India Ink: On Kissing, Bollywood, and Rebellion

Gardiner Harris’s recent piece in the New York Times made me do a double take, not just because of the attachment of the word “bombshell” before Katrina Kaif, which to me is somewhat like using “razor-sharp” as the defining adjective for President George W. Bush, but because of the cultural “Rubicon-crossing” significance attributed to a scene in “Jab Tak Hai Jaan:”

A pivotal screen kiss reflected the changing romantic landscape here. Kissing scenes were banned by Indian film censors until the 1990s, and Shah Rukh Khan, a Bollywood heartthrob who is one of the world’s biggest movie stars, has been teasing Indian audiences in dozens of films since then by bringing his lips achingly close to those of his beautiful co-stars. But his lips never touched any of theirs until he kissed the Bollywood bombshell Katrina Kaif in “Jab Tak Hai Jaan,” which was released in December 2012.

Mr. Khan tried to soften the impact by saying in a published interview that his director made him do it. But the cultural Rubicon had been crossed.

As a longtime pop culture buff and dispassionate observer of screen-kisses, while I may agree with the author’s observation of Shah Rukh Khan’s lips historically tending toward those of his heroine’s but never quite getting there, like the limit of a function, I firmly dispute the notion that Mr. Khan’s tepid liplock has given the kiss the acceptability it did not have before. That’s because kisses have been in mainstream Indian movies since the late 1920s with reigning screen diva, Devika Rani’s kiss with her off-screen husband, Himanshu Rai, for a full four minutes in “Karma” (1933) being the veritable stuff of legends.

It is true, of course, that Indian movies have had far more people chasing each other around the trees than kissing, and that is primarily because of the dictates of the dreaded censor board, the cheerless cinematic embodiment of the Nehruvian ideal of big-government intruding into every aspect of national life, which made directors move the camera away at strategic moments to two flowers touching each other.

But around the time when I started watching movies, which was the mid-1980s, kisses and intimacy were very much part of big-banner Bollywood, be it in “Ram Teri Ganga Maili” (1985) or “Janbaaz” (1986) or “Qayamat Se Qayamat Se Tak” (1986) and the truly shuddering scene in “Dayavan” (1988) between the venerable Vinod Khanna and an upcoming actress by the name of Madhuri Dixit, a sequence responsible for many VCRs getting jammed due to excessive pausing and replaying (or so my unscientific survey tells me).

Then of course, there was Aamir Khan establishing his reputation for commitment to detail and the embracing of variety by kissing Juhi Chawla in “Qayamat Se Qayamat” (1986) and “Love Love Love” (1986), Pooja Bhatt in “Dil Hai Ki Manta Naheen” (1991), Pooja Bedi in “Jo Jeeta Hai Sikander” (1992) and then Karishma Kapoor in “Raja Hindustani” (1997) for a full 40 seconds, if experts are to be believed.

In the 2000s, there were movies that had 17 kissing scenes in them, and an actor by the name of Emran Hashmi had made kissing a calling card in each of his movies, earning the sobriquet “serial kisser.”

I don’t want to keep on inserting citations to prior art — after all, this is not a journal paper — but my point is that by 2012, when “Jab Tak Hai Jaan” came to pass, Indian audiences had been quite desensitized to on-screen kissing.

In other words, it is no big whoop. Or should I say, no big “mwah.”

So if it’s not the influence of movies, why then do we see more public displays of affection (of which kissing is but one manifestation) in Indian cities today than say 10 or 20 years ago?

Here is my explanation: The last decade or so has seen a social revolution in urban India. More men and more women are working together. There are more coeducational institutions than ever before. Social media have allowed people to find others with similar interests and points of view, subverting traditional social walls that prevent free interaction, and then they could keep in touch discreetly, through cellphones and instant messaging. (In my day, we had to use the single rotary phone kept in the living room, making it impossible to have a secret conversation.)

As a result, there are more opportunities for meeting people and maintaining relationships. This naturally leads to more unmarried couples or couples that are not married to each other.

Getting a room every time one wants to kiss one’s partner or hold hands is neither financially viable nor practically feasible. Budget hotels are loath to rent rooms to couples without proof of “marriage” because of the fear of police raids. Some even collude with crooked cops to do a bit of extortion, since couples are willing to pay to avoid being hauled to the police station. Being outside, in parks and deserted spaces, does not totally protect couples from the police, but at least it is better than being busted at a hotel.

