Abstract: The integration of three-dimensional (3D) printing and virtual surgical planning (VSP) has introduced a new standard in spinal surgery, enabling highly individualized preoperative preparation and intraoperative execution. By virtually reconstructing patient anatomy, surgeons can identify critical vascular corridors, analyze endplate morphology, determine optimal interbody cage geometry for best anatomical fit, and predefine screw trajectories and entry points with exceptional accuracy. This level of planning reduces intraoperative uncertainty and minimizes the risk of implant malposition, particularly in anatomically complex scenarios, such as the current case report. Quantitative assessment of alignment correction can also be performed preoperatively, allowing the surgeon to model and predict postoperative spinal balance with greater precision. This technology is particularly advantageous in congenital spinal anomalies, such as hemivertebrae, where orientation can be challenging and anatomical landmarks are often distorted or partially obscured. We report the application of 3D printed patient-specific implants (PSIs) in conjunction with VSP to perform a single-level, stand-alone anterior lumbar interbody fusion (ALIF) for the treatment of congenital scoliosis due to a left hemivertebra, associated with progressive left L5/S1 foraminal stenosis. The patient presented with severe left L5 radicular pain and motor–sensory radiculopathy. The use of a PSI facilitated precise reconstruction of the spinal column, optimized implant fit and enhanced surgical accuracy in this technically complex case.

Abstract: Background/Objectives: Severe asthma in routine practice often involves long-standing disease, multimorbidity, and prior biologic failure, settings underrepresented in pivotal tezepelumab trials. This study evaluated 52 week real world effectiveness and safety of tezepelumab in a highly comorbid, predominantly T2 high, biologic experienced severe asthma cohort from the Canary Islands. Methods: TEZNERIFE is a multicenter, retrospective phase IV study including consecutive adolescents and adults with GINA Step 5 severe uncontrolled asthma treated with tezepelumab 210 mg every 4 weeks for 12 months. Clinical outcomes, lung function, type 2 biomarkers, upper airway symptoms, and Biologics Asthma Response Score (BARS) were assessed at baseline, 26 weeks, and 52 weeks. Results: Fifty six patients (mean age 53.5 years, 71% female, mean asthma duration 30 years, 84% T2 high; 71% with ≥1 prior biologic) were analyzed. ACT improved from 11.5±3.7 to 15.9±4.7 at 26 weeks and 17.5±4.7 at 52 weeks (both p<0.0001), while annualized exacerbations declined from 2.79±2.0 to 0.50±0.72 and 0.51±0.89 (both p<0.0001). Maintenance oral corticosteroid dose fell from 10.2±8.3 to 6.9±2.4 mg/day at 52 weeks (p=0.014). FEV1% predicted increased from 69.3±19.2% to 75.3±17.7% and 76.2±20.6% (p=0.004 and p=0.001), and blood eosinophils decreased from 234±231 to 146±120 and 147±110 cells/µL (p=0.001 and p=0.013). At one year, 18.9% and 67.9% were classified as good and intermediate responders by BARS; 13.2% were insufficient responders. Two patients discontinued due to non serious adverse events while no treatment related serious events occurred. Conclusions: In this difficult to treat, multimorbid, biologic experienced population, tezepelumab achieved sustained improvements in asthma control, exacerbations, lung function, eosinophilic inflammation, and corticosteroid exposure over 52 weeks, supporting upstream alarmin inhibition as a versatile strategy in complex severe asthma.

Abstract:

