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

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LowCostomy: the Low-Cost Colostomy Bag for Africa

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It’s common for a Pratt engineering student like me to be surrounded by incredible individuals who work hard on their revolutionary projects. I am always in awe when I speak to my peers about their designs and processes.

So, I couldn’t help but talk to sophomore Joanna Peng about her project: LowCostomy.

Rising from the EGR101 class during her freshman year, the project is about building  a low-cost colostomy bag — a device that collects excrement outside the patient after they’ve had their colon removed in surgery. Her device is intended for use in under-resourced Sub-Saharan Africa.

“The rates in colorectal cancer are rising in Africa, making this a global health issue,” Peng says. “This is a project to promote health care equality.”

The solution? Multiple plastic bags with recycled cloth and water bottles attached, and a beeswax buffer.

“We had to meet two criteria: it had to be low cost; our max being five cents. And the second criteria was that it had to be environmentally friendly. We decided to make this bag out of recycled materials,” Peng says. 

Prototype of the LowCostomy bag

For now, the team’s device has succeeded in all of their testing phases. From using their professor’s dog feces for odor testing, to running around Duke with the device wrapped around them for stability testing, the team now look forward to improving their device and testing procedures.

“We are now looking into clinical testing with the beeswax buffer to see whether or not it truly is comfortable and doesn’t cause other health problems,” Peng explains.

Poster with details of the team’s testing and procedures

Peng’s group have worked long hours on their design, which didn’t go unnoticed by the National Institutes of Health (NIH). Out of the five prizes they give to university students to continue their research, the NIH awarded Peng and her peers a $15,000 prize for cancer device building. She is planning to use the money on clinical testing to take a step closer to their goal of bringing their device to Africa.

Peng shows an example of the beeswax port buffer (above). The design team of Amy Guan, Alanna Manfredini, Joanna Peng, and Darienne Rogers (L-R).

“All of us are still fiercely passionate about this project, so I’m excited,” Peng says. “There have been very few teams that have gotten this far, so we are in this no-man’s land where we are on our own.”

She and her team continue with their research in their EGR102 class, working diligently so that their ideas can become a reality and help those in need.

Post by Camila Cordero, Class of 2025

250,000-Year-Old Child Adds to the Mystery of Our Human Origins

Based on the small size of Leti’s skull and on the combination of baby teeth and unerupted adult teeth, researchers estimate that the Homo naledi child would have been 4-6 years old.

Look at the palm of your hand and spread your fingers wide. Now imagine squeezing your body through a gap narrower than the distance between the tip of your thumb and the tip your pinkie finger. Let’s make this a bit worse: the gap is in complete darkness, its walls are rough stone, and all you have is a tiny headlamp. Ok, now that you are there, all you have to do is carefully find and recover dime-sized fragments of an invaluable treasure.

That’s how researchers recovered the first Homo naledi child’s skull ever to be found.

The finding was revealed this week in two papers published in the journal PaleoAnthropology by an international team of 21 researchers.

Homo naledi are possibly our most mysterious long-lost cousins. They are an ancient human relative that lived in what is now South Africa, approximately 350 to 250 thousand years ago. They were first discovered in the Rising Star Cave system in 2013, in a research expedition led by Lee Berger, Professor and chair of Palaeo-Anthropology and Director of the Centre for Exploration of the Deep Human Journey at the University of Witwatersand.

The research team, which includes Steven Churchill, professor of evolutionary anthropology at Duke, named the child Leti (pronounced Let-e), after the Setswana word “letimela” meaning “the lost one”.

Leti was found in one of the previously unexplored narrow fissures that radiate from Rising Star’s known chambers. His resting site was a 15 cm wide and 80 cm long gap where only the smallest (and bravest) of explorers could fit.

Explorer Becca Peixoto wedges herself between cave rock walls to get to Leti’s skull.

Marina Elliot, lead author of the first paper and one of the explorers to first discover Homo naledi, said in a press conference that excavating Leti’s remains required explorers to wedge themselves practically upside down between two rock walls.

Finding yet another fossil in a prolific site may not seem groundbreaking, but finding a child’s skull is a major achievement. First of all, children’s bones are thin and fragile, and rarely withstand the test of time.

Second, finding a child’s skull gives researchers a precious glimpse into the development of Homo naledi.

“A child’s skull allows us to study how Homo naledi grew and developed, and how their growth rate and schedule compares to other hominid species, and to our own,” Churchill said.

In addition to skull fragments, researchers also recovered two worn baby teeth and four unworn adult teeth that were yet to erupt. These findings show that Leti would have been between four and six years old at the time of her or his death.

