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INTRODUCTION: The course of maternal antiviral prophylaxis to prevent mother-to-child transmission of hepatitis B virus (HBV-MTCT) varies greatly, and it has not been demonstrated in a randomized controlled study. METHODS: In this multicenter, open-label, randomized controlled trial, eligible pregnant women with HBV DNA of 5.3-9.0 log10 IU/mL who received tenofovir alafenamide fumarate (TAF) from the first day of 33 gestational weeks to delivery (expected eight-week) or to four-week postpartum (expected twelve-week) were randomly enrolled at a 1:1 ratio and followed until six-month postpartum. All infants received standard immunoprophylaxis (hepatitis B immunoglobulin and vaccine). The primary endpoint was the safety of mothers and infants. The secondary endpoint was infants' HBV-MTCT rate at seven months of age. RESULTS: Among 119 and 120 intention-to-treat pregnant women, 115 and 116 women were followed until delivery, and 110 and 112 per-protocol mother-infant dyads in two groups completed the study. Overall, TAF was well tolerated, no one discontinued therapy due to adverse events (0/239, 0%, 95% confidence interval [CI] 0%-1.6%), and no infant had congenital defects or malformations at delivery (0/231, 0%, 95% CI 0%-1.6%). The infants' physical development at birth (n=231) and at seven months (n=222) were normal. Furthermore, 97.0% (224/231, 95% CI 93.9%-98.5%) of women achieved HBV DNA <5.3 log10 IU/mL at delivery. The intention-to-treat and per-protocol infants' HBV-MTCT rates were 7.1% (17/239, 95% CI 4.5%-11.1%) and 0% (0/222, 95% CI 0%-1.7%) at seven months of age. Comparatively, 15.1% (18/119, 95% CI 9.8%-22.7%) versus 18.3% (22/120, 95% CI 12.4%-26.2%) of women in the two groups had mildly elevated alanine aminotransferase levels at three-month and six-month postpartum, respectively (P=0.507); notably, no one experienced alanine aminotransferase flare (0% [0/119, 95% CI 0%-3.1%] versus 0% [0/120, 0%-3.1%]). DISCUSSION: Maternal TAF prophylaxis to prevent HBV-MTCT is generally safe and effective, and expected eight-week prenatal duration is feasible. ClinicalTrials.gov, NCT04850950.
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Chalcogen bond catalysis, particularly cationic hypervalent chalcogen bond catalysis, is considered to be an effective strategy for organocatalysis. In this work, the cationic hypervalent chalcogen bond catalysis for the Povarov reaction between N-benzylideneaniline and ethyl vinyl ether was investigated by density functional theory (DFT). The catalytic reaction involves the cycloaddition process and the proton transfer process, and the rate-determining step is the cycloaddition process. Cationic hypervalent tellurium derivatives bearing CF3 and F groups exhibit superior catalytic activity. For the rate-determining step, the Gibbs free energy barrier decreases as the positive electrostatic potential of the chalcogen bond catalysts increases. More importantly, the Gibbs free energy barrier has a strong linear correlation with the electrostatic energy of the chalcogen bond in the catalyst-substrate complex. Furthermore, the catalytic reactions include the endo pathway and exo pathway. The C-Hâ â â π interaction between the substituent of the ethyl vinyl ether and the aryl ring of the N-benzylideneaniline contributes to the endo-selectivity of the reaction. This research contributes to a deeper understanding of chalcogen bond catalysis, providing insights for designing chalcogen bond catalysts with high performance.
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Chalcogen bond (ChB) catalysis, as a new type in the field of non-covalent bond catalysis, has become a hot research topic in the field of organocatalysis in recent years. In the present work, we investigated the catalytic performance of a series of hypervalent ChB catalysis based on the intramolecular Aza-Michael reaction of aminochalcone. The reaction includes the carbon-nitrogen bond coupling step (key step) and the proton transfer step. The catalytic performance of mono-dentate pentafluorophenyl chalcogen bond donor ChB1 was comparable to that of bis-dentate chalcogen bond donor ChB4, and stronger than that of mono-dentate chalcogen bond donors ChB2 and ChB3. The formation of the chalcogen bond between the catalyst and the carbonyl oxygen atom of the reactant, causing the charge rearrangement of the reactant and C(1) charge of the -C-Ph group to become more positive, thereby the ChB catalysis promoted the nucleophile reaction. The electron density of the chalcogen bond of the pre-complex, the most positive electrostatic potentials of the catalyst, and the NPA charge of the key atom are proportional to the Gibbs energy barrier of the C-N bond coupling process, which provides an idea to predict the catalytic activity of the ChB catalysis.
