The efficacy and synthetic versatility of asymmetric organocatalysis have contributed enormously to the field of organic synthesis since the early 2000s. As asymmetric organocatalytic methods mature, ...they have extended beyond the academia and undergone scale-up for the production of chiral drugs, natural products, and enantiomerically enriched bioactive molecules. This review provides a comprehensive overview of the applications of asymmetric organocatalysis in medicinal chemistry. A general picture of asymmetric organocatalytic strategies in medicinal chemistry is firstly presented, and the specific applications of these strategies in pharmaceutical synthesis are systematically described, with a focus on the preparation of antiviral, anticancer, neuroprotective, cardiovascular, antibacterial, and antiparasitic agents, as well as several miscellaneous bioactive agents. The review concludes with a discussion of the challenges, limitations and future prospects for organocatalytic asymmetric synthesis of medicinally valuable compounds.
This review provides a comprehensive overview of the recent applications of organocatalytic strategies in pharmaceutical synthesis, with a focus on the preparation of antiviral, anticancer, neuroprotective, cardiovascular, antibacterial and antiparasitic agents.
Acne vulgaris is a cutaneous chronic inflammatory disorder with complex pathogenesis. Four factors play vital roles in acne pathophysiology: hyperseborrhea and dysseborrhea, altered keratinization of ...the pilosebaceous duct,
Cutibacterium acnes
(
C. acnes
) and inflammation. The main hormones responsible for the development of acne vulgaris include androgens, insulin and insulin-like growth factor-1. Other factors involved in this process are corticotropin-releasing hormone, α-melanocyte-stimulating hormone and substance P. Wnt/β-catenin signaling pathway, phosphoinositide 3-kinase (PI3K)/Akt pathway, mitogen-activated protein kinase pathway, adenosine 5′-monophosphate-activated protein kinase pathway and nuclear factor kappa B pathway participate in the modulation of sebocyte, keratinocyte and inflammatory cell (e.g. lymphocytes, monocytes, macrophages, neutrophils) activity. Among all the triggers and pathways mentioned above, IGF-1-induced PI3K/Akt/Forkhead box protein O1/mammalian target of rapamycin (mTOR) C1 pathway is the most important signaling responsible for acne pathogenesis. Commonly used anti-acne agents include retinoids, benzoyl peroxide, antibiotics and hormonal agents (e.g. spironolactone, combination oral contraceptive and flutamide). New approaches including peroxisome proliferator-activated receptor γ modifier, melanocortin receptor antagonists, epigallocatechin-3-gallate, metformin, olumacostat glasaretil, stearoyl-CoA desaturase inhibitor omiganan pentahydrochloride, K
D
PT, afamelanotide, apremilast and biologics have been developed as promising treatments for acne vulgaris. Although these anti-acne agents have various pharmacological effects against the diverse pathogenesis of acne, all of them have a synergistic mode of action, the attenuation of Akt/mTORC1 signaling and enhancement of p53 signal transduction. In addition to drug therapy, diet with no hyperglycemic carbohydrates, no milk and dairy products is also beneficial for treatment of acne.
During the Coronavirus Disease 2019 (COVID-19) pandemic, frontline nurses face enormous mental health challenges. Epidemiological data on the mental health statuses of frontline nurses are still ...limited. The aim of this study was to examine mental health (burnout, anxiety, depression, and fear) and their associated factors among frontline nurses who were caring for COVID-19 patients in Wuhan, China.
A large-scale cross-sectional, descriptive, correlational study design was used. A total of 2,014 eligible frontline nurses from two hospitals in Wuhan, China, participated in the study. Besides sociodemographic and background data, a set of valid and reliable instruments were used to measure outcomes of burnout, anxiety, depression, fear, skin lesion, self-efficacy, resilience, and social support via the online survey in February 2020.
On average, the participants had a moderate level of burnout and a high level of fear. About half of the nurses reported moderate and high work burnout, as shown in emotional exhaustion (n = 1,218, 60.5%), depersonalization (n = 853, 42.3%), and personal accomplishment (n = 1,219, 60.6%). The findings showed that 288 (14.3%), 217 (10.7%), and 1,837 (91.2%) nurses reported moderate and high levels of anxiety, depression, and fear, respectively. The majority of the nurses (n = 1,910, 94.8%) had one or more skin lesions, and 1,950 (96.8%) nurses expressed their frontline work willingness. Mental health outcomes were statistically positively correlated with skin lesion and negatively correlated with self-efficacy, resilience, social support, and frontline work willingness.
The frontline nurses experienced a variety of mental health challenges, especially burnout and fear, which warrant attention and support from policymakers. Future interventions at the national and organisational levels are needed to improve mental health during this pandemic by preventing and managing skin lesions, building self-efficacy and resilience, providing sufficient social support, and ensuring frontline work willingness.
To evaluate the effectiveness of web-based mobile health interventions on paediatric patients and their parents in the day surgery context, where the primary outcome was children's pre-operative ...anxiety and secondary outcomes were postoperative pain and parents' anxiety and satisfaction with entire course of the day surgery.
A systematic review and meta-analysis of randomized controlled trials.
