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This introduction to the forum marking the 75th anniversary of the Department of International Relations (IR) at the Australian National University (ANU) is organised in three parts. First, it 'looks back' at the origins and evolution of the department, highlighting the opportunities and tensions that have arisen from the housing of the department within administrative units concerned with area studies, particularly the Asia-Pacific region. 'Looking around' at the department today, the paper notes the prevalence of work on issue-areas previously unexplored (such as gender, justice and security) or being re-explored (particularly diplomacy), as well as the close relationship between theory and practice that emerges from the department's base in Canberra at Australia's national university. Finally, the introduction 'looks forward', using themes developed in the papers that make up this forum around ethical silences and openings to examine the public responsibilities of scholars, both in ANU's Department of IR and further afield, around research, teaching and engagement. [ABSTRACT FROM AUTHOR]

Despite the prominence of the resilience concept in democracy studies, attempts to actually measure democratic resilience, and to understand the causal pathways that link a political system’s capacity to remain or become resilient (‘resilience capacity’) to its actual degree of resilience (‘resilience performance’), remain rare. Using a fuzzy set Qualitative Comparative Analysis (fsQCA), this study examines the level of democratic resilience and the causal pathways through which capacities impact the resilience performance of 18 countries and 35 cases in Asia-Pacific in the context of two exogenously induced crises. We show that, despite the pessimistic mood in current democratisation studies, there is considerable variation in the resilience performance of electoral regimes in this region. Furthermore, we identify two equally sufficient combinations of causal conditions to explain democratic resilience and a single sufficient condition to explain weak or absent democratic resilience. [ABSTRACT FROM AUTHOR]

This study scrutinizes the common wisdom concerning Turkey's crucial geopolitical significance and central physical location against the backdrop of four global transformations that are taking place in the twenty-first century. These tectonic shifts include China's rise and the ongoing Sino-US rivalry, trade routes and supply chains favoring the Asia-Pacific, technological changes brought by the fourth Industrial Revolution and finally, the decarbonization process. Based on an examination of these new dynamics, the article concludes that Turkey's geographical location and its traditional 'bridge' status between Asia and Europe no longer provides it the strategic leverage it had enjoyed in the twentieth century. [ABSTRACT FROM AUTHOR]

At the 2014 summit of the Conference on Interaction and Confidence Building Measures in Asia, Chinese President, Xi Jinping with New Asian Security Concept, announced the slogan of 'Asia for Asians' or 'Asia belongs to Asians', and he played a leading role in the reactivation of CICA. In this sense, it can be stated that China has aimed to play a more active role in shaping the existing regional security order in Asia-Pacific. Although the regional policies of the United States, starting with the 'Pivot to Asia' and continuing with the 'Free and Open Indo-Pacific' strategy and the regional and international developments in China's strategic environment have increased China's need for CICA, it served as a kind of soft balancing act, rather than hard balancing act, that increased diplomatic maneuverability for China. In this regard, the article attempts to explain why CICA remains a soft balancing act in China's regional security policies, taking into account a number of factors such as power parity/disparity, economic dependence/interdependence, threat perception and increasing institutionalization in the international system, and attempts to explore why CICA is becoming an increasingly important regional security institution for China. [ABSTRACT FROM AUTHOR]

Introduction: Reporting of sex and gender analysis in medical research has been shown to improve quality of the science and ensure findings are applicable to women and men. There is conflicting evidence on whether efforts by funding agencies and medical journals to encourage reporting of sex and gender analysis have resulted in tangible improvements. This study mapped the inclusion of sex and gender analysis in stroke and dementia research conducted in the Asia-Pacific region. Methods: A systematic search for Asia-Pacific stroke and dementia research was conducted in PubMed and papers included from the period 2012 to 2022. Eligible studies were reviewed for inclusion of a primary sex or gender focus and categorized by type of sex and gender analysis. Author gender was determined using an algorithm and its associations with inclusion of sex and gender analysis were examined. Results: Total Asia-Pacific publications increased from 109 in 2012 to 313 in 2022, but the rate of studies with a primary sex or gender focus did not increase significantly (R2 = 0.06, F(1, 9) = 0.59, p = 0.46). Australia, China, India, Japan, and South Korea produced the most publications over the study period and were the only countries with at least 50 publications. The impact of author gender was mixed, with female first authorship associated with inclusion of sex or gender analysis and last female authorship associated with studies having a primary sex or gender focus. Conclusions: In the Asia-Pacific, brain health research is currently centred around high-income countries, and efforts are needed to ensure research findings are applicable throughout the region. While there was a general increase in brain health publications over the last decade, the rate of sex and gender analysis was unchanged. This demonstrates that even with efforts in some countries in place, there is currently a lack of progress in the Asia-Pacific region to produce more research focussing on sex and gender analysis. [ABSTRACT FROM AUTHOR]

The purpose of this scoping literature review was to examine the available evidence on the discussion of lesbian, gay, bisexual, transgender/gender diverse, queer, and intersex (LGBTQI+) populations in published journal articles on social work education in the Asia-Pacific region. Using a modified PRISMA framework, the research team searched 33 English-language Q1 and Q2 journals (with an impact factor ranging from 0.5 to 2.8) in social work. The initial search yielded 4,468 results related to LGBTQI+ inclusion. Once full-text articles were reviewed, 15 relevant articles remained. Most articles were from Australia and Aotearoa/New Zealand and several were empirical papers. The chief finding was that the literature focused on preparing students with appropriate affirmative and strengths focused language for effectively intervening with LGBTQI+ communities. We found gaps in LGBTQI+ inclusive education in the literature, particularly in developing regions of the Asia-Pacific. Future research in social work education in the Asia-Pacific should explore opportunities for enhancing LGBTQI+ inclusion within the region. [ABSTRACT FROM AUTHOR]

