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Sarah Avery

DURHAM, N.C. – Glioblastoma brain tumors are especially perplexing. Inevitably lethal, the tumors occasionally respond to new immunotherapies after they’ve grown back, enabling up to 20% of patients to live well beyond predicted survival times.

What causes this effect has long been the pursuit of researchers hoping to harness immunotherapies to extend more lives.

New insights from a team led by Duke’s Preston Robert Tisch Brain Tumor Center provide potential answers. The team found that recurring glioblastoma tumors with very few mutations are far more vulnerable to immunotherapies than similar tumors with an abundance of mutations.

The finding, appearing online Jan. 13 in the journal Nature Communications, could serve as a predictive biomarker to help clinicians target immunotherapies to those tumors most likely to respond. It could also potentially lead to new approaches that create the conditions necessary for immunotherapies to be more effective.

“It’s been frustrating that glioblastoma is incurable and we’ve had limited progress improving survival despite many promising approaches,” said senior author David Ashley, M.D., Ph.D., professor in the departments of Neurosurgery, Medicine, Pediatrics and Pathology at Duke University School of Medicine.

“We’ve had some success with several different immunotherapies, including the poliovirus therapy developed at Duke,” Ashley said. “And while it’s encouraging that a subset of patients who do well when the therapies are used to treat recurrent tumors, about 80% of patients still die.”

Ashley and colleagues performed genomic analyses of recurrent glioblastoma tumors from patients treated at Duke with the poliovirus therapy as well as others who received so-called checkpoint inhibitors, a form of therapy that releases the immune system to attack tumors.

In both treatment groups, patients with recurrent glioblastomas whose tumors had few mutations survived longer than the patients with highly mutated tumors. This was only true, however, for patients with recurrent tumors, not for patients with newly diagnosed disease who had not yet received treatment.

“This suggests that chemotherapy, which is the standard of care for newly diagnosed glioblastoma, might be altering the inflammatory response in these tumors,” Ashley said, adding that chemotherapy could be serving an important role as a primer to trigger an evolution of the inflammation process in recurrent tumors.

Ashley said the finding in glioblastoma could also be relevant to other types of tumors, including kidney and pancreatic cancers, which have similarly shown a correlation between  low tumor mutations and improved response to immunotherapies. 

In addition to Ashley, study authors include Matthias Gromeier, Michael C. Brown, Gao Zhang, Xiang Lin, Yeqing Chen, Zhi Wei, Nike Beaubier, Hai Yan, Yiping He, Annick Desjardins, James E. Herndon II, Frederick S. Varn, Roel G. Verhaak, Junfei Zhao, Dani P. Bolognesi, Allan H. Friedman, Henry S. Friedman, Frances McSherry, Andrea M. Muscat, Eric S. Lipp, Smita K. Nair, Mustafa Khasraw, Katherine B. Peters, Dina Randazzo, John H. Sampson, Roger E. McLendon and Darell D. Bigner.

The study received support from The Brain Tumor Research Charity, Jewish Communal Fund, Circle of Service Foundation, Uncle Kory Foundation, Department of Defense (W81XWH-16-1-0354) and the National Institutes of Health (R35CA197264, P01CA154291, P50CA190991, R01NS108773, R01NS099463, R21NS112899, P01CA225622, F32CA224593). Support was also received through the Angels Among Us fundraising event and a gift from the Asness Family.

Authors Gromeier, Brown, Desjardins, Bolognesi, Henry Friedman, Nair, Sampson, Bigner and Ashley own intellectual property related to the poliovirus therapy, which has been licensed to Istari Oncology, Inc. Gromeier, Desjardins, Bolognesi, Allan Friedman, Henry Friedman and Bigner hold equity in Istari Oncology, Inc. Additional disclosures are provided in the published study.

 

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Stephanie Lopez

DURHAM, N.C. -- Today marked the beginning of the vaccination rollout for hundreds of thousands of Duke Health patients and community members who will qualify for the next phase of COVID-19 vaccination directed by the North Carolina Department of Health and Human Services. 

Duke Health vaccinated its first person outside of the state’s 1a category, ushering in a new phase of the rollout that will extend over the coming weeks and months.  Vaccinations are by appointment only and in limited supply. Over time, all will have access to the vaccine.
 
