New material temporarily tightens skin. 

“Second skin” polymer could also be used to protect dry skin and deliver drugs.

Scientists at MIT, Massachusetts General Hospital, Living Proof, and Olivo Labs have developed a new material that can temporarily protect and tighten skin, and smooth wrinkles. With further development, it could also be used to deliver drugs to help treat skin conditions such as eczema and other types of dermatitis.

The material, a silicone-based polymer that could be applied on the skin as a thin, imperceptible coating, mimics the mechanical and elastic properties of healthy, youthful skin. In tests with human subjects, the researchers found that the material was able to reshape “eye bags” under the lower eyelids and also enhance skin hydration. This type of “second skin” could also be adapted to provide long-lasting ultraviolet protection, the researchers say.

“It’s an invisible layer that can provide a barrier, provide cosmetic improvement, and potentially deliver a drug locally to the area that’s being treated. Those three things together could really make it ideal for use in humans,” says Daniel Anderson, an associate professor in MIT’s Department of Chemical Engineering and a member of MIT’s Koch Institute for Integrative Cancer Research and Institute for Medical Engineering and Science (IMES).

Anderson is one of the authors of a paper describing the polymer in the May 9 online issue of Nature Materials. Robert Langer, the David H. Koch Institute Professor at MIT and a member of the Koch Institute, is the paper’s senior author, and the paper’s lead author is Betty Yu SM ’98, ScD ’02, former vice president at Living Proof. Langer and Anderson are co-founders of Living Proof and Olivo Labs, and Yu earned her master’s and doctorate at MIT.

Scientists at MIT and elsewhere have developed a new material that can temporarily protect and tighten skin, and smooth wrinkles. With further development, it could also be used to deliver drugs to help treat various skin conditions.

Mimicking skin

As skin ages, it becomes less firm and less elastic — problems that can be exacerbated by sun exposure. This impairs skin’s ability to protect against extreme temperatures, toxins, microorganisms, radiation, and injury. About 10 years ago, the research team set out to develop a protective coating that could restore the properties of healthy skin, for both medical and cosmetic applications.

“We started thinking about how we might be able to control the properties of skin by coating it with polymers that would impart beneficial effects,” Anderson says. “We also wanted it to be invisible and comfortable.”

The researchers created a library of more than 100 possible polymers, all of which contained a chemical structure known as siloxane — a chain of alternating atoms of silicon and oxygen. These polymers can be assembled into a network arrangement known as a cross-linked polymer layer (XPL). The researchers then tested the materials in search of one that would best mimic the appearance, strength, and elasticity of healthy skin.

“It has to have the right optical properties, otherwise it won’t look good, and it has to have the right mechanical properties, otherwise it won’t have the right strength and it won’t perform correctly,” Langer says.

The best-performing material has elastic properties very similar to those of skin. In laboratory tests, it easily returned to its original state after being stretched more than 250 percent (natural skin can be elongated about 180 percent). In laboratory tests, the novel XPL’s elasticity was much better than that of two other types of wound dressings now used on skin — silicone gel sheets and polyurethane films.

“Creating a material that behaves like skin is very difficult,” says Barbara Gilchrest, a dermatologist at MGH and an author of the paper. “Many people have tried to do this, and the materials that have been available up until this have not had the properties of being flexible, comfortable, nonirritating, and able to conform to the movement of the skin and return to its original shape.”

The XPL is currently delivered in a two-step process. First, polysiloxane components are applied to the skin, followed by a platinum catalyst that induces the polymer to form a strong cross-linked film that remains on the skin for up to 24 hours. This catalyst has to be added after the polymer is applied because after this step the material becomes too stiff to spread. Both layers are applied as creams or ointments, and once spread onto the skin, XPL becomes essentially invisible.

High performance

The researchers performed several studies in humans to test the material’s safety and effectiveness. In one study, the XPL was applied to the under-eye area where “eye bags” often form as skin ages. These eye bags are caused by protrusion of the fat pad underlying the skin of the lower lid. When the material was applied, it applied a steady compressive force that tightened the skin, an effect that lasted for about 24 hours.

In another study, the XPL was applied to forearm skin to test its elasticity. When the XPL-treated skin was distended with a suction cup, it returned to its original position faster than untreated skin.

