research papers that changed the world

The Top Ten Scientific Discoveries of the Decade

Breakthroughs include measuring the true nature of the universe, finding new species of human ancestors, and unlocking new ways to fight disease

Jay Bennett

Former associate web editor, science.

Millions of new scientific research papers are published every year , shedding light on everything from the evolution of stars to the ongoing impacts of climate change to the health benefits (or determents) of coffee to the tendency of your cat to ignore you . With so much research coming out every year, it can be difficult to know what is significant, what is interesting but largely insignificant, and what is just plain bad science . But over the course of a decade, we can look back at some of the most important and awe-inspiring areas of research, often expressed in multiple findings and research papers that lead to a true proliferation of knowledge. Here are ten of the biggest strides made by scientists in the last ten years.

New Human Relatives

The human family tree expanded significantly in the past decade, with fossils of new hominin species discovered in Africa and the Philippines. The decade began with the discovery and identification of Australopithecus sediba , a hominin species that lived nearly two million years ago in present-day South Africa. Matthew Berger, the son of paleoanthropologist Lee Berger, stumbled upon the first fossil of the species, a right clavicle, in 2008, when he was only 9 years old. A team then unearthed more fossils from the individual, a young boy, including a well-preserved skull, and A. sediba was described by Lee Berger and colleagues in 2010 . The species represents a transitionary phase between the genus Australopithecus and the genus Homo , with some traits of the older primate group but a style of walking that resembled modern humans.

Also discovered in South Africa by a team led by Berger, Homo naledi lived much more recently, some 335,000 to 236,000 years ago, meaning it may have overlapped with our own species, Homo sapiens. The species, first discovered in the Rising Star Cave system in 2013 and described in 2015 , also had a mix of primitive and modern features, such as a small brain case (about one-third the size of Homo sapiens ) and a large body for the time, weighing approximately 100 pounds and standing up to five feet tall. The smaller Homo luzonensis (three to four feet tall) lived in the Philippines some 50,000 to 67,000 years ago , overlapping with several species of hominin. The first H. luzonensis fossils were originally identified as Homo sapiens, but a 2019 analysis determined that the bones belonged to an entirely unknown species.

These three major finds in the last ten years suggest that the bones of more species of ancient human relatives are likely hidden in the caves and sediment deposits of the world, waiting to be discovered.

Taking Measure of the Cosmos

When Albert Einstein first published the general theory of relativity in 1915, he likely couldn’t have imagined that 100 years later, astronomers would test the theory’s predictions with some of the most sophisticated instruments ever built—and the theory would pass each test. General relativity describes the universe as a “fabric” of space-time that is warped by large masses. It’s this warping that causes gravity, rather than an internal property of mass as Isaac Newton thought.

One prediction of this model is that the acceleration of masses can cause “ripples” in space-time, or the propagation of gravitational waves. With a large enough mass, such as a black hole or a neutron star, these ripples may even be detected by astronomers on Earth. In September 2015, the LIGO and Virgo collaboration detected gravitational waves for the first time, propagating from a pair of merging black holes some 1.3 billion light-years away. Since then, the two instruments have detected several additional gravitational waves , including one from a two merging neutron stars.

Another prediction of general relativity—one that Einstein himself famously doubted —is the existence of black holes at all, or points of gravitational collapse in space with infinite density and infinitesimal volume. These objects consume all matter and light that strays too close, creating a disk of superheated material falling into the black hole. In 2017, the Event Horizon Telescope collaboration —a network of linked radio telescopes around the world—took observations that would later result in the first image of the environment around a black hole, released in April 2019 .

The Hottest Years on Record

Scientists have been predicating the effects of burning coal and fossil fuels on the temperature of the planet for over 100 years. A 1912 issue of Popular Mechanics contains an article titled “ Remarkable Weather of 1911: The Effect of the Combustion of Coal on the Climate—What Scientists Predict for the Future ,” which has a caption that reads: “The furnaces of the world are now burning about 2,000,000,000 tons of coal a year. When this is burned, uniting with oxygen, it adds about 7,000,000,000 tons of carbon dioxide to the atmosphere yearly. This tends to make the air a more effective blanket for the earth and to raise its temperature. The effect may be considerable in a few centuries.”

Just one century later, and the effect is considerable indeed. Increased greenhouse gases in the atmosphere have produced hotter global temperatures, with the last five years (2014 to 2018) being the hottest years on record . 2016 was the hottest year since the National Oceanic and Atmospheric Administration (NOAA) started recording global temperature 139 years ago. The effects of this global change include more frequent and destructive wildfires, more common droughts, accelerating polar ice melt and increased storm surges. California is burning, Venice is flooding, urban heat deaths are on the rise, and countless coastal and island communities face an existential crisis—not to mention the ecological havoc wreaked by climate change, stifling the planet’s ability to pull carbon back out of the atmosphere.

In 2015, the United Nations Framework Convention on Climate Change (UNFCCC) reached a consensus on climate action, known as the Paris Agreement. The primary goal of the Paris Agreement is to limit global temperature increases to 1.5 degrees Celsius over pre-industrial levels . To achieve this goal, major societal transformations will be required, including replacing fossil fuels with clean energy such as wind, solar and nuclear; reforming agricultural practices to limit emissions and protect forested areas; and perhaps even building artificial means of pulling carbon dioxide out of the atmosphere.

Editing Genes

Ever since the double-helix structure of DNA was revealed in the early 1950s , scientists have hypothesized about the possibility of artificially modifying DNA to change the functions of an organism. The first approved gene therapy trial occurred in 1990, when a four-year-old girl had her own white blood cells removed, augmented with the genes that produce an enzyme called adenosine deaminase (ADA), and then reinjected into her body to treat ADA deficiency, a genetic condition that hampers the immune system’s ability to fight disease. The patient’s body began producing the ADA enzyme, but new white blood cells with the corrected gene were not produced, and she had to continue receiving injections .

Now, genetic engineering is more precise and available than ever before, thanks in large part to a new tool first used to modify eukaryotic cells (complex cells with a nucleus) in 2013 : CRISPR-Cas9. The gene editing tool works by locating a targeted section of DNA and “cutting” out that section with the Cas9 enzyme. An optional third step involves replacing the deleted section of DNA with new genetic material. The technique can be used for a wide range of applications, from increasing the muscle mass of livestock, to producing resistant and fruitful crops, to treating diseases like cancer by removing a patient’s immune system cells, modifying them to better fight a disease, and reinjecting them into the patient’s body.

In late 2018, Chinese researchers led by He Jiankui announced that they had used CRISPR-Cas9 to genetically modify human embryos, which were then transferred to a woman’s uterus and resulted in the birth of twin girls—the first gene-edited babies. The twins’ genomes were modified to make the girls more resistant to HIV, although the genetic alterations may have also resulted in unintended changes . The work was widely condemned by the scientific community as unethical and dangerous, revealing a need for stricter regulations for how these powerful new tools are used, particularly when it comes to changing the DNA of embryos and using those embryos to birth live children.

Mysteries of Other Worlds Revealed

Spacecraft and telescopes have revealed a wealth of information about worlds beyond our own in the last decade. In 2015, the New Horizons probe made a close pass of Pluto, taking the first nearby observations of the dwarf planet and its moons. The spacecraft revealed a surprisingly dynamic and active world, with icy mountains reaching up to nearly 20,000 feet and shifting plains that are no more than 10 million years old—meaning the geology is constantly changing. The fact that Pluto—which is an average of 3.7 billion miles from the sun , about 40 times the distance of Earth—is so geologically active suggests that even cold, distant worlds could get enough energy to heat their interiors, possibly harboring subsurface liquid water or even life.

A bit closer to home, the Cassini spacecraft orbited Saturn for 13 years , ending its mission in September 2017 when NASA intentionally plunged the spacecraft into the atmosphere of Saturn so it would burn up rather than continue orbiting the planet once it had exhausted its fuel. During its mission, Cassini discovered the processes that feed Saturn’s rings , observed a global storm encircle the gas giant, mapped the large moon Titan and found some of the ingredients for life in the plumes of icy material erupting from the watery moon Enceladus. In 2016, a year before the end of the Cassini mission, the Juno spacecraft arrived at Jupiter, where it has been measuring the magnetic field and atmospheric dynamics of the largest planet in the solar system to help scientists understand how Jupiter—and everything else around the sun—originally formed.

In 2012, the Curiosity rover landed on Mars, where it has made several significant discoveries, including new evidence of past water on the red planet , the presence of organic molecules that could be related to life, and mysterious seasonal cycles of methane and oxygen that hint at a dynamic world beneath the surface. In 2018, the European Space Agency announced that ground-penetrating radar data from the Mars Express spacecraft provided strong evidence that a liquid reservoir of water exists underground near the Martian south pole .

Meanwhile, two space telescopes, Kepler and TESS, have discovered thousands of planets orbiting other stars. Kepler launched in 2009 and ended its mission in 2018, revealing mysterious and distant planets by measuring the decrease in light when they pass in front of their stars. These planets include hot Jupiters, which orbit close to their stars in just days or hours; mini Neptunes, which are between the size of Earth and Neptune and may be gas, liquid, solid or some combination; and super Earths, which are large rocky planets that astronomers hope to study for signs of life. TESS, which launched in 2018, continues the search as Kepler’s successor. The space telescope has already discovered hundreds of worlds , and it could find 10,000 or even 20,000 before the end of the mission.

Fossilized Pigments Reveal the Colors of Dinosaurs

The decade began with a revolution in paleontology as scientists got their first look at the true colors of dinosaurs. First, in January 2010, an analysis of melanosomes—organelles that contain pigments—in the fossilized feathers of Sinosauropteryx , a dinosaur that lived in China some 120 to 125 million years ago, revealed that the prehistoric creature had “reddish-brown tones” and stripes along its tail . Shortly after, a full-body reconstruction revealed the colors of a small feathered dinosaur that lived some 160 million years ago , Anchiornis , which had black and white feathers on its body and a striking plume of red feathers on its head.

The study of fossilized pigments has continued to expose new information about prehistoric life, hinting at potential animal survival strategies by showing evidence of countershading and camouflage . In 2017, a remarkably well-preserved armored dinosaur which lived about 110 million years ago, Borealopelta , was found to have reddish-brown tones to help blend into the environment . This new ability to identify and study the colors of dinosaurs will continue to play an important role in paleontological research as scientists study the evolution of past life.

Redefining the Fundamental Unit of Mass

In November 2018, measurement scientists around the world voted to officially changed the definition of a kilogram , the fundamental unit of mass. Rather than basing the kilogram off of an object—a platinum-iridium alloy cylinder about the size of a golf ball—the new definition uses a constant of nature to set the unit of mass. The change replaced the last physical artifact used to define a unit of measure. (The meter bar was replaced in 1960 by a specific number of wavelengths of radiation from krypton, for example, and later updated to define a meter according to the distance light travels in a tiny fraction of a second .)

By using a sophisticated weighing machine known as a Kibble balance, scientists were able to precisely measure a kilogram according to the electromagnetic force required to hold it up. This electric measurement could then be expressed in terms of Planck’s constant, a number originally used by Max Planck to calculate bundles of energy coming from stars .

The kilogram was not the only unit of measure that was recently redefined. The changes to the International System of Units, which officially went into effect in May 2019 , also changed the definition for the ampere, the standard unit of electric current; the kelvin unit of temperature; and the mole, a unit of amount of substance used in chemistry. The changes to the kilogram and other units will allow more precise measurements for small amounts of material, such as pharmaceuticals, as well as give scientists around the world access to the fundamental units, rather than defining them according to objects that must be replicated and calibrated by a small number of labs.

First Ancient Human Genome Sequenced

In 2010, scientists gained a new tool to study the ancient past and the people who inhabited it. Researchers used a hair preserved in permafrost to sequence the genome of a man who lived some 4,000 years ago in what is now Greenland , revealing the physical traits and even the blood type of a member of one of the first cultures to settle in that part of the world. The first nearly complete reconstruction of a genome from ancient DNA opened the door for anthropologists and geneticists to learn more about the cultures of the distant past than ever before.

Extracting ancient DNA is a major challenge. Even if genetic material such as hair or skin is preserved, it is often contaminated with the DNA of microbes from the environment, so sophisticated sequencing techniques must be used to isolate the ancient human’s DNA. More recently, scientists have used the petrous bone of the skull , a highly dense bone near the ear, to extract ancient DNA.

Thousands of ancient human genomes have been sequenced since the first success in 2010, revealing new details about the rise and fall of lost civilizations and the migrations of people around the globe . Studying ancient genomes has identified multiple waves of migration back and forth across the frozen Bering land bridge between Siberia and Alaska between 5,000 and 15,000 years ago. Recently, the genome of a young girl in modern Denmark was sequenced from a 5,700-year-old piece of birch tar used as chewing gum, which also contained her mouth microbes and bits of food from one of her last meals.

A Vaccine and New Treatments to Fight Ebola

This decade included the worst outbreak of Ebola virus diseases in history. The epidemic is believed to have begun with a single case of an 18-month-old-boy in Guinea infected by bats in December 2013. The disease quickly spread to neighboring countries, reaching the capitals of Liberia and Sierra Leone by July 2014, providing an unprecedented opportunity for the transmission of the disease to a large number of people. Ebola virus compromises the immune system and can cause massive hemorrhaging and multiple organ failure. Two and a half years after the initial case, more than 28,600 people had been infected, resulting in at least 11,325 deaths, according to the CDC .

The epidemic prompted health officials to redouble their efforts to find an effective vaccine to fight Ebola. A vaccine known as Ervebo, made by the pharmaceutical company Merck, was tested in a clinical trial in Guinea performed toward the end of the outbreak in 2016 that proved the vaccine effective. Another Ebola outbreak was declared in the Democratic Republic of the Congo in August 2018, and the ongoing epidemic has spread to become the deadliest since the West Africa outbreak, with 3,366 reported cases and 2,227 deaths as of December 2019 . Ervebo has been used in the DRC to fight the outbreak on an expanded access or “compassionate use” basis . In November 2019, Ervebo was approved by the European Medicines Agency (EMA) , and a month later it was approved in the U.S. by the FDA .

In addition to a preventative vaccine, researchers have been seeking a cure for Ebola in patients who have already been infected by the disease. Two treatments, which involve a one-time delivery of antibodies to prevent Ebola from infecting a patient’s cells, have recently shown promise in a clinical trial in the DRC . With a combination of vaccines and therapeutic treatments, healthcare officials hope to one day eradicate the viral infection for good .

CERN Detects the Higgs Boson

Over the past several decades, physicists have worked tirelessly to model the workings of the universe, developing what is known as the Standard Model. This model describes four basic interactions of matter, known as the fundamental forces . Two are familiar in everyday life: the gravitational force and the electromagnetic force. The other two, however, only exert their influence inside the nuclei of atoms: the strong nuclear force and the weak nuclear force.

Part of the Standard Model says that there is a universal quantum field that interacts with particles, giving them their masses. In the 1960s, theoretical physicists including François Englert and Peter Higgs described this field and its role in the Standard Model. It became known as the Higgs field, and according to the laws of quantum mechanics, all such fundamental fields should have an associated particle, which came to be known as the Higgs boson.

Decades later, in 2012, two teams using the Large Hadron Collider at CERN to conduct particle collisions reported the detection of a particle with the predicted mass of the Higgs boson, providing substantial evidence for the existence of the Higgs field and Higgs boson. In 2013, the Nobel Prize in Physics was awarded to Englert and Higgs “for the theoretical discovery of a mechanism that contributes to our understanding of the origin of mass of subatomic particles, and which recently was confirmed through the discovery of the predicted fundamental particle.” As physicists continue to refine the Standard Model, the function and discovery of the Higgs boson will remain a fundamental part of how all matter gets its mass, and therefore, how any matter exists at all.

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Jay Bennett was the associate web editor, science, for Smithsonian .

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The Top 30 Global Sustainability Research Papers in 2019

In 2019, record-high global temperatures and climate change took central stage in global news headlines, culminating with a declaration from more than 11,000 scientists from around the world that a climate emergency exists on Earth. This declaration got people talking on social media and in the news, more so than any other scientific publication in 2019.

Altmetric annually ranks the 100 scientific papers that glean the most media attention as a simple measure of what sparks public interest. In 2019, they examined over 62 million media mentions of 2.7 million research articles. The altmetric score does not measure the calibre of the research or researcher.

At Future Earth, we used the list to identify the top 30 global sustainability articles. We were guided by the United Nations Sustainable Development Goals (SDGs), which recognize that eradicating poverty in all its forms and dimensions, combating inequality within and among countries, preserving the planet, creating sustained, inclusive and sustainable economic growth, and fostering social inclusion are linked to each other and are interdependent.

Taking a closer look at the top five, the rising threat posed by climate change (SDG 13) was a central concern in 2019 as reflected by this year’s top two papers. The health of our oceans (SDG 14) and global terrestrial biodiversity (SDG 15) also find their way into the top five, with the third ranked paper discussing increasing vulnerability to sea level rise and coastal flooding, while the fourth ranked paper examines the potential of global reforestation to mitigate the effects of climate change. Rounding out the top five, a global study between 1990-2017 analyzed the health effects linked to dietary risks (SDG 3). Together, these papers reflect the many connections among natural and human systems by highlighting just how important the life supporting SDGs (6, 13, 14, and 15) are to supporting healthy, equitable, and sustainable livelihoods on Earth.

Of the top 30, nearly half of the global sustainability articles are concerned with climate change, with another third related to health, nutrition, and climate. Papers discussing biodiversity and plastics also make their way onto the list.

Read on for the full top 30 of 2019 and see earlier lists here (January – April 2019 ), here (May – August 2019 ) and here (2018 in review) .

The top 30 global sustainability articles in 2019, by Altmetric score:

• World Scientists’ Warning of a Climate Emergency (November 2019) BioScience . Altmetric score: 10,966
• Climate tipping points too risky to bet against (November 2019) Nature . Altmetric score: 8556
• New elevation data triple estimates of global vulnerability to sea-level rise and coastal flooding (October 2019) Nature Communications . Altmetric score: 7,135
• The global tree restoration potential (July 2019) Science . Altmetric score: 6,356
• Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 (April 2019) The Lancet . Altmetric score: 5,868
• Worldwide decline of the entomofauna: A review of its drivers (April 2019) Biological Conservation . Altmetric score: 5,438
• Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable foods (February 2019) The Lancet . Altmetric score: 4,561
• Committed emissions from existing energy infrastructure jeopardize 1.5°C climate target (August 2019) Nature . Altmetric score: 4,434
• Concerns of young protesters are justified (April 2019) Science . Altmetric score: 4,349
• Global warming impairs stock-recruitment dynamics of corals (April 2019) Nature . Altmetric score: 4,121
• Eat less meat: UN climate-change report calls for change to human diet (August 2019) Nature . Altmetric score: 3,861
• No evidence for globally coherent warm and cold periods over the preindustrial Common Era (July 2019) Nature . Altmetric score: 3,898
• Decline of the North American avifauna (October 2019) Science . Altmetric score: 3,368
• Earth system impacts of the European arrival and the Great Dying in the Americas after 1492 (March 2019) Quaternary Science Reviews . Altmetric score: 3,290
• Spending at least 120 minutes in a week in nature is associated with good health and wellbeing (June 2019) Scientific Reports . Altmetric score: 3,249
• Permafrost collapse is accelerating carbon release (April 2019) Nature . Altmetric score: 3,014
• The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission Report (February 2019) The Lancet . Altmetric score: 2,973
• How fast are the oceans warming? (January 2019) Science . Altmetric score: 2,882
• Acceleration of ice loss across the Himalayas over the past 40 years (June 2019) Science Advances . Altmetric score: 2,767
• The 2019 report of the Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by climate change (November 2019) The Lancet . Altmetric score: 2,752
• 40 years ago, scientists predicted climate change. And hey, they were right (July 2019) The Conversation . Altmetric score: 2,724
• Ice sheet contributions to future sea level rise from structured expert judgment (May 2019) PNAS . Altmetric score: 2,620
• Dissecting racial bias in an algorithm used to manage the health of populations (October 2019) Science . Altmetric score: 2,584.
• International humanitarian norms are violated in Hong Kong (December 2019) The Lancet . Altmetric score: 2,538
• Four decades of Antarctic Ice Sheet mass balance from 1979-2017 (January 2019) PNAS . Altmetric score: 2,494
• Urban Nature Experiences Reduce Stress in the Context of Daily Life Based on Salivary Biomarkers (April 2019) Frontiers in Psychology . Altmetric score: 2,312
• Plastic Teabags Release Billions of Microparticles and Nanoparticles into Tea (September 2019) Environmental Science and Technology . Altmetric score: 2,305
• White and wonderful? Microplastics prevail in snow from the Alps to the Arctic (August 2019) Science Advances . Altmetric score: 2,253
• Arthropod decline in grasslands and forests is associated with landscape-level drivers (October 2019) Nature . Altmetric score: 2,240
• Nudging out support for a carbon tax (May 2019) Nature Climate Change . Altmetric score: 2,190

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The present and future of AI

Finale doshi-velez on how ai is shaping our lives and how we can shape ai.

Finale Doshi-Velez, the John L. Loeb Professor of Engineering and Applied Sciences. (Photo courtesy of Eliza Grinnell/Harvard SEAS)

How has artificial intelligence changed and shaped our world over the last five years? How will AI continue to impact our lives in the coming years? Those were the questions addressed in the most recent report from the One Hundred Year Study on Artificial Intelligence (AI100), an ongoing project hosted at Stanford University, that will study the status of AI technology and its impacts on the world over the next 100 years.

The 2021 report is the second in a series that will be released every five years until 2116. Titled “Gathering Strength, Gathering Storms,” the report explores the various ways AI is  increasingly touching people’s lives in settings that range from  movie recommendations  and  voice assistants  to  autonomous driving  and  automated medical diagnoses .

Barbara Grosz , the Higgins Research Professor of Natural Sciences at the Harvard John A. Paulson School of Engineering and Applied Sciences (SEAS) is a member of the standing committee overseeing the AI100 project and Finale Doshi-Velez , Gordon McKay Professor of Computer Science, is part of the panel of interdisciplinary researchers who wrote this year’s report. 

We spoke with Doshi-Velez about the report, what it says about the role AI is currently playing in our lives, and how it will change in the future.  

Q: Let's start with a snapshot: What is the current state of AI and its potential?

Doshi-Velez: Some of the biggest changes in the last five years have been how well AIs now perform in large data regimes on specific types of tasks.  We've seen [DeepMind’s] AlphaZero become the best Go player entirely through self-play, and everyday uses of AI such as grammar checks and autocomplete, automatic personal photo organization and search, and speech recognition become commonplace for large numbers of people.  

In terms of potential, I'm most excited about AIs that might augment and assist people.  They can be used to drive insights in drug discovery, help with decision making such as identifying a menu of likely treatment options for patients, and provide basic assistance, such as lane keeping while driving or text-to-speech based on images from a phone for the visually impaired.  In many situations, people and AIs have complementary strengths. I think we're getting closer to unlocking the potential of people and AI teams.