Study Design: A prospective web-based survey. Purpose: Although intraoperative neurophysiological monitoring (IONM) is critical in spine surgery, its usage is largely based on the surgeon's discretion, and studies on its usage trends in Asia–Pacific countries are lacking. This study aimed to examine current trends in IONM usage in Asia–Pacific countries. Overview of Literature: IONM is an important tool for minimizing neurological complications and detecting spinal cord injuries after spine surgery. IONM can be performed using several modalities, such as transcranial electrical stimulation-muscle evoked potentials (Tc-MEP) and somatosensory evoked potentials (SEP). Methods: Spine surgeons of the Asia–Pacific Spine Society were asked to respond to a web-based survey on IONM. The questionnaire covered various aspects of IONM, including its common modality, Tc-MEP details, necessities for consistent use, and recommended modalities in major spine surgeries and representative surgical procedures. Results: Responses were received from 193 of 626 spine surgeons. Among these respondents, 177 used IONM routinely. Among these 177 respondents, 17 mainly used SEP, whereas the majority favored Tc-MEPs. Although a >50% decrease is the commonly used alarm point in Tc-MEP, half of the Tc-MEP users had no protocols planned for such scenarios. Moreover, half of the Tc-MEP users experienced complications, with bite injuries being the most common. Most respondents strongly recommended IONM in deformity surgery for pediatric and adult populations and tumor resection surgery for intramedullary spinal cord tumors. Conversely, IONM was the least recommended in lumbar spinal canal stenosis surgery. Conclusions: Spine surgeons in Asia–Pacific countries favored IONM use, indicating widespread routine utilization. Tc-MEP was the predominant modality for IONM, followed by SEPs. [ABSTRACT FROM AUTHOR]

Context: The emergence of pan-resistant bacteria requires the development of new antibiotics and antibiotic potentiators. Objective: This review identifies antibacterial phenolic compounds that have been identified in Asian and Pacific Angiosperms from 1945 to 2023 and analyzes their strengths and spectra of activity, distributions, molecular masses, solubilities, modes of action, structures-activities, as well as their synergistic effects with antibiotics, toxicities, and clinical potential. Methods: All data in this review was compiled from Google Scholar, PubMed, Science Direct, Web of Science, and library search; other sources were excluded. We used the following combination of keywords: 'Phenolic compound', 'Plants', and 'Antibacterial'. This produced 736 results. Each result was examined and articles that did not contain information relevant to the topic or coming from non-peer-reviewed journals were excluded. Each of the remaining 467 selected articles was read critically for the information that it contained. Results: Out of ∼350 antibacterial phenolic compounds identified, 44 were very strongly active, mainly targeting the cytoplasmic membrane of Gram-positive bacteria, and with a molecular mass between 200 and 400 g/mol. 2-Methoxy-7-methyljuglone, [6]-gingerol, anacardic acid, baicalin, vitexin, and malabaricone A and B have the potential to be developed as antibacterial leads. Conclusions: Angiosperms from Asia and the Pacific provide a rich source of natural products with the potential to be developed as leads for treating bacterial infections. [ABSTRACT FROM AUTHOR]

With the election of Donald Trump as US president again, the 'Great Debate' about transatlantic burden-sharing for the defence of Europe that started in 1950, but remained subdued during and since the Cold War, has reached a head and will determine the future of transatlantic relations. Trump has regularly suggested, often vituperatively, that he believes the cost of NATO outweighs the benefits. While he may not attempt to withdraw the United States from NATO, his national-security team appears poised to substantially diminish US ground forces in Europe and American responsibility for European security to turn primary attention to the Asia-Pacific. Whether the Europeans are willing or able to step forward to fill the gap remains unclear. More coordinated spending between the European members of the Alliance is required, with a greater focus on fielding combat-ready troops and revitalising the continent's defence-industrial base. [ABSTRACT FROM AUTHOR]

Copyright of Cappadocia Journal of Education (KAPED) is the property of Nevsehir Haci Bektas Veli Universitesi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Generalized pustular psoriasis (GPP) is a rare, chronic, heterogeneous, and potentially life‐threatening disease characterized by primary, sterile, and macroscopically visible pustules with or without systemic symptoms. There are ethnic differences in the genetic mutations associated with GPP that might affect the clinical manifestations and treatment responses. Currently, there is limited evidence from the patient population in the Asia‐Pacific (APAC) region, resulting in a general paucity of information on the effective management of patients with GPP in this region. This modified Delphi panel study aimed to identify current evidence and gain advanced insights to facilitate the development of a regionally tailored APAC consensus on the management of GPP. A systematic literature review (SLR) was conducted to identify published literature and develop consensus statements on (i) definition and clinical course, (ii) diagnosis of GPP, (iii) treatment outcomes, goals, and monitoring measures, and (iv) optimal management strategies and clinical practices. Statements were rated by a panel of dermatologists in two rounds, with the threshold for consensus at ≥80% agreement. Twenty experts from the APAC region reached consensus on 106 statements that were developed based on the SLR and experts' collective expertise. The experts agreed that GPP is a rare, severe, and potentially life‐threatening condition that is distinct from plaque psoriasis. This consensus emphasized the importance of a tailored treatment strategy taking into account the GPP flare severity and each patient's unique clinical circumstances. The experts reached consensus on the severity classification of GPP flares and recommended first‐line and maintenance treatment options for adult GPP, childhood GPP, and GPP in pregnancy. These consensus outcomes have been synthesized into treatment algorithms to guide dermatologists in the APAC region in their clinical decision‐making processes. [ABSTRACT FROM AUTHOR]

