ABSTRACT This article reviews twenty-five years of research on the role of emotions during organizational change and proposes avenues for future research. Building on an analysis of articles published in the Journal of Change Management: Reframing Leadership and Organizational Practice (JCM) from 2000 to 2024, we trace the development of scholarship in the field and synthesize contributions. We also uncover how the research published in JCM has substantially influenced the wider field by integrating perspectives from psychology, sociology, and institutional theory, thereby advancing an interdisciplinary understanding of the role of emotions in change processes. Persistent gaps remain, however, which also provide opportunities for future research. We identify collective emotions, emotional contagion, and affective climates; the politics of affect; and the non-linear and temporal nature of emotional experiences and responses as particularly promising areas for future research. Finally, advancing our understanding of the role of emotions during organizational change requires methodological pluralism and engagement with emerging organizational contexts such as digital transformation, sustainability transitions, and global crises.

Axial imaging is typically obtained following operative reduction of developmental dysplasia of the hip (DDH) to confirm a concentric reduction. Although the utility of axial imaging has been studied following the index reduction, its value following spica cast exchange remains unclear. This single-center study included all children 2 years or younger with idiopathic DDH who underwent closed or open reduction between 2012 and 2023. Patients with concurrent osteotomies or dysplasia secondary to syndromic/neuromuscular causes were excluded. Institutional protocol during this period consisted of 3 months of immobilization with a spica cast exchange at 6 weeks for all closed or medial open reductions. Axial imaging (CT or MRI) was typically obtained after both the index procedure and cast exchange to confirm reduction. A retrospective review was conducted to assess how often axial imaging directly altered clinical management, defined as an unplanned return to the operating room or a documented change in management based on imaging findings per the treating surgeon's notes. Minimum follow-up was 1 year. Descriptive statistics were used to summarize patient characteristics and arthrogram findings. The cohort included 91 patients (124 hips): 92 (74%) hips underwent closed reduction, and 32 (26%) underwent open reduction. The median age at index reduction was 7.7 months, with 52% (n=47/91) above 6 months old. Of those with preoperative radiographs (n=98), most hips were IHDI grade 3 (29%, n=27) or 4 (39%, n=38). Axial imaging changed management in 3% of hips after the index reduction (4/92 closed reductions, 0/32 open reductions). Among 124 hips receiving axial imaging at cast exchange (92=MRI, 32=CT), only 1 hip was dislocated (<1%). Analysis of a separate cohort of 12 hips that did not receive axial imaging at cast exchange suggests that an adequate arthrogram (no medial dye pool and deep concentric reduction) is sufficient to confirm reduction. Axial imaging at the time of spica cast exchange rarely alters clinical management and should not be routinely obtained unless otherwise indicated by a concerning intraoperative arthrogram. Level IV-retrospective case series.

This study aims to analyze the scope of electronic business systems from the perspectives of technology, business processes, and management through a qualitative descriptive approach based on literature review. Data were collected from textbooks, scientific journals, and relevant empirical studies discussing the development and implementation of e-business systems in various organizational contexts. The analysis focuses on key aspects, including business models, technological infrastructure, data security and privacy, as well as human resources and change management. The findings indicate that electronic business systems represent an integrated framework that extends beyond online transactions to encompass internal process integration, strategic decision-making, and value creation. Effective implementation of e-business requires alignment between business models and market characteristics, supported by reliable technology and robust data protection mechanisms. In addition, organizational readiness, digital literacy, and adaptive management play a crucial role in ensuring successful digital transformation

Global Engineering and R&amp;D service organizations face an enduring challenge: executive strategic visions rarely translate into operational results. This disconnect constrains performance across billion-dollar revenue segments. The Strategic Transformation Office framework provides a solution—a centralized mechanism that bridges boardroom aspirations with ground-level execution. Operating as an executive office extension, the STO unifies three domains: strategic account governance with C-suite advisory, complete M&amp;A integration cycles, and R&amp;D innovation management at scale. Through coordinated governance, deliberate execution strategies, and careful performance monitoring, this framework addresses the layered complexity of global service distribution. At the center, organizational ambidexterity enables businesses to improve existing processes while also creating future capacity by means of specialized institutions. Multiple elements determine success: sincere executive support, methodical talent acquisition, slow release strategies, and complex change management. Large engineering services firms wrestling with coordination tangles, integration obstacles, and innovation demands beyond traditional structures' capabilities will find this model especially relevant.

