The Final Frontier: China,Taiwan, and the United States in Strategic Competition for Central America

China’s rise as a global power corresponded with a diminution of Taiwanese diplomacy, which has left Central America as the last region to host a continuous bloc of countries that recognize the ROC. In this article, we argue that China’s success in gaining diplomatic recognition from Taiwan’s former allies has largely resulted from China's economic policy, specifically its promises of large-scale infrastructure projects and the integration of Central American economies with Chinese markets. However, there are limits to how far China has advanced in gaining full recognition from the region. The competing political and economic interests of China, Taiwan, the United States, and the Central American countries themselves, continue to influence patterns of diplomatic switching. More specifically, we argue that the threat of punitive measures from the United States combined with a turn in Taiwanese diplomacy toward assistance efforts to combat Covid-19 may deter future switching in the short to medium-term. Our analysis offers case studies of four Central American countries (Costa Rica, Panama, El Salvador and Nicaragua) to illustrate the multi-year processes by which China’s economic strategy leads to diplomatic switching and examine the paths ahead for the remaining holdouts facing the prospect of economic and political penalties by the United States.

     

Fatality involving complications of bupivacaine toxicity and hypersensitivity reaction

This case represents unusual findings of elevated bupivacaine and tryptase concentrations following local anesthetic, bupivacaine, administered as a scalene nerve block for elective rotator cuff repair surgery. Following bupivacaine injection, the patient exhibited almost immediate seizure activity, bradycardia, and cardiac arrest. Resuscitative efforts including cardiopulmonary bypass restored a cardiac rhythm. However, the clinical medical status of the patient progressively declined and he died 7 h following administration of the local anesthetic. Autopsy revealed several abnormalities of the heart including cardiomegaly, myocardial bridging, and lipomatous hypertrophy of the intraatrial septum, which may have contributed to bradycardia and arrhythmia. Postmortem toxicology results revealed elevated bupivacaine and tryptase concentrations. Elevated postmortem bupivacaine concentrations 7 h following administration and abrupt onset of seizures indicate unintentional intravascular injection instead of nerve and tissue infiltration. An elevated postmortem tryptase concentration points to the possibility of a hypersensitivity reaction to bupivacaine.     

Sevoflurane concentrations in blood, brain, and lung after sevoflurane-induced death

Sevoflurane concentrations in blood, brain, and lung were measured in an individual apparently dying from sevoflurane inhalation. Sevoflurane is a volatile nonflammable fluorinated methyl isopropyl ether inhaled anesthetic, chemically related to desflurane and isoflurane. The incidence of abuse of sevoflurane is lower than that of other drugs of abuse possibly due to its inaccessibility to the general public and less pleasurable and addicting effects. The dead subject was an anesthetist found prone in bed holding an empty bottle of sevoflurane (Ultane). Serum, urine, and liver were screened for numerous drugs and metabolites using enzyme immunoassays and gas chromatography-mass spectrometry. Analysis did not reveal presence of any drug, including ethanol, other than sevoflurane. Sevoflurane was determined by headspace gas chromatography and revealed concentrations of 15 microg/mL in blood and 130 mg/kg in brain and lung. Autopsy revealed pulmonary edema and frothing in the lung, pathological findings associated with death by sevoflurane or hypoxia. The cause of death was ruled as sevoflurane toxicity and the manner of death as accident.     

Hyaluronidase as a liquefying agent for chemical analysis of vitreous fluid

Vitreous humor is a suitable specimen for postmortem clinical chemistry because the analytes remain relatively stable after death and they closely reflect blood levels immediately prior to death. The viscous nature of vitreous fluid, however, presents analytical problems including imprecision and inaccuracy. Various preanalytical treatments, such as boiling, high speed centrifugation, microfiltration and dilution have been used. These techniques are labor intensive and add to imprecision and inaccuracy. Because glycosaminoglycans contribute significantly to the viscosity of vitreous humor, we used hyaluronidase as a liquefying agent. We compared the results of analyses in 33 vitreous humor specimens after hyaluronidase treatment with the results after either no treatment or specimen dilution. Seventeen of the 33 specimens could not be analyzed without dilution. Even after dilution, several analytes still could not be measured. Hyaluronidase treatment negated the need for sample dilution and had no significant effect on the analyses.     

Education for Child Labour: Evaluating the National Child Labour Policy in West Bengal,India

Transitioning child labourers from work to education is a key component of global efforts to eliminate child labour. In India, the National Child Labour Project is the central programme aimed at achieving this goal. This paper examines the operation of the project in the state of West Bengal using original survey data collected in 2008. The survey reveals a number of promising findings, including high rates of provision of both midday meals and free learning materials to students, as well as evidence of adequate schooling quality and availability. However, areas of concern were also identified, including irregularities in stipend payments to parents of child labourers who send their children to school and inadequate provision of free health services to children who attend school rather than work. These operational short-comings revealed by the survey reduce the incentive and ability parents have to send their children to school rather than work and, accordingly, undermine the effectiveness of the project.     

Human securitization of water? A case study of the Indus Waters Basin

In the large and growing literature on hydropolitics, insecurity generated through water-related conflicts is most often conceptualized under a model of economic resource scarcity. Conflict is generally reduced to the question of who has water, who needs water and thus what cost, in economic, political or military terms, is appropriate to acquiring access to water. This article argues that while such analyses effectively chart the central resource-strategic relations involved in the geopolitics of water, they nonetheless disregard the deeper biological and cultural (that is social, ethnic, religious) significance of water in any water conflict. Such analyses, it claims, are too strongly linked to the traditional (as opposed to human) security discourse and therefore run the risk of misdiagnosing the complexity of the water resource challenge. To respond to this challenge the article will develop a human security ‘metrics’ for analysing water-based conflicts in human security terms. It will then compare an analysis of the Indus Waters Treaty based upon the human security approach with an analysis based on a ‘traditional’ security assessment of the treaty in order to assess the viability of the two approaches. Finally, the article will link the comparative assessments back to the water wars literature, drawing conclusions about its strengths and weaknesses and the possibility of a synthesis of traditional and human security in the analysis of water conflict.