Duke Research Blog

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

Category: Business/Economics Page 1 of 5

Designing Tomorrow, One Healthcare Innovation at a Time

Imagine a live, health-focused version Shark Tank open to the public: presentations from real health professionals, presenting real innovations they developed to address real health care issues. And yes, there are real money awards at stake.

It’s the 2019 Duke Health Innovation Jam.

At ten minutes ‘til show time, people gather in small groups clothed in suits, business attire, and white coats. They chat in low voices. The hum of comfortable conversation buzzes through the room. The sixth floor of the Trent Semans Center is quite the setting. Three sides of the room are encapsulated in glass and you can easily see an expansive view of both Duke’s West and Medical campuses, as well as luscious green trees comprising parts of Duke’s Forest. Naturally, there is a glorious view of the Chapel, basked in sunlight.

This light finds its way into the room to shine on various research posters at the back displayed on a few rows of mobile walls. Though a few strays meander through the stationary arrangements – stopping to look more closely at particular findings – most people make their way into the room and find a seat as the minutes dwindle away. The hum grows and there is a bit of anticipatory energy among those readying themselves to present.

At three minutes after 10, the program director of the Duke Institute for Health Innovation, Suresh Balu, takes position at the front of the room, standing before the small stage at center that is surrounded by lots of TV monitors. No seat in the room is a bad one. Balu indicates that it is time to begin and the hum immediately dissipates. He explains the general format of the event: six pitches total, five minutes to present, eight minutes to answer questions from investors, a show-of-hand interest from investors, and transition to the next pitch, followed by deliberation and presentation of awards.

After a round of thanks, introduction of the emcee – Duke’s Chief of Cardiology, Dr. Manesh Patel – the curtains opened – figuratively – on Duke’s fifth annual Innovation Jam.

Groups presented on the problems they were addressing, their proposed innovations, and how the innovations worked. There was also information about getting products into the market, varying economic analysis, next steps or detailed goals for the projection of the projects, and analysis of the investment they are currently seeking and for what purposes.

The first group pitched an idea about patient-centric blood draw and suggest a device to plug into existing peripheral draws to reduce the frequent poking and prodding that hospital patients often experience during their hospital stay when blood is needed for lab tests. Next up was a group who designed an intelligent microscope for automated pathology that has a programmable system and uses machine learning to automate pathological blood analysis that is currently highly time consuming. Third at bat was a group that made a UV light bag to clean surgical drain bags that frequently become colonized with bacteria and are quite frankly “nasty” – according to the presenter.

Batting cleanup was PILVAS – Peripherally Inserted Left Ventricular Vent Anticoagulation System – which is a device that would be accessory to VA ECMO support to reduce thromboembolism and stroke that are risks of ECMO. Fifth was the ReadyView and ReadyLift, a laparoscopic tool set that is much cheaper than current laparoscopic tools and methods, and because of its ability to be used with any USB compatible laptop, it would increase access to laparoscopic surgery in countries that have a high need for it. Last, but not least, was an innovation that is the first synthetic biometric osteochondral graft for knee cartilage repair that hopes to improve knee osteoarthritis surgical care as the first hydrogel with the same mechanical properties of cartilage.

Following a quick ten-minute break for investors to huddle around and discuss who should win the awards – $15,000 for Best Innovation and $15,000 for Best Presentation – the winners were announced. Drumroll, please.

ReadyView won Best Presentation and the synthetic osteochondral graft won Best Innovation. A pair of representatives from Microsoft were also in attendance – a first for the Innovation Jam – and awarded SalineAI, the group who designed the intelligent microscope with an independent award package.

Patel, the emcee, says we are in the midst of a fourth industrial revolution.

“What is the biggest cinema in the world?” Patel asked. “Netflix,” he says. Industries are reimagining themselves and healthcare is no exception.

What is the best healthcare system of the future going to look like? Of course, we really don’t know, but there are certainly people who are already doing more than just think about it.

From Jails to Detention Centers: a Disconcerting Immigration History

The political climate for the past ten years has been anything but calm, and central to political struggles in D.C. and elsewhere has been the ethical issues surrounding immigrant detention. But for Brianna Nofil (T ‘12), there has never been a better time to research the questions that intrigue her the most.  