Roy Cuttino, 75, became Duke’s first to receive the vaccine under the state’s 1b guidelines, which includes adults 75 years or older and frontline essential workers. The retired IBM employee received his first dose by appointment at 7 a.m. today. 
 
“I weighed pieces of information a while back,” Cuttino said, “but with COVID being as bad as it is, I knew the opinion of deciding to take the vaccine, as opposed to not taking it, was very important.”
 
Duke Health is contacting patients and working with community groups to invite people 75 and older to make appointments as supplies of the vaccine are received from NC DHHS. Cuttino tells us he received word that he was eligible to receive the shot yesterday.
 
“My reaction was, I’m ready,” Cuttino said, “because not only did I think getting the vaccine is important to stay safe, but having it here at Duke, an institution like Duke, you know, I feel much more comfortable.”
 
84-year-old Joseph Falco and his wife 79-year-old Barbara Falco were also among the first to be vaccinated at Duke under the expanded rollout.
 
The Falcos’s daughter, Dina White, watched as the couple received their first doses. She cheered them on for moral support, and rushed to hug her mother, with tears in her eyes, right after the nurse affixed a bandage over the injection site.
 
“This moment was really emotional for me and for my parents I think, but more so for me as a daughter, trying to protect them every day,” White said. “It’s been a really rough year for our family, and I think for everybody’s family, and I’m thankful that today they were able to take this first step. It’s one more way to stay safe.”
 
The 1b vaccinations took place on the Duke University campus, where Duke Health plans to vaccinate at least 85 people today who qualify under the new guidelines, with vaccination volumes increasing as supplies allow. 

“This is an exciting day for Duke Health, and we're proud to be among the first to administer vaccines to patients and community members over the age of 75,” said Thomas Owens, M.D., president of Duke University Hospital and senior vice president of Duke University Health System.

“Safe and effective vaccines are essential in our fight against the COVID-19 pandemic, since they provide another way to stay safe and prevent the spread of infection. We are following the state's plan for distribution, and we are committed to providing equitable access to vaccination for our patients and the community. 

“Since supply is limited and it will take some time to provide vaccinations for everyone who wants them, we urge patients and community members to please be patient, but we are grateful to see the excitement from these first individuals who have received their vaccination.”
 
The health system will continue to vaccinate its employees who qualify under the state’s 1a guidelines at Duke University Hospital, Duke Regional Hospital and Duke Raleigh Hospital.

People ages 75 or older are eligible to receive the vaccine. For more information visit this site: https://www.dukehealth.org/covid-19-update/covid-19-vaccine-update

 

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Sarah Avery

DURHAM, N.C. – An aggressive COVID-19 surveillance and testing effort at Duke University was highly effective in minimizing the spread of the disease among students on campus, according to a case study appearing Tuesday in the CDC’s Morbidity and Mortality Weekly Report. 

The successful Duke campaign was launched before the start of the semester. Ahead of arriving on campus, all enrolled students were required to self-quarantine for 14 days, sign a code of conduct pledge to obey mask-wearing and social distancing guidelines and have a COVID test.

Once classes started, the university conducted regular surveillance testing using pooled samples to conserve resources, daily symptom self-monitoring, contact tracing with quarantine, and regular testing for those who were symptomatic or had been exposed to someone with COVID-19. 

The result: The average per-capita infection prevalence among students was lower than in the surrounding community, and large outbreaks seen on other campuses were avoided. Overall, combined testing approaches identified 84 cases among students, with 51% occurring among asymptomatic people. 

“Our experience at Duke shows that combined risk reduction strategies and surveillance testing can significantly lower transmissions on college campuses and beyond,” said lead author Thomas Denny, professor of medicine at Duke University School of Medicine and chief operating officer at the Duke Human Vaccine Institute. 

