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Laugesen posted an update 7 months, 1 week ago
Due to the inevitable inter-study correlation between test sensitivity (Se) and test specificity (Sp), mostly because of threshold variability, hierarchical or bivariate random-effects models are widely used to perform a meta-analysis of diagnostic test accuracy studies. Conventionally, these models assume that the random-effects follow the bivariate normal distribution. However, the inference made using the well-established bivariate random-effects models, when outlying and influential studies are present, may lead to misleading conclusions, since outlying or influential studies can extremely influence parameter estimates due to their disproportional weight. Therefore, we developed a new robust bivariate random-effects model that accommodates outlying and influential observations and gives robust statistical inference by down-weighting the effect of outlying and influential studies. The marginal model and the Monte Carlo expectation-maximization algorithm for our proposed model have been derived. A simulation study has been carried out to validate the proposed method and compare it against the standard methods. Regardless of the parameters varied in our simulations, the proposed model produced robust point estimates of Se and Sp compared to the standard models. Moreover, our proposed model resulted in precise estimates as it yielded the narrowest confidence intervals. The proposed model also generated a similar point and interval estimates of Se and Sp as the standard models when there are no outlying and influential studies. Two published meta-analyses have also been used to illustrate the methods.Recent outbreak of novel Coronavirus disease (Covid-19) pandemic around the world is associated with severe acute respiratory syndrome. The death toll associated with the pandemic is increasing day by day. GA-017 mouse SARS-CoV-2 is an enveloped virus and there are ample evidences that its Spike protein (S-protein) is mainly associated with pathogenesis as it is surface-exposed and mediates entry into host cells by binding to angiotensin-converting enzyme-2 (ACE-2) receptor. Therefore, it is the main target of neutralizing antibodies upon infection and there is always a quest to inhibit the S-protein which in turn may help in controlling diseases caused by SARS-CoV-2 in humans. The role of Chloroquine and Hydroxychloroquine as potential treatments for Covid-19 is still under debate globally because of some side effects associated with it. This study involves the In silico interactions of Chloroquine and Hydroxychloroquine with the S-protein of SARS-CoV-2. With the help of various computational methods, we have re-explored the potential role of both of these antiviral drugs for the treatment of Covid-19 patients by comparing the efficacy of both of the drugs to bind to S-protein at its host receptor region. In our research Hydroxychloroquine exhibited potential inhibitory effectsof S-protein with binding energy -7.28 kcal/mol than Chloroquine (-6.30 kcal/mol) at SARS-CoV-2 receptor recognition of susceptible cells. The outcomes of this research strongly appeal for in vivo trials of Hydroxychloroquine for the patients infected with Covid-19. Furthermore, the recommended doses of Hydroxychloroquine may reduce the chances of catching Covid-19 to the healthcare workers and staff who are in contact with or delivering direct care to coronavirus patients as long as they have not been diagnosed with Covid-19. We further hypothesize that the comparative S-protein-drug docking interactions may help to understand the comparative efficacy of other candidate repurposing drugs until discovery of a proper vaccine.Reproductive coercion (RC) refers to behaviors that interfere with contraception use or pregnancy and that limit reproductive autonomy. This article presents the results of a qualitative exploratory study of 21 young women in Canada who experienced RC perpetrated by an intimate partner along with the associated consequences. Results reveal that nonconsensual condom removal occurred more often in uncommitted relationships without violence, whereas pressure to become pregnant and pregnancy coercion occurred more often in committed relationships where other forms of violence were also present. Participants reported numerous repercussions on their psychological, sexual, and reproductive health and on their emotional and relational well-being.Renal Monomorphology in COVID-19 with Acute Renal Insufficiency Abstract. A 78-year-old ventilator-dependent COVID-19 patient developed severe renal failure with an estimated glomerular filtration rate of 20 ml/min per 1.73 m2 and nephrotic proteinuria. Sonography showed echo-dense and enlarged kidneys with high resistance indices (>0.8). Echocontrast sonography showed a delayed renal perfusion. In the further course of the disease renal function recovered, kidney size decreased and the renal perfusion normalized. An acute COVID-19-associated interstitial nephritis is postulated.The levels of reactive oxygen species (ROS) are tightly controlled and regulated by Nuclear Factor Erythroid-2-Like 2 (Nrf2) transcription factor, which is the main regulator of antioxidant responses and its suppressor protein Kelch-like ECH-associated protein 1 (Keap1). Our previous study has identified six novel changes in Nrf2/Keap1 pathway in pediatric ALL, which were described for the first time. These changes in the pathway are likely to alter the evolutionary process of amino acids and cause structural changes in the final products of genes. In this study, we aimed to compare the pathogenicity of eight determined mutations reported in our previous study by utilizing different programs with different algorithms and molecular dynamics simulation. Since it is too difficult to handle each existing mutation in a wet laboratory, in silico methods may give suggestion to choose the important mutations for further analysis and to establish the appropriate patient population and conduct wet laboratory studies. For this purpose, four different algorithms were used to evaluate the effects of single amino acid mutation. In addition, root-mean-square deviation, root-mean-square fluctuation and free-energy landscape analyses were performed to observe stability, flexibility and energetically favorable conformations, respectively, for each amino acid mutation. As a result, our study emphasizes the importance of Keap1 mutations in pediatric ALL Nrf2/Keap1 pathway, a total of eight mutations, two of which were shown for the first time in our study. Especially the mutations in the Keap1 Broad-Complex, Tramtrack and Bric-à-brac domain are worthy of attention.Communicated by Ramaswamy H. Sarma.