Based on similarities between the soil of the fissure where Leti was found and the better-known areas of the cave, Tebogo Makhubela, senior lecturer of Geology at the University of Johannesburg and author of the papers, estimated that Leti has been hidden in Rising Star for over 250,000years.

The discovery of Leti’s skull also deepens the mystery of how Homo naledi’s remains ended up in such a deep, dark, and treacherous cave.

Berger’s team had previously hypothesized that the first 15 Homo naledi individuals found in Rising Star had been disposed there by their own species, as a burial. This hypothesis created an uproar: could a small-brained hominin from over 300,000years ago bury their dead, just like we do?

Leti’s skull was found on a small shelf at the back of the cave’s fissure. No other bones were found, suggesting that Leti’s head may have been deliberately placed there. Leti, as well as all other Homo naledi fossils ever found, showed no evidence of being dragged by predators, carried by water, or tumbled around in any other way.

“Those were social individuals. Seeing one of their own being picked apart by animals could have been very distressing,” Churchill said. “Purposeful disposal of their bodies still seems like the most likely explanation.”

Berger is undeterred by nay-sayers. “This is science,” Berger said at a press conference. “We will continue testing and challenging our hypotheses with every piece of data that we get.”

The researchers hope that other teams around the world will study Leti and other Homo naledi fossils. To that end, Leti’s skull was CT-scanned, and its scans can be downloaded from Morphosource, an open access repository of museum specimens’ 3D scans hosted at Duke University.

Leti will probably not be the last treasure to come out of Rising Star’s spider web of narrow passages.

“I can’t wait to go back to South Africa and see what else is waiting for us in that cave,” said Juliet Brophy, Professor of Geography and Anthropology at Louisiana State University and lead author of the paper describing Leti’s skull.

“This finding makes us remember that exploration is always worth doing,” said Elliot, who is a researcher at Simon Fraser University and Witwatersand University. “There is a lot still out there to be found”.

The Rising Star cave system is known for being extremely dangerous to explore.

Elliot et al. was funded by the National Geographic Society, the Lyda Hill Foundation, the South African National Research Foundation, and the Gauteng Provincial Government, for funding the discovery, recovery and ongoing analyses of the material. Additional support was provided by ARC (DP140104282).

Brophy et al. was funded by the National Geographic Society, the Lyda Hill Foundation, the South African National Research Foundation, the South African Centre for Excellence in Palaeosciences, The University of the Witwatersrand, the Vilas Trust, the Fulbright Scholar Program, Louisiana State University, North Carolina State University, the Texas A&M University College of Liberal Arts Seed Grant program and the Texas A&M College of Liberal Arts Cornerstone Faculty Fellowship.

Citations:

“Expanded Explorations of the Dinaledi Subsystem, Rising Star Cave System, South Africa.” Marina C. Elliot,Tebogo V. Makhubela, Juliet K. Brophy, Steven E. Churchill, Becca Peixoto, Elen M. Feuerriegel, Hannah Morris, Rick Hunter, Steven Tucker, Dirk Van Rooyen, Maropeng Ramalepa, Mathabela Tsikoane,Ashley Kruger, Carl Spander, Jan Kramers, Eric Roberts, Paul H.G.M. Dirks,John Hawks,Lee R. Berger. PaleoAnthropology, November 2021. DOI: https://doi.org/10.48738/2021.iss1.68.

“Immature Hominin Craniodental Remains From a New Localityin the Rising Star Cave System, South Africa.” Juliet K. Brophy, Marina C. Elliot, Darryl J. De Ruiter, Debra R. Bolter, Steven E. Churchill, Christopher S. Walker, John Hawks, Lee Berger. PaleoAnthropology, November 2021, DOI: https://doi.org/10.48738/2021.iss1.64.

By Marie-Claire Chelini
By Marie-Claire Chelini

In the World Capital of Vanilla Production, Nearly Three out of Four Farmers Say They Don’t Have Enough to Eat

A new study investigates why and what they can do about it

Madagascar, famous for its lemurs, is home to almost 26 million people. Despite the cultural and natural riches, Madagascar is one of the poorest countries in the world. Over 70% of Malagasy people are farmers, and food security is a constant challenge. Rice is the most important food crop, but lately an internationally-prized crop has taken center stage: vanilla. Most of the world’s best quality vanilla comes from Madagascar. While most Malagasy farmers live on less than $2 per day, selling vanilla can make some farmers rich beyond their dreams, though these profits come with a price, and a new study illustrates it is not enough to overcome food insecurity.