Hence what one sees as increased public displays of affection is merely the inevitable effect of an increasing number of young couples in urban India, who, because of an antiquated legal system with ill-defined notions of “public decency,” unfortunately find themselves unable to have safe spaces of their own.

The biggest threat to their safety is not the police but young men described in Mr. Harris’s piece, those who “often sit and stare hungrily at kissing couples,” India’s increasingly angry and volatile class of getting-it-nots, those that desperately wish to have but do not, who see these displays of affection as arrogant flaunting of privilege. Many of these frustrated young men coalesce to form mobs of moral police, who then attack couples, especially women, in public places under the comforting banner of protecting Indian tradition.

And so an important cultural battle rages on, in the parks and in pubs and in other common spaces, one that reflects one of modern India’s defining conflicts, that between ordinary people in pursuit of individual happiness and a legal and social system that insists on imposing, interfering and getting in their way — where a kiss is no longer just a kiss but a small symbol of unintentional rebellion.

By the light of day, Arnab Ray is a research scientist at the Fraunhofer Center For Experimental Software Engineering and also an adjunct assistant professor at the Computer Science department of the University of Maryland at College Park. Come night, he metamorphoses into blogger, novelist (“May I Hebb Your Attention Pliss” and “The Mine”) and columnist. He is on Twitter at @greatbong.

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‘Bloodless’ Lung Transplants for Jehovah’s Witnesses

Eric Kayne for The New York Times

SHARING HOME AND FAITH A Houston couple hosted Gene and Rebecca Tomczak, center, in October so she could get care nearby.

HOUSTON — Last April, after being told that only a transplant could save her from a fatal lung condition, Rebecca S. Tomczak began calling some of the top-ranked hospitals in the country.

She started with Emory University Hospital in Atlanta, just hours from her home near Augusta, Ga. Then she tried Duke and the University of Arkansas and Johns Hopkins. Each advised Ms. Tomczak, then 69, to look somewhere else.

The reason: Ms. Tomczak, who was baptized at age 12 as a Jehovah’s Witness, insisted for religious reasons that her transplant be performed without a blood transfusion. The Witnesses believe that Scripture prohibits the transfusion of blood, even one’s own, at the risk of forfeiting eternal life.

Given the complexities of lung transplantation, in which transfusions are routine, some doctors felt the procedure posed unacceptable dangers. Others could not get past the ethics of it all. With more than 1,600 desperately ill people waiting for a donated lung, was it appropriate to give one to a woman who might needlessly sacrifice her life and the organ along with it?

By the time Ms. Tomczak found Dr. Scott A. Scheinin at The Methodist Hospital in Houston last spring, he had long since made peace with such quandaries. Like a number of physicians, he had become persuaded by a growing body of research that transfusions often pose unnecessary risks and should be avoided when possible, even in complicated cases.

By cherry-picking patients with low odds of complications, Dr. Scheinin felt he could operate almost as safely without blood as with it. The way he saw it, patients declined lifesaving therapies all the time, for all manner of reasons, and it was not his place to deny care just because those reasons were sometimes religious or unconventional.

“At the end of the day,” he had resolved, “if you agree to take care of these patients, you agree to do it on their terms.”

Ms. Tomczak’s case — the 11th so-called bloodless lung transplant attempted at Methodist over three years — would become the latest test of an innovative approach that was developed to accommodate the unique beliefs of the world’s eight million Jehovah’s Witnesses but may soon become standard practice for all surgical patients.

Unlike other patients, Ms. Tomczak would have no backstop. Explicit in her understanding with Dr. Scheinin was that if something went terribly wrong, he would allow her to bleed to death. He had watched Witness patients die before, with a lifesaving elixir at hand.

Ms. Tomczak had dismissed the prospect of a transplant for most of the two years she had struggled with sarcoidosis, a progressive condition of unknown cause that leads to scarring in the lungs. The illness forced her to quit a part-time job with Nielsen, the market research firm.

Then in April, on a trip to the South Carolina coast, she found that she was too breathless to join her frolicking grandchildren on the beach. Tethered to an oxygen tank, she watched from the boardwalk, growing sad and angry and then determined to reclaim her health.

“I wanted to be around and be a part of their lives,” Ms. Tomczak recalled, dabbing at tears.

