Duke Research Blog

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

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Piloting Aviation Mental Healthcare

With more than 100,000 flights taking off per day, the safety of air travel is a far-reaching issue.

Air travel remains one of the safest forms of transportation, but are there things we can do to make it safer?

While air travel is by far the safest method of transportation — you are more likely to die from a car crash or even a shark attack than from an airplane crash — accidents do happen and can result in highly publicized fatalities.

Chris Kenedi is working with the ICAO to improve treatment of mentally ill pilots.

Auckland Hospital internist and psychiatrist Chris Kenedi, MD, MPH, is working with the International Civil Aviation Organization (ICAO) to improve safety of air travel by focusing on an issue that is usually only questioned in instances of tragedy: the mental health of pilots.

While screening procedures do currently exist, they are not enough for the extent of risk factors that are present in the pilot population.
Being a pilot is a high-stress job. It involves long hours, separation from family, and irregular sleep schedules, all of which can contribute to or exacerbate mental conditions.

Many pilots experiencing symptoms are unwilling to ask for help, because admitting mental illness can lead to a pilot’s license being revoked, which would not only affect financial circumstances but also be felt as a loss of identity.

Although data regarding aviation mental health is sparse, what is available suggests  mental health issues are among the greatest contributing factors to suicide and homicide-suicide incidents of plane accidents.

When Kenedi completed a systematic review of all data on the mental health of pilots and the current standard procedures, he found a deeply flawed system. Case studies of crashes caused by suicidal pilots showed that psychiatrists cleared them for flight even after episodes indicating a much deeper psychological imbalance.

One pilot who drove his car into a barrier, attempted to steal the car of a woman trying to help him, and slit his wrists so deeply that he required two years of rehabilitation before regaining all of his mobility, was diagnosed with a general anxiety disorder and cleared to fly without proper treatment.

In order to prevent further grave oversights, Kenedi suggests requiring the psychiatrist who assesses a pilot’s ability to fly to be separate from the treating psychiatrist. This separation prevents the assessing psychiatrist from having his or her judgement confounded by a relationship with the patient and thus becoming an advocate rather than an impartial assessor.

Kenedi said that alcohol and substance abuse treatments for pilots have been effective, however. Rather than relying on random drug and alcohol tests to disqualify impaired pilots, the system provides non-judgmental treatment and an opportunity to return to piloting.

Kenedi recommends a shift to treating mental illness in pilots in a similar way, so that individuals are not afraid to step forward and ask for help. Educating mental healthcare providers is also important, so that pilots are receiving the best care possible.

With proper resources and treatment, pilots with mental health concerns should be able to maintain their identity as pilots while gaining renewed resilience and support through the mental health system. This shift would hopefully help to prevent some of the small amount of air travel accidents that occur because of pilot issues.

By Sarah Haurin

 

How Climate Change Limits Educational Access

Regions with agricultural economies suffer greatly from climate change.

The effects of climate change can creep into nearly every aspect of life in heavy-hit areas. They may even limit children’s access to education, says Nicholas School of the Environment graduate Heather Randell.

“Investments in education are an important pathway out of poverty, yet lack of access remains a barrier,” Randall said in a presentation to Nicholas School students and faculty.

Randell became interested in the relationship between climate change and education when she visited Ethiopia before pursuing her doctorate. She noticed many school-age kids were working rather than pursuing an education, and began to wonder what factors influence children’s time use.

Heather Randell PhD is a sociologist and demographer for the National Socio-Environmental Synthesis Cener (SESYNC).

Although the UN’s Millennium Development Goals and Beyond 2015 aimed to ensure universal primary education for all school-age children, 20 percent of children in Sub-Saharan Africa were still out of school in 2017.

Using data from the Ethiopian Rural Household Survey, Randell found that when children experience milder temperatures and more ample rainfall during their early life, they are more likely to stay in school longer. This trend can be attributed to the close ties between the economy and climate in agricultural areas like those in rural Ethiopia.

Agricultural economies are inherently dependent on temperature and rainfall. Increased temperature and decreased rainfall lower crop yield, which in turn decreases individual families’ incomes.

