Research Blog

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

Students exploring the Innovation Co-Lab

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

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

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

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

How to be a Global Inventor

Gadgets, devices, doo-dads, oh my! The Duke Global Health Institute (DGHI)  recently hosted three of its members to lead a panel on creating medical devices for low- and middle-income countries. The event was called “Global Medical Device Innovation: Three Models for Creation and Commercialization.”

Each sought to decrease costs and increase scalability for medical procedures. In short, they are expert inventors who are doing good in the world. 

Two of the most prominent inventors of our era. Image courtesy of Disney.

We’ll go step-by-step in a moment, but to start you on your journey to being just like our panelists, here’s a short glossary:

Standard-of-care: a public health term for the way things are usually done.

IRB: institutional review board, a group of people, usually based in universities, that protect human subjects in research studies. 

Screening: when doctors look at signs your body might show to determine
whether you need to be tested for certain conditions. 

Supply-chain: the movement of materials your product goes through before, during, and after manufacturing. It is a general term for a group of different suppliers, factories, vendors, advertisers, researchers, and others that work separately. 

Regulatory pathways: supply-chain for government approvals and other paperwork you need to have before introducing your product to the public.

Step 1: Meet your Mentors

Walter Lee is Chief of Staff of the Department of Head and Neck Surgery & Communication Sciences, Co-Director of the Head and Neck Program, and an affiliate faculty member at the Duke Global Health Institute. He presented ENlyT (pronounced like en-light), a newfangled nasopharyngoscope – a camera that goes down your nose and down your throat to screen for cancer. He wants to expand with partners in Vietnam and Singapore. 

Marlee Kreiger helped found the Center for Global Women’s Health Technologies at Duke in 2007. Since then, she has led the Center in many interdisciplinary and international ventures. In fact, the Center for Global Women’s Health Technologies spans both the Pratt School of Engineering and the Trinity College of Arts and Sciences. She presented on the Callascope, a pocket-sized colposcope – a camera device for cervical cancer screening. 

Julias Mugaga will soon be a visiting scholar at Duke – until then, he heads Design Cube at Makerere University in Uganda. He presented his KeyScope, a plug-and-play surgical camera with 0.3% of the cost of standard-of-care cameras. 

Kreiger’s presentation slides

Step 2: Name your Audience

DGHI has “global” in the name, so it is no surprise that these presenters serve communities around the world. Perhaps something that inventors like Dr. Doofenshmirtz often get wrong is that new innovation should come at the benefit of underserved communities, not at the cost of them. For Lee, that focus would be in his collaborations in Vietnam; for Mugaga it was his community in Uganda; and for Kreiger, it was the many studies conducted in Zambia, Tanzania, Kenya, Costa Rica, Honduras, and India.

Each of the presenters could agree that the main strategy is simple: find partners. Community members on the ground. Organizations that can benefit from your presence.

Another prominent–albeit villainous–inventor, Dr. Doofenshmirtz. Image courtesy of Disney.

Another notable aspect of your audience will be the certification you vie for. Depending on your location, you may need different permissions to distribute your product, or even begin on the journey to secure funding from certain sources.

In the United States, the most relevant regulatory pathway is FDA clearance, which is notably less restrictive than the CE mark distributed in the European Union. Both certifications are accepted in other countries, but many of the inventors on the panel opted to secure a CE mark to potentially appeal to a wider variety of governments around the world.

ISO is an international organization that is also necessary for certification, particularly if you are looking to test a medical product. No reason to be dragged down by the paperwork, though! When asked about securing Ugandan product certification, Mugaga declared, “This is one of the most exciting journeys I have taken.” His path to clearance was even more wrought with uncertainty – without steady sources of material in the Ugandan economy, it is harder to earn FDA or CE approval, two of the most widely-acknowledged certifications in the world. 

Mugaga’s presentation slides

Step 3: Test 

Now that you have permission, you can start changing lives. Many participants in our panelists’ studies were patients in community health clinics across the globe. Their partners in these clinics also had the opportunity to save tens to hundreds of thousands of dollars in equipment. While it seems like a no-brainer, there are ethical concerns that need to be addressed first. For that, you need to fill out…. You guessed it: more paperwork. IRB approval is usually granted by educational institutions (as you should recall from my handy glossary), and is crucial to secure before any testing with humans is started. In fact, the government (and most private investors) won’t even give you a second glance if you ask them for money without IRB approval. 

