Research Blog

Why Do Some Dogs Need High Chairs, and How Can Genetics Help?

On November 17, 2022

In Animals, Biology, Genetics/Genomics, Lecture, Medicine

Jake, a German shepherd dog in a Bailey chair. Dogs with megaesophagus must eat in a vertical position to help food travel to their stomachs.
Photo credit: Beth Grant

Some dogs have to eat in a high chair—or, more specifically, a Bailey Chair. The chair keeps them in a vertical position while they eat so that gravity can do the work their bodies can’t: moving food from the mouth to the stomach.

These dogs have megaesophagus, an esophagus disorder that can prevent dogs from properly digesting food and absorbing nutrients. When you swallow a bite of food, it travels down a muscular tube, the esophagus, to the stomach. In humans, the esophagus is vertical, so our esophageal muscles don’t have to fight against gravity. But because dogs are quadrupeds, a dog’s esophagus is more horizontal, so “there is a greater burden on peristaltic contractions to transport the food into the stomach.” In dogs with megaesophagus, the esophagus is dilated, and those contractions are less effective. Instead of moving properly into the stomach, food can remain in the esophagus, exacerbating the problem and preventing proper digestion and nutrient absorption.

Leigh Anne Clark, Ph.D., an associate professor at Clemson University, recently spoke at Duke about megaesophagus in dogs and its genetic underpinnings. She has authored dozens of publications on dog genetics, including five cover features. Her research primarily involves “[mapping] alleles and genes that underlie disease in dogs.” In complex diseases like megaesophagus, that’s easier said than done. “This disease has a spectrum,” Clark says, and “Spoiler: that makes it more complicated to map.”

Clinical signs of megaesophagus, or mega for short, include regurgitation, coughing, loss of appetite, and weight loss. (We might use the word “symptom” to talk about human conditions, but “a symptom is something someone describes—e.g., I feel nauseous. But dogs can’t talk, so we can only see ‘clinical signs.’”) Complications of mega can include aspiration pneumonia and, in severe cases, gastroesophageal intussusception, an emergency situation in which dogs “suck their stomach up into their esophagus.”

Sometimes megaesophagus resolves on its own with age, but when it doesn’t it requires lifelong management. Mega has no cure, but management can involve vertical feeding, smaller and more frequent meals, soft foods, and sometimes medication. Even liquid water can cause problems, so some dogs with mega receive “cubed water,” made by adding a “gelatinous material” to water, instead of a normal water bowl.

In dogs, mega can be either congenital, meaning present at birth, or acquired. In cases of acquired megaesophagus, the condition is “usually secondary to something else,” and the root cause is often never determined. (Humans can get mega, too, but as with acquired mega in dogs, mega in humans is usually caused by a preexisting condition. The best human comparison, according to Clark, might be achalasia, a rare disorder that causes difficulty swallowing.) Clark’s current research focuses on the congenital form of the disease in dogs.

Her laboratory recently published a paper investigating the genetic foundation of mega. Unlike some diseases, mega isn’t caused by just one genetic mutation, so determining what genes might be at play required some genetic detective work. “You see mega across breeds,” Clark says, which suggests an environmental component, but the disease is more prevalent in some breeds than others. For instance, 28 percent of all diagnoses are in German shepherds. That was a “red flag” indicating that genes were at least partly responsible.

Clark and her collaborators chose to limit their research study to German shepherds. Despite including a wide range of dogs in the study, they noticed that males were significantly overrepresented. Clark thinks that estrogen, a hormone more abundant in females, may have a protective effect against mega.

Clark and her team performed a genome-wide association study (GWAS) to look for alleles that are more common in dogs with mega. One allele that turned out to be a major risk factor was a variant of the MCHR2 gene, which plays a role in feeding behaviors. In breeds where mega is overrepresented, like German shepherds, “we have a situation where the predominant allele in the population is also the risk allele,” says Clark.

Using the results of the study, they developed a test that can identify which version of the gene a given dog has. The test, available at veterinary testing companies, is designed “to help breeders reduce the frequency of the risk allele and to plan matings that are less likely to produce affected puppies.”

Duke’s Women Engineers Conquer a Texas-Sized Career Fair

By Kyla Hunter

On November 16, 2022

In Engineering, Students

I never would have imagined a scenario where a blazer, a folder of 30 resumes, and a cowboy hat were all packed together in the same suitcase.

