Symptomatic seizures in preterm newborns: a review on clinical features and prognosis

Neonatal seizures are the most common neurological event in newborns, showing higher prevalence in preterm than in full-term infants. In the majority of cases they represent acute symptomatic phenomena, the main etiologies being intraventricular haemorrhage, hypoxic-ischemic encephalopathy, central nervous system infections and transient metabolic derangements.Current definition of neonatal seizures requires detection of paroxysmal EEG-changes, and in preterm newborns the incidence of electrographic-only seizures seems to be particularly high, further stressing the crucial role of electroencephalogram monitoring in this population. Imaging work-up includes an integration of serial cranial ultrasound and brain magnetic resonance at term-equivalent age. Unfavourable outcomes following seizures in preterm infants include death, neurodevelopmental impairment, epilepsy, cerebral palsy, hearing and visual impairment. As experimental evidence suggests a detrimental role of seizures per se in determining subsequent outcome, they should be promptly treated with the aim to reduce seizure burden and long-term disabilities. However, neonatal seizures show low response to conventional anticonvulsant drugs, and this is even more evident in preterm newborns, due to intrinsic developmental factors. As a consequence, as literature does not provide any specific guidelines, due to the lack of robust evidence, off-label medications are often administered in clinical practice

Monitoring of newborns at high risk for brain injury

Due to the increasing number of surviving preterm newborns and to the recognition of therapeutic hypothermia as the current gold standard in newborns with hypoxic-ischaemic encephalopathy, there has been a growing interest in the implementation of brain monitoring tools in newborns at high risk for neurological disorders. Among the most frequent neurological conditions and presentations in the neonatal period, neonatal seizures and neonatal status epilepticus, paroxysmal non-epileptic motor phenomena, hypoxic-ischaemic encephalopathy, white matter injury of prematurity and stroke require specific approaches to diagnosis. In this review we will describe the characteristics, aims, indications and limitations of routinely available diagnostic techniques such as conventional and amplitude-integrated EEG, evoked potentials, cranial ultrasound and brain MRI. We will conclude by briefly outlining potential future perspectives from research studies

The good, the bad and the blend: The strategic role of the “middle leadership” in work-family/life dynamics during remote working

The ongoing epidemiological crisis has suddenly steered us towards a new futuristic work scenario in which most service sector employees work remotely, which could be a permanent reality for most service sector employees. This paper focuses on the strategic role that leadership could play in the radical change process that is taking place in work environments. Particular attention was paid to the role of ‘middle managers’ who perform an important function as a link between the strategic vision of top management and the workforce. In addition, special attention was paid to gender differences in work-life dynamics, which are particularly relevant in countries with traditional cultural identities. As this is a conceptual contribution, the most recent studies on this specific role of middle managers have been taken into account and embedded in the current scenario. Therefore, the main contribution in terms of originality was that the current review aimed to leverage such a legacy of knowledge and create a system of evidence-based practical implications for effectively supporting change in organizational culture through the identification of the most appropriate middle management leadership models for remote working that could prevent and/or limit any psychosocial risks (e.g., workaholism and technostress) and longer-term outcomes such as sustainable work-life interface

Entrepreneurial self-efficacy in Italy: an empirical study from a gender perspective

Entrepreneurial self-efficacy (ESE) is a key factor for the promotion of entrepreneurship. Literature emphasizes the need for and, indeed, recommends a gender perspective in the study of ESE. The aim of this study is twofold: To begin analyzing some of the psychometric properties of the McGee, Peterson, Mueller, and Sequeira (2009) ESE scale in the Italian context, and to explore the gender differences in the ESE levels in an Italian sample of entrepreneurs and non-entrepreneurs. Confirmatory factor analysis, multigroup confirmatory factor analysis and a 2 × 2 MANOVA were conducted. The results support the possible use of McGee et al.'s ESE scale in the Italian context. Furthermore, they reveal that the gender difference in the sample of non-entrepreneurs is greater than in the entrepreneur sample. The main practical implication is that women entrepreneurs should receive specific training both before and after creating a new venture.info:eu-repo/semantics/publishedVersio

A daily diary investigation on the job-related affective experiences fueled by work addiction

