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1.
Small ; 20(26): e2310838, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38214694

RESUMO

Although bioactive compounds (BCs) have many important functions, their applications are greatly limited due to their own defects. The development of nanocarriers (NCs) technology has gradually overcome the defects of BCs. NCs are equally important as BCs to some extent. Self-assembly (SA) methods to build NCs have many advantages than chemical methods, and SA has significant impact on the structure and function of NCs. However, the relationship among SA mechanism, structure, and function has not been given enough attention. Therefore, from the perspective of bottom-up building mechanism, the concept of SA-structure-function of NCs is emphasized to promote the development of SA-based NCs. First, the conditions and forces for occurring SA are introduced, and then the SA basis and molecular mechanism of protein, polysaccharide, and lipid are summarized. Then, varieties of the structures formed based on SA are introduced in detail. Finally, facing the defects of BCs and how to be well solved by NCs are also elaborated. This review attempts to describe the great significance of constructing artificial NCs to deliver BCs from the aspects of SA-structure-function, so as to promote the development of SA-based NCs and the wide application of BCs.


Assuntos
Portadores de Fármacos , Sistemas de Liberação de Medicamentos , Portadores de Fármacos/química , Sistemas de Liberação de Medicamentos/métodos , Nanopartículas/química , Humanos , Lipídeos/química
2.
Chemistry ; 30(11): e202303504, 2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38059680

RESUMO

Scalable [3+2] cycloaddition of alkynyl boronates and in situ generated unstabilized azomethine ylide is reported for the first time. The selective formation of either 1 : 1 or 1 : 2 cycloaddition products was achieved by carefully optimizing the reaction conditions, mainly by controlling the reactant stoichiometry, catalyst loading, and internal temperature. The developed protocol tolerated many valuable functional groups, including TMS, protected alcohol (as ether or THP derivatives), or aldehyde (as acetal). Further common C-C and C-heteroatom bond-forming reactions, as well as scaled-up procedures demonstrate the utility of the prepared compounds as building blocks for organic synthesis and drug discovery.

3.
Chemistry ; 30(17): e202304080, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38200698

RESUMO

Utilization of well-defined siloxane molecules allows for the construction of functional siloxane-based nanoporous materials based on the molecular design. Herein, a novel class of siloxane-based porous materials is synthesized via cross-linking of dimethylsilyl- and dimethylvinylsilyl-functionalized cage siloxanes with double-6-ring (D6R) geometry. Compared with the conventional double-4-ring cage siloxane, this study highlights the characteristics of D6R siloxanes as building blocks, demonstrating their high surface area and chemical stability. Furthermore, density functional theory calculations show their unique cation encapsulation ability.

4.
Chemistry ; 30(8): e202303519, 2024 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-38018776

RESUMO

Three unusual ajmaline-macroline type bisindole alkaloids, alsmaphylines A-C, together with their postulated biogenetic precursors, were isolated from the stem barks and leaves of Alstonia macrophylla via the building blocks-based molecular network (BBMN) strategy. Alsmaphyline A represents a rare ajmaline-macroline type bisindole alkaloid with an S-shape polycyclic ring system. Alsmaphylines B and C are two novel ajmaline-macroline type bisindole alkaloids with N-1-C-21' linkages, and the former possesses an unconventional stacked conformation due to the presence of intramolecular noncovalent interactions. The chemical structures including absolute configurations of alsmaphylines A-C were established by comprehensive spectroscopic analyses, electronic circular dichroism (ECD) calculations, and single-crystal X-ray crystallography. In addition, a plausible biosynthetic pathway of these bisindole alkaloids as well as their ability to promote the protein synthesis on HT22 cells were discussed.


