Another sleepless night: Does a leader's poor sleep lead to subordinate's poor sleep? A spillover/crossover perspective

Given the importance of sleep to an individual's health and well‐being, relatively little research has been conducted in the management and organizational behaviour literature on the relationship between sleep and work behaviour. Using spillover/crossover theory, we extended the current literature by investigating the possible supervisor–subordinate sleep relationship and introduced a serial mediation mechanism to answer how a supervisor's poor night's sleep translates into his/her subordinate's poor night's sleep. We conducted an experience sampling study involving 101 supervisors and subordinates over five consecutive working days (N = 505 occasions). Results verified that the spillover effect of supervisors’ poor sleep on their next‐day abusive supervisory behaviour has a crossover effect on their subordinates’ poor sleep. Finally, results indicated that subordinate's physical exercise has the capacity to mitigate the influence of abusive supervision on subordinate’ poor sleep. Future research should continue to examine the supervisor–subordinate sleep relationship and identify interventions in both the work and non‐work domains of supervisor and subordinates as avenues for improving sleep health.     

Once-a-day HAART: dream or reality?

A constant and nearly absolute adherence is required to ensure a successful long-lasting outcome of highly active antiretroviral therapy (HAART). Pill burden and regimen complexity are important contributors to adherence problems. The most significant treatment-related strategy to improve adherence may be the reduction in the number and frequency of pills to be taken every day. If one accepts the concept that once-daily therapy is likely to benefit patients, then the issue turns to whether we have adequate drugs to implement once-daily HAART. There is quite a difference between using a once-a-day drug within an HAART regimen and designing an HAART regimen that is dosed once daily. To date, studies that explore the feasibility of once-a-day HAART regimens are still few, mostly exploratory, not controlled, and performed in a limited number of patients. However, most data are consistent one with the other, and evidence on the utility of such regimens is growing. Once-daily therapy cannot be the answer to all the questions that complex and life-long therapies give rise to, but it could be a further choice that can meet the needs of many patients. The range of once-daily options is expanding rapidly, and the patients' request for easier therapies that are respectful of their lifestyle could be fulfilled.     

Neurotrophic receptor TrkB: Is it a predictor of poor prognosis for carcinoma patients?

The neurotrophic receptor tyrosine kinase TrkB, while binding its high affinity ligand brain-derived neurotrophic factor (BDNF), will play an essential role for nervous system development, neuronal survival, differentiation, and maintenance. However, accumulating evidences implies that TrkB signal pathway may also be involved in a variety of human cancers, in which TrkB is likely to play a role in initiation and metastasis of carcinomas. Overexpression of TrkB is often correlated with the tumorigenesis, angiogenesis and drug resistance in these malignancies, contributing significantly to the metastasis and aggressive phenotype of these poor prognosis tumors. The evidences to show the significant contribution of TrkB to malignancy not only came from solid tumors such as neoblastoma, pancreas cancer, Wilm's tumor and hepatocarcinoma, but also came from haematological malignancies such as Hodgkin lymphoma and multiple myeloma. In summary, besides its role in development and function of nervous system, TrkB is likely to also play a role in initiation and metastasis of carcinoma although it still remains to be further investigated and confirmed. Emerging data have suggested that TrkB may be a mediator as well as a marker of carcinogenesis and metastasis, therefore TrkB may be used as a valuable target for cancer therapy especially for the metastatic tumors with poor prognosis.     

What predicts poor mother-infant interaction in schizophrenia?

BACKGROUND: Poor clinician-rated parenting outcome and observed interactive deficits in mothers with schizophrenia admitted to a psychiatric mother and baby unit (MBU) reflect continuing concerns over the parenting capacity of this group. However, little is known about whether interaction deficits are accounted for by severity of illness or adverse social circumstances typically experienced by these mothers. METHOD: Thirty-eight women with severe perinatal illness (schizophrenia n=13; affective disorders n=25) and their infants were observed in play interaction a week prior to MBU discharge. Clinical and sociodemographic data were also obtained. RESULTS: Mothers with schizophrenia and their infants were rated to have poorer interactive behaviour than the affective disorders group. Infant avoidance of the mother was associated with a lack of maternal sensitivity and responsiveness. The deficits in mother-infant interaction found in the schizophrenia group could not be accounted for by our measures of illness severity or factors relating to adverse social circumstances. CONCLUSIONS: The results replicate and extend previous findings showing poor interactive behaviours in mothers with schizophrenia, their infants, and in the dyad, in a range of areas following clinical recovery. The findings suggest that factors other than illness duration, dose of medication, marital status and occupational status are explanatory for the interactive deficits associated with maternal schizophrenia. Parenting interventions that aim to improve maternal sensitivity need to be developed specifically for this group.     

DHEA as a miracle drug in the treatment of poor responders; hype or hope?

Dehydroepiandrosterone (DHEA) is being presented as a miracle-drug for the treatment of women responding poorly to gonadotrophin stimulation, while the debate on its actual effectiveness is still ongoing. We would like to present how insufficient the current evidence of acceptable quality is to warrant a conclusion that DHEA supplementation is an effective treatment for women with diminished ovarian reserve. We believe that large-scale, well-designed confirmatory studies are necessary to prove the efficacy of DHEA before it can be recommended for routine use.     

