Research Blog

Following the people and events that make up the research community at Duke

COVID and Our Education

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With mask mandates being overturned and numerous places going back to “normal,” COVID is becoming more of a subconscious thought. Now, this is not a true statement for the entire population, since there are people who are looking at the effects of the pandemic and the virus itself.

I attended a poster presentation for the “The Pandemic Divide” event hosted here at Duke by the Samuel Dubois Cook Center on Social Equity. To me, all the poster boards conveyed the theme of how COVID-19 had affected our lives in more ways than just our health. One connection that particularly caught my eye would be the one between American Education and COVID.

The poster for the conference

As a student who lived through COVID while attending high school, I can safely say that the pandemic has affected education. However, based on the posters I saw, it is important to know that education, too, has a strong and impactful impact on COVID-19.

Dr. Donald J. Alcendor after a great presentation

The first evidence I saw was from Donald J. Alcendor, an associate professor of microbiology and immunology at Meharry Medical College in Nashville. His poster was about the hesitancy surrounding COVID-19 vaccines. One way he and his team figured out to lessen the hesitance from the public was to improve the public’s trust. To achieve this, Alcendor and his team sent trusted messengers into the community. One of the types of messengers they provided was scientists who studied COVID-19. These scientists were able to bring factual information about the disease, how it spreads, and the best course of action to act against it. Alcendor and his research team also brought in “vaccine ambassadors” to the community and a mobile unit to help give the community vaccines. He noted that this was accomplished with support from the Bloomberg Foundation’s Greenwood Initiative, which addresses Black health issues.

With this mobile unit, Alcendor and his team were able to reach people and help those who were otherwise unable to receive help for themselves because of their lack of transportation. They provided people from all backgrounds with help and valuable information.

Alcindor said he and his team planned pop-up events based on where the community they were trying to reach congregates. With the African American community, he planned pop-up events at churches and schools. Then for the Latino community, he planned pop-events where families tend to gather, and he held events in Latin0 neighborhoods. In addition, he made sure that the information was available in Spanish at all levels, from the flyers and the surveys, to the vaccinators themselves.

All of these amenities that he and his group provided were able to educate the community about COVID-19 and improve their trust in the scientists working on the disease. Alcendor and his team were able to impact COVID-19 through education, and by going to the event, it was evident to me that he was not the only one who accomplished this.

Dr. Colin Cannonier and his poster

Colin Cannonier, an associate professor of economics at Belmont University in Nashville, asked and answered the question, “does education have an impact on COVID? Specifically, does it change health and wellbeing?” To answer this question, he researched how education about COVID can affect a person. He discovered that when a person is more educated about COVID, how it is spread, and its symptoms, they are more likely to keep the pandemic in check through their behavior. He came to this conclusion because he realized that when higher educated people know more about COVID, they exhibit behaviors to remain healthy, meaning that they would follow the health protocols given by the health officials.

While this may seem like common sense that the more educated a person is, the more they make smart choices pertaining to COVID, this shows how important education is and how deadly ignorance is. Cannonier’s research gave tangible evidence to show that education is a weapon against diseases. Unfortunately, it is evident that some officials did not believe in educating the public about the virus or the virus itself, and that proved to be extremely deadly.

To fully capture the relationship between COVID and education, one must also talk about how COVID-19 affected education.

Ms. Stacey Akines and her wonderful poster

Stacey Akines, a history graduate student at Carnegie Mellon University, studied how education was changed by the pandemic.

First, she realized that COVID schooling crossed over with homeschooling. Then she uncovered that more Black people started to research and teach their children about Black history. This desire to teach youth more about their history caused an increase in the number of Black homeschoolers. In fact, the number of Black homeschoolers doubled during the fall of 2020. While to some, this change to homeschooling may have a negative impact on one’s life, it actually gives the student more opportunities to learn things.

It is no secret that there are many books being banned here in the U.S., and there are many state curriculums that are changing to erase much of Black history. Homeschooling a child gives the parent an opportunity to ensure that the education they receive is true to and tells their history

Unlike me, where during high school, education felt lackluster and limited because of COVID, some parents saw an opportunity to better their child’s education.

A hall of Posters

I hope that it is clear that the relationship between COVID and education is a complex one. Both can greatly impact each other, whether it’s for the better or for the worse. COVID thrives when we are uneducated, and it very nearly destroyed education too, but for the efforts of some dedicated educators.

