3D printing might save your life one day. It's transforming medicine and health care.
What can 3D printing do for medicine? The "sky is the limit," says Northwell Health researcher Dr. Todd Goldstein.
- Medical professionals are currently using 3D printers to create prosthetics and patient-specific organ models that doctors can use to prepare for surgery.
- Eventually, scientists hope to print patient-specific organs that can be transplanted safely into the human body.
- Northwell Health, New York State's largest health care provider, is pioneering 3D printing in medicine in three key ways.
Imagine that a health emergency strikes and you need an organ transplant – say, a heart. You get your name on a transplant list, but you find out there's a waiting period of six months. Tens of thousands of people find themselves in this dire situation every year. But 3D printing has the potential to change that forever.
The technology could usher in a future where transplantable organs can be printed not only cheaply, but also to the exact anatomical specifications of each individual patient.
What other innovations could 3D printing bring to medicine and health care? The sky is the limit, according to Dr. Todd Goldstein, a researcher with the corporate venturing arm of Northwell Health, New York State's largest health care provider and an industry leader in 3D-printing research and development.
"It comes down to what people can think up and dream up what they want to use 3D printing for," Goldstein says. "Ideally, you would hope that 50 years from now you'd have on-demand, 3D printing of organs."
While that's still on the horizon for researchers, 3D printing is already improving lives by revolutionizing medicine in three key areas.
Printing realistic, customized organ models
3D printers can take images from MRI, PET, sonography or other technologies and convert them into life-size, three-dimensional models of patients' organs. These models serve as hands-on visualization tools that help surgeons plan the best approaches for complex procedures.
They also allow doctors to customize patient-specific models prior to surgery. For example, Northwell employs 3D printing in several clinical applications:
- Tumor resection models clearly highlight the tumor and surrounding tissue
- Orthopedic models are useful for pre-surgery measuring and medical device adjustments
- Vascular models identify malformations in organs, tumors, sliced chambers, blood flow, valves, muscle tissue, and calcifications
- Dentistry oral implants and appliances can be created in just one day, significantly reducing wait periods for Northwell dentists and their patients
Using realistic models not only delivers better health results but also shortens operating times. That gives patients less time under anesthesia, and hospitals potential savings of millions of dollars over just a few years.
Being able to visualize procedures before they occur also helps to comfort patients and their families. Take, for instance, the case of Barnaby Goberdhan, a man who discovered that his young son, Isaiah, had an aggressive tumor in his palate. Goberdhan met with Neha A. Patel, MD, a pediatric otolaryngologist at Cohen Children's Medical Center, a Northwell Health hospital, to discuss the procedure and learn about it with help from a 3D-printed model.
"Having a 3D printed depiction of my son was really helpful when talking with the doctor about his surgery," said Mr. Goberdhan. "The doctor was able to do more than talk me through what they were going to do – Dr. Patel showed me. There is almost nothing more frightening and stressful than having your child go through surgery. There were several options Dr. Patel walked us through for the best way to preserve Isaiah's teeth and prevent additional cuts within his mouth. I wanted all of my questions answered so I could be less fearful and more prepared to talk my son through what he was about to face. I wanted Isaiah to feel prepared. With the 3D model, we both felt more at ease."
For years, 3D printing surgical models was prohibitively expensive. Now, more affordable systems such as Formlabs' Form Cell give more hospitals across the country access to the technology in order to produce realistic, patient-specific models, usually within one day.
Credit: Northwell Health
While 3D-printed organs are a long way in the future, today's technology is well suited for manufacturing prosthetics. 3D-printed prosthetics are often remarkably more affordable and personalized than their traditional counterparts. That's a big deal for many families, especially those with children who outgrow prosthetics and are forced to buy new ones.
One recent breakthrough in 3D-printed prosthetics came when Dan Lasko, a former Marine who lost the lower part of his left leg in Afghanistan, wanted the ability to swim with his prosthetic leg. Wearing prosthetics in water has been possible for years, but they typically slow swimmers down. No device had been able to go seamlessly from land to water or to help propel its wearer through the water.
To fix that, Northwell Health recently funded a project that developed The Fin – the world's first truly amphibious prosthetic. With The Fin, Lasko and his family can go straight into the pool from the locker room – or the diving board.
"I got back in the pool with my two young sons and for the first time was able to dive into the pool with them," Lasko said.
3D-printed prosthetics will help improve the daily lives of the nearly 2 million Americans who've lost a limb. That's promising because the increasing prevalence of Type 2 diabetes is expected to greatly increase the number of amputees in the U.S., according to a study published in the Archives of Physical Medicine and Rehabilitation.
For years, 3D printers have manufactured various products: phone cases, toys, and even operational guns. To produce these objects, the machines heat a raw material, typically plastic, and build the object layer-by-layer according to a particular design.
3D bioprinting, a young field developed by researchers with Northwell Health, may someday perform the same process but instead with living cells in a raw material called bioink.
