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

Author: Olivia Ares

Medicine Under a Microscope

Duke Research Week 2022 featured a range of speakers from across all disciplines. The Lefkowitz Distinguished Lecture on January 31st highlighted some of our favorite things here at Duke Research Blog: ingenuity and perspective. 

Dr. Huda Yahya Zoghbi’s career spans decades; her Wikipedia page sports an “Awards and Honors” section that takes up my entire computer screen. She is a geneticist, neuroscientist, pediatric neurologist, pharmaceutical executive, and literature lover. Her presentation kicked off 2022 Research Week with a discussion of her work on Rett Syndrome. (View the session)

Rett Syndrome is a rare genetic disorder. The gene that researchers identified as the driver of the syndrome is MeCP2, which is especially active in brain cells. Certain mutations of this one gene can be responsible for a loss of speech, development issues, and persistent fidgeting. 

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The MeCP2 protein. Image: Wikipedia Commons

Children with Rett Syndrome faced chronic misdiagnosis, and even with proper care were limited by a lack of research.

Duke’s Dr. Robert Lefkowitz introduced Zoghbi at the beginning of the seminar and explained how she came to become the leading expert on this relatively unknown disorder. After completing medical school in Beirut in the midst of the ravaging Lebanese Civil War, she came to Texas Children’s Hospital, where she was able to observe and diagnose her first case of the syndrome, a process spurred by a simple interest in a newly-published journal article.

Holistic knowledge of Rett Syndrome is completely dependent on genetic research. A mutation on the MeCP2 gene causes errors in transcription, the reading out of DNA in your cells which leads to the production of proteins.

The mutated gene’s MeCP2 protein is then lacking the ability to do its job, which is helping other genes be expressed, or actively transcribed.

It’s a vicious cycle; like when you go to sleep late one night, so you sleep in the next day, then go to sleep late the next night, then sleep in the next day, and so forth.

In order to simulate and measure the effect of different kind of mutations on the MeCP2 gene, Zoghbi and her team studied genetically modified mice. While Rett Syndrome is caused by a lack of MeCP2 function, an overactive MeCP2 gene causes MeCP2 duplication syndrome. Varying degrees of gene efficiency then produce varying degrees of severity in the syndrome’s traits, with fatality at either end of the curve.  

Varying degrees of phenotype severity.

Zoghbi’s talk focused mainly on the mechanics of the disorder on a genetic level, familiar territory to both Nobel Laureate Lefkowitz and Duke Medicine Dean Mary Klotman, who shared some discussion with Zoghbi.

This medicine on a microscale is applicable to treating genetic disorders, not just identifying them. Zoghbi has been able to experimentally correct MeCP2 duplication disorder in mice by modifying receptors in a way that reverses the effects of the disorder.

The symptoms of Rett Syndrome are physical; they present themselves as distinct phenotypes of a subtle difference in genotype that’s too small to see. The field of genetics in medicine is responsible for making that connection.

Post by Olivia Ares, Class 2025

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How is Universal Healthcare Like the Waterboarding Debate?

The Duke Medical Ethics Journal (DMEJ) is an undergraduate publication started in Spring of 2020 that examines conversations around universal patient-doctor responsibility. In other words, they’re training the next generation of healthcare providers to ask big questions and make informed decisions. So, we owe them a huge thank-you in advance. 

On Sunday, October 24th, DMEJ hosted Dr. Gopal Sreenivasan to speak with current members. The event was open to the public as part of the club’s mission to promote ethical practices across all fields. Dr. Sreenivasan is a moral philosopher, but he is also a professor of medicine at Duke Medical School. His position as the “Crown Professor of Ethics at the Trent Center for Bioethics, Humanities & History of Medicine,” is part of an initiative to connect societal arts and sciences aspects of Duke University to the Medical School. 

Dr. Gopal Sreenivasan

“Today, I want to talk to you all about the human right to health,” he opened. 

Sreenivasan’s talk was focused on the question of how individual countries can provide healthcare or insure health.  “One division within the human right to health is the division between health and healthcare,” he clarified. “Another is the difference between a regular right and a human right.” 

As a philosopher, Sreenivasan took the issue of access to health and placed it on a universal scale. He addressed the social determinants of health (callback time!) as part of the solution, alongside more direct-but-still-indirect healthcare actions like vaccinations. His conclusion? We are ultimately moving away from the narrative that we have a right to healthcare and towards the narrative that we have a human right to health

“You have a right to health, but that does not necessarily mean you are going to be healthy. There are still factors that affect this which are under no one’s control. It doesn’t mean that if you don’t live to be 80 or 85 that your right has been violated. But you’re still entitled to a broader range of things than just health.”