There's a much greater recognition that we should not be waiting for AI tools to become mainstream before making sure they are ethical.

Q: Over the course of 100 years, these reports will tell the story of AI and its evolving role in society. Even though there have only been two reports, what's the story so far?

There's actually a lot of change even in five years.  The first report is fairly rosy.  For example, it mentions how algorithmic risk assessments may mitigate the human biases of judges.  The second has a much more mixed view.  I think this comes from the fact that as AI tools have come into the mainstream — both in higher stakes and everyday settings — we are appropriately much less willing to tolerate flaws, especially discriminatory ones. There's also been questions of information and disinformation control as people get their news, social media, and entertainment via searches and rankings personalized to them. So, there's a much greater recognition that we should not be waiting for AI tools to become mainstream before making sure they are ethical.

Q: What is the responsibility of institutes of higher education in preparing students and the next generation of computer scientists for the future of AI and its impact on society?

First, I'll say that the need to understand the basics of AI and data science starts much earlier than higher education!  Children are being exposed to AIs as soon as they click on videos on YouTube or browse photo albums. They need to understand aspects of AI such as how their actions affect future recommendations.

But for computer science students in college, I think a key thing that future engineers need to realize is when to demand input and how to talk across disciplinary boundaries to get at often difficult-to-quantify notions of safety, equity, fairness, etc.  I'm really excited that Harvard has the Embedded EthiCS program to provide some of this education.  Of course, this is an addition to standard good engineering practices like building robust models, validating them, and so forth, which is all a bit harder with AI.

I think a key thing that future engineers need to realize is when to demand input and how to talk across disciplinary boundaries to get at often difficult-to-quantify notions of safety, equity, fairness, etc. 

Q: Your work focuses on machine learning with applications to healthcare, which is also an area of focus of this report. What is the state of AI in healthcare? 

A lot of AI in healthcare has been on the business end, used for optimizing billing, scheduling surgeries, that sort of thing.  When it comes to AI for better patient care, which is what we usually think about, there are few legal, regulatory, and financial incentives to do so, and many disincentives. Still, there's been slow but steady integration of AI-based tools, often in the form of risk scoring and alert systems.

In the near future, two applications that I'm really excited about are triage in low-resource settings — having AIs do initial reads of pathology slides, for example, if there are not enough pathologists, or get an initial check of whether a mole looks suspicious — and ways in which AIs can help identify promising treatment options for discussion with a clinician team and patient.

Q: Any predictions for the next report?

I'll be keen to see where currently nascent AI regulation initiatives have gotten to. Accountability is such a difficult question in AI,  it's tricky to nurture both innovation and basic protections.  Perhaps the most important innovation will be in approaches for AI accountability.

Topics: AI / Machine Learning , Computer Science

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Five papers that shook the world

In 1905 an anonymous patent clerk in Bern rewrote the laws of physics in his spare time. Matthew Chalmers describes Einstein's miraculous year

Most physicists would be happy to make one discovery that is important enough to be taught to future generations of physics students. Only a very small number manage this in their lifetime, and even fewer make two appearances in the textbooks. But Einstein was different. In little more than eight months in 1905 he completed five papers that would change the world for ever. Spanning three quite distinct topics – relativity, the photoelectric effect and Brownian motion – Einstein overturned our view of space and time, showed that it is insufficient to describe light purely as a wave, and laid the foundations for the discovery of atoms.

Perhaps even more remarkably, Einstein’s 1905 papers were based neither on hard experimental evidence nor sophisticated mathematics. Instead, he presented elegant arguments and conclusions based on physical intuition. “Einstein’s work stands out not because it was difficult but because nobody at that time had been thinking the way he did,” says Gerard ‘t Hooft of the University of Utrecht, who shared the 1999 Nobel Prize for Physics for his work in quantum theory. “Dirac, Fermi, Feynman and others also made multiple contributions to physics, but Einstein made the world realize, for the first time, that pure thought can change our understanding of nature.”

And just in case the enormity of Einstein’s achievement is in any doubt, we have to remember that he did all of this in his “spare time”.

Statistical revelations

In 1905 Einstein was married with a one-year-old son and working as a patent examiner in Bern in Switzerland. His passion was physics, but he had been unable to find an academic position after graduating from the ETH in Zurich in 1900. Nevertheless, he had managed to publish five papers in the leading German journal Annalen der Physik between 1900 and 1904, and had also submitted an unsolicited thesis on molecular forces to the University of Zurich, which was rejected.

Most of these early papers were concerned with the reality of atoms and molecules, something that was far from certain at the time. But on 17 March in 1905 – three days after his 26th birthday – Einstein submitted a paper titled “A heuristic point of view concerning the production and transformation of light” to Annalen der Physik.

Einstein suggested that, from a thermodynamic perspective, light can be described as if it consists of independent quanta of energy ( Ann. Phys., Lpz 17 132-148). This hypothesis, which had been tentatively proposed by Max Planck a few years earlier, directly challenged the deeply ingrained wave picture of light. However, Einstein was able to use the idea to explain certain puzzles about the way that light or other electromagnetic radiation ejected electrons from a metal via the photoelectric effect.

Maxwell’s electrodynamics could not, for example, explain why the energy of the ejected photoelectrons depended only on the frequency of the incident light and not on the intensity. However, this phenomenon was easy to understand if light of a certain frequency actually consisted of discrete packets or photons all with the same energy. Einstein would go on to receive the 1921 Nobel Prize for Physics for this work, although the official citation stated that the prize was also awarded “for his services to theoretical physics”.

“The arguments Einstein used in the photoelectric and subsequent radiation theory are staggering in their boldness and beauty,” says Frank Wilczek, a theorist at the Massachusetts Institute of Technology who shared the 2004 Nobel Prize for Physics. “He put forward revolutionary ideas that both inspired decisive experimental work and helped launch quantum theory.” Although not fully appreciated at the time, Einstein’s work on the quantum nature of light was the first step towards establishing the wave-particle duality of quantum particles.

On 30 April, one month before his paper on the photoelectric effect appeared in print, Einstein completed his second 1905 paper, in which he showed how to calculate Avogadro’s number and the size of molecules by studying their motion in a solution. This article was accepted as a doctoral thesis by the University of Zurich in July, and published in a slightly altered form in Annalen der Physik in January 1906. Despite often being obscured by the fame of his papers on special relativity and the photoelectric effect, Einstein’s thesis on molecular dimensions became one of his most quoted works. Indeed, it was his preoccupation with statistical mechanics that formed the basis of several of his breakthroughs, including the idea that light was quantized.

After finishing a doctoral thesis, most physicists would be either celebrating or sleeping. But just 11 days later Einstein sent another paper to Annalen der Physik, this time on the subject of Brownian motion. In this paper, “On the movement of small particles suspended in stationary liquids required by the molecular-kinetic theory of heat”, Einstein combined kinetic theory and classical hydrodynamics to derive an equation that showed that the displacement of Brownian particles varies as the square root of time ( Ann. Phys., Lpz 17 549-560).

This was confirmed experimentally by Jean Perrin three years later, proving once and for all that atoms do exist (see Einstein’s random walk ). In fact, Einstein extended his theory of Brownian motion in an additional paper that he sent to the journal on 19 December, although this was not published until February 1906.

A special discovery

Shortly after finishing his paper on Brownian motion Einstein had an idea about synchronizing clocks that were spatially separated. This led him to write a paper that landed on the desks of Annalen der Physik on 30 June, and would go on to completely overhaul our understanding of space and time. Some 30 pages long and containing no references, his fourth 1905 paper was titled “On the electrodynamics of moving bodies” ( Ann. Phys., Lpz 17 891-921).

In the 200 or so years before 1905, physics had been built on Newton’s laws of motion, which were known to hold equally well in stationary reference frames and in frames moving at a constant velocity in a straight line. Provided the correct “Galilean” rules were applied, one could therefore transform the laws of physics so that they did not depend on the frame of reference. However, the theory of electrodynamics developed by Maxwell in the late 19th century posed a fundamental problem to this “principle of relativity” because it suggested that electromagnetic waves always travel at the same speed.

Either electrodynamics was wrong or there had to be some kind of stationary “ether” through which the waves could propagate. Alternatively, Newton was wrong. True to style, Einstein swept away the concept of the ether (which, in any case, had not been detected experimentally) in one audacious step. He postulated that no matter how fast you are moving, light will always appear to travel at the same velocity: the speed of light is a fundamental constant of nature that cannot be exceeded.

Combined with the requirement that the laws of physics are the identical in all “inertial” (i.e. non-accelerating) frames, Einstein built a completely new theory of motion that revealed Newtonian mechanics to be an approximation that only holds at low, everyday speeds. The theory later became known as the special theory of relativity – special because it applies only to non-accelerating frames – and led to the realization that space and time are intimately linked to one another.

In order that the two postulates of special relativity are respected, strange things have to happen to space and time, which, unbeknown to Einstein, had been predicted by Lorentz and others the previous year. For instance, the length of an object becomes shorter when it travels at a constant velocity, and a moving clock runs slower than a stationary clock. Effects like these have been verified in countless experiments over the last 100 years, but in 1905 the most famous prediction of Einstein’s theory was still to come.

After a short family holiday in Serbia, Einstein submitted his fifth and final paper of 1905 on 27 September. Just three pages long and titled “Does the inertia of a body depend on its energy content?”, this paper presented an “afterthought” on the consequences of special relativity, which culminated in a simple equation that is now known as E  =  mc 2 ( Ann. Phys., Lpz 18 639-641). This equation, which was to become the most famous in all of science, was the icing on the cake.

“The special theory of relativity, culminating in the prediction that mass and energy can be converted into one another, is one of the greatest achievements in physics – or anything else for that matter,” says Wilczek. “Einstein’s work on Brownian motion would have merited a sound Nobel prize, the photoelectric effect a strong Nobel prize, but special relativity and E  =  mc 2 were worth a super-strong Nobel prize.”

However, while not doubting the scale of Einstein’s achievements, many physicists also think that his 1905 discoveries would have eventually been made by others. “If Einstein had not lived, people would have stumbled on for a number of years, maybe a decade or so, before getting a clear conception of special relativity,” says Ed Witten of the Institute for Advanced Study in Princeton.

‘t Hooft agrees. “The more natural course of events would have been that Einstein’s 1905 discoveries were made by different people, not by one and the same person,” he says. However, most think that it would have taken much longer – perhaps a few decades – for Einstein’s general theory of relativity to emerge. Indeed, Wilczek points out that one consequence of general relativity being so far ahead of its time was that the subject languished for many years afterwards.

The aftermath

By the end of 1905 Einstein was starting to make a name for himself in the physics community, with Planck and Philipp Lenard – who won the Nobel prize that year – among his most famous supporters. Indeed, Planck was a member of the editorial board of Annalen der Physik at the time.

Einstein was finally given the title of Herr Doktor from the University of Zurich in January 1906, but he remained at the patent office for a further two and a half years before taking up his first academic position at Zurich. By this time his statistical interpretation of Brownian motion and his bold postulates of special relativity were becoming part of the fabric of physics, although it would take several more years for his paper on light quanta to gain wide acceptance.

1905 was undoubtedly a great year for physics, and for Einstein. “You have to go back to quasi-mythical figures like Galileo or especially Newton to find good analogues,” says Wilczek. “The closest in modern times might be Dirac, who, if magnetic monopoles had been discovered, would have given Einstein some real competition!” But we should not forget that 1905 was just the beginning of Einstein’s legacy. His crowning achievement – the general theory of relativity – was still to come.

Box: Elsewhere in 1905

Einstein’s annus mirabilis tends to overshadow other scientific developments that took place in 1905. So what else was going on in the year that cellophane was invented, the neon sign made its debut, and people were getting to grips with tea bags for the first time? In terms of the number of citations in physics and physical-chemistry journals since 1945, three of Einstein’s 1905 papers feature in the top five, according to Werner Marx and Manuel Cardona of the Max Planck Institute for Solid State Research in Stuttgart. Indeed, his papers on Brownian motion and special relativity take first and second place, respectively, with 1467 and 642 citations (his papers on the photoelectric effect and E = mc 2 are fifth and 11th). The fourth most-cited paper of 1905 was by Paul Langevin, who derived a fundamental formula in kinetic theory – clearly a popular subject at the time – while Lawrence Bragg published a paper about the energy loss of alpha particles in different media, which became the sixth most-cited paper of the year.

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Promises and Pitfalls of Technology

Politics and privacy, private-sector influence and big tech, state competition and conflict, author biography, how is technology changing the world, and how should the world change technology.

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Josephine Wolff; How Is Technology Changing the World, and How Should the World Change Technology?. Global Perspectives 1 February 2021; 2 (1): 27353. doi: https://doi.org/10.1525/gp.2021.27353

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Technologies are becoming increasingly complicated and increasingly interconnected. Cars, airplanes, medical devices, financial transactions, and electricity systems all rely on more computer software than they ever have before, making them seem both harder to understand and, in some cases, harder to control. Government and corporate surveillance of individuals and information processing relies largely on digital technologies and artificial intelligence, and therefore involves less human-to-human contact than ever before and more opportunities for biases to be embedded and codified in our technological systems in ways we may not even be able to identify or recognize. Bioengineering advances are opening up new terrain for challenging philosophical, political, and economic questions regarding human-natural relations. Additionally, the management of these large and small devices and systems is increasingly done through the cloud, so that control over them is both very remote and removed from direct human or social control. The study of how to make technologies like artificial intelligence or the Internet of Things “explainable” has become its own area of research because it is so difficult to understand how they work or what is at fault when something goes wrong (Gunning and Aha 2019) .

This growing complexity makes it more difficult than ever—and more imperative than ever—for scholars to probe how technological advancements are altering life around the world in both positive and negative ways and what social, political, and legal tools are needed to help shape the development and design of technology in beneficial directions. This can seem like an impossible task in light of the rapid pace of technological change and the sense that its continued advancement is inevitable, but many countries around the world are only just beginning to take significant steps toward regulating computer technologies and are still in the process of radically rethinking the rules governing global data flows and exchange of technology across borders.

These are exciting times not just for technological development but also for technology policy—our technologies may be more advanced and complicated than ever but so, too, are our understandings of how they can best be leveraged, protected, and even constrained. The structures of technological systems as determined largely by government and institutional policies and those structures have tremendous implications for social organization and agency, ranging from open source, open systems that are highly distributed and decentralized, to those that are tightly controlled and closed, structured according to stricter and more hierarchical models. And just as our understanding of the governance of technology is developing in new and interesting ways, so, too, is our understanding of the social, cultural, environmental, and political dimensions of emerging technologies. We are realizing both the challenges and the importance of mapping out the full range of ways that technology is changing our society, what we want those changes to look like, and what tools we have to try to influence and guide those shifts.

Technology can be a source of tremendous optimism. It can help overcome some of the greatest challenges our society faces, including climate change, famine, and disease. For those who believe in the power of innovation and the promise of creative destruction to advance economic development and lead to better quality of life, technology is a vital economic driver (Schumpeter 1942) . But it can also be a tool of tremendous fear and oppression, embedding biases in automated decision-making processes and information-processing algorithms, exacerbating economic and social inequalities within and between countries to a staggering degree, or creating new weapons and avenues for attack unlike any we have had to face in the past. Scholars have even contended that the emergence of the term technology in the nineteenth and twentieth centuries marked a shift from viewing individual pieces of machinery as a means to achieving political and social progress to the more dangerous, or hazardous, view that larger-scale, more complex technological systems were a semiautonomous form of progress in and of themselves (Marx 2010) . More recently, technologists have sharply criticized what they view as a wave of new Luddites, people intent on slowing the development of technology and turning back the clock on innovation as a means of mitigating the societal impacts of technological change (Marlowe 1970) .

At the heart of fights over new technologies and their resulting global changes are often two conflicting visions of technology: a fundamentally optimistic one that believes humans use it as a tool to achieve greater goals, and a fundamentally pessimistic one that holds that technological systems have reached a point beyond our control. Technology philosophers have argued that neither of these views is wholly accurate and that a purely optimistic or pessimistic view of technology is insufficient to capture the nuances and complexity of our relationship to technology (Oberdiek and Tiles 1995) . Understanding technology and how we can make better decisions about designing, deploying, and refining it requires capturing that nuance and complexity through in-depth analysis of the impacts of different technological advancements and the ways they have played out in all their complicated and controversial messiness across the world.

These impacts are often unpredictable as technologies are adopted in new contexts and come to be used in ways that sometimes diverge significantly from the use cases envisioned by their designers. The internet, designed to help transmit information between computer networks, became a crucial vehicle for commerce, introducing unexpected avenues for crime and financial fraud. Social media platforms like Facebook and Twitter, designed to connect friends and families through sharing photographs and life updates, became focal points of election controversies and political influence. Cryptocurrencies, originally intended as a means of decentralized digital cash, have become a significant environmental hazard as more and more computing resources are devoted to mining these forms of virtual money. One of the crucial challenges in this area is therefore recognizing, documenting, and even anticipating some of these unexpected consequences and providing mechanisms to technologists for how to think through the impacts of their work, as well as possible other paths to different outcomes (Verbeek 2006) . And just as technological innovations can cause unexpected harm, they can also bring about extraordinary benefits—new vaccines and medicines to address global pandemics and save thousands of lives, new sources of energy that can drastically reduce emissions and help combat climate change, new modes of education that can reach people who would otherwise have no access to schooling. Regulating technology therefore requires a careful balance of mitigating risks without overly restricting potentially beneficial innovations.

Nations around the world have taken very different approaches to governing emerging technologies and have adopted a range of different technologies themselves in pursuit of more modern governance structures and processes (Braman 2009) . In Europe, the precautionary principle has guided much more anticipatory regulation aimed at addressing the risks presented by technologies even before they are fully realized. For instance, the European Union’s General Data Protection Regulation focuses on the responsibilities of data controllers and processors to provide individuals with access to their data and information about how that data is being used not just as a means of addressing existing security and privacy threats, such as data breaches, but also to protect against future developments and uses of that data for artificial intelligence and automated decision-making purposes. In Germany, Technische Überwachungsvereine, or TÜVs, perform regular tests and inspections of technological systems to assess and minimize risks over time, as the tech landscape evolves. In the United States, by contrast, there is much greater reliance on litigation and liability regimes to address safety and security failings after-the-fact. These different approaches reflect not just the different legal and regulatory mechanisms and philosophies of different nations but also the different ways those nations prioritize rapid development of the technology industry versus safety, security, and individual control. Typically, governance innovations move much more slowly than technological innovations, and regulations can lag years, or even decades, behind the technologies they aim to govern.

In addition to this varied set of national regulatory approaches, a variety of international and nongovernmental organizations also contribute to the process of developing standards, rules, and norms for new technologies, including the International Organization for Standardization­ and the International Telecommunication Union. These multilateral and NGO actors play an especially important role in trying to define appropriate boundaries for the use of new technologies by governments as instruments of control for the state.

At the same time that policymakers are under scrutiny both for their decisions about how to regulate technology as well as their decisions about how and when to adopt technologies like facial recognition themselves, technology firms and designers have also come under increasing criticism. Growing recognition that the design of technologies can have far-reaching social and political implications means that there is more pressure on technologists to take into consideration the consequences of their decisions early on in the design process (Vincenti 1993; Winner 1980) . The question of how technologists should incorporate these social dimensions into their design and development processes is an old one, and debate on these issues dates back to the 1970s, but it remains an urgent and often overlooked part of the puzzle because so many of the supposedly systematic mechanisms for assessing the impacts of new technologies in both the private and public sectors are primarily bureaucratic, symbolic processes rather than carrying any real weight or influence.

Technologists are often ill-equipped or unwilling to respond to the sorts of social problems that their creations have—often unwittingly—exacerbated, and instead point to governments and lawmakers to address those problems (Zuckerberg 2019) . But governments often have few incentives to engage in this area. This is because setting clear standards and rules for an ever-evolving technological landscape can be extremely challenging, because enforcement of those rules can be a significant undertaking requiring considerable expertise, and because the tech sector is a major source of jobs and revenue for many countries that may fear losing those benefits if they constrain companies too much. This indicates not just a need for clearer incentives and better policies for both private- and public-sector entities but also a need for new mechanisms whereby the technology development and design process can be influenced and assessed by people with a wider range of experiences and expertise. If we want technologies to be designed with an eye to their impacts, who is responsible for predicting, measuring, and mitigating those impacts throughout the design process? Involving policymakers in that process in a more meaningful way will also require training them to have the analytic and technical capacity to more fully engage with technologists and understand more fully the implications of their decisions.

At the same time that tech companies seem unwilling or unable to rein in their creations, many also fear they wield too much power, in some cases all but replacing governments and international organizations in their ability to make decisions that affect millions of people worldwide and control access to information, platforms, and audiences (Kilovaty 2020) . Regulators around the world have begun considering whether some of these companies have become so powerful that they violate the tenets of antitrust laws, but it can be difficult for governments to identify exactly what those violations are, especially in the context of an industry where the largest players often provide their customers with free services. And the platforms and services developed by tech companies are often wielded most powerfully and dangerously not directly by their private-sector creators and operators but instead by states themselves for widespread misinformation campaigns that serve political purposes (Nye 2018) .

Since the largest private entities in the tech sector operate in many countries, they are often better poised to implement global changes to the technological ecosystem than individual states or regulatory bodies, creating new challenges to existing governance structures and hierarchies. Just as it can be challenging to provide oversight for government use of technologies, so, too, oversight of the biggest tech companies, which have more resources, reach, and power than many nations, can prove to be a daunting task. The rise of network forms of organization and the growing gig economy have added to these challenges, making it even harder for regulators to fully address the breadth of these companies’ operations (Powell 1990) . The private-public partnerships that have emerged around energy, transportation, medical, and cyber technologies further complicate this picture, blurring the line between the public and private sectors and raising critical questions about the role of each in providing critical infrastructure, health care, and security. How can and should private tech companies operating in these different sectors be governed, and what types of influence do they exert over regulators? How feasible are different policy proposals aimed at technological innovation, and what potential unintended consequences might they have?

Conflict between countries has also spilled over significantly into the private sector in recent years, most notably in the case of tensions between the United States and China over which technologies developed in each country will be permitted by the other and which will be purchased by other customers, outside those two countries. Countries competing to develop the best technology is not a new phenomenon, but the current conflicts have major international ramifications and will influence the infrastructure that is installed and used around the world for years to come. Untangling the different factors that feed into these tussles as well as whom they benefit and whom they leave at a disadvantage is crucial for understanding how governments can most effectively foster technological innovation and invention domestically as well as the global consequences of those efforts. As much of the world is forced to choose between buying technology from the United States or from China, how should we understand the long-term impacts of those choices and the options available to people in countries without robust domestic tech industries? Does the global spread of technologies help fuel further innovation in countries with smaller tech markets, or does it reinforce the dominance of the states that are already most prominent in this sector? How can research universities maintain global collaborations and research communities in light of these national competitions, and what role does government research and development spending play in fostering innovation within its own borders and worldwide? How should intellectual property protections evolve to meet the demands of the technology industry, and how can those protections be enforced globally?

