The accelerating use of algorithmic systems in public administration exposes a standardization gap between technical AI assurance and institutional accountability. This article develops a tiered accountability and reporting standards framework for decisions made under public authority. A qualitative design science method combines comparative institutional analysis, structured absence analysis, and standards architecture design. The empirical basis comprises international standards, the United States Department of Government Efficiency (DOGE)–Treasury access episode as an institutional control precursor, Australia’s Robodebt scheme as an automated-decision failure, and public sector governance arrangements in Estonia, Singapore, Japan, South Korea, Canada, and the United States. A replicable coding protocol traces documented accountability gaps to five auditable primitives: provenance tracking, decision logging, role attribution, contestability, and post-deployment audit. The primitives are organized into minimum, heightened, and systemic/constitutional tiers according to material influence, rights and essential service effects, civil service integrity, institutional independence, and substitutive capacity. The article also specifies a Public Sector Algorithmic Accountability Statement (PAAS), crosswalks its ten disclosure fields to GRI 1, GRI 2, and GRI 3, and demonstrates its operation through a fully worked hypothetical benefits eligibility application. A tier assignment decision aid, an assurance cycle, and a cost–feasibility model support implementation, including in small institutions. The framework’s novelty lies not in claiming new lifecycle controls, but in consolidating those controls around the public decision configuration, escalating them according to public authority consequences, and joining internal evidence to comparable public reporting. The proposal shifts standardization from AI system certification alone toward auditable institutional answerability, governance sustainability, and constitutional integrity.

In this article, we unpack what we believe to be a discriminatory and discrediting label afforded to growing populations of Australians — Culturally and Linguistically Diverse (CaLD). This term is used to describe everyone who is not Aboriginal or Torres Islander or Anglo-Saxon/Anglo-Celtic. Through qualitative, semi-structured, in-depth ethnographic interviews and thematic analysis, including some abductive analysis, we aimed to investigate how those labelled CaLD experienced this term, including their feelings about being constructed as CaLD, and how they believed they were impacted by this label. Using both labelling theory ( Durkheim, 1938 ) and linguistic racism theory ( Tankosić & Dovchin, 2023 ), we argue that while the term CaLD was originally intended as ‘inclusionary othering,’ the category perpetuates monolithic othering on the basis of language and culture, masking a broad range of ethnic identities common to Australia and upholding systemic practices of subjugation such as linguistic racism as mechanisms for continued ideological, political, and social dominance. Individuals to whom this label is applied continually walk the tightrope between the access and affordances it may offer and its capacity to both highlight and erase difference. The study’s implications indicate there needs to be greater consultation with the communities involved about terms used to label and set them apart.

Cell therapies are increasingly manufactured in closed, automated culture systems, yet decisions about cell quality, safety, and release still rely largely on sparsely executed, destructive, and offline assays. Over the past 5 years, significant progress has been made in developing biosensors capable of real-time measurement of key biochemical and physicochemical indicators including metabolites, ionic species, and protein-associated stress indicators within cell culture environments. However, most systems remain disconnected from manufacturing workflows and fail to support actionable process control. This opinion article discusses the next phase of innovation and the need to reposition biosensors as process analytical technology, shifting the field from descriptive monitoring toward integrated, decision-driven control of cell therapy manufacturing.

The development of grade-level or age-level reading proficiency continues to be a challenge for a number of d/Deaf and hard of hearing (d/Dhh) children and adolescents. There have also been ongoing research debates on recommending evidence-based or effective practices to facilitate the acquisition of reading skills. These debates are fueled, in part, by the major principles of three broad frameworks: Paul’s Qualitative Similarity Hypothesis, Marschark’s Cognitive “Qualitative Difference” Hypothesis, and Mayberry’s L1-Timing Hypothesis. These frameworks highlight the tension between developmental similarity (continuity) and emerging neurocognitive reading research on d/Dhh individuals. The present commentary discusses the three frameworks, highlighting strengths and criticisms as well as similarities and differences, and concludes with a proposed integrative perspective with implications for classroom practices. This integration provides recommendations for further research, necessary for improving the reading levels of d/Deaf and hard of hearing students.

