Application of Informatics Tools to Facilitate the Practice of Precision Medicine with Genomic Testing and Clinical Data

The practice of precision medicine considers a variety of sources of information to optimize patient care. Factors such as patient demographics, clinical history, and lab test values have well understood effects on treatment outcomes and influence decision making. However, effective inclusion of biomolecular data such as protein expression and DNA sequencing data within the practice of precision medicine needs continued study. Informatics tools offer solutions to allow these complex data sources to be effectively embraced. Utilization of informatics tools to visualize data pertaining to the gene selection practices of pharmacogenomic (PGx) tests effectively communicated large amounts of information into concise heatmaps. After a thorough search identifying potential PGx tests, their detection rates were assessed based on their gene targets and the genomic frequencies of various ethnic groups. Detection rates were defined as the proportion of a prospective ethnic population where PGx tests selected both variants within genotypes of requiring alterations in medication therapy. Detection rates had high levels of variance between different assays and ethnic groups. Our results strongly support the practice of clinicians considering a patient’s ethnic background when selecting a PGx test that is right for them to ensure effective testing. In addition to genetic test selection, applied informatics tools allow for better utilization of biomolecular information in patient prognosis assessment and therapy selection. We demonstrated this on a cohort on non-small cell lung cancer patients receiving immune checkpoint inhibitor (ICI) therapy. Through multivariate statistical models and vi survival analyses, we demonstrated the impact of various clinical and biomolecular variables on patient survival. Our results showed patients experiencing immune related adverse events (irAEs) and their timing had a significant impact on patient survival time. Additionally, we demonstrated the timing of genotype targeted tyrosine kinase inhibitor therapy relative to ICI therapy has a significant impact on patient survival time as well. Variables with less understood associations with patient survival were effectively contextualized with common clinical variables within multivariate modeling approaches. Continued implementation of informatics approaches is vital to effectively embrace a precision medicine approach in patient care

Drawing Board Projects: The case for design experiences without three-dimensional realisation

In the context of the school curriculum, projects and investigations, as we all know, are now considered indispensible; although I recall being inspir~d by a certain History master in the late 1940s who set us, as fourth-formers, research exercises on such topics as Jethro Tull, Turnip Townsend, and other agricultural and industrial pioneers of the 18th and 19th centuries. In those days, of course, we still called it ";homework";, even though the work involved extended field trips into the archives of the public library. Exercises such as these would now be properly termed ";investigations";, since there is no sense of ";projection"; into the future or into the production of an original creation or artefact. Since that time, the Project Technology team and others have done much to place technology more widely into the traditional school environment so that, in addition to the analytical study of other peoples efforts, children and students are encouraged to experience the design process for themselves and the exhilaration and inevitable frustrations that are inseparable from it.The design process, as Deere 1 and others2 have shown, is the essential core of Technology and any technological project should therefore incorporate a strong element of design; if the prime purpose of an exercise is analysis rather than synthesis, then it might be better described as an investigation

Reviews

The following publications have been reviewed by the mentioned authors;The Child and the City by Colin Ward, reviewed by John EgglestonEngineering Science for Technicians Vol. 1 by M. Donagh, Waterworth and Phillips, reviewed by Michael SayerTeaching Industrial Education Principles and Practices by Robert C. Andrews and Emanuel E. Ericson, reviewed by Denis TabernerSalt-Glazed Ceramics by Jack Troy, reviewed by Michael PaffardAmerican Book Design and William Morris by Susan Otis Thompson, reviewed by John EgglestonTerracotta: the Technique of Fired Clay Sculpture by Bruno Luccessi and Margit Malstrom, reviewed by Michael Paffar

