Research Blog

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

Students exploring the Innovation Co-Lab

International Experience Shaped Epidemiologist’s Career Path

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Note: Each year, we partner with Dr. Amy Sheck’s students at the North Carolina School of Science and Math to profile some unsung heroes of the Duke research community. This is the sixth of eight posts.

In the complex world of scientific exploration, definitive answers often prove elusive, and each discovery brings with it a nuanced understanding that propels us forward. Dr. Dana Kristine Pasquale’s journey in public health serves as a testament to the intricate combination of exploration and redirection that have shaped her into the seasoned scientist she is today.

Pasquale said her scientific path has been  “…a nonlinear journey, that’s been a series of over-corrections. As I’ve gone from one thing to another, that hasn’t turned out to be what I expected.”

Dana Pasquale Ph.D.

Anchored in her formative years in a study abroad experience in Angola, Africa during undergraduate studies, Pasquale’s exposure to clinical challenges left an indelible mark. She keenly observed the cyclic nature of treating infections by shadowing a local physician. 

“We would treat the same people from month to month for the same kinds of infections,” she recalled. 

Things like economic and social barriers weren’t as stark there – everyone was at the same level, and there was no true impact that she could make investigating them. This realization sparked a profound understanding that perhaps a structural, community-focused intervention could holistically address healthcare needs – water, sanitation, etc. It set the course for her future research endeavors.

Upon returning to the U.S., she orchestrated a deliberate shift in her academic trajectory, choosing to immerse herself in medical anthropology at the University of North Carolina-Chapel Hill. Her mission was clear: to unravel how local communities conceptualize health. Engaging with mothers and child health interventionists, she delved into health behavior, yet found herself grappling with persistent frustrations. 

“I found [health behavior] frustrating because there were still a lot of structural issues that made things impossible,” she says. “And even when you think you’re removing some of the barriers, you’re not removing the most important ones.”

 Rather than being a roadblock, this frustration became a catalyst for Pasquale, propelling her toward the realms of epidemiology and sociology. Here, the exploration of macro and structural factors aligned seamlessly with her vision for sustainable public health, providing the missing pieces to the intricate puzzle she was trying to solve. She didn’t expect to end up here until her mentor suggested going back to school for it.

As principal investigator of Duke’s RDS2 COVID-19 Research and Data Services project during the early months of the pandemic, Pasquale navigated the challenges associated with transitioning contact-tracing efforts online. Despite hurdles in data collection due to the project’s reliance on human interaction and testing, the outcome was an innovative online platform, minimizing interaction and invasiveness. This accomplishment beautifully intertwines with her ongoing work on scalable strategies to enhance efficiency in public health activities during epidemics. 

“We had a lot of younger people say that they would prefer to enter their contacts online rather than talk to someone… something that could be a companion to public health, not subverting contact-tracing, which is an essential public health activity.”

Pasquale’s expansive portfolio extends to an HIV Network Analysis for contact tracing and intelligent testing allocation. Presently, she is immersed in a project addressing bacterial hospital infections among patients and hospital personnel, a testament to her unwavering commitment to tackling critical health challenges from various angles.

When queried about her approach to mentoring and teaching, Pasquale imparts a valuable piece of wisdom from her mentor: “If you’re not completely embarrassed by the first work you ever presented at a conference, then you haven’t come far enough.” 

Her belief in the transformative power of mistakes and the non-linear trajectory in science resonates in her guidance to students, encouraging them to not only accept but embrace the inherent twists and turns in their scientific journeys. As they navigate their scientific journeys, she advocates for the importance of learning and growing from each experience, fostering resilience and adaptability in the ever-evolving landscape of scientific exploration.

Guest Post by Ashika Kamjula, North Carolina School of Math and Science, Class of 2024

Scientific Passion and the Aspirations of a Young Scientist

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Note: Each year, we partner with Dr. Amy Sheck’s students at the North Carolina School of Science and Math to profile some unsung heroes of the Duke research community. This is the fifth of eight posts.

Meet Dr. Oyindamola Adefisayo – Oyinda to her friends – a Postdoctoral Research Fellow at Duke. She’s exploring bacterial factors in host-pathogen interactions using mice. 

During our interview, parallels in our journeys became clear. Even as a high school senior, I could strongly identify with Dr. Adefisayo’s work and share similar passions. I envisioned myself evolving into an inspiring scientist just like her and felt a strong connection with my aspirations as a high school senior.

Originally from Lagos, Nigeria, Dr. Adefisayo came to the U.S. via the African Leadership Academy in Johannesburg. Like me, she left home at 16 for a two-year residential program for teenagers. It was filled with passionate and driven students like I’m with at NCSSM. Oyinda earned her B.A. in Biology at Clark University, specializing in the genetic basis of wing and eye development in the fruitfly Drosophila melanogaster.