These conflicts between countries sometimes appear to challenge the feasibility of truly global technologies and networks that operate across all countries through standardized protocols and design features. Organizations like the International Organization for Standardization, the World Intellectual Property Organization, the United Nations Industrial Development Organization, and many others have tried to harmonize these policies and protocols across different countries for years, but have met with limited success when it comes to resolving the issues of greatest tension and disagreement among nations. For technology to operate in a global environment, there is a need for a much greater degree of coordination among countries and the development of common standards and norms, but governments continue to struggle to agree not just on those norms themselves but even the appropriate venue and processes for developing them. Without greater global cooperation, is it possible to maintain a global network like the internet or to promote the spread of new technologies around the world to address challenges of sustainability? What might help incentivize that cooperation moving forward, and what could new structures and process for governance of global technologies look like? Why has the tech industry’s self-regulation culture persisted? Do the same traditional drivers for public policy, such as politics of harmonization and path dependency in policy-making, still sufficiently explain policy outcomes in this space? As new technologies and their applications spread across the globe in uneven ways, how and when do they create forces of change from unexpected places?

These are some of the questions that we hope to address in the Technology and Global Change section through articles that tackle new dimensions of the global landscape of designing, developing, deploying, and assessing new technologies to address major challenges the world faces. Understanding these processes requires synthesizing knowledge from a range of different fields, including sociology, political science, economics, and history, as well as technical fields such as engineering, climate science, and computer science. A crucial part of understanding how technology has created global change and, in turn, how global changes have influenced the development of new technologies is understanding the technologies themselves in all their richness and complexity—how they work, the limits of what they can do, what they were designed to do, how they are actually used. Just as technologies themselves are becoming more complicated, so are their embeddings and relationships to the larger social, political, and legal contexts in which they exist. Scholars across all disciplines are encouraged to join us in untangling those complexities.

Josephine Wolff is an associate professor of cybersecurity policy at the Fletcher School of Law and Diplomacy at Tufts University. Her book You’ll See This Message When It Is Too Late: The Legal and Economic Aftermath of Cybersecurity Breaches was published by MIT Press in 2018.

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November 6, 2018 marks the 20th anniversary of the seminal paper “Embryonic stem cell lines derived from human blastocysts,” published in Science . The paper documented a breakthrough that occurred when University of Wisconsin-Madison and WiNPRC scientist James Thomson, VMD, PhD, developed a technique to successfully isolate and culture human embryonic stem cells from patient-donated, lab-fertilized embryos.

Thomson was successful again in 2007 when he became the first to grow induced pluripotent stem cells. Induced pluripotent stem cells behave similarly to embryonic stem cells with their source being genetically reprogrammed mature cells, such as skin cells. Thomson derived this type of cell with WiNPRC scientist Junying Yu, publishing again in Science .

Scientists predicted both of these cell types could someday be useful for drug discovery and transplant medicine. Today, those predictions are coming true.

Embryonic and induced pluripotent stem cells can become virtually any cell in the body. Scientists and doctors study these cells and their derivatives to learn more about basic biology and genetic origins of disease. They also use them for cell, tissue and organ transplant studies, as well as for pharmaceutical testing and studying the effects of environmental toxins on human cells and tissues.

Both types of stem cells, which Thomson and other NPRC scientists advanced from rodents to nonhuman primates and then to humans in the 1990s, are already in early clinical trials for macular degeneration, spinal cord injury, heart disease, ALS and more. There are currently 27 clinical trials around the world involving embryonic stem cells and their derivatives. Another 42 trials involve the use of induced pluripotent stem cells.

These discoveries underscore the importance of basic science and are excellent examples of how basic science can lead to applied science, clinical trials, entrepreneurship and expanding business and industry. Globally, the market for products related to stem cell discoveries is projected to reach more than $270.5 billion by 2025, according to a 2017 Transparency Market Research report.

A whole new era of science and medicine sprung from those early 1990s discoveries with nonhuman primates. The NPRCs continue to advance research in both human and nonhuman primates involving embryonic stem cells, induced pluripotent stem cells, tissue-specific (adult) stem cells and gene editing of both stem cells and mature cells. We look forward to the cell and regenerative medicine discoveries that are still to come!

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5 ways university research has changed the world

University research is responsible for much more than airy-fairy academia. It has fundamentally impacted all of our lives, from our conceptions of society to the light we use to experience it.

Universities are particularly influential in science and social progression due to their position as hubs of knowledge.

This research is now more crucial than ever as the 21 st  century brings a tirade of challenges, issues and hurdles to overcome to prevent global collapse – without universities investigating how the world is expected to change environmentally, politically and socially over coming years, we are left blind as the clock ticks on.

And if the ways in which research has impacted our lives so far is anything to go by, these discoveries and progressions in thought will be monumental to how we view the world around us and experience the future.

If you still don’t believe the value of university research in enlightening our lives, explaining our place in the world, progressing technology and medicine, and ultimately shaping our world views, check out the five most significant research breakthroughs that impact our lives everyday…

That feel-good feeling

The sudden flood of endorphins when you see your crush or do some exercise is now a well-documented phenomenon, all thanks to research from the University of Aberdeen .

Hans Kosterlitz and John Hughes were the first to discover that endorphins naturally occur in the body back in 1975. This led to many studies on what causes endorphins to be released and how they influence mental health.

Brain imaging and research papers allow us to understand the brain better. Source: Giphy

Researchers are still investigating the human body and what causes neural reactions in the brain to produce physical responses to this day, and it’s likely these studies will reveal even more insight into how we manoeuvre through our daily lives.

Genetic fingerprinting

Every individual is unique – or at least our fingerprints are.

This is all thanks to Alec Jeffreys’s research at the University of Leicester in 1985. He discovered that each person’s fingerprint is totally unique, making it a reliable and foll-proof identification technique.

Fingerprints are now commonly used in crime investigations and border controls. They are even being implemented for everyday identification needs like unlocking smartphones and replacing household keys, all thanks to technological advancements.

Genetic fingerprints have revolutionised identification models. Source: Giphy

The world’s first computer

You wouldn’t even be reading this if it wasn’t for Freddie Williams and Tom Kilburn’s research at the University of Manchester in 1948.

They created the world’s first stored-program computer, and while it was almost unrecognisable from the smartphone, laptop or slim desktop you’re likely reading this article on, it paved the way for video games, the internet and instant communication, things that are so central to our lives today.

The earth as a living organism

In 1995, James Lovelock proposed the theory that the earth is more than just a stagnant rock we inhabit, but rather a living organism that’s constantly reacting and adapting to its circumstances at Yale University.

Research showed us the earth is alive. Source: Giphy

The ‘Gaia hypothesis’, as he called it, changed attitudes towards the earth and revived the notion of stewardship towards the environment. His research showed that our world is a self-regulating entity in its own right instead of inanimate land we live on.

This research paved the way for environmental concern that is so central to protecting humanity and the quality of life as we move towards the future.

The universe is expanding

It’s now common knowledge that the universe is infinitely expanding, starting from a single explosion in the Big Bang – but this wasn’t always the case.

Until Edwin Hubble’s research and the University of Chicago in 1924, there was a whole host of hypotheses about the universe – not many based in science.

The mysteries of the universe still remain out there. Source: Giphy

From Aristotle’s conception that the earth is the centre of the universe overseen by God, to Buddhist monks believing we exist on the back of a cosmic turtle’s back, there have been many theories about the universe throughout history.

While universities all over the world continue to research the mysteries of the universe to this day, it was Hubble who first uncovered the biggest mystery of all – the universe is expanding.

This has sparked infinitely more questions about the nature of the universe: what is it expanding from? What is it expanding into? Is there life elsewhere? How and why is there life on earth? The list goes on…

Among these incredible university research breakthroughs are hundreds of others that help fill in the gaps of our existence and beyond – but there’s still an infinite amount of discoveries and progressions to be made.

Faculty and graduate students play a central role in seeking out and exploring these research areas – and it’s them who will continue to push the frontiers of knowledge as we move through the rocky terrain of the 21 st  century.

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Can research change the world?

Author: Mariette DiChristina

Editor-in-Chief, Scientific American

As cities expand in our increasingly urban world, we see both new challenges and opportunities—the subjects of a meeting next week of government leaders and industry experts in Singapore called the World Cities Summit (WCS). We at Springer Nature believe that great multidisciplinary research needs to be informing these discussions. 

That’s why I’m co-hosting Science and the Sustainable City , an event co-located with the WCS and part of a bigger effort at Springer Nature to connect people across disciplines to tackle the world’s biggest societal challenges, to find out what scientists think, and to learn how business and policy leaders can best use research to inform policies, programs and technologies.

It’s an area I’m really passionate about. As Editor-in-Chief of Scientific American , one of the great privileges of my job is traveling to many events around the world that bring together great minds from across sectors to discuss big problems facing humanity, and thinking through - with these experts – how science can help them to get more done.

I also often talk to researchers, across many disciplines, who know the research that they’re doing would be valuable to those making policy or developing business solutions to emerging trends. But they don’t always know how to get their research into the hands of the people having those conversations and making those decisions. I have no doubt that many of the answers to the world’s toughest challenges are already out there, being worked on in labs and institutes around the globe. But a spark needs a catalyst to make a fire. As publishers, we are constantly thinking about how to make the research we publish have as a great an impact in the real world as possible and we have the capacity to act as that catalyst.

I have no doubt that many of the answers to the world’s toughest challenges are already out there, being worked on in labs and institutes around the globe. But a spark needs a catalyst to make a fire. As publishers, we are constantly thinking about how to make the research we publish have as a great an impact in the real world as possible and we have the capacity to act as that catalyst.

Springer Nature strengthens connections between science, policy and business

We launched Springer Nature Grand Challenges in 2017 as a way to help strengthen connections between science, policy and business, and to help support researchers in turning their insights into action. We are initially focusing on five priority global challenges: Sustainable Cities; Global Health; Climate Change; the Digitally Transformed World; and the Food-Energy-Water Nexus. These are ‘grand’ challenges because making meaningful progress against them requires strong, sustained interaction among professional communities and among the research fields themselves. The approach to these issues must be multidisciplinary, so another of our goals is to break down disciplinary silos, both in our own publishing and across the global research community. 

One of the things we know about human endeavors is that we always do better when we’re working together. A major inspiration for the program was responding to the following questions: ‘How can we join things up for people? How can we join  them  up and bring them closer together?’ And finally, ‘How can we share information in an accessible way to help the world grapple with some of its most challenging problems?’

Supporting the research community in their mission to change the world

We’re working on a few different areas to support the research community in their mission to change the world. We’re fostering cross-journal collaborations within Springer Nature and collecting together research, analysis and commentary on key topics – regardless of traditional research boundaries – to tackle challenges in a less siloed, discipline-focused way and better facilitate discussion and change. We’re also fostering cross-departmental collaboration within Springer Nature, which has resulted in more complementary editorial strategies to address complex issues such as climate change and global health. And we’re encouraging discussion about the importance of policymakers engaging with science on a regular basis, as well as the role of media and publishing companies in disseminating research findings in an accurate and unbiased way. This week I’m in Tokyo and delighted to have been invited to be taking part in a conversation series at the United Nations University on just this topic. 

I have been really inspired by how excited everybody in our organization has been to participate in this initiative. This is a real reflection of the mission-driven nature of the company: that we really want to benefit the communities we serve with our publishing. I’ve been extremely gratified that we have people coming up to us asking how they can support the Grand Challenges initiative as well. It really has the capacity to bring people together, not just at Springer Nature, but across the globe.

I have been really inspired by how excited everybody in our organization has been to participate in this initiative. This is a real reflection of the mission-driven nature of the company: that we really want to benefit the communities we serve with our publishing.

We hope that, by bringing groups together in new ways, we can help to transform research into effective policies and practices to tackle issues as broad as improving life in cities and reducing urban impact on the rest of the planet. The Science and the Sustainable City Summit is an important milestone for us in doing this, and I can’t wait to hear in Singapore about what others are doing to facilitate positive change for all of us to live more sustainably on our beautiful—and finite—world.

Mariette DiChristina is the Editor-in-Chief of Scientific American and Executive Vice President of Editorial & Publishing for Nature Research’s Magazines division. She is the eighth (and first female) Editor-in-Chief of the magazine that is considered one of the oldest and most popular science magazines in the world. Ms. DiChristina has also been selected as a Fellow of the American Association for the Advancement of Science, was both an adjunct professor and visiting scholar at New York University, and has served on various boards/committees. She has been widely recognized for her formidable role in digital publishing and media.

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There is unequivocal evidence that Earth is warming at an unprecedented rate. Human activity is the principal cause.

• While Earth’s climate has changed throughout its history , the current warming is happening at a rate not seen in the past 10,000 years.
• According to the Intergovernmental Panel on Climate Change ( IPCC ), "Since systematic scientific assessments began in the 1970s, the influence of human activity on the warming of the climate system has evolved from theory to established fact." 1
• Scientific information taken from natural sources (such as ice cores, rocks, and tree rings) and from modern equipment (like satellites and instruments) all show the signs of a changing climate.
• From global temperature rise to melting ice sheets, the evidence of a warming planet abounds.

The rate of change since the mid-20th century is unprecedented over millennia.

Earth's climate has changed throughout history. Just in the last 800,000 years, there have been eight cycles of ice ages and warmer periods, with the end of the last ice age about 11,700 years ago marking the beginning of the modern climate era — and of human civilization. Most of these climate changes are attributed to very small variations in Earth’s orbit that change the amount of solar energy our planet receives.

The current warming trend is different because it is clearly the result of human activities since the mid-1800s, and is proceeding at a rate not seen over many recent millennia. 1 It is undeniable that human activities have produced the atmospheric gases that have trapped more of the Sun’s energy in the Earth system. This extra energy has warmed the atmosphere, ocean, and land, and widespread and rapid changes in the atmosphere, ocean, cryosphere, and biosphere have occurred.

Earth-orbiting satellites and new technologies have helped scientists see the big picture, collecting many different types of information about our planet and its climate all over the world. These data, collected over many years, reveal the signs and patterns of a changing climate.

Scientists demonstrated the heat-trapping nature of carbon dioxide and other gases in the mid-19th century. 2 Many of the science instruments NASA uses to study our climate focus on how these gases affect the movement of infrared radiation through the atmosphere. From the measured impacts of increases in these gases, there is no question that increased greenhouse gas levels warm Earth in response.

Scientific evidence for warming of the climate system is unequivocal.

Intergovernmental Panel on Climate Change

Ice cores drawn from Greenland, Antarctica, and tropical mountain glaciers show that Earth’s climate responds to changes in greenhouse gas levels. Ancient evidence can also be found in tree rings, ocean sediments, coral reefs, and layers of sedimentary rocks. This ancient, or paleoclimate, evidence reveals that current warming is occurring roughly 10 times faster than the average rate of warming after an ice age. Carbon dioxide from human activities is increasing about 250 times faster than it did from natural sources after the last Ice Age. 3

The Evidence for Rapid Climate Change Is Compelling:

Global Temperature Is Rising

The planet's average surface temperature has risen about 2 degrees Fahrenheit (1 degrees Celsius) since the late 19th century, a change driven largely by increased carbon dioxide emissions into the atmosphere and other human activities. 4 Most of the warming occurred in the past 40 years, with the seven most recent years being the warmest. The years 2016 and 2020 are tied for the warmest year on record. 5 Image credit: Ashwin Kumar, Creative Commons Attribution-Share Alike 2.0 Generic.

The Ocean Is Getting Warmer

The ocean has absorbed much of this increased heat, with the top 100 meters (about 328 feet) of ocean showing warming of 0.67 degrees Fahrenheit (0.33 degrees Celsius) since 1969. 6 Earth stores 90% of the extra energy in the ocean. Image credit: Kelsey Roberts/USGS

The Ice Sheets Are Shrinking

The Greenland and Antarctic ice sheets have decreased in mass. Data from NASA's Gravity Recovery and Climate Experiment show Greenland lost an average of 279 billion tons of ice per year between 1993 and 2019, while Antarctica lost about 148 billion tons of ice per year. 7 Image: The Antarctic Peninsula, Credit: NASA

Glaciers Are Retreating

Glaciers are retreating almost everywhere around the world — including in the Alps, Himalayas, Andes, Rockies, Alaska, and Africa. 8 Image: Miles Glacier, Alaska Image credit: NASA

Snow Cover Is Decreasing

Satellite observations reveal that the amount of spring snow cover in the Northern Hemisphere has decreased over the past five decades and the snow is melting earlier. 9 Image credit: NASA/JPL-Caltech

Sea Level Is Rising

Global sea level rose about 8 inches (20 centimeters) in the last century. The rate in the last two decades, however, is nearly double that of the last century and accelerating slightly every year. 10 Image credit: U.S. Army Corps of Engineers Norfolk District

Arctic Sea Ice Is Declining

Both the extent and thickness of Arctic sea ice has declined rapidly over the last several decades. 11 Credit: NASA's Scientific Visualization Studio

Extreme Events Are Increasing in Frequency

The number of record high temperature events in the United States has been increasing, while the number of record low temperature events has been decreasing, since 1950. The U.S. has also witnessed increasing numbers of intense rainfall events. 12 Image credit: Régine Fabri,  CC BY-SA 4.0 , via Wikimedia Commons

Ocean Acidification Is Increasing

Since the beginning of the Industrial Revolution, the acidity of surface ocean waters has increased by about 30%. 13 , 14 This increase is due to humans emitting more carbon dioxide into the atmosphere and hence more being absorbed into the ocean. The ocean has absorbed between 20% and 30% of total anthropogenic carbon dioxide emissions in recent decades (7.2 to 10.8 billion metric tons per year). 1 5 , 16 Image credit: NOAA

1. IPCC Sixth Assessment Report, WGI, Technical Summary . B.D. Santer et.al., “A search for human influences on the thermal structure of the atmosphere.” Nature 382 (04 July 1996): 39-46. https://doi.org/10.1038/382039a0. Gabriele C. Hegerl et al., “Detecting Greenhouse-Gas-Induced Climate Change with an Optimal Fingerprint Method.” Journal of Climate 9 (October 1996): 2281-2306. https://doi.org/10.1175/1520-0442(1996)009<2281:DGGICC>2.0.CO;2. V. Ramaswamy, et al., “Anthropogenic and Natural Influences in the Evolution of Lower Stratospheric Cooling.” Science 311 (24 February 2006): 1138-1141. https://doi.org/10.1126/science.1122587. B.D. Santer et al., “Contributions of Anthropogenic and Natural Forcing to Recent Tropopause Height Changes.” Science 301 (25 July 2003): 479-483. https://doi.org/10.1126/science.1084123. T. Westerhold et al., "An astronomically dated record of Earth’s climate and its predictability over the last 66 million years." Science 369 (11 Sept. 2020): 1383-1387. https://doi.org/10.1126/science.1094123

2. In 1824, Joseph Fourier calculated that an Earth-sized planet, at our distance from the Sun, ought to be much colder. He suggested something in the atmosphere must be acting like an insulating blanket. In 1856, Eunice Foote discovered that blanket, showing that carbon dioxide and water vapor in Earth's atmosphere trap escaping infrared (heat) radiation. In the 1860s, physicist John Tyndall recognized Earth's natural greenhouse effect and suggested that slight changes in the atmospheric composition could bring about climatic variations. In 1896, a seminal paper by Swedish scientist Svante Arrhenius first predicted that changes in atmospheric carbon dioxide levels could substantially alter the surface temperature through the greenhouse effect. In 1938, Guy Callendar connected carbon dioxide increases in Earth’s atmosphere to global warming. In 1941, Milutin Milankovic linked ice ages to Earth’s orbital characteristics. Gilbert Plass formulated the Carbon Dioxide Theory of Climate Change in 1956.

3. IPCC Sixth Assessment Report, WG1, Chapter 2 Vostok ice core data; NOAA Mauna Loa CO2 record O. Gaffney, W. Steffen, "The Anthropocene Equation." The Anthropocene Review 4, issue 1 (April 2017): 53-61. https://doi.org/abs/10.1177/2053019616688022.

4. https://www.ncei.noaa.gov/monitoring https://crudata.uea.ac.uk/cru/data/temperature/ http://data.giss.nasa.gov/gistemp

5. https://www.giss.nasa.gov/research/news/20170118/

6. S. Levitus, J. Antonov, T. Boyer, O Baranova, H. Garcia, R. Locarnini, A. Mishonov, J. Reagan, D. Seidov, E. Yarosh, M. Zweng, " NCEI ocean heat content, temperature anomalies, salinity anomalies, thermosteric sea level anomalies, halosteric sea level anomalies, and total steric sea level anomalies from 1955 to present calculated from in situ oceanographic subsurface profile data (NCEI Accession 0164586), Version 4.4. (2017) NOAA National Centers for Environmental Information. https://www.nodc.noaa.gov/OC5/3M_HEAT_CONTENT/index3.html K. von Schuckmann, L. Cheng, L,. D. Palmer, J. Hansen, C. Tassone, V. Aich, S. Adusumilli, H. Beltrami, H., T. Boyer, F. Cuesta-Valero, D. Desbruyeres, C. Domingues, A. Garcia-Garcia, P. Gentine, J. Gilson, M. Gorfer, L. Haimberger, M. Ishii, M., G. Johnson, R. Killick, B. King, G. Kirchengast, N. Kolodziejczyk, J. Lyman, B. Marzeion, M. Mayer, M. Monier, D. Monselesan, S. Purkey, D. Roemmich, A. Schweiger, S. Seneviratne, A. Shepherd, D. Slater, A. Steiner, F. Straneo, M.L. Timmermans, S. Wijffels. "Heat stored in the Earth system: where does the energy go?" Earth System Science Data 12, Issue 3 (07 September 2020): 2013-2041. https://doi.org/10.5194/essd-12-2013-2020.

7. I. Velicogna, Yara Mohajerani, A. Geruo, F. Landerer, J. Mouginot, B. Noel, E. Rignot, T. Sutterly, M. van den Broeke, M. Wessem, D. Wiese, "Continuity of Ice Sheet Mass Loss in Greenland and Antarctica From the GRACE and GRACE Follow-On Missions." Geophysical Research Letters 47, Issue 8 (28 April 2020): e2020GL087291. https://doi.org/10.1029/2020GL087291.