Reviews

The following publications have been reviewed by the mentioned authors;The Art of Print Making by Erich Rhein, reviewed by John LancasterDevelopments in Art Teaching by Terence Wooff, reviewed by John LancasterResources by Jack Bainbridge, reviewed by Michael SayerPower by Jack Bainbridge, reviewed by Michael SayerThe Potter's Complete Book of Clay and Glazes by James Chappell, reviewed by Michael PaffardWriting and Illuminating Lettering by Edward Johnston, reviewed by John LancasterBasic Mathematics for Technicians by C. W. Schofield, reviewed by F. R. WatsonDesign and Technology - Plastics by R. Millett, reviewed by Michael SayerObjective and Completion Tests in CSE Woodwork Theory by Ernest Clarke, reviewed by Denis TabernerObjectice and Completion Tests in CSE Metalwork Theory by Ernest Clarke, reviewed by Denis Taberne

Factors affecting color correction of retroreflective markings

A nighttime field study was conducted to assess the effects of retroreflective material area, distribution, and color on judgments of conspicuity. Participants, seated in a stationary vehicle, took part in a pairwise comparison of the stimuli. The independent variables included retroreflective power, area and distribution of the retroreflective material, color of the retroreflective material, participant age, and participant gender. The results indicate that color (white, fluorescent yellow-green, and fluorescent red-orange) was a significant factor in the judgment of conspicuity, as might be predicted from the Helmholtz-Kohlrausch effect. In addition, color interacted with the distribution of material at the high level of retroreflective power. The area of the retroreflective material was also significant. The present study, in agreement with a number of previous studies, indicates that color influences the conspicuity of retroreflective stimuli, but that the results are not always in agreement with color correction factors prescribed in ASTM E 1501. The discrepancy between empirically derived color correction factors seems to be attributable to an interaction of the stimulus size (subtended angle) and color, which previous studies have not extensively examined. To a lesser degree, the retroreflective power of a material also appears to influence conspicuity. While the ASTM correction factors may be appropriate for intermediate subtended solid angles, particularly for nonsaturated colors, smaller correction factors appear appropriate for markings subtending small angles (approaching point sources), and larger factors for larger subtended angles of saturated stimuli.The University of Michigan Industry Affiliation Program for Human Factors in Transportation Safetyhttp://deepblue.lib.umich.edu/bitstream/2027.42/91263/1/102869.pd

Reviews

The following publications have been reviewed by the mentioned authors;The Art of the Engineer by Ken Baynes and Francis Pugh, reviewed by Michael SayerVictorian Crafts Revived by Anne Hulbert, reviewed by Andor GommeA Potter's Mexico by Irwin and Emily Whittaker, reviewed by Michael PaffardPainting Without a Brush by Roy Sparkes, reviewed by Edward PhelpsMaking Wooden Toys by Roger Polley, reviewed by Bob NeillMetalwork Theory by R. A. Mold, reviewed by Leslie Deem

A novel ‘triple drawdown’ method highlights deficiencies in invasive alien crayfish survey and control techniques

Freshwater crayfish can be successful invaders that threaten native biota and aquatic ecosystems in numerous countries worldwide. Nonetheless, the inability of conventional crayfish survey techniques like trapping and handsearching to yield quantitative population data has limited the understanding of crayfish invasion biology and associated ecological impacts. Here, we employed a novel ‘triple drawdown’ (TDD) method to sample invasive populations of signal crayfish Pacifastacus leniusculus in a headwater stream in Northern England. The method was compared with conventional techniques of trapping and handsearching. The TDD method proved to be an effective technique with high capture efficiency, reporting signal crayfish densities from 20.5 to 110.4 animals/m2 at our study sites. These numbers exceed any previous estimates for similar streams. The TDD showed the vast majority of individuals across all sites were juvenile or sub‐adult (<26 mm CL), with only 2.3% of the population large enough (≥35 mm CL) to be caught in standard traps. Synthesis and applications. The triple drawdown (TDD) method demonstrates strong inefficiencies and biases in conventional crayfish survey and management techniques. Trapping is not recommended for representative sampling or control of juvenile dominated populations. TDDs, which can be adapted and modified to operate in multiple habitat types and freshwater systems, generate robust quantitative data on invasive crayfish population demographics in situ. This can advance our understanding of the biology of an important invader of freshwater systems around the world. Obtaining this data prior and post‐intervention is fundamental to evaluate invasive crayfish management, and we recommend the TDD method to assess the effectiveness of future control measures