@article {130, title = {Elevated Polygenic Burden for Autism Spectrum Disorder Is Associated With the Broad Autism Phenotype in Mothers of Individuals With Autism Spectrum Disorder.}, journal = {Biol Psychiatry}, volume = {89}, year = {2021}, month = {2021 03 01}, pages = {476-485}, abstract = {

BACKGROUND: Autism spectrum disorder (ASD) is a multifactorial neurodevelopmental disorder that encompasses a complex and heterogeneous set of traits. Subclinical traits that mirror the core features of ASD, referred to as the broad autism phenotype (BAP), have been documented repeatedly in unaffected relatives and are believed to reflect underlying genetic liability to ASD. The BAP may help inform the etiology of ASD by allowing the stratification of families into more phenotypically and etiologically homogeneous subgroups. This study explores polygenic scores related to the BAP.

METHODS: Phenotypic and genotypic information were obtained from 2614 trios from the Simons Simplex Collection. Polygenic scores of ASD (ASD-PGSs) were generated across the sample to determine the shared genetic overlap between the BAP and ASD. Maternal and paternal ASD-PGSs were explored in relation to BAP traits and their child{\textquoteright}s ASD symptomatology.

RESULTS: Maternal pragmatic language was related to child{\textquoteright}s social communicative atypicalities. In fathers, rigid personality was related to increased repetitive behaviors in children. Maternal (but not paternal) ASD-PGSs were related to the pragmatic language and rigid BAP domains.

CONCLUSIONS: Associations emerged between parent and child phenotypes, with more associations emerging in mothers than in fathers. ASD-PGS associations emerged with BAP in mothers only, highlighting the potential for a female protective factor, and implicating the polygenic etiology of ASD-related phenotypes in the BAP.

}, keywords = {Autism Spectrum Disorder, Autistic Disorder, Child, Fathers, Female, Humans, Male, Mothers, Phenotype}, issn = {1873-2402}, doi = {10.1016/j.biopsych.2020.08.029}, author = {Nayar, Kritika and Sealock, Julia M and Maltman, Nell and Bush, Lauren and Cook, Edwin H and Davis, Lea K and Losh, Molly} } @article {123, title = {Efficient Estimation and Applications of Cross-Validated Genetic Predictions to Polygenic Risk Scores and Linear Mixed Models.}, journal = {J Comput Biol}, volume = {27}, year = {2020}, month = {2020 04}, pages = {599-612}, abstract = {

Large-scale cohorts with combined genetic and phenotypic data, coupled with methodological advances, have produced increasingly accurate genetic predictors of complex human phenotypes called polygenic risk scores (PRSs). In addition to the potential translational impacts of identifying at-risk individuals, PRS are being utilized for a growing list of scientific applications, including causal inference, identifying pleiotropy and genetic correlation, and powerful gene-based and mixed-model association tests. Existing PRS approaches rely on external large-scale genetic cohorts that have also measured the phenotype of interest. They further require matching on ancestry and genotyping platform or imputation quality. In this work, we present a novel reference-free method to produce a PRS that does not rely on an external cohort. We show that naive implementations of reference-free PRS either result in substantial overfitting or prohibitive increases in computational time. We show that our algorithm avoids both of these issues and can produce informative in-sample PRSs over a single cohort without overfitting. We then demonstrate several novel applications of reference-free PRSs, including detection of pleiotropy across 246 metabolic traits and efficient mixed-model association testing.

}, issn = {1557-8666}, doi = {10.1089/cmb.2019.0325}, author = {Mefford, Joel and Park, Danny and Zheng, Zhili and Ko, Arthur and Ala-Korpela, Mika and Laakso, Markku and Pajukanta, P{\"a}ivi and Yang, Jian and Witte, John and Zaitlen, Noah} } @article {82, title = {Electronic health record phenotypes associated with genetically regulated expression of CFTR and application to cystic fibrosis.}, journal = {Genet Med}, volume = {22}, year = {2020}, month = {2020 07}, pages = {1191-1200}, abstract = {

PURPOSE: The increasing use of electronic health records (EHRs) and biobanks offers unique opportunities to study Mendelian diseases. We described a novel approach to summarize clinical manifestations from patient EHRs into phenotypic evidence for cystic fibrosis (CF) with potential to alert unrecognized patients of the disease.

