It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
The oceans are full of living things, with microscopic algae (phytoplankton) at the base of the marine food chain. These organisms make a living in the same way as land plants, using the sunlight that penetrates the upper 100 meters or so of the ocean as the energy source by which they synthesise organic matter for their cells. Every year, these tiny algae make about as much organic carbon as land plants. Like land plants, they obtain the building blocks of their cells from the surrounding environment – not a soil in this case but the seawater solution they live in.
But unlike the land ecosystem, when these algae die, they fall into the dark deep ocean, where their dead cells decay due to the action of bacteria. Therefore, the elements they need to grow are lost from the part of the ocean in which they live, and go back into seawater solution in the deep ocean. Somehow these elements must be returned from the deep ocean again to the surface where the whole cycle can begin again. The elements these organisms need are the same as on land – carbon of course, nitrogen and phosphorous - the elements that are applied to agricultural land in fertilisers - and the many metals that all life requires, like iron, zinc and others.
Phytoplankton are important for our climate because the carbon they remove from the surface ocean is removed from contact with the atmosphere into the deep ocean, keeping atmospheric carbon dioxide lower than it would otherwise be. In the discussion of strategies to mitigate current and future CO2rise, one option is to massively increase the rate at which oceanic algae do all this.
But, in fact, the rate at which they do it depends on the availability in the seawater solution of “nutrient” elements – the nitrogen, phosphorous and trace metals that are very scarce in the upper sunlit ocean. So, how these elements are removed from the upper ocean and recycled back there from the deep is crucial for how the past, current and future climate of the Earth operates.
In the new paper, ETH Zurich researchers lead by geochemist Derek Vance have used tracers of ocean chemistry to discover that a substantial proportion of many of the metals are, in fact, removed quickly and permanently from the seawater solution by a process other than biology: by incorporation into solid manganese-oxide particles that precipitate from seawater and which fall all the way through the ocean into the sediment at the bottom.
But they have also discovered that the metals are returned to the deepest seawater by chemical reactions that take place in the sediment and that release the metals from the solid manganese oxide, back into solution. Finally, we have used a numerical model of the transport physics in the ocean to show that the metals released to solution within the sediment, and that leak across the interface between the sediment and the deep ocean, are mixed back up through the ocean.
“Our study changes how we view ocean chemistry, and its impact on ocean biology and climate”, Derek Vance says. For the first time, it shows that leakage of material that was once thought to be permanently lost from the oceans to the solid sediment at the bottom is crucial to how researchers think about the seawater solution and the many elements it contains that are crucial to how ocean biology works.
Reference
Du J, Haley BA, McManus J, Blaser P, Rickli J, Vance D: Abyssal seafloor as a key driver of ocean trace-metal biogeochemical cycles, Nature (2025), doi: 10.1038/s41586-025-09038-3
Scans of the painting during various stages in its restoration. At left is the damaged piece, with the middle panel showing a map of the different kinds of damage present; green lines show full splits in the underlying panel support, thin red lines depict major paint craquelure, blue areas correspond to large paint losses, while pink regions show smaller defects like scratches. At right is the restored painting with the applied laminate mask.
Art restoration takes steady hands and a discerning eye. For centuries, conservators have restored paintings by identifying areas needing repair, then mixing an exact shade to fill in one area at a time. Often, a painting can have thousands of tiny regions requiring individual attention. Restoring a single painting can take anywhere from a few weeks to over a decade.
In recent years, digital restoration tools have opened a route to creating virtual representations of original, restored works. These tools apply techniques of computer vision, image recognition, and color matching, to generate a “digitally restored” version of a painting relatively quickly.
Still, there has been no way to translate digital restorations directly onto an original work, until now. In a paper appearing today in the journal Nature, Alex Kachkine, a mechanical engineering graduate student at MIT, presents a new method he’s developed to physically apply a digital restoration directly onto an original painting.
The restoration is printed on a very thin polymer film, in the form of a mask that can be aligned and adhered to an original painting. It can also be easily removed. Kachkine says that a digital file of the mask can be stored and referred to by future conservators, to see exactly what changes were made to restore the original painting.