The researchers also tested the material’s ability to prevent water loss from dry skin. Two hours after application, skin treated with the novel XPL suffered much less water loss than skin treated with a high-end commercial moisturizer. Skin coated with petrolatum was as effective as XPL in tests done two hours after treatment, but after 24 hours, skin treated with XPL had retained much more water. None of the study participants reported any irritation from wearing XPL.

“I think it has great potential for both cosmetic and noncosmetic applications, especially if you could incorporate antimicrobial agents or medications,” says Thahn Nga Tran, a dermatologist and instructor at Harvard Medical School, who was not involved in the research.

Living Proof has spun out the XPL technology to Olivo Laboratories, LLC, a new startup formed to focus on the further development of the XPL technology. Initially, Olivo’s team will focus on medical applications of the technology for treating skin conditions such as dermatitis.


Hyperloop One Passes Second Full System Test — Faster Than Ever Before


Hyperloop One has just put its tech through another test, which it passed with flying colors by going 308 km/h (192 mph) — faster than ever before. So, how long until we see the technology implemented, and what challenges will it have to overcome to get to this stage?

Hyperloop One tests are growing ever more impressive, reaching faster speeds and, in the process, showing us what the technology is really capable of. During the latest evaluation, on Saturday, the pod reached speeds of 308 km/h (192 mph) down the company’s 500-meter (1,640-foot) test track in Nevada, before gliding to a graceful halt.

This is a remarkable improvement on the company’s first full system test earlier this summer. During this outing, it traveled farther by a factor of 4.5 times, reached speeds 2.7 times faster, and achieved 3.5 times the horsepower.

 Shervin PishevarHyperloop One co-founder, told CNBC, “We’ve got the Hyperloop working. It’s the dawn now […] of the commercialization of the hyperloops. We’ve got conversations and dialogues with governments around the world.”

Pishevar was referring to the worldwide travel he has been undertaking recently. The company is currently looking at various cities in the U.S. to build a loop and is also planning on installing the system in Europe. In fact, Hyperloop One is already undertaking feasibility studies in Finland, Moscow, the Netherlands, Sweden, Switzerland, the United Arab Emirates, and the U.K.

Despite these successes, there are still hurdles that need to be overcome before we see the transportation system of the future. Most prominently, it will need to achieve the right-of-way allowances, land acquisitions, and regulatory approvals that other means of transportation like the railway enjoy.

However, this announcement gives us a reassuring reminder that the future of transport isn’t far away.

ISS Serves as Stepping-Stone to Deep Space Exploration

ISS Serves as Stepping-Stone to Deep Space Exploration

With manned missions to Mars on the horizon, NASA is leveraging the unique capabilities of the International Space Station (ISS) to conduct research into critical exploration technologies. 

At the recent International Space Station Research and Development Conference in Washington, DC, Human Exploration and Operations Directorate Associate Administrator William Gerstenmaier led a discussion about how the agency is using the ISS to explore and resolve technological barriers to crewed deep space missions.

“Station is really a one of a kind testbed,” he said. “It’s a catalyst for the commercial market. It’s an engine of discovery. And, more importantly, it’s a stepping-stone to exploration.”

To reduce risk to crew during long-duration deep space travel, the agency is conducting a spectrum of investigations into areas such as radiation, fire safety, health and human performance, and life support. The ISS is ideally situated to host these investigations because it offers a zero-gravity environment in which to test concepts that cannot be explored fully on Earth, yet it is relatively accessible so that work can be ongoing and progressive.

One area of focus is on the habitation systems that will be crucial to maintaining crew health during deep space missions. Robyn Gatens, Deputy Director, ISS Division at NASA Headquarters (HQ), is leading the system maturation team for the environmental control and life support systems and environmental monitoring systems that will be used in the Orion spacecraft. Gatens and her team are working on a range of systems, including life support, air, water, and waste management. Although these systems exist on the ISS today, they will need to evolve before they are adequate for long-duration missions.

A key challenge in developing the new systems is constraints related to size. Because Orion is significantly smaller than the space station, any systems on the spacecraft will have to be miniaturized in comparison to those used on the station.

A second issue is efficiency. The space station recycles slightly less than half of the oxygen from the existing air system. For the future exploration system, said Gatens, “[W]e want to get to at least 75% of what we call ‘air loop closure.’ Similarly, on the water system today we recover about 95% of the water. And that sounds like a lot, but that still carries a logistic penalty that we want to do better for future missions. So we’re trying to improve that to over 98%.”