Denny said the Duke experience relied on a combination of strategies. In addition to the testing and quarantining before students arrived on campus, the measures included: 

·       Creating a smartphone app for daily symptom self-monitoring and reporting;

·       Having students living on campus conduct twice-weekly tests themselves, using kits with prelabeled tubs, swabs and specimen bags; off-campus students tested at least once a week;

·       Strategically locating sites across campus to collect testing samples from students;

·       Batching samples in a process called pooled testing, with five samples grouped and analyzed for the presence of the virus. Batches that registered positives were then broken into individual samples and tested separately to identify the source of the positive. The Duke Human Vaccine Institute processed 80,000 samples from August-October. 

“By late summer there were still things we didn’t fully understand about SARS-CoV-2 transmission, so there was some uncertainty going into the fall semester,” said Steve Haase, associate professor in Duke’s departments of Biology and Medicine. “Over the course of the semester we’ve learned many things, including that it is possible to limit the spread of the virus and create a safer environment for our students to have that invaluable on-campus learning experience.” 

“Thanks to the collaboration of literally hundreds of dedicated individuals, along with the high level of engagement by our students, we have had a very positive fall,” said co-author Kyle Cavanaugh, vice president of Administration at Duke University. “Our dynamic surveillance testing strategy has served as a key component of our experience that has also included very high compliance with masking, social distancing and other key public health behaviors.” 

In addition to Denny, Haase and Cavanaugh, study authors include Laura Andrews, Mattia Bonsignori, Michael B. Datto, Anastasia Deckard, C. Todd Demarco, Nicole DeNaeyer, Carol A. Epling, Thaddeus Gurley, Chloe Hallberg, John Harer, PhD, Charles L. Kneifel, Mark J. Lee, Raul Louzao, M. Anthony Moody; Zack Moore, Christopher R. Polage, Jamie Puglin, P. Hunter Spotts, John A. Vaughn and Cameron R. Wolfe. 

Note to Editors:  

Duke has prepared a seven-minute YouTube video explaining the pool testing program: https://youtu.be/GezlHXfhCBA 

Duke officials and researchers involved in this project will be available to answer questions during a Zoom media briefing from 11 a.m.-noon (ET) Wednesday, Nov. 18. Register here.

 

 

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Sarah Avery

DURHAM, N.C. -- Children who are later diagnosed with autism and/or attention deficit hyperactivity disorder visit doctors and hospitals more often in their first year of life than non-affected children, suggesting a potential new way to identify the conditions early.

The findings from Duke Health researchers, appearing online Oct. 19 in the journal Scientific Reports, provide evidence that health care utilization patterns in a baby’s first year can be gleaned from electronic medical records, serving as a roadmap to provide timely diagnoses and treatments that could improve outcomes and reduce health care costs.

Autism spectrum disorder (ASD) affects approximately 1.5% of children in the United States and attention deficit hyperactivity disorder (ADHD) affects about 11% of U.S. children. ADHD symptoms are also present in up to 60% of children with ASD. The diagnoses are associated with higher utilization of health care services, at great expense to families.

“This study provides evidence that children who develop autism and ADHD are on a different path from the beginning,” said lead author Matthew Engelhard, M.D., Ph.D., a senior research associate at Duke. “We have known that children with these diagnoses have more interactions with the health care system after they’ve been diagnosed, but this indicates that distinctive patterns of utilization begin early in these children’s lives. This could provide an opportunity to intervene sooner.”
“We know that children with ASD and ADHD often receive their diagnosis much later, missing out on the proven benefits that early interventions can bring,” said Geraldine Dawson, Ph.D., director of the Duke Center for Autism and Brain Development and the Duke Institute for Brain Sciences. “Owing to the brain’s inherent malleability -- its neuroplasticity -- early detection and intervention are critical to improving outcomes in ASD, especially in terms of language and social skills.”
Engelhard and colleagues, including senior authors Dawson and Scott Kollins, Ph.D., used 10 years of data collected from the electronic health records of nearly 30,000 patients, primarily at Duke University Health System, who had at least two well-child visits before age one.

Patients were grouped as having later been diagnosed with ASD, ADHD, both conditions or no diagnosis. The researchers then analyzed the first-year records for hospital admissions, procedures, emergency department visits and outpatient clinical appointments. 

For the children who were later found to have one or both of the diagnoses, their births tended to result in longer hospital stays compared to children without the disorders. 

