Search Results (5,736)

Background: Percutaneous left atrial appendage closure (LAAC) provides an alternative to oral anticoagulation (OAC) in atrial fibrillation (AF) patients who are at high bleeding risk. Prior studies have suggested sex-related differences in procedural outcomes, with women demonstrating higher peri-procedural complication rates. Data on long-term outcomes, however, remain inconsistent. Methods: We analyzed 407 consecutive patients with AF who underwent LAAC between 2010 and 2023 in four Israeli medical centers participating in the LEADER registry. Baseline characteristics, procedural data, and clinical outcomes were compared between men and women. The primary efficacy endpoint was ischemic stroke or systemic embolism at 1 year. The primary safety endpoint was a composite of all-cause mortality, procedural complications, or major bleeding at 1 year. Results: Of 407 patients, 285 (70%) were men and 122 (30%) were women. The mean age was 77 ± 8.4 years with similar CHA₂DS₂-VASc and HAS-BLED scores across sexes. Device implantation exceeded 99% in both sexes. Major peri-procedural complications occurred in 6.4% overall, without significant sex-based differences (men 7.0%, women 4.9%, p = 0.51). At 1-year follow-up, Kaplan–Meier estimates for the primary efficacy endpoint of ischemic stroke/systemic embolism (2.6%), the primary safety endpoint (19.2%), major bleeding (8.9%), and all-cause mortality (9.3%) were comparable between men and women (all p > 0.1). Conclusions: In contrast to prior large registries reporting higher peri-procedural risk in women, this real-world multicenter experience demonstrated no significant sex differences in either peri-procedural or long-term outcomes following LAAC. These findings support LAAC as an effective and safe stroke-prevention strategy in AF, irrespective of sex. Full article

Energy communities in Denmark, Italy, and Norway were investigated to explore factors that enable or hinder the behavioral and social transformations necessary to achieve a socially just environmental transition, particularly in projects involving vulnerable individuals. This study seeks to understand how energy communities drive behavioral change and social transformation by examining seven energy communities in Denmark, Italy, and Norway. Consequently, 57 semi-structured interviews were conducted among the seven cases. This paper suggests fostering behavioral shifts towards energy-saving practices in Norway and Denmark to reduce energy consumption and mitigate energy vulnerability. Education and awareness-raising on energy-saving measures in Italy have already led to tangible changes in daily behaviors among vulnerable groups. Across all countries, prior environmental attitudes, trust in project leaders and project plans, and community support were crucial in driving participation and behavioral change. Additionally, financial incentives motivated some participants, especially those from vulnerable groups facing high living costs. Key enablers of change included access to knowledge and a sense of community, while barriers like financial constraints and time limitations hindered broader participation. The study highlights the importance of involving vulnerable individuals in decision-making to enhance their sense of ownership and commitment to energy-saving practices. For sustainable behavioral change, it is essential to address environmental motivations and the financial, political, social, and practical considerations that affect vulnerable populations’ decision to join energy communities. Full article

The Hamas attack of 7 October 2023 and the ensuing war profoundly destabilized Jewish–Arab relations within Israel, intensifying fear, mistrust, and intercommunal tensions. Focusing on the mixed city of Haifa, this article examines the potential and limitations of interreligious dialogue under conditions of acute conflict. It analyzes the Haifa Multi-Religious Initiative, convened by the University of Haifa shortly after the outbreak of war, which brought together Jewish, Muslim, Christian, and Druze religious leaders in a series of facilitated encounters. Drawing on participant observation and qualitative analysis, the study proposes a three-dimensional model of dialogue—structural, relational, and transformative—to assess how religious leadership operates within institutional constraints, power asymmetries, and identity negotiations. The findings highlight both the capacity of religious leaders to foster trust and civic solidarity at the local level and the significant limits imposed by political pressures and communal accountability. The article argues that interreligious dialogue can contribute to urban peacebuilding, not by resolving conflict, but by sustaining shared civic life amid protracted violence. Full article

