Abstract: We reviewed the recent fire regimes in the semi-arid savannas of Etosha National Park and adjacent areas in northern Namibia using MODIS satellite imagery from 2001 – 2025 across gradients of mean annual rainfall (200 – 500 mm), land ownership, and vegetation types. Fires were highly seasonal, concentrated in the two driest months of the year (September and October). The average fire return period over 25 years was 6.9 years in Etosha National Park, but more than four times greater (31.8 years) on adjacent freehold farms. The proportion of the area burned annually ranged from zero to over 30% and the fire regime was dominated by a few episodic but extreme fire events. Some findings were counter-intuitive in that certain vegetation types in areas of low mean annual rainfall (< 300 mm) burned frequently (fire return period 4.3 years) while others experienced infrequent fires (fire return periods 34 – 206 years) in higher rainfall areas (> 400 mm). Current fire management practices have attempted to reconstruct natural fire regimes and are not based on ecological understanding, and further research, based on monitoring of dynamic interactions between rainfall, fuel accumulation, levels of herbivory and the extent of fires are needed to explain these findings.

Abstract: Background and Objectives: Communication gaps contribute substantially to anxiety, depression, and post-traumatic stress disorder (PTSD) among relatives of critically ill patients. This study evaluated whether supplementing routine bedside meetings with a concise, co-designed informational brochure was associated with reduced psychological distress and improved satisfaction among family members in the intensive care unit (ICU). Materials and Methods: We conducted a single-centre prospective before–after observational study in a mixed medical–surgical ICU in Naples, Italy. Relatives of adult patients with an ICU length of stay &gt;72 h completed the Hospital Anxiety and Depression Scale (HADS) and the Short Screening Scale for PTSD (SSS-PTSD) at ICU discharge. The pre-intervention phase enrolled 12 relatives (May–September 2018); following a co-design and staff training period, the post-intervention phase enrolled 23 relatives (April–October 2019). Primary outcomes were the prevalence of anxiety (HADS-A ≥8), depression (HADS-D ≥8), and probable PTSD (SSS-PTSD ≥4). Groups were compared using Fisher’s exact test and the Mann–Whitney U test. Results: Anxiety remained highly prevalent (100% pre vs. 95.7% post; p = 1.00). Depression severity decreased, with median HADS-D scores declining from 13 (IQR 10–18) to 9 (IQR 7–12) (p = 0.021), while the prevalence of HADS-D ≥8 was lower post-intervention (91.7% vs. 73.9%; p = 0.38). The prevalence of probable PTSD was numerically reduced from 58.3% to 30.4% (p = 0.116). Perceived comprehension improved (7.9 ± 1.1 vs. 8.6 ± 0.9; p = 0.037), whereas objective comprehension remained unchanged. Overall family satisfaction increased (FS-ICU-24: 66 ± 15 vs. 75 ± 12; p = 0.041). Staff depersonalization decreased from 35% to 10% (p = 0.048). Conclusions: In this real-world before–after study, integrating a low-cost, co-designed brochure into clinician–family communication was associated with reduced depressive symptom severity, a numerical reduction in PTSD prevalence, and improved satisfaction, without adverse effects on staff well-being. These findings support the use of structured written information in family-centred ICU care.

Abstract: Against the sustained growth of China’s live streaming commerce, immersion is pivotal for consumer decision-making, yet existing studies overlook continuous moderators and systematic transmission mechanisms. Based on the SOR theory, this study explores how immersion influences purchase intention via trust, with shopping involvement as a moderator. Data from 455 Chinese live streaming shoppers were collected via Wenjuanxing and analyzed using SPSS 27.0, PROCESS macro, and AMOS 31.0. Results show immersion positively impacts trust, trust fully mediates the immersion-purchase intention link, and shopping involvement strengthens the immersion-trust effect for high-involvement consumers. This study enriches SOR theory’s application in digital consumption, offers marketers insights for immersive design and differentiated strategies, and contributes to sustainable consumption by reducing impulsive purchases through trust.