Background: Pseudomonas aeruginosa is an opportunistic pathogen with both intrinsic and acquired antimicrobial resistance. High-risk clones are associated with carbapenem resistance because they frequently harbour and disseminate carbapenemase genes and other resistance determinants, enabling their persistence and spread in healthcare settings. Carbapenem-resistant strains have limited treatment options. However, genomic data on high-risk clones circulating in Ghana remain limited. Methods: This cross-sectional study was conducted between December 2023 and January 2024 in eight government hospitals in Accra, Ghana. Clinical isolates were collected from multiple specimen types and identified using standard antimicrobial susceptibility testing in accordance with CLSI guidelines to determine resistance profiles, and subsequently confirmed by MALDI-TOF-MS, Whole-genome sequencing was carried out using the Illumina NextSeq 2000 platform. Bioinformatic analyses were then conducted to determine sequence types, identify antimicrobial resistance genes and virulence factors, and assess phylogenetic relationships among the isolates. Results: High-risk international clones (ST235, ST244, ST308, and ST773) predominated. Low SNP differences (≤10 SNPs) indicated recent clonal transmission within and between hospitals. Serotype O11 was dominant and strongly associated with high-risk clones. Isolates carried multiple resistance determinants, including aminoglycoside-modifying enzymes and ESBL genes (blaCTX-M-15, blaTEM-1B) — carbapenemase genes, particularly blaNDM-1, coexisted with blaOXA-50 variants. Findings demonstrate local clonal expansion, global relatedness, and the emergence of a novel sequence type (ST5336) in Ghana. Conclusion: High-risk clones, especially ST773, are widely circulating in hospitals across Accra, indicating ongoing transmission and clonal expansion. The emergence of the novel ST5336, emphasize the urgent need for enhanced genomic surveillance and antimicrobial stewardship in Ghana. Significance of this research article: This work strengthens the evidence base needed to inform infection prevention strategies, antimicrobial stewardship programs, and the implementation of routine genomic surveillance to curb the spread of high-risk, carbapenem-resistant clones in Ghana and similar resource-limited settings.

Abstract:

The Gibbs Paradox (concerning the entropy of mixing and entropic extensivity) was explored in depth by Edwin Jaynes (1992). We take up Jaynes’ treatment, considering the special cases for which entropy is (approximately) extensive, and the general case in which it is not. We also explore the Holographic Principle which (strictly speaking) excludes the extensivity of entropy. The formalism of Quantitative Geometrical Thermodynamics shows that, being isomorphic to energy, it is entropy production (not entropy) that is extensive. As a corollary, Shannon information is also not extensive, although information production is extensive.

Abstract: According to its published mission, the European Collaborative Cloud for Cultural Heritage (ECCCH), a most recent flagship initiative of the European Commission, cur-rently being developed by the EU-funded project ECHOES, is “…a digital ecosystem designed to serve as a platform for cultural heritage professionals, researchers, and in-stitutions across Europe… to unify Europe’s fragmented cultural heritage sector through advanced digital collaboration…”. While recognizing that “…one of the most persistent challenges in the European cultural heritage sector is the dispersion of data in incom-patible formats and isolated institutional practices…”, the ECCCH advances “…a unified approach (that) will radically transform and greatly facilitate … collaborative research…”, promoting the engagement with small, peripheric Cultural Heritage (CH) institutions and providing (tangible and intangible) CH data under their custody. The article describes an experiment in assessing the readiness of available digital data on a specific type of CH objects, namely Cypriot Late Bronze Age figurines. Most of the ca. 170 figurines un-earthed were found in Cyprus, where they were also produced. Out of these, ca. a third are hosted in museums in Cyprus, and the others are dispersed in some 36 museums, primarily in the UK, museums across ten EU countries, the USA and the Russian Fed-eration. Less than half of them provide, through their digital, open-access collections catalogue, information on these figurines. The study reported here investigated the usefulness of this information for conducting synthetic research on their nature and the socio-cultural role they may have fulfilled while in use in the past. Consequently, the study explored the potential of the information provided by these museums to be inte-grated and expressed through the Heritage Digital Twin concept, at the core of the ECCCH.

Abstract: An extensive survey of early blight of tomato was conducted in Peshawar and Hazara divisions of Khyber Pakhtunkhwa province, during the fruit bearing period of 2014 of the crop. Comparatively more disease incidence and severity was observed in Peshawar than Hazara Division. Data also revealed that more disease was prevalent in district Haripur than Abbottabad and Mansehra. The isolates of Alternaria solani collected during the survey were different in terms of their cultural characteristics and aggressiveness. Isolates from Peshawar division showed rapid growth on Potato Dextrose Agar medium and produced higher number of spores ml−1 as compared to isolates collected from Hazara Division. Moreover these also produced the largest size lesion (20.6mm) when compared with those collected from Hazara Division. A positive linear trend was observed when lesion size was regressed over colony diameter and spores concentration indicating that isolates showing aggressiveness also showed more radial growth and produced more spores mlˉ1. The studies also confirmed the existence of cultivar specific aggressiveness amongst the isolates of A. solani in screen house experiment. Isolates adapted on respective cultivars caused high disease severity, number of lesions per plant and lesion size with concurrent reduction in yield. Isolate AsRJ previously adapted on variety Red Jambo when inoculated on the same variety produced high disease severity (64.02%) and lesion size (8.2mm), with the lowest yield (436.71g). A similar trend was observed for other isolate and cultivar combinations which could have serious implications for cultivation of a particular variety on vast acreages over time.