Assuntos
Alcaloides , Alstonia , Oxindóis , Alstonia/química , Ajmalina , Alcaloides Indólicos/química , Estrutura Molecular , Alcaloides/química
5.
Chem Rec ; 24(2): e202300283, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37873869

RESUMO

Modern organic chemistry is a titan supporting and reinforcing pharmaceutical, agricultural, food and material science products. Over the past decades, the organic compounds market has been evolving to meet all the research demands. In this regard, medicinal chemistry is especially dependent on available chemical space as subtle tuning of the molecule structure is required to create a drug with relevant physicochemical properties and a remarkable activity profile. The recent rapid evolution of synthetic methodology to deploy fluorine has brought fluorinated compounds to the spotlight of MedChem community. And now unique properties of fluorine still keep fascinating more and more as its justified installation into a molecular framework has a beneficial impact on membrane permeability, lipophilicity, metabolic stability, pharmacokinetic properties, conformation, pKa , etc. The backward influence of medicinal chemistry on organic synthesis has also changed the landscape of the latter towards new fluorinated topologies as well. Such complex relationships create a flexible and ever-changing ecosystem. Given that MedChem investigations strongly lean on the ability to reach suitable building blocks and the existence of reliable synthetic methods in this review we collected advances in the chemistry of respectful, but still enigmatic gem-difluorinated aza-heterocyclic building blocks.

6.
Chem Rec ; 24(2): e202300258, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37753806

RESUMO

This review disclosed synthetic approaches to sulfonyl amides from non-sulfonyl halogenated precursors. Known methods were systematized into groups and subgroups according to the type of starting organosulfur compound. Thiols, disulfides, and sulfonamides form a group of S(II)-containing precursors, which are used in oxidative amination reactions. An important and versatile group for oxidative amination is represented with S(IV)-containing compounds, i. e., sufinates, sulfinamides, DMSO, N-sulfinyl-O-(tert-butyl)hydroxylamine, etc. A series of S(VI)-containing precursors for amination reactions (except sulfonyl halides) include sulfonic acids, sulfonyl azides, thiosulfonates, and sulfones. All approaches are represented with the most prominent examples of the resulting sulfonamides, which could be obtained in high yields mostly via short reaction sequences. Promising electrochemical methods for the preparation of sulfonamides from thiols, disulfides, sulfonamides, sulfinic acid derivatives, and dimethyl sulfoxide under mild and green conditions are also highlighted.

7.
Bioorg Med Chem Lett ; 100: 129614, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38199329

RESUMO

Electrochemical transformations are a subject of increasing interest in early drug discovery due to its ability to assemble complex scaffolds under rather mild reaction conditions. In this context, we became interested in electrochemical decarboxylative cross-coupling (DCC) protocols of redox-active esters (RAEs) and halo(hetero)arenes. Starting with the one-step electrochemical synthesis of novel methylamino-substituted heterocycles we recognized the potential of this methodology to deliver a novel approach to ß- and γ- amino acids by starting from the corresponding RAEs. Our work finally resulted in the delivery of novel and highly valuable trifunctional building blocks based on ß- and γ-amino-acid scaffolds.


Assuntos
Aminoácidos , Ésteres , Eletroquímica , Estrutura Molecular , Aminoácidos/química , Ésteres/química , Oxirredução
8.
Chem Biodivers ; : e202400799, 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-39031575

RESUMO

Chalcones are a group with recognized biological potential against many diseases, including cancer. Thus, studies on these structure have become an attractive chemical strategy to optimize their biological activities. One of the synthetic routes used to obtain chalcone derivatives is esterification using either commercial acid chlorides or carboxylic acids. This work focuses on preparing chalcone derivatives and investigating their biological potential against cancer cells. Compound 1 was synthetized by Claisen-Schmidt condensation followed by esterification of the 3'-OH, resulting in eight compounds named 1a-b and 2a-f. All structures were confirmed by 1H and 13C NMR and FT-IR, and cytotoxicity was evaluated in the HCT 116 (colon adenocarcinoma), MCF-7 (breast adenocarcinoma), and CCD-18Co (nontumoral colon fibroblasts) cell lines. Chalcone derivatives were generally more active toward the colon cancer cell line, and 1a and 2b were selected for IC50 determination, presenting IC50 values of approximately 10 µM in HCT 116 cells and above 20 µM in both MCF7 and CDC-18-Co cells, suggesting moderate selectivity. Additionally, we tested compounds 1a and 2b in combination with doxorubicin, but they did not act synergistically with this anthracycline. In conclusion, considering these compounds obtained by the esterification reaction, 1a and 2d showed better results against cytotoxic cells.