Biodiversity loss can destabilize ecosystem functioning. How biodiversity-stability relationships are interlinked across trophic levels remains poorly investigated, however, limiting our ability to predict ecosystem-level consequences of declining biodiversity. Here, we analyze the drivers of multi-year herbivore community stability-as a key connector between primary producers and higher trophic levels-and its coupling with host tree diversity and growth stability along a subtropical tree diversity gradient. Phylogenetic diversity, abundance asynchrony and population stability of herbivores emerge as key intra-community regulators of herbivore temporal stability. These regulators, in turn, are strongly affected by changes in tree species richness through tree functional diversity, tree growth asynchrony, and tree growth population stability. Importantly, accounting for herbivore dietary specialization unveils clear stabilizing effects of tree species richness on the community stability of specialists but not of generalists. For the overall herbivore community, higher tree richness results in less stable abundance dynamics. Our findings suggest that biodiversity loss will propagate bottom-up to affect the stability of communities at higher trophic levels, and particularly destabilize communities of more vulnerable specialists. Global change and plantation management may thus also compromise biodiversity conservation by reducing abundance and species richness stability of higher trophic levels.

ABSTRACT Purpose Enterprise collaboration technologies have been recognized for enabling effective digital collaboration among employee and overcoming temporal and spatial barriers. However, organization-wide adoption of these types of new technologies remains an operational challenge to generating business value. Thus, organizations use interventions, such as change management programs, to support systems implementations. Prior literature on social networks has shown that interactions among interdependent employees influence technology adoption and use. The purpose of this paper is to examine the impact of a service provider’s change management program on end users’ subsequent advocacy to others in their network, as well to understand the complex downstream effects of advocacy on current usage, continued usage, and intention to recommend. This research recognizes the critical role of peer recommendation in network good adoption and positions net promoter score as a key predictor of sustained system use. Methodology/approach This study adopts a quantitative approach using various regression analysis based on survey data. Data for the study was collected from 587 employees, as part of a change management project supporting a large-scale customer digital transformation, regarding their perceptions of the change and experience with the new enterprise collaboration technology. Findings The results of the research highlight the role of specific dimensions related to change management in explaining subsequent advocacy outcomes. According to the data, the change management process positively impacts end users’ subsequent likelihood to recommend a new digital collaboration technology to peers in their organization. The empirical research demonstrated that higher advocacy of a new enterprise collaboration technology within one’s network significantly predicts one’s current use, which in turn impacts one’s intention to continue using the technology, and this sequential pathway ultimately influences one’s likelihood to recommend the technology to others in the network. Further, the effect of current use on one’s likelihood to recommend is mediated via future intentions to use. Contribution This research bridges knowledge on technology adoption, change management, and individual level of advocacy by examining the role of peer recommendation in adoption of enterprise collaboration technologies. While the net promoter score has been widely used in consumer behavior research focused on consumer goods industries, studies have yet to examine how the measure might be implemented as a key indicator of network good adoption at the individual enterprise level, by measuring the employee-level net promoter scores within a client-organization.