Yet these are the items I found sprawled across my floor on the eve of Wednesday, October 20, as I prepared to fly to Houston to attend the 2022 Society of Women Engineers Conference in Houston, Texas.

*Members of the Duke Chapter of the Society of Women Engineers attend the annual conference in Houston, Texas.* *(I’m third from left in front row)*

The Society of Women Engineers (SWE) is an international organization that empowers and advocates for women in engineering and technology. Founded in 1950, SWE is on a mission to establish engineering as an attractive profession to women, and provide the resources and opportunities necessary for them to pursue it. Through training programs, scholarships, and outreach, SWE builds leadership skills, creates opportunities, and promotes inclusion. The global network of women engineers across all ages and disciplines creates a valuable support system for underrepresented individuals in engineering.

The SWE conference is the world’s largest conference for women in engineering and technology. It has occurred on an annual basis ever since 1951 when the first convention was held in New York City. In the past few years, the SWE conference has been known to attract 8,000+ attendees, continuously growing and breaking attendance records.

*Duke SWE members land in Houston airport after a three hour flight from Durham, eagerly anticipating the start of the conference the next morning.*

Like many colleges, Duke has a SWE student chapter, and every year takes people to the national conference. This year, 22 students were able to attend the three-day conference, with their flights and hotel costs covered.

The weekend was full of inspirational keynote speakers, carefully crafted workshops, and endless opportunities to meet powerful and impressive female engineers from across the country. For the Duke students, the weekend was additionally a meaningful bonding experience, and a significant moment in the pursuit of our academic and professional goals.

For many attendees, the main event is the career fair, which takes place during the first and second days of the conference. Not having any experience at a nationwide conference, I was expecting an event similar to your average college career fair: cardboard posters on folding tables. This could not have been further from the truth for the SWE conference!

Companies had massive set-ups, towering displays, signs hanging from the ceiling, carpeting laid out underneath, tables and chairs, and a dozen employees representing the same company. The room itself was so big you couldn’t see one end from the other side.

The career fair, which spans two days of the conference, is a main component of the conference for many attendees. With over 300 companies in attendance, there were plentiful opportunities for internships, jobs, and networking.

Crowds began to gather for half an hour before the fair began. Once the doors opened, the waves of people surged in and immediately dispersed, weaving between the booths and racing to their first destination.

After separating from my peers and walking around a bit to get a feel for the environment, I gave myself a pep talk, pulled one resume out of my folder, and walked up to my first booth. After scanning a QR code to register, I was asked about my major and then directed to the right employee to talk to.

She scanned over my resume for about twenty seconds before slapping a post-it note on it, handing it to a man behind her, and instructing me to “go with him.”

Along with a few other nervous students, the man began leading us on a walk past all the booths. We reached the end of the room and kept walking, through a small opening in a big partition that stretched across the entire room. On the other side, we emerged into a much quieter atmosphere: an equally large room full not of booths, but of curtains. Dozens of rows of small rooms, created by curtain partitions, were set up for each company. After being directed to yet another person, I was brought inside one of the ominous curtain rooms for a spontaneous 15 minute interview.

I had heard from peers that on-site interviews are often conducted, but I was not prepared for the spontaneous and vastly accelerated nature of the process. After the interview, I was released back into the career fair to race to the next booth.

Almost every student left the conference with some level of success.

Throughout the day, constant messages were shot through various group chats announcing updates, interviews, new contacts, and other exciting revelations. It was easy to lose track of each other throughout the fair, but every notification felt like a wave of breaking news.

The conference is supposed to be an accelerated recruitment process – many people made connections or discovered opportunities that may lead to eventual jobs or internships. In an environment that was so uplifting and supportive of women, it was easy to celebrate each other’s victories, and be reminded that one person’s success was shared by all of us.

*Duke women in engineering across grades and disciplines bond and relax over dinner after a long day at the conference.*

While the first night at the hotel was spent mostly frantically preparing for interviews the next day, the second and third nights allowed plenty of time for group outings and exploring the city of Houston.

Whether looking for internships or full-time opportunities, female engineering students at Duke were brought together across grades and disciplines to share in an incredibly inspirational and memorable weekend. Through the highs and lows of the weekend, we were able to participate in the same shared experiences: stressing over interviews, navigating networking, and exploring our futures as engineers.

And, of course, one more extremely monumental memory from the trip was pretending to be part of a bachelorette party on the flight home (good thing we brought a cowboy hat!).

