OR < 10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable.
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http://dx.doi.org/10.1093/chemse/bjaa081DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7799216PMC
January 2021

NIH Workshop Report: sensory nutrition and disease.

Am J Clin Nutr 2020 Dec 9. Epub 2020 Dec 9.

Department of Nutrition Science, Purdue University, West Lafayette, IN, USA.

In November 2019, the NIH held the "Sensory Nutrition and Disease" workshop to challenge multidisciplinary researchers working at the interface of sensory science, food science, psychology, neuroscience, nutrition, and health sciences to explore how chemosensation influences dietary choice and health. This report summarizes deliberations of the workshop, as well as follow-up discussion in the wake of the current pandemic. Three topics were addressed: A) the need to optimize human chemosensory testing and assessment, B) the plasticity of chemosensory systems, and C) the interplay of chemosensory signals, cognitive signals, dietary intake, and metabolism. Several ways to advance sensory nutrition research emerged from the workshop: 1) refining methods to measure chemosensation in large cohort studies and validating measures that reflect perception of complex chemosensations relevant to dietary choice; 2) characterizing interindividual differences in chemosensory function and how they affect ingestive behaviors, health, and disease risk; 3) defining circuit-level organization and function that link and interact with gustatory, olfactory, homeostatic, visceral, and cognitive systems; and 4) discovering new ligands for chemosensory receptors (e.g., those produced by the microbiome) and cataloging cell types expressing these receptors. Several of these priorities were made more urgent by the current pandemic because infection with sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the ensuing coronavirus disease of 2019 has direct short- and perhaps long-term effects on flavor perception. There is increasing evidence of functional interactions between the chemosensory and nutritional sciences. Better characterization of this interface is expected to yield insights to promote health, mitigate disease risk, and guide nutrition policy.
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http://dx.doi.org/10.1093/ajcn/nqaa302DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779223PMC
December 2020

Fatigue, Stress, and Functional Status are Associated With Taste Changes in Oncology Patients Receiving Chemotherapy.

J Pain Symptom Manage 2020 Nov 28. Epub 2020 Nov 28.

Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California, USA; Department of Medicine, School of Medicine, University of California, San Francisco, California, USA. Electronic address:

Context: A common complaint among oncology patients receiving chemotherapy is altered taste perception.

Objective: The purpose of this study was to evaluate for differences in common symptoms and stress levels in patients who reported taste changes.

Methods: Patients were receiving chemotherapy for breast, gastrointestinal, gynecological, or lung cancer. Change in the way food tastes (CFT) was assessed using the Memorial Symptom Assessment Scale before the patients' second or third cycle of chemotherapy. Valid and reliable instruments were used to assess for depressive symptoms, state and trait of anxiety, cognitive impairment, diurnal variations in fatigue and energy, sleep disturbance, and pain. Stress was assessed using the Perceived Stress Scale and the Impact of Events Scale-Revised. Multiple logistic regression was used to evaluate for risk factors associated with CFT.

Results: Of the 1329 patients, 49.4% reported CFT. Patients in the CFT group reported higher levels of depression, anxiety, fatigue, and sleep disturbance as well as higher levels of general and disease specific stress. Factors associated with CFT group included being non-White; receiving an antiemetic regimen that contained a neurokinin-1 receptor antagonist with two other antiemetics; having a lower functional status; higher levels of morning fatigue; and reporting higher scores on the hyperarousal subscale of the Impact of Event Scale-Revised.

Conclusions: This study provides new evidence on associations between taste changes and common co-occurring symptoms and stress in oncology patients receiving chemotherapy. Clinicians need to evaluate for taste changes in these patients because this symptom can effect patients' nutritional intake and quality of life.
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http://dx.doi.org/10.1016/j.jpainsymman.2020.11.029DOI Listing
November 2020

Eliciting Willingness and Beliefs towards Participation in Genetic Psychiatric Testing in Black/African American Mothers at Risk for Depression.

Behav Sci (Basel) 2020 Nov 26;10(12). Epub 2020 Nov 26.

School of Nursing, Essex County College, Newark, NJ 07102, USA.

