As an academic research institution, Emory’s faculty and staff conduct studies across every discipline, from the sciences to the humanities. Here’s a sample of recent grant awards and the work they will support, plus highlights from some published research findings.
Grants highlighted:
- Assessing a method to control Aedes-borne diseases
- Cystic Fibrosis Foundation support of palliative care research
- COVID-19 contact tracing app development
- Improving global health campaigns
- Ethics of artificial intelligence in field of radiology
Publications highlighted:
- Pharmacies under-prescribing buprenorphine in rural Kentucky
- Artificial intelligence to detect optic nerve abnormalities
- Trends in outpatient procedural sedation from 2007–2018
- Measles persistence prior to vaccines
- Examining household air pollution
- A new “inequality” lottery theory
- The non-existent “reasonable person” standard
- Ethical considerations facing cardiothoracic surgeons
Grants
Assessing a method to control Aedes-borne diseases
Researchers from Emory College, the Emory School of Medicine and Rollins School of Public Health received a $6.5 million grant to quantify the epidemiological impacts of targeted indoor residual spraying (TIRS) on viral diseases spread by Aedes aegypti mosquitos, including dengue fever, Zika, chikungunya and yellow fever. The award is from the National Institute of Allergy and Infectious Diseases.
The five-year project, set in Merida, Mexico, will begin in August. Emory will lead a consortium in a randomized control trial to test TIRS — spraying where the mosquitos rest inside homes. Previous Emory research identified TIRS as a promising method to reduce disease transmission. Combining data from epidemiology and entomology with a randomized clinical trial will provide the highest level of evidence needed to determine the effectiveness of TIRS.
The principal investigator for the project is Gonzalo Vazquez-Prokopec, an associate professor in the Department of Environmental Sciences. Emory co-investigators include Matthew Collins, assistant professor in the School of Medicine’s Division of Infectious Diseases, and Lance Waller, professor of biostatics at Rollins.
Cystic Fibrosis Foundation support of palliative care research
Emory researchers received a three-year, $3.1 million grant from the Cystic Fibrosis Foundation to conduct a five-site, international clinical trial of specialty palliative care for adults with cystic fibrosis.
The study is the first trial of specialty palliative care in CF, and could lead to important changes regarding the standard of care received by people with CF. Dio Kavalieratos, associate professor and director of research and quality in Emory’s Division of Palliative Medicine, is the lead investigator of the first-of-its-kind trial, which hopes to enroll 264 adults with cystic fibrosis and their caregivers.
COVID-19 contact tracing app development
Researchers from Emory College’s Department of Computer Science, the School of Medicine, Nell Hodgson School of Nursing and Rollins School of Public Health, along with two other institutions, received a $160,000 grant from the National Science Foundation to develop a real-time contact tracing app. The proposed app will guard the privacy of individuals who choose to use it, while also allowing them to monitor their risk of exposure to the virus that causes COVID-19.
The app will be designed to balance public health needs and privacy protection by allowing anonymous users to control and refine how frequently their data is captured and the amount of detail in the data. The research team is investigating additional protocols, such as differential privacy-based perturbation and encryption, for further privacy enhancement and will explore privacy-preserving mechanisms to share the collected data for research studies.
The principal investigator for the one-year project is Li Xiong, professor in Emory’s Department of Computer Sciences and the School of Medicine’s Department of Biomedical Informatics. Co-investigators at Emory are Vicki Hertzberg, professor in the School of Nursing, and Lance Waller, professor in Rollins School of Public Health. Additional collaborators are at the University of Southern California and the University of Texas Health Science Center.
Improving global health campaigns
Jim Lavery, Ph.D., Conrad N. Hilton Chair in Global Health Ethics and Professor in the Rollins School of Public Health and Center for Ethics at Emory University, has received a $100,000 grant from the Bill & Melinda Gates Foundation’s Grand Challenges Explorations program to examine ways to improve global health campaigns.
Lavery says the grant is a good example of how paying explicit attention to ethics in global health programs can also improve program performance. He says that the Research Fairness Initiative (RFI) framework, developed by his grant partners at the Council for Health Research for Development in Geneva, offers a unique conceptual architecture that could guide organizational learning to strengthen campaign partnerships in ways that make them more fair and more effective. Lavery says that such an advance would be very good for global health funders, high-income country researchers and for host country partners and health systems in low and middle-income countries.
Ethics of artificial intelligence in field of radiology
John Banja, medical ethicist at the Center for Ethics, recently was awarded a two-year grant at $50,000 per year from the Advanced Radiology Services Foundation. The grant will fund research, articles and podcasts in the field of radiology as it relates to the ethics of artificial intelligence.