Abstract: Background: Knowledge management in global health is essential in response to ageing populations, increasing morbidity, and rising expectations of care. The Knowledge Model about Person Care promotes health systems organized around individuals rather than diseases. Within this framework, vulnerability—understood as the risk of physical or moral harm—can be assessed through Basic Care Variables (BVC) that determine individuals’ need and capacity for self-care. Primary care health information systems provide an opportunity to operationalize these variables at the population level. Methods: This study applies Deductive Methodology to extrapolate community-level health indicator data to population-level vulnerability measures. Using the electronic Primary Care Objective Monitoring tool (e-SOAP) from the Community of Madrid, we analyzed health and social care indicators derived from primary care clinical information systems. The mathematical architecture of selected indicators was used as an approximation to Model-Based Systems Engineering. Results: Primary care indicators enabled the identification and aggregation of community-level data reflecting BCV. The system supports multi-level analysis (regional, managerial, institutional, and professional), facilitating grouped and anonymized data extraction for future vulnerability assessment. Conclusion: A minimum set of primary care indicators can effectively estimate community vulnerability, supporting person-centred health system management and informed decision-making.

Abstract: We evaluated global radiotherapy practices in the management of early-stage (AJCC/UICC 8th edition stages I-II) glottic cancer (ESGC). A cross-sectional online survey was conducted in March 2025 across centers worldwide. Data was collected on clinical practices, including staging, CT simulation, target volumes delineation, organs-at-risk contouring, radiotherapy techniques, dose and fractionation schedules, treatment delivery techniques, and image guidance practices. A total of 181 responses were received, primarily from Asia (41.4%) and Europe (24.3%). Most respondents were from non-academic public centers (44.2%), with multidisciplinary team involvement reported by 84.5%. Head and neck CT scan was the most used staging modality (80.1%). Intensity-Modulated Radiation Therapy was the most common planning technique (82.9%). Hypofractionated radiotherapy schedules predominated for T1 (84%) and T2 (72.4%) disease. T1a was typically treated with whole-larynx target volume (72.4%). Use of ipsilateral involved vocal cord irradiation varied by geographical region (p = 0.015), being most common in North America (44.8%) and Europe (38.6%). Accelerated fractionation for T2 also differed significantly (p < 0.001), with the highest use reported in North America (41.4%). Daily Cone-Beam Computed Tomography was acquired by (58.2%). 70% of respondents expressed interest in the results of a future phase III randomized trial comparing stereotactic body radiation therapy to conventional radiotherapy. Significant global variations in radiotherapy practices for ESGC were observed, likely reflecting disparities in access and differences in institutional protocols. The development and implementation of standardized, evidence-based global guidelines are essential to harmonize care, minimize toxicity, and improve outcomes for patients with ESGC.

Abstract: The Johnson–Mehl–Avrami–Kolmogorov (JMAK) formalism provides a classical framework for describing polymer crystallization kinetics; its applicability under finite-domain confinement requires quantitative assessment. In this work, the influence of one-dimensional geometric restriction on cylindrical growth in polymer thin films is investigated using a stochastic Monte Carlo approach. The model considers site-saturated nucleation on randomly distributed cylindrical nanofibers with constant radial growth velocity under hard-wall boundary conditions. Crystallization kinetics were evaluated through automated segmented regression of the double-logarithmic JMAK representation. Under confinement, the Avrami plot departs from single-slope linearity and exhibits two successive quasi-linear regimes characterized by effective parameter pairs (n₁, ln k₁) and (n₂, ln k₂). The primary exponent n₁ remains thickness-independent, consistent with early-stage radial expansion prior to boundary interaction. The secondary exponent n₂ displays a non-monotonic dependence on reduced film thickness, reflecting the competing influence of wall-induced truncation and inter-fiber impingement on late-stage transformation. These results support a geometric interpretation in which finite-domain constraints modify effective growth dimensionality and provide a reproducible framework for analyzing dual-regime Avrami behavior in confined crystallization systems.