Post by Jakaiyah Franklin, Class of 2025

A Peek Inside the Climate Situation (V)room

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As part of this year’s Energy Week at Duke, graduate and undergraduates were able to participate in a competitive “situation room” style event in which participants were split into five teams and given seventy-five minutes to create a plan for expanding EV (electric vehicle) access in Durham. 

For just over an hour in a Fuqua School of Business classroom, my fellow participants and I mulled over the complexities of an issue facing municipalities across the country and produced a variety of solutions, representative of the range of specialties within each group. One more CS-minded group proposed an app to both help residents locate charging stations and help the city collect data on the use of new EV infrastructure, while another group explored the technological and price saving perks of utility pole-mounted charging stations.

The resulting ideas were reviewed by a panel of judges who covered multiple areas of EV expertise: Jennifer Weiss, Senior Advisor for Climate Change Policy at the North Carolina Department of Transportation; Matt Abele, Director of Marketing and Communications at North Carolina Sustainable Energy Association; Sean Ackley, E-Mobility Segment Lead at Hitachi Americas, Ltd.; and Evian Patterson, Assistant Transportation Director in the Durham Department of Transportation.

The goal of Duke’s EnergyWeek is to “promote collaboration, knowledge-sharing, and professional networking” for students interested in the energy sector.  The situation room event was not strictly research oriented – our team rooms had windows and we were given free supper and lemonade – but it promoted the fundamentals of research: idea generation, collaboration, and outside-of-the-box thinking. 

The victors of the 2023 EnergyWeek Situation Room (photo: Michael Wood III)

The teams were tasked with crafting a strategy that combined technical, business, marketing, and policy considerations to increase EV penetration in Durham.  The teams operated under a hypothetical $10 million budget and strategies were to align with the Justice40 initiative, the federal plan to ensure that forty percent of the benefits of new clean transit jobs flow to “disadvantaged communities that are marginalized, underserved, and overburdened by pollution.”

Participants were encouraged to consider “potential barriers to EV adoption, the existing distribution of EV charging stations, and opportunities for community and business involvement” and to be creative.

My team was comprised of students from a range of scholarly backgrounds, from a freshman beginning a mechanical engineering track to a grad student at the Nicholas School with prior work and research in school bus electrification policy.  For our plan, we spent little time discussing electric cars and instead focused on expanding access to electric micro-mobility and electrified public transportation.  

Our team consulted this map from the Durham Bike+Walk Implementation plan in determining that electric cars are not a silver bullet
(map: durhamnc.gov)

We had many reasons for doing so.  Many Durham residents don’t own cars, so the likelihood of increasing the adoption of electric cars in a timely and affordable manner seems low.  Countries around the world are instead focusing on expanding e-bike access, citing, in addition to climate and affordability concerns, the desire to move away from the safety issues and traffic burden of car-centric urban design. 

We saw Durham, which is expected to double in population in just twenty-five years, as a city perfectly positioned to develop around micro-mobility and robust public transportation before it’s too late and set an example for growing urban centers across the country.  We used our $10 million to add bike lanes, fund electric buses, and subsidize electric bikes across income levels.

Our team placed second (no big deal!) and walked away with a full stomach and a rekindled spark to break the Duke bubble and get involved in the exciting development of the Bull City.

My winnings!
By Addie Geitner, Class of 2025

Why Do Some Dogs Need High Chairs, and How Can Genetics Help?

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Jake, a German shepherd dog in a Bailey chair. Dogs with megaesophagus must eat in a vertical position to help food travel to their stomachs.
Photo credit: Beth Grant

Some dogs have to eat in a high chair—or, more specifically, a Bailey Chair. The chair keeps them in a vertical position while they eat so that gravity can do the work their bodies can’t: moving food from the mouth to the stomach.

These dogs have megaesophagus, an esophagus disorder that can prevent dogs from properly digesting food and absorbing nutrients. When you swallow a bite of food, it travels down a muscular tube, the esophagus, to the stomach. In humans, the esophagus is vertical, so our esophageal muscles don’t have to fight against gravity. But because dogs are quadrupeds, a dog’s esophagus is more horizontal, so “there is a greater burden on peristaltic contractions to transport the food into the stomach.” In dogs with megaesophagus, the esophagus is dilated, and those contractions are less effective. Instead of moving properly into the stomach, food can remain in the esophagus, exacerbating the problem and preventing proper digestion and nutrient absorption. 

Leigh Anne Clark, Ph.D., an associate professor at Clemson University, recently spoke at Duke about megaesophagus in dogs and its genetic underpinnings. She has authored dozens of publications on dog genetics, including five cover features. Her research primarily involves “[mapping] alleles and genes that underlie disease in dogs.” In complex diseases like megaesophagus, that’s easier said than done. “This disease has a spectrum,” Clark says, and “Spoiler: that makes it more complicated to map.”

