Predicting oral anticoagulant response using a pharmacodynamic model

We developed a pharmacokinetic and pharmacodynamic model of warfarin absorption, metabolism, and anticoagulant action appropriate for guiding anticoagulant therapy. The model requires only two independently adjustable parameters to describe warfarin's effect on individual patients. For any given individual, these parameters are rapidly and inexpensively identified using a computer program based on the model. Test data were generated by superimposing Gaussian noise on dose-response curves calculated with the model. Then the computer program was applied to the test data. Future prothrombin complex activities (PCA's) and maintenance doses were predicted accurately early in the course of drug administration. In addition, the program accurately predicted PCA response in two groups of normal volunteers.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44006/1/10439_2006_Article_BF02363455.pd

Heterozygous ANKRD17 loss-of-function variants cause a syndrome with intellectual disability, speech delay, and dysmorphism

ANKRD17 is an ankyrin repeat-containing protein thought to play a role in cell cycle progression, whose ortholog in Drosophila functions in the Hippo pathway as a co-factor of Yorkie. Here, we delineate a neurodevelopmental disorder caused by de novo heterozygous ANKRD17 variants. The mutational spectrum of this cohort of 34 individuals from 32 families is highly suggestive of haploinsufficiency as the underlying mechanism of disease, with 21 truncating or essential splice site variants, 9 missense variants, 1 in-frame insertion-deletion, and 1 microdeletion (1.16 Mb). Consequently, our data indicate that loss of ANKRD17 is likely the main cause of phenotypes previously associated with large multi-gene chromosomal aberrations of the 4q13.3 region. Protein modeling suggests that most of the missense variants disrupt the stability of the ankyrin repeats through alteration of core structural residues. The major phenotypic characteristic of our cohort is a variable degree of developmental delay/intellectual disability, particularly affecting speech, while additional features include growth failure, feeding difficulties, non-specific MRI abnormalities, epilepsy and/or abnormal EEG, predisposition to recurrent infections (mostly bacterial), ophthalmological abnormalities, gait/balance disturbance, and joint hypermobility. Moreover, many individuals shared similar dysmorphic facial features. Analysis of single-cell RNA-seq data from the developing human telencephalon indicated ANKRD17 expression at multiple stages of neurogenesis, adding further evidence to the assertion that damaging ANKRD17 variants cause a neurodevelopmental disorder.Neurolog

Receipt of seminal fluid proteins causes reduction of male investment in a simultaneous hermaphrodite

Mating partners often have conflicting interests when copulating [1-3]. One of the major agents affecting female mating partners is seminal fluid, transferred along with sperm. The role of seminal fluid proteins (SFPs) in reproductive success is well studied in separate-sexed animals [4, 5] but is much less so in simultaneous hermaphrodites [6]. The latter potentially have a unique target to exploit for the sperm donor's own benefit: the male function of their mating partners [7, 8]. Here we show that, in the great pond snail Lymnaea stagnalis, receipt of specific SFPs reduces both sperm transfer and paternity success in a subsequent insemination event. Lowering investment in the mating partner's male function constitutes a novel role for SFPs. This demonstrates for the first time that hermaphrodites alter their mates' male as well as female reproductive output [6]. Although it remains to be tested whether this represents mate manipulation or an adaptive response of recipients [9], our findings identify male investment as a new target for postcopulatory sexual selection [10]. © 2014 Elsevier Ltd