9.
Cardiol Young ; 34(1): 1-10, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38037810

RESUMO

Surgical repair of channels between the ventricles is enhanced when the surgeon knows precisely where to place a patch, or baffle, so as to restore septal integrity. The paediatric cardiologist should provide the necessary information. Communication will be enhanced if the same words are used to account for the structures in question. Currently, however, the same term, namely "ventricular septal defect," is used to account for markedly different areas within the heart. Closure of perimembranous defects found in hearts with concordant or discordant ventriculo-arterial connections restores the integrity of the ventricular septum, at the same time separating the systemic and pulmonary blood streams. When both arterial trunks arise from the right ventricle, in contrast, the surgeon when placing a baffle so as to separate the blood streams, does not close the channel most frequently described as the "ventricular septal defect." In this review, we show that the perimembranous lesions as found in hearts with concordant or discordant ventriculo-arterial connections are the right ventricular entrances to the areas subtended beneath the hinges of the leaflets of the aortic or pulmonary valves. When both arterial trunks arise from the right ventricle, and the channel between the ventricles is directly subaortic, then the channel termed the "ventricular septal defect" is the left ventricular entrance to the comparable space subtended beneath the aortic root. We argue that recognition of these fundamental anatomical differences enhances the appreciation of the underlying morphology of the various lesions that reflect transfer, during cardiac development, of the aortic root from the morphologically right to the morphologically left ventricle.


Assuntos
Comunicação Interventricular , Transposição dos Grandes Vasos , Septo Interventricular , Criança , Humanos , Comunicação Interventricular/cirurgia , Comunicação Interventricular/patologia , Ventrículos do Coração/cirurgia , Aorta/patologia
10.
Int J Health Plann Manage ; 39(2): 262-277, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38169038

RESUMO

BACKGROUND: Oral diseases affect close to 3.5 billion people worldwide and there has been a call by the World Health Organization (WHO) to integrate oral health into the Universal Health Coverage (UHC) agenda. OBJECTIVES: To collate and synthesise information regarding the status of integration of oral health into the health systems covered by UHC across the 11 countries in the South East Asian Regional Office. METHODS: Drawing on the framework of the six building blocks of health systems as devised by WHO, we compared the public dental care coverage models, with a focus on outpatient dental care in these countries. We gathered this information from publicly available resources, databases and peer-reviewed publications to populate the template guided by the WHO Health System Building Blocks. RESULTS: We found a poor access to oral health care, lopsided distribution of manpower, rickety health information systems, and private sector domination and inadequate or absent financing mechanisms for outpatient procedures. The private sector was dominant in all countries except Thailand and Srilanka. Financing was absent in most countries and deficient in Thailand and Indonesia. Dental workforce was deficient in most countries except India, Srilanka, and Thailand. Health information systems were weak with no dental items under price control. Better UHC indicators did not guarantee a lower oral disease burden. CONCLUSIONS: Our review highlighted the close connection between service quality and human resources, governance, and finance. There is a need to establish standardised dental treatment guidelines that are uniformly adopted across countries, integrate oral health into national health and development programs, push for functional oral health research through collecting robust surveillance, economic, and social impact data and the development of cost-effective strategies tailored to each country's unique needs.


Assuntos
Saúde Bucal , Cobertura Universal do Seguro de Saúde , Indonésia , Tailândia , Sri Lanka
11.
Angew Chem Int Ed Engl ; 63(15): e202319758, 2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38353649

RESUMO

Fluorinated small molecules are commonly used in functional small-molecule chemistry, and N-difluoromethyl (N-CF2H) compounds are particularly intriguing due to their unique and unexplored physiochemical properties. However, despite limited progress, a general methodological approach to the synthesis of N-CF2H compounds remains elusive. Here, guided by computation, we present a simple and practical protocol to access N-CF2H amides and related carbonyl derivatives. The protocol involves a one-pot conversion of thioformamides through desulfurization-fluorination and acylation, providing N-difluoromethylcarbamoyl fluoride building blocks that can be further diversified to a variety of unexplored N-CF2H carbonyl compounds with rich functionality. Additionally, preliminary studies on their properties and stability showcased their potential application in pharmaceuticals and agrochemicals.