Children later diagnosed with ASD had higher numbers of procedures, including intubation and ventilation, and more outpatient specialty care visits for services such as physical therapy and eye appointments. 

Children who were later found to have ADHD had more procedures, notably including blood transfusions, as well as more hospital admissions and more emergency department visits.

Studies show that treatments for these disorders work best when they begin early in a child’s life, Dawson said. Understanding that there are signals available in a child’s electronic health record could help lead to earlier and more targeted therapies.

“We are hopeful that these early utilization patterns can eventually be combined with other sources of data to build automated surveillance tools to help parents and pediatricians identify which kids will benefit most from early assessment and treatment,” Kollins said.

The researchers said they plan to conduct additional analyses to explore more fully what specific health concerns prompted the extra doctor and hospital visits.

“We want to understand these distinctions in greater detail and identify them as soon as possible to make sure children have access to the resources they need,” Engelhard said.

In addition to Engelhard, Kollins and Dawson, study authors include Samuel I. Berchuck, Jyotsna Garg, Ricardo Henao, Andrew Olson and Shelley Rusincovitch.

The study received funding from the National Institute of Child Health and Human Development (P50HD093074), the National Institute of Mental Health (R01MH121329), National Institute on Drug Abuse (K24DA023464) and Duke FORGE.
 

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Sarah Avery

DURHAM, N.C. – A team of Duke Health scientists have identified biomarkers that accurately identify numerous viral infections across the clinical stages of disease, advancing a potential new way to guide treatment, quarantine decisions, and other clinical and public health interventions in the setting of endemic and pandemic infectious diseases. 

The blood-based test uses a gene expression assay to correctly predict nine different respiratory viral infections -- including influenza, enterovirus, adenovirus and coronaviruses known to cause common colds. It shows the body’s genes responding to a pathogen before symptoms are present.

“While our study was conducted prior to the COVID-19 pandemic, our data show that these biomarkers of viral infection are present and detectable before clinical disease develops and thus could form the basis of novel approaches to early identification and management of emerging viral outbreaks and pandemics,” said Micah McClain, M.D., Ph.D., associate professor in the Department of Medicine at Duke and lead author of a study publishing online Sept. 24 in The Lancet Infectious Diseases.

McClain said additional studies are ongoing to determine the genomic markers’ effectiveness in detecting SARS-CoV-2, the strain of coronavirus that causes COVID-19. Preliminary findings from those studies have been posted on a public website and the data are currently under peer review. 

McClain and colleagues in the Duke Center for Applied Genomics and Precision Medicine have been working for years to develop and fine-tune tests that quickly distinguish bacterial infections from viral infections – a public health need to assure that antibiotics are properly prescribed. Antibiotics are ineffective against viruses, and their improper use has fueled the rise of treatment-resistant bacteria. 

The current study advances that work and provides a clinically applicable approach to not only identify a viral infection, but to do so before symptoms develop and often before standard viral PCR tests become positive.

The researchers enrolled 1,465 college students at Duke between 2009 and 2015 and monitored them for the entire academic year for the presence and severity of eight symptoms of respiratory tract infections. Participants filled out a daily web-based survey, rating symptoms on a scale of 0–4. 

Index cases were defined as study participants who reported a 6-point increase in a cumulative daily symptom score. Biospecimens were collected from 264 index cases with clinical illness, of whom 150 had a respiratory viral cause confirmed by traditional PCR testing of nasopharyngeal samples. 

Close contacts of the sick study participants – roommates, close friends and partners considered to be at increased risk of developing symptoms -- were monitored for five days for symptoms and viral shedding. The researchers also measured gene expression responses using the blood-based 36-gene RT-PCR assay. 

Of the 555 close contacts enrolled and sampled, 162 developed symptoms of respiratory tract infection during observation, of whom 106 had confirmed illness based on traditional viral PCR testing. 

For most of the study participants, the gene expression test accurately predicted viral infection up to three days before maximum symptoms, often prior to any symptom onset or detectable viral shedding.

For influenza, the assay was 99% accurate in predicting illness, 95% accurate for adenovirus and 93% accurate for the cold-causing coronavirus strain.

