South Korea's 2024 medical school expansion: From healthcare reform to constitutional crisis.

Diplomatic relations between the Republic of Armenia and the United States of America were established on 7 January, 1992. Since the political-economic relations between the Republic of Armenia and the USA have grown rapidly, and these relations have their contribution to the development of cooperation between the two states in the defense sphere, including military education, military medicine, cybersecurity directions, as well as international peacekeeping missions. All these also create the basis for military-technical cooperation. At the same time, the United States is actively participating in the reforms being implemented in the Armenian Armed Forces, including the introduction of a professional sergeant system. The cooperation between Armenia and the United States in the defense sphere, especially military-technical cooperation, creates a possibility for Armenia to get access to new western advanced military technologies and to diversify the cooperation in the defense sphere.

Indonesia's National Data Center (PDN) was targeted by a ransomware attack on June 20, 2024, paralyzing 210 government agencies, causing manual immigration procedures, and exposing significant weaknesses in Indonesia's cyber governance system. The National Cyber ​​and Crypto Agency (BSSN) was mandated under Presidential Regulation 47/2023 to coordinate the response, but the response operation remained disorganized due to various agencies working independently without a unified leadership system, including the Indonesian National Armed Forces (TNI) operating independently despite possessing a Cyber ​​Unit (Satsiber) with adequate cyber warfare capabilities. The attack on the PDN ultimately revealed three governance weaknesses: a lack of a unified command system for conducting national-scale response operations, the separation of military resources from the protection of civilian infrastructure, and a systemic failure to maintain adequate operational readiness. Through a comparative analysis of cyber command models in the United States, Singapore, South Korea, and Australia, combined with an institutional assessment using the McKinsey 7S and NIST frameworks, we propose an integrated defense architecture. The establishment of a Joint Cyber ​​Defense Task Force (JCDTF) operating under a proposed civilian-military organization, the National Cyber ​​Security Coordination Center (NCCC), would create a single command system for crisis response and maintain democratic civilian control through established legal authority, mandatory parliamentary oversight, and limitations on operational areas. This framework would address existing governance weaknesses through democratic cyber governance principles that can also be used by ASEAN countries to address their civil-military integration challenges in handling national-scale cyber incidents.

The mission demands and the local environment associated with the United Nations peacekeeping operations (PKO) are psychologically stressful. This study aimed to identify longitudinal trajectories of psychological distress associated with PKO deployment and examine the influence of pre-deployment resilience. Additionally, we investigated the associations of post-deployment job stressors and support factors with the psychological distress trajectories. A prospective cohort study was conducted among the Japan Ground Self-Defense Forces personnel deployed to the United Nations Mission in the Republic of South Sudan between November 2015 and May 2017 in 6-month deployment rotations. Data was collected from pre-deployment to up to 24 months post-deployment. Psychological distress was measured using the Kessler Psychological Distress Scale, and latent growth mixture modeling (LGMM) identified distinct trajectories. We also examined the associations of pre-deployment resilience, assessed by the Tachikawa Resilience Scale, and general mental health, assessed by the 30-item General Health Questionnaire, with post-deployment job stressors and support factors, assessed by the Brief Job Stress Questionnaire. This study was approved by the institutional review board of the National Defense Medical College. Latent growth mixture modeling identified 4 trajectories: Resilient (57.9%), Recovery (18.6%), Chronic (13.0%), and Delayed (10.5%). Multinomial logistic regression revealed officer rank, pre-deployment sleep disturbance, and anxiety and dysphoria as risk factors among the Chronic group, while resilience, especially cognitive flexibility, was a protective factor. At 12 months post-deployment, quantitative and qualitative job overloads were risk factors among Chronic and Delayed groups, respectively, and supervisor support was a protective factor among the Chronic group. Approximately one-fourth of the personnel experienced long-term psychological distress. Higher levels of pre-deployment resilience with cognitive flexibility, good sleep quality, and stable mood might play key protective roles. Post-deployment job stressors and support factors were also associated with psychological outcomes, highlighting the importance of strengthening post-deployment support systems along with pre-deployment interventions to enhance resilience, improve sleep, and stabilize mood to promote mental health among PKO personnel.

ABSTRACT This article analyzes the leadership style of Russian President Vladimir Putin during his first public appearance after Russian military forces invaded the southern Ukrainian region of Crimea. The March 4, 2014, press conference lasted 64 min and was an opportunity to examine Putin's leadership style under conditions of uncertainty and stress. The author describes Putin's self‐presentation, thought process, emphasis on masking aggression and masking his personal needs/experiences; as well as engaging in moralistic as well as legalistic/factual lecturing, how he presents his allies and his rivals, discusses implicit thought content, and concludes with a description of Putin's core leadership dynamics.