The 29th Asia-Pacific Regional Space Agency Forum (APRSAF) meeting reconfirmed the forum’s vital role in regional space initiatives that can further help global coordination in space activities. This report presents such perspective from an intra-region participant’s point of view. It highlights key discussions from the 2023 plenary session, emphasizing the Space Policy and Law Working Group’s contributions. The importance of the APRSAF’s National Space Legislation Initiative (NSLI) in harmonizing space laws and the involvement of young scholars in policy shaping are underscored. The report obeserves the opportunities and challenges in regional space cooperation in the Asia-Pacific region.

Theoretical research indicates that foreign interference, and even allegations thereof, cause long-term negative effects: they erode trust, damaging the bilateral relationship, and lead to a greater polarization of the political system and society due to the securitization of the relationship with the presumed interferer. The article examines the case of how the Australian government and society have reacted to the perceived attempts of interference by the People’s Republic of China (PRC). It tests theoretical hypotheses by answering the question of what are the implications of the above-mentioned issue for Australia - China relations and Australia’s politics. The study has identified that the rhetoric about foreign interference by the PRC into Australia’s internal affairs has been publicly attributed to a complex of attempts at unwanted influence not only in politics but also in other domains such as society, economics, education and mass media. This issue served as a critical juncture in initiating a downward trend in bilateral relations by significantly eroding Australia’s trust in China and public opinion about it as well as by prompting the Australian government to reassess its policy vis-à-vis the PRC against the background of challenging geopolitical landscape of the Asia-Pacific. The securitization of cross-border links with China has become a notable phenomenon. As a result of these events as well as other foreign policy factors, Australia - China relations deteriorated significantly. The Australian government promptly took a hard stance against the perceived foreign interference, becoming the first to adopt a special legislation to combat it. This issue was instrumentalized in political competition, especially by the Liberal Party of Australia. However, there has been no polarization of the Australian political system and society. The result has been a broad public and bipartisan consensus on the need for a greater transparency and public scrutiny over the links with China, as well as the establishment of an effective system to counter foreign interference. The Australian case demonstrates that the instrumentalization of the interference issue may lead not to a polarization but, on the contrary, to a domestic consensus over standing up to a perceived threat.

Abstract Background The Asia-Pacific (APAC) region includes a significant proportion of the global population currently living with overweight and obesity. This modelling analysis was conducted to quantify the incidence of obesity-related comorbidities and change in obesity-related costs over 10 years with a hypothetical 10% weight loss in Australia, South Korea, Thailand, and India. Methods An epidemiological-economic model was used to describe current prevalence and direct medical costs of ten obesity-related comorbidities, including type 2 diabetes and hypertension, in adults aged 20–69 years living with obesity, and estimate incidence and costs over 10 years. Incidence reduction and the associated savings by 2032 were then estimated for a 10% weight-loss scenario. Results The total estimated medical costs for the ten obesity-related comorbidities in 2022 were 2.9, 7.5, 10.2, and 23.3 billion USD in Australia, South Korea, Thailand, and India, respectively. Costs increase to 6.9, 18.4, 23.5, and 44.3 billion USD in 2032, if insufficient action is taken. A 10% weight reduction would result in estimated savings of 0.3, 1.2, 2.2, and 3.0 billion USD in Australia, South Korea, Thailand, and India, respectively, in 2032, with cumulative savings over the 10-year period of 1.8, 7.0, 13.0, and 17.4 billion USD. Incidence of comorbidities were estimated to rise less in the weight-loss scenario. Conclusions The financial, societal, and health benefits of a substantial but achievable 10% weight loss in adults living with obesity, and the consequences of insufficient action, are pronounced in the APAC region. To achieve sustained weight loss in the real world, policy actions for addressing barriers to obesity management are required.