She knew there was danger in refusing to take blood. But she thought the greater peril would come from offending God.

“I know,” she said, “that if I did anything that violates Jehovah’s law, I would not make it into the new system, where he’s going to make earth into a paradise. I know there are risks. But I think I am covered.”

Cutting Risks, and Costs

The approach Dr. Scheinin would use — originally called “bloodless medicine” but later re-branded as “patient blood management” — has been around for decades. His mentor at Methodist, Dr. Denton A. Cooley, the renowned cardiac pioneer, performed heart surgery on hundreds of Witnesses starting in the late 1950s. The first bloodless lung transplant, at Johns Hopkins, was in 1996.

But nearly 17 years later, the degree of difficulty for such procedures remains so high that Dr. Scheinin and his team are among the very few willing to attempt them.

In 2009, after analyzing Methodist’s own data, Dr. Scheinin became convinced that if he selected patients carefully, he could perform lung transplants without transfusions. Hospital administrators resisted at first, knowing that even small numbers of deaths could bring scrutiny from federal regulators.

“My job is to push risk away,” said Dr. A. Osama Gaber, the hospital’s director of transplantation, “so I wasn’t really excited about it. But the numbers were very convincing.”

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Haruhiko Kuroda Expected to Be Named Head of Bank of Japan

TOKYO — A financial policy expert and harsh critic of the Bank of Japan’s efforts to combat deflation is set to be the government’s choice to take over the nation’s central bank.

Toru Hanai/Reuters

Haruhiko Kuroda is a harsh critic of the Bank of Japan’s track record on deflation.

The official, Haruhiko Kuroda, a veteran of global financial circles and current head of the Asian Development Bank, will be nominated as the bank’s governor to take over next month, according to a ruling party lawmaker with knowledge of those plans.

Prime Minister Shinzo Abe has instructed ruling party officials to start negotiating with opposition parties to clear the way for Mr. Kuroda’s appointment, which must be approved by a divided parliament, the lawmaker said.

“This is a critical time for Japan’s economy, and we must avoid, at all costs, a failure to gain parliamentary approval for this appointment,” NHK, the public broadcaster, quoted Mr. Abe as telling ruling party executives Monday morning.

With Mr. Kuroda at its helm, the bank could take much bolder steps to kick-start economic growth. Mr. Kuroda has publicly criticized the Bank of Japan for not going far enough to fight deflation, and has urged the bank to adopt inflation targets and to expand an asset-buying program to pump more cash into the Japanese economy.

Mr. Kuroda’s global experience — as vice minister for international affairs at Japan’s powerful Finance Ministry from 1999 to 2003, and as president of the Manila-based Asian Development Bank starting in 2005 — could also help Tokyo navigate foreign criticism that its monetary policies are intended to weaken the yen to give Japanese exporters a competitive edge.

The yen has weakened by over 10 percent in the last three months as Mr. Abe laid out his monetary agenda, pushing the outgoing central bank governor, Masaaki Shirakawa, to start taking a more aggressive monetary stance. But Mr. Abe had indicated that a change at the bank’s top ranks was needed to break with the bank’s cautious past. On Monday, the yen fell to a 33-month low.

Kikuo Iwata, a professor at Gakushuin University in Tokyo and another vocal critic of the central bank, is set to be tapped for one of its two deputy governor spots, according to the lawmaker. Mr. Iwata is the author of several books, including “Stop Deflation, Now” and “Is the Bank of Japan Really Trustworthy?”

Mr. Kuroda beat out a fellow former senior Finance Ministry official, Toshiro Muto, who had strong backing among both bureaucrats and local politicians but lacks the top-level global contacts. Mr. Muto was also viewed as being more cautious than Mr. Kuroda on monetary policy.

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The Texas Tribune: Advocates Seek Mental Health Changes, Including Power to Detain

Matt Rainwaters for Texas Monthly

The Sherman grave of Andre Thomas’s victims.

SHERMAN — A worried call from his daughter’s boyfriend sent Paul Boren rushing to her apartment on the morning of March 27, 2004. He drove the eight blocks to her apartment, peering into his neighbors’ yards, searching for Andre Thomas, Laura Boren’s estranged husband.

Expanded coverage of Texas is produced by The Texas Tribune, a nonprofit news organization. To join the conversation about this article, go to texastribune.org.