Black/African American women are at high risk for depression, yet are underrepresented in psychiatric genetic research for depression prevention and treatment. Little is known about the factors that influence participation in genetic testing for Black/African American women at risk. The purpose of this study was to elicit the beliefs that underlie participation in genetic testing for depression in Black/African American mothers, a subgroup at high risk. Willingness to participate in genetic testing procedures was also determined. A qualitative, descriptive design was employed. Exactly 19 mothers aged 21-42 completed open-ended questionnaires. Directed content and descriptive analyses of the text were conducted based on the Theory of Planned Behavior. Salient beliefs included: behavioral advantages-diagnosing/detecting depression (31.6%), finding cure/treatment (21.1%); disadvantages-not finding follow-up treatment/help (21.1%); salient referents, who approves-family members (47.4%), agencies/organizations (26.3%); who disapproves-church associates (21.1%). Control beliefs included: barriers-unpleasant/difficult testing procedures (42.1%), limited knowledge about the purpose of testing (26.3%); facilitator-a convenient location (21.1%). Most mothers (89.5%) indicated willingness to participate in testing. Interventions can target families, address barriers, emphasize future benefits, and use convenient locations and community-based participatory research methods. Policies can address social determinants of participation to increase inclusion of these mothers in psychiatric genetic research.
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http://dx.doi.org/10.3390/bs10120181DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7760786PMC
November 2020

Objective Sensory Testing Methods Reveal a Higher Prevalence of Olfactory Loss in COVID-19-Positive Patients Compared to Subjective Methods: A Systematic Review and Meta-Analysis.

Chem Senses 2020 12;45(9):865-874

Monell Chemical Senses Center, Philadelphia PA, USA.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has currently infected over 6.5 million people worldwide. In response to the pandemic, numerous studies have tried to identify the causes and symptoms of the disease. Emerging evidence supports recently acquired anosmia (complete loss of smell) and hyposmia (partial loss of smell) as symptoms of COVID-19, but studies of olfactory dysfunction show a wide range of prevalence from 5% to 98%. We undertook a search of Pubmed/Medline and Google Scholar with the keywords "COVID-19," "smell," and/or "olfaction." We included any study that quantified smell loss (anosmia and hyposmia) as a symptom of COVID-19. Studies were grouped and compared based on the type of method used to measure smell loss-subjective measures, such as self-reported smell loss, versus objective measures using rated stimuli-to determine if prevalence differed by method type. For each study, 95% confidence intervals (CIs) were calculated from point estimates of olfactory disturbances. We identified 34 articles quantifying anosmia as a symptom of COVID-19 (6 objective and 28 subjective), collected from cases identified from January 16 to April 30, 2020. The pooled prevalence estimate of smell loss was 77% when assessed through objective measurements (95% CI of 61.4-89.2%) and 44% with subjective measurements (95% CI of 32.2-57.0%). Objective measures are a more sensitive method to identify smell loss as a result of infection with SARS-CoV-2; the use of subjective measures, while expedient during the early stages of the pandemic, underestimates the true prevalence of smell loss.
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http://dx.doi.org/10.1093/chemse/bjaa064DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7543258PMC
December 2020

The Microbiome, Metabolomics, and Nursing Science: Part 2.

Biol Res Nurs 2021 Jan 8;23(1):5-6. Epub 2020 Oct 8.

School of Nursing, 12330The University of Texas at Austin, TX, USA.

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http://dx.doi.org/10.1177/1099800420964593DOI Listing
January 2021

The Microbiome, Metabolomics, and Nursing Science: Part 1.

Biol Res Nurs 2020 10;22(4):434-435

School of Nursing, 12330University of Texas at Austin, TX, USA.

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http://dx.doi.org/10.1177/1099800420943674DOI Listing
October 2020

Leveraging Microbiome Science From the Bedside to Bench and Back: A Nursing Perspective.