Purpose – The aim of this study was to investigate the role of immersive gaming on brand coolness and brand equity, with particular emphasis on fashion gaming collaborations. We used game theory as a theoretical framework to analyse immersive branding strategies and gain a deeper understanding of fashion consumers’ decision-making process in gaming environments. Gender, as a significant factor affecting gamers, has been studied as a moderator that impacts the overall proposed framework. Design/methodology/approach – A quantitative method was used to assess the significance of relationships within the proposed model empirically. The partial least squares structural equation modelling technique was implemented to assess the relationships of the framework with a sample size of 160 active Malaysian gamers. Findings – The findings indicate that brand equity is positively associated with perceived brand coolness. Furthermore, of the three core values of online games, perceived enjoyment is most strongly associated with perceived brand coolness, ahead of the values of self-expression and perceived emotional challenge. The results of the multigroup analysis further suggest that in the fashion industry, building brand equity through online games is strongly related to perceived brand coolness among female respondents, the role of perceived brand coolness being weaker among male respondents. Originality/value – The study contributes to the existing literature by providing a deeper understanding of the impact of immersive gaming branding practices on the overall equity of the fashion brand. The results provide insight for fashion brand managers into the significant effect on consumer behaviour outcomes of fashion-gaming collaborations. 研究目的 – 本研究擬探討身歷其境的遊戲體驗在品牌酷感和品牌資產上所扮演的角色; 研究特別強調裝扮遊戲的合作。研究人員以博弈論作為研究的理論框架,來分析沉浸品牌策略、和對時裝消費者在遊戲的環境中如何作出決策取得更深入的瞭解。研究人員探討了性別作為影響遊戲參與者的重要因素,這因素被視為為整個被提出的框架帶來調節的影響和作用。 研究設計/方法/理念 – 研究人員採用定量方法進行研究,目的為於被提出的模型內之各種關聯的意義進行以經驗為依據的評估。研究人員採用了基於偏最小平方法的結構方程模型研究法,來對一個包含160名活躍的馬來西亞遊戲參與者的樣本進行框架的各個聯繫的評估研究。 研究結果 – 研究結果顯示,品牌資產與品牌酷感成正相關; 而且,在網絡遊戲的三個核心價值中,感知享受與品牌酷感之間的聯繫最為強烈和密切,超過自我表現和感知情感挑戰兩者的價值; 多群組的分析結果更暗示了在時裝產業裡,透過網絡遊戲去建立品牌資產在女性回應者中是與品牌酷感有強烈密切的關係; 而在男性回應者中,品牌酷感所扮演的角色則較弱。 研究的原創性/價值 – 本研究使我們能更深入認識沉浸遊戲品牌的慣常做法如何影響時裝品牌的整體資產。研究結果為時裝品牌經理提供了啟示,使他們明瞭時裝遊戲的合作會給消費者行為產生重要的影響。

The emergence of Covid-19 in late 2019 rapidly shattered the Asia-Pacific region (APR), a bastion of economic dynamism, and it became the epicenter of the global health crisis. This unprecedented pandemic not only triggered a public health catastrophe but also unleashed a financial storm, exposing vulnerability within the region's interconnected economies. This study identifies the factors driving volatility spillovers within Asian-Pacific financial markets during the initial wave of the Covid-19 pandemic (January 2020–February 2021). We analyze the interplay of pandemic transmission dynamics, government interventions, central bank policies, and socioeconomic variables. Our findings reveal a robust and persistent association between the rising number of Covid-19 cases per million and volatility spillovers. We introduce three novel determinants—the number of intensive care unit beds, population density, and the proportion of the elderly population—which significantly impact volatility transmission in response to new cases. Stringent government measures, such as travel bans and lockdowns, mitigate volatility spillovers. Conversely, central bank policies increase volatility spillovers. These insights contribute to a deeper understanding of financial market dynamics in the context of global health emergencies. This knowledge equips policy makers in the APR with valuable tools for navigating future crises.

This paper examines the perspectives of educators on whether internationalisation at a distance (IaD) democratises student mobility in higher education. Adopting a collaborative autoethnographic approach, the analysis focuses on the perspectives of educators involved in virtual mobility practices in relation to three prompts: (1) IaD's capacity for democratisation, (2) IaD practices and the achievement of more equitable, accessible and inclusive education and (3) tensions that emerge from implementing IaD practices in institutional contexts. Applying a three‐dimensional theory of justice that supports parity of participation in social life (Scales of Justice, 2009), this paper explores educators' perceptions of IaD's potential to democratise student mobility. The findings demonstrate beliefs that IaD can only democratise student mobility to a certain extent. As educators embrace IaD as a set of inclusive and equitable practices, they also question the unequal availability of material, social and cultural resources that could realise the potential of IaD for students. Situated within IaD discourses in the Asia‐Pacific region, which have received little attention in the broader research field of virtual mobility, this paper reinforces the emerging recognition of the fundamental yet often overlooked tensions between internationalisation and democratisation. Practitioner notes What is already known about this topic Internationalisation at a distance (IaD) is a growing practice in higher education internationalisation where students learn in their ‘home country’ aided by digital technologies with curriculum and educators located in a different geographical location. IaD blurs the boundaries of internationalisation and brings into question binaries such as ‘international/domestic’, ‘home/abroad’ and ‘geographic/virtual’, while inviting researchers, educators and institutions to rethink how they can reframe their internationalisation efforts. What this paper adds This paper probes the extent to which IaD can be seen as a more democratic form of student mobility, particularly in relation to addressing unequal participation of students in geographic mobility experiences. It shows that the potential of IaD to be democratising can be conflated into inclusive and equitable discourses without necessarily addressing structural, cultural and social barriers to student mobility. The paper highlights that IaD is best placed to address issues of distribution when it comes to ensuring students full parity of participation in mobility experiences. In this sense, IaD supports more students from disadvantaged backgrounds or with a disability to be able to participate fully in the educational, cultural and social gains afforded by internationalisation. The paper demonstrates IaD is not equipped to address issues of recognition and representation when it comes to ensuring students full parity of participation in mobility experiences. There is very little change to the locus of decision‐making regarding which mobility experiences are available to which students in IaD. Implications for practice and/or policy The paper recognises the potential of IaD as an internationalisation practice that shifts the deficit discourses surrounding virtual mobility and can enable wider access to mobility experiences. Practitioners in internationalisation efforts should consider what other mechanisms and initiatives need to be established institutionally to complement the potential of IaD, particularly mechanisms and initiatives around material, cultural and social resources that are unequally distributed and negatively impact students when it comes to mobility experiences. There is a pressing need to rethink IaD not as a ‘saviour’ or ‘one‐size‐fits‐all’ for all the injustices that are part of internationalisation practices in higher education institutions. IaD is a step in the right direction that still requires a significant shift in power dynamics to allow parity in decision‐making for institutions outside privileged Global North contexts. What is already known about this topic Internationalisation at a distance (IaD) is a growing practice in higher education internationalisation where students learn in their ‘home country’ aided by digital technologies with curriculum and educators located in a different geographical location. IaD blurs the boundaries of internationalisation and brings into question binaries such as ‘international/domestic’, ‘home/abroad’ and ‘geographic/virtual’, while inviting researchers, educators and institutions to rethink how they can reframe their internationalisation efforts. What this paper adds This paper probes the extent to which IaD can be seen as a more democratic form of student mobility, particularly in relation to addressing unequal participation of students in geographic mobility experiences. It shows that the potential of IaD to be democratising can be conflated into inclusive and equitable discourses without necessarily addressing structural, cultural and social barriers to student mobility. The paper highlights that IaD is best placed to address issues of distribution when it comes to ensuring students full parity of participation in mobility experiences. In this sense, IaD supports more students from disadvantaged backgrounds or with a disability to be able to participate fully in the educational, cultural and social gains afforded by internationalisation. The paper demonstrates IaD is not equipped to address issues of recognition and representation when it comes to ensuring students full parity of participation in mobility experiences. There is very little change to the locus of decision‐making regarding which mobility experiences are available to which students in IaD. Implications for practice and/or policy The paper recognises the potential of IaD as an internationalisation practice that shifts the deficit discourses surrounding virtual mobility and can enable wider access to mobility experiences. Practitioners in internationalisation efforts should consider what other mechanisms and initiatives need to be established institutionally to complement the potential of IaD, particularly mechanisms and initiatives around material, cultural and social resources that are unequally distributed and negatively impact students when it comes to mobility experiences. There is a pressing need to rethink IaD not as a ‘saviour’ or ‘one‐size‐fits‐all’ for all the injustices that are part of internationalisation practices in higher education institutions. IaD is a step in the right direction that still requires a significant shift in power dynamics to allow parity in decision‐making for institutions outside privileged Global North contexts. [ABSTRACT FROM AUTHOR]

