Paradigm Shift Research Articles

Future-proofing geotechnics workflows: accelerating problem-solving with large language models

ABSTRACT The integration of Large Language Models (LLMs), such as ChatGPT, into the workflows of geotechnical engineering has a high potential to transform how the discipline approaches problem-solving and decision-making. This paper investigates the practical uses of LLMs in addressing geotechnical challenges based on opinions from a diverse group, including students, researchers, and professionals from academia, industry, and government sectors gathered from a workshop dedicated to this study. After introducing the key concepts of LLMs, we present preliminary LLM solutions for four distinct practical geotechnical problems as illustrative examples. In addition to the basic text generation ability, each problem is designed to cover different extended functionalities of LLMs that cannot be achieved by conventional machine learning tools, including multimodal modelling under a unified framework, programming ability, knowledge extraction, and text embedding. We also address the potentials and challenges in implementing LLMs, particularly in achieving high precision and accuracy in specialised tasks, and underscore the need for expert oversight. The findings demonstrate the effectiveness of LLMs in enhancing efficiency, data processing, and decision-making in geotechnical engineering, suggesting a paradigm shift towards more integrated, data-driven approaches in this field.

Integrating AI-driven Wearable Technology in Oncology Decision Making: A Narrative Review.

Clinical decision-making in oncology is a complex process influenced by numerous disease-related factors, patient demographics, and logistical considerations. With the advent of Artificial Intelligence (AI), precision medicine is undergoing a shift towards more precise and personalized care. Wearable device technology complements this paradigm shift by offering continuous monitoring of patient vitals, facilitating early intervention, and improving treatment adherence. The integration of these technologies promises to enhance the quality of oncological care, making it more responsive and tailored to individual patient needs, thereby enabling wider implementation of such applications in the clinical setting. This review article addresses the integration of wearable devices and AI in oncology, exploring their role in patient monitoring, treatment optimization, and research advancement along with an overview of completed clinical trials and utility in different aspects. The vast applications have been exemplified using several studies and all the clinical trials completed till date have been summarized in table 2. Additionally, we discuss challenges in implementation, regulatory considerations, and future perspectives for leveraging these technologies to enhance cancer care and radically changing the global health sector. AI is transforming cancer care by enhancing diagnostic, prognostic, and treatment planning tools, thus making precision medicine more effective. Wearable technology facilitates continuous, non-invasive monitoring, improving patient engagement and adherence to treatment protocols. The combined use of AI and wearables aids in monitoring patient activity, assessing frailty, predicting chemotherapy tolerance, detecting biomarkers, and managing treatment adherence. Despite these advancements, challenges, such as data security, privacy, and the need for standardized devices persist. In the foreseeable future, wearable technology can hold significant potential to revolutionize personalized oncology care, empowering clinicians to deliver comprehensive and tailored treatments alongside standard therapy.

Evolution of Treatment Strategies for Gestational Trophoblastic Neoplasia: Chemotherapy, Immunotherapy, and Molecular Targeted Therapy.

In addressing Gestational Trophoblastic Neoplasia (GTN), it is imperative to acknowledge the evolving landscape of treatment options, especially in light of the challenges posed by traditional methods. While historically, surgical interventions, radiation therapy, and chemotherapeutic agents have been the mainstays, the emergence of resistance and high-risk scenarios necessitates a reevaluation of our therapeutic approaches. Our review highlights the promising advancements in immunotherapy and molecular targeted therapy as viable alternatives for GTN management. The introduction of immune checkpoint inhibitors and kinase inhibitors offers a paradigm shift, particularly for patients resistant to conventional chemotherapy regimens. These novel therapies not only exhibit efficacy but also demonstrate manageable toxicity profiles, particularly in high-risk cases. However, integrating these innovative treatments into established international guidelines presents a formidable task. As we move forward, it is imperative that future research not only prioritizes fertility preservation but also rigorously evaluates long-term toxicity implications. International collaboration becomes pivotal in addressing the nuances of this rare and complex disease. In conclusion, our review underscores the need for a nuanced approach to GTN treatment, one that prioritizes reduced toxicity and improved quality of life. By embracing the advancements in immunotherapy and molecular targeted therapy, we can pave the way for more effective and patient-centered care in the management of GTN.