Exertional heat stroke (EHS) remains a persistent threat to military operations, necessitating a shift from traditional thermal load perspectives toward a "heat sepsis" mechanism characterized by systemic inflammation and multiorgan injury. Recent advances emphasize the importance of objective risk assessment through standardized Heat Tolerance Tests (HTTs) and the use of biomarkers like plasma homocysteine and copeptin to gauge physiological readiness. Effective prevention strategies now integrate 7–14 day acclimatization protocols, real-time environmental monitoring via wearable sensors, and proactive hydration. Furthermore, immediate acute management using Ice-Cold Water Immersion (ICWI) has been proven to achieve superior cooling rates and reduce morbidity, highlighting the need for a multidisciplinary approach that bridges physiology, technology, and education to safeguard service members.

Background: Basic Military Training (BMT) in the Canadian Armed Forces includes high physical demands. Given low levels of fitness in the Canadian population, the Basic Training Fitness Test (BTFT) was introduced to assess early readiness, and a Pre Basic Military Training (Pre-BMT) program was developed to support preparation. Objective: This study aimed to identify predictors of BTFT success and examine the influence of Pre BMT engagement. Methods: From January to November 2024, 3933 candidates (687 female) completed assessments during week one of BMT including the BTFT, body composition analysis, and a Pre-BMT engagement survey. Logistic regression with elastic net regularization models predicted BTFT success for the full cohort and by sex. Results: Overall BTFT success was 91.8%, with males outperforming females (96.2% vs. 70.9%). The full cohort model (AUC = 0.87) retained sex, body fat percentage, skeletal muscle mass, age, height, candidate type, recruitment duration, and Pre-BMT engagement. Lower body fat, greater muscle mass, younger age, and officer cadet status were associated with higher odds of success; female sex predicted lower odds. The male model (AUC = 0.82) also retained height, while the female model (AUC = 0.78) included previous pregnancy, but excluded candidate type and Pre-BMT engagement. Engagement level was not a significant predictor in any model. Conclusions: Body composition emerged as the strongest determinant of BTFT success, underscoring the value of targeted pre-conditioning to increase muscle mass and reduce adiposity. Tailored training strategies that account for sex may enhance readiness. Given low Pre-BMT participation, its potential role in candidate preparation warrants further study.

The Indonesia–Malaysia land border in Kalimantan is a strategic area with a high vulnerability to illegal cross-border activities, particularly through unofficial routes known as jalan tikus (rat paths), which continue to increase in number. Border security efforts remain largely dependent on conventional patrols, which are constrained by limited personnel, difficult terrain, and insufficient infrastructure, resulting in suboptimal surveillance effectiveness. In this context, the Physical Barrier System (PBS) serves as a critical technical solution, functioning as a physical obstacle, an early detection mechanism, and a deterrent to prevent illegal border crossings. This study aims to analyse the technical and design aspects of PBS implementation in supporting the border security operations of the Indonesian National Armed Forces (Tentara Nasional Indonesia, TNI) using a qualitative-descriptive approach. Data were collected through literature review, analysis of operational and regulatory documents, and empirical reports from Border Security Battalions, and analysed using thematic categorization and source triangulation. The findings reveal that PBS deployment remains uneven and weakly integrated with sensor-based technologies, while its design has not yet fulfilled the principles of defense-in-depth, Crime Prevention Through Environmental Design (CPTED), and integrated access control. This study proposes an optimized PBS framework incorporating modular, terrain-adaptive design, intrusion detection sensors, early warning systems, structural reinforcement, and data integration with sector command posts.

This article discusses Ishiuchi Miyako (1947–)’s 1979 photobook, Zesshō, Yokosuka Story as her distinctive response to images of Yokosuka produced by her mentors such as Tōmatsu Shōmei (1930–2012), Daidō Moriyama (1938–), and Tokiwa Toyoko (1928–2019). From the onset of Yokosuka project, Ishiuchi, who grew up in Yokosuka, had a strong determination to present “real” Yokosuka, distancing herself from above-noted photographers who reduced the entire city into a camptown by highlighting and typifying the presence of the American GIs, camptown sex workers, and mixed-race children. This paper highlights how Ishiuchi presents a distinctive visual narrative in Yokosuka Story that is personal, temporal, and historical. It is personal, grounded in Ishiuchi’s own history, memories, and emotions associated with Yokosuka. At the same time, it reflects the city’s transformation in the late 1970s, marked by processes of urbanization and shifts in the presence and visibility of the US military. The photobook’s visual narrative also highlights Yokosuka’s history as a major port city that was home to the Imperial Japanese Navy since the Meiji period through 1945, and a site of Japan Self-Defense Forces (created in 1954) and a huge US naval base since 1945. On the whole, this paper argues that Zesshō, Yokosuka Story, is Ishiuchi’s Zesshō [絶唱], a Japanese term meaning best of all performances or sublime song or poem, dedicate to her hometown.