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Heterobimetallic complexes have recently garnered considerable attention in organic synthesis owing to their high activity and selectivity, which surpass those of monometallic complexes. In this study, the detailed mechanisms of terminal alkyne dimerization activated by the heterobimetallic Zr/Co complex, as well as the different stereoselectivities of Me3SiC≡CH and PhC≡CH dimerization, were investigated and elucidated by using density functional theory calculations. After excluding the three-molecule reaction and outer-sphere mechanisms, the inner-sphere mechanism was determined as the most optimal process. The inner-sphere mechanism involves four processes: THF dissociation and coordination of the first alkyne; ligand migration and C-H activation; N2 dissociation and insertion of the second alkyne; and reductive elimination. The stereoselectivity between the E-/Z- and gem-isomers is determined by the C-C coupling mode of the two alkynes and that of the E- and Z-isomers is determined by the sequence of the C-C coupling and hydrogen migration in the reductive elimination process. Me3SiC≡CH dimerization yields only an E-isomer owing to the large differences in the distortion and interaction energies, whereas PhC≡CH dimerization produces an E-, Z-, and gem-isomers owing to the reduced interaction energy differences.
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Glycogen synthase kinase 3ß (GSK-3ß) is a potential therapeutic target for the treatment of a variety of human diseases. Here, we report the design and synthesis of a series of thieno[3,2-c]pyrazol-urea derivatives and evaluation of their GSK-3ß inhibitory activity. Among these analogues, the compound without substitution on terminal phenyl ring (3a) was found to be the most potent GSK-3ß inhibitor with an IC50 of 74.4 nM, while substitution on the terminal phenyl (3b-3p) led to decreased potency, independent of the position, size, or electronic properties of the substituents. Kinase selectivity assay revealed that 3a showed good selectivity over a panel of kinases, but was less selective over CDK1, CDK2 and CDK5. Additionally, the pharmacological properties of the synthesized compounds were investigated computationally by the SwissADME and the results showed that most of the compounds have good ADME profiles.
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Desenho de Fármacos , Glicogênio Sintase Quinase 3 beta , Inibidores de Proteínas Quinases , Pirazóis , Ureia , Pirazóis/química , Pirazóis/farmacologia , Pirazóis/síntese química , Humanos , Glicogênio Sintase Quinase 3 beta/antagonistas & inibidores , Glicogênio Sintase Quinase 3 beta/metabolismo , Ureia/farmacologia , Ureia/análogos & derivados , Ureia/química , Ureia/síntese química , Relação Estrutura-Atividade , Inibidores de Proteínas Quinases/farmacologia , Inibidores de Proteínas Quinases/síntese química , Inibidores de Proteínas Quinases/química , Estrutura Molecular , Quinase 3 da Glicogênio Sintase/antagonistas & inibidores , Quinase 3 da Glicogênio Sintase/metabolismo , Relação Dose-Resposta a DrogaRESUMO
Criegee intermediates (CIs), the key intermediates in the ozonolysis of olefins in atmosphere, have received much attention due to their high activity. The reaction mechanism of the most simple Criegee intermediate CH2OO with vinyl alcohol (VA) was investigated by using the HL//M06-2X/def2TZVP method. The temperature and pressure dependent rate constant and product branching ratio were calculated using the master equation method. For CH2OO + syn-VA, 1,4-insertion is the main reaction channel while for the CH2OO + anti-VA, cycloaddition and 1,2-insertion into the O-H bond are more favorable than the 1,4-insertion reaction. The 1,4-insertion or cycloaddition intermediates are stabilized collisionally at 300 K and 760 torr, and the dissociation products involving OH are formed at higher temperature and lower pressure. The rate constants of the CH2OO reaction with syn-VA and anti-VA both show negative temperature effects, and they are 2.95 × 10-11 and 2.07 × 10-13 cm3 molecule-1 s-1 at 300 K, respectively, and the former is agreement with the prediction in the literature.
