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

Author: Cydney Livingston Page 1 of 2

We Are Not All Living The COVID Moment Equally

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We are all living within the Covid moment, but we are not living within the Covid moment equally. The pandemic has exposed a recurrent rift in the United States’ healthcare system: Black Americans and other people of color (POC) are both disproportionately impacted by health issues and disproportionately lack access to care.

In a recent study on North Carolina conditions, Duke researchers found that the “odds of testing positive for [Covid] were higher for both Black and Hispanic individuals as well as within neighborhoods with a higher proportion of Black or Hispanic residents – confirming that Black and Hispanic communities are disproportionately affected.”

In a Coronavirus Conversation sponsored last week by the Science & Society Initiative, Thomas Williams J.D. discussed this and related issues with Duke scholars Keisha L. Bentley-Edwards, Ph.D. of medicine and Jay A. Pearson, M.P.H., Ph.D of public policy.

Williams opened the panel by emphasizing the relevance of this moment: Current Covid impacts are directly informed by historical inequities and intricately span into the future. This is but one system of plaguing racism.

To speak about the intimate intersection of race and healthcare in America, Pearson offered grounding insight to systemic and structural racism. The United States is a country filled with patterns that produce and reproduce systematic advantages for those who are white while simultaneously disadvantaging people of color, most often Black and indigenous populations. Racism in America greatly transcends personal acts of racialized discrimination and harassment, he said. Racism in America is multiplex, foundational, and rooted within our society’s core.

“The U.S. national identity is tied to structural racism. …This is who we are, this is who we’ve been since the beginning of this country,” Pearson said, “The racialized inequities of Covid are simply the latest [manifestations]. We shouldn’t be surprised.”

A recently circulating figure states that 96% of people with severe outcomes or death from Covid had comorbidities, the presence of health conditions in addition to Covid. But Bentley-Edwards cautioned against misuse of this claim: “Many of these people would be alive if not for Covid.”

Though many who have died from the virus had underlying conditions, it is ultimately the virus that killed them. Communities of color often have disproportionate prevalence of underlying conditions, making them more susceptible to complications from Covid. But even when the prevalence of underlying conditions is the same among white and non-white populations, people of color are more likely to be more negatively affected by them.

For example, cardiovascular disease is similarly distributed between white and Black people, yet Black people are more likely to die of it, and at a younger age, compared to white people. Similarly, Black and other POC populations who contract Covid are more likely to die despite similar rates of contracting the virus in certain regions of the country.

Dr. Bentley-Edwards speaking during Friday’s virtual Coronavirus Conversation

Pearson and Bentley-Edwards also offered their insights on who is seen as essential and who is seen as dispensable in the United States.

Those who have been on the front lines with the most exposure and risks have been laborers who are most often under-valued Black and Brown peoples, Bentley-Edwards said. Though Covid terminology has come to dub them essential, it is undeniable that our society continues to see these types of workers as dispensable or replacable, and thus does not protect the people responsible for protecting us. Because many people of color live in multi-generational households as a culturally protective factor, increased chance of contracting Covid has led to uncertainties on the safety of returning home to young and elderly family members, she said. Further, the disproportionate unemployment rate of 13% for Black Americans compared to the 8.4% national rate is a staggering one. Since insurance is tied to employment, Black and Brown communities often avoid treatments due to the financial burden of unaffordable and inaccessible care.

Within the pandemic, we have seen the ever-present epidemiological impacts of police brutality and murder in the U.S with fresh eyes, the panelists said. In many ways, Black peoples’ experiences with healthcare mirrors that of their experiences with police – likely because both systems are anchored by an unjust nucleus.

“[Covid and police brutality] are slightly different manifestations of the same phenomenon,” Pearson said. We are able to easily identify the murders of individuals such as Breonna Taylor, George Floyd, and Ahmaud Arbery as stolen lives due to racist actions, however the slow burn of a racist health care system is less easily conceptualized or reconciled with, he said. Either way, the cause is one and the same.

Racism within systems that are meant to protect have generated a deep mistrust from Black and Brown people. Williams brought up the issue of a potential Covid vaccination amongst communities of color. “You have to know the history and why they would hesitate,” Bentley-Edwards said, bringing up the Tuskegee experiments and the work of J. Marion Sims. These accounts offer grim revelation of a heinous, racist history of exploiting vulnerable people for scientific and medical explorations.

Bentley-Edwards said that governments and healthcare institutions must address the rightful apprehensions of Black and Brown people in order to decrease vaccine hesitancy and serve at-risk communities. “What are they going to do differently?”

Williams also proposed the notion of data collection as a source of bias: In what ways are the data informatics that are collected reflections of an inequitable system? Bentley-Edwards and Pearson both suggest that to understand the current moment, as well as the healthcare system more largely, there needs to be collection and analysis of racial data. Additionally, there simply needs to be measurements for indicators beyond conventional ones which do not properly account for impacts on communities of color.

