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

Author: Vibhav Nandagiri

Keeping the Aging Brain Connected With Words and Music

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In an era of seemingly endless panaceas for age-based mental decline, navigating through the clutter can be a considerable challenge.

However, a team of Duke researchers, led by cognitive neuroscientist Edna Andrews, PhD, think they may have found a robust and long-term solution to countering this decline and preventing pathologies in an aging brain. Their approach does not require an invasive procedure or some pharmacological intervention, just a good ear, some sheet music, and maybe an instrument or two.

Dr. Edna Andrews, pictured in 2017. (Photo by Megan Mendenhall/Duke Photography)

In early 2021, Andrews and her team published one of the first studies to look at musicianship’s impact in building cognitive brain reserve. Cognitive brain reserve, simply put, is a way to qualify the resilience of the brain in the face of various pathologies. High levels of cognitive reserve can help stave off dementia, Parkinson’s disease or multiple sclerosis for years on end. These levels are quantified through structural measurements of gray matter and white matter in the brain. The white matter may be thought of as the insulated wiring that helps different areas of the brain communicate.

In this particular study, Andrews’ team focused on measurements of white matter integrity through an advanced MRI technique known as diffusion tensor imaging, to see what shape it is in.

Previous neuroimaging studies have revealed that normal aging leads to a decrease in white matter integrity across the brain. Over the past fifteen years, however, researchers have found that complex sensory-motor activities may be able to slow down and even reverse the loss of white matter integrity. The two most robust examples of complex sensory-motor activities are multilingualism and musicianship.

Andrews has long been fascinated by the brain and languages. In 2014, she published one of the seminal texts in the field of cognitive neurolinguistics where she laid the groundwork for a new neuroscience model of language. Around the same time, she published the first and to-date only longitudinal fMRI study of second language acquisition. Her findings, built upon decades of research in cognitive neuroscience and linguistics, served as the foundation for her popular FOCUS course: Neuroscience/Human Language.

Dr. Andrews’ 2014 book. Published by Cambridge University Press

In more recent years, she has shifted her research focus to understanding the impact of musicianship on cognitive brain reserve. Invigorated by her lived experience as a professional musician and composer, she wanted to see whether lifelong musicianship could increase white matter integrity as one ages. She and her team hypothesized that musicianship would increase white matter integrity in certain fiber tracts related to the act of music-making

To accomplish this goal, she and her team scanned the brains of eight different musicians ranging in age from 20 years to 67 years old. These musicians dedicated an average of three hours per day to practice and had gained years’ worth of performance experience. After participants were placed into the MRI machine, the researchers used diffusion tensor imaging to calculate fractional antisotropy (FA) values for certain white matter fiber tracts. A higher FA value meant higher integrity and, consequently, higher cognitive brain reserve. Andrews and her team chose to observe FA values in two fiber tracts, the superior longitudinal fasciculus (SLF) and the uncinate fasciculus (UF), based on their relevance to musicianship in previous studies.

Relative location of subcortical white matter fiber tracts (lateral view). Image from Wikipedia

Previous studies of the two fiber tracts in non-musicians found that their integrity decreased with age. In other words, the older the participants, the lower their white matter integrity in these regions. After analyzing the anisotropy values via linear regression, they observed a clear positive correlation between age and fractional anisotropy in both fiber tracts. These trends were visible in both tracts of both the left and right hemispheres of the brain. Such an observation substantiated their hypothesis, suggesting that highly proficient musicianship can increase cognitive brain reserve as one ages.

These findings expand the existing literature of lifestyle changes that can improve brain health beyond diet and exercise. Though more demanding, neurological changes resulting from the acquisition and maintenance of language and music capabilities have the potential to endure longer into the life cycle.

Andrews is one of the strongest advocates of lifelong learning, not solely for the satisfaction it brings about, but also for the tangible impact it can have on cognitive brain reserve. Picking up a new language or a new instrument should not be pursuits confined to the young child.

It appears, then, that the kindest way to treat the brain is to throw something new at it. A little bit of practice couldn’t hurt either.

Post by Vibhav Nandagiri, Class of 2025

The Most Important 26 Hours of My First Term at Duke

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As any first-year will tell you, the scramble for joining new clubs can be a daunting one. As the dust settled from the Involvement Fair, I looked at the fistful of flyers overflowing from my desk. One of these flyers stood out to me in particular: Student Collaborative on Health Policy (SCOHP). The program, backed by the Duke Margolis Center for Health Policy, seeks to educate, serve, and research within the Duke and Durham community regarding the social, economic, and political determinants of health care.