Nurs Res 2021 Jan/Feb;70(1):3-5

Katherine A. Maki, PhD, RN, NP-BC, is Postdoctoral Fellow, Clinical Center, National Institutes of Health, Bethesda, Maryland. Paule V. Joseph, PhD, RN, FNP-BC, is Lasker Clinical Research Scholar, National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland. Nancy J. Ames, PhD, RN, is Clinical Nurse Scientist, Clinical Center, National Institutes of Health, Bethesda, Maryland. Gwenyth R. Wallen, PhD, RN, is Chief Nurse Officer and Chief of Nursing Research and Translational Science, Clinical Center, National Institutes of Health, Bethesda, Maryland.

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http://dx.doi.org/10.1097/NNR.0000000000000475DOI Listing
February 2021

Taste the Pain: The Role of TRP Channels in Pain and Taste Perception.

Int J Mol Sci 2020 08 18;21(16). Epub 2020 Aug 18.

Sensory Science and Metabolism Unit (SenSMet), National Institute of Nursing Research, National Institutes of Health, Bethesda, MD 20892, USA.

Transient receptor potential (TRP) channels are a superfamily of cation transmembrane proteins that are expressed in many tissues and respond to many sensory stimuli. TRP channels play a role in sensory signaling for taste, thermosensation, mechanosensation, and nociception. Activation of TRP channels (e.g., TRPM5) in taste receptors by food/chemicals (e.g., capsaicin) is essential in the acquisition of nutrients, which fuel metabolism, growth, and development. Pain signals from these nociceptors are essential for harm avoidance. Dysfunctional TRP channels have been associated with neuropathic pain, inflammation, and reduced ability to detect taste stimuli. Humans have long recognized the relationship between taste and pain. However, the mechanisms and relationship among these taste-pain sensorial experiences are not fully understood. This article provides a narrative review of literature examining the role of TRP channels on taste and pain perception. Genomic variability in the gene has been associated with alterations in various pain conditions. Moreover, polymorphisms of the gene have been associated with alterations in salty taste sensitivity and salt preference. Studies of genetic variations in genes or modulation of TRP pathways may increase our understanding of the shared biological mediators of pain and taste, leading to therapeutic interventions to treat many diseases.
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http://dx.doi.org/10.3390/ijms21165929DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460556PMC
August 2020

Untargeted Metabolomic Approach Shows No Differences in Subcutaneous Adipose Tissue of Diabetic and Non-Diabetic Subjects Undergoing Bariatric Surgery: An Exploratory Study.

Biol Res Nurs 2021 Jan 7;23(1):109-118. Epub 2020 Aug 7.

Sensory Science & Metabolism Unit, Biobehavioral Branch, Division of Intramural Research, National Institute of Nursing Research, 2511National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.

Background: Obesity plays a major role in the development of insulin resistance (IR) and diabetes (T2DM). Increased adipose tissue (AT) is particularly of interest because it activates a chronic inflammatory response in adipocytes and other tissues. AT plays key endocrine and metabolic functions, acting in the regulation of insulin sensitivity and energy homeostasis. Additionally, it can be easily collected during bariatric surgery. The purpose of this pilot study was to explore the potential differences in AT metabolism, through comparing the untargeted metabolomic profiles of diabetic and non-diabetic obese patients undergoing bariatric surgery.

Methods: For this exploratory study, samples were collected from 17 subjects. Subcutaneous AT (SAT) samples from obese-diabetic (n = 8) and Obese-non-Diabetic (n = 9) subjects were obtained from the Human Metabolic Tissue Bank. Untargeted metabolomic profiling was performed by Metabolon® Inc. Statistical analysis was performed using the MetaboAnalyst 4.0 platform.

Results: Among the 421 metabolites identified and analyzed there were no significant differences between the Obese-Diabetics and the Obese-non-Diabetics. Small changes were observed by fold change analysis mainly in lipid (n = 12; e.g. NEFAs) and amino acid (n = 8; e.g. BCAAs) metabolic pathways. Dysregulation of these metabolites has been associated with IR and other T2DM-related pathophysiological processes.

Conclusion: Obesity may influence SAT metabolism masking T2DM-dependent dysregulation. Better understanding the metabolic differences within SAT in diabetic populations may help identify potential biomarkers for diagnosis and monitoring of T2DM in patients undergoing bariatric surgery.
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http://dx.doi.org/10.1177/1099800420942900DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874365PMC
January 2021

Recent smell loss is the best predictor of COVID-19: a preregistered, cross-sectional study.

