Abstract: Background: Hereditary transthyretin amyloidosis (ATTRv) is a rare multisystemic disease with variable phenotypic expression. No published data exist on the clinical characteristics of ATTRv in Peruvian population.Objective: To describe the demographic, genetic, and clinical characteristics of patients with ATTRv in Peru, and to determine the distribution of clinical phenotypes according to internationally validated criteria.Methods: Descriptive, observational, retrospective case series of patients with ATTRv confirmed by molecular genetic testing, evaluated in Lima, Peru, between 2021 and December 2025 (IMPAC-FE study). Demographic, genetic, neurological (NIS, Norfolk QOL-DN, PND), autonomic (COMPASS-31, SUDOSCAN), and cardiovascular variables (echocardiography, septal thickness, E/e', apical sparing pattern, Tc99m-pyrophosphate scintigraphy, NT-proBNP, troponin) were evaluated. Phenotypes were classified according to AHA/ACC criteria and the THAOS registry.Results: Twenty-three patients were included (69.6% male, median age 60 years, IQR 45-70). The variants were Val142Ile (56.5%), Ala65Val (34.8%), and Val50Met (8.7%). Overall phenotype distribution: preclinical 34.8%, mixed 39.1%, cardiac 21.7%, neurological 4.3%. Norfolk QOL-DN (n=18): median 6.0. COMPASS-31 (n=18): median 6.0. LVEF (n=16): mean 60.5%. LV Mass (n=12): mean 102.9g. Troponin T (n=9): median 47 ng/L. PYP Scintigraphy (n=9): Perugini 3 in 77.8%.Conclusions: This first case series of ATTRv in Peruvian population shows clinical and genetic heterogeneity, with predominance of Val142Ile and Ala65Val variants, and a phenotypic distribution compatible with international registries. The high proportion of preclinical patients and extended cardiovascular evaluation reinforce the need for early diagnosis and timely initiation of disease-modifying therapies.

Abstract: This paper presents a robust linear-quadratic attitude-tracking controller for a nonlinear spacecraft with disturbances. Quaternions are used to represent the spacecraft’s attitude to prevent gimbal lock associated with Euler angles. Nonlinear rotation dynamics are controlled by nonlinear dynamic inversion (NDI) with an augmented linear-quadratic controller. However, quaternions in rotation dynamics can encounter singularities during dynamic inversion, leading to numerical instability in control input calculations. To resolve this problem, we propose a new NDI method based on the Lagrange equation for quaternion dynamics. Since NDI may not fully compensate for nonlinearities due to unknown disturbances or modeling errors, a nonlinear disturbance observer is incorporated into the controller to compensate for disturbances. Simulations are performed to compare with previous work and according to a real attitude control testbed with gravity disturbances. Validation results demonstrate strong disturbance rejection and singularity-free performance for the proposed controller framework.

Abstract: Electron configurations are known to provide (valuable) insights into the electronic structure and behavior of atoms. They specify which and how the electronic (sub-) shells are occupied, and is thus an essential ingredient for most atomic observables. When combined with the shell model and the successive filling of shells, these configurations help explain the Periodic Table and much of chemical binding. They also establish a qualitative framework for analyzing excitation, ionization and relaxation processes and may facilitate–a wide range of–astrophysical and plasma simulations. — Here, we review the role of electron configurations for understanding atomic behavior in interactions with particles and radiation. In particular, we identify several central requirements for an efficient treatment of configuration lists and define a domain-specific language in order to generate, manipulate and analyze such lists as well as to extract physically relevant information. We also demonstrate the implementation of this language in Jac, the Jena Atomic Calculator. An efficient handling of configurations will refine the coupling of structure codes with the spectral synthesis of plasma radiation, the setup of ionic cascades or even non-LTE plasma simulations. This common framework for dealing with electron configurations therefore improves consistency, reproducibility and scalability of atomic modeling.