Abstract Background Karius testing (KT) utilizes cell-free DNA metagenomic next-generation sequencing to detect infectious organisms in plasma samples. More data on the clinical impact of KT in large cohorts are needed to understand its utility and relevance in different clinical syndromes. We examined the utilization, patient clinical characteristics, and clinical impact of KT in a retrospective cohort of adults at a large tertiary care center. Methods Retrospective review of all KT completed for adult patients at the Medical University of South Carolina from January 2022 to November 2024. Clinical impact (positive, negative, or neutral) was assessed using pre-specified criteria. Descriptive analyses of microorganisms identified, patient characteristics, and clinical impact were performed. Results 228 patients had a KT; 94 (41%) were immunocompromised (Table 1). Main indications for testing were to establish a diagnosis of a problem presumed to be infectious (n=149, 65%) and to exclude infection (n=72, 32%) (Table 2). KT was positive in 123 (54%) patients. The most frequent organisms detected are outlined in Table 3. Mean time from KT collection to result was 4.57 days. KT had a positive clinical impact in 71 (31%) patients, mainly through identification of a microorganism considered by clinical care providers to be pathogenic (n=52). KT had a neutral clinical impact in 154 (68%) patients, mainly because negative KT results did not lead to changes in patient management (n=107). There was a negative clinical impact due to KT in 3 (1%) patients, including 2 patients with increased length of hospital stay (Table 4). In 60 (26%) patients, KT identified an organism when standard testing was negative. Standard testing and KT were concordantly positive in 35 (15%) patients and concordantly negative in 105 (46%) patients. In 17 (8%) patients, KT returned negative when standard testing was positive. Conclusion Among adults with a wide variety of clinical syndromes, KT had a positive clinical impact in nearly one-third, with rare negative impact. In over one-quarter of tested adults, KT identified an organism that was not discovered with standard testing. Further studies should seek to identify clinical syndromes where KT has the highest likelihood of clinical utility. Disclosures Rachel Burgoon, Pharm.D., Merck: Grant/Research Support

The purpose of this study was to understand the clinical indications and utility of a barium swallow study in patients who have already been investigated with an upper gastrointestinal (UGI) endoscopy. It would be useful to determine the additional diagnostic information provided by a barium swallow study given endoscopy is considered the gold standard for examining the UGI tract. This retrospective study examined all barium swallow studies performed at a single tertiary hospital and identified patients who had been investigated with an UGI endoscopy in the preceding 6 months. The radiology request forms, barium swallow reports, UGI endoscopy reports and clinic letters were reviewed to determine the most frequent clinical indications, quantify and characterise new findings on barium swallow and determine the proportion of patients with alteration in management. Between 1 January 2023 and 30 September 2023, 105 of 318 patients investigated with barium swallow studies had received a recent UGI endoscopy. Over half of the study requests were non-specific, aimed at identifying the cause of dysphagia. A total of 59 studies (56.2%) demonstrated findings that were not apparent on UGI endoscopy. The most common new finding was dysmotility (n = 53, 89.8%). Of the patients with new findings, 24 (40.7%) experienced no change in management, nine (15.2%) were offered lifestyle advice, seven (11.9%) were referred to speech and language therapy and seven (11.9%) were started on medication. A barium swallow study is a helpful adjunct to UGI endoscopy, especially in the diagnosis of dysmotility.

Evaluation of Swallow Function in Patients with Congenital Diaphragmatic Hernia.

This paper critically reexamines John Kotter’s Eight-Step Model for leading organizational change, exploring its enduring relevance and limitations in the context of today’s dynamic, technology-driven business environment. While Kotter’s framework has become a foundational reference in leadership education and change management practice, its linear and top-down orientation faces challenges when applied to continuous transformation efforts requiring agility, cross-functional coordination, and decentralized decision-making. By contrasting Kotter’s model with contemporary approaches such as Agile, Lean, and adaptive leadership, the analysis highlights areas where the framework must evolve to remain effective. The paper draws on both scholarly literature and applied frameworks from major consulting firms to examine how Kotter’s principles have been embedded, adapted, and extended in practice. It also explores theoretical intersections between Kotter’s leadership emphasis and modern paradigms such as servant, transformational, and adaptive leadership, arguing that these approaches enrich Kotter’s original model by promoting distributed authority, continuous learning, and systemic responsiveness. Through this updated lens, the study proposes a hybridized view of change leadership that integrates Kotter’s structured process with flexible, people-centric strategies to address the current realities of business transformation. The result is a nuanced perspective on how organizations can pursue sustainable change by balancing strategic discipline with adaptive capacity, preserving the strengths of Kotter’s vision while enhancing its practical relevance.