Authors:
Richard C Gerkin Kathrin Ohla Maria Geraldine Veldhuizen Paule V Joseph Christine E Kelly Alyssa J Bakke Kimberley E Steele Michael C Farruggia Robert Pellegrino Marta Y Pepino Cédric Bouysset Graciela M Soler Veronica Pereda-Loth Michele Dibattista Keiland W Cooper Ilja Croijmans Antonella Di Pizio M Hakan Ozdener Alexander W Fjaeldstad Cailu Lin Mari A Sandell Preet B Singh V Evelyn Brindha Shannon B Olsson Luis R Saraiva Gaurav Ahuja Mohammed K Alwashahi Surabhi Bhutani Anna D'Errico Marco A Fornazieri Jérôme Golebiowski Liang-Dar Hwang Lina Öztürk Eugeni Roura Sara Spinelli Katherine L Whitcroft Farhoud Faraji Florian Ph S Fischmeister Thomas Heinbockel Julien W Hsieh Caroline Huart Iordanis Konstantinidis Anna Menini Gabriella Morini Jonas K Olofsson Carl M Philpott Denis Pierron Vonnie D C Shields Vera V Voznessenskaya Javier Albayay Aytug Altundag Moustafa Bensafi María Adelaida Bock Orietta Calcinoni William Fredborg Christophe Laudamiel Juyun Lim Johan N Lundström Alberto Macchi Pablo Meyer Shima T Moein Enrique Santamaría Debarka Sengupta Paloma Paloma Domínguez Hüseyin Yanık Sanne Boesveldt Jasper H B de Groot Caterina Dinnella Jessica Freiherr Tatiana Laktionova Sajidxa Mariño Erminio Monteleone Alexia Nunez-Parra Olagunju Abdulrahman Marina Ritchie Thierry Thomas-Danguin Julie Walsh-Messinger Rashid Al Abri Rafieh Alizadeh Emmanuelle Bignon Elena Cantone Maria Paola Cecchini Jingguo Chen Maria Dolors Guàrdia Kara C Hoover Noam Karni Marta Navarro Alissa A Nolden Patricia Portillo Mazal Nicholas R Rowan Atiye Sarabi-Jamab Nicholas S Archer Ben Chen Elizabeth A Di Valerio Emma L Feeney Johannes Frasnelli Mackenzie Hannum Claire Hopkins Hadar Klein Coralie Mignot Carla Mucignat Yuping Ning Elif E Ozturk Mei Peng Ozlem Saatci Elizabeth A Sell Carol H Yan Raul Alfaro Cinzia Cecchetto Gérard Coureaud Riley D Herriman Jeb M Justice Pavan Kumar Kaushik Sachiko Koyama Jonathan B Overdevest Nicola Pirastu Vicente A Ramirez S Craig Roberts Barry C Smith Hongyuan Cao Hong Wang Patrick Balungwe Marius Baguma Thomas Hummel John E Hayes Danielle R Reed Masha Y Niv Steven D Munger Valentina Parma

medRxiv 2020 Jul 26. Epub 2020 Jul 26.

Background: COVID-19 has heterogeneous manifestations, though one of the most common symptoms is a sudden loss of smell (anosmia or hyposmia). We investigated whether olfactory loss is a reliable predictor of COVID-19.

Methods: This preregistered, cross-sectional study used a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n=4148) or negative (C19-; n=546) COVID-19 laboratory test outcome. Logistic regression models identified singular and cumulative predictors of COVID-19 status and post-COVID-19 olfactory recovery.

Results: Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean±SD, C19+: -82.5±27.2 points; C19-: -59.8±37.7). Smell loss during illness was the best predictor of COVID-19 in both single and cumulative feature models (ROC AUC=0.72), with additional features providing no significant model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms, such as fever or cough. Olfactory recovery within 40 days was reported for ~50% of participants and was best predicted by time since illness onset.

