Duke Research Blog

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

Author: Karl Bates (Page 1 of 18)

Smart Phones Are the New Windows to the Soul

It’s one of those things that seems so simple and elegant that you’re left asking yourself, “Geez, why didn’t I think of that?”

Say you were trying to help people lose weight, prep for a surgery or take their meds every day. They’re probably holding a smartphone in at least one of their hands — all you need to do is enlist that ever-present device they’re staring at to bug them!

So, for example, have the health app send a robo-text twice a day to check in: “Did you weigh yourself?” Set up a group chat where their friends all know what they’re trying to accomplish: “We’re running today at 5, right?”

This is a screenshot of a Pattern Health app for pre-operative patients.

It’s even possible to make them pinky-swear a promise to their phone that they will do something positive toward the goal, like walking or skipping desert that day. And if they don’t? The app has their permission to lock them out of all their apps for a period of time.

Seriously, people agree to this and it works.

Two app developers on this frontier of personalized, portable “mHealth” told a lunchtime session  sponsored by the Duke Mobile App Gateway on Thursday that patients not only willingly play along with these behavioral modification apps, their behaviors change for the better.

The idea of using phones for health behavior came to pediatric hematologist Nirmish Shah MD one day while he attempted to talk to a 16-year-old sickle cell disease patient as she snapped selfies of herself with the doctor. Her mom and toddler sister nearby both had their noses to screens as well. “I need to change how I do this,” Shah thought to himself.

Pediatric hematologist Nirmish Shah MD

Pediatric hematologist Nirmish Shah MD is director of Duke’s sickle cell transition program.

Twenty health apps later, he’s running phase II clinical trials of phone-based interventions for young sickle cell patients that encourage them to stay on their medication schedule and ask them often about their pain levels.

One tactic that seems to work pretty well is to ask his patients to send in selfie videos as they take their meds each day. The catch? The female patients send a minute or so of chatty footage a day. The teenage boys average 13 seconds, and they’re grumpy about it.

Clearly, different activities may be needed for different patient populations, Shah said.

While it’s still early days for these approaches, we do have a lot of behavioral science on what could help, said Aline Holzwarth, a principal of the Center for Advanced Hindsight and head of behavioral science for a Durham health app startup called Pattern Health.

Aline Gruneisen Holzwarth

Aline Holzwarth is a principal in the Center for Advanced Hindsight.

“It’s not enough to simply inform people to eat better,” Holzwarth said. The app has to secure a commitment from the user, make them set small goals and then ask how they did, enlist the help of social pressures, and then dole out rewards and punishments as needed.

Pattern Health’s app says “You need to do this, please pick a time when you will.” Followed by a reward or a consequence.

Thursday’s session, “Using Behavioral Science to Drive Digital Health Engagement and Outcomes, was the penultimate session of the annual Duke Digital Health Week. Except for the Hurricane Florence washout on Monday, the week  has been a tremendous success this year, said Katie McMillan, the associate director of the App Gateway.

New Blogger: Victoria Priester Loves Animals and Books

Hi! My name is Victoria Priester, and I’m a sophomore at Duke and one of this year’s new Duke Research bloggers.

Victoria meeting a very intelligent mammal.

I’m pre-vet, but I’ve always been a bookworm and have a love for expressing myself through writing that has given me a strained relationship with word counts. I’ll try to keep this intro post brief!

I’m majoring in English in addition to taking pre-veterinary classes, so my time in the library so far this year has been spent alternating between drawing resonance structures for organic chemistry and reading Jane Eyre in the Gothic Reading Room, which is my favorite study spot on campus.

Effective puppy medicine includes hugging and kissing.

I grew up in the suburbs of Washington, D.C. and now I work in the veterinary department at Duke Lemur Center. I’m also an editor and opinion columnist for The Chronicle. My favorite part of the academic scene at Duke is that pursuing such different interests at the same time is encouraged.

This year, I’m a part of the Bass Connections team that is studying how using expressive writing for resilience can help cancer patients process their experiences during treatment. I love finding new ways to connect my passion for writing with my interest in science, conservation and zoology.

