Center for Security Studies

To eradicate cervical cancer, the World Health Organization (WHO) targets 90% human papillomavirus (HPV) vaccination coverage in girls by the age of 15 until 2030. In Greece, data regarding how close the country is to meeting this target, is completely lacking. To assess annual HPV vaccination coverage among individuals aged 9-15years in Greece (2022-2024). This is a retrospective, population-based cohort study using the Greek National Electronic Prescription Database to record all HPV vaccine doses dispensed from 1/1/2019 to 31/12/2024. The annual vaccination coverage was estimated as the proportion of eligible population receiving at least one dose or the full vaccination scheme from January 1st, 2019, through December 31st of the respective reference year. Full vaccination scheme by age 15 was defined - according to national recommendations - as two doses at a minimum interval of 6months. From 2022 to 2024, the proportion of individuals 9-15years old, who appropriately initiated vaccination increased from 34.7% (2022) to 41.4% (2024) in girls and from 10.8% (2022) to 31.4% (2024) in boys. The proportion of children who initiate HPV vaccination at the age of 9, increased from 3.5% and 3.4% in 2022 to 8.0% and 7.4% in 2024 in girls and boys respectively. Among girls turning 15, appropriate vaccine initiation rate marginally exceeded 63.0% throughout the study period while full vaccination coverage increased from 47.7% in 2022 to almost 52.5% in 2024. Despite notable improvements in HPV vaccination uptake among adolescents in Greece between 2022 and 2024, coverage levels remain suboptimal relative to the WHO's 90% target. Limited early initiation despite national recommendations starting at age 9, highlight the need for targeted strategies to promote timely HPV vaccination and accelerate progress toward elimination goals.

During the past decade, major spacefaring nations have updated their space governance, establishing space forces and space commands now designed to address the evolving threat landscape in outer space. In parallel, the threat landscape has also evolved in cyberspace with a skyrocketing number of attacks coming from an increasingly diversified pool of actors, requiring governance changes authorizing the establishment of cyber forces and cyber commands. Both space and cyberspace are now increasingly recognized as warfighting domains and armed forces are conducting, or training to conduct, cyber-enabled space operations, which remain a new set of operations for which governance, operational modes, processes, and doctrines have to be adopted. The paper will aim at providing an overview of the governance of cyber-enabled operations in space and cyber commands and the challenges that these new missions face from the organizational perspective. First, the paper will provide case studies on the United States, the United Kingdom, Germany, and France, looking particularly into the governance, mandates and responsibilities regarding cyber operations. Then, the paper will analyze challenges and shortcomings associated with the establishment of responsibilities for cyber operations in Space and Cyber Commands. Finally, the paper will provide an overview of evolving governance issues and questions that will influence the roles such space cyber operations will assume in dynamically changing battlefield settings. • In France, Germany, and the United Kingdom, the entity responsible for the cyberdefense of space systems depends on the nature of the targeted system. • In the three analyzed European countries, cyber commands are responsible for the cyberdefense of space systems, while in the United States, the Space Force is. • The distribution of cyberdefense responsibilities is not always clear for space and cyber commands’ staff. • Cyber adversaries can exploit organizational confusion just as effectively as technical vulnerabilities. • Coordination and incident response mechanisms regarding cyber incidents on commercial satellites used by armed forces create new governance challenges.

The escalating threat of climate-driven wildfires, land abandonment, wildland–urban interface expansion, and inadequate forest management poses an existential challenge to Mediterranean oak ecosystems, for which traditional fire suppression has proven insufficient. This paper presents a combination of integrated fire management (IFM) and closer-to-nature forest management (CTNFM) in a representative mixed Pyrenean oak (Quercus pyrenaica) forest at Quinta da França (QF), in Portugal. It is structured around three main objectives designed to evaluate this pioneer integrated approach: (1) to describe the integration of IFM and CTNFM within an agro-silvo-pastoral landscape; (2) to qualitatively assess its ecological, operational, and socio-economic outcomes; and (3) to quantitatively evaluate the effectiveness of two key nature-based solutions (NbSs), that is, prescribed burning and planned grazing, in reducing wildfire risk and enhancing forest resilience and biodiversity. By strategically combining proactive fuel reduction with biodiversity-oriented silviculture, the QF case provides a replicable model for managing analogous Mediterranean forested areas facing similar risks. This integrated approach supports forest multifunctionality, advancing both prevention and adaptation goals, and directly contributes to the ambitious targets set by the European Union’s New Forest and Biodiversity Strategies for 2030, marking a significant step towards a more sustainable and fire-resilient future for such Mediterranean landscapes.

Multiple parameters define the treatment course with biologics for a psoriatic patient while treatment switches are often associated with worse prognosis. The purpose of this study was to describe the switching patterns of biologics for psoriasis in the Greek market landscape and to detect associated factors that may impact the evolvement of selected therapy. This is a retrospective cohort study using data recorded in the nationwide digital prescription database of Greece. Patients with a diagnosis for psoriasis, with or without concomitant psoriatic arthritis (PsA), who had initiated a biologic treatment between January 1st 2016 and December 31st 2020 were included. Overall, 6,772 biologic-naïve patients were included. Patients treated with infliximab demonstrated the highest switching rates while those treated with ustekinumab and secukinumab the lowest. Secukinumab and brodalumab had the lowest rates of switch or re-initiation 12 months after initiation. Switches from secukinumab to brodalumab and ustekinumab and from adalimumab to secukinumab and ustekinumab were more frequently observed. The risk was significantly higher for patients with concurrent PsA and for women, while patients treated with brodalumab, secukinumab and ustekinumab demonstrated a lower risk compared to adalimumab. Antibodies against interleukins have lower switching rates compared to more traditional biologics. The time to switch is longer for the first transition highlighting the necessity to establish long term therapeutic options early in the treatment course. Concurrent PsA or gender may have a significant impact in outcome, thus they need to be considered before the launch of a selected therapy.

The Pakistan-Bangladesh bilateral relationship has long been overshadowed by historical legacies, particularly the event of 1971, shaping mutual perceptions and foreign policy orientations. However, the political transformation in Bangladesh following the ousting of Sheikh Hasina in August 2024 has opened new avenues for recalibrating ties. This paper centres on three core research questions: i. How emerging economic, political, and security interests are redefining Pakistan-Bangladesh engagement?; ii. How Bangladesh’s evolving relationship with India is influencing Dhaka’s recalibration toward Islamabad?; and iii. What structural and political impediments continue to constrain the institutionalisation of a durable partnership between Dhaka and Islamabad? Employing a qualitative research methodology, including document analysis, case studies, and expert interviews, the paper underscores the necessity of institutionalising economic partnerships, minilateral frameworks, and strategic security coordination between Bangladesh and Pakistan.

Robotic modernisation lies at the forefront of military innovations that are transforming the character of warfare in contemporary times. In particular, the growing autonomy and AI augmentation in military robots could substantially alter the traditional conduct of warfare. This paper primarily evaluates the development, testing and deployment of Unmanned Ground Vehicles (UGVs) and Unmanned Underwater Vehicles (UUVs) being undertaken by the US and Chinese militaries. The rising autonomous capability of these robots could transform the character of warfare and, in turn, significantly augment military capabilities through greater force multiplication, enhanced precision and reduced risk to human soldiers. Nevertheless, these transformations could lead to the robotic arms race that might significantly amplify security dilemma among great powers and, in turn, raise the likelihood of a full-fledged conflict. Additionally, the robotic transformations and growing autonomy in warfare cause ethical concerns in terms of dehumanisation of warfare, erosion of accountability and unpredictability associated with AI’s black box problem. Lastly, the paper offers a set of pragmatic measures that could minimise the downsides of military robots while advocating human-in-the-loop model.

Abstract This research paper introduces the LAW-GAME project, an innovative initiative aimed at improving law enforcement professional training using gamification technologies. LAW-GAME’s primary goal is to bridge the theoretical knowledge and practical application gap by immersing police officers in a safe and controlled virtual environment. LAW-GAME is made up of four distinct “mini games,” each of which is designed to train and evaluate police officers in critical areas of law enforcement. Within an immersive virtual environment, these modules provide comprehensive training on forensic examination, evidence collection, crime scene analysis, communication, persuasion, negotiation, counterterrorism strategies, intelligence gathering, car accident scene investigation, evidence handling, and interviewing techniques. Furthermore, LAW-GAME’s architecture incorporates cutting-edge technologies such as virtual reality devices for real-time communication and advanced artificial intelligence techniques to create an immersive and effective training platform. In addition, the paper describes the user’s journey through the LAW-GAME ecosystem, emphasizing the seamless integration of training content, immersive simulations, and real-time feedback. The user’s progress is constantly monitored, assisting in skill development and knowledge expansion. In conclusion, the LAW-GAME project represents a significant advancement in law enforcement training, addressing the growing complexities of criminal activities in the European Union. LAW-GAME equips officers with the essential competencies required to combat modern challenges by leveraging gamification and AI-assisted procedures.

Abstract The ProSPeReS project is aimed toward developing a protection system for places of worship against man-made threats while moving beyond sole conventional technical security measures and preserving a balance between the security of places of worship (PWs) and their open nature. The basis of this endeavor and simultaneously an essential element for informed decision-making with respect to the protection of PWs, is a risk-based approach applied through vulnerability assessment (VA). During the project, various VAs were undertaken for selected PWs, entailing site surveys and in situ VA workshops with the participation of the sites’ personnel, competent local authorities, and first responders. The results of the VAs performed during the project, revealed gaps not only related to technical security measures but also security culture, awareness, involvement, and training of PW staff regarding security procedures, and finally, the lack of cooperation and information exchange among stakeholders in general. These gaps, combined with the inherent traits of PWs such as their open nature, high concentration of people, and their symbolic/cultural value, result in them being soft targets, vulnerable to various potential man-made threats.