Conclusions: As smell loss is the best predictor of COVID-19, we developed the ODoR-19 tool, a 0-10 scale to screen for recent olfactory loss. Numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (10
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http://dx.doi.org/10.1101/2020.07.22.20157263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386529PMC
July 2020

Metabolic Profiling of Blood and Urine for Exploring the Functional Role of the Microbiota in Human Health.

Biol Res Nurs 2020 10 29;22(4):449-457. Epub 2020 Jul 29.

Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.

The quantification of metabolites in blood and urine allows nurses to explore new hypotheses about the microbiome. This review summarizes findings from recent studies with a focus on how the state of the science can influence future nursing research initiatives. Metabolomics can advance nursing research by identifying physiologic/pathophysiologic processes underlying patients' symptoms and can be useful for testing the effects of nursing interventions. To date, metabolomics has been used to study cardiovascular, respiratory, endocrine, autoimmune, and infectious conditions, with research focused on understanding the microbial metabolism of substrates resulting in circulating/excreted biomarkers such as trimethylamine N-oxide. This review provides specific recommendations for the collection of specimens and goals for future studies.
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http://dx.doi.org/10.1177/1099800420941080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874358PMC
October 2020

Objective sensory testing methods reveal a higher prevalence of olfactory loss in COVID-19 positive patients compared to subjective methods: A systematic review and meta-analysis.

medRxiv 2020 Jul 6. Epub 2020 Jul 6.

Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has currently infected over 6.5 million people worldwide. In response to the pandemic, numerous studies have tried to identify the causes and symptoms of the disease. Emerging evidence supports recently acquired anosmia (complete loss of smell) and hyposmia (partial loss of smell) as symptoms of COVID-19, but studies of olfactory dysfunction show a wide range of prevalence, from 5% to 98%. We undertook a search of Pubmed/Medline and Google Scholar with the keywords 'COVID-19', 'smell', and/or 'olfaction'. We included any study that quantified olfactory loss as a symptom of COVID%[minus]19. Studies were grouped and compared based on the type of method used to measure smell loss - subjective measures such as self-reported smell loss versus objective measures using rated stimuli - to determine if prevalence rate differed by method type. For each study, 95% confidence intervals (CIs) were calculated from point estimates of olfactory disturbance rates. We identified 34 articles quantifying anosmia as a symptom of COVID-19, collected from cases identified from January 16 to April 30, 2020. The pooled prevalence estimate of smell loss was 77% when assessed through objective measurements (95% CI of 61.4-89.2%) and 45% with subjective measurements (95% CI of 31.1-58.5%). Objective measures are a more sensitive method to identify smell loss as a result of infection with SARS-CoV-2. The use of subjective measures, while expedient during the early stages of the pandemic, underestimates the true prevalence of smell loss.
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http://dx.doi.org/10.1101/2020.07.04.20145870DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359533PMC
July 2020

COVID-19 and the Chemical Senses: Supporting Players Take Center Stage.

Neuron 2020 07 1;107(2):219-233. Epub 2020 Jul 1.

Leibniz Institute for Food Systems Biology at the Technical University of Munich, Freising, Germany. Electronic address:

The main neurological manifestation of COVID-19 is loss of smell or taste. The high incidence of smell loss without significant rhinorrhea or nasal congestion suggests that SARS-CoV-2 targets the chemical senses through mechanisms distinct from those used by endemic coronaviruses or other common cold-causing agents. Here we review recently developed hypotheses about how SARS-CoV-2 might alter the cells and circuits involved in chemosensory processing and thereby change perception. Given our limited understanding of SARS-CoV-2 pathogenesis, we propose future experiments to elucidate disease mechanisms and highlight the relevance of this ongoing work to understanding how the virus might alter brain function more broadly.
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http://dx.doi.org/10.1016/j.neuron.2020.06.032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328585PMC
July 2020

The Role of Extracellular Vesicles in β-Cell Function and Viability: A Scoping Review.

Front Endocrinol (Lausanne) 2020 11;11:375. Epub 2020 Jun 11.

Sensory Science & Metabolism Unit, Biobehavioral Branch, National Institute of Nursing Research, Division of Intramural Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, United States.