Her Ph.D. at Memorial Sloan Kettering in New York City focused on Immunology and Microbial Pathogenesis.  She studied mycobacteria, examining DNA damage response pathways, antibiotic resistance, and mutagenesis. The work connected with her knowledge of Nigeria’s high tuberculosis burden as she sought practical applications. She found that a delay in the machinery of DNA copying itself triggered a damage repair pathway called PafBC. 

Beyond the lab, Oyinda’s passion for ballroom dancing reflects her belief that science is an art, since there’s so much creativity and artistic sense that goes into being a scientist. This resonated with me too. I use painting as an outlet during my research on environmental stressors and antibiotics at NCSSM.

I was inspired by Dr. Adefisayo’s beliefs and passions. She continues her scientific career by delving deeper into protocol development, data analysis, and global knowledge-sharing. Her goal is to learn from bacterial and host genetics and contribute to  simplifying and expediting life science research for professionals worldwide.

Guest post by Emily Alam, North Carolina School of Math and Science, Class of 2024.

How Do Animals – Alone or in Groups – Get Where They’re Going?

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Note: Each year, we partner with Dr. Amy Sheck’s students at the North Carolina School of Science and Math to profile some unsung heroes of the Duke research community. This is the of fourth eight posts.

In the intricate world of biology, where the mysteries of animal behavior unfold, Dr. Jesse Granger emerges as a passionate and curious scientist with a Ph.D. in biology and a penchant for unraveling the secrets of how animals navigate their surroundings.

Her journey began in high school when she posed a question to her biology teacher about the effect of eye color on night vision. Unable to find an answer, they embarked together on a series of experiments, igniting a passion that would shape Granger’s future in science.

Jesse Granger in her lab at Duke

Granger’s educational journey was marked by an honors thesis at the College of  William & Mary that delved into the potential of diatoms, single-cell algae known for their efficiency in capturing light, to enhance solar panel efficiency. This early exploration of light structures paved the way for a deeper curiosity about electricity and magnetism, leading to her current research on how animals perceive and use the electromagnetic spectrum.

Currently, Granger is involved in projects that explore the dynamics of animal group navigation. She is investigating how animals travel in groups to find food, with collective movement and decision-making.  

Among her countless research endeavors, one project holds a special place in Granger’s heart. Her study involved creating a computational model to explore the dynamics of group travel among animals.  She found that agents, a computational entity mimicking the behavior of an animal, are way better at getting where they are going as part of a group than agents who are traveling alone.

Granger’s daily routine in the Sönke Johnson Lab revolves around computational work. While it may not seem like a riveting adventure to an outsider, to her, the glow of computer screens harbors the key to unlocking the secrets of animal behavior. Coding becomes her toolkit, enabling her to analyze data, develop models, and embark on simulations that mimic the complexities of the natural world.

Granger’s expertise in coding extends to using R for data wrangling and NetLogo, an agent-based modeling program, for simulations. She describes the simulation process as akin to creating a miniature world where coded animals follow specific rules, giving rise to emergent properties and valuable insights into their behavior. This skill set seamlessly intertwined with her favorite project, where the exploration of group dynamics and navigation unfolded within the intricate landscapes of her simulated miniature world.

In the tapestry of scientific exploration, Jesse Granger emerges as a weaver of knowledge, blending biology, physics, and computation to unravel the mysteries of animal navigation. Her journey, marked by curiosity and innovation, not only enriches our understanding of the natural world but also inspires the next generation of  scientists to embark on their unique scientific odysseys.      

Guest Post by Mansi Malhotra, North Carolina School of Science and Math, Class of 2025.

Solving More Medical Device Challenges by Teaching Others How

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Note: Each year, we partner with Dr. Amy Sheck’s students at the North Carolina School of Science and Math to profile some unsung heroes of the Duke research community. This is the third of eight posts.

Eric Richardson is a professor of the practice in Biomedical Engineering and founding director of Duke Design Health. His research and teaching centers around medical device design and innovation, with a focus on underserved communities. 

Eric Richardson, Ph.D.

Richardson has always had a strong desire to enhance people’s wellbeing. Growing up, he wanted to be a doctor, but during high school, he was drawn towards the creative and problem-solving aspects of engineering. After earning a bachelor’s degree in mechanical engineering, he pivoted to biomedical engineering for graduate work. While pursuing his PhD degree, he developed a profound interest in cardiac devices. 

Through technology, Richardson has been able to impact the lives of many. He first worked in industry as a Principal R&D Engineer at Medtronic, where he helped develop transcatheter heart valves that have now helped over a million patients. However, it was his love for teaching that brought him to academia. Over the past decade as a professor, his interests have shifted towards global health and helping underserved communities. 