CENTRAL, CINAHL, Scopus, Ovid MEDLINE, and Web of Science were systematically searched without time limits (up to December 2018).
Studies were appraised using the Cochrane risk of bias tool. A random effect meta-analysis of children's pre-operative anxiety was performed.
Eight studies with a total of 722 patients were included in the analysis. The effectiveness of web-based mobile health interventions, including age-appropriate videos, web-based game apps, and educational preparation games made for the hospital environment, was examined in pre-operative settings. A meta-analysis (N = 560 children) based on six studies found a statistically significant reduction in pre-operative anxiety measured by the Modified Yale Pre-operative Anxiety Scale with a moderate effect size. Three studies reported parental satisfaction.
Web-based mobile health interventions can reduce children's pre-operative anxiety and increase parental satisfaction. Web-based mobile health interventions could be considered as non-pharmacological distraction tools for children in nursing. There is not enough evidence regarding the effectiveness of reducing children's postoperative pain and parental anxiety using similar interventions.
Web-based mobile health interventions reduce children´s pre-operative anxiety and could therefore be considered as non-pharmacological distraction tools for children in nursing.
In nature, prenylation and geranylation are two important metabolic processes for the creation of hemiterpenoids and monoterpenoids under enzyme catalysis. Herein, we have demonstrated bioinspired ...unnatural prenylation and geranylation of oxindoles using the basic industrial feedstock isoprene through ligand regulation under Pd catalysis. Pentenylated oxindoles (with C5 added) were attained with high selectivity when using a bisphosphine ligand, whereas upon switching to a monophosphine ligand, selectivity toward geranylated oxindoles (with C10 added) was achieved. Moreover, the head‐to‐head product could be further isomerized to an internal skipped diene under Pd−H catalysis. No stoichiometric by‐product was formed in the process.
A practical strategy has been developed for the bioinspired and ligand‐regulated chemoselective unnatural prenylation and geranylation of oxindoles with isoprene under Pd catalysis. The selectivity was governed by modulating the coordination geometry of the Pd catalyst.
Thiophene‐based rings are one of the most widely used building blocks for the synthesis of sulfur‐containing molecules. Inspired by the redox diversity of these features in nature, we demonstrate ...herein a redox‐divergent construction of dihydrothiophenes, thiophenes, and bromothiophenes from the respective readily available allylic alcohols, dimethyl sulfoxide (DMSO), and HBr. The redox‐divergent selectivity could be manipulated mainly by controlling the dosage of DMSO and HBr. Mechanistic studies suggest that DMSO simultaneously acts as an oxidant and a sulfur donor. The synthetic potentials of the products as platform molecules were also demonstrated by various derivatizations, including the preparation of bioactive and functional molecules.
We report herein a redox‐divergent construction of dihydrothiophenes, thiophenes, and bromothiophenes from readily available allylic alcohols, dimethyl sulfoxide (DMSO), and HBr, respectively. This strategy can serve for the programmable and concise synthesis of bioactive and functional molecules.
Aims
To synthesize the effectiveness of web‐based psychosocial interventions on self‐efficacy, anxiety, depression, quality of life (QoL), non‐specific psychological and cancer‐specific distress ...among patients with colorectal cancer (CRC).
Design
A systematic review and meta‐analysis.
Data sources
Six databases (PubMed, PsycINFO, Embase, Scopus, CINAHL and CNKI) were searched from inception to December 2021.
Review methods
Experimental/quasi‐experimental studies involving patients with CRC for the improvement of aforementioned outcomes were included. Two reviewers screened and extracted the data, and assessed studies' methodological quality using risk of bias tools. Meta‐analyses and narrative syntheses were performed.
Results
Nineteen studies consisting of 1386 participants were identified. Cognitive‐behavioural therapy delivered online was the most common trialled web‐based psychosocial intervention. Meta‐analyses revealed no positive effect for self‐efficacy (standardized mean difference 0.93, 95% CI: 0.52 to 1.35, p < .01) and minimal benefit for QoL (mean difference MD 2.83, 95% CI: −0.31 to 5.98, p = .08) but significant positive effects for anxiety (MD −2.23, 95% CI: −3.31 to −1.14, p < .01) and depression (MD −2.84, 95% CI: −4.09 to −1.59, p < .01) among CRC survivors in the intervention group as compared with the control group. Narrative synthesis suggested possible benefits in reducing distress.
Conclusion
Web‐based psychosocial interventions are promising alternatives to conventional delivery methods in reducing patients' anxiety, depression and distress. However, evidence on self‐efficacy and QoL remains inconsistent. More adequately powered, well‐designed trials with targeted and theory‐based interventions are required to ascertain findings.
Impact
By highlighting the potential of web‐based psychosocial interventions in reducing anxiety and depression among CRC survivors, this review has put forth beneficial information supporting the use and acceptance of web‐based care delivery in light of COVID‐19 restrictions and nationwide lockdowns. Meanwhile, the paucity of empirical support reflects the necessity of more extensive research to test and improve other health outcomes.
PROSPERO registration number: CRD42021261396
ABSTRACT
Aims and objective
To explore the experiences and support needs of parents of children with recently diagnosed autism spectrum disorder (ASD) in Singapore.