One big hurdle many of the panelists noted was a distrust of the technology and institution it came from – a foreign entity testing their products on you does not always invoke fear, but it certainly does not always promote trust. Kreiger noted that the work of their community health partners does the heavy lifting on that front; not only are they known community pillars, but they have authority to promote health technology through their existing relationships. If you run into trouble identifying partners in your inventorship journey–never fear. Lee has a message for you: “Ask around. At Duke, there’s always an expert around who’s willing to lend you their time.”

Step 4: Distribute

Now that you are an expert, your invention works, and you’re saving lives, you can attempt to cement your design as standard-of-care. This may look different depending on where in the world you want to distribute, but the next step is to contract a large-scale manufacturer. Your materials have been sourced by now (FDA says they better be) — so finding someone to put them together at an industrial scale should be easy! Your cost may fluctuate at this scale with the increased labor costs, but bulk production and distribution altogether should provide you, your institution, and your clients the best possible chance at changing the world. 

Lee did not receive NIH funding until his fourth attempt at applying. Kreiger did not settle on the first manufacturer contracted. Mugaga is still in the process of securing a CE mark. And yet, all of them are success stories. You can see the ENlyT saving lives in hospitals in Vietnam; you can track the reallocation of $18,000 in savings from purchasing a Calloscope; and if you’re lucky, you’ll catch Mulgaga on campus next year as a visiting scholar at Duke!

Post by Olivia Ares, Class of 2025

Putting Stronger Guardrails Around AI

AI regulation is ramping up worldwide. Duke AI law and policy expert Lee Tiedrich discusses where we’ve been and where we’re going.
AI regulation is ramping up worldwide. Duke AI law and policy expert Lee Tiedrich discusses where we’ve been and where we’re going.

DURHAM, N.C. — It’s been a busy season for AI policy.

The rise of ChatGPT unleashed a frenzy of headlines around the promise and perils of artificial intelligence, and raised concerns about how AI could impact society without more rules in place.

Consequently, government intervention entered a new phase in recent weeks as well. On Oct. 30, the White House issued a sweeping executive order regulating artificial intelligence.

The order aims to establish new standards for AI safety and security, protect privacy and equity, stand up for workers and consumers, and promote innovation and competition. It’s the U.S. government’s strongest move yet to contain the risks of AI while maximizing the benefits.

“It’s a very bold, ambitious executive order,” said Duke executive-in-residence Lee Tiedrich, J.D., who is an expert in AI law and policy.

Tiedrich has been meeting with students to unpack these and other developments.

“The technology has advanced so much faster than the law,” Tiedrich told a packed room in Gross Hall at a Nov. 15 event hosted by Duke Science & Society.

“I don’t think it’s quite caught up, but in the last few weeks we’ve taken some major leaps and bounds forward.”

Countries around the world have been racing to establish their own guidelines, she explained.

The same day as the US-led AI pledge, leaders from the Group of Seven (G7) — which includes Canada, France, Germany, Italy, Japan, the United Kingdom and the United States — announced that they had reached agreement on a set of guiding principles on AI and a voluntary code of conduct for companies.

Both actions came just days before the first ever global summit on the risks associated with AI, held at Bletchley Park in the U.K., during which 28 countries including the U.S. and China pledged to cooperate on AI safety.

“It wasn’t a coincidence that all this happened at the same time,” Tiedrich said. “I’ve been practicing law in this area for over 30 years, and I have never seen things come out so fast and furiously.”

The stakes for people’s lives are high. AI algorithms do more than just determine what ads and movie recommendations we see. They help diagnose cancer, approve home loans, and recommend jail sentences. They filter job candidates and help determine who gets organ transplants.

Which is partly why we’re now seeing a shift in the U.S. from what has been a more hands-off approach to “Big Tech,” Tiedrich said.

Tiedrich presented Nov. 15 at an event hosted by Duke Science & Society.

In the 1990s when the internet went public, and again when social media started in the early 2000s, “many governments — the U.S. included — took a light touch to regulation,” Tiedrich said.

But this moment is different, she added.

“Now, governments around the world are looking at the potential risks with AI and saying, ‘We don’t want to do that again. We are going to have a seat at the table in developing the standards.’”

Power of the Purse

Biden’s AI executive order differs from laws enacted by Congress, Tiedrich acknowledged in a Nov. 3 meeting with students in Pratt’s Master of Engineering in AI program.