Richardson aims to design technology to fit the needs of people, and bridge the gap of “translation” between research and product development. During his time in industry, Richardson realized that the vast majority of medical device research doesn’t go anywhere in terms of helping patients. 

“That point of translation… is really where most technology and research dies, so I really wanted to be at that end of it, trying to figure out that pipeline of getting research, getting technology, all the way into the clinic,” Richardson says. “I would argue that is probably the hardest step of the whole process is actually getting a product together, developing it, doing the clinical trials, and doing the manufacturing and regulatory steps.” 

A prototype of Richardson’s latest device.

Through his teaching, Richardson emphasizes product design, interdisciplinary approaches, and industry-academia partnerships to best meet the needs of underserved communities. One of his favorite courses to teach is the Design Health Series, a four-course sequence that he was brought to Duke to develop. In this class, interdisciplinary teams of graduate students, ranging from medicine to business, work together to design medical devices. They learn how to identify problems in medicine, develop a solution, and translate that into an actual product. 

Richardson also encourages engineers to look at the broader picture and tackle the right problems. According to Richardson, challenges in global and emerging markets often aren’t due to a particular device, but rather, a multilayered system of care, ranging from a patient’s experience within a clinic to a country’s whole healthcare system. From this vantage point, he believes it’s important for engineers to determine where to intervene in the system, where the need is greatest, and to consider any unintended consequences. 

“I think that there is so much great talent in the world, so many exciting problems to go after. I wish and hope that people will think a little more carefully and deliberately about what problems they go after, and the consequences of the problems that they solve,” he says. 

Richardson is currently working on an abdominal brace for Postural Tachycardia Syndrome (POTS) patients – people who feel lightheaded after standing up – that is currently in clinical trials. While he is always eager to tackle different projects, as an educator, he believes the most important part of academia is training the next generation of engineers. 

“I can only do a couple projects a year, but I can teach a hundred students every year that can then themselves go and do great things.”

Guest Post by Arianna Lee, North Carolina School of Science and Mathematics, Class of 2025.

Pioneering New Treatments in Deep Brain Stimulation for Parkinson’s Disease

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Note: Each year, we partner with Dr. Amy Sheck’s students at the North Carolina School of Science and Math to profile some unsung heroes of the Duke research community. This is the second of eight posts.

Meet a star in the realm of academic medicine – Dr. Kyle Todd Mitchell!

A man who wears many hats – a neurologist with a passion for clinical care, an adventurous researcher, and an Assistant Professor of Neurology at Duke – Mitchell finds satisfaction in the variety of work, which keeps him “driven and up to date in all the different areas.”

Dr. Mitchell holds a deep brain stimulation device.

Dr. Mitchell’s educational journey is marked by excellence, including a fellowship at the University of California San Francisco School of Medicine, a Neurology Residency at Washington University School of Medicine, and an M.D. from the Medical College of Georgia. Beyond his professional accolades, he leads an active life, enjoying running, hiking, and family travels for rejuvenation. 

Dr. Mitchell’s fascination with neurology ignited during his exposure to the field in medical school and residency. It was a transformative moment when he witnessed a patient struggling with symptoms experience a sudden and remarkable improvement through deep brain stimulation. This therapy involves the implantation of a small electrode in the brain, offering targeted stimulation to control symptoms and bringing relief to individuals grappling with the challenges of Parkinson’s Disease.

“You don’t see that often in medicine, almost like a light switch, things get better and that really hooked me,” he said. The mystery and complexity of the brain further captivated him. “Everything comes in as a bit of a mystery, I liked the challenge of how the brain is so complex that you can never master it.” 

Dr. Mitchell’s research is on improving deep brain stimulation to alleviate the symptoms of  Parkinson’s disease, the second most prevalent neurodegenerative disorder, which entails a progressive cognitive decline with no cure. Current medications exhibit fluctuations, leading to tremors and stiffness as they wear off. Deep brain stimulation (DBS), FDA-approved for over 20 years, provides a promising alternative. 

Dr. Mitchell’s work involves creating adaptive algorithms that allow the device to activate when needed and deactivate so it is almost “like a thermostat.” He envisions a future where biomarkers recorded from stimulators could predict specific neural patterns associated with Parkinson’s symptoms, triggering the device accordingly. Dr. Mitchell is optimistic, stating that the “technology is very investigational but very promising.”

A key aspect of Dr. Mitchell’s work is its interdisciplinary nature, involving engineers, neurosurgeons, and fellow neurologists. Each member of the team brings a unique expertise to the table, contributing to the collaborative effort required for success. Dr. Mitchell emphasizes, “None of us can do this on our own.”