“Because there’s a digital record of what mask was used, in 100 years, the next time someone is working with this, they’ll have an extremely clear understanding of what was done to the painting,” Kachkine says. “And that’s never really been possible in conservation before.”
As a demonstration, he applied the method to a highly damaged 15th century oil painting. The method automatically identified 5,612 separate regions in need of repair, and filled in these regions using 57,314 different colors. The entire process, from start to finish, took 3.5 hours, which he estimates is about 66 times faster than traditional restoration methods.
Kachkine acknowledges that, as with any restoration project, there are ethical issues to consider, in terms of whether a restored version is an appropriate representation of an artist’s original style and intent. Any application of his new method, he says, should be done in consultation with conservators with knowledge of a painting’s history and origins.
“There is a lot of damaged art in storage that might never be seen,” Kachkine says. “Hopefully with this new method, there’s a chance we’ll see more art, which I would be delighted by.”
Digital connections
The new restoration process started as a side project. In 2021, as Kachkine made his way to MIT to start his PhD program in mechanical engineering, he drove up the East Coast and made a point to visit as many art galleries as he could along the way.
“I’ve been into art for a very long time now, since I was a kid,” says Kachkine, who restores paintings as a hobby, using traditional hand-painting techniques. As he toured galleries, he came to realize that the art on the walls is only a fraction of the works that galleries hold. Much of the art that galleries acquire is stored away because the works are aged or damaged, and take time to properly restore.
“Restoring a painting is fun, and it’s great to sit down and infill things and have a nice evening,” Kachkine says. “But that’s a very slow process.”
As he has learned, digital tools can significantly speed up the restoration process. Researchers have developed artificial intelligence algorithms that quickly comb through huge amounts of data. The algorithms learn connections within this visual data, which they apply to generate a digitally restored version of a particular painting, in a way that closely resembles the style of an artist or time period. However, such digital restorations are usually displayed virtually or printed as stand-alone works and cannot be directly applied to retouch original art.
“All this made me think: If we could just restore a painting digitally, and effect the results physically, that would resolve a lot of pain points and drawbacks of a conventional manual process,” Kachkine says.
“Align and restore”
For the new study, Kachkine developed a method to physically apply a digital restoration onto an original painting, using a 15th-century painting that he acquired when he first came to MIT. His new method involves first using traditional techniques to clean a painting and remove any past restoration efforts.
“This painting is almost 600 years old and has gone through conservation many times,” he says. “In this case there was a fair amount of overpainting, all of which has to be cleaned off to see what’s actually there to begin with.”
He scanned the cleaned painting, including the many regions where paint had faded or cracked. He then used existing artificial intelligence algorithms to analyze the scan and create a virtual version of what the painting likely looked like in its original state.
Then, Kachkine developed software that creates a map of regions on the original painting that require infilling, along with the exact colors needed to match the digitally restored version. This map is then translated into a physical, two-layer mask that is printed onto thin polymer-based films. The first layer is printed in color, while the second layer is printed in the exact same pattern, but in white.
“In order to fully reproduce color, you need both white and color ink to get the full spectrum,” Kachkine explains. “If those two layers are misaligned, that’s very easy to see. So I also developed a few computational tools, based on what we know of human color perception, to determine how small of a region we can practically align and restore.”
Kachkine used high-fidelity commercial inkjets to print the mask’s two layers, which he carefully aligned and overlaid by hand onto the original painting and adhered with a thin spray of conventional varnish. The printed films are made from materials that can be easily dissolved with conservation-grade solutions, in case conservators need to reveal the original, damaged work. The digital file of the mask can also be saved as a detailed record of what was restored.
For the painting that Kachkine used, the method was able to fill in thousands of losses in just a few hours. “A few years ago, I was restoring this baroque Italian painting with probably the same order magnitude of losses, and it took me nine months of part-time work,” he recalls. “The more losses there are, the better this method is.”
He estimates that the new method can be orders of magnitude faster than traditional, hand-painted approaches. If the method is adopted widely, he emphasizes that conservators should be involved at every step in the process, to ensure that the final work is in keeping with an artist’s style and intent.
