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Abstract Social connections among individuals are essential components of social‐ecological systems (SESs), enabling people to take actions to more effectively adapt or transform in response to widespread social‐ecological change. Although scholars have associated social connections and cognitions with adaptive capacity, measuring actors' social networks may further clarify pathways for bolstering resilience‐enhancing actions. We asked how social networks and socio‐cognitions, as components of adaptive capacity, and SES regime shift severity affect individual landscape management behaviours using a quantitative analysis of ego network survey data from livestock producers and landcover data on regime shift severity (i.e. juniper encroachment) in the North American Great Plains. Producers who experienced severe regime shifts or perceived high risks from such shifts were not more likely to engage in transformative behaviour like prescribed burning. Instead, we found that social network characteristics explained significant variance in transformative behaviours. Policy implications: Our results indicate that social networks enable behaviours that have the potential to transform SESs, suggesting possible leverage points for enabling capacity and coordination toward sustainability. Particularly where private lands dominate and cultural practices condition regime shifts, clarifying how social connections promote resilience may provide much needed insight to bolster adaptive capacities in the face of global change. Read the free Plain Language Summary for this article on the Journal blog.

The COVID-19 pandemic affected and continues to modify students' social life and as a result may impact their long-term development. This study is a part of a larger research project focused on the psychological impacts of the COVID-19 pandemic on university students. For this manuscript, we employed content analysis to analyze 1,327 quotes related to changes in social experiences and outcomes related to these changes from a sample of 1,099 students from seven universities across the United States. Five major themes emerged from the data, including meaningful relationships, struggling emotions, missing out, social responsibility, and stagnant autonomy. These themes suggest that the COVID-19 pandemic could impact students' development in terms of building social competence, recognizing and managing their emotions, becoming an independent adult, building mature and meaningful relationships with others, establishing identity, developing purpose, and building integrity (Chickering's Seven Vectors). We calculated the frequency and percentage of each theme and provided suggestions for future research and practice. Recommendations for future research include in-depth exploration of students' experiences during and after the pandemic using qualitative and longitudinal approaches. We also suggest adjusting practices among those who work with students to focus on a multiplicity of developmental goals unmet due to the COVID-19 pandemic.

The development of cerebral cavernous malformations (CCMs) is a well-recognized sequela of irradiation to the brain in pediatric tumors, particularly in medulloblastoma, glioma, and acute lymphoblastic leukaemia. So far, only one case of cerebral cavernoma after chemotherapy with autologous hematopoietic stem cell transplantation (HSCT) has been described. We describe a case of a patient with medulloblastoma aged 18 months at the time of oncological diagnosis who was treated with high-dose chemotherapy followed by HSCT and who developed CCM two years later. The patient was not treated for vascular malformation since he remained asymptomatic until now and is regularly followed with neuro-radiological check-ups. This represents the second case of acquired cavernoma developed in a patient who has not received radiation therapy.

Kikuchi-Fujimoto disease (KFD, histiocytic necrotizing lymphadenitis) is a rare, benign disease in which the presenting clinical and radiological features often result in misclassification as a malignant process. We present the first report of concurrent KFD in the draining lymph nodes of a malignant phyllodes tumour, adding to the growing number of reports of KFD occurring in the context of malignancy, further compounding the existing diagnostic difficulties. An increased awareness of this condition with consideration for inclusion in the differential diagnosis of lymphadenopathy is required for improved diagnosis of this under-recognized entity.

Objective: The aim of this retrospective article is to evaluate postoperative outcomes after extracapsular dissection for small benign superficial parotid neoplasms (

Abstract Beef production systems are at the center of ongoing discussion and debate on food systems sustainability. There is a growing interest among beef producers, consumers, and other beef supply chain stakeholders in achieving greater sustainability within the industry, but the relationship of this interest to general sustainability issues such as climate change, biodiversity loss, food security, livelihood risks, and animal welfare concerns is unclear. Specifically, there is very little research documenting how beef producers define and view the concept of sustainability and how to achieve it. Producer perspectives are critical to identifying constraints to sustainability transitions or to help build agreement with other producers about the shared values such transitions may support. Through a secondary analysis of survey data of U.S. beef producers (n = 911) conducted in 2021 by the Trust in Food division of Farm Journal, a corporation that provides content, data, and business insights to the agricultural community (e.g., producers, processors/distributors, and retailers), we investigated what “sustainable beef” means to U.S. beef producers, highlighting the key components and constraints they perceive to achieving desirable sustainability outcomes. Leveraging the three-pillar model of sustainability as a framework for analysis, we identified key themes producers use to define “sustainable beef.” We found that producers collectively viewed sustainability as: (1) multidimensional and interconnected; (2) semi-closed and regenerative; (3) long-lasting; and (4) producer-centered, although an integrated perspective uniting these aspects was rare. We discuss how these perspectives may be the basis for sustainability efforts supported by producers and raise future research considerations toward a shared understanding of what sustainability is and what is needed for enduring sustainability solutions in the U.S. beef industry.