A native of South Florida, Nofil has felt the undercurrent of immigration tensions throughout her life as a resident of a region with a large population of immigrants. Central to this tension was Krome Detention Center — a looming, overpowering presence in her community. Krome, which was a missile testing facility for most of 20th century, has only recently been converted to an institution to house detained immigrants. Krome had always been there, but exactly what its existence meant in her hometown was not usually acknowledged, and as Nofil remarked, “There was a reason people living there had a hazy understanding of what was going on.” 

While at Duke, Nofil, who double majored in history and public policy studies with a minor in education, let her experiences growing up lead her to a senior thesis on the history and privatization of U.S. immigration detention — which, according to Duke history professor Gunther Peck, was nothing less than “stunning.” In a round-table forum on October 1, Nofil delved deeper into her central academic interests — of which she has written about in publications such as Time and Atlas Obscura — as well as her current studies as a doctoral candidate at Columbia University.

Jose A. Iglesias for the Miami Herald

Coming to Duke, Nofil used the resources and classes in the history department to answer two chief questions: what power structures were in place to confirm an institution like Krome’s significance in the community? And where exactly did this power come from?  

These questions lead her to her current focus at Columbia, which is the history of immigrant detention centers in the 20th century. Her main argument? “U.S immigration has always really relied on jails.” 

By the early 1900s, immigration was taking hold as a major historical event in the U.S and the federal government took its chances on what it saw as the perfect solution — let local communities handle immigration, and thus control what could (and eventually would become) a growing problem. This led to a network of contracts in the 20th century that paid sheriffs of small, lower-income towns all over America a nightly rate to “board” immigrants in jails. 

One case study, as Nofil points out, centered around Chinese immigrants in the early 1900s who came to northern New York from Canada. They were held in local jails all throughout the county while their cases were processed, and communities see the booming immigrant detention business as net-positive for the community. Within mere months, these Chinese jails had created an arms race of sorts. Communities competed and clamored for more contracts from the federal government as they saw incomes in their town continue to grow. 

It’s easy to see the moral dilemma of profiting off of detaining immigrants, but what is even more concerning is why the federal government pawned off a federal responsibility to communities, thus ensuring a lack of standardization in immigrant treatment across the country. So while there was relative support surrounding the business, unease soon began to emerge. As quota laws and anti-trafficking measures were created, Canadian and European immigrants also made their way over to the U.S, prompting foreign countries to finally notice  — and ask — whether communities utilizing prisons as detention centers was ethically sound. Newspapers around this time started publishing op-eds and editorials, and soon a resistance against profiting off of jailing immigrants cropped up — something Nofil adds is “inspiring” to see, especially in the context of our own times. 

The perpetual failure of jails has allowed immigration in the modern day to position big detention centers as a humane alternative. But what does that mean for immigration detention today? As Nofil posits, early forms of resistance are inspiring because it assures us that jailing immigrants was always questioned by communities, even at that time. Communities were capable of distinguishing right from wrong, even amidst the issue of immigration where the makeup and economy of their communities were at risk of changing. As the conversation concluded, one central theme seemed to stand out — that to understand the consequences of immigration detention centers, we must look to the past to see how detention started, and only by understanding the origins can we work toward a better solution. 

By Meghna Datta
By Meghna Datta

Digging Into Durham’s Eviction Problem

This is what 20 years of evictions looks like. It’s an animated heat map of Durham, the streets overlaid with undulating blobs of red and orange and yellow, like a grease stain.

Duke students in the summer research program Data+ have created a time-lapse map of the more than 200,000 evictions filed in Durham County since 2000.

Dark red areas represent eviction hotspots. These neighborhoods are where families cook their favorite meals, where children do their homework, where people celebrate holidays. They’re also where many people live one crisis away from losing their neighbors, or becoming homeless themselves.

Duke junior Samantha Miezio points to a single census tract along NC 55 where, in the wake of an apartment building sale, more than 100 households received an eviction notice in that spot in one month alone. It “just speaks to the severity of the issue,” Miezio said.

Miezio was part of a team that spent 10 weeks this summer mapping and analyzing evictions data from the Durham County Sheriff’s Office, thanks to an effort by DataWorks NC to compile such data and make it more accessible.

The findings are stark.