By Kyla Hunter, Class of ’23

Duke’s Most-Cited — The Scholars Other Scientists Look To

By Karl Bates

On November 15, 2022

In Behavior/Psychology, Biology, Chemistry, Faculty, Immunology, Medicine, Nanotech, Neuroscience

It’s not enough to just publish a great scientific paper.

Somebody else has to think it’s great too and include the work in the references at the end of their paper, the citations. The more citations a paper gets, presumably the more important and influential it is. That’s how science works — you know, the whole standing-on-the-shoulders-of-giants thing.

So it always comes as a chest swelling affirmation for Dukies when we read all those Duke names on the annual list of Most Cited Scientists, compiled by the folks at Clarivate.

This year is another great haul for our thought-leaders. Duke has 30 scientists among the nearly 7,000 authors on the global list, meaning their work is among the top 1 percent of citations by scientific field and year, according to Clarivate’s Web of Science citation index.

As befits Duke’s culture of mixing and matching the sciences in bold new ways, most of the highly cited are from “cross-field” work.

Duke’s Most Cited Are:

Biology and Biochemistry

Charles A. Gersbach

Robert J. Lefkowitz

Clinical Medicine

Scott Antonia

Christopher Bull Granger

Pamela S. Douglas

Adrian F. Hernandez

Manesh R. Patel

Eric D. Peterson

Cross-Field

Chris Beyrer

Stefano Curtarolo

Renate Houts

Tony Jun Huang

Ru-Rong Ji

Jie Liu

Jason Locasale

Edward A. Miao

David B. Mitzi

Christopher B. Newgard

John F. Rawls

Drew T. Shindell

Pratiksha I. Thakore

Mark R. Wiesner

Microbiology

Barton F. Haynes

Neuroscience and Behavior

Quinn T. Ostrom

Pharmacology and Toxicology

Evan D. Kharasch

Plant and Animal Science

Xinnian Dong

Sheng Yang He

Psychiatry and Psychology

Avshalom Caspi

William E. Copeland

E. Jane Costello

Terrie E. Moffitt

Social Sciences

Michael J. Pencina

John W. Williams

Congratulations, one and all! You’ve done us proud again.

Truman Scholar Maya Durvasula, T’18, on her Research Journey Through Duke and Beyond

By Meghna Datta

On November 14, 2022

In Global Health, Policy, Students

Maya Durvasula, T’18, and a current Ph.D. student at Stanford University, grew up in Albuquerque, New Mexico. “And it’s hard to grow up there without a very keen sense of what it looks like when policy doesn’t work for people,” she remarks.

After graduating high school with an interest in politics, she decided to take a gap year and bounced around organizations in New Mexico, working for the state legislature, political campaigns, and even a think tank. In hindsight, she says, “Having a block of time where you have time is super helpful.” One thing she learned was that she didn’t really want to do politics. “People were making policy, but debates were heavy on feelings and politics and light on facts.”

A high school mentor suggested that maybe she would get along better with economists than politicians, so once she got to Duke, she took that to heart.

As a first-year, she says, she knew she wanted to be exposed to a lot of things, and she knew she wanted to do research, but she wasn’t really sure what “research” meant for a first-year. In the beginning, she cold-emailed a lot of people and received multiple rejections.

After rejection, though, eventually something clicks, and for Durvasula, what clicked were three main research projects she undertook in her time at Duke.

The instinct is always to start with where you want to end up and then work backward, but you don’t know where you’re going to end up”
Maya Durvasula, T’18

Her first experience in a research group was a joint venture between an academic team in China and at UNC-Chapel Hill. Their group studied behavioral interventions to increase the uptake of health technologies, with a particular focus on sexual health. Usually, as a country industrializes, the rates of sexually transmitted infections will drop, but in China, rates of HIV and syphilis continued to rise as the economy grew. Durvasula and the team looked at different interventions that might make testing for HIV more attractive to patients, such as alternative testing locations, different advertisement design, and compensation.

She also did a project with Duke professor Bob Korstad in the history department and the Samuel DuBois Cook Center on Social Equity, looking at the history of housing in Durham. Finally, she worked with her primary advisor, Duke economics professor Duncan Thomas, in his joint lab with UNC’s Elizabeth Frankenberg, on projects related to household decision-making in Indonesia.