One of the reasons I want to be a veterinarian is because I think veterinarians can and do play a crucial role in species conservation in zoos and animal sanctuaries. However, there is still a lot left to be learned about the animal species they care for.

For example, there is a species of lemur that consistently develops dental problems in captivity that lead to tooth loss, so there must be something about its diet in captivity compared to its diet in Madagascar that affects the health of its teeth. I care a lot about research concerning animals, conservation and pets, in addition to the health benefits of cathartic writing.

Victoria REALLY likes books.

I follow National Geographic on Twitter and read their articles as often as I can, but I usually end up just telling all of the cool facts I just learned to my parents, close friends or anyone else who is close enough to me to feel a slight obligation to listen and feign interest.

Through blogging, I hope to find a platform to synthesize new scientific findings surrounding animals, marine life or cathartic writing and post them to a place where people who care about and want to read about these topics can find them.

Post by Victoria Priester

First Population Health Conference Shares Energy, Examples

Logo: Population Health at Duke‘Population Health’ is the basis of a new department in the School of Medicine, a byword for a lot of new activity across campus , and on Tuesday the subject of a half-day symposium that attempted to bring all this energy together.

For now, population health means a lot of different things to a lot of different people.

The half-day symposium drew an overflow crowd of faculty and staff. (photo – Colin Huth)

“We’re still struggling with a good definition of what population health is,” said keynote speaker Clay Johnston, MD, PhD, dean of the new Dell School of Medicine in Austin, Texas. Smoking cessation programs are something most everyone would agree is taking care of the population outside of the clinic. But improved water quality? Where does that fit?

“We have an intense focus on doctors and their tools,” Johnston said. Our healthcare system is optimized for maximum efficiency in fee-for-service care, that is, getting the most revenue out of the most transactions. “But most of health is outside the clinic,” Johnston said.

Perhaps as a result, the United States pays much more for health care, but lives less well, he said. “We are noticeably off the curve,” when compared to health care costs and outcomes in other countries.

This graphic from a handout shared at the conference shows how population health spans the entire university.

This graphic from a handout shared at the conference shows how population health spans the entire university.

As an example of what might be achieved in population health with some re-thinking and a shift in resources, the Dell School went after the issue of joint pain with input from their engineering and business schools. Rather than diagnosing people toward an orthopedic surgery – for which there was a waitlist of about 14 months – their system worked with patients on alternatives, such as weight loss, physical therapy and behavioral changes before surgery. The 14-month backlog was gone in just three months. Surgeries still happen, of course, but not if they can be comfortably delayed or avoided.

“Payment for prevention needs serious work,” Johnston said. “You need to get people to buy into it,” but in diabetes or depression for example, employers should stand to gain a lot from having healthier employees who miss fewer days, he said.

Health Affairs Chancellor Eugene Washington commented several times, calling the discussion “very interesting and very valuable.” (photo -Colin Huth)

Other examples flowed freely the rest of the afternoon. Duke is testing virtual ‘telemedicine’ appointments versus office visits. Evidence-based prenatal care is being applied to try to avoid expensive neonatal ICU care. Primary care and Emergency Department physicians are being equipped with an app that helps them steer sickle cell patients to appropriate care resources so that they might avoid expensive ED visits.

Family practitioner Eugenie Komives, MD, is part of a team using artificial intelligence and machine learning to try to predict which patients are most likely to be hospitalized in the next six months. That prediction, in turn, can guide primary care physicians and care managers to pay special attention to these patients to help them avoid the hospital. The system is constantly being evaluated, she added. “We don’t want to be doing this if it doesn’t work.”

Community health measures like walkability and grocery stores are being mapped for Durham County on a site called Durham Neighborhood Compass, said Michelle Lyn, MBA, chief of the division of community health. The aim is not only to see where improvements can be made, but to democratize population health information and put it in peoples’ hands. “(Community members) will have ideas we never could have thought of,” Lyn said. “We will be able to see change across our neighborhoods and community.”

Patient input is key to population health, agreed several speakers. “I don’t think we’ve heard them enough,” said Paula Tanabe, PhD, an associate professor of nursing and medicine who studies pain and sickle cell disease.  “We need a bigger patient voice.”

