Factors associated with returning to work in head and neck cancer survivors in Singapore: A preliminary exploratory mixed-methods approach study.

BACKGROUND: Little is known about return-to-work (RTW) among Asian head and neck cancer (HNC) survivors. We investigated the prevalence and factors associated with RTW among HNC patients with in Singapore. METHODS: In this cross-sectional mixed-methods study, 80 HNC patients, who had been working prior to diagnosis, completed questionnaires and 15 participated in qualitative interviews to explore perceived barriers and facilitators of RTW. Multivariate logistic regression was used to evaluate factors associated with not-returning-to-work (NRTW) within 6 months of treatment completion. RESULTS: Thirty-five participants reported NRTW 43.8%. Multivariable analysis showed that patients with advanced stage (III-IV) cancer (odds ratios [OR] = 4.51, 95% confidence intervals [CI]: 1.15-13.28, p = 0.006), multi-modality treatment (OR = 4.62, 95% CI: 1.38-15.52, p = 0.013), and pink-collar jobs (OR = 9.30, 95% CI: 1.70-50.83, p = 0.010) had higher odds of NRTW. CONCLUSION: The factors associated with employment after HNC treatment are complex. Identification of key modifiable factors may lead to improved RTW outcomes.

"Zipped Synthesis" by Cross-Metathesis Provides a Cystathionine ß-Synthase Inhibitor that Attenuates Cellular H2S Levels and Reduces Neuronal Infarction in a Rat Ischemic Stroke Model.

The gaseous neuromodulator H2S is associated with neuronal cell death pursuant to cerebral ischemia. As cystathionine ß-synthase (CBS) is the primary mediator of H2S biogenesis in the brain, it has emerged as a potential target for the treatment of stroke. Herein, a "zipped" approach by alkene cross-metathesis into CBS inhibitor candidate synthesis is demonstrated. The inhibitors are modeled after the pseudo-C 2-symmetric CBS product (l,l)-cystathionine. The "zipped" concept means only half of the inhibitor needs be constructed; the two halves are then fused by olefin cross-metathesis. Inhibitor design is also mechanism-based, exploiting the favorable kinetics associated with hydrazine-imine interchange as opposed to the usual imine-imine interchange. It is demonstrated that the most potent "zipped" inhibitor 6S reduces H2S production in SH-SY5Y cells overexpressing CBS, thereby reducing cell death. Most importantly, CBS inhibitor 6S dramatically reduces infarct volume (1 h post-stroke treatment; ∼70% reduction) in a rat transient middle cerebral artery occlusion model for ischemia.