The Four Committees of SCOHP

Intrigued, I ventured to the Social Sciences building the following Sunday afternoon for their inaugural GBM. The event was lively, filled with a dizzying number of avenues for involvement. One such avenue that was the SCOHP-organized Health Policy Case Competition, advertised as a two-day team sprint to develop and pitch solutions to a pressing health care problem. The prizes were handsome: $1,000 for 1st place, $500 for 2nd place, and $250 for 3rd place, courtesy of the Margolis Center and RTI International. Furthermore, participants would be given access to mentors and industry leaders with vast experience in the area of public health.

Six teams, each consisting of three to five members, participated in the case-writing festivities. On Friday, September 10 at 5:00 PM, the case document was released. Our task: to develop a five-year plan aimed at increasing the screening for human papillomavirus (HPV) in either Malawi, South Africa, or Eswatini via a novel imaging technology known as microbeads. A considerably complex task given the vast number of social, institutional, and political barriers lying between the new technology and the women who needed it the most, not to mention the potential for HPV developing into cervical cancer if left undetected and untreated.

The Case Competition Title Document

Our team, Team J, assumed the role of a local NGO partnering with the Eswatini government. The preliminary hours of the competition were spent sifting through a sea of research. We read reviews of tissue imaging technology, feasibility studies on drug distribution networks, and mathematical projections of healthcare costs. At once invigorating and ceaselessly frustrating, the process of developing a comprehensive solution required significant mental and physical rearrangement. The nine hours following the release of the case were spent in a variety of popular campus study spots, from Bostock to Rubenstein Library, The Coffeehouse to dorm common rooms. In the early morning hours, our plan had finally begun to take shape.

A meager five hours of rest separated Day One of the competition from Day Two. After a night of brainstorming and research, we were left with three hours to finalize our five-minute proposals before a hard 12:00 PM deadline. As the deadline approached, we changed into our best attire from the clavicle up (the marvels of Zoom) and sat down. For the next hour and change, ideas flowed thickly and quickly; eager and persuasive tones emanating from our screens, tense silence as the judges moved into breakout rooms for deliberation.

The top three teams, Team J included, were selected for a final presentation round. The guidelines for this round: strengthen the argument, lengthen the presentation. We were in the final stretch. What followed was two hours of remarkably focused work, the likes of which I had never experienced in a team setting. As we sat down for the deciding presentation of the competition, I felt an immense sense of pride, not only in our solution, but also in our twenty-six hour transformations from perplexed receivers to confident presenters. This confidence and breadth of knowledge was visible in all three teams over the course of their fifteen-minute presentations and subsequent five-minute Q&A’s.

Team J’s Final Round Presentation Over Zoom

As the clock struck 7:00 PM on Saturday, September 11, the judges had submitted their verdict, at which point the teams turned towards the screen with rapt attention. The SCOHP organizers began reading the final standings. In what was described as an extremely close decision for the judges, Team J ended up winning first place. Battling the equally powerful forces of disbelief and sleep deprivation, we let out a collective breath. It was all over.

At the time of the competition, I had yet to complete a month at Duke. I didn’t know it then, but those twenty-six hours would end up being some of the most impactful in my first semester. The competition offered an entirely different approach to learning, one that was grounded in interdisciplinary inquiry and effective collaboration. And to think–it all started with a flyer buried underneath many other flyers.

Post by Vibhav Nandagiri, Class of 2025

Duke University Energy Week Part 1: The Energy Conference

Organized by students with support from the Duke University Energy Initiative and the Center for Energy, Development, and the Global Environment (EDGE) at The Fuqua School of Business, the 2021 Energy Week at Duke brought together business and technology leaders within the energy industry to provide audience members insight into the industry’s future.

The focal point of this article will be the Energy Conference, which occurred on November 10. If you’re curious about the future of clean energy within North Carolina, my colleague at the Duke Research Blog, Nhu Bui (Class of 2024), wrote a fascinating piece on the Energy Innovation Showcase.