8. National Snow and Ice Data Center World Glacier Monitoring Service

9. National Snow and Ice Data Center D.A. Robinson, D. K. Hall, and T. L. Mote, "MEaSUREs Northern Hemisphere Terrestrial Snow Cover Extent Daily 25km EASE-Grid 2.0, Version 1 (2017). Boulder, Colorado USA. NASA National Snow and Ice Data Center Distributed Active Archive Center. doi: https://doi.org/10.5067/MEASURES/CRYOSPHERE/nsidc-0530.001 . http://nsidc.org/cryosphere/sotc/snow_extent.html Rutgers University Global Snow Lab. Data History

10. R.S. Nerem, B.D. Beckley, J. T. Fasullo, B.D. Hamlington, D. Masters, and G.T. Mitchum, "Climate-change–driven accelerated sea-level rise detected in the altimeter era." PNAS 15, no. 9 (12 Feb. 2018): 2022-2025. https://doi.org/10.1073/pnas.1717312115.

11. https://nsidc.org/cryosphere/sotc/sea_ice.html Pan-Arctic Ice Ocean Modeling and Assimilation System (PIOMAS, Zhang and Rothrock, 2003) http://psc.apl.washington.edu/research/projects/arctic-sea-ice-volume-anomaly/ http://psc.apl.uw.edu/research/projects/projections-of-an-ice-diminished-arctic-ocean/

12. USGCRP, 2017: Climate Science Special Report: Fourth National Climate Assessment, Volume I [Wuebbles, D.J., D.W. Fahey, K.A. Hibbard, D.J. Dokken, B.C. Stewart, and T.K. Maycock (eds.)]. U.S. Global Change Research Program, Washington, DC, USA, 470 pp, https://doi.org/10.7930/j0j964j6 .

13. http://www.pmel.noaa.gov/co2/story/What+is+Ocean+Acidification%3F

14. http://www.pmel.noaa.gov/co2/story/Ocean+Acidification

15. C.L. Sabine, et al., “The Oceanic Sink for Anthropogenic CO2.” Science 305 (16 July 2004): 367-371. https://doi.org/10.1126/science.1097403.

16. Special Report on the Ocean and Cryosphere in a Changing Climate , Technical Summary, Chapter TS.5, Changing Ocean, Marine Ecosystems, and Dependent Communities, Section 5.2.2.3. https://www.ipcc.ch/srocc/chapter/technical-summary/

Header image shows clouds imitating mountains as the sun sets after midnight as seen from Denali's backcountry Unit 13 on June 14, 2019. Credit: NPS/Emily Mesner Image credit in list of evidence: Ashwin Kumar, Creative Commons Attribution-Share Alike 2.0 Generic.

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Research papers that changed the world

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Over the last few decades, we have been gifted with knowledge from some of the brightest minds in the world who played a vital role in the advancement of human civilisation. Their research papers containing their unique findings changed the world as we know it.

In different fields of knowledge especially in science and technology, there have been some phenomenal research papers which everyone should know about. The knowledge from these papers impact our lives to this day, and yet we do not know about most of them.

Here is a short list of such high impact papers:

• "The Anatomy of a Large-Scale Hypertextual Web Search Engine" by Sergey Brin and Lawrence Page. This paper was the beginning of the Google search algorithm.
• "Xen and the Art of Virtualization" by Paul Barham, Boris Dragovic, Keir Fraser, Steven Hand, Tim Harris, Alex Ho, Rolf Neugebauer, Ian Pratt, and Andrew Warfield.

This paper proposed the idea of lightweight hypervisors. As a result, virtual machine monitors became much more lightweight and is the reason why cloud computing can scale as well as it does today. 

• "Experiments in Plant Hybridisation" by Johann Gregor Mendel

This paper contributed to the concepts of traits, specifically that offspring inherit traits from their parents via genes.

• “A Symbolic Analysis of Relay and Switching Circuits” and “A Mathematical Theory of Communication” by Claude Shannon

The first paper connected Boolean algebra and electronic circuits and the second laid the foundations for information theory, which is the probabilistic method through which we can send and receive digital signals.

• "Molecular Structure of Nucleic Acids: A Structure for Deoxyribose Nucleic Acid" by James Watson and Francis Crick

They found the structure of the molecule DNA that encodes life and figured out how it stores abnormally copious amounts of information to give rise to everything living on this planet

• "The Transistor, A Semi-Conductor Triode" by J. Bardeen and W. H. Brattain

This research paper started the birth of modern electronics.

• "Does the Inertia of a Body Depend Upon Its Energy Content?" by Albert Einstein

This paper describes the famous equation, E=mc 2 .

• “Antiseptic Principle of the Practice of Surgery” by Joseph Surgery

This paper laid the foundations of modern surgery by introducing sterilization of surgical instruments before cleaning of wounds. This dramatically increased the survival rate of patients.

• “General Theory of Employment, Interest and Money” by John Maynard Keynes

This paper put forward a theory based upon the notion of aggregate demand to explain variations in the overall level of economic activity.

• “Protein measurement with the folin phenol reagent” by Oliver H. Lowry, Nira J. Rosebrough, A. Lewis Farr, and Rose J. Randall

This paper is the most cited research paper ever in the scientific literature that describes the Lowry protein assay allowing determination of the total level of protein in a solution.

It would take pages to list all the research papers and their underlying inventions that changed the world around us. At our leisure, we can take a look into some of these papers depending on our area of interest and gather valuable knowledge from them.

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New Research Reveals Full Diversity of Killer Whales as Two Species Come into View on Pacific Coast

March 27, 2024

Long viewed as one worldwide species, killer whale diversity now merits more. Southern Resident Connections - Post 35

Scientists have resolved one of the outstanding questions about one of the world’s most recognizable creatures, identifying two well-known killer whales in the North Pacific Ocean as separate species.

Killer whales are one of the most widespread animals on Earth. They have long been considered one worldwide species known scientifically as Orcinus orca , with different forms in various regions known as “ecotypes.”

However, biologists have increasingly recognized the differences between resident and Bigg’s killer whales. Resident killer whales maintain tight-knit family pods and prey on salmon and other marine fish. Bigg’s killer whales roam in smaller groups, preying on other marine mammals such as seals and whales. (Killer whales actually belong to the dolphin family.) Bigg’s killer whales, sometimes called transients, are named for Canadian scientist Michael Bigg, the first to describe telltale differences between the two types.

He noted in the 1970s that the two animals did not mix with each other even when they occupied many of the same coastal waters. This is often a sign of different species.

The finding recognizes the accuracy of the listing of Southern Resident killer whales as a Distinct Population Segment warranting protection under the Endangered Species Act in 2005. At the time, NOAA described the distinct population segment as part of an unnamed subspecies of resident killer whales in the North Pacific.

Now a team of scientists from NOAA Fisheries and universities have assembled genetic, physical, and behavioral evidence. The data distinguish two of the killer whale ecotypes of the North Pacific Coast—residents and Bigg’s—as separate species.

“We started to ask this question 20 years ago, but we didn’t have much data, and we did not have the tools that we do now,” said Phil Morin, an evolutionary geneticist at NOAA Fisheries’ Southwest Fisheries Science Center and lead author of the new paper . “Now we have more of both, and the weight of the evidence says these are different species.”

Genetic data from previous studies revealed that the two species likely diverged more than 300,000 years ago and come from opposite ends of the killer whale family tree. That makes them about as genetically different as any killer whale ecotypes around the globe. Subsequent studies of genomic data confirm that they have evolved as genetically and culturally distinct groups, which occupy different niches in the same Northwest marine ecosystem.

“They’re the most different killer whales in the world, and they live right next to each other and see each other all the time,” said Barbara Taylor, a former NOAA Fisheries marine mammal biologist who was part of the science panel that assessed the status of Southern Residents. “They just do not mix.”

Recognizing New Species

The Taxonomy Committee of the Society of Marine Mammalogy will determine whether to recognize the new species in its official list of marine mammal species . The committee will likely determine whether to accept the new designations at its next annual review this summer.

The scientists proposed scientific names for the new species based on their earliest published descriptions in the 1800s. Neither will keep the ubiquitous worldwide moniker, orca . The team proposed to call resident killer whales Orcinus ater , a Latin reference to their dominant black coloring. Bigg’s killer whales would be called Orcinus rectipinnus , a combination of Latin words for erect wing, probably referring to their tall, sharp dorsal fin.

Both species names were originally published in 1869 by Edward Drinker Cope, a Pennsylvania scientist known more for unearthing dinosaurs than studying marine mammals. He was working from a manuscript that California whaling captain Charles Melville Scammon had sent to the Smithsonian Institution describing West Coast marine mammals, including the two killer whales. While Cope credited Scammon for the descriptions, Scammon took issue with Cope for editing and publishing Scammon’s work without telling him. (See accompanying story .)

The Smithsonian Institution had shared Scammon’s work with Cope, and a Smithsonian official later apologized to Scammon for what he called “Cope’s absurd blunder.”

Species Reflect Ecosystem

The contested question of whether Southern Residents were distinct enough to merit endangered species protections initially drove much of the research that helped differentiate the two species, said Eric Archer, who leads the Marine Mammal Genetics Program at the Southwest Fisheries Science Center and is a coauthor of the new research paper. The increasing processing power of computers has made it possible to examine killer whale DNA in ever finer detail. He said the findings not only validate protection for the animals themselves, but also help reveal different components of the marine ecosystems the whales depend on.

“As we better understand what makes these species special, we learn more about how they use the ecosystems they inhabit and what makes those environments special, too,” he said.

The new research synthesizes the earliest accounts of killer whales on the Pacific Coast with modern data on physical characteristics.

 The team also use aerial imaging (called photogrammetry ), and measurement and genetic testing of museum specimens at the Smithsonian and elsewhere. While the two species look similar to the untrained eye, the evidence demonstrates they are very different species. The two species use different ecological niches, such as specializing in different prey, said Kim Parsons, a geneticist at the NOAA Fisheries Northwest Fisheries Science Center in Seattle and coauthor of the new research.

Recent research with drones that collect precise aerial photos has helped differentiate Bigg’s killer whales as longer and larger. This might better equip them to go after large marine mammal prey. The smaller size of residents is likely better suited to deep dives after their salmon prey, said John Durban, an associate professor at Oregon State University’s Marine Mammal Institute. His killer whale drone research is done collaboratively with Holly Fearnbach, a researcher at SR³.

The different prey of the two species may also help explain their different trajectories. Southern Residents are listed as endangered in part because of the scarcity of their salmon prey. Bigg’s killer whales, by contrast, have multiplied while feeding on plentiful marine mammals, including California sea lions.

While killer whales represent some of the most efficient predators the world has ever seen, Durban said science is still unraveling the diversity among them. The identification of additional killer whale species is likely to follow. One leading candidate may be “Type D” killer whales identified in the Southern Ocean around Antarctica.

Other killer whales in Antarctic waters also look very different from the best-known black and white killer whales. This reflects a wider diversity within the species, said Durban, who has used drones to study killer whales around the world. “The more we learn,” he said, “the clearer it becomes to me that at least some of these types will be recognized as different species in due course.”

Southern Resident Connections

Southern Resident killer whales are icons of a vibrant but struggling marine ecosystem that is important to us all. Join us in exploring the ecological connections that tie this system together, and the ways we are protecting and working to recover the whales we all care so much about.

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More Information

• New Research Reveals Two Species of Killer Whale
• How Scientists Chose Names for Newly Identified Killer Whale Species
• Two Species of Killer Whale Infographic
• Marine Mammal Genetics Research
• 2004 Status Review of Southern Resident Killer Whales
• Saving the Southern Resident Killer Whales
• Listing of Southern Resident Killer Whale Under the ESA
• Killer Whale Ecotypes Poster

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This paper is in the following e-collection/theme issue:

Published on 2.4.2024 in Vol 26 (2024)

The Impact of Digital Self-Monitoring of Weight on Improving Diabetes Clinical Outcomes: Quasi-Randomized Study

Authors of this article:

Original Paper

• ‪Yifat Fundoiano-Hershcovitz 1 , PhD   ; 
• Marilyn D Ritholz 2 , PhD   ; 
• David L Horwitz 3 , MD, PhD   ; 
• Ephraim Behar 1 , MSc   ; 
• Omar Manejwala 1 , MD   ; 
• Pavel Goldstein 4 , PhD  

1 Dario Health, Caesarea, Israel

2 Joslin Diabetes Center, Harvard Medical School, Boston, MA, United States

3 DLH Biomedical Consulting, Las Vegas, NV, United States

4 School of Public Health, University of Haifa, Haifa, Israel

Corresponding Author:

‪Yifat Fundoiano-Hershcovitz, PhD

Dario Health

Caesarea, 3079821

Phone: 972 525296979

Email: [email protected]

Background: The management of type 2 diabetes (T2D) and obesity, particularly in the context of self-monitoring, remains a critical challenge in health care. As nearly 80% to 90% of patients with T2D have overweight or obesity, there is a compelling need for interventions that can effectively manage both conditions simultaneously. One of the goals in managing chronic conditions is to increase awareness and generate behavioral change to improve outcomes in diabetes and related comorbidities, such as overweight or obesity. There is a lack of real-life evidence to test the impact of self-monitoring of weight on glycemic outcomes and its underlying mechanisms.

Objective: This study aims to assess the efficacy of digital self-monitoring of weight on blood glucose (BG) levels during diabetes management, investigating whether the weight changes may drive glucose fluctuations.

Methods: In this retrospective, real-world quasi-randomized study, 50% of the individuals who regularly used the weight monitoring (WM) feature were propensity score matched with 50% of the users who did not use the weight monitoring feature (NWM) based on demographic and clinical characteristics. All the patients were diagnosed with T2D and tracked their BG levels. We analyzed monthly aggregated data 6 months before and after starting their weight monitoring. A piecewise mixed model was used for analyzing the time trajectories of BG and weight as well as exploring the disaggregation effect of between- and within-patient lagged effects of weight on BG.

Results: The WM group exhibited a significant reduction in BG levels post intervention ( P <.001), whereas the nonmonitoring group showed no significant changes ( P =.59), and both groups showed no differences in BG pattern before the intervention ( P =.59). Furthermore, the WM group achieved a meaningful decrease in BMI ( P <.001). Finally, both within-patient ( P <.001) and between-patient ( P =.008) weight variability was positively associated with BG levels. However, 1-month lagged back BMI was not associated with BG levels ( P =.36).

Conclusions: This study highlights the substantial benefits of self-monitoring of weight in managing BG levels in patients with diabetes, facilitated by a digital health platform, and advocates for the integration of digital self-monitoring tools in chronic disease management. We also provide initial evidence of testing the underlying mechanisms associated with BG management, underscoring the potential role of patient empowerment.

Introduction

People with type 2 diabetes (T2D) face challenging self-management regimens to improve glycemia and decrease morbidity and mortality while often dealing with high costs of care [ 1 ]. Obesity is one of the most common, serious, and costly medical condition in the United States, with a prevalence of 41.9% from 2017 to 2020 [ 2 ]. After a dramatic increase in its prevalence over several decades, obesity has become a major public health crisis in the United States [ 3 ]. Obesity has become one of the leading causes of death, as it is known to be the main risk factor for several noncommunicable diseases, particularly T2D [ 4 ]. It is crucial to take effective and decisive actions to hinder both the rise in the prevalence of obesity and the prevention and treatment of obesity and other obesity-related comorbidities. Approximately 80% to 90% of patients with T2D have overweight or obesity, which imposes a considerable burden on individuals, families, communities, and the health system [ 5 , 6 ].

Obesity and overweight are considered the primary accelerators for the T2D inflammatory component inducing progressive loss of beta cell insulin secretion with coexisting insulin resistance [ 7 - 9 ]. In addition, the expansion of white adipose tissue is related to a changed microenvironment in obesity, which impairs insulin signaling, reduces insulin-stimulated glucose transport activity, and accelerates beta cell dysfunction [ 10 ].

Previous studies have shown the beneficial effect of weight-lowering treatment on diabetes outcomes [ 11 ].

Healthful weight reduction in patients with obesity can improve glucose metabolism [ 12 ]. Weight reduction via carbohydrate-restricted nutritional intervention in patients with preobesity or obesity and prediabetes or T2D may contribute to improvement or remission in diabetes mellitus [ 13 ].

Antiobesity therapies for the treatment of patients with obesity and T2D include those that reduce body weight and improve glucose levels and other metabolic parameters. Considering the prevalence of obesity-related conditions such as adiposopathy and the fact that a significant portion of patients in cardiovascular outcomes trials for T2D had overweight or obesity, there is support for the “treat obesity first” therapeutic approach [ 13 ]. It is recommended in the guidelines for obesity that appropriate 5% to 10% weight loss can achieve significant metabolic improvement [ 14 ]. For the prevention of T2D, even modest weight reduction as little as 5%, can significantly reduce diabetes-associated complications [ 15 , 16 ]. Previous studies have shown that changes in various indexes such as blood lipid, blood glucose (BG), and insulin improved when weight loss reached 15% [ 14 ]. Furthermore, long-term tight weight control resulted in significant glycemic improvement, particularly demonstrated in the overweight population with T2D [ 17 , 18 ].

One of the goals of chronic condition management is to increase awareness and generate behavioral change to improve clinical outcomes. Behavior change for effective self-management was proven to improve health outcomes and quality of life in people living with chronic conditions such as obesity, T2D, and heart disease [ 19 ]. Underlying well-intentioned lifestyle messages is the assumption that if people deem health important, are aware of exercise and nutrition guidelines, and have access to healthy options to maintain proper levels of nutrition, diet, and exercise, then they will make healthier choices [ 20 ]. The American Diabetes Association guidelines state that lifestyle management should be intensive and involve frequent follow-ups [ 21 ].

Despite these recommendations, data from the National Health and Nutrition Examination Survey indicate that only 54.6% of patients reported receiving any diabetes education and only 13.4% had received an educational visit of any kind [ 16 ]. Earlier studies showed that helping participants with goal setting and self-monitoring of behavior, for instance, using a logbook and receiving feedback on the outcome of behavior, was associated with better intervention effects [ 22 ].

Facilitating behavior change involves using a series of strategies aimed at empowering patients, enabling them to take increasing control of their condition. This includes setting clear, achievable, and personalized goals, as well as enhancing self-efficacy [ 23 - 25 ]. The timing of health information and feedback focuses on when health behavior messages are delivered to people with diabetes. As diabetes care visits usually take place every 3 months, there can be a significant gap between these appointments and the daily engagement in desired behaviors. This gap makes it challenging to offer timely behavioral prompts or reinforcement [ 26 ].

In fact, patients’ mindset may modulate health outcomes, including glucose levels, in patients with diabetes [ 27 ]. Indeed, increasing perceived self-monitoring would be expected to result in subsequent health benefits [ 28 ], including glucose control in diabetes [ 29 ]. Individuals possess significant psychological influence over their health [ 30 ].

Currently, traditional health care models are being revamped with digital technologies. Digital platforms have the potential to improve our ability to enhance the delivery of health care for individual patients as well as empower patients to have more control over, and make better-informed decisions about, their health. Treatment optimization through digital health could enhance users’ alertness to their health condition through real-time monitoring, leading to effective treatments that build awareness of their daily health-related behaviors and promote increased engagement with those behaviors [ 31 - 34 ]. Technology-driven solutions can help people with diabetes build awareness of their daily health-related behaviors and promote increased engagement with those behaviors [ 32 - 34 ].

Communication of test results has been shown to be highly desired by people who have overweight, and lifestyle-focused educational messages providing advice, motivational reminders, and support have also been shown to be effective in improving chronic conditions [ 35 ]. Using a mobile platform for self-management purposes could facilitate individuals with chronic conditions in gaining insight into and controlling their BG and weight levels. Self-monitoring is a core component of behavioral obesity treatment; however, it is unknown how digital health has been used for self-monitoring and what engagement rates are achieved in these interventions [ 36 ].

Mobile apps have been shown to improve diabetes outcomes via education and support for adherence to evidence-based recommendations [ 37 - 40 ]. Mobile technology has emerged as a potentially useful platform to facilitate weight management [ 41 ]. Mobile apps for weight management typically offer similar features, including self-monitoring of diet and physical activity. Users can set goals within specified time frames and input data into the app, often receiving reminders or text messages. These apps have shown promising results [ 41 ]. Numerous digital health technologies have been developed to support the self-management of single chronic diseases, primarily diabetes. These technologies provide timely feedback, enhance patient education, and support the behavioral changes necessary for effective weight management. Recent research has indicated that digital self-monitoring tools can significantly influence health behaviors in patients with T2D, leading to better management of their condition [ 42 , 43 ]. However, given the rise in the number of people managing multiple chronic conditions, it is imperative to design and implement digital health technologies to deal with the additional complexities of multiple chronic conditions, such as the management of multiple symptoms and self-management tasks, avoiding further burden or inconvenience to the user [ 44 - 46 ]. Integrating the management of multiple conditions onto a single platform, where users can monitor their measurements and relevant lifestyle parameters, interact with all their data, share their data, and receive educational support, could help to minimize the known burden of multimorbidity self-management [ 47 - 49 ].

However, there is limited research on platforms that have been implemented to tackle multimorbidity or evaluated over longitudinal periods [ 45 ]. Specifically, the current literature is missing rigorous real-life studies to test the role of a simple self-monitoring of weight and diabetes management platform to better understand the direct association between weight monitoring and glycemic outcomes. Mainly, data are lacking on whether more frequent self-monitoring of those 2 conditions (weight and glycemia) has any impact on body weight and glycemic control in real-world clinical practice among patients with T2D and obesity [ 50 ]. In addition, many of these exclusively weight loss programs are time consuming and costly [ 51 ].

Our study seeks to address this gap by exploring the efficacy of digital self-monitoring of weight in managing BG levels in patients with T2D who are also managing their weight. We used a retrospective analysis of a home-use digital platform containing a diabetes BG meter and weight monitoring system with full longitudinal data capture using a supportive mobile platform among people with T2D and overweight levels. We followed users for 6 months before and 6 months after using the app for self-monitoring of weight and compared them with a matched control group that never used weight monitoring on the platform. We hypothesized that self-monitoring of weight would result in a significant improvement in BG levels. Moreover, weight monitoring (WM) will be associated with a reduction in weight levels. We also hypothesized a linkage between the changes in weight levels and the reduction in BG levels.

This study used the Dario Health digital therapeutics solution for chronic conditions to support the self-management of BG and weight levels. The platform combines an innovative meter with a phone app that is available for both Android and iOS devices. The glucose meter consists of a small pocket-sized holder for strips, a lancet, and the meter. The meter is removed from the holder and plugged directly into a cell phone, effectively converting the cell phone into the display screen for the meter. Weight level monitoring data are logged manually into the app on a special data entry screen ( Figure 1 ).

Connecting the BG meter directly to the phone and adding weight levels improves the quality of data collection. Additional information for weight measurement includes an informative color scale of weight ranges reflecting the Centers for Disease Control and Prevention definitions for BMI (kg/m 2 ) interpretation: <18.5 is underweight, 18.5 to 24.9 is healthy weight, 25.0 to 29.9 is overweight, and ≥30.0 is obese [ 52 ]. All information is stored in the users’ logbook in the app “attached” to the specific BG or weight reading. Data are uploaded to the cloud for backup and further analysis. Digital platform functions include interface design elements as well as specific educational content, wording, or digital interventions that affect the users’ choices in the digital environment; these functions provide personal health information and prompt feedback.