Co-investigators include Richard Duszak, vice chair for health policy and practice in Emory’s Department of Radiology and Imaging Sciences, and Norman Beauchamp, executive vice president of health sciences at Michigan State University.
Publications
Among various kinds of disclosures typically required in research and clinical scenarios, providing risk information to patients and research participants figures prominently. When questions arise over which risks should be disclosed, law and ethics have long proposed that they be disclosed according to what a reasonable person would want to know.
In his cover article of the current issue of the Hastings Center Report, John Banja, a medical ethicist at the Center for Ethics, argues that the “reasonable person standard” has never been up to the task and, in fact, has never been used. He argues that a reasonable person standard does not exist and that Western courts have been using an autonomous person standard to govern risk disclosure all along.
Examining household air pollution
The Rollins School of Public Health, in collaboration with schools of medicine at Johns Hopkins University and Colorado State University, is leading the Household Air Pollution Intervention Network study, a multi-country, randomized, controlled field trial to assess the impact of cleaner burning cooking stoves on household air pollution and health in four low- and medium-income countries.
In a series of three papers published on April 29, 2020, in Environmental Health Perspectives, HAPIN investigators describe the rationale and overall design of the study and the key methods employed. Rollins authors on the papers include Thomas Clasen, Dana Boyd Barr, Kyle Steenland, Ajay Pillarisetti, Jiawen Liao, Jeremy Sarnat, Miles A. Kirby, Howard Chang, Lance Waller, Savannah Gupton and P. Barry Ryan.
Pharmacies under-prescribing buprenorphine in rural Kentucky
Hannah L. F. Cooper, Rollins Chair in Substance Use Disorders, is lead author on a paper published in the International Journal of Drug Policy that looks at buprenorphine dispensing behaviors in rural Kentucky.
Buprenorphine is the first medication for treating opioid disorders (MOUD) that U.S. pharmacists have been charged with dispensing widely. This medication is vital to curbing overdoses, hepatitis C, HIV and other drug-related harms.
Given concerns that harmful drug use may increase vulnerability to COVID-related morbidity and mortality, access to buprenorphine and other MOUD may help reduce community-level burdens of the current pandemic. However, emerging evidence suggests that pharmacists in rural areas are refusing to do so. To investigate this trend, the researchers conducted a qualitative analysis that examined the buprenorphine dispensing behaviors of pharmacists in 12 rural Kentucky counties that are at an epicenter of the U.S. opioid epidemic.
Tunable frictional properties in hydrogels
The Proceedings of the National Academy of Sciences (PNAS) published research by Emory physicists showing that hydrogels have unique, tunable frictional properties. The work was led by Emory alum Nicholas Cuccia while he was an undergraduate in the lab of Justin Burton, Emory associate professor of physics and senior author of the paper.
Hydrogels are materials that live in between the liquid and solid worlds. They consist of a tangled web of long, chain-like molecules surrounded by water, and often are used as mimics of biological materials. The physicists investigated their frictional properties on smooth surfaces and found a rich spectrum of behaviors that can be directly linked to their microscopic properties. Knowing at the molecular level how to control friction gives the ability to change it, or tune it, for various applications. Their results may guide molecular design principles for hydrogel materials including soft contact lenses, artificial joints and soft robotic devices.
Co-authors include Emory alums Suraj Pothineni and Brady Wu and Emory post-doctoral fellow Joshua Mendez-Harper.
Adult visual cortex rapid reorganization
Proceedings of the National Academy of Sciences (PNAS) published a study on the visual cortex by Daniel Dilks, associate professor in Emory’s Department of Psychology, and Emory graduate student Yaseen Jamal.
It is well established that the developing brain has a remarkable capacity for change, but controversy continues about the extent to which such plasticity exists in the adult brain, especially in the adult primary visual cortex. The researchers devised a novel, simple experiment to investigate this question. They used fMRI and behavioral measures while they blocked part of the visual cortex in healthy adult humans simply by patching one eye. Strikingly, within just minutes of deprivation, the visual cortex began responding to visual stimuli that it does not respond to when one eye is not patched.
The results provide the best evidence to date that, not only can the adult primary visual cortex change, it can do so within minutes. The findings may have implications for understanding and treating problems related to vision loss.
Trends in outpatient procedural sedation from 2007–2018
Emory Department of Pediatrics faculty Pradip P. Kamat, Courtney E. McCracken, Harold K. Simon and other researchers looked into trends in outpatient procedural sedation from 2007 to 2018. Pediatric subspecialists routinely provide procedural sedation outside the operating room.
The study aimed to identify significant trends in outpatient procedural sedation using the Pediatric Sedation Research Consortium. The researchers found an increase in pediatric hospitalists providing sedation and a significant decrease in the use of chloral hydrate and pentobarbital by providers. Further studies are required to see if sedation services decrease costs and optimize resource use.
