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- All Subjects: Evolution
- All Subjects: Diabetes
- Creators: School of Molecular Sciences
One of the largest problems facing modern medicine is drug resistance. Many classes of drugs can be rendered ineffective if their target is able to acquire beneficial mutations. While this is an excellent showcase of the power of evolution, it necessitates the development of increasingly stronger drugs to combat resistant pathogens. Not only is this strategy costly and time consuming, it is also unsustainable. To contend with this problem, many multi-drug treatment strategies are being explored. Previous studies have shown that resistance to some drug combinations is not possible, for example, resistance to a common antifungal drug, fluconazole, seems impossible in the presence of radicicol. We believe that in order to understand the viability of multi-drug strategies in combating drug resistance, we must understand the full spectrum of resistance mutations that an organism can develop, not just the most common ones. It is possible that rare mutations exist that are resistant to both drugs. Knowing the frequency of such mutations is important for making predictions about how problematic they will be when multi-drug strategies are used to treat human disease. This experiment aims to expand on previous research on the evolution of drug resistance in S. cerevisiae by using molecular barcodes to track ~100,000 evolving lineages simultaneously. The barcoded cells were evolved with serial transfers for seven weeks (200 generations) in three concentrations of the antifungal Fluconazole, three concentrations of the Hsp90 inhibitor Radicicol, and in four combinations of Fluconazole and Radicicol. Sequencing data was used to track barcode frequencies over the course of the evolution, allowing us to observe resistant lineages as they rise and quantify differences in resistance evolution across the different conditions. We were able to successfully observe over 100,000 replicates simultaneously, revealing many adaptive lineages in all conditions. Our results also show clear differences across drug concentrations and combinations, with the highest drug concentrations exhibiting distinct behaviors.
Cancer rates vary between people, between cultures, and between tissue types, driven by clinically relevant distinctions in the risk factors that lead to different cancer types. Despite the importance of cancer location in human health, little is known about tissue-specific cancers in non-human animals. We can gain significant insight into how evolutionary history has shaped mechanisms of cancer suppression by examining how life history traits impact cancer susceptibility across species. Here, we perform multi-level analysis to test how species-level life history strategies are associated with differences in neoplasia prevalence, and apply this to mammary neoplasia within mammals. We propose that the same patterns of cancer prevalence that have been reported across species will be maintained at the tissue-specific level. We used a combination of factor analysis and phylogenetic regression on 13 life history traits across 90 mammalian species to determine the correlation between a life history trait and how it relates to mammary neoplasia prevalence. The factor analysis presented ways to calculate quantifiable underlying factors that contribute to covariance of entangled life history variables. A greater risk of mammary neoplasia was found to be correlated most significantly with shorter gestation length. With this analysis, a framework is provided for how different life history modalities can influence cancer vulnerability. Additionally, statistical methods developed for this project present a framework for future comparative oncology studies and have the potential for many diverse applications.
Type 2 Diabetes Mellitus (T2DM) is a leading cause of health disparities, among Hispanic populations, which are disproportionately afflicted by T2DM. The growing research strongly argues that diabetes treatment interventions should be culturally sensitive to address the needs of their target populations. Nonetheless, there is little consensus regarding the necessary components of a culturally sensitive intervention. This review will examine the intervention contents and activities, and the strategies that have been implemented into culturally sensitive diabetes treatment interventions. This review will also to observe how interventions handle complex issues such as the heterogeneity of Hispanic populations and communities. The overarching research questions examined in this study were, “What are the core components of the culturally tailored diabetes interventions currently implemented with Hispanic populations in the US, and why are they needed?” and 2) “How are studies evaluating the impact of their interventions, and how can the proposed study designs be improved?”
Method.
A systematic review across 3 databases was used to identify culturally sensitive diabetes treatment interventions (CSDTI) developed for Hispanic populations. Accordingly, we searched for studies designed to treat Hispanic individuals already diagnosed with having T2DM. All identified studies provided information on the core components of these culturally sensitive interventions, while only studies that included a control or comparison group were used to assess how the studies evaluated outcomes.
Results.
First, we examined intervention effects as examined from two study designs. We examined a total of [17] interventions in this section. Our review of one study design (Design #1 Studies) includes 12 studies that developed a culturally sensitive intervention and evaluated it using a one-group pretest posttest design, or did not evaluate their intervention at all. A second study design (Design #2 Studies) includes 5 studies. These consisted of a two-group randomized controlled field study that conducted pre-post analyses of the culturally adapted intervention comparing it against a control or comparison group. The heterogeneity of all studies made a conventional meta-analysis impossible.
Second, another review section focused on examining and describing various culturally sensitive core components, we examined a total of 17 studies to describe the types of culturally sensitive components that were incorporated into the diabetes treatment intervention. This analysis resulted in a list of 11 general types of culturally sensitive components as included within these 17 interventions. Of the articles that used control or comparison groups, the manner in which interventions evaluated different outcome measures and their conclusions regarding success were examined.
Discussion.
The culturally sensitive aspects identified from these articles were used to address diverse issues that included: (a) communication barriers, (b) the inclusion of cultural relevant content, for relevance to Hispanic/Latinx patients’ lives, (c) selecting appropriate channels and settings for interventions, and (d) addressing specific cultural values, traditions, and beliefs that can either help or hinder healthy behaviors. It should be noted that the Hispanic populations are extremely heterogeneous, and so interventions that would be sensitive culturally to some sectors of a Hispanic community may not be sensitive to other Hispanic sectors of that same community. The issue of heterogeneity of Hispanic communities was addressed well by the authors of some articles and ignored by others.
Conclusions.
It was ultimately impossible draw quantitative conclusions regarding the efficacy or effectiveness of these two types of diabetes treatment interventions (CSDTIs) as delivered to their targeted sample of Hispanic participants. An emerging conclusion is that factors including ethics, cost, and lack of community acceptance, may constitute factors contributing to the higher proportion of one-group pre-test post-test designs and lower proportion of rigorous scientific designs. In the latter case, some communities oppose the use of randomized controlled studies within their community, and thus that objection may explain the low numbers of these randomized controlled studies. The use of viable and rigorous alternatives to RCTs have been proposed to address this community concern. In this review, the author sought to conduct comparative studies between culturally adapted interventions and their associated unaltered or minimally altered evidence-based interventions, although there exists various difficulties that are associated with the conduct of these analyses.
Core components of CSDTIs for Hispanic adults were identified, and their purposes were explained. Additionally, suggestions for improvement to studies were made, to aid in improving our knowledge of CSDTIs through future studies.