Every hour in Durham, at least one renter is threatened with losing their home. About 1,000 eviction cases were filed a month against tenants between 2010 and 2017. That’s roughly one for every 280 residents in Durham, where evictions per capita is one of the highest in the state and double the national average.

The data tell us that while Durham’s evictions crisis has actually improved from where it was a few years ago, stubborn hotspots persist, said team member Ellis Ackerman, a math major at North Carolina State University.

When the students looked at the data month by month, a few things stood out. For one, winter evictions are common. While some countries such as France and Austria ban winter evictions to keep from pushing people onto the street in the cold, in Durham, “January is the worst month by far,” said team member Rodrigo Araujo, a junior majoring in computer science. “In the winter months utility bills are higher; they’re struggling to pay for that.”

Rodrigo Araujo (Computer Science, 2021) talks about the Durham evictions project.

The team also investigated the relationship between evictions and rents from 2012 to 2014 to see how much they move in tandem with each other. Their initial results using two years’ worth of rent data showed that when rents went up, evictions weren’t too far behind.

“Rents increased, and then two months later, evictions increased,” Miezio said.

But the impacts of rising rents weren’t felt evenly. Neighborhoods with more residents of color were significantly affected while renters in white neighborhoods were not. “This crisis is disproportionately affecting those who are already at a disadvantage from historical inequalities,” Miezio said.

A person can be evicted for a number of reasons, but most evictions happen because people get behind on their rent. The standard guideline is no more than 30% of your monthly income before taxes should go to housing and keeping the lights on.

But in Durham, where 47% of households rent rather than own a home, only half of renters meet that goal. As of 2019 an estimated 28,917 households are living in rentals they can’t afford.

The reason is incomes haven’t kept pace with rents, especially for low-wage workers such as waiters, cooks, or home health aides.

Durham’s median rents rose from $798 in 2010 to $925 in 2016. That’s out of reach for many area families. A minimum wage worker in Durham earning $7.25/hour would need to work a staggering 112 hours a week — the equivalent of nearly three full-time jobs — to afford a modest two-bedroom unit in 2019 at fair market rent, according to a report by the National Low Income Housing Coalition.

Spending a sizable chunk of your income on housing means having less left over for food, child care, transportation, savings, and other basic necessities. One unexpected expense or emergency — maybe the kid gets sick or the car needs repairs, or there’s a cut back on hours at work — can mean tenants have a harder time making the rent.

“Evictions are traumatic life experiences for the tenants,” and can have ripple effects for years, Miezio said.

Tenants may have only a few days to pay what’s due or find a new place and move out. The Sheriff may come with movers and pile a person’s belonging on the curb, or move them to a storage facility at the tenant’s expense.

A forced move can also mean children must change schools in the middle of the school year.

Benefits may go to the wrong address. Families are uprooted from their social support networks of friends and neighbors.

Not every case filed ends with the tenant actually getting forced out, “but those filings can still potentially inhibit their ability to find future housing,” Miezio said. Not to mention the cost and hassle of appearing in court and paying fines and court fees.

Multiple groups are working to help Durham residents avoid eviction and stay in their homes. In a partnership between Duke Law and Legal Aid of North Carolina, the Civil Justice Clinic’s 2-year-old Eviction Diversion Program provides free legal assistance to people who are facing eviction.

“The majority of people who have an eviction filed against them don’t have access to an attorney,” Miezio said.

In a cost-benefit analysis, the team’s models suggest that “with a pretty small increase in funding to reduce evictions, on the order of $100,000 to $150,000, Durham could be saving millions of dollars” in the form of reduced shelter costs, hospital costs, plus savings on mental health services other social services, Ackerman said.

Ellis Ackerman, a senior math major from NC State University, talks about the Durham evictions research project.

Moving forward, they’re launching a website in order to share their findings. “I’ve learned HTML and CSS this summer,” said Miezio, who is pursuing an individualized degree program in urban studies. “That’s one of the things I love about Data+. I’m getting paid to learn.”

Miezio plans to continue the project this fall through an independent study course focused on policy solutions to evictions, such as universal right to counsel.

