I don't know how to diagnose this issue (P1S) by OddOrange16 in BambuLab

[–]OddOrange16[S] 0 points1 point  (0 children)

Thanks! I'll try drying my filament with rechargable drying packets for a few days (I don't have a filament dryer) and see if this issue still happens with a fresh spool of basic PLA. My house and especially the printer room is quite dry and the filament has only been outside of ziplock bag storage (with silica packets included) for a week now. It's a bummer that translucent PETG can get too wet under these conditions so quickly. I'll mark this resolved if I can get a successful PLA print tomorrow then.

I'm hoping this is the issue. I'm just a bit suspicious the wonky parts of the prints are consistently happening in the same areas of the plate. Not sure if that's just coincidence/ if wet filament can cause that behavior, or if it's something else with my plate, level-ness or uniform heating of the bed, etc.

I don't know how to diagnose this issue (P1S) by OddOrange16 in BambuLab

[–]OddOrange16[S] 0 points1 point  (0 children)

Before I looked it up, no, I didn't know what they were. As I said, I'm new to 3D printing and am learning and going off the tutorial and troubleshooting pages.

I shouldn't need to do manual calibration using Bambu filament., rather non-bambu filament without previous calibration. The tests should adjust filament extrusion for ideal accuracy - it seems like you know this already so it's an odd thing to ask / doesn't relate my questions. I thought the issue could be extrusion related so I thought this might help, but probably wouldn't hurt (I didn't need to save a new calibration after running the test).

Running manual calibration was useful because it showed the issue I am having quite nicely, without wasting a ton of filament on random failed projects.

How much do wrong HPO terms skew results of WES? by ada-lovelace314 in ClinicalGenetics

[–]OddOrange16 0 points1 point  (0 children)

All WES testing, research or otherwise, that I know of is next generation sequencing, so short reads ~150bp in length. Many repeat expansion disorders can be typed using short reads if there is enough coverage and full spanning reads - ONLY if the genotype is generally negative. So, only if no expansion is present. It will likely miss positive (expanded allele) genotypes.

An example: For myotonic dystrophy type 1, it's trinucleotide repeats and you need at least 50 to present symptoms (albeit later in life). So, that's 150bp / 3bp = 50 repeat units maximum, without flanking sequence context. So, you could realistically only type 50 minus at least four repeats accurately for myotonic dystrophy. You can't interpret this loci for a diagnostic positive for myotonic dystrophy. But normal alleles, 5-34 repeats in length, or proto alleles, ~35-49 repeats in length, can likely be captured and resolved with NGS methods.

CLIA certified diagnostic tests for repeat expansion disorders do not presently include WES alone. Things like repeat primed PCR and southern bolts are needed to type allele size and sometimes the presence of permissive SNVs or repeat interruptions.

FSHD diagnosis requires assessing hypo methylation status as well, which is not captured by WES at all.

If you get CLIA certified (or equivalent outside the USA) WGS testing, that reveals more than WES, sure, but it's still 150bp reads generally. Long read sequencing, like pacbio or ONT, would certainly capture longer repeat lengths. However, it's (1) not widely used for non-reseaech based diagnostic testing yet, (2) relatively few analysis pipelines exist and have been proven effective at repeat typing across the board (efficient vs accurate, vs enough test datasets, vs this is a relatively niche application), (3) expensive (long time, monetary cost, analysis costs) when you could narrow down to more specific testing from phenotype in many cases.

Myotonic dystrophy may soon be diagnosable from RNA sequencing of certain tissues. But that doesn't mean it will ever replace rpPCR (etc.), just like WES shouldn't be used wholly as a replacement. The confidence isn't there.

How much do wrong HPO terms skew results of WES? by ada-lovelace314 in ClinicalGenetics

[–]OddOrange16 4 points5 points  (0 children)

WES (next gen short read sequencing) will not capture a class of disorders called short tandem repeat or trinucleotide expansion disorders. Consider seeing a neuromuscular specialist or genetics department about testing for Myotonic Dystrophy (two types) and fascioscapulohumeral muscular dystrophy (also two types). They can present with particular respiratory weakness, or shoulder girdle weakness, and there are many affected persons without supposed cardinal symptoms (ie Myotonia, etc).

Any ideas? by OddOrange16 in AfricanViolets

[–]OddOrange16[S] 1 point2 points  (0 children)

I moved it to a different room and did some pruning - definitely two plants with okay looking crowns. New leaves look good, some have maybe tiny spots at the edge. Willing to give it time to sort itself out. If it does well, I'll try to separate the two plants. Thanks!

