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.

The nineteenth-century invention of smallpox vaccination in Great Britain has been well studied for its significance in the history of medicine as well as the ways in which it exposes Victorian anxieties regarding British nationalism, rural and urban class struggles, the behaviors of women, and animal contamination. Yet inoculation against smallpox by variolation, vaccination’s predecessor and a well-established Chinese medical technique that was spread from east to west to Great Britain, remains largely understudied in modern scholarly literature. In the early 1700s, Lady Mary Wortley Montagu, credited with bringing smallpox variolation to Great Britain, wrote first about the practice in the Turkish city of Adrianople and describes variolation as a “useful invention,” yet laments that, unlike the Turkish women who variolate only those in their “small neighborhoods,” British doctors would be able to “destroy this [disease] swiftly” worldwide should they adopt variolation. Examined through the lens of Edward Said’s Orientalism, techno-Orientalism, and medical Orientalism and contextualized by a comparison to British attitudes toward nineteenth century vaccination, eighteenth century smallpox variolation’s introduction to Britain from the non-British “Orient” represents an instance of reversed Orientalism, in which a technologically deficient British “Occident” must “Orientalize” itself to import the superior medical technology of variolation into Britain. In a scramble to retain technological superiority over the Chinese Orient, Britain manufactures a sense of total difference between an imagined British version of variolation and a real, non-British version of variolation. This imagination of total difference is maintained through characterizations of the non-British variolation as ancient, unsafe, and practiced by illegitimate practitioners, while the imagined British variolation is characterized as safe, heroic, and practiced by legitimate British medical doctors. The Occident’s instance of medical technological inferiority brought about by the importation of variolation from the Orient, which I propose represents an eighteenth-century instance of what I call medical techno-Orientalism, represents an expression of British anxiety over a medical technologically superior Orient—anxieties which express themselves as retaliatory attacks on the Orient and variolation as it is practiced in the Orient—and as an expression of British desire to maintain medical technological superiority over the Orient.

Hundreds of thousands of people die annually from malaria; a protozoan of the genus Plasmodium is responsible for this mortality. The Plasmodium parasite undergoes several life stages within the mosquito vector, the transition between which require passage across the lumen of the mosquito midgut. It has been observed that in about 15% of parasites that develop ookinetes in the mosquito abdomen, sporozoites never develop in the salivary glands, indicating that passage across the midgut lumen is a significant barrier in parasite development (Gamage-Mendis et al., 1993). We aim to investigate a possible correlation between passage through the midgut lumen and drug-resistance trends in Plasmodium falciparum parasites. This study contains a total of 1024 Anopheles mosquitoes: 187 Anopheles gambiae and 837 Anopheles funestus samples collected in high malaria transmission areas of Mozambique between March and June of 2016. Sanger sequencing will be used to determine the prevalence of known resistance alleles for anti-malarial drugs: chloroquine resistance transporter (pfcrt), multidrug resistance (pfmdr1) gene, dihydropteroate synthase (pfdhps) and dihydrofolate reductase (pfdhfr). We compare prevalence of resistance between abdomen and head/thorax in order to determine whether drug resistant parasites are disproportionately hindered during their passage through the midgut lumen. A statistically significant difference between resistance alleles in the two studied body sections supports the efficacy of new anti-malarial gene surveillance strategies in areas of high malaria transmission.

The social determinants of health (SDOH) represent factors that impact the health and effectiveness/compliance of a treatment plan for a patient. The SDOH include such factors as economic stability, education, home and community context, access to healthcare, neighborhood and built environment, and personal behavior. The purpose of this study is to determine the extent of collection and integration of SDOH into clinical practice, and the usefulness of this information in medical decision making. Following a thorough literature review, an online survey was deployed to physicians and administrators around the country, with the aim of answering the following questions: 1) Do provider practices collect information on a patient's social determinants of health? 2) If yes, how is that information being used, if at all? 3) If not, what is preventing them from doing so? 4) Do the answers to questions 1-3 differ based on the type of payment model (Fee-for-Service or Capitation) to which the practice is subject? The results of the study suggest that fee-for-service payment environments present less incentive to use a patient's SDOH in medical decision making.

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.