“Housing access and stability are important to Durham,” said Duke’s vice president for Durham affairs Stelfanie Williams. “Applied research projects such as this, reflecting a partnership between the university and community, are opportunities for students to ‘learn by doing’ and to collaborate with community leaders on problem-solving.”

Data+ 2019 is sponsored by Bass Connections, the Rhodes Information Initiative at Duke, the Social Science Research Institute, the Duke Energy Initiative, and the departments of Mathematics and Statistical Science.

Other Duke sponsors include DTECH, Science, Law, and Policy Lab, Duke Health, Duke University Libraries, Sanford School of Public Policy, Nicholas School of the Environment, Duke Global Health Institute, Development and Alumni Affairs, the Duke River Center, Representing Migrations Humanities Lab, Energy Initiative, Franklin Humanities Institute, Duke Forge, the K-Lab, Duke Clinical Research, Office for Information Technology and the Office of the Provost, as well as the departments of Electrical & Computer Engineering, Computer Science, Biomedical Engineering, Biostatistics & Bioinformatics and Biology.

Government funding comes from the National Science Foundation. Outside funding comes from Exxon Mobil, the International Institute for Sustainable Development (IISD), Global Financial Markets Center, and Tether Energy.

Writing by Robin Smith; Video by Wil Weldon
Post by Robin Smith Video by Wil Weldon

Magazine Covers Hew to Stereotypes, But Also Surprise

Data + Women’s Spaces

Media plays a large role in the lives of most people. It’s everywhere. Even if you don’t actively purchase magazines, you are exposed to the covers in daily life. They are at newsstands, in grocery stores, in waiting rooms, online and more. Intrigued by the messages embedded in magazine covers, Nathan Liang (psychology, statistics), Sandra Luksic (philosophy, political science) and Alexis Malone (statistics) sought out to understand how women are represented in media as a part of a research project in the Data+ program.

Data+ is one of the many summer research opportunities at Duke. It’s a 10-week program focused on data science that allows undergraduate students to explore different research topics using data-driven approaches. Students work collaboratively in small interdisciplinary teams and develop skills to marshal, analyze, and visualize data.

The team’s project, titled Women’s Spaces, focused on a primary research question: Which messages are pervasive in women’s and men’s magazines and how do these messages change over time, across magazines, and between different target audiences.

Together, the team analyzed 500+ magazine covers published between January 2010 and June 2018, from Cosmopolitan, Esquire, Essence, Good Housekeeping and Seventeen. They used image analysis, text analysis and sentiment analysis in order to understand how women are represented on the magazine covers.

To conduct image analysis the team used Microsoft Azure Face Detect with Python in order to identify cover models. This software accounted for perceived emotions, age and race. They also noted the race/ethnicity and hair length of the cover models. Their research revealed that excluding Essence, 85 percent of magazine covers were white and had below average body sizes. One specific thing they found was that men had a greater range of emotions while women seemed to always appear happy. Furthermore, there was less emotional variance among minorities and in general, no Asian men. However, they did note that there may have been a software bias in that Microsoft Azure may not have picked up as well on the emotions of minorities.

In order to conduct text analysis, the team had to self-type the text on the magazine covers because oftentimes the text on magazine covers was layered on top of images making it hard for software to detect. This reduced the number of magazines that they were able to analyze because it took up so much time. They then used a Term Frequency-Inverse Document Frequency (tf-idf) algorithm to determine both how often a term occurred on the cover how important a term was. Their results revealed several keywords associated with different magazines. Some of these include sex (Cosmopolitan),  curvy, beauty, and business (Essence), cooking, cleaning, and kitchen (GH), cute (Seventeen), and cars, America, and Barbeque (Esquire)

Tf-idf word cloud for all magazines

Lastly, they conducted a sentiment analysis. Sentiment analysis involved computationally identifying the opinions expressed in the magazine covers to determine their attitude on the topic being displayed. While sentiment libraries exist, there were not any that had magazine/advertising industry-specific sentiments and thus, were not usable for the research. As a result, the team created their own sentiment dictionary with categories like “positive,” “negative,” “sex,” “sell-words,” “appearance,” “home,” “professional,” “male” and “female.”

At the end of the summer, their main takeaway was that magazines tend to reinforce gender norms and stereotypes. The covers also backed up some of the established preconceived notions they had about magazines. However, they also discovered messages of empowerment. Interestingly, these were often connected to beauty as well as consumerism.