A notable part of her undergraduate time at Duke was winning the Truman Scholarship. What was most valuable to her about the Truman was the people she met. “Most people I’ve met are defined by picking something they care about and doing a lot with it,” she says. And it’s inspiring to be surrounded by people who love what they do and immerse themselves so wholly in it.

Durvasula graduated Duke with numerous experiences and accolades under her belt. But from there, how did she find her way to doing a Ph.D. at the intersection of law, technology, and economics? As she describes it, the interplay between economics and law is inextricable. Both economic incentive and legal institutions affect the rate and direction of innovation, which affects how quickly technology is developed, and ultimately what products ends up in our hands. A question at the heart of her research is wondering how to make sure the value of this technology is distributed equally across society.

So five to ten years from now, where will we see Durvasula? She sees herself remaining in academia, although at some point she wants to work in public service. “I love learning new things, and I want to take advantage of being in a space where people are always willing to teach you things.”

And in that vein, her advice to a curious Duke student is to explore everything. “The instinct is always to start with where you want to end up and then work backward, but you don’t know where you’re going to end up,” she said.

Pursue the questions that you find exciting, and let that point you in the right direction – clearly, Durvasula is proof that this process will take you places.

Post by Meghna Datta, Class of 2023

Feeling Lonely? What We Want From Our Relationships Can Change With Age

By Robin Smith

On November 14, 2022

In Behavior/Psychology, Students

*Not feeling the holiday cheer this year? The gap between expectations and reality can leave people feeling lonely. Photo by madartzgraphics.*

Not everyone’s holiday plans resemble a Hallmark card.

If the “most wonderful time of the year” isn’t your reality, you’re not alone. You might have an idea of a festive picture-perfect holiday season, but what actually transpires doesn’t always measure up.

And that’s where loneliness comes from, says King’s College London graduate student Samia Akhter-Khan, first author of a new study on the subject.

“Loneliness results from a discrepancy between expected and actual social relationships,” Akhter-Khan said.

Together with Duke psychology and neuroscience Ph.D. Leon Li, Akhter-Khan and colleagues co-authored a paper on why people feel lonely, particularly in later life, and what we can do about it.

“The problem that we identified in current research was that we haven’t really thought about: What do people expect from their relationships?” Akhter-Khan said. “We work with this definition of expectations, but we don’t really identify what those expectations are and how they change across cultures or over the lifespan.”

In every relationship, we expect certain basics. We all want people in our lives who we can ask for help. Friends we can call on when we need them. Someone to talk to. People who “get” us. Someone we can trust. Companions with whom we can share fun experiences.

But the team’s theory, called the Social Relationship Expectations Framework, suggests that older people may have certain relationship expectations that have gone overlooked.

Akhter-Khan’s first clue that the causes of loneliness might be more complex than meets the eye came during a year she spent studying aging in Myanmar from 2018 to 2019. At first, she assumed people generally wouldn’t feel lonely — after all, “people are so connected and live in a very close-knit society. People have big families; they’re often around each other. Why would people feel lonely?”

But her research suggested otherwise. “It actually turns out to be different,” she said. People can still feel lonely, even if they don’t spend much time alone.

What efforts to reduce loneliness have neglected, she said, is how our relationship expectations change as we get older. What we want from social connections in, say, our 30s isn’t what we want in our 70s.

The researchers identified two age-specific expectations that haven’t been taken into account. For one, older adults want to feel respected. They want people to listen to them, to take an interest in their experiences and learn from their mistakes. To appreciate what they’ve been through and the obstacles they have overcome.

They also want to contribute: to give back to others and their community and pass along traditions or skills through teaching and mentoring, volunteering, caregiving, or other meaningful activities.

Finding ways to fulfill these expectations as we get older can go a long way towards combating loneliness in later life, but research has largely left them out.

“They’re not part of the regular scales for loneliness,” Li said.

Part of the reason for the oversight may be that often the labor and contributions of older people are unaccounted for in typical economic indices, said Akhter-Khan, who worked in 2019-20 as a graduate research assistant for a Bass Connections project at Duke on how society values care in the global economy.

“Ageism and negative aging stereotypes don’t help,” she added. A 2016 World Health Organization survey spanning 57 countries found that 60% of respondents said that older adults aren’t well respected.

Loneliness isn’t unique to older people. “It is a young people’s problem as well,” Akhter-Khan said. “If you look at the distribution of loneliness across the lifespan, there are two peaks, and one is in younger adulthood, and one is an old age.”

