Thursday, November 04, 2021

Hybrid cars' green credentials under scrutiny

Sales of hybrid cars, which use both a conventional combustion engine and a small electric motor, could soon overtake those of p
Sales of hybrid cars, which use both a conventional combustion engine and a 
small electric motor, could soon overtake those of petrol vehicles in the EU.

Hybrid cars are increasingly popular in the European Union as eco-conscious drivers turn away from their more polluting petrol and diesel counterparts, but environmentalists warn they're not as green as they seem.

Sales of the cars, which use both a conventional combustion engine and a small electric motor, allowing owners to drive a few kilometres without emitting CO2, could soon overtake those of petrol vehicles in the EU.

In the third quarter of this year, 20.7 percent of cars sold in the bloc were new hybrid versions whose batteries are recharged by collecting wasted energy from elsewhere, like braking, and 9.1 percent were hybrid plug-ins that can be charged from an electric outlet.

Close to 40 percent were petrol-powered, 17.6 percent diesel and just 9.8 percent were fully electric.

Cheaper than fully , they also provide some reassurance for those worried about their battery running out of power at a time when charging stations are still not widespread.

Auto giants like Toyota, Stellantis, Renault and Hyundai-Kia are banking on hybrids, not least because they allow them to comply with EU norms on CO2 emissions at a lesser cost than fully electric cars.

'Barely cleaner'

But are they truly less polluting, or more of a transition solution as the world edges towards ditching petrol and diesel altogether?

Greenpeace and the pressure group Transport & Environment believe that hybrids actually slow down this transition.

They want to accelerate the shift to fully electric and to other forms of transport, pointing out that hybrids aren't that green.

"Conventional 'full' hybrids in particular, which run for the majority of the time on fossil fuel energy, are barely any cleaner than traditional petrol and diesel engines," Greenpeace said last year.

Marie Cheron of France's Nicolas Hulot Foundation, an environmental group, concurred.

"For example, some hybrids have been bought for fleets (of cars), they do not have a system that allows them to recharge, people don't charge them, and so they don't drive electric."

But Philippe Degeilh, an engineer at IFP Energies Nouvelles (Ifpen), an energy, transport and environment research group, said people just need to be educated in how to use hybrids correctly.

According to an Ifpen study published at the end of 2020, hybrids emit an average of 12 percent less CO2 than a similar petrol-powered car.

That rises to 33 percent in town, while it drops to almost zero on highways.

Plug-ins that are driven smoothly—draining batteries less—and often recharged are "capable of nearing zero emissions," according to Ifpen.

"A household that has just one car can have a better environmental record with a hybrid rather than with an electric car equipped with a large battery. It's designed to do 50 kilometres a day and sometimes to go on holiday," said Degeilh.

To stay or not?

Meanwhile, fully electric cars aren't necessarily all that green either.

Their batteries, which are getting bigger and bigger, require a lot of energy in their production.

Where the electricity comes from is also important to determine their environmental credentials.

The debate around hybrids is also a political one.

As the EU plans to ban the sale of petrol and diesel engines from 2035, some of the auto industry wants to ensure a role for hybrids.

"We think the  is here to stay," Jim Crosbie, head of Toyota Motor Manufacturing France, told AFP.

Hybrids—excluding plug-ins—represent 70 percent of the Japanese group's sales in Western Europe.

"If we're talking about a model life cycle of seven to nine years, it will remain an important asset for us in the years to come," he said.Sales of electric cars charge ahead in Europe

© 2021 AFP

Augmented reality: an early taste of the metaverse?

Under Peggy Johnson, Magic Leap has pivoted to developing augmented reality goggles for professionals, including surgeons
Under Peggy Johnson, Magic Leap has pivoted to developing augmented reality
 goggles for professionals, including surgeons.

When Facebook unveiled a mock-up last week of the "metaverse"—supposedly the internet of the future—it showed people transported to a psychedelic world of flying fish and friendly robots.

But while even Facebook CEO Mark Zuckerberg acknowledges these kinds of experiences could be many years away, some enthusiasts argue that a more modest version of the metaverse is already here.

"We're in the early stages of the metaverse, in some ways," Peggy Johnson, CEO of Magic Leap, told AFP at the Web Summit in Lisbon on Tuesday.

Magic Leap makes augmented reality (AR) headsets, which have already been used by surgeons preparing to separate a pair of conjoined twins, and by factory supervisors carrying out site inspections.

In both cases, information popped up before the users' eyes about what they were seeing.

It might not feel quite as immersive—or as kooky—as the virtual reality (VR) experiences that Zuckerberg wants to eventually bring to people's homes. But it nonetheless blurs the divide between the physical world and the digital one, a key idea behind the metaverse.