In a presentation, the team explained that one of the lessons they took away from the summer was that Data science is not objective, but biases are hard to spot. They noted that throughout the process they made sure to question their methodologies of analyzing data. It was particularly challenging to determine where the biases were coming into play: be it their questions, data sources or even understanding of feminism. Because of the interdisciplinary nature of the project, combining humanities with data science, the team was academically diverse. Luksic stated in the presentation that she, especially, came in skeptical of the idea that technology was assumed to be “objective”.

Luksic added, “It’s one thing to know, on a abstract level, that data science is not objective. It is another thing entirely to try to do or practice data science in a way that minimizes your subjectivities. Ultimately, we hope for a data science that can incorporate subjectivity in a way that emphasizes differences, such as between black-centered feminism and anti-black feminism.”

The discoveries made by the team play into a larger discussion about women’s roles in media and how that influences feminism and empowerment in relation to marketing and how that impacts women’s movements.

Luksic stated, “the versatility of data science allowed us to pursue multiple different paths with different conceptions of feminisms underlying them, which was exciting and empowering.”

By Anna Gotskind

Finding Success in Science and the Economic Brain

How can we understand how humans make decisions? How do we measure the root of motivation?

Gregory Samanez-Larkin, an assistant professor in Psychology & Neuroscience at Duke, uses neuroeconomic and neuromarketing approaches to seek answers to these questions. He combines experimental psychology and economics with neuroimaging and statistical analysis as an interdisciplinary approach to understanding human behavior.

Gregory Samanez-Larkin 

From studying the risk tendencies in different age groups to measuring the effectiveness of informative messages in health decision-making,Samanez-Larkin’s diverse array of research reflects the many applications of neuroeconomics.

He finds that neuroeconomic and neurofinance tools can help spot vulnerabilities and characteristics within groups of people.

Though his Motivated Cognition & Aging Brain Lab at Duke, he would like to extend his work to finding interventions that would encourage healthier or optimal decision-making. Many financial organizations and firms are interested in these questions.

While Samanez-Larkin has produced some very influential research in the field, the path to his career was not a straightforward one.Raised in Flint, Michigan, he found that the majority of people around him were not very career-oriented. He found a passion for wakeboarding, visual art, and graphic design.

As an undergraduate at the University of Michigan-Flint, he was originally on a pre-business track. But after taking various psychology courses and assisting in research, Samanez-Larkin was captivated by the excitement and the advances in brain imaging at the time.

However, misconceptions about the field caused him to question whether or not going into research was the right fit, leading him to seek jobs in marketing and advertising instead. But in job interviews, he ended up questioning the methods and the ways companies explained the appeal of different ways of advertising. Realizing that he really enjoyed asking questions and evaluating how things work, he reconsidered pursuing science.

After a series of positive experiences in a research position in San Francisco, Samanez-Larkin began his graduate studies at Stanford University. The growing field of neuroeconomics — which combined his diverse set of interests in neuroscience, psychology, and economics — continued the “decade-long evolution” of Samanez-Larkin’s career.

Samanez-Larkin’s experiences in his career journey are reflected strongly in his approach to teaching.

“I feel like my primary responsibility is to help people become successful,” he says, as we sit comfortably on the sofas in his office.“Everything I do is for that.”

In his courses, Samanez-Larkin emphasizes the need to think critically and evaluate information, consistently asking questions like, “How do we know something works or not? How do I know how to evaluate if it works or not? How can I become a good consumer of scientific information?”

In his teaching, Samanez-Larkin hopes to set students up with usable, translatable skills that are applicable to any field.

Samanez-Larkin also hopes to support his students in the same way he received support from his previous mentors. “It’s cool to learn about how the brain works, but ultimately, I’m just trying to help people do something.”

Guest Post by Ariba Huda, NCSSM 2019

Aging and Decision-Making

Who makes riskier decisions, the young or the old? And what matters more in our decisions as we age — friends, health or money? The answers might surprise you.

Kendra Seaman works at the Center for the Study of Aging and Human Development and is interested in decision-making across the lifespan.