Children in Ethiopia are less likely to continue their education if they experienced hotter temperatures and less rainfall in their early childhood.

With less disposable income, families are more likely to spend their money on necessities like food rather than on schooling fees. Families are also more likely to pull children out of school so kids can work and contribute to the diminished family income.

After finding these patterns in Ethiopia, Randell expanded her research to include regions in the tropics, including Central America, the Caribbean, South America, East Africa, West Africa and Southeast Asia. Each of these regions has variations in their typical rainfall and temperatures, but all are inherently susceptible to climate change because of their location near the equator.

From her research in Ethiopia, Randell found two mechanisms by which climate change influences educational outcomes.

Comparing standardized census and climate data from these regions, Randell found a similar pattern, with increased temperature and changes in rainfall being associated with decreased educational outcomes.

This study also found that climate change and its negative effects often outweigh typical advantages that improve educational access, such as parents who have had a longer schooling.

Randell concluded her talk by stating that true and lasting change to educational accessibility will only be brought about by policy change. School must be less expensive and more accessible, and more importantly, livelihood diversification must be taught and encouraged. Families must learn how to generate income in ways other than agriculture so that their income and familial decisions are more resilient to climate variability.

By Sarah Haurin

Smoking Weed: the Good, Bad and Ugly

DURHAM, N.C. — Research suggests that the earlier someone is exposed to weed, the worse it is for them.

Very early on in our life, we develop basic motor and sensory functions. In adolescence, our teenage years, we start developing more complex functions — cognitive, social and emotional functions. These developments differ based on one’s experience growing up — their family, their school, their relationships — and are fundamental to our growth as healthy human beings.

This process has shown to be impaired when marijuana is introduced, according to Dr. Diana Dow-Edwards of SUNY Downstate Medical Center.

Sure, a lot of people may think marijuana isn’t so bad…but think again. At an Oct. 11 seminar at Duke’s Center on Addiction & Behavior Change, Dow-Edwards enlightened those who attended with correlations between smoking the reefer and things like IQ, psychosis and memory.

(https://media.makeameme.org/created/Littering-and-SMOKIN.jpg)

Dow-Edwards is currently a professor of physiology and pharmacology and clearly knows her stuff. She was throwing complicated graphs and large studies at us, all backing up her primary claim: the “dose-response relationship.” Basically the more you smoke (“dose”), the more of a biological effect it will have on you (“response”).

Looking at pot users after adolescence showed that occasionally smoking did not cause a big change in IQ, and frequently smoking affected IQ a little. However, looking at adults who smoked during adolescence correlated to a huge drop of around 7 IQ points for infrequent smokers and 10 points for frequent smokers. Here we see how both age and frequency play a role in weed’s effect on cognition. So if you are going to make the choice to light up, maybe wait until your executive functions mature around 24 years old.

Smoking weed earlier in life also showed a strong correlation with an earlier onset of psychosis, a very serious mental disorder in which you start to lose sense of reality. Definitely not good. I’m not trynna get diagnosed with psychosis any time soon!

One perhaps encouraging study for you smokers out there was that marijuana really had no effect on long-term memory. Non-smokers were better at verbal learning than heavy smokers…until after a three week abstinence break, where the heavy smokers’ memories recovered to match the control groups’. So while smoking weed when you have a test coming up maybe isn’t the best idea, there’s not necessarily a need to fear in the long run.

(Hanson et al, 2010)

A similar study showed that signs of depression and anxiety also normalized after 28 days of not smoking. Don’t get too hyped though, because even after the abstinence period, there was still “persistent impulsivity and reduced reward responses,” as well as a drop in attention accuracy.

A common belief about weed is that it is not addicting, but it actually is. What happens is that after repetitively smoking, feeling high no longer equates to feeling better than normal, but rather being sober equates to feeling worse than normal. This can lead to irritability, reduced appetite, and sleeplessness. Up to 1/2 of teens who smoke pot daily become dependent, and in broader terms, 9 percent of people who just experiment become dependent.

In summary, “marijuana interferes with normal brain development and maturation.” While it’s not going to kill you, it does effect your cognitive functions. Plus, you are at a higher risk for mental disorders like psychosis and future dependence. So choose wisely, my friends.