Paroxysmal nocturnal hemoglobinuria (PNH) clones can be identified in a significant proportion of patients with aplastic anemia (AA). Screening for PNH clones at the time of an AA diagnosis is recommended by national and international guidelines. In this report, an expert panel of physicians discusses current best practices and provides recommendations for managing PNH in patients with AA in the Asia–Pacific region. Plasma/serum lactate dehydrogenase (LDH) levels and reticulocyte count should be measured with every blood test. PNH clone size should be monitored regularly by flow cytometry, with on-demand testing in the event of a rise in LDH level ± reticulocyte count or development of symptoms such as thrombosis. Monitoring for PNH clones can guide the choice of initial AA treatment, although flow cytometry has resource implications which may present a challenge in some Asia–Pacific countries. The treatment of patients with both PNH and AA depends on which condition predominates; following PNH treatment guidelines if hemolysis is the main symptom and AA treatment guidelines if bone marrow failure is severe (regardless of whether hemolysis is mild or moderate). The expert panel's recommendations on the monitoring and treatment of PNH in patients with AA are practical for healthcare systems in the Asia–Pacific region. [ABSTRACT FROM AUTHOR]

The Indo-Pacific has rapidly become the world's geopolitical and geo-economic epicentre. Consequently, much scholarly attention has been focused on Sino–United States superpower competition and on the policies of the region's great and middle powers. However, since Europe has engaged late with the Indo-Pacific, its policies remain under-examined. This Special Issue fills a lacuna in our knowledge through a dedicated appraisal of German, British, Italian, and European Union approaches to the Indo-Pacific. This introductory article provides an analytical survey of the impetus for Europe's new awareness of the Indo-Pacific's importance. It then sheds light on the European approach based on a tripartite framework comprising economy, security, and norms, which is adopted by all the articles in this Special Issue to draw out comparative insights. This research thus contributes to the literature on both European and Indo-Pacific strategic landscapes by examining an understudied development under a novel joint assessment. [ABSTRACT FROM AUTHOR]

Italy is the only 'Big Four' European country and 'Quint' North Atlantic Treaty Organization (NATO) member ostensibly uninterested in the world's geopolitical and geoeconomic epicentre. However, a number of developments contradict the assumption that Rome overlooks the importance of the Indo-Pacific. By analysing official policies, naval deployments, new partnerships and evolving trajectories, this article reveals that Italy's strategic engagement with the Indo-Pacific is already significant and unfolding under three broad areas: (a) economy ; (b) security ; and (c) norms. It then assesses the benefits and risks of this developing foreign policy, and argues that the former outweigh the latter, a condition which is conducive to the establishment of an official Italian Indo-Pacific strategy. As the first scholarly work on the Italian role in the Indo-Pacific, this research makes a novel contribution to the literature on both Italian foreign policy and the Indo-Pacific security landscape, by investigating a complementary approach to that of existing Indo-Pacific strategies. [ABSTRACT FROM AUTHOR]