The monthly average weight level, which was defined as the means of all of a user’s weight measurements taken over a 30-day interval, was used as the core outcome metric. The monthly average BG level, which was defined as the meaning of all of a user’s BG measurements taken over a 30-day interval, was used as another outcome metric. The mobile platform collected the following medical and sociodemographic information (by self-report) for each user: sex, age, BMI during registration, physical activity level, stress level (0=no stress and 10=very stressed), alcohol consumption (number of drinks per week), smoking (0=never and 3=yes), and added comorbidities (such as high lipids, chronic kidney disease, cardiovascular disease, sleep disorder, cancer, or stress and depression). Socioeconomic status (median household income) was matched by applying zip code data to Census [ 53 ] and app engagement (number of app sessions per month). All data were transferred and stored in compliance with the Health Insurance Portability and Accountability Act requirements using Amazon Web Services database solutions. All data were anonymized before extraction for this study.

Study Population

A retrospective data study was performed on the Dario database on individuals who used the Dario platform between 2017 and 2023. The users purchased the device via a direct-to-consumer channel. The inclusion criteria were as follows: individuals who reported in the Dario app as diagnosed with T2D with a BG level of >140 mg/100 mL and BMI >25 kg/m 2 in their first month on the platform (baseline) and weight monitoring system (WM group) and used the weight monitoring system (WM monitoring). The resulting group of users was matched through the propensity scores procedure with users with similar clinical parameters but who have not been using the weight monitoring (non–weight monitoring; [NWM] group).

Study Design

The aim of our study design was to evaluate the impact of weight monitoring on BG levels. For the WM group, it was crucial to establish a clear start point for weight monitoring to assess its effects accurately. This start point is a defined intervention onset, marking when participants began actively monitoring their weight using the digital platform.

Conversely, for the NWM group, such a start point for “nonintervention” does not inherently exist, as these participants did not engage in weight monitoring. Hence, selecting a random start point for this group was a methodological necessity. This approach ensures that any observed differences in outcomes are attributable to the act of weight monitoring itself, rather than temporal factors or external influences. Therefore, the comparison between the groups hinges on the presence or absence of weight monitoring behavior. Using this approach, we enhanced the internal validity of the study. This allowed us to isolate the effect of weight monitoring from that of other variables and assess its impact on BG levels more accurately.

Propensity Scores: Causal Inference

Propensity score matching was used in this study to address potential confounding factors and enhance the comparability of the WM and NWM groups. The rationale behind using propensity score matching lies in its ability to reduce bias and mimic the randomization process, thereby facilitating causal inference in observational studies [ 54 ].

In originally nonrandomized studies, it is common for treatment assignment (in this case, use of the weight monitoring system) to be influenced by patient characteristics and other confounding variables. These factors may introduce bias and affect the estimation of treatment effects. Propensity score matching offers a systematic approach to account for such biases and create comparable treatment and control groups [ 55 ].

The propensity score, defined as the conditional probability of receiving the treatment given a set of observed covariates, summarizes the individual’s likelihood of being assigned to the WM group. By incorporating a comprehensive set of covariates that are potential confounders, such as age, sex, initial BG and BMI levels, smoking status, alcohol consumption, stress level, comorbidities, median household income, and platform engagement, the propensity score attempts to balance the distribution of these covariates between the WM and NWM groups.

Matching participants based on their propensity scores allows a comparison between similar individuals who only differ in terms of the treatment received. This strategy helps to reduce selection bias and confounding effects, enabling a more valid estimation of the causal effect of weight monitoring on glycemic control.

The use of propensity score matching aligns with the principle of exchangeability, as it creates groups that are comparable in terms of observed characteristics. By achieving a balance on observed covariates, the propensity score matching enhances the internal validity of the study and strengthens the plausibility of causal inference from the observed associations [ 56 ].

In this study, the propensity scores were calculated for each participant using the “matchit()” function from the R package matchit , which followed a nearest-neighbor approach, and the distance metric used was based on logistic regression using a 1:1 ratio between the 2 study groups [ 57 ].

To achieve balanced groups, nearest-neighbor matching with a caliper width of 0.1 SDs of the propensity score was applied. The matching procedure aimed to identify, for each WM user, a corresponding NWM participant with the closest propensity score. Participants without suitable matches were excluded from the analysis. Figure 2 presents the efficacy of the matching procedure for balancing the groups. A caliper width of 0.05 SDs was reached for all the parameters except alcohol consumption which remained within 0.1 SDs.

Ethical Considerations

All data used for the analysis were anonymized before extraction for this study. The study received an exemption from the institutional review board under the Ethical and Independent Review Services, a professional review board, which issued the institutional review board exemption for this study (18032-06#) [ 58 ]. The users who participated in the study were provided with a Terms of Use document mentioning the legally valid consent of the end user for the company to collect and access their information. The use of the app, site, or services shall be deemed to constitute user consent to be legally bound by these Terms and the Privacy Policy. Please refer to the current “Terms-of-use” at the link [ 59 ].

Analytic Approach

Traditionally, a classical linear longitudinal model assumes a single-slope growth pattern for changes in an outcome variable over time. However, empirical data often exhibit more complex patterns that cannot be adequately captured by such a simple model. In our study, we used piecewise-based mixed-effects models to allow for greater flexibility in modeling trajectories over time [ 60 ].

The piecewise model approach offers the advantage of accommodating different linear trends in the data across distinct regions. Specifically, we used a mixed piecewise model to assess differential changes in the WM and NWM groups in the monthly average BG level in 2 segments: before and after weight monitoring use. This approach enabled us to capture the potential changes in BG trajectories associated with the introduction of the monitoring system. Using a statistical model that accounted for curvilinear changes, we were able to test the complex effects and capture the dynamics of the associated BG fluctuations.

For the analysis, the time data were centered around the beginning of the weight monitoring period. We included a 6-month timeframe before and after this point to capture the potential impact of weight monitoring use. In the NWM group, we randomly selected a cutoff point and included data collected during the 6 months before and after the simulated cutoff point. To model the temporal changes in the monthly average weight level between the WM and NWM groups, we fitted a piecewise-based mixed-effects model. The piecewise cutoff point was set at the initiation of weight monitoring, assuming a change in the time-related trajectory of the monthly average BG level between the 2 groups. We incorporated interaction terms between the time trajectories and groups to capture this differential effect. Thus, 2 time parameters (pre and postintervention) were used as covariates, the groups (WM and NWM) were considered as a factor, and the monthly number of BG measurement served as a potential confounding variable. All the tests were 2-tailed and the type 1 error was set to 5%. The model included random intercepts and random slopes for the time trajectory after the piecewise cutoff, accounting for individual variability in BG changes.

In addition, we used mixed model analysis to examine the time trajectory of BMI changes (covariate) for the initial 6 months of weight monitoring in the WM group, controlling for baseline BMI and the number of monthly BMI measures as confounding variables. These models included random intercepts and random slopes of the time trajectory to capture individual variations in weight changes over time. Unstandardized regression weights (B), test statistics ( t ), and associated significance ( P values) were reported.

Finally, the monthly BMI levels were disaggregated to separate within- and between-person variabilities using person-level centering and person-level aggregation [ 61 ]. In addition, a 1-month lagged within-person BMI was calculated. Thereafter, a mixed model was applied to test the 1-month lagged and simultaneous association of monthly within-person BMI changes and between-person BMI with the monthly average BG level. All the model predictors were defined as covariates.

In total, 1932 users were included in the study. The WM group included 50% users, and the NWM group, matched through the propensity scores procedure, included 50% users. The study cohort comprised 51.6% (997/1932) of men, and 60.82% (1175/1932) of the participants had comorbidities. The average age of the participants was 62.8 (SD 12.5) years, with an average BMI of 35.4 (SD 7.3). The median household income for the participants was US $68,200 (SD US $25,100). The distribution of the other parameters is presented in Table 1 by study group.

No differences were found between the WM and NWM groups. The study included individuals with diabetes who monitored their BG levels and weight using the Dario platform.

The distribution of various sample characteristics overall and by WM and NWM groups is presented in Table 1 , and any significant differences were shown.

a WM: weight monitoring.

b NWM: non–weight monitoring.

c BG: blood glucose.

Weight Monitoring Is Associated With BG Levels

The results from the piecewise mixed model analysis indicated a significant interaction between the time trajectory, starting weight monitoring and the group (B=3.02; t =6.03; P <.001) on BG levels ( Table 2 ). Specifically, the WM group demonstrated a significant reduction in the BG levels (B=−2.81; t =−8.88; P <.001), whereas the NWM group did not exhibit a significant time trend (B=0.21; t =0.55; P =.59; Figure 3 ). Before weight monitoring, there was no significant difference observed in BG time trends between the 2 groups (B=0.69; t =1.06; P =.29). Furthermore, we investigated the proportion of users who achieved a BG level reduction in their last month of measurement less than the average BG levels of 154 mg/100 mL, 183 mg/100 mL, and 212 mg/100 mL, equivalent to estimated glycated hemoglobin (HbA 1c ) of 7.0, 8.0, and 9.0, respectively [ 62 ]. Remarkably, of the 966 users examined per group, 45% (435/966) versus 36% (348/966), 71% (686/966) versus 59% (570/966), and 85% (821/966) versus 76% (734/966) of the WM versus NWM individuals demonstrated substantial reductions in HbA 1c levels of <154 mg/100 mL, 183 mg/100 mL, and 212 mg/100 mL, respectively ( P <.001 for all).

a BG: blood glucose.

b σ2 residual variability=843.15; τ00 UID random intercept=2099.24; τ11 UID.time2 random slope of the second slope=53.68; ρ01 UID: covariance between the random intercept and slope=−0.27; intraclass correlation=0.72.

c #BG measurements=number of BG measurements per month.

d time1represents the piecewise slopes before the weight monitoring intervention.

e NWM: non–weight monitoring.

f time2 represents the piecewise slopes after the weight monitoring intervention.

BMI Fluctuations and the Link to BG

During the weight monitoring period ( Table 3 ) of the WM group, a significant decrease in BMI was observed (B=−0.13; t =−9.35; P <.001).

Interestingly, the number of monthly measurements was negatively associated with BMI (B=−0.003; t =−2.22; P =.03). Furthermore, the findings of the lagged analysis disaggregating within- and between-person variabilities shed light on BMI as a potential mechanism driving BG ( Table 4 ). Specifically, the analysis demonstrated that an increase in within-person BMI was associated with elevated BG levels (B=4.67; t =3.47; P <.001). Similarly, an increase in between-person BMI was found to be associated with higher BG levels (B=0.61; t =2.65; P =.008). However, the 1-month lagged back BMI was not associated with BG levels (B=−0.77; t =−0.91; P =.36).

b σ2 residual variability=0.24; τ00 UID random intercept=1.29; τ11 UID.time random slope of the time=0.17; ρ01 UID covariance between the random intercept and slope=−0.25; intraclass correlation=0.93.

c time represents the slope over 6 months after the intervention.

b WM: weight monitoring.

c σ2 residual variability=464.96; τ00 UID random intercept=1684.51; τ11 UID.time random slope of the within-person BMI=325.17; ρ01 UID covariance between the random intercept and slope=−0.01; intraclass correlation=0.80.

Principal Findings

This study examined the ability of people with diabetes to regulate BG levels through simple weight monitoring. It used propensity score matching for the control group and used a piecewise mixed model as a statistical framework to describe the nonlinear behavior in BG levels, comparing 2 user cohorts over time. Our analysis indicated that before the weight monitoring phase, both groups demonstrated flat trajectories in BG levels. However, after starting the use of the self-monitoring of weight, the WM group experienced a significant reduction in BG levels, whereas the NWM group’s BG levels remained flat.

In addition, by disaggregating within- and between-person BMI variabilities, we showed an association between both BMI sources and BG levels, suggesting that general BMI levels and BMI fluctuations can potentially contribute to BG modulation. However, a lagged analysis did not find an association between within-person BMI fluctuations and next-month BG levels, which does not support the claim of BMI as a potential mechanism of BG changes.

This study demonstrates that the use of digital tools for self-monitoring of weight can significantly affect BG levels in patients with T2D. This finding offers a practical approach to enhancing T2D management, especially for the majority of patients who are also dealing with overweight or obesity issues. Given that weight loss has been consistently shown to improve glycemic control in patients with T2D, as highlighted in previous studies [ 12 - 16 , 25 ], our findings reinforce the importance of weight management as an integral part of diabetes care. Self-monitoring can enhance patient awareness and engagement in their health management, leading to better outcomes. This aligns with the growing body of evidence suggesting that patient engagement and empowerment are critical in managing chronic conditions such as T2D [ 34 , 40 , 63 , 64 ].

Self-monitoring is the centerpiece of behavioral weight loss intervention programs. A significant association between self-monitoring and weight loss was consistently reported for various health conditions; however, the level of evidence was weak due to methodological limitations [ 65 ]. The use of self-monitoring in behavioral changes has a strong theoretical foundation. Self-management was defined as “the personal application of behavior-change tactics that produces a desired change in behavior” [ 66 ]. Through self-management interventions, individuals learn to identify occurrences of their own target responding, accurately self-recording the target response, self-evaluating their behavior, and self-delivering reinforcement as a consequence [ 67 ].

Although self-monitoring has been described as the cornerstone of behavioral treatment for weight loss, there is a limited examination conducted in the literature [ 65 ]. More recently, self-weighing has been introduced as a monitoring component. Daily weighing is valuable for individuals trying to lose weight or prevent weight gain [ 68 ]. Consistent with our findings, frequent self-weighing was associated with a lower fat intake, a greater history of dieting to lose weight, and a lower current BMI [ 68 , 69 ].

Previous systematic reviews provided extensive evidence that self-monitoring via digital health, including weight, diet, and physical activity, is associated with superior weight loss [ 36 ]. It was specifically shown how distinct features of a digital therapeutic app have the potential to deliver equitable person-centric care and how digital engagement can play a key role in enhancing a person’s chronic condition self-management [ 63 , 64 , 70 , 71 ].

Self-monitoring has been shown repeatedly to be an important feature of behavioral weight loss digital programs [ 71 ]. Self-monitoring of weight and diet were positively correlated with weight loss, and the more consistently the monitoring occurred, the better the weight loss [ 72 , 73 ]. Self-monitoring is also a core component of behavioral obesity treatment, but there is limited knowledge about the efficacy of digital self-monitoring of weight in diabetes [ 36 ]. We had previously demonstrated how digital engagement and digital blood pressure monitoring may improve diabetes management [ 34 , 74 ]. Prominently, in this study, the WM and NWM groups were not different in their digital engagement. In addition, the median household income distribution of users in both groups was comparable, suggesting that the digital solution is desired and affordable across lower-, middle-, and high-income levels to enhance glycemic and weight loss outcomes. Mobile apps can successfully help patients lose weight and represent a cost-effective and accessible alternative to intensive in-person weight loss programs [ 51 ].

From a psychological perspective, it is assumed that individuals using a digital platform may develop more active roles in managing their health, and self-monitoring affects health in part or in whole via the placebo effect, initiated by mindset modulations [ 75 ]. In the realm of physical exercise, a compelling body of research highlights the remarkable impact of mindset on various health parameters. It has been demonstrated that individuals’ mindsets about stress could profoundly alter their cortisol levels and influence various hormonal and cardiovascular functions when confronted with stressful situations [ 76 ]. Levy et al [ 77 ] conducted a noteworthy study that revealed a significant association between individuals’ mindsets about aging and their cardiovascular function as well as their actual longevity. A notable example of this phenomenon is evident in the study conducted by Crum and Langer [ 28 ], who investigated the effects of mindset on hotel room attendants. These workers, upon adopting the mindset that their daily work constituted a form of beneficial exercise, experienced substantial improvements in several critical health indicators, including weight, BMI, and systolic blood pressure. The potential mechanism may include beliefs and feelings of control people have over their health [ 28 , 78 ]. Collectively, these studies illuminate the potent role of the mindset in shaping various aspects of physical health, providing a background for the potential effect of weight monitoring on BG levels through mindset changes, considering the absence of a quasi-causal association between BMI and BG levels. There is evidence supporting the idea that the placebo effect plays a role in prompting the psychological benefits associated with health-related outcomes [ 79 ]. Treatments are delivered in a context that includes social and physical signals, verbal suggestions, and clinical history. This context is actively interpreted by the brain and can elicit expectations, memories, and emotions, which in turn can influence health-related outcomes in the body [ 79 ]. Considering the absence of a quasi-causal association between BMI and BG levels, one may consider the effect of self-weighing on BG levels to be mediated by perceptional processes, including mindset modulation.

In agreement with previous studies, we found that the WM group, which monitored their weight, also improved their BMI levels over time [ 80 ]. There is strong and consistent evidence that obesity management can delay the progression from prediabetes to T2D and is highly beneficial in treating T2D [ 80 - 83 ]. A significant overlap between T2D and overweight or obesity in etiology and disease mechanisms was broadly investigated. Previous studies have shown a significant improvement in all diabetes-related outcomes, including weight reduction, in patients with T2D and those who have overweight [ 17 ]. Controlling both diseases through weight management requires an intensive multidisciplinary approach [ 84 , 85 ]. As body weight increases, patients become more insulin resistant [ 86 ], which further drives the need for higher doses of antihyperglycemic medications to keep BG levels in the target range, which then may increase weight gain [ 17 ]. It was observed that in obese individuals, adipose tissue releases increased amounts of nonesterified fatty acids, glycerol, hormones, proinflammatory cytokines, and other factors that are involved in the development of insulin resistance. Insulin resistance associated with dysfunction of pancreatic islet beta cells results in the failure to maintain BG levels within the target range [ 86 ]. Losing weight can alleviate many of these issues. While losing weight, the pancreas is better able to keep up with the body’s need for insulin. In some cases, weight loss is enough to restore BG to a normal level, which eliminates diabetes or even lowers the need for insulin therapy or other medications to control diabetes [ 87 ]. However, other important components may also play a role in weight and BG levels, and other laboratory tests may need to be performed by health care providers.

Monitoring several chronic conditions may have the potential to offer a greater means for helping people with diabetes who have overweight or obesity effectively modulate their glycemia and weight than managing each condition separately. The findings of this study suggest the need for further exploration of how digital health platforms can be effectively integrated into routine clinical practice. Future research should focus on how these tools can be optimized for individual patient needs and how they can be incorporated into broader diabetes management programs. In addition, exploring the long-term impacts of such interventions on patient outcomes and health care use will be valuable. We expect that our analytical framework will be useful for examining other chronic conditions and metabolic syndrome outcomes (eg, lipid profile).

Limitations

As in all studies involving retrospective real-world data, groups were not randomly assigned, and treatment protocols were not prescribed. The propensity score matching approach, while comprehensive, introduces potential biases due to selection methods, which may not be fully mitigated. Unobserved confounders, measurement errors, and other limitations inherent to observational studies may still impact the validity of causal inferences. Nevertheless, propensity score matching represents a rigorous analytical technique that is widely accepted and applied in observational studies to approximate the design and control of randomized controlled trials, making it a valuable tool in the pursuit of causal inference. In this study, we relied on self-reported data for measurements, including weight and BMI. Although self-reporting is a common and practical method in many observational and digital health studies, it can be subject to inaccuracies due to factors such as recall bias or the desire to present oneself in a certain light.

In this real-world data analysis, we designed our timescale to capture changes over a 6-month period both before and after the initiation of weight monitoring. Nevertheless, it is worth noting that the research question of interest in this study could potentially be explored at various temporal scales, including daily, weekly, or monthly intervals. Given the practical challenges associated with monitoring daily changes in real-world settings, most studies in this domain tend to emphasize monthly fluctuations. Moreover, while BG levels offer real-time data and are sensitive to immediate changes in diabetes management, they do not provide a comprehensive view of long-term glycemic control. In addition, longer-term weight monitoring can provide a long-term perspective on glycemic control. Monitoring HbA 1c levels over a longer period would provide additional insights into the long-term effects of self-monitoring of weight on glycemic control. However, our study was designed to assess the short-term impacts of digital self-monitoring of weight on BG levels with increased resolution compared to HbA 1c . The 6-month period was chosen as it provides a sufficient window to observe significant changes in BG levels in response to weight management, without extending to long-term effects where other variables might confound the results. In addition, the average BMI of the participants was 35.0 (SD 7.3), which is considered a unique population of obesity. Furthermore, longer-term follow-up with these participants is needed because it is not clear how long this weight loss and glycemic improvement will last and what needs to be added for increased sustainability.

Conclusions

In summary, our study underscored the tangible benefits of self-monitoring of weight in the modulation of BG levels among people with diabetes. By leveraging an innovative analytical framework, we found that self-monitoring of weight led to significant reductions in BG levels in the WM group, despite the lack of a direct causal link between BMI fluctuations and BG changes. Drawing from extensive evidence, both historical and from our study, the act of self-monitoring seems to foster a heightened sense of agency and potentially influence health outcomes through mindset modulations.

From a practical standpoint, these findings reinforce the importance of digital health tools in chronic disease management, especially in the realms of diabetes and obesity. Digital self-monitoring platforms not only offer scalable and affordable solutions but also empower individuals to take a proactive role in their health journey. Moreover, the convergence of digital health tools with robust psychological mechanisms, such as the placebo effect and mindset modulation, paves the way for a holistic approach to health care.

This research may also open the door to a myriad of possibilities. While we have illuminated the potential effects of self-monitoring of weight on diabetes management, similar methods could be deployed to investigate the impact on other chronic conditions and metabolic syndrome outcomes. Furthermore, with advancing technology, more granular, real-time data can be leveraged to delve deeper into the daily or even hourly impacts of such interventions. Future studies should also focus on investigating the mechanisms underlying the comorbidity of diabetes and obesity and their management, identifying, and applying mediation models that drive behavioral change that goes beyond multiple chronic conditions.

In light of the significant overlap between T2D and obesity, there is an imperative need to conceptualize and design multifaceted interventions. Blending digital innovation, behavioral science, and clinical knowledge, we can usher in a new era of person-centric health care that is not only responsive but also preemptive. The journey has just begun, and the road ahead promises transformative potential for patients and health care systems alike.

Conflicts of Interest

YFH, EB, and OM are employees of Dario Health. MDR and DLH serve as Dario Health scientific advisory board members, and PG has received a consulting fee to assist with analyses but otherwise has no conflicts of interest.