12.
Angew Chem Int Ed Engl ; 63(17): e202319627, 2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38443313

RESUMO

High-performing n-type polymers are crucial for the advance of organic electronics field, however strong electron-deficient building blocks with optimized physicochemical properties for constructing them are still limited. The imide-functionalized polycyclic aromatic hydrocarbons (PAHs) with extended π-conjugated framework, high electron deficiency and good solubility serve as promising candidates for developing high-performance n-type polymers. Among the PAHs, phenanthrene (PhA) features a well-delocalized aromatic π-system with multiple modifiable active sites . However, the PhA-based imides are seldom studied, mainly attributed to the synthetic challenge. Herein, we report two functionalized PhAs, CPOI and CPCNI, by simultaneously incorporating imide with carbonyl or dicyanomethylene onto PhA. Notably, the dicyanomethylene-modified CPCNI exhibits a well stabilized LUMO energy level (-3.84 eV), attributed to the synergetic inductive effect from imide and cyano groups. Subsequently, based on CPOI and CPCNI, two polymers PCPOI-Tz and PCPCNI-Tz were developed. Applied to organic thin-film transistors, owing to the strong electron-deficiency of CPCNI, polymer PCPCNI-Tz shows an improved electron mobility and largely decreased threshold voltage compared with PCPOI-Tz. This work affords two structurally novel electron-deficient building blocks and highlights the effectiveness of dual functionalization of PhAs with strong electron-withdrawing groups for devising n-type polymers.

13.
Beilstein J Org Chem ; 20: 950-958, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38711589

RESUMO

Tetrazole is widely utilized as a bioisostere for carboxylic acid in the field of medicinal chemistry and drug development, enhancing the drug-like characteristics of various molecules. Typically, tetrazoles are introduced from their nitrile precursors through late-stage functionalization. In this work, we propose a novel strategy involving the use of diversely protected, unprecedented tetrazole aldehydes as building blocks. This approach facilitates the incorporation of the tetrazole group into multicomponent reactions or other chemistries, aiding in the creation of a variety of complex, drug-like molecules. These innovative tetrazole building blocks are efficiently and directly synthesized using a Passerini three-component reaction (PT-3CR), employing cost-effective and readily available materials. We further showcase the versatility of these new tetrazole building blocks by integrating the tetrazole moiety into various multicomponent reactions (MCRs), which are already significantly employed in drug discovery. This technique represents a unique and complementary method to existing tetrazole synthesis processes. It aims to meet the growing demand for tetrazole-based compound libraries and novel scaffolds, which are challenging to synthesize through other methods.

14.
J Comput Chem ; 44(26): 2096-2102, 2023 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-37381904

RESUMO

The ongoing COVID-19 pandemic, and constant demand for new therapies in unmet clinical needs, necessitates strategies to identify drug candidates for rapid clinical deployment. Over the years, fragment-based drug design (FBDD) has emerged as a mainstream lead discovery strategy in academia, biotechnology start-ups, and large pharma. Chemical building block libraries are the fundamental component of virtually any FBDD campaign. Current trends focus on smaller and smarter libraries that offer synthetically amenable starting points for rational lead generation. Therefore, there remains an ever-increasing need for new methods to generate fragment libraries to seed early-stage drug discovery programs. Here, we present FRAGMENTISE-a new user-friendly, cross-platform tool for user-tunable retrosynthetic small-molecule fragmentation. FRAGMENTISE allows for visualization, similarity search, annotation, and in-depth analysis of the fragment databases in the medicinal chemistry context. FRAGMENTISE is available as standalone software for Linux, Windows, and macOS users, with a graphical interface or command-line version.