METHODS: We estimated genetically predicted expression (GReX) of cystic fibrosis transmembrane conductance regulator (CFTR) and tested for association with clinical diagnoses in the Vanderbilt University biobank (N = 9142 persons of European descent with 71 cases of CF). The top associated EHR phenotypes were assessed in combination as a phenotype risk score (PheRS) for discriminating CF case status in an additional 2.8 million patients from Vanderbilt University Medical Center (VUMC) and 125,305 adult patients including 25,314 CF cases from MarketScan, an independent external cohort.

RESULTS: GReX of CFTR was associated with EHR phenotypes consistent with CF. PheRS constructed using the EHR phenotypes and weights discovered by the genetic associations improved discriminative power for CF over the initially proposed PheRS in both VUMC and MarketScan.

CONCLUSION: Our study demonstrates the power of EHRs for clinical description of CF and the benefits of using a genetics-informed weighing scheme in construction of a phenotype risk score. This research may find broad applications for phenomic studies of Mendelian disease genes.

}, keywords = {Adult, Cystic Fibrosis, Cystic Fibrosis Transmembrane Conductance Regulator, Electronic Health Records, Humans, Mutation, Phenotype}, issn = {1530-0366}, doi = {10.1038/s41436-020-0786-5}, author = {Zhong, Xue and Yin, Zhijun and Jia, Gengjie and Zhou, Dan and Wei, Qiang and Faucon, Annika and Evans, Patrick and Gamazon, Eric R and Li, Bingshan and Tao, Ran and Rzhetsky, Andrey and Bastarache, Lisa and Cox, Nancy J} } @article {116, title = {Epidemiology of Functional Seizures Among Adults Treated at a University Hospital.}, journal = {JAMA Netw Open}, volume = {3}, year = {2020}, month = {2020 12 01}, pages = {e2027920}, abstract = {

Importance: Functional seizures (formerly psychogenic nonepileptic seizures), paroxysmal episodes that are often similar to epileptic seizures in their clinical presentation and display no aberrant brain electrical patterns, are understudied. Patients experience a long diagnostic delay, few treatment modalities, a high rate of comorbidities, and significant stigma due to the lack of knowledge about functional seizures.

Objective: To characterize the clinical epidemiology of a population of patients with functional seizures observed at Vanderbilt University Medical Center (VUMC).

Design, Setting, and Participants: This case-control study included patients with functional seizures identified in the VUMC electronic health record (VUMC-EHR) system from October 1989 to October 2018. Patients with epilepsy were excluded from the study and all remaining patients in the VUMC medical center system were used as controls. In total, the study included 1431 patients diagnosed with functional seizures, 2251 with epilepsy and functional seizures, 4715 with epilepsy without functional seizures, and 502 200 control patients who received treatment at VUMC for a minimum of a 3 years. Data were analyzed from November 2018 to March 2020.

Exposure: Diagnosis of functional seizures, as identified from the VUMC-EHR system by an automated phenotyping algorithm that incorporated International Classification of Diseases, Ninth Revision (ICD-9) codes, International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes, Current Procedural Terminology codes, and natural language processing.

Main Outcomes and Measures: Associations of functional seizures with comorbidities and risk factors, measured in odds ratios (ORs).

Results: Of 2 346 808 total patients in the VUMC-EHR aged 18 years or older, 3341 patients with functional seizures were identified (period prevalence, 0.14\%), 1062 (74.2\%) of whom were women and for which the median (interquartile range) age was 49.3 (39.4-59.9) years. This assessment replicated previously reported associations with psychiatric disorders including posttraumatic stress disorder (PTSD) (OR, 1.22; 95\% CI, 1.21-1.24; P < 3.02 {\texttimes} 10-5), anxiety (OR, 1.14; 95\% CI, 1.13-1.15; P < 3.02 {\texttimes} 10-5), and depression (OR, 1.14; 95\% CI, 1.13-1.15; P < 3.02 {\texttimes} 10-5), and identified novel associations with cerebrovascular disease (OR, 1.08; 95\% CI, 1.06-1.09; P < 3.02 {\texttimes} 10-5). An association was found between functional seizures and the known risk factor sexual assault trauma (OR, 10.26; 95\% CI, 10.09-10.44; P < 3.02 {\texttimes} 10-5), and sexual assault trauma was found to mediate nearly a quarter of the association between female sex and functional seizures in the VUMC-EHR.

Conclusions and Relevance: This case-control study found evidence to support previously reported associations, discovered new associations between functional seizures and PTSD, anxiety, and depression. An association between cerebrovascular disease and functional seizures was also found. Results suggested that sexual trauma may be a mediating factor in the association between female sex and functional seizures.