Pediatric olecranon fractures are uncommon periarticular injuries with unclear treatment guidelines for varying magnitudes of intra-articular displacement. Similar to other pediatric elbow fractures, minimally displaced fractures are treated nonsurgically, and potential for further displacement following nonsurgical treatment exists. This study assesses the incidence and risk factors for further displacement after nonsurgical treatment of minimally displaced pediatric olecranon fractures. A retrospective review was conducted on patients aged 0 to 15 years with isolated olecranon fractures treated nonsurgically at a single institution. Radiographic measurements of intra-articular and nonarticular displacement on lateral views were collected with follow-up imaging done until confirmed radiographic union. Patients with more than 1-mm change in displacement on the articular side during treatment were identified. Fractures were classified at specified locations, including zone 1 (proximal 1/3), zone 2 (middle 1/3), and zone 3 (distal 1/3). A total of 64 patients met inclusion criteria, 42 (65.6%) were males, and the average age at injury was 8.25 years. Casting without closed reduction was the definitive treatment method in 59 patients (92.2%). Of the fractures observed, 30 (46.9%) occurred in zone 1, followed by 23 patients (35.9%) in zone 2 and 11 patients (17.2%) in zone 3. Interval displacement was seen in 14 patients at follow-up visits (21.9%) with greater body mass index observed in the redisplacement group (P = 0.053). Change in management was required in two patients (3.1%). Displacement of ≥1 mm at initial evaluation did not affect the rate of subsequent displacement at follow-up visit (P = 0.571). Neither fracture zone nor fracture configuration were statistically significant for change in fracture displacement. Further displacement was observed in 20% of minimally displaced olecranon fractures regardless of the zone and magnitude of initial displacement with a small percentage leading to a change in the management. Close radiographic follow-up for nonsurgically treated olecranon fractures is recommended.

DBSMatchMaker (https://www.dbsmatchmaker.com), launched publicly in December 2024, is a freely accessible, web-based platform that connects clinicians treating rare genetic movement disorders with deep brain stimulation (DBS). To characterize the first year of adoption and early clinical impact of DBSMatchMaker. We evaluated global uptake, usage patterns, and early insights from December 2024 to December 2025. We analyzed aggregate, deidentified submissions; required fields included genetic diagnosis and DBS target, with optional three-point treatment response ratings. Forty-one clinicians from 39 institutions across 20 countries submitted 158 unique cases spanning 58 monogenic movement disorders, most commonly GNAO1-, KMT2B-, PANK2-, ADCY5-, and SGCE-related disorders. Among entries with outcome ratings, 84.6% reported strong or moderate benefit. The system generated 614 clinician matches, including several that led to changes in management or multicenter research case series. Early adoption highlights global engagement and clinical utility. DBSMatchMaker serves as a living repository that lowers barriers to data sharing and supports data-driven DBS decision-making. © 2026 International Parkinson and Movement Disorder Society.