ML-based predictive gut microbiome analysis for health assessment

Personalised medicine is a rapidly evolving field to which many resources have been devoted recently. It represents a paradigm shift from a one-size-fits-all approach to healthcare, focusing instead on tailoring treatments and diagnoses to individual patients. This study aims to contribute to this transition by leveraging recent advancements in microbiome research. An earlier study that computed the Gut Microbiome Health Index (GMHI), a potent indicator capable of predicting disease presence with approximately 70% of accuracy, serves as the foundation for this research. Positive values of the GMHI are associated with healthy subjects and negative values to non-healthy ones. The objective of this study is twofold: firstly, to advance the use of the GMHI through the application of two distinct machine learning techniques, a Fully Connected Neural Network and an Autoencoder, secondly, to adapt the GMHI for a unique dataset of COVID-19 patients. The employment of these two neural network architectures facilitated an enhancement in predictive accuracy to approximately 74.5%, surpassing the GMHI baseline accuracy of 70.95%. Simultaneously, the application of the GMHI, recalibrated using species specifically identified in the COVID-19 dataset, demonstrated a substantial increase in accuracy by 17% (achieving an accuracy of 76%). These promising results in distinguishing COVID-19 patients, highlight the potential and broad applicability of this approach in the sphere of personalized medicine and directly relating the COVID-19 disease to one’s microbiome and its composition.

The modern and the Monster: heritage activism in the post-socialist city between performance and performativity

ABSTRACT This paper explores the role of urban grassroot movements in the social configuration of contentious heritage and multiple temporalities and political articulations of heritage defense activism. Using the case study method, the paper traces the genealogy of one urban movement in defense of socialist modernist heritage in contemporary Montenegro, shedding light on the process of slow political recognition as opposed to the wide and rampant repertoire of urban contention and socio-cultural appropriation. Focusing on the events following the announcement of the construction of the 12-floor skyscraper (colloquially dubbed “the Monster”) in the immediate proximity of the iconic modernist Hotel Podgorica, the paper theorizes the capacity of urban activism in the contemporary post-socialist city to activate heritage dynamics and leverage urban knowledge as a tool of cultural control. Relying on a multi-method approach including participatory observations, interviews, urban and critical discourse analysis, and the archival research, this paper provides a multi-perspectival analysis of the complex interactions between contentious heritage, grassroot movements and political performativity in the post-socialist city. The results shed light on the evolving role of citizenship in urban development, signaling a paradigm shift towards engaged architecture and emancipatory urban activism as mechanisms for mitigating institutional inefficiencies and political performativity.

Polar cap region and plasma drift in pulsars

ABSTRACT Pulsars often display systematic variations in the position and/or intensity of the subpulses, the components that comprise each single pulse. Although the drift of these subpulses was observed in the early years of pulsar research, and their potential for understanding the elusive emission mechanism was quickly recognized, there is still no consensus on the cause of the drift. We explore the electrodynamics of two recently proposed or refined drift models: one where plasma lags behind corotation, connecting the drift with the rotational pole; and another where plasma drifts around the electric potential extremum of the polar cap. Generally, these are different locations, resulting in different drift behaviours, that can be tested with observations. In this study, however, we specifically examine these models in the axisymmetric case, where the physics is well understood. This approach seems counter-intuitive as both models then predict similar large-scale plasma drift. However, it allows us to show, by studying conditions within the sparks for both models, that the lagging behind corotation model is inconsistent with Faraday’s law. The modified carousel (MC) model, where plasma drifts around the electric potential extremum, not only aligns with Faraday’s law, but also provides a future direction for developing a comprehensive model of plasma generation in the polar cap region. Unlike previous models, which considered the drift only inside the discharging regions, the MC model reveals that the electric field between the discharges is not completely screened, and plasma drifts there – a paradigm shift for the drifting subpulse phenomenon.

Post-COVID-19 Era, 15th Minutes City New Urban Model Changing Housing Design and Models

This research centered on the transition from sustainability to the post-COVID-19 era, significantly altered and transformed cities, city plans, and housing models holistically approach. Although the academic world concentrating on sustainable urban and housing design since the 1990s, the pandemic has emerged as a critical paradigm shift in context since 2019. During the COVID-19 period the Paris city 15 minutes concept, first introduced by Paris Mayor A. Hidalgo initially sparked controversy as temporary now considered permanent in Paris recently, Oxford. In the post-pandemic era, sustainability has become significant on the global agenda, shaping cities, city models, and residences through profound and radical changes. Some efforts are supported by Climate-change conferences in the world and subsequently some determinations like the Paris Agreement and UN declarations that guide more livable environments and houses. Due to COVID-19 the newly emerged conditions and compulsory changes that have taken place in the cities the social isolation, distance living, and remote working led to radical changes in the living style, environment, city plans, housing models, and typologies holistically. Although many publications have been published in the last few years about the pandemic and the Paris City 15 minutes concept, they only address the city and urban scale solutions. There is no research with a holistic approach that relates the subject from the urban scale to the architectural scale, housing, and blocks. Within the 15-minute concept, searched, developed, innovative, and sustainable urban and housing-oriented suggestions for cities in the future are presented at the end of the research. In conclusion, it is revealed that the issue of sustainability has gained importance with an increasing momentum in the world agenda, witnessed the radical changes in cities and residences, in the post-COVID-19 period in the last 2-3 years.