To help illustrate this for my fellow visual learners, I’ve made a fun little visual aid. 

Sreenivasan laid out a verbal map to demonstrate the confusion policy makers face about addressing the wellbeing of their constituents. If you believe healthcare is a right, you believe the government has a different role to play than if you believe health is a right. You may expect less of them in terms of handling indirect factors like social determinants and vaccines. If you believe healthcare is a human right, you expect all governments to provide healthcare access universally. This is different from Sreenivasan’s preferred view: health is a human right. All people are entitled to all aspects of their health being addressed all the time in every way in every place. 

The word human in “human right” indicates universality the same way removing the care from “healthcare” does; they both broaden the scope. 

After that lovely philosophical grammatical discussion (Do colorless green ideas sleep furiously?) as our foundation, Sreenivasan moved on to a challenging analogy: waterboarding

“It does not belong to the nature of a right that everyone has to have it. But it does seem to belong to the nature of a human right that everyone has to have it. Take the human right to not be tortured, for example.”

Your moral view may differ on whether or not it is a human right not to be tortured. You may think the right should apply to all people, or no people, or only some people. But you also may think that the right should apply to only certain aspects of torture; maybe you think that specifically waterboarding doesn’t count.

(The debate around whether or not waterboarding counts as torture and whether or not it is prohibited under human rights legislation is one that has been around for a long time. Torture has been banned by multiple American presidents in multiple environments, but the language around waterboarding in particular is highly controversial. You can read more about the debate here.)

“It’s not that some people have a human right not to be tortured which protects them from waterboarding, and other people have a human right not to be tortured but it is somehow lesser and does not protect them from waterboarding. You can’t pick and choose the content based on the person for whom the right belongs.”

So, how is the waterboarding debate like universal healthcare?

For one, it’s a matter of exclusion. It’s a matter of moral philosophy. It’s a matter of definition. 

The question of whether there should be universal healthcare goes far beyond the question of whether healthcare is a right. 

How do we improve access? Who is at fault for rising drug prices? How is America’s healthcare system different than other countries? These questions must start with questions of definition. Who is our target audience? Who is included? Who is excluded? What is included? What is excluded? 

“It seems intuitive that human rights are all or nothing.” Sreenivasan explained. “Either everyone has them or no one has them. But then you must say that their content also has to be the same.”

Post by Olivia Ares, Class 2025

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If Homer Had a Guitar

Most ninth-graders in the U.S. read The Odyssey for English class. Not that many sing it, though. 

Since 2001, Joe Goodkin has traveled the U.S. performing his retelling of The Odyssey. “These poems were meant to be felt, not studied, and I think my work can add that element back into how we encounter them today,” he says. 

Last week, he premiered his new work: an American Blues re-telling of The Iliad. 

The Duke Classical Studies Department hosted Goodkin to perform this piece on Friday, October 22nd in the Sarah P. Duke Gardens (The weather being lovely, he remarked: “Thank you, Zeus. I must have performed the right number of hecatombs”).

The Blues of Achilles re-tells The Iliad from eleven different perspectives. “This is what I envisioned these songs being,” Goodkin confessed to his audience. “Us doing exactly what they did 3,000 years ago— sitting around, listening to stories of the Trojan War.”

He’s referring to the fact that epic poems were written to be sung as performances rather than read as stories (Although if you’re like me and your only prior knowledge of the Trojan War came from Madeline Miller, you might be confused). Homer’s The Odyssey and The Iliad lose some of their musicality when translated into English and read off of a page, but Goodkin aims to re-invigorate those stories. 

Goodkin’s work is a form of artistic research used to better understand Greek culture. He gives the example of The Singer of Tales, a book about the importance of oral tradition as a form of research. Written in 1960 by Harvard professor Albert Lord, The Singer of Tales focuses on illiterate oral poets of former Yugoslavia and compares their methods to Homeric epic. Cool, right? While it seems a bit far-fetched, Goodkin is actually doing something similar.

“While I don’t expect my work to be as important or scholarly as that book,” Goodkin notes, “I think [my work] can be a way for modern audiences to treat the epic poems as experiences rather than just artifacts.”

Joe Goodkin performed in the Sarah P. Duke Gardens on Friday, Oct. 22.