Abstract: Early cancer detection has historically relied on episodic, population-based screening strategies interpreted against fixed thresholds. Although effective in selected contexts, such approaches detect disease primarily after structural or biochemical abnormalities become overt. Advances in genomics, liquid biopsy, and metabolomics now permit a conceptual transition from static screening toward longitudinal, biologically calibrated surveillance. This review proposes an integrated early-detection architecture grounded in four complementary dimensions of tumorigenesis: inherited susceptibility, somatic field evolution, molecular residual disease, and functional metabolic remodeling. Germline variants establish life-course risk and recalibrate surveillance intensity. Somatic mutational signatures and field cancerization describe spatial conditioning of tissues long before overt malignancy. Circulating tumor DNA (ctDNA) provides temporal resolution by tracking clonal persistence after therapy. Extending this framework, emerging evidence from microbiome and metabolomic studies supports the hypothesis that sustained alterations in volatile organic compound (VOC) profiles may reflect early tumor–microbiome ecosystem shifts. Although a comprehensive wearable multi-gas detection device is not yet clinically available, current technological advances render continuous “volatomics” biologically plausible and conceptually aligned with trajectory-based monitoring. Rather than advocating a single transformative assay, this manuscript argues for convergence: longitudinal biomarker baselines, germline priors, tumor-informed molecular templates, ctDNA dynamics, and prospective metabolic sensing integrated within a calibrated decision system. Such a platform would function not as a replacement for established diagnostic tools, but as a stratified triage architecture capable of identifying sustained biological deviation warranting further evaluation. Early detection, in this reframed paradigm, becomes a dynamic process of recognizing evolving biological drift rather than a binary event triggered by threshold crossing.

Abstract: The Box–Cox transformation is widely used to induce approximate normality and linearity in statistical modelling. Within the Power Normal framework, it embeds non-Gaussian variables into a latent Gaussian structure where conditional relationships become linear. However, the inverse transformation does not generally preserve these functional relationships when returning to the original scale. In this paper, we formally analyze the discrepancy between the inverse image of the linear regression function in the transformed domain and the true conditional expectation in the original scale. We derive an explicit second-order decomposition showing that the conditional mean in the original scale consists of the inverse-transformed linear predictor plus a curvature-induced correction term proportional to the conditional variance. This distortion term depends explicitly on the transformation parameter and the local geometry of the inverse Box-Cox function. The analysis reveals that the loss of structural preservation under inversion is an intrinsic consequence of the nonlinear transformation and can be interpreted as a second-order Jensen-type correction. Numerical illustrations based on simulated bivariate Power Normal models confirm the theoretical findings. These results clarify a structural limitation of transformation-based Gaussian modelling and provide insight into its implications for statistical inference and applied modelling.

Abstract: AbstractBruceine A is a major quassinoid isolated from the seeds of Brucea javanica and has been reported to exhibit significant anticancer and antiplasmodial activities. Structural modification of Bruceine-A through semisynthesis is a rational approach to improve its biological potential. This study aimed to design and evaluate semisynthesized pathways for Bruceine-A derivatives and to elucidate the reaction mechanism. Two semisynthesis routes were evaluated: (i) a protection–deprotection strategy involving tert-butyldimethylsilyl chloride (TBDMS-Cl), and (ii) a direct acylation approach. Due to limitations in material availability and reaction complexity, the second pathway was selected. Direct acylation of Bruceine A in N,N-dimethylformamide (DMF) using imidazole as a base catalyst successfully yielded 3-O-chlorobenzoylbruceine (P1). Structural elucidation was performed using UV, IR, ^1H-NMR, ^13C-NMR, and LC–MS. The results demonstrate that direct acylation at the C-3 hydroxyl group is an efficient and selective strategy for the semisynthesis of Bruceine A derivatives.Keywords: Bruceine A, quassinoid, semisynthesis, acylation, Brucea javanica, 3-O-chlorobenzoylbruceine