Ethical considerations facing cardiothoracic surgeons
During a pandemic, the primary responsibility of community, government and health care systems is to isolate the disease and slow transmission. Stopping or slowing the spread of disease decreases the number of individuals exposed and mitigates the surge of critically ill patients into health care systems.
Kathy Kinlaw, associate director of Emory’s Center for Ethics and director of the center's program in health sciences and ethics, is the co-author of an article published in The Annals of Thoracic Surgery. She explores the ethical considerations facing cardiothoracic surgeons in pandemics because they possess a unique and highly relevant spectrum of skills that are frequently in short supply during a pandemic.
Measles persistence prior to vaccines
An international team of researchers recently published a study showing that before the introduction of a vaccine, measles could persist in large population centers and spread among sets of smaller towns. Max Lau, assistant professor at the Rollins School of Public Health, was first author of the article, published in the journal Nature Ecology & Evolution.
The model details measles dynamics over 40 years of data collected in England and Wales and provides data on the importance of spatial modeling for the long-term control of global epidemics. This could help inform the long-term public health response to the current COVID-19 pandemic.
Encoding pitch changes in vocalizations
The Journal of Neuroscience is publishing research from Emory’s Department of Biology on how the brain encodes pitches in sound that can carry meaning. Robert Liu, a professor in Emory’s Department of Biology and Center for Translational Social Neuroscience, is senior author of the paper and first author is Kelly Chong, a graduate student in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory.
A whistle’s pitch can convey meaning, as in whistle pitch variations used to train dogs for specific commands. Some human languages, such as Mandarin, also use pitch trajectories to distinguish sound categories. How and where the brain records these pitch trajectories as their meaning is learned is not well understood, especially for short duration sounds.
The researchers investigated this question in mice, since mice “pups” use ultrasonic whistles to communicate to adults. They found that “off” responses encoded by single neurons in the primary and secondary auditory cortex of the adult female mouse can be highly sensitive to fine pitch changes. However, it is in secondary, but not primary, regions of the auditory cortex where this sensitivity improves, specifically for pup whistles after maternal experience with pups. The findings contribute to the understanding of communication sound processing and plasticity within the auditory cortex.
Graduate students Dakshitha Anandakumar (Emory and Georgia Tech) and Alex Dunlap (Georgia Tech) and Emory undergraduate Dorottya Kacsoh are co-authors.
Artificial intelligence to detect optic nerve abnormalities
New findings published by Nancy J. Newman, director of neuro-ophthalmology at Emory Eye Center, and fellow neuro-ophthalmologist Valérie Biousse, along with a group of researchers from the BONSAI group and Singapore National Eye Centre, showed that artificial intelligence can be used to accurately detect papilledema and other non-papilledema optic disc abnormalities from ocular fundus photographs.
According to their findings, a deep-learning system can accurately differentiate between abnormal optic discs and normal optic discs 99 percent of the time, and between papilledema and normal optic discs 98 percent of the time. The full paper is available here along with commentary.
A new “inequality” lottery theory
Does a lottery have to always give everyone an equal chance of winning to be fair? Gerard Vong argues that it does not, in a ground-breaking paper that challenges the status quo and offers a new “inequality” theory about how certain scarce goods should be distributed fairly.
Vong, an assistant professor and director of the master of arts in bioethics program, published his new theory in the journal Ethics. He argues it can be fair to allocate a scarce benefit, such as lifesaving medical intervention, via a lottery that gives people unequal chances of winning. Vong says “inequality” lottery theories are rarely defended, and his article seeks to upend this status quo by giving new and decisive arguments against all extant lottery theories of fairness while proposing and defending a new “inequality” theory of fairness.
Indoor air pollution assessments in Tibet
Environmental Pollution published research on indoor air pollution in Tibet led by Wenlu Ye, a graduate student in Rollins School of Public Health, and Eri Saikawa, associate professor in Emory College’s Department of Environmental Sciences. Globally, 2.8 billion people depend on solid fuel for cooking and heating. The resulting household air pollution (HAP) results in more than 1.5 million deaths annually and is associated with low birth weight, chronic obstructive pulmonary disease and ischemic heart disease.
The researchers collected data from households in villages in the Eastern Tibetan Plateau that used diverse types of stoves and fuels. The results showed that HAP exposures were pervasively high. In addition to biomass burning, the study found that new sources of air pollution, from traffic and garbage burning, may be adding more to personal HAP exposure. Finally, the research showed that awareness of HAP exposure and associated health effects was low in the households sampled. The researchers recommend that health education programs should be implemented to strengthen motivation for positive changes.
Co-authors include Alexander Avramov, an Emory staff scientist; and Seung-Hyun Cho and Ryan Chartier, researchers at RTI International.