"With VR, you put on a device, and then you're in another world," Johnson said. "With AR, you put on a device, you're still in your world, but we're augmenting it with digital content."

So far, many people's experiences of AR have been limited to playing Pokemon Go or experimenting with image filters that transplant a comical pair of ears onto someone's face.

But it is in healthcare that the true potential of AR is starting to be realised, Johnson said.

Magic Leap's first augmented reality headset, released in 2018, failed to take off among the general public
Magic Leap's first augmented reality headset, released in 2018, failed to take off
 among the general public.

"You can call in experts who can look at the same thing as you are, from another part of the world," she said. "During surgery, you can lay down digital lines where perhaps the incision is going to occur."

Founded in 2010, Magic Leap's initial mission to bring AR to the masses generated huge hype and nearly $2.3 billion in venture funding.

Early promo material imagined it being used to bring a killer whale into a gymnasium full of schoolchildren.

But when Magic Leap's first headset was finally revealed in 2018, there was widespread disappointment; the product was too bulky and expensive to catch on among the general public.

The company was forced to lay off around half its staff last year.

Restaurant reviews and forgotten names

Johnson, a former Microsoft executive, took over as CEO in August 2020 and pivoted towards developing the goggles for use by professionals.

The Florida-based company last month announced that it has raised another $500 million in funding, with a new headset, the Magic Leap 2, set to be released in 2022.

The updated version is more lightweight, but it is still set to be used mostly by people accustomed to wearing goggles at work—like surgeons performing delicate work, or defence industry specialists.

If the AR revolution arrives, the market may be a crowded one with companies like Snapchat's developer, Snap, trialling spectacl
If the AR revolution arrives, the market may be a crowded one with companies
 like Snapchat's developer, Snap, trialling spectacles.

Google Glass, a pair of "smart glasses" that failed to take off when they launched in 2014, has similarly re-emerged as a product aimed at professional users.

Johnson predicted it might still be "a few more years" before Magic Leap or one of its competitors creates an AR headset that could feasibly be worn by consumers everywhere.

But that's the moment when Johnson predicts that AR could really transform our everyday lives.

It might, she suggested, allow us to see reviews for restaurants pinging before our eyes as we walk down a street perusing the options.

Forgotten someone's name? No problem. As they walk towards you, it could appear above their head.

"Right now we're all looking down at our mobile phones," Johnson said. Augmented reality, she hopes, could help us to soak up the world around us—a world with extra information layered over the top of it.

If that revolution arrives, the market may be a crowded one. Facebook is working on its own AR headset, while Apple is rumoured to be following suit. Snapchat's developer, Snap, is meanwhile trialling a new pair of its "Spectacles" on AR artists.

What does Johnson think the metaverse will look like in 15 years?

"I think you'll go back home to pick up your glasses because you left them at home," she predicted. "The same way you do with your mobile phone today."

Facebook assembles team to build 'metaverse'

© 2021 AFP

Study finds public support for nuclear energy in Southeast Asia generally low

nuclear plant
Credit: CC0 Public Domain

Nuclear energy may be the world's second-largest low carbon energy source for generating electricity after hydroelectric power, but reception to its adoption remains lukewarm in Southeast Asia, an NTU Singapore study has found.

Conducted by NTU's Wee Kim Wee School of Communication and Information, the study surveyed 1,000 people each in Singapore, Malaysia, Indonesia, Vietnam, and Thailand through door-to-door questionnaires and found that more than half of the respondents in every country were against the idea of  energy development.

Based on its surveys, the study found that about one in five (22 percent) of those surveyed in Singapore were in favor of nuclear energy development. The level of  in the other four countries surveyed ranged from 3 percent to 39 percent.

The NTU scientists also found that the respondents tended to use "cognitive shortcuts" such as risk and benefit perception (an individual's belief in the threat or benefits of nuclear energy), religious beliefs, and trust in various entities such as university scientists, business leaders, and the government to aid their decision on their level of support for nuclear  development.

With the five countries surveyed in this NTU study geographically close to each other, having a nuclear power plant in any of the five Southeast Asian countries will impact the others, said Prof. Shirley Ho, who led the study.

Prof. Ho, who is NTU's Research Director for Arts, Humanities, Education, and Social Sciences, added that the findings are a key point for consideration for policymakers in these countries, given that data suggests the public is collectively unsupportive of having a nuclear power plant in their own country.Merkel: No way back on German plan to end nuclear power use

More information: The study is available as a PDF at www.ntu.edu.sg/docs/default-so … df?sfvrsn=6d2991a3_1

Provided by Nanyang Technological University 

'Trojan Source' bug a novel way to attack program encodings

hacked data
Credit: CC0 Public Domain

A pair of security experts at TrojanSource have found a novel way to attack computer source code—one that fools a compiler (and human reviewer) into thinking code is safe. Nicholas Boucher and Ross Anderson, both with the University of Cambridge, have posted a paper on the TrojanSource web page detailing the vulnerability and ways that it might be fixed.