Abstract: Architect Vladimir Potočnjak (1904-1952), a cofounder of Croatian Modern Movement is almost nonexistent in the recent Croatian architectural history. The research of archival sources, accompanied by acquired drawings and books from his library, comprised thor-ough analysis of his realizations, projects and publications. Potočnjak graduated from the Architectural Department of Zagreb’s Institute of Technology in 1926 and apprenticed to Adolf Loos in Paris where he improved drawing skills, subsequently to Ernst May in Frankfurt a/M and finally to Hugo Ehrlich in Zagreb. Between 1931 and 1945 he was li-censed architectural engineer in Kingdom of Yugoslavia and successively in the Inde-pendent State of Croatia, additionally an architectural critic and theoretician preoccupied with problems of standardization. After 1945 he was appointed senior manager for archi-tecture in the collectivized Croatian Stately Design and Planning Institute. Cooperating with Zlatko Neumann, junior architects Antun Ulrich and Dragica Perak, in 1947 he won Yugoslav competition for the Federal Government Presidency Palace, later the Federal Ex-ecutive Council Palace, today the Palata “Srbije”. Fully preoccupied to its construction un-til his death, he concurrently translated Ernst Neufert’s “Bauordnungslehre” in Serbo-Croatian. Although classically educated, Potočnjak blended Modern Architectural narrative with layers of German Expressionism, visible on seminal drawings of Palata “Srbije”.

Abstract: Staphylococcus aureus remains to be one of the leading causes of global mortality. The most common class of antibiotics used to treat S. aureus infections are Next-Generation β-lactams (NGBs), as they are highly efficacious and have low adverse effects. NGB resistance in S. aureus is classically attributed to Penicillin-Binding Protein-2a (PBP2a), but previous studies from our group have also implicated altered expression of Penicillin-Binding Protein-4 (PBP4) with high-level NGB resistance. PBP4 is the only low-molecular mass (LMM) PBP present in S. aureus; it is also the only known LMM PBP with transpeptidase activity, giving it the unique ability to bring about peptidoglycan cross-linking. In this article, we review some of the recent findings from our group, which reveal that mutations associated with PBP4 lead to altered protein expression and NGB resistance in both MSSA and MRSA backgrounds. We discuss the clinical relevance of PBP4-associated mutations, particularly in Methicillin Resistant Lacking mec (MRLM) isolates, as well as the combined effect of altered expression of PBP4 and GdpP. Finally, this review summarizes the potential role played by PBP4 in S. aureus virulence. Together, we highlight the increasing relevance of PBP4 as a mediator of NGB resistance and discuss its potential to be an important factor during infection diagnosis and therapy.

Abstract: Surgical resection of liver and lung metastases in breast cancer is increasingly considered a viable option for select patients with oligometastatic disease. Historically regarded as palliative, surgery is now supported by retrospective data suggesting potential survival benefits, particularly in patients with hormone receptor-positive or HER2-positive tumors, long disease-free intervals, and limited metastatic burden. This narrative review summarizes recent evidence on the surgical management of breast cancer metastases to the liver and lung, with a focus on patient selection, perioperative outcomes, and long-term survival. Liver metastasectomy has shown 5-year overall survival rates of up to 60% in well-selected patients, while pulmonary metastasectomy offers comparable outcomes when resection is complete and nodal involvement is absent. Minimally invasive techniques and non-surgical approaches, such as microwave ablation and stereotactic radiotherapy, expand treatment options for patients unfit for surgery. The review also explores emerging tools influencing surgical decision-making, including circulating tumor DNA for minimal residual disease detection, transcriptomic profiling to predict organotropism, and artificial intelligence (AI)-driven platforms that assist with surgical planning and multidisciplinary case evaluation. While prospective validation remains limited, these technologies may help redefine surgical candidacy through biologically informed algorithms. Ultimately, the integration of surgery within a multimodal, personalized treatment strategy – guided by systemic control, tumor biology, and evolving digital tools – represents a promising direction for selected patients with visceral breast cancer metastases.

Abstract: Glycine N-methyltransferase (GNMT), a S-adenosylmethionine (SAM)-dependent methyltransferase, is primarily expressed in the liver and plays a key role in regulating liver metabolism and protecting against liver injury. Several studies have shown that deficiency or downregulation of GNMT is strongly associated with the pathogenesis of hepatocellular carcinoma (HCC), highlighting its critical role as a tumor suppressor. Other studies have shown that GNMT is also strongly correlated with the pathogenesis of metabolic dysfunction-associated fatty liver disease (MAFLD). Although many factors regulate GNMT expression, recent studies have identified microRNAs (miRNAs), such as miR-873-5p and miR-224, as key post-transcriptional regulators that directly target GNMT mRNA and suppress its expression in HCC and MAFLD. This review provides an overview of GNMT’s role in liver physiology and how its dysregulation contributes to the progression of HCC and MAFLD, with a focus on the regulation of GNMT by miR-873-5p and miR-224. We also highlight the potential of these two miRNAs as biomarkers and therapeutic targets for HCC and MAFLD, discussing emerging strategies such as antisense-based inhibition, gene therapy, and small-molecule inducers aimed at restoring GNMT expression.