“Our study demonstrates the potential of this gene expression-based testing approach,” McClain said. “We can use the body’s natural immune response signals to detect a viral infection with a high degree of accuracy even at a time when people have been exposed to the pathogen but don’t yet feel sick.”

In addition to McClain, study authors include Florica J. Constantine, Bradly P. Nicholson, Marshall Nichols, Thomas W. Burke, Ricardo Henao, Daphne C Jones, Lori L. Hudson, L. Brett Jaggers, Timothy Veldman, Anna Mazur, Lawrence P. Park, Sunil Suchindran, Ephraim L. Tsalik, Geoffrey S. Ginsburg, Christopher W. Woods.

The study received funding support from the U.S. Defense Advanced Research Projects Agency.

Study authors Burke, Tsalik, Ginsburg and Woods have financial relationships with Predigen, an emerging company in precision medicine that is a spin-out from Duke University. Predigen was founded to advance the technology to clinical use.
 

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Sarah Avery

DURHAM, N.C. – Financial strains such as high debt, low income and unemployment are associated with suicide attempts and should be considered key factors when assessing mental health interventions, a new study from Duke Health researchers shows.

While the study was undertaken before the COVID-19 pandemic, the findings are especially relevant within the context of the economic downturn triggered by the spread of the virus.

“Our research shows that financial stressors play a major role in suicides, and this needs to be recognized and appreciated in light of the unprecedented financial instability triggered by the COVID-19 pandemic,” said Eric Elbogen, Ph.D., a professor of Psychiatry and Behavioral Sciences at Duke, and lead author of a study publishing online Sept. 3 in the American Journal of Epidemiology.

“We could well be seeing a dramatic increase in suicide rates moving forward,” Elbogen said.

Elbogen and colleagues noted that financial problems have long been considered a risk factor for suicide, but often as a contributing factor amid other mental health issues, such as substance abuse and depression, and not as a driving force. Additionally, suicide rates have risen in recent years regardless of economic conditions, although they are higher during downturns. 

To determine whether financial strain was a singular, primary factor leading to suicidal thoughts and self-harm, Elbogen and colleagues used nationally representative data of U.S. adults interviewed from 2001-02, followed by a second interview of the same respondents in 2004-05.

They found cumulative financial strain predicted suicide attempts that occurred between the two study periods. Financial debt/crisis, unemployment, past homelessness and lower income were each associated with subsequent suicide attempts. 

Study respondents who experienced those four financial strains had 20 times higher predicted probability of attempting suicide compared to respondents who experienced none of the financial problems. The results were similar for people having suicidal thoughts. 

“Our study, while assessing this connection using pre-COVID data, shows a direct risk that should raise alarm as millions of people experience economic hardship resulting from the pandemic,” Elbogen said. He pointed to recent U.S. Census Bureau data showing that half of Americans have experienced loss in employment income and over a quarter of Americans are now experiencing housing insecurity as a result of the pandemic.

“Although the ultimate health impact of COVID-19 is still unknown, it is all but certain that the longer infections spread, there will likely be more people who will experience significant financial strain resulting from work stoppages and disruption,” Elbogen said.

In addition to Elbogen, study authors include Megan Lanier, Ann Elizabeth Montgomery, Susan Strickland, H. Ryan Wagner and Jack Tsai. Elbogen, Montgomery, and Tsai are affiliated with the Department of Veterans Affairs, National Center on Homelessness among Veterans and Strickland is affiliated with the Department of Veterans Affairs, Office of Mental Health and Suicide Prevention.

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Sarah Avery

DURHAM, N.C. – Duke physician Eric Westman was one of the first champions of masking as a means to curtail the spread of coronavirus, working with a local non-profit to provide free masks to at-risk and under-served populations in the greater Durham community.

But he needed to know whether the virus-blocking claims mask suppliers made were true, to assure he wasn’t providing ineffective masks that spread viruses along with false security. So he turned to colleagues in the Duke Department of Physics: Could someone test various masks for him? 

Martin Fischer, Ph.D., a chemist and physicist, stepped up. As director of the Advanced Light Imaging and Spectroscopy facility, he normally focuses on exploring new optical contrast mechanisms for molecular imaging, but for this task, he MacGyvered a relatively inexpensive apparatus from common lab materials that can easily be purchased online. The setup consisted of a box, a laser, a lens, and a cell phone camera. 

