Friday, April 23, 2021

Heartbeat can help detect signs of consciousness in patients after a coma

A novel diagnostic method for patients with disorders of consciousness

UNIVERSITY OF LIEGE

A new study conducted jointly by the University of Liege (Belgium) and the Ecole normale superieure - PSL (France) shows that heart brain interactions, measured using electroencephalography (EEG), provide a novel diagnostic avenue for patients with disorders of consciousness. This study is published in the Journal of Neuroscience.

Catherine Tallon-Baudry (ENS, CNRS) introduces : "The scientific community already knew that in healthy participants, the brain's response to heartbeats is related to perceptual, bodily and self-consciousness. We now show that we can obtain clinically meaningful information if we probe this interaction in patients with disorders of consciousness." In the past decades several important improvements for the diagnosis of these patients have been made, yet, it remains a big challenge to measure self-consciousness in these patients that cannot communicate.

For their study, the researchers included 68 patients with a disorder of consciousness. Fifty-five patients suffered from the minimally conscious state, and showed fluctuating but consistent signs of consciousness but were unable to communicate, and 13 patients in the unresponsive wakefulness state (previously called vegetative state) who do not show any behavioural sign of awareness. These patients were diagnosed using the coma recovery scale-revised, a standardized clinical test to assess conscious behaviour.

"As these patients suffered from severe brain injury, they might be unable to show behavioural signs of awareness. Therefore, we also based our diagnosis on the brain's metabolism as probe for consciousness. This is a state-of-the art neuroimaging technique that helps to improve the diagnosis of patients with disorders of consciousness. Although these scans are very informative, they can only be acquired in specialized centers," says Jitka Annen (GIGA Consciousness, ULiege).

The researchers recorded brain activity during resting state (i.e. without specific task or stimulation). They selected EEG segments right after a heartbeat and EEG segments at random timepoints (i.e. not time-locked to a heartbeat). They then used machine learning algorithms to classify (or diagnose) patients into the two diagnostic groups.

Diego Candia-Rivera (ENS) further comments: "EEG segments not locked to heartbeats were informative to predict if a patient was conscious or not, but EEG segments locked to heartbeats were more accurate in doing so. Our results indicate that the heartbeat evoked potential can give us supplementary evidence for the presence of consciousness."

It is important to note that the heartbeat evoked responses were more in accordance with the diagnosis based on brain metabolism than the diagnosis based on behavioural assessment. It seems therefore that the heartbeat evoked response can be used to measure a perspective of self-consciousness that is not assessed successfully using behavioural tools.

"The next challenge is to translate our findings to clinical applications so that all patients with disorders of consciousness can benefit from better diagnosis using widely available bedside assessment technologies," concludes Steven Laureys, head of GIGA Consciousness research unit and Centre du Cerveau (ULiege, CHU Liege).

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Key Points

Question What patterns of opioid prescribing exist following the first opioid prescription in a cohort of opioid-naive youths (aged 10-21 years)?

Findings In this cohort study including 189 477 youths, there were 2 distinct trajectories; and 65.3% of patients in the high-risk trajectory group filled opioids at 12 months compared with 13.1% in the low-risk trajectory. Differences between the 2 trajectories persisted beyond 12 months, with a greater proportion of both opioid fills and opioid use disorder diagnoses in the high-risk group.

Meaning Among the highest-risk trajectory, even short and low-dose opioid prescriptions were associated with increased risk of persistent opioid use.

Abstract

Importance Although prescription opioids are the most common way adolescents and young adults initiate opioid use, many studies examine population-level risks following the first opioid prescription. There is currently a lack of understanding regarding how patterns of opioid prescribing following the first opioid exposure may be associated with long-term risks.

Objective To identify distinct patterns of opioid prescribing following the first prescription using group-based trajectory modeling and examine the patient-, clinician-, and prescription-level factors that may be associated with trajectory membership during the first year.