Memory Retention and Cultural Resonance: Exploring the Impact of Ephemeral Digital Narratives

The accelerating progress of the digital landscape has led to the rise of consumption of content that is short-lived and fast-paced. In this context, social media platforms such as Instagram and Snapchat have become predominant for their effective use of temporary digital content that lasts for a brief period (usually 24 hours) before disappearing. Ephemerality has become the zeitgeist of the 21st century. In a world where immediacy and instant gratification are highly valued, the pattern of consumption of digital media is also aligned to such quick snippets of information rather than watching a long video. This paradigm shift is redefining how people perceive time and memory in the digital age. This preliminary study analyses the effect of such ephemeral digital narratives on the memory retention of consumers and also explores the implications of such content on cultural and collective memory. A sample of 100 participants ranging from the age of 18-35 years, were exposed to curated ephemeral content from Instagram and Snapchat for seven days. Participants were exposed to different media types, presentation styles, and cognitive demands. Daily surveys examined their memory retention using various question formats. The study examined ten hypotheses using Analysis of Variance (ANOVA) to determine how media type (video, image, both), presentation style (visual, verbal/textual, both), cognitive processing demands (shallow, deep processing), and question format affect recall effectiveness.

Elucidating the potential of isorhapontigenin in targeting the MgrA regulatory network: a paradigm shift for attenuating MRSA virulence.

As methicillin-resistant Staphylococcus aureus (MRSA) exhibits formidable resistance to many drugs, the imperative for alternative therapeutic strategies becomes increasingly evident. At the heart of our study is the identification of a novel inhibitor through fluorescence anisotropy assays, specifically targeting the crucial multiple gene regulator A (MgrA) regulatory network in S. aureus. Isorhapontigenin (Iso), a natural compound, exhibits outstanding inhibitory efficacy, modulating bacterial virulence pathways without exerting direct bactericidal activity. This suggests a paradigm shift toward attenuating virulence instead of purely focusing on bacterial elimination. Through comprehensive in vitro and in vivo evaluations, we elucidated the complex interplay between Iso and MgrA, leading to reduced S. aureus adhesion, and overall virulence. At the cellular level, Iso offers significant protection to A549 cells infected with S. aureus, reducing cellular damage. Importantly, Iso augments the chemotaxis of neutrophils, curtailing the immune evasion capabilities of S. aureus. Furthermore, in vivo investigations highlight the notable effectiveness of Iso against MRSA-induced pneumonia and within the Galleria mellonella infection model, underscoring its pivotal role in the evolving realm of antibacterial drug discovery. Significantly, when Iso is used in combination with vancomycin, it outperforms its solo application, indicating a more pronounced therapeutic impact. This seminal research emphasizes Iso's potential as a primary defense against the surge of multidrug-resistant pathogens, heralding new prospects in antimicrobial therapy.

Paradigm Shift in Higher Education: National Education Policy (NEP 2020)

Education plays a crucial role in human development, serving the acquisition of knowledge and skills. The landscape of education in India has transformed, since independence. This transformation has touched upon various facets of education, reshaping its structure and priorities. The National Education Policy of 1986, along with a revised version in 1992, has been an integral part of educational discourse. The unveiling of the National Education Policy (NEP) in 2020 heralds a fresh vision for education in India. NEP 2020 envisions an education system starting from pre-primary to various aspects of higher education. The perspective of NEP 2020 is to cater to the unique capabilities of every student and their holistic development. NEP 2020 has opened doors to many initiatives for higher education that will impart quality education. NEP 2020 has proposed advancement in higher education: moving towards interdisciplinary and multidisciplinary education, faculty and institutional autonomy, various measures to enhance student experiences, formation of a single regulatory body for governing higher education, measures to include a large number of student enrolment by the means of online education and distance education. The researcher will highlight various recommendations of NEP 2020 concerning various suggestions enlisted in the policy for Higher education. The researcher will shed light on initiatives for multidisciplinary education, optimal learning environment, internationalization of higher education, equity and inclusion in higher education, and vocational education with effect from NEP 2020. The paper emphasizes the significant changes in higher education institutions, including the creation of multidisciplinary universities, colleges, and programs.