Even before the COVID-19 pandemic, world leaders began sounding the alarm on loneliness as a public health issue. Britain became the first country to name a minister for loneliness, in 2018. Japan followed suit in 2021.

That’s because loneliness is more than a feeling – it can have real impacts on health. Persistent loneliness has been associated with higher risks of dementia and Alzheimer’s disease, heart disease and stroke, and other health problems. Some researchers suggest it’s comparable or riskier than smoking and obesity.

The researchers hope that if we can better understand the factors driving loneliness, we might be better able to address it.

CITATION: “Understanding and Addressing Older Adults’ Loneliness: The Social-Relationship Expectations Framework,” Samia C. Akhter-Khan, Matthew Prina, Gloria Hoi-Yan Wong, Rosie Mayston, and Leon Li. Perspectives on Psychological Science, Nov. 2, 2022. DOI: 10.1177/17456916221127218

How Art Reflected Child Mortality in the 20th Century

By Vibhav Nandagiri

On November 10, 2022

In Art, History, Humanities, Medicine

How does parenting change when infant and child mortality affects every family in society? Recent history may provide an answer. For the entirety of the 19th Century, child mortality was ubiquitous. In the year 1880, nearly 35% of children born in the United States passed away in their first five years. The medical literature that explores the common diseases and public health inadequacies, though expansive, often fails to address the central humanistic questions surrounding such widespread death. How were these children mourned? How did grieving families move on? And how has this mourning changed in the context of the past hundred years of medical advancement?

These guiding questions drove Dr. Perri Klass, Professor of Journalism and Pediatrics at NYU, to pen her recently published book, “The Best Medicine: How Science and Public Health Gave Children a Future.” A distinguished clinician, author, and medical historian, Klass explored prominent art and literary works from this era of high infant and child mortality at the recent Trent Humanities in Medicine Lecture at the Duke School of Medicine, titled “One Vacant Chair: Remembering Children”.

Throughout the lecture, Klass guided the audience through famous portraits, poems, and prose produced in the 18th Century that memorialized children who had died at a young age. Perhaps the most famous fictional account of childhood death in the 19th century emerged in Uncle Tom’s Cabin by Harriet Beecher Stowe. The emotionally wrenching death scene of young Eva, who succumbed to tuberculosis, struck a chord with virtually all those who read the novel. Published in 1852, Uncle Tom’s Cabin would go on to be reproduced in theaters across the country for several decades, the death scene becoming a ubiquitous anchor that often brought the audience to tears. Klass further described how Beecher Stowe drew from her personal experience, the death of her son Charlie from cholera only a few years prior to the writing of the book, to create this powerful literary scene.

“Uncle Tom’s Cabin.” Published in 1852 by Harriet Beecher Stowe.

Beecher Stowe was not the only author whose personal experience impacted their art. Charles Dickens, deeply impacted by the death of his children, had created a slew of sentimental yet mortal child characters in his stories. One of the most prominent examples, young Nell from “The Old Curiosity Shop,” was published in installments and developed a strong following. Dickens ended the series with the death of twelve-year old Nell, much to the outrage of international readers.

Perhaps it’s no surprise that parents chose to memorialize their deceased children through literature and art. Wealthy families would often contract famous portrait artists were often contracted to depict their dead children. Some, including the Rockefellers and the Stanfords, channeled the deaths of their children and grandchildren into resourced academic institutions.

For grief to drive philanthropy and art is not a new phenomenon, but the sources of grief that drive such artistic and financial overtures today have changed considerably. Klass sought to bridge this knowledge gap and pull closer the history to which society has the privilege of being oblivious. Maybe, even, it would even inform how we cope with the mortality of young people today.

“How do we situate ourselves in a world where infant and child mortality is so low?” Klass asked at the beginning of her presentation.

The past does not reveal one clear answer, but it does provide a tapestry of options, many lost in our modern collective memory, for mourning, for celebrating, and for memorializing.

Post by Vibhav Nandagiri, Class of 2025

Meet the Power Tools Pro Who Keeps Students Safe While They Learn by Doing

By Kyla Hunter

On November 10, 2022

In Engineering, Students

When engineering student Katie Drinkwater signed up for the Machine Shop Tools Mastery Unit for her Engineering 101 class, she was completely unsure about what to expect. As a freshman with no prior experience, she felt intimidated by the prospect of stepping foot into a place with such powerful and potentially dangerous machinery. Now a senior in Pratt and a member of Duke Motorsports, Drinkwater has since become much more comfortable spending time around lathes, bandsaws and other power equipment. Along with many other members of the Duke community, she attributes much of her positive experience to the guidance and support of Duke Machine Shop Manager, Steve Earp.