Abstract: Chytridiomycosis caused by Batrachochytrium dendrobatidis (Bd) continues to threaten amphibian biodiversity; however, Bd-associated microbiome signatures in salamanders remain inconsistent across studies. Here, we tested whether Bd detection is linked to shifts in salamander skin bacterial communities and, critically, whether it alters the architecture of microbial associations. We reanalyzed publicly available 16S rRNA amplicon data from Eurycea bislineata, Notophthalmus viridescens, and Desmognathus monticola, comparing Bd-detectable (Bd+) and Bd-non-detectable (Bd−) samples. Standard diversity and compositional analyses (alpha/beta diversity, PERMANOVA) showed no significant Bd-associated differences at broad community scales, and the dominant phyla were conserved across conditions. In contrast, differential abundance approaches (LEfSe and ANCOM-BC) identified the targeted Bd-associated taxa. Network inference and community detection revealed pronounced reorganization of the modular structure, with minimal overlap in module membership between Bd+ and Bd− networks and strong condition-specific turnover in stringent “core” networks. Modularity and robustness patterns were host-dependent and highlighted clearer contrasts between tolerant and susceptible hosts under targeted node removal. Together, these results show that Bd detection may leave the overall composition largely intact while reshaping the microbial association structure, supporting network topology as a sensitive complementary lens for detecting disease-linked community changes in amphibian skin microbiomes.

Abstract: A field experiment was conducted during 2022–23 to 2024–25 at the AICRPDA Research Farm, Tamil Nadu Agricultural University, Kovilpatti, India, to evaluate climate-smart agri-horti systems integrating aonla (Phyllanthus emblica Gaertn.) and custard apple (Annona squamosa L.) with annual intercrops under rainfed conditions. The experiment, laid out in a split-plot design with three replications, included fruit tree species as main plots and blackgram (Vigna mungo L.), greengram (Vigna radiata L.), clusterbean (Cyamopsis tetragonoloba L.), and foxtail millet (Setaria italica L.) as sub-plot treatments. Custard apple–based systems consistently produced higher fruit yield (2674–3306 kg ha⁻¹), intercrop biomass, and blackgram equivalent yield (1337–1653 kg ha⁻¹) than aonla-based systems (1980–2538 kg ha⁻¹ of fruit yield), and 891–1142 kg ha⁻¹ of blackgram equivalent yield of intercrops, respectively), primarily due to improved light availability and favourable canopy architecture. Clusterbean and foxtail millet recorded the highest intercrop yields, whereas pulse intercrops enhanced tree growth, soil nitrogen availability, and system sustainability through biological nitrogen fixation. Maximum rainwater use efficiency and land equivalent ratio were achieved under custard apple + clusterbean and aonla + foxtail millet combinations, indicating superior resource-use efficiency. Relative economic efficiency peaked in aonla + foxtail millet (341.2%), while the highest system profitability was recorded in custard apple + foxtail millet (₹352.4 ha⁻¹ day⁻¹). Soil fertility improved significantly over the study period, with increases in soil organic carbon (1.05–1.76 g kg⁻¹), available nitrogen (9–11 kg ha⁻¹), and potassium (8–14 kg ha⁻¹), particularly under pulse-based systems, whereas available phosphorus in soil remained unchanged. The study demonstrates that integrating short-duration legumes and millets with perennial fruit trees enhances productivity, profitability, rainwater-use efficiency, and soil health, providing a resilient and sustainable strategy for intensifying rainfed agroecosystems.