Clinical signs of megaesophagus, or mega for short, include regurgitation, coughing, loss of appetite, and weight loss. (We might use the word “symptom” to talk about human conditions, but “a symptom is something someone describes—e.g., I feel nauseous. But dogs can’t talk, so we can only see ‘clinical signs.’”) Complications of mega can include aspiration pneumonia and, in severe cases, gastroesophageal intussusception, an emergency situation in which dogs “suck their stomach up into their esophagus.”

Leigh Anne Clarke of Clemson University

Sometimes megaesophagus resolves on its own with age, but when it doesn’t it requires lifelong management. Mega has no cure, but management can involve vertical feeding, smaller and more frequent meals, soft foods, and sometimes medication. Even liquid water can cause problems, so some dogs with mega receive “cubed water,” made by adding a “gelatinous material” to water, instead of a normal water bowl.

In dogs, mega can be either congenital, meaning present at birth, or acquired. In cases of acquired megaesophagus, the condition is “usually secondary to something else,” and the root cause is often never determined. (Humans can get mega, too, but as with acquired mega in dogs, mega in humans is usually caused by a preexisting condition. The best human comparison, according to Clark, might be achalasia, a rare disorder that causes difficulty swallowing.) Clark’s current research focuses on the congenital form of the disease in dogs.

Her laboratory recently published a paper investigating the genetic foundation of mega. Unlike some diseases, mega isn’t caused by just one genetic mutation, so determining what genes might be at play required some genetic detective work. “You see mega across breeds,” Clark says, which suggests an environmental component, but the disease is more prevalent in some breeds than others. For instance, 28 percent of all diagnoses are in German shepherds. That was a “red flag” indicating that genes were at least partly responsible.

Clark and her collaborators chose to limit their research study to German shepherds. Despite including a wide range of dogs in the study, they noticed that males were significantly overrepresented. Clark thinks that estrogen, a hormone more abundant in females, may have a protective effect against mega.

Clark and her team performed a genome-wide association study (GWAS) to look for alleles that are more common in dogs with mega. One allele that turned out to be a major risk factor was a variant of the MCHR2 gene, which plays a role in feeding behaviors. In breeds where mega is overrepresented, like German shepherds, “we have a situation where the predominant allele in the population is also the risk allele,” says Clark.

Using the results of the study, they developed a test that can identify which version of the gene a given dog has. The test, available at veterinary testing companies, is designed “to help breeders reduce the frequency of the risk allele and to plan matings that are less likely to produce affected puppies.”

Post by Sophie Cox, Class of 2025

Duke’s Women Engineers Conquer a Texas-Sized Career Fair

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I never would have imagined a scenario where a blazer, a folder of 30 resumes, and a cowboy hat were all packed together in the same suitcase.

Yet these are the items I found sprawled across my floor on the eve of Wednesday, October 20, as I prepared to fly to Houston to attend the 2022 Society of Women Engineers Conference in Houston, Texas.

Members of the Duke Chapter of the Society of Women Engineers attend the annual conference in Houston, Texas. (I’m third from left in front row)

The Society of Women Engineers (SWE) is an international organization that empowers and advocates for women in engineering and technology. Founded in 1950, SWE is on a mission to establish engineering as an attractive profession to women, and provide the resources and opportunities necessary for them to pursue it. Through training programs, scholarships, and outreach, SWE builds leadership skills, creates opportunities, and promotes inclusion. The global network of women engineers across all ages and disciplines creates a valuable support system for underrepresented individuals in engineering.

The SWE conference is the world’s largest conference for women in engineering and technology. It has occurred on an annual basis ever since 1951 when the first convention was held in New York City. In the past few years, the SWE conference has been known to attract 8,000+ attendees, continuously growing and breaking attendance records.

Duke SWE members land in Houston airport after a three hour flight from Durham, eagerly anticipating the start of the conference the next morning.

Like many colleges, Duke has a SWE student chapter, and every year takes people to the national conference. This year, 22 students were able to attend the three-day conference, with their flights and hotel costs covered.

The weekend was full of inspirational keynote speakers, carefully crafted workshops, and endless opportunities to meet powerful and impressive female engineers from across the country. For the Duke students, the weekend was additionally a meaningful bonding experience, and a significant moment in the pursuit of our academic and professional goals.