For more articles on mental health and criminal justice in Texas, as well as a timeline of the Andre Thomas case: texastribune.org

Matt Rainwaters for Texas Monthly

Laura Boren

He drove past the brightly colored slides, swings and bouncy plastic animals in Fairview Park across the street from the apartment where Ms. Boren, 20, and her two children lived. He pulled into a parking spot below and immediately saw that her door was broken. As his heart raced, Mr. Boren, a white-haired giant of a man, bounded up the stairwell, calling out for his daughter.

He found her on the white carpet, smeared with blood, a gaping hole in her chest. Beside her left leg, a one-dollar bill was folded lengthwise, the radiating eye of the pyramid facing up. Mr. Boren knew she was gone.

In a panic, he rushed past the stuffed animals, dolls and plastic toys strewn along the hallway to the bedroom shared by his two grandchildren. The body of 13-month-old Leyha Hughes lay on the floor next to a blood-spattered doll nearly as big as she was.

Andre Boren, 4, lay on his back in his white children’s bed just above Leyha. He looked as if he could have been sleeping — a moment away from revealing the toothy grin that typically spread from one of his round cheeks to the other — except for the massive chest wound that matched the ones his father, Andre Thomas (the boy was also known as Andre Jr.), had inflicted on his mother and his half-sister as he tried to remove their hearts.

“You just can’t believe that it’s real,” said Sherry Boren, Laura Boren’s mother. “You’re hoping that it’s not, that it’s a dream or something, that you’re going to wake up at any minute.”

Mr. Thomas, who confessed to the murders of his wife, their son and her daughter by another man, was convicted in 2005 and sentenced to death at age 21. While awaiting trial in 2004, he gouged out one of his eyes, and in 2008 on death row, he removed the other and ate it.

At least twice in the three weeks before the crime, Mr. Thomas had sought mental health treatment, babbling illogically and threatening to commit suicide. On two occasions, staff members at the medical facilities were so worried that his psychosis made him a threat to himself or others that they sought emergency detention warrants for him.

Despite talk of suicide and bizarre biblical delusions, he was not detained for treatment. Mr. Thomas later told the police that he was convinced that Ms. Boren was the wicked Jezebel from the Bible, that his own son was the Antichrist and that Leyha was involved in an evil conspiracy with them.

He was on a mission from God, he said, to free their hearts of demons.

Hospitals do not have legal authority to detain people who voluntarily enter their facilities in search of mental health care but then decide to leave. It is one of many holes in the state’s nearly 30-year-old mental health code that advocates, police officers and judges say lawmakers need to fix. In a report last year, Texas Appleseed, a nonprofit advocacy organization, called on lawmakers to replace the existing code with one that reflects contemporary mental health needs.

“It was last fully revised in 1985, and clearly the mental health system has changed drastically since then,” said Susan Stone, a lawyer and psychiatrist who led the two-year Texas Appleseed project to study and recommend reforms to the code. Lawmakers have said that although the code may need to be revamped, it will not happen in this year’s legislative session. Such an undertaking requires legislative studies that have not been conducted. But advocates are urging legislators to make a few critical changes that they say could prevent tragedies, including giving hospitals the right to detain someone who is having a mental health crisis.

From the time Mr. Thomas was 10, he had told friends he heard demons in his head instructing him to do bad things. The cacophony drove him to attempt suicide repeatedly as an adolescent, according to court records. He drank and abused drugs to try to quiet the noise.

bgrissom@texastribune.org

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Iraq President’s Health Is Improving, Doctor Says

KIRKUK, Iraq (Reuters) - Iraqi President Jalal Talabani is now able to talk, his doctor said, adding he was hopeful the Kurdish statesman would soon be fit to return to Iraq from Germany, where he has been receiving medical treatment for a stroke.

A peace-maker who often mediated among Iraq's Shi'ite, Sunni and Kurdish factions, 79-year-old Talabani was flown abroad in December in critical condition.

"I am in continuous contact with the German team treating President Talabani," said Najmaldin Karim, who is also governor of the city of Kirkuk.

"He can talk now with the people around him and started to think in a good way. I and the German team are optimistic that he will get much better and can return back to Iraq soon."

During Talabani's absence, Iraq's political crisis has intensified, with thousands of Sunni Muslims taking to the streets in protest against the Shi'ite-led government

The veteran politician often worked to ease tensions in the country's fragile power-sharing government and negotiated between Baghdad and the autonomous Kurdistan region, which are locked in feud over land and oil rights.