Abstract: The article explains the narcissism leadership paradox in the existing organizations in relation to the rhetoric of ethics used strategically to legitimize the use of control. The loss of trust in leaders and in employees are both practiced in the sense that leaders manifest the disjunction between organizational discourses and reality by instantiating values in superficial ways in what they say and in real ways in what they do. The study relies on three guiding questions: (1) How do narcissistic leaders legitimize themselves by thinking that they are right in the moral sense? (2) What are a few of the stressors related to employees where ethics and practice collide? (3) Does dissonance cause organizational cynicism? Semi-structured interviews with 24 employees working in Higher Education Institutes were used to collect qualitative data to answer the following questions: The similar patterns and their comparison across cases were determined by coding and performing thematic analysis in computer through excel. The outcomes show 3 broad themes. First, the Virtue Costume demonstrates that both virtues signaling and moral language are being offered to fulfill personal interest and acquire power. Second, Branding the Self as the Company causes us to concentrate on how egoistic leaders project their own image as the identity and values of the company. Third, the Contagion of Cynicism explains how employees who become disillusioned, cynical and detached respond when they feel hypocrisy in the words and actions of their leaders. The paper associate’s impression management and moral justification of narcissist leaders with falling trust and calls on authentic leadership and open cultural supervision to restrain cynicism and provide theoretical and practical organizational knowledge. This study’s implications build on the dark triad perspective advanced by Alowais and Suliman, which demonstrated that Leader Dark Triad (LDT) traits can cascade into Employee Dark Triad (EDT) behaviors within organizational settings. Extending this logic, the present study shows that narcissistic leaders’ ethical rhetoric can similarly shape organizational climates in ways that reinforce manipulative dynamics, highlighting how seemingly ethical leadership signals may mask deeper patterns of influence and behavioral contagion.

Abstract: Previous studies suggest that elevated competitive anxiety may increase the likeli-hood of injury. The present research aims to examine the role of competitive anxiety as a predictor of injury occurrence, frequency, and severity. A cross-sectional, correlational de-sign was conducted with 131 athletes, (mean age = 16.49 years), predominantly male. In-juries data were obtained through medical record review, and competitive anxiety was assessed using the Competitive Anxiety Inventory-2. Empirical frequency distributions, descriptive statistics, non-parametric tests, and logistic and ordinal regression models were employed. A high incidence of injuries was observed, although most were minor. Competitive anxiety was characterized by elevated levels of cognitive anxiety and self-confidence. Injured athletes exhibited greater overall competitive anxiety (r = .31, p < .001), with higher levels observed among those who sustained more injuries (ε² = .12, p = .001), and a very large effect was found in relation to injury severity (ε² = .17, p < .001). The occurrence of injury can only be predicted in 10.9–14.7% of cases through increased cogni-tive and somatic anxiety, whereas an increase across all dimensions of competitive anxi-ety predicts a greater number (13–14%) and severity (20.3–21.8%) of injuries. These find-ings underscore the importance of developing skills to manage competitive anxiety, par-ticularly its cognitive dimension and maintaining optimal levels of self-confidence in young athletes.

Abstract: Blast furnace gas (BFG) must be deeply purified when it is as fuel for combined-cycle power generation. To improve collection efficiency of the fine particulate dust in BFG by wet electrostatic precipitators (WESPs), this study implemented measures such as optimizing nozzle atomization performance and spatial distribution of droplets, along with adding chemical agglomeration agents and surfactants, These approaches pro-moted the chemical agglomeration of fine dust and enhanced dust collection efficiency. The results show that under overlapping spray conditions, the 1/8 solid cone nozzle produced the smallest droplets size with the most uniform spatial distribution, exhib-iting a d50 of 141.17 μm. When this nozzle was used in combination with guar gum (GG) as a chemical agglomerant, the d50 of BFG dust increased from 8.46 μm to 14.75 μm. The synergistic application of 5 mg/m³ sesbania gum (SBG) and 5 mg/m³ oc-tylphenol ethoxylate (OP-10) further increased the dust d50 to 19.08 μm. Using the 1/8 solid cone nozzle and with an XTG concentration of 5 mg/m³, resulted in the highest dust collection efficiency of 96.76%, while the synergistic use of SBG/OP-10 achieved an efficiency of 97.69%. This study elucidates the influence of nozzle atomization charac-teristics and spray liquid type on dust agglomeration and collection efficiency, providing both theoretical and practical foundations for the deep purification of blast furnace gas.

