Abstract: Background/Objectives: Rates of postoperative recurrence of varicose veins range from 7% to 62%. We analyzed factors associated with recurrent varicose veins (RVVs) of the lower extremities after interventional treatment. Methods: We enrolled 99 patients (114 lower extremities) with RVVs admitted from January 2018 to June 2025 (71 women, 76 limbs; 28 men, 31 limbs; average age (SD) 63.9 (9.8) years). Duplex ultrasound scanning, magnetic resonance venography, or computed tomography venography were performed. The presence of a residual great saphenous vein, primary deep venous valve insufficiency, incompetent perforating veins, and iliac vein stenosis were recorded. We analyzed the charts of patients who underwent operations for recurrent varicose veins for associated factors. Results: We recorded residual trunk of the great saphenous vein in 55 limbs (48.3%), deep venous valve insufficiency in 47 (41.2%), incompetent perforating veins in 7 (6.1%), anterior accessory saphenous vein insufficiency in 2 (1.8%), and small saphenous vein insufficiency in 2 (1.8%). Iliofemoral venography indicated 31 limbs (27.2%; left lower, 24; right lower, 7) with a nonthrombotic iliac vein compression lesion. After identifying associated factors, retreatments—high ligation and stripping of the great saphenous vein or iliac vein stent implantation or small saphenous vein dissection ligation and stripping—were performed. The venous clinical severity score was 7 (interquartile range, 5–10) on admission and 3 (interquartile range, 2–4) 3 months after discharge.Conclusions: RVVs are associated with multiple factors, including inadequate initial surgical techniques, nonthrombotic iliac vein compression lesions, deep venous valve insufficiency, small saphenous vein insufficiency, and incompetent perforating veins. Performing detailed imaging before retreatment is essential to identify factors associated with RVVs and prevent recurrence.

Abstract: Numerous metrics, like as visitor numbers, tourism net profit, and hotel occupancy rates, are included in the dataset, which covers 77 provinces. A baseline-based concept of shock-recovery is introduced to measure the impact and the different recovery paths in different regions. Recurrent neural networks incorporate engineered elements that capture seasonality, trend dynamics, shock strength, volatility, and recovery tim-ing. Importantly, latent spatial heterogeneity and cross-regional dependencies are learned inside a single architecture by integrating province-level spatiotemporal em-beddings. To jointly forecast tourism demand and net profit, models called Long Short-Term Memory (LSTM) and Gated Recurrent Unit (GRU) are created. Using a time-preserving evaluation technique, model performance is assessed against statisti-cal time-series baselines and XGBoost. In early 2020, the results show a structural break that exceeded the 95% decline, along with significantly unequal recovery pat-terns. By roughly 22-28% in RMSE and 14-16% in MAPE, the suggested deep learning models surpass baselines, exhibiting superior ability to capture spatial heterogeneity and nonlinear recovery dynamics.

Abstract: Corporate governance reforms in emerging and frontier markets frequently assume that strengthening board oversight, audit committees, and ownership monitoring will improve audit quality and enhance firm value. Yet, in weak institutional environments, these mechanisms often function symbolically rather than substantively. This study rethinks the governance–audit–value nexus by integrating Agency Theory, Institutional Theory, and the concept of symbolic governance to explain why governance may appear structurally robust while failing to constrain managerial discretion. Using panel data from Ghanaian listed firms between 2015 and 2023, the analysis shows that audit committee independence and board independence are negatively associated with both audit quality and firm value, indicating that formal independence without expertise, authority, or enforcement capacity does not translate into meaningful oversight. By contrast, institutional and managerial ownership positively influence both outcomes, suggesting that incentive alignment and informed monitoring can substitute for weak formal governance. Foreign ownership improves firm value but does not consistently enhance audit quality, while macroeconomic conditions such as inflation and GDP growth further shape firm performance. The study advances the literature by reconceptualising governance effectiveness in weak institutional environments, demonstrating that governance mechanisms may exist in form without functioning in substance. The findings underscore the need for governance reforms that prioritise enforcement capacity, board expertise, and audit committee competence rather than structural compliance alone.