Abstract: Background/Objectives: The EGFR T790M gatekeeper mutation drives resistance in non-small cell lung cancer by sterically hindering inhibitors and restoring ATP affinity. As emerging C797S mutations render covalent inhibitors obsolete, novel non-covalent strategies are critical. This study identifies inhibitors that redefine the mutant methionine sulfur atom as a primary stabilizing anchor rather than a liability. Methods: A reinforcement learning-based generative AI framework (DrugEx) sampled 100,000 molecules, prioritized through QSAR-based classification (mean ROC-AUC: 0.91 ± 0.01) and physicochemical filtering. Four lead candidates underwent 200 ns all-atom molecular dynamics (MD) simulations. Mechanistic stability and energetic convergence were quantified via Free Energy Landscape (FEL) analysis, post-simulation Ramachandran validation, and ensemble-averaged Molecular Mechanics Generalized Born Surface Area (MM-GBSA) binding free energy calculations. Results: Candidate 106 demonstrated high mutation tolerance by redistributing interactions toward the Met790 sulfur atom, contrasting with reference scaffolds 14 and 88 which suffered significant affinity loss. MD analysis revealed that potency is fundamentally dictated by successful recruitment of the thioether environment, locking the complex within a narrow, well-defined thermodynamic basin. Candidate 106 maintained stable binding (−11.0 kcal/mol by docking) corroborated by a robust MM-GBSA ΔGbind of −50.51 kcal/mol, primarily driven by persistent π-sulfur contacts (85% occupancy). Ramachandran analysis confirmed over 90% favored region occupancy, ensuring interactions occur without non-physical protein strain. Conclusions: Successful T790M/C797S resistance bypass is achievable by exploiting the gatekeeper methionine’s electronic environment. This mutation-aware blueprint provides a non-covalent strategy that avoids the metabolic and resistance-prone liabilities of covalent warheads.

Abstract: Background: Individuals with long-standing type 1 diabetes (T1D) remain at elevated cardiovascular risk (CVR). Adiponectin (ADNC) and leptin (LEP) are adipokines involved in metabolic and vascular homeostasis, yet their relevance for CVR stratification in T1D is unclear. This study examined the associations of ADNC and LEP with CVR categories derived from the Steno Type 1 Risk Engine (ST1RE) and the 2019 ESC Guidelines on Diabetes, Pre-diabetes and Cardiovascular Diseases (ESC 2019), with particular attention to potential sex-related differences. Methods: A cross-sectional study included 124 adults with long-standing T1D and 59 age- and sex-matched non-diabetic participants. Serum ADNC and LEP concentrations were measured using standardized immunoassays. CVR was assessed using ST1RE and ESC 2019 algorithms. Multivariable models adjusted for age and body mass index (BMI) were used to examine determinants of adipokine concentrations and their associations with CVR categories. Results: Participants with T1D exhibited higher circulating ADNC concentrations than non-diabetic individuals (p < 0.001). LEP levels were significantly associated with sex (p < 0.001). In adjusted analyses, sex and BMI remained significantly associated with adipokine concentrations. Higher LEP levels showed a significant positive association with higher ESC 2019 CVR category (OR 1.84; 95% CI 1.19–2.84; p = 0.006), whereas ADNC and the LEP×sex interaction showed no significant association. Neither adipokine was significantly associated with ST1RE-derived risk categories. Conclusion: In adults with long-standing T1D, LEP showed an association with ESC 2019-based CVR stratification, whereas neither LEP nor ADNC was associated with ST1RE-derived risk categories.

Abstract: Osteoporosis arises from disrupted bone remodeling, and growing evidence shows that gut microbiota and their metabolites have a major influence on skeletal health through the gut-bone and gut-brain-bone axes. In this systematic review, we synthesize findings from 932 studies to identify key microbial taxa, metabolites, and signaling pathways that modulate osteoblast and osteoclast activities. Short‑chain fatty acids (SCFA), tryptophan‑derived metabolites, and β‑D‑glucuronidase-related estrogen regulation emerge as central microbial mechanisms affecting bone formation and resorption. By integrating these data with the Phylobone extracellular matrix proteins database, we highlight Osteopontin and Cathepsin K as important downstream mediators linking microbial signals to bone matrix turnover. Probiotic strains (particularly Lactobacillus rhamnosus GG and L. reuteri) show potential to improve bone health through metabolic, immune, and endocrine pathways. Together, these findings outline a mechanistic framework connecting gut function to skeletal biology and identify promising microbiome‑based targets for osteoporosis interventions.