Acknowledging the challenges they face, especially when dealing with human subjects, Dr. Mitchell underscores the importance of ensuring research has a high potential for success. However, the most rewarding aspect, according to him, is being able to improve the quality of life for patients and their families affected by debilitating diseases.

Dr. Mitchell has a mindset of constant improvement, emphasizing the improvement of current technologies and pushing the boundaries of innovation. 

“It’s never just one clinical trial — we are always thinking how we can do this better,” he says. 

The pursuit of excellence is not without its challenges, particularly when attempting to improve on already effective technologies. Dr. Mitchell juggles his hats of being an educator, caregiver, and researcher daily. So let us tip our own hats and be inspired by Dr. Mitchell’s unwavering dedication to positively impact the lives of those affected by neurological disorders.

Guest post by Amy Lei, North Carolina School of Science and Math, Class of 2025.

From Occupational Therapy to Stroke Research

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Note: Each year, we partner with Dr. Amy Sheck’s students at the North Carolina School of Science and Math to profile some unsung heroes of the Duke research community. This is the first of 8 posts.

Dr. Kimberly Hreha’s journey to studying stroke patients was not a straightforward one, but it started very early.

“My mom was a special ed teacher, and so I would go into her class and volunteer. There was an occupational therapist I met and they really kind of drove my decision to become an occupational therapist.” 

After earning a masters degree in occupational therapy, Hreha worked as an OT for 5 years and became fascinated by stroke survivors and ways to help them live their lives normally again. She was able to do this when she moved to the Kessler Institute for Rehabilitation and began working with a neurologist to study spatial neglect.

Kimberly Hreha and her Prism Adaptation goggles.

“If a stroke happens in the right hemisphere of the brain, the person neglects the left side of space,” Hreha said. “Imagine yourself standing in a room, and I want you to describe to me what the space is. [You would say] Oh my dresser’s on the right side, my bed’s on the right, my picture frame’s on the right. And you would not tell me anything on the left.” 

She further explained that this is not due to blindness in the left eye, the left eye usually can see just fine, it’s simply that the brain ignores the entire left side of space. 

Hreha co-developed a solution and treatment for this issue. It uses a pair of goggles with modified lenses, to move you into left space. I got to try it out to see how it worked.

Hreha first had me touch my hand to my chest and then touch a pen she was holding. I did this easily without the goggles on. When I tried again with the goggles on, I completely missed and put my finger too far to the right. I kept trying to touch the pen with the goggles on until I had retrained my brain to touch it consistently. Next, she had me take the goggles off and try touching the pen again. I went to touch the pen, but I missed it because my finger went too far to the left! 

Hreha explained to me that she had just gotten me into left space. In stroke patients with left spatial neglect, she told me, they could use the goggles to help train them to stop neglecting left space, helping them to vastly improve their lives. 

The goggle therapy, formally called prism adaptation, is a simple treatment that is practiced for 20 minutes a day for 10 days. For this Hreha won the Young Investigator Award in Post-Acute Stroke Rehabilitation in 2018 for her contribution to stroke research. Seeing her passion for her treatment and her happiness to have created something that helps stroke patients was very gratifying for me.

Hreha is also working on finding a connection between stroke patients and dementia, something that she hopes will further help the stroke survivor community. This is a research project that is ongoing for her, and one that she hopes to gain valuable data analysis and research practices skills from.  

Finally, she talked to me about her goals for the future. Hreha hopes to do a collaborative study with people at the low-vision clinic, get a grant for her prism adaptation research, and create a right brain stroke clinic at Duke to be able to do large scale research to help right brain stroke patients. 

As a researcher, she still also finds time to keep up her OT practice, by working as an OT one full day each month. Keeping true to her love of helping others, she said, “That little part of that clinical time just reminds me why I’m doing the research I’m doing. And that when I’m doing the data work, it is, at the end of the day, about that person who is in front of me in the clinic.”

Guest Post by Prithu Kolar, Class of 2025, North Carolina School of Science and Math.

Inventors, Assemble: The Newest Gadgets Coming Out of Duke

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What do a smart toilet, an analog film app, and metamaterial computer chips have in common? They were all invented at Duke!

The Office for Translation & Commercialization—which supports Duke innovators bringing new technologies to market—recently hosted its fifth annual Invented at Duke celebration. With nine featured inventors and 300 attendees, it was an energetic atmosphere to network and learn.

Attendees mingle in Penn Pavilion. Credit: Brian Mullins Photography.

When event organizer Fedor Kossakovski was selecting booths, the name of the game was diversity—from medicine to art, from graduate students to faculty. “Hopefully people feel like they see themselves in these [inventors] and it’s representative of Duke overall,” he said. Indeed, as I munched through my second Oreo bar from the snack table and made the rounds, this diversity became apparent. Here are just two of the inventions on display:

Guided Medical Solutions

The first thing you’ll notice at Jacob Peloquin’s booth is a massive rubber torso.