(Writing by Isabel Coles; Editing by Nick Macfie)

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Oscar Pistorius gets bail as murder trial looms

PRETORIA, South Africa (AP) — Oscar Pistorius walked out of court Friday — free at least for now — after a South African magistrate released him on bail, capping four days of often startling testimony that foreshadowed a dramatic trial in the Valentine's Day slaying of his girlfriend.

But as he was driven away, chased by photographers and cameramen, questions continued to hound the double-amputee Olympian about what actually happened the night he gunned down Reeva Steenkamp inside a locked bathroom in his home.

Pistorius is charged with premeditated murder, and even Chief Magistrate Desmond Nair expressed doubts about his story that he mistook the 29-year-old model for an intruder and fired out of fear.

"Why would (Pistorius) venture further into danger" by going into the bathroom at all, Nair asked.

Cries of "Yes!" went up from Pistorius' supporters when Nair announced his decision to a packed courtroom after a nearly two-hour explanation of the ruling.

Nair set bail at 1 million rand ($113,000), with $11,300 in cash up front and proof that the rest is available. The 26-year-old track star was also ordered to hand over his passports, turn in any guns he owns and keep away from his upscale home in a gated community in Pretoria, which is now a crime scene.

He cannot leave the district of Pretoria without his probation officer's permission and is not allowed to consume drugs or alcohol, the magistrate said. His next court appearance was set for June 4.

Earlier, Pistorius alternately wept and appeared solemn and composed, especially as Nair criticized police procedures in the case and as a judgment in the track star's favor appeared imminent. He showed no reaction as he was granted bail.

Pistorius left the courthouse in a silver Land Rover just over an hour after the bail conditions were set. The vehicle, tailed by motorcycles carrying television cameramen, later pulled into the home of Pistorius' uncle.

"We are relieved at the fact that Oscar got bail today, but at the same time we are in mourning for the death of Reeva, with her family," said Pistorius' uncle, Arnold Pistorius. "As a family, we know Oscar's version of what happened on that tragic night and we know that that is the truth and that will prevail in the coming court case."

Dozens of journalists and international and local television crews had converged on the red-brick courthouse to hear the decision — a sign of the global fascination with a case involving a once-inspirational athlete and his beautiful girlfriend, a law school graduate and budding reality TV show contestant.

Nair said Pistorius' sworn statement, an unusual written account of what happened during the pre-dawn hours of Feb. 14, had helped his application for bail.

"I come to the conclusion that the accused has made a case to be released on bail," Nair said.

Pistorius said he shot Steenkamp accidentally, believing she was an intruder in his house. He described "a sense of terror rushing over" him and feeling vulnerable because he stood only on his stumps before opening fire.

Prosecutors say he intended to kill Steenkamp as she cowered in fear behind the locked bathroom door after a loud argument between the two.

Yet despite poking holes in Pistorius' version of events and bringing up incidents they say highlight his temper, the state's case started to unravel during testimony by the lead investigator, Detective Warrant Officer Hilton Botha.

Botha, who faces seven charges of attempted murder in an unrelated incident, was removed from the case Thursday. His replacement, the nation's top detective, Vinesh Moonoo, stopped by the hearing briefly Friday.

While Nair leveled harsh criticism at Botha for "errors" and "blunders," he said one man does not represent an investigation and that the state could not be expected to put all "the pieces of the puzzle" together in such a short time.

The prosecution accepted the judge's decision without protest. "We're still confident in our case," prosecution spokesman Medupe Simasiku said.

Pistorius faced the sternest bail requirements in South Africa because of the seriousness of the charge, which carries a life sentence if convicted. His defense attorneys had to prove that he would not flee the country, would not interfere with witnesses or the case, and his release would not cause public unrest.

Nair questioned whether Pistorius would be a flight risk when he stood to lose a fortune in cash, cars, property and other assets. Nair also said that while it had been shown that Pistorius had aggressive tendencies, he did not have a prior record of offenses for violent acts.

Anticipating the shape of the state's case at trial, he said he had serious questions about Pistorius' account: Why didn't he try to locate his girlfriend if he feared an intruder was in the house? Why didn't he try to determine who was in the bathroom before opening fire? And why did he venture into perceived "danger" in the bathroom when he could have taken other steps to ensure his safety?