Autophagy in clear cell ovarian cancer,a potential marker for hypoxia and poor prognosis?#

Autophagy contributes to cell survival and is up‐regulated under hypoxia in many different cancers. Ovarian cancer has a poor prognosis and is generally resistant to chemotherapy. Through genetic profiling, it has becoming evident that ovarian cancer has distinct subtypes but the significance of these subtypes in ovarian cancer remains unclear. In this issue, Dr Lum and colleagues have presented evidence that autophagy as measured by LC3A staining occurs in a clear cell ovarian cancer that is correlated with hypoxic regions and poor overall survival. In addition, autophagy under hypoxia appears to be higher in clear cell ovarian cancer cells compared to other subtypes. This indicates that autophagy could be a factor in drug resistance and poor survival in clear cell ovarian cancer patients. This insight could lead to a better understanding of the role of autophagy under hypoxia in human ovarian cancer and could be a valuable biomarker for the development of better therapies for clear cell ovarian cancers. Copyright © 2012 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

Is there a link between an extremely poor response to ovarian hyperstimulation and early ovarian failure?

BACKGROUND: It has been previously reported that a group of 12 infertile women, who had a normal baseline hormonal profile and did not respond to repeated ovarian stimulation with gonadotrophins, developed ovarian failure within a few months. Based on this observation, we carried out a controlled retrospective cohort study to examine whether non-response to ovarian stimulation is linked to early ovarian failure. METHODS: All patients aged 35-40 years who had cancelled IVF cycles for non-response between 1991 and 1993 in our centre were asked to report on the subsequent development of menopausal symptoms, menopause or commencement of hormone replacement therapy. A control group consisted of patients with the same age and similar medical history, who had IVF the same year and responded well. RESULTS: Eleven out of the 12 patients of the non-response group developed menopausal symptoms within 7 years, compared with only four out of 24 in the control group. Similarly, eight out of 12 non-responders either went into menopause or started using hormone replacement therapy compared with one out of 24 in the control group. Using Fisher's exact test, the differences were highly significant (P < 0.0001). The median age at development of menopausal symptoms in the study group was 40 years (range 38-45). The median time between non-response and development of menopausal symptoms was 4 years (range 1-7). CONCLUSION: We carried out a controlled retrospective cohort study that showed a strong association between an extremely poor response to ovarian hyperstimulation and early ovarian failure.     

Metastatic Adenocarcinoma of Prostate in a 28-Year-Old Male: The outcome is poor in young patients?

Prostate cancer is common in older patients. Rarity in younger population limits the study of natural history and prognosis in this population. Most of the published data has reported poor outcome in younger patients with metastatic prostate cancer. Here, we report a case of prostate cancer in 28-year-old male who presented with bone metastasis. After bilateral inguinal orchidectomy, he was started on anti-androgen therapy and received palliative radiotherapy for bone metastasis. There was only a slight decrease in prostate-specific antigen (PSA) level and pelvic disease post treatment. Subsequently, he was started on opioid analgesics (by World Health Organization, WHO, step ladder) in view of persistent pain. The index case is being presented for its rarity and probable poor outcome in young patients and to stress on the fact that the possibility of primary prostatic adenocarcinoma should be investigated in a male presenting with bone metastasis irrespective of the age.     

Estrogen therapy for hepatectomy patients with poor liver function?

Estrogen is well known to promote liver regeneration after partial hepatectomy. Administration of estradiol prior to partial hepatectomy also induces increased activity of DNA synthesis. Endogenous aromatase plays a key role in the conversion of testosterone to estradiol. The aromatase activity was induced by IL-6, which is a key factor for liver regeneration. It has been reported that IL-6 interacts with gp80/130 receptor and regulates the STAT1/3 pathway to induce DNA synthesis in hepatocyte. The IL-6 induced aromatase activity results in increased serum estradiol level. This corresponded well with observation that estradiol was elevated after partial hepatectomy. Therefore, it is very likely that estradiol and IL-6 synergize in stimulation of hepatocyte proliferation during liver regeneration. We propose that a short-term estradiol treatment may be beneficial for patients with poor liver function after hepatectomy.     

Preimplantation genetics: an explanation for poor human fertility?

Compared with other mammals, humans as a species are relatively infertile. Various studies suggest that in young, unselected couples, who are trying to conceive, 20–25% of them should be successful each monthly cycle (Bonde et al . 1998; Edwards & Brody, 1995). This compares with an average of 70% in captive baboons for example (Stevens, 1997). Interestingly, the implantation rate after in vitro fertilisation (IVF) at best averages around 20% per embryo transferred (Edwards & Beard, 1999). Evidence is steadily accumulating to prove that the major cause of implantation failure in humans after both in vivo and in vitro fertilisation is the high incidence of chromosomal abnormality. Combining data from cytogenetic studies of spontaneous abortions with those obtained from preimplantation embryos suggests that meiotically derived aneuploidy occurs in 25% of conceptions, an order of magnitude higher than is found in other well studied species such as the mouse (Hassold & Jacobs, 1984; Jamieson, 1994). Additionally, interphase fluorescent in situ hybridisation (FISH) analysis of three day old human embryos has shown that up to 50% are chromosomally mosaic (Delhanty et al . 1997; Munné et al . 1998), further increasing the chance of implantation failure. This review covers the evidence accumulating from a variety of sources that poor fertility in humans has a chromosomal basis.