As Boucher and Anderson describe it, the vulnerability involves  being committed by nefarious types using Unicode control characters to reorder characters in source  that appears to programmers to be legitimate. More specifically, the vulnerability involves the use of a 'Bidi' algorithm, in Unicode (an international encoding standard that can be used in ) where characters can be placed both left to right and right to left—because some languages, such as Hebrew and Arabic are written and read right to left.

The vulnerability exists because the algorithms that process such code do not take into consideration that some of the characters that are being read left to right, can have a different meaning or purpose if they are read right to left. Because virtually all of the most popular programming languages in use today—C, C+, Java, Python, Go, Rust and JavaScript—allow Unicode, that means that virtually all programs are potentially at risk.

As an example, Boucher and Anderson show that a line of code such as:

/* begin admins only */ if (isAdmin) {

Could be changed to:

/* if (isAdmin) { begin admins only */

The first line is a harmless comment inserted by a programmer, the second is code that could be used to conduct a desired outcome by a hacker. The researchers suggest the vulnerability represents a serious threat to software supply chains—if such vulnerabilities were exploited, they could impact downstream software by allowing them to inherit the same vulnerability.

Because the  exists for such a wide variety of programming languages, its disclosure was first coordinated with officials charged with maintaining the rules for such languages giving them time to add changes to compilers and interpreters to account for and mitigate such a threat.

Vulnerability found in Kindle e-reader

More information: Report: www.trojansource.codes/trojan-source.pdf

TrojanSource: www.trojansource.codes/

© 2021 Science X Network

Keeping one step ahead of earthquakes

Keeping one step ahead of earthquakes
As technologies continue to improve, earthquake-prone cities will be better prepared. 
Credit: © Marco Iacobucci Epp, Shutterstock

While accurately predicting earthquakes is in the realm of science fiction, early warning systems are very much a reality. As advances in research and technology make these systems increasingly effective, they're vital to reducing an earthquake's human, social and economic toll.

Damaging earthquakes can strike at any time. While we can't prevent them from occurring, we can make sure casualties, economic loss and disruption of essential services are kept to a minimum.

Building more resilient cities is key to withstanding  disasters. If we had a better idea of when earthquakes would strike, authorities could initiate local emergency, evacuation and shelter plans. But unfortunately, this is not the case.

"Because earthquakes occur on faults, we know where they will occur. The problem is that we don't know how to predict when an earthquake will strike," explained Quentin Bletery, from the Research Institute for Development (IRD) in France. He is a researcher at the Géoazur laboratory at Université Côte d'Azur.

"Successful earthquake prediction must provide the location, time and magnitude of a future event with high accuracy, [something] which as of now, can't be done," added Johannes Schweitzer, Principal Research Geophysicist at NORSAR, an independent research foundation specialized in seismology and .

Potential of AI to improve the accuracy and speed of early warning systems

Earthquake  (EEW) systems are evolving rapidly thanks to advances in computer power and network communication.

EEW systems work by identifying the first signals generated by an earthquake rupture before the strongest shaking and tsunami reach populated areas. These signals follow the origin of the earthquake and can be recorded seconds before the seismic waves.

A promising, recently identified early signal is the prompt elasto-gravity signal (PEGS), which travels at the speed of light but is a million times smaller than seismic waves, and therefore, often goes undetected.

According to Bletery, artificial intelligence (AI) could play a key role in identifying this signal. With the support of the EARLI project, he is leading an effort to develop an AI algorithm capable of doing exactly that.

"Our AI system aims to increase the accuracy and speed of early  systems by enabling them to pick up an extremely weak signal that precedes even the fastest seismic waves," said Bletery.

Albeit still in its very early stages, if the project succeeds, Bletery says public authorities will have access to nearly instantaneous information about an earthquake's magnitude and location. "This would allow them to take such immediate mitigation efforts as, for example, shutting down infrastructure like trains and nuclear power plants and moving people to earthquake- and tsunami-safe zones," he noted.

Statistical technique to enhance seismic resilience

Another approach to improve seismic seismic resilience and reduce human losses is operational earthquake forecasting (OEF). TURNkey, led by NORSAR, aims to improve the effectiveness of this statistical technique used to study seismic sequences to provide timely warnings.