CardioPharmaGENET COST Action network aims to advance personalized medicine in cardiovascular care by leveraging pharmacogenomics (PGx) to optimize drug therapies. In cardiovascular medicine, this approach is especially critical, given the significant patient variability in drug responses to therapies. The main goal is to establish a pan-European network that addresses several key challenges that hinder the widespread adoption of PGx in cardiovascular care. These challenges include the lack of a centralized knowledge hub for clinicians and policymakers, insufficient integration of PGx into clinical practice, and inconsistent policy frameworks across Europe. The project also seeks to utilize AI and machine learning to streamline the analysis of large-scale genomic data and enhance clinical decision-making. The network includes five working groups (WG) to tackle these issues: WG1 evaluates the current landscape of cardiovascular PGx, identifying key gaps in research, clinical integration, and available resources; WG2 develops optimized guidelines for applying PGx in cardiovascular therapies, focusing on patient stratification based on genetic and demographic profiles; WG3 focuses on advancing digital and AI tools to improve PGx data analysis and implementation in clinical settings; WG4 analyzes regulatory frameworks across Europe, proposing policy changes to facilitate seamless integration of PGx into healthcare systems; WG5 handles communication, dissemination, and stakeholder engagement, ensuring that findings and guidelines are accessible to all stakeholders, including clinicians, researchers, and policymakers. By addressing these challenges, the network will help bridge the gap between PGx research and clinical practice, improving cardiovascular patient outcomes and promoting equitable healthcare access across Europe. This manuscript represents the COST Association-approved Memorandum of Understanding of COST Action CA24165 CardioPharmaGENET.

Summary Background Second-hand smoke (SHS) exposure remains a major source of morbidity and mortality among non-smokers. This study presents the first dedicated Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) publication to systematically quantify SHS prevalence and evaluate its effect as a global risk factor across a broader range of outcomes. Methods Using the GBD 2023 comparative risk assessment framework, we estimated SHS exposure prevalence and attributable disease burden across 204 countries and territories from 1990 to 2023, stratified by age and sex. Exposure estimates were derived by synthesising population-based surveys and household composition data through spatiotemporal Gaussian process regression. Relative risks for nine health outcomes, now including asthma, were estimated using the Burden of Proof methodology, and applied to calculate attributable deaths and disability-adjusted life-years (DALYs). Findings In 2023, an estimated 2·71 billion (95% UI 2·44–3·02) people worldwide were exposed to SHS, including 767 million (687–858) children aged 0–14 years. Age-standardised prevalence was highest in southeast Asia, east Asia, and Oceania (48·4% [44·0–53·4]), with female individuals in some countries experiencing nearly 1·8 times the exposure prevalence of male individuals. Despite a 22·2% (10·6–32·4) decline in global age-standardised prevalence since 1990, this progress has not been sufficient to reduce the absolute number of exposed individuals, which has remained stable globally and has risen sharply in sub-Saharan Africa (98·5% [62·0–144·4] increase) and North Africa and the Middle East (72·1% [47·8–101·8] increase). In 2023, SHS exposure accounted for 1·66 million (1·33–2·07) deaths and 44·8 million (35·8–54·3) DALYs globally. Ischaemic heart disease was the leading contributor to SHS-attributable DALYs (12·0 million [9·31–15·2]) overall, while lower respiratory infections predominated among children (5·16 million [3·48–7·12]). Interpretation We estimated that SHS remains a substantial driver of global health loss, particularly through cardiovascular and paediatric respiratory diseases. Persistent geographical disparities and growing absolute numbers of exposed individuals in several regions underscore the urgent need for accelerated implementation and enforcement of comprehensive tobacco control measures, particularly to protect women and children in both public and domestic environments. Funding Bloomberg Philanthropies and the Gates Foundation.

Simple Summary This paper presents a narrative review of the legal and policy framework for the use of animals in scientific procedures in Bosnia and Herzegovina, focusing on the 3Rs principles (Replacement, Reduction, Refinement). Although the country has made progress in aligning its laws with European standards, important gaps remain in practice, including limited national coordination, lack of detailed guidance, insufficient training, and limited support for alternative methods that do not use animals. The review highlights the need for stronger coordination, clearer rules, better training, and more investment in alternative methods to improve animal welfare and research quality. It also discusses policy options, such as enhanced regional cooperation and a potential joint centre to promote humane and modern research methods, which could help Bosnia and Herzegovina and neighbouring countries move closer to European standards. Overall, improving the ethical use of animals in research is important not only for animal protection, but also for scientific quality, reproducibility, and public trust.

A discrete, anomaly-free $\mathbb Z_9$ gauge symmetry may persist to the deep infrared, exactly forbidding proton decay. This $\mathbb Z_9$ can emerge from Higgsing a lepton-flavour non-universal $U(1)_X$ that generates realistic neutrino masses and mixings through a high-scale seesaw and predicts an additional light Goldstone. Adding an anomaly-free chiral heavy-quark sector turns this mode into the QCD axion. The same selection rules that ban proton decay also forbid PQ-violating operators below a suitably high dimension, $d_{\rm PQ}\gtrsim10$, including operators involving the heavy quarks that radiatively match onto the scalar potential. We construct explicit models viable when PQ breaking occurs before or after inflation; in the latter case, avoiding stable heavy relics and eliminating the string-wall network tightly constrain the heavy-quark spectrum. We identify restricted regions of parameter space where thermal leptogenesis remains viable and, for $d_{\rm PQ}\geq13$, can coexist with a high-quality axion constituting all of the dark matter.