The push for new and different kind of data is supported by a growing evidence for the manifestations of inequality within biological bodies. For example, Pearson spoke about his own research on telomeres, a protective structure on the ends of chromosomes that protect DNA from degradation. Telomeres are telling both of stress and aging. Pearson’s work found that the average Black American woman is six to seven biological years older than a white American woman of the same age by evaluating telomere lengths, controlling for income, education, and other important socioeconomic factors. This indicates physiological affects linked to the stresses and disproportionalities of race down to the cellular level. Through genetics, mental health, and other physical degradations, the impacts of racism and racist healthcare quite literally last a lifetime and are even intergenerational.

Diagram of telomere from a study conducted by Dr. Pearson

Pearson closed the panel by urging attendees to take action where they find themselves. Though the need for animated policy which reflects recent discussions and protests is dire, the local spaces we find ourselves in need to be reshaped as well – including our universities.

In this moment, our responsibilities to one another have become more obvious than ever before. We must become more adept in thinking about and taking action for the communities in which we live and are connected to, whether they are comprised of people who look like us or not.

Post by Cydney Livingston

Covid Tested the Resilience of Duke’s Research

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Like nearly all other aspects of life, the normal routines of Duke research labs came to a grinding halt due to COVID-19. Duke researchers shared their reflections on the struggles and insights the process of research shutdown and reboot has had within their labs during a Virtual Research Town Hall on Thursday, September 3rd.

The Town Hall, titled “The Impact of COVID 19 on Research at Duke, Overcoming Challenges and Pressures” was moderated by Duke Vice President for Research, Larry Carin (Ph.D.). Dr. Carin mentioned that discussion of shutting down the research enterprise began in February, and at that point in time it seemed nearly hysterical. However, by mid-March shut-down plans were fully in progress, leaving labs out of commission until mid-June. To get research at Duke back underway, labs were forced to significantly reduce the density of people in facilities and no undergraduate students were allowed to participate.

Though most of the basic science labs are back in operation now, human subjects research trials have had a slower return. In no way is it business as usual. Detailed planning and scheduling, a focus on social distancing, and daily health surveys are all part of the new normal. “There is almost a Big Brother feel to this,” Dr. Carin said, comparing the moderated tracking of who enters facilities through their DukeCard swipes to George Orwell’s 1984 dystopian society.

Associate Professor Debra Silver Ph.D. spoke about her neurodevelopmental lab in molecular genetics and microbiology (MGM). In the three-month shutdown, lab members focused on writing reviews, grants, manuscripts, and took online classes to improve skills. Since re-opening, Silver’s lab has implemented lab shifts, pre-scheduled experiments, and coordinated use of shared equipment. Some of the biggest issues are the trainees missing out on critical networking and undergraduates forced to transition to nearly exclusively online work. Silver also voiced serious concern for the mental and physical health of lab members, logistical coordination of childcare and homeschooling, challenges faced by international trainees, and the need for flexibility. However, there were some silver linings as well. The Silver Lab engaged with lots of seminars, had joint lab meetings, and the mutual support for one another grew immensely under the unique circumstances.

Dr. West points out the enduring emotional impacts of COVID.

Both Silver’s lab and the West Lab, led by professor Anne West Ph.D. in neurobiology, are heavily reliant on mice for wet lab work. The mandates to reduce their mouse colonies by more than 50% was a large task and now that the labs are up and running, re-expanding the colonies has been a primary focus. West said that, similar to the Silver Lab members, half of her team picked up writing or a computational project while the other half attended online classes or meetings during shutdown. Undergraduates read and presented research papers – which turned out to be a very fruitful training experience.

One major roadblock for the West Lab’s reopening were the murders of George Floyd, Breonna Taylor, and Ahmoud Arbery. The civic unrest surrounding these deaths and the revivalism of the Black Lives Matter movement became a frequent point of discussion in lab meetings. Some members of the West Lab were unable to work during this time. West emphasized the importance of lowered expectations. She asked everyone to focus on one core experiment and to try to come into the lab for at least a few hours a day, a few days a week. The lab has been gaining traction with new data and research papers nearing completion. Like other panelists, West discussed prevailing issues including anxiety and depression, continued societal uncertainties, and the questionable financial future for research.

Assistant professor of anesthesiology Jamie R. Privratsky MD, Ph.D. highlighted COVID’s impact on clinical and critical care research. Among the positive impacts are the Society of Critical Care Medicine’s COVID-19 registry database, the abilities to do observational and database research work, and research opportunities for working with COVID patients. However, the rest of critical care research has been completely sidelined, clinician-scientists have been moved to mostly clinical duties, and there have been lots of administrative hurdles for conducting COVID related research.

A slide from Dr. Pivratsky’s presentation.