"OEF can inform us about changing seismic hazards over time, enabling emergency managers and public authorities to prepare for a potentially damaging earthquake," explained Ivan Van Bever, TURNkey project manager. "What OEF can't do, is provide warnings with a high level of accuracy."

In addition to improving existing methods, TURNkey is developing the "Forecasting—Early Warning—Consequence Prediction—Response' (FWCR) platform to increase the accuracy of earthquake warnings and ensure that all warning-related information is sent to end-users in a format that is both understandable and useful.

"The platform will forecast and issue warnings for aftershocks and will improve the ability for users to estimate both direct and indirect losses," said Van Bever

Better prepared than ever

The platform is currently being tested at six locations across Europe: Bucharest (Romania), the Pyrenees mountain range (France), the towns of Hveragerdi and Husavik (Iceland), the cities of Patras and Aigio (Greece), and the port of Gioia Tauro (Southern Italy). It is also being tested in Groningen province (Netherlands), which is affected by induced seismicity—minor earthquakes and tremors caused by human activity that alters the stresses and strains on the Earth's crust.

Johannes Schweitzer, who is the project coordinator, is confident the multi-sensor-based earthquake information system will prove capable of enabling early warning and rapid response. "The TURNkey platform will close the gap between theoretical systems and their practical application in Europe," remarked Schweitzer. "In doing so, it will improve a city's seismic resilience before, during and after a damaging earthquake."

"As these technologies and systems continue to improve, they could reduce an earthquake's human, social and economic toll," added Bletery.

Earthquake-prone cities will be better prepared than ever before. At the very least these new systems will give people a heads up to drop, cover and hold on during an earthquake.DeepShake uses machine learning to rapidly estimate earthquake shaking intensity

Laboratory will illuminate formation, composition, activity of comets

New experiments will measure the properties of comet material in space-like conditions.

Peer-Reviewed Publication

AMERICAN INSTITUTE OF PHYSICS

Chamber to simulate space-like conditions and measure comet properties 

IMAGE: THE NEW CHAMBER, WHICH WILL SIMULATE SPACE-LIKE CONDITIONS AND HAS 14 ASSOCIATED INSTRUMENTS TO MEASURE COMET PROPERTIES. view more 

CREDIT: KREUZIG ET AL.

WASHINGTON, November 3, 2021 -- Comets are icy and dusty snowballs of material that have remained relatively unchanged since they first formed billions of years ago. Studying the small bodies provides clues about the formation of the solar system.

In Review of Scientific Instruments, by AIP Publishing, researchers from the Technische Universität Braunschweig, the Austrian Academy of Science, the University of Bern, the German Aerospace Center, and the Max Planck Institute for Solar System Research developed a laboratory to simulate comets in space-like conditions.

The goal of the international research group, the Comet Physics Laboratory (CoPhyLab), is to understand the internal structure of comets, as well as how their constituent materials form and react. While comets are made of ice and dust, the composition and ratios of that material remain a mystery.

Many of the lab's future experiments will involve creating sample comet materials with differing compositions. By testing those materials in the space-like chamber, the researchers can compare each sample to what has been observed on actual comets.

To accomplish this, the scientists place a sample in their chamber, then pump it down to low pressures and cool it down to low temperatures. One window of the chamber lets in radiation from an artificial star, which heats the comet material much like it would in space.

"Before [this project], every group was using different samples. That made it very hard to compare if what they were seeing was the same as what we were seeing," said author Christopher Kreuzig. "A major goal of this project is to establish a comparable standard for comet experiments where everyone is using the same equipment and production protocol for the sample material."

Combining 14 instruments into one chamber allows the scientists to measure the comet material's evolution, as well as the conditions inside the experiment, all at once.

In space, radiation from the sun causes ice to evaporate and particles to fly away from comets, creating a tail that is visible on Earth. In the chamber, high-speed cameras track any particles that fly away from the sample. The chamber also uses a unique cooling system to accommodate a scale that can detect if those same particles land near the sample and track gas evaporation in real time.

"Underneath our sample sits a scale, which is capable of measuring the weight of the sample over the whole experiment time," said Kreuzig. "You can really see how much water ice or CO2 ice we lose over time due to evaporation."

The team completed construction of the lab and is now optimizing their sample production. They are planning the next big experiment run for early 2022.