Homer’s works were integral to Greek life and values. Storytelling, to the Greeks, was the main form of broad communication and cultural unity. Modern organizations like the International Storytelling Center recognize the importance of oral literature and its effect on our cultural understanding.

We tell stories all day every day (heck, you’re even reading one right now!); Goodkin, and other storytellers, use this link to connect with their audience and convey an understanding of other cultures and viewpoints. Goodkin’s The Blues of Achilles reflects many attributes of the original, as well. For one, the chronology of the story is reversed. “I wanted my audience to have the same sort of idea a Greek audience would have about the end of the story. You have different things in play when the audience knows the end of the story. Even thinking about time in The Iliad, it’s very elastic and funky. So I wanted to recreate some of that disorientation,” he explained. 

The Blues of Achilles is a blues composition— and blues music, like epic poems, is a culture-specific art form. In explaining his interpretations, Goodkin said: “I thought, ‘If Homer’s Iliad is “The Wrath of Achilles”, I have to interpret that line in a different way, like a poet would.’” (Author’s note: Remind you of anything?) “For one, ‘blues’ is in his name— áchos laós means the grief of the people.”

In re-telling these epics, Goodkin is not only bringing another perspective to the classics scene, but connecting it to American culture. “Blues music is our oral tradition. It was composed and came to be as an art form largely the same way the Greek epic did, by these bards-slash-singer-songwriters,” he explains. 

Homer retellings, interpretations, and translations differ across time and perspective, but they all intend to revive the poems for their audience. Whether or not we see the connections to our lives, these myths originated many archetypes we are familiar with (Just ask Meg Ryan). In the end, Greek myths are all human stories about tragedy, war, love, loss, and morality, and they are as relevant today as they were 3,000 years ago.

If you’re interested in working with the Gardens for your class or research, contact kati.henderson@duke.edu or visit this link.

Post by Olivia Ares, Class 2025

Dr. Laura Richman is Defining Health by its Social Determinates

In 2010, the Affordable Care Act sparked a nationwide debate on the extent of responsibility the American government has over our healthcare. But Dr. Laura Richman has been asking that question since long before that. 

Richman is a health psychologist. “I examine psychosocial factors that have an impact on health behaviors and health outcomes,” she explains, sitting across from me at the Law School café. (Neither of us were wearing a cardigan. It was rather hot outside). 

Laura Richman Ph.D. is an associate professor in population health sciences. (image: Scholars@Duke)

Richman is an associate professor at Duke in the Population Health Sciences, an associate of the Duke Initiative for Science & Society, and, coincidentally, my professor in the Science & the Public FOCUS cluster. She co-teaches the course Science, Law, and Policy with Dr. Yousef Zafar, in which we examine the social determinants of health through the lens of cancer screening, diagnosis, and treatment.

After graduating from the University of Virginia in 1997 with a Ph.D. in social psychology, Richman worked at a sort of think-tank for health professionals collaborating on social issues. This inspired her to pursue health research through the lens of social determinants.

“There was a lot of work on substance use, on mental health, on behavioral disorders. That certainly contributed to my continued interest in factors that have an influence on these [health] outcomes,” she said. 

Continuing in this work, she became a research associate at the School of Public Health at Harvard University; Richman described her time at Harvard as “exciting,” which is not a word used by many to describe empirical research environments. “Certainly there’s that really robust relationship between low income, low education, low job status and poor health outcomes, but a lot of those pathways— like the ones we talk about in class, Olivia— had not been studied.” 

She’s referring to the public health concept of ‘upstream’ and ‘downstream’ solutions. (The river parable goes as follows: when you observe a trend in people drowning in a certain river, you are presented with different ways of solving the problem. You can start pulling people out of the river and saving them one at a time, which is called a “downstream” solution in public health. You can also prevent people from falling into the river, which is called an “upstream” solution.)

(courtesy of SaludAmerica!)

Richman’s professional research explores another crucial social determinant of health we discussed in class: perceived versus actual discrimination. She asked whether marginalization — objectively or subjectively — can affect functioning, “both psychologically and cognitively. Like, how does it affect their thought processes? Their decision-making? Then, how does that affect their health?” You can read her study here

One thing I noted immediately was Richman’s affinity for creative research design. In a lab she headed at Duke, she conducted one experiment with a student that tested the aforementioned effect of marginalization on health decisions. They provided subjects with a choice between unhealthy and healthy snack options after watching a video of, reading a passage about, or imagining members of their community experience discrimination.