Duke postdoctoral fellow Kendra Seaman, Ph.D. uses mathematical models and brain imaging to understand how decision-making changes as we age. In a talk to a group of cognitive neuroscientists at Duke, Seamen explained that we have good reason to be concerned with how older people make decisions.

Statistically, older people in the U.S. have more money, and additionally more expenditures, specifically in healthcare. And by 2030, 20 percent of the US population will be over the age of 65.

One key component to decision-making is subjective value, which is a measure of the importance a reward or outcome has to a specific person at a specific point in time. Seaman used a reward of $20 as an example: it would have a much higher subjective value for a broke college student than for a wealthy retiree. Seaman discussed three factors that influence subjective value: reward, cost, and discount rate, or the determination of the value of future rewards.

Brain imaging research has found that subjective value is represented similarly in the medial prefrontal cortex (MPFC) across all ages. Despite this common network, Seaman and her colleagues have found significant differences in decision-making in older individuals.

The first difference comes in the form of reward. Older individuals are likely to be more invested in the outcome of a task if the reward is social or health-related rather than monetary. Consequently, they are more likely to want these health and social rewards  sooner and with higher certainty than younger individuals are. Understanding the salience of these rewards is crucial to designing future experiments to identify decision-making differences in older adults.

A preference for positive skew becomes more pronounced with age.

Older individuals also differ in their preferences for something called “skewed risks.” In these tasks, positive skew means a high probability of a small loss and a low probability of a large gain, such as buying a lottery ticket. Negative skew means a low probability of a large loss and a high probability of a small gain, such as undergoing a common medical procedure that has a low chance of harmful complications.

Older people tend to prefer positive skew to a greater degree than younger people, and this bias toward positive skew becomes more pronounced with age.

Understanding these tendencies could be vital in understanding why older people fall victim to fraud and decide to undergo risky medical procedures, and additionally be better equipped to motivate an aging population to remain involved in physical and mental activities.

Post by undergraduate blogger Sarah Haurin

Post by undergraduate blogger Sarah Haurin

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

Duke’s Researchers Are 1 Percent of the Top 1 Percent

This year’s listing of the world’s most-cited researchers is out from Clarivate Analytics, and Duke has 34 names on the list of 3,400 researchers from 21 fields of science and social science.

Having your publication cited in a paper written by other scientists is a sign that your work is significant and advances the field. The highly-cited list includes the top 1 percent of scientists cited by others in the years 2005 to 2015.

“Citations by other scientists are an acknowledgement that the work our faculty has published is significant to their fields,” said Vice Provost for Research Lawrence Carin. “In research, we often talk about ‘standing on the shoulders of giants,’ as a way to explain how one person’s work builds on another’s. For Duke to have so many of our people in the top 1 percent indicates that they are leading their fields and their work is indeed something upon which others can build.”

In addition to the Durham researchers, Duke-NUS, our medical school in Singapore,  claims another 13 highly cited scientists.

The highly-cited scientists on the Durham campus are:

Barton Haynes

CLINICAL MEDICINE
Robert Califf
Christopher Granger
Kristin Newby
Christopher O’Connor
Erik Magnus Ohman
Manesh Patel
Michael Pencina
Eric Peterson

ECONOMICS AND BUSINESS
Dan Ariely
John Graham
Campbell Harvey

Drew Shindell

ENVIRONMENT/ECOLOGY
John Terborgh
Mark Wiesner

GEOSCIENCES
Drew Shindell

IMMUNOLOGY
Barton Haynes

MATHEMATICS
James Berger

Georgia Tomaras

Georgia Tomaras

MICROBIOLOGY
Bryan Cullen
Barton Haynes
David Montefiori
Georgia Tomaras

PHARMACOLOGY & TOXICOLOGY
Robert Lefkowitz

PHYSICS
David R. Smith

PLANT AND ANIMAL SCIENCE
Philip Benfey

Terrie Moffitt

Terrie Moffitt

PSYCHIATRY & PSYCHOLOGY
Angold, Adrian
Caspi, Avshalom
Copeland, William E
Costello, E J
Dawson, Geraldine
Keefe, Richard SE
McEvoy, Joseph P
Moffitt, Terrie E

SOCIAL SCIENCES (GENERAL)
Deverick Anderson
Kelly Brownell
Michael Pencina

Global Health Research from Zika to Economics

Brazil, Kenya and China: this week, the sixth annual Global Health Research Showcase proved that Global Health majors truly represent global interests.