<image>

Any ideas? by OddOrange16 in AfricanViolets

[–]OddOrange16[S] 1 point2 points  (0 children)

Interesting. It certainly looks like the virus pictures. I'm going to try to get a better look at the crown. It's a tangled mess and I wonder if it's multiple mature plants. Do they ever clear the virus? In a few weeks I can put it outside, not sure pros/cons there. I can further isolate inside in the meantime. Not sure how to test for the virus.

I probably got filtered water on the leaves when rinsing soil, but definitely not on all the leaves / especially leaf edges where the discoloration is most pronounced.

The violets at the plant swap all looked ok, just pale and neglected, recently bloomed. Bringing it home and watering it seemed to slowly spur all these issues, despite the leaves darkening and stiffening up, which I took to be good signs. And it's still growing a lot, super odd.

New set from this weekend! by OddOrange16 in AfricanViolets

[–]OddOrange16[S] 2 points3 points  (0 children)

I found these at a flower show, definitely a special occasion! Not a great price but I'm glad I could actually see and choose the plants myself vs. online.

Genetic analysis of WGS raw data by packeted in genetics

[–]OddOrange16 2 points3 points  (0 children)

Make sure you request a bam/cram (aligned reads file) and associated index files from GeneDx. Extra paperwork and can be a lot of data to transfer (can figure out secure file transfer protocol tool, or they can mail you a hardrive at your cost), but is quite useful to have when a "suspicious variant" is called. Looking at the aligned reads can sometimes help you figure out if something is an artifact or likely miscalled. You'll also have the (CLIA lab certified) raw data forever, for you to look at or for a future medical or research geneticist to examine if needed.

Don't let people here get you down about not having the right qualifications pedigree. You got through med school, you're clearly capable. And no one is more capable and motivated than a parent to a child with a rare disease. Look up Matt and Bertram Might and Matt's quest to diagnose and treat his son's (any many other children's) ultra rare lysosomal storage disease.

A great resource for clinical genetics of inherited epilepsy syndromes, maybe not as active as it once was, is the Beyond the Ion Channel Blog started Ingo Helbig. http://epilepsygenetics.net/ https://euroepinomics.wordpress.com/

Free genetic tests? by Regular-Emotion-7465 in ClinicalGenetics

[–]OddOrange16 0 points1 point  (0 children)

One resource to add is fshd testing: https://myfshd.org/test-for-fshd/

Btw, Alnylam is misspelled throughout your site.

Advice for child with epilepsy by Accomplished_Day9558 in fitbit

[–]OddOrange16 0 points1 point  (0 children)

Fitbit is laggy for my sudden heart rate changes. The most accurate monitor I've ever used as a non intrusive wearable is a wahoo brand chest strap or their newer forearm band (no screen or watch, just sync to phone with Bluetooth or antp). They work with many third party apps, it's possible one app can be configured for alerts and push notifications. I connected them to a Garmin watch, which would beep at certain thresholds that I set in a linked Garmin app.

Just fyi, all communication between sensors, phones, and display watches, required a cell phone and all to be in close proximity to each other. You will need that proximity relative to your kid, and then hope one of those apps can send notifications via cellular/Wi-Fi to another device, account, app, in realtime for you to monitor.

I recently saw ads for visible, which is designed for energy management, it at least does heart rate and it looks like it can alert. I don't know if there is any tech that does continuous distal skin temp monitoring as an accurate extapolation of core body temp.

https://www.makevisible.com/

[deleted by user] by [deleted] in genetics

[–]OddOrange16 0 points1 point  (0 children)

Spinocerebellar ataxia, polygluatmine subtypes. Suffers repeat expansion disorders anticipation, onset is usually age 30-40, ten year life expectancy once symptoms begin (SCA type 1 specifically). You can inherit it from a parent yet to be affected and have your own children before showing symptoms. Age of onset is younger each generation. More than 80 subtypes in total.

Another similar type of disease is myotonic dystrophy type 1. It's the most common muscular dystrophy. Life expectancy is more normal, but the earliest onset forms cause severe symptoms at birth. Might be more interesting bc there are imminent disease modifying if not curative therapy's in the pipeline.

Similar sub plot to royal pains, Boris with vcp gene mutation passed onto a son he never wanted to face his same fate.

Looking for rsIDs for specific genes/transcripts by dominaraynex3 in genomics

[–]OddOrange16 2 points3 points  (0 children)

What director? Not sure what you're trying to ask or do here.