Design, Setting, and Participants This cohort study examined Pennsylvania Medicaid enrollees’ claims data from 2010 through 2016. Participants were aged 10 to 21 years at time of first opioid prescription. Data analysis was performed in March 2020.

Main Outcomes and Measures This study used group-based trajectory modeling and defined trajectory status by opioid fill.

Results Among the 189 477 youths who received an initial opioid prescription, 107 562 were female (56.8%), 81 915 were non-Latinx White (59.6%), and the median age was 16.9 (interquartile range [IQR], 14.6-18.8) years. During the subsequent year, 47 477 (25.1%) received at least one additional prescription. Among the models considered, the 2-group trajectory model had the best fit. Of those in the high-risk trajectory, 65.3% (n = 901) filled opioid prescriptions at month 12, in contrast to 13.1% (n = 6031) in the low-risk trajectory. Median age among the high-risk trajectory was 19.0 years (IQR, 17.1-20.0 years) compared with the low-risk trajectory (17.8 years [IQR, 15.8-19.4 years]). The high-risk trajectory received more potent prescriptions compared with the low-risk trajectory (median dosage of the index month for high-risk trajectory group: 10.0 MME/d [IQR, 5.0-21.2 MME/d] vs the low-risk trajectory group: 4.7 MME/d [IQR, 2.5-7.8 MME/d]; P < .001). The trajectories showed persistent differences with more youths in the high-risk trajectory going on to receive a diagnosis of opioid use disorder (30.0%; n = 412) compared with the low-risk group (10.1%; n = 4638) (P < .001).

Conclusions and Relevance This study’s results identified 2 trajectories associated with elevated risk for persistent opioid receipt within 12 months following first opioid prescription. The high-risk trajectory was characterized by older age at time of first prescription, and longer and more potent first prescriptions. These findings suggest even short and low-dose opioid prescriptions can be associated with risks of persistent use for

New data could inform youth-focused pandemic messaging

Polls of people aged 14 to 24 about masks, distancing and more show the importance of focusing communications on protecting others

MICHIGAN MEDICINE - UNIVERSITY OF MICHIGAN

Research News

Now that teens and young adults across the country account for an increasing share of COVID-19 cases, and many have become eligible for vaccination, several recently published studies based on polls of this age group provide insights into the kinds of messaging that might work best for both preventing transmission and vaccine uptake.

Using data from text-message polls of people between the ages of 14 and 24 taken at several points in 2020, researchers from the University of Michigan find a clear theme: that most young people are taking COVID-19 seriously and trying to follow public health guidance, and that many of them they are motivated by the desire to protect others.

The latest paper, in the Journal of Adolescent Health's May issue, finds that 86% of young people are moderately or very concerned about spreading COVID-19. The data come from the MyVoice poll, which allows open-ended answers to questions texted to a national sample of young people.

At the time the poll was taken, 89% said they wear masks or other face coverings all or most of the time - and the most common reason they gave was to prevent themselves from spreading the coronavirus.

But nearly 20% said that they made exceptions when they were near people they considered close contacts or part of their "pod," and 16% said they based their mask-wearing behavior on social cues, such as whether they felt they could trust that the people they were with had been cautious about potential sources of exposure.

Melissa DeJonckheere, Ph.D., the first author of the paper and an assistant professor in U-M's Department of Family Medicine, says, "By and large, youth thought they were doing the right thing and following face covering guidelines, even when making exceptions. At the time our data were collected, youth were engaged and concerned about their impact on others, and overall wanted to do their part."

Kao-Ping Chua, M.D., Ph.D., senior author and an assistant professor of pediatrics, says that the findings have implications for improving messaging to young people around COVID-19 vaccination, as well as mask use. "Public health campaigns should leverage youths' desire to protect others and not be the cause of spread. Youth may not be very strongly motivated to get a vaccine to protect themselves. A message like "Get a vaccine to protect your grandparents" might be more effective."