ABSTRACT Background Undescended testis (UDT) persisting into adulthood increases risks of infertility and testicular cancer. In Saudi Arabia, delayed diagnosis is common and population prevalence of undiagnosed adult UDT is unknown. This study estimated point prevalence of previously unrecognized UDT among healthy young adult males in Riyadh and explored sociocultural barriers to early care. Methods A cross-sectional, examination-based screening was conducted January – August 2025 at Al Kharj Armed Forces Hospital. Simple random sampling recruited 1349 Saudi males aged 18–28 from university, military and community populations. Trained senior surgeons performed standardized genital examinations; inter-examiner agreement was high (k = 0.91). Structured interviews assessed awareness, stigma, and reasons for non-consultation. Prevalence with 95% Wilson confidence intervals and χ2 tests evaluated associations. Results Mean age was 22.4 ± 2.6 years. Thirty-six participants had previously undiagnosed UDT, yielding a prevalence of 2.67% (95% CI 1.8–3.5%). All cases were unilateral (58.3% right, 41.7% left; p = 0.41). Most UDT were non-palpable (94.4%); associated anomalies were rare (2.8%). Reported reasons for non-consultation included lack of awareness/unnoticed abnormality (66.7%), social stigma (27.8%), and perceived familial normalization (5.6%). Conclusions The observed high prevalence of undiagnosed UDT in Riyadh young adults exceeds typical adult estimates, indicating missed opportunities for early detection. Low awareness and sociocultural stigma are the main barriers; urgent actions include targeted education, routine genital screening in child and adolescent health encounters, standardized referral pathways, and individualized oncological surveillance or management for newly diagnosed adults.

Background Heritage corridors represent complex cultural landscapes shaped by the historical interplay between military defense and transportation connectivity. However, the synergistic mechanisms behind this interplay remain underexplored. Methods This study investigated these synergistic mechanisms by which military defense systems and transportation networks influenced the settlement spatial patterns within China’s heritage corridors, using the Guangou section of the Great Wall as a representative case. Through an interdisciplinary approach that integrated historical document analysis, field surveys, remote sensing interpretation, and historical GIS spatial analysis, we constructed a tripartite research framework of “element identification-spatial quantification-mechanism interpretation”. Specific analytical methods included: 1. Euclidean distance and viewshed analyses to assess the spatial control exerted by defense facilities; 2. Cost-path analysis and buffer zone analysis to reconstruct historical transportation networks; and 3. Spatial overlay and raster calculation to quantify defense-connectivity interactions. Results Our findings revealed that settlement evolution underwent three distinct historical phases. Prior to the Ming Dynasty, settlements exhibited a dispersed, “mountain-water adjacent” distribution. During the Ming period, four distinctive settlement types emerged: High Defense-High Connectivity (HDHC) pass-courier station complexes, High Defense-Low Connectivity (HDLC) frontier military zones, Low Defense-High Connectivity (LDHC) plain waterway settlements, and Low Defense-Low Connectivity (LDLC) remote mountainous enclaves. Among these, the Guangou axial zone demonstrated an optimal defense-connectivity synergy model. In the Qing Dynasty phase, spatial configurations transitioned from “defensive control” to “connectivity empowerment”, characterized by “linear bead-like” and “planar networked” distribution patterns. Conclusion This study innovatively proposed a theoretical framework and quantitative indicator system for “defense-connectivity” synergistic evolution. It developed a spatial analysis technical approach that integrated multi-source data fusion and multi-method integration, revealed the evolution patterns and mechanisms of different spatial types in the formation of heritage corridors, and established a spatial management methodology for the protection of linear cultural heritage. Our findings would not only deepen the understanding of the evolution patterns of defensive settlement systems, but also provide precise spatial management references for the “holistic protection” and “living inheritance” of the Great Wall National Cultural Park, offering a replicable analytical framework for global studies on similar heritage corridors.