Extracellular vesicles (EVs) released by cells throughout the body have been implicated in diabetes pathogenesis. Understanding the role of EVs in regulation of β-cell function and viability may provide insights into diabetes etiology and may lead to the development of more effective screening and diagnostic tools to detect diabetes earlier and prevent disease progression. This review was conducted to determine what is known from the literature about the effect of EV crosstalk on pancreatic β-cell function and viability in the pathogenesis of diabetes mellitus, to perform a gap analysis for future research directions, and to discuss implications of available evidence for diabetes care. The literature search yielded 380 studies from which 31 studies were determined to meet eligibility criteria. The majority of studies had the disease context of autoimmunity in T1DM. The most commonly studied EV crosstalk dynamics involved localized EV-mediated communication between β-cells and other islet cells, or between β-cells and immune cells. Other organs and tissues secreting EVs that affect β-cells include skeletal muscle, hepatocytes, adipocytes, immune cells, bone marrow, vascular endothelium, and mesenchymal stem cells. Characterization of EV cargo molecules with regulatory effects in β-cells was conducted in 24 studies, with primary focus on microRNA cargo. Gaps identified included scarcity of evidence for the effect on β-cell function and viability of EVs from major metabolic organs/tissues such as muscle, liver, and adipose depots. Future research should address these gaps as well as characterize a broader range of EV cargo molecules and their activity in β-cells.
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http://dx.doi.org/10.3389/fendo.2020.00375DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300279PMC
June 2020

Role of Olfaction in Human Health: A Focus on Coronaviruses.

Allergy Rhinol (Providence) 2020 Jan-Dec;11:2152656720928245. Epub 2020 Jun 5.

Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland.

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http://dx.doi.org/10.1177/2152656720928245DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278301PMC
June 2020

Corona Viruses and the Chemical Senses: Past, Present, and Future.

Chem Senses 2020 May 14. Epub 2020 May 14.

Temple University, Philadelphia (PA), USA.

A wealth of rapidly evolving reports suggests that olfaction and taste disturbances may be manifestations of the novel COVID-19 pandemic. While otolaryngological societies worldwide have started to consider chemosensory evaluation as a screening tool for COVID-19 infection, the true nature of the relationship between the changes in chemosensory ability and COVID-19 is unclear. Our goal with this review is to provide a brief overview of published and archived literature, as well as the anecdotal reports and social trends related to this topic up to April 29, 2020. We also aim to draw parallels between the clinical/chemosensory symptomology reported in association to past coronavirus pandemics (such as SARS and MERS) and the novel COVID-19. This review also highlights current evidence on persistent chemosensory disturbances after the infection has resolved. Overall, our analysis pinpoints the need for further studies: 1) to better quantify olfaction and taste disturbances associated with SARS-CoV-2 infection, compared to those of other viral and respiratory infections, 2) to understand the relation between smell, taste, and chemesthesis disturbances in COVID-19, and 3) to understand how persistent are these disturbances after the infection has resolved.
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http://dx.doi.org/10.1093/chemse/bjaa031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7239211PMC
May 2020

Gene co-expression networks are associated with obesity-related traits in kidney transplant recipients.

BMC Med Genomics 2020 03 10;13(1):37. Epub 2020 Mar 10.

Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, 20892, USA.

Background: Obesity is common among kidney transplant recipients; However biological mediators of obesity are not well understood in this population. Because subcutaneous adipose tissue can be easily obtained during kidney transplant surgery, it provides a unique avenue for studying the mechanisms of obesity for this group. Although differential gene expression patterns were previously profiled for kidney transplant patients, gene co-expression patterns can shed light on gene modules not yet explored on the coordinative behaviors of gene transcription in biological and disease processes from a systems perspective.

Methods: In this study, we collected 29 demographic and clinical variables and matching microarray expression data for 26 kidney transplant patients. We conducted Weighted Gene Correlation Network Analysis (WGCNA) for 5758 genes with the highest average expression levels and related gene co-expression to clinical traits.