Two other recent MyVoice papers found similarly high percentages of youth reported following rules about social distancing for the most part, but making exceptions for close contacts including situations where young people seemed to be misinterpreting public health guidance. Protecting others was cited as the most common motivation for distancing and following other guidance.

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Citations:

Journal of Adolescent Health
Volume 68, Issue 5, May 2021, Pages 873-881
https://www.sciencedirect.com/science/article/abs/pii/S1054139X21001002

Preventive Medicine Reports June 2021 https://www.sciencedirect.com/science/article/pii/S2211335521000462

Annals of Family Medicine March 2021 https://www.annfammed.org/content/19/2/141

Brazil prostitutes strike for first-line Covid shots

Prostitutes in the city of Belo Horizonte in southeast Brazil have gone on strike for a week, demanding to be included in the group of front-line workers receiving priority coronavirus vaccines

© DOUGLAS MAGNO Sex workers protest at Rua Guaicurus, in Belo Horizonte, in Brazil's Minas Gerais state on April 5, 2021, asking to be considered a priority group to receive the vaccine against Covid-19

Thousands of sex workers in the city have been forced by pandemic-related closure of hotels -- where they rented rooms to sell their services -- to solicit for clients on the street, they say.

"We are in the front line, moving the economy and we are at risk," Cida Vieira, president of the Association of Prostitutes of Minas Gerais state, told AFP. "We need to get vaccinated."

Vieira and other women held a protest Monday in a street lined with shuttered hotels where they used to ply their trade, waving placards declaring: "Sex workers are professionals" and "Sex work and health."

© DOUGLAS MAGNO Sex workers protest at Rua Guaicurus, in Belo Horizonte, in Brazil's Minas Gerais state on April 5, 2021, asking to be considered a priority group to receive the vaccine against Covid-19

"We are part of the priority group because we deal with various types of people and our lives are at risk," said Lucimara Costa, one of the protesting prostitutes.

The government has prioritized health workers, teachers, the elderly, indigenous people and people with underlying health conditions for the first vaccination round.

It hopes to vaccinate these priority groups, some 77 million people, in the first half of 2021, but experts say this may drag into September due to the shortage of doses.

"We are a priority group, we are health educators, peer educators. We form part of that group, since we give information about STIs for men, distribute condoms..." said Vieira.

Like the rest of Brazil, Minas Gerais state has been battling a second pandemic wave, but the number of deaths per 100,000 inhabitants, at 121, is among the lowest in the country.

The Covid-19 pandemic has claimed more than 332,000 lives in Brazil, a toll second only to the United States.

mel/js/mlr/caw
AFP 2021-04-07

Hubble celebrates 31st birthday with giant star on the edge of destruction

ESA/HUBBLE INFORMATION CENTRE

Research News

IMAGE: IN CELEBRATION OF THE 31ST ANNIVERSARY OF THE LAUNCH OF THE NASA/ESA HUBBLE SPACE TELESCOPE, ASTRONOMERS AIMED THE CELEBRATED OBSERVATORY AT ONE OF THE BRIGHTEST STARS SEEN IN OUR GALAXY... view more
CREDIT: NASA, ESA AND STSCI

The giant star featured in this latest Hubble Space Telescope anniversary image is waging a tug-of-war between gravity and radiation to avoid self-destruction. The star, called AG Carinae, is surrounded by an expanding shell of gas and dust -- a nebula -- that is shaped by the powerful winds of the star. The nebula is about five light-years wide, which equals the distance from here to our nearest star, Alpha Centauri.

The huge structure was created from one or more giant eruptions several thousand years ago. The star's outer layers were blown into space, the expelled material amounting to roughly 10 times the mass of our Sun. These outbursts are typical in the life of a rare breed of star called a Luminous Blue Variable (LBV), a brief unstable phase in the short life of an ultra-bright, glamorous star that lives fast and dies young. These stars are among the most massive and brightest stars known. They live for only a few million years, compared to the roughly 10-billion-year lifetime of our own Sun. AG Carinae is a few million years old and resides 20 000 light-years away inside our Milky Way galaxy. The star's expected lifetime is between 5 million and 6 million years.

