Sino-Japanese Relations: Interdependence, Rivalry and Regional Security

Rivalry within interdependence is possible. Trade and investment ties alone are not sufficient to bring peace and security to a relationship, the responsiveness of the political leadership to economic interdependence is critical. Responsiveness can be influenced by a history of conflict in a relationship, national ambitions or by a military which espouses expansionist plans. Britain and Germany before 1914 demonstrated that interdependence and rivalry can coexist and may degenerate into war. This can happen when one side under the influence of a dominant military falsely assumes that the other would be constrained by interdependence from responding to its military action. Both Japan and China have become bound by a tight economic interdependence despite their historical animosities. These animosities could be exacerbated by military modernization and China’s plans to develop a naval capability to protect its sealanes. Japan would be prompted to respond to the development of Chinese naval power which would aggravate existing rivalry with Beijing. To reduce the impact of this rivalry both ASEAN and the United States should clearly signal to Beijing that military action over Taiwan or naval expansion without transparency would be unacceptable. Otherwise false assumptions would arise in Beijing that interdependence would constrain responses to China’s risk taking.

PLoS Medicine Issue Image | Vol. 6(1) January 2009

Don Fawcett (1917–2009): Unlocking Nature's Closely Guarded Secrets

CellCell biology owes some of its greatest discoveries to the electron microscope, and few were more passionate about its power to “wrest from nature her closely guarded secrets” than Don Wayne Fawcett. A pioneer of electron microscopy and one of its greatest practitioners for studying the organization of cells and tissues, Fawcett died at his home in Missoula, Montana on May 7, 2009 at the age of 92. Don W. Fawcett Fawcett was born in 1917 on a farm in Iowa, where his father and grandfather had raised purebred sheep and cattle until his father's poor health forced the family to leave the farm and move to Boston, where Fawcett's father managed a successful wool business. Fawcett attended high school at the famous Boston Latin School. Upon graduation, he matriculated at Harvard College, followed by Harvard Medical School, where he connected with Anatomy Professor George Wislocki. “I stole as much time as I could from my course work to do independent research on projects that included studies on the vascular bundles of aquatic mammals, and the amedullary bones of the manatee,” he recalled. Fawcett perfected the art and technology of microscopy in the early days of cell biology, which emerged as a modern field in the 1940s after the electron microscope became more widely available. He would routinely cut thin sections at home, before venturing in the early morning hours to his lab at Harvard, where he viewed them with the microscope that would do so much to reveal the secrets of form and function. He kept a microtome at home, and it was rumored that he also had a private collection of diamond knives to help achieve his unparalleled results. Tom Pollard, a student at Harvard during Fawcett's chairmanship, recalls how Fawcett used his skills in the darkroom to produce spectacular prints of electron micrographs to illustrate the key features of each image. He may have been most renowned as the first person to describe and depict in detail human spermatozoa, and he published extensively on the anatomy of male reproductive cellular anatomy. Fawcett published a collection of his fine-structure micrographs in The Cell, a classic cell biology text that features all the major cell structures [1], and was author of several editions of Bloom and Fawcett: A Textbook of Histology, the definitive histology textbook to generations of students [2]. Fawcett, elected as the first president of the newly formed American Society for Cell Biology in 1961, described the early days of electron microscopy as “filled with the same excitement and anticipation of discovery that attends the opening up of a new continent for geographic exploration. Every tissue and organ studied revealed beauty and order in its organization that we had not imagined” [3]. While in college, Fawcett illustrated a book on athletic bandaging that had been written by the football team's physician. This may have been his only contribution as an illustrator; his later and more widely popular books were illustrated by Sylvia Collard Keen. In the summers, Fawcett worked on Bailey's Island off the coast of Maine, where he embalmed and prepared small sharks for sale to colleges for comparative anatomy courses. This early interest in anatomy served him well when he trained in surgery at Harvard. Fawcett's predominant memory of his clinical training was being on duty in the emergency ward the night of the infamous Cocoanut Grove Nightclub disaster of 1942, which claimed 492 lives in one of the deadliest fires in American history. “We had been having a quiet evening when, without advance notice, we received 115 seriously burned patients within an hour and a half. Mobilizing all of the off-duty staff that I could reach, I continued on duty for 30 hours doing all I could to relieve the pain and dress the burns of the victims.” Fawcett served