By Will Sheehan

Will Sheehan

Engineering Design Pod: The Newest Innovation Center

You guys have to check out the brand new Engineering Design Pod! What used to be the Blue Express Cafe, this giant oval-shaped room with huge glass windows under the LSRC is now a space for creation.

Duke Engineering Design Pod entrance

Duke Engineering’s new Design Pod for students is in the Levine Science Research Center.

There’s essentially all the equipment in there that an engineer could ever want, organized ever so beautifully in labeled drawers and hung on walls: screwdrivers, nails, hammers, saws, pool noodles… plus, there are scientific-looking tables (a.k.a. workbenches), rolly-stools, extension chords that come down from the ceiling, even TVs… this place is frickin’ awesome!

worktables in Duke Engineering Design Pod

Everything in the Design Pod is on wheels for easy reconfiguration

The “Design Pod” was created alongside Duke’s new engineering design course in order to to foster learning through hands-on experience. Students have tested out the 3D printer to create items such as a skull and even chess pieces. There’s a massive laser printer, foam cutter, panel saw, and more to come. At one end of the  room there are lots of cubbies, used for holding backpacks so they don’t get in the way. In the future, team projects will be stored there, too. Several big whiteboards on wheels are scattered around the room, which students take advantage of to outline their work and draw up ideas. Almost everything is on wheels, in fact, because as Dr. Ann Saterbak explained to me, the pod is “designed to be a flexible space.” It really is a special place, carefully geared toward collaboration and innovation. Just being in there made me want to create something!

UNC chess board

Awkward! One student made a UNC-themed chessboard in Duke’s new Design Pod.

Kyra McDonald, a freshman currently taking the engineering design course, says it’s her favorite class. The class is split up into teams and each team picks from a list of projects that they will pursue for the whole semester — examples include things like a flexible lemur feeder and a drone water sampler. What she likes so much about the class is rather than a typical lecture where you listen and take notes the whole time, this design course is all about working in your team and applying what you know to real-world scenarios.

Dr. Saterbak further developed this point. Although this is her first year at Duke, in her experience students not only get a good sense of what engineers actually do, but also leave with a “concrete, practical thing” which they are proud of and can talk about at job interviews. All the cool features that make up the design pod — the tools, the room, the flexibility — are there so Dr. Saterbak’s previous experience can become a reality for Duke students.

Duke Engineering Design Pod

A 3D printed skull in the Design Pod

Because they’re still in the pre-design phase, the freshman in the class haven’t really needed to use the space to its full potential.

But that will come as soon as the physical creation starts happening. Students in the class will have special access to the design pod off-hours, so get ready because the innovation levels are about to be booming!

Story and Photos By Will Sheehan Will Sheehan

Designing Drugs Aimed at a Different Part of Life’s Code

Individual RNA molecules fluoresce inside a breast cancer cell.

Individual RNA molecules fluoresce inside a breast cancer cell. Credit: Sunjong Kwon, Oregon Health & Science University, via Flickr.

Most drugs work by tinkering with the behavior of proteins. Like meddlesome coworkers, these molecules are designed to latch onto their target proteins and keep them from doing what they need to do.

If a protein is responsible for speeding up a reaction, the drug helps slow the reaction down. If a protein serves as a gatekeeper to a cell, regulating what gets in and what stays out, a drug changes how many molecules it lets through.

But proteins aren’t the only doers and shakers in our bodies. Scientists are finding that strings of RNA — known primarily for their role in shuttling genetic information from nucleus-bound DNA to the cell’s protein-manufacturing machinery — can also play a major role in regulating disease.

A portrait of Amanda Hargrove

Amanda Hargrove is an assistant professor of chemistry at Duke University.

“There has been what some people are calling an RNA revolution,” said Amanda Hargrove, assistant professor of chemistry at Duke. “In some diseases, non-coding RNAs, or RNAs that don’t turn into protein, seem to be the best predictors of disease, and even to be driving the disease.”

Hargrove and her team at Duke are working to design new types of drugs that target RNA rather than proteins. RNA-targeted drug molecules have the potential help treat diseases like prostate cancer and HIV, but finding them is no easy task. Most drugs have been designed to interfere with proteins, and just don’t have the same effects on RNA.