The technology and materials used by deep space crew—even their clothing—will have to be extremely durable because replacements will not be available. “The thing that kind of keeps me up at night is thinking ahead to when we load up the deep space transport and we’re sending the crew off to Mars and we close the door—and whatever spares are inside is what they’ve got,” she said.

Reliability, she added, may be the greatest challenge. “The simpler we can make it, the less complex we can make it, then the more reliable it is.”

Radiation monitoring and shielding as well as fire safety are other critical areas of investigation on the space station. Thanks to a radiation monitor on the Curiosity rover, NASA knows that the radiation environment on Mars is surprisingly similar to that of the ISS. The greater concern is the radiation exposure crew will face in getting to the red planet.

“The big problem is the transit phase, where you have no shielding other than what’s in your spacecraft,” said Gerstenmaier. To monitor radiation levels in the Orion spacecraft, the agency has created sensors the size of a thumbnail. Developing sufficient radiation shielding within the spacecraft, however, is still underway and will be essential to protecting crew health.

Other means of supporting astronauts’ well-being are being investigated on station. Experience on the ISS has confirmed that exercise is a key component in maintaining crew health in low gravity environments. Starting in 2020, NASA will test the Advanced Twin Lifting and Aerobics System (ATLAS), a compact combination weight lifting and rowing machine. To fit into Orion, ATLAS will weigh a mere 200 pounds compared with the four thousand pounds of exercise equipment currently on the ISS.

Significant psychological as well as physical stressors await crew during long-duration missions, including the challenge of living in a confined space in a hostile environment with just a few other people for up to three years at a time. There will be a 20-minute lag in communications between the spacecraft and Earth, making it difficult for astronauts to obtain support from the ground in an emergency situation, and no opportunity to send a crew member home should they become ill.

“As soon as you burn for Mars, you’re going to Mars. You’re not going to have resupply. You’re not going to be turning around and dropping somebody off. So you have to take care of people while you’re there,” said NASA Human Research Program (HRP) Director William Paloski.

The HRP has been working with the ISS to develop a series of one-year missions that will involve 10 crew by 2024. “The first year-in-space study was quite a success. Now that we know how to do it, we need to go and get a big enough “n” that has some meaningful data [so we] know what to expect in the breadth of the astronaut corps,” said Paloski.

HRP is also setting up a number of isolation facilities on the ground so that future crew can prepare themselves for the experience of a two- to three-year trip with only a few companions. They’ve established a short-duration isolation facility at Johnson Space Center (JSC) and will be doing four-month, eight-month, and twelve-month stays with multi-national crews at a facility in Russia as well as winter missions in Antarctica.

One of the many challenges for the agency in developing systems to support manned missions beyond LEO is the need to accommodate improvements in technologies as they become available. To address this, said Gerstenmaier, “I think the thing that’s really important is we keep an architecture and a plan that’s open enough that as new technology comes on, we can insert it relatively quickly.”

Considering the work ahead in preparing to send humans to Mars, he said, “When I look at the engineering challenge, it is monumental. But it’s exactly what we ought to be doing. And the first step in that is really station.”

Physicists Have Mimicked an Elusive ‘Synthetic’ Magnetic State

One of quantum physics’ most mysterious phenomena.


Researchers have managed to mimic one of physics’ most sought-after phenomena – a strange ‘synthetic’ magnetic state that has previously only been seen in hard-to-study solid materials.

This means the team can finally use an experimental model to test the behaviour, known as spin-orbit coupling, which could play a big role in developing the future of ultra-fast ‘spintronic‘ devices and quantum computers.

The team was able to model this synthetic magnetic state using an atomic clock, which are usually used to keep more precise time thanks to lasers isolating the atoms and using their electrons to keep a beat. In this case, the jumping of confined atoms due to an effect called quantum tunnelling made a good model for the spin-orbit interaction seen in electrons in crystalline solids.

Crystalline solids are a type of ‘true’ solid, which have their atoms or molecules all neatly arranged in an ordered, symmetrical, and repeating pattern. Minerals with a cubic structure, such as diamonds, are crystalline solids, and so are metals like gold.

On the macro scale, we have a pretty good understanding of how these materials work, but on the quantum scale – when you get down to looking at individual atoms as bunches of particles – they display some pretty weird properties.