In a paper published June 25, 2021 in the journal Food Security, a team of scientists collaborating between Duke University and in Madagascar set out to investigate the links between natural resource use, farming practices, socioeconomics, and food security. Their recently published article in the journal Food Security details intricate interactions between household demographics, farming productivity, and the likelihood of experiencing food shortages.

Vanilla beans, Wikimedia Commons

The team interviewed almost 400 people in three remote rural villages in an area known as the SAVA region, an acronym for the four main towns in the region: Sambava, Andapa, Vohemar, and Antalaha. The Duke University Lemur Center has been operating conservation and research activities in the SAVA region for 10 years. By partnering with local scientists, the team was able to fine-tune the way they captured data on farming practices and food security. Both of the Malagasy partners are preparing graduate degrees and expanding their research to lead the next generation of local scientists.

Farmers harvesting the rice fields in Madagascar. Credit: Wikimedia Commons.

The international research team found that a significant proportion of respondents (up to 76%) reported that they experienced times during which did not have adequate access to food during the previous three years. The most common cause that they reported was small land size; most respondents estimated they owned less than 4 hectares of land (<10 acres), and traditional farming practices including the use of fire to clear the land are reducing yields and leading to widespread erosion. The positive side is that the more productive the farm, especially in terms of rice and vanilla harvests, the lower the probability of food insecurity. There was an interaction between rice and vanilla harvests, such that those farmers that produced the most rice had the lowest probability of food insecurity, even when compared to farmers who grew more vanilla but less rice. Though vanilla can bring in a higher price than rice, there are several factors that make vanilla an unpredictable crop.

The vanilla market is subject to extreme volatility, with prices varying by an order of magnitude from year to year. Vanilla is also a labor- and time-intensive crop; it requires specific growing conditions of soil, humidity, and shade, it takes at least 3 years from planting to the first crop. Without the natural pollinators in its home range of Mexico, Malagasy vanilla requires hand pollination by the farmers, and whole crops can be devastated by natural disasters like disease outbreaks and cyclones. Further, the high price of vanilla brings with it ‘hot spending,’ resulting in cycles of boom and bust for impoverished farmers. Because of the high price, vanilla is often stolen, which leads farmers to spend weeks in their fields guarding the vanilla from thieves before harvesting. It also leads to early harvests, before the vanilla beans have completely ripened, which degrades the quality of the final products and can exacerbate price volatility.

In addition to the effects of farming productivity on the probability of food insecurity, the research revealed that household demographics, specifically the number of people living in the household, had an interactive effect with land size. Those farmers that had larger household sizes (up to 10 in this sample) had a higher probability of experiencing food insecurity than smaller households, but only if they had small landholdings. Those larger families that had larger landholdings had the lowest food insecurity. These trends have been documented in many similar settings, in which larger landholdings require more labor, and family labor is crucial to achieving food sovereignty.

The results have important implications for sustainable development in this system.  The team found that greater rice and vanilla productivity can significantly reduce food insecurity. Therefore, a greater emphasis on training in sustainable, and regenerative, practices is necessary. There is momentum in this direction, with new national-level initiatives to improve rice production and increase farmers’ resilience to climate change. Further, many international aid organizations and NGOs operating in Madagascar are already training farmers in new, regenerative agriculture techniques. The Duke Lemur Center is partnering with the local university in the SAVA region to develop extension services in regenerative agriculture techniques that can increase food production while also preserving and even increasing biodiversity. With a grant from the General Mills, the Duke Lemur Center is developing training modules and conducting workshops with over 200 farmers to increase the adoption of regenerative agriculture techniques.

Further, at government levels, improved land tenure and infrastructure for securing land rights is needed because farmers perceive that the greatest cause of food insecurity is their small landholdings. Due to the current land tenure infrastructure, securing deeds and titles to land is largely inaccessible to rural farmers. This can lead to conflicts over land rights, feelings of insecurity, and little motivation to invest in more long-term sustainable farming strategies (e.g., agroforestry). By improving the ability of farmers to secure titles to their land, as well as access agricultural extension services, farmers may be able to increase food security and productivity, as well as increased legal recognition and protection.

To move forward as a global society, we must seek to achieve the United Nation (UN) Sustainable Development Goals (SDGs). One of the SDGs is Goal #2, Zero Hunger. There are almost one billion people in the world who do not have adequate access to enough safe and nutritious food. This must change if we expect to develop sustainably in the future. Focusing on some of the hardest cases, Madagascar stands out as a country with high rates of childhood malnutrition, prevalence of anemia, and poverty. This year, more than one million people are negatively impacted by a three-year drought that has resulted in mass famine and a serious need for external aid. Sadly, these tragedies occur in one of the most biodiverse places on earth, where 80-90% of the species are found no where else on earth. This paradox results in a clash between natural resource conservation and human wellbeing.

