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

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How To Hold a Bee and Not Get Stung

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Pictured from left to right are Lindsey Weyant, Andrew McCallum, and Will Marcus.

On Saturday, September 25, the Wild Ones club hosted an insect-themed outing with Fred Nijhout, an entomology professor at Duke. We visited a pond behind the Biological Sciences Building bordered by vegetation. Apparently, the long grasses and flowers are prime habitat for insects, which are often attracted to sunny areas and edge habitat. Along with several other students, I practiced “sweeping” for insects by swishing long nets through vegetation, a delightfully satisfying activity, especially on such a gorgeous fall day.

A species of skipper feeding on a flower. According to Fred Nijhout, the best way to distinguish butterflies (including skippers) from moths is by looking for knobbed antennae, characteristic of butterflies but not moths.

Professor Nijhout says much of his research focuses on butterflies and moths, but the insect biology class he teaches has a much broader focus. So does this outing. In just a couple hours, our group finds a wide array of species.

A milkweed bug (left) and a soldier beetle, two of the species we saw on Sunday.

Many of the insects we see belong to the order Hemiptera, a group sometimes referred to as “true bugs” that includes more than 80,000 species. We find leafhoppers that jump out of our nets while we’re trying to look at them, a stilt-legged bug that moves much more gracefully on its long legs than I ever could on stilts, spittlebugs that encase themselves in foam as larvae and then metamorphose into jumping adults sometimes called froghoppers, and yet another Hemipteran with a wonderfully whimsical name (just kidding): the plant bug.

Professor Nijhout shows us a milkweed leaf teeming with aphids (also in the order Hemiptera) and ants. He explains that this is a common pairing. Aphids feed on the sap in leaf veins, which is nutrient-poor, so “they have special pumps in their guts that get rid of the water and the sugars” and concentrate the proteins. In the process, aphids secrete a sugary substance called honeydew, which attracts ants.

The honeydew excreted as a waste product by the aphids provides the ants with a valuable food source, but the relationship is mutualistic. The presence of the ants affords protection to the aphids. Symbiosis, however, isn’t the only means of avoiding predation. Some animals mimic toxic look-alikes to avoid being eaten. Our group finds brightly colored hoverflies, which resemble bees but are actually harmless flies, sipping nectar from flowers. Professor Nijhout also points out a brightly colored milkweed bug, which looks toxic because it is.

Sixteen species of hoverfly, all of which are harmless. Note that hoverflies, like all flies, have only one pair of wings, whereas bees have two.
Image from Wikipedia user Alvesgaspar (GNU Free Documentation License, Creative Commons license).

Humans, too, can be fooled by things that look dangerous but aren’t. As it turns out, even some of our most basic ideas about risk avoidance—like not playing with bees or eating strange berries—are sometimes red herrings. When we pass clusters of vibrant purple berries on a beautyberry bush, Professor Nijhout tells us they’re edible. “They’re sweet,” he says encouragingly. (I wish I could agree. They’re irresistibly beautiful, but every time I’ve tasted them, I’ve found them too tart.) And on several occasions, to the endless fascination of the Wild Ones, he catches bees with his bare hands and offers them to nearby students. Male carpenter bees (which can be identified by the patch of yellow on their faces) have no stinger, and according to Professor Nijhout, their mandibles are too weak to penetrate human skin. It’s hard not to flinch at the thought of holding an angry bee, but there’s a certain thrill to it as well. When I cup my hands around one of them, I find the sensation thoroughly pleasant, rather like a fuzzy massage. The hard part is keeping them from escaping; it doesn’t take long for the bee to slip between my hands and fly away.

Professor Nijhout in his element, about to capture a male carpenter bee (below) by hand.

The next day, I noticed several bees feeding on a flowering bush on campus. Eager to test my newfound knowledge, I leaned closer. Even when I saw the telltale yellow faces of the males, I was initially hesitant. But as I kept watching, I felt more wonder than fear. For perhaps the first time, I noticed the way their buzzy, vibrating bodies go momentarily still while they poke their heads into blossoms in search of the sweet nectar inside. Their delicate wings, blurred by motion when they fly, almost shimmer in the sunlight while they feed.

Gently, I reached out and cupped a male bee in my hands, noticing the way his tiny legs skittered across my fingers and the soft caress of his gossamer wings against my skin. When I released him, his small body lifted into the air like a fuzzy UFO.

I realize this new stick-my-face-close-to-buzzing-bees pastime could backfire, so I don’t necessarily recommend it, especially if you have a bee allergy, but if you’re going to get face-to-face with a carpenter bee, you might at least want to check the color of its face.

Damla Ozdemir, a member of the Wild Ones, with a giant cockroach in Professor Nijhout’s classroom.