IntroductionThe COVID-19 pandemic has posed significant challenges to the education system, leading to changes in student academic performance and mental health. The aim of this study was to evaluate variables relating to changes in academic performance and mental health during the pandemic.MethodsWe carried out a cross-sectional study from 28 February 2022 to 13 April 2022, during the free SARS-CoV-2 screening campaign offered by Sapienza University of Rome. A structured questionnaire was constructed to explore the decline in academic performance during the COVID-19 pandemic. The Coronavirus Anxiety Scale (CAS), a validated self-reporting mental health screener of dysfunctional anxiety associated with the coronavirus crisis, was used.ResultsA sample of 1,134 students was enrolled. A total of 25.4% of the participants reported a decline in academic performance. In addition, Coronavirus Anxiety Scale scores revealed that 133 (11.5%) students had a dysfunctional anxiety problem due to COVID-19. A multivariable logistic regression model showed that being a senior student (aOR: 0.70 95% CI: 0.52–0.96) and having good financial status (aOR: 0.64, 95% CI: 0.47–0.88) decrease the likelihood of a decline in academic performance, while not being Italian (aOR: 2.12, 95% CI: 1.29–3.48), having felt the need for psychological support (aOR: 2.58, 95% CI: 1.87–3.55) and being enrolled in a science/technology faculty (aOR: 1.81, 95% CI: 1.27–2.57) were more likely to result in a decline in academic performance.ConclusionOur results show that the pandemic has affected academic performance. The COVID-19 emergency highlighted the importance of considering mental health and economic status in policymaking to effectively support students.

Objectives: The purpose of this study was to investigate faculty and students' reactions to the COVID-19 emergency move to online classes. The goal was to better inform instructional strategies to be used in similar circumstances and to inform best practices in online pedagogy. Method: Online surveys were administered to students and faculty near the end of the semester to evaluate different aspects of the transition. Classes included in the study were scheduled as full-semester, on-campus classes but made an emergency switch to online post-spring break, after eight weeks. Results: Students' and faculty's comfort levels at the time of the switch depended on the amount of prior experience they had in online teaching and learning. Individual students and faculty experienced varying degrees of ease of adjustment to the switch in format from in-class to online. Faculty had to adapt quickly to determine the best way to replicate the in-class experience. Many faculty would depend on familiarity with technology and creativity with its usage. To varying degrees, comfort level improved as the semester progressed for both faculty and students. Still, a majority of students expressed less interest than before in taking online classes. Conclusions: The level of preparedness of faculty and students determined the outcome of this natural experiment. The adjustment was easier for those with prior experience with the online format and/or for those who felt comfortable with the format. Implication for Practice: As faculty and students prepare to return to the classroom, consideration can be given to best practices in online pedagogy to support students and faculty. Our findings point to the need for institutional preparedness for unforeseen circumstances.

BACKGROUND: This study proposed a classification of the vertical portion of the facial nerve (VPFN) location, incorporating the previous classifications regarding the posterior-to-anterior and medial-to-lateral dimensions. We also evaluated the implication of this proposed classification on the round window visibility during pediatric cochlear implantation (CI). METHODS: It was a retrospective multicenter observational cohort study. This study included 334 cases that underwent CI between 2015 and 2022 at multiple referral institutes. Two physicians evaluated the preoperative computed tomography images of 334 patients and determined the radiological type of the VPFN. These types were matched with intraoperative round window accessibility. RESULTS: The Spearman’s correlation coefficient showed a strong correlation between the proposed VPFN type and the intraoperative round window visibility, as the P-value was