LBVs have a dual personality. They appear to spend years in semi-quiescent bliss and then they erupt in a petulant outburst, during which their luminosity increases -- sometimes by several orders of magnitude. These behemoths are stars in the extreme, far different from normal stars like our Sun. In fact AG Carinae is estimated to be up to 70 times more massive than our Sun and shines with the blinding brilliance of 1 million suns.

Major outbursts such as the one that produced the nebula featured in this image occur a few times during a LBV's lifetime. A LBV star only casts off material when it is in danger of self-destruction. Because of their massive forms and super-hot temperatures, luminous blue variable stars like AG Carinae are in a constant battle to maintain stability. It's an arm-wrestling contest between radiation pressure from within the star pushing outward and gravity pressing inward. This arm-wrestling match results in the star's expanding and contracting. The outward pressure occasionally wins the battle, and the star expands to such an immense size that it blows off its outer layers, like a volcano erupting. But this outburst only happens when the star is on the verge of coming apart. After the star ejects the material, it contracts to its normal (large) size, settles back down, and becomes stable again.

LBV stars are rare: fewer than 50 are known among the galaxies in our local group of neighbouring galaxies. These stars spend tens of thousands of years in this phase, a blink of an eye in cosmic time. Some are expected to end their lives in titanic supernova blasts, which enrich the Universe with the heavier elements beyond iron.

Like many other LBVs, AG Carinae remains unstable. It has experienced lesser outbursts that have not been as powerful as the one that created the present nebula. Although AG Carinae is semi-quiescient now, its searing radiation and powerful stellar wind (streams of charged particles) have been shaping the ancient nebula, sculpting intricate structures as outflowing gas slams into the slower-moving outer nebula. The wind is travelling at up to 1 million kilometres per hour, about 10 times faster than the expanding nebula. Over time, the hot wind catches up with the cooler expelled material, ploughs into it, and pushes it farther away from the star. This "snowplough" effect has cleared a cavity around the star.

The red material is glowing hydrogen gas laced with nitrogen gas. The diffuse red material at upper left pinpoints where the wind has broken through a tenuous region of material and swept it into space. The most prominent features, highlighted in blue, are filamentary structures shaped like tadpoles and lopsided bubbles. These structures are dust clumps illuminated by the star's light. The tadpole-shaped features, most prominent at left and bottom, are denser dust clumps that have been sculpted by the stellar wind. Hubble's sharp vision reveals these delicate-looking structures in great detail.

The image was taken in visible and ultraviolet light. Hubble is ideally suited for observations in ultraviolet light because this wavelength range can only be viewed from space.

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More information:

The Hubble Space Telescope is a project of international cooperation between ESA and NASA.

Each year in the month of April, ESA/Hubble uses the telescope's anniversary as an opportunity to develop special initiatives to engage and involve the public in this annual milestone. You can explore all of the ESA/Hubble 31st Anniversary initiatives that have been and will be announced here: ESAHubble.org/Hubble31. You can engage with ESA/Hubble's 31st anniversary activities on social media using #Hubble31.

The observations were conducted as part of the Hubble observing program 16434 (PI: Christopher Britt). They were taken with Hubble's Wide Field Camera 3 UVIS channel.

As Hubble celebrates it's 31st year of operations, below are some captivating facts about the famous observatory's achievements and impact:

Launched on 24 April 1990, the NASA/ESA Hubble Space Telescope has made more than 1.5 million observations of about 48 000 celestial objects.

In its 31-year lifetime, the telescope has racked up more than 181 000 orbits around our planet, totaling over 7.2 billion kilometres.

Hubble observations have produced more than 169 terabytes of data, which are available to present and future generations of researchers.

Astronomers using Hubble data have published more than 18 000 scientific papers, with more than 900 of those papers published in 2020.