If you could hold all the world’s insects in one hand and all the humans in the other, the insects would outweigh us. More than 900,000 species of insects have been discovered, and there may be millions more still unknown to science. Given their abundance and diversity, even the experts often encounter surprises.“Every year I see things I’ve never seen before,” Professor Nijhout told us. Next time you step outside, take a closer look at your six-legged company. You might be surprised by what you see.

By Sophie Cox, Class of 2025

Cemetery, Community, Classroom: Collaborating to Honor the Dead

Open Durham

The institutional neglect and indignity faced by many African Americans during and after the Jim Crow era in the South didn’t end when their lives did. In a panel hosted by the Duke Office of Durham & Community Affairs on Sept. 10, a community leader, Duke professor, and undergraduate student discussed some of the work they are doing to combat the marginalization of Durham’s deceased in Geer Cemetery, two miles from Duke’s campus. 

Debra Taylor Gonzalez-Garcia, President, Friends of Geer Cemetery

Founded on land purchased from Frederick and Polly Geer by John O’Daniel, Nelson Mitchell, and Willie Moore in 1877, Geer Cemetery is the final resting place for over 3000 of Durham’s African American citizens. As Maplewood Cemetery was segregated, from 1877 until the opening of Beechwood cemetery in 1924 Geer served as the only cemetery for the African American dead. Lacking public funding and under fire from the health department for overcrowding, Geer Cemetery closed in the 1930s and, in the absence of a plan for its continued upkeep, fell into a state of disrepair

President of Friends of Geer Cemetery Debra Taylor Gonzalez-Garcia provided a brief history of Geer Cemetery. 

The nonprofit Friends of Geer Cemetery was formed in 2003 by “concerned citizens and neighbors” and has worked to “restore the cemetery’s grounds and research its histories” under their mission statement “restore, reclaim, respect.” According to Gonzalez-Garcia, work consists of maintaining the cemetery grounds, repairing headstones, writing life stories, and advocating for recognition. 

Friends of Geer Cemetery has accomplished a lot in terms of restoration: in 2004 the cemetery was unrecognizable, with broken headstones, overgrowth, and sunken burials. Today, with the help of Keep Durham Beautiful, Preservation Durham, and other volunteers, the entire cemetery can now be easily viewed.

The organization also continues to work tirelessly toward their other objectives, reclamation and respect. By mining local records, research volunteers have created a database which includes approximately 1,651 burials, but efforts are ongoing. 

Gonzalez-Garcia expressed excitement about the organization receiving grant funding for an archaeological survey. “[The survey] will help us to map out burials, because currently, there is no map,” Gonzalez-Garcia said. “We aren’t sure where people are buried.” 

The community leader discussed how efforts to reclaim Geer Cemetery bring about questions that reckon with white supremacy in general. “We’re not told stories of the African Americans who built Durham,” Gonzalez-Garcia said. “Why do we know so much about Washington Duke, and nothing of Augustus Shepard? Why should Maplewood still exist and not Geer Cemetery?” 

Adam Rosenblatt

Associate Professor of the Practice in International Comparative Studies Adam Rosenblatt expressed his interest in how care for the dead is “bound up with human rights and social justice.” This interest is personal: he has his own graveless ancestors who disappeared in the Holocaust. He expressed his passion for educating others about “places of mourning in our midst” through “community-engaged” scholarship.

Along with Gonzalez-Garcia, Rosenblatt sponsored a Story+ program at Duke entitled Geer Cemetery: Labor, Dignity, and Practices of Freedom in an African American Burial Ground. With the help of sponsors and a graduate mentor, Duke undergraduates Nyrobi Manuel, Kerry Rork, and Huiyin Zhou researched the cemetery closely in order to “uncover the stories of ordinary citizens and add these stories back into the historic narrative about Geer.” The researchers produced three unique, interactive digital projects which will contribute to the Friends of Geer Cemetery’s online platform for education and outreach. 

Rosenblatt discussed one challenge the Story+ engaged with: What really constitutes a human subject? The IRB’s definition doesn’t include the dead; there’s no IRB protocols for researching the dead and their stories. Many archives disappear entirely, or are fragmented.

Nyrobi Manuel

Nyrobi Manuel, a Duke undergraduate, was one of Rosenblatt and Golzalez-Garcia’s mentees. Manuel took Rosenblatt’s course “Death, Burial, and Justice in the Americas” and says the course inspired her to dig deeper into African American death practices. Through the Story+, Manuel researched John C. Scarborough, who established the fifth-oldest Black-owned funeral home in the country. She produced a project entitled “Scarborough and Hargett Funeral Home: Dignified Death and Compassion in the Black Community.” 

Manuel discussed her findings. Many funeral directors became important figures in their community, and John C. Scarborough was no different. A philanthropist and important community member, he helped to establish Scarborough Nursery School, North Carolina’s oldest licensed nursery school.