Part of the problem is that proteins and RNA have many fundamental differences, Hargrove said. While proteins are made of strings of twenty amino acids that can twist into myriad different shapes, RNA is made of strings of only four bases — adenine, guanine, cytosine and uracil.

“People have been screening drugs for different kinds of RNA for quite a while, and historically have not had a lot of success,” Hargrove said. “This begged the question, since RNA has such chemically different properties than proteins, is there something different about the small molecules that we need in order to target RNA?”

To find out, graduate student Brittany Morgan and research associate Jordan Forte combed the scientific literature to identify 104 small molecules that are known interact with specific types of RNA. They then analyzed 20 different properties of these molecules, and compared their properties to those of collections of drug molecules known to interact with proteins.

The team found significant differences in shape, atomic composition, and charge between the RNA-active molecules and the protein-active molecules. They plan to use the results to compile a collection of molecules, called a library, that are chosen to better “speak the language” of the RNA-active molecules. They hope this collection of molecules will be more likely to interact with RNA in therapeutically beneficial ways.

“We found that there are differences between the RNA-targeted molecules and the protein-targeted drugs, and some of them are pretty striking,” Hargrove said. “What that means is that we could start to enrich our screening libraries with these types of molecules, and make these types of molecules, to have better luck at targeting RNA.”

Discovery of Key Physicochemical, Structural, and Spatial Properties of RNA-Targeted Bioactive Ligands.” Brittany S. Morgan, Jordan E. Forte, Rebecca N. Culver, Yuqi Zhang and Amanda Hargrove. Angewandte Chemie, Sept. 18, 2017. DOI: 10.1002/anie.201707641

Kara J. Manke, PhDPost by Kara Manke

Rare Cancers and Precision Medicine in Southeast Asia

Data collected through genomics research is revolutionizing the way we treat cancer. But a large population of cancer patients are being denied the benefits of this research.

Patrick Tan MD, PhD is a professor of cancer and stem cell biology at Duke-NUS Medical School in Singapore.

In 2016, less than one percent of all the existing genomic data came from the 60% of the world population living outside of the US, Europe, and Japan. Furthermore, 70% of patients who die from cancer this year will come from Asia, Africa and Central and South America.

Patrick Tan, M.D., Ph.D., and the Duke-National University of Singapore (Duke-NUS) Medical School are key players in an effort to rectify this discrepancy, specifically as it exists in Southeast Asia.

In his talk, sponsored by the Duke Center for Applied Genomics and Precision Medicine, Tan focused specifically on his work in northeast Thailand with cholangiocarcinoma (CCA), or bile duct cancer.

Liver fluke

Liver flukes like this are parasites of fish that migrate to human hosts who eat the fish raw, leading to a form of bile duct cancer.

While CCA is rare in most of the world, it appears at 100 times the global rate in the region of Thailand where Tan and his colleagues work. Additionally, CCA in this region is of a separate and distinct nature.

CCA in this region is linked with a parasitic infection of the bile ducts called a liver fluke.  Residents of this area in Thailand have a diet consisting largely of raw fish, which can be infected by the liver fluke and transmitted to the person who eats the fish.

Because of the poverty in this area, encouraging people to avoid eating raw fish has proven ineffective. Furthermore, healthcare is not readily available, so by the time most patients are diagnosed, the disease has progressed into its later and deadly stage.

The life cycle of liver flukes. (Graphic U.S. Centers for Disease Control)

Tan’s genomic research has discovered certain factors at the gene level that make liver-fluke positive CCA different from other CCA. Thus genomic data specific to this population is vital to improve the outcomes of patients with CCA.

Duke-NUS Precision Medicine (PRISM) has partnered up with the National Heart Research Institute Singapore (NHRIS) in SPECTRA, a program designed to create a database of genomic data from the healthy Asian population. SPECTRA is sequencing the genomes of 5,000 healthy Asians in order to create a baseline to which they can compare the genomes of unhealthy individuals.

These and other programs are part of a larger effort to make precision medicine, or healthcare tailored to an individual based on factors like family history and genomic markers, accessible throughout southeast Asia.