}, keywords = {Adult, Anxiety, Case-Control Studies, Comorbidity, Delayed Diagnosis, Depression, Female, Hospitals, University, Humans, Male, Mental Disorders, Middle Aged, Odds Ratio, Risk Factors, Seizures, Stress Disorders, Post-Traumatic}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2020.27920}, author = {Goleva, Slavina B and Lake, Allison M and Torstenson, Eric S and Haas, Kevin F and Davis, Lea K} } @article {120, title = {Evidence for secondary-variant genetic burden and non-random distribution across biological modules in a recessive ciliopathy.}, journal = {Nat Genet}, volume = {52}, year = {2020}, month = {2020 11}, pages = {1145-1150}, abstract = {

The influence of genetic background on driver mutations is well established; however, the mechanisms by which the background interacts with Mendelian loci remain unclear. We performed a systematic secondary-variant burden analysis of two independent cohorts of patients with Bardet-Biedl syndrome (BBS) with known recessive biallelic pathogenic mutations in one of 17 BBS genes for each individual. We observed a significant enrichment of trans-acting rare nonsynonymous secondary variants in patients with BBS compared with either population controls or a cohort of individuals with a non-BBS diagnosis and recessive variants in the same gene set. Strikingly, we found a significant over-representation of secondary alleles in chaperonin-encoding genes-a finding corroborated by the observation of epistatic interactions involving this complex in vivo. These data indicate a complex genetic architecture for BBS that informs the biological properties of disease modules and presents a model for secondary-variant burden analysis in recessive disorders.

}, keywords = {Alleles, Bardet-Biedl Syndrome, Cohort Studies, Exome, Genetic Variation, Humans}, issn = {1546-1718}, doi = {10.1038/s41588-020-0707-1}, author = {Kousi, Maria and S{\"o}ylemez, Onuralp and Ozanturk, Ayseg{\"u}l and Mourtzi, Niki and Akle, Sebastian and Jungreis, Irwin and Muller, Jean and Cassa, Christopher A and Brand, Harrison and Mokry, Jill Anne and Wolf, Maxim Y and Sadeghpour, Azita and McFadden, Kelsey and Lewis, Richard A and Talkowski, Michael E and Dollfus, H{\'e}l{\`e}ne and Kellis, Manolis and Davis, Erica E and Sunyaev, Shamil R and Katsanis, Nicholas} } @article {50, title = {Efficient Variant Set Mixed Model Association Tests for Continuous and Binary Traits in Large-Scale Whole-Genome Sequencing Studies.}, journal = {Am J Hum Genet}, volume = {104}, year = {2019}, month = {2019 02 07}, pages = {260-274}, abstract = {

With advances in whole-genome sequencing (WGS) technology, more advanced statistical methods for testing genetic association with rare variants are being developed. Methods in which variants are grouped for analysis are also known as variant-set, gene-based, and aggregate unit tests. The burden test and sequence kernel association test (SKAT) are two widely used variant-set tests, which were originally developed for samples of unrelated individuals and later have been extended to family data with known pedigree structures. However, computationally efficient and powerful variant-set tests are needed to make analyses tractable in large-scale WGS studies with complex study samples. In this paper, we propose the variant-set mixed model association tests (SMMAT) for continuous and binary traits using the generalized linear mixed model framework. These tests can be applied to large-scale WGS studies involving samples with population structure and relatedness, such as in the National Heart, Lung, and Blood Institute{\textquoteright}s Trans-Omics for Precision Medicine (TOPMed) program. SMMATs share the same null model for different variant sets, and a virtue of this null model, which includes covariates only, is that it needs to be fit only once for all tests in each genome-wide analysis. Simulation studies show that all the proposed SMMATs correctly control type I error rates for both continuous and binary traits in the presence of population structure and relatedness. We also illustrate our tests in a real data example of analysis of plasma fibrinogen levels in the TOPMed program (n = 23,763), using the Analysis Commons, a cloud-based computing platform.