Abstract: This study examines the impact of digital transformation on the operational efficiency and sustained competitive advantage of SMEs in the context of a developing country. Rather than analyzing digitalization in isolation, this research integrates three key dimensions - digital strategic orientation, digital adaptive capability, and digital technology sophis-tication - into a comprehensive framework offering a holistic perspective on the effects of digital transformation in SMEs. Based on a survey of 216 Turkish SMEs, this research employs structural equation modeling using Smart PLS to assess the relationships be-tween these digital transformation dimensions and firm performance. The findings reveal that all three sub-categories of digital transformation positively influence operational efficiency. Furthermore, operational efficiency positively impacts sustained competitive advantage highlighting the transformative role of digital transformation in sustaining SME competitiveness. This multi-dimensional approach provides a comprehensive view of how digital transformation enhances SME efficiency beyond simple technology adoption. The study advances our theoretical understanding by demonstrating that digital transformation requires digital strategy integration into corporate strategy, awareness of emerging digital technologies, and the development of digital adaptive capabilities to drive SME performance. The findings suggest that SMEs should embed digitalization into daily business and e-commerce operations, enhance their capacity to adopt digital tools, and invest in technological infrastructure to achieve sustained competitiveness.

Abstract: National Institute for Health and Care Excellence (NICE) and National Clinical Guideline for Stroke 2023 (NCGFS23) guidelines recommend specialist TIA clinic assessment within 24 hours of symptom onset of suspected TIA. There is limited evaluation of TIA clinic services in the United Kingdom (UK) and Republic of Ireland (ROI). This study aims to assess attendee characteristics, NICE/NCGFS23 adherence, and clinical outcomes across the UK and ROI.DelAys in TIA Evaluation and Service (DATES) is a prospective national audit and service evaluation delivered through an established collaborative (The Neurology and Neurosurgery Interest Group (NANSIG)). All UK and ROI outpatient rapid-access TIA clinics are eligible. All index suspected TIA presentations will be included, irrespective of final diagnosis. Centres will register as an audit/service evaluation without altering routine practice. Data will be collected electronically, with blinded independent validation. The primary outcome is adherence to the NICE/NCGFS23 recommended 24-hour target. Secondary outcomes include presenting symptoms, diagnosis, investigations, treatment, and onward referral.DATES is anticipated to be the largest prospective study presenting in-depth evaluation of UK/ROI TIA clinic attendances. Our results will provide real-world data on TIA pathways and potentially improve existing services.

Abstract: Large language models (LLMs) now form a regular part of scientific research practice, where they are used to assist with hypothesis formulation, literature synthesis, and various forms of formal reasoning. Their use builds on earlier ideas of \emph{delegated cognition} and brings into sharper focus questions about how epistemic agency and moral responsibility are distributed across human--machine arrangements. This paper develops a conceptual and formal framework for examining these hybrid modes of reasoning, drawing on an analogy with familiar academic hierarchies in which a principal investigator (PI) coordinates and supervises junior collaborators. Within this framework, three related operators are distinguished: \emph{verification} $V(g)$, which concerns logical consistency and empirical adequacy; \emph{responsibility mapping} $R(g)$, which assigns epistemic and moral accountability to human agents; and \emph{epistemic value} $E(g)$, which characterizes the justificatory status and cognitive standing of a result, regardless of whether it is produced by a human or an artificial system. Verification and moral authorship are treated as closely connected aspects of epistemic responsibility, in the sense that verifying a claim amounts to accepting responsibility for its truth. On this view, the ethical boundary in scientific research is not drawn between human and machine reasoning, but between \emph{responsible} and \emph{negligent} forms of delegation within a distributed cognitive system. The paper also introduces the notion of an \emph{epistemic audit} as an institutional mechanism, comparable to established quality-assurance practices, for documenting transparency, reproducibility, and coherence in AI-assisted research. The analysis contributes to ongoing discussions in cognitive epistemology and the philosophy of AI concerning authorship, verification, and responsibility in extended systems of scientific reasoning.