*The Welcome Night at the Student Machine Shop is an open-house event early in the semester that introduces new students into all that the Duke student machine shop has to offer.*

“When I went in to make my first part, I was very nervous and intimidated,” Drinkwater says. “I thought that I would be expected to know how to use the machines, but this couldn’t have been farther from the truth. Steve helped my partner and me with every step but didn’t infringe on our ownership of the project. I always feel free to ask questions and check in with Steve, but I am still expected to do my own work.”

Drinkwater isn’t alone. “Steve is definitely a friendly face you can rely on in the Pratt student shop. His vast skills and experience are one thing, but being able to teach people new to the shop in such an engaging way sets him apart. Steve has helped me make custom tools, solve problems that seemed impossible, and has helped me learn something new every time I walk into the shop,” says John Smalley, ME ‘23 and president of Duke Aero Society.

Managing the Student Shop for nearly 15 years, Earp is a vital and beloved mentor to all students that frequent the shop. Not only responsible for the set-up, organization, and operation of the shop, Earp also ensures that thorough safety practices are properly established and upheld. Part of this dedication to safety involved spearheading a brand new initiative: The Student Shop Managers Consortium.

*Steve Earp (left), Jennifer Ganley, Connor Gregg, Alexandra Gray, Greg Bumpass, Josh Klinger (right) gather to show new students around the machine shop during the Welcome Night.*

In 2013, following a tragic accident at Yale University that involved the death of a student using the student machine shop, Earp became determined to take action to ensure no such incidents ever occur again. “I started investigating, and trying to find other people that do my job at other universities,” he explained. After sending out an email to dozens of other engineering schools, Earp was left with no responses. However, he refused to let this deter him. “I had to drill down over the next two years and find that one guy or gal that operates and manages that shop,” he recalls. One by one, Earp built a network across the country, eventually organizing and hosting the first conference here at Duke University in 2015 with about 65 student shop managers. Earp recalls the positive feedback from all the attendees, revealing that this was the first time these individuals with the same job had been able to communicate with those in similar positions: “nobody ever knew that there was somebody like them somewhere else.” Since then, the conference has occurred on an annual basis, hosted by different universities from Yale to Washington University in St. Louis, and even virtually during the pandemic. Most importantly, this network has allowed for more conversation and accountability in making student safety a priority. Demonstrating his passion for student shops and commitment to student safety, Earp was recently named the President of this organization.

The emphasis on safety is something Drinkwater has experienced since the first time she stepped in the shop to complete her Tools Mastery assignment. “A machine shop can be a very dangerous environment — something Steve knows from personal experience — so he and Greg take safety training very seriously,” she explains. “They want every student to respect the environment without being afraid of it.” After completing the very thorough online and in-person components of the safety training, Drinkwater felt proud to pick up her shop badge. In a sentiment echoed by all of the engineering community, Drinkwater concludes, “I feel very lucky to have Steve as our shop manager. His wealth of experience, genuine interest in students’ learning, and good-humored disposition are extremely valuable additions to the Pratt community.”

Duke Alum Dr. Quinn Wang on Medicine, a Healthcare Startup, and the Senior Thesis That Started it All

By Meghna Datta

On November 8, 2022

In Entrepreneurship, Medicine, Students

As a senior at Duke University in 2010, Dr. Quinn Wang was simply Quinn, an undergraduate English major on the pre-med track, wondering how to combine her love for medicine with her love for English. This is how her senior thesis was conceived – Through the Lens of Medicine: Landscapes of Violence in Cormac McCarthy’s Blood Meridian (1985), All the Pretty Horses (1992), and No Country for Old Men (2005) – which ended up winning the English department’s award for “Most Original Honors Thesis.”

Fast forward 12 years, and Wang can now call herself a double Dukie, having completed medical school here. She went on to complete ophthalmology residency at UCSF and this past Saturday, November 5, came back to her alma mater as part of the Duke Medical Ethics Journal’s Medicine, Humanities, and Business celebration to talk to an eager audience at Schiciano Auditorium about her path from Duke until now.