Assuntos
COVID-19 , Bibliotecas de Moléculas Pequenas , Humanos , Bibliotecas de Moléculas Pequenas/química , Pandemias , Descoberta de Drogas , Desenho de Fármacos
15.
Chem Rec ; 23(9): e202300027, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37016509

RESUMO

This account describes the evolution of a research programme that started by linking fluoromethylene (-CHF-) groups along aliphatic chains and then progressing to alicyclic rings with contiguous fluorine atoms. Different stereoisomers of aliphatic chains tend to adopt low polarity conformations. In order to force polar conformations, the programme began to address ring systems and in particular cyclohexanes, to restrain conformational freedom and co-aligned C-F bonds. The flagship molecule, all-cis-1,2,3,4,5,6-hexafluorocyclohexane 7, emerged to be the most polar aliphatic compound recorded. The polarity arises because there are three co-aligned triaxial C-F bonds and the six fluorines occupy one face of the ring. Conversely the electropositive hydrogens occupy the other face. These have been termed Janus face cyclohexanes after the Roman god with two faces. The review outlines progress by our group and others in preparing derivatives of the parent cyclohexane 7, in order to explore properties and potential applications of these Janus cyclohexanes.

16.
Bioorg Med Chem ; 91: 117405, 2023 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-37421711

RESUMO

Boronic acids are essential building blocks used for the synthesis of bioactive molecules, the generation of chemical libraries and the exploration of structure-activity relationships. As a result, more than ten thousand boronic acids are commercially available. Medicinal chemists are therefore facing a challenge; which of them should they select to maximize information obtained by the synthesis of new target molecules. The present article aims to help them to make the right choices. The boronic acids used frequently in the synthesis of bioactive molecules were identified by mining several large molecular and reaction databases and their properties were analyzed. Based on the results a diverse set of boronic acids covering well the bioactive chemical space was selected and is suggested as a basis for library design for the efficient exploration of structure-activity relationships. A Boronic Acid Navigator web tool which helps chemists to make their own selection is also made available at https://bit.ly/boronics.


Assuntos
Ácidos Borônicos , Bibliotecas de Moléculas Pequenas , Ácidos Borônicos/química , Bases de Dados Factuais , Bibliotecas de Moléculas Pequenas/farmacologia
17.
Methods ; 197: 54-62, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-33677061

RESUMO

Biosensing atomic force microscopy (AFM) offers the unique feature to determine the energy landscape of a bimolecular interaction at the real single molecule level. Furthermore, simultaneous and label-free mapping of molecular recognition and the determination of sample topography at the nanoscale gets possible. A prerequisite and one of the major parts in biosensing AFM are the bio-functionalized AFM tips. In the past decades, different approaches for tip functionalization have been developed. Using these functionalization strategies, several biological highly relevant interactions at the single molecule level have been explored. For the most common approach, the use of a heterobifunctional poly(ethylenglycol) crosslinker, a broad range of linkers for different chemical coupling strategies is available. Nonetheless, the time consuming functionalization protocol as well as the broad distribution of rupture length reduces the possibility of automation and may reduce the accuracy of the results. Here we present a stable and fast forward approach based on tetra-functional DNA tetrahedra. A fast functionalization and a sharp defined distribution of rupture length gets possible with low effort and high success rate. We tested the performance on the classical avidin biotin system by using tetrahedra with three disulfide legs for stable and site directed coupling to gold coated tips and a biotinylated end at the fourth vertex. A special advantage appears when working with a DNA aptamer as sensing molecule. In this case, the fourth strand can be extended by a certain DNA sequence complementary to the linkage part of an aptamer. This AFM tip functionalization protocol was applied on thrombin using DNA aptamers directed against the fibrinogen binding side of human thrombin.


Assuntos
Aptâmeros de Nucleotídeos , Avidina , Aptâmeros de Nucleotídeos/metabolismo , Avidina/química , Avidina/metabolismo , Biotina/química , DNA , Humanos , Microscopia de Força Atômica/métodos
18.
J Nanobiotechnology ; 21(1): 293, 2023 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-37620914

RESUMO

The regeneration of weight-bearing bone defects and critical-sized cartilage defects remains a significant challenge. A wide range of nano-biomaterials are available for the treatment of bone/cartilage defects. However, their poor compatibility and biodegradability pose challenges to the practical applications of these nano-based biomaterials. Natural biomaterials inspired by the cell units (e.g., nucleic acids and proteins), have gained increasing attention in recent decades due to their versatile functionality, compatibility, biodegradability, and great potential for modification, combination, and hybridization. In the field of bone/cartilage regeneration, natural nano-based biomaterials have presented an unparalleled role in providing optimal cues and microenvironments for cell growth and differentiation. In this review, we systematically summarize the versatile building blocks inspired by the cell unit used as natural nano-based biomaterials in bone/cartilage regeneration, including nucleic acids, proteins, carbohydrates, lipids, and membranes. In addition, the opportunities and challenges of natural nano-based biomaterials for the future use of bone/cartilage regeneration are discussed.