What’s always drawn Gonzalez-Garcia to Geer Cemetery is its “quiet beauty” and sense of connection. Though her ancestors are buried in Virginia, where she’s from, Geer Cemetery seeks to tell stories of African Americans through “emancipation and reconstruction: throughout history.” Geer is special because it seeks to tell the story of her “blood relatives” while also celebrating the history of Durham, which, she said fondly, is “my community now.”

A New Algorithm for “In-Betweening” images applied to Covid, Aging and Continental Drift

Collaborating with a colleague in Shanghai, we recently published an article that explains the mathematical concept of ‘in-betweening,’in images – calculating intermediate stages of changes in appearance from one image to the next.

Our equilibrium-driven deformation algorithm (EDDA) was used to demonstrate three difficult tasks of ‘in-betweening’ images: Facial aging, coronavirus spread in the lungs, and continental drift.

Part I. Understanding Pneumonia Invasion and Retreat in COVID-19

The pandemic has influenced the entire world and taken away nearly 3 million lives to date. If a person were unlucky enough to contract the virus and COVID-19, one way to diagnose them is to carry out CT scans of their lungs to visualize the damage caused by pneumonia.

However, it is impossible to monitor the patient all the time using CT scans. Thus, the invading process is usually invisible for doctors and researchers.

To solve this difficulty, we developed a mathematical algorithm which relies on only two CT scans to simulate the pneumonia invasion process caused by COVID-19.

We compared a series of CT scans of a Chinese patient taken at different times. This patient had severe pneumonia caused by COVID-19 but recovered after a successful treatment. Our simulation clearly revealed the pneumonia invasion process in the patient’s lungs and the fading away process after the treatment.

Our simulation results also identify several significant areas in which the patient’s lungs are more vulnerable to the virus and other areas in which the lungs have better response to the treatment. Those areas were perfectly consistent with the medical analysis based on this patient’s actual, real-time CT scan images. The consistency of our results indicates the value of the method.

The COVID-19 pneumonia invading (upper panel) and fading away (lower panel) process from the data-driven simulations. Red circles indicate four significant areas in which the patient’s lungs were more vulnerable to the pneumonia and blue circles indicate two significant areas in which the patient’s lungs had better response to the treatment. (Image credit: Gao et al., 2021)
We also applied this algorithm to simulate human facial changes over time, in which the aging processes for different parts of a woman’s face were automatically created by the algorithm with high resolution. (Image credit: Gao et al., 2021. Video)

Part II. Solving the Puzzle of Continental Drift

It has always been mysterious how the continents we know evolved and formed from the ancient single supercontinent, Pangaea. But then German polar researcher Alfred Wegener proposed the continental drift hypothesis in the early 20th century. Although many geologists argued about his hypothesis initially, more sound evidence such as continental structures, fossils and the magnetic polarity of rocks has supported Wegener’s proposition.

Our data-driven algorithm has been applied to simulate the possible evolution process of continents from Pangaea period.

The underlying forces driving continental drift were determined by the equilibrium status of the continents on the current planet. In order to describe the edges that divide the land to create oceans, we proposed a delicate thresholding scheme.

The formation and deformation for different continents is clearly revealed in our simulation. For example, the ‘drift’ of the Antarctic continent from Africa can be seen happening. This exciting simulation presents a quick and obvious way for geologists to establish more possible lines of inquiry about how continents can drift from one status to another, just based on the initial and equilibrium continental status. Combined with other technological advances, this data-driven method may provide a path to solve Wegener’s puzzle of continental drift.

The theory of continental drift reconciled similar fossil plants and animals now found on widely separated continents. The southern part after Pangaea breaks (Gondwana) is shown here evidence of Wegener’s theory. (Image credit: United States Geological Survey)
The continental drift process of the data-driven simulations. Black arrow indicates the formation of the Antarctic. (Image credit: Gao et al., 2021)

The study was supported by the Department of Mathematics and Physics, Duke University.

CITATION: “Inbetweening auto-animation via Fokker-Planck dynamics and thresholding,” Yuan Gao, Guangzhen Jin & Jian-Guo Liu. Inverse Problems and Imaging, February, 2021, DOI: 10.3934/ipi.2021016. Online: http://www.aimsciences.org/article/doi/10.3934/ipi.2021016

Yuan Gao

Yuan Gao is the William W. Elliot Assistant Research Professor in the department of mathematics, Trinity College of Arts & Sciences.

Jian-Guo Liu is a Professor in the departments of mathematics and physics, Trinity College of Arts & Sciences.

Jian-Guo Liu

Using Data Science for Early Detection of Autism

Autism Spectrum Disorder can be detected as early as six to twelve months old and the American Academy of Pediatrics recommends all children be screened between twelve and eighteen months of age.

But most diagnoses happen after the age of 4, and later detection makes it more difficult and expensive to treat.

