Institute for Security Studies

Introduction: Neighborhood socioeconomic status is a key determinant of geographical disparities in life expectancy within countries. These disparities can influence a community’s disaster resilience and are critical factors to consider in disaster management. However, previous studies on this topic have not adequately accounted for spatial spillover effects, where the conditions in one region may impact neighboring areas. This study aimed to examine the association between neighborhood socioeconomic factors and life expectancy in Japanese municipalities, explicitly considering spatial spillover effects. Findings from this study could inform the development of regional indicators of disaster resilience from a socioeconomic perspective. Methods: This cross-sectional ecological study analyzed 1,732 Japanese municipalities, with life expectancy as the outcome variable and ten socioeconomic factors plus two control variables as explanatory variables. Moran’s I was first calculated for the residuals of the linear regression model to examine the presence of spatial dependency. The Spatial Durbin Error Model was then applied to identify both direct effects within a municipality and spillover effects from adjacent areas. Results: Moran’s I for the linear regression model was statistically significant, indicating the presence of spatial dependency. Unemployment and education levels showed spillover effects in the same direction as their direct effects, suggesting that improved conditions in one area are associated with increased life expectancy in neighboring areas as well. Conversely, taxable income showed a negative spillover effect for females, suggesting that improvements in income level in neighboring areas might contribute to adverse social or psychological impacts. Conclusion: The study demonstrated the need to consider spatial spillover effects of socioeconomic factors from neighboring regions on health, in addition to direct effects from the region of interest. These findings offer insights for disaster management policymakers and practitioners in developing regional indicators and targeted interventions to strengthen disaster resilience and mitigate vulnerabilities across interconnected areas.

AI systems produce large volumes of logs as they interact with tools and users. Analysing these logs can help understand model capabilities, propensities, and behaviours, or assess whether an evaluation worked as intended. Researchers have started developing methods for log analysis, but a standardised approach is still missing. Here we suggest a pipeline based on current best practices. We illustrate it with concrete code examples in the Inspect Scout library, provide detailed guidance on each step, and highlight common pitfalls. Our framework provides researchers with a foundation for rigorous and reproducible log analysis.

Sodium taurocholate cotransporting polypeptide (NTCP) is a hepatic transmembrane (TM) protein that functions both as a bile acid transporter and as a host receptor for hepatitis B and D viruses via the viral preS1 binding. The structural and mechanistical determinants for NTCP’s dual functions remain largely undefined. In this study, using comprehensive structure-guided alanine-scanning mutagenesis based on the cryo-electron microscopy structure of the preS1/NTCP complex, we identified 13, 8 and 9 NTCP amino acid residues critical for viral infection, preS1 binding, and bile acid transport, respectively. Key residues overlappingly regulating viral receptor and transporter functions were located primarily at TM1 and TM8, whereas TM5 and outer-surface NTCP loops mediated viral receptor-specific activity. In addition to 8 amino acids key to preS1 binding, 5 residues likely acted at a post-preS1 binding step of infection. We further found naturally-occurring single nucleotide polymorphism-associated F274C/S NTCP variants abolished viral receptor function, via the potential conformational changes in bile acid tunnel and outer-surface hollow, as analyzed by molecular dynamics simulations. Our domain-specific structural-functional map of NTCP defines the mechanism how NTCP’s dual functionality is separately regulated, and provides a framework for designing selective antiviral agents that preserve bile acid transport.