Monitoring and evaluation are crucial for healthcare quality assurance. This study systematically aims to explore the unique challenges encountered during the implementation of mandatory hospital accreditation in a centralized healthcare context and develops a set of operationally sound solutions. A qualitative methodology was utilized, with semi-structured interviews conducted with 17 hospital managers, supervisors and accreditation officials in Iranian hospitals in 2024. Participants were selected through purposive sampling with maximum variation, and interviews continued until theoretical saturation. Lincoln and Guba's criteria were applied to ensure the data's trustworthiness. The data were analyzed using the content analysis technique with MAXQDA 10 software. Twenty-two challenges were identified in the themes of leadership and strategic management; human capital development and engagement and contextual coordination and adaptation. In total, 26 practical solutions were also identified for implementing the accreditation program in hospitals. This study provides a comprehensive examination of the experiences of specialists and experts regarding the challenges of hospital accreditation and practical solutions for addressing these challenges. In fact, this research offers multi-dimensional, actionable recommendations for policymakers, accreditation management bodies and service providers, moving beyond mere compliance to leverage accreditation for genuine competitive advantage and public accountability. While this research provides essential data for administrative decision-makers overseeing the accreditation process, we recognize that a purely administrative focus is inherently one-sided. Therefore, to fully realize the social and political value of our findings, this section translates the results into multi-dimensional, actionable recommendations for various key groups: For policymakers/governmental bodies (establish a cross-sectoral review board composed of representatives from patient advocacy groups, insurance providers and regulatory agencies to periodically review and validate accreditation criteria against current societal expectations, ensuring relevance and public accountability), accreditation management bodies and industry/service providers (service providers must move beyond mere compliance by utilizing the findings of this study to proactively map internal processes against the high-implementability factors identified). This involves viewing accreditation not as a hurdle, but as a roadmap for competitive advantage through demonstrable quality assurance that directly influences patient trust and market share. This study yields significant implications across several domains, capitalizing on the crucial role of accreditation in enhancing quality, ensuring patient safety and promoting stakeholder satisfaction. Despite the implementation of accreditation requirements in hospitals and continuous monitoring, we still observe shortcomings and deficiencies in some cases, which are addressed in hospital accreditation standards. By identifying the challenges faced by hospitals in this area locally and providing practical solutions, as well as implementing corrective interventions, positive steps can be taken towards the effective implementation of accreditation in hospitals. Previous studies largely focus on challenges within voluntary accreditation models (e.g. JCI and ACS), where commitment is market-driven. This study, conversely, investigates these challenges within the nationally mandated, highly centralized and culturally hierarchical Iranian healthcare context. This shift in mandatory governance creates unique friction points, such as the intense impact of frequent management changes and political influence on resource allocation, which are absent or minimized in voluntary systems. The identification of challenges directly linked to international sanctions (e.g. resource shortages and outdated technology) is a novel contribution that connects quality improvement literature with geopolitical realities. This link is vital for understanding accreditation barriers in sanctioned or developing economies and has not been adequately addressed in the existing global literature. While generalizability across all countries is limited, the findings serve as a crucial benchmark for the wider set of Middle Eastern, highly centralized, and developing economies facing similar governance and resource constraints. The 22 challenges and 26 solutions identified offer a localized framework that is highly applicable to systems operating under similar resource pressures.

BackgroundBlood‐based biomarkers (BBMs) offer a cost‐effective, non‐invasive approach for detecting Alzheimer's disease (AD) pathology, but their impact on improving diagnostic certainty and patient management remains unclear. The PLASMAR study is a prospective, single‐center, blinded, randomized controlled trial assessing the effect of early versus delayed BBM adoption on clinical practice in a public hospital memory clinic. This abstract presents an interim analysis on changes in patient management.MethodFrom February to October 2024, 224 patients with cognitive or behavioral complaints (GDS 2–4) referred to the memory clinic at Hospital del Mar (Barcelona, Spain) were prospectively enrolled. Eligibility criteria are detailed in Table 1. At baseline, blood samples were collected for BBMs, and neurologists assessed diagnostic confidence based on routine clinical evaluation without BBM results. Participants were randomized to the Early (BBM results disclosed at 3 months) or Late (disclosed at 9 months) arms. Patient management changes were compared between arms. Plasma p‐tau217 levels, classified by validated cutoffs, stratified patients into low, intermediate, or high risk for AD pathology.ResultOf 224 enrolled patients, 27 were lost to follow‐up, leaving 197 participants (mean age 71.6 ± 8.9 years; 56.9% female). There were no demographic differences between study arms. Initial diagnoses included SCD (44.7%), MCI (31.4%), or dementia (21.3%), with AD suspected in 30%. By December 2024, 114 patients (87 Early, 27 Late) had BBM results disclosed. AD risk was classified as low (52.4%), intermediate (17.5%), or high (30%). At 3‐months follow‐up, Early‐arm patients had higher discharge rates and initiated AchEIs sooner (p <0.01), while Late‐arm patients more frequently received longitudinal cognitive monitoring (p <0.01). Among SCD patients, Early‐arm participants had higher discharge rates and underwent more lumbar punctures for CSF biomarkers according to their AD pathology risk (p <0.05), while Late‐arm patients were more likely to undergo cognitive monitoring (p <0.001). Among MCI patients, Early‐arm participants had higher discharge rates (p <0.01). Similar trends were observed in the low‐risk AD group (p <0.05).ConclusionThis interim analysis demonstrates that early disclosure of BBM results influences patient management and accelerates the initiation of specific AD treatments, also reducing the need for follow‐up of cognitive assessments.