VR visualization supports research on molecular networks

A new VR platform enables the display of huge amounts of data. This can be helpful in the study of rare genetic defects, among other things.

CEMM RESEARCH CENTER FOR MOLECULAR MEDICINE OF THE AUSTRIAN ACADEMY OF SCIENCES

Research News

IMAGE: GREEN-SCREEN COMPOSITION SHOWING A USER IMMERSED IN THE GENOME-SCALE MOLECULAR INTERACTION NETWORK. view more
CREDIT: SEBASTIAN PIRCH, PUBLISHED IN NATURE COMMUNICATIONS 2021.

Networks offer a powerful way to visualize and analyze complex systems. However, depending on the size and complexity of the network, many visualizations are limited. Protein interactions in the human body constitute such a complex system that can hardly be visualized. Jörg Menche, Adjunct Principal Investigator at the CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Professor at the University of Vienna and research group leader at Max Perutz Labs (Uni Wien/MedUni), and his team developed an immersive virtual reality (VR) platform that solves this problem. With the help of VR visualization of protein interactions, it will be possible in the future to better recognize correlations and identify those genetic aberrations that are responsible for rare diseases.

The larger and more complex networks are, the more difficult their visualization on the screen becomes. Conventional computer programs quickly reach their limits. This challenge was addressed by network scientist Jörg Menche and his research group at the CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences. They developed a VR platform for exploring huge amounts of data and their complex interplay in a uniquely intuitive fashion.

The body as a network

The representation of complex data can be particularly important in the search for the cause of rare diseases, because the human body, with its approximately 20,000 proteins that are encoded in the human genome and interact with each other, represents a huge complex network. Whether movement or digestion - at the molecular level, all biological processes are based on the interaction between proteins. If the protein interactions are illustrated in a network, a barely representable picture of about 18,000 dots - proteins - and about 300,000 lines between these dots will be created. Menche and his research group used the virtual reality (VR) platform they developed to make this image "readable" and, in collaboration with St. Anna Children's Cancer Research, succeeded in making the entirety of protein interactions visible for the first time. This makes it possible to interactively explore the vast and complex network.

Approaching the cause of rare immune diseases

For their study, published in Nature Communications, first author Sebastian Pirch and Menche's research group identified connection patterns between different protein complexes in the human body and linked them to their biological functions. In addition, the scientists used global databases to identify specific protein complexes associated with a particular disease. "While conventional forms of representation would look like a proverbial 'hairball', the 3-dimensional representation enables the precise analysis and observation of the different protein complexes and their interactions," says study author Pirch. This can be particularly important in the identification of rare genetic defects and crucial for therapeutic measures. "On the one hand, our study represents an important proof of concept of our VR platform; on the other hand, it directly demonstrates the enormous potential of visualizing molecular networks," says project leader Menche. "Especially in rare diseases, severe immune diseases, protein complexes associated with specific clinical symptoms can be analyzed in more detail to develop hypotheses about their respective pathobiological mechanisms. This facilitates the approach to disease causes and subsequently the search for targeted therapeutic measures."

About the VR platform

The platform developed by Menche's research group is designed for maximum flexibility and extensibility. Key features include the import of user-defined code for data analysis, easy integration of external databases, and a high degree of design freedom for arbitrary elements of user interfaces. The researchers were able to draw on technology normally used in the development of 3D computer games, such as the globally popular game Fortnite. By publishing the source code, the researchers hope to convince other developers of the potential of virtual reality for analyzing scientific data.

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The study "VRNetzer: A Virtual Reality Network Analysis Platform" was published in the journal Nature Communications on April 23, 2021. DOI: 10.1038/s41467-021-22570-w.