Abstract: The CLIA-CA-62 assay is an in vitro diagnostic device registered in Russia and Kazakhstan for measuring a marker specific to epithelial carcinomas. This pilot project aimed to assess CA-62 utility for primary cancer screening in an asymptomatic cohort in Kazakhstan. The trial was interrupted in January 2022 for reasons unrelated to the scientific program before clinical outcomes could be obtained. Available baseline data were therefore used to characterize the CA-62 value distribution and perform a scenario-based assessment of estimated assay specificity at a reference value of 5,000 U/mL. The analysis included 1,214 quantitative CA-62 measurements from asymptomatic healthcare workers aged 45–70 years, collected during annual preventive examinations between September and October 2021. The distribution was markedly right-skewed, with 92.5% of samples in the normal zone (median: 3,371 U/mL; IQR: 1,965–4,415 U/mL; 95th percentile: 6,309 U/mL). At the 5,000 U/mL cutoff, 7.5% of results (91/1,214) were elevated. Scenario-based modeling assuming cancer prevalence of 0.5–2.5% and assay sensitivity of 65–95% yielded an estimated specificity of 92.79–94.75%. These findings provide an analytical foundation for prospective verification of CA-62 in primary screening settings.

Abstract: Psychedelic drugs are serotonergic hallucinogens that can be divided into two types: naturally occurring (psilocybin, psilocin, and N,N-dimethyltryptamine) and synthetic (LSD, MDMA, 2,5-dimethoxy-4-iodoamphetamine, and ketamine). Psychedelics generally work on 5-hydroxytryptamine receptors and might be useful in cognitive enhancement, brain connectivity, neuroplasticity, and neuronal regeneration. These properties could be used in the pharmacological treatment of selected mental disorders. Autism spectrum disorders include a group of developmental disorders characterized by social communication issues, the presence of restricted interests as well as repetitive behaviors that impact the quality of life of patients and their caregivers. Currently, there are no authorized drugs for the treatment of the symptomatic features of ASD, but drugs are used for comorbid psychopathological aspects, but the efficacy and tolerability of such treatments are often questionable. Here, studies demonstrating the therapeutic utility of using psychedelic substances in autism are reported. These findings suggest a therapeutic potential of psychedelics for some aspects of symptoms associated with autism spectrum disorder.

Abstract: Low Earth Orbit (LEO)-based positioning, navigation, and timing (PNT) systems have attracted growing interest owing to their strong transmission power and rapid Precise Point Positioning (PPP) convergence. A key challenge in realizing such systems is constructing a pseudo noise (PN) code family large enough to accommodate hundreds of satellites while maintaining competitive correlation performance. In this study, we propose the Concatenated Weil (C.W.) family, an extended Weil construction that concatenates two Weil sequences whose prime periods sum to the target code length, motivated by the Goldbach conjecture. A two-stage search---auto-correlation screening followed by cross-correlation screening---identifies 608 candidate codes satisfying the correlation thresholds of established modernized Radio Navigation Satellite System (RNSS) families. A subsequent spectral refinement based on the minimum-to-average Power Spectral Density (PSD) ratio removes codes with deep spectral nulls, yielding a final family of 588 balanced codes. Benchmarking against modernized RNSS PN families demonstrates that the proposed family achieves the largest family size while maintaining comparable correlation performance, thereby providing a viable PN solution for large-scale LEO-PNT constellations.

Abstract: Background/Objectives: This study aimed to quantify the kinetic demands of multiple hops in series, movement tasks that are commonly used in strength and conditioning and physiotherapeutic practice. Focus was placed on comparing the demands of a quintuple-hop task to a triple-hop task, with particular focus on quantifying the eccentric braking stretch-load demands. Methods: Forty-four male university athletes (age 20.1 ± 1.4 years; body mass 71.2 ± 8.6 kg; stature 171.9 ± 5.1 cm) completed the hopping tasks across track-embedded force platforms, where braking and propulsion kinetics were measured across 54x track-embedded force platforms. Results: Significant (p < 0.001) averaged in-creases in maximal vertical (~32%) and horizontal braking impulses (~56%) for both TH and QH tasks were noted across hops. The last two hops of the QH task were found to have greater averaged vertical (~58%) and horizontal (~180%) stretch-load demands than the two initial hops (p < 0.001). Conclusions: This is the first study in which an extensive summary of kinetic measures for both triple and quintuple hops has been reported. The findings highlight the biomechanical, stretch-load aspects of these exercises, which can help practitioners better prescribe and program hops for injury prevention, rehabilitation, and performance enhancement.