She began her story during the infamous year of 2020, when she was forced to stop seeing patients at her private practice in California’s Bay Area due to COVID-19. Restless and anxious about how her patients were doing, she tried to keep up with them as best she could, but of course there were limitations. And then, a few months in, one of her patients went blind.

This tragic moment sparked a frustrating realization by Wang that in the tech capital of the world – San Francisco – there was still no good way to test people’s eyesight from home to prevent what should have been preventable. She decided to put together something herself, guided by the one question she thought was most important to answer until COVID-19 abated and people could come into clinics again – “how do we make sure people don’t go blind?”

Wang took common visual eye-testing tools used in clinics, and with some simple Photoshop editing and a little bit of code, turned them into a series of easy multiple-choice questions that could be answered from home. This simple but powerful transformation turned into Quadrant Eye, a start-up she co-founded with software engineer Kristine Hara.

A common visual tool used to test eyesight is the Snellen chart

The Quadrant Eye journey has taken her from running a private practice as an ophthalmologist to taking the plunge into business by applying to and getting selected for Y Combinator, which calls itself a “graduate school for startups”. YC invests $500,000 into a selection of early-stage startups twice a year. Then, for three intense months, they provide support to get startups off the ground and in good shape to present to investors for funding. At YC, Hara worked on turning Quadrant Eye into an app, and Wang renewed hundreds of prescriptions.

Ultimately, though, the most significant place Quadrant Eye has led Wang to is a journey of self-mastery that applies to any human endeavor, from building a startup to doing research to just getting up every morning. As she describes, startup life entails always learning new things and always messing up – which, for someone who professes that “I don’t like to do things I’m not good at” – can be challenging. She candidly admitted that she, like everyone, has bad days, when sometimes all she can do is throw in the towel and end work early. “I have more doubts than I care to admit,” Wang says, but at the end of the day, “we’re all climbing our own mountains”. Pushing through requires “superhuman effort” but it’s worth it.

And as for that English thesis? Wang describes how Quadrant Eye’s very first investor – “let’s call him Charlie” – asked her all the requisite questions investors ask early-stage startups (think Shark Tank). But he also asked her for something non-traditional – all fifty or so pages of her undergraduate honors thesis she had written ten years back. Apparently, he had seen a mention of it on LinkedIn and was intrigued. A few weeks later, Wang received a phone call that he was interested in investing – and he admitted that her thesis had played a part. To him, the uniqueness and quality of her thesis showed that Wang could problem-solve, communicate well, and think creatively, and Wang herself agrees. “My English thesis showed me that I can do hard things,” she said, and if Quadrant Eye is any indication, clearly, she can.

Post by Meghna Datta, Class of 2023

Insights on Health Policy Research from Undergraduate Cynthia Dong

By Meghna Datta

On November 7, 2022

In Medicine, Neuroscience, Students

“After COVID-19,” senior Cynthia Dong (T’23) remarks, “so much of what was wrong with the medical system became visible.”

Duke undergraduate Cynthia Dong, Class of 2023

This realization sparked an interest in how health policy could be used to shape health outcomes. Dong, who is pursuing a self-designed Program II major in Health Disparities: Causes and Policy Solutions, is a Margolis Scholar in Health Policy and Management. Her main research focus is telehealth and inequitable access to healthcare. Her team looks at patient experiences with telehealth, and where user experience can be improved. In fact, she’s now doing her thesis as an offshoot of this work, researching how telehealth can be used to increase access to healthcare for postpartum depression.

In addition to her health policy work, however, Dong also works as a research assistant in the neurobiology lab of Dr. Anne West, and her particular focus is on the transcription mechanism of the protein BDNF, or brain-derived neurotrophic factor.

While lab research can be clearly visualized by most people (think pipettes, rows of benches littered with bottles and plastic tubes, blue rubber gloves everywhere), health policy research is perhaps a little more abstract. When asked what the process of research through Margolis is like, Dong says that “it’s not team-based or individual – it’s a lot of both.” This looks like individual research on specific topics, talking to different stakeholder groups and people with certain expertise, and then convening for weekly team meetings.

For Dong, research has been invaluable in teaching her to apply knowledge to something tangible. Doing that, you’re often “forced to understand that not everything is in my control.” But on the flip side, research can also be frustrating for her because so much of it is uncertain. “Will your paper get published? Is what you’re doing relevant to the research community? Will people invest in you?”