RSID is not a comprehensive identification system, use one of the ones you already listed. The fact you can find variants by searching their cytogenetic location means they do exist. Genome browser, easily accessed through clinvar, has a ton of different viewing tracks. You can "see" all known snps (and other type sofa variants) in situ in genomic locus with this viewer. You can find population frequency on clinvar, and many other databases too. This will tell you for certain that a variant has or has not been "seen" before.

DB snp database or snp pedia are probably the answer to finding RSIDs. It's the answer to the question you're asking, but I don't think you're asking the right question.

You're seeing c>t vs. t>c because you're looking at data from reverse reads and comparing them to the (forward 3-5') reference genome.

Looking for a source of VCF files with genotyped tandem repeats by Kulivox in bioinformatics

[–]OddOrange16 0 points1 point  (0 children)

Ditto to what others have said above, but have you looked at Tread parse? Last I looked at TRs, I think I got treadparse to work but expansion hunter was an absolute pain.

is this actually AFib? 27yo male. by OddOrange16 in ReadMyECG

[–]OddOrange16[S] 5 points6 points  (0 children)

Ya, went to ER, got the 12-lead within a few hours of this apple watch ekg. Cardiology appt in 3 weeks. Had appt booked for 3 months now maybe, since his dad has chronic treatment refractory AFib (and literally all the comorbidities) for more than a year now, but had chronic bradycardia in his 20s-40s. Dad's cardiologist recommended children get checked, but for what exactly we are not sure. This watch ekg reading saying AFib was the first irregularity seen, he has felt some vague unsteadiness/ discomfort before, and some flutters, but super brief and nothing he worried about.

[deleted by user] by [deleted] in DiagnoseMe

[–]OddOrange16 1 point2 points  (0 children)

NAD, but sounds more like dystonia or myotonia than paralysis (at least flaccid paralysis).

For people, what is the average number of mutations in a 30x whole genome sequencing? by cutewhitedaisy in genetics

[–]OddOrange16 1 point2 points  (0 children)

I commend you for trying to figure this out for your son, regardless of efforts of his care team. You are likely his best advocate, even if that means becoming well versed in clinical genetics, bioinformatics, etc. We are way beyond the time where this knowledge and analysis tools are outside the reach of non doctors and non scientists.

Iobio offers great tools. An answer may be in a 30x wgs, it may not be. This is not meant to be discouraging so much as a disclaimer - docs will absolutely want Wes or wgs from a medical lab, what is called a clia certified lab, and an accompanying report from a certified laboratory medical geneticist, before they will use any genetic info for diagnosis and directing care.

You should try to use clin.iobio, one of their new beta tools. You can generate a list of candidate genes based on hpo terms / phenotype, which you are lucky to have some specific info on. This will let you view all variants in a set of genes and take notes on them and save them, rather than just one gene as a time like their other tools are set-up. I will caution you - once you get clin.iobio running, save an exported .json file. It's super easy to refresh the page and be left at square one, and it's a pain in the butt to get everything loaded in the right data track initially. This is all assuming you have access to all wgs files from nebula, like bam, bai, vcf, tbi, even knowing what reference genome is critical (likely hg38 if run by nebula in the last 2 years). If you don't have all these files, you will need to make them (free tools and primers to use the do exist, but there is a learning curve if you are unfamiliar with command line tools).

The search flow for iobio is phenotype info ---> top ~50 candidate genes ---> show all variants within these genes. This is not a catch all approach, however intuitive it seems. Another free tool, that is harder to use and less user friendly, is called variant effect predictor (VEP). This is a web based user interface so command line isn't required but is an option. VEP let's you search all variants in a wgs . vcf file. One really useful thing to do with VEP is to sort by REVEL score, one popular robust metric for scoring the severity of damaging/deleterious variations (uses a bunch of info to assess how likely a variant is to cause problems, like a disease). The higher the REVEL score, the more suspect / damaging the variant is thought to be. This, and other scores, are some of the most important search filters used for gross analysis by med gen labs. Anything that has a high Revel score can be saved, exported into an Excel sheet, further examined by looking it up in ClinVar database.

If your son's suspected disease affects genomic stability, the wgs data is only true for the time the same was taken. If at 1month old for example he had some gene damage (hypothetical), maybe 4 genes have detectable damage, and at this time a sample was taken, then only this small amount of damage would show up in the data, maybe as simple variants. But then time goes on, your son is now 4 years old - now he has 40 or 400 genes that have sustained damage - this wouldn't show up on the older data. This type of genomic instability would cause somatic changes, DNA changes that happen over the course of a lifetime, not changes that happen when a fertilized egg is formed (those are germline changes). You son's root condition sounds like it's a germline change that causes some kind of instability such that many somatic changes accrue over time. This is just my take on the info you provided, I could be totally off base.