Abstract: This paper introduces a novel theoretical framework for classifying Autonomous Mobile Robots (AMRs) into three hierarchical layers: Perception, Cognition, and Operation. Unlike prior hardware-centric taxonomies, our approach, grounded in a structured review of seminal works, foundational methodologies, and state-of-the-art advances, explicitly integrates locomotion mechanisms (wheeled, legged), application domains (industrial, agricultural), and autonomy levels with navigation strategies. The framework unifies terrestrial navigation techniques into a cohesive taxonomy, clarifying modular boundaries and interdependencies. Serving as both a conceptual guide and educational tool, it empowers researchers to evaluate trade-offs in sensor configurations, decision-making algorithms, and trajectory execution under real-world constraints. A comparative analysis positions this framework against established navigation architectures, highlighting its role as a high-level reference design for modular implementations. By bridging theoretical principles with system optimization, the framework enhances interoperability across robotic platforms. Ultimately, this work delivers a practical design atlas, structuring the end-to-end pipeline of autonomous navigation to guide researchers and practitioners in selecting algorithms suited to their specific robotic platforms and mission requirements.

Abstract: Objective: To identify the clinical effectiveness of laser photobiomodulation in the treatment of orofacial paresthesia in a public university clinic in Northeast Brazil. Methods: A retrospective, observational study was conducted using secondary data from 125 patients treated at the Biophotonics Center of the Faculty of Dentistry of the Federal University of Bahia from 2003 to 2019 with a confirmed diagnosis of orofacial paresthesia. Data collection included the sociodemographic profile, clinical and dental history, and the patients' main complaint. The therapeutic protocol employed an infrared diode laser (λ 700–808 nm), in continuous mode, with applications every 48 hours, totaling 12 individualized sessions. Nerve sensitivity was measured in each session using the Visual Analogue Scale (VAS), with pain reduction and movement considered as response variables. The data were analyzed, and the study was approved by the ethics committee of FOUFBA (protocol 60327516500005024). Results: Tooth extraction was identified as the main etiological factor of paresthesia (60%), with an average of three treatment cycles per patient. At the end of the intervention, 67% of individuals achieved satisfactory results, with significant clinical improvement or total remission of symptoms. Cases resulting from orthognathic surgery required higher cyclic doses, although no statistically significant difference was found between dosage and clinical outcome. Laser photobiomodulation proved to be an effective and viable therapeutic modality for sensory recovery and management of orofacial paresthesias.

Abstract: Industrial effluents contaminated with heavy metals are a major environmental issue, prompting the need for sustainable bioremediation methods. Microbially induced calcium carbonate precipitation (MICP) is a remediation method that offers a long-term solution for enhancing soil mechanical properties, as well as reducing pollution from heavy metals. The objectives of the current study include screening and identifying native ureolytic bacteria from soil in Karad, as well as assessing calcite precipitation by ureolytic metallotolerant bacteria. The effectiveness of the isolated bacteria in removing lead as a heavy metal was tested in the medium. This research focuses on the removal of Pb heavy metal by using the MICP method. Samples of wastewater were taken from calcareous soils and effluents contaminated with heavy metals. Ureolytic bacteria were identified using urea agar medium, and nine positive isolates were obtained by using Christensen’s media. Ureolytic isolates were then screened for their tolerance to metal Pb²⁺ as well as calcium precipitation. The maximum tolerance ranged from 2 mM to 8 mM, depending on the metal ion. The potential isolate was identified through 16S rRNA gene sequencing. Lysinibacillus fusiformis was recognized as a urease-producing, metallotolerant bacterium with calcium precipitating. By using Lysinibacillus fusiformis, 85 % of the lead was removed. This is to evaluate Lysinibacillus-mediated MICP for Pb bioremediation from under environmentally relevant conditions, treated for real wastewater applications.”