Considerable operational and financial costs are associated with musculoskeletal injury (MSKI) across military organisations. Following an MSKI, reaching 'medically fully deployable' status is often contingent on meeting physical employment standards. Strength training has a critical role to play in military physical preparation, injury mitigation and guiding rehabilitation practice. Low levels of muscle strength are associated with increased MSKI risk, and previous MSKI is a leading risk factor for re-injury. When an MSKI does occur, it is essential that all attempts to mitigate the risk of secondary MSKI are met. Maximal force (muscle strength) and rapid force (rate of force development and reactive strength) production have been identified as important strength characteristics requiring targeted training interventions and assessment prior to returning to operational roles. This review investigates the importance of strength training and its assessment during late-stage rehabilitation to inform return-to-duty exit criteria, meet physical employment standards and mitigate secondary MSKI.

Introduction: As one of the core executive functions, working memory involves the temporary storage and mental manipulation of information. These processes are essential for effective performance across a wide range of tasks (Miyake & Friedman, 2012). Military settings are often characterized by high physical and psychological demands. How individuals process information under such stressful conditions is therefore critical for successful performance. Consequently, it is important to identify the factors that contribute to an efficiently functioning working memory. Previous research has demonstrated associations between physical fitness and executive functions (e.g., Huang et al., 2015). However, few studies have examined this relationship in young, healthy adults, particularly within military contexts. The aim of the present study was therefore to investigate associations between working memory and physical fitness in a young, healthy population in a military setting. Methods: One hundred thirty-four male recruits from the Infantry School of the Swiss Armed Forces, with a mean age of 19 years, participated in the study. Working memory was assessed using a spatial N-back task administered with E-Prime. Reaction time and accuracy were extracted as outcome variables, separately for target and non-target trials. Physical performance was measured using the Swiss Army’s official fitness test, which included a shuttle-run test to assess aerobic endurance, as well as two muscle-strength tests: holding a plank position for as long as possible and pushing a medicine ball as far as possible with both hands from a seated position. Results: Correlation analyses revealed a significant positive association between the Shuttle run performance and accuracy in the spatial N-back task (r = .27, p = .003). In contrast, no significant correlations were found between the two strength tests and working memory performance (r = -.03, p = .73; r = -.004, p = .97). Discussion/Conclusion: Higher working memory performance is associated with better aerobic fitness amond young adults in a military setting. This result is consistent with previous findings with other populations (e.g. Noh et al., 2024) and may have practical implications for training in such environments. However, more research is needed to elucidate a causal relationship and potential benefits of interventions in a military setting.

Musculoskeletal injuries are a leading cause of morbidity, medical downgrade and discharge within the UK Armed Forces. The Defence Medical Rehabilitation Centre (DMRC) provides consultant-led, interdisciplinary residential rehabilitation based on a biopsychosocial model. In 2023-2024, DMRC delivered 2-week and 3-week lower limb rehabilitation programmes. This service evaluation compared their clinical effectiveness and explored staff experiences. Service personnel (SP) who completed the 2-week (April-December 2023) or 3-week (January-September 2024) courses were assessed at admission and 3-month review. Patient-reported outcome measures (PROMs) included the Tampa Scale of Kinesiophobia, Musculoskeletal Health Questionnaire (MSK-HQ), Brief Pain Inventory, Generalised Anxiety Disorder Scale-7 and Patient Health Questionnaire. Functional assessment tests (FATs) comprised single leg press (5-repetition maximum), glute and hamstring bridges, straight and bent knee calf raises, and side plank. Staff with experience of both models completed an anonymous questionnaire exploring perceived differences. Data were analysed for 110 SP: 49 (2 weeks) and 61 (3 weeks). Across both models, all PROMs and FATs improved significantly over time (p<0.001). No significant group or group*time effects were observed (p>0.05), except for the left glute bridge (p<0.05). Staff reported a preference for the 3-week model, citing greater opportunity for one-to-one sessions, skill consolidation and personalised progression. Both 2-week and 3-week lower limb rehabilitation programmes at DMRC significantly improved pain, function and psychological well-being in UK Armed Forces personnel. Although no statistical differences were identified between models, qualitative feedback supports the 3-week format for complex or persistent presentations, reinforcing the value of longer, individualised, biopsychosocial, interdisciplinary rehabilitation within military healthcare.