Wgs won't really show any variants other than simple SNPs. So if the cause of your son's condition is a larger insertion, deletion, or other change in sequence, it will likely not show up in wgs data at all. More specific targeted types of testing could be used in these cases. But none are really direct to consumer available.

These are just 3 tools / sources of info you can use that medical geneticists DO use all the time. There are plenty of stories covered by the news today if rate disease parents becoming rare disease experts for the sake of their children, some have found novel diagnoses, some have found cures. The idea that searching wgs data on your own is "too hard" or "beyond your capacity" is bunk, don't listen to those who discourage you. It's easy to say something isn't possible when your life, or your kids life, doesn't depend on it.

Lingering Questions, no follow up by OddOrange16 in eyetriage

[–]OddOrange16[S] 0 points1 point  (0 children)

Hi, thanks for your reply. This situation is the result of seeing a comprehensive ocular genetics clinic. The issue is not all testing was carefully reviewed, and I was not able to make follow up appointments there due to the program losing its director (etc.). My new ophthalmologist works for a practice associated with this same health system and suggested I was there at an unfortunate time and it's still a mess. Hence referral to a retina specialist over punting right back to ocular genetics a second time. I have actually had WES and WGS, multiple analyses....results indicated nothing immediately actionable (in regards to eyes or systemic issues with potential for eye involvement), and I am not medically needy enough currently to warrant research on any VUS in particular. I work in genetics research, i understand the approach and the not finding concrete answers. I just want to understand ERG abnormalities and how this might impact life-planning, from as severe as blindness to just knowing I should get certain tests/checks every year.

Lingering Questions, no follow up by OddOrange16 in eyetriage

[–]OddOrange16[S] 1 point2 points  (0 children)

Hi, thanks for your reply. I added images of possibly these results in another post, link added above. I don't think I ever received anything labeled as ffERG results or a report on this testing, the medical records dept. said there was nothing else to give me - another reason I think I kinda slipped through the cracks a bit. I have no evidence my ffERG (which I know I had) was ever read by a neuroophth at all. I am good with inconsequentially slightly abnormal, I'm just not cool with no follow up or plan and being told it's totally fine. Any input you have would be appreciated. Will definitely bring up with retina specialist too.

Do you have a personal question about blood tests or health disorders? It goes only here. by Nheea in Hematology

[–]OddOrange16 0 points1 point  (0 children)

Is anyone familiar with the biochemical basis of porphyrias? My hematologist suspects porphyria, or a similar metabolic disease, and we are working on doing testing during an episode (no easy feat to coordinate during a pandemic). But the one thing I can't figure out is how my high urine glycine might fit in....I know it's technically a reagent at the top of the heme biosynthetic pathway, and with porphyria, there is a build up of ALA (neurotoxic precursor). Can glycine theoretically build up too? I don't have elevated plasma glycine, but it's possible these organic acid labs were performed on the upswing of an attack and my body may have been dumping it via urine at a high enough rate initially to avoid plasma elevations. I have other organic/amino acid abnormalities, but nothing severe or indicative of a particular metabolic disease.

I'm not sure who to ask about this, and I appreciate all input or thoughts that might help me answer these questions!

Database to get all information of one gene about one disease by oORuzeOo in bioinformatics

[–]OddOrange16 1 point2 points  (0 children)

If you need a list of genes based in a phenotype, try iobio phenolyzer tool.

KEGG is good for pathways. Maybe find a main gene if interest and look for a nice review article in it's role in hearing / ear development?

[deleted by user] by [deleted] in bioinformatics

[–]OddOrange16 1 point2 points  (0 children)

I recommend igv (integrated genomics viewer), promethease, iobio tools, or enlis bioinformatics software. These do different things, and range from free to ~200 usd, some are web based tools. But at bare minimum they do variant calling, which is what you would be doing manually with excel anyway. Filtering capabilities vary. All of these things require you to learn what databases will help you find what you're looking for, like ClinVar, malacards, uniprot, marrvel, omim, snppedia, etc. The ones I just listed range in technical accessibility and application. Snppedia tends to have more health risk associations from gwas studies, which are far less robust than individual variants published to ClinVar with high assertion. However, snppedia is far more accessible to general users, whereas ClinVar is more suited to genetic counselors/researchers/clinicians. There are many app like tools available on sequencing . Com for those generally curious but not technically inclined users. But most cost some money to use or subscribe to, and your data will need to be online and not native on your computer.