Health Affairs Chancellor and Duke Health CEO Eugene Washington, MD, has made population health one of the themes of his leadership. “We really take seriously this notion of shaping the future of population health,” he said in his introductory remarks. “When I think of the future, I think about how well-positioned we are to have impact on the lives of the community we serve.”

Lesley Curtis, PhD, chair of the newly formed Department of Population Health Sciences in the School of Medicine, said Duke is creating an environment where this kind of work can happen.

“I, as an organizer of this, didn’t know about half of these projects today!” Curtis said. “There’s so much going on at an organic level that the challenge to us is to identify what’s going on and figure out how to go forward at scale.”

Post by Karl Leif Bates

Game-Changing App Explores Conservation’s Future

In the first week of February, students, experts and conservationists from across the country were brought together for the second annual Duke Blueprint symposium. Focused around the theme of “Nature and Progress,” this conference hoped to harness the power of diversity and interdisciplinary collaboration to develop solutions to some of the world’s most pressing environmental challenges.

Scott Loarie spoke at Duke’s Mary Duke Biddle Trent Semans Center.

One of the most exciting parts of this symposium’s first night was without a doubt its all-star cast of keynote speakers. The experiences and advice each of these researchers had to offer were far too diverse for any single blog post to capture, but one particularly interesting presentation (full video below) was that of National Geographic fellow Scott Loarie—co-director of the game-changing iNaturalist app.

iNat, as Loarie explained, is a collaborative citizen scientist network with aspirations of developing a comprehensive mapping of all terrestrial life. Any time they go outside, users of this app can photograph and upload pictures of any wildlife they encounter. A network of scientists and experts from around the world then helps the users identify their finds, generating data points on an interactive, user-generated map of various species’ ranges.

Simple, right? Multiply that by 500,000 users worldwide, though, and it’s easy to see why researchers like Loarie are excited by the possibilities an app like this can offer. The software first went live in 2008, and since then its user base has roughly doubled each year. This has meant the generation of over 8 million data points of 150,000 different species, including one-third of all known vertebrate species and 40% of all known species of mammal. Every day, the app catalogues around 15 new species.

“We’re slowly ticking away at the tree of life,” Loarie said.

Through iNaturalist, researchers are able to analyze and connect to data in ways never before thought possible. Changes to environments and species’ distributions can be observed or modeled in real time and with unheard-of collaborative opportunities.

To demonstrate the power of this connectedness, Loarie recalled one instance of a citizen scientist in Vietnam who took a picture of a snail. This species had never been captured, never been photographed, hadn’t been observed in over a century. One of iNat’s users recognized it anyway. How? He’d seen it in one of the journals from Captain James Cook’s 18th-century voyage to circumnavigate the globe.

It’s this kind of interconnectivity that demonstrates not just the potential of apps like iNaturalist, but also the power of collaboration and the possibilities symposia like Duke Blueprint offer. Bridging gaps, tearing down boundaries, building up bonds—these are the heart of conservationism’s future. Nature and Progress, working together, pulling us forward into a brighter world.

Post by Daniel Egitto

 

 

Hearing Loss and Depression Are Connected

Jessica West is a PhD candidate in sociology.

Jessica West, a PhD student in sociology at Duke, has found that hearing loss creates chronic stress but that high levels of social support – from family, friends and others – can help alleviate depression. Given that hearing loss is a growing social and physical health problem, her study suggests a need for increased vigilance regarding hearing loss among older adults, West said.

Her study was published in the November issue of Social Science & Medicine and is available here.

Here, West discusses her research.

Your research examines the correlation between hearing loss and depression. That seems a logical connection: why study it in the way you did?

Despite how common hearing loss is, it is actually quite understudied. A handful of studies have looked at the relationship between hearing loss and mental health over time, but the results from these studies are mixed: some find a relationship between hearing loss and more depressive symptoms, while others do not. On top of the mixed findings, most studies have been based overseas, and studies based in the U.S. have tended to use state-specific datasets, like the Alameda County Study, which drew from Oakland and Berkeley, CA.

I use the Health and Retirement Study, which is nationally representative of adults aged 50 and older in the U.S., and therefore more generalizable to the U.S. population.

