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I know a doctor who's been running a research project since the 90s using a database application with a proprietary format. Said doctor had the option of upgrading to a version which was a front-end to Excel in the 00's... but didn't... and then the company sold their product to Microsoft and closed down, taking their format conversion app with them.
I also know a test lab using a blood gas analyser running off a built-in Windows NT PC. Those things cost an arm and a leg, so they'll keep running it until it dies and replace it with something more modern.
Frankly I'd trust windows XP over w10/11 for an offline system that is used for only one thing and one thing only
Until the hardware breaks and you can’t find refinements.
Edit: replacements, bloody autocorrect!