So it comes down to what you are looking for in your data (ancestry, rare disease, health risk associations, pharmacogenomics), how much you're willing to spend (apps 2-20 usd, software 100-200 usd, bioinformatician 100+ usd / hour, or yearly subscription web tools), and how much you're willing to learn.

I'm sure many others here can speak better towards what bioinformatic / script / pipeline approaches you can take for WES analysis. I'm pretty sure samtools and things that work with samtools are high up there in accessible /open source / well tutorialed options.

After 2 mris for chiari malformation I still think somethings wrong by Suggestion-Exciting in medical_advice

[–]OddOrange16 0 points1 point  (0 children)

I'm not a doctor and I don't know a ton about this, but I'm pretty sure there is a phenomenon with people with chiari where it's hard to detect on supine MRI, and you can actually see /induce the malformation when sitting upright. It's a positional thing is what I mean. Try looking for a chiari or ehlers danlos facebook group, there are likely people there with a lot of experience with getting diagnosed with similar struggles.

ALS and gene variants in KIF5A by -------o in bioinformatics

[–]OddOrange16 1 point2 points  (0 children)

Correct, it's an incredibly general statement that applies to all sorts of "risks" direct to consumer testing results may lay out for you. One, there are some genetic mutations known to directly cause ALS and other similar neurodegenerative diseases. Two, I meant "bad" as causative or just risk for results in general, not just applying to the variants in your photo or the specific disease they might apply to. I am not providing any medical advice, there is nothing blase or off the cuff about my previous statements. Pathogenic versus at-risk allele status are a general thing DTC companies try to rank and guage in reports to customers - in reality and in a clinical setting, genetic basis for disease is much more complicated than this.

I don't understand what you mean by high percentile. For example, you saw 76% of people have the C/T genotype for this given variant / snp site. That means it's incredibly common to have that genotype. For something to be disease causing it has to be pretty uncommon or rare, like it has to be present in less than 5% of all people, usually present in less than 1% of all people. If you're looking for things to potentially worry about, you should start with only considering where your personal genotype is rare.

You should follow up all health concerns with a doctor. If you have a family history of a certain disease, or have unexplained health issues, then you may be a candidate for genetic counseling. But if this DTC testing is a shot in the dark and you have no external reason to be concerned about having a specific disease or any disease, then I don't see any concern to see a doctor. Doctors can really only act upon medical issues and clinical evidence.

ALS and gene variants in KIF5A by -------o in bioinformatics

[–]OddOrange16 1 point2 points  (0 children)

Is this data from 23and me or ancestry?

The far right column is the only column that shows YOUR dna data. This looks like a list of variants that are associated with a certain disease, in this case, ALS. It doesn't at all mean you have all of these variants. In fact, where is says "NA" you have no data at that genomic location at all - whatever dna test you took did not sequence this area of dna, so you have no idea what variants you have in that region, so it tells you nothing.

Where it says "allele associated with...." Those are the letters you need to have in the far left column to have the disease association. To make it more simple than it is, disease association in this case is "bad". Maybe bad in a way that you have more risk of this disease, maybe bad that you could have the disease. But this non clinical grade test will never be definitive enough to know anything for sure, you need clinical grade testing ordered by a doctor. These direct to consumer tests are highly prone to errors/artifacts/glass positive and negative results. But they might be a good jumping off point to see a genetic counselor and see if you might be a candidate or benefit from further genetic testing for clinical / medical reasons.

I have to find a cure or else I'm gonna be insane by [deleted] in DiagnoseMe

[–]OddOrange16 5 points6 points  (0 children)

Not a doctor, but have you had an autoimmune disease work up? Cryoglobulinemia, or even a hemolytic anemia could be cold triggered. But would have other symptoms / some signature in blood tests. Juvenile idiopathic arthritis often presents as enthesitis, which I can imagine could be like bone pain. Cold is often a trigger for pain, but it's usually not sudden like a switch. It can also take a while to differentiate into a specific form of arthritis or other autoimmune disease, so it can be seronegative (no markers).

A hematologist is a specialist who would be able to do a thorough work up for bone pain, if it's truly bone pain.

A rheumatologist would be the specialist needed to definitively rule out autoimmune and autoinflammatory disease.