In that vein, research has humbled her a lot. “What it means to try to solve a societal problem is that it’s not always easy, you have to break it down into chunks, and even those chunks can be hard to solve.”

After graduation, Dong plans on taking a couple of gap years to be with family and scribe before ultimately pursuing an MD-MPH. Because research can be such a long, arduous process, she says that “It took me a long time to realize that the work we do matters.” In the future, though, she anticipates that her research through Margolis will directly inform her MPH studies, and that “with the skills I’ve learned, I can help create good policy that can address the issues at hand.”

Inside Biblical Research with Duke’s Mark Goodacre

By Olivia Ares

On November 3, 2022

In Faculty, Humanities, Religion

This is part two of a two-part series; last week we looked at what biblical research is and why it matters—this week we’re looking at how it’s conducted.

“Sometimes I have to take a running start to the word ‘religion,'” says Mark Goodacre, chair of the religious studies department at Duke.

A beautiful sentiment.

He corrects himself: “That is, I have trouble saying the word itself. I often have to stop and think so I don’t stumble over it.”

A considerate pause: “Department of…Re-lig-ious Studies*.* There we go.”

Goodacre has a podcast about the New Testament. His students have admitted to using his calming British timbre to lull themselves into a sense of peace. When I met with him over Zoom, he was back in Cambridge visiting his brand-new granddaughter. Other than being one of the world’s most forefront New Testament scholars, he is also an ABBA superfan.

Goodacre consulted on the Gospel of Matthew for the New Revised Standard Version Updated Edition—the most modern scholarly edition of the Bible. He argued to the board that the commonly translated “leper” should be considered “person with leprosy” and “deaf-mute” as “person who could neither see nor hear.”

Goodacre is one of hundreds of New Testament scholars around the world who are working towards a greater understanding of historical and theological Christianity.

Coming from outside the world of biblical research, it may be difficult to understand the relationship between religious texts and academia. You can think of it like this: in an academic setting, the Bible is heavily seasoned with nuance, slow-roasted for decades at a time, pulled apart, chopped into little chunks of knowledge, placed in boiling vats of outside context, and served objectively with a fresh garnish of analysis.

“You’re taking the tools you have in the arts and sciences, and you’re not treating religious texts any differently,” Goodacre says. “People often think you have to treat sacred things differently, but they are still the product of human beings in specific contexts at specific points in history. Subject them to proper scrutiny— like you would to any modern writer.”

Last week, we looked at why biblical research matters. But perhaps that relationship goes both ways; researchers are constantly inspired by the world of arts and sciences, the conversations they have with students—and more than that, current events. Today, as much as in any decade, the Bible is a central topic of debate in public policy and ethical issues that affect people all over the world. Goodacre gives us some examples:

“For example, take slavery in America; sometimes the same passage in the Bible would be referred to by both abolitionists and slave owners. Modern scholars are able to provide context to those passages and truly defend the arguments of abolitionists.”

As a Brit, Goodacre finds the American separation of church and state an interesting concept. As a scholar, he is able to provide context and voice to arguments made on both sides.

“It is healthy for our politics and culture to have people who can have intelligent discussions about the Bible in issues in our courts like marriage, divorce, sexuality, abortion.”

Goodacre makes sure to teach historical analysis tools in his classes. Among those tools include the ability to view texts from different perspectives; beyond being able to step away from politics to provide an outside view, scholars also need to be able to get even closer to the text. Different views on the text have been the consensus at different points in history, and often scholars find reasons to visit and revisit translations and interpretations for different analyses.

*Some books written by Goodacre, images courtesy of Google Books.*

For example, Goodacre teaches a class at Duke called Jesus and Film, and in the class he repeatedly revisits the issue of the persistent white, European Jesus depiction in even modern art. Since graduating from Oxford years ago, he has revisited the same material he once studied with a feminist perspective despite being taught it in a male-dominated space.

“For someone like me who went to grad school a few decades ago,” he says, “it’s a liberating thing to take feminist and racial perspectives with the weight they deserve.”

What does this have to do with us non-religious studies folks? Perhaps some of us follow the scientific method to conduct our experiments, others the engineering method and even others use literary analysis or investigation methods or whatever we need to get to the root of a problem. All of these methods and more are encompassed within the realm of religious studies and biblical research; by looking at a problem from all angles, and without treating sanctity as an exception to scrutiny, scholars are able to work.