Daniel A. Grande, director at the Orthopedic Research Laboratory in the Feinstein Institute for Medical Research, an arm of Northwell Health, said he and his team first pursued 3D bioprinting by modifying 3D printers so they'd accept living cells.
"My initial concept of 3D printing was early studies that looked at modifying ink-jet printers, where we incorporate a bioink that includes cells within a delivery vehicle," Grande says. "That hydrogel can then be polymerized, or hardened, upon heat or UV-light stimulation, so that we can actually make a complex structure, three-dimensionally, that incorporates living cells. The hardened hydro-gel is then able to keep the cells alive and viable. It's also biocompatible, so it can be safely implanted in humans."
It's a promising enterprise, and it can radically change how we experience medical care.
"3D bioprinting's potential is almost limitless and has the potential to replace many different parts of the human body," says Michael Dowling, president and CEO at Northwell Health, and author of Health Care Reboot. "Researchers envision a future with 3D printers in every emergency room, where doctors are able to print emergency implants of organs and bones on demand and revolutionize the way medicine is practiced."
Dr. Todd Goldstein explains more about 3D bioprinting below:
New research suggests you can't fake your emotional state to improve your work life; you have to feel it.
What is deep acting?<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTQ1NDk2OS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNTY5MzA0Nn0._s7aP25Es1CInq51pbzGrUj3GtOIRWBHZxCBFnbyXY8/img.jpg?width=1245&coordinates=333%2C-1%2C333%2C-1&height=700" id="ddf09" class="rm-shortcode" data-rm-shortcode-id="9dc42c4d6a8e372ad7b72907b46ecd3f" data-rm-shortcode-name="rebelmouse-image" data-width="1245" data-height="700" />
Arlie Russell Hochschild (pictured) laid out the concept of emotional labor in her 1983 book, The Managed Heart.
(Photo: Wikimedia Commons)<p>Deep and surface acting are the principal components of emotional labor, a buzz phrase you have likely seen flitting about the Twittersphere. Today, "<a href="https://www.bbc.co.uk/bbcthree/article/5ea9f140-f722-4214-bb57-8b84f9418a7e" target="_blank">emotional labor</a>" has been adopted by groups as diverse as family counselors, academic feminists, corporate CEOs, and each has redefined it with a patented spin. But while the phrase has splintered into a smorgasbord of pop-psychological arguments, its initial usage was more specific.</p><p>First coined by sociologist Arlie Russell Hochschild in her 1983 book, <a href="https://www.ucpress.edu/book/9780520272941/the-managed-heart" target="_blank"><em>The Managed Heart</em></a>, emotional labor describes the work we do to regulate our emotions on the job. Hochschild's go-to example is the flight attendant, who is tasked with being "nicer than natural" to enhance the customer experience. While at work, flight attendants are expected to smile and be exceedingly helpful even if they are wrestling with personal issues, the passengers are rude, and that one kid just upchucked down the center aisle. Hochschild's counterpart to the flight attendant is the bill collector, who must instead be "nastier than natural."</p><p>Such personas may serve an organization's mission or commercial interests, but if they cause emotional dissonance, they can potentially lead to high emotional costs for the employee—bringing us back to deep and surface acting.</p><p>Deep acting is the process by which people modify their emotions to match their expected role. Deep actors still encounter the negative emotions, but they devise ways to <a href="http://www.selfinjury.bctr.cornell.edu/perch/resources/what-is-emotion-regulationsinfo-brief.pdf" target="_blank">regulate those emotions</a> and return to the desired state. Flight attendants may modify their internal state by talking through harsh emotions (say, with a coworker), focusing on life's benefits (next stop Paris!), physically expressing their desired emotion (smiling and deep breaths), or recontextualizing an inauspicious situation (not the kid's fault he got sick).</p><p>Conversely, surface acting occurs when employees display ersatz emotions to match those expected by their role. These actors are the waiters who smile despite being crushed by the stress of a dinner rush. They are the CEOs who wear a confident swagger despite feelings of inauthenticity. And they are the bouncers who must maintain a steely edge despite humming show tunes in their heart of hearts.</p><p>As we'll see in the research, surface acting can degrade our mental well-being. This deterioration can be especially true of people who must contend with negative emotions or situations inside while displaying an elated mood outside. Hochschild argues such emotional labor can lead to exhaustion and self-estrangement—that is, surface actors erect a bulwark against anger, fear, and stress, but that disconnect estranges them from the emotions that allow them to connect with others and live fulfilling lives.</p>