Authors: Sebastian Pirch, Felix Müller, Eugenia Iofinova, Julia Pazmandi, Christiane V. R. Hütter, Martin Chiettini, Celine Sin, Kaan Boztug, Iana Podkosova, Hannes Kaufmann & Jörg Menche

Funding: This work was supported by the Vienna Science and Technology Fund (WWTF) through projects VRG15-005 and NXT19-008, and by an Epic MegaGrant.

Jörg Menche studied physics in Leipzig, Recife and Berlin. He did his PhD with Reinhard Lipowsky at the Max-Planck-Institute for Colloids and Interfaces in Potsdam (Germany), and was a postdoctoral fellow with Albert-László Barabási at Northeastern University and at the Center for Cancer Systems Biology at Dana Farber Cancer Institute in Boston. He joined CeMM in 2015 as a Principal Investigator. In September 2020, he received a joint professorship at the Max Perutz Labs and the Faculty of Mathematics of the University of Vienna, and became CeMM Adjunct PI.

The mission of CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences is to achieve maximum scientific innovation in molecular medicine to improve healthcare. At CeMM, an international and creative team of scientists and medical doctors pursues free-minded basic life science research in a large and vibrant hospital environment of outstanding medical tradition and practice. CeMM's research is based on post-genomic technologies and focuses on societally important diseases, such as immune disorders and infections, cancer and metabolic disorders. CeMM operates in a unique mode of super-cooperation, connecting biology with medicine, experiments with computation, discovery with translation, and science with society and the arts. The goal of CeMM is to pioneer the science that nurtures the precise, personalized, predictive and preventive medicine of the future. CeMM trains a modern blend of biomedical scientists and is located at the campus of the General Hospital and the Medical University of Vienna. http://www.cemm.at

The Max Perutz Labs are a research institute established by the University of Vienna and the Medical University of Vienna to provide an environment for excellent, internationally recognized research and education in the field of Molecular Biology. Dedicated to a mechanistic understanding of fundamental biomedical processes, scientists at the Max Perutz Labs aim to link breakthroughs in basic research to advances in human health. The Max Perutz Labs are located at the Vienna BioCenter, one of Europe's hotspots for Life Sciences, and host around 50 research groups, involving more than 450 scientists and staff from 40 nations. http://www.maxperutzlabs.ac.at

St. Anna CCRI is an internationally renowned multidisciplinary research institution with the aim to develop and optimize diagnostic, prognostic, and therapeutic strategies for the treatment of children and adolescents with cancer. To achieve this goal, it combines basic research with translational and clinical research and focus on the specific characteristics of childhood tumor diseases in order to provide young patients with the best possible and most innovative therapies. Dedicated research groups in the fields of tumor genomics and epigenomics, immunology, molecular biology, cell biology, bioinformatics and clinical research are working together to harmonize scientific findings with the clinical needs of physicians to ultimately improve the wellbeing of our patients. http://www.ccri.at, http://www.kinderkrebsforschung.at

Army, ASU publish human-autonomy communication tips

U.S. ARMY RESEARCH LABORATORY

Research News

IMAGE: ARMY RESEARCHERS PUBLISH A PAPER SUGGESTING HOW FUTURE SOLDIERS WILL COMMUNICATE IN COMPLEX AND AUTONOMOUS ENVIRONMENTS. view more
CREDIT: U.S. ARMY PHOTO ILLUSTRATION

ABERDEEN PROVING GROUND, Md. -- Army and Arizona State University researchers identified a set of approaches to help scientists assess how well autonomous systems and humans communicate.

These approaches build on transformational scientific research efforts led by the Army's Robotics Collaborative Technology Alliance, which evolved the state of robots from tools to teammates and laid the foundation for much of the service's existing research into how humans and robots can work together effectively.

As ideas for autonomous systems evolve, and the possibilities of ever-more diverse human-autonomy teams has become a reality; however, no clear guidelines exist to explain the best ways to assess how well humans and intelligent systems communicate, Army researchers said.