For many attendees, the main event is the career fair, which takes place during the first and second days of the conference. Not having any experience at a nationwide conference, I was expecting an event similar to your average college career fair: cardboard posters on folding tables. This could not have been further from the truth for the SWE conference!

Companies had massive set-ups, towering displays, signs hanging from the ceiling, carpeting laid out underneath, tables and chairs, and a dozen employees representing the same company. The room itself was so big you couldn’t see one end from the other side. 

The career fair, which spans two days of the conference, is a main component of the conference for many attendees. With over 300 companies in attendance, there were plentiful opportunities for internships, jobs, and networking.

Crowds began to gather for half an hour before the fair began. Once the doors opened, the waves of people surged in and immediately dispersed, weaving between the booths and racing to their first destination. 

After separating from my peers and walking around a bit to get a feel for the environment, I gave myself a pep talk, pulled one resume out of my folder, and walked up to my first booth. After scanning a QR code to register, I was asked about my major and then directed to the right employee to talk to.

She scanned over my resume for about twenty seconds before slapping a post-it note on it, handing it to a man behind her, and instructing me to “go with him.”

Along with a few other nervous students, the man began leading us on a walk past all the booths. We reached the end of the room and kept walking, through a small opening in a big partition that stretched across the entire room. On the other side, we emerged into a much quieter atmosphere: an equally large room full not of booths, but of curtains. Dozens of rows of small rooms, created by curtain partitions, were set up for each company. After being directed to yet another person, I was brought inside one of the ominous curtain rooms for a spontaneous 15 minute interview.

I had heard from peers that on-site interviews are often conducted, but I was not prepared for the spontaneous and vastly accelerated nature of the process. After the interview, I was released back into the career fair to race to the next booth.

Almost every student left the conference with some level of success.

Throughout the day, constant messages were shot through various group chats announcing updates, interviews, new contacts, and other exciting revelations. It was easy to lose track of each other throughout the fair, but every notification felt like a wave of breaking news.

The conference is supposed to be an accelerated recruitment process – many people made connections or discovered opportunities that may lead to eventual jobs or internships. In an environment that was so uplifting and supportive of women, it was easy to celebrate each other’s victories, and be reminded that one person’s success was shared by all of us.

Duke women in engineering across grades and disciplines bond and relax over dinner after a long day at the conference.

While the first night at the hotel was spent mostly frantically preparing for interviews the next day, the second and third nights allowed plenty of time for group outings and exploring the city of Houston.

Whether looking for internships or full-time opportunities, female engineering students at Duke were brought together across grades and disciplines to share in an incredibly inspirational and memorable weekend. Through the highs and lows of the weekend, we were able to participate in the same shared experiences: stressing over interviews, navigating networking, and exploring our futures as engineers.

And, of course, one more extremely monumental memory from the trip was pretending to be part of a bachelorette party on the flight home (good thing we brought a cowboy hat!).

By Kyla Hunter, Class of ’23

Duke’s Most-Cited — The Scholars Other Scientists Look To

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It’s not enough to just publish a great scientific paper.

Somebody else has to think it’s great too and include the work in the references at the end of their paper, the citations. The more citations a paper gets, presumably the more important and influential it is. That’s how science works — you know, the whole standing-on-the-shoulders-of-giants thing.

So it always comes as a chest swelling affirmation for Dukies when we read all those Duke names on the annual list of Most Cited Scientists, compiled by the folks at Clarivate.

This year is another great haul for our thought-leaders. Duke has 30 scientists among the nearly 7,000 authors on the global list, meaning their work is among the top 1 percent of citations by scientific field and year, according to Clarivate’s Web of Science citation index.

As befits Duke’s culture of mixing and matching the sciences in bold new ways, most of the highly cited are from “cross-field” work.

Duke’s Most Cited Are:

Biology and Biochemistry

Charles A. Gersbach       

Robert J. Lefkowitz         

Clinical Medicine

Christopher Bull Granger             

Pamela S. Douglas           

Adrian F. Hernandez      

Manesh R. Patel               

Eric D. Peterson

Cross-Field

Chris Beyrer

Stefano Curtarolo

Renate Houts 

Tony Jun Huang  

Ru-Rong Ji

Jie Liu

Jason Locasale  

Edward A. Miao

David B. Mitzi    

Christopher B. Newgard

John F. Rawls   

Drew T. Shindell

Pratiksha I. Thakore       

Mark R. Wiesner              

Microbiology

Barton F. Haynes             

Neuroscience and Behavior

Quinn T. Ostrom              

Pharmacology and Toxicology

Evan D. Kharasch

Plant and Animal Science

Xinnian Dong    

Sheng Yang He                 

Psychiatry and Psychology

Avshalom Caspi

William E. Copeland

E. Jane  Costello               

Terrie E. Moffitt

Social Sciences

Michael J. Pencina          

John W. Williams              

Congratulations, one and all! You’ve done us proud again.