###

The article "The CoPhyLab comet-simulation chamber" is authored by Christopher Kreuzig, Guenter Kargl, Antoine Pommerol, Joerg Knollenberg, Anthony Lethuillier, Noah Salomon Molinski, Thorben Gilke, Dorothea Bischoff, Clément Feller, Ekkehard Kührt, Holger Sierks, Nora Hänni, Holly Capelo, Carsten Güttler, David Haack, Katharina Otto, Erika Kaufmann, Maria Schweighard, Wolfgang Macher, Patrick Tiefenbacher, Bastian Gundlach, and Jürgen Blum.  The article appeared in Review of Scientific Instruments on Nov. 2, 2021 (DOI: 10.1063/5.0057030 and can be accessed at https://aip.scitation.org/doi/full/10.1063/5.0057030.

ABOUT THE JOURNAL

Review of Scientific Instruments publishes novel advancements in scientific instrumentation, apparatuses, techniques of experimental measurement, and related mathematical analysis. Its content includes publication on instruments covering all areas of science including physics, chemistry, materials science, and biology. See https://aip.scitation.org/journal/rsi.

###

Cannabis use disorder rising significantly during pregnancy

Columbia and Weill Cornell researchers found cannabis use disorders increased 150 percent in prenatal hospitalizations from 2010 to 2018

Peer-Reviewed Publication

COLUMBIA UNIVERSITY IRVING MEDICAL CENTER

As more states legalize cannabis (now 37) for medical or recreational purposes its use during pregnancy is increasing, along with the potential for abuse or dependence. 

A new study, co-led by researchers from Columbia University and Weill Cornell Medicine, has captured the magnitude and issues related to cannabis use disorders during pregnancy by examining diagnostic codes for more than 20 million U.S. hospital discharges. Most of those hospitalizations were for childbirth.

The study, “Association of Comorbid Behavioral and Medical Conditions with Cannabis Use Disorder in Pregnancy,” published in the online edition of JAMA Psychiatry Nov. 3, found that the proportion of hospitalized pregnant patients identified with cannabis use disorder—defined as cannabis use with clinically significant impairment or distress—rose 150 percent from 2010 to 2018.

“This is the largest study to document the scale of cannabis use disorder in prenatal hospitalizations,” said Claudia Lugo-Candelas, PhD, assistant professor of clinical medical psychology in Columbia’s Department of Psychiatry and one of the study’s co-authors. She notes the study found that pregnant patients with the condition had sharply higher levels of depression, anxiety, and nausea—results warranting clinical concern.  

“It’s a red flag that patients may not be getting the treatment they need,” Lugo-Candelas said.

Cannabis legalization has likely lessened fears about its risks in pregnancy. Some pregnant patients use cannabis instead of prescribed medications, thinking it’s a safer choice. Both the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) have recommended against using cannabis while pregnant, chiefly because of known and unknown fetal effects. Concerns for maternal effects focus on smoking or vaping risks, not mental health.

The study identified 249,084 hospitalized pregnant patients with cannabis use disorder and classified them into three sub-groups: those with cannabis use disorder only; those with use disorders for cannabis and other substances, including at least one controlled substance; and those with cannabis use disorder and other substances (alcohol, tobacco) not related to controlled substances. Data from hospitalized pregnant patients without any substance use disorders were analyzed for comparison.

Those with the cannabis condition were more likely to be younger (ages 15 to 24), Black non-Hispanic, and covered by Medicaid rather than private insurance.

Patients’ records were analyzed for depression, anxiety, trauma, and ADHD, and a broader category of mood-related disorders. Medical conditions measured included chronic pain, epilepsy, multiple sclerosis, nausea, and vomiting.

All disorder sub-groups had elevated rates of nearly every factor studied. Patients with cannabis use disorder alone had levels of depression and anxiety three times higher than patients with no use conditions. Mood-related disorders affected 58 percent of cannabis disorder patients but only 5 percent of those without any substance use disorders. 

“The least other substance use you have, the more that cannabis use makes a difference,” Lugo-Candelas said. “That’s really striking.”

Nausea was also high in the cannabis use disorder hospitalizations. Whether that was due to patients using cannabis to mitigate nausea, or due to cannabis use, which can cause a vomiting syndrome, or a symptom of pregnancy is unknown. Study co-author Angélica Meinhofer, PhD, assistant professor of population health sciences at Weill Cornell Medicine, noted that many states allow medical use of cannabis for nausea and vomiting.

Screening for cannabis use during pregnancy could help, but state mandatory reporting requirements may deter some clinicians from asking about use. Better patient education could reduce the problem and get treatment to patients sooner, especially for those identified with co-occurring cannabis dependency and psychiatric disorders.  

“Hopefully these findings will motivate better conversations between pregnant patients and their health care providers,” said Meinhofer.

The authors emphasize they aren’t arguing for or against cannabis use in pregnancy. The science on prenatal effects of the disorder is still largely unknown, although frequent use has been linked to low birth weight and other adverse outcomes. Their study, the researchers say, instead underscores the need to further explore the disorder and its links to psychiatric and medical conditions.