As he replaces a punctured layer of rubber skin with a shiny new one, Peloquin beckons us over to watch. Using his OptiSETT device, he demonstrates easy insertion and placement of a chest tube.

“Currently, the method that’s used is you make an incision, and then place your fingers through, and then take the tube and place that between your fingers,” Peloquin explained. This results in a dangerously large incision that cuts through fascia and muscle; in fact, one-third of these procedures currently end in complications.

Peloquin’s device is a trocar—a thin plastic cylinder with a pointed tip at one end and tubing coming out of the other. It includes a pressure-based feedback system that tells you exactly how deep to cut, avoiding damage to the lungs or liver, and a camera to aid placement. Once the device is inserted, the outer piece can be removed so only the tubing remains.

Peloquin demonstrates his OptiSETT device. Credit: Brian Mullins Photography.

Peloquin—a mechanical engineering graduate student—was originally approached by the surgeons behind OptiSETT to assist with 3D printing. “They needed help, so I kind of helped those initial prototypes, then we realized there might be a market for this,” he said. Now, as he finishes his doctorate, he has a plethora of opportunities to continue working on OptiSETT full-time—starting a company, partnering with the Department of Defense, and integrating machine learning to interpret the camera feed.

It’s amazing how much can change in a couple years, and how much good a rubber torso can do.

GRIP Display

This invention is for my fellow molecular biology enthusiasts—for the lovers of cells, genes, and proteins!

The theme of Victoria Goldenshtein’s booth is things that stick together. It features an adorable claw machine that grabs onto its stuffed animal targets, and a lime green plastic molecule that can grab DNA. Although the molecule looks complex, Goldenshtein says its function is straightforward. “This just serves as a glue between protein and the DNA [that encodes it].”

Goldenshtein—a postdoctoral associate in biomedical engineering—uses her lime green molecular model to demonstrate GRIP’s function. Credit: Brian Mullins Photography.

Goldenshtein applies this technology to an especially relevant class of proteins—antibodies. Antibodies are produced by the immune system to bind and neutralize foreign substances like disease. They can be leveraged to create drug therapies, but first we need to know which gene corresponds to which antibody and which disease. That’s where GRIP steps in.

“You would display an antibody and you would vary the antibody—a billion different variations—and attach each one to the system. This grabs the DNA,” Goldenshtein said.

Then, you mix these billions of antibody-DNA pairs with disease cells to see which one attaches. Once you’ve found the right one, the DNA is readily available to be amplified, making an army of the same disease-battling antibody. Goldenshtein says this method of high-throughput screening can be used to find a cancer cure.

Although GRIP be but small, its applications are mighty.

Explore Other Booths

  • Coprata: a smart toilet that tracks your digestive health
  • inSoma Bio: a polymer that aids soft-tissue reconstruction
  • Spoolyard: a platform for exploring digital footage with analog film techniques
  • FaunaLabs: smart watches for our furry friends
  • G1 Optics: a tonometer to automatically detect eye pressure
  • TheraSplice: precision RNA splicing to treat cancer
  • Neurophos: metamaterial photonics for powering ultra-fast AI computation

As I finished my last Oreo bar and prepared for the trek back to East Campus, I was presented with a parting gift—a leather notebook with “Inventor” embossed on the cover. “No pressure,” said the employee who was handing them out with a wink.

I thought about the unique and diverse people I’d met that night—an undergraduate working in the Co-Lab, an ECE graduate student, and even a librarian from UNC—and smiled. As long as we each keep imagining and scribbling in our notebooks, there’s no doubt we can invent something that changes the world.

Post by Michelle Li, Class of 2027

Liam Frumkin and AHAV: Improving Lives Through Simple Snacks

We’re all familiar with the quintessential elementary school bake sale: hand-drawn posters, homemade treats, and shockingly high price tags, all in the name of charity. However, for Duke sophomore Liam Frumkin, his Few Quad bake sale resulted in a potential Shark Tank Product.

Liam Frumkin, Trinity '26
Liam Frumkin, Trinity ’26

Frumkin is a 20 year old economics major who recently got back from a gap year developing AHAV, a snack company specializing in healthy treats. AHAV, which means “to love” in Hebrew, has a mission statement “To Improve Lives Through Simple Snacks and Simple Ingredients!” Through selling healthy cookie dough bites and donating a portion of the proceeds to the National Eating Disorders Association (NEDA) and No Kid Hungry, Frumkin has been able to turn his bake sale into an amazing entrepreneurial venture. 

Frumkin’s story started seven years ago when he began to develop an eating disorder. Throughout his freshman and sophomore years of high school, Frumkin remembers losing unhealthy amounts of weight through constant exercise and eating very little. At grocery stores, he was overwhelmed by ingredient lists and nutritional contents of the snacks lining the aisles. 