Teleneurocritical care (TeleNCC) aims to project expertise to hospitals lacking dedicated neurocritical care. However, its influence on clinical care remains underexplored. We prospectively studied two TeleNCC cohorts. Within a tertiary care medical decision-making cohort, TeleNCC consultants documented recommended changes in prespecified aspects of evaluation and management for patients at a tertiary care hospital with neurosurgery, neurology, and critical care but without dedicated neurocritical care. In a separate community process measure cohort, TeleNCC consultants documented prespecified process measures (consultation duration, transfer to tertiary care versus local patient retention, and approaches to brain death determination) for patients across ten community hospitals lacking on-site neurology support. Differences were evaluated by site and diagnosis. Within the tertiary care medical decision-making cohort (n = 123), TeleNCC consultants recommended changes in evaluation and management for 71.8% of patients, including neuroimaging, neuromonitoring, medication initiation/adjustment, operative management, and de-escalation from critical care. TeleNCC consultations often did not require video evaluation. Within the community process measure cohort (n = 1493), consultation duration varied by site. Tertiary care transfer was rare (0-9.2% among 9 of 10 hospitals), although patients with subarachnoid hemorrhage (SAH) weretransferred more frequently (38.5%; p < 0.001) than patients with toxic-metabolic/systemic encephalopathy, hypoxic-ischemic encephalopathy, or other cerebrovascular disorders. Community hospital providers evaluated 47 patients for brain death under TeleNCC guidance; 16 (61.5%) of 26 patients evaluated by clinical criteria alone met criteria, as well as 16 (76.2%) of 21 patients evaluated via additional ancillary testing. For patients at a tertiary care hospital, TeleNCC consultants recommended changes in medical decision-making for the vast majority of patients, whereas community hospital patients receiving TeleNCC consultation as their initial neurologic evaluation rarely required transfer to tertiary care, despite complex conditions, including suspected brain death. These observational cohorts demonstrate the versatility and efficiency of TeleNCC across care settings, although interventional studies are needed to evaluate the impact of TeleNCC on clinical outcomes.

Introduction Although the full impact of the COVID-19 pandemic on opioid overdose management across urban and rural settings may take years to fully elucidate, poison center teleconsultations provide valuable early indicators of emerging clinical patterns. We examined the epidemiological and clinical effects of the pandemic on teleconsultations involving intentional opioid exposures from United States poison centers. Methods We conducted a quasi-experimental study (2018–2022) of intentional opioid overdoses reported to United States poison centers. Through multivariable multinomial and logistic regression, we assessed the relationships between time (pre-COVID-19 versus after COVID-19 onset) and geography (urban or rural) with change in the following outcomes: opioid cases; clinical disposition (admission to a critical care unit, non-critical care unit, psychiatric admission); and clinical management (naloxone, endotracheal intubation). Results While there was only a 1% (mean difference 0.8%; 95% CI: 0.7–0.8) increase in the proportion of opioid overdoses, trends and clinical management were different compared to pre-COVID-19 urban cases. Admission to critical care units declined during the COVID-19 era for both urban (adjusted odds ratio: 0.59; 95% CI: 0.56–0.63) and rural (adjusted odds ratio: 0.67; 95% CI: 0.61–0.74) patients. Naloxone administration decreased during the pandemic in both urban (adjusted odds ratio: 0.69; 95% CI: 0.65–0.72) and rural (adjusted odds ratio: 0.84; 95% CI: 0.77–0.92) settings. Endotracheal intubation rates were lower in rural (adjusted odds ratio: 0.74; 95% CI: 0.62–0.88) and urban (adjusted odds ratio: 0.67; 95% CI: 0.61–0.74) settings during COVID-19, with rural patients consistently showing lower odds compared to pre-COVID urban patients. Discussion The COVID-19 pandemic was associated with a reduction in critical interventions for opioid overdoses reported to poison centers, highlighting potential disruptions or changes in overdose management across both urban and rural settings. Conclusions These findings add to evidence that the COVID-19 pandemic may have disrupted overdose care protocols, potentially impacting outcomes for individuals with opioid-related emergencies.