“It will take a lot of deliberation about the ethical challenges involved at every stage in this process to see how can this be applied in a way that’s most consistent with conservation principles,” he says. “We’re setting up a framework for developing further methods. As others work on this, we’ll end up with methods that are more precise.”
This work was supported, in part, by the John O. and Katherine A. Lutz Memorial Fund. The research was carried out, in part, through the use of equipment and facilities at MIT. Nano, with additional support from the MIT Microsystems Technology Laboratories, the MIT Department of Mechanical Engineering, and the MIT Libraries.
###
Written by Jennifer Chu, MIT News
Journal
Nature
Article Title
“Physical restoration of a painting with a digitally-constructed mask”
New virtual reality training tool combats contamination of portable medical equipment
Mass General Brigham-developed VR training modules incorporate gamification; clinicians at seven facilities in pilot study found modules enjoyable
A screengrab of the VR training module showing infection risks on portable medical equipment. The training module incorporates gamification to engage learners.
Infection control researchers at Mass General Brigham have developed a virtual reality (VR) tool to train clinicians on core concepts in infection control, including cleaning and disinfecting portable medical equipment, to prevent the spread of infections throughout healthcare facilities. They successfully piloted the VR training tool at seven facilities across the United States, and their hope is such training can increase staff competency and improve patient safety. The work is published in Infection Control & Hospital Epidemiology.
“Devices such as blood pressure cuffs, glucometers, and portable imaging machines are everywhere in healthcare, and study after study has shown healthcare is failing at cleaning and disinfecting them, leading to risk of healthcare-associated infections,” said senior author Erica S. Shenoy, MD, PhD, chief of Infection Control for Mass General Brigham. “We know that when core infection control practices are correctly and consistently applied, the risk to patients is reduced; but we also know that the way we have been teaching these practices for decades is not delivering.”
Healthcare-associated Infections affect 1-in-31 patients, result in almost 100,000 deaths annually, and incur $28.4 billion in direct medical costs. Up to 75% of these infections are preventable through implementation of core infection prevention practices. Studies have reported between 25% to 100% of portable medical equipment to be contaminated and shared portable medical equipment has been implicated in transmission of healthcare-associated infections.
Shenoy and her colleagues developed an immersive VR module that uses head-mounted displays and guides learners through a simulated inpatient healthcare environment. The module incorporates gamification and visualization of invisible contamination, where learners review and apply cleaning and disinfection concepts to two different devices: a vital signs machine and a point-of-care ultrasound machine.
“We wanted clinicians to be able to ‘see the unseen’ risk and be completely immersed in a way that could lead to improved knowledge and skills when back in the real world,” explained Shenoy.
In the study’s initial phase, 31 participants were trained and provided feedback, which was used to revise the training module. Then, an additional 44 participants tried the revised module, 39 of whom (88.6%) reported an overall positive experience. Survey comments from learners often touted their enjoyment of the immersive and virtual, hands-on environment of the platform. While half reported negative physical sensations (motion sickness is common among new VR users), only a few participants reported module challenges, such as difficulty with transporting portable medical equipment, donning and doffing their virtual gloves, or understanding instructions.
Additional research is underway and has moved beyond user experience and acceptability to focus on testing learners’ knowledge, skills, and competency after training with the VR module.
“In busy, complex healthcare settings, a new kind of training is needed that increases muscle memory for these core infection control practices,” said Shenoy. “Maybe not surprising, but certainly encouraging to our team, was that learners expressed joy and excitement for the training. We know that when learners are engaged, they are more likely to retain the information.”
Authorship: Additional Mass General Brigham co-authors include Esteban A. Barreto, PhD, MA, Michelle S. Jerry, BS, Vianelly GarcÃa, MPH, Chloe V. Green, Andrea S. Greenfield, MSN, CIC, and Eileen F. Searle, PhD, RN. Disclosures: The authors declare no relevant conflicts of interest. Funding: This work was supported by a cooperative agreement from the Centers for Disease Control and Prevention (CDC), CK22-2203. The CDC was not involved in preparation, submission, or review of the manuscript Paper cited: Barreto E. et al. “A Virtual Reality Training Pilot Study for Cleaning and Low-Level Disinfection of Portable Medical Equipment”” Infection Control & Hospital Epidemiology DOI: 10.1017/ice.2025.89
This survey study found that after Dobbs, 42% of survey respondents who provided abortions in states banning abortion relocated to another state. Almost all clinicians who relocated from any policy context relocated to states not banning abortion.