Abstract: Gibberellins (GAs) is a key endogenous hormone regulating chrysanthemum flowering, and Gibberellin INSENSITIVE DWARF1 (GID1) is the core receptor of the gibberellin (GA) signaling pathway. However, the functional mechanism of CmGID1A remains unelucidated. Here, we constructed CmGID1A-RNAi silencing lines, and characterized the biological function of CmGID1A by phenotypic identification, protein interaction assays, qRT-PCR and RNA-seq. The results of RT-qPCR showed that CmGID1A responds to short days and gibberellins. Inhibition of the expression of CmGID1A can significantly promote the transition of chrysanthemum from the vegetative growth stage to the reproductive growth stage and accelerate its flowering process. Bimolecular fluorescence complementation (BiFC) and yeast two-hybrid (Y2H) assays confirmed that CmGID1A interacts with the DELLA protein CmRGL1 in a gibberellin-dependent manner. RNA-seq results revealed that silencing of CmGID1A leads to a significant up-regulation of downstream Ethylene Response Factor 6 (ERF6) expression. Collectively, CmGID1A acts as a GA receptor to mediate GA signal transduction via interacting with CmRGL1, and regulates the expression of CmERF6 and other downstream genes, thereby participating in the regulation of floral transition in chrysanthemum. This study clarifies the core role of CmGID1A in the GA signaling pathway and provides novel experimental data for enriching the molecular regulatory mechanism of GA in floral transition in chrysanthemum.

Abstract: Selenium (Se), a vital trace element, plays a significant role in maintaining vascular health and may offer protective effects against atherosclerosis. Its actions are mediated through Se-dependent selenoenzymes and selenoproteins, which enhance antioxidant defense, modulate inflammatory responses, and promote autophagy. These processes collectively help prevent cellular senescence - a state associated with age-related vascular decline characterized by oxidative stress, DNA damage, pro-inflammatory activity, and endothelial dysfunction. Epidemiological evidence consistently shows that low Se status is associated with increased risk of atherosclerotic cardiovascular disease within a narrow concentration range. However, clinical trials have not demonstrated clear reductions in cardiovascular events or mortality with Se supplementation alone. Overall, current evidence indicates that Se modulates key mechanisms involved in vascular aging and atherosclerosis, particularly redox balance, immune activation, and vascular cell homeostasis. This comprehensive review summarizes current epidemiological, clinical, and experimental research on the role of Se in cardiovascular health. It underscores Se's potential as a promising strategy for the prevention and treatment of atherosclerosis, while also acknowledging the complexities and nuances of its effects on vascular health. A deeper understanding of the cellular and molecular mechanisms involved could pave the way for targeted interventions aimed at reducing the burden of atherosclerotic cardiovascular disease.

Abstract: We develop a comprehensive quantum-mechanical and field-theoretic framework for a complex scalar field whose modulus encodes a local time density and whose internal phase carries a U(1) structure. This field, which we call the timeon, admits a potential with two thermodynamically distinct minima: a null-stress vacuum phase and a deeper condensed, highly stable atomic phase. We show that localised, finite-energy atomic-phase domains embedded within the vacuum couple naturally to a conventional matter wavefunction ψ(x,t), giving rise to a new class of composite eigenstates — Baryon Partner States (BPS). These states are elements of the composite Hilbert space H_ψ ⊗ H_Φ and function as the fundamental excitations of the theory. We derive the complete Lagrangian and Hamiltonian governing the timeon field, obtain the coupled Euler–Lagrange equations for the composite system, and construct static, spherically symmetric BPS configurations satisfying regularity and finite-energy boundary conditions. Each BPS exhibits a topologically constrained core, a nontrivial radial profile, and a quantised U(1) phase winding. These structures endow the states with emergent mass, charge, and confinement properties. Baryonic mass arises entirely from spatial gradients and potential energy of the field configuration; charge originates from the internal phase winding; and confinement emerges as an energetic and geometric necessity — continuous unwinding of the phase is forbidden without traversal of configurations carrying arbitrarily large energy cost, preventing fractional excitations from existing in isolation. Vacuum-to-atomic tunnelling and atomic-phase nucleation processes are analysed in detail, including energy barriers, critical radii, and transition amplitudes for metastable decay. The local matter density |ψ|² acts as a compression parameter that dynamically lowers nucleation thresholds and drives the formation of atomic-phase regions. Linearization about both homogeneous phases and static BPS configurations yields the complete small-oscillation spectrum of the theory; these internal modes form a predictive excitation tower and correspond directly to resonances in scattering processes. By promoting the translational degree of freedom of a BPS to a dynamical modulus, we derive its effective nonrelativistic Lagrangian and identify a renormalized inertial mass. Pairwise interactions between BPSs generate an effective potential consisting of strong short-range repulsion, an intermediate-range attractive well, and Yukawa-like long-range decay. This structure supports two-body bound states, determines low-energy scattering phase shifts, and produces resonances when collision energies match internal excitation frequencies. Extending to many-body systems, we show that BPSs form stable clusters analogous to small nuclei. A systematic low-energy effective field theory is obtained by integrating out internal BPS modes. Together, these results demonstrate that mass, charge, confinement, excitation spectra, scattering behaviour, and nuclear-like structure can emerge from the dynamics of a single complex field coupled to a matter wavefunction.