In a proof-of-concept study appearing online Aug. 7 in the journal Science Advances, Fischer, Westman and colleagues report that the simple, low-cost technique provided visual proof that face masks are effective in reducing droplet emissions during normal wear.

“We confirmed that when people speak, small droplets get expelled, so disease can be spread by talking, without coughing or sneezing,” Fischer said. “We could also see that some face coverings performed much better than others in blocking expelled particles.”

Notably, the researchers report, the best face coverings were N95 masks without valves – the hospital-grade coverings that are used by front-line health care workers. Surgical or polypropylene masks also performed well.

But hand-made cotton face coverings provided good coverage, eliminating a substantial amount of the spray from normal speech.

On the other hand, bandanas and neck fleeces such as balaclavas didn’t block the droplets much at all.

“This was just a demonstration - more work is required to investigate variations in masks, speakers, and how people wear them – but it demonstrates that this sort of test could easily be conducted by businesses and others that are providing masks to their employees or patrons,” Fischer said.

“Wearing a mask is a simple and easy way to reduce the spread of COVID-19,” Westman said. “About half of infections are from people who don’t show symptoms, and often don’t know they’re infected. They can unknowingly spread the virus when the cough, sneeze and just talk.

“If everyone wore a mask, we could stop up to 99% of these droplets before they reach someone else,” Westman said. “In the absence of a vaccine or antiviral medicine, it’s the one proven way to protect others as well as yourself.”

Westman and Fischer said it’s important that businesses supplying masks to the public and employees have good information about the products they’re providing to assure the best protection possible.

“We wanted to develop a simple, low-cost method that we could share with others in the community to encourage the testing of materials, masks prototypes and fittings,” Fischer said. “The parts for the test apparatus are accessible and easy to assemble, and we’ve shown that they can provide helpful information about the effectiveness of masking.”

Westman said he put the information immediately to use: “We were trying to make a decision on what type of face covering to purchase in volume, and little information was available on these new materials that were being used.”

The masks that he was about to purchase for the “Cover Durham” initiative? 

“They were no good,” Westman said. “The notion that ‘anything is better than nothing’ didn’t hold true.”

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Sarah Avery

DURHAM, N.C. – Athletes are always looking for ways to enhance their natural abilities, and spend hours performing training exercises that build muscle memory, speed, endurance and coordination.

But exercising the eyes? In a study conducted by Duke Health researchers, a concerted training regimen for the eyes shows the potential to help athletes and others improve coordination skills.

Publishing in the journal Psychology of Sport and Exercise, the researchers demonstrate that vision training for a group of college baseball players led to improvements in their batting practice performance.

“This was a first-of-kind study comparing players who were randomized to either undergo dynamic vision training drills or placebo drills that were matched in difficulty, but did not alter vision,” said senior author Greg Appelbaum, Ph.D., associate professor in the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine. “While the study size was small, the methodology was rigorous and we were able to determine a benefit from the intervention compared to the placebo.”

Appelbaum and colleagues, including researchers at Indiana University, enrolled 24 collegiate baseball players on the Duke and Indiana varsity teams. About half the players were randomly assigned to undergo regular circuits of vision training exercises that got more difficult as they progressed, including:

• Tossing and catching a ball wearing eyewear that created a strobe effect to improve hand-eye coordination.

• Assessing when a runway of fast, moving lights would intersect from opposite directions in a drill designed to enhance anticipatory skills.

• Using computer screens to track the movement of small targets over space or between screens to build dynamic and binocular visual skills.

Players assigned to the placebo group performed visual tasks that were designed to be similarly engaging but ineffective, such as doing binocular training exercises with just one eye. Players were unaware of whether they were receiving the active intervention or the placebo.

Prior to and after the vision training program, which lasted 10 weeks during the off season, the researchers measured the players’ batting performance during instrumented batting practice and measured the players’ visual skills using a battery of digital tasks. In addition, the researchers obtained batting statistics from the players for the NCAA games they played in the season before and after the intervention.