Duke Energy Conference Organizing Team (photo by Jacob Hervey)

Over the course of eight hours, the Conference schedule alternated between a series of keynote addresses and fireside chats. The latter centered around a particular topical focus; each chat involved a faculty moderator and three industry experts whose organizations lie at the cutting edge of the climate transition within the private sector. In addition to the moderator’s questions, conference participants were invited to ask questions about the visions and innovations of their company.

The first fireside chat – Energy Transition Plans, Projects, and Pathways – broadly centered around the decarbonization of the energy industry. The speakers were Mallik Angalakudati, SVP of Strategy & Innovation at Washington Gas, Kirsten Knoepfle-Thorne, General Manager of Strategy at Chevron, and Jon Rodriguez, Energy Business Director of Engine Power Plants at Wartsila. All three acknowledged their companies’ traditional reliance on fossil fuels and stressed the need for emissions reduction moving into the future. The avenues each company was pursuing to reach this end varied considerably from green hydrogen to battery energy storage systems to carbon capture.

The second chat – Renewable Transportation – sought to highlight the latest innovations of firms within the burgeoning electric vehicle (EV) market. The panel consisted of Liz Finnegan (Fuqua ’17), Electric Vehicle Infrastructure and Energy at Rivian, Pei-Wen Hsu (Fuqua ’97), Global EV Marketing Director at Ford, and Kameale Terry, Co-Founder and CEO of ChargerHelp!. From launching new vehicles to servicing software breakdowns at charging stations across the nation, these speakers brought a wealth of perspectives to a high-growth market. They reinforced the certainty and necessity of mass consumer adoption of EV innovations, offering multiple roadmaps for the coming decades in transportation technologies.

Speakers from second fireside chat engaging with audience (photo by Jacob Hervey)

The third chat – Investing in Climate Tech Solutions – addressed the financial side of climate tech solutions. The speakers were Nneka Kibuule, SVP at Aligned Climate Capital, Lisa Krueger, President of US Operations at AES, and Sophie Purdom, co-founder of Climate Tech VC and an early-stage investor. Each speaker targeted climate solutions at different developmental stages, from early-stage ventures to companies ready for their IPOs. Taken as a whole, their firms reflected the robust nature of the financial ecosystem available to aspiring climate entrepreneurs and firms.

The three fireside chats engaged a number of angles through which the private sector can collectively curb climate change. As lab-developed technologies reach sufficient scale, the efficacy of climate solutions depend not solely on the quality of the innovation, but rather the quality of their implementation.

The conference conveniently coincided with the final few days of the COP26 Climate Summit in Glasgow, Scotland. As policy leaders half a world away wrangled over the minutiae of coal usage and climate financing, it became clear that a different sort of conversation was taking place on our campus. By engaging with the Energy Conference, even the most ardent skeptics of climate change progress would find it hard to deny the tangible shift in priorities that have occurred over the past few years. The prioritization of environmental concerns by the energy industry is now a given. The bigger question to consider is whether their plans and promises are sufficient to avert climate disaster.

Post by Vibhav Nandagiri

Discipline Makes You Free: Exploring Nigerian Militarism in the Late 20th Century

Six years after Nigeria gained its independence from Great Britain in 1960, a bloody military coup transferred power to the nation’s armed forces.

The ensuing forty-year period was marked by eight different military regimes and a Civil War, which were often demarcated by similarly violent coups that overthrew the initial Republic. Brief interludes of constitutional republics occasionally emerged, but these periods were short-lived and quickly replaced by another military government.

The eight different Heads of State under different military governments (Top row from left to right: Aguiyi-Ironsi, Gowon, Mohammed, Obasanjo. Bottom row from left to right: Buhari, Babangida, Abacha, Abubakar).

The heads of these regimes were military strongmen, soldiers who had risen through the chain of command and sought to rule the nation with near-absolute power. Samuel Fury Childs Daly (PhD), a professor in Duke’s African and African American Studies department and author of the acclaimed book A History of the Republic of Biafra: Law, Crime, and the Nigerian Civil War, sought to dive deeper into the political philosophies of these authoritarian rulers.

Daly says the writings and opinions of these autocrats often receives insufficient attention in the modern accounts of Nigerian history. The title of his lecture through the Franklin Humanities Institute, “How Soldiers Think,” attempted to address this lack of analysis by asking several important questions: What did these soldiers believe? Why did they enact the laws that they did? How did they envision Nigeria’s future?

