Introduction: Functional heterogeneity, defined as variations between and within tumours, is the underlying cause for malignant tumour processes such as tumour progression, metastasis and treatment resistance. In particular, cancer stem cells (CSCs) could be important contributors to functional heterogeneity within tumours, as CSCs can differentiate into different tumorous cells. This study aims to identify models for the genesis of functional heterogeneity among cancer cells and strategies for targeting CSCs. Methods: Using an integrated review process, various models for functional heterogeneity genesis in cancer and cancer stem cell treatments were explored. Papers that explicitly focused on either explaining a model for the genesis of functiona l heterogeneity in cancer or on describing targeting strategies for CSCs were included. To conduct our search the following databases were used: PubMed, OVID (Medline), and Web of Science. Results: Several prominent models for genesis of cancer functional heterogeneity were identified, including the hierarchy model, stochastic model, and plasticity model. There is no definitive model as different types of cancer may follow different models of functional heterogeneity. However, multiple models suggest that CSCs, tumor cells with acquired or innate multipotency, are responsible for enhancing tumour progression. Hence, many therapeutic methods have been explored to target CSCs including: interfering with signalling pathways, targeting biomarkers, exerting transcriptional control, damaging quiescence, disrupting the microenvironment and immunotherapy. Discussion: This study identified a gap in current literature to be the lack of clinical studies, with the majority of experiments being conducted on mice models or in vitro. As such the applicability of the findings on a human in vivo level are unclear. Strengths of this paper include the extensive scope of literature reviewed, while limitations include the lack of a quality assessment stage. Conclusion:This study suggests that CSCs are involved in the development of functional heterogeneity in tumours and identifies some preliminary strategies to target them. However, more clinical trials are needed to further validate current proposed treatments. By developing CSC-specific therapies, functional heterogeneity amongst cancer cells can be decreased, which will prevent cancer cells from continuing to progress. As a result, these treatments will be more likely to effectively treat cancer.
Introduction As a result of the Covid‐19 pandemic, anatomy education has had to adopt online modes of delivery. Previous research conducted on student views towards an online undergraduate anatomy and physiology course revealed areas of both strong preference (e.g., asynchronous lectures) and strong dislike (e.g., virtual specimens) within the online format. As restrictions are lessened and students transition back into in‐person learning, there exists the unique opportunity to examine the views of a consistent cohort of students towards virtual and in‐person modes of course delivery. Objective The current study seeks to compare the views of a single cohort of students experiencing both the online and in‐person anatomy and physiology course. To avoid the considerable drawbacks of course evaluations relying on Likert scales and traditional qualitative analysis, Q‐methodology is being used to measure the different perspectives of students between the two teaching modalities. Method Q‐methodology will be used to assess opinions of students enrolled in the same undergraduate introductory anatomy and physiology course.A list of 41 opinion‐based statements regarding anatomy education was compiled. Students will sort the statements in a quasi‐normal grid based on their degree of agreement with the statements. The rankings will then undergo a by‐person factor analysis which categorizes students with shared perceptions into groups allowing educators to better understand and respond to the needs of students. Students will have the opportunity to respond to the survey at two points: at the end of the Fall 2021 semester after a primarily online mode of delivery, and at the end of the Winter 2022 semester following a primarily in person mode of delivery. Results Data collection and analysis are anticipated to be completed in March of 2022. Conclusion We hypothesize that Q‐methodology will enable us to discover student views specifically relevant to their experience in both the online and in‐person format of the course. We predict that this study will help identify areas of strength in both virtual and in‐person learning environments. These findings will be useful in integrating the strengths of both learning environments when developing future course offerings.
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