Traditional management practices are essential for maintaining the biodiversity of many semi-natural grassland habitats. Abandonment of these practices is leading to shrub encroachment and a decline in biodiversity in many European regions. For this reason, understanding the social processes behind transforming traditional management practices and the subsequent habitat changes is currently a major focus of ecological research. We aimed to identify ecologically relevant indirect drivers (economic, demographic, institutional, cultural, and technological) impacting Natura 2000 grassland habitats since the mid-twentieth century in two neighbouring Central European post-communist countries, Hungary and Romania. Ecological memory on 21 semi-natural grassland localities was collected through 60 oral history interviews from knowledgeable locals. The studied localities were covered by semi-natural grasslands listed in the Habitats Directive, Annex I: 1.) Semi-natural dry grasslands (6210); 2.) Alluvial meadows of river valleys (6440); and 3.) Pannonic salt steppes and salt marshes (1530*). We asked about three time periods (before: 1950-1961, during: 1962-1989, and after socialist collective farming: 1990-2007). We identified 211 mentions of indirect drivers and categorised them into five main indirect driver categories. Economic drivers were the most often mentioned indirect driver categories for alluvial and saline habitats. Demographic drivers, such as ageing, labour shortage, and rural-urban migration, were highly intertwined and most pronounced for dry semi-natural grasslands. We found that the impacts of ecologically relevant social processes beginning in the 1960s-1970s became visible only decades later, reflected by delayed changes in grassland management and vegetation (e.g. shrub encroachment, spread of weeds and invasive species). Migration to cities was amplified by changing lifestyles and values, leading to a decrease in the village labour force and a consequent ageing of inhabitants, ultimately resulting in a major decline in livestock numbers and in traditional management practices. We argue that the decline of grassland management in the 1990s and 2000s was driven by long-term social processes that began in the 1960s. We argue, that appropriate subsidy schemes and governance models are essential to support surviving traditional farming practices, integrate biodiversity conservation with cultural heritage, and sustain innovative rural communities transitioning within Europe's marginalised agricultural landscapes.