His eating disorder came to its peak during his junior year, when he was hospitalized and began professional treatment for his eating disorder. Throughout treatment, Frumkin began to cook more in order to create snacks that both satisfied his cravings, and felt comfortable and safe to eat. At first, he says, Frumkin was doing this “just for [him]self”. 

When Frumkin arrived at Duke in August of 2021, he continued cooking in his dorm kitchens. Intrigued, his dorm-mates and friends would stop by to inquire and try Frumkin’s creations. Frumkin said he received stellar feedback about the nutritional value and deliciousness of his treats (I can confirm, having tried AHAV chocolate chip cookie dough bites, that they are, in fact, delicious). Because of his obsession with Shark Tank (I’m sure we can all relate), Frumkin began looking into how to capitalize on his passion of creating nutritional snacks. 

Liam and his very first batch of cookie dough bites.

And so, Frumkin began to hold bake sales in front of Few Quad on West Campus, selling ziploc bags of his homemade treats. Within a couple of months, he had made thousands of dollars, far surpassing my elementary school bake sales. When the Duke Administration caught wind of Frumkin’s bake sales, they informed him that the sale of foods without a license were illegal and encouraged him to find a professional kitchen.

Frumkin agreed with Duke and began searching for a professional kitchen, eventually finding a Duke alumnus who had started their own food business through an accelerator program called Union Kitchen. Union Kitchen accepts eight people a year and in exchange for 10% equity, allows access to kitchens, resources, and connections.

Frumkin applied to the program with zero expectations, not even telling his parents about his plans. However, after receiving the good news, his parents were nothing but supportive.

Liam and his parents in the AHAV kitchen.

With nothing but a few suitcases and ziploc bags of cookie dough bites, Frumkin began his semester off, moved to Washington D.C., and started work on AHAV. 

Pretty soon, a gap semester turned into a gap year, and Frumkin launched AHAV on January 1, 2023. At the time of the launch, Frumkin had already partnered with local retail stores to sell AHAV products in-store. When I talked with Frumkin, he expressed immense appreciation for Union Kitchen’s connections and their help getting his company off the ground.

Liam and the first bag of AHAV ever produced.

Frumkin turned to TikTok and Instagram to share his own journey with his eating disorder and to market AHAV, receiving resounding support from his followers, who resonated with both Frumkin’s story and AHAV’s mission. AHAV has more than 120,000 followers across various social media platforms and a team of six full-time employees based out of Washington D.C.

The AHAV logo

From applying for Shark Tank, to grocery stores like Trader Joe’s and Whole Foods, AHAV clearly has a bright future. AHAV has also donated over 120,000 meals to kids in need and helped over 6,000 kids get treatment for their eating disorders. Frumkin’s philanthropy has really lived up to AHAV’s meaning of “to love” and the heart-based logo. 

During his time-off, Frumkin found himself struggling with loneliness, having no consistent interactions with students his own age. Since he’s been back, Frumkin says he’s still searching for that perfect work-life-school balance. Despite this, he still says it is hands-down the smartest decision he’s ever made, which he largely credits to Duke’s support. During his time-off, Frumkin said Time Away From Duke was extremely supportive and accommodating. Since being back on campus, he’s reached out to the Innovation & Entrepreneurship Office and connected with fellow Duke students who are eager to help with video editing, marketing, etc. Frumkin also found support from Duke’s extensive alumni network, which he met through the pre-orientation group Project Edge, as well as the Duke in Silicon Valley program. 

Frumkin says that as a freshman, he still continued to struggle with disordered eating. He frequently met with a nutritionist from Duke Student Health, who he says was very helpful, specifically around his obsession with nutrients and ingredients. Frumkin stressed that students with eating disorders can fight their battles together. He says one of the most rewarding parts of starting AHAV has been sharing his journey and helping other people realize that they’re not alone. 

By Emily Zou, Class of 2027

It’s a Bird… It’s a Plane… It’s Comic Medicine!

Picture a comic book. Maybe you think of Superman or the Hulk, all cosmic green and razzmic berry, pressed into the glossy pages of your favorite childhood graphic novel. Or maybe you think of the Sunday paper. Calvin and Hobbes inked between the op-eds and the sports column. Maybe you think of punk rock zines, or political cartoons, or Mad magazine.

Now, put your first thought aside. Walk to the Duke Medical School library and descend to the first floor. Nestled in the quiet reading room, among the serious tomes on pancreatic enzymes and brain anatomy, is a collection of comic books. 