"There are improbabilities which need to be explored," Nair said, adding that Pistorius could clarify these matters by testifying under oath at trial.

Sharon Steenkamp, Reeva's cousin, said the model's family would not be watching the bail decision and had not been following the hearing.

"It doesn't make any difference to the fact that we are without Reeva," she told The Associated Press.

Before the hearing, Pistorius' longtime coach, Ampie Louw, said he hoped to put the runner back into his training routine if he got bail.

"The sooner he can start working the better," said Louw, who persuaded the double-amputee to take up track as a teenager a decade ago. But he acknowledged Pistorius could be "heartbroken" and unwilling to immediately pull on the carbon-fiber running blades that earned him the nickname "Blade Runner."

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AP Sports Writer Gerald Imray contributed to this report from Johannesburg.

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Jon Gambrell can be reached at www.twitter.com/jongambrellAP .

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Drone Pilots Found to Get Stress Disorders Much as Those in Combat Do

U.S. Air Force/Master Sgt. Steve Horton

Capt. Richard Koll, left, and Airman First Class Mike Eulo monitored a drone aircraft after launching it in Iraq.

The study affirms a growing body of research finding health hazards even for those piloting machines from bases far from actual combat zones.

“Though it might be thousands of miles from the battlefield, this work still involves tough stressors and has tough consequences for those crews,” said Peter W. Singer, a scholar at the Brookings Institution who has written extensively about drones. He was not involved in the new research.

That study, by the Armed Forces Health Surveillance Center, which analyzes health trends among military personnel, did not try to explain the sources of mental health problems among drone pilots.

But Air Force officials and independent experts have suggested several potential causes, among them witnessing combat violence on live video feeds, working in isolation or under inflexible shift hours, juggling the simultaneous demands of home life with combat operations and dealing with intense stress because of crew shortages.

“Remotely piloted aircraft pilots may stare at the same piece of ground for days,” said Jean Lin Otto, an epidemiologist who was a co-author of the study. “They witness the carnage. Manned aircraft pilots don’t do that. They get out of there as soon as possible.”

Dr. Otto said she had begun the study expecting that drone pilots would actually have a higher rate of mental health problems because of the unique pressures of their job.

Since 2008, the number of pilots of remotely piloted aircraft — the Air Force’s preferred term for drones — has grown fourfold, to nearly 1,300. The Air Force is now training more pilots for its drones than for its fighter jets and bombers combined. And by 2015, it expects to have more drone pilots than bomber pilots, although fighter pilots will remain a larger group.

Those figures do not include drones operated by the C.I.A. in counterterrorism operations over Pakistan, Yemen and other countries.

The Pentagon has begun taking steps to keep pace with the rapid expansion of drone operations. It recently created a new medal to honor troops involved in both drone warfare and cyberwarfare. And the Air Force has expanded access to chaplains and therapists for drone operators, said Col. William M. Tart, who commanded remotely piloted aircraft crews at Creech Air Force Base in Nevada.

The Air Force has also conducted research into the health issues of drone crew members. In a 2011 survey of nearly 840 drone operators, it found that 46 percent of Reaper and Predator pilots, and 48 percent of Global Hawk sensor operators, reported “high operational stress.” Those crews cited long hours and frequent shift changes as major causes.

That study found the stress among drone operators to be much higher than that reported by Air Force members in logistics or support jobs. But it did not compare the stress levels of the drone operators with those of traditional pilots.

The new study looked at the electronic health records of 709 drone pilots and 5,256 manned aircraft pilots between October 2003 and December 2011. Those records included information about clinical diagnoses by medical professionals and not just self-reported symptoms.

After analyzing diagnosis and treatment records, the researchers initially found that the drone pilots had higher incidence rates for 12 conditions, including anxiety disorder, depressive disorder, post-traumatic stress disorder, substance abuse and suicidal ideation.

But after the data were adjusted for age, number of deployments, time in service and history of previous mental health problems, the rates were similar, said Dr. Otto, who was scheduled to present her findings in Arizona on Saturday at a conference of the American College of Preventive Medicine.

The study also found that the incidence rates of mental heath problems among drone pilots spiked in 2009. Dr. Otto speculated that the increase might have been the result of intense pressure on pilots during the Iraq surge in the preceding years.