Truman Scholar Maya Durvasula, T’18, on her Research Journey Through Duke and Beyond

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Maya Durvasula, T’18, and a current Ph.D. student at Stanford University, grew up in Albuquerque, New Mexico. “And it’s hard to grow up there without a very keen sense of what it looks like when policy doesn’t work for people,” she remarks.

Maya Durvasula, T’18

After graduating high school with an interest in politics, she decided to take a gap year and bounced around organizations in New Mexico, working for the state legislature, political campaigns, and even a think tank. In hindsight, she says, “Having a block of time where you have time is super helpful.” One thing she learned was that she didn’t really want to do politics. “People were making policy, but debates were heavy on feelings and politics and light on facts.”

A high school mentor suggested that maybe she would get along better with economists than politicians, so once she got to Duke, she took that to heart.

As a first-year, she says, she knew she wanted to be exposed to a lot of things, and she knew she wanted to do research, but she wasn’t really sure what “research” meant for a first-year. In the beginning, she cold-emailed a lot of people and received multiple rejections.

After rejection, though, eventually something clicks, and for Durvasula, what clicked were three main research projects she undertook in her time at Duke.

The instinct is always to start with where you want to end up and then work backward, but you don’t know where you’re going to end up”

Maya Durvasula, T’18

Her first experience in a research group was a joint venture between an academic team in China and at UNC-Chapel Hill. Their group studied behavioral interventions to increase the uptake of health technologies, with a particular focus on sexual health. Usually, as a country industrializes, the rates of sexually transmitted infections will drop, but in China, rates of HIV and syphilis continued to rise as the economy grew. Durvasula and the team looked at different interventions that might make testing for HIV more attractive to patients, such as alternative testing locations, different advertisement design, and compensation.

She also did a project with Duke professor Bob Korstad in the history department and the Samuel DuBois Cook Center on Social Equity, looking at the history of housing in Durham. Finally, she worked with her primary advisor, Duke economics professor Duncan Thomas, in his joint lab with UNC’s Elizabeth Frankenberg, on projects related to household decision-making in Indonesia.

Duke Economics Thesis Symposium in 2018

A notable part of her undergraduate time at Duke was winning the Truman Scholarship. What was most valuable to her about the Truman was the people she met. “Most people I’ve met are defined by picking something they care about and doing a lot with it,” she says. And it’s inspiring to be surrounded by people who love what they do and immerse themselves so wholly in it.

Duke Economics Graduation, 2018

Durvasula graduated Duke with numerous experiences and accolades under her belt. But from there, how did she find her way to doing a Ph.D. at the intersection of law, technology, and economics? As she describes it, the interplay between economics and law is inextricable. Both economic incentive and legal institutions affect the rate and direction of innovation, which affects how quickly technology is developed, and ultimately what products ends up in our hands. A question at the heart of her research is wondering how to make sure the value of this technology is distributed equally across society.

So five to ten years from now, where will we see Durvasula? She sees herself remaining in academia, although at some point she wants to work in public service. “I love learning new things, and I want to take advantage of being in a space where people are always willing to teach you things.”

And in that vein, her advice to a curious Duke student is to explore everything. “The instinct is always to start with where you want to end up and then work backward, but you don’t know where you’re going to end up,” she said.

Pursue the questions that you find exciting, and let that point you in the right direction – clearly, Durvasula is proof that this process will take you places.

Post by Meghna Datta, Class of 2023

Feeling Lonely? What We Want From Our Relationships Can Change With Age

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Not feeling the holiday cheer this year? The gap between expectations and reality can leave people feeling lonely. Photo by madartzgraphics.

Not everyone’s holiday plans resemble a Hallmark card.

If the “most wonderful time of the year” isn’t your reality, you’re not alone. You might have an idea of a festive picture-perfect holiday season, but what actually transpires doesn’t always measure up.

And that’s where loneliness comes from, says King’s College London graduate student Samia Akhter-Khan, first author of a new study on the subject.

“Loneliness results from a discrepancy between expected and actual social relationships,” Akhter-Khan said.

Together with Duke psychology and neuroscience Ph.D. Leon Li, Akhter-Khan and colleagues co-authored a paper on why people feel lonely, particularly in later life, and what we can do about it.