"The future Army is going to have complex teams in terms of how they will involve autonomy in different ways," said Dr. Anthony Baker, postdoctoral scientist at the U.S. Combat Capabilities Development Command, known as DEVCOM, Army Research Laboratory. "There is a clear need to be able to measure communication in those types of teams because communication is what defines teamwork. It reflects how the team thinks, plans, makes decisions and succeeds or fails.

If you can't measure how the team is doing, you can't do anything to improve their performance, their decision-making, all of those things that make it more likely for the Army to maintain a decisive overmatch on the battlefield and for the warfighter to accomplish the mission, he said.

In the recently published Human-Intelligent Systems Integration journal paper Approaches for Assessing Communication in Human-Autonomy Teams, researchers listed 11 critical approaches for assessing communication in human-autonomy teams. Baker said their focus is to change Soldier involvement with those systems.

The approach considers communication structure:

Who is saying what to whom and when
Dynamics, or how interaction patterns evolve over time
Emotion, which looks at how information is communicated through facial expressions and vocal features like tone and pitch
Content, which draws on different aspects of words and phrases themselves

"If we want Soldiers and intelligent systems to work well together, we have to have the right measurement tools to analyze and study their communication because communication is so critical to how well they can perform," Baker said.

As lead author on the paper, Baker said it won't be enough to study these things after the teams are fielded.

"We need the measurement tools while those teams and technologies are being developed by the Army," he said.

Because multi-domain operations are fundamentally dependent on improving the efficiency and optimization of communications within and between domains, the goal of this cross-cutting work is for these systems to be able to work with teams more naturally, he said.

According to Baker, this work may also provide a critical roadmap for analyzing communication in complex human-autonomy team structures such as those forecasted for Next Generation Combat Vehicle operations.

"There may be a time when a smart, load-carrying mule robot should carry a squad's extra gear completely independently and without Soldier involvement, but there is also a push in some areas to make it so that if systems do need to involve Soldiers, they can do so in a way that's more natural for the Soldiers, like working with a human teammate," Baker said.

Consider how a Soldier telling a robotic system, "I need you to take that gear up the hill and wait an hour before going to the next zone," is much easier than inputting a series of buttons and switches on a remote control.

"We want intelligence assessments, command and control decisions and other important things like that to be possible with less Soldier involvement, but we still want Soldier engagement for some things, and we want it to be easier," Baker said. "Hence why the RCTA had a large focus on making Soldier-robot interactions more efficient."

The Robotics CTA was a decade-long research initiative began in 2009 that coalesced a community of researchers from the Army, academia and industry to identify scientific gaps and move the state of the art in ground combat robotics. Strategic investments in Army-led foundational research resulted in advanced science in four critical areas of ground combat robotics that effect the way U.S. warfighters see, think, move and team.

Baker said it laid the groundwork for a lot of how the Army thinks about human-robot interaction and drove the shift in how government and industry look at robots as teammates, rather than just tools.

The laboratory's Human-Autonomy Teaming essential research program, or HAT ERP, continues down paths started in the RCTA, which laid broad building blocks for how to describe, model, design and implement new ways of partnering humans and robots, which are intelligent systems with physical forms.

"RCTA was not interested in explaining or providing ways to study communication between human teammates, instead being aimed at how humans and robots communicate," Baker said. "Our work looks at it from the perspective that we will need ways to study the communication of any type of team-whether or not those teams currently involve any number of robots or autonomy. We want to be agnostic to the overall makeup of the team, so we provide communication assessments suitable for many different scenarios."

These communication assessment approaches also apply to Soldier-only teams as well.

"Imagine a future human-autonomy team that has to re-task an autonomous vehicle to go join another platoon, and now the team is just humans only," he said. "Our work seeks to provide the literature with ways to analyze communication in those teams, no matter what they look like or what they're supposed to do, so that we can draw conclusions about how well they are working together and accomplishing their goals."

Future research will seek to validate some of the approaches identified in the paper using datasets collected from Next Generation Combat Vehicle lab studies and field experiments, Baker said.