}, keywords = {Chromosomes, Human, Pair 4, Cloud Computing, Female, Fibrinogen, Genetic Association Studies, Genetics, Population, Humans, Male, Models, Genetic, National Heart, Lung, and Blood Institute (U.S.), Precision Medicine, Research Design, Time Factors, United States, Whole Genome Sequencing}, issn = {1537-6605}, doi = {10.1016/j.ajhg.2018.12.012}, author = {Chen, Han and Huffman, Jennifer E and Brody, Jennifer A and Wang, Chaolong and Lee, Seunggeun and Li, Zilin and Gogarten, Stephanie M and Sofer, Tamar and Bielak, Lawrence F and Bis, Joshua C and Blangero, John and Bowler, Russell P and Cade, Brian E and Cho, Michael H and Correa, Adolfo and Curran, Joanne E and de Vries, Paul S and Glahn, David C and Guo, Xiuqing and Johnson, Andrew D and Kardia, Sharon and Kooperberg, Charles and Lewis, Joshua P and Liu, Xiaoming and Mathias, Rasika A and Mitchell, Braxton D and O{\textquoteright}Connell, Jeffrey R and Peyser, Patricia A and Post, Wendy S and Reiner, Alex P and Rich, Stephen S and Rotter, Jerome I and Silverman, Edwin K and Smith, Jennifer A and Vasan, Ramachandran S and Wilson, James G and Yanek, Lisa R and Redline, Susan and Smith, Nicholas L and Boerwinkle, Eric and Borecki, Ingrid B and Cupples, L Adrienne and Laurie, Cathy C and Morrison, Alanna C and Rice, Kenneth M and Lin, Xihong} } @article {42, title = {Error-prone bypass of DNA lesions during lagging-strand replication is a common source of germline and cancer mutations.}, journal = {Nat Genet}, volume = {51}, year = {2019}, month = {2019 01}, pages = {36-41}, abstract = {

Studies in experimental systems have identified a multitude of mutational mechanisms including DNA replication infidelity and DNA damage followed by inefficient repair or replicative bypass. However, the relative contributions of these mechanisms to human germline mutation remain unknown. Here, we show that error-prone damage bypass on the lagging strand plays a major role in human mutagenesis. Transcription-coupled DNA repair removes lesions on the transcribed strand; lesions on the non-transcribed strand are preferentially converted into mutations. In human polymorphism we detect a striking similarity between mutation types predominant on the non-transcribed strand and on the strand lagging during replication. Moreover, damage-induced mutations in cancers accumulate asymmetrically with respect to the direction of replication, suggesting that DNA lesions are resolved asymmetrically. We experimentally demonstrate that replication delay greatly attenuates the mutagenic effect of ultraviolet irradiation, confirming that replication converts DNA damage into mutations. We estimate that at least 10\% of human mutations arise due to DNA damage.

}, keywords = {Cells, Cultured, DNA, DNA Damage, DNA Repair, DNA Replication, Germ-Line Mutation, Humans, Mutagenesis, Neoplasms, Polymorphism, Single Nucleotide, Transcription, Genetic}, issn = {1546-1718}, doi = {10.1038/s41588-018-0285-7}, author = {Seplyarskiy, Vladimir B and Akkuratov, Evgeny E and Akkuratova, Natalia and Andrianova, Maria A and Nikolaev, Sergey I and Bazykin, Georgii A and Adameyko, Igor and Sunyaev, Shamil R} } @article {49, title = {An evolutionary compass for detecting signals of polygenic selection and mutational bias.}, journal = {Evol Lett}, volume = {3}, year = {2019}, month = {2019 Feb}, pages = {69-79}, abstract = {

Selection and mutation shape the genetic variation underlying~human traits, but the specific evolutionary mechanisms driving~complex trait variation are largely unknown. We developed a statistical method that uses polarized genome-wide association study (GWAS) summary statistics from a single population to detect signals of mutational bias and selection. We found evidence for nonneutral signals on variation underlying several traits (body mass index [BMI], schizophrenia, Crohn{\textquoteright}s disease, educational attainment, and height). We then used simulations that incorporate simultaneous negative and positive selection to show that these signals are consistent with mutational bias and shifts in the fitness-phenotype relationship, but not stabilizing selection or mutational bias alone. We additionally replicate two of our top three signals (BMI and educational attainment) in an external cohort, and show that population stratification may have confounded GWAS summary statistics for height in the GIANT cohort. Our results provide a flexible and powerful framework for evolutionary analysis of complex phenotypes in humans and other species, and offer insights into the evolutionary mechanisms driving variation in human polygenic~traits.