Corresponding Author: To contact the corresponding author, Dana Howard, PhD, email dana.howard@osumc.edu.
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
Journal
JAMA Network Open
Feedback for surgeons curbs excess opioid prescriptions scripts
Penn study shows providing tailored data improves prescribing, maintains patient comfort
PHILADELPHIA— Tailored feedback to surgeons dramatically cuts excessive opioid prescriptions for common surgeries, aligning them with evidence-based guidelines without affecting patient pain control. This approach offers a promising strategy to combat the opioid crisis by aligning prescribing practices with evidence-based guidelines, addressing the critical issue of overprescribing, where excessive opioid prescriptions can lead to harmful side effects and can lead to dependence in some patients or diversion of unused pills. The findings, by researchers in the Perelman School of Medicine at the University of Pennsylvania, were published today in JAMA Surgery.
The study leveraged behavioral science and patient-reported data to nudge surgeons and supporting nurse practitioners and physician assistants to compare their prescribing practices with those of colleagues prescribing after similar procedures throughout their health system, offering a scalable model that could transform pain management while prioritizing patient safety and comfort.
“This work moves us closer to personalized pain management,” said M. Kit Delgado, MD, MS, director of the Nudge Unit, Co-Chair of the Penn Medicine Opioid Task Force, and an associate professor of Emergency Medicine. “By right sizing opioid prescriptions based on patient needs by procedure, we’re lowering the risk of harms while ensuring patients get the care they need.”
Driven by Patient Feedback Over the past five years, the Center for Insights to Outcomes at Penn Medicine developed a text-messaging system to track patients’ pain and opioid use, revealing that patients often used far fewer pills than prescribed—for example, only 10 of 30 pills for procedures like knee surgery. This data informed the trial’s guidelines and feedback approach.
“What’s powerful about this approach is that it gives surgeons actionable data they can control,” said Anish Agarwal, MD, MPH, chief wellness officer in the Department of Emergency Medicine and deputy director of the Center for Insights to Outcomes. “We saw every group improve, which was surprising and exciting.”
The trial provided surgical prescribers with data comparing their opioid prescribing to peer averages, Penn Medicine’s patient-informed guidelines. An innovative aspect of the feedback was also showing data on how many pills patients take on average after a given procedure and how well they did with managing their pain if they received a prescription within the guideline recommend amount. Conducted across multiple high-volume surgical divisions, the study showed that when surgeons had this data, there was a substantial increase in guideline adherence, and less overprescribing. Before they had the data, 60% of prescriptions for patients in the control group exceeded recommendations. Notably, these improvements were sustained even after feedback stopped, and patients’ pain scores remained unchanged, ensuring effective pain management.
The study was partially funded by the US Food and Drug Administration (HHSF223201810209C) and a philanthropic grant from the Abramson Family Foundation.
### Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, excellence in patient care, and community service. The organization consists of the University of Pennsylvania Health System (UPHS) and Penn’s Raymond and Ruth Perelman School of Medicine, founded in 1765 as the nation’s first medical school.
The Perelman School of Medicine is consistently among the nation's top recipients of funding from the National Institutes of Health, with $580 million awarded in the 2023 fiscal year. Home to a proud history of “firsts,” Penn Medicine teams have pioneered discoveries that have shaped modern medicine, including CAR T cell therapy for cancer and the Nobel Prize-winning mRNA technology used in COVID-19 vaccines.
The University of Pennsylvania Health System cares for patients in facilities and their homes stretching from the Susquehanna River in Pennsylvania to the New Jersey shore. UPHS facilities include the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, Chester County Hospital, Doylestown Health, Lancaster General Health, Princeton Health, and Pennsylvania Hospital—the nation’s first hospital, chartered in 1751. Additional facilities and enterprises include Penn Medicine at Home, GSPP Rehabilitation, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.
Penn Medicine is an $11.9 billion enterprise powered by nearly 49,000 talented faculty and staff.