Background: Occupational gender segregation is a key driver of labor market inequality and is prominent across occupations, within occupations, and within workplace task groups. This paper explores how structural arrangements and cultural messages shape women’s preferences for working with men vs. women. With respect to structural arrangements, we analyze how women’s relative power on a team influences their partner preference. With respect to cultural messages, we examine how one common source of information that has the potential to either challenge or reify notions of gender difference—sexual harassment policy training—affects partner preference. Methods: We conducted a laboratory experiment in which we placed 100 college-aged women in positions they may commonly find themselves in at the start of a new job—identifying coworkers to partner with on group tasks—and varied (1) their relative power on the team (leader or helper) and (2) exposure to workplace training (sexual harassment or ergonomic computer setup). We then assessed their attitudinal and behavioral preference for working with a female vs. a male partner on a decision-making task. Results: Women, particularly women assigned to a leadership position, more often chose to work with a female partner. Sexual harassment training did not affect women leaders’ attitudes about working with a male partner but those in a helper role expressed more positive attitudes about working with a man after sexual harassment training. These findings document how macro-level processes can shape workplace gender segregation, thus identifying mechanisms underlying the reproduction of gender inequality. Full article

Teacher education systems globally experience a gap in implementation between policy aspirations and everyday enactment, with implications for initial teacher education (ITE), the quality of practicums, professional identity, and teacher recruitment and retention. Situated in Malta’s superdiverse context and informed by international debates on professional capital, care ethics, inclusion, and ecological conceptions of agency, this article introduces the Responsive Teacher Formation Framework (RTFF). This original, theoretically integrated, and empirically grounded framework foregrounds four interdependent pillars of professional formation: belonging, wellbeing, autonomy and agency. Drawing on a two-year, multi-strand national inquiry synthesising perspectives from children, families, newly qualified teachers, learning support educators, and school leaders, we integrated artefact-elicitation, focus groups, interviews, and questionnaires using reflexive thematic analysis and cross-strand configurational synthesis. Through a meta-synthesis convergence of the different strands of the study, recurrent tensions surface, including procedural versus lived belonging; attention versus neglect of wellbeing; nominal autonomy versus fragile system supports and policy endorsement versus constrained agency. The findings demonstrate how these complexities are experienced across the ITE–school interface. We argue that the RTFF offers a coherent and tractable syntax for ITE programme (re)design that is both theoretically robust and practically adaptable, diagnostically sensitive to local context, and implementable at scale. The model contributes to international discourse by linking fragmented debates on these four pillars into a responsive framework of, and for, teacher formation. Beyond the Maltese case, the RTFF offers an adaptable orientation for superdiverse settings seeking to transition from compliance-driven quality assurance to formation-centred professional excellence. The article concludes by outlining how the RTFF can anchor more integrated and sustainable policy, as well as nurture professional learning communities, thereby advancing the transformation of teacher education for academic excellence. Full article

From a knowledge-based perspective, monopolizing knowledge is getting difficult and is an emerging source for innovation and organizational performance. This study explores to what extent knowledge sources stimulate green innovation to enhance organizational performance, with moderation affecting resource orchestrion capability. Data were collected from Chinese manufacturing industries during February and April 2025. This study employed SmartPLS 4.1.12, which is widely used to analyze complex models of mediation and moderation for first- and second-order constructs. The results show that knowledge sources, both internal and external, act as stimulants to promote green innovation and improve organizational performance. In addition, green innovation also positively mediates between knowledge sources and organizational performance. Furthermore, resource orchestration capability strengthens the relationship between knowledge sources and green innovation. Future research may broaden the concept beyond other industrial businesses. Green innovation, tacit knowledge management, affective trust, and task efficiency can also be explored to stimulate organizational performance. This study provides proof that knowledge sources are essential for green innovation. Managers and organization leaders should encourage knowledge sharing initiatives inside and outside the company to improve organizational performance and green innovation. This study fills existing research areas that have received limited empirical attention and improve understanding of knowledge sources, inside and outside organizations, to boost green innovation and overall performance. Mediation and moderation research explores knowledge sources to foster green innovation and organizational performance. Full article

Satellite swarm operations require robust methodologies to distinguish between leader-induced reference frame biases (global errors) and individual follower anomalies (local deviations). This is the challenge of distributed fault diagnosis. In leader–follower topologies, distinguishing between a global reference error (leader satellite broadcasting incorrect navigation data) and a local node error (follower satellite drifting) is mathematically ambiguous when we use standard methods. Even recent unsupervised frameworks, such as Model-Guided Online Transfer Learning (MGOTL), that excel at single-satellite component diagnosis, suffer from adaptation and signal bleed when they are applied directly to distributed topologies. Therefore, we propose the Isolation-First Consensus Anomaly Detection (IF-CAD) framework for Decoupling Global and Local Faults in Satellite Swarms. We introduce a Smart Freeze mechanism to prevent the learning of persistent faults and a hierarchical logic that prioritizes local isolation over global agreement. The IF-CAD framework successfully decouples global leader faults from local follower faults. Fault detection remains stable even during long-duration anomalies. Full article