Many colleagues share Dr. Privratsky’s mixed thoughts on the gains and losses during the halt of critical care research. For those who were able to conduct some research, the risks to personal health also posed looming anxiety and danger. Dr. Privratsky chose to do what he could being physically away from his lab and worked to update protocols, maintain electronic lab notebooks, write methods sections of papers, and care for his mouse colony. He also submitted three grant proposals and said that he left the shutdown with a clearer vision and direction for his research.

The School of Medicine’s Vice Dean for Basic Science, Colin S. Duckett Ph.D. closed the town hall with encouraging reflections. Out of 17,000 Duke administered COVID tests, there have been very few positives. Duckett emphasized how seriously the Duke community and its recently returned students are taking the continued threat of Coronavirus. Though communications persist as a challenge and many argue that life right now just doesn’t feel right, Duckett called attendees’ attention to the fact that the research enterprise was successfully ramped down, ramped back up, and lab activities have made a nearly completely return. This was and continues to be no small feat and is possible due to highly collaborative efforts, he said.

Good news from Dr. Duckett about the state of Duke’s research enterprise.

Further, there were large insights gleaned from this collective experience; those of researchers’ resiliency, the importance of community, and the need to look beyond work and check in on each other as human beings. Research and the people who make it possible do not exist in a vacuum away from society. Their work and their well-being are subject to the pandemic just like everyone else. Yet, similar to the broader global public, researchers and their research are emerging stronger than before in the face of COVID-19.

Post by Cydney Livingston

Who Makes Duke? Visualizing 50 Years of Enrollment Data

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Millions of data points. Ten weeks. Three Duke undergraduates. Two faculty facilitators. One project manager and one pretty cool data visualization website.

Meet 2020 Data+ team “On Being a Blue Devil: Visualizing the Makeup of Duke Students.”

Undergraduates Katherine Cottrell (’21), Michaela Kotarba (’22) and Alexander Burgin (’23) spent the last two and a half months looking at changes in Duke’s student body enrollment over the last 50 years. The cohort, working with project manager Anna Holleman, professor Don Taylor and university archivist Valerie Gillispie, used data from each of Duke’s colleges spanning back to 1970. Within the project, the students converted 30 years of on-paper data to machine-readable data which was a hefty task. “On Being a Blue Devil” presented their final product during a Zoom-style showcase Friday, July 31: An interactive data-visualization website. The site is live now but is still being edited as errors are found and clarifications are added.

The cover page of the launched interactive application.

The team highlighted a few findings. Over the last 20 years, there has been a massive surge in Duke enrollment of students from North Carolina. Looking more closely, it is possible that grad enrollment drives this spike due to the tendency for grad students to record North Carolina as their home-state following the first year of their program. Within the Pratt School of Engineering, the number of female students is on an upward trend. There is still a prevalent but closing gap in the distribution between male and female undergraduate engineering enrollment. A significant drop in grad school and international student enrollment in 2008 corresponds to the financial crisis of that year. The team believes there may be similar, interesting effects for 2020 enrollment due to COVID-19.

However, the majority of the presentation focused on the website and all of its handy features. The overall goal for the project was to create engaging visualizations that enable users to dive into and explore the historic data for themselves. Presentation attendees got a behind-the-scenes look at each of the site’s pages.

Breakdown of enrollment by region within different countries outside of the United States.

The “Domestic Map” allows website visitors to select the school, year, sex, semester, and state they wish to view. The “International Map” displays the same categories, with regional data replacing state distributions for international countries. Each query returns summary statistics on the number of students enrolled per state or region for the criteria selected.

A “Changes Over Time” tab clarifies data by keeping track of country and territory name changes, as well as changes in programs over the five decades of data. For example, Duke’s nursing program data is a bit complicated: One of its programs ended, then restarted a few years later, there are both undergraduate and graduate nursing schools, and over a decade’s worth of male nursing students are not accounted for in the data sets.

The “Enrollment by Sex” tab displays breakdown of enrollment using the Duke-established binary of male and female categories. This data is visualized in pie charts but can also be viewed as line graphs to look at trends over time and compare trends between schools.

“History of Duke” offers an interactive timeline that contextualizes the origins of each of Duke’s schools and includes a short blurb on their histories. There are also timelines for the history of race and ethnicity at Duke, as well as Duke’s LGBTQ history. Currently, no data on gender identity instead of legal sex was made available for the team. This is why they sought to contextualize the data that they do have. If the project continues, Cottrell, Kotarba, and Burgin strongly suggest that gender identity data be made accessible and included on the site. Racial data is also a top priority for the group, but they simply did not have access to this resource for during the duration of their summer project.  

Timeline of Duke’s various schools since it was founded in the 1830’s.

Of course, like most good websites, there is an “About” section. Here users can meet the incredible team who put this all together, look over frequently asked questions, and even dive deeper into the data with the chance to look at original documents used in the research.