“The problem that we identified in current research was that we haven’t really thought about: What do people expect from their relationships?” Akhter-Khan said. “We work with this definition of expectations, but we don’t really identify what those expectations are and how they change across cultures or over the lifespan.”

In every relationship, we expect certain basics. We all want people in our lives who we can ask for help. Friends we can call on when we need them. Someone to talk to. People who “get” us. Someone we can trust. Companions with whom we can share fun experiences.

But the team’s theory, called the Social Relationship Expectations Framework, suggests that older people may have certain relationship expectations that have gone overlooked.

Akhter-Khan’s first clue that the causes of loneliness might be more complex than meets the eye came during a year she spent studying aging in Myanmar from 2018 to 2019. At first, she assumed people generally wouldn’t feel lonely — after all, “people are so connected and live in a very close-knit society. People have big families; they’re often around each other. Why would people feel lonely?”

But her research suggested otherwise. “It actually turns out to be different,” she said. People can still feel lonely, even if they don’t spend much time alone.

What efforts to reduce loneliness have neglected, she said, is how our relationship expectations change as we get older. What we want from social connections in, say, our 30s isn’t what we want in our 70s.

The researchers identified two age-specific expectations that haven’t been taken into account. For one, older adults want to feel respected. They want people to listen to them, to take an interest in their experiences and learn from their mistakes. To appreciate what they’ve been through and the obstacles they have overcome.

They also want to contribute: to give back to others and their community and pass along traditions or skills through teaching and mentoring, volunteering, caregiving, or other meaningful activities.

Finding ways to fulfill these expectations as we get older can go a long way towards combating loneliness in later life, but research has largely left them out.

“They’re not part of the regular scales for loneliness,” Li said.

Part of the reason for the oversight may be that often the labor and contributions of older people are unaccounted for in typical economic indices, said Akhter-Khan, who worked in 2019-20 as a graduate research assistant for a Bass Connections project at Duke on how society values care in the global economy.

“Ageism and negative aging stereotypes don’t help,” she added. A 2016 World Health Organization survey spanning 57 countries found that 60% of respondents said that older adults aren’t well respected.

Loneliness isn’t unique to older people. “It is a young people’s problem as well,” Akhter-Khan said. “If you look at the distribution of loneliness across the lifespan, there are two peaks, and one is in younger adulthood, and one is an old age.”

Even before the COVID-19 pandemic, world leaders began sounding the alarm on loneliness as a public health issue. Britain became the first country to name a minister for loneliness, in 2018. Japan followed suit in 2021.

That’s because loneliness is more than a feeling – it can have real impacts on health. Persistent loneliness has been associated with higher risks of dementia and Alzheimer’s disease, heart disease and stroke, and other health problems. Some researchers suggest it’s comparable or riskier than smoking and obesity.

The researchers hope that if we can better understand the factors driving loneliness, we might be better able to address it.

CITATION: “Understanding and Addressing Older Adults’ Loneliness: The Social-Relationship Expectations Framework,” Samia C. Akhter-Khan, Matthew Prina, Gloria Hoi-Yan Wong, Rosie Mayston, and Leon Li. Perspectives on Psychological Science, Nov. 2, 2022. DOI: 10.1177/17456916221127218

Robin Smith
By Robin Smith

How Art Reflected Child Mortality in the 20th Century

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How does parenting change when infant and child mortality affects every family in society? Recent history may provide an answer. For the entirety of the 19th Century, child mortality was ubiquitous. In the year 1880, nearly 35% of children born in the United States passed away in their first five years. The medical literature that explores the common diseases and public health inadequacies, though expansive, often fails to address the central humanistic questions surrounding such widespread death. How were these children mourned? How did grieving families move on? And how has this mourning changed in the context of the past hundred years of medical advancement?

These guiding questions drove Dr. Perri Klass, Professor of Journalism and Pediatrics at NYU, to pen her recently published book, “The Best Medicine: How Science and Public Health Gave Children a Future.” A distinguished clinician, author, and medical historian, Klass explored prominent art and literary works from this era of high infant and child mortality at the recent Trent Humanities in Medicine Lecture at the Duke School of Medicine, titled “One Vacant Chair: Remembering Children”.