The Indo-Pacific region, linking the Indian and Pacific Oceans through Southeast Asia, is becoming increasingly significant in academic discourse and global politics. The geopolitical background of the idea is evident as it connects several major powers around China. However, can the concept serve as a cornerstone for a viable regional setting beyond geopolitics? And in extension, why do some regions institutionalize while others are unable to do the same? Drawing on social constructivism and region-building theories, we argue that three intersubjectively shared preconditions—proximity, interests, and identity—play a crucial role in regional consolidation. We posit that this framework operates as a scale, wherein meeting these conditions positively influences region formation and institutionalization. Comparing the Indo-Pacific to the Asia-Pacific and Southeast Asia, we contend that while the latter two possessed these components, the Indo-Pacific severely lacks shared ideas of proximity and identity, and the component of interests remains contested. We conclude that this limitation significantly hampers the possibility of the Indo-Pacific emerging as a viable and intersubjectively shared regional framework. [ABSTRACT FROM AUTHOR]

HCV RNA test determines current active infection and is a requirement prior to initiating HCV treatment. We investigated trends and factors associated with post‐diagnosis HCV RNA testing rates prior to HCV treatment, and risk factors for first positive HCV RNA among people living with HIV (PLHIV) with HCV in the Asia‐Pacific region. PLHIV with positive HCV antibody and in follow‐up after 2010 were included. Patients were considered HCV‐antibody positive if they ever tested positive for HCV antibody (HCVAb). Repeated measures Poisson regression model was used to analyse factors associated with post‐diagnosis HCV RNA testing rates from positive HCVAb test. Factors associated with time to first positive HCV RNA from positive HCVAb test were analysed using Cox regression model. There were 767 HCVAb positive participants included (87% from LMICs) of whom 11% had HCV RNA tests. With 163 HCV RNA tests post positive HCVAb test, the overall testing rate was 5.05 per 100 person‐years. Factors associated with increased testing rates included later calendar years of follow‐up, HIV viral load ≥1000 copies/mL and higher income countries. Later calendar years of follow‐up, ALT >5 times its upper limit of normal, and higher income countries were associated with shorter time to first positive HCV RNA test. Testing patterns indicated that uptake was predominantly in high income countries possibly due to different strategies used to determine testing in LMICs. Expanding access to HCV RNA, such as through lower‐cost point of care assays, will be required to achieve elimination of HCV as a public health issue. [ABSTRACT FROM AUTHOR]

Respiratory syncytial virus (RSV) represents a significant burden on older adults (aged ≥ 50 years) globally and can lead to acute respiratory tract infections with substantial morbidity and mortality. However, there is a significant gap in knowledge regarding RSV infection in older adults, particularly in the Asia‐Pacific region. This knowledge gap underscores the need for targeted and comprehensive studies to fully understand the nuanced epidemiology of RSV in ageing populations. This review synthesises data from various countries, emphasising the impact of RSV on older populations in the Asia‐Pacific region. The overall proportions of RSV‐related ARIs among older patients ranged from 0.2% to 5.6%. Among older adult patients with CAP, RSV accounted for 1.1%–10.3% of cases. However, it is crucial to note that the diversity in reported percentages highlights the influence of factors such as geographic location, health care settings and diagnostic practices. The most common symptoms observed in older adults with RSV infection were cough, sputum production and fever, followed by dyspnoea, sore throat and rhinorrhoea. Most of the old adults with RSV infection had underlying diseases, and RSV can cause significant morbidity and mortality in old adults. Treatment of RSV infections predominantly involve supportive care, with aerosolised ribavirin reserved for severe cases, especially immunocompromised patients. Emerging antiviral agents, including fusion and nucleoprotein inhibitors, offer promising avenues for future therapeutics. The recent approval of the bivalent RSV prefusion F protein‐based vaccine for individuals aged 60 and older represents a milestone in preventive strategies. In conclusion, RSV infection remains a significant threat to older adults in the Asia‐Pacific region, necessitating ongoing research and surveillance efforts. The recent vaccine approval marks a positive milestone, but further studies are crucial for refining prevention and treatment approaches. [ABSTRACT FROM AUTHOR]

This rapid review aimed to present a comprehensive overview of barriers, facilitators, and effective interventions that promote vaccination uptake by older adults in the Asia-Pacific region. Rapid review methodology was applied, using two databases (PubMed, Embase). Articles were included if studies were conducted in Australia, Singapore, Indonesia, and the Philippines; included human population ≥50 years of age, and was published from 2016 to August 2022. Related articles were not found from Indonesia and Philippines. A total of 23 articles met the inclusion criteria, with 19 reporting on barriers and facilitators, whereas, four articles reported effective interventions to promote vaccination uptake. Among the 19 studies that identified barriers and facilitators to vaccination uptake, the more common factors were social influences (n = 8/19), perceived benefits of vaccine (n = 7/19), and perceived vaccine safety (n = 6/19). Interventions that focused on supporting clinicians were found to be effective in leading them to recommend vaccinations among older adults, such as creating awareness on the low baseline vaccination rates among older adults, provision of structured health assessment, and nurse reminders. More studies are needed to ascertain the barriers and facilitators to uptake, as well as to identify effective interventions influencing vaccine uptake among older adults in the Asia-Pacific region. [ABSTRACT FROM AUTHOR]