Congress continues to consider various AI legislative proposals, such as the recently introduced bipartisan Artificial Intelligence Research, Innovation and Accountability Act, “which creates a little more hope for Congress,” Tiedrich said.

What gives the administration’s executive order more force is that “the government is one of the big purchasers of technology,” Tiedrich said.

“They exercise the power of the purse, because any company that is contracting with the government is going to have to comply with those standards.”

“It will have a trickle-down effect throughout the supply chain,” Tiedrich said.

The other thing to keep in mind is “technology doesn’t stop at borders,” she added.

“Most tech companies aren’t limiting their market to one or two particular jurisdictions.”

“So even if the U.S. were to have a complete change of heart in 2024” and the next administration were to reverse the order, “a lot of this is getting traction internationally,” she said.

“If you’re a U.S. company, but you are providing services to people who live in Europe, you’re still subject to those laws and regulations.”

From Principles to Practice

Tiedrich said a lot of what’s happening today in terms of AI regulation can be traced back to a set of guidelines issued in 2019 by the Organization for Economic Cooperation and Development, where she serves as an AI expert.

These include commitments to transparency, inclusive growth, fairness, explainability and accountability.

For example, “we don’t want AI discriminating against people,” Tiedrich said. “And if somebody’s dealing with a bot, they ought to know that. Or if AI is involved in making a decision that adversely affects somebody, say if I’m denied a loan, I need to understand why and have an opportunity to appeal.”

“The OECD AI principles really are the North Star for many countries in terms of how they develop law,” Tiedrich said.

“The next step is figuring out how to get from principles to practice.”

“The executive order was a big step forward in terms of U.S. policy,” Tiedrich said. “But it’s really just the beginning. There’s a lot of work to be done.”

Robin Smith
By Robin Smith

Who Really Benefits from Big Bucks College Athletics?

The furious dribbles across the hardwood floors. The seas of blue consuming the stands. Anyone who has ever attended, or even heard of the legendary Duke Vs UNC basketball game likely holds a vivid picture of the intense nature of this game.

While there is little question that this multi-million dollar event is the most beneficial of the year for both programs, a recent collaboration between the faculty from both schools raised the question: Beneficial for whom? 

Friday, Nov. 10, I had the pleasure of attending a sports symposium organized by Duke and UNC with a focus on the exploitive nature of collegiate athletics. Duke hosted, but both schools brought in a multitude of faculty members, attorneys, and media professionals to discuss a wide range of topics regarding the relationship between college sports and the detrimental effects on athletes. Despite the immense range of topics, there was a common consensus among all speakers and attendees of the event: Some things must change. 

Panelists (l-r) Victoria Jackson, Maddie Salamone, Olu Kopano, and Payton Barish.

They said there are three major problems that currently plague the world of college athletics: the lack of representation, the lack of long-term benefits, and most importantly, the illusion of success portrayed to these athletes.  

Among athletes, a lack of representation in decision-making spheres appears to be a double-sided problem. Any remedy seems far-fetched without major structural changes.

A number of decision-making bodies exist for the purpose of addressing athletic issues and decisions. One of the most notable is the NCAA’s Student-Athlete Advisory Committee (SAAC), a representative body created for the purpose of granting athletes a voice. However, its limited scope, the athletes’ lack of knowledge on certain issues, and the lack of authority granted to the athletes’ decisions highlight the conference’s inability to serve as a proper representative body.

Many attribute this lack of representation to the fact that athletes are stretched far too thin, stripping them of the time needed to truly understand the expectations of the rules established by the NCAA. Symposium speakers argued that time and resources need to be built into their schedules, and not used as an extra burden, to grant them clarity on their rights, structural changes, and shifts in power that affect them. 

Panelists also said many athletes emerge from college without developing fundamental life skills such as being able to do their own taxes. Many are left unable to properly afford to manage injuries sustained in college as they aren’t granted any long-term/lifelong healthcare services. And many international athletes are unequipped to deal with the visa-based issues  that may arise from an inability to not only manage expectations set by their sport but also those set by their schools, and even ICE.

Throughout the symposium, a common point made was the fact that there are abundant staff present for the development of the game, but few staff for the development of the athletes as individuals.

This idea formed the second consensus of the discussion: there needs to be a more intentional focus on the resources for athletes, not only based in athletic performance, but also within the scope of mental, physical and long-term health across the board. 