Dr. Perri Klass, MD

Throughout the lecture, Klass guided the audience through famous portraits, poems, and prose produced in the 18th Century that memorialized children who had died at a young age. Perhaps the most famous fictional account of childhood death in the 19th century emerged in Uncle Tom’s Cabin by Harriet Beecher Stowe. The emotionally wrenching death scene of young Eva, who succumbed to tuberculosis, struck a chord with virtually all those who read the novel. Published in 1852, Uncle Tom’s Cabin would go on to be reproduced in theaters across the country for several decades, the death scene becoming a ubiquitous anchor that often brought the audience to tears. Klass further described how Beecher Stowe drew from her personal experience, the death of her son Charlie from cholera only a few years prior to the writing of the book, to create this powerful literary scene.

“Uncle Tom’s Cabin.” Published in 1852 by Harriet Beecher Stowe.

Beecher Stowe was not the only author whose personal experience impacted their art. Charles Dickens, deeply impacted by the death of his children, had created a slew of sentimental yet mortal child characters in his stories. One of the most prominent examples, young Nell from “The Old Curiosity Shop,” was published in installments and developed a strong following. Dickens ended the series with the death of twelve-year old Nell, much to the outrage of international readers.

Perhaps it’s no surprise that parents chose to memorialize their deceased children through literature and art. Wealthy families would often contract famous portrait artists were often contracted to depict their dead children. Some, including the Rockefellers and the Stanfords, channeled the deaths of their children and grandchildren into resourced academic institutions.

For grief to drive philanthropy and art is not a new phenomenon, but the sources of grief that drive such artistic and financial overtures today have changed considerably. Klass sought to bridge this knowledge gap and pull closer the history to which society has the privilege of being oblivious. Maybe, even, it would even inform how we cope with the mortality of young people today.

“How do we situate ourselves in a world where infant and child mortality is so low?” Klass asked at the beginning of her presentation.

The past does not reveal one clear answer, but it does provide a tapestry of options, many lost in our modern collective memory, for mourning, for celebrating, and for memorializing.

Post by Vibhav Nandagiri, Class of 2025

Meet the Power Tools Pro Who Keeps Students Safe While They Learn by Doing

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When engineering student Katie Drinkwater signed up for the Machine Shop Tools Mastery Unit for her Engineering 101 class, she was completely unsure about what to expect. As a freshman with no prior experience, she felt intimidated by the prospect of stepping foot into a place with such powerful and potentially dangerous machinery. Now a senior in Pratt and a member of Duke Motorsports, Drinkwater has since become much more comfortable spending time around lathes, bandsaws and other power equipment. Along with many other members of the Duke community, she attributes much of her positive experience to the guidance and support of Duke Machine Shop Manager, Steve Earp.

The Welcome Night at the Student Machine Shop is an open-house event early in the semester that introduces new students into all that the Duke student machine shop has to offer.

“When I went in to make my first part, I was very nervous and intimidated,” Drinkwater says. “I thought that I would be expected to know how to use the machines, but this couldn’t have been farther from the truth. Steve helped my partner and me with every step but didn’t infringe on our ownership of the project. I always feel free to ask questions and check in with Steve, but I am still expected to do my own work.”

Drinkwater isn’t alone. “Steve is definitely a friendly face you can rely on in the Pratt student shop. His vast skills and experience are one thing, but being able to teach people new to the shop in such an engaging way sets him apart. Steve has helped me make custom tools, solve problems that seemed impossible, and has helped me learn something new every time I walk into the shop,” says John Smalley, ME ‘23 and president of Duke Aero Society.

Managing the Student Shop for nearly 15 years, Earp is a vital and beloved mentor to all students that frequent the shop. Not only responsible for the set-up, organization, and operation of the shop, Earp also ensures that thorough safety practices are properly established and upheld. Part of this dedication to safety involved spearheading a brand new initiative: The Student Shop Managers Consortium. 

Steve Earp (left), Jennifer Ganley, Connor Gregg, Alexandra Gray, Greg Bumpass, Josh Klinger (right) gather to show new students around the machine shop during the Welcome Night.

In 2013, following a tragic accident at Yale University that involved the death of a student using the student machine shop, Earp became determined to take action to ensure no such incidents ever occur again. “I started investigating, and trying to find other people that do my job at other universities,” he explained. After sending out an email to dozens of other engineering schools, Earp was left with no responses. However, he refused to let this deter him. “I had to drill down over the next two years and find that one guy or gal that operates and manages that shop,” he recalls. One by one, Earp built a network across the country, eventually organizing and hosting the first conference here at Duke University in 2015 with about 65 student shop managers. Earp recalls the positive feedback from all the attendees, revealing that this was the first time these individuals with the same job had been able to communicate with those in similar positions: “nobody ever knew that there was somebody like them somewhere else.” Since then, the conference has occurred on an annual basis, hosted by different universities from Yale to Washington University in St. Louis, and even virtually during the pandemic. Most importantly, this network has allowed for more conversation and accountability in making student safety a priority. Demonstrating his passion for student shops and commitment to student safety, Earp was recently named the President of this organization. 