By Sarah Haurin

 

Students Bring Sixty Years of Data to Life on the Web

For fields like environmental science, collecting data is hard.

Fall colors by Mariel Carr

Fall colors in the Hubbard Brook Experimental Forest, in New Hampshire’s White Mountains.

Gathering results on a single project can mean months of painstaking measurements, observations and notes, likely in limited conditions, hopefully to be published in a highly specialized journal with a target audience made up mostly of just other specialists in the field.

That’s why when, this past summer, Duke students Devri Adams, Camila Restrepo and Annie Lott set out with  graduate students Richard Marinos, Matt Ross and Professor Emily Bernhardt to combine over six decades of data on the Hubbard Brook Experimental Forest into a workable, aesthetically pleasing visualization website, they were really breaking new ground in the way the public can appreciate this truly massive store of information.

The site’s navigation shows users what kinds of data they might explore in beautiful fashion.

Spanning some 8,000 acres of New Hampshire’s sprawling White Mountain National Forest, Hubbard Brook has captured the thoughts and imaginations of generations of environmental researchers. Over 60 years of study and authorized experimentation in the region have brought us some of the longest continuous environmental data sets ever collected, tracking changes across a variety of factors for the second half of the 20th century.

Now, for the first time ever, this data has been brought together into a comprehensive, agile interface available to specialists and students alike. This website is developed with the user constantly in mind. At once in-depth and flexible, each visualization is designed so that a casual viewer can instantly grasp a variety of factors all at the same time—pH, water source, molecule size and more all made clearly evident from the structures of the graphs.

Additionally, this website’s axes can be as flexible as you need them to be; users can manipulate them to compare any two variables they want, allowing for easy study of all potential correlations.

All code used to build this website has been made entirely open source, and a large chunk of the site was developed with undergrads and high schoolers in mind. The team hopes to supplement textbook material with a series of five “data stories” exploring different studies done on the forest. The effects of acid rain, deforestation, dilutification, and calcium experimentation all come alive on the website’s interactive graphs, demonstrating the challenges and changes this forest has faced since studies on it first began.

The team hopes to have created a useful and user-friendly interface that’s easy for anyone to use. By bringing data out of the laboratory and onto the webpage, this project brings us one step further in the movement to make research accessible to and meaningful for the entire world.

Post by Daniel Egitto

New Blogger Will Sheehan: Freshman with a Love of the Outdoors

Hi there! My name is Will Sheehan, and I’m a freshman at Duke. While I’m currently undecided, I plan on studying electrical and computer engineering and possibly double majoring in computer science. I grew up on Maui, Hawaii, but now live with my mom in Austin, Texas. I spend my summers and winters with my dad Will Sheehan by the oceanback on Maui surfing, dirt biking, hiking and more. I like to think that spending so much time in the outdoors has given me a deep appreciation for nature, and in return a fiery passion for sciences like physics and chemistry.

The summer before  junior year I traveled to Beijing, China to live with a host family for a month. Having to speak their language nearly the whole time, I turned to journaling in order to empty my thoughts. They effortlessly spilled onto the page; it felt as if I couldn’t write fast enough, and that my ideas would flee before I could cement them in ink.

I soon found a new love for personal writing. The next summer I interned for a company named ShakaCode, and while I learned the ins and outs of applying Ruby on Rails to website development I blogged about my experience. As soon as school started, my old calculus teacher approached me, saying how he had read my blogWill Sheehan riding a dirt bike and loved my style of writing as well as what I had to say. That year in advanced calculus he had our class use blogs as a way to track our progress in whatever project or research we were pursuing.

Attempting to communicate complex, specialized information is an intriguing challenge that I find satisfying to complete. I have developed this skill not only through my blogging experience but also through tutoring in math the past couple years. While I do plan on pursuing computer science, I am still entirely open to a career in scientific research. Discovering something new has been a dream of mine for as long as I can remember.

Will Sheehan on a cliffI hope that as a part of the Duke Research Blog I get to share new, important findings with our community as I further my own understanding along the way. I see this as a learning opportunity for both myself and those around me, and hope that Duke takes an interest in all that I have to say about the cool stuff they might not normally know about!