as a battalion surgeon and Captain in the European Theater in World War II, but, before shipping out, he married Dorothy Secrest, his wife of 68 years, who survives him. After the war, Fawcett returned to Harvard, where he served as an instructor. He sought out Keith Porter, another pioneering electron microscopist, at the Rockefeller Institute. There, with Porter and George Palade, Fawcett recalled in 2000 that he, working with his illustrious colleagues, “undertook a project on the fine structure of ciliated epithelium that revealed the 9+2 pattern of microtubules in the cilia for the first time in a metazoan.” In 1955 Fawcett moved to Cornell Medical School in New York City and established an electron microscope laboratory. He had become what today might be characterized as the quintessential descriptive scientist; later generations of cell biologists and biochemists would build on his seminal work. After four years at Cornell, Fawcett again returned to Harvard as Hersey Professor of Anatomy and Chairman of the Department. The endowment for his chairmanship had been established by Ezekiel Hersey in 1770 with a gift of 1,000 pounds, and, Fawcett recalled, “My salary reflected the size of that endowment.” In 1976 Fawcett resigned the chairmanship and became Senior Associate Dean for Preclinical Science, a position for which, by his own description, he was ill-suited. After spending time annually for several years in Africa, where he indulged his profound love of and talent for animal and nature photography, Fawcett left Boston in 1985 to take the position of Senior Scientist at the International Laboratory for Research on Animal Diseases in Nairobi, Kenya. There, he worked in parasitology in a well-equipped laboratory financed by the World Bank and other international agencies. Its mission was to find methods of controlling two parasitic diseases, theileriosis (also known as East Coast Fever) and trypanosomiasis, which together killed hundreds of thousands of cattle annually in East and Central Africa. Fawcett relished the freedom from administrative duties that he enjoyed there. With just a small German microscope and all the accessories he needed, Fawcett could devote all his energy to studying what he considered an interesting new field. He found that he was able to “add significantly to what was then known about the parasites and their arachnid and dipteran vectors.” When Fawcett retired from his work in Africa, he and Dorothy established a new home in Montana, because the rural environment suited them and they wanted to be close to family. In 1988, the Fawcett Lecture was established at Harvard Medical School in Fawcett's honor. His greatest professional legacy, according to Harvard colleague Dan Goodenough, may have been his talent for identifying and recruiting young talent, including Susumu Ito, Betty Hay (who succeeded him as Chair of Anatomy at Harvard and later as President of the ASCB), and Jean-Paul Revel, also to become an ASCB president. Fawcett recruited dozens of postdoctoral fellows, many of whom also went on to become leaders of cell biology. He “guided” his proteges by procuring for them modest start-up funds, finding them a lab or bench, and wishing them well. They were left completely free to pursue their own research questions alone or through other relationships they may have developed. Tom Pollard, the Chair of Cell Biology and Anatomy at Johns Hopkins for many years and now at Yale, says that Fawcett “changed my life.” Pollard describes how, after accepting a neurology residency at University of California San Francisco, Fawcett, who had attended a talk that Pollard had given as a medical student, called him and asked him to consider basic science instead. Pollard rerouted back to Harvard, where Fawcett gave him a princely start-up fund of US$500 and left him to follow his own curiosity. Fawcett, together with Keith Porter, Montrose Moses, Morgan Harris, Hans Ris, Hewson Swift, and Herbert Taylor, founded the American Society for Cell Biology in 1960. They charged themselves with organizing the inaugural scientific meeting of the embryonic society in Chicago where Fawcett was elected its first president. Despite his leadership roles, Fawcett was uncommonly solitary in his work and private in his personal life. Goodenough describes him as “fair, generous, and austere,” recounting how Fawcett encouraged his early interest in black-and-white photography at a time when Goodenough was a graduate student and couldn't even dream of purchasing good equipment. Fawcett unhesitatingly lent him his fine cameras, lenses, and darkroom equipment. Yet, Fawcett never failed to greet a young faculty member to Harvard with the admonition that they had not a prayer of being asked to stay on the senior faculty. Similarly, in later years, though Fawcett was clearly devoted to his and Dorothy's four children, his colleagues cannot recall ever meeting them. A contributing factor may have been that Fawcett suffered profoundly from migraine headaches, which he did not reveal to his colleagues and for which he delayed seeking treatment for many decades—a choice that may have caused him to withdraw for hours of silent endurance—until he finally agreed to seek medical attention. In addition to his wife, Don Fawcett is survived by four children—Dona Boggs, Robert Fawcett, Joseph Fawcett, and Mary Papish—and 13 grandchildren.