Don't fake it till you make it<p>Most studies on emotional labor have focused on customer service for the obvious reason that such jobs prescribe emotional states—service with a smile or, if you're in the bouncing business, a scowl. But <a href="https://eller.arizona.edu/people/allison-s-gabriel" target="_blank">Allison Gabriel</a>, associate professor of management and organizations at the University of Arizona's Eller College of Management, wanted to explore how employees used emotional labor strategies in their intra-office interactions and which strategies proved most beneficial.</p><p>"What we wanted to know is whether people choose to engage in emotion regulation when interacting with their co-workers, why they choose to regulate their emotions if there is no formal rule requiring them to do so, and what benefits, if any, they get out of this effort," Gabriel said in <a href="https://www.sciencedaily.com/releases/2020/01/200117162703.htm" target="_blank">a press release</a>.</p><p>Across three studies, she and her colleagues surveyed more than 2,500 full-time employees on their emotional regulation with coworkers. The survey asked participants to agree or disagree with statements such as "I try to experience the emotions that I show to my coworkers" or "I fake a good mood when interacting with my coworkers. Other statements gauged the outcomes of such strategies—for example, "I feel emotionally drained at work." Participants were drawn from industries as varied as education, engineering, and financial services.</p><p>The results, <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Fapl0000473" target="_blank" rel="noopener noreferrer"><em>published in the Journal of Applied Psychology</em></a>, revealed four different emotional strategies. "Deep actors" engaged in high levels of deep acting; "low actors" leaned more heavily on surface acting. Meanwhile, "non-actors" engaged in negligible amounts of emotional labor, while "regulators" switched between both. The survey also revealed two drivers for such strategies: prosocial and impression management motives. The former aimed to cultivate positive relationships, the latter to present a positive front.</p><p>The researchers found deep actors were driven by prosocial motives and enjoyed advantages from their strategy of choice. These actors reported lower levels of fatigue, fewer feelings of inauthenticity, improved coworker trust, and advanced progress toward career goals. </p><p>As Gabriel told <a href="https://www.psypost.org/2021/01/new-psychology-research-suggests-deep-acting-can-reduce-fatigue-and-improve-your-work-life-59081" target="_blank" rel="noopener noreferrer"><em>PsyPost</em> in an interview</a>: "So, it's a win-win-win in terms of feeling good, performing well, and having positive coworker interactions."</p><p>Non-actors did not report the emotional exhaustion of their low-actor peers, but they also didn't enjoy the social gains of the deep actors. Finally, the regulators showed that the flip-flopping between surface and deep acting drained emotional reserves and strained office relationships.</p><p>"I think the 'fake it until you make it' idea suggests a survival tactic at work," Gabriel noted. "Maybe plastering on a smile to simply get out of an interaction is easier in the short run, but long term, it will undermine efforts to improve your health and the relationships you have at work. </p><p>"It all boils down to, 'Let's be nice to each other.' Not only will people feel better, but people's performance and social relationships can also improve."</p>
You'll be glad ya' decided to smile<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="88a0a6a8d1c1abfcf7b1aca8e71247c6"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/QOSgpq9EGSw?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>But as with any research that relies on self-reported data, there are confounders here to untangle. Even during anonymous studies, participants may select socially acceptable answers over honest ones. They may further interpret their goal progress and coworker interactions more favorably than is accurate. And certain work conditions may not produce the same effects, such as toxic work environments or those that require employees to project negative emotions.</p><p>There also remains the question of the causal mechanism. If surface acting—or switching between surface and deep acting—is more mentally taxing than genuinely feeling an emotion, then what physiological process causes this fatigue? <a href="https://www.frontiersin.org/articles/10.3389/fnhum.2019.00151/full" target="_blank">One study published in the <em>Frontiers in Human Neuroscience</em></a><em> </em>measured hemoglobin density in participants' brains using an fNIRS while they expressed emotions facially. The researchers found no significant difference in energy consumed in the prefrontal cortex by those asked to deep act or surface act (though, this study too is limited by a lack of real-life task).<br></p><p>With that said, Gabriel's studies reinforce much of the current research on emotional labor. <a href="https://journals.sagepub.com/doi/abs/10.1177/2041386611417746" target="_blank">A 2011 meta-analysis</a> found that "discordant emotional labor states" (read: surface acting) were associated with harmful effects on well-being and performance. The analysis found no such consequences for deep acting. <a href="https://doi.apa.org/doiLanding?doi=10.1037%2Fa0022876" target="_blank" rel="noopener noreferrer">Another meta-analysis</a> found an association between surface acting and impaired well-being, job attitudes, and performance outcomes. Conversely, deep acting was associated with improved emotional performance.</p><p>So, although there's still much to learn on the emotional labor front, it seems Van Dyke's advice to a Leigh was half correct. We should put on a happy face, but it will <a href="https://bigthink.com/design-for-good/everything-you-should-know-about-happiness-in-one-infographic" target="_self">only help if we can feel it</a>.</p>
Archaeologists discover a cave painting of a wild pig that is now the world's oldest dated work of representational art.
- Archaeologists find a cave painting of a wild pig that is at least 45,500 years old.
- The painting is the earliest known work of representational art.
- The discovery was made in a remote valley on the Indonesian island of Sulawesi.
Oldest Cave Art Found in Sulawesi<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="a9734e306f0914bfdcbe79a1e317a7f0"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/b-wAYtBxn7E?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
The Persian polymath and philosopher of the Islamic Golden Age teaches us about self-awareness.
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