They don’t chronicle the kryptonite of superheroes or the adventures of Asterix. Instead, the curated Graphic Medicine Collection features soldiers with PTSD, mothers of children with Down Syndrome, and transgender patients’ gender-affirming care. They illustrate child loss, chronic illness, addiction, anxiety, autism, epilepsy, COVID, cancer, heart disease, reproductive health, and so on and so forth. 

photo credit: @dukemedlibrary (Instagram)

In 2007, physician and cartoonist Ian Williams coined the term “graphic medicine.” He writes that the “use of the word ‘medicine’ was not meant to connote the foregrounding of doctors over other healthcare professionals or over patients or comics artists, but, rather the suggestion that use of comics might have some sort of therapeutic potential – ‘medicine’ as in the bottled panacea, rather than the profession.” 

Dr. Ian Williams, GP and cartoonist

Duke’s Graphic Medicine Collection seeks to destigmatize, depicting everything from a patient’s experience with terminal cancer to STI prevention. Unsurprisingly, comics have long been used to educate and to challenge social taboos.

In 1954, they were controversial enough to trigger a congressional hearing. Despite grossing nearly $75 million in nickels and dimes (the cost of a comic in 1948), comic books fed the flames (often literally) of moral panics that came to dominate the Cold War era. 

In 1949, a small town Missouri girl scout troop burned a six foot tall stack of comics at the behest of their parents, teachers, and the local priest. This event followed the publication of an article written by New York City psychiatrist Dr. Fredric Wertham which drew a correlation between the occasional vulgar language and violent imagery in comic book and increased incidence of juvenile delinquency.   

Although Congress found no correlation between comics and criminal activity, ultimately disagreeing with Wertham, the comic industry created the “Comics Code Authority” out of fear of government censorship. Comics with everything from violence to werewolves, zombies, vampires and ghosts were banned. Though the comic code undeniably cowed their content, cartoonists continued to use the medium to criticize and confront stigmas. 

In the 60s and 70s, for example, “subversive women cartoonists, queer cartoonists, [and] cartoonists of color” disseminated their work in political circles. Later, in 1989, cartoonist Garry Trudeau depicted the first openly gay comic character Andy Lippincott’s diagnosis with HIV/AIDS. Though some gay activists criticized Trudeau’s portrayal, his comics nonetheless challenged the public’s stereotypes, fears, and ostracization of HIV/AIDS patients and Lippincott’s impact was wide-felt and humanizing.

Garry Trudeau’s Doonesbury comic character Andy Lippincott is depicted here in the fictional AIDS quilt. Lippincott was later given a real panel in the quilt.

In fact, in 1990, when Trudeau illustrated Lippincott’s death due to AIDS complications, an obituary was written for the fictional character in the San Francisco Chronicle: “… Lippincott, an affable man who had attempted to cope with the devastating disease with a continual patter of gallows humor, dies quietly in his bed, the window open to a sunny day and a coveted C.D. of the Beach Boys ‘Wouldn’t It be Nice’ playing.”

In the 2000s, like so many other middle school girls, when I turned 10 or 11, I was handed the American Girl’s “Care and Keeping of You.” The book includes comic strip-esque graphics and informational panels about everything from menstrual health to acne. It revolutionized the conversations that were and, more importantly, weren’t happening around girl’s health and puberty.

To put it simply: “Girls didn’t seem to have the courage to ask their own mothers these questions, but they were sending them to faceless magazine staffers in Middleton, Wisconsin.” Since its publication in 1998, “The Care & Keeping of You” has sold 7 million copies and counting. 

From cancer to STIs to AIDS to puberty, comics clearly do have a place in medicine. 

In recent decades, there has been a push in American healthcare for the medical humanities — a holistic movement that advocates for the intersection of science and art in medicine and medical education. Keith Wailoo, an American historian and professor at Princeton University, writes about the need for medical humanities:

“… [P]rofessional and human crisis has spawned the search for meaning and introspection about life, illness, recovery, human suffering, the care of the body and spirit, and death. Medicine’s social dilemmas, its professional controversies, human health crises, social tensions over topics from AIDS to abortion and genetics, as well as the profession’s very identity and its claim to authority have catalyzed and fed a growing demand for answers about meaning.”

Among the serious tomes included in Duke’s collection is the following spread from Tessa Brunton’s autobiographical “Notes from a Sickbed,” illustrating the onset and progression of her chronic illness. As Brunton writes, “catharsis” seems to best embody Duke’s Graphic Medicine collection. Like so many other comic strips, “Notes from a Sickbed” is a “bottled panacea.” Brunton confronts her illness and grapples with her own “search for meaning,” depicting her reality with humor, earnestness, and dialogue bubbles.

All of this to say: comics continue to have a place in medicine.