One in 40 children is diagnosed with Autism Spectrum Disorder and Duke currently serves about 3,000 ASD patients per year. To improve care for patients with ASD, Duke researchers have been working to develop a data science approach to early detection.

Geraldine Dawson, the William Cleland Distinguished Professor in the Department of Psychiatry & Behavioral Sciences and Director of the Duke Center for Autism and Brain Development, and Dr. Matthew Engelhard, a Conners Fellow in Digital Health in Psychiatry & Behavioral Sciences, recently presented on the advances being made to improve ASD detection and better understand symptoms.

The earlier ASD is detected, the easier and less expensive it is to treat. Children with ASD face challenges in learning and social environments.

ASD differs widely from case to case, however. For most people, ASD makes it difficult to navigate the social world, and those with the diagnosis often struggle to understand facial expressions, maintain eye contact, and develop strong peer relations.

However, ASD also has many positive traits associated with it and autistic children often show unique skills and talents. Receiving a diagnosis is important for those with ASD so that they can receive learning accommodations and ensure that their environment helps promote growth. 

Because early detection is so helpful researchers began to ask:

“Can digital behavioral assessments improve our ability to screen for neurodevelopmental disorders and monitor treatment outcomes?”

Dr. geraldine DawsoN

The current approach for ASD detection is questionnaires given to parents. However, there are many issues in this method of detection such as literacy and language barriers as well as requiring caregivers to have some knowledge of child development. Recent studies have demonstrated that digital assessments could potentially address these challenges by allowing for direct observation of the child’s behavior as well as the ability to capture the dynamic nature of behavior, and collect more data surrounding autism.

“Our goal is to reduce disparities in access to screening and enable earlier detection of ASD by developing digital behavioral screening tools that are scalable, feasible, and more accurate than current paper-and-pencil questionnaires that are standard of care.”

Dr. Geraldine Dawson

Guillermo Sapiro, a James B. Duke Distinguished Professor of Electrical and Computer Engineering, and his team have developed an app to do just this.

On the app, videos are shown to the child on an iPad or iPhone that prompt the child’s reaction through various stimuli. These are the same games and stimuli typically used in ASD diagnostic evaluations in the clinic. As they watch and interact, the child’s behavior is measured with the iPhone/iPad’s selfie camera. Some behavioral symptoms can be detected as early as six months of age are, such as: not paying as much attention to people, reduced affective expression, early motor differences, and failure to orient to name.

In the proof-of-concept study, computers were programmed to detect a child’s response to hearing their name called. The child’s name was called out by the examiner three times while movies were shown. Toddlers with ASD demonstrated about a second of latency in their responses. 

Another study used gaze monitoring on an iPhone. Nearly a thousand toddlers were presented with a split screen where a person was on one side of the screen and toys were on the other. Typical toddlers shifted their gaze between the person and toy, whereas the autistic toddlers focused more on the toys. Forty of the toddlers involved in the study received an ASD diagnosis. Using eye gaze, researchers were also able to look at how toddlers responded to speech sounds as well as to observe early motor differences because toddlers with ASD frequently show postural sway (a type of head movement).

“The idea behind the app is to begin to combine all of these behaviors to develop a much more robust ASD algorithm. We do believe no one feature will allow us to detect ASD in developing children because there is so much variation”

DR. GERALDINE DAWSON

The app has multiple features and will allow ASD detection to be done in the home. Duke researchers are now one step away from launching an at-home study. Other benefits of this method include the ability to observe over time with parents collecting data once a month. In the future, this could be used in a treatment study to see if symptoms are improving.

Duke’s ASD researchers are also working to integrate information from the app with electronic health records (EHR) to see if information collected from routine medical care before age 1 can help with detection.

Post by Anna Gotskind

The SolarWinds Attack and the Future of Cybersecurity

Cybersecurity is the protection of computer systems and networks in order to prevent theft of or damage to their hardware, software, or electronic data. While cybersecurity has been around since the 1970s, its importance and relevance in mainstream media as well as politics is growing as an increased amount of information is stored electronically. In 1986, approximately 1% of the world’s information was stored in a digital format; by 2006, just twenty years later, this had increased to 94%.

Cyber Hacking has also become more prominent with the advent of the Digital Revolution and the start of the Information Era which began in the 1980s and rapidly grew in the early 2000s. It became an effective political form of attack to acquire confidential information from foreign countries. 

In mid-December of 2020, it was revealed that several U.S. companies and even government agencies were victims of a cyberattack that began in September of 2019. 

The Sanford School of Public Policy hosted a leading cybersecurity reporter Sean Lyngaas to lead a discussion on the national security implications of the SolarWinds hack with Sanford Professor David Hoffman as well as Visiting Scholar and Journalist Bob Sullivan. Lyngaas graduated from Duke in 2007 and majored in Public Policy at the Sanford School. 