BackgroundAdvancing antimicrobial stewardship programs (ASP) has led to various metrics for assessing antimicrobial consumption. Since introducing the antimicrobial spectrum index (ASI) in 2017, similar metrics, such as days of antibiotic spectrum coverage (DASC), have emerged to better evaluate antimicrobial use, particularly considering de-escalation process. This study assessed antimicrobial consumption with a de-escalation process using DASC in 12 hospitals across three regions in Japan.Table 1.Characteristics of participating hospitalsFigure 1.Trend of monthly DASC/DOT and DOT per 1,000 patient-days stratified by hospital types.MethodsIntravenous antimicrobial consumption data from 12 Japanese hospitals (April 2016–March 2024) were collected. The participating hospitals were located in three regions: West (Okinawa, n=6), East (Tokyo, n=5), and Midwest (Aichi, n=1). Monthly antimicrobial consumption was expressed as days of therapy (DOT) and then converted to DASC per 1,000 patient-days (PD). Hospital-wide de-escalation was evaluated using DASC/DOT. The correlation between DASC/DOT (a new metric) and DOT per 1,000 PD (a conventional metric) was assessed using Spearman’s rank-order correlation test. Hospital characteristics, including ASP availability, and infectious disease consultation, were also collected.Figure 2.Trends of DOT per 1,000 PD, DASC per 1,000 PD and DASC/DOT stratified by hospital regionsResultsA total of 96 months of data were analyzed. Monthly median DOT, DASC, and DASC/DOT were 303.4, 2107.0, and 7.2, respectively. There was little correlation between DASC/DOT and DOT per 1,000 PD (rho=0.11; P< 0.73). University hospitals (median 7.7) and a cancer center (median 8.0) had higher DASC/DOT than the remaining 9 community hospitals (median 6.9), likely owing to the availability of transplant services and a larger number of ICU beds (Figure 1 and Table 1). A substantial decrease in DASC/DOT at one university hospital since August 2022 was observed, likely due to implementing a hospital-wide restriction of carbapenem use. Median DASC/DOTs in East and West were 6.9 and 7.2, respectively, suggesting that the de-escalation process has progressed more at hospitals in Tokyo than at hospitals in Okinawa (Figure 2).ConclusionDASC/DOT, showing little correlation with traditional DOT per 1,000 PD, is a useful metric to assess antimicrobial use and de-escalation process. A regional-level and hospital type-level comparisons can help identify facilities needing further ASP promotion.DisclosuresAll Authors: No reported disclosures

This research focused on the nature and scope of Kenya’s digital diplomatic communication within the Eastern African Region between 2013 and 2024. Kenya’s digital diplomacy and diplomatic communication in the Eastern Africa region for the period between 2013 and 2024. The researcher investigated the aspect of Kenya’s digitized diplomatic communication. To aid in the study the researcher investigated the following objectives, how the integration of digital technologies reconfigured Kenya’s diplomatic communication in the region, challenges occasioned by the relatively new practice. The researcher deployed two complementary theories to aid the study. These are the actor specific grounded theory and the soft power theory. The study adopted an exploratory research design, and used qualitative data collection techniques, interviews and questionnaires for quantitative data. The study was conducted within Kenya, with the target population being staff at the ministry of foreign and diaspora affairs, missions in the region and other key experts in digital diplomacy. The sampling technique deployed was purposive and was aimed at a specific set of participants for the purpose collecting nuanced data related to the study topic. The study findings revealed that digital diplomatic communication in the region is influenced Kenya’s digital diplomacy efforts. Despite Kenya’s progress the conduct of digital diplomacy is hampered by challenges ranging from institutional gaps to a framework that is evolving but not adequate on the face of a dynamic digital technology environment. The study concludes by suggesting various recommendations that can help improve the conduct of digital diplomacy by Kenya in the Eastern Africa region.

This study analyses leadership patterns in Ghana's health and security institutions since 1992, with a particular emphasis on the sex composition of senior positions in the Ghana Health Service, the Armed Forces, and the Police Service. A mixed-methods approach was employed, comprising a qualitative literature review, quantitative analysis of the Ghana Police Service rank hierarchies, assessment of the Military Occupational Physical Assessment Test in relation to Military Occupational Specialties, and content analysis of relevant sections of the Affirmative Action Act (2024). In 2025, women represented 39% of doctors (5,068/12,900), 30% of police officers (12,945/43,968), and 15% of soldiers (2,400/16,000) in Ghana. Leadership in the Ghana Armed Forces remained male-dominated, with fewer than five female Generals among 115 in the forces and only one female Inspector-General of Police since 1992. Statistical analysis of police rank distribution showed a significant association between sex and rank (χ², p < 0.05), indicating persistent disparities in career progression. Findings highlight systemic institutional barriers affecting women's advancement in Ghana's health and security sectors. Targeted institutional reforms aligned with the requirements and merit-based principles of the Affirmative Action Act (2024) are necessary to address the disparities and strengthen equitable representation.