One of these is a type of strange behaviour known as spin-orbit coupling, where individual electrons behave as if they possess magnetic properties. If scientists can understand how this works and how to tap into that ability, it could help them create better quantum materials for super-fast computers and electronics.

Spin-orbit coupling is where the spin of an electron (the direction of its moment) is locked into its orbit around the nucleus, and creates all kind of weird and useful effects, such as a weak magnetic force.

This phenomenon one of the most important features in topological materials – strange materials that conduct electricity on the surface but act as insulates on the inside, and were honoured in this year’s Nobel Prize.

Topological materials are so fascinating for scientists because they could be used to create ‘spintronic’ devices that are based on the spin of electrons rather than usual electrical charge – and they could also create quantum computers of the future.

But achieving spin-orbit coupling in solid materials is incredibly challenging. So physicists from the Joint Institute of Laboratory Astrophysics (JILA) in Colorado did the same thing with their atomic clock instead.

To do this, they locked a strontium atom’s spin – which is like a tiny internal bar magnet – with the atom’s external motion through the optical lattice.

After doing this with thousands of these strontium atoms within the clock, they were able to create a synthetic magnetic field that lasted for 160 seconds – plenty of time to study some of the signatures of spin-orbit coupling in detail, such as watching the atoms rippling through the lattice.

“The atoms move from site to site on the lattice (a crystal of light created by the laser), and that’s a lot like the physics you get in a solid like a metal or other material where electrons move around in a periodic crystalline structure,” said one of the researchers, Shimon Kolkowitz.

There’s still a lot to learn about how spin-orbit coupling works, but the team hopes that now they have a way to easily model the phenomenon, they might have a better chance of unlocking its secrets.

They’re now planning to make a 3D version of the atomic clock to get more insight into what’s going on.

“Spin-orbit coupling is useful for studying novel quantum materials,” said lead researcher Jun Ye.

“By using our atomic clock for quantum simulation, we hope to stimulate new insights and shed new light on emerging behaviours of topological systems that are useful for robust quantum information processing and spintronics.”

The more we understand about these weird quantum behaviours, the more we understand about the rest of the world, so we can’t wait to learn more.

The research has been published in Nature. 

Who Needs Hard Drives? Scientists Store Film Clip in DNA. 

It was one of the very first motion pictures ever made: a galloping mare filmed in 1878 by the British photographer Eadweard Muybridge, who was trying to learn whether horses in motion ever become truly airborne.

More than a century later, that clip has rejoined the cutting edge. It is now the first movie ever to be encoded in the DNA of a living cell, where it can be retrieved at will and multiplied indefinitely as the host divides and grows.

The advance, reported on Wednesday in the journal Nature by researchers at Harvard Medical School, is the latest and perhaps most astonishing example of the genome’s potential as a vast storage device.

Scientists already have managed to translate all of Shakespeare’s sonnets into DNA. George Church, a geneticist at Harvard and one of the authors of the new study, recently encoded his own book, “Regenesis,” into bacterial DNA and made 90 billion copies of it.

 “A record for publication,” he said in an interview.

With the new research, he and other scientists have begun to wonder if it may be possible one day to do something even stranger: to program bacteria to snuggle up to cells in the human body and to record what they are doing, in essence making a “movie” of each cell’s life.

 When something goes wrong, when a person gets ill, doctors might extract the bacteria and play back the record. It would be, said Dr. Church, analogous to the black boxes carried by airplanes whose data is used in the event of a crash.

At the moment, all that is “the other side of science fiction,” said Ewan Birney, director of the European Bioinformatics Institute and a member of the group that put Shakespeare’s sonnets in DNA. “Storing information in DNA is this side of science fiction.”

Dr. Church and Seth Shipman, a geneticist, and their colleagues began by assigning each pixel in the black-and-white film a DNA code based on its shade of gray. The vast chains of DNA in each cell are made of just four molecules — adenine, guanine, thymine and cytosine — arranged in enormously varied configurations.

The geneticists ended up with a sequence of DNA molecules that represented the entirety of the film. Then they used a powerful new gene editing technique, Crispr, to slip this sequence into the genome of a common gut bacteria, E. coli.

Despite the modification, the bacteria thrived and multiplied. The film stored in the genome was preserved intact with each new generation of progeny, the team found.