The burden of colorectal cancer (CRC) is high in the Asia‐Pacific region, and several countries in this region have among the highest and/or fastest growing rates of CRC in the world. A significant proportion of patients will present with or develop metastatic CRC (mCRC), and BRAFV600E‐mutant mCRC represents a particularly aggressive phenotype that is less responsive to standard chemotherapies. In light of recent therapeutic advances, an Asia‐Pacific expert consensus panel was convened to develop evidence‐based recommendations for the diagnosis, treatment, and management of patients with BRAFV600E‐mutant mCRC. The expert panel comprised nine medical oncologists from Australia, Hong Kong, Singapore, and Taiwan (the authors), who met to review current literature and develop eight consensus statements that describe the optimal management of BRAFV600E‐mutant mCRC in the Asia‐Pacific region. As agreed by the expert panel, the consensus statements recommend molecular testing at diagnosis to guide individualized treatment decisions, propose optimal treatment pathways according to microsatellite stability status, advocate for more frequent monitoring of BRAFV600E‐mutant mCRC, and discuss local treatment strategies for oligometastatic disease. Together, these expert consensus statements are intended to optimize treatment and improve outcomes for patients with BRAFV600E‐mutant mCRC in the Asia‐Pacific region. [ABSTRACT FROM AUTHOR]

Background: The Asia-Pacific (APAC) region includes a significant proportion of the global population currently living with overweight and obesity. This modelling analysis was conducted to quantify the incidence of obesity-related comorbidities and change in obesity-related costs over 10 years with a hypothetical 10% weight loss in Australia, South Korea, Thailand, and India. Methods: An epidemiological-economic model was used to describe current prevalence and direct medical costs of ten obesity-related comorbidities, including type 2 diabetes and hypertension, in adults aged 20–69 years living with obesity, and estimate incidence and costs over 10 years. Incidence reduction and the associated savings by 2032 were then estimated for a 10% weight-loss scenario. Results: The total estimated medical costs for the ten obesity-related comorbidities in 2022 were 2.9, 7.5, 10.2, and 23.3 billion USD in Australia, South Korea, Thailand, and India, respectively. Costs increase to 6.9, 18.4, 23.5, and 44.3 billion USD in 2032, if insufficient action is taken. A 10% weight reduction would result in estimated savings of 0.3, 1.2, 2.2, and 3.0 billion USD in Australia, South Korea, Thailand, and India, respectively, in 2032, with cumulative savings over the 10-year period of 1.8, 7.0, 13.0, and 17.4 billion USD. Incidence of comorbidities were estimated to rise less in the weight-loss scenario. Conclusions: The financial, societal, and health benefits of a substantial but achievable 10% weight loss in adults living with obesity, and the consequences of insufficient action, are pronounced in the APAC region. To achieve sustained weight loss in the real world, policy actions for addressing barriers to obesity management are required. [ABSTRACT FROM AUTHOR]

The British Labour Party, after 14 years out of office, is grappling with a dynamic global strategic environment that has been transformed during that period. It has committed to a 'NATO-first' defence and security policy and presided over the United Kingdom's military pullback 'east of Suez' in the 1960s and 1970s, raising questions about the fate of the 'Indo-Pacific tilt' unveiled by the Conservative government three years ago. With its Strategic Defence Review and its first full budget, the new government has the opportunity to take ownership of the tilt. There may be synergies among capabilities that can add value in both the Euro-Atlantic and Asia-Pacific regions, in particular with respect to aircraft carriers, submarines and new fighter aircraft. The UK's paramount challenge is to achieve the right balance between integrated and sovereign capabilities so as to add value without overstretching limited resources or descending to mere tokenism. [ABSTRACT FROM AUTHOR]

Copyright of Relaciones Internacionales (1699-3950) is the property of Autonomous University of Madrid, Spain, International Relations Studies Group (GERI) Law Faculty and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Relaciones Internacionales (1699-3950) is the property of Autonomous University of Madrid, Spain, International Relations Studies Group (GERI) Law Faculty and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Since the discovery of hepatitis C virus (HCV) in 1989, we now have curative treatment options with direct-acting antiviral therapies. By increasing the rate of treatment and reducing transmission, the eradication of HCV is potentially achievable. Nonetheless, the feasibility and implementation of this goal remains challenging. This article sums up the approach to managing children with HCV in the Asia–Pacific region and lists some of the difficulties and complexities surrounding this issue. [ABSTRACT FROM AUTHOR]

Human-induced climate change will likely cause more intense and frequent cyclones and typhoons, as noted in the Intergovernmental Panel on Climate Change (IPCC) report Climate Change 2021: The Physical Science Basis. Within the Asia-Pacific region, regional security discussions at the leadership level focus on the imminent threats to states and societies of more frequent and intense extreme weather events and sea-level rise as it is the world's most exposed region. This article examines recent developments and discourse regarding climate change in the Asia-Pacific security architecture using the Association of Southeast Asian Nations (ASEAN) as a case study. It finds increasing recognition of climate change and its implications for peace and security within the regional security architecture. Debates over how best to address it to overcome an atomised approach to climate change impacts on peace and security in the region remain unresolved, but recent pronouncements at the leadership level signal an emerging mindset shift in understanding climate change within the regional security discourse. However, the substantive discussions largely take place in hybrid forums, albeit with official recognition in more traditional platforms, which may undermine efforts for an inclusive regional discourse on the climate change impacts on peace and security in ASEAN. [ABSTRACT FROM AUTHOR]

ABSTRACTHerpes zoster (HZ) is a painful rash which typically affects older adults. This is of concern in Asia-Pacific given its aging population. As HZ epidemiology and burden are evolving, this systematic literature review aimed to update the current understanding of HZ burden and associated costs for selected Asia-Pacific locales. MEDLINE and Embase were searched for English articles of HZ studies conducted in Australia, China, Hong Kong, Japan, Korea, New Zealand, Singapore, and Taiwan. Eligible outcomes included HZ incidence and prevalence, occurrence of HZ-related complications, healthcare resource utilization, costs, and HZ-associated quality of life outcomes. This paper focused on HZ data in the general adult population (N = 90 articles). Substantial HZ-related disease and economic burden were observed in these locales, consistent with global trends. These findings reinforce the increasing burden of HZ and need for preventive strategies, which may include raising awareness and encouraging timely vaccination.