Lyngaas did not have a direct route into cybersecurity journalism. After completing his Masters in International Relations from The Fletcher School of Law and Diplomacy at Tufts University he moved to Washington D.C. to pursue a career as a policy analyst. However, at night when he was not applying for jobs he began pitching stories to trade journals. Despite not being a “super technical guy” Lyngaas ended up becoming passionate about cybersecurity and reporting on the increasing amounts of news surrounding the growing topic. Since 2012 Lyngaas has done extensive reporting on cybersecurity breaches and recently has published several detailed reports on the SolarWinds incident. 

Sean Lyngaas

The SolarWinds attack is considered one of the most impactful cybersecurity events in history as a result of its intricacy and the number of government and private sector victims. Lyngaas explained that most people had not heard of SolarWinds until recently, but the company nevertheless, provides software to a multitude of fortune 500 companies and government agencies. One of the software products they sell is Orion, an IT performance monitoring platform that helps businesses manage and optimize their IT infrastructure. The Hackers infiltrated Orion’s update software and over several months sent out malicious updates to 18,000 companies and government agencies. Among the victims of this espionage campaign were the U.S. Justice Department and Microsoft. As a result of the campaign, countless email accounts were infiltrated and hacked.

“A perfect example of someone robbing a bank by knocking out the security guard and putting on his outfit to have access.” 

Bob Sullivan

Sullivan added that this hack is particularly concerning because the target was personal information whereas previous large-scale hacks have been centered around breaching data. Additionally, SolarWind’s core business is not cybersecurity, however, they work with and provide software to many cybersecurity companies. The attack was revealed by FireEye, a cybersecurity company that announced they had been breached.

“FireEye got breached and they are the ones usually investigating the breaches”

Sean lyngaas

This situation has prompted both those involved in the cybersecurity industry as well as the public to reconsider the scope of cyberhacking and what can be done to prevent it.

“Computer spying by nation states has been going on for decades but we talk about it more openly now.” Lyngass stated. 

Lyngaas added that the public is now expecting more transparency especially if there are threats to their information. He feels we need to have better standards for companies involved in cyber security. Solarwinds arguably was not using cybersecurity best practices and had recently made price cuts which may have contributed to their vulnerability. Hoffman explained that SolarWinds had been using an easy-to-guess password to their internal systems which allowed hackers access to the software update as well as the ability to sign a digital signature. 

“We are not going to prevent these breaches; we are not going to prevent the Russians from cyber espionage.” Lyngaas stated

However, he believes by using best practices we can uncover these breaches earlier and react in a timely manner to reduce damage. Additionally, he thinks there needs to be a shift in government spending in terms of the balance between cyber defense and offense. Historically, there has been a lack of transparency in government cyber spending, however, it is known that there has been more spent on offense in the last several years.

Changes are starting to be made in the cybersecurity landscape that hopefully should aid in reducing attacks or at least the severity of their impacts. California recently created a law centered around publicizing breaches which will increase transparency. The panelists added that the increasing amount of news and information available to the public about cybersecurity is aiding efforts to understand and prevent it. President Biden was openly speaking about cybersecurity in relation to protecting the election from hackers and continues to consider it an urgent issue as it is crucial in order to protect confidential U.S. information. 

As Lyngaas explained, it is practically impossible to completely prevent cyber attacks, however, through increasing transparency and using best practices, incidents like the SolarWinds hack will hopefully not have effects of the same scale again.

Post by Anna Gottskind

Her Research Path Winds Through a Plant’s Growth

The beauty of research is that it allows you to take control of your own path.

“We are very lucky to be in the position to decide what we love to do and do it,” says Tai-ping Sun, a Duke biology professor studying the plant hormone GA. Researchers get to take control of their own path, she said. Every day is an opportunity to learn something new, design and analyze experiments and decide what direction to take.

Tai-ping Sun is a professor of Biology at Duke

Sun studies the GA signaling pathway because it regulates plant growth and development. She got interested in GA when she was a post-doctoral fellow at Harvard University in 1988. At the time, a lot of tools needed to be developed. As she was developing new tools to clone plant genes, she came across a GA mutant that was different. Her research is very important to understanding how the mutations in the GA signaling pathways can control the height of a plant. In fact, she says, GA mutations were one of the reasons for the success of the “Green Revolution” in the 1960s.

Sun’s current research revolves around identifying the mechanisms of the cell that make GA hormones and identifying how GA mutations have affected this pathway. Her team has identified important facets of the pathway, such as the structure and function of the nuclear receptors that allow for transcription that drives the GA response. Her team has also identified transcription factors that control the rate of the signaling pathway such as the DELLA proteins that act as master growth repressors to inhibit GA response. In fact one of her favorite discoveries is that GA triggers destruction of the DELLA proteins to activate the GA signaling pathway.

A figure from a 2004 paper by Sun on plant growth.
All three of the mutants grew less well than wild type plants.