Abstract: Oculomics represents a paradigm shift in medicine, redefining the eye as a non-invasive window into systemic health rather than merely a target of disease. This emerging interdisciplinary field leverages high-resolution ocular imaging—including fundus photography, optical coherence tomography (OCT), and OCT angiography—along with molecular analysis of ocular biofluids to identify biomarkers of cardiovascular, metabolic, neurodegenerative, renal, and environmental diseases. Grounded in the retina’s shared embryological, neurovascular, and metabolic pathways with the brain and systemic vasculature, oculomics enables the detection of subclinical pathological processes often years before overt clinical manifestations. The integration of artificial intelligence, particularly deep learning, has been instrumental in decoding complex, high-dimensional ocular data, transforming routine eye examinations into scalable platforms for predictive risk stratification and personalized medicine. Unlike prior reviews focused on technological implementation or clinical integration, this work provides a mechanistic, disease-centric synthesis that maps quantitative retinal and tear-fluid biomarkers to underlying systemic pathophysiology, offering a granular blueprint for future translational research. This review synthesizes the biological rationale, key technologies, and disease-specific evidence underpinning oculomics, while critically examining its translational framework—termed “Healthcare from the Eye.” We also address persistent challenges related to standardization, clinical validation, ethical governance, and health system integration. As these barriers are addressed, oculomics is poised to reposition ophthalmology at the forefront of preventive and precision medicine, making routine eye care a gateway to early systemic health assessment and intervention.

Abstract: The block-and-lock strategy aims to achieve a functional cure for human immunodeficiency virus type 1 (HIV-1) infection by enforcing durable, drug-independent silencing of proviral transcription. Several latency-promoting agents have been described that effectively limit viral reactivation in vitro or in animal models. However, most approaches induce only partial or reversible transcriptional repression and have not yet been translated into safe and effective clinical interventions. This review summarizes the molecular mechanisms underlying block-and-lock strategies and critically evaluates the limitations of current candidate compounds. We highlight recent advances in understanding HIV-1 integration site selection, focusing on the roles of lens epithelium-derived growth factor p75 (LEDGF/p75) and cleavage and polyadenylation specificity factor subunit 6 (CPSF6) in directing proviral integration toward gene-dense, transcriptionally active chromatin. Pharmacological disruption of the LEDGF/p75–integrase interaction by LEDGF/p75 inhibitors (LEDGINs) redirects proviral integration toward less transcriptionally active genomic regions that are more resistant to reactivation. Recent tandem knockout studies, however, demonstrate that CPSF6 plays a dominant role in guiding HIV-1 integration toward gene-dense, transcriptionally active chromatin. LEDGIN treatment has been linked to the preferential targeting of proviruses to heterochromatin-rich regions within the nuclear interior. By contrast, CPSF6 knockout redirects integration toward peripheral heterochromatin, especially lamina-associated domains (LADs), genomic regions typically exhibiting stronger and more stable transcriptional repression than interior heterochromatin. These findings suggest that therapeutic modulation of CPSF6 may exert a more profound and durable effect on proviral silencing within a block-and-lock framework. Nevertheless, complete CPSF6 ablation is associated with severe cellular toxicity. The challenges associated with CPSF6-related adverse effects and potential strategies to overcome these limitations are discussed.

Abstract: Machine learning capabilities are expanding into scientific domains at an accelerating pace. When applied to high energy physics pattern discovery, they will generate candidates faster than traditional evaluation can absorb. ML finds patterns in past data. It is inherently post hoc. Whether those patterns reflect structure or coincidence is unknowable at discovery time. This limitation applies equally to human and computational pattern finding. What differs is scale. ML candidate generation is effectively unbounded, while human evaluation capacity remains fixed. When generation rate exceeds evaluation bandwidth, binary accept or reject degenerates to random sampling. Information theoretically, the only response that preserves ranking under a finite evaluation budget is stratification. By focusing on stratification rather than binary filtering, rule adjustments can be made retroactively, thresholds tuned as results accumulate, and evaluation bandwidth focused on top ranked candidates. This paper attempts to codify those criteria, proposing seven computationally evaluable standards for stratifying ML generated patterns. The goal is not to deliver verdicts but to prioritize which candidates merit preregistration and longitudinal tracking. The framework preserves the essential paradigm: pattern plus theory equals potentially real physics. Patterns alone, however striking, remain candidates until theoretical understanding arrives. Making these criteria explicit enables prefiltering at scale while creating a collaborative resource rather than a competitive one. ML capabilities extend what physicists can search while preserving how physicists evaluate. We offer this provisional framework for community calibration, with the goal of developing validation infrastructure before the capability fully arrives.