ABSTRACTIn Singapore, population aging and rising life expectancy are increasing herpes zoster (HZ) burden, which may be reduced by vaccination. The present study modeled the public health impact of HZ vaccination in Singapore using ZOster ecoNomic Analysis (ZONA) model adapted with Singapore-specific key model inputs, where available. Base case analysis was conducted in adults ≥ 50 years of age (YOA), exploring three vaccination strategies (no vaccination, recombinant zoster vaccine [RZV], zoster vaccine live [ZVL]) under mass vaccination setting (30% coverage). Scenario and sensitivity analyses were performed. Out of 1.51 million adults in 2021 (base case population), 406,513 (27.0%) cases of HZ, 68,264 (4.5%) cases of post-herpetic neuralgia (PHN), and 54,949 (3.6%) cases of other complications were projected without vaccination. RZV was estimated to avoid 73,129 cases of HZ, 11,094 cases of PHN, and 9,205 cases of other complications over the subjects’ remaining lifetime; ZVL would avoid 17,565 cases of HZ, 2,781 cases of PHN, and 1,834 cases of other complications. The number needed to vaccinate to prevent one case of HZ/PHN was lower for RZV (7/41) than ZVL (26/163). Among all five age-stratified cohorts (50–59/60–64/65–69/70–79/≥80 YOA), RZV (versus no vaccination/ZVL) avoided the largest number of cases in the youngest cohort, 50–59 YOA. Results were robust under scenario and sensitivity analyses. Mass vaccination with RZV is expected to greatly reduce the public health burden of HZ among Singapore individuals ≥ 50 YOA. Findings support value assessment and decision-making regarding public health vaccination strategies for HZ prevention in Singapore.

Abstract Primary liver cancer is the third leading cause of cancer-related mortality. The increasing prevalence of metabolic syndrome and alcohol consumption, along with the existing burden of viral hepatitis, could significantly heighten the impact of primary liver cancer. However, the specific effects of these factors in the Asia–Pacific region, which comprises more than half of the global population, remain largely unexplored. This study aims to analyze the epidemiology of primary liver cancer in the Asia–Pacific region. We evaluated regional and national data from the Global Burden of Disease study spanning 2010 to 2019 to assess the age-standardized incidence, mortality, and disability-adjusted life years associated with primary liver cancer in the Asia–Pacific region. During the study period, there were an estimated 364,700 new cases of primary liver cancer and 324,100 deaths, accounting for 68 and 67% of the global totals, respectively. Upward trends were observed in the age-standardized incidence rates of primary liver cancer due to metabolic dysfunction-associated fatty liver disease (MASLD) and alcohol-associated liver disease (ALD) in the Asia–Pacific region, as well as an increase in primary liver cancer from Hepatitis B virus infection in the Western Pacific region. Notably, approximately 17% of new cases occurred in individuals aged 15–49 years. Despite an overall decline in the burden of primary liver cancer in the Asia–Pacific region over the past decade, increases in incidence were noted for several etiologies, including MASLD and ALD. However, viral hepatitis remains the leading cause, responsible for over 60% of the total burden. These findings underscore the urgent need for comprehensive strategies to address the rising burden of primary liver cancer in the Asia–Pacific region.

Introduction: Atezolizumab plus bevacizumab is a commonly used first-line regimen for advanced hepatocellular carcinoma (HCC) treatment owing to its superior outcomes compared to sorafenib. However, optimal subsequent treatment options for patients with HCC who progressed on first-line atezolizumab plus bevacizumab remain unclear. Methods: This multinational, multi-institutional, retrospective study included patients with HCC from 22 centers in five Asia-Pacific countries who were treated with first-line atezolizumab plus bevacizumab, which was discontinued for any reason. The endpoints included progression-free survival (PFS) and overall survival (OS) according to patient characteristics and second-line regimens. Results: Between June 2016 and May 2023, 1,141 patients were treated with first-line atezolizumab plus bevacizumab, of whom 629 (55.1%) received subsequent treatment. Sorafenib and lenvatinib were the most commonly administered second-line regimens (53.9% and 25.6%, respectively). Overall, the median PFS and OS were 2.9 and 8.0 months, respectively. Lenvatinib had longer PFS (4.0 vs. 2.3 months) and OS (8.0 vs. 6.3 months) than sorafenib. Patients treated with tyrosine kinase inhibitor (TKI) plus immune checkpoint inhibitor (ICI) (n = 50, 8.3%) showed PFS and OS of 5.4 and 12.6 months, respectively. Lower tumor burden and lenvatinib or TKI plus ICI use were associated with longer second-line PFS. Preserved liver function was associated with improved OS. Conclusions: In patients with HCC who progressed on first-line atezolizumab plus bevacizumab, sorafenib and lenvatinib were the most commonly used second-line regimens in Asia-Pacific countries, with lenvatinib resulting in longer OS than sorafenib. The second-line TKI plus ICI combination exhibited promising efficacy, suggesting the potential role of continuing ICIs beyond disease progression.