Each of the three undergrads of the “On Being a Blue Devil” team gained valuable transferable skills – as is a goal of Duke’s Data+ program. But the tool they created is likely to go far beyond their quarantined summer. Their website is a unique product that makes data fun to play with and will drive a push for more data to be collected and included. Future researchers could add many more metrics, years, and data points to the tool, causing it to grow exponentially.

Many Duke faculty members are already vying for a chance to talk with the team about their work.  

Medicine’s ‘Digital Health’ Future

“How often do we get to see a new field [of medicine] grow?” asked Satasuk “Joy” Bhosai (MD MPH), the chief of digital health and strategy for the Duke Clinical Research Institute.

Bhosai offered insights to the rapidly emerging and expanding field of digital health in her talk “Digital Health: How Do We Scale?” at Duke’s School of Nursing on Wednesday, March 4th.

Joy Bhosai, MD MPH

Digital health is a blanketing term that refers to a wide – and growing – array of services and products that merge digital technologies with healthcare to improve its quality, efficiency, and personalization. To put it simply: Digital health is the computerization of healthcare. Some of the largest, current digital trends of health care, according to Bhosai, are Artificial Intelligence (AI)/Machine Learning (ML), digital therapeutics, and innovations in delivery models. However, she presented a graphic (shown below) that shows the reach of the field.

Digital health is an expansive field that encompasses many types of products and services in the field of healthcare.

Bhosai focused on the challenges to digital health’s progress and the role that academia and research play in addressing these issues. “Having an idea and the technology are only the beginning,” Bhosai said.

To prove her point, Bhosai highlighted the company Proteus. Once valued at $1.5 billion, they are now struggling to stay afloat because they haven’t provided the data on effectiveness that investors needed.

She also pointed out the collaboration between Google and Ascension.  The duo teamed up with great technological potential to work on digital healthcare, but they received major pushback because Ascension released patients’ medical records to Google without patient knowledge or consent.

In the life cycle of developing and implementing digital health tools, Bhosai said that most companies falter or fail between beta testing and scaling. “To reach scale, evidence, and the right partners are needed.”

She proposed three main challenges as current limiters to breaking through the difficult transition that crushes so many digital health companies: 1) translating ideas to action, 2) evaluation and validation, and 3) adoption and scale.

Bhosai believes that there are many ways that academia and research could play a role in addressing these issues. Academics and researchers could give insight to the applicability of products, offer guidance on clinical utility, provide networks of contacts and support, materialize solutions, and build innovations at the front of business and growth models.

Bhosai’s proposed life cycle of digital health innovations.

This could help with things such as workflow, which may not be actualized in the product design of digital health products. One venture-backed attempt at putting information into a wearable, glasses-like device caused physicians to become very dizzy and disoriented – a problem that could have been avoided if medical specialists were integrated in the design process.

One success story is the company Akili, a digital therapeutic company that addresses cognitive impairments. A team at Duke, led by Scott Kollins, PhD, conducted a controlled clinical trial using the therapeutics and proved that the software led to improvements in treatment groups. The results of the study were submitted to the Federal Drug Administration (FDA) so that Akili can make claims around these findings in support of their service. Many other digital health products could benefit from these types of trials that provide evidence of their potential impacts in healthcare.

“Providers and academics are needed in health tech,” said Bhosai. This is a crucial connection to make for the future of the digital health field. Bhosai also pointed out that digital health tool users are not always a customer. For example, hospital systems are often the intended users of digital health services, but most hospitals have technical requirements that must be met in order to adopt a service. A product may be amazing but be barred from consideration for use because it would fail system security audits.

Products that are directly consumed by customers also must integrate into a patient’s lifestyle. “When products are high-touch, you may lose engagement,” Bhosai stated, “Patients don’t want to log onto three different apps when they could just log onto one.”

As digital health grows rapidly, companies in the field should work to navigate the health policies in place, understand the landscape of healthcare, and collaborate with academics and researchers to be successful and provide the best services for this new field of medicine.

If Netflix Died, Culture Might Die With It

What happens when Netflix dies? To open Duke Libraries’ Fair Use Week, Kyle Courtney, copyright advisor for Harvard University, and Will Cross, director of the Copyright and Digital Scholarship Center at North Carolina State University, spoke at Duke about the threats that licensing and copyright pose to cultural heritage on February 24th.

One responsibility – among many – of modern-day librarians is that of preservation. However, streaming services like Netflix and Hulu change the ways that librarians are able to do their jobs. Though Cross said that the constraints of copyright may actually help librarians archive culture in its many forms, licensing has introduced the need to negotiate preservation work.

Consumer-licensed materials, such as those provided on streaming services, have a bias of economic efficiency and make the mission of archiving nearly impossible, leaving many wondering, “How do we librarian? How do we scholar?”