Abstract: Background: Drug-resistant tuberculosis (DR-TB) remains a major public health challenge in South Africa, particularly in rural settings with high HIV co-infection rates. Under-standing predictors of treatment response among people living with HIV is essential for improving clinical management and programmatic outcomes. This study aimed to iden-tify socio-demographic and clinical predictors of treatment outcomes among HIV-positive individuals diagnosed with multidrug-resistant (MDR) and extensively drug-resistant tuberculosis (XDR-TB) in the rural Eastern Cape Province, South Africa. Methods: A ret-rospective cohort study was conducted using routinely collected clinical records of DR-TB patients initiated on treatment between January 2020 and December 2024 at two public healthcare facilities. A total of 239 patients with complete treatment outcome data were included. Treatment outcomes were classified as favorable (cured or treatment completed) or unfavorable (death, treatment failure, or loss to follow-up). Descriptive statistics were used to summaries patient characteristics, while univariate and multivariable logistic re-gression analyses were performed to identify factors associated with treatment outcomes. Results: Most participants were aged ≤39 years (58%), male (60%), unemployed (90%), and without income (80%). MDR-TB accounted for 40% of cases, rifampicin-resistant TB (RR-TB) for 53%, and XDR-TB for 7.1%. Multivariable analysis showed that XDR-TB was the strongest independent predictor of unfavorable treatment outcome (AOR = 0.18; 95% CI: 0.06–0.58; p = 0.004). Income status was also significantly associated with outcome, with participants reporting some income having lower odds of favorable outcomes (AOR = 0.46; 95% CI: 0.23–0.92; p = 0.036). The model demonstrated modest predictive perfor-mance (AUC = 0.67). Conclusion: These findings highlight the dominant influence of re-sistance phenotype particularly XDR-TB on treatment prognosis among HIV-positive DR-TB patients in rural Eastern Cape. Integrating early resistance profiling, intensified clinical management of XDR-TB, and socioeconomic support mechanisms may improve treatment outcomes in high-burden rural settings.

Abstract: Cultural-heritage destinations are adopting digital twins and Living Labs to improve conservation, safety, and visitor experience. Operationalising these initiatives requires trustworthy interfaces capable of answering questions grounded in authoritative sources under public-sector governance constraints. We present a Sovereign Conversational Assistant (SCA) based on a small-language-model (SLM) plus retrieval-augmented generation (RAG) platform designed for the next generation Libelium Heritage Living Lab. This assistant is, therefore, agnostic from any specific LLM. Testing has focused on the usage of newly released, Barcelona Supercomputing Center’s own BSC-LT/ALIA-40b-instruct-2601 as well as the mistralai/Mistral-Small-3.2-24B-Instruct-2506, one of the SoTA standard bearer for mid-size SLMs. It integrates provenance logging, safety controls, and language enforcement. We evaluate the assistant benchmark on 19 tests across five categories: historical queries, client experience, data analysis, hallucination resistance, and safety/ethics. Our findings reveal that while both models adeptly retrieve factual historical and operational information, their reliability diverges under complex conditions. Mistral achieved a 100% pass rate across all tests, demonstrating strong analytical capabilities without hallucination and keeping up with the multilingual and safety guardrails, too. In contrast, ALIA struggled with numerical values drifting during data analysis and exhibited vulnerabilities in cross-language scenarios. The results show that a compact, sovereign RAG stack running on ALIA can meet core information needs in English and Spanish for Heritage Living Labs, while highlighting the necessity of refusal robustness and explicit multilingual control for public-facing deployment.