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Understanding the intricate relationships between diseases is critical for both prevention and recovery. However, there is a lack of suitable methodologies for exploring the precedence relationships within multiple censored time-to-event data, resulting in decreased analytical accuracy. This study introduces the Censored Event Precedence Analysis (CEPA), which is a nonparametric Bayesian approach suitable for understanding the precedence relationships in censored multivariate events. CEPA aims to analyze the precedence relationships between events to predict subsequent occurrences effectively. We applied CEPA to neonatal data from the National Health Insurance Service, identifying the precedence relationships among the seven most commonly diagnosed diseases categorized by the International Classification of Diseases. This analysis revealed a typical diagnostic sequence, starting with respiratory diseases, followed by skin, infectious, digestive, ear, eye, and injury-related diseases. Furthermore, simulation studies were conducted to demonstrate CEPA suitability for censored multivariate datasets compared to traditional models. The performance accuracy reached 76% for uniform distribution and 65% for exponential distribution, showing superior performance in all four tested environments. Therefore, the statistical approach based on CEPA enhances our understanding of disease interrelationships beyond competitive methodologies. By identifying disease precedence with CEPA, we can preempt subsequent disease occurrences and propose a healthcare system based on these relationships. [ABSTRACT FROM AUTHOR]

AlphaFold2 (AF2) models have had wide impact but mixed success in retrospective ligand recognition. We prospectively docked large libraries against unrefined AF2 models of the σ 2 and serotonin 2A (5-HT2A) receptors, testing hundreds of new molecules and comparing results with those obtained from docking against the experimental structures. Hit rates were high and similar for the experimental and AF2 structures, as were affinities. Success in docking against the AF2 models was achieved despite differences between orthosteric residue conformations in the AF2 models and the experimental structures. Determination of the cryo-electron microscopy structure for one of the more potent 5-HT2A ligands from the AF2 docking revealed residue accommodations that resembled the AF2 prediction. AF2 models may sample conformations that differ from experimental structures but remain low energy and relevant for ligand discovery, extending the domain of structure-based drug design.

The neurotransmitter γ-aminobutyric acid (GABA) activates the metabotropic GABA B receptor to generate slow, prolonged inhibitory signals that regulate the neural circuitry. The GABA B receptor is an obligate heterodimeric G protein-coupled receptor (GPCR) comprised of GBR1 and GBR2 subunits, each with extracellular, seven-helix transmembrane (7TM), and coiled-coil domains. To understand how GABA-driven conformational changes in the extracellular domain are transmitted to the 7TM domain during signal transduction, we determined cryo-electron microscopy (EM) structures of GABA B in two different states: an antagonist-bound inactive state, and an active state in which both the GABA agonist and a positive allosteric modulator (PAM) are bound. In the inactive state, the TM3 and TM5 helices in the two 7TM domains engage in cholesterol-mediated as well as direct interactions, resulting in an open conformation. GABA binding forces the extracellular domains of GBR1 and GBR2 into a compact form, relocating the linkers that connect the extracellular and 7TM domains closer to each other. The movement of the linker along with the associated extracellular loop 2 of the 7TM domain reorients the two 7TM domains and creates a new interface with the TM5, TM6 and TM7 helices in a closed conformation. PAM binding to the interface between the TM6 and TM6 helices stabilizes the active 7TM domain conformation. The relayed structural rearrangement results in significant conformational changes in the TM helices, as well as intracellular loop 3 in GBR2, which may promote the binding and activation of the Gi/o proteins., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)