Industry 4.0 technologies: an examination of benefits, challenges and critical success factors for implementation in the Saudi construction industry

Purpose The construction industry is witnessing a paradigm shift as a consequence of the fourth industrial revolution (IR 4.0). The implementation of IR4.0 technologies is, however, elementary in emerging economies such as Saudi Arabia. Therefore, the purpose of this paper is to carry out an examination of benefits, challenges and critical success factors for IR4.0 implementation in the construction industry in Saudi Arabia. Design/methodology/approach The methodology entailed a thorough review of the extant literature and consultation with experienced construction professionals in Saudi Arabia through questionnaire surveys. The data collected was further analyzed using the relative importance index approach and the confirmatory factor analysis. Findings The most important benefits, challenges and critical success factors established by this study include “Improved Communication and Coordination,” “Cost of implementation (initial investment and maintenance)” and “Clear goals and objectives,” respectively. Confirmatory factor analysis established a theoretical model to serve as a foundation for IR4.0 adoption in the Saudi construction industry. Research limitations/implications The limitations may be perceived in terms of the local context of the research, as well as the sample size. This prevents the potential for generalization of the study’s results. Practical implications It is of practical value to the Saudi construction industry in facilitating the successful implementation of technology through policies, frameworks and best practice guidance. Originality/value The study advances the theoretical knowledge of technology implementation in the construction industry. Emerging economies such as Saudi Arabia seeking to leverage the capabilities of digital technologies will find the results of this to be of crucial value.

Revolutionizing Organizational Communication in Industry 4.0: Unlocking Opportunities and Overcoming Challenges in Bangladesh

This paper examines the impact of Industry 4.0 on organizational communication, exploring the opportunities and challenges presented by this revolutionary paradigm shift. The study employs a qualitative research methodology, drawing on academic literature, case studies, and in-depth interviews with national and international organizations. By evaluating the importance of effective communication in the Internet of Things (IoT) era, the paper assesses the opportunities and identifies the challenges of Industry 4.0 in organizational communication. The study delves into the complex relationship between technology and communication, outlining best practices for implementing communication tools and artificial intelligence (AI) in Industry 4.0. Effective communication is crucial for success in Industry 4.0, as it enables individuals to collaborate effectively and share ideas, leading to improved decision-making and problem-solving. However, information overload, miscommunication, and isolation risks must be mitigated to ensure effective communication. Investing in employee training and development, establishing clear communication protocols, and balancing virtual and face-to-face communication can help organizations manage these risks effectively. Mitigating the risks associated with organizational communication in Industry 4.0 is crucial to ensure that organizations can successfully leverage the opportunities presented by this era of digitalization. Recommendations include adopting cybersecurity measures, streamlining communication processes, protecting personal information, ensuring clarity and transparency, regularly updating data security measures, and promoting inclusive communication to overcome social barriers and ensure sustainable organizational communication.

Print Culture and The Spectacle 2.0

This paper describes creative printmaking practices that employ art as a platform for alternative voices that critique DeBord’s modern-day exploitation systems in the Society of the Spectacle1 (Debord, 1967). The specific art practices discussed aim to tempt mainstream participants caught within the Spectacle’s cycle to recognise, evaluate, and reconsider the impact these systems have on contemporary society. The creative industries have spent much time ‘on mute’ throughout the past two years. While navigating the ever-changing lockdowns and restrictions, art practitioners – whose role is often to bring people together physically – have been forced to operate in isolation from behind a keyboard. As visual practitioners, we must speak out in response to these COVID-related paradigm shifts with the most effective post-pandemic voice we can muster: our art practice. This paper suggests that a potent reaction to our impacted creative lives comes from understanding how the Spectacle’s mechanisms operate in a contemporary sense during this pandemic. At the same time, it discusses how art can be used to challenge the principles and ethics of a culture caught within the Spectacle. The paper also discusses historical and contemporary artists and art practices that utilise the same techniques, mediums, and frameworks employed by the Spectacle to expose the mechanisms of present-day Spectacle 2.0. These artists, who draw from print culture, utilise methodologies that successfully navigate the risks of becoming part of the ongoing cycle that the Spectacle perpetuates.