}, issn = {2056-3744}, doi = {10.1002/evl3.97}, author = {Uricchio, Lawrence H and Kitano, Hugo C and Gusev, Alexander and Zaitlen, Noah A} } @article {73, title = {Exome sequencing reveals a high prevalence of BRCA1 and BRCA2 founder variants in a diverse population-based biobank.}, journal = {Genome Med}, volume = {12}, year = {2019}, month = {2019 Dec 31}, pages = {2}, abstract = {

BACKGROUND: Pathogenic variants in BRCA1 and BRCA2 (BRCA1/2) lead to increased risk of breast, ovarian, and other cancers, but most variant-positive individuals in the general population are unaware of their risk, and little is known about prevalence in non-European populations. We investigated BRCA1/2 prevalence and impact in the electronic health record (EHR)-linked BioMe Biobank in New York City.

METHODS: Exome sequence data from 30,223 adult BioMe participants were evaluated for pathogenic variants in BRCA1/2. Prevalence estimates were made in population groups defined by genetic ancestry and self-report. EHR data were used to evaluate clinical characteristics of variant-positive individuals.

RESULTS: There were 218 (0.7\%) individuals harboring expected pathogenic variants, resulting in an overall prevalence of 1 in 139. The highest prevalence was in individuals with Ashkenazi Jewish (AJ; 1 in 49), Filipino and other~Southeast Asian (1 in 81), and non-AJ European (1 in 103) ancestry. Among 218 variant-positive individuals, 112 (51.4\%) harbored known founder variants: 80 had AJ founder variants (BRCA1 c.5266dupC and c.68_69delAG, and BRCA2 c.5946delT), 8 had a Puerto Rican founder variant (BRCA2 c.3922G>T), and 24 had one of 19 other founder variants. Non-European populations were more likely to harbor BRCA1/2 variants that were not classified in ClinVar or that had uncertain or conflicting evidence for pathogenicity (uncertain/conflicting). Within mixed ancestry populations, such as Hispanic/Latinos with genetic ancestry from Africa, Europe, and the Americas, there was a strong correlation between the proportion of African genetic ancestry and the likelihood of harboring an uncertain/conflicting variant. Approximately 28\% of variant-positive individuals had a personal history, and 45\% had a personal or family history of BRCA1/2-associated cancers. Approximately 27\% of variant-positive individuals had prior clinical genetic testing for BRCA1/2. However, individuals with AJ founder variants were twice as likely to have had a clinical test (39\%) than those with other pathogenic variants (20\%).

CONCLUSIONS: These findings deepen our knowledge about BRCA1/2 variants and associated cancer risk in diverse populations, indicate a gap in knowledge about potential cancer-related variants in non-European populations, and suggest that genomic screening in diverse patient populations may be an effective tool to identify at-risk individuals.

}, issn = {1756-994X}, doi = {10.1186/s13073-019-0691-1}, author = {Abul-Husn, Noura S and Soper, Emily R and Odgis, Jacqueline A and Cullina, Sinead and Bobo, Dean and Moscati, Arden and Rodriguez, Jessica E and Loos, Ruth J F and Cho, Judy H and Belbin, Gillian M and Suckiel, Sabrina A and Kenny, Eimear E} } @article {67, title = {Extreme Polygenicity of Complex Traits Is Explained by Negative Selection.}, journal = {Am J Hum Genet}, volume = {105}, year = {2019}, month = {2019 Sep 05}, pages = {456-476}, abstract = {

Complex traits and common diseases are extremely polygenic, their heritability spread across thousands of loci. One possible explanation is that thousands of genes and loci have similarly important biological effects when mutated. However, we hypothesize that for most complex traits, relatively few genes and loci are critical, and negative selection-purging large-effect mutations in these regions-leaves behind common-variant associations in thousands of less critical regions instead. We refer to this phenomenon as flattening. To quantify its effects, we introduce a mathematical definition of polygenicity, the effective number of independently associated SNPs (M), which describes how evenly the heritability of a trait is spread across the genome. We developed a method, stratified LD fourth moments regression (S-LD4M), to estimate M, validating that it produces robust estimates in simulations. Analyzing 33 complex traits (average N = 361k), we determined that heritability is spread \~{}4{\texttimes} more evenly among common SNPs than among low-frequency SNPs. This difference, together with evolutionary modeling of new mutations, suggests that complex traits would be orders of magnitude less polygenic if not for the influence of negative selection. We also determined that heritability is spread more evenly within functionally important regions in proportion to their heritability enrichment; functionally important regions do not harbor common SNPs with greatly increased causal effect sizes, due to selective constraint. Our results suggest that for most complex traits, the genes and loci with the most critical biological effects often differ from those with the strongest common-variant associations.

