PurposeThis study aims to develop a framework that explains how and when telework is related to emotional exhaustion and task performance, by conceiving work overload as a mediator and self-leadership as a moderator. For this purpose, two studies were conducted. Study 1 aims to understand whether telework would be related to emotional exhaustion and task performance and if work overload would mediate such relationships. Study 2 aims to analyze whether self-leadership was a significant moderator of the mediated relations found in Study 1.Design/methodology/approachThe hypotheses were tested in a sample of 207 (in Study 1) and 272 (in Study 2) participants, which were exclusively teleworking. The results were analyzed using PROCESS macro in SPSS.FindingsThe results of Study 1 showed that telework dimensions were negatively related to work overload, which consequently decreased emotional exhaustion and increased task performance. In Study 2, self-leadership moderated the indirect effect of work overload on the relationship between telework and emotional exhaustion, such that the indirect effect was stronger for those who scored higher in self-leadership. However, it was not significant for task performance.Originality/valueThis paper adds to research on telework by focusing on the employee's mental health and performance, in the context of mandatory confinement. The authors identified telework dimensions that may act as resources to cope with the increased work overload inherent to telework, as well as the importance of personal resources in these relationships.

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Introduction: In the last two decades there have been advances in the diagnosis and management of neonatal cholestasis, which may have changed its epidemiology, diagnostic accuracy, outcomes, and survival. Our goal was to characterize these changes over time in our setting. Methods: Retrospective cohort study in a tertiary center, enrolling patients born between January 1985 and October 2019. The cohort was divided into two periods, before (A; n = 67) and after (B; n = 87) the year 2000; and in two groups, according to patient's outcome (favorable, unfavorable). Overall survival and survival with and without orthotopic liver transplant (OLT) were evaluated in the two periods (A and B) and in different subgroups of underlying entities. Results: We found that the age of cholestasis recognition decreased significantly from period A to period B [median 43 days and 22 days, respectively, (p < 0.001)]; the changes in epidemiology were relevant, with a significant decrease in alpha-1-antitrypsin deficiency (p < 0.001) and an increase in transient cholestasis (p = 0.004). A next-generation sequencing (NGS) panel available since mid-2017 was applied to 13 patients with contributory results in 7, but, so far, only in 2 patients led to conclusive diagnosis of underlying entities. The number of cases of idiopathic cholestasis did not vary significantly. Over time there was no significant change in the outcome (p = 0.116). Overall survival and survival without OLT had no significant improvement during the period of observation (in periods A and B, 86 vs. 88%, and 85 vs. 87%, respectively). However, in period B, with OLT we achieved the goal of 100% of survival rate. Conclusions: Our data suggest that transient cholestasis became a very important subset of neonatal cholestasis, requiring specific guidance. The NGS panels can provide Santos Silva et al. Neonatal Cholestasis Over Time important inputs on disease diagnosis but, if applied without strict criteria and expertise, they can open a Pandora's box due to misinterpretation. Despite all the advances in accurate diagnosis and timely management-including early recognition of cholestasis-the improvement in patient outcomes and survival were still not significant. Keywords: neonatal cholestasis, transient cholestasis, neonatal cholestasis epidemiology, cholestasis risk factors, neonatal cholestasis survival, next generation sequencing panel NGS panel evolution Mid-2017 (54 genes) Since the end of 2019 (95 genes) Genes ABCB11,

Background The Montreal classification categorizes patients with ulcerative colitis (UC) based on their macroscopic disease extent. Independent of endoscopic extent, biopsies through all colonic segments should be retrieved during index colonoscopy. However, the prognostic value of histological inflammation at diagnosis in the inflamed and uninflamed regions of the colon has never been assessed. Methods This was a multicenter retrospective cohort study of newly diagnosed patients with treatment-naïve proctitis and left-sided UC. Biopsies from at least 2 colonic segments (endoscopically inflamed and uninflamed mucosa) were retrieved and reviewed by 2 pathologists. Histological features in the endoscopically inflamed and uninflamed mucosa were scored using the Nancy score. The primary outcomes were disease complications (proximal disease extension, need for hospitalization or colectomy) and higher therapeutic requirements (need for steroids or for therapy escalation). Results Overall, 93 treatment-naïve patients were included, with a median follow-up of 44 months (range, 2-329). The prevalence of any histological inflammation above the endoscopic margin was 71%. Proximal disease extension was more frequent in patients with histological inflammation in the endoscopically uninflamed mucosa at diagnosis (21.5% vs 3.4%, P = 0.04). Histological involvement above the endoscopic margin was the only predictor associated with an earlier need for therapy escalation (adjusted hazard ratio, 3.69; 95% confidence interval, 1.05-13.0); P = 0.04) and disease complications (adjusted hazard ratio, 4.79; 95% confidence interval, 1.10-20.9; P = 0.04). Conclusions The presence of histological inflammation in the endoscopically uninflamed mucosa at the time of diagnosis was associated with worse outcomes in limited UC.