Autonomous navigation of underwater vehicles in infrastructure-limited environments presents persistent challenges due to the constraints of traditional acoustic positioning systems. Sparse long baseline (sparse LBL) navigation, which relies on a minimal set of acoustic transponders, offers a promising alternative but suffers from geometric ambiguity and reduced robustness without external aiding. This paper introduces an integrated approach to measurement-based navigation and control in the sparse LBL setting with two base transponders, focusing on three key components. First, a novel three-stage navigation algorithm is proposed, which enables unambiguous robust leader–follower formation position estimation using only two acoustic transponders and onboard measurements. Second, a hybrid state estimation framework is developed to fuse asynchronous data from inertial sensors, depth measurements, and acoustic ranging, accommodating measurement uncertainty and timing variability. Third, there is a nonlinear trajectory tracking controller based on state-dependent coefficients (SDCs) technique. The combined approach enables accurate and robust leader–follower structure navigation with minimal acoustic infrastructure and is suitable for deployment in dynamic or remote underwater scenarios. The numerical simulations demonstrate the acceptable motion control accuracy. Full article

This study examines educators’ perceptions of diversity prioritisation in leadership promotion practices within primary and post-primary schools in the Republic of Ireland, with particular attention to generational differences informed by generational cohort theory. Using a quantitative, cross-sectional design, data were collected via an anonymous online survey (N = 123). Participants, comprising practising teachers and school leaders, rated their agreement with statements relating to the current prioritisation of diversity, the extent to which diversity should be prioritised, and the perceived impact of diversity on leadership effectiveness and school performance. Eight diversity dimensions were examined: age, disability, gender, national origin and culture, race and ethnicity, sexual orientation, social class, and religion. Descriptive analyses revealed broad support for diversity in leadership promotions across all age groups, with the strongest endorsement consistently expressed by the youngest cohort (20–29 years), suggesting a possible generational pattern within this exploratory sample. Overall, the findings point toward widespread but uneven support for diversity in leadership, shaped by generational shifts. This study highlights perceived support for more transparent, structured, and diversity-sensitive promotion frameworks within this sample to align practice with evolving professional values. Full article

Digital transformation is a key driver of economic and social progress, and assessing its evolution is essential for guiding public policies. In the European Union (EU), until 2022 the European Commission published the quantitative values of the Digital Economy and Society Index (DESI); however, it is no longer being published, which makes it difficult to compare the digitalisation process between Member States. This study proposes a new composite index, the DESI-DP2, constructed using the distance P2 methodology (DP2), which provides a synthetic and up to date measurement of the digitalisation levels in the twenty-seven EU countries in 2025, both at an aggregate term and by dimensions. The results reveal notable stability in the ranking of countries, with Denmark, Finland, the Netherlands, and Sweden as persistent leaders, and Bulgaria and Romania among the most lagging countries. Moreover, although digitalisation is positively associated with human development, a high level of development alone is not sufficient to ensure strong digital performance. Finally, the study identifies a shift in the explanatory factors behind cross-country differences, from digital skills toward the digital transformation of the business sector, offering relevant insights for the design of public policies within the framework of the European Digital Decade. Full article

Sustainable corporate governance plays an essential role in promoting responsible economic growth and enhancing social and environmental well-being in emerging economies. In this context, Environmental, Social, and Governance (ESG) performance has become an important indicator of a firm’s commitment to sustainable development and its alignment with the United Nations Sustainable Development Goals, particularly SDG 8 and SDG 12. This study investigates the impact of Environmental, Social, and Governance (ESG) performance on the financial sustainability of publicly listed companies in Thailand, a rapidly developing Southeast Asian economy where empirical evidence remains limited. Using an unbalanced panel dataset of 965 firm-year observations across multiple industries, multiple regression models were employed to assess the influence of ESG performance on two financial indicators: return on capital employed and return on assets. Granger causality tests were also conducted to explore directional relationships between sustainability performance and financial outcomes. The empirical results reveal a significant negative short-term association between ESG performance and return on assets (ROA), whereas the relationship with return on capital employed (ROCE) is statistically insignificant. The causality analysis indicates that ESG performance Granger-causes ROA, implying that sustainability-driven strategic decisions may precede and influence financial outcomes over time. Additionally, leverage emerges as a key constraint to financial sustainability, negatively affecting both ROCE and ROA. These findings underscore the challenge of striking a balance between sustainability investments and immediate profitability in emerging markets. Policymakers and business leaders are encouraged to promote supportive governance frameworks, reduce financial barriers, and foster ESG-driven practices that contribute to long-term sustainable competitiveness and inclusive development. Full article