• Amante DJ, Harlan DM, Lemon SC, McManus DD, Olaitan OO, Pagoto SL, et al. Evaluation of a diabetes remote monitoring program facilitated by connected glucose meters for patients with poorly controlled type 2 diabetes: randomized crossover trial. JMIR Diabetes. Mar 11, 2021;6(1):e25574. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Bryan S, Afful J, Carroll M, Te-Ching C, Orlando D, Fink S, et al. National health and nutrition examination survey 2017–March 2020 prepandemic data files—development of files and prevalence estimates for selected health outcomes. Centers for Disease Control and Prevention. 2021. URL: https://www.cdc.gov/nchs/data/nhsr/nhsr158-508.pdf [accessed 2024-03-16]
• Cawley J, Biener A, Meyerhoefer C, Ding Y, Zvenyach T, Smolarz BG, et al. Direct medical costs of obesity in the United States and the most populous states. J Manag Care Spec Pharm. Mar 2021;27(3):354-366. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Leitner DR, Frühbeck G, Yumuk V, Schindler K, Micic D, Woodward E, et al. Obesity and type 2 diabetes: two diseases with a need for combined treatment strategies - EASO can lead the way. Obes Facts. 2017;10(5):483-492. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Nianogo RA, Arah OA. Forecasting obesity and type 2 diabetes incidence and burden: the ViLA-obesity simulation model. Front Public Health. 2022;10:818816. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Ruze R, Liu T, Zou X, Song J, Chen Y, Xu R, et al. Obesity and type 2 diabetes mellitus: connections in epidemiology, pathogenesis, and treatments. Front Endocrinol (Lausanne). 2023;14:1161521. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Eizirik DL, Pasquali L, Cnop M. Pancreatic β-cells in type 1 and type 2 diabetes mellitus: different pathways to failure. Nat Rev Endocrinol. Jul 2020;16(7):349-362. [ CrossRef ] [ Medline ]
• American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2019. Diabetes Care. Jan 2019;42(Suppl 1):S13-S28. [ CrossRef ] [ Medline ]
• Versini M, Jeandel PY, Rosenthal E, Shoenfeld Y. Obesity in autoimmune diseases: not a passive bystander. Autoimmun Rev. Sep 2014;13(9):981-1000. [ CrossRef ] [ Medline ]
• Tuomi T, Santoro N, Caprio S, Cai M, Weng J, Groop L. The many faces of diabetes: a disease with increasing heterogeneity. Lancet. Mar 22, 2014;383(9922):1084-1094. [ CrossRef ] [ Medline ]
• Thom G, Messow CM, Leslie WS, Barnes AC, Brosnahan N, McCombie L, et al. Predictors of type 2 diabetes remission in the Diabetes Remission Clinical Trial (DiRECT). Diabet Med. Aug 2021;38(8):e14395. [ CrossRef ] [ Medline ]
• Bays HE. Why does type 2 diabetes mellitus impair weight reduction in patients with obesity? A review. Obes Pillars. Sep 2023;7:100076. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Bays HE, Bindlish S, Clayton TL. Obesity, diabetes mellitus, and cardiometabolic risk: an obesity medicine association (OMA) clinical practice statement (CPS) 2023. Obes Pillars. Mar 2023;5:100056. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Kong DX, Xiao Y, Zhang ZX, Liu YB. Study on the correlation between metabolism, insulin sensitivity and progressive weight loss change in type-2 diabetes. Pak J Med Sci. 2020;36(7):1523-1528. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Scheen AJ, Van Gaal LF. Combating the dual burden: therapeutic targeting of common pathways in obesity and type 2 diabetes. Lancet Diabetes Endocrinol. Nov 2014;2(11):911-922. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Apovian CM, Okemah J, O'Neil PM. Body weight considerations in the management of type 2 diabetes. Adv Ther. Jan 2019;36(1):44-58. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Hamdy O, Ashrafzadeh S, Mottalib A. Weight management in patients with type 2 diabetes: a multidisciplinary real-world approach. Curr Diab Rep. Jul 17, 2018;18(9):66. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Bolignano D, Zoccali C. Effects of weight loss on renal function in obese CKD patients: a systematic review. Nephrol Dial Transplant. Nov 2013;28 Suppl 4:iv82-iv98. [ CrossRef ] [ Medline ]
• Araújo-Soares V, Hankonen N, Presseau J, Rodrigues A, Sniehotta FF. Developing behavior change interventions for self-management in chronic illness: an integrative overview. Eur Psychol. 2019;24(1):7-25. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Grady PA, Gough LL. Self-management: a comprehensive approach to management of chronic conditions. Am J Public Health. Aug 2014;104(8):e25-e31. [ CrossRef ] [ Medline ]
• Davies MJ, D'Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, et al. Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. Dec 2018;41(12):2669-2701. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Samdal GB, Eide GE, Barth T, Williams G, Meland E. Effective behaviour change techniques for physical activity and healthy eating in overweight and obese adults; systematic review and meta-regression analyses. Int J Behav Nutr Phys Act. Mar 28, 2017;14(1):42. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Magkos F, Yannakoulia M, Chan JL, Mantzoros CS. Management of the metabolic syndrome and type 2 diabetes through lifestyle modification. Annu Rev Nutr. 2009;29:223-256. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Estabrooks PA, Nelson CC, Xu S, King D, Bayliss EA, Gaglio B, et al. The frequency and behavioral outcomes of goal choices in the self-management of diabetes. Diabetes Educ. 2005;31(3):391-400. [ CrossRef ] [ Medline ]
• Reynolds LR, Anderson JW. Practical office strategies for weight management of the obese diabetic individual. Endocr Pract. 2004;10(2):153-159. [ CrossRef ] [ Medline ]
• Hood KK, Hilliard M, Piatt G, Ievers-Landis CE. Effective strategies for encouraging behavior change in people with diabetes. Diabetes Manag (Lond). 2015;5(6):499-510. [ FREE Full text ] [ Medline ]
• Raffali A, Asraf RM. Fostering growth mindset principles in the prevention of type 2 diabetes through a narrative game. Int J Learn Teach Educ Res. 2023;22(2):244-261. [ FREE Full text ] [ CrossRef ]
• Crum AJ, Langer EJ. Mind-set matters: exercise and the placebo effect. Psychol Sci. Feb 2007;18(2):165-171. [ CrossRef ] [ Medline ]
• Park C, Pagnini F, Reece A, Phillips D, Langer E. Blood sugar level follows perceived time rather than actual time in people with type 2 diabetes. Proc Natl Acad Sci U S A. Jul 19, 2016;113(29):8168-8170. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Lee KS, Feltner FJ, Bailey AL, Lennie TA, Chung ML, Smalls BL, et al. The relationship between psychological states and health perception in individuals at risk for cardiovascular disease. Psychol Res Behav Manag. 2019;12:317-324. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Awad A, Trenfield SJ, Pollard TD, Ong JJ, Elbadawi M, McCoubrey LE, et al. Connected healthcare: improving patient care using digital health technologies. Adv Drug Deliv Rev. Nov 2021;178:113958. [ CrossRef ] [ Medline ]
• Cahn A, Akirov A, Raz I. Digital health technology and diabetes management. J Diabetes. Jan 2018;10(1):10-17. [ CrossRef ] [ Medline ]
• Han J, King F, Klonoff D, Drincic A, Crosby KP, Robinson T, et al. Digital diabetes congress 2019. J Diabetes Sci Technol. Sep 2019;13(5):979-989. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Fundoiano-Hershcovitz Y, Hirsch A, Dar S, Feniger E, Goldstein P. Role of digital engagement in diabetes care beyond measurement: retrospective cohort study. JMIR Diabetes. Feb 18, 2021;6(1):e24030. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Chow CK, Redfern J, Hillis GS, Thakkar J, Santo K, Hackett ML, et al. Effect of lifestyle-focused text messaging on risk factor modification in patients with coronary heart disease: a randomized clinical trial. JAMA. 2015;314(12):1255-1263. [ CrossRef ] [ Medline ]
• Patel ML, Wakayama LN, Bennett GG. Self-monitoring via digital health in weight loss interventions: a systematic review among adults with overweight or obesity. Obesity (Silver Spring). Mar 2021;29(3):478-499. [ CrossRef ] [ Medline ]
• Michie S, Yardley L, West R, Patrick K, Greaves F. Developing and evaluating digital interventions to promote behavior change in health and health care: recommendations resulting from an international workshop. J Med Internet Res. Jun 29, 2017;19(6):e232. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Offringa R, Sheng T, Parks L, Clements M, Kerr D, Greenfield MS. Digital diabetes management application improves glycemic outcomes in people with type 1 and type 2 diabetes. J Diabetes Sci Technol. May 25, 2018;12(3):701-708. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Bollyky JB, Melton ST, Xu T, Painter SL, Knox B. The effect of a cellular-enabled glucose meter on glucose control for patients with diabetes: prospective pre-post study. JMIR Diabetes. Oct 07, 2019;4(4):e14799. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Osborn CY, van Ginkel JR, Rodbard D, Heyman M, Marrero DG, Huddleston B, et al. One drop | mobile: an evaluation of hemoglobin A1c improvement linked to app engagement. JMIR Diabetes. Aug 24, 2017;2(2):e21. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Ghelani DP, Moran LJ, Johnson C, Mousa A, Naderpoor N. Mobile apps for weight management: a review of the latest evidence to inform practice. Front Endocrinol (Lausanne). 2020;11:412. [ FREE Full text ] [ CrossRef ] [ Medline ]
• MacPherson MM, Merry KJ, Locke SR, Jung ME. mHealth prompts within diabetes prevention programs: a scoping review. Mhealth. 2022;8:20. [ FREE Full text ] [ CrossRef ] [ Medline ]
• MacPherson MM, Merry KJ, Locke SR, Jung ME. Effects of mobile health prompts on self-monitoring and exercise behaviors following a diabetes prevention program: secondary analysis from a randomized controlled trial. JMIR Mhealth Uhealth. Sep 05, 2019;7(9):e12956. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Stellefson M, Chaney B, Barry AE, Chavarria E, Tennant B, Walsh-Childers K, et al. Web 2.0 chronic disease self-management for older adults: a systematic review. J Med Internet Res. Feb 14, 2013;15(2):e35. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Doyle J, Murphy E, Gavin S, Pascale A, Deparis S, Tommasi P, et al. A digital platform to support self-management of multiple chronic conditions (ProACT): findings in relation to engagement during a one-year proof-of-concept trial. J Med Internet Res. Dec 15, 2021;23(12):e22672. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Ancker JS, Witteman HO, Hafeez B, Provencher T, Van de Graaf M, Wei E. "You get reminded you're a sick person": personal data tracking and patients with multiple chronic conditions. J Med Internet Res. Aug 19, 2015;17(8):e202. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Doyle J, Murphy E, Kuiper J, Smith S, Hannigan C, Jacobs A, et al. Managing multimorbidity: identifying design requirements for a digital self-management tool to support older adults with multiple chronic conditions. In: Proceedings of the 2019 CHI Conference on Human Factors in Computing Systems. 2019. Presented at: CHI '19; May 4-9, 2019;1-14; Glasgow, Scotland. URL: https://dl.acm.org/doi/10.1145/3290605.3300629
• Lim CY, Berry AB, Hartzler A, Hirsch T, Carrell DS, Bermet ZA, et al. Facilitating self-reflection about values and self-care among individuals with chronic conditions. In: Proceedings of the 2019 CHI Conference on Human Factors in Computing Systems. 2019. Presented at: CHI '19; May 4-9, 2019;1-12; Glasgow, Scotland. URL: https://dl.acm.org/doi/10.1145/3290605.3300885 [ CrossRef ]
• Caldeira C, Gui X, Reynolds TL, Bietz M, Chen Y. Managing healthcare conflicts when living with multiple chronic conditions. Int J Hum Comput Stud. Jan 2021;145:102494. [ FREE Full text ] [ CrossRef ]
• Tomah S, Mahmoud N, Mottalib A, Pober DM, Tasabehji MW, Ashrafzadeh S, et al. Frequency of self-monitoring of blood glucose in relation to weight loss and A1C during intensive multidisciplinary weight management in patients with type 2 diabetes and obesity. BMJ Open Diabetes Res Care. 2019;7(1):e000659. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Ufholz K, Werner J. The efficacy of mobile applications for weight loss. Curr Cardiovasc Risk Rep. Mar 23, 2023;17(4):83-90. [ FREE Full text ] [ CrossRef ] [ Medline ]
• About adult BMI. Centers for Disease Control and Prevention. URL: https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html [accessed 2022-05-03]
• Measuring America's people, places, and economy. The United States Census Bureau. URL: https://www.census.gov/ [accessed 2024-03-16]
• Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res. May 2011;46(3):399-424. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Rosenbaum PR, Rubin DB. Constructing a control group using multivariate matched sampling methods that incorporate the propensity score. Am Stat. Mar 12, 2012;39(1):33-38. [ CrossRef ]
• Stuart EA. Matching methods for causal inference: a review and a look forward. Stat Sci. Feb 01, 2010;25(1):1-21. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Ho D, Imai K, King G, Stuart EA. MatchIt: nonparametric preprocessing for parametric causal inference. J Stat Softw. 2011;42(8):1-28. [ CrossRef ]
• Home page. Ethical & Independent Review Services (E&I). URL: https://eandireview.com/ [accessed 2023-06-13]
• Terms of use. DarioHealth Corp. URL: https://www.dariohealth.com/terms-of-use/ [accessed 2024-03-16]
• Kohli N, Peralta Y, Zopluoglu C, Davison ML. A note on estimating single-class piecewise mixed-effects models with unknown change points. Int J Behav Dev. Feb 15, 2018;42(5):518-524. [ CrossRef ]
• Yardley L, Morrison L, Bradbury K, Muller I. The person-based approach to intervention development: application to digital health-related behavior change interventions. J Med Internet Res. Jan 30, 2015;17(1):e30. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ, et al. A1c-Derived Average Glucose Study Group. Translating the A1C assay into estimated average glucose values. Diabetes Care. Aug 2008;31(8):1473-1478. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Frias J, Virdi N, Raja P, Kim Y, Savage G, Osterberg L. Effectiveness of digital medicines to improve clinical outcomes in patients with uncontrolled hypertension and type 2 diabetes: prospective, open-label, cluster-randomized pilot clinical trial. J Med Internet Res. Jul 11, 2017;19(7):e246. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Shan R, Sarkar S, Martin SS. Digital health technology and mobile devices for the management of diabetes mellitus: state of the art. Diabetologia. Jun 8, 2019;62(6):877-887. [ CrossRef ] [ Medline ]
• Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc. Jan 2011;111(1):92-102. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Cooper JO, Heron TE, Heward WL. Applied Behavior Analysis. 3rd edition. Old Bridge, NJ. Pearson Prentice Hall; 2020.
• Erhard P, Wong T, Barnett M, Falcomata T, Lang R. Self-management skills and applied behavior analysis. In: Matson JL, Sturmey P, editors. Handbook of Autism and Pervasive Developmental Disorder: Assessment, Diagnosis, and Treatment. Cham, Switzerland. Springer; 2022;957-973.
• Linde JA, Jeffery RW, French SA, Pronk NP, Boyle RG. Self-weighing in weight gain prevention and weight loss trials. Ann Behav Med. Dec 2005;30(3):210-216. [ CrossRef ] [ Medline ]
• Patel ML, Hopkins CM, Brooks TL, Bennett GG. Comparing self-monitoring strategies for weight loss in a smartphone app: randomized controlled trial. JMIR Mhealth Uhealth. Feb 28, 2019;7(2):e12209. [ FREE Full text ] [ CrossRef ] [ Medline ]
• ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 1. improving care and promoting health in populations: standards of care in diabetes-2023. Diabetes Care. Jan 01, 2023;46(Supple 1):S10-S18. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Lin PH, Grambow S, Intille S, Gallis JA, Lazenka T, Bosworth H, et al. The association between engagement and weight loss through personal coaching and cell phone interventions in young adults: randomized controlled trial. JMIR Mhealth Uhealth. Oct 18, 2018;6(10):e10471. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Burke LE, Warziski M, Starrett T, Choo J, Music E, Sereika S, et al. Self-monitoring dietary intake: current and future practices. J Ren Nutr. Jul 2005;15(3):281-290. [ CrossRef ] [ Medline ]
• Baker RC, Kirschenbaum DS. Self-monitoring may be necessary for successful weight control. Behav Ther. Jun 1993;24(3):377-394. [ CrossRef ]
• Gershoni T, Ritholz MD, Horwitz D, Manejwala O, Donaldson-Pitter T, Fundoiano-Hershcovitz Y. Glycemic management by a digital therapeutic platform across racial/ethnic groups: a retrospective cohort study. Applied Sciences. Dec 29, 2022;13(1):431. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Tighe SA, Ball K, Kensing F, Kayser L, Rawstorn JC, Maddison R. Toward a digital platform for the self-management of noncommunicable disease: systematic review of platform-like interventions. J Med Internet Res. Oct 28, 2020;22(10):e16774. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Crum AJ, Salovey P, Achor S. Rethinking stress: the role of mindsets in determining the stress response. J Pers Soc Psychol. Apr 2013;104(4):716-733. [ CrossRef ] [ Medline ]
• Levy BR, Slade MD, Kunkel SR, Kasl SV. Longevity increased by positive self-perceptions of aging. J Pers Soc Psychol. Aug 2002;83(2):261-270. [ CrossRef ] [ Medline ]
• Salvia MG, Ritholz MD, Craigen KL, Quatromoni PA. Women's perceptions of weight stigma and experiences of weight-neutral treatment for binge eating disorder: a qualitative study. EClinicalMedicine. Feb 2023;56:101811. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Wager TD, Atlas LY. The neuroscience of placebo effects: connecting context, learning and health. Nat Rev Neurosci. Jul 2015;16(7):403-418. [ FREE Full text ] [ CrossRef ] [ Medline ]
• ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. on behalf of the American Diabetes Association. 8. Obesity and weight management for the prevention and treatment of type 2 diabetes: standards of care in diabetes-2023. Diabetes Care. Jan 01, 2023;46(Suppl 1):S128-S139. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Rothberg AE, McEwen LN, Kraftson AT, Fowler CE, Herman WH. Very-low-energy diet for type 2 diabetes: an underutilized therapy? J Diabetes Complications. 2014;28(4):506-510. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Garvey WT, Ryan DH, Bohannon NJ, Kushner RF, Rueger M, Dvorak RV, et al. Weight-loss therapy in type 2 diabetes: effects of phentermine and topiramate extended release. Diabetes Care. Dec 2014;37(12):3309-3316. [ CrossRef ] [ Medline ]
• Davies MJ, Bergenstal R, Bode B, Kushner RF, Lewin A, Skjøth TV, et al. NN8022-1922 Study Group. Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE diabetes randomized clinical trial. JAMA. Aug 18, 2015;314(7):687-699. [ CrossRef ] [ Medline ]
• Garber AJ, Abrahamson MJ, Barzilay JI, Blonde L, Bloomgarden ZT, Bush MA, et al. Consensus statement by the American association of clinical endocrinologists and American college of endocrinology on the comprehensive type 2 diabetes management algorithm - 2018 executive summary. Endocr Pract. Jan 2018;24(1):91-120. [ CrossRef ] [ Medline ]
• ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. on behalf of the American Diabetes Association. 5. Facilitating positive health behaviors and well-being to improve health outcomes: standards of care in diabetes-2023. Diabetes Care. Jan 01, 2023;46(Supple 1):S68-S96. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. Dec 14, 2006;444(7121):840-846. [ CrossRef ] [ Medline ]
• Bishop S. Losing weight can have big impact on those with diabetes. Mayo Clinic News Network. URL: https:/​/newsnetwork.​mayoclinic.org/​discussion/​losing-weight-can-have-big-impact-on-those-with-diabetes/​ [accessed 2023-08-06]

Abbreviations

Edited by G Eysenbach, T Leung; submitted 28.11.23; peer-reviewed by Y Ding, T de Azevedo Cardoso; comments to author 02.01.24; revised version received 18.02.24; accepted 22.02.24; published 02.04.24.

©‪Yifat Fundoiano-Hershcovitz, Marilyn D Ritholz, David L Horwitz, Ephraim Behar, Omar Manejwala, Pavel Goldstein. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 02.04.2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

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How Virtual Reality Technology Has Changed Our Lives: An Overview of the Current and Potential Applications and Limitations

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No new data were created or analyzed in this study. Data sharing is not applicable to this article.

Despite virtual reality (VR) being initially marketed toward gaming, there are many potential and existing VR applications in various sectors and fields, including education, training, simulations, and even in exercise and healthcare. Unfortunately, there is still a lack of general understanding of the strengths and limitations of VR as a technology in various application domains. Therefore, the aim of this literature review is to contribute to the library of literature concerning VR technology, its applications in everyday use, and some of its existing drawbacks. Key VR applications were discussed in terms of how they are currently utilized or can be utilized in the future, spanning fields such as medicine, engineering, education, and entertainment. The main benefits of VR are expressed through the text, followed by a discussion of some of the main limitations of current VR technologies and how they can be mitigated or improved. Overall, this literature review shows how virtual reality technology has the potential to be a greatly beneficial tool in a multitude of applications and a wide variety of fields. VR as a technology is still in its early stages, but more people are becoming interested in it and are optimistic about seeing what kind of changes VR can make in their everyday lives. With how rapidly modern society has adapted to personal computers and smartphones, VR has the opportunity to become the next big technological turning point that will eventually become commonplace in most households.

1. Introduction

This literature review aims to contribute to the library of literature on the applications of virtual reality (VR), how they are currently used and can be used in the future, and some of the strengths and difficulties that come with using VR.

Virtual reality (VR) refers to a computer-generated, three-dimensional virtual environment that users can interact with, typically accessed via a computer that is capable of projecting 3D information via a display, which can be isolated screens or a wearable display, e.g., a head-mounted display (HMD), along with user identification sensors [ 1 ]. VR can mainly be divided into two categories: non-immersive, and immersive [ 2 ]. Non-immersive VR utilizes a combination of screens surrounding the user to present virtual information [ 3 ]. A typical example of this is driving or flight simulations in which the user sits in a chair with multiple screens around them, giving them the feeling of being in the cockpit or driver’s seat without being fully immersed. Immersive VR refers to using a wearable display, e.g., HMD, to track a user’s movement and present the VR information based on the position of users [ 4 ], which allows them to experience 360 degrees of the virtual environment. This immersive experience is what most people think of when it comes to VR and is one of the most marketable aspects of VR technology. In between immersive and non-immersive VR, there is also augmented reality (AR). AR makes use of computer-generated imagery that is overlayed on physical elements in the real world, which can be found in many applications, such as stores providing a virtual fitting application for people to “try on” clothes. Mixed reality (XR) represents the spectrum between the physical and digital worlds, combining AR and VR to allow users to both immerse themselves in a virtual world while also being somewhat grounded in reality.