Results: A total of 35 co-expression modules were detected, two of which showed associations with obesity-related traits, mainly at baseline. Gene Ontology (GO) enrichment was found for these two clinical trait-associated modules. One module consisting of 129 genes was enriched for a variety of processes, including cellular homeostasis and immune responses. The other module consisting of 36 genes was enriched for tissue development processes.

Conclusions: Our study generated gene co-expression modules associated with obesity-related traits in kidney transplant patients and provided new insights regarding the cellular biological processes underlying obesity in this population.
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http://dx.doi.org/10.1186/s12920-020-0702-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063809PMC
March 2020

A Systematic Review of Taste Differences Among People With Eating Disorders.

Biol Res Nurs 2020 01 4;22(1):82-91. Epub 2019 Sep 4.

Sensory Science & Metabolism Unit, Biobehavioral Branch, Division of Intramural Research, Department of Health and Human Services, National Institutes of Health, Bethesda, MD, USA.

Background: Eating disorders are a significant cause of morbidity and mortality. The etiology and maintenance of eating-disorder symptoms are not well understood. Evidence suggests that there may be gustatory alterations in patients with eating disorders.

Objective: This article systematically reviews research assessing gustatory differences in patients with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED).

Method: A systematic review was performed, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, examining taste and eating disorders. We reviewed electronic databases and identified 1,490 peer-reviewed English-language studies. Of these, 49 met inclusion criteria.

Results: Studies employed psychophysical measures ( = 27), self-reported questionnaires ( = 5), and neuroimaging techniques (i.e., electroencephalography, functional magnetic resonance imaging; = 17). Psychophysical studies showed that individuals with BN, in general, had greater preference for sweetness than healthy controls, and those with AN had a greater aversion for fat than controls. In neuroimaging studies, findings suggested that predictable administration of sweet-taste stimuli was associated with reduced activation in taste-reward regions of the brain among individuals with AN (e.g., insula, ventral, and dorsal striatum) but increased activation in BN and BED.

Discussion: To our knowledge, this systematic review is the first to synthesize literature on taste differences in AN, BN, and BED. The inconsistency and variability in methods used across studies increased difficulties in comparing studies and disease processes. Further studies with well-defined population parameters are warranted to better understand how taste varies in patients with eating disorders.
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http://dx.doi.org/10.1177/1099800419872824DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912928PMC
January 2020

Neuropsychological Symptoms and Intrusive Thoughts Are Associated With Worse Trajectories of Chemotherapy-Induced Nausea.

J Pain Symptom Manage 2020 03 2;59(3):668-678. Epub 2019 Nov 2.

School of Nursing, University of California, San Francisco, California, USA. Electronic address:

Context: Although chemotherapy-induced vomiting is well controlled with evidence-based antiemetic regimens, chemotherapy-induced nausea (CIN) remains a significant clinical problem.

Objectives: Study purposes, in a sample of outpatients with breast, gastrointestinal, gynecological, or lung cancer who received two cycles of chemotherapy (CTX, n = 1251), were to evaluate for interindividual differences in the severity of CIN and to determine which demographic, clinical, symptom, and stress characteristics are associated with higher initial levels as well as with the trajectories of CIN.

Methods: Patients were recruited during their first or second cycle of CTX. Patients completed self-report questionnaires a total of six times over two cycles of CTX. Hierarchical linear modeling was used to evaluate for interindividual differences in and characteristics associated with the severity of CIN.

Results: Across the two cycles of CTX, higher levels of sleep disturbance, depression, and morning fatigue, as well as higher levels of intrusive thoughts, were associated with higher initial levels of CIN. In addition, lower functional status scores and shorter cycle lengths were associated with higher initial levels of CIN, and younger age and higher emetogenicity of the CTX regimen were associated with both higher initial levels as well as worse trajectories of CIN severity.

Conclusion: These findings suggest that common symptoms associated with cancer and its treatment are associated with increased severity of CIN. Targeted interventions for these symptoms may reduce the burden of unrelieved CIN.
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http://dx.doi.org/10.1016/j.jpainsymman.2019.10.023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7024637PMC
March 2020

CE: Knowledge of Precision Medicine and Health Care: An Essential Nursing Competency.

