Vilnius University

This study develops a conceptual framework to theorise how digitally augmented Communities of Practice (CoPs), such as the Slow Food Movement, can support sustainable food systems transformation through advanced knowledge management. Although digital innovation is increasingly applied in agri-food systems, much of the literature remains technocentric, focusing on infrastructure and automation, while overlooking how digital tools mediate community-based knowledge flows and adaptive capabilities. Addressing this gap, we integrate Nonaka and Takeuchi's SECI model with Teece's dynamic capabilities framework to examine how Artificial Intelligence (AI) and Metaverse technologies enable CoPs to create, share, and transform knowledge. The main contribution is the DEKA-CoPs model (Digitally Enabled Knowledge Architecture in Communities of Practice), which explains how digital mediation can enhance epistemic agility, collaborative innovation, and system adaptability. Methodologically, the paper uses a theory-building approach to develop four propositions that can guide future empirical work. This framework advances knowledge management and sustainability literature by shifting the focus from firm-based innovation to digitally enabled, community-led knowledge infrastructures. It offers practical implications for policymakers, technologists, and sustainability practitioners interested in designing inclusive, adaptive platforms that embed local knowledge in agri-food transitions. • Theorisation of digitally-enabled communities of practice by merging SECI and dynamic capabilities frameworks. • Unified model for innovation knowledge architecture for digital communities of practice in sustainable food systems. • AI and Metaverse as participatory epistemologies for sustainable food system innovation. • AI and Metaverse's role in inclusive, community-led agrifood system innovation. • Conceptualisation of digitally-enabled communities of practice as knowledge architectures.

In Estonia, Latvia, and Lithuania, the push for care integration has gained momentum, being seen as an innovative approach to allocate resources more efficiently and improve patient outcomes. This study investigates the progress of integrating care in the Baltic countries from 2019 to 2024 to detail key learnings. We undertook a cross-country study to better understand the progress in care integration in the Baltics with a two-round, 21-item questionnaire on the adoption of integrated care reforms in 2019 and 2024. Responses were analyzed to capture countries' policy environments and their conduciveness to the uptake of integrated care. Country-specific experiences with implementation of care were further explored via case studies of pilot programmes. The pace of implementing integrating care varied. Existing barriers, workforce challenges and payment schemes have impeded integration across health and social care. Despite this, political commitment across successive governments to new and innovative service delivery and collaboration for chronic care management underscores an important prerequisite toward achieving more integrated and person-centred healthcare. The three case studies illustrate hurdles that come with shifting care settings and expanding roles for some workers. Integrating care across providers and the social and health sectors is an incremental process that needs long-term political support to address persistent barriers. The Baltic countries' experiences indicate challenges in bringing together stakeholders in areas such as data interoperability, new financing models and reorganization of workforce and skills mixing. Further work should advance evidence on patient-centred solutions for evolving needs.

Cardiac organ damage (OD) is associated with increased risk of cardiovascular disease. However, limited knowledge exists on cardiac OD in young patients with cryptogenic ischaemic stroke (CIS). To explore prevalence and covariates of cardiac OD in patients with CIS compared to controls participating in the SECRETO study. We analysed data from 427 patients with CIS aged <50 years and 361 age- and sex-matched controls. OD was defined as presence of abnormal left ventricular (LV) geometry (LV hypertrophy or concentric remodelling) or left atrial enlargement (LAE) assessed by echocardiography, using sex-specific threshold values. Compared to controls, patients had higher prevalences of obesity and tobacco smoking, patent foramen ovale (PFO) (52% vs. 25%) and abnormal LV geometry (12% vs. 7%, all p < 0.01), while presence of LAE did not differ. In multivariable analyses, CIS was associated with presence of abnormal LV geometry (odds ratio 1.86 [95% confidence interval 1.09-3.20], p=0.024). In separate multivariable analyses in patients only, obesity was associated with both abnormal LV geometry and LAE (both p < 0.01), and higher systolic blood pressure only with presence of abnormal LV geometry (p < 0.001). No significant association with PFO was found. In young patients with CIS participating in the SECRETO study, abnormal LV geometry was more prevalent compared to age- and sex-matched controls and associated with presence of higher blood pressure and obesity. The results point to the importance of blood pressure and weight control in CIS to prevent progression of cardiac OD and recurrent cardiovascular events.

Multi-omics in combination with advanced computational methodologies synthesizes diverse omics data to provide deeper insights into molecular interactions and offers transformative potential for unravelling phenomenon behind disease complexities, improving diagnostics, disease prevention, and personalized treatments. This integrative strategy enables our understanding of gene-environment relationships, chronic disease progression, and the intricate molecular pathways involved in health. Effective multi-omics analyses require robust data sharing, accessibility, interoperability, and governance, which are critical for linking genomic elements to phenotypic traits. The Global Alliance for Genomics and Health advocates for responsible data-sharing practices, by promoting key principles such as transparency and equity. By emphasizing a collaborative approach to data utilization, our proposed framework seeks to advance improved disease prevention and treatment strategies. Multi-disciplinary collaboration, encompassing researchers, clinicians, policy makers, and patient representatives, is pivotal for driving innovation and addressing rare disease diagnostics. The success of multi-omics applications hinges on the establishment of comprehensive datasets, understanding the functional implications of multi-omic variation, adherence to findable, accessible, interoperable, reusable (FAIR) and Collective Benefit, Authority to Control, Responsibility, and Ethics (CARE) principles, and the strengthening of global genomic commons, benefiting scientific research, drug development, and broader health initiatives. Our review highlights essential components of multi-omics integration, underscoring its potential to transform the landscape of precision medicine and improved patient outcomes worldwide.

Old Polish and Old Czech texts show a wider range of irrealis marking in complement clauses with speech-act and epistemic stance verbs in comparison with contemporary Polish, where this marking is restricted to negative polarity contexts and the complementation of verbs with an inherently negative meaning like wątpić ‘doubt’. The article offers an analysis of this marking type, which went out of use in the Middle Polish period, when it was ousted by constructions with dubitative complementisers like jakoby. An analogous development can be observed in Old Czech. The Old Polish and Old Czech facts raise questions about the nature of the more widely attested irrealis uses in the scope of overt or implicit negation. In the case of the latter, irrealis use is often ascribed to the action of negation, which suspends veridicality or assertivity. The facts discussed in the article suggest that negative polarity contexts merely facilitate the manifestation of the dubitative irrealis without being a condition on its use. Certain languages, including Old Polish and Old Czech, show a wider use not licensed by negation, which points to an implicational pattern: dubitative irrealis manifests itself at least, but not exclusively, in the scope of negative polarity. The dubitative irrealis in complementation sheds doubt on veridicality-based interpretations or realis vs irrealis distinctions.