Background
Raising a child with ...ASD is challenging for parents, especially in the initial period following the diagnosis. Limited studies have focused on parents’ perspectives.
Design
A qualitative descriptive design study.
Methods
Thirteen parents were recruited from a developmental and behavioural paediatric outpatient clinic of a tertiary hospital in Singapore from October–December 2018. Adult parents, who were primary caregivers of 2–10‐year‐old children diagnosed with ASD in the preceding 3 months to 2 years, were recruited. Semi‐structured individual face‐to‐face interviews were conducted based on an interview guide. Thematic analysis was used to analyse the data. Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist was used for reporting.
Results
Common themes were analysed using constant comparative method to generate results. Four themes emerged after 13 interviews: (1) adjusting psychologically, (2) changing lifestyle, (3) contending with hurdles to services and (4) needing informational, tangible and emotional support.
Conclusions
Findings suggested a need for more formal support networks, targeted resource platforms and accessibility of services to help support parents better after receiving a diagnosis of ASD in their child.
Relevance to clinical practice
Enhancing current healthcare and social policies to improve the provision of standardised and targeted information to parents, establishing formal support networks, facilitating access to childcare services, and involving domestic helpers/nannies as dedicated caregivers and trainers could better support parents.
Aim
To examine the effectiveness of a postnatal psychoeducation programme in enhancing maternal self‐efficacy and social support and reducing postnatal depression among primiparas.
Background
...Primiparas experience various challenges during the early postnatal period with low self‐efficacy, depression and lack of social support. Support in the form of postnatal educational programmes is needed to improve these outcomes of primiparas.
Design
A randomized controlled two‐group pre‐test–post‐test design was adopted.
Methods
Data were collected from June–December 2012 in a public hospital in Singapore from 122 primiparas, who were randomly assigned to the intervention (n = 61) or control group (n = 61). The intervention group received postnatal psychoeducation programme and routine care while the control group received routine care only. The Maternal Parental Self‐Efficacy scale, Perinatal Infant Care Social Support scale and Edinburgh Postnatal Depression Scale were used to measure outcomes of maternal parental self‐efficacy, social support and postnatal depression. The mean percentage changes of all three outcome variables from baseline to 6 and 12 weeks postpartum between groups were used when performing repeated measures multivariate analysis of covariance.
Results
The intervention group had significantly higher scores of maternal parental self‐efficacy and social support and lower scores of postnatal depression at 6 and 12 weeks postpartum when compared with the control group.
Conclusion
The postnatal psychoeducation programme was effective in improving maternal outcomes and hence could be introduced as routine care with ongoing evaluation in the postnatal period. Future studies could focus on the effects of this programme on other populations.
Trial registration no: ISRCTN15886353.
Aims
To evaluate preliminary effects of a newly developed STOMA psychosocial intervention programme that was delivered via a multi‐modal and multi‐dimensional approach on the improvement of outcomes ...of colorectal cancer patients with stoma.
Background
With a distorted body image and the loss of an essential body function, stoma patients face difficulties in everyday life in terms of physical, psychological, and social aspects. Few studies have explored effects of psychosocial interventions on improving stoma‐related health outcomes.
Design
This was a two‐group pre‐test‐post‐test pilot randomized controlled trial.
Methods
Fifty‐three participants were recruited from July 2015–November 2016 in a tertiary public hospital in Singapore. They were randomized into either intervention group (N = 29) or control group (N = 24). Stoma care self‐efficacy, acceptance of stoma, stoma proficiency, length of hospital stay, anxiety and depression and quality of life were measured. IBM SPSS 24.0 was used to analyse the data.
Results
There was an improvement in acceptance of stoma in the intervention group (p < 0.05). Significant effects on stoma care self‐efficacy, stoma proficiency, length of hospital stay, anxiety and depression level and quality of life were not shown.
Conclusion
This study developed a feasible and applicable psychosocial intervention programme and generated preliminary evidence in the positive outcomes of colorectal cancer patients with stoma. Future studies can explore technology‐based interventions to provide a more sustainable support for patients with stoma.
目的
评估新制定的造口社会心理干预方案的初步效果,该方案通过多模式和多维方法实施,以改善结直肠癌造口患者预后。
背景
由于生理状态改变,并丧失了基本的生理功能,造口患者在日常生活中面临生理、心理和社会方面的困难。而很少有研究探讨社会心理干预对改善造口相关的健康结果的影响。
设计
两组随机对照试验,包括预测和后测。
方法
2015年7月至2016年11月,在新加坡的一家三级公立医院招募了53名受试者。受试者被随机分为干预组(29例)和对照组(24例),测量了造口护理自我效能、造口接受度、造口熟练程度、住院时间、患者的焦虑和抑郁程度以及患者的生活质量。采用IBM SPSS 24.0对数据进行分析。
结果
两组随机对照试验,包括预测和后测。
结论
本研究制定了一个适用可行的社会心理干预方案,初步证实结直肠癌造口患者预后良好。未来的研究可以探索基于技术的干预措施,为造口患者提供可持续的支持。
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