Cross offered that modern-day culture is being built behind paywalls and that terms of service and contract laws prioritize the gain of individual companies and minimize the ways in which digital culture manifested on Netflix, Hulu, and other streaming companies are able to serve society. In other words, culture is becoming privately owned.

Cross also argued that if libraries didn’t already exist, there would no longer be any way to create them because even freely available items such as certain e-books are being made exclusively available through consumer licensed spaces.

Enter Fair Use. Fair Use is a doctrine in US copyright law that allows certain copyrighted materials to be used without permission from or payment to copyright holders if the use complies with four factors of use. The policy benefits scholars, students, and the general public in many ways by facilitating information-sharing and knowledge-creation. It can grant the use of copyrighted works for particular purposes and limits the monopoly of a copyright owner over the work in question. Courtney and Cross believe that Fair Use could provide a potential solution to the limitations currently being put on librarians’ ability to preserve content from streaming services.

The Fair Use logo

The current lack of a market for preserving streaming service content is a positive for people like Courtney and Cross who are advocating the need to archive these types of work. Not having a market means preservation poses little to no harm to the business of streaming services. Several case studies offer additional hope for the potential to circumvent preservation restrictions by using the rights of Fair Use.

However they said, there is little time to waste. So far, companies like Netflix are currently hesitant or completely reluctant to engage in the conversations about archival preservation that Courtney and Cross bring to the table.

Courtney says that companies like Hulu or Disney+ are not thinking about having scholars watch “Black Mirror” 100 years from now, but rather about earnings from fiscal quarter-to-quarter. Licensing does not address preservation or access concerns, and if all the streaming services suddenly went belly-up it’s probable that some of the unique content from these companies would be lost forever.

“If we don’t act … we may be losing culture left, right, and center,” Courtney said.

Post by Cydney Livingston

Man’s Best Friend, Our Relationship to Dogs

The average dog costs its human owner $10,000-20,000 over the course of its lifetime, from vet care and grooming to treats and toys to the new fad of doggie DNA testing. But what’s in it for us? Researcher Kerri Rodriguez – a Duke alum of evolutionary anthropology and current grad student with Purdue University’s College of Veterinary Medicine – explores just that.

Rodriguez is a member of the OHAIRE Lab at Purdue, which stands for the Organization for Human-Animal Interaction Research and Education. Continuing her work from undergrad, Rodriguez researches the dynamic duo between humans and dogs – a relationship some 15,000 to 40,000 years in the evolutionary making. Rodriguez returned to Duke to speak on February 12th, honoring both Darwin Day and Duke’s second annual Dog Day.

It’s well-known that dogs are man’s best friend, but they do much more than just hang out with us. Dogs provide emotional support when we are stressed or anxious and are highly attentive to us and our emotional states.

In a study of 975 adult dog owners, dogs ranked closely to romantic partners and above best friends, children, parents, and siblings when their owners were asked who they turn to when feeling a variety of ways. Dogs provide non-judgmental support in a unique way. They have also been found to reduce levels of the stress hormone cortisol, lower perceived stress in individuals, improve mood, and improve energy up to 10 hours after interactions. Therapy dogs are prevalent on many college campuses now due to these impacts and are found in hospitals for the same reasons, having been found to reduce subjective pain, increase good hormones and dampen bad ones, causing some patients to require less pain medications.

(Creative Commons)

 Along with reduced stress, dogs make us healthier in other ways, from making us exercise to reducing risk of cardiovascular disease. A study of 424 heart attack survivors found that non-dog owners were four times more likely to be deceased one year after the attack than victims who owned dogs.

The increased social interaction that dogs offer their human companions is also quite amazing due to the social facilitation effect they provide by offering a neutral way to start conversations. One study with people who have intellectual disabilities found that they received 30% more smiles along with increased social interactions when out in public with a dog. Similar studies with people who use wheelchairs have produced similar results, offering that dogs decreased their loneliness in public spaces and led to more social engagements.

Rodriguez also shared results from a study dubbed Pet Wingman. Using dating platforms Tinder and Bumble, researchers found that after one month, simulated profiles containing pictures with dogs received 38% more matches, 58% more messages, and 46% more interactions than simulated profiles without. Even just having a dog in photos makes you appear more likable, happier, relaxed, and approachable – it’s science!

 A large bulk of Rodriguez’s own work is focused on dogs in working roles, particularly the roles of a service dog. She explained that unlike therapy or emotional support dogs, service dogs are trained for one person, to do work and perform tasks to help with a disability, and are the only dogs granted public access by the American Disability Association. Rodriguez is particularly interested in the work of dogs who help American veterans with post-traumatic stress disorder (PTSD).