I frame hearing loss as a physical health stressor that can impact mental health, and that social support can alter this relationship by preventing a person from experiencing stress or reducing the severity of a reaction to it. To the best of my knowledge, this is the first paper to link hearing loss to health outcomes in this way.

What might surprise people about your findings?

More than one-fifth of the people in my sample have fair to poor hearing (23.12% or 1,405 people in the first wave). Hearing loss is really common in the U.S.

Also, I found that social support is most beneficial in easing the burden of hearing loss among people with significant hearing loss. Overall, this suggests that hearing loss is a chronic stressor in people’s lives and that responses to this stressor will vary by the level of social resources that people have available to them.

What does ‘social support’ mean in real terms? What can the family and friends do for a person with hearing loss to help them?

For people with hearing loss, it’s important that they feel able to lean on, talk to, and rely on family, friends, spouses or partners, and children. And going a step further, people with hearing loss need to know that these important people in their lives truly understand the struggles they face. What this means is that people with hearing loss can benefit quite a lot from having a network of people that they feel comfortable discussing things with or reaching out to when needed.

Do people with hearing loss have adequate mental health resources or care available to them?

My research shows that social support is really important for people with hearing loss. One suggestion I make in my paper is that audiologic – or hearing — rehabilitation programs could include educational training for significant others, like spouses or friends, to emphasize the importance of supporting people with hearing impairment. Audiologists, primary care physicians, family, and friends are all key resources that could be targeted in such rehabilitation programs.

 What is your next project related to hearing loss?

 I am currently working on several projects related to hearing loss. In one, I am looking at the relationship between an individual’s hearing loss and his/her spouse’s mental health outcomes. Few population-based studies have examined the relationship between hearing loss and spousal mental health longitudinally, so I hope this study will shed light on the experience of spousal disability within marriages.

Another project I am working on looks at hearing loss from a life course perspective. In other words, I am looking at people who self-reported hearing loss before the age of 16 and seeing how their hearing loss influenced their marriages, academics and careers. A better understanding of how early life hearing loss influences later life outcomes has implications for earlier identification of hearing loss and/or the use of assistive technology to help people remain socially, academically, and economically engaged.

CITATION: West, Jessica S. 2017. “Hearing Impairment, Social Support, and Depressive Symptoms among U.S. Adults: A Test of the Stress Process Paradigm.” Social Science & Medicine 192(Supplement C):94-101.

 Read the paper 

Guest post by Eric Ferreri, News and Communications

Jonathan Mattingly: Mathematics and Maps to Define Democracy

Jonathan Mattingly is the chair of mathematics at Duke and an alumnus of the NC School of Science and Math

What began as an undergraduate project looking at how to create a “typical” map of congressional districts expanded to a national investigation for Duke mathematics chair Jonathan Mattingly. He was generous enough to speak to me about some of his recent work in mathematically investigating gerrymandering and the communication which followed between lawmakers and statisticians.

By strategically manipulating certain lines, it is possible to ensure a certain number of seats for one party even if that party does not win the majority vote. What “Team Gerrymandering” set out to do was to create an algorithm which would create the least biased map possible. The use of the term “fair” is complex in this instance, as politics and geography are very rarely simple enough to be split fairly.

An example of a mathematical model of precincts and districts.

In Wisconsin, the algorithm which “Team Gerrymandering” developed was used to prove that the voting districts were being disproportionately drawn in favor of the Republican votes, a trend which had was also been seen after the 2015 elections in North Carolina districts.

By strategically manipulating certain lines, it is possible to ensure a certain number of seats for one party even if that party does not win the majority vote. What “Team Gerrymandering” set out to do was to create an algorithm which would create the least biased map possible. The use of the term “fair” is complex in this instance, as politics and geography are very rarely simple enough to be split fairly.

The algorithm developed was then submitted as an brief amicus curae brief and used (it was used as a piece of appellate evidence) in the Wisconsin case Whitford vs. Bill. case. The mathematicians hoped to , in an attempt to prove that the districting of Wisconsin is an outlier in comparison to thousands of other mapping simulations run under their algorithm, which provide statistically sound data.