Rape in War Is Common, Devastating, and Too Often Ignored

This month's Editorial discusses the unconscionable use of rape as a weapon of war and calls for more pressure to be put on international authorities to take concerted action and to make protection from sexual violence a central part of peacekeeping efforts.

Waging Peace through Neglected Tropical Disease Control: A US Foreign Policy for the Bottom Billion

It comes as no surprise that poverty breeds political instability, and some of the most troubled regions on our planet are disproportionately represented by nations with large numbers of people who live on less than US$1 per day. It has been observed that most of the people living in the societies of the ‘‘bottom billion,’’ i.e., the world’s poorest people who live on little or no money, are either currently engaged in a civil war or have recently been through one, and today civil war breaks out almost exclusively in low-income countries [1]. In such areas the risk of conflict has been shown to increase as the starting income of the country diminishes [1]. With respect to international conflicts and civil war, poor infant and child health represent important fellow travelers with poverty. Previous analyses by one of us show that nations with the highest infant and under-five child mortality rates are the ones most likely to engage in war [2–4]. Childhood infections together with malnutrition by far account for the greatest burden of pediatric morbidity and mortality in developing countries, so that infectious diseases operate in synergy with poverty to promote conflict. Among the possible factors accounting for the relationship between infection and conflict are the adverse impact of the former on the agricultural workforce, agricultural productivity, the health of families, and the stability of communities and community leaders [5–7]. The neglected tropical diseases (NTDs) represent possibly the worst of all diseases in terms of their destabilizing effects and their relationship to conflict. The NTDs are the most common infections of the bottom billion, in whom they cause chronic, debilitating, disabling, and disfiguring effects [8]. One of the most important features of the NTDs is their tendency not only to occur in the setting of poverty, but also to exacerbate poverty and to destabilize communities [8] (Box 1). For example, the chronic and irreversible limb lymphedema caused by lymphatic filariasis reduces agricultural productivity by causing people to alter their activities or even stop working altogether [9]. Blinding eye disease caused by trachoma and onchocerciasis (river blindness) can also disable subsistence agricultural workers [8], as do hookworm infection and schistosomiasis because they each produce severe anemia, which weakens both the mind and the body [10,11]. In developing countries, hookworm and schistosomiasis frequently occur together and are coendemic with malaria to produce profound anemia [12–14]. Moreover, when NTDs such as river blindness become pervasive, subsistence farmers are sometimes forced to flee or abandon their fields and migrate to areas with poor soils or inadequate climate [15]. For all of these reasons, NTDs have a pivotal role in the world’s food crisis, particularly in developing countries. In addition to their agricultural impact, the NTDs, especially hookworm and other helminth infections, contribute to the ‘‘poverty trap’’ through their adverse effects on education because they interfere with child cognition and learning [16]. Through such mechanisms, chronic hookworm infection in childhood reduces future wage earning by 43% [17]. Worms also injure pregnant women and cause low birth weight [10,11]. The adverse impact of NTDs on agricultural productivity, education, future wage earning, and the health of mothers and children in low-income countries accounts for the observation that there are multiple and intimate connections between pervasive NTDs and conflict [18–21]. Beyrer et al. have identified important links between NTDs and war, conflict, and human rights, especially from lymphatic filariasis and other NTDs among marginalized ethnic populations in Myanmar and vector-borne NTDs such as leishmaniasis and Chagas disease that emerge with civil conflicts and guerilla activities in Colombia and southern Mexico [20]. The war-torn belt in Africa that stretches from the East in Sudan, through Central African Republic and the Democratic Republic of the Congo in Central Africa, to Angola in West Africa exhibits some of the highest rates of NTDs in the world, including the important vectorborne NTDs human African trypanosomiasis (HAT) and leishmaniasis [19,21]. Tens of millions of people in this region are afflicted with hookworm and other soil-transmitted helminth infections, schistosomiasis, and concurrent co-infections with hookworm and schistosomiasis [14]. Shown in Table 1 is a list of selected countries that comprise diplomatic ‘‘hot spots’’ for the United States of America, in terms of their volatility and current or recent track record of conflict, or because of their deteriorated relationships with the