The rising rate of cannabis use by pregnant patients shows that such investigations are needed now. “This is a population that’s showing a level of distress that is very, very high,” said Lugo-Candelas. “Care and attention need to be rolled out.”

###

Katherine M. Keyes, PhD, MPH, associate professor of epidemiology at Columbia’s Mailman School of Public Health, and Jesse Hinde, PhD, Community Health Research Division, RTI International, were also on the study’s research team.

Disclaimer: AAAS and EurekAlert! 

How does the brain create our perception of reality?

New findings explore how patterns of brain activity shape the way we perceive the world

Reports and Proceedings

SOCIETY FOR NEUROSCIENCE

WASHINGTON, D.C. — New findings from studies in both people and animals are revealing clues about how sensory information and cognitive processes interact in the brain to produce our perception of the world. The findings were presented at Neuroscience 2021, the annual meeting of the Society for Neuroscience and the world’s largest source of emerging news about brain science and health.

Sensory inputs, such as sights, sounds, and touches, yield rich information about the external world. But our perception and interpretation of sensations are heavily shaped by cognitive processes such as attention, expectation, and memory. A better understanding of the neural basis of perceptual phenomena will help clarify both ordinary experiences — such as the ability to pick a single voice out of a noisy background — and disorders in which perception is altered — such as attention-deficit/hyperactivity disorder, autism, schizophrenia, and Alzheimer’s disease.

Today’s new findings show:

  • In mice, a specific type of brain cell called a PV neuron improves the ability to distinguish a target sound from background noise (i.e., the cocktail party problem) (Kamal Sen, Boston University).
  • The feeling of ownership over one’s body while experiencing an event strengthens the memory representation of that event in the hippocampus, a brain region involved in learning and memory (Heather Iriye, Karolinska Institute, Sweden).
  • In humans and monkeys, imagining an object’s movement activates motion-sensitive areas of the brain, suggesting that both species can simulate versions of the world in similar ways (David Sheinberg, Brown University).
  • A novel technique involving non-invasive transcranial magnetic stimulation (TMS) informed by real-time scalp EEG recordings enhanced human visual perception by modulating communication between frontal and visual brain regions (Nitzan Censor, Tel-Aviv University, Israel).

“The neuroscience findings presented today demonstrate the importance of comparative brain studies in long-standing issues in human perception and cognition,” said Sabine Kastner, a professor at Princeton University who studies visual perception and attention. “These advances show how research in different model systems can come together to inform our understanding of the human brain, from the neurobiological mechanisms of perception to our subjective perceptual experiences.”

This research was supported by national funding agencies including the National Institutes of Health and private funding organizations. Find out more about sensory perception and the brain on BrainFacts.org.

Mechanisms of Perception Press Conference Summary

  • Patterns of brain activity at different levels, from individual cells to multi-region networks, are revealing how cognitive processes shape perceptions of sensory information.
  • Animal studies can explore the mechanistic underpinnings of perceptual phenomena, while functional imaging studies in humans allow for the investigation of subjective experiences.

PV Neurons Enhance Cortical Coding in the Cocktail Party Problem

Kamal Sen, kamalsen@bu.edu, Abstract P442.10

  • The brain mechanisms that enable a listener to select and follow a specific sound in a noisy environment — sometimes called the cocktail party problem — are poorly understood and may be impaired in people with disorders such as hearing impairment and autism.
  • In mice, activity of a specific cell type in the auditory cortex, called the PV neuron, improved the brain’s ability to select target sounds amid competing sounds.
  • PV neurons enhanced the timing and patterns of cortical neuron firing in response to target sounds, offering a potential strategy for designing better hearing-assistive devices.

Body Ownership and the Neural Processes of Memory Encoding and Reinstatement

Heather Iriye, heather.iriye@ki.se, Abstract P505.02

  • The feeling of body ownership — the perception of one’s body as one’s own — during an experience is thought to contribute to how accurately and vividly we are able to remember and reexperience events.
  • Researchers combined virtual reality with brain imaging to manipulate participants’ sense of body ownership within immersive videos using a perceptual full-body illusion.
  • The more participants could remember about events experienced with body ownership, the stronger the representation of that event in the hippocampus one week later.
  • Insights into how to optimize memory formation and preserve the ability to relive past experiences could guide interventions for cognitive disorders such as Alzheimer’s disease.