(Creative Commons)

 Around one out of five post-9/11 military veterans have PTSD and the disorder is difficult to treat. Service dogs are becoming increasingly popular to help combat effects of PTSD, ranking at the third highest placed type of service dog in the United States. PTSD service dogs are able to use their body weight as a grounding method, provide tactile interruption, reduce hypervigilance, and prevent crowding of their veterans. However, because of the lack of research for the practice, the Veterans Association doesn’t support the use of the dogs as a therapy option. This is an issue Rodriguez is currently trying to address.           

 Working with a group called K9s for Warriors, Rodriguez’s research evaluated the mental health, social health, quality of life, and cortisol levels of veterans who have received service dogs and those who were on the wait list for dogs. Veterans with service dogs had lower PTSD symptoms, better mental health, and better social health. Rodriguez is now working on a modification to this study using both veterans and their spouses that will be able to measure these changes to their well-being and health over time, as well as assessing the dog’s health too. Unlike other organizations, K9s for Warriors uses 90% shelter dogs, most of which are mutts. Each dog is as unique as the human it is placed with, but no bond is any less special.

By Cydney Livingston

Undergraduate Research in Duke’s Wired! Lab

Meet Jules Nasco, a sophomore studying Political Science and Philosophy, Politics, and Economics.

Jules is intrigued by the theories behind “how and why people form governments.” Yet, beyond her participation in various theatrical performances, commitment to several social and living-learning communities, and multiple campus jobs — from being a tour guide to editing Twitter and the Medium blog for DukeStudents — Jules also brandishes the role of undergraduate researcher in the Wired! Lab.

Duke’s Wired Lab is dedicated to digital art history and visual culture. The group – facilitated by Olga Grlic and Bill Broom and comprised of three current undergraduates – works in conjunction with the University of Catania in Italy and senior researchers around the world. Jules works specifically on the Medieval Kingdom of Sicily database, “a collection of historic images of the medieval monuments and cities in the Kingdom of Sicily, available as an open-source resource for travelers, researchers, academics, and anyone curious about the history of this part of the world!”

Since the spring semester of her first year at Duke, Jules has been searching high and low through public and private “collections, museums, archives, libraries, and publications in search of relevant paintings, drawing, etchings, photographs, or other images for the database.” She says that this can be as straightforward and easy as checking the permissions of a digital photo and downloading it or as complicated as contacting persons about image rights or scanning and editing photos from old books. Jules also collects metadata about the images she compiles such as artist or photographer, the date it was produced, the reason for production, or any relevant notes about the work. This data is then reviewed and added onto by senior researchers before being added to the public database.

The work can lead to “super-duper cool discoveries.” Earlier this year, Jules found an illustration of Salerno in a book that was drawn over 500 years ago, which led the team to a collection containing another illustration – likely by the same unknown author – likely drawn solely to depict the event of someone’s execution. However, the execution drawing is now the oldest depiction collected by the Wired! Lab of Castel Nuovo in Naples, which is one of the most prominent monuments studied by the lab.

The photo of Castel Nuovo in Naples that undergraduate researcher Jules found.

Though she admits that more career-focused endeavors may eventually take precedence over her work in the database, it’s her passion for art history that initially drew Jules into the research. Knowing that other pursuits would fill her time at Duke, she wanted to keep her interests alive in other ways. After participating in the Medieval and Renaissance Europe FOCUS program, Jules’ professor introduced her to Olga and Bill and the project. “The rest is art history!”

Jules’ favorite part of the work is the feeling that she is “meaningfully contributing to a community of interested travelers, researchers, and academics.”

Jules is able to provide people globally with information about a part of the world that she believes may otherwise be too hard to find. Her work facilitates and spreads knowledge in an interactive way, which she says makes the sometimes-tedious parts all worth it. In their data review at the end of each semester, Jules is able to see where in the world the database has been accessed and finds it awesome to know that people in Africa, Asia, and Australia use the information she has helped provide.

Post by Cydney Livingston

Visual Perception in Congenitally Blind Adults

Vision provides a rich source of information that most people’s lives revolve around. Yet, for blind people, how do they conceive of visual intake and what happens to regions of the brain dedicated to vision if a person doesn’t have typical visual input? These are questions that drive Marina Bedny PhD, an Assistant Professor of Psychological and Brain Sciences and principal investigator of a neuroplasticity and development lab at John Hopkins University.

Bedny spoke at Duke’s Institute for Brain Sciences on Friday, January 17th, about her work with congenitally blind adults. Her lab explores similarities and distinctions of visual perceptions between blind and seeing people and seeks to understand how nuanced, natural variation in experience shapes the human mind and brain.

Many of the studies Bedny discussed have very important linguistic components. In one trial, she investigated the meaning of verbs pertaining to light events and visual perception as compared to touch, amodal, auditory, and motion verbs.