Achieving the UN’s SDGs will not be easy; in fact, we are falling far short of our targets after the first decade. The next ten years will determine if we meet these goals or not, and our collective actions as a global society will dictate whether we transform our society for a sustainable future or continue with the self-destructive path we have been following. Further research and interventions are still needed to conserve biodiversity and improve human livelihoods.

Science in haiku: // Interdisciplinary // Student poetry

On Friday, August 2, ten weeks of research by Data+ and Code+ students wrapped up with a poster session in Gross Hall where they flaunted their newly created posters, websites and apps. But they weren’t expecting to flaunt their poetry skills, too! 

Data+ is one of the Rhodes Information Initiative programs at Duke. This summer, 83 students addressed 27 projects addressing issues in health, public policy, environment and energy, history, culture, and more. The Duke Research Blog thought we ought to test these interdisciplinary students’ mettle with a challenge: Transforming research into haiku.

Which haiku is your
favorite? See all of their
finished work below!

Eric Zhang (group members Xiaoqiao Xing and Micalyn Struble not pictured) in “Neuroscience in the Courtroom”
Maria Henriquez and Jake Sumner on “Using Machine Learning to Predict Lower Extremity Musculoskeletal Injury Risk for Student Athletes”
Samantha Miezio, Ellis Ackerman, and Rodrigo Aruajo in “Durham Evictions: A snapshot of costs, locations, and impacts”
Nikhil Kaul, Elise Xia, and Mikaela Johnson on “Invisible Adaptations”
Karen Jin, Katherine Cottrell, and Vincent Wang in “Data-driven approaches to illuminate the responses of lakes to multiple stressors”.

By Vanessa Moss

An Expert’s Perspective on Mental Health

In honor of Mental Health Awareness Week and Depression Awareness Month, I interviewed Rae Jean Proeschold-Bell,  an associate research professor of Global Health in the Duke Global Health Institute whose research focuses on positive mental health, clergy health, and the integration of care within health systems.

In 2007, Proeschold-Bell founded the Clergy Health Initiative, a program developed to improve health outcomes among the clergy of North Carolina. In their first study, they performed a longitudinal survey of nine Methodist churches in North Carolina to determine the clergy’s health status. It was found that the clergy had a far higher obesity rate (41%) than the rest of North Carolina (29%). High rates of chronic disease associated with overweight/obese individuals were also present. The most interesting find, though, was that depression rates were double that of the regional average. Why?

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Proeschold-Bell has conducted research in Kenya, Tanzania, Peru, India, and the U.S.

“Being the leader of an organization is difficult, says Proeschold-Bell. Churches are extremely underfunded and are constantly pressed for time. Pastors are expected to do all of the spiritual work that being a pastor entails, and also act as business managers for the church. But, thanks to donations from the Duke Endowment, Proeschold-Bell was able to develop three interventions to improve clergy health. Since then, she’s retrieved ten years of data that has allowed for further improvements in holistic health for the clergy of North Carolina.

When asked about depression specifically, Proeschold-Bell said that “the current model in place to treat depression does not work.” We focus strictly on treating the issue by mitigating its symptoms through an antidepressant, instead of pulling at the issue from multiple roots.

She says our efforts should be focused on increasing positive mental health. Positive mental health refers to the presence of positive emotions and good functioning (in both individual and social environments). Work being done by Corey Keyes at Emory has shown that individuals with high positive mental health are less likely to develop depression and chronic disease. By focusing our efforts towards improving one’s overall mental wellbeing, we can get individuals “ahead of the curve” and prevent them from even being depressed in the first place, says Proeschold-Bell.

Further research focusing on positive emotions has been conducted by Barbara Fredrickson at UNC, who suggests that positive emotions have been scientifically proven to increase people’s open-mindedness. Those with more positive emotions have been more willing to try new things and open up to other people, says Proeschold-Bell. These positive emotions connect greatly to one’s ability to be resilient, and there is research to be done in the overlap between possessing these emotions and being able to recover from situations of trauma and conflict that can be mentally straining.

To tackle mental health issues, we must look at them holistically and extensively. Not only do these issues need to be covered from all angles, but interventions need to be culturally competent and context-specific. Keeping these values in mind, will help improve global mental health outcomes.

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Post by: Lola Sanchez-Carrion

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