A problem such as this is a prime example of the bridge between the Humanities and STEM fields, which become increasingly separate as the level of expertise rises. as this truly bridges the humanities and STEM fields:, a solution has been found, but effectively communicating it was not as simple.

When asked about explaining and publishing this work in order to submit it as evidence, Mattingly admitted that it was, at times difficult, but it only further proved how important the effort is.

“It starts with a conversation. I’m willing to explain it, but you have to be willing to listen.”

A team full of lawyers looking to win a case is arguably a highly motivated audience, but this is not always the case. Mattingly, who is a 1988 graduate of the NC School of Science and Math which I attend, mentioned being at parties and hearing people state, “Oh, I’m no good at math, it’s just numbers and letters to me,” but he could never recount anyone saying “Oh, I don’t see the point in using language, or reading a dictionary.” These may seem like harmless comments, but a subconscious form of selective ignorance is still selective ignorance.

In light of the gerrymandering case, and “Team Gerrymandering’s” involvement in it, we are called to think again about the importance of fields we are not necessarily involved in, especially the STEM fields. What other patterns aren’t we noticing because we failed to look? Where else could we be improving if we were willing to listen? If we both don’t try, then we aren’t getting anywhere.”

The results of the Whitman vs Gill case are expected in June of 2018, and until then, the conversation must continue.

UPDATE: On Jan. 9, a federal court panel struck down North Carolina’s Congressional district maps on the grounds that they had been gerrymandered to favor Republicans. Mattingly commented.

Guest post by Paris Geolas, a senior at the North Carolina School of Science and Math

Beatriz Morris: Providing Pediatric Care in Two Languages

“‘Betty, education is the most important thing,” her father said. “We lost our home, our land, our cars, our farm, everything we have ever owned. But what I have in my head, no one can take away from me.’”

Six-year-old Beatriz glanced back up at her father and then towards the new life ahead of her. She would remember this moment in all of her years to come.

Beatriz Morris MD

Beatriz Morris, MD, practices pediatric medicine in English and Spanish at Duke Children’s Primary Care near the Southpoint Mall.

Beatriz and her family immigrated to the United States from Cuba seeking religious freedom and an escape from communism with nothing more than the clothes on their backs. Beatriz’s father instilled a lesson in her that day which she now sees as a life philosophy. She prioritizes learning, for it is the one thing no one else has power over.

Learning English at the age of six was not a hard task for Beatriz, and she is still bilingual. Today, she is Dr. Beatriz Morris, practicing pediatric medicine at Duke Children’s Primary Care near the Southpoint Mall. She completed her residency at Emory University and  has been in practice for over 20 years, but never imagined she would be walking the path that she is today.

“I never thought I would be a pediatrician. It was not on my list, it was not anything to me,” said Dr. Morris. She uses a proverb to remind us to never say never. “Never say you’re not going to be drinking from this water because you will be drinking gallons.”

Dr. Morris went to undergraduate school intending to pursue art, with a specific career goal in mind – to illustrate medical textbooks. To meet the requirements for a medical illustration major in graduate school, she ended up receiving enough credits in both art and science to double major for her bachelor’s degree. But in applying to illustration school, she never could have predicted what happened next.

“I went to medical school because I did not get into art school,” Dr. Morris explained. “Eventually I did an internship year at a rotation after medical school, doing a little bit of everything. The good thing was that I started in pediatrics.”

From there on out, Dr. Morris never looked back. She has been practicing in pediatrics for over twenty years, embracing both her Hispanic and American heritages. Speaking both Spanish and English allows Dr. Morris to make her patients comfortable by not only knowing their languages, but also having a deep understanding of both cultures.

Dr. Morris explained how that something seemingly simple, such as the phrasing of questions, can determine a patient’s comfort level. For example, in American culture, it is polite of the doctor to ask permission of the patient before beginning the consultation, such as saying ‘Do you mind if we talk about your weight?’

In Hispanic culture, this verbiage would make the doctor appear unknowledgeable to the patient. The patient is more trusting of the doctor through confidence, by saying something like ‘Let me tell you what you need to do about your weight.’

“A lot of times people feel more comfortable speaking in their own language,” she said. “There are colloquialisms of phrases, things like that, that make talking in their native language a lot easier for them.”