Abstract: Sodium-ion batteries (SIBs) have emerged as one of the most promising alternatives to lithium-ion systems, driven by the abundance and low cost of sodium resources as well as the urgent demand for sustainable large-scale energy storage. In recent years, re-markable advances have been achieved in electrode materials, electrolytes, and inter-facial engineering, which have significantly improved the electrochemical performance of SIBs. Hard carbons and alloy-type anodes have shown encouraging progress in balancing capacity and stability, while layered oxides, polyanionic compounds, and Prussian blue analogues are leading candidates for cathodes due to their structural diversity and tunable redox properties. Concurrently, the development of advanced liquid and solid electro-lytes, together with strategies to control the solid–electrolyte interphase (SEI) and cathode–electrolyte interphase (CEI), is enhancing safety and long-term cycling. Despite these achievements, critical challenges remain, including limited energy density, volumetric expansion in alloying anodes, interfacial instability, and scalability issues. This review provides a comprehensive overview of the fundamental principles, recent material in-novations, and failure mechanisms of SIBs, and highlights the current status of industrial progress led by companies such as Faradion, HiNa Battery, CATL, and Tiamat. Finally, future perspectives are discussed, emphasizing the role of sodium-ion technology in grid-scale storage, renewable energy integration, and sustainable battery recycling. By bridging academic advances and industrial development, this article outlines the roadmap toward the commercialization of sodium-ion batteries.

Abstract: The environmental impacts from fossil fuel use have accelerated the global transition to sustainable energy sources. Hydrogen has become a promising alternative due to its high energy density and clean combustion. However, hydrogen production streams are frequently contaminated with methane, which needs efficient, durable, and cost-effective purification technologies such as Pressure Swing Adsorption (PSA). The present study provides a comparative evaluation of biomass-derived activated carbons and a commercial activated carbon for hydrogen–methane separation. High surface-area activated carbons were synthesized from sustainable pine and birch precursors via chemical activation using potassium hydroxide (KOH, impregnation ra-tio 3:1) at 800 °C. Their adsorption performance was systematically assessed in a fixed-bed PSA system operating at pressures of 25, 35, and 50 bar, with a gas mixture of hydrogen-methane, where methane feed concentrations was ranging from 10 to 30 vol%. The biomass-derived activated carbons showed well-developed textural characteristics, with specific surface areas up to 1416 m² g⁻¹, exceeding that of the commercial reference material (1023 m² g⁻¹). This improved pore structure was reflected in their adsorption behavior at an operating pressure of 50 bar, the birch-derived carbon achieved a me-thane uptake of 10.5 mol kg⁻¹, more than twice the capacity measured for the commercial adsorbent of 5.30 mol kg⁻¹. Beyond initial adsorption capacity, the study emphasizes operational durability and reusability. Cyclic adsorption–desorption experiments, supported by Raman spectroscopy, revealed pronounced structural degradation in the commercial activated carbon under repeated operational stress, as indicated by an increase in the ID/IG ratio from 1.08 to 1.24. In contrast, the biomass-derived activated carbons preserved their morphological integrity and adsorp-tion efficiency over successive cycles. These findings demonstrate that pine- and birch-derived activated carbons are not only sustainable alternatives but also operationally stable adsorbents capable for hydrogen purification pro-cesses.

Abstract: What if a court verdict could never be altered---not today, not tomorrow, and not even in the age of quantum computers? This paper introduces \textbf{TRUST-Court}, a next-generation digital judiciary framework that makes court records \textbf{tamper-proof, transparent, and quantum-secure}. Every participant in a case---plaintiff, defendant, lawyer, and judge---receives a verified digital identity and signs court proceedings using \textbf{post-quantum cryptographic algorithms standardized by NIST in 2024}. Hearings are transcribed in real time, digitally signed by all parties, and permanently sealed using multi-layer cryptographic protection before being anchored to a blockchain for public verification.The system integrates permissioned blockchain infrastructure (Hyperledger Fabric), public verification anchoring (Polygon), and post-quantum cryptographic primitives including \textbf{ML-DSA, ML-KEM, SLH-DSA, SHA-3, and AES-256}. To address the large data sizes of post-quantum signatures, we introduce practical storage optimization techniques such as Merkle-tree batching, signature aggregation, and archival compression, achieving \textbf{60--80\% storage reduction} while preserving security guarantees. Through case studies from the United States, India, and Ireland, TRUST-Court demonstrates how judicial records can become mathematically verifiable public artifacts. By preventing document tampering, eliminating transcript disputes, and enabling citizen-level verification of verdicts, the framework offers a pathway toward a judiciary where \textbf{truth, once recorded, becomes permanently unalterable}.