“As a scientist, the most exciting thing is to discuss experimental data, and then trying to deduce hypothesis or modify models and then come up with new experiments for testing,” she said.

But research is not without its challenges, Sun says “not everything that you do works out the first time.” That’s why she says that as a researcher the most important thing is to have an interest in your field as well as perseverance.

Guest post by Anika Jain, Class of 2021, NC School of Science and Math

Quantifying the effects of structural racism on health

Photo from Scholars@Duke

America is getting both older and Blacker. The proportion of non-white older adults is increasing, and by 2050 the majority of elderly people will be racial minorities. In his Langford Lecture “Who gets sick and why? How racial inequality gets under the skin” on November 10, Professor Tyson H. Brown discussed the importance of studying older minorities when learning about human health. His current project aims to address gaps in research by quantifying effects of structural racism on health. 

Health disparities result in unnecessary fatalities. Dr. Brown estimates that if we took away racial disparities in health, we could avoid 229 premature deaths per day. Health disparities also have substantial economic costs that add up to about 200 billion dollars annually. Dr. Brown explained that the effects of structural racism are so deadly because it is complex and not the same as the overt, intentional, interpersonal racism that most people think of. Thus, it is easier to ignore or to halt attempts to fix structural racism. Dr. Brown’s study posits that structural racism has five key tenets: it is multifaceted, interconnected, an institutionalized system, involves relational subordination and manifests in racial inequalities in life chances. 

A motivator for Brown’s research was that less than 1% of studies of the effects of race on health have focused on structural racism, even though macro level structural racism has deleterious effects on health of Black people. When thinking about inequalities, the traditional mode of thinking is the group that dominates (in this case, white people) receives all benefits and the subordinates (in Dr. Brown’s study, Black people) receive all of the negative effects of racism. In this mode of thinking, whites actively benefit from social inequality. However, Dr. Brown discussed another theory: that structural racism and its effects on health undermines the fabric of our entire society and has negative impacts on both whites and Blacks. It is possible for whites to be harmed by structural racism, but not to the same extent as Black people. 

Dr. Brown identified states as “important institutional actors that affect population health.” As a part of his research, he made a state level index of structural racism based off of data from 2010. The index was composed of nine indicators of structural racism, which combine to make an overall index of structural racism in states. In mapping out structural racism across the domains, the results were not what most people might expect. According to Dr. Brown’s study, structural racism tends to be highest in the midwest of the United States, rather than the south. These higher levels of structural racism were associated with worse self-rated health: one standard deviation increase in level of structural racism correlated with the equivalent of two standard deviation increases in age. In other words, a person who is affected by structural racism has similar self-rated health to people two age categories above them who do not experience negative effects of structural racism. 

As the structural racism index increases, the Black-white difference in COVID-19 related deaths also increases. Overall, Dr. Brown found that structural racism is a key driver of inequalities in COVID-19 deaths between whites and Blacks. Looking forward, Dr. Brown is interested in learning more about how contemporary forms of racism contribute to inequality—such as searching racial slurs on Google and implicit bias, both of which are high in the southern United States. 

After his discussion, colleagues raised questions about what can be done to eliminate negative effects of structural racism. Dr. Brown listed options such as rent protection, COVID-19 test sites in lower income communities and another stimulus bill. He also explained that the distribution of a COVID-19 vaccine needs to be done in an ethical manner and not exclude those who are less fortunate who really need the vaccine. We also need better data collection in general—the more we know about the effects of structural racism, the better we will be able to adapt equity practices to mitigate harm on Black communities.

By Victoria Priester

Most Highly Cited List Includes 37 from Duke

Five of the ten Duke women included in the most highly-cited list this year. Their scholarly publications are viewed as important and influential by their peers. (Clockwise from upper left: Costello, Curtis, Dawson, Bernhardt, Moffitt)

Duke’s leading scholars are once again prominently featured on the annual list of “Most Highly Cited Researchers.”

Thirty-seven Duke faculty were named to the list this year, based on the number of highly cited papers they produced over an 11-year period from January 2009 to December 2019.  Citation rate, as tracked by Clarivate’s Web of Science, is an approximate measure of a study’s influence and importance.

Barton Haynes

Two Duke researchers appear in two categories: Human Vaccine Institute Director Barton Haynes, and Michael Pencina, vice dean of data science and information technology in the School of Medicine.

And two of the Duke names listed are new faculty, recruited as part of the Science & Technology initiative: Edward Miao in Immunology and Sheng Yang He in Biology.

Michael Pencina

This year, 6,127 researchers from 60 countries are being recognized by the listing. The United States still dominates, with 41 percent of the names on the list, but China continues to grow its influence, with 12 percent of the names.