The concept of VR was first introduced in the 1960s, with Morton’s creation of the Telesphere Mask and the Sensorama [ 5 ]. The original technologies served the purpose of immersing the user in the video display around them, making them feel like they are a part of the video. The Ultimate display was an idea developed by Ivan Sutherland [ 6 ], operating on a similar concept of allowing the user to feel immersed in a computer-generated environment using multiple input and output devices [ 7 , 8 ]. Following the creation of the Sensorama and the idea of the Ultimate display in the 1960s, the next large boom in VR technology development occurred in the early 2010s. During this period of time, VR was still considered a gimmick—it was expensive and was not considered a technology that would ever become popular with the general public. This, however, started to shift in 2012, when Palmer Luckey debuted his prototype for the first Oculus [ 9 ]. In 2014, Facebook acquired Oculus after seeing the interest it garnered, leading to a significant increase in the popularity of VR devices for home use. Since then, VR has grown to become more popular and accessible to the everyday consumer, with more VR headsets available on the market, such as the HTC Vive, Samsung VR, Oculus, Google Cardboard, and more.

Despite VR being initially marketed toward gaming, there are many potential and existing VR applications in various sectors and fields, including education, training, simulations, and even in exercise and healthcare. Unfortunately, there is still a lack of general understanding of the strengths and limitations of VR as a technology in various application domains. Some of the largest issues with current VR technology are hard to overcome and can span from technical to financial and health issues. Technological limitations regarding users feeling uncomfortable or ill while using a VR headset, the inaccessibility of this technology to most people due to the high price of the associated hardware, and the lack of technical standardization are all current issues that the tech industry is hoping to overcome with research and future improvements.

Overall, this literature review serves the purpose of covering how different types of VR applications can be utilized, as well as providing information on the advantages and drawbacks of using VR technology in various application domains.

In order to present a reliable literature review, an extensive search was performed using common journal search engines/websites, e.g., Google Scholar, JSTOR, MDPI, ResearchGate, PubMed, and Science Direct, which includes peer-reviewed studies and articles. Keywords and phrases used in searching for sources include a combination of “VR” or “virtual reality” with “Education”, “Simulation,” “Games”, “Virtual”, “Immersive”, “Non-immersive”, “Training”, “Application”, “Manufacturing”, “Industrial”, “Medical”, “Healthcare”, and “Entertainment”. The variety in keywords helped yield different results for VR not only as a technology but also in major use cases where it has already been utilized for different industries and fields. The gathered papers and articles were then reviewed to further select representative and up-to-date evidence.

Papers were selected with the goal of providing sufficient coverage of the topic by presenting an overarching summary rather than an exhaustive review of every type of application within VR. Having a large variety of papers does not guarantee that every particular use case of VR is covered, but it does provide a wide breadth of use cases of VR that are currently applied, as well as opportunity spaces for VR applications in the future. As shown in Figure 1 , 145 papers were initially collected, but only 77 were thoroughly reviewed to provide enough coverage without unnecessary advanced technical details. Five additional papers and articles were added after review to accommodate additional information, resulting in a total of 82 sources used for the final literature review.

General structure of the paper selection and literature review.

Included papers were those that clearly presented a specific VR application, those that showed clear negative or positive outcomes of VR usage, or papers that provided relevant background information on a specific VR technology. Exclusion criteria included disregarding papers that had an overt focus on VR hardware components, excluding studies that may have mentioned VR without it being the focus, and rejecting papers that became repetitive after utilizing other papers on similar topics. The following sections provide detailed reviews based on various VR applications and domains.

3. Reviews of VR Technology Applications

The technological applications of VR have advanced to a point where they can be applied to an extensive range of fields and industries outside of just gaming or entertainment. Many have started to take advantage of VR in performing tasks that are hard to practice due to limited resources or the inherent risks and dangers associated with said tasks that can sometimes lead to catastrophic consequences. The greatest strength of VR is that it opens up opportunities for people to practice these tasks in a safe capacity while also being immersed enough for it to feel realistic and transferable to the real world and depict almost any situation accurately [ 10 ]. This section covers some of the main categories of VR applications and provides examples of how these applications are applied or can be applied to different use cases across various fields.

One of the most widely used and largely applicable applications of VR is the simulation aspect, which can be uniquely created and customized to suit users’ needs. There are two main types of simulations: immersive and non-immersive. As mentioned above, non-immersive VR simulations usually include multiple screens and some type of platform or apparatus that mimics the activities or tasks in reality [ 3 ]. Immersive VR simulations differ in terms of using HMDs in place of screens and can either utilize a control platform or apparatus such as the ones used in non-immersive simulations [ 11 ] or can instead be fully contained within a virtual setup and require no external setups or platforms. Whether users opt for immersive or non-immersive VR simulations, there is no significant difference in the performance, and the results appear to be very similar in fulfilling the simulation’s purpose [ 12 ]. There is, however, a slight advantage to using immersive VR simulations with HMDs, as they are capable of fully immersing the user in the simulated environment and giving them a more thorough experience [ 13 ].

3.1. Industrial Simulation Applications

VR simulations have many applications that can span from training simulation to prototyping, designing, and testing tools and objects. Some commonly used VR simulations in the industrial domain include driving simulators, flight simulators for pilots, and combat simulators for military personnel, all of which provide training to users in highly dangerous circumstances without putting them at risk during the training process [ 14 ]. Among the many use cases, two typical simulation applications are further discussed in the following sections.

3.1.1. Driving Simulations

One major use of VR simulations is driving simulations for both driving training and within the automotive industry; VR provides the ability to create driving simulations in which users can be placed in risky driving scenarios without real danger [ 15 ]. Driving simulators can be useful in multiple capacities, such as observing driving behavior to collect data or training inexperienced drivers in a low-stress environment.

VR driving simulations can be used to train young or novice drivers and help them understand their mistakes or point out some bad driving habits they need to adjust. Within a simulation, drivers can be placed in a virtual vehicle within an environment resembling a cityscape, with their behaviors and actions observed and recorded to later analyze for any issues or mistakes or to see if the drivers made the correct decisions in a given scenario [ 16 ]. After conducting the simulation, drivers can be informed of their mistakes and receive feedback about how to improve their behaviors in an actual driving situation. These driving simulations can also be beneficial in training young drivers with neurodevelopmental disorders such as autism spectrum disorder (ASD) [ 17 ], who may otherwise have difficulties learning in an uncontrolled environment.

Another application of VR driving simulations is the ability to collect real-time data on how users react to different scenarios as drivers on the road in a simulated environment. This data can be used in multiple capacities, such as designing better safety features in a vehicle, providing a better user experience for drivers, developing training modules for drivers, and for use in autonomous vehicle (AV) research and development. AVs have been an emerging field of technology that will continue to develop and advance, with VR simulations continuously providing opportunities for safe and efficient data collection and user testing [ 18 ]. One common issue in the field is developing trust between users and autonomous vehicles and understanding how to mitigate the distrust most people have in this technology [ 19 ]. It is important to ensure users have a certain level of trust in an AV so as to ensure drivers take over when appropriate. Accordingly, putting users in a VR driving simulation in which they interact with an autonomous vehicle virtually can yield substantial amounts of data on how users behave within that environment while also ensuring that users feel safe in the process and can become accustomed to being in an AV [ 20 ].

3.1.2. Product Design and Prototyping

One application of VR that can be useful is the ability to look at 3D models in a virtual space in a way that is difficult to visualize via a screen. Prototypes or preliminary designs for products can be modeled and shown in a virtual environment for test and evaluation purposes [ 21 ]. One significant advantage of showing these models in VR is presenting a virtual prototype or part without spending a lot of time, money, effort, or material on building the prototype in real life. Through simulations, VR can also show how the product would react under different conditions. Simulations can be run in VR to show the effect of different interactions between the prototype and surrounding subjects [ 22 ]. This can help the prototype designers determine if any areas of the prototype need to be improved based on the simulated interaction results. The ability to see the product in a virtual environment can also provide the ability to make changes to VR design for a quick turnaround and faster results, which could increase the speed of prototyping, reduce prototype production waste, and increase the understanding of the functions of the prototype.

3.2. Education

Educational applications of VR have not been utilized much yet, but there are many promising examples and studies of how beneficial VR can be in an educational environment. Using VR can help increase student attention by keeping them engaged with what is happening inside the VR environment [ 23 , 24 ]. Most teenage students find it challenging to pay attention in class, especially when they feel that the discussed topics are not relevant to them. When students use exciting technologies such as VR, they are more interested and engaged with what they are learning while immersed in a virtual environment [ 25 , 26 ]. VR headsets are also useful in blocking out visual and auditory distractions, creating an opportunity for the student to focus on teaching materials better. Such VR approaches open up more opportunities for teachers to interact one-on-one with students and have more useful and beneficial teacher–student interactions [ 27 ].

VR also provides the opportunity for students to construct and practice their own knowledge by being able to engage in meaningful experiences. Students are able to immersively engage in educational activities and gain a better understanding of the topic at hand [ 28 ]. VR also has the capability of transporting students to different environments, allowing them to learn and explore various concepts safely and efficiently. This can be especially useful to demonstrate environments that are impossible to visit in reality, such as underwater or space [ 29 , 30 ].

Mixed reality can be considered an extended VR application, which can be applied to real learning environments, such as exploring laboratory experiments [ 31 ]. Students can wear an HMD that shows information and instructions about the laboratory they will experience and can interact with items in reality to recreate what is simulated to them in VR. Essentially, students are still fully aware of their surroundings while also having a better visual understanding and representation of their task, which can help reduce mistakes, allow students to be more independent, and keep students interested and engaged.

With the start of the COVID-19 pandemic, there has been a sudden increase in virtual learning, with many classes being held via online meeting platforms and others being fully asynchronous. VR offers a new, unique approach to asynchronous learning; VR can create a learning environment in which a student can participate in lectures and ask questions to virtual instructors with pre-generated answers [ 32 ]. It is particularly important for students to feel immersed in the virtual environment in order to keep them engaged [ 33 ]. Virtual environments can be created to look just like real-life classrooms where students can walk around and work with other students on assignments [ 34 ]. The issue with asynchronous classroom experiences is that not all of a student’s questions will necessarily be answered; information will be limited to what is currently updated within the virtual experience. Thus, VR-based virtual education does provide a better experience to students than watching videos online, but it cannot replace the experience of being in a classroom with teachers who can directly engage with students.

With VR technology further advancing, VR could also be used for live, synchronous classes where students can engage with classmates and teachers from the comfort of their homes in real time. This would have been especially beneficial when schools were closed due to the pandemic, but it can also provide a way for students to attend classes while experiencing health difficulties, traveling, or living in other countries, etc. Even though live classes have not yet really been held using VR, such applications can be developed in the future, especially with some of the current development being made in both asynchronous learning and social interaction.

3.3. Public Health

Another domain in which VR has been utilized is within public health and wellness. Due to the immersive nature of VR, it can be used to simulate experiences that can directly impact people’s health. Some examples include providing immersive training simulations to medical personnel, offering a new method of exercise or meditation, and presenting therapists with opportunities to better help and understand their patients.

3.3.1. Medical Training

VR simulations provide the opportunity for medical professionals to practice procedures before operating on a patient, which has proven to help provide patients with better outcomes more consistently and reduce the incidence of mistakes. Preparation and practice in VR help improve patient outcomes because medical personnel are better prepared for each patient’s unique circumstances before operating [ 35 , 36 ].

In terms of learning how to perform procedures, medical students can train in an interactive virtual environment that can be programmed with different scenarios, which allows a student to experience real-life scenarios with virtual patients [ 37 ]. The virtual environment can be programmed in a multitude of diverse ways so the student can be prepared and better accustomed to different types of scenarios they may face with future patients. The simulation can be programmed so that a video can be played, showing how to effectively use a tool or object when the user looks at it [ 38 ]. The simulation can also provide hints or step-by-step instructions to students so they know how to perform the surgery properly. All these practices are much more hands-on than reading a textbook and more realistic than practicing on mannequins with minimal risks to a real patient, which makes VR a perfect tool to assist student learning.

Medical students are not the only ones who can benefit from VR simulations; seasoned medical professionals and surgeons can also benefit from this technology. Patient-specific virtual reality simulations (PSVR) are a technology that allows doctors to practice actual upcoming operations in VR [ 39 ]. This technology allows surgeons to practice customized procedures to match their patients’ specific needs and circumstances. A patient’s medical history and physical attributes can be created in the simulation and programmed with the most likely outcomes. When a surgeon performs a task or action in the simulation, the appropriate or most likely reaction can be programmed to simulate what would occur in real life under the same circumstance. This provides an opportunity for surgeons to plan out their surgery beforehand in a virtual environment, allowing them to be better prepared and more confident in their plan for the surgery ahead [ 40 ].

3.3.2. Exergaming, Fitness and Sports

With the initial focus of VR being on gaming, developers saw an opportunity for the emergence of a genre of games called exergames, in which users participate in physical activities to achieve the goals of the game. “The core concept of exergaming rests on the idea of using vigorous body activity as the input for interacting with engaging digital game content with the hope of supplanting the sedentary activity that typifies traditional game interaction that relies on keyboards, gamepads, and joysticks” [ 41 ]. VR games tend to fall under the category of exergames by requiring the user to stand up and move around in order to interact with the environment. Games such as Beat Saber (Beat Games, Prague, Czech Republic) make the user move around frequently to fulfill the game’s requirements.

Using VR as a workout tool helps gamify exercise, which can greatly assist users in staying motivated and engaged by providing them with goals to achieve during their workout. A study performed by Segura-Orti on dialysis patients shows that patients that used VR exercises instead of conventional physical activities had an increased level of physical activity compared to those who worked out using conventional methods [ 42 , 43 ]. This is probably due to the more enjoyable experience of getting exercise in game form that real life has failed to achieve with exercise apps and challenges. Some current examples include the implementation of treadmills and stationary bicycles with VR applications that allow users to physically run/cycle in place while virtually traveling through a virtual environment. These types of immersive experiences can make users’ workouts more enjoyable and can help encourage those new to fitness to start exercising from home in a new and exciting fashion.

VR technology is also being utilized in sports, where it is used to train athletes to improve their skills and can help provide them with physical therapy and rehabilitation. In terms of athletic training, VR presents a great method of perceptual-cognitive skills training [ 44 ], where users are able to experience and learn from video-based playback in an immersive environment rather than on a screen. This can be especially useful in customizing training for players in large team sports, such as football, basketball, or soccer [ 45 ]. VR allows individuals to repeatedly practice skills with lower risks of harm, which helps reduce injury. When injuries do occur in the real world, VR can be used in the rehabilitation process by allowing athletes to train from anywhere and at any time, even in the absence of a trainer or facility.

3.3.3. Therapy and Meditation

Another use of VR is in mental health therapy and meditation. The immersive nature of VR provides the flexibility to create various types of environments or experiences. Accordingly, VR can be used to experience situations that are hard to come by in real life, or that can be dangerous to go through in real life. For example, for those who suffer from post-traumatic stress disorder (PTSD), VR can be a way to experience situations that can trigger traumatic events within a safe, controlled capacity. Specific scenarios can be recreated in a virtual environment, and the patient can experience them in the presence of a therapist in order to receive help dealing with their trauma [ 46 ]. This type of therapy is similar to exposure therapy, in which patients confront what triggers them in order to slowly heal from their trauma [ 47 ].

For people who have certain disorders that may be hard to explain with words, VR can be a safe way to put people in scenarios that may trigger their disorders and observe their behaviors. Allowing a therapist to observe the situation can give them a better insight into why their patient is reacting in a certain way, which will allow them to better treat their patient [ 48 ].

Another application of VR is to use the immersive nature of the technology for meditation purposes. With the ability to experience a calm virtual environment that fully blocks distractions, VR presents a unique form of meditation that may be otherwise difficult to achieve at home. Studies on the use of VR in meditation have shown a slight increase in positive effects and a state of mindfulness in users after the meditation experience [ 49 ]. One study showed that VR meditation was more successful in reducing pre-exam anxiety in college students than watching a meditation video, where 71% of those using VR reported lower anxiety levels compared to 47% of the control group [ 50 ]. VR mediation has been shown to be useful in calming healthcare workers, especially during the COVID-19 pandemic. Virtual reality plus neurofeedback (VR + NF) meditation was shown to decrease the user’s anger, tension, depression, vigor, fatigue, and confusion [ 51 ]. Navarro-Haro et al. experienced an immersive VR mediation simulation and reported an increase in mindfulness and a reduction in negative emotional stress [ 52 ]. They were also less sad and less angry after the simulation. Mediation experts acknowledge that meditation with VR can be an immensely helpful and unique experience that is not yet fully utilized, and studies such as the one discussed here show promising results for this use of VR.

3.4. Social Interaction

VR provides the ability to transport users to a virtual environment in which they can interact with other users. This provides an opportunity to create social connections that may otherwise be hard to create or maintain. Social interaction via VR can be especially helpful for those with autism, as it provides a way for them to practice their communication skills. Users are able to participate in virtual cognition training to better improve their social skills, such as emotion recognition, social attribution, and analogical reasoning [ 53 ]. There are even programs in which young adults with high-functioning autism can participate that are designed with the purpose of increasing their social skills. These programs train users to better recognize facial expressions, body language, and emotions from a person’s voice [ 54 ]. These programs have lasting effects on the users, as they gain the ability to recognize other people’s emotions within the training that they can carry forward in their lives.

Social virtual reality also provides a new way for people to connect over long distances. Virtual spaces can be created in a VR environment and allow users to interact with each other in a realistic setting; users can have realistic avatars and talk to each other as if they were face-to-face [ 55 ]. This method of communication can be as effective as talking to another person in real life as long as the users feel immersed in the environment. When the users are immersed in the virtual environment, they have a better sense of presence, and their responses are more genuine [ 56 ]. This was especially popular during the COVID-19 pandemic when social distancing and travel restrictions made it much harder for people to see and speak with their loved ones [ 57 ]. Being able to attend events and experience activities with others via VR has provided a substitute for real-life interactions that is more realistic than merely speaking over the phone or via video chat [ 58 ].

3.5. Entertainment

The most prominent application of VR among the general public is within the sphere of entertainment, with VR offering new ways for users to experience several types of media in an immersive capacity.

One such form of media consumption within VR is watching movies, shows, or videos. VR offers new ways for users to experience visual media due to its ability to immerse users in a virtual world. VR displays are able to play 360° videos and allow the users to move around in the virtual environment, which provides the user with a more immersive experience and allows them to interact with the world as they see fit [ 59 ]. Users now have more control over what they want to pay attention to in a video and can experience videos in a whole new way.

Another application is virtual travel and tourism. Virtual tourism allows users to experience immersive tourism in simulated environments based on real landscapes or locations. This can make travel attainable to many people that would otherwise not be able to afford the time or money needed to physically visit faraway destinations. Examples of VR tourism include virtual museum visits, navigating areas using applications such as Google Street View, and virtual tours of popular destinations such as the Grand Canyon or the Great Wall of China. The concept of virtually visiting other countries or worlds has existed since the 90s [ 60 ], but there was a boost in interest recently due to travel constraints during the COVID-19 pandemic [ 61 ], with more people seeking travel experiences from the confines of their homes.

Live music is another form of entertainment that seems to be gaining traction as another large application of VR. Virtual reality has the ability to change the way people experience concerts, offering users the ability to attend and enjoy concerts from anywhere in the world. Prerecorded concerts are already available as a VR experience, with videos of the concerts filmed in 360 using omnidirectional cameras, allowing users to move their heads around and feel like they are physically present at the concert [ 62 ]. This can be an opportunity for users who do not have the ability to travel or could not get tickets to still enjoy the show. This will also allow users to see parts of the concert they could not see even if they were there due to cameras either being positioned on stage or close to the stage. The livestreaming of concerts in VR is still not technologically applicable, but it seems like the music industry is aiming to make it a reality at some point in the future with further VR development. As part of the most significant applications of VR, gaming has gained huge popularity recently, with headsets becoming more accessible and game developers investing more in the VR landscape. Many users have purchased VR headsets to play popular games such as Beat Saber , Super-Hot , and Job Simulator (Menlo Park, Prague, Czech Republic), some of the top-selling VR games. Besides designated VR games, many other games that were not initially made for VR are also being developed to include this capability and expand the options gamers have concerning their in-game experience. The rise of VR gaming popularity in recent years owes to the immersive capabilities of HMDs to immerse the users in the game environment, blocking out all external distractions [ 63 ] and giving the users a better sense of presence [ 64 ]. Players can experience the game from their point of view, which allows users to experience games in a whole new way [ 65 ].

4. Limitations and Side Effects of VR

Despite VR being a powerful and versatile tool, current VR technology has some evident limitations and drawbacks. These limitations include technological limits on what VR can do, how accessible VR is to the general public, and some of the side effects of using VR devices.

4.1. Technological Limitations

As a technology still in the earlier stages of development on a grand scale, VR has made significant leaps in evolution. Still, more substantial progress must occur before VR can be fully utilized in all possible applications and purposes.

Right now, the standardization of VR technology and presentation is still limited [ 66 ]; every developer may have their own interface specifications and functionality associated with their technology, and applications are not easily transferable between devices. The only standardization that can be observed as of now tends to be with popular games that are developed to be used across different VR platforms. It is also hard to troubleshoot bugs and receive proper support for any issues due to the lack of standardization. Hopefully, with time and progress in VR development, the technology can become more streamlined and provide better usability for users and transferability between devices. There are currently efforts to standardize VR, but these efforts are new, and the process is still in its infancy [ 67 ].

Other issues include hardware and software requirements for professional VR development, as most VR development software tends to take up a lot of data space on computers and have high-power consumption [ 68 ]. VR headsets also tend to be very heavy and can cause physical strain on users, causing headaches and pain, especially around the neck and shoulders [ 69 ]. As of now, it is not yet known what kind of detrimental effects VR use will have on users’ eyesight, but it is known that it can cause strain, especially with prolonged usage [ 70 ].

Another common issue is the lag between the user’s movements and the visual display within a VR headset [ 71 ]. A lot of the time, the headset’s tracking does not keep up properly with the user’s movements, which not only decreases their immersion but can also cause dizziness or “cybersickness,” which is explained in more detail below [ 71 , 72 ].

Cybersickness

One of the crucial issues with VR usage is VR-induced motion sickness, or “cybersickness” [ 73 , 74 ]. Cybersickness is a phenomenon where users will feel symptoms similar to motion sickness (i.e., nausea, dizziness, lightheadedness) as a result of using a VR device [ 71 ]. It is not yet known exactly why this occurs, but there are a few theories to explain this phenomenon. The most likely theory is known as the “sensory conflict theory,” which states that the excessive mismatch between the motion a user perceives visually and the lack of the corresponding movement in their body causes a conflict [ 71 , 72 , 75 ]. This happens when there is a disparity between the user’s visual system and vestibular system, which is the sensory system responsible for providing the brain with information about motion, head position, and spatial orientation [ 76 ]. Another explanation for cybersickness is the “ecological hypothesis”, which states that when people are not able to perceive or react to new dynamic situations, postural instability occurs [ 77 ].