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OBJECTIVES: This systematic review and meta-analysis aimed to determine the prevalence of loneliness and social isolation among informal carers of individuals with dementia and to identify potential influencing factors. METHODS: We conducted a comprehensive search across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, CINAHL, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG. Our search strategy covered the inception of the databases up to September 16, 2023, with an updated search conducted on March 8, 2024. Prevalence estimates of loneliness and social isolation, presented with 95% confidence intervals, were synthesized through meta-analysis. Subgroup analyses and meta-regression were employed to explore potential moderating variables and heterogeneity. RESULTS: The study encompassed 27 research papers involving 11,134 informal carers from 17 different countries. The pooled prevalence of loneliness among informal carers of individuals with dementia was 50.8% (95% CI: 41.8%-59.8%), while the pooled prevalence of social isolation was 37.1% (95% CI: 26.7%-47.6%). Subgroup analyses and meta-regression indicated that various factors significantly influenced the prevalence of loneliness and social isolation. These factors included the caregiving setting, study design, the intensity of loneliness, geographical location (continent), data collection time, and the choice of assessment tools. CONCLUSIONS: This study underscores the substantial prevalence of loneliness and social isolation among informal carers of individuals with dementia. It suggests that policymakers and healthcare providers should prioritize the development of targeted interventions and support systems to alleviate loneliness and social isolation within this vulnerable population.
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Cuidadores , Demência , Solidão , Isolamento Social , Humanos , Solidão/psicologia , Demência/psicologia , Demência/enfermagem , Isolamento Social/psicologia , Cuidadores/psicologia , PrevalênciaRESUMO
As important noncovalent interactions, halogen bonds have been widely used in material science, supramolecular chemistry, medicinal chemistry, organocatalysis, and other fields. In the past 15 years, halogen bond catalysis has become a developed field in organocatalysis for the catalysts' advantages of being environmentally friendly, inexpensive, and recyclable. Halogen bonds can induce various organic reactions, and halogen bond catalysis has become a powerful alternative to the fully explored hydrogen bond catalysis. From a physical chemistry view, this perspective provides an overview of the latest progress and key examples of halogen bond catalysis via activation of the lone pair systems of organic functional group, π systems, and metal complexes. The research progresses in halogen bond catalysis by our group were also introduced.
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The metal-involving Ch···M chalcogen bond and the conventional Ch···O chalcogen bond between ChX2 (Ch = Se, Te; X = CCH, CN) acting as a Lewis acid and M(acac)2 (M = Pd, Pt; Hacac = acetylacetone) acting as a Lewis base were studied by density functional theory calculations. It has been observed that the nucleophilicity of the PtII complexes is higher than that of the corresponding PdII complexes. As a result, the PtII complexes tend to exhibit a more negative interaction energy and larger orbital interaction. The strength of the chalcogen bond increases with the increase of the chalcogen atom and the electronegativity of the substituent on the Lewis acid and vice versa. The metal-involving chalcogen bond shows a typical weak closed-shell noncovalent interaction in the (HCC)2Ch···M(acac)2 complexes, while it exhibits a partially covalent nature in the (NC)2Ch···M(acac)2 complexes. The conventional Ch···O chalcogen bond displays the character of a weak noncovalent interaction, and its strength is generally weaker than that of metal-involving Ch···M interactions. It could be argued that the metal-involving chalcogen bond is primarily determined by the correlation term, whereas the conventional chalcogen bond is mainly governed by the electrostatic interaction.
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Single-walled carbon nanotubes (SWCNTs) have gained a lot of attention in the past few decades due to their promising optoelectronic properties. In addition, SWCNTs can form complexes that have good chemical stability and transport properties with other optical functional materials through noncovalent interactions. Elucidating the detailed mechanism of these complexes is of great significance for improving their optoelectronic properties. Nevertheless, simulating the photoinduced dynamics of these complexes accurately is rather challenging since they usually contain hundreds of atoms. To save computational efforts, most of the previous works have ignored the excitonic effects by employing nonadiabatic carrier (electron and hole) dynamics simulations. To properly consider the influence of excitonic effects on the photoinduced ultrafast processes of the SWCNT-tetraphenyl porphyrin (H2TPP) complex and to further improve the computational efficiency, we developed the nonadiabatic molecular dynamics (NAMD) method based on the extended tight binding-based simplified Tamm-Dancoff approximation (sTDA-xTB), which is applied to study the ultrafast photoinduced dynamics of the noncovalent SWCNT-porphyrin complex. In combination with statically electronic structure calculations, the present work successfully reveals the detailed microscopic mechanism of the ultrafast excitation energy transfer process of the complex. Upon local excitation on the H2TPP molecule, an ultrafast energy transfer process occurs from H2TPP (SWCNT-H2TPP*) to SWCNT (SWCNT*-H2TPP) within 10 fs. Then, two slower processes corresponding to the energy transfer from H2TPP to SWCNT and hole transfer from H2TPP to SWCNT take place in the 1 ps time scale. The sTDA-xTB-based electronic structure calculation and NAMD simulation results not only match the previous experimental observations from static and transient spectra but also provide more insights into the detailed information on the complex's photoinduced dynamics. Therefore, the sTDA-xTB-based NAMD method is a powerful theoretical tool for studying the ultrafast photoinduced dynamics in large extended systems with a large number of electronically excited states, which could be helpful for the subsequent design of SWCNT-based functional materials.