Purpose This research explores leadership within highly innovative organizational contexts, focusing on the challenges faced by leaders and the mindset required to navigate innovation and related paradigm shifts of this complex era. Specifically, it aims to assess the applicability and validity of a recently proposed leadership model in such innovative environments. Design/methodology/approach Following Action Research principle of combining research and practical intervention, this research used a two-phase qualitative design on a single case study of Zucchetti, the leading IT Italian company. Five focus groups with 76 senior managers and five in-depth interviews with top leaders (among which president and vice-presidents) have been combined with data collected from primary and secondary sources within the company as well as public information. Findings This work empirically validates a recent leadership model proposed in the literature (i.e. STP leadership) within an innovative context that is conductive to higher innovative performances, highlighting its applicability and relevance to modern business environments such as Zucchetti. However, the results suggest a necessary adjustment: the three dimensions of the model are not equally important. In particular, this study recognizes the “P” area (People) as the most critical and central dimension of the model, emphasizing its fundamental role in driving successful leadership and innovation practices. Furthermore, the study sheds light on the role of leadership in driving innovation by identifying, respectively, four key skills and four essential managerial approaches for leading innovation effectively. Practical implications The practical applications of this study are mainly threefold. First, investing in leadership development programs based on the STP model is critical to maintain a dominant position in the current scenario as well as to continuously innovate for an incumbent firm. Second, fostering an entrepreneurial, ambidextrous and flat leadership culture based on trust (with a strong delegation of authority system in place) at the middle-management level is a necessary condition for being continuously innovating. Third, orienting recruiting and career advancement strategies to skills like flexibility, authenticity, coaching and change management are key for improving an innovation culture. These actions aim to build leadership effectiveness, strengthen organizational resilience and drive sustainable innovation. Originality/value Through practice-based evidence, this research is valuable for both practitioners and scholars aiming to understand the role of efficient leaders in leading innovation given nowadays constraints and challenges. Furthermore, this study makes a significant contribution to the literature by utilizing a cutting-edge leadership model and adopting a cross-level approach that integrates insights from different and multilevel perspectives. Considering the viewpoints of diverse leadership levels (senior managers and top managers) with varying roles and backgrounds, this study offers a richer and more holistic understanding and gives the possibilities to understand alignments and discrepancies. Unlike previous research, which has analyzed findings in isolation, this work provides a more multidimensional comprehension of the phenomenon.

The United States plays a significant role in fulfilling global soybean demand. Recent weather and changing management practices have increased oomycete-induced diseases in soybean fields in the U.S. and, more specifically, in Wisconsin. This study aimed to assess the oomycete diversity and abundance in soybean-growing regions in Wisconsin, characterize the pathotypes of Phytophthora sojae, and compare them to the soybean Rps genes historically deployed in Wisconsin's commercial cultivars. Over two years, 274 soil samples from 39 counties were successfully baited for oomycetes using a soybean leaf disc assay. In total, 388 isolates were identified from four oomycete genera. Overall, Globisporangium was the most abundant genus detected. Although a low diversity was observed in the samples, a high diversity was observed across counties, likely influenced by their geographic locations and the years sampled. While P. sojae was isolated at low frequency, the hypocotyl pathotyping assay identified two pathotypes with alleles 1a, 1b, 1c, 1k, and 3b. Analysis of the deployed Rps genes in variety trials in Wisconsin from 2015 to 2024 indicated a high frequency of the Rps1c and Rps1k genes in commercial cultivars. The pathotypes detected in this study suggest that the deployment of these genes is no longer effective, so the use of cultivars with the Rps3a gene is highly recommended. The insights regarding the oomycete population diversity and abundance in the state will enable the deployment of targeted disease management, addressing yield reductions caused by pathogenic oomycete species.

Background: Gastroesophageal reflux disease (GERD) remains one of the most prevalent gastrointestinal disorders worldwide. Between 2015 and 2025, advances in understanding its multifactorial pathophysiology have driven significant changes in pharmacological management. Aim: This review summarizes key developments in GERD pathophysiology and evaluates significant pharmacological advances from 2015 to 2025, including comparative safety profiles, limitations of current therapies, and emerging treatment directions. Methods: A structured search of PubMed, Google Scholar, and major open-access databases was performed using keywords related to GERD, pathophysiology, proton pump inhibitors, P-CABs, prokinetics, neuromodulators, and novel therapies. Results: Proton pump inhibitors remain first-line therapy but show variable efficacy in non-erosive disease and refractory symptoms. Newer agents such as potassium-competitive acid blockers, modern prokinetics, alginate-based formulations, neuromodulators, and mucosal protectants offer therapeutic benefits in selected phenotypes. Comparative analyses highlight the importance of optimizing long-term PPI use and monitoring potential adverse effects. Advances in diagnostics and improved understanding of sensory and functional mechanisms have enabled more individualized treatment strategies. Conclusions: Pharmacological management of GERD has evolved substantially over the past decade, shifting toward mechanism-based and patient-specific therapy. Future progress will depend on integrating high-resolution diagnostics, refining reflux phenotypes, and developing novel treatments that target mucosal integrity, hypersensitivity, and non-acid reflux.