Cybersickness does not always come with virtual experiences, but the issue can be exacerbated by several factors. Some individual factors include prolonged VR exposure; the user’s predisposition to motion sickness, fatigue, or nausea; and how adapted a user is to VR applications [ 71 , 78 ]. Cybersickness symptoms also seem to be less frequent when users are sitting instead of standing. Symptoms tend to worsen when a user is experiencing a high-speed simulation or game. Being a passive participant makes users more susceptible to symptoms than when they are in control of the simulation [ 71 , 79 , 80 ].

There are also some technical factors that can increase the likelihood of cybersickness occurring. These issues include noticeable lags (delays in the visual display can cause symptoms), position tracking errors (better head tracking reduces symptoms), and flicker in the visual display [ 71 , 72 ].

Cybersickness is one of the most uncomfortable issues that comes with VR usage, and if users continue to experience these uncomfortable symptoms, this can present a huge hindrance to the widespread development and utilization of VR applications [ 72 , 77 ].

4.2. Accessibility

As VR technology evolves, it is becoming more accessible, especially compared to its earlier stages. The cost of VR headsets on the market is still higher than most people can afford, but their current pricing is on par with most gaming consoles. Headsets such as Oculus Quest 2 cost about $300 for the base model and can be fully operated without the need for a computer, making it one of the more accessible headsets on the market. Most other headsets require using a computer that is “VR-ready”, meaning a high-end computer with a powerful graphics card that can manage VR applications. VR-ready computers tend to be more expensive than most computers, making this type of VR headset more expensive overall and out of reach for most people. This makes cost one of the larger barriers for people to get into VR as regular consumers, which is a hindrance to the growth of VR as a household technology.

VR as a field also includes augmented reality (AR) and mixed reality (XR), which are less immersive forms of virtual experiences where users still operate in the real world with a virtual overlay. AR and XR applications are more accessible to people due to their development for use on mobile devices, which are much more common with most people owning or having access to one. A common example of this type of application is AR games such as the popular Pokémon Go , which combines using a smartphone with a physical exploration of the real world [ 81 ] in search of “Pokémon” around them that can only be observed via their phones. Distances are tracked based on a user’s steps, and users can connect fitness apps to the game in order to increase rewards gained from crossing long distances. These types of games and applications can encourage people to be more physically active by gamifying the walking experience [ 82 ]. Similar smartphone games and applications can be a more accessible entry point for people interested in VR but who lack the funds to invest in an immersive headset and computer setup.

5. Conclusions

This literature review has shown how virtual reality technology has the potential to be a greatly beneficial tool in a multitude of applications and a wide variety of fields. Current applications span different domains such as engineering, education, medicine, and entertainment. With VR technology gaining popularity and traction, more VR applications can be further utilized in the future, both in improving current use cases as well as expanding to more domains. The hope is that with more VR technological breakthroughs and development, the current limitations and issues can be overcome, making long-term VR usage more realistic and accessible to more people.

Overall, VR as a technology is still in its early stages, but more people are becoming interested in it and are optimistic about seeing what kind of changes VR can make in their everyday lives. However, more and more application scenarios are under development by experts from different fields, which allows for more specific applications and development. With how rapidly modern society has adapted to personal computers and smartphones, VR has the opportunity to become the next big technological turning point that will eventually become commonplace in most households.

Funding Statement

This research received no external funding.

Author Contributions

Conceptualization, A.H. and B.J. methodology, A.H. and B.J. validation, B.J.; formal analysis, A.H.; investigation, A.H.; resources, A.H.; data curation, A.H.; writing—original draft preparation, A.H.; writing—review and editing, B.J.; visualization, A.H.; supervision, B.J. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Data availability statement, conflicts of interest.

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Baltimore bridge collapse: a bridge engineer explains what happened, and what needs to change

Associate Professor, Civil Engineering, Monash University

Disclosure statement

Colin Caprani receives funding from the Department of Transport (Victoria) and the Level Crossing Removal Project. He is also Chair of the Confidential Reporting Scheme for Safer Structures - Australasia, Chair of the Australian Regional Group of the Institution of Structural Engineers, and Australian National Delegate for the International Association for Bridge and Structural Engineering.

Monash University provides funding as a founding partner of The Conversation AU.

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When the container ship MV Dali, 300 metres long and massing around 100,000 tonnes, lost power and slammed into one of the support piers of the Francis Scott Key Bridge in Baltimore, the bridge collapsed in moments . Six people are presumed dead, several others injured, and the city and region are expecting a months-long logistical nightmare in the absence of a crucial transport link.

It was a shocking event, not only for the public but for bridge engineers like me. We work very hard to ensure bridges are safe, and overall the probability of being injured or worse in a bridge collapse remains even lower than the chance of being struck by lightning.

However, the images from Baltimore are a reminder that safety can’t be taken for granted. We need to remain vigilant.

So why did this bridge collapse? And, just as importantly, how might we make other bridges more safe against such collapse?

A 20th century bridge meets a 21st century ship

The Francis Scott Key Bridge was built through the mid 1970s and opened in 1977. The main structure over the navigation channel is a “continuous truss bridge” in three sections or spans.

The bridge rests on four supports, two of which sit each side of the navigable waterway. It is these two piers that are critical to protect against ship impacts.

And indeed, there were two layers of protection: a so-called “dolphin” structure made from concrete, and a fender. The dolphins are in the water about 100 metres upstream and downstream of the piers. They are intended to be sacrificed in the event of a wayward ship, absorbing its energy and being deformed in the process but keeping the ship from hitting the bridge itself.

The fender is the last layer of protection. It is a structure made of timber and reinforced concrete placed around the main piers. Again, it is intended to absorb the energy of any impact.

Fenders are not intended to absorb impacts from very large vessels . And so when the MV Dali, weighing more than 100,000 tonnes, made it past the protective dolphins, it was simply far too massive for the fender to withstand.

Read more: I've captained ships into tight ports like Baltimore, and this is how captains like me work with harbor pilots to avoid deadly collisions

Video recordings show a cloud of dust appearing just before the bridge collapsed, which may well have been the fender disintegrating as it was crushed by the ship.

Once the massive ship had made it past both the dolphin and the fender, the pier – one of the bridge’s four main supports – was simply incapable of resisting the impact. Given the size of the vessel and its likely speed of around 8 knots (15 kilometres per hour), the impact force would have been around 20,000 tonnes .

Bridges are getting safer

This was not the first time a ship hit the Francis Scott Bridge. There was another collision in 1980 , damaging a fender badly enough that it had to be replaced.

Around the world, 35 major bridge collapses resulting in fatalities were caused by collisions between 1960 and 2015, according to a 2018 report from the World Association for Waterborne Transport Infrastructure. Collisions between ships and bridges in the 1970s and early 1980s led to a significant improvement in the design rules for protecting bridges from impact.

Further impacts in the 1970s and early 1980s instigated significant improvements in the design rules for impact.

The International Association for Bridge and Structural Engineering’s Ship Collision with Bridges guide, published in 1993, and the American Association of State Highway and Transporation Officials’ Guide Specification and Commentary for Vessel Collision Design of Highway Bridges (1991) changed how bridges were designed.

In Australia, the Australian Standard for Bridge Design (published in 2017) requires designers to think about the biggest vessel likely to come along in the next 100 years, and what would happen if it were heading for any bridge pier at full speed. Designers need to consider the result of both head-on collisions and side-on, glancing blows. As a result, many newer bridges protect their piers with entire human-made islands.

Of course, these improvements came too late to influence the design of the Francis Scott Key Bridge itself.

Lessons from disaster

So what are the lessons apparent at this early stage?

First, it’s clear the protection measures in place for this bridge were not enough to handle this ship impact. Today’s cargo ships are much bigger than those of the 1970s, and it seems likely the Francis Scott Key Bridge was not designed with a collision like this in mind.

So one lesson is that we need to consider how the vessels near our bridges are changing. This means we cannot just accept the structure as it was built, but ensure the protection measures around our bridges are evolving alongside the ships around them.

Second, and more generally, we must remain vigilant in managing our bridges. I’ve written previously about the current level of safety of Australian bridges, but also about how we can do better.

This tragic event only emphasises the need to spend more on maintaining our ageing infrastructure. This is the only way to ensure it remains safe and functional for the demands we put on it today.

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The world is driven by liquid-vapor phase change

Uc engineering professor gets nsf career award to fund research on liquid films.

University of Cincinnati professor Kishan Bellur is captivated by evaporation — a phenomenon that is happening all the time, all around us, but few of us notice. Most liquid surfaces, for example, water in a test tube, are not flat. There is a slight curvature to it called the meniscus. As the liquid evaporates, it climbs up the side of the tube forming a very thin liquid film that is hard to see with the naked eye. Understanding the evaporation process and the behavior of these films are the focus of Bellur's latest research. 

Kishan Bellur. Photo/Corrie Mayer/CEAS Marketing

Bellur, an assistant professor of mechanical engineering, received the highly regarded National Science Foundation CAREER Award to fund his research on the behavior of thin evaporating liquid films for the next five years. 

Scientists are interested in studying these films because of their unique properties. Despite appearing to be stable, they actually dance around or oscillate, triggered by different factors, all of which result in a transfer of energy. This oscillation under the right conditions can move the meniscus, causing the liquid to shift up or down.

"The connection between the thin film and the rest of the meniscus is relatively unknown. That is the focus of the project," Bellur said. "We are running experiments and doing computer modeling to connect the currently unknown pieces of all length scales — from thin films to the bulk menisci." 

During his doctoral studies, Bellur became interested in thin films while studying storage and evaporation of liquid hydrogen (rocket fuel) at extremely low temperatures. He realized that as hydrogen evaporates inside spacecraft tanks, it wicks up the sides of the wall and forms a thin liquid film that can oscillate. By delving deeper into the properties of these films and the wicking behaviors, a realization dawned on him. 

"Digging deeper into why these films oscillate, it turns out the film stability is all about a mismatch between the evaporation and condensation process," Bellur said. 

Kishan Bellur became interested in thin films during his doctoral studies. Photo/Corrie Mayer/CEAS Marketing

Evaporation is a very energy intensive process. To evaporate something, heat is applied, however, the temperature remains constant. This is one of those unique processes where heat transport does not require a temperature change. Additionally, the thin film, where much of this evaporation takes place, covers an extremely small area, making it a very efficient heat transfer mechanism in terms of square footage. Bellur and his team at the UC Lab for Interfacial Dynamics  are studying how they can leverage these behaviors to develop better, more efficient heat transfer devices and make make advancements in space technology, hydrogen energy, and advanced manufacturing. 

Paired with the research Bellur and his team are conducting, this NSF award also focuses on education and outreach. When Bellur was walking around a local farmers market, a realization struck him: phase change and fluid dynamics are key ingredients in cooking. 

Scientific principles are all around the kitchen. For instance, the bubbling dynamics of boiling water to cook pasta, the heat transfer processes when baking a cake, the reaction of baking powder when added to a recipe; these are all examples of seemingly simple cooking tasks that are grounded in science. In short, the kitchen is a laboratory that is used by almost everyone. 

Graduate students in Kishan Bellur's lab participate in meaningful research under his guidance. Photo/Corrie Mayer/CEAS Marketing

Bellur and his engineering undergraduate students are partnering with the Hyde Park Farmers Market in Cincinnati to set up a booth with demonstrations to showcase the science happening in the kitchen with marketgoers. 

"I realized we could use the humble kitchen as an accessible personal laboratory to teach people about basic scientific principles," Bellur said. 

The goal of this outreach is to educate the public on scientific principles that are occurring in daily life and inspire them to think about science. 

In addition to the NSF CAREER project, Bellur is also involved with many facets of space research including that on the International Space Station. Currently through an NSF and Center for Advancement of Science in Space program, he is working on a unique sensor module to gather new data from a boiling and condensation experiment on the ISS. Bellur is also funded through the NASA Physical Sciences Informatics program wherein he and his team are extracting unique insights from data gathered in prior ISS experiments. 

Bellur advocates for undergraduate student research and fosters student development through various programs such as NSF Research Experiences for Undergraduates and the Louis Stokes Alliance for Minority Participation . 

Featured image at top: Kishan Bellur received the prestigious National Science Foundation CAREER Award for his research on thin liquid films. Photo/Corrie Mayer/CEAS Marketing

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University of Cincinnati professor Kishan Bellur is captivated by evaporation - a phenomena that is happening all the time, all around us, but few of us notice. Most liquid surfaces, for example, water in a test tube, are not flat. There is a slight curvature to it called the meniscus. As the liquid evaporates, it climbs up the side of the tube forming a very thin liquid film that is hard to see with the naked eye. Understanding the evaporation process and the behavior of these films are the focus of Bellur's latest research.

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The Five Minutes That Brought Down the Francis Scott Key Bridge

When a massive cargo ship lost power in Baltimore, crews scrambled to control the ship and to evacuate the bridge lying ahead. But it was too late.

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By Annie Correal ,  Nicholas Bogel-Burroughs ,  Campbell Robertson ,  Michael Forsythe and Mike Baker

Nicholas Bogel-Burroughs and Campbell Robertson reported from Baltimore, Annie Correal and Michael Forsythe from New York, and Mike Baker from Seattle.

Follow our live coverage of the Francis Scott Key Bridge collapse in Baltimore .

“Hold all traffic on the Key Bridge.”

The terse command from an officer in Baltimore’s busy commercial shipping port was one of the first warnings of a disaster that experts now predict will transform shipping on the Eastern Seaboard and change how ships and bridges function around the world. But after the cargo ship Dali lost power early Tuesday, there were precious few minutes to act.

In those minutes, many people — from the ship’s crew, who sent out a mayday signal, to the transportation authority police officers, who stopped traffic heading onto the Francis Scott Key Bridge — did what they could to avert catastrophe, most likely saving many lives.

And yet — no matter what anyone did — several factors made catastrophe all but inevitable. When a ship of this size loses engine power, there is little to be done to correct its course, even dropping an anchor down. And the Key Bridge was particularly vulnerable. As long ago as 1980, engineers had warned that the bridge, because of its design, would never be able to survive a direct hit from a container ship.

The collision and subsequent collapse of the bridge swallowed up seven road workers and an inspector who could not be alerted and pulled off the bridge in time; two were pulled alive out of the water, but four others are still missing and presumed dead. Two bodies were retrieved on Wednesday, authorities said.

Also caught up in the disaster were the ship’s 21 crew members, all from India, who had prepared for a long journey to Sri Lanka on the Dali. While none of them were hurt, they would be held on board for more than a day as the ship sat in the harbor, the ruins of the bridge tangled around it, as authorities began their investigation.

The accident, the deadliest bridge collapse in the United States in more than a decade, will have a lasting impact on the Port of Baltimore, with its 8,000 workers, and industries that rely on the port, which is the leading American hub for auto and other wheeled equipment, said Pete Buttigieg, the U.S. transportation secretary, on Wednesday.

“It’s difficult to overstate the impact of this collision,” Mr. Buttigieg said.

He compared the Dali, roughly as long a city block, to the size of an American aircraft carrier.

“A hundred thousand tons, all going into this pier all at once,” he said of the impact on the bridge support structure.

Officials from the National Transportation Safety Board, which is leading the investigation into the accident, boarded the Dali on Tuesday night to gather documentation. They obtained data from the voyage data recorder, the equivalent of an aircraft’s black box, hoping that it could help investigators determine what led to the accident.

Mr. Buttigieg said that any private party found liable in the accident “will be held responsible.”

The ship left the Port

of Baltimore around

1 a.m. on Tuesday.

Ship called for

tugboats to return

Francis Scott

Alarms sounded on ship

Traffic onto bridge was halted

The ship hit

at 1:28 a.m.

Alarms sounded

Traffic onto bridge

Sources: MarineTraffic, Google Earth

By Agnes Chang, Weiyi Cai, and Leanne Abraham

It was about half an hour past midnight on Tuesday when the Dali, loaded with cargo containers, departed its dock, guided by two tugboats, as is customary. On board was a local harbor pilot with more than 10 years of experience and deep familiarity with Baltimore’s port, as well as an apprentice pilot in training.

The sky above the Patapsco River was clear and still, lit by a full moon.

At 1:25 a.m., after the two tugboats detached and turned back, the Dali had accelerated to about 10 miles per hour as it approached the Key Bridge. But just then, according to a timeline released by the National Transportation Safety Board on Wednesday, “numerous audible alarms” started sounding on the ship.

For reasons still being investigated, the ship’s powerful propulsion system stopped. The lights flickered out.

The ship had a “complete blackout,” according to Clay Diamond, head of the American Pilots’ Association, who was briefed on the account of the pilot of the Dali. (The chair of the N.T.S.B., Jennifer Homendy, said officials were still trying to determine whether the power failure was complete.)

The harbor pilot noticed the ship starting to swing right, in the direction of one of the piers holding up the Key Bridge. At 1:26, he called for the tugs to return; he urged the captain to try to get the engine back up and directed the crew to steer hard left. As a last ditch measure, at 1:27, he ordered the crew to throw down the port anchor.

One of the tugboats, the Eric McAllister, turned around and raced back toward the ship.

But the failures onboard were cascading. The emergency generator had kicked on, sending a puff of thick smoke belching from the ship’s exhaust stack and briefly restoring the lights, radar and steering. It did not help. With no effective propulsion, the 95,000-ton ship had become an unstoppable object, drifting toward one of the most heavily traveled bridges in Baltimore.

On land, officers with the Maryland Transportation Authority moved swiftly into action. “I need one of you guys on the South side, one of you guys on the North side, hold all traffic on the Key Bridge,” someone is heard saying on the audio recording of emergency radio traffic that night. “There’s a ship approaching that just lost their steering. So until they get that under control, we’ve got to stop all traffic.”

Vehicles were held on either side of the bridge as the ship continued its inexorable drift toward the 1.6-mile-long span.

A minute later, the officers turned their attention to several workers, some of them immigrants from Guatemala, Honduras, El Salvador and Mexico, who were still laboring on the bridge in the chilly darkness, taking advantage of the light traffic at night to fix potholes.

“There’s a crew up there,” one officer is heard saying on the audio recording of the radio exchange between officers. “You might want to notify whoever the foreman is, see if we could get them off the bridge temporarily.”

But even then, the ship was striking the bridge. Almost at once, the pier buckled and collapsed, twisting over the ship, with its cargo containers stacked high on the deck. Then the rest of the bridge went, breaking into sections as it plummeted and splashed into the dark river waters below.

“The size and weight of these ships make them really difficult, even with propulsion, to stop them,” said Stash Pelkowski, a professor at State University of New York Maritime College and a retired Coast Guard rear admiral. With no power, he said, “There was very little the pilot or the crew on the Dali could do.”

The collapse had happened in seconds. Except for the stumps of the piers, the central span of the bridge had plunged into the frigid river — where divers would spend the whole day searching amid twisted metal for survivors — by 1:29 a.m.

“Dispatch, the whole bridge just fell down!” an officer called out. “Whoever, everybody, the whole bridge just collapsed.”

Stray ships had long been seen as a risk to the Key Bridge. Just a few years after the Baltimore structure was constructed in 1977, a vessel crash knocked down the Sunshine Skyway Bridge in Tampa Bay, Fla., killing 35 people.

Officials acknowledged that the Key Bridge would not be able to withstand that kind of direct hit from a heavy cargo vessel. “I would have to say if that ship hit the Bay Bridge or the Key Bridge — I’m talking about the main supports, a direct hit — it would knock it down,” John Snyder, the director of engineering for the state Toll Facilities Administration told the Baltimore Sun at the time.

But building a bridge that could withstand such an impact was simply not economically feasible, he said. When the bridge was built, cargo ships were not the size they are today. A much smaller freighter did hit the bridge in 1980 , but the bridge stood strong.

Minutes after the bridge collapsed on Tuesday, both tugboats that had accompanied the Dali arrived on scene, followed soon by the Coast Guard and the Baltimore City Fire Department.

Two of the workers who had been on the bridge were rescued from the water. The others could not be found.

Jack Murphy, who owns Brawner Builders, the company whose workers had been on the bridge, got a phone call about the collapse and raced to the area, about a 30-minute drive away. He stayed by the bridge all night, and eventually began making calls to the men’s families.

Two workers’ bodies were discovered in a red pickup truck found near the bridge debris, police said Wednesday. They were identified as Alejandro Hernandez Fuentes, 35, an immigrant from Mexico, and Dorlian Ronial Castillo Cabrera, 26, a native of Guatemala.

About two miles from the bridge, Andrew Middleton had been lying awake when he heard the crash. He first thought it was thunder, maybe a low-flying jet.

It was only when he awoke a few hours later that he saw the news of the collapsed bridge. “I thought to myself, I was just with those guys yesterday,” he said.

Mr. Middleton, who runs Apostleship of the Sea, a program that ministers to sailors coming through the port, had driven the ship’s captain and a few crew members to Walmart on Monday to stock up on goods for the 28-day voyage ahead — toothpaste, snacks, clothes, Bluetooth speakers.

He recalled the captain telling him their next port was Sri Lanka, but that they were taking a longer route, down around South Africa, in order to avoid recent Houthi attacks on cargo ships in the Red Sea.

Mr. Middleton immediately messaged the crew on WhatsApp after hearing the news on Tuesday, he said, and “they responded within a few minutes saying that everyone was OK,” he said.

Around the site of the bridge collapse, firefighters and rescuers in diving gear were swarming around the shore, followed by news crews. John McAvoy, who owns a nearby restaurant, had driven over with hot meals — chicken, crab balls and pretzel bites — to hand out to the crews.

But by nightfall on Tuesday, officials had called off the rescue efforts and said they would switch to searching for bodies. “The water’s deep, visibility’s low, it’s cold as I-don’t-know-what,” said Kevin Cartwright, a spokesman for the Fire Department.

The signs of all that had changed were only starting to become clear on Wednesday. The U.S. Army Corps of Engineers said it was mobilizing more than 1,100 specialists to clear the wreckage of the bridge and unblock the Port of Baltimore’s shipping lane. In the meantime, Mr. Buttigieg, the secretary of transportation, said the East Coast would have to rely more heavily on ports outside Baltimore.

Mr. McAvoy said the tragedy would ripple over the port for years.

Fishing crews always have found their way home following the Key Bridge, he said. “It’s going to change a lot of things for a lot of people.”

Reporting was contributed by Daniel Victor , Jacey Fortin , Zach Montague , Eduardo Medina , Miriam Jordan and Judson Jones . Susan C. Beachy contributed research.

Annie Correal reports from the U.S. and Latin America for The Times. More about Annie Correal

Nicholas Bogel-Burroughs reports on national stories across the United States with a focus on criminal justice. He is from upstate New York. More about Nicholas Bogel-Burroughs

Campbell Robertson reports on Delaware, the District Columbia, Kentucky, Maryland, Ohio, Pennsylvania and Virginia, for The Times. More about Campbell Robertson

Michael Forsythe a reporter on the investigations team at The Times, based in New York. He has written extensively about, and from, China. More about Michael Forsythe

Mike Baker is a national reporter for The Times, based in Seattle. More about Mike Baker