Introduction Despite nurses representing the largest healthcare professional group, the number is not enough for global health coverage. Understanding Generation Z students’ intrinsic and extrinsic motivations, internal and external influences, and beliefs in choosing nursing education is crucial. This knowledge empowers universities to enhance nursing program enrollment through targeted promotion and recruitment strategies. Objective The aim was to understand why Italian students of Generation Z choose the Nursing Degree Course. Methods In this pilot study, a cross-sectional design was used. A survey with closed and open answers analyzing demographics, opinions, and motivations among new enrolled nursing students was administered on the first day of the Bachelor of Nursing Degree course. Descriptive statistics were used. Quantitative data were analyzed with Chi-square and ANOVA tests and qualitative data underwent content analysis and coding. Correlation analysis explored relationships between qualitative and quantitative results. Results Forty first-year students (85% female, average age 22) completed the questionnaire. The choice of the degree pathway, as the first or second option, is influenced by intrinsic and extrinsic motivations, the student's opinions, and family and social influences. Significant positive and negative associations were evidenced. Negative factors affecting choice included location and the responsibility for nursing care, while positive factors included role models, family advice, passion, curiosity for healthcare, the desire to help others, and family influences on decision-making. Conclusions Among Italian generation Z students, the choice of the nursing degree pathway is influenced by social models, family advice, passion, the desire to help others, and curiosity. Universities should be more proactive in their recruitment and promotion efforts, transforming these events into vibrant meeting points for professionals from diverse nursing specialties. They should also implement robust information policies that highlight career possibilities spanning clinical practice, management, education, and research areas within the field.

Craniosynostoses (CRS) are caused by the premature fusion of one or more cranial sutures, with isolated nonsyndromic CRS accounting for most of the clinical manifestations. Such premature suture fusion impacts both skull and brain morphology and involves regions far beyond the immediate area of fusion. The combined use of different neuroimaging tools allows for an accurate depiction of the most prominent clinical–radiological features in nonsyndromic CRS but can also contribute to a deeper investigation of more subtle alterations in the underlying nervous tissue organization that may impact normal brain development. This review paper aims to provide a comprehensive framework for a better understanding of the present and future potential applications of neuroimaging techniques for evaluating nonsyndromic CRS, highlighting strategies for optimizing their use in clinical practice and offering an overview of the most relevant technological advancements in terms of diagnostic performance, radiation exposure, and cost-effectiveness.

Plantar fasciitis is one of the most common causes of foot pain; in 35% of cases, it is also associated with bone edema of the heel. The aim of this study was to investigate the relationship between bone edema and the outcomes of temperature-controlled high-energy adjustable multi-mode emission laser (THEAL) and/or exercises in patients with plantar fasciitis. A prospective randomized clinical trial was designed, in which 48 patients suffering from plantar fasciitis, with or without bone edema, were treated with temperature-controlled high-energy adjustable multi-mode emission laser and exercises (the laser group) or with exercises only (the control group). The patients were evaluated at recruitment (T0) and at 2 (T1) and 6 months (T2), monitoring pain (with the Visual Analogue Scale), functionality (with the Foot Function Index), perception of improvement (with the Roles and Maudsley Score), and fascia thickness (with ultrasound examination). In both groups, there was a significant improvement in pain, functional recovery, perception of remission, and a reduction in plantar fascia thickness at T1 and T2. The laser group presented statistically better values at T2 for the Roles and Maudsley Score (z: 2.21; 0.027). The regression analysis showed that a greater reduction in fascia thickness occurred in the laser group (p-value: 0.047). In conclusion, the two conservative treatments were effective in patients suffering from plantar fasciitis, even in the presence of bone edema, but with lesser results.

In late December 2019, SARS-CoV-2 was identified as the cause of a new pneumonia (COVID-19), leading to a global pandemic declared by the WHO on 11 March 2020, with significant human, economic, and social costs. Although most COVID-19 cases are asymptomatic or mild, 14% progress to severe disease, and 5% develop critical illness with complications such as interstitial pneumonia, acute respiratory distress syndrome (ARDS), and multiple organ dysfunction syndrome (MODS). SARS-CoV-2 primarily targets the respiratory system but can affect multiple organs due to the widespread presence of angiotensin-converting enzyme 2 (ACE2) receptors, which the virus uses to enter cells. This broad distribution of ACE2 receptors means that SARS-CoV-2 infection can lead to cardiovascular, gastrointestinal, renal, hepatic, central nervous system, and ocular damage. The virus triggers the innate and adaptive immune systems, resulting in a massive cytokine release, known as a “cytokine storm”, which is linked to tissue damage and poor outcomes in severe lung disease. Interleukin-6 (IL-6) is particularly important in this cytokine release, with elevated levels serving as a marker of severe COVID-19. IL-6 is a multifunctional cytokine with both anti-inflammatory and pro-inflammatory properties, acting through two main pathways: classical signalling and trans-signalling. Classical signalling involves IL-6 binding to its membrane-bound receptor IL-6R and then to the gp130 protein, while trans-signalling occurs when IL-6 binds to the soluble form of IL-6R (sIL-6R) and then to membrane-bound gp130 on cells that do not express IL-6R. The soluble form of gp130 (sgp130) can inhibit IL-6 trans-signalling by binding to sIL-6R, thereby preventing it from interacting with membrane-bound gp130. Given the central role of IL-6 in COVID-19 inflammation and its association with severe disease, we aimed to analyse the behaviour of IL-6 and its soluble receptor complex during different waves of the pandemic. This analysis could help determine whether IL-6 levels can serve as prognostic markers of disease severity.