Background and aims: We studied the quality of the job-related emotional experiences associated with work addiction. We hypothesized that work addiction would fuel both a higher level of daily job-related negative affect and a lower level of daily job-related positive affect and that such affective experiences would mediate the relationship between work addiction and emotional exhaustion reported at the end of the working day. Additionally, in light of typical behaviors and cognitions associated with work addiction, we also hypothesized that work addiction would modify the relationships between day workload and same day emotional strain reactions (i.e., job-related negative affect and job-related positive affect). Methods: Participants were 213 workers (42.5% female), most of whom holding a high-profile job position, who were followed for 10 consecutive working days in the context of a daily diary study. Results: Multilevel analyses controlling for neuroticism revealed that work addiction was uniquely and positively related to daily job-related negative affect and that the latter mediated the relationship between work addiction and daily emotional exhaustion. On the other hand, work addiction was not negatively related to daily job-related positive affect; this relationship emerged only when removing neuroticism from the model. Additionally, work addiction strengthened the relationship between day workload and day job-related negative affect. Discussion: Results indicate that work addicted are characterized by the experience of a negatively connotated affect during work, and that this kind of affect may be a mechanism explaining the work addiction-burnout relationship

Evaluation of the safety factors of shotcrete linings during the creep stage

Sprayed concrete linings (SCLs) used in tunnels generally develop secondary deformations over time, even in the presence of constant stress levels within the lining. These deformations influence the loading process on the lining and therefore also the stress levels within the support structure. The behaviour of a SCL in a tunnel was investigated under different operating conditions in order to evaluate the effect of secondary deformations on the evolution of stability conditions (safety margins with respect to the possible concrete failure) over time, after completion of the tunnel construction. A parametric analysis was performed to study eight different types of tunnels, with variable geometry and rock quality, and eight different types of sprayed concrete. The 64 cases of the parametric analysis covered the vast range of variability of influential parameters and yielded useful information concerning the effects of secondary deformations over time on the static behaviour of the lining and on the safety factor with reference to the possible failure of the sprayed concrete

Genetic neonatal-onset epilepsies and developmental/epileptic encephalopathies with movement disorders: A systematic review

Despite expanding next generation sequencing technologies and increasing clinical in-terest into complex neurologic phenotypes associating epilepsies and developmental/epileptic encephalopathies (DE/EE) with movement disorders (MD), these monogenic conditions have been less extensively investigated in the neonatal period compared to infancy. We reviewed the medical literature in the study period 2000–2020 to report on monogenic conditions characterized by neonatal onset epilepsy and/or DE/EE and development of an MD, and described their electroclinical, genetic and neuroimaging spectra. In accordance with a PRISMA statement, we created a data collection sheet and a protocol specifying inclusion and exclusion criteria. A total of 28 different genes (from 49 papers) leading to neonatal-onset DE/EE with multiple seizure types, mainly featuring tonic and myoclonic, but also focal motor seizures and a hyperkinetic MD in 89% of conditions, with neonatal onset in 22%, were identified. Neonatal seizure semiology, or MD age of onset, were not always available. The rate of hypokinetic MD was low, and was described from the neonatal period only, with WW domain containing oxidoreductase (WWOX) pathogenic variants. The outcome is characterized by high rates of associated neurodevelopmental disorders and microcephaly. Brain MRI findings are either normal or nonspecific in most conditions, but serial imaging can be necessary in order to detect progressive abnormalities. We found high genetic heterogeneity and low numbers of described patients. Neurological phenotypes are complex, reflecting the involvement of genes necessary for early brain development. Future studies should focus on accurate neonatal epileptic phenotyping, and detailed description of semiology and time-course, of the associated MD, especially for the rarest conditions

A salvage surgical solution for recurrent lymphangioma of the prepuce

Treatment of lymphangioma, circumscriptum of the prepuce is often technically demanding. Many different medical and surgical approaches have been described over the years, none of which has proved completely successful. We describe a case in which skin deficiency was a problem after prior multiple excisions of lymphangiomatous tissue. We decided to bury the degloved shaft in the scrotum. After 6 months the penis was raised and reconstructed using scrotal skin; this achieved satisfactory skin coverage. In such cases piliferous follicles can easily be dealt with at a later stage by cosmetic treatment.We believe this technical, approach may be a valid alternative to conventional procedures (i.e. grafts and flaps) especially when extensive resection makes skin coverage particularly difficult. (C) 2004 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved

P300 component in euthymic patients with bipolar disorder type I, bipolar disorder type II and healthy controls: a preliminary event-related potential study

The aim of the present study was to investigate P300 event-related potential components in euthymic bipolar disorder type I (BDI) and bipolar disorder type II (BDII) patients and matched controls. A total of 10 BDI patients, 10 BDII patients and 10 healthy individuals were enrolled in the study. Event-related potential data were collected according to a standard auditory 'oddball' paradigm. A significant groups effect in both the peak amplitude (P<0.001) and the mean amplitude (P<0.001) was observed; post-hoc comparisons showed that the peak and mean amplitudes of BDI and BDII patients were significantly lower than the peak and mean amplitudes of the healthy controls. The neurophysiological patterns found in the present study might at least partially reflect the presence of a mild selective cognitive impairment in euthymic BDI and BDII patients. From a clinical point of view, these evidences support the potential role of cognitive interventions in the treatment of BD