Cholera Epidemics, War and Disasters around Goma and Lake Kivu: An Eight-Year Survey

Background During the last eight years, North and South Kivu, located in a lake area in Eastern Democratic Republic of Congo, have been the site of a major volcano eruption and of numerous complex emergencies with population displacements. These conditions have been suspected to favour emergence and spread of cholera epidemics. Methodology/Principal Findings In order to assess the influence of these conditions on outbreaks, reports of cholera cases were collected weekly from each health district of North Kivu (4,667,699 inhabitants) and South Kivu (4,670,121 inhabitants) from 2000 through 2007. A geographic information system was established, and in each health district, the relationships between environmental variables and the number of cholera cases were assessed using regression techniques and time series analysis. We further checked for a link between complex emergencies and cholera outbreaks. Finally, we analysed data collected during an epidemiological survey that was implemented in Goma after Nyiragongo eruption. A total of 73,605 cases and 1,612 deaths of cholera were reported. Time series decomposition showed a greater number of cases during the rainy season in South Kivu but not in North Kivu. Spatial distribution of cholera cases exhibited a higher number of cases in health districts bordering lakes (Odds Ratio 7.0, Confidence Interval range 3.8–12.9). Four epidemic reactivations were observed in the 12-week periods following war events, but simulations indicate that the number of reactivations was not larger than that expected during any random selection of period with no war. Nyiragongo volcanic eruption was followed by a marked decrease of cholera incidence. Conclusion/Significance Our study points out the crucial role of some towns located in lakeside areas in the persistence of cholera in Kivu. Even if complex emergencies were not systematically followed by cholera epidemics, some of them enabled cholera spreading.

Dynamics of Socioeconomic Risk Factors for Neglected Tropical Diseases and Malaria in an Armed Conflict

Background Armed conflict and war are among the leading causes of disability and premature death, and there is a growing share of civilians killed or injured during armed conflicts. A major part of the civilian suffering stems from indirect effects or collateral impact such as changing risk profiles for infectious diseases. We focused on rural communities in the western part of Côte d'Ivoire, where fighting took place during the Ivorian civil war in 2002/2003, and assessed the dynamics of socioeconomic risk factors for neglected tropical diseases (NTDs) and malaria. Methodology The same standardized and pre-tested questionnaires were administered to the heads of 182 randomly selected households in 25 villages in the region of Man, western Côte d'Ivoire, shortly before and after the 2002/2003 armed conflict. Principal Findings There was no difference in crowding as measured by the number of individuals per sleeping room, but the inadequate sanitation infrastructure prior to the conflict further worsened, and the availability and use of protective measures against mosquito bites and accessibility to health care infrastructure deteriorated. Although the direct causal chain between these findings and the conflict are incomplete, partially explained by the very nature of working in conflict areas, the timing and procedures of the survey, other sources and anecdotal evidence point toward a relationship between an increased risk of suffering from NTDs and malaria and armed conflict. Conclusion New research is needed to deepen our understanding of the often diffuse and neglected indirect effects of armed conflict and war, which may be worse than the more obvious, direct effects.

Success in Developing Regions: World Records Evolution through a Geopolitical Prism

A previous analysis of World Records (WR) has revealed the potential limits of human physiology through athletes' personal commitment. The impact of political factors on sports has only been studied through Olympic medals and results. Here we studied 2876 WR from 63 nations in four summer disciplines. We propose three new indicators and show the impact of historical, geographical and economical factors on the regional WR evolution. The south-eastward path of weighted annual barycenter ( i.e. the average of country coordinates weighting by the WR number) shows the emergence of East Africa and China in WR archives. Home WR ratio decreased from 79.9% before the second World War to 23.3% in 2008, underlining sports globalization. Annual Cumulative Proportions (ACP, i.e. the cumulative sum of the WR annual rate) highlight the regional rates of progression. For all regions, the mean slope of ACP during the Olympic era is 0.0101, with a maximum between 1950 and 1989 (0.0156). For European countries, this indicator reflects major historical events (slowdown for western countries after 1945, slowdown for eastern countries after 1990). Mean North-American ACP slope is 0.0029 over the century with an acceleration between 1950 and 1989 at 0.0046. Russia takes off in 1935 and slows down in 1988 (0.0038). For Eastern Europe, maximal progression is seen between 1970 and 1989 (0.0045). China starts in 1979 with a maximum between 1990 and 2008 (0.0021), while other regions have largely declined (mean ACP slope for all other countries  = 0.0011). A similar trend is observed for the evolution of the 10 best performers. The national analysis of WR reveals a precise and quantifiable link between the sport performances of a country, its historical or geopolitical context, and its steps of development.