}, issn = {1537-6605}, doi = {10.1016/j.ajhg.2019.07.003}, author = {O{\textquoteright}Connor, Luke J and Schoech, Armin P and Hormozdiari, Farhad and Gazal, Steven and Patterson, Nick and Price, Alkes L} } @article {7, title = {The Effects of Migration and Assortative Mating on Admixture Linkage Disequilibrium.}, journal = {Genetics}, volume = {205}, year = {2017}, month = {2017 Jan}, pages = {375-383}, abstract = {

Statistical models in medical and population genetics typically assume that individuals assort randomly in a population. While this simplifies model complexity, it contradicts an increasing body of evidence of nonrandom mating in human populations. Specifically, it has been shown that assortative mating is significantly affected by genomic ancestry. In this work, we examine the effects of ancestry-assortative mating on the linkage disequilibrium between local ancestry tracks of individuals in an admixed population. To accomplish this, we develop an extension to the Wright-Fisher model that allows for ancestry-based assortative mating. We show that ancestry-assortment perturbs the distribution of local ancestry linkage disequilibrium (LAD) and the variance of ancestry in a population as a function of the number of generations since admixture. This assortment effect can induce errors in demographic inference of admixed populations when methods assume random mating. We derive closed form formulae for LAD under an assortative-mating model with and without migration. We observe that LAD depends on the correlation of global ancestry of couples in each generation, the migration rate of each of the ancestral populations, the initial proportions of ancestral populations, and the number of generations since admixture. We also present the first direct evidence of ancestry-assortment in African Americans and examine LAD in simulated and real admixed population data of African Americans. We find that demographic inference under the assumption of random mating significantly underestimates the number of generations since admixture, and that accounting for assortative mating using the patterns of LAD results in estimates that more closely agrees with the historical narrative.

}, keywords = {Alleles, Black or African American, Datasets as Topic, Gene Frequency, Genetics, Population, Genomics, Human Migration, Humans, Linkage Disequilibrium, Models, Genetic, Models, Statistical, Polymorphism, Single Nucleotide}, issn = {1943-2631}, doi = {10.1534/genetics.116.192138}, author = {Zaitlen, Noah and Huntsman, Scott and Hu, Donglei and Spear, Melissa and Eng, Celeste and Oh, Sam S and White, Marquitta J and Mak, Angel and Davis, Adam and Meade, Kelly and Brigino-Buenaventura, Emerita and LeNoir, Michael A and Bibbins-Domingo, Kirsten and Burchard, Esteban G and Halperin, Eran} } @article {11, title = {Estimating the selective effects of heterozygous protein-truncating variants from human exome data.}, journal = {Nat Genet}, volume = {49}, year = {2017}, month = {2017 May}, pages = {806-810}, abstract = {

The evolutionary cost of gene loss is a central question in genetics and has been investigated in model organisms and human cell lines. In humans, tolerance of the loss of one or both functional copies of a gene is related to the gene{\textquoteright}s causal role in disease. However, estimates of the selection and dominance coefficients in humans have been elusive. Here we analyze exome sequence data from 60,706 individuals to make genome-wide estimates of selection against heterozygous loss of gene function. Using this distribution of selection coefficients for heterozygous protein-truncating variants (PTVs), we provide corresponding Bayesian estimates for individual genes. We find that genes under the strongest selection are enriched in embryonic lethal mouse knockouts, Mendelian disease-associated genes, and regulators of transcription. Screening by essentiality, we find a large set of genes under strong selection that are likely to have crucial functions but have not yet been thoroughly characterized.

}, keywords = {Algorithms, Animals, Bayes Theorem, Exome, Gene Frequency, Genetic Predisposition to Disease, Genetic Variation, Genome-Wide Association Study, Genotype, Heterozygote, Humans, Mice, Knockout, Models, Genetic, Mutation, Selection, Genetic, Sequence Analysis, DNA}, issn = {1546-1718}, doi = {10.1038/ng.3831}, author = {Cassa, Christopher A and Weghorn, Donate and Balick, Daniel J and Jordan, Daniel M and Nusinow, David and Samocha, Kaitlin E and O{\textquoteright}Donnell-Luria, Anne and MacArthur, Daniel G and Daly, Mark J and Beier, David R and Sunyaev, Shamil R} }