Both blind and sighted people displayed nearly identical results when comparing the different types of verbs used in the study. This showed that there were no differences in what blind people knew about the terms. Analysis of the verbs revealed that linguistic dimensions of intensity and instability were used to evaluate the words’ comparative meanings. Blind people agreed more on the comparison of sound emission and touch perception words. This shows that blind participants have more aligned comprehension of the meanings of other sensory terms compared to sighted people.

In other cases, Bedny’s lab assessed what blind individuals know about color. One study used three object types – natural kinds, functional artifacts, and non-functional artifacts. These categories were used to evaluate agreeance not only on color, but the relevancy of color to certain objects’ functions as well.

Another crucial question of Bedny’s work looks at how the innate structure of the brain constrains cortical function. The findings show that the visual system in blind participants has been repurposed for higher cognitive functions and that portions of the visual system connected to high cognitive abilities are invaded by the visual systems. Along with repurposing visual regions for linguistic use, Bedny’s lab found that visual regions of the brain are active during numerical processing tasks too.

Blind people display additional activity in the visual centers of their brain in numerous studies beyond having the same regional brain responsiveness as sighted people. Though further research is necessary, Bedny proposes that there is a sensitive period during development that is critical to the specialization of the brain. Study participants who have adult-onset blindness do not show the same sensitivity and patterned responses in visual cortices repurposed for different functions as congenitally blind subjects.

At birth, the human cortex is pluripotent – providing the best of both worlds, Bedny said. The brain is prepared but highly flexible. Her studies have repeatedly shown that the brain is built for and transformed by language, and they underscore the importance of nature and nurture in human development.

Post by Cydney Livingston

Understanding and Addressing Vaccine Hesitancy

In the midst of increasing outbreaks of vaccine-preventable disease, Duke global health researcher Lavanya Vasudevan (PhD, MPH, LPH) is investigating the reasons for vaccine hesitancy with focus on America and Tanzania.

Vaccine hesitancy refers to the refusal of or delay in accepting vaccinations, despite their availability. Vasudevan hopes to figure out what interventions will change the minds of target populations on such a heated topic.

She presented at Duke’s Global Health Institute on November 15th about her “big 5 research areas:” identification of sub-optimal vaccine uptake, contextualization of barriers to uptake, measuring parental concern, debunking misinformation, and developing and testing strategies aimed at addressing vaccine hesitancy.

Lavanya Vasudevan presenting at Duke’s Global Health Institute.

Globally, Vasudevan says that there are too many kids playing catch-up with their vaccines, meaning that even when children are getting vaccinated, the vaccinations they receive are not on time with the scheduled progression of immunizations, putting them at risk for contracting disease. Different countries measure vaccination coverage in different ways and on different timelines, which makes it harder to understand where sub-optimal vaccine uptake is happening. A better standard for assessing timeliness of vaccines is crucial. Vasudevan is working to confront this issue to gain better understanding of who and where hesitancy is coming from.

Identification of specific regions of vaccine hesitancy is crucial to navigating interventions, she added. Vasudevan wants to be able to pinpoint areas and understand the context-specific issues that vary across time, place, and vaccine type in order to be most effective.

She said that her work in Tanzania has provided insight to the problem of geographic accessibility and lack of proper supplies in the country, prompting delayed and missed vaccinations among 72% of children, according to self-reporting by their mothers. Tanzanian mothers expressed their frustrations during interviews. They frequently arrange to go to a clinic where vaccinations are offered on specific dates and travel long distances to get there. However, if there are not enough kids who come to be vaccinated, the facilities just won’t vaccinate those who did manage to show up for immunizations.  

Though the qualitative data gained through extensive interviewing and group discussions has been extremely useful and rich, Vasudevan says there is a need for quantitative tools that can rapidly screen for parent’s concerns when it comes to the vaccination of their children. Qualitative data is simply not informative on a large scale.

A review of pre-existing measures evaluated 159 studies, but the quantitative scales found were often complex and context-specific, as well as designed and validated for high-income settings. On this basis, Vasudevan and her larger research team decided to design a scale for use in Tanzania because of its specificity in addressing the contexts of the region. Tailored counseling is also being used to address the local concerns and issues.

Another parallel research project that Vasudevan is involved with aims to identify common vaccine myths, creating a taxonomy to tag these myths and developing and testing an intervention that will highlight and debunk misinformation found on the internet. The current end-goal for the work being done is a “vaccine fact-checker” that could be used on web browsers to identify the myths in vaccine-related information found online.

A common example of needles and vials containing immunization products (Creative Commons).

In closing, Vasudevan identified three main areas for developing and testing intervention strategies. She says these are behavioral nudges, educational strategies, and vaccination policy and legislation.

There is a need for parent-focused strategies that recognize parental concern for their child’s safety on all sides of the vaccination issue, she said. Stringent policies are likely to alienate hesitant parents rather than increasing vaccine uptake. This is why Vasudevan is so focused on understanding and contextualizing issues specific to hesitancy among parents. It seems that increase of vaccinations and improvement of immunization timeliness lies in hearing and reconciling with parental apprehensions and underlying root causes of these hesitations.