Andrew Odlyzko, a mathematics professor and expert on digital technology at the University of Minnesota who was not involved in the new research, called it “fascinating.”

 Imagine, he said, “the impossibility of controlling secrets, when those secrets are encoded in the genomes of the bacteria in our guts or on our skins.”

The renowned physicist Richard Feynman proposed half a century ago that DNA could be used for storage in this way. That was long before the molecular biology revolution, and decades before anyone could sequence DNA — much less edit it.

“Biology is not simply writing information; it is doing something about it,” Dr. Feynman said in a 1959 lecture.

“Consider the possibility that we too can make a thing very small which does what we want!”

Dr. Feynman’s idea “was a seminal piece — it gave us a direction,” said Leonard Adleman, a mathematician at the University of Southern California and co-inventor of one of the most used public cryptography systems, RSA (the A is for Adleman).

In 1994, Dr. Adleman reported that he had stored data in DNA and used it as a computer to solve a math problem. He determined that DNA can store a million million times more data than a compact disc in the same space.

 And data storage is a growing problem. Not only are significant amounts being generated, but the technology used to store it keeps becoming obsolete, like floppy disks.
 DNA is never going out of fashion. “Organisms have been storing information in DNA for billions of years, and it is still readable,” Dr. Adleman said. He noted that modern bacteria can read genes recovered from insects trapped in amber for millions of years.

For Dr. Shipman and Dr. Church, the immediate challenge is the brain. It contains 86 billion neurons, and there’s no easy way to know what they’re doing.

“Right now, we can measure one neuron at a time with electrodes, but 86 billion electrodes would not fit in your brain,” Dr. Church said. But gene-edited bacteria would “fit very nicely.”

The idea is to have bacteria engineered as recording devices drift up to the brain in the blood and take notes for a while. Scientists would then extract the bacteria and examine their DNA to see what they had observed in the brain neurons.

Dr. Church and his colleagues have already shown in past research that bacteria can record DNA in cells, if the DNA is properly tagged.

 “People’s intuition is tremendously poor about just how small DNA molecules are and how much information can be packed into them,” Dr. Birney said.
And while these are futuristic ideas, biotechnologies have been arriving much faster than anyone predicted, Dr. Church said.

He gave as an example the sequencing of the human genome. The first effort took years and cost $3 billion. The wildest optimists predicted that maybe in six decades each sequencing would cost $1,000.

“It turned out it was six years, rather than six decades,” Dr. Church said.

Could We Make New Organs?

Research is making impressive advances in using 3-D printing to fabricate living tissues, but it will be years before we can transplant printed organs into human beings.

Right now, more than 120,000 people in the United States require an organ transplant to survive, but there are far fewer donors—in January, for instance, only 2,577 transplants were performed. That’s why some scientists have been exploring the prospect of using 3-D printing or related technologies to make organs in a matter of days. Not only would this shrink the gap between supply and demand, but it could eliminate the need for donors altogether. And if built using a patient’s own cells, printable organs could also reduce the risk of transplant rejection.

Scientists are not close to this goal, but they are making steps in the right direction—such as printing accurate models of organ shapes and building passages for blood flow.


Research into printable organs falls within the broader field of bioprinting: the printing of any living structure made of cells. The most basic level of organ design begins with very thin, printed tissue that can be used to create a scaffold, a model of an organ that can’t yet function on its own but is more than just a plastic replica. In their early days, printed scaffolds were made from a synthetic material, and living cells were added later. But in the early 2000s, Anthony Atala, director of the Wake Forest Institute for Regenerative Medicine, helped streamline this process by developing a 3-D printer that could deposit the rubbery, synthetic model with tissue already layered on.

As bioprinting research pushes forward, the major challenge is no longer just creating these organlike structures but, rather, keeping them alive. Cells are incorporated into bio-inks that are printed layer by layer to create a swath of living tissue. It’s the same idea behind the back-and-forth motion of an ink cartridge in a traditional printer. But only cells printed on the outermost layers of the tissue can freely access oxygen and expel waste—processes vital to cell survival. Cells on the innermost layers suffocate and die.

The solution is to print not just a scaffold but also a tissue’s vasculature—a system of increasingly small pathways that can reach the innermost layers of cells, delivering blood and oxygen and carrying away waste.