A Decade Later, How Much of Rwanda's Musculoskeletal Impairment Is Caused by the War in 1994 and by Related Violence?

Background In 1994 there was a horrific genocide in Rwanda following years of tension, resulting in the murder of at least 800,000 people. Although many people were injured in addition to those killed, no attempt has been made to assess the lasting burden of physical injuries related to these events. The aim of this study was to estimate the current burden of musculoskeletal impairment (MSI) attributable to the 1994 war and related violence. Methodology/Principal Findings A national cross-sectional survey of MSI was conducted in Rwanda. 105 clusters of 80 people were selected through probability proportionate to size sampling. Households within clusters were selected through compact segment sampling. Enumerated people answered a seven-question screening test to assess whether they might have an MSI. Those who were classed as potential cases in the screening test were examined and interviewed by a physiotherapist, using a standard protocol that recorded the site, nature, cause, and severity of the MSI. People with MSI due to trauma were asked whether this trauma occurred during the 1990–1994 war or during the episodes that preceded or followed this war. Out of 8,368 people enumerated, 6,757 were available for screening and examination (80.8%). 352 people were diagnosed with an MSI (prevalence = 5.2%, 95% CI = 4.5–5.9%). 106 cases of MSI (30.6%) were classified as resulting from trauma, based on self-report and the physiotherapist's assessment. Of these, 14 people (13.2%) reported that their trauma-related MSI occurred during the 1990–1994 war, and a further 7 (6.6%) that their trauma-related MSI occurred during the violent episodes that preceded and followed the war, giving an overall prevalence of trauma-related MSI related to the 1990–1994 war of 0.3% (95% CI = 0.2–0.4%). Conclusions/Significance A decade on, the overall prevalence of MSI was relatively high in Rwanda but few cases appeared to be the result of the 1994 war or related violence.

Early Life Exposure to Famine and Colorectal Cancer Risk: A Role for Epigenetic Mechanisms

Background Exposure to energy restriction during childhood and adolescence is associated with a lower risk of developing colorectal cancer (CRC). Epigenetic dysregulation during this critical period of growth and development may be a mechanism to explain such observations. Within the Netherlands Cohort Study on diet and cancer, we investigated the association between early life energy restriction and risk of subsequent CRC characterized by the (promoter) CpG island methylation phenotype (CIMP). Methodology/Principal Findings Information on diet and risk factors was collected by baseline questionnaire (n = 120,856). Three indicators of exposure were assessed: place of residence during the Hunger Winter (1944–45) and World War II years (1940–44), and father's employment status during the Economic Depression (1932–40). Methylation specific PCR (MSP) on DNA from paraffin embedded tumor tissue was performed to determine CIMP status according to the Weisenberger markers. After 7.3 years of follow-up, 603 cases and 4631 sub-cohort members were available for analysis. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals for CIMP+ (27.7%) and CIMP- (72.3%) tumors according to the three time periods of energy restriction, adjusted for age and gender. Individuals exposed to severe famine during the Hunger Winter had a decreased risk of developing a tumor characterized by CIMP compared to those not exposed (HR 0.65, 95%CI: 0.45–0.92). Further categorizing individuals by an index of ‘0–1’ ‘2–3’ or ‘4–7’ genes methylated in the promoter region suggested that exposure to the Hunger Winter was associated with the degree of promoter hypermethylation (‘0–1 genes methylated’ HR = 1.01, 95%CI:0.74–1.37; ‘2–3 genes methylated’ HR = 0.83, 95% CI:0.61–1.15; ‘4–7 genes methylated’ HR = 0.72, 95% CI:0.49–1.04). No associations were observed with respect to the Economic Depression and WWII years. Conclusions This is the first study indicating that exposure to a severe, transient environmental condition during adolescence and young adulthood may result in persistent epigenetic changes that later influence CRC development.