The emphasis on safety is something Drinkwater has experienced since the first time she stepped in the shop to complete her Tools Mastery assignment. “A machine shop can be a very dangerous environment — something Steve knows from personal experience — so he and Greg take safety training very seriously,” she explains. “They want every student to respect the environment without being afraid of it.” After completing the very thorough online and in-person components of the safety training, Drinkwater felt proud to pick up her shop badge. In a sentiment echoed by all of the engineering community, Drinkwater concludes, “I feel very lucky to have Steve as our shop manager. His wealth of experience, genuine interest in students’ learning, and good-humored disposition are extremely valuable additions to the Pratt community.”

By Kyla Hunter, ’23

Duke Alum Dr. Quinn Wang on Medicine, a Healthcare Startup, and the Senior Thesis That Started it All

As a senior at Duke University in 2010, Dr. Quinn Wang was simply Quinn, an undergraduate English major on the pre-med track, wondering how to combine her love for medicine with her love for English. This is how her senior thesis was conceived – Through the Lens of Medicine: Landscapes of Violence in Cormac McCarthy’s Blood Meridian (1985), All the Pretty Horses (1992), and No Country for Old Men (2005) – which ended up winning the English department’s award for “Most Original Honors Thesis.”

Dr. Quinn Wang

Fast forward 12 years, and Wang can now call herself a double Dukie, having completed medical school here. She went on to complete ophthalmology residency at UCSF and this past Saturday, November 5, came back to her alma mater as part of the Duke Medical Ethics Journal’s Medicine, Humanities, and Business celebration to talk to an eager audience at Schiciano Auditorium about her path from Duke until now.  

She began her story during the infamous year of 2020, when she was forced to stop seeing patients at her private practice in California’s Bay Area due to COVID-19. Restless and anxious about how her patients were doing, she tried to keep up with them as best she could, but of course there were limitations. And then, a few months in, one of her patients went blind.

This tragic moment sparked a frustrating realization by Wang that in the tech capital of the world – San Francisco – there was still no good way to test people’s eyesight from home to prevent what should have been preventable. She decided to put together something herself, guided by the one question she thought was most important to answer until COVID-19 abated and people could come into clinics again – “how do we make sure people don’t go blind?”

Wang took common visual eye-testing tools used in clinics, and with some simple Photoshop editing and a little bit of code, turned them into a series of easy multiple-choice questions that could be answered from home. This simple but powerful transformation turned into Quadrant Eye, a start-up she co-founded with software engineer Kristine Hara.

A common visual tool used to test eyesight is the Snellen chart

The Quadrant Eye journey has taken her from running a private practice as an ophthalmologist to taking the plunge into business by applying to and getting selected for Y Combinator, which calls itself a “graduate school for startups”. YC invests $500,000 into a selection of early-stage startups twice a year. Then, for three intense months, they provide support to get startups off the ground and in good shape to present to investors for funding. At YC, Hara worked on turning Quadrant Eye into an app, and Wang renewed hundreds of prescriptions.

Quadrant Eye

Ultimately, though, the most significant place Quadrant Eye has led Wang to is a journey of self-mastery that applies to any human endeavor, from building a startup to doing research to just getting up every morning.  As she describes, startup life entails always learning new things and always messing up – which, for someone who professes that “I don’t like to do things I’m not good at” – can be challenging. She candidly admitted that she, like everyone, has bad days, when sometimes all she can do is throw in the towel and end work early. “I have more doubts than I care to admit,” Wang says, but at the end of the day, “we’re all climbing our own mountains”. Pushing through requires “superhuman effort” but it’s worth it.

And as for that English thesis? Wang describes how Quadrant Eye’s very first investor – “let’s call him Charlie” – asked her all the requisite questions investors ask early-stage startups (think Shark Tank). But he also asked her for something non-traditional – all fifty or so pages of her undergraduate honors thesis she had written ten years back. Apparently, he had seen a mention of it on LinkedIn and was intrigued. A few weeks later, Wang received a phone call that he was interested in investing – and he admitted that her thesis had played a part. To him, the uniqueness and quality of her thesis showed that Wang could problem-solve, communicate well, and think creatively, and Wang herself agrees. “My English thesis showed me that I can do hard things,” she said, and if Quadrant Eye is any indication, clearly, she can.

Post by Meghna Datta, Class of 2023

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