Am J Nurs 2019 10;119(10):34-42

Ruth Lebet is a nurse scientist at the Children's Hospital of Philadelphia and program director of the Pediatric and Neonatal Clinical Nurse Specialist Programs at the University of Pennsylvania School of Nursing, Philadelphia. Paule V. Joseph is a Lasker Clinical Research Scholar, tenure-track investigator, and National Institutes of Health (NIH) Distinguished Scholar in the Division of Intramural Research, National Institute of Nursing Research (NINR), NIH, U.S. Department of Health and Human Services, Bethesda, MD. Edwin N. Aroke is an assistant professor in the Nurse Anesthesia Program, University of Alabama at Birmingham School of Nursing. The authors acknowledge Joan Austin, PhD, RN, FAAN, distinguished professor emerita, Indiana University School of Nursing, Indianapolis, and Ann Cashion, PhD, RN, FAAN, NINR scientific director, for their helpful feedback on this manuscript. Contact author: Ruth Lebet, The authors and planners have disclosed no potential conflicts of interest, financial or otherwise. The opinions expressed in this article are those of the authors, who are solely responsible for the interpretation and reporting of the data herein. No statements in this article should be construed as an official recommendation, interpretation, or policy of the NIH, the U.S. government, the University of Pennsylvania, or the University of Alabama at Birmingham.

Advances in genetic and genomic research, combined with the rapid development of new technologies, have reshaped our understanding of health and disease processes, generating what have collectively become known as "omics" sciences. These sciences are now an integral part of health care delivery, with nurses and nurse scientists at the forefront, implementing and adapting genomic technologies in the clinical setting while advancing knowledge in these areas. With the increasing focus on precision medicine and health care, integrating genetic and genomic knowledge has become an essential competency in nursing care, research, and education, as it enables nurses to collaborate effectively with patients in improving their health and well-being.
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http://dx.doi.org/10.1097/01.NAJ.0000586168.93088.3cDOI Listing
October 2019

Co-occurring Gastrointestinal Symptoms Are Associated With Taste Changes in Oncology Patients Receiving Chemotherapy.

J Pain Symptom Manage 2019 11 23;58(5):756-765. Epub 2019 Jul 23.

Department of Physiological Nursing, School of Nursing, University of California San Francisco, San Francisco, California, USA. Electronic address:

Context: Over 80% of patients with cancer report taste changes. Despite the high prevalence of this symptom and its negative effects on health, few studies have assessed its association with other gastrointestinal (GI) symptoms.

Objectives: Determine the occurrence, frequency, severity, and distress of patient-reported "change in the way food tastes" (CFT) and identify phenotypic and GI symptoms characteristics associated with its occurrence.

Methods: Patients receiving chemotherapy for breast, GI, gynecological, or lung cancer completed demographic and symptom questionnaires prior to their second or third cycle of chemotherapy. CFT was assessed using the Memorial Symptom Assessment Scale. Differences in demographic, clinical, and GI symptom characteristics were evaluated using parametric and nonparametric tests.

Results: Of the 1329 patients, 49.4% reported experiencing CFT in the week prior to their second or third cycle of chemotherapy. In the univariate analysis, patients who reported CFT had fewer years of education; were more likely to be black or Hispanic, mixed race, or other; and had a lower annual household income. A higher percentage of patients with CFT reported the occurrence of 13 GI symptoms (e.g., constipation, diarrhea, abdominal cramps, feeling bloated). In a multivariable logistic regression analysis, compared with patients with breast cancer, patients with lung cancer (odds ratio = 0.55; P = 0.004) had a decrease in the odds of being in the CFT group. Patients who received a neurokinin-1 receptor antagonist and two other antiemetics were at an increased odds of being in the CFT group (odds ratio = 2.51; P = 0.001). Eight of the 13 GI symptoms evaluated were associated with an increased odds of being in the CFT group.

Conclusions: This study provides new evidence on the frequency, severity, and distress of CFT in oncology patients undergoing chemotherapy. These findings suggest that CFT is an important problem that warrants ongoing assessments and nutritional interventions.
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http://dx.doi.org/10.1016/j.jpainsymman.2019.07.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6823134PMC
November 2019