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Recently, chalcogen bond catalysts with telluronium cations have garnered considerable attention in organic reactions. In this work, chalcogen bond catalysis on the bromination reaction of anisole with N-bromosuccinimide (NBS) with the telluronium cationic catalysts has been explored with density functional theory (DFT). The catalytic reaction is divided into two stages: the bromine transfer step and the proton transfer step. Based on the computational results, one can find the rate-determining step is the bromine transfer step. Moreover, the present study elucidates that a stronger chalcogen bond between catalysts and NBS will give better catalytic performance. Additionally, this work also clarified the importance of the electrostatic and polarization effects in the chalcogen bond between the oxygen atom of NBS and the Te atom of the catalyst in this bromination reaction. The electrostatic and polarization effects are significantly influenced by the electron-withdrawing ability of the substitution groups on the catalysts. Moreover, the structure-property relationship between the strength of chalcogen bond, electrostatic effect, polarization effect and catalytic performance are established for the design of more efficient chalcogen bond catalysts.
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Recently, the green and high efficient of chalcogen bond (ChB) catalysis has been aroused great interest. In this work, the ChB catalysis has been applied to the intramolecular Rauhut-Currier (RC) reaction of bis(enones). The mechanism was divided into four processes: the promoter addition process, the carbon-carbon bond coupling process, the hydrogen transfer process, and the promoter elimination process. This study shows that the ChB catalyst could act on the promoter and reactant in the RC reaction, respectively. And the path 2 of ChB catalyst direct acting on the reactant is considered to be a relatively favorable channel of the reaction due to a lower energy barrier. In addition, all six catalysts could achieve good catalytic effect. Analysis of the properties shows that the formation of chalcogen bond mainly promotes the charge transfer of LP(O)-BD*(C-Se) in the carbon-carbon bond formation (key step), so that the charge of C(4) atom become more positive, thereby accelerating the reaction.
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There have been remarkable advances in the syntheses and applications of groups 13 and 14 homonuclear ethene analogues. However, successes are largely limited to aryl- and/or silyl-substituted species. Analogues bearing two or more heteroatoms are still scarce. In this work, the block-localized wavefunction (BLW) method at the density functional theory (DFT) level was employed to study dialumene and disilene bearing two amino substituents whose optimal geometries exhibit significantly stretched central M=M (M=Al or Si) double bonds compared with aryl- and/or silyl-substituted species. Computational analyses showed that the repulsion between the lone electron pairs of amino substituents and M=M π bond plays a critical role in the elongation of the M=M bonds. Evidently, replacing the substituent groups -NH2 with -BH2 can enhance the planarity and shorten the central double bonds due to the absence of lone pair electrons in BH2 .