Dr. Morris wakes up every day excited to do her job. She reflected on the moment when she knew that pediatrics was the specialty she was meant to work in. On her internship rotation, Dr. Morris spoke to a nurse, who then told her that she would make a great pediatrician.

“That moment was when I started thinking that pediatrics might be a calling for me. This might be something that I did not think of, but it might be my purpose in life. This career has been the best choice I have made.”

Her advice to those looking for a lifelong fulfilling career is best described by how you feel waking up in the morning. Is waking up to go to work dreadful, or are you opening your eyes happy, knowing that you have the privilege to do what you love for another day?

“Don’t do something because it will be easy, for money, or because your parents tell you to,” she advised. “Do something because it is in your heart. If they close the door on you, open the window,” Dr. Morris said.

Samantha GonskiGuest Post by Samantha Gonski, a senior at North Carolina School of Science and Math

David Carlson: Engineering and Machine Learning for Better Medicine

How can we even begin to understand the human brain?  Can we predict the way people will respond to stress by looking at their brains?  Is it possible, even, to predict depression based on observations of the brain?

These answers will have to come from sets of data, too big for human minds to work with on our own. We need mechanical minds for this task.

Machine learning algorithms can analyze this data much faster than a human could, finding patterns in the data that could take a team of researchers far longer to discover. It’s just like how we can travel so much faster by car or by plane than we could ever walk without the help of technology.

David Carlson Duke

David Carlson in his Duke office.

I had the opportunity to speak to David Carlson, an assistant professor of Civil and Environmental Engineering with a dual appointment at the Department of Biostatistics and Bioinformatics at Duke University.  Through machine learning algorithms, Carlson is connecting researchers across campus, from doctors to statisticians to engineers, creating a truly interdisciplinary research environment around these tools.

Carlson specializes in explainable machine learning: algorithms with inner workings comprehensible by humans. Most deep machine learning today exists in a “black box” — the decisions made by the algorithm are hidden behind layers of reasoning that give it incredible predictive power but make it hard for researchers to understand the “why” and the “how” behind the results. The transparent algorithms used by Carlson offer a way to capture some of the predictive power of machine learning without sacrificing our understanding of what they’re doing.

In his most recent research, Carlson collaborated with Dr. Kafui Dzirasa, associate professor of psychiatry and behavioral sciences and assistant professor in neurobiology and neurosurgery, on the effects of stress on the brains of mice, trying to understand the underlying causes of depression.

“What’s happening in neuroscience is the amount of data we’re sorting through is growing rapidly, and it’s really beginning to outstrip our ability to use classical tools,” Carlson says. “A lot of these classical tools made a lot more sense when you had these small data sets, but now we’re talking about this canonically overused word, Big Data”

With machine learning algorithms, it’s easier than ever to find trends in these huge sets of data.  In his most recent study, Carlson and his fellow researchers could find patterns tied to stress and even to how susceptible a mouse was to depression. By continuing this project and looking at new ways to investigate the brain and check their results, Carlson hopes to help improve treatments for depression in the future.

In addition to his ongoing research into depression, Carlson has brought machine learning to a number of other collaborations with the medical center, including research into autism and patient care for diabetes. When there’s too much data for the old ways of data analysis, machine learning can step in, and Carlson sees potential in harnessing this growing technology to improve health and care in the medical field.

“What’s incredibly exciting is the opportunities at the intersection of engineering and medicine,” he said. “I think there’s a lot of opportunities to combine what’s happening in the engineering school and also what’s happening at the medical center to try to create ways of better treating people and coming up with better ways for making people healthier.”

Guest Post by Thomas Yang, a junior at North Carolina School of Math and Science.

Kathleen Pryer: A Passion for the Little-Loved Fern

Most people don’t see in ferns the glory and grandeur of the mighty angiosperms — the flowering plants — but to those who can, ferns may seem like the only thing you could spend your time researching.

Fei-wei Li, Kathleen Pryer

Kathleen Pryer, with former graduate student Fei-Wei Li. (Duke photography)

Kathleen Pryer, a professor of biology at Duke, is an example of one of these people who found their calling in ferns. But she didn’t know it would be ferns from the beginning.