Post by Will Sheehan

New Blogger Lydia Goff: Freshman with a Passion for Science Communication

Hey! My name is Lydia Goff. I am a first-year at Duke and plan to double major in English and biology in order to pursue a career in science writing. I was born in Waukesha, Wisconsin but raised primarily in the Charlotte area. My junior year of high school I transitioned from homeschool to Gaston Day School where I developed my interest in scientific research. Neither of my parents attended college so my primary teachers were books. Homeschooling instilled my love of reading which grew into an interest in writing, but it also limited my resources.

I had no exposure to scientific research until my junior year at Gaston Day when I became involved in the International Genetically Engineered Machine (iGEM) team. We worked on genetically engineering E. coli K12 so that it would die if accidentally released into the environment through a process called a kill switch. Particularly in developing countries with restricted supplies, improper disposal of genetically engineered bacteria can lead to water supply contamination. Working with my team and amazing faculty mentor showed me not only how interesting scientific research is, but also the global benefits.

A smiling woman

Lydia Goff in front of Baldwin Auditorium.

In iGEM, I ended up taking the lead in communications. Many of my teammates could understand and perform scientific procedures with a remarkable skill but struggled to communicate their ideas. I love being able to discuss the passions of others. These interactions allow me to continuously learn and to help others express themselves. Until that leadership role in iGEM, I was unsure about a major. I enjoyed writing and reading but also the STEM world. My interests bounced from calculus to creative writing to genetic engineering to art history. As I got older and the “What do you want to major in?” question became increasingly relevant, the idea of choosing one subject to focus on was painful. I did not want to stop learning about genetic engineering and neuroscience and astronomy in order to become a writer. For me, science writing and this blog represent the opportunity to never stop learning. They allow me to bounce around from lecture to laboratory and meet experts in a variety of fields, to discover the inspirations and implications of their research, and to express their ideas and discoveries to any curious person.

Post by Lydia Goff

New Blogger Ameya Sanyal: Freshman Inspired by 'Kitchen Experiments'

Hello! My name is Ameya Sanyal and I’m an incoming Trinity Freshman. While I’ve lived in Madison, WI for the past 12 years, I was born in Roswell, NM. I use she/her/hers pronouns and live with my parents, Amit and Paulomi, my younger sister, Anika, and my goldendoodle, Zain.

When I was little, my dad used to host “Science Sundays.” From vinegar volcanoes to Dr. Seuss’s “oobleck,” I was captivated. These hands-on-activities — which I fondly called “kitchen experiments” — were only the beginning of my interest in science.

A man and three woman smiling.

My family and I experimenting with our camera.

Throughout elementary and middle school, I eagerly awaited science class. I loved to learn about real-life examples; projectile motion came alive with classroom rocket demonstrations and nitrogen fixation took on meaning with a field trip to a teacher’s farm.

In high school, I became frustrated as the science classes seemed to only cover core concepts. Although I recognized the importance of building a strong foundation in biology, chemistry and physics, I wanted to know more about the applications of basic scientific principles.

At this juncture, my interest in social studies began to grow. I joined various activist and leadership groups and explored the link between people and social change. In electives such as Government & Politics and Psychology, I could immediately see how skills such as knowing my rights and understanding my behavior in a nature-nurture context were valuable.

In the future, I’d like to become an activist-doctor and interact directly with patients while uniting with other physicians to pursue social change. Consequently, I hope to pursue an interdisciplinary major combining political science and medicine.

Three women in traditional Indian clothing.

My family and I celebrating Diwali, the festival of lights.

At Duke, I’d like to explore how communication across disciplines can result in increased health and wellness. As an aspiring Global Health and Biology double major, I am excited to think critically about the driving forces between social inequities and brainstorm how new scientific discoveries can be utilized in finding a solution to public health crises.

I am looking forward to writing about the impact of social determinants on health and wellness and emerging healthcare research and technologies. Apart from being a member of the research team, I hope to get involved with GlobeMed and the Hindu Students Association. If you see me volunteering in the Durham community or at Hindu celebrations, please say hi!

Post by Ameya Sanyal

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