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Pepper the robot talks to itself to improve its interactions with people

CELL PRESS

Research News

Volume 90%

VIDEO: THIS VIDEO SHOWS PEPPER THE ROBOT EXPLAINING ITS REASONING AND HOW THAT CAN HELP RESOLVE CONFLICTS WITH HUMAN USERS. view more

CREDIT: ANTONIO CHELLA, ARIANNA PIPOTONE

Ever wondered why your virtual home assistant doesn't understand your questions? Or why your navigation app took you on the side street instead of the highway? In a study published April 21st in the journal iScience, Italian researchers designed a robot that "thinks out loud" so that users can hear its thought process and better understand the robot's motivations and decisions.

"If you were able to hear what the robots are thinking, then the robot might be more trustworthy," says co-author Antonio Chella, describing first author Arianna Pipitone's idea that launched the study at the University of Palermo. "The robots will be easier to understand for laypeople, and you don't need to be a technician or engineer. In a sense, we can communicate and collaborate with the robot better."

Inner speech is common in people and can be used to gain clarity, seek moral guidance, and evaluate situations in order to make better decisions. To explore how inner speech might impact a robot's actions, the researchers the researchers built a cognitive model of inner speech that makes robots able to speak to themselves and deployed them in a commercially-available Pepper robot.

The scientists found that, with the help of inner speech, Pepper is better at solving dilemmas. In one experiment, the user asked Pepper to place the napkin at the wrong spot, contradicting the etiquette rule. Pepper started asking itself a series of self-directed questions and concluded that the user might be confused. To be sure, Pepper confirmed the user's request, which led to further inner speech.

"Ehm, this situation upsets me. I would never break the rules, but I can't upset him, so I'm doing what he wants," Pepper said to itself, placing the napkin at the requested spot. Through Pepper's inner voice, the user can trace its thoughts to learn that Pepper was facing a dilemma and solved it by prioritizing the human's request. The researchers suggest that the transparency could help establish human-robot trust.

Comparing Pepper's performance with and without inner speech, Pipitone and Chella discovered that the robot had a higher task-completion rate when engaging in self-dialogue. Thanks to inner speech, Pepper outperformed the international standard functional and moral requirements for collaborative robots--guidelines that machines, from humanoid AI to mechanic arms at the manufacturing line, follow.

"People were very surprised by the robot's ability," says Pipitone. "The approach makes the robot different from typical machines because it has the ability to reason, to think. Inner speech enables alternative solutions for the robots and humans to collaborate and get out of stalemate situations."

Although hearing the inner voice of robots enriches the human-robot interaction, some people might find it inefficient because the robot spends more time completing tasks when it talks to itself. The robot's inner speech is also limited to the knowledge that researchers gave it. Still, Pipitone and Chella say their work provides a framework to further explore how self-dialogue can help robots focus, plan, and learn.

"In some sense, we are creating a generational robot that likes to chat," says Chella. The authors say that, from navigation apps and the camera on your phone to medical robots in the operation rooms, machines and computers alike can benefit from this chatty feature. "Inner speech could be useful in all the cases where we trust the computer or a robot for the evaluation of a situation," Chella says.

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This work was supported by the Air Force Office of Scientific Research.

iScience, Pipitone and Chella: "What robots want? Hearing the inner voice of a robot" https://www.cell.com/iscience/fulltext/S2589-0042(21)00339-4

iScience (@iScience_CP) is an open access journal from Cell Press that provides a platform for original research and interdisciplinary thinking in the life, physical, and earth sciences. The primary criterion for publication in iScience is a significant contribution to a relevant field combined with robust results and underlying methodology. Visit: http://www.cell.com/iscience. To receive Cell Press media alerts, contact press@cell.com.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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Friday, April 23, 2021

Trajectories of Opioid Use Following First Opioid Prescription in Opioid-Naive Youths and Young Adults

Pepper the robot talks to itself to improve its interactions with people

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