As an undergraduate, she had thought she wanted to be an animal behaviorist, having read books by Jane Goodall, so she enrolled in McGill University in Montreal (she’s Canadian by the way) in the animal behavior program and didn’t end up taking a single botany course until her senior year.  For her final project she worked with snails, a starkly slow endeavor, she thought. Slower even than ferns. After getting her degree in animal behavior, she decided she wanted a masters working with plants, but before jumping right in with only one class’ worth of experience with plants, she worked as a technician for a budding ecologist.  While working there, the ecologist’s wife, who did her masters on ferns, took her on a trip to the annual meeting of the botanical society of America in Blacksburg, VA, a 13-hour trip.

In Virginia, she went on a 2-day field trip through Virginia, led by fern expert Warren Wagner, finding ferns with 107 other people who were mad about ferns.

“It was just serendipity really.”

After that, the idea of ferns stuck, and she’s been working with them ever since.  She’s gotten the chance to name or rename many species of fern, and she created the genus Gaga, named after the singer.  Another new genus she found is soon to be named Mandela by her as well; a nice change from the usual names of “old white guys,” given to new genera, she said.

Through it all though, Pryer is most proud of a paper from 2001, which showed that all modern ferns originated from a central progenitor, showing that they aren’t as archaic as most people think. That paper made the cover of Nature, and has been cited hundreds of times since.

In the end, I guess it’s really hard to tell where you’ll end up.  If an aspiring animal behaviorist can jump to the world of ferns and make a successful career out of it, surely there’s hope for the rest of us too.  In the end, all that matters is if you’re doing what you love, and as for Kathleen Pryer, she’ll keep doing what she loves as long as there’s a “chair and a microscope” for her to sit at.

Isaac PoarchGuest Post by Isaac Poarch, a senior at the North Carolina School of Science and Math

Leonor Corsino: Research and Care Toward Alleviating Diabetes

Dr. Leonor Corsino works to relieve the prevalent issues regarding diabetes and obesity. An endocrinologist and professor at the Duke School of Medicine, her passions lie in understanding the struggles that diabetics face through comprehensive patient care and communication.

Leonor Corsino

Her interests in endocrinology began at a young age. She grew up watching her father and many other members of her family challenged with balancing a normal life alongside diabetes. When she progressed to medical school, she was fascinated by the workings of the hormonal system, one of the most neatly regulated of all the biological systems.

“When it works in harmony, everything is perfect, but when something goes off, it affects many other organs,” she says.

Corsino believes that patient-provider communication is the most important thing for the makings of a good endocrinologist. As the Associate Director for Masters in Biomedical Sciences, she aims to teach students pursuing a career as a healthcare professional to be empathetic. “[A student] can be the smartest person in world, but if [they] don’t know how to communicate with the patient, their ability to provide care gets compromised.”

Another factor that plays a role in providing good patient care is the amount of time available to treat each person, according to Corsino. Although Corsino always aspires to treat her patients to the best of her abilities, occasionally, the limited time she has with each individual can impose difficulties with empathizing and treating patients. However, many regular patients don’t mind when their appointments are delayed because they know that they will receive better care when they are able to get her undivided attention.

Beyond her clinical expertise, Corsino’s research focuses on similar issues. Through her research, she intends to improve the healthcare of minorities in the country, as they are the groups that are most affected by diabetes. In the past 11 years, she has introduced interventions to improve and maintain weight loss and worked with pharmaceutical companies to look at potential drugs to treat diabetes. She intends to answer the questions “How do we motivate people to exercise? What is the reason some people struggle with diabetes and other people don’t?”

Corsino has found that biological factors play an equal role to environmental factors in the risk of getting diabetes. Sometimes, even if a patient strictly adheres to the prescribed treatment, they still don’t see the same results and progress as others do. This distinction can be attributed to things like differences in fat distribution and insulin resistance.

In her work, Dr. Corsino tries to alleviate the stress and difficulties that those with diabetes and obesity encounter. As a doctor and professor, she inspires others to pursue a career in public health and provide healthcare to those who need it.

Sindhu PolavaramGuest Post by Sindhu Polavaram, a senior at North Carolina School of Science and Math

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