In one study we read for Science, Law, and Policy, the stress effect of discrimination towards Arabic-named individuals after 9/11 was measured through the birth outcomes of Arabic-named mothers pregnant during that time. When I asked her about this, she said, “Particularly working with students, I think that they just bring so much energy and creativity to the research. Surveys serve their purpose — I think they’re really important, but I think there are just lots of opportunities to do more with research designs and research questions. I like trying to approach things from a different angle.” 

Richman is also working on a book. She is studying relational health — health as determined by the opioid epidemic, the obesity crisis, and social isolation associated with aging. She hopes her project will be used in classrooms (and by the interested layman), and that the value of social determinants of health is reflected in increased funding dollars, more people interested in health disparities, more focus in medical education on the screening and referral system, and stimulating dialogue among people in positions of power on a policy level.

Post by Olivia Ares, Class of 2025

‘Anonymous Has Viewed Your Profile’: All Networks Lead to Re-Identification

For half an hour this rainy Wednesday, October 6th, I logged on to a LinkedIn Live series webinar with Dr. Jiaming Xu from the Fuqua School of Business. I sat inside the bridge between Perkins and Bostock, my laptop connected to DukeBlue wifi. I had Instagram open on my phone and was tapping through friends’ stories while I waited for the broadcast to start. I had Google Docs open in another tab to take notes. 

The title of the webinar was “Can Anyone Truly Be Anonymous Online?” 

Xu spoke about “network privacy,” which is “the intersection of network analysis and data privacy.” When you make an account, connect to wifi, share your location, search something online, or otherwise hint at your personal information, you are creating a “user profile”: a network of personal data that hints at your identity. 

You are probably familiar with how social media companies track your decisions to curate a more engaging experience for you (i.e. the reason I scroll through TikTok for 5 minutes, then 30 minutes, then… Oh no! Two hours have gone by). Other companies track other kinds of data— data that isn’t always just for algorithmic manipulation or creepy-accurate Amazon ads (i.e. “Hey! I was just thinking about buying cat litter. How did Mr. Bezos know?”). Your name, work history, date of birth, address, location, and other critical identifying factors can be collected even if you think your profile is scrubbed clean. In a rather on-the-nose anecdote to his LinkedIn audience on Wednesday, Xu explained that in April 2021, over 500 million user profiles on LinkedIn were hacked. Valuable, “sensitive, work-related data,” he noted, was made vulnerable. 

Image courtesy of Flickr

So, what do you have to worry about? I know I tend to not worry about my personal information online; letting companies collect my data benefits me. I can get targeted Google ads about things I’m interested in and cool filters on Snapchat. In a medical setting, Xu said, prediction algorithms may help patients’ health in the long run. But even anonymized and sanitized data can be traced back to you. For further reading: in an essay published in July 2021, philosophers Evan Selinger and Judy Rhee elaborate on the dangers of “normalizing surveillance.”

The meat of Xu’s talk was how your data can be traced back to you. Xu gave three examples. 

The first was a study conducted by researchers at the University of Texas- Austin attempting to identify users submitting “anonymous” reviews for movies on Netflix (keep in mind this was 2007, so picture the red Netflix logo on the DVD box accordingly). To achieve this, they cross-referenced the network of reviews published by Netflix with the network of individuals signed up on IMDB; they matched those who reviewed movies similarly on both platforms with their public profiles on IMDB. You can read more about that specific study here. (For those unafraid of the full research paper, click here). 

Let’s take a pause to learn a new vocab word! “Signatures.” In this example, the signature was users’ movie ratings. See if you can name the signature in the other two examples.

The second example was conducted by the same researchers; to identify users on Twitter who shared their data anonymously, it was simply a matter of cross-referencing the network of Twitter users with Flickr users. If you know a guy who knows a guy who knows a guy who knows a guy, you and that group of people are likely to initiate that same chain of following each other on every social media platform you have (it may remind you of the theory that you are connected by “six degrees of separation” from every person on the planet, which, as it turns out, is also supported by social media data). The researchers were able to identify the correct users 30.8% of the time. 

Time for another vocab break! Those users who connect groups of people who know a guy who know a guy who know a guy are called “seeds.” Speaking of which, did you identify the signature in this example? 

Image courtesy of Flickr

The third and final example was my personal favorite because it was the funkiest and creative. Facebook user data— also “scrubbed clean” before being sold to third-party advertisers— was overlain with LinkedIn user data to reveal a network of connections that are repeated. How did they match up those networks, you ask? First, the algorithm assigned a computed score to every individual user based on how many Facebook friends they have and one for every user based on how many LinkedIn connections they have. Then, each user was assigned a list of integers based on their friends’ popularity score. Bet you weren’t expecting that. 