ABSTRACT This research article examines three interrelated questions: whether the use of the Wagner Group signals the end of the anti-mercenary norm; how some African states are using these companies to assert sovereignty and shape security partnerships; and what the broader geopolitical implications are of incorporating PMCs into national security frameworks in the Sahel. The analysis finds that the long-standing ban on mercenary activities has, in practice, been replaced by a new normative framework that accepts the dual use of private military forces in both offensive and defensive roles, where local circumstances allow. This shift, as the analysis demonstrates, leverages growing African agency and reflects the strategic recalibration of certain African states, which are moving away from Western security models towards arrangements they consider more consistent with local geopolitical, historical, and socio-economic imperatives. Concluding that the anti-mercenary norm is effectively dead and that agency through PMCs is emerging, the author highlights the need for robust Africa-centred frameworks to protect local populations from the unintended consequences of PMC involvement and calls for a reassessment of global security governance to address the emerging power dynamics of multiple partners.

Investigating the fair play understanding of the leading personnel in physical education and sports activities within the military system offers a unique opportunity to merge military ethical values with sports culture. Currently, there is a lack of detailed studies in the literature examining the fair play understanding of military leaders in the Turkish Armed Forces and their contributions to sports activities. This study aims to address this gap by exploring the behaviours and fair play understanding of these military leaders in sporting activities. This cross-sectional study involved 259 officers, non-commissioned officers, and specialist sergeants from the Türkiye Presidential Guard Regiment Command. The "Multidimensional Sportspersonship Scale" was utilized to assess the sportspersonship understanding of the personnel. Data were collected through online forms and analysed using SPSS software to examine correlations with demographic data. The results indicated that the fair play and sportspersonship understandings of military personnel leading physical education and sports activities were lower than those of civilians. Factors such as stress and the struggle for survival, particularly in battlefield scenarios, often conflict with the concept of sportspersonship. Military leaders, who are typically raised with a warrior mentality, tend to prioritize other values over sportspersonship in their training. These findings raise important questions about the role and importance of fair play and sportspersonship behaviours within the military system. This study provides empirical data on fair play in the military context, contributing to the literature and helping to fill the existing gap in this field. Sportspersonship among military personnel appears to be primarily caused by hierarchical values and institutional discipline rather than active sports participation. Family socialization also affects fair-play attitudes. Military sports programs that include ethics-based education might be able to balance physical training with moral development.

Food security is a vital component of national stability, particularly amid multidimensional threats such as climate change, land-use conversion, and illegal food distribution. Riau Province faces serious food security vulnerabilities due to environmental degradation, frequent forest and land fires, and a strong dependence on external food supplies. These conditions highlight the urgent need for an integrated food security strategy supported by synergy among defense and security institutions. This study analyzes the interoperability strategy between the Indonesian National Armed Forces (TNI) and the Indonesian National Police (Polri) in securing national food resources through a holistic security approach, with a specific focus on Riau Province and Pekanbaru City. Using a qualitative descriptive method and a case study approach, the research incorporates policy analysis, literature review, and secondary data from government agencies. The findings indicate that TNI–Polri coordination remains fragmented and lacks a structured interoperability mechanism. Key challenges include weak policy alignment, limited data sharing, and insufficient technological support for monitoring. Nevertheless, synergy opportunities exist through establishing a joint command center, developing technology-based food intelligence systems, and strengthening cross-sectoral regulatory frameworks. Overall, a holistic TNI–Polri interoperability strategy offers a strategic pathway to reinforce food security and enhance national resilience against non-traditional threats

Iron Deficiency Anemia Among Pediatric Celiac Disease Patients at the Armed Forces Hospital Southern Region: Prevalence, Predictors, and Outcomes

Post-conflict societies often experience high levels of violence after demobilizing armed groups. Is this violence driven by resettling former combatants within civilian communities? And how can states prevent this form of violence? We answer the first question affirmatively but argue that the rise in violence is chiefly the result of targeted attacks against ex-combatants. These revenge killings may spill over, creating more insecurity for host communities. The state can prevent this kind of violence by providing protection for ex-combatants. We theorize that credible state security guarantees reduce violence through two mechanisms: first, by deterring attacks through physical protection, and second, by encouraging ex-combatants to rely on the state for security provision. Drawing on geo-located data from 12,000 fighters of the Revolutionary Armed Forces of Colombia (FARC), we show that the presence of ex-combatants increased targeted assassinations and general homicide rates after the 2016 Peace Agreement. These effects were compounded when ex-combatants became more visible and identifiable through participation in collective economic projects or collaboration with civilians – two hallmarks of community-based peacebuilding. However, state protection moderated these effects. FARC members who received state protection were more likely to trust state agents and report security threats to them. Unlike previous studies that focus on reconciliation between civilians and ex-combatants, this paper theorizes the role of the state in rebuilding state–rebel bonds during Disarmament, Demobilization, and Reintegration (DDR).

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.