One area of focus that Vasudevan feels is underutilized is pre-natal care. Reduction of the divide between obstetrician/gynecologists (OBGYNs) and pediatric care may be a crucial component to educate parents and enrich their understanding about vaccinations following the birth of the child.

Beyond everything else, she said, building trust is essential; simply providing information to parents is not enough. It takes time and empathy to be enable parents to make healthy vaccination choices. Providing credible resources in a safe environment while tuning in to the causes of hesitancy may be the next step to the reduction of vaccine-preventable disease, a current top ten threat to global health.

Post by Cydney Livingston

The Anthropology of “Porkopolis”

Alex Blanchette, cultural anthropologist and lecturer in anthropology and environmental studies at Tufts University, is a scholar of pork production.

As America’s pork industry is continually pushed to ever greater production, so are the human beings who labor to breed, care for, and slaughter these animals.

Blanchette, who gave a talk hosted by the Ethnography Workshop at Duke on November 4th, said there is an intimate relationship between pig and person. The quality of the factory farm worker’s life is tied to that of the porcine species.

Alex Blanchette of Tufts University

Blanchette’s current work will be published in the 2020 ethnographic book – Porkopolis: American Animality, Standardized Life, and the “Factory” Farm. The book is focused on the consequences of human labor and identity that are bound to the pig – an animal which has become more industrialized over time due to corporations’ goal of a mass produced, standardized pig predictable in nature, uniform in existence, and easy to slaughter.

A common practice in factory farming is the ‘runting’ of litters, genetically making piglets smaller to increase the number each sow produces. But this practice has propelled a fundamental shift in the need for human workers to act as neonatal nurses, what Blanchette calls “external prosthetics,” to care for the newborns. Blanchette described one extraordinary worker responsible for taking care of piglet litters, saving the weak and deformed after birth. She has taken measures so drastic as to give a piglet mouth-to-mouth, incubate them in her pockets, and quickly form body-casts out of duct-tape for the small creatures. This worker has had the chance to study over 400,000 piglets in her seven-year career, encountering conditions of the pig body that no scientist has seen in real life.

Blanchette explained the active engagement required in any portion of the factory production. For example, people working with pregnant sows have to be extremely conscious of the way that the pigs are perceiving them to keep the sensory state of the mother pigs balanced. This means avoiding touching them unless work requires it, not wearing perfumes on the job, and taking overall care and precision in every motion throughout the workday. The danger is the risk of causing mass miscarriages and spontaneous abortions within a barn of sows because of their genetically engineered weakness and inability to handle stresses.

Piglets nursing in a device known as a farrowing crate.

Blanchette said one worker could be seen standing in the exact same place over the course of 1,000 compiled picture frames. He developed this habit to prevent large hogs in open pens from knocking him down and biting his legs while he was working. This is something that Blanchette said he couldn’t manage for more than a few minutes even though he too has worked within the pork industry before.

Workers on slaughter and “disassembly” lines are responsible for making the same exact cut or slice 9,500 times a day.

And finally, the conformation of human labor to the precisions of the factory pig often does not stop at the end of the work shift. In rural factory farming areas, corporations try to re-engineer the human communities in which their workers live to further regulate the human body outside of work because of potential impacts on the pigs. For example, workers’ socialization has been monitored by companies in some cases due to the threat of communicable disease reaching the hogs through human kinship.

No worker knows the pig from birth to death, but for the individual portion of the pig’s life for which they are responsible, they are bound intimately and intricately to the hog, Blanchette said. These people are also disproportionately people of color and immigrant workers who are underpaid for how strenuous, demanding, and encapsulating this labor is. Workers in factory farms often have little protections, and Blanchette’s work gives new life to the consequences of industrial capitalism in America as the pig has become a product of vertical integration in rural communities.

We have long been moving at the speed limits of human physiology in the pork industry,  Blanchette said. In 2011, one company’s annual effort to improve their corporation was to build a new human clinic on the jobsite to treat cuts and injuries acquired on the slaughter lines. This clinic was also responsible for assessing new hires in order to match the strongest part of their body to a place on the line where they would be most productive.

The interior of a typical confined animal feeding operation (CAFO).

Factory farms are actively searching for new money to be found in the pig and to have a closed-loop system which uses every aspect of its life and death for profit. This has caused a deep integration of the “capital swine” into everyday human life for the laborers and communities sustained by these economic ventures.

The Trump administration recently removed standards for pork slaughter line speeds and ultimately reduced overall regulations. People like Blanchette are already considering something you too might be wondering, What happens next? Where does pork and the human labor behind it go from here?

Post by Cydney Livingston

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