Here are a few texts in Duke’s Graphic Medicine Collection:

“Notes from a Sickbed” by Tessa Brunton
“Camouflage: the hidden lives of autistic women” by Dr. Sara Bargiela
“Kimiko Does Cancer” by Kimiko Tobimatsu
“First Year Out” by Sabrina Symington

You can check out the entire Comic Medicine Collection here: https://mclibrary.duke.edu/about/blog/new-graphic-medicine-collection

Post by Alex Clifford, Class of 2024

Capital, Canaries, or Catalysts: Insurance Industry’s Role in Climate

Mining foreman R. Thornburg shows a small cage with a canary used for testing carbon monoxide gas in 1928. Credit: George McCaa, U.S. Bureau of Mines

Throughout the 19th and 20th centuries, canaries were used in coal mines to assess the risk of toxic gasses. If the birds became ill or passed away, their fate served as a warning for miners to vacate the premises. 

Similarly to how a canary detects unseen risks, the insurance industry is responsible for matching assets to liabilities based upon risks, according to Francis Bouchard, the managing director for climate at the insurance company Marsh McLennan. Bouchard spoke at Duke University on November 10 to discuss the insurance sector’s responsibility to tackle risks as a result of climate change.

During a one-year residency that begins in January, Bouchard will explore ways in which the insurance sector can incentivize and support advances in management of climate risks by helping Duke to build new research partnerships and networks with the insurance and other affected sectors.

Historically, the insurance industry has served as a catalyst to influence safety regulations for the welfare of citizens, as opposed to a canary that withers under risks. Take, for instance, the World Columbian Exposition in Chicago in 1893. It was the first time in history “anyone would deploy electricity on a large level,” Bouchard said. Therefore, an insurance company sent an engineer to examine the security of the electricity and determine the hazards for attendees. Consequently, the brightest minds of this sector banded together to create the Underwriters Laboratories, which is now the largest testing laboratory in the United States. 

But more recently, the insurance sector has not acted as a catalyst in its role to address climate risk. Several policies and systems “distort the purity of the risk signals insurance companies send.” Firstly, its inability to combat systemic level risks as they are providing individual incentives. The industry is highly effective in “handling individual risk and incentivizing immediate actions to address an immediate risk,” Bouchard said, but this method cannot translate on a systemic level.

Secondly, the insurance sector provides a “temporal mismatch” as they sell 12 months of risk, but the lasting impacts of climate change will not occur within a year. Therefore, their “ability to capture in a 12 month policy, decades worth of climate change risk is impossible.”

Thirdly, the regulations for insurance differ between states. In most states, the insurance commissioner dictates the price of insurance based upon the company’s risk assessment because when “risk goes up, price of risk also goes up.” When citizens cannot afford insurance, commissioners are more likely to side with the experts of the insurance companies as opposed to their disadvantaged constituents.

Finally, their climate model is not advanced enough to estimate how specific cities will change within a few decades due to climate change. Therefore, it cannot entirely predict its risks either. 

You can watch Bouchard’s talk, with slides, on YouTube

The insurance industry has been successful in its asset-liability matching “in committing some of its capital to advancing climate technology or green technology.” However, this sector receives “publicity around insurance companies withdrawing capital from wildfire or climate exposed jurisdiction.”

This system is explained by the TCFD Filing, which was created by the Bank of International Settlements to discover insurance companies exposure to climate transition issues, physical risks from climate change, and their strategy to aid clients. Essentially, most insurance companies are not “concerned about physical risks” as they would simply reprice their 12-month insurance policy if there is a heightened threat to physical risk. According to Bouchard, the “insurance industry has already signaled through its TCFD filings precisely what their strategy is: ‘we’re gonna play this game as long as we can and then we’re going to withdraw.’” Therefore, an insurance company would continue to increase their cost until a person can no longer afford its price or actually endures physical damage to which they would cease providing insurance. “These last resort-type mechanisms are when the government steps in,” Bouchard said. He even estimates that the government will control 30% of this $1 trillion industry ($2 trillion globally) within ten years. This is dangerous as the government is already enduring fiscal dilemmas and will not be equipped to manage the complexity of the sector.

Bouchard, with 30 years of experience in this industry, said he “truly, truly believes in the social role that the industry plays. I’m petrified that we’re not going to be there to help society cope with climate with the technical knowledge we have, the expertise we have, the mechanisms we have, and the money.” If the sector continues upon this path, they will dissolve under the risks, similarly to a canary in a mine. 

Francis Bouchard’s work in combating climate battles with insurance is of the utmost necessity. Continued global warming will force citizens to rely on this industry for aid against climate disasters. The most recent Conference of Parties, created by the United Nations for climate change discussions, recognized the insurance industry as a “key finance player in climate transition alongside private industry and government because the world is recognizing that we have a key part to play.”

By Samera Eusufzai, Class of 2026

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