Abstract: It has been more than 25 years since the introduction of the Hallmarks of cancer by Hanahan D et al., in which they foresaw cancer research developing into a logical science based on its underlying principles. No doubt, since then, treatment approaches have evolved into personalized medicine, offering excellent benefits to a select patient population. However, three major underlying components of heterotypic interactions in cancer, i.e., the mutational evolution of cancer stem cells, epithelial-mesenchymal plasticity (EMP), and cancer remodeled extracellular matrix, remain vexing issues even today in patients who have failed therapy. Further, Epithelial-mesenchymal plasticity (EMP) is a set of to-and-fro transitions between mesenchymal & epithelial features, with interconnected signaling pathways across space and time, yielding hybrid phenotypes of evolutionary heterogeneity. The EMP, in turn, is embedded in the heterogeneous web of vascular, metabolic, mutational, and immune-suppressive reprogramming of the tumor microenvironment (TME) induced by the Hypoxia-ROS-HEF1α-TGFβ labyrinthine. Countering each hallmark of cancer requires a multiphase strategy with reprogramming/ reversion of transitional states. Incorporating epigenetic modifiers into the treatment protocol is the present frontier in oncology. Consequently, this review proposes a phased anti-hallmark-of-cancer protocol in a comprehensive Combination, Timing, and Sequencing (CTS) approach to improve outcomes while minimizing toxicities.

Abstract: This position paper argues that long-horizon robotics should optimize persistent autonomy, not only longer reset-based episodes. Real deployments require robots that remain safely useful over days to months while accumulating memory, adapting to evolving human preferences, recovering from inevitable failures, and managing constrained physical and computational resources. Many embodied AI evaluations still inherit the logic of episodic reinforcement learning---where environments are frequently reset and hidden human labor is often unreported---but continuous operation exposes vulnerabilities in state continuity, resource coupling, recovery, and maintenance. Although long-term autonomy is not conceptually new, recent progress in generalist robot policies, open robot datasets, and language-conditioned control makes persistence a primary machine-learning evaluation target rather than a deferred downstream systems-engineering concern. As base policies grow more competent, the practical bottlenecks of autonomy concentrate in memory staleness, hidden intervention burden, recovery loops, and maintenance debt. To align evaluation with these realities, we propose a persistent-autonomy scorecard and a layered benchmark blueprint centered on long-run service utility, intervention burden, recovery quality, proactive usefulness, memory hygiene, uptime, and wear-adjusted throughput. By treating persistence as the fundamental scientific object, modern robot learning can focus on systems that turn calendar time into compounding competence rather than relying on isolated task success.

Abstract: We processed the life expectancy data of age group less than 1 year old from the Institute for Health Metrics and Evaluation (IHME) in contiguous USA and a set of 33 environmental variables (or features ) from the European Centre for Medium-Range Forecasts (ECMWF) from the years 2003 through 2019. Visualizing the IHME data we identified the massive disparity in life expectancy in contiguous USA where counties in southern states have relatively less life expectancy compared to counties in northern states. We made use of machine learning to estimate the life expectancy and obtained moderate accuracy as coefficient of determination (R2) and Root Mean Square Error (RMSE) between the true and estimated values were found to be 0.77 and 1.18 year respectively in an independent test set using only a set of 5 environmental variables. Our key finding shows that apart from well-known pollutants such as particulate matter (PM), ozone, carbonmonoxide, it is essential to reduce pollutants such as formaldehyde, sulphate aerosols, dust aerosols; increase vegetation areas, and good working condition such as lower wet-bulb temperature can potentially increase life expectancy in the US. Future work can include socio-economic variables such as household income, poverty rate and other relevant features to create a comprehensive set of variables to improve the results and livelihood of people.