Incremental progress

In 2014, Jennifer Lewis, a professor of biologically inspired engineering at Harvard University, successfully began printing vasculature in her lab. The main focus of Lewis’s research for now is on using 3-D-printed tissue equipped with blood vessels to test potential drugs for chemical toxicity in living tissue.

In hopes of making another step toward printing a fully functioning organ, Lewis is working on printing small regions of organs. Right now, she’s designing nephrons, the tiny units that make up the kidney: they allow the organ to remove waste from the body and filter blood, among other vital processes. Before Lewis can print a kidney, she has to figure out how to print a single nephron. But that “is at best still only a millionth of a kidney,” she cautions. “That’s the scale that this field is at right now.”

“I personally believe that at this point in history, organ printing is like a moon shot,” Lewis says. “We should drive toward that goal, no question about it, but we’re far away. We’re really far away.”

3-D-Printed Skin Leads the Way Toward Artificial Organs

Researchers claim that additive manufacturing can now produce functional skin, and the first internal organs may be ready within six years.

The initial hype surrounding 3-D printing may have started to fade, but researchers using the technique to create living tissue are showing encouraging results.

3-D printing parts of our anatomy is not a new idea. The basic premise: insert the correct cells into a polymer or gel, print them out into a 3-D structure, and then allow the cells to grow into a living entity. If such a feat can be achieved, it could provide a supply of organs for transplant patients and remove the need for donors.

This week, Spanish scientists from Madrid have published researchdescribing new hardware that’s capable of printing functional human skin. The device creates the individual layers of skin, such as the dermis and epidermis, one atop the other. It does that by depositing plasma containing skin cells into precise geometries that allow the cells to flourish.

The researchers claim that the end results will be suitable for both transplantation and lab testing of new products. Initial transplants into mice also suggest that it’s safe, though the synthetic skin has yet to be approved for use in humans. Other organizations, such as L’Oreal, are also attempting to create skin using similar approaches.

But while this success lines up alongside other notable achievements, such as creating blood vessels and even synthetic ovaries for mice, 3-D-printing techniques have yet to yield entire organs for use in humans. That’s largely because printing cells in complex geometries without killing them remains difficult. Because it is flat and neatly layered, skin lends itself to printing—but rendering a heart is rather more difficult.

So just how far away from 3-D-printed human organs are we, exactly? The Economist has just taken a look at the entire bio-printing landscape to establish that. It suggests that recent advances in producing some of the more simple organs mean that the first 3-D-printed livers and kidneys for human transplant could flop out of a device within the next six years.

3-D-Printed Artificial Heart Beats Like the Real Thing But Isn’t Much Use Yet. 

It pumps blood using ventricles like those of a real heart, but it begins to degrade after just 3,000 beats.

It looks like a real heart. It moves like a real heart. And while it won’t be taking over the job of a real heart any time soon, it does hint at a future of smaller and more human-like artificial organs.

This new silicone heart was developed by researchers at the Functional Materials Laboratory at ETH Zurich in Switzerland. It’s built using 3-D printing techniques, which are increasingly popular for creating synthetic organs, in order to create an internal structure that mimics that of a real human heart, with right and left ventricles.

Unlike the real thing, though, it also includes a central chamber that can be inflated and deflated by an external pump—essentially acting as the muscle. But there’s a bigger limitation than its need for external drive. As the team reports in the journal Artificial Organs, the silicone begins to degrade after 3,000 beats—equivalent to about 45 minutes, which would make it little use in practice.

Even so, the device does suggest that it might be possible to create better artificial hearts in the coming years. Most current devices use mechanical approaches to pump blood, which can develop faults and can damage the blood they’re pumping. An artificial heart more closely based on human physiology could overcome those issues.

Then again, the best alternative might be to build whole new biological organs from scratch in the lab—but that’s still a little way off yet.

Researchers Use Eye-Tracking Technology to Assess Wrong-Patient Errors

R&E researcher examines the value of pairing photographs with radiographs in detecting wrong-patient errors.

New RSNA-funded research shows that patient photographs paired with radiographs may reduce wrong-patient errors and improve image assessment without increasing interpretation time.

With a 2015 Canon U.S.A./RSNA Research Medical Student Grant, Alex Chung, MD, and colleagues used eye-tracking technology to assess the visual attention of radiologists examining radiographs with and without paired photographs.