The study found that pilots of both manned and unmanned aircraft had lower rates of mental health problems than other Air Force personnel. But Dr. Otto conceded that her study might underestimate problems among both manned and unmanned aircraft pilots, who may feel pressure not to report mental health symptoms to doctors out of fears that they will be grounded.

She said she planned to conduct two follow-up studies: one that tries to compensate for possible underreporting of mental health problems by pilots and another that analyzes mental health issues among sensor operators, who control drone cameras while sitting next to the pilots.

“The increasing use of remotely piloted aircraft for war fighting as well as humanitarian relief should prompt increased surveillance,” she said.

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Many States Say Cuts Would Burden Fragile Recovery

States are increasingly alarmed that they could become collateral damage in Washington’s latest fiscal battle, fearing that the impasse could saddle them with across-the-board spending cuts that threaten to slow their fragile recoveries or thrust them back into recession.

Some states, like Maryland and Virginia, are vulnerable because their economies are heavily dependent on federal workers, federal contracts and military spending, which will face steep reductions if Congress allows the automatic cuts, known as sequestration, to begin next Friday. Others, including Illinois and South Dakota, are at risk because of their reliance on the types of federal grants that are scheduled to be cut. And many states simply fear that a heavy dose of federal austerity could weaken their economies, costing them jobs and much-needed tax revenue.

So as state officials begin to draw up their budgets for next year, some say that the biggest risk they see is not the weak housing market or the troubled European economy but the federal government. While the threat of big federal cuts to states has become something of a semiannual occurrence in recent years, state officials said in interviews that they fear that this time the federal government might not be crying wolf — and their hopes are dimming that a deal will be struck in Washington in time to avert the cuts.

The impact would be widespread as the cuts ripple across the nation over the next year.

Texas expects to see its education aid slashed hundreds of millions of dollars, which could force local school districts to fire teachers, if the cuts are not averted. Michigan officials say they are in no position to replace the lost federal dollars with state dollars, but worry about cuts to federal programs like the one that helps people heat their homes. Maryland is bracing not only for a blow to its economy, which depends on federal workers and contractors and the many private businesses that support them, but also for cuts in federal aid for schools, Head Start programs, a nutrition program for pregnant women, mothers and children, and job training programs, among others.

Gov. Bob McDonnell of Virginia, a Republican, warned in a letter to President Obama on Monday that the automatic spending cuts would have a “potentially devastating impact” and could force Virginia and other states into a recession, noting that the planned cuts to military spending would be especially damaging to areas like Hampton Roads that have a big Navy presence. And he noted that the whole idea of the proposed cuts was that they were supposed to be so unpalatable that they would force officials in Washington to come up with a compromise.

“As we all know, the defense, and other, cuts in the sequester were designed to be a hammer, not a real policy,” Mr. McDonnell wrote. “Unfortunately, inaction by you and Congress now leaves states and localities to adjust to the looming threat of this haphazard idea.”

The looming cuts come just as many states feel they are turning the corner after the prolonged slump caused by the recession. Gov. Martin O’Malley of Maryland, a Democrat, said he was moving to increase the state’s cash reserves and rainy day funds as a hedge against federal cuts.

“I’d rather be spending those dollars on things that improve our business climate, that accelerate our recovery, that get more people back to work, or on needed infrastructure — transportation, roads, bridges and the like,” he said, adding that Maryland has eliminated 5,600 positions in recent years and that its government was smaller, on a per capita basis, than it had been in four decades. “But I can’t do that. I can’t responsibly do that as long as I have this hara-kiri Congress threatening to drive a long knife through our recovery.”

Federal spending on salaries, wages and procurement makes up close to 20 percent of the economies of Maryland and Virginia, according to an analysis by the Pew Center on the States.

But states are in a delicate position. While they fear the impact of the automatic cuts, they also fear that any deal to avert them might be even worse for their bottom lines. That is because many of the planned cuts would go to military spending and not just domestic programs, and some of the most important federal programs for states, including Medicaid and federal highway funds, would be exempt from the cuts.

States will see a reduction of $5.8 billion this year in the federal grant programs subject to the automatic cuts, according to an analysis by Federal Funds Information for States, a group created by the National Governors Association and the National Conference of State Legislatures that tracks the impact of federal actions on states. California, New York and Texas stand to lose the most money from the automatic cuts, and Puerto Rico, which is already