Abstract: Nerolidol (NER) is a sesquiterpene alcohol with recognized antimicrobial potential, whose applications as pure substance are limited by hydrophobicity, instability, and cytotoxicity. Invasomes, i.e. liposomes with terpene ingredients, offer a strategy to improve its delivery; however, the NER loading limits compatible with vesicle integrity are still unclear. Here, Nerolidol-loaded invasomes were produced using a controlled simil-microfluidic coaxial injection process. As a preliminary step, unloaded liposomes were fabricated to consolidate operating conditions and ensure their reproducible colloidal properties. Thereafter, formulations with progressively decreasing nominal NER loads were investigated to evaluate vesicle size, polydispersity, ζ-potential, encapsulation efficiency, effective loading, and stability. High nominal loads promoted turbidity, size increase (by agglomeration coalescence phenomena), and structural instability, whereas formulations containing approximately 1–2% NER achieved nearly complete encapsulation, Z-average ≈ 300 nm, |ζ| > 30 mV, and satisfactory physical stability. Antimicrobial and cytotoxic profiles of representative formulations, previously evaluated in an independent study, confirmed biological activity. Overall, this work identifies a realistic loading window for Nerolidol invasomes and highlights the suitability of the simil-microfluidic approach to obtain scalable, well-controlled formulations, providing a rational basis for their future biological assessment. Nerolidol invasomes systems indeed can be considered a promising versatile platform for antimicrobial applications, including prospective use in animal feed.

Abstract: Surface ozone monitoring remains challenging due to sparse ground networks and limited satellite boundary-layer sensitivity. This study evaluates, for the first time, China's Environmental Trace Gases Monitoring Instrument II (EMI-II) for estimating surface ozone over the Beijing–Tianjin–Hebei (BTH) region. EMI-II total ozone columns (TOCs) are retrieved using the differential optical absorption spectroscopy (DOAS) algorithm and validated against the TROPOspheric Monitoring Instrument (TROPOMI) (R = 0.96), Geostationary Environment Monitoring Spectrometer (GEMS) (R = 0.97), and the World Ozone and Ultraviolet Radiation Data Centre (WOUDC) ground measurements (R > 0.92, bias < 4%). TOCs are then combined with ERA5 meteorology, satellite NO2/HCHO, and surface observations within machine learning models, achieving cross-validated R2 of 0.94 and RMSE of 12.29 μg/m3 for surface ozone estimation. EMI-II estimates show strong agreement with independent observations (R = 0.97, RMSE = 10.05 μg/m3) and reproduce seasonal gradients, with summer concentrations (130 μg/m3) more than double winter levels (59 μg/m3). Estimation skill is regime-dependent: performance comparable to TROPOMI occurs under strong photochemical activity, while reduced sensitivity occurs under weak radiation and stable boundary layers—consistent with averaging kernel diagnostics. This first comprehensive validation demonstrates that EMI-II, despite vertical sensitivity limitations, provides meaningful surface ozone constraints under favorable atmospheric conditions. The framework is transferable to other regions and sensors, supporting broader applications of national satellite assets in air pollution monitoring.

Abstract: Background Betahistine is widely used in the symptomatic treatment of vestibular vertigo and Ménière-related disorders, and therapeutic benefit depends on how rapidly effective drug levels become available after administration. Conventional tablets rely on gastric disintegration and dissolution prior to absorption. Orodispersible tablets (ODTs) disperse in the oral cavity and may enable earlier drug uptake and improved systemic availability. This study investigated whether a betahistine ODT provides faster drug availability, greater absorption, and improved bioavailability-related performance compared with a conventional tablet using a mechanistic in vitro evaluation. Methods Betahistine ODT and conventional immediate-release tablets containing the same labeled dose were evaluated in a sequential physiological model. Oral cavity performance was assessed in artificial saliva by measuring disintegration time, wetting behavior, and early drug release during the first 15 minutes. A two-stage gastric-to-intestinal pH transition model was applied to determine the fraction of drug remaining dissolved and immediately available for absorption. Pre-gastric uptake was evaluated using porcine buccal mucosa mounted in Franz diffusion cells by measuring drug transport across the tissue over time. Intestinal epithelial transfer was examined using polarized epithelial monolayers, and cumulative drug transport was quantified. Plasma protein binding and drug stability were evaluated in saliva, gastric, and intestinal media to exclude differences related to degradation or binding. Results The ODT disintegrated rapidly in artificial saliva (24.8 ± 6.1 s) compared with the conventional tablet (412 ± 95 s, p < 0.001). Rapid dispersion produced markedly faster release; within 10 minutes 82.7 ± 6.4% of the dose was released from the ODT versus 21.5 ± 7.2% from the conventional tablet (p < 0.001). After transition to intestinal conditions, the dissolved fraction available for absorption at 30 minutes was 88.5 ± 7.2% for the ODT and 54.2 ± 9.8% for the conventional tablet (p < 0.001). Buccal permeation was substantially higher with the ODT, showing greater flux (8.1 ± 1.4 vs 2.7 ± 0.9 μg/cm²/h, p < 0.001) and shorter lag time (12.4 ± 4.2 vs 28.7 ± 6.8 min, p < 0.001). Intestinal epithelial permeability was similar between formulations; however, cumulative transported drug at 120 minutes was greater for the ODT (486 ± 88 ng vs 312 ± 74 ng, p = 0.004). Plasma protein binding and chemical stability were comparable in all media. Conclusion Betahistine orodispersible tablets produced immediate oral dispersion, a larger early dissolved fraction, and earlier mucosal uptake, resulting in greater epithelial transfer despite unchanged intrinsic permeability. The findings demonstrate faster drug availability, enhanced absorption, and improved bioavailability-related performance compared with conventional tablets. Reduced gastric residence and partial pre-gastric uptake further suggest a potential improvement in gastrointestinal tolerability together with a faster onset of therapeutic action.

Abstract: Introduction: Bodybuilding is fundamentally influenced by biomechanical efficiency, which plays a crucial role in optimizing muscular development and minimizing the risk of injury. Despite its widespread significance, the systematic integration of biomechanical principles in bodybuilding practice remains insufficiently explored, especially within emerging fitness communities. Objective: The primary aim of this systematic review is to synthesize current scientific evidence regarding the biomechanical principles that underpin effective bodybuilding techniques. The review seeks to identify key mechanical factors that influence performance outcomes and to propose practical recommendations for enhancing training efficacy and athlete safety. Methodology: A comprehensive analysis of 23 peer-reviewed studies was conducted, focusing on the relationship between biomechanical variables such as joint angles, body alignment, and load application and their effects on muscle recruitment and strength enhancement. The studies were selected based on relevance, methodological quality, and contribution to applied bodybuilding biomechanics. Results: The findings indicate that precise manipulation of joint positioning, optimized load distribution, and correct body posture significantly improve muscle activation and strength development. These elements, when systematically applied, contribute to greater training efficiency and reduced injury incidence. Discussion: The outcomes of this review corroborate existing literature in sports science, while offering bodybuilding-specific insights that address a notable research gap. The contextual relevance to Albania further underscores the need for biomechanical education in evolving fitness sectors.Conclusions: Incorporating biomechanical principles into bodybuilding training can substantially improve performance, safety, and long-term health outcomes. Future research should pursue longitudinal and intervention-based studies to further validate these findings and inform practice.

Abstract: Concern is expressed in Australia about a group of children called dual-involved children. Dual-involved children live in families who are described as having multiple and complex needs, where a child is referred first to a child protection court and later to a juvenile justice court as the child has committed offences. One concern is that these families and children commonly do not receive early intervention therapy. Method. The article provides a rapid review of research relevant to early intervention for children with increased likelihood of developing a mental disorder and offending. Results. Sixteen psychological models of child development are identified that have generated research and evidence about child development trajectories that are relevant to provision of early therapy to meet needs of children who are vulnerable to developing a mental disorder and becoming a dual-involved child. The review summarises effect sizes associated with each model. Cohorts of children who follow trajectories of aggressive behaviour are one focus. Conclusion. The review concludes there is a need for targeted therapy interventions for parents of vulnerable children using a systemic approach to supplement universal parenting interventions. Topics for further research are identified, including a need for research into how therapists who use a systemic approach might practice in ways that avoid ethical dilemmas that arise when working with two members of one family.

Abstract: In this paper, we construct a probabilistic model of a sliding mode. This model is based on the moment a random walk with positive jumps crosses a certain critical level. It is assumed that the jump magnitude has a geometric distribution. If the initial state is negative and the critical level is zero, then after crossing this level, a random walk begins in the opposite direction until it crosses zero again. As a result, motion orthogonal to the slip line is defined as a regenerative process, in which the moments of regeneration are the moments of zero crossings from right to left. An estimate of the Qi Fan metric of the maximum deviation of this random walk over a certain time interval is constructed under the assumption that the time and magnitude of the jumps are reduced by a factor of m. This estimate is found to be of the order of lnm/m as m→∞ and characterizes the deviation of a random trajectory orthogonal to the slip line. In the model of motion along a slip line, its velocity is assumed to assume fixed values when the trajectory of motion orthogonal to the slip line is above or below zero. Using the central limit theorem for the integral of a regenerative process, an estimate of the non-uniformity of motion of a random trajectory along the slip line is constructed. It is found that the characteristic magnitude of this non-uniformity is of the order of 1/m as m→∞. This indicates that the accumulation of random errors during motion along the slip line is significantly faster than during motion orthogonal to the slip line.

Abstract: Reactive oxygen species are essential signalling molecules that regulate numerous aspects of skeletal muscle physiology. These effects are mediated through redox post-translational modifications on protein cysteine thiols, which influence the structure and function of redox-sensitive proteins. Mass spectrometry–based redox proteomic approaches have greatly advanced our ability to detect and characterise cysteine redox modifications, revealing a broad network of redox-sensitive proteins and pathways in skeletal muscle. Recent methodological developments enable quantification of the stoichiometry of reversible oxidative modifications at specific cysteine residues, providing critical insight into the extent and functional relevance of site-specific redox regulation. Redox proteomic approaches are being employed to improve our understanding of the specific redox protein modifications underlying physiological and pathophysiological processes in skeletal muscle. This review summarises current proteomic strategies for quantifying redox post-translational modifications and their application to study redox signalling in skeletal muscle. Emerging experimental approaches that offer the potential to study the specific roles of site-specific redox modifications in muscle physiology are also discussed. Collectively, these technologies present exciting opportunities to define the mechanistic roles of individual cysteine residues in muscle biology and help uncover new therapeutic avenues for conditions characterised by impaired redox homeostasis.

Abstract: This review explores the catalytic conversion of carbon dioxide (CO2) into glycerol carbonate (GC), positioning this pathway as a sustainable strategy that couples environmental mitigation with the valorization of surplus glycerol from biodiesel production. Glycerol carbonate maintains extensive industrial utility as a green solvent, chemical intermediate, and functional component in polymers, cosmetics, and packaging. Distinct from prior literature, this study systematically integrates the evaluation of catalysts derived from agro-industrial waste and hybrid catalytic systems, correlating their structural architectures with catalytic efficiency. The review evaluates diverse catalytic frameworks, with a primary focus on heterogeneous systems. Silica-based materials are highlighted, particularly those synthesized from rice husk ash, an abundant amorphous silica source. The sol–gel method is identified as a robust route for engineering porous matrices with high surface areas and tunable structural properties. Furthermore, the doping of silica with metal oxides, such as niobium oxide (Nb2O5) and nickel oxide (NiO), is discussed as a strategic approach to introduce synergistic acid–base sites and redox properties that facilitate CO2 activation. The integration of ionic liquids into hybrid systems is also examined as a promising frontier to enhance reaction kinetics and selectivity. Finally, this review delineates the nexus between agro-industrial waste management and the reduction of greenhouse gas emissions, proposing a circular economy framework for the biodiesel value chain.

Abstract: Yellow fever remains a major public health threat in endemic and re-emerging regions of Africa and South America, with recent outbreaks highlighting persistent gaps in prevention and surveillance. Pregnant women represent a particularly vulnerable population, yet the epidemiology, clinical impact, and preventive strategies for yellow fever in pregnancy are insufficiently characterized. Physiological and immunological changes during gestation may increase susceptibility to severe disease and contribute to adverse maternal and fetal outcomes, including miscarriage, stillbirth, preterm birth, and, in rare cases, perinatal transmission. Diagnostic challenges, overlapping clinical presentations with other arboviral and hepatic diseases, and limited access to specialized care further complicate clinical management in many endemic settings. This perspective provides a comprehensive overview of yellow fever in pregnancy during the 2024–2026 outbreak in the Americas, including a risk-stratification framework for prevention. We summarize current evidence on epidemiology, pathophysiology, diagnosis, and supportive care, and examine prevention strategies with particular emphasis on vaccination. Accumulated observational evidence and substantial real-world experience have not demonstrated an increased risk of serious adverse events and generally support the effectiveness of yellow fever vaccination during pregnancy when administered with appropriate clinical judgment. In high-risk settings, the benefits of maternal immunization clearly outweigh theoretical concerns, supporting a flexible, risk-based approach, despite relatively limited evidence. We also discuss national and international policies, post-pregnancy booster recommendations, and the importance of integrating vaccination assessment into antenatal care. Finally, we highlight critical knowledge gaps and research priorities, including the need for prospective registries and strengthened pharmacovigilance. Coordinated clinical and public health strategies are essential to protect maternal and neonatal health and to reduce the burden of yellow fever in endemic and re-emerging settings.

Abstract: Background/Objective: Nurses play a central role in operationalizing integration through coordination, screening, nursing care processes, community empowerment, and reporting. This study to examine the empirical distribution of an Implementation Fidelity Index (IFI) for nurse-led integrated primary care in Indonesia, grounded in five core domains: planning and coordination, early detection, nursing care processes, community education and empowerment, and reporting. Methods: We conducted a cross-sectional, facility-based online survey in 2025 among registered nurses working in Indonesian primary health care facilities (Puskesmas) and involved in integrated primary care activities. Implementation was measured using a structured 28-item questionnaire across five domains: planning/coordination, early detection, nursing care processes, community education/empowerment, and reporting (Likert 1–5). Domain scores were calculated as the mean of items within each domain; the overall Implementation IFI was calculated as the mean across all items and as the summed total score (range 28–140). We summarized domain and overall distributions (mean, SD, range) and examined inter-domain associations using Spearman correlations. Results: A total of 252 nurses completed the survey with no missing item responses. Overall IFI (item-mean) was 3.99 (SD 0.92; range 1.04–5.00), corresponding to a total score mean of 111.84 (SD 25.90; range 29–140). Domain means were highest for nursing care processes (4.28, SD 0.91) and early detection (4.09, SD 0.94), and lowest for community education/empowerment (3.75, SD 1.10). Using mean ±1 SD thresholds, 12.3% of nurses were categorized as low implementers, 71.8% moderate, and 15.9% high, indicating substantial heterogeneity. Inter-domain correlations were consistently positive and moderate-to-strong (ρ≈0.54–0.80; p&lt;0.001). Conclusions: Nurse-led integrated primary care implementation in Indonesia was moderate-to-high overall but uneven across nurses and domains, with comparatively weaker performance in community empowerment and reporting.

Abstract: The peroxisome proliferator-activated receptor alpha (PPARα) is a ligand-activated nuclear transcription factor belonging to the nuclear receptor superfamily. Although classically characterised as the master regulator of hepatic fatty acid oxidation (FAO) and lipid catabolism, accumulating evidence positions PPARα as an indispensable molecular conductor at the feto-maternal interface. Within the human placenta, PPARα is expressed in both cytotrophoblast and syncytiotrophoblast layers throughout gestation, where it governs mitochondrial and peroxisomal β-oxidation, orchestrates pro-resolution inflammatory signalling, modulates trophoblast differentiation and invasion, and participates in epigenetic programming of the developing fetus. Derangements of placental PPARα activity are increasingly identified in major obstetric complications, including preeclampsia, gestational diabetes mellitus, and intrauterine growth restriction, where aberrant lipid accumulation, heightened oxidative stress, and amplified pro-inflammatory cytokine signalling converge. This review synthesises current knowledge on the molecular biology and genomic targets of PPARα in the placenta, its integration with maternal metabolic adaptations of pregnancy, its role in nutrient sensing and fetal programming, and the consequences of its dysregulation in pregnancy pathology. We further discuss emerging therapeutic implications of PPARα modulation and outstanding questions in this rapidly evolving field.