L’eremitismo calabrese si sviluppò lentamente, dalla grotta passò alla laura e da questa al monastero ed al cenobio. Il monastero, per essere tale, presupponeva un certo numero di monaci che potessero vivere anche in grotte separate con a capo una guida ed aventi una chiesa in cui tutti potessero raccogliersi per l’ufficio e la liturgia. Il cenobio invece richiedeva un impianto più avanzato, con una vita veramente in comune, un refettorio, un dormitorio, i beni, gli strumenti, gli indumenti in comune, come già contemplato dalla legislazione giustinianea

Ménière's disease (MD) patients may suffer episodes of sudden falls, named Tumarkin drop attacks (DAs). This fall occurs abruptly and without warning or loss of consciousness. DAs usually aggravate the clinical picture of MD and are challenging to manage. The present report describes a case treated by cochlear implantation (CI) due to concomitant deafness and offers some clinical considerations for this condition. A male patient aged 48 years with a 10-year history of definite bilateral MD had profound SNHL on the right and severe SNHL on the left side. He suffered from intermittent attacks of vertigo, ear fullness, and tinnitus and, in the last year, had developed DAs and experienced 14 episodes in the previous six months. The preoperative category of acoustic performance was 3. The Dizziness Handicap Inventory (DHI) questionnaire showed a total score of 46, which indicated a moderate degree of disability. A CI was planned for the right side. The patient did not report any further DAs episode for two years since then. The postoperative category of acoustic performance became 11, and the postoperative DHI questionnaire showed a decrease in the total score (from 46 to 19), which indicated a mild disability. Unilateral CI effectively alleviated the DAs associated with bilateral MD. Our report proposes a new modality for managing vertiginous symptoms in cases of MD with hearing loss without the need for more aggressive surgical interventions with the need for clinical trials to confirm our results.

Mesenchymal breast tumors are a rare and diverse group of tumors that present some of the most challenging cases for multidisciplinary breast cancer teams. As a result of overlapping morphologies and a lack of large-scale studies on these tumors, practices are often heterogeneous and slow to evolve. Herein, we present a non-systematic review that focuses on progress, or lack thereof, in the field of mesenchymal breast tumors. We focus on tumors originating from fibroblastic/myofibroblastic cells and tumors originating from less common cellular origins (smooth muscle, neural tissue, adipose tissue, vascular tissue, etc.).

Introduction: The purpose of this study was to identify effective individualized positive behavior support strategies and cognitive behavior therapy strategies for young adults who are deafblind. It discusses findings specific to four young adult students with CHARGE syndrome. Methods: This collaborative action research study employed collective case study design and elements of grounded theory analysis. Principles of positive behavior support and modified cognitive behavior therapy supported the identification and implementation of individualized behavioral interventions that addressed environment arrangement, sensory needs and sensitivities, and how adults communicated with the students. Results: Eight themes were identified as being important to each of the students, although to varying degrees. These were: provide structure, establish and maintain a positive climate, address students' sensory needs and sensitivities, support on-task behavior, support transitions between activities and environments, support mature behavior, support students in coping with anxiety, and use adult language supports. Each theme included multiple strategies. Discussion: Proactive and reactive strategies must be individualized even when children share an etiology. Educational team members must know each student's preferences, likes, dislikes, reinforcers, and unique communication needs in order to identify and effectively implement behavioral supports. Modified cognitive behavior therapy may be helpful in addressing the anxiety experienced by individuals with CHARGE syndrome. Teams require time to collaborate on behavioral assessment, the identification of individualized behavioral strategies, and the effectiveness of behavioral plans. Implications for practitioners: Providing well-structured environments and teaching rules and routines can reduce anxiety because students know what to expect. Educational team members should prevent sensory overload, provide structured desensitization opportunities, and teach relaxation techniques to these students. Adult communication must be positive, clarify what will happen next, and redirect behaviors when needed.