The COVID-19 pandemic and subsequent lockdown had a substantial impact on normal research operations. Researchers needed to adapt their methods to engage at-home participants. One method is crowdsourcing, in which researchers use social media to recruit participants, gather data, and collect samples. We utilized this method to develop a diagnostic test for Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS). Participants were recruited via posts on popular social-media platforms, and enrolled via a website. Participants received and returned a mail kit containing bladder symptom surveys and a urine sample cup containing room-temperature preservative. Using this method, we collected 1254 IC/BPS and control samples in 3 months from all 50 United States. Our data demonstrate that crowdsourcing is a viable alternative to traditional research, with the ability to reach a broad patient population rapidly. Crowdsourcing is a powerful tool for at-home participation in research, particularly during the lockdown caused by the COVID-19 pandemic.

Alzheimer’s disease effects a large percentage of elderly dementia patients and is diagnosed on the basis of amyloid plaques and neurofibrillary tangles (NFTs) present in the brain. Urinary incontinence (UI) is often found in the elderly populations and multiple studies have shown that it is more common in Alzheimer’s disease patients than those with normal cognitive function. However, the link between increased UI and Alzheimer’s disease is still unclear. Amyloid plaques and NFTs present in micturition centers of the brain could cause a loss of signal to the bladder, resulting in the inability to properly void. Additionally, as Alzheimer’s disease progresses, patients become less likely to recognize the need or understand the appropriate time and place to void. There are several treatments for UI targeting the muscarinic and β3 adrenergic receptors, which are present in the bladder and the brain. While these treatments may aid in UI, they often have effects on the brain with cognitive impairment side-effects. Acetylcholine esterase inhibitors are often used in treatment of Alzheimer’s disease and directly oppose effects of anti-muscarinics used for UI, making UI management in Alzheimer’s disease patients difficult. There are currently over 200 pre-clinical models of Alzheimer’s disease, however, little research has been done on voiding disfunction in these models. There is preliminary data suggesting these models have similar voiding behavior to Alzheimer’s disease patients but much more research is needed to understand the link between UI and Alzheimer’s disease and discover better treatment options for managing both simultaneously.

Purpose: We sought to determine if urinary cytokine concentration profiles were different between various bladder conditions. Materials and Methods: Participants at three clinical sites completed a demographics survey and provided a urine sample in a collection cup containing a room-temperature urine preservative. Participants were divided into the following categories based on physician-documented diagnosis: asymptomatic control, nonulcerative interstitial cystitis (IC), overactive bladder with incontinence (OAB wet), urinary tract infection (UTI), and bladder cancer. Urinary cytokines were measured through Luminex multiplex assay. Results: Two hundred and seventy-seven urine samples were collected from three clinical sites. Urinary pro-inflammatory cytokines had an increasing trend in bladder disease versus control, with a significant increase for chemokine (C-X-C) ligand 1 growth-regulated protein alpha CXCL1 (GRO). Further analyses demonstrated that patients with UTI had significantly higher levels of GRO and interleukin-8 (IL-8) in comparison to control, nonulcerative IC, OAB wet, and bladder cancer. Both are chemokines that stimulate chemotaxis resulting in the rapid accumulation of immune cells such as neutrophils. IL-6 levels overall were at the lower limit of assay range but were significantly increased in urine of UTI patients versus IC patients. MCP-1 (CCL2) had the least separation among the control group and the various bladder diseases. Conclusion: Urinary concentrations of GRO were higher in disease state compared to control. Specifically, levels of GRO and IL-8 were higher in urine samples from patients with UTI compared to controls and other bladder conditions. Comparing and contrasting urinary cytokines may help improve our understanding of these important bladder diseases with great unmet needs.

Concerns have been raised that the lack of progress regarding limited surgical resources in low-and middle-income countries (LMICs) would lead to a new crisis. In 2015, it was estimated that there was a shortage of 1.1 million surgical staff disproportionately affecting LMICs. 1 Conditions for smaller surgical subspecialties like urology are even more discouraging: Nigeria, the most populous country in Africa, has one urologist per 3.2 million people. 2 These discrepancies are expected to worsen following the COVID-19 pandemic, which not only halted local medical and surgical care due to preferential management of patients infected with SARS-CoV-2, but also directly affected the personal health and already stretched resources of medical providers. The pandemic also limited international aid that may have been typically provided if it were not for the global shutdown.Global surgical mission groups serve a much-needed purpose in these under-resourced locations. Prior to the COVID-19 pandemic, over 250 000 surgeries were performed by surgical volunteer organizations (SVOs) in LMICs. 3 These organizations play an even more important role in helping expose and train local providers.International Volunteers in Urology (IVUmed) is a surgical mission group conducting surgical workshops in LMICs, while also focusing on creating a sustainable training pipeline. Its aim is to eventually hand over the entire surgical workshop and the training program to local physicians in LMICs so that they can independently expand and support themselves. Before the pandemic, IVUmed was performing 25 missions in 13 countries per year. On average, it provided care for 812 patients, performing 564 cases and training 296 local surgeons at an estimated service value of US$4 204 217.60 annually. As the COVID-19 virus spread around the globe, domestic and international travel came to a halt, as did surgical missions. 4 It has been over two years since the onset of the COVID-19 pandemic and since IVUmed's last workshop. As vaccines were developed and are being deployed, and as LMICs are adjusting to a postpandemic landscape, the question remains of how and when to restart surgical missions in these regions.

Introduction:Clinical research can be expensive and time consuming due to high associated costs and/or duration of the study. We hypothesized that urine sample collection using online recruitment and engagement of research participants via social medial has the potential to reach a large population in a small timeframe, at a reasonable cost.Methods:We performed a retrospective cost analysis of a cohort study comparing cost per sample and time per sample for both online and clinically recruited participants for urine sample collection. During this time, cost data were collected based on study associated costs from invoices and budget spreadsheets. The data were subsequently analyzed using descriptive statistics.Results:Each sample collection kit contained 3 urine cups, 1 for the disease sample and 2 for control samples. Out of the 3,576 (1,192 disease + 2,384 control) total sample cups mailed, 1,254 (695 control) samples were returned. Comparatively, the 2 clinical sites collected 305 samples. Although the initial startup cost of online recruitment was higher, cost per sample for online recruited was found to be $81.45 compared to $398.14 for clinic sample.Conclusions:We conducted a nationwide, contactless, urine sample collection through online recruitment in the midst of the COVID-19 pandemic. Results were compared with the samples collected in the clinical setting. Online recruitment can be utilized to collect urine samples rapidly, efficiently, and at a cost per sample that was 20% of an in-person clinic, and without risk of COVID-19 exposure.