Clinical Medicine:

Robert M. Califf, Lesley H. Curtis, Pamela S. Douglas, Christopher Bull Granger, Adrian F. Hernandez, L. Kristen Newby, Erik Magnus Ohman, Manesh R. Patel, Michael J. Pencina, Eric D. Peterson.

Environment and Ecology:

Emily S. Bernhardt, Stuart L. Pimm, Mark R. Weisner.

Geosciences:

Drew T. Shindell

Immunology:

Barton F. Haynes, Edward A. Miao

Microbiology:

Barton F. Haynes

Plant and Animal Science:

Sheng Yang He

Psychiatry and Psychology:

Avshalom Caspi, E. Jane Costello, Renate M. Houts, Terrie E. Moffitt

Social Sciences:

Michael J. Pencina

Cross-Field:

Dan Ariely, Geraldine Dawson, Xinnian Dong, Charles A. Gersbach, Ru-Rong Ji, Robert J. Lefkowitz, Sarah H. Lisanby, Jie Liu, Jason W. Locasale, David B. Mitzi, Christopher B. Newgard, Ram Oren, David R. Smith, Avner Vengosh.

The evolutionary advantage of being friendly

We’ve all heard the term “survival of the fittest,” which scientist Charles Darwin famously coined to explain how organisms with heritable traits that give them an advantage — such as avoiding predators or beating out others for the chance to mate — are able to survive and pass on these advantageous traits to their offspring.

In his talk with ClubEvMed last Tuesday, Brian Hare of Duke Evolutionary Anthropology explained key points from his new book that he co-authored with his wife and research partner, Vanessa Woods, entitled Survival of the Friendliest: Understanding Our Origins and Rediscovering Our Common Humanity

Image from Penguin Random House

The term “fittest” is often associated with animals who are physically stronger or of more value than others, but being “fit” can also include an organism’s ability to communicate well with others in its group, which can provide an evolutionary advantage. For example, more social animals can form alliances with each other and protect each others’ young, so the whole population stays stronger in terms of number.

Hare cited a comparison between chimpanzees and bonobos, both of which have the potential for infanticide by aggressive males in a group. However, bonobos have zero cases of infanticide because female bonobos are able to communicate well and form alliances to protect each others’ young from aggressive males. Since the high cost of aggression for males outweighs the benefit, the males are friendlier, and the young bonobos survive. While this is a specific case with wild animals, other species have adopted social skills as a method of survival through domestication or self-domestication. 

Image from brianhare.net

Hare referred to dogs as “exhibit A” of survival of the friendliest via domestication, because humans have bred dogs that are more playful, approachable and patient for centuries. Dogs are exceptionally good at understanding, responding to and communicating with humans as a result of domestication. Hare also explained one Russian study in which they began selecting foxes based on their friendliness towards people. They bred the most friendly foxes together and then compared the friendliness of their offspring to the offspring of randomly bred foxes. The results showed that friendlier foxes differed in physiology in addition to behavior, and were better at cooperating and communicating with humans. This is an example of self-domestication, which changes development patterns and has increased fitness via friendliness. Friendliness in this case means skill in cooperating and communication. 

Survival of the Friendliest argues that humans today are the friendliest species of human, which may be why we have lasted so long evolutionarily. However, with the new type of friendliness also comes a new type of aggression. Mother bears are kind and nurturing to their cubs, but also have the most potential for aggression when they feel their cubs are threatened. Similarly in humans, when we feel people who share our identity are threatened, we want to protect those individuals.

Hare and Woods reason that this desire to protect also reduces our ability to cooperate or communicate with those who we feel threaten us or threaten our “group”— whether this be our family, our race or another trait. When our ability to communicate is reduced, we begin to dehumanize those who we feel threaten the people who share our identity. This then becomes a cycle, where people dehumanize those who they believe are dehumanizing them.

In order to stop this cycle, Hare and Woods argue that humans will need to alter their view of who they believe “belongs” to their group to include more people. We need to communicate openly and build a desire to protect other humans, rather than dehumanize them.

By Victoria Priester

Scholars Examine Duke’s History of Unequal Medical Care for Black People

Conversations on and actions toward making American medicine less racist continue to grow. At Duke, that includes looking at our own history as a hospital and medical center serving a diverse community.

In a Sept. 22 virtual conversation, Duke physicians Damon Tweedy M.D., Associate Professor of Psychiatry and Behavioral Sciences, and Jeffrey Baker M.D., Ph.D., Director of the Trent Center for Bioethics, Humanities, and History of Medicine, spoke about the history of Duke’s legacies of race and memory. (Watch the presentation here.)

The career of Dr. Baker, who is a professor of both pediatrics and history, has taken him around the globe, right back to his hometown of Durham –where he said he has found the most interesting story of all.

After becoming Director for the Trent Center in 2016, he was approached with “hunger” by Durham natives to know their hometown’s story. Through oral and archival sources, Dr. Baker has broached Duke hospital’s history with humility in hopes of uncovering and contextualizing the historical roles of race in Duke medicine and Durham.