Assuntos
Cartilagem , Ácidos Nucleicos , Materiais Biocompatíveis/farmacologia , Regeneração Óssea , Ciclo Celular
19.
BMC Health Serv Res ; 23(1): 473, 2023 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-37165367

RESUMO

INTRODUCTION: Uganda has high maternal, neonatal, and under-five mortality rates. This study documents stakeholder perspectives on best practices in a maternal and newborn health (MNH) quality-improvement programme implemented in the West Nile region of Uganda to improve delivery and utilisation of MNH services. METHODS: This exploratory cross-sectional qualitative study, conducted at the end of 2021, captured the perspectives of stakeholders representing the different levels of the healthcare system. Data were collected in four districts through: interviews with key informants working at all levels of the health system; focus group discussions with parents and caretakers and with community health workers; and interviews with individual community members whose lives had been impacted by the MNH programme. The initial content analysis was followed by a deductive synthesis pitched according to the different levels of the health system and the health-systems building blocks. RESULTS: The findings are summarised according to the health-systems building blocks and an account is given of three of the interventions most valued by participants: (1) data use for evidence-based decision making (with regard to human resources, essential reproductive health commodities, and financing); (2) establishment of special newborn care units and high-dependency maternity units at district hospitals and training of the health workforce (also with reference to other infrastructural improvements such as the provision of water, sanitation and hygiene facilities at health facilities); and (3) community referral of pregnant women through a commercial motorcycle voucher referral system. CONCLUSION: The MNH programme in the West Nile region adopted a holistic and system-wide approach to addressing the key bottlenecks in the planning, delivery, and monitoring of quality MNH services. There was general stakeholder appreciation across the board that the interventions had the potential to improve quality of care and newborn and maternal health outcomes. However, as the funding was largely donor-driven, questions about government ownership and sustainability in the context of limited resources remain.


Assuntos
Saúde do Lactente , Serviços de Saúde Materna , Recém-Nascido , Feminino , Humanos , Gravidez , Uganda/epidemiologia , Estudos Transversais , Nações Unidas
20.
BMC Health Serv Res ; 23(1): 946, 2023 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-37667225

RESUMO

Progress on surgical system strengthening has been slow due to a disconnect between evidence generation and the information required for effective policymaking. This systematic mapping review sought to assess critical research gaps in the field of global surgery guided by the World Health Organisation Health Systems building block framework, analysis of authorship and funding patterns, and an exploration of emerging research partnership networks. Literature was systematically mapped to identify, screen, and synthesize results of publications in the global surgery field between 2015 and March 2022. We searched four databases and included literature published in seven languages. A social network analysis determined the network attributes of research institutions and their transient relationships in shaping the global surgery research agenda. We identified 2,298 relevant studies out of 92,720 unique articles searched. Research output increased from 453 in 2015-16 to 552 in 2021-22, largely due to literature on Covid-19 impacts on surgery. Sub-Saharan Africa (792/2298) and South Asia (331/2298) were the most studied regions, although high-income countries represented a disproportionate number of first (42%) and last (43%) authors. Service delivery received the most attention, including the surgical burden and quality and safety of services, followed by capacity-building efforts in low- and middle-income countries. Critical research in economics and financing, essential infrastructure and supplies, and surgical leadership necessary to guide policy decisions at the country level were lacking. Global surgical systems remain largely under-researched. Knowledge diffusion requires an emphasis on developing sustainable research partnerships and capacity across low- and middle-income countries. A renewed focus must be given to equipping countries with tools for effective decision-making to enhance investments in high-quality surgical services.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Ásia Meridional , Fortalecimento Institucional , Bases de Dados Factuais , Renda
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