Dr. Samuel Fury Childs Daly (PhD)

The story of Nigerian militarism, according to Daly, has its roots in the decolonization process. The soldiers and lawmakers of the later 20th century found their inspiration in one of the most famous decolonial thinkers: Frantz Fanon. Fanon’s two seminal works – Black Skin, White Masks and The Wretched of The Earth – were rooted heavily in his experience as a trained psychiatrist and a soldier for the Front de Libération National, the Algerian nationalist movement that fought against French colonial rule during the French-Algerian War (1954-1962). His advocacy for violent decolonization inspired anticolonial fury within Nigerian intellectuals and soldiers alike, leading to the widely accepted notion that military violence could be both reparative and restorative.

Fanon, in many ways, gave these soldiers a language of revolution, but, as Daly points out, many of them found his socialist politics to be too radical for Nigerian society. To the military rulers, the ideal system of governance was ascetic, masculine, and heavily disciplined.

In many ways, these soldiers sought to craft Nigeria in their own image–an image of order and self-control, a society where civilians needed to be tamed.

To create this society, the soldiers relied heavily on criminal law and the law enforcement apparatus. To them, law served as a tool of social engineering, albeit one that didn’t always work in their favor. Despite setting up a plethora of friendly judges throughout the judicial system, occasional rulings would rub military officers the wrong way. Nonetheless, they were able to exercise their heavy influence over the legislative and judicial systems to set forth programs aimed to reduce the perceived disease of chaos that plagued the Nigerian population.

One of the major initiatives Daly highlighted was the infamous War Against Indiscipline (WAI). The WAI initiated a number of often draconian programs such as the mandate to queue in an orderly manner for buses. Those who refused to form a line would be promptly whipped or beaten by an officer. Other social reforms outside of WAI centered heavily around sacrifice and control, such as the requirements for women to dress modestly and for men to stay fit; in fact, exercise was routinely used as public punishment for unruly activity.

These behavioral and punitive measures were heavily inspired by the rigid and militaristic upbringing of these autocrats, which is precisely why they were so unpopular with civilians. Daly describes several misconceptions within these leaders’ political philosophy – their treatment of politics as binary, their desire for conformity, their misconstrued knowledge of what their people want – that ultimately led to the instability of their regimes.

Through a unique combination of warped decolonization rhetoric, militaristic attitudes, and malleable jurisprudence, Nigerian political practices of the late 20th century offer a glimpse at the shortcomings of discipline as a primary political ethos. The societies formed under the military heads of state were illiberal and, contrary to the title of this article, decidedly unfree.

*the images from this article were obtained from Dr. Daly’s 2021 presentation “How Soldiers Think” through the Franklin Humanities Institute.

Post by Vibhav Nandagiri, Class of 2025

Integrating Pediatric Care in NC: Behavioral Health Perspectives

In healthcare, developing a new treatment is often half of the battle. The other half lies in delivering these treatments to those communities who need them the most. Coordinating care delivery is the goal of NC Integrated Care for Kids (InCK), an integrated pediatric service delivery and payment platform looking to serve 100,000 kids within five counties — Alamance, Orange, Durham, Granville, and Vance — in central North Carolina. The project is a collaborative effort between Duke, UNC, and the NC Department of Health and Human Services (DHHS) funded by a federal grant from the Centers for Medicare and Medicaid Services (CMS). The program’s executive director is Dr. Charlene Wong (MD, MSPH), a Duke researcher, physician, and professor who leads an interdisciplinary team of researchers and policy experts as they explore ways to reduce costs via integrating care for North Carolina youth enrolled in Medicaid and Children’s Health Insurance Program (CHIP).

The five counties that are part of NC InCK

I recently had the opportunity to speak with two of InCK’s service partners: Dr. Gary Maslow (MD, MPH) and Chris Lea (Duke ’18). Both work within the Behavioral Health group of InCK, which seeks to use behavioral health expertise through collaborative care and training providers to help support pediatric care. Maslow, a professor at the Duke Medical School, has focused heavily on child and developmental psychiatry throughout his career. Having entered medical school with a desire to work in pediatric hematology, Maslow recalls how a conversation with a mentor steered him in the direction of behavioral health. At the time, Maslow was part of the Rural Health Scholars program at Dartmouth College; while discussing his aspirations, one of his professors asked him to consider conditions outside of cancer, leading Maslow to consider chronic illness and eventually child psychiatry. “Kids have other problems,” Maslow’s professor told him.

