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Investigation. Il manifesto uncovered a high number of errors — or frauds — in research substantially led by Health Minister Orazio Schillaci using AI image software called ImageTwin.

Understanding the edited images and recycled research that Schillaci signed

Reusing the same microscope image to illustrate completely different things in a scientific publication inevitably calls its validity into question, although it doesn’t necessarily signal fraud. It can happen to anyone to mix up two files by mistake.

However, when the same mistake is happening too often, this should set off alarm bells for those in charge of a lab: there might be one particular researcher who is either too distracted or dishonest, unless, that is, the whole team is colluding to commit outright fraud.

After all, image recycling is one of the most frequently used methods for faking scientific research. The temptation to resort to it comes when an experiment has not yielded the desired result, or hasn’t been carried out at all: instead of admitting failure, a dishonest researcher might pretend that things have gone right after all, using as evidence an image that was obtained in a completely different context, modified so as to obscure this fact.

The likelihood that someone will check and discover the misdeed is very low: this takes rather sophisticated computer tools, which are available to few researchers and are little used by the scientific journals themselves.

To identify the anomalies in the publications of the research group led by Minister Schillaci, il manifesto used the software called ImageTwin. This software, developed by an Austrian startup, is able to use artificial intelligence to compare a particular image with a database of tens of millions of images used in the scientific literature in a matter of seconds, identifying any duplicates, including if digital retouching was applied.

We found at least a dozen suspicious images in publications dating from the 2018-2022 period, when the current minister was first dean of the Faculty of Medicine at Tor Vergata University and then rector of the university.

Many of the publications deal with a sensitive topic: cancer diagnosis and treatment. The most egregious case is found in an article published in 2021 in the Journal of Clinical Medicine by the group led by Schillaci (who, in the text of the article, claims responsibility for its supervision, conception, methodology and drafting), in which an image of prostate cancer cells is featured. However, that same image had already been used in another 2019 publication in the International Journal of Molecular Sciences, again bearing the name of the minister – but here it supposedly depicted breast cancer cells. For that article, Schillaci claimed responsibility for validating the data and revising the text.

But the trail goes even further: it turns out that the 2019 article also recycled a microscope image that it claimed was of bone cells from metastases generated by breast cancer; however, the original image was taken from an article on bones that had nothing to do with breast cancer (nor any connection to Minister Schillaci).

In other suspicious cases, the same image is used twice in the same article to illustrate different phenomena, edited as necessary. This can be seen in a 2018 publication in the journal Contrast Media & Molecular Imaging under the name of Schillaci and his team, where the same image is used to illustrate prostate cancer cells in metastatic patients and – after an enlargement that makes it visually unrecognizable – in nonmetastatic patients as well.

The same phenomenon occurs in a study published in 2019 in the Journal of Clinical Medicine for which the minister is credited with conception, validation, supervision and drafting, and where the same image is used twice to illustrate two different experiments.

In another article in Applied Sciences (2021), there is a side-by-side comparison supposedly between cells subjected to early drug treatment and untreated cells. However, the images used for the two experiments are actually the same image, cropped differently. For this article, Schillaci was also in charge of data management, as well as the design and supervision of the study, and he is also listed as the “corresponding author,” i.e., the researcher to be contacted for any further inquiries (usually the one who is most familiar with the research).

Digital analysis reveals more duplicate images: in the journal Cancer Research Reports in 2020 and in a 2020 issue of the Journal of Clinical Medicine. As it happens, the last article in which the same microscope image is used to show different phenomena dates back to 2022, a few months before Schillaci left the position of rector for the portfolio of Health Minister: it was published in the journal Molecular and Cellular Biochemistry. For this work, Minister Schillaci is listed as the originator, supervisor, author of the first draft, and responsible for data management.

Contacted by il manifesto, one of the scientists in Schillaci’s group, a co-author of all the publications in question, readily admitted the errors when confronted with the evidence, but claimed they were nothing more than accidental mishaps that are always possible in such cases.

The Health Minister responded to us as follows: “This is the first time I’m hearing about this news, I had no knowledge of it. I am not an expert in electron microscopy, I trusted the person who provided those images. We will check if there are indeed errors.”

It’s not possible to determine who was the material author of the errors or manipulations. However, the rules of the scientific community are clear: those who lead a team of researchers and put their names to their publications bear the onus of ensuring their authenticity.

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