This method sort of improves upon the Twitter/Flickr example, but in addition to overlaying networks and chains of users, it better matches who is who. Since you are likely to know a guy who knows a guy who knows a guy, but you are also likely to know all of those guys down the line, following specific chains does not always accurately convey who is who. Unlike the seeds signature, the friends’ popularity signature was able to correctly re-identify users most of the time. 

Sitting in the bridge Wednesday, I was connected to many networks that I wouldn’t think could be used to identify me through my limited public data. Now, I’m not so sure.

So, what’s the lesson here? At the least, it was fun to learn about, even if the ultimate realization leaves us powerless against big data analytics. Your data has monetary value, and it is not as secure as you think: but it may be worth asking whether or not we even have the ability to protect our anonymity.

New Blogger Olivia Ares: Building Bridges

My name is Olivia Ares (she/her), and I’d like to provide the opportunity for you to get to know me better. In true blog post fashion, here are some quick facts at the outset:

  1. I’m from Johnson City, TN, which probably doesn’t mean anything to you unless you’re a fan of Mountain Dew or Logan from Gilmore Girls.
  2. I’m a freshman here at Duke, and I plan on majoring in Evolutionary Anthropology. For now.
  3. My party trick is knowing way too much about celebrities.
  4. I’m half-Cuban, but I’m also a vegetarian, which is a tragedy in seven words. At least I’ll always have moros y christianos.
  5. I play the fiddle; not the violin. What’s the difference, you ask?
  6. Those close to me claim I have a “cardigan problem.” (By that, they mean that I own an obscene amount of cardigans. If you ask me, that sounds like the exact opposite of a problem.)
Pictured here is my green three-quarter sleeve cardigan with flower-shaped buttons, which provides a colorful accent.

You may be asking yourself what interest I could possibly have in being a research blogger, since I’m clearly destined for a future in comedy (or cardigan connoisseurship). And especially since, as you’ll soon learn, I’m not a science person.

Like a lot of people during our year of virtual school, I went through a lifetime of hobby phases in a matter of months. I started with baking, which only lasted until the bread flour ran out. I watched a lot of movies that I had always wanted to see (which often disappointed), and I rewatched a lot of movies I loved (which never disappointed). I tried learning the guitar, but I never practiced enough to build up the right callouses, so I never practiced at all. I discovered a love for puzzles and an utter lack of skill for them. I downloaded The Sims 4 on a free trial, spent months building a super cool house, then deleted the whole game.

My three favorite things in one picture: lavender cold brew, Taylor Swift, and my blue wool cardigan.

The only thing that’s stuck so far has been reading. In middle school, we used to stay up late with a flashlight under our covers to finish books, then abruptly lost all motivation somewhere between The Giver and The Scarlet Letter. I think we forgot along the way that there are no rules to reading; there’s no one to impress. There’s no one to sample your sourdough or judge your twangy, painful acoustic cover of “Three Blind Mice.” Reading is something you do purely for yourself.

Reading makes information and ideas universally accessible; it connects worlds using only ink on a page. There’s this myth that analytical minds are not creative minds and vice versa, and it alienates people: people who would bring such great perspectives to the table if they hadn’t been defined by a checklist of abilities. Reading is for everyone to find what they love and to love what they find (or hate it; one of the great things about doing things for yourself is that you can just quit whenever you want to).

Scientific research, on the other hand, is something produced for everyone. Humans exploring more and more about the world is something that affects all of us, despite the research being conducted only by a select few of us.

My black long-sleeve cardigan is a personal favorite, as it goes with pretty much everything.

Freshman year of high school, I finished chemistry with a B, which was a miracle considering I was rocking a D around November. I had to change my way of looking at the material; I couldn’t remember the makeup of an atom, but I could remember it if I thought about the stories of individuals who built off of each model in succession. I didn’t understand stoichiometry, but I did understand you have to balance equations just like weights on a scale or kids on a see-saw.

My point is: everyone sees things differently. Exclusivity in different fields is fabricated to make information and education elitist, and it is not reflective of individuals’ ability to understand the world. If you want to read about cool science stuff, you shouldn’t feel left out because you’re more of an art history person. If you want to read about cool art history stuff, you shouldn’t feel left out because you’re an aerospace engineer.


So I like to think that I can be that bridge for some people; at the very least, I can do it for myself.

Post by Olivia Ares, Class of 2025

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