Abstract: The development of new energy technologies is  crucial for the future competitiveness of the automotive industry. Green innovation is a key driver of industrial transformation and advancement. Companies in the new energy vehicle (NEV) sector play a critical role in the automotive supply chain and demonstrate their green innovation capabilities across the industry. The dual-credit policy, a major governmental regulatory incentive, has a significant impact on the innovation performance of NEVs. Therefore, it is important to examine its influence on green innovation outcomes. This study is grounded in institutional theory and the resource-based view, and informed by the TOE (Technology-Organization-Environment) analytical framework. It aims to develop a theoretical model to investigate the interplay among technological, organizational, and environmental factors in fostering green innovation. Using panel data from 21 NEV companies spanning the period 2014–2024, the research employs the dynamic fuzzy-set Qualitative Comparative Analysis (fsQCA) method to identify causal configurations associated with high green innovation performance. The results show that no single factor is necessary for achieving superior outcomes. Configuration analysis reveals 3 dominant pathways: the “Technology-driven+Environment-pulled” pathway, the “Technology-driven+Organizational collaboration” pathway and the ”Technology-organization-environment tripartite linkage“ pathway. This study advances theoretical understanding by moving beyond unidimensional analyses and offering a holistic perspective on the multiple equifinal paths to high green innovation performance. It also provides practical insights for NEV firms to strategically align their technological, organizational, and environmental resources to enhance green innovation performance.

Abstract: Background: Epstein-Barr virus related acute pharyngotonsillitis is common in children and adolescents, and is generally managed successfully with positive outcomes by both ENT specialists and the pediatricians. However, a variety of acute, life-threating complications can occur, including upper airway obstruction and infectious or dysimmune sequelae. Methods: This paper describes our recent experience with four pediatric patients presenting with severe ENT manifestations of infectious mononucleosis (IM) that led to life-threating complications, all managed over the past three years at our tertiary pediatric hospital. Results: We report four cases (two boys and two girls) aged 5 to 16 years, hospitalized with complicated EBV-related pharyngotonsillitis. Presentations included respiratory distress (cases 1 and 2), fatal hemophagocytic lymphoistiocitytosis (case 3), and a retropharyngeal abscess (case 4). Conclusions: The prognosis of IM in the pediatric population is generally favourable. However, acute life-threating complications may arise. In such cases, timely and coordinated multidisciplinary management involving ENT specialists, pediatricians, and anesthesiologists is critical.

Abstract: Rabies remains a persistent zoonotic threat in Ghana despite the availability of effective countermeasures such as mass dog vaccination and timely post-exposure prophylaxis (PEP). We conducted a cross-sectional household survey (n = 450) and complementary focus group discussions to assess community knowledge, risk perception, bite-management practices, and determinants of dog vaccination across urban and rural settings. Results indicated that while 68 % of respondents had heard of rabies, only 42 % correctly identified dogs as the main source of transmission. Although 58 % perceived dog bites as dangerous, 36 % preferred traditional remedies over medical treatment, and only 31 % reported vaccinating their dogs. Educational level, urban versus rural residence, and prior exposure to dog-bite incidents significantly influenced knowledge and practices. These findings highlight gaps in awareness and preventive behaviour that hinder rabies control. Strengthening rabies elimination efforts in Ghana requires integrating community education, improved dog vaccination campaigns, accessible PEP, and coordinated One Health interventions.

Abstract: To address critical issues in traditional quality control methods for discrete Eulerian solutions in underwater magnetic target detection—such as excessive filtering of valid solutions during divergence suppression, parameter settings reliant on subjective experience, and insufficient noise resistance—this study proposes a novel approach combining the Artificial Protozoa Optimizer (APO) with DBSCAN clustering. Based on the distribution characteristics of discrete Euler solutions, an optimization objective function incorporating Euler solution residual penalty terms and contour line coefficients was constructed. The APO algorithm identifies DBSCAN clustering parameters that minimize this objective function, thereby enhancing clustering precision and accuracy. This method selects optimal Euler solution sets, enabling high-precision localization of magnetic targets. Simulation and field test results demonstrate that compared to statistical screening methods, the optimized algorithm achieves a 52.52% and 76.33% increase in the retention rate of valid solutions for noise-free and noisy data, respectively, while reducing the retention rate of invalid solutions by 28.57% and 94.21%. In field data, the average deviation from the true center of gravity is reduced by 26.37%.