Despite protocols that require ensuring patient identity by checking two unique identifiers whenever a procedure is done, radiographs taken in emergency departments (EDs) or intensive care unit settings are at a higher risk of wrong-patient identification errors because patients often cannot provide the unique identifier information.

While previous research has demonstrated that a paired photograph of the patient taken simultaneously at the time of the radiograph increases the detection rate of wrong-patient errors, there is some concern that the photos are a distraction or may increase interpretation time.

“Our specific aim was to incorporate eye-tracking technology and objectively quantify the degree of distraction posed by photographs,” said Dr. Chung, a transitional year resident at Emory University School of Medicine, Atlanta.

Eye-Tracking Technology Yields Results

The study comprised 10 radiologists (six male, four female) from the University of Arizona specializing in a variety of areas including general, abdominal, cardiothoracic and pediatric radiology. Dr. Chung and colleagues obtained patient data (radiographs and photographs) at Emory University and conducted the eye tracking observer study at the University of Arizona.

The subjects reviewed 21 portable chest radiographs in two phases. First, the images were provided without patient photographs and the radiologists were asked to note the placement of various tubes and lines. To prevent recall bias, Dr. Chung and his team allowed at least three weeks to pass before performing the next review. In the second phase, the images were paired with photographs and subjects were asked to perform the same task noting placement of lines and tubes.

Eye-tracking technology measured how long the subjects focused on various areas of the image and the total time spent looking at each case. The technology also noted the distraction rate, or number of times the subjects’ eyes scanned off the radiograph either to view image labels, or in the second phase, to view the photograph.

In both phases, the images were presented on an LCD display, ambient room lighting levels were controlled, the average distance between the observer and the screen was 35 cm, and the eye-tracking equipment sampled eye positions every one-sixtieth of a second with an accuracy of 0.4 degrees and a precision of 0.34 degrees.

The findings from both studies showed that overall time spent viewing the cases did not increase with the addition of the photograph.

“Radiologists compensated by integrating the examination of the photo into their search by decreasing, somewhat, their time on the x-ray image,” said Elizabeth Anne Krupinski, PhD, professor and vice chair for research in the Department of Radiology and Imaging Science at Emory University, who supervised Dr. Chung’s research.

After each phase, the subjects completed a survey collecting demographic information and answering questions about how they acquire patient information, their opinions about the photographs and which body areas they would like included in patient photographs.

Following the first study, all subjects indicated that they would be significantly likely to contact the referring provider if they detected a critical result. After the second study, the subjects were asked to indicate how much more likely they were to call the referring provider if an important finding was detected with the photographs present than without. Seven providers reported no difference, two reported slightly more, and one reported significantly more when photographs were present.

“This research shows that having photographs may help communicative and empathic dimensions of the interpretation process as well,” Dr. Chung said.

“This study was important, because it was the first of its kind to assess the impact of providing patient photographs during image interpretation on the way radiologists search images for findings,” Dr. Krupinski said.

Results May Personalize the Reading Experience

The research findings also show promise for the patient-radiologist relationship, said Srini Tridandapandi, PhD, MD, MBA, a radiologist at Emory University who helped develop the technology to add photographs to radiographs.

“With widespread adoption of PACS over the last couple of decades, we have ‘lost the patient’ and such photographs may help bring the patient back to the radiologist,” said Dr. Tridandapandi, who also served as Dr. Chung’s mentor.

Dr. Chung agreed, noting that this preliminary study provides a firm rationale for conducting a clinical study. “In the future, a study that explores whether the diagnostic accuracy of the reports is affected by the presence of photographs is warranted,” he said.

Dr. Chung credits the RSNA Research Medical Student Grant program with helping him develop grant writing skills and providing support for securing protected time at his institution. He plans to conduct additional research as he pursues a career in academics.


VR Can Be Used to Help Automated Driving Systems Make Ethical Traffic Decisions

The ability to engineer decision-making using machine-learning algorithms could offer an acceptable path toward handing over the car keys to self-driving systems.

 The ability to engineer decision-making using machine-learning algorithms could offer an acceptable path toward handing over the car keys to self-driving systems.
The age of self-driving cars is upon us. Companies including Google, Ford, Waymo, Lyft, Uber, and Volvo are all already testing them in cities around the world, with semi-autonomous cars already available for sale. But while the future of automated driving seems assured, so far there’s no consensus on how to incorporate moral decision-making into computer systems that would inform how they operate.