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Given the extraordinary versatility in chemical reactions and applications, boron compounds have gained increasing attentions in the past two decades. One of the remarkable advances is the unprecedented preparation of unsaturated boron species. Notably, Braunschweig etâ al. found that the cyclic (alkyl)(amino) carbenes (CAACs) stabilized diboron molecules (CAAC)2 B2 (SR)2 host unpaired electrons and exist in the 90°-twisted diradical form, while other analogues, such as N-heterocyclic carbenes (NHCs), stabilized diboron molecules prefer a conventional B=B double bond. Since previous studies recognized the differences in the steric effect between CAAC and NHC carbenes, here we focused on the role of thiol substituents in (CAAC)2 B2 (SR)2 by gradually localizing involved electrons. The co-planarity of the thiol groups and the consequent captodative effect were found to be the culprit for the 90°-twisted diradical form of (CAAC)2 B2 (SR)2 . Computational analyses identified two forces contributing to the π electron movements. One is the "push" effect of lone pairs on the sulfur atoms which boosts the π electron delocalization between the BB center and CAACs. The other is the π electron delocalization within each (CAAC)B(SR) fragment where the pull effect originates from the π electron withdrawal by CAACs. There are two such independent and orthogonal push-pull channels which function mainly in individual (CAAC)B(SR) fragments. This enhanced π push-pull effect in the triplet state facilitates the electronic excitation in (CAAC)2 B2 (SR)2 by reducing the singlet-triplet gap.
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Bimetallic synergistic catalysis is one of the most effective and powerful strategies for the synthesis of oxazolones, an important species in organic synthesis. In this work, the mechanism of AuCl(PMe3)/AgOTf-Pd(0) ([Au-Pd]) bimetallic catalyst-catalyzed oxazolone synthesis using N-alkynyl carbamates as precursors was studied in detail by DFT calculations and the catalytic performances of a series of bimetallic catalysts were evaluated. The results show that the reaction begins from the [Au]-catalyzed cycloisomerization of N-alkynyl carbamates. After the five-membered intermediate is formed, the [Pd(0)]-catalyzed cycle starts, which contains three steps: oxidation addition, transmetalation, and reductive elimination. The whole reaction belongs to a catalyzed catalysis, and the reductive elimination is the rate-determining step. In the transmetalation process, both the [Pd(0)] catalyst and the ionic bridge are necessary. For the [Au-Pd]-catalyzed process, it is Cl- as the bridge, not OTf-. The cheaper metal compound, AgCl(PMe3), can serve as the alternative of AuCl(PMe3) to co-catalyze with the [Pd(0)] catalyst for the title reaction.
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Halogen bond catalysis, especially iodine derivatives catalysis, has attracted increasing attention in recent years owing to the advantages of relatively cheap, stable, green, easy to handle, and favorable catalytic activity. To obtain insights into the catalytic mechanism and activity of halogen bond donor catalysts, iodine(I)-based and iodine(III)-based halogen bond catalysis on the Friedel-Crafts reaction were investigated in this study. The entire reaction contains several key steps: carbon-carbon bond coupling, proton transfer, hydroxyl departure, indole addition, and deprotonation process. According to the energetic span model, iodine(III)-based donor catalysts exhibit higher catalytic activity than iodine(I)-based catalysts and double cationic catalysts are more potent than single cationic ones. For halogen bond catalysis, the Gibbs energy barriers have linear relation to the electron density at the halogen bond critical points. Furthermore, the Gibbs energy barriers are also linearly related to the integral charge values of the increased region of electron density outside the oxygen atom of reactants. Therefore, the stronger halogen bond results in lower Gibbs energy barrier, and the stronger polarization further benefits the halogen bond catalysis.
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Halogen bond donor catalysts have been widely used in organic reactions because they are environmentally friendly, inexpensive and recyclable. The [4+2] cycloaddition reaction is a key reaction in organic synthesis because of its ease of use, fast speed, and wide range of applications. In this work, halogen bond catalysis in the [4+2] cycloaddition reaction between 2-alkenylindoles was investigated based on DFT calculations. There are two modes of Iâ¯π halogen bond catalysis: either on the ethenyl of 2-alkenylindole (mode A) or on the five-membered ring of 2-alkenylindole (mode B). Both modes involve two steps: the formation of carbon-carbon bonds and the formation of six-membered rings. Gibbs free energy barriers were determined to investigate the stereoselectivity of the endo pathway and exo pathway. For mode A, the exo products were more easily generated when the substituent R = H, and the N-Hâ¯π interaction promoted high endo selectivity in the case of the substituent R = Ph. For mode B, an increasing proportion of endo products can be obtained in the order of catalyst I2, IBr and ICl. The πâ¯π interaction of the substituent R = Ph promotes the [4+2] cycloaddition reaction, which is consistent with the experimental observation that R = Ph has a higher yield than R = H. The study of different catalytic modes and stereoselectivity would provide new ideas for the further study of the [4+2] cycloaddition reaction.