With the rapid development of the Internet of Vehicles (IoV), the explosive growth of data traffic within the system has led to a surge in demand for spectrum resources. However, the strict limitations on spectrum supply make the construction of an efficient and reasonable resource allocation scheme crucial for IoV. To maximize social benefits and improve security in the resource allocation process under IoV spectrum scarcity, this paper proposes a dynamic spectrum allocation (DSA) scheme based on a consortium blockchain framework. In this scheme, we design a demand-based vehicle priority classification method and propose a novel hybrid consensus mechanism—PhDPoR—which integrates practical byzantine fault tolerance (PBFT) and Hierarchical Delegated Proof of Reputation. Furthermore, we construct a multi-leader, multi-follower (MLMF) Stackelberg game model and utilize smart contracts to implement an immutable on-chain record of spectrum resource allocation, thereby deriving the optimal spectrum pricing and purchase strategy. Experimental results show that the proposed scheme not only effectively optimizes the utility of both supply and demand sides and improves overall social benefits while ensuring efficiency, but also significantly outperforms baseline algorithms in identifying and mitigating malicious nodes, thus verifying its feasibility and application value in complex IoV environments. Full article

Background: Post-stroke spasticity (PSS) is a common complication in stroke survivors, significantly impairing functional recovery and quality of life. Despite its prevalence, Italy lacks national guidelines or structured good clinical practice documents, resulting in heterogeneous clinical management. Methods: An Italian Delphi study was conducted to establish expert-based recommendations for PSS management. A panel of 93 rehabilitation medicine specialists and neurologists, each with over 5 years of experience in PSS management with botulinum toxin A (BoNT-A), participated in two rounds of voting on 47 statements drafted and approved by seven Key Opinion Leaders (KOLs), recognized for their national and international expertise. Consensus was defined as ≥75% of respondents answering ‘strongly agree’ or ‘somewhat agree’. Results: In Round 1, consensus was reached for 90% of statements; five items did not achieve the threshold. After revision and a second round, consensus was achieved for all items, including consideration of lesion site in clinical management and the role of adjuvant post-injection interventions. The panel’s heterogeneity ensured broad representativeness. Conclusion: This Delphi study provides the first structured Italian expert recommendations for PSS management. Full consensus was reached in all 47 statements and in the Symptoms domain, particularly regarding pain, stiffness and heaviness, which highlights the importance of a structured framework to support consistent, individualized care. By standardizing patient assessment, treatment planning, and follow-up strategies, these findings provide a practical reference for clinicians. Full article

Enhancing employee well-being and performance has become a top priority for SMEs as a result of both economic and sociopolitical turmoil. This study investigates the effect of job autonomy on employee resilience while also evaluating how the outcomes of this study relate back to employee well-being and performance. In addition, it investigates whether sustainable leaders and providing informational support will moderate these associations in the context of the current crisis impacting Lebanese SMEs. A questionnaire was designed to collect the data. The sample comprised 204 employees representing 10 SMEs in Lebanon. PLS-SEM was used to analyse the collected data. The results of this study demonstrate that when SMEs provide employees with job autonomy, it increases employee resilience, which, in turn, positively impacts employee well-being and performance within a crisis recovery culture. Further, sustainable leadership and providing informational support to employees are important factors to strengthen the aforementioned associations. As such, this study will aid in building on the literature about resilience and sustainable management in post-conflict environments, as well as providing useful insights for SME leaders who wish to build healthy, sustainable, high-performing workforces within fragile economic systems. Full article

Women are essential to the growth of any progressive society. Equal access to employment is necessary for both women’s empowerment and global economic growth. However, discrimination against women persists at all career levels, making it challenging for them to overcome barriers to leadership such as access to personalized learning opportunities, mentorship, and career development programs. In addition, women leaders must navigate intergenerational change and transform existing systems to ensure that the experiences of all women within the organization are visible and valued, regardless of age. With different generations working together, the integration of Artificial Intelligence (AI) into leadership training presents revolutionary prospects for enhancing the skillsets of women leaders, especially in historically male-dominated industries. This article provides evidence of how AI-generated content can help women leaders bridge intergenerational gaps and create a more collaborative environment. Furthermore, we present a practical framework that women managers can implement to foster strong intergenerational connections by leveraging AI in pursuit of inclusive leadership and gender equity. Full article