This past summer, Duke PhD student Tulika Singh explored complementary diagnosis techniques for Zika virus pregnant women in Vitoria, Brazil. Zika is difficult to diagnose “because the PCR-based test can only tell if you’ve had Zika virus within about ten days of the infection,” Singh said. “That’s a big problem for enrolling pregnant women into our study on Zika transmission and maternal immunity.”

To combat this issue, Singh and her thesis advisor Sallie Permar trained collaborators to use the whole virion ELISA (WVE) laboratory technique which may reveal if an individual has been exposed to Zika. ELISA detects Zika through testing for the antibodies that most likely would have been produced during a Zika infection. Singh’s work allows the research team to better assess whether women have been exposed to Zika virus during pregnancy, and will ultimately guide Zika vaccine design. 

Master of Science in Global Health candidate Carissa Novak examined why some HPV positive women in Western Kenya are not seeking preventive measures against cervical cancer. All the women diagnosed with HPV were referred to the Country Hospital but only “33 to 42 percent actually sought treatment” leading to Novak’s main research question, “Why did so few women seek treatment?” To answer this question, she sent out quantitative questionnaires to 100 women and then followed up by interviewing 20 of them. She surveyed and interviewed both women who had and had not sought treatment. Her results showed that transportation and cost hinder treatment acquirement and that the women who did seek treatment were often directed to by a health worker or actively trying to prevent cervical cancer. Novak believes that increasing women’s trust and understanding of the health care system will assist in improving the percentage who seek treatment.

In Kunshan, China, Brian Grasso evaluated the development of Kunshan’s health system in relation to its economic development. “Kunshan is now China’s richest county-level city and it used to be a small farm town…My main take away was that economic growth has strengthened Kunshan’s health systems while also creating new health challenges,” Grasso said. What are some of these new health challenges? Some of them include air pollution, increased stress in manufacturing jobs and more car accidents. Grasso determines that other developing health systems should learn from Kunshan that without proper regulations poor health can result in the midst of progress.

Post by Lydia Goff

New Blogger Nirja Trivedi: Neuroscience Junior with Infinite Curiosity

My name is Nirja Trivedi and I’m a junior from Seattle interested in the intersections between health, technology and business. At Duke, I’m the co-president of P.A.S.H., a writer for the Standard and a member of B.O.W.

Nirja Trivedi blocking the sun with her hand

Nirja Trivedi

During high school, I considered liberal arts and scientific research to be separate disciplines: if technology was my strength then philosophy must be my weakness. In my two years at Duke, I have experienced the duality of these fields through participating in the Global Health Focus Program, developing my own research projects, working with professors and now applying to write for Duke Research. Science truly is for everyone; no matter your field, interests or opinion. Research and discovery are conduits for every mind. Research isn’t just the forefront of innovation, it paves the way for the future.

Growing up with a passion for service and influenced by my family in the medical field, the research I leaned towards combined aspects of community and health. My senior project in high school examined traumatic brain injury (TBI) in youth sports, which provided the research-based approach for designing my own Concussion Prevention Program. After my first semester, I wanted to discover what kinds of research I wanted to fully integrate myself in. I began research with the Duke Institute of Brain Sciences and spent my summer volunteering for the Richman Lab, which examines the effects of psychosocial factors like discrimination, social hierarchies and power. After I declared my Neuroscience major, I spent the year assisting in studies at the Autism Clinic, sparking my interest in technology.

Nirja Trivedi on a mountain top

Nirja Trivedi on a mountain top.

Now going into my third year, my interests in scientific discovery have only grown. From insight into the human psyche and social economic behavior to medical advances, I love the complexity of the human mind and how it fuels innovation.

My unrestricted interests guided me to the Innovation & Entrepreneurship Certificate as well as this writing position, both which foster an environment of curiosity and inspiration. Through writing, I hope to connect with faculty, discover areas of research I never knew existed, widen my breadth of scientific knowledge, and connect students to research opportunities. The threshold of knowledge is where you draw the line – why not make it infinite?

Post by Nirja Trivedi

Page 1 of 5

Powered by WordPress & Theme by Anders Norén