Results demonstrated that the players who underwent the active intervention showed significant improvements in batting practice, hitting the ball further and with a higher arc, compared to those from the placebo group. While no significant improvements were identified in the actual game statistics, the authors said availability of these data were limited, because many of the enrolled players did not play during the seasons before or after the visual training occurred.

“The act of hitting a pitched baseball is widely considered to be among the most challenging activities in all of sports,” Appelbaum said. “Our study demonstrates that vision training can lead to better batting performance. These findings are also likely not limited to baseball and, in fact, could be applied to other sports and activities in which people need to make rapid decisions on visual information such as marksmanship or tennis.”

Appelbaum said the research was funded by the U.S. Army Research Office (W911NF-15-1-0390), which has interest in using these training approaches to help soldiers and others maintain visual abilities in high-demand situations.

"This project is a good example of when Army investments show dual-use benefits for broader society,” said Dr. Frederick Gregory, program manager, Army Research Office, an element of the U.S. Army Combat Capabilities Development Command’s Army Research Laboratory. “Supporting rigorous testing of methods that are intended to augment cognitive performance and resilience for the soldier will undoubtedly benefit first-line responders and other members of society who also do very important jobs under pressure."

In addition to Appelbaum, study authors include Sicong Liu, Lyndsey M. Ferris, Susan Hilbig, Edem Asamoa, John L. LaRue, Don Lyon, Katie Connolly and Nicholas Port.

 

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B-roll of athletes participating in the training is available:

https://duke.box.com/s/v2engtfdxir9iv783t7ddqhz3igj520w

KANNAPOLIS, N.C. -- Duke’s MURDOCK Study has launched a COVID-19 research project to follow the health of hundreds of North Carolina volunteers for several months. The study will also test a sub-group for COVID-19 infection and potential immunity to the novel coronavirus that causes the disease.

The MURDOCK Cabarrus County COVID-19 Prevalence and Immunity (C3PI) Study is a partnership with the Duke University School of Medicine and North Carolina Department of Health and Human Services to understand the community prevalence of COVID-19 and to monitor the disease over time. Enrollment began June 9.

Study participants complete online surveys about their health every two weeks. This summer, a smaller cohort will do at-home nasal swabs to test for COVID-19 infection and give blood samples to look for antibodies that indicate prior infection and could indicate immunity.

Volunteers for the project are already enrolled in the MURDOCK Study, a landmark community-based health research initiative in Cabarrus County. Founded in 2008, the MURDOCK Study has more than 12,500 participants and is based at the Duke Clinical and Translational Science Institute (CTSI) office in Kannapolis, where a team of Duke employees launched the COVID-19 study in a matter of weeks.

“We can quickly and efficiently engage the MURDOCK Study cohort and our team in Kannapolis to ask and answer important scientific questions, as in the case of COVID-19,” said L. Kristin Newby, M.D., principal investigator for the MURDOCK C3PI Study and faculty director for Duke CTSI’s Translational Population Health Research group. “Our participants are highly committed to helping move research forward and to helping their community. The MURDOCK Study is uniquely suited to respond, recruit, and generate data during this kind of public health emergency.”

The study will follow the health and well-being of volunteers for at least six months and examine how the COVID-19 pandemic has affected them and their households. Researchers are especially interested in learning more about the behaviors of both symptomatic and asymptomatic people over time.

“Understanding the impact of disease across the state and among our most vulnerable populations is essential to effectively target public health interventions,” said Chris Woods, M.D., co-principal investigator for the MURDOCK C3PI Study and co-director for Duke’s Hubert-Yeargan Center for Global Health.

“This partnership between the longstanding MURDOCK program and NCDHHS will provide some of those necessary data regarding infection rate over time,” Woods said. “This is also a great model for additional public-private collaborations to reduce disparities in health.”

The MURDOCK C3PI Study is part of a statewide effort to learn more about what percentage of people have no symptoms and better understand the true number of COVID-19 infection in the state. The North Carolina Department of Health and Human Services is also collaborating with the University of North Carolina at Chapel Hill and East Carolina University on similar research to assess COVID-19 prevalence in Chatham and Pitt counties.