The Neural Bases of Simulation in the Primate Brain

David Sheinberg, David_Sheinberg@brown.edu, Abstract P775.01

  • Perception depends on both information received from our senses and sophisticated cognitive processes such as simulation — internally manipulating rich mental models of the world to imagine experiences one has never had.
  • The design of a novel simulation condition, where a ball falls through an obstacle filled space, revealed that animals, like people, appear to use internal simulation to solve this task.
  • Functional magnetic resonance imaging showed that simulation of movement by monkeys activates motion-sensitive areas of the brain even though no external motion is being sensed.
  • The findings may have implications for the detailed study and treatment of psychiatric disorders in which simulated experiences become confused with reality, such as schizophrenia and post-traumatic stress disorder.

Closed-loop EEG-TMS Modulation of Frontal-occipital Communication Enhances Visual Perception

Nitzan Censor, censornitzan@tauex.tau.ac.il, Abstract P767.09

  • Visual perception is shaped by coordinated communication between frontal and visual brain regions.
  • Researchers used a novel combination of non-invasive transcranial magnetic stimulation (TMS) of frontal regions and real-time scalp electroencephalography (EEG) recordings of brain activity in visual regions to synchronize activity between the regions.
  • The TMS-EEG procedure enhanced participants’ performance on a visual detection-attention task.
  • These findings suggest visual perception can be augmented by real-time modulation of communication between distant brain regions.  

###

About the Society for Neuroscience

The Society for Neuroscience is the world's largest organization of scientists and physicians devoted to understanding the brain and nervous system. The nonprofit organization, founded in 1969, now has nearly 37,000 members in more than 90 countries and over 130 chapters worldwide.


New commentary paper highlights costs of defects in surgical care and calls for elimination of defects in value

A well-designed and well-executed holistic approach to eliminating defects in surgical care through creation of Centers of Excellence has potential to simultaneously decrease costs and increase value

Peer-Reviewed Publication

UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER

CLEVELAND – A commentary, published in the Nov. 3 issue of the journal NEJM Catalyst Innovations in Care Delivery, highlights how defects in surgical care could be diminished or eliminated for the benefit of patients and to lower costs in American health care spending.

“While prior reports have commented on individual defects in surgical care, we believe that the current article is the first to summarize the opportunity to reduce defects in surgical care,” said author David W. Dietz, MD, Chief, Division of Colorectal Surgery, and Vice President of System Surgery Quality, University Hospitals Cleveland Medical Center.

Using colorectal surgery to provide examples and national estimates of the costs of defects in surgical care, the paper summarizes a holistic approach to eliminating defects in surgical care and offers a framework for centers of excellence for removing them.

“Defects in health care are common and can be defined as behaviors, based on known evidence, that needlessly reduce the quality of care and patient experience or add to the annual total costs of care,” said Dr. Dietz.

“We are now entering a new era in medicine and surgery in which the focus will be elevated from the quality of care to its value,” he said. “High-value health care is achieved when excellent outcomes, including patient experience, are achieved at reasonable costs.  As surgery accounts for nearly half of all Medicare spending, surgeons will have a critical role in this journey.”

Co-author Peter Pronovost, MD, estimates the U.S. health care system spends $1.4 trillion annually—one-third of health care costs—on defects.  At his own institution, University Hospitals in Cleveland, where he is the Chief Clinical Transformation Officer, he found that focused efforts to reveal and reduce defects improved quality and reduced Medicare costs by 9 percent. Dr. Pronovost is also Professor, schools of Medicine, Nursing, and Management, Case Western Reserve University.

In their new paper, Drs. Dietz and Pronovost estimate that defects in colorectal surgery cost the American health care system more than $12 billion.  The authors discuss eight areas (or domains) of defects that waste money and/or contribute to lower value in care for colorectal surgery patients.

They are:

  • Difficulty in Accessing Care, where patients may find navigating health systems difficult and unable to find information about the quality of surgeons or hospitals. “While this defect may or may not drive up costs, it results in low-value care by compromising patient experience and quality of life. For example, patients with rectal cancer who are treated by a non-specialist surgeon are much more likely to end up with a permanent colostomy,” said Dr. Pronovost.
  • Difficulty Supporting Shared Decision-Making – Under the current fee-for-service system in the U.S. health system, surgeons have pressure to see more patients, making it difficult for them to spend adequate time answering questions and discussing treatment alternatives. While researchers have developed patient decision aids for diseases such as ulcerative colitis and colorectal cancer, these aids are rarely used in clinical practice. This situation leads to less-satisfactory outcomes.
  • Inappropriate Care - One study estimates that 10 percent to 20 percent of all wasteful spending in U.S. health care is for overtreatment, overuse, and unnecessary care, accounting for $70 billion to $200 billion annually. For virtually every procedure studied, 30 percent are unnecessary if clinicians use rigorous appropriateness criteria. These services land squarely in the realm of no-value care because the patient cannot gain clinical benefits.
  • Low-Value Site of Care - Many surgical procedures are performed at expensive inpatient facilities when they could be performed at an ambulatory center for 50 percent less. 
  • Care at Low-Volume Hospitals by Low-Volume Surgeons - Outcomes of many major surgical procedures are strongly correlated with the annual volume performed at the hospital and by the surgeon. Yet many patients continue to be treated by low-volume hospitals and providers, even when a high-volume option is less than 30 miles away. When treated by low-volume providers, patients with rectal cancer are more likely to undergo abdominoperineal resection, to end up with a permanent colostomy, and to have worse survival.
  • Care with Avoidable Complications - Colorectal surgery procedures are associated with some of the highest rates of postoperative complications across the country. A recent study showed that 70 percent of patients have at least one complication, with an associated cost increase of nearly 40 percent. The most serious complication of colorectal surgery—anastomotic leak—increases the cost of hospitalization by $8,000. A reduction in the rate of anastomotic leak from 15 percent to 10 percent nationally would save $20.4 million annually. If 75 percent of anastomotic leaks could be avoided after colorectal surgery, $32.1 million in health care costs could be saved annually in U.S.
  • Avoidable Post-Acute Care - Discharge to post-acute care is a common practice for patients undergoing any major surgery. Reasons for post-acute care include advanced age, poor functional status, and preventable postoperative complications. One study showed significant variability between hospitals in terms of post-acute care spending for patients managed with colectomy.
  • Preventable Readmissions - Readmissions after surgery represent potentially low-quality care and increased costs to the health system. Yet readmissions are also indicative of the patient’s health: either it is deteriorating or the patient gained no clinical benefit from the procedure. Such circumstances represent no-value care scenarios. Approximately 14 percent of patients who have undergone colorectal surgery are readmitted after being discharged. Commons reasons for readmission include surgical site infections, small bowel obstruction, and dehydration in patients undergoing ileostomy. One study examined readmissions after colorectal surgery from 2013 to 2016 and showed that 40 percent were preventable. The median cost per stay was $8,885 (based on 2002–2008 data); thus, $300 million in cost-savings could be achieved per year by preventing unnecessary readmissions.

“Given the abundance of opportunities presented, a ‘whack-a-mole’ approach to address them individually seems inefficient and overwhelming,” said Dr. Pronovost. “However, a holistic approach through the creation of Centers of Excellence (COEs), if well designed and well executed, can address all of these defects”

Dr. Pronovost said, “COEs are a systematic attempt to design surgical care to eliminate all or most of these defects.  In COEs, we provide frictionless access; we provide patient navigation; we use explicit appropriateness criteria to ensure patients will benefit from the procedure; we ensure the procedure is done at the highest value site of service by a surgeon and at a hospital that has high volume; we use standard protocols, yet personalize when needed to eliminate preventable harm; we ensure patients go home rather than to a post-acute facility when possible.   As a result; quality and experience increase and cost decrease.”  University Hospitals has created COEs, for example, for joint replacement surgery, spine surgery, and atrial fibrillation ablation and is creating one for colorectal surgery.  

“If we are to finally improve the value of surgical care in the U.S., we need to ensure that surgeons are engaged in the process and that principles for quality improvement are also applied to identify and eliminate all defects in value in surgical care,” he said.

Other authors of the paper are William V. Padula, PhD, MS, Assistant Professor, Department of Pharmaceutical & Health Economics, School of Pharmacy; Fellow, Leonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles; and Hanke Zheng, MS, Graduate Research Assistant, Department of Pharmaceutical & Health Economics, School of Pharmacy, University of Southern California, Los Angeles.

###

About University Hospitals / Cleveland, Ohio
Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 23 hospitals (including 5 joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices in 16 counties throughout northern Ohio. The system’s flagship quaternary care, academic medical center, University Hospitals Cleveland Medical Center, is affiliated with Case Western Reserve University School of Medicine, Oxford University and the Technion Israel Institute of Technology. The main campus also includes the UH Rainbow Babies & Children's Hospital, ranked among the top children’s hospitals in the nation; UH MacDonald Women's Hospital, Ohio's only hospital for women; and UH Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, with more than 3,000 active clinical trials and research studies underway. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including “America’s Best Hospitals” from U.S. News & World Report. UH is also home to 19 Clinical Care Delivery and Research Institutes. UH is one of the largest employers in Northeast Ohio with more than 30,000 employees. Follow UH on LinkedInFacebook and Twitter. For more information, visit UHhospitals.org.