Nursing Education and Artificial Intelligence.

The American Association of Colleges of Nursing (AACN) is shifting the nursing education paradigm to competency-based education. Competency-based nursing education focuses on the nursing students' demonstration of knowledge. This shift in nursing education will rely on performance measures and data to determine success. Data and artificial intelligence can provide the nursing student with a targeted evaluation from the nursing faculty. Building on prior applications of "precision" and the use of data to drive precision medicine or precision nursing, nursing informatics is well-positioned for this paradigm shift to support data and artificial intelligence in nursing education. Little is understood about the concept of "precision nursing education" and its implications. We completed a concept analysis and defined the concept of "precision nursing education" as the use of data and artificial intelligence to measure student nurses' performance with competency-based nursing education.

Next-Generation strategies to combat antimicrobial resistance: Integrating genomics, CRISPR, and novel therapeutics for effective treatment

Antimicrobial resistance (AMR) poses a significant threat to global public health, necessitating innovative strategies to combat this escalating issue. This review outlines next-generation approaches integrating genomics, CRISPR technology, and novel therapeutics to effectively address AMR. Genomic techniques enable comprehensive understanding of the genetic mechanisms underpinning resistance, facilitating the development of targeted interventions. By sequencing the genomes of resistant pathogens, researchers can identify resistance genes, track their spread, and predict emerging resistance patterns. CRISPR-Cas systems offer a revolutionary tool for combating AMR through precise genome editing. This technology can disrupt resistance genes, restore antibiotic sensitivity, and develop bacteriophage therapies that selectively target resistant bacteria. Moreover, CRISPR-based diagnostics enable rapid, accurate detection of resistant strains, enhancing infection control measures. The advent of novel therapeutics, such as antimicrobial peptides, bacteriophage therapy, and synthetic biology-derived compounds, provides alternative treatment options. These therapeutics can bypass traditional resistance mechanisms and exhibit efficacy against multi-drug resistant organisms. Additionally, integrating artificial intelligence (AI) and machine learning with genomics and CRISPR can accelerate the discovery of new antibiotics and predict resistance trends, optimizing treatment regimens. Implementing these next-generation strategies requires robust global collaboration, regulatory frameworks, and investment in research and development. By combining genomics, CRISPR, and novel therapeutics, we can create a multifaceted approach to overcome AMR, ensuring effective treatments and safeguarding public health. This integration represents a paradigm shift in antimicrobial strategy, offering hope for a future where resistant infections can be effectively managed and treated. Keywords: Integrating Genomics, Antimicrobial Resistance, CRISPR, Therapeutic

A Biological Approach to Metalworking Based on Chitinous Colloids and Composites

AbstractBiological systems evolve with minimum metabolic costs and use common components, and they represent guideposts toward a paradigm of manufacturing that is centered on minimum energy, local resources, and ecological integration. Here, a new method of metalworking that uses chitosan from the arthropod cuticle to aggregate colloidal suspensions of different metals into solid ultra‐low‐binder‐content composites is demonstrated. These composites, which can contain more than 99.5% metal, simultaneously show bonding affinity for biological components and metallic characteristics, such as electrical conductivity. This approach stands in contrast with existing metalworking methods, taking place at ambient temperature and pressure, and being driven by water exchange. Furthermore, all the nonmetallic components involved are metabolized in large amounts in every ecosystem. Under these conditions, the composites’ ability to be printed and cast into functional shapes with metallic characteristics is demonstrated. The affinity of chitometallic composites for other biological components also allows them to infuse metallic characteristics into other biomaterials. The findings and robust manufacturing examples go well beyond basic demonstrations and offer a generalizable new approach to metalworking. The potential for a paradigm shift toward biomaterials based on their unique characteristics and the principles of their manufacturing methods is highlighted.

Building stronger foundations: exploring a collaborative faculty mentoring workshop for in-depth growth