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The use of a superlattice structure is an effective strategy to develop novel perovskites and obtain excellent light-absorbing materials. Based on first-principles calculations, we systematically studied the properties of intrinsic point defects at the interface of the FAPbI3/MAPbI3 superlattice. Our calculations show that charged defects are easier to form as compared to neutral ones at the superlattice interface due to low formation energies. Most defects with low formation energies have a shallow level in the band gap, and some deep level defects have high formation energies, so the superlattice perovskite exhibits high defect tolerance. PbI3+ is a dominant and detrimental defect, which acts as a non-radiative recombination center because it has low formation energy and a deep transition level. To avoid the generation of PbI3+ defects, it is suggested to synthesize FAPbI3/MAPbI3 superlattices under I-rich conditions. The calculated light absorption coefficients and photovoltaic performance parameters demonstrate that the presence of defects leads to a certain degree of reduction in light absorption and power conversion efficiency (PCE) of solar cells made of FAPbI3/MAPbI3 superlattices, but the excellent performance of the perovskite solar cell (PSC) is basically retained. The superlattice perovskites are still promising candidates for light-absorbing materials of PSCs. This study is expected to contribute to a better understanding of the properties of defects at the superlattice interface and provide theoretical support for the design of high performance PSCs.
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Except for the well-known σ-hole regium bonds formed by metal nanoparticles and M(I) (M = Cu, Ag, and Au) derivatives, the existence of π-hole regions located above and below the Au atom in gold(III) derivatives suggests that gold(III) also functions as an efficient electrophilic site. In this study, a comprehensive analysis was conducted on the electrophilicity of trichloro-(p-toluonitrilo-N)-gold(III) derivatives AuL3(NCC6H4X) (L = Cl, Br, CN; X = NH2, CH3, CF3, NC, and CN) and the nature of π-hole regium bonds in the AuL3(NCC6H4X)â¯LB (LB = NH3, N(NH3)3, CH2O, C2H2, C2H4, C6H6) and (AuCl3(NCC6H4Y))n (Y = Cl, CN, NC, NO2; n = 2, 3)) complexes. The characteristics of the π-hole regium bonds were studied with respect to the influence of ligands and substituents, the strength of intermolecular interactions between Au(III) derivatives and Lewis bases, and those in the polymers. In the case of the AuL3(NCC6H4X)â¯NH3 complexes, the strength of the regium bonds increases gradually in the order of L = Cl < Br < CN and X = NH2 < CH3 < CF3 ≈ NC < CN. The ligands (L) attached to the Au atom exert a significant effect on the strength of the π-hole regium bonds in comparison to the substituents (X) on the benzene ring. The regium bonds are primarily dominated by electrostatic interaction, accompanied by moderate contribution from polarization. Linear relationships were identified between the electrostatic energies and the local most positive potentials over the Au atom, as well as between the polarization energies and the amount of charge transfer. Most of the π-hole regium bonds in the AuL3(NCC6H4X)â¯LB complexes exhibit the characters of closed shell noncovalent interactions. In the polymers (AuCl3(NCC6H4Y))n, weak face-to-face π-π stacking interactions are also present, in addition to regium bonds. The trimers displayed a slightly negative cooperativity in comparison to the dimers.
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Exposure to workplace bullying increases the risk of sickness absence. However, the extent and direction of this relationship for different follow-up lengths are not well established. To provide evidence regarding the direction and extent of the relationship between workplace bullying and different durations of sickness absence. We searched nine databases from their inception to 29 November 2022. Multiple independent observers screened the literature, extracted the data and used the Risk Of Bias In Non-randomised Studies of Exposure to assess the methodological quality. The overall effect sizes of odds ratio, relative risk, hazard ratio and 95% confidence intervals were calculated. Our meta-analysis demonstrated a 26% increased risk of sick leave among workers exposed to workplace bullying for all follow-up lengths (95% CI 1.18 to 1.35), even after adjusting for confounding factors. Moreover, we found a significant association between long-term sickness absence and a higher likelihood of subsequent exposure to workplace bullying, with a pooled OR of 1.63 (95% CI 1.21 to 2.04). Our study established a bidirectional relationship between workplace bullying and long-term sickness absence, highlighting that it increases the risk of sickness absence at different follow-up lengths among employees who have been bullied. Hence, organisations should be mindful of workers who resume work after prolonged absences due to illness and adopt appropriate management strategies to prevent workplace bullying.