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But the earlier organisms were not part of some holistic order that specif- ically created environmental conditions of future habitability as a property of that order. My more detailed technical criticisms of the central tenet Volk, , along with those from Kirchner , were not addressed by Lovelock. Lovelock calls for a marriage of geology and biology. I applaud that! Surely going deeper in Gaia theory requires technical debate about the biosphere, not vows.

During the course of my career as a modeler, as someone who assembles com- ponents into mathematical systems, I have consistently sought emergent properties.

If I could see the property of the whole system by knowing its parts as separate components then I would have no need to construct systems. Gaia theory has no future if we are encouraged to accept truth through envisaging without geochemical knowledge. Vision and instinct might help us formulate ideas for what to explore and test I have no qualms there , but we cannot accept visions and instincts as final truths about how the biosphere works, a situation especially crucial today in light of the environmental crisis.

I personally thank Jim Lovelock for many insights. But to explicate the principles of this coupling and thus see deeper into Gaia theory will require more than anti-reductionist philosophical statements and vague allusions to emergence. We need to test a multitude of different, competing visions and intuitions via real data and carefully constructed simulations of the biosphere so that truth can be found by the procedure of science, the same hard- won cultural evolutionary process that gave us quantum mechanics and molecular and evolutionary biology.

References Kirchner, J. Change 52, — Lovelock, J.

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Change 57, 1—3. Schwartzman, D. It will also require a specialized infrastructure to run the assays, as well as a team of experts to process and analyze results, including strong bioinformatics support. That would be the bailiwick of Dr. Routbort then sounded a warning.

Individual patient biology may be the key to whether labs can reliably interpret a negative finding. Plunging into the data, Dr. Routbort in the assay, and some had very high circulating variant allele frequencies, with a wide range in between.

Looking at outcomes, the researchers found that patients with positive detectable circulating RET MT had poorer prognosis. Routbort said. A colon cancer study had similar findings. Monitoring specific mutations, researchers found that a significant number of patients had a positive ctDNA spike that preceded radiographic detection.

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Monitoring was done every three months, with both tests. In addition, Dr.

Routbort said, clearance of ctDNA after chemotherapy was associated with superior progression-free survival. Though these findings emerged from a limited study set, he conceded, it offers the intriguing possibility that clearance in ctDNA-positive patients might be as good, and possibly better than, imaging.

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It depends on the organ involved, Dr. An assay with 0. Should the goal be one tumor molecule? He sees labs trying to target sensitivity between 0. Using a panel-based technique can be more complicated. Echoing Dr. But that only scales to a certain amount, because all of these techniques involve some library prep PCR or even sequencing PCR, depending on your methodology. Achieving higher specificity and linearity requires unique molecular indexes, or UMIs, he said.

Sensitivity appears to be between 0.

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Ordering is limited to certain types of cancers for now. Rather than placing it among other blood tests in the EMR, the lab positioned it as a biomarker, similar to solid tumor testing. The lab also began running another panel in early , called the solid tumor genomic assay, or STGA MD Anderson does not excel at creative test monikers, he joked , which is an amplicon-based assay with an average depth coverage of 1,—2, The lab uses an existing genomic analysis and reporting application called OncoSeek, which it built in , when Dr.

Routbort came aboard. These are called genomically, which requires inference of fusion transcript junctions and may limit sensitivity.

Especially helpful, he said, is the ability to show the population frequency—basically, the frequency with which they see a variant within the particular platform. Routbort broke down the first 1, cases done on the LB70 by tumor type: thoracic, 44 percent; GI, 43 percent; head and neck including thyroid , five percent; GU, three percent; melanoma, one percent; and other, four percent. The number of correlative cases in the database are, for now, limited, he said, mostly due to limited access to primary tumor samples.

A less specific way of looking at correlation is to look at multiple measurements from the same patient. Routbort reported. Amanda Winters, MD, PhD, and her colleagues are using digital droplet PCR for adult acute myeloid leukemia patients in a variety of settings, including post-transplant. One is a retrospective study involving patients whose DNA had been obtained previously from bone marrow biopsy, looking at AML-associated mutations pre- and post-transplant.

Winters says. They also designed a variety of patient-specific assays for use in certain clinical trial cohorts. In that setting, a microgram of DNA is used per sample; Dr. Winters and her colleagues use ng of DNA per sample in their work.

The data correlates between the two assays, she says, but the sensitivity is lower in the test using less DNA. Emerging data from flow cytometry-based MRD analysis suggest that detecting relapse before it occurs clinically might be useful in modifying therapy.

Following a known founder mutation is much more reliable and can help clinicians feel more confident in their treatment choices. For their clinical trial patients, she and her colleagues have looked at combining MRD data derived from droplet PCR with flow MRD data, which was used to guide initial therapy.

In some cases, therapy has been modified by removing one or two drugs the patient is receiving; if the MRD numbers are good, that might allow clinicians to reduce toxicity of therapy. In other cases, therapy might be expanded. Winters points to another possible role for droplet PCR. They do much better if you transplant them with lower burden. Winters describes.Secondary navigation Search. Notify me of new posts via email. Sensitivity is excellent, as she noted, and it is cost-effective for rapid genotyping and serial monitoring for specific, critical mutations.

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A less specific way of looking at correlation is to look at multiple measurements from the same patient.

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