BackgroundMentorship training programs demand a paradigm shift from theory-driven to hands-on practical approach with prioritization of preparation of mentors and mentees for their roles through self-awareness and targeted professional development planning. There is a lack of evidence generated from the health professions education institutions of global south regarding effectiveness of workshops in fostering mentorship culture.MethodsThis mixed method study with convergent parallel design was conducted through a collaborative mentoring workshop; “Faculty Mentoring-Building stronger by digging deeper” by Aga khan University Medical College, Karachi and University of Lahore, Punjab, Pakistan. Objective of the research was to emphasize the importance of faculty mentoring program, roles and responsibilities of mentors and mentees and perception of the participants regarding the associated role of institutions. It aimed to educate faculty members to develop personal development plans for becoming effective mentors and mentees. The demographic data was collected before the workshop, during the workshop data was collected from SWOT analysis, followed by goal settings and the action plans made by participants at the end. Post workshop online feedback was acquired by a questionnaire to comprehend participants’ educational attainment. Association between quantitative findings was done through ANOVA, while the qualitative data was subjected to thematic analysis.ResultsTotal of 37 faculty members participated in the hands-on workshop. All faculty equally perceived the workshop as satisfactory and reported that hands-on practice led to positive experience of setting clear goals and action plans in developing oneself both as mentor and mentee. Themes identified were; Faculty Mentorship Program, Personal development Plan of Mentors and Mentees and Building Positive Mentor-Mentee Relationships. Voluntary structured program, choice of more than one faculty mentor and portfolio development based on personal SWOT was recommended by participants for the success of formal mentoring programs.ConclusionMedical Faculty of Pakistani Universities at all career levels is interested in development of formal mentoring programs in their universities. Formal training for the same is also recommended by the participants. Institutions should cultivate a culture of mentorship that supports the professional growth and success of academics for cultivating the minds that are in turn shaping our future generations.

Sociological Analysis of Restorative Justice in Rehabilitative Law Enforcement for Drug Abuse Cases

The escalating trend in drug abuse, particularly among the youth, necessitates a unified approach from all law enforcement entities to address this shift in paradigm. It is essential to view drug addicts and victims of drug abuse not only as perpetrators but also as victims, warranting the incorporation of rehabilitation as an alternative form of punishment. The severity of narcotics crime in Indonesia poses a profound threat not only to individual health both physical and mental but also to societal well-being and national development, potentially compromising state security and sovereignty. This paper explores the enforcement of narcotics law in Indonesia as dictated by Law Number 35 of 2009 and examines the application of restorative justice, a concept often referred to in criminal law enforcement, which emphasizes recovery and atonement for the perpetrator or their family towards the victim, facilitating out-of-court reconciliatory efforts. By examining the legal sociological perspective, this research advocates for resolving narcotics-related criminal cases through means that prioritize restoration over retribution. It argues for a restorative justice approach, where the focus shifts from imprisonment to alternatives like medical and social rehabilitation, aiming for a resolution that restores harmony and agreement between involved parties, thereby aligning legal outcomes with societal values and needs.

Rising sun in the cyber domain: Japan’s strategic shift toward active cyber defense

This paper provides an in-depth analysis of Japan’s evolving cyber defense capabilities and explores its future challenges. National security has transformed in the twenty first century, with cyberspace becoming a key conflict domain. Japan, like other nations, has adapted to these changes. In 2022, the Japanese government introduced its active cyber defense concept. The National Security Strategy of 2022 stated the government’s posture for active cyber defense, which pre-emptively neutralizes adversary computers. This marked a turning point in Japan’s security and defense. This strategic shift, which occurred notably between 2000 and 2022, exemplifies Japan’s transition in the cyber domain. The scope of protecting cyberspace has evolved from primarily safeguarding civilian infrastructure to adopting proactive measures. This evolution is analyzed in the paper, which contrasts Japan’s approach with Western nations’ military-driven cyber policies. Additionally, the multifaceted challenges and opportunities arising from this paradigm shift in cyber capability development are explored. The analysis encompasses key aspects, including the policy formation, international cooperation, budgetary allocations, and the progress of organizational structures regarding the cyber domain. Furthermore, the study explores Japan’s future trajectory in cyber defense, with a particular focus on its role within the ‘Multi-Domain Defense Force’ and the dynamics of the Japan-US alliance.

Approach to the patient: New era emerges for craniopharyngioma management.

Papillary craniopharyngioma (PCP) and adamantinomatous craniopharyngioma (ACP) are distinct, slow growing tumors of the suprasellar region. Their location, composition and biology have historically evaded successful surgical, radiation, and medical therapy. Meanwhile compromise of critical structures either by tumor or treatments increase morbidity, impacting patient and carer quality of life. There has been a paradigm shift in the management of PCP, stemming from the discovery of BRAFV600E mutation in its tumorigenesis. Such a treatment breakthrough may soon be the case for ACP, changing the landscape of craniopharyngioma management. We use a case of ACP, partially responding to ERK inhibitor therapy to demonstrate chronicity of disease progression and discuss modern management strategies highlighting the importance of access to tumour agnostic clinical trials, and future directions.