Modifiable pre-treatment factors are associated with quality of life in women with gynaecological cancers at diagnosis and one year later: Results from the HORIZONS UK national cohort study.

OBJECTIVE: Personalised care requires the identification of modifiable risk factors so that interventions can be implemented rapidly following a gynaecological cancer diagnosis. Our objective was to determine what pre-treatment factors are associated with quality of life (QOL) at baseline (pre-treatment) and 12 months. METHODS: 1222 women with a confirmed diagnosis of endometrial, ovarian, cervical or vulvar cancer from 82 UK NHS hospitals agreed to complete questionnaires at baseline, three and 12 months. Questionnaires included measures of QOL, health, lifestyle, support and self-management. The primary outcome measure was QOL as measured by Quality of Life in Adult Cancer Survivors (QLACS). Sites provided clinical data at baseline, six and 12 months. Linear regression models were constructed to examine the association between baseline characteristics and QOL outcomes. RESULTS: QOL declined between baseline and 3 months, followed by an improvement at 12 months. Baseline (pre-treatment) factors associated with worse QOL at both baseline and 12 months were depression, anxiety, living in a more deprived area and comorbidities which limit daily activities, whereas higher self-efficacy and age of 50+ years were associated with better QOL. CONCLUSIONS: Depression, anxiety and self-efficacy are modifiable risk factors that can impact on QOL. Screening for these, and assessment of whether comorbidities limit daily activities, should be incorporated in a holistic needs assessment and interventions to improve self-efficacy should be made available. Care can then be personalised from the outset to enable all women with a gynaecological cancer the opportunity to have the best QOL.

Understanding optoelectronic properties of cyano-terminated oligothiophenes in the context of intramolecular charge transfer.

In this paper we have prepared a new series of oligothiophenes capped with hexyl groups and a variety of strong acceptors, mainly cyanovinyl moieties. An exhaustive analysis of the absorption, photophysical, electrochemical, solid state, nonlinear optical and vibrational properties has been presented guided by theoretical calculations. The investigation is centered on the efficiency of the intramolecular charge transfer (i.e., chain length and acceptor dependence) and its impact on all the relevant electronic, structural, optical, and vibrational properties. The most significant features imparted by the acceptors through the π-conjugated oligothiophene path are (i) intense visible electronic absorptions, (ii) tuned fluorescence wavelength emissions, (iii) solid state π-stacking, (iv) ambipolar redox behavior, (v) S(1) ⇝ S(0) internal conversion as being the major route for the deactivation of the excited state, and (vi) large electronic and vibrational contributions to their nonlinear optical response (hyperpolarizability). The analysis establishes connections between the different properties of the materials and structure-function relationships useful in organic electronics.

The discovery and optimisation of benzazepine sulfonamide and sulfones as potent agonists of the motilin receptor.

Optimisation of a series of benzazepine sulfonamide hit compounds identified from high throughput screening led to the discovery of a new series of tractable, potent motilin receptor agonists.

Discovery of N-(3-fluorophenyl)-1-[(4-([(3S)-3-methyl-1-piperazinyl]methyl)phenyl)acetyl]-4-piperidinamine (GSK962040), the first small molecule motilin receptor agonist clinical candidate.

N-(3-fluorophenyl)-1-[(4-([(3S)-3-methyl-1-piperazinyl]methyl)phenyl)acetyl]-4-piperidinamine 12 (GSK962040) is a novel small molecule motilin receptor agonist. It possesses excellent activity at the recombinant human motilin receptor and also at the native rabbit motilin receptor where its agonist activity results in potentiation of the amplitude of neuronal-mediated contractions of isolated gastric antrum tissue. Compound 12 also possesses highly promising pharmacokinetic profiles in both rat and dog, and these results, in combination with further profiling in human native tissue and an in vivo model of gastrointestinal transit in the rabbit, have led to its selection as a candidate for further development.

The discovery of biaryl carboxamides as novel small molecule agonists of the motilin receptor.

Optimisation of urea (5), identified from high throughput screening and subsequent array chemistry, has resulted in the identification of pyridine carboxamide (33) which is a potent motilin receptor agonist possessing favourable physicochemical and ADME profiles. Compound (33) has demonstrated prokinetic-like activity both in vitro and in vivo in the rabbit and therefore represents a promising novel small molecule motilin receptor agonist for further evaluation as a gastroprokinetic agent.

Inhibition by tianeptine of neuronally mediated contractions in the rat isolated gastrointestinal tract.

The antidepressant tianeptine is associated with a small but significant incidence of gastrointestinal (GI) side effects, including nausea and constipation. Since the site of action of tianeptine is not clear, we looked for an ability of this drug to directly interfere with GI motility. The effects of tianeptine were studied in rat isolated stomach and colon preparations, in which neuronally mediated (predominantly cholinergic) contractions were evoked by electrical field stimulation. Tianeptine concentration dependently inhibited these contractions in both stomach (0.3-10microM; n=2-5) and colon (1-10microM; n=3-6). This activity was likely to be prejunctional, since contractions evoked by carbachol were unaffected by tianeptine 1microM. Further, the inhibitory activity of tianeptine was unaffected by inhibitors of 5-hydroxytryptamine and noradrenaline re-uptake, adenosine metabolism, nitric oxide synthesis and tryptophan dehydroxylase. Thus, our experiments demonstrate a pathway by which tianeptine affects GI functions and this could explain the side effects observed. It is not known if the mechanism of this activity is also related in any way to the therapeutic action of tianeptine within the CNS.