Abstract: The “Great Filter” hypothesis proposes that the apparent absence of extraterrestrial civilizations, despite the vastnumber of potentially habitable planets, is the result of one or more extremely improbable steps, or “filters,” in theevolution of intelligent life. These filters may lie either in humanity’s future, predicting our eventual self-destruction, or in our evolutionary past, implying that intelligent civilizations are rare. Based on empirical evidenceand evolutionary analysis, this study argues that no probable future filter exists with sufficient destructive capabilityto account for the absence of evidence of extraterrestrial intelligent life. Instead, several improbable and sequentiallydependent events in Earth’s geological and biological history have been hypothesized as effective filters, includingthe Theia collision initiating plate tectonics, tectonic activity providing sufficient sustained chemical energy toenable abiogenesis, and the evolutionary dominance of mammals. By estimating the probabilities of these unlikelyevents, the probability of a civilization arising was calculated to be less than one per ~1040 star systems—while thereare estimated to be only ~1030 stars in the observable universe. These findings suggest that Earth may host the onlytechnological civilization within its cosmic horizon.

Abstract: The informal learning spaces (ILSs), as the core carrier supporting students’ autonomous learning and social interaction, has become an indispensable component of modern campuses. However, the existing researches still have limitations in terms of the ambiguous concept of ILSs, and the lack of analysis of the synergy effect of social and physical dimension factors on students’ performances. To further explore the above problems, this review conducts a systematic literature review and retrieved 33 empirical studies in the fields of education, architecture and library science from 2000 to 2025. The results of this review show that ILSs can be defined as a dynamic ecosystem that integrate technological infrastructure, flexible layouts, and social interaction to accommodate diverse learning needs. Meanwhile, ILSs design needs to coordinate and balance the multiple influencing factors of the social dimension and the physical dimension. This review can provide design guidelines for educators, architects and policymakers that take into account both students’ needs and adaptive functional configurations, thereby providing a practical path for achieving inclusive learning environments and sustainable campus development.

Abstract: Trachoma, caused by Chlamydia trachomatis (Ct), persists as a major cause of preventable blindness despite the global SAFE strategy. Understanding how Ct genovars and genovariants influence infection dynamics and clinical outcomes is crucial for sustaining elimination efforts and informing vaccine development. A four-year longitudinal study was conducted in a trachoma-endemic region of Tanzania across multiple rounds of mass drug administration (MDA) with azithromycin. Ct infections were genotyped by ompA sequencing to identify genovars and genovariants. Associations between genetic variants, bacterial load, and clinical signs of trachoma were assessed. Following MDA, a shift in Ct genovar prevalence occurred from genovar B to genovar A. Genovar B was associated with more severe clinical signs, including follicles, papillae, and scarring, whereas genovar A infections exhibited higher bacterial loads. Among 121 individuals with recurrent infections, 94% were re-infected with the same genovar, indicating limited protective immunity and incomplete clearance despite MDA coverage exceeding 60%. The genovariants B2, B9, and A2 predominated, with an A→T amino acid substitution in B9 potentially modifying antigenic recognition. Post-MDA, normalized genovariant diversity increased, suggesting ongoing transmission or strain reintroduction. Distinct genovar-associated clinical and immunological patterns underscore the need to elucidate genovar-specific virulence and immune evasion mechanisms. These findings provide key insights for optimizing trachoma control and advancing vaccine development.

Abstract: Background/Objectives: Achieving a balanced wholefood diet while stabilising glycae-mic management is challenging for many people with type 2 diabetes (T2D) due to barri-ers such as food preparation skills, time, and medication effects. Diabetes-specific nutri-tional formulas (DSNF) are nutritionally complete products designed to support glycae-mic management and overall nutritional adequacy and may complement wholefood die-tary approaches when these are not feasible or are insufficient. Despite growing clinical evidence of efficacy, practical guidance for routine use is limited. Methods: A multidisci-plinary expert working group developed a Clinical Practice Guide (CPG) for integrating DSNF into diabetes care. Development was informed by a literature review and iterative consensus among experts, including representatives of the Australian Diabetes Society, Australian Diabetes Educators Association, and the Royal Australian College of General Practitioners. Results: The CPG outlines a three-step pathway: (1) Assess suitability (clinical indications, contraindications, preferences, cultural context); (2) Tailor the approach (indi-vidual goals, dose/timing relative to weight and body composition goals and observed glycaemic patterns, integration with lifestyle care); and (3) Monitor progress (baseline, 2–4 weeks to assess initial response, then 3, 6, and 12 months for glycaemic indices, weight/body composition where available, and medication review). Conclusions: This CPG provides practical, multidisciplinary guidance for the person-centred use of DSNF as an adjunct to standard care, supporting translation of current evidence into clinical prac-tice and promoting consistent, multidisciplinary implementation.