Dr. Gary Maslow (MD, MPH)
Chris Lea (Duke ’18)

When looking at healthcare networks, especially those in rural areas in North Carolina, Maslow noticed a disaggregated service and payment network where primary care providers were not getting the necessary education to support the behavioral health needs of children. His work with Lea, a third-year medical student at Duke, has centered around looking at Medicaid data to understand provider distribution, medication prescription, and access to therapy based one’s area of residence. Lea’s path to NC InCK began as an undergraduate at Duke, where he obtained a B.S. in psychology in 2018. As he explains, mental health has been a vested interest of his for years, a passion reinforced by coursework, research at the Durham VA Medical Center, and NC InCK. He discussed the important of appropriate crisis response, specifically how to prepare families and providers in the event of pediatric behavioral health crises such as aggression or suicidality, as critical in improving behavioral health integration. These safety plans are critical both before a potential crisis and after an actual crisis occurs.

Two main goals of Maslow and Lea’s work are to increase the implementation of safety plans for at-risk youth and expand follow-up frequency in primary care settings. The focus on primary care physicians is especially critical considering the severe shortage of mental health professionals around North Carolina.

The behavioral health group is but one subset of the larger NC InCK framework. The team is led by Chelsea Swanson (MPH). Other collaborators include Dr. Richard Chung (MD), Dan Kimberg, and Ashley Saunders. NC InCK is currently in a two-year planning period, with the program’s launch date slated for 2022.

Services provided by NC InCK

New Blogger Vibhav Nandagiri: The Curious Student Blogger

Hey everyone! My name is Vibhav Nandagiri, I use he/him/his pronouns, and I’m currently a first-year student at Duke. Amidst the sea of continuous transition brought upon by college, one area of my identity that has stayed fairly constant is my geography. I’ve lived in North Carolina for sixteen of my eighteen years, and my current home lies just twenty minutes from campus in sunny, suburban Cary, NC.

The two missing years are accounted for through my adventures in my parents’ hometown–Hyderabad, India–as a toddler. Spending some of my earliest years surrounded by a large and loving family impacted my life profoundly, forever cementing a strong connection to my emotional, cultural, and linguistic roots.

The latter had a secondary impact on me, one I wouldn’t discover until my parents enrolled me in preschool after returning to the States. With hubris, I marched into my first day of class, ready to seize the day, until I soon discovered an uncomfortable fact: I couldn’t speak English. I am told through some unfortunate stories that I struggled considerably during my first month in a new, Anglicized environment; however, I soon learned the quirks of this language, and two-year-old me, perhaps realizing that he had some catching up to do, fully immersed himself in the English language.

Nowadays, I read quite a bit. Fiction and journalism, academic and satire, I firmly believe that all styles of literature play a role in educating people on the ebbs and flows of our world. In recent years, I’ve developed a thematic fascination with the future. The genre of far-future science fiction, with its rich exploration of hypothetical advanced societies, has led me to ask pressing questions about the future of the human species. How will society organize itself politically? What are the ethical implications of future medical advancements? Will we achieve a healthy symbiosis with technology? As a Duke Research Blogger, I hope to find answers to these questions while getting a front-row, multidisciplinary seat to what the future has to offer. It’s an invigorating opportunity to grow as a writer and communicator, to have my curiosity piqued on a weekly basis, to understand the futuristic visions of innovators at the top of their field.

Prior to Duke, I had the opportunity to conduct research at the Appalachian State University Pediatric Exercise and Physiology Lab, where I co-authored a published paper about adolescent fat metabolism. Not only was I introduced to the academic research process, but I also learned the importance of communicating my findings clearly through writing and presentations. I intend to bring these valuable lessons and perspectives to the Duke Research Blog.

Beyond exercise science, I am intrigued by a diverse range of research areas, from Public Health to Climate Change to Business to Neuroscience, the latter of which I hope to explore further through the Cognitive Neuroscience and Law FOCUS. I was drawn to the program for the opportunity to build strong relationships with professors and investigators; I intend to approach my work at the Duke Research Blog with a similar keenness to listen and connect with researchers and readers alike. When I’m not reading or typing away furiously at my computer, you can find me hitting on the tennis courts, singing Choral or Indian Classical music, or convincing my friends that my music taste is better than theirs.

Post By Vibhav Nandagiri, Class of 2025

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