Abstract: Rivers are the main source of water supply for the Crimean Peninsula, making their chemical status crucial for the regional water security. The study is based on results of geochemical surveys conducted in 2015 – 2018 during different hydrological phases in rivers of the northern macroslope of the Crimean Mountains (the Salgir, Belbek, Kacha, and Alma) and the southern coast (the Derekoyka, Ulu-Uzen, Demerdzhi, and Uchan-Su). Background levels of most elements in water and suspended matter are comparable to their global averages. In impacted areas metal contents exceed background by up to 10–20 times. Dissolved metal contamination is typical during low-water periods, whereas increased values in suspended matter is primarily associated with flood events. Suspended matter is enriched in Bi, Cd, Sb, Zn, Cu, Sn, Pb, W, and Mn, consistent with the geochemical signature of urban road dust in Crimean cities. Among the rivers of the northern part of Crimea, the highest pollution is typical for the Salgir River, on the southern coast - for the Uchan-Su River. Metal(loid)s inputs to suspended matter is predominantly controlled by natural sources, the highest anthropogenic impact is related to construction activities (releasing calcareous dust), urban wastewater, vehicle emissions, and agricultural practices, particularly vineyards.

Abstract: The transition to energy independence requires the application of flexible approaches and the diversification of distributed energy generation technologies. This article substantiates the feasibility of using a hybrid power supply system incorporating renewable generation sources and a cogeneration plant to enhance the reliability of power supply to centralised heat supply boiler houses. Criteria and approaches to structuring and balancing the hybrid system are proposed, based on an analysis of the nature of electricity consumption and the nature of generation by its structural elements, using the example of Ukraine’s district heating enterprises. The structure of the hybrid system has been determined, taking into account seasonal variations in operation and the stochastic nature of load and generation, whilst applying economic and environmental approaches in accordance with the institutional requirements of the European Union and Ukraine. A discrete mathematical model of the energy balance with a system of technical constraints is proposed to justify the parameters of the hybrid system’s components. It is proposed that the parameters of the structural elements of the photovoltaic power station, wind power station, storage battery and cogeneration plant be determined on the basis of actual electricity consumption data from a district heating boiler house. Operating modes of the hybrid power supply system have been established depending on technological requirements and conditions for integration with the centralised electricity grid. The results obtained can be used in the design of hybrid power supply systems for district heating enterprises.

Abstract: Long-term disposal and management of nuclear waste is one of the major hurdles for nuclear energy. Deep geological disposal, an idea originating in the 1970s, is currently the preferred path being followed in many countries. However, acceptance of this approach is hindered by societal concerns around the safety of the “one-million years” geological disposal and passing the waste burden to future generations. iMAGINE, an integrated nuclear system based on molten salt fast reactor technology with self-sustained iso-breeding, online clean-up and reverse reprocessing, has been proposed as an innovative way to eliminate the demand for a long-term high-level waste disposal. In this work, we investigate the use of iMAGINE as a technological approach for reimagining high-level nuclear waste management by overcoming the challenges of classical partitioning and transmutation (P&T). After discussing the current status and limitations of P&T along with an overview of the nuclear waste classification and management framework existing in major nuclear power producing countries, we demonstrate the potential impact of iMAGINE in simplifying the disposal of high-level waste. The results indicate that among the key long-lived radionuclides, many lie well below the criteria for requiring deep geological disposal. Besides Finland, India and Russia where most (or all) of the important long-lived fission products exceed current high-level waste thresholds, only two to three fission products (generally with half-lives from 30 to 100 years) exceed the national limits in Canada, China, France, Germany, Japan, and South Korea, while concrete conclusions can’t be drawn for the UK and US based on available information. The results presented here do not aim to make inflated claims but should be seen as the scientific basis for deeper discussions amongst all nuclear waste disposal stakeholders to explore a novel technological solution for rethinking high-level waste management and possibly eliminating the need for a “one-million years” geological disposal.

Abstract: Sustaining high performance in private healthcare requires that internal organizational processes actively reinforce the values employees carry into their daily work. This study examines how organizational communication and internal branding shape employee commitment, positioning commitment as a foundational condition for sustainable organizational performance in health services. Drawing on quantitative data from 247 healthcare professionals, a structured questionnaire validated through reliability analysis and Confirmatory Factor Analysis was used to assess the direct and indirect pathways between these constructs. Multiple regression analysis confirmed that both organizational communication and internal branding are significant positive predictors of employee commitment, with communication carrying a marginally stronger direct effect. Mediation analysis further revealed that internal branding mediates the relationship between organizational communication and employee commitment, accounting for approximately 29 percent of the total effect. These findings suggest that coherent communication structures and well-anchored internal branding practices function as complementary mechanisms that, together, support the workforce stability and internal alignment that sustainable service delivery requires. The study concludes by proposing an integrated managerial framework that brings these two strategic levers into closer coordination, with the aim of advancing long-term organizational sustainability in the private healthcare sector.