Objective. To analyze the ethical, psychological, and social dimensions of contemporary aesthetic surgery, with particular emphasis on empathy in clinical decision-making, patient autonomy, body image disturbance, and the risks associated with unregulated practice. Narrative review. This manuscript is based on a qualitative narrative review of the literature in plastic surgery, bioethics, psychology, and public health, including professional guidance documents and selected epidemiological reports. Available evidence was examined through the core principles of medical ethics: beneficence, non-maleficence, autonomy, and justice. Aesthetic surgery increasingly operates at the intersection of medicine, consumer culture, and digitally mediated beauty ideals. The literature indicates that requests for aesthetic procedures may be shaped by social media exposure, unrealistic expectations, and, in some patients, body dysmorphic disorder or other psychological vulnerabilities. Ethical practice, therefore, requires empathic communication, careful assessment of indications, and willingness to decline procedures that are unlikely to benefit the patient. The growing presence of unlicensed providers further underlines the need for stronger regulation and public education. Conclusion. Aesthetic surgery should remain grounded in medical professionalism, with empathic ethical judgment, psychological vigilance, and patient safety at the center of care.

Background: Obesity is associated with impaired health-related quality of life, including reduced sexual satisfaction. Metabolic and bariatric surgery leads to substantial weight loss and favorable changes in body composition; however, its association with sexual satisfaction as a health-related outcome remains insufficiently explored. The aim of this study was to examine changes in body composition and sexual satisfaction six months following metabolic and bariatric surgery. Methods: This prospective study included 40 women with obesity who underwent metabolic and bariatric surgery performed according to standard clinical indications and multidisciplinary team recommendations. Body composition parameters were assessed using bioelectrical impedance analysis, and sexual satisfaction was evaluated using the New Sexual Satisfaction Scale at baseline and six months postoperatively. Changes in anthropometric, body composition, and sexual satisfaction measures were analyzed using nonparametric statistical tests. Results: Six months after surgery, significant changes were observed in body composition and sexual satisfaction. Median body weight decreased from 119.55 to 100.80 kg, BMI from 42.15 to 35.65 kg/m2, and visceral fat level from 14.50 to 11.00 (all p < 0.001). Although absolute skeletal muscle mass decreased significantly (28.40 to 26.30 kg, p < 0.001), its relative proportion increased (25.35% to 25.90%, p = 0.002). Median total NSSS score increased from 62.50 to 69.50, with significant improvements in both NSSS subscales (all p < 0.001). Conclusions: Metabolic and bariatric surgery was associated with significant improvements in body composition and sexual satisfaction six months postoperatively. These findings suggest that improvements in physical health following metabolic and bariatric surgery may be accompanied by enhancements in sexual well-being.

Emergency procedures are an important domain for safety education. Modern multimedia technologies aim to aid this process by replacing real‐life drills and hazard procedures with virtual simulations. However, there is a limited amount of existing research on this topic, especially focusing on the Western Balkans region. This paper presents a 3D virtual learning environment for emergency procedures in the form of a serious game. The virtual user manual uses the 2D fire evacuation plan of a university building in Ohrid, North Macedonia, for teaching civilians about multiple emergency procedures emergency exits, fire alarms, fire extinguishers, and wall hydrants. A case study was performed on 90 participants from Bosnia and Herzegovina and North Macedonia. Four different scenarios of interest were utilized, general knowledge about emergency procedures, emergency exit simulation, virtual user manual simulation, and emergency procedures involving a cultural heritage site. The achieved results indicate that participants are open to the usage of modern multimedia technologies, that familiarity with the presented location affects the success of learning, and that there is a strong potential for successful usage of virtual user manuals in the region of the Western Balkans in the future.

The paper examines how geometric design parameters affect crankshaft fracture due to fatigue using the finite element method. It explores the influence of the fillet radius on the crankpin journal, the shape of the grooves on the splined shaft, and their interaction on the crankshaft’s fatigue behavior. Using established material traits and operating load magnitudes, a finite element analysis (FEA) computational model of the crankshaft was created, and stress simulation was performed. Following the obtained results, critical points on the crankshaft were identified, followed by fatigue analysis and lifespan evaluation. Numerical simulations showed that increasing the fillet radius on the crankpin journal significantly reduces stress concentration and boosts the crankshaft’s fatigue life. Altering the geometry of the grooves on the splined shaft redistributes stress and moderately extends its lifespan. The best results came from combining both geometric changes, demonstrating the synergistic effect of optimizing design parameters. The findings provide numerical insight into the relationship between geometric features and fatigue behaviour of crankshafts and may support further research on geometry-based design optimization.