Finally, the illusion of success offered to athletes was a major grievance expressed during the symposium. When signing athletes on to the team, it is customary for recruiters to essentially promise athletes an idea of future success, whether it be through going pro or earning financial liberation. This, however, has proven to not be the case for everyone, as most careers end after those four years of college. This idea is detrimental to athletes who’s intense dedication and tunnel vision toward these goals often prevent them from developing a Plan B. Many become susceptible to difficulties recovering from this, fueled by a lack of resources and representation. 

While athletes are now able to receive compensation for their “names, images and likenesses” (NIL), it is still breadcrumbs compared to the amount going to coaches and staff. This illusion is fueled by scholarships and third-party sponsorships that allow the parties currently bringing in million dollars salaries to under-compensate the source of this income: the athletes themselves. Many at the symposium concluded that this was a job for the athletes to fix, while others claimed that this problem belonged to the coaches, recruiters, and universities. Both parties, however, agreed that this change must come immediately, or these issues will continue to hurt many more athletes in the long run. 

Keynote speaker Dr. Victoria Jackson of Arizona State University during her opening statements.

By Gabrielle Douglas, Class of 2027

Most Highly Cited: 30 for ’23

It’s that most wonderful time of the year: The official list of Clarivate’s Most Highly Cited Scientists came out this morning.  Scientists all over the world came racing down the stairs in their PJs to see if Clarivate had left a treat under the tree for them.

L-R: Odgers, Scolnic, Dong, Hernandez, Harrington, Smith, Ostrom and Lopes.

Good news – there are 30 Duke names on the list!

Being highly cited is a point of pride for researchers. To make the cut, a paper has to be ranked in the top 1 percent for its field for the last decade. Clarivate’s “Institute for Scientific Information” crunches all the numbers.

Mostly, the names on this year’s list of Duke authors are the usual titans. Oddly, some returning names have changed categories since last year — but that’s okay, they’re still important.

And there are three fresh faces: Cardiologist Renato Delascio Lopes, MD Ph.D., who studies atrial fibrillation; David R. Smith Ph.D. of physics and electrical engineering, who’s a leading light in the field of metamaterials; and Dan Scolnic Ph.D. of physics, who’s measuring the expansion of the universe and trying to figure out the dark energy that apparently drives it.

Five of the Duke names on the list this year are co-authors in the Terrie Moffit and Avshalom Caspi lab, a hugely influential group of psychologists and social scientists. Honnalee Harrington, Renate Houts, Caspi, Moffitt, and UC Irvine professor and Duke adjunct Candice Odgers are studying human development from cradle to grave using two cohorts of life-long study participants in New Zealand and England.

Two other longitudinal scientists, Jane Costello and William Copeland of the Great Smoky Mountains Study, are also on the list.

There are 6,938 highly cited scientists this year, from 69 countries and regions. Several appear in more than one division. The United States still dominates with 38 percent of the honorees, but Chinese scientists are on the rise at 16 percent.

The most highly cited Duke authors are:

Biology and Biochemistry

Charles A. Gersbach

Clinical Medicine

Christopher Bull Granger             

Adrian F. Hernandez      

Renato D. Lopes              

Cross-Field

Stefano Curtarolo

Xinnian Dong    

HonaLee Harrington

Renate Houts   

Tony Jun Huang               

Ru-Rong Ji

Robert Lefkowitz

Jason Locasale  

David B. Mitzi    

Christopher B. Newgard               

Michael J. Pencina    

Bryce B. Reeve                      

Pratiksha I. Thakore       

Mark R. Wiesner              

Microbiology    

Barton F. Haynes

Neuroscience and Behavior

Quinn T. Ostrom                              

Pharmacology and Toxicology

Evan D. Kharasch             

Physics

David R. Smith  

Plant and Animal Science

Sheng Yang He                 

Psychiatry and Psychology

Avshalom Caspi                

E. Jane Costello

Terrie E. Moffitt

Space Science  

Dan Scolnic        

Duke Affiliated:

Cross Field

Po-Chun Hsu – University of Chicago, Adjunct Assistant Professor in Mechanical Engineering and Materials Science at Pratt School of Engineering

Candice Odgers, UC Irvine, Adjunct at Duke

Environment and Ecology

Robert B. Jackson, Stanford University, Adjunct Professor of Earth and Ocean Science at Nicholas School of the Environment

William E. Copeland, University of Vermont, adjunct in psychiatry and behavioral sciences, School of Medicine.

Page 3 of 102

Powered by WordPress & Theme by Anders Norén