Dr. Tweedy, author of Black Man in a White Coat, attended Duke for medical school in the 1990s. He was warned that it was a plantation and an institution built on tobacco and slave money.

Though Dr. Baker proposed that in many ways the hospital structure often reflects plantation hierarchies in which there is racialization of who holds what jobs and power, he said Duke’s endowment money actually came from technological progress within tobacco production rather than slavery or plantations directly.

The Duke family’s vision for the hospital was quite different from actual outcomes in practice, Dr. Baker said. The Dukes were considered racial progressives in their time and the endowment they provided to launch the Duke Medical School and Hospital in 1930 was meant to improve health and education in North Carolina and train primary care doctors for the state.

“However,” Dr. Baker said, “there were two realities: Jim Crow and the Great Depression.”

Dr. Tweedy and Dr. Baker via Zoom

During the era of Jim Crow segregation, Duke’s primary care doctors were all white, and nearly all male. Though the hospital cared for both Black and white patients, they were segregated by race. Black patients had separate wards, and waiting areas for pediatric care were separated racially by days of the week. Waiting areas for adult patients functioned without appointments, but only white people were seen before noon. It’s likely that the care granted to white people in the first half of the day was superior to that of Black people receiving care at 4 pm or told to return the next day, he said.

Original floor plans for the Duke Hospital.

The Great Depression also generated a diversion from plans in the 1940s. When the Duke Hospital came close to bankruptcy, it chose to open private clinics on the side for revenue – which had an unintended consequence. The clinics brought a lot of money into Duke, Dr. Baker said, but it also reinforced distinctions between those who could pay for treatment and those who couldn’t. Over time, the disparities expanded with shifts towards hospital beds for insured and private patients.

In one terrible example, Maltheus “Sunny” Avery, a North Carolina A & T graduate who got into a car wreck in Burlington, NC in 1950, was diagnosed with an epidermal hematoma — a clot near his brain — and sent to Duke for emergency brain surgery. But he was refused treatment due to inadequate room in the “colored” ward.

Avery was redirected to Lincoln Hospital, Durham’s Black hospital, where he died shortly after admission. Though Dr. Baker said this story quickly faded from white memory, it is something that has retained severe importance in the popular memory of Black Durhamites. This narrative is also often conflated with a similar story about Dr. Charles Drew, the Black inventor of blood banking, who died despite attempts at rescue at a white hospital in Alamance, NC. He is often misremembered as having died from the refusal of care in a racially divided South, even though he was not.

News coverage of Sunny’s death.

Duke’s first Black medical student, Delano “Dale” Meriwether, arrived the same year the hospital began desegregation, 1963, and he was the first Black M.D. in 1967. Meriwether was the only Black medical student for four years before other brave pioneers joined the school.

Dr. Tweedy reflected on his own medical school experiences at Duke during clinical rotations just a little more than 20 years ago.

“I was asked to help suture a deep gash on a Black patient’s forehead,” he said, “The patient asked if we were experimenting on him since I was still a student.” In the private clinics, he once “couldn’t go anywhere near” a white patent with a minor lesion on their arm, let alone suture that patient.

Dr. Baker said there are two narratives surrounding Duke Hospital’s desegregation. One assumes that desegregation was quick and easy and uneventful, while the other proposes that systems of racial segregation were simply transformed rather than eradicated. The latter narrative better applies to the public and private clinics that had become nearly completely racialized over time, Baker said.

Even though segregation was no longer legal,  Black patients received care from less experienced medical residents in the public clinics, while white patients received care from attending physicians in the nicer, private environments.

Dr. Baker said that Duke has a complicated relationship with the community of Durham. He said the merger of Durham Regional Hospital with Duke Health in the late 1990s tapped into some long-term tensions and distrust between Duke and other medical facilities of Durham.

Dr. Tweedy pointed out that Duke researchers always have trouble recruiting Black patients for clinical studies, despite the fact that Durham County is about half Black and Hispanic. There is some distrust to overcome, but a diverse patient population is essential to creating robust study data that ensures that treatments will work for everyone, he said.

Medical professionals “need more than just science,” Baker concluded. He said that being trained as scientists often inclines doctors to think that they are above the larger contexts and histories they exist within, and that they can somehow remain objective.

“We have come out of specific stories and backgrounds,” Dr. Baker said. “[When we treat patients], we have to think about what story we are walking into.”

“We all carry our bags of ‘stuff'” that complicate patient prognosis and care, Dr. Tweedy concurred.

As Ann Brown (M.D., M.H.S), Vice Dean for Faculty, stated at the beginning of the conversation, “In order to move forward, we must understand where we come from.”

This is true of our nation as a whole, and Duke is certainly no exception.

Post by Cydney Livingston

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