Saliva specimens are widely used for coronavirus disease 2019 (COVID-19) testing using RT-qPCR due to their advantages over nasopharyngeal swabs of being non-invasive and self-collectable. However, saliva collection can be time-consuming in individuals with reduced saliva secretion, including those with diabetes, diseases involving salivary glands such as Sjögren’s syndrome, and older adults. In this study, we evaluated the diagnostic performance of mouth rinse specimens, which can be easily collected even from individuals with reduced saliva secretion, as an alternative to saliva for RT-qPCR COVID-19 testing. Among the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive specimens analyzed, 88.2% were derived from patients possessing risk factors associated with reduced salivary secretion, including diabetes, use of medications such as anticholinergics or antihistamines, smoking, and older age. The analysis results of mouth rinse specimens demonstrated 96.7% overall agreement with those of saliva specimens, with a sensitivity of 94.1% and specificity of 100%; however, the viral load in the mouth rinse specimens was lower than that in saliva because of sample dilution. These findings suggest that mouth rinse specimens are a practical, versatile, and reliable alternative specimen for RT-qPCR COVID-19 testing.

Purpose: This study examines campus security practices in Malaysian public universities using Crime Prevention Through Environmental Design (CPTED), focusing on how environmental design and organisational culture shape students’ and staff members’ perceptions of safety. Design/methodology/approach – A qualitative, exploratory design using Focus Group Discussions (FGDs) across four public universities was employed. Thematic analysis mapped participant insights onto five CPTED components to identify environmental and operational safety gaps. Findings— Results reveal persistent weaknesses in access control, surveillance coverage, patrol visibility, boundary clarity, and environmental maintenance. There is inconsistent safety communication, limited emergency systems, and underdeveloped technological integration. These shortcomings collectively weaken safety culture and heighten perceived vulnerability Practical implications—Universities should enhance surveillance infrastructure, upgrade access-control mechanisms, adopt third-generation CPTED technologies, and strengthen safety communication and enforcement. Originality/value—This study offers one of the first qualitative CPTED-based assessments of Malaysian campuses, providing a comprehensive diagnostic framework for improving campus safety culture and environmental security.

Available methods for predicting the onset and progression of diabetic kidney disease (DKD) and end-stage kidney disease (ESKD) are not yet ready for clinical application. We used a Japanese diabetes cohort study (J-DREAMS) to examine whether the Ahlqvist et al diabetes clustering is useful for stratifying DKD or ESKD outcomes independent of known risk factors in real-world settings. Data-driven cluster analysis using k-means was performed based on GAD antibody levels, age at diagnosis, BMI, HbA1c and HOMA2 estimates of beta cell function and insulin resistance in 12,093 individuals with type 1 or type 2 diabetes. The risk of developing DKD/ESKD was analysed using Kaplan-Meier analysis and the Cox proportional hazards model. Diabetes clustering classified individuals in the J-DREAMS cohort into five subtypes, the clinical characteristics of which were comparable to those of the previously reported five subtypes. Kaplan-Meier curve analysis showed that events for chronic kidney disease (CKD) stages 3b, 4 and 5 were highest in the severe insulin-resistant diabetes subtype. The Cox proportional hazards model showed that the severe insulin-resistant diabetes subtype had significant HRs after correction for multiple confounding factors. The Cox proportional hazards model showed that each subtype had a diverse combination of factors associated with CKD stage 3b and proteinuria events. Data-driven analysis provides diabetes subtyping, which can predict the probability of developing DKD/ESKD; each subtype has diverse combinations of factors predisposing to DKD development and progression. Data-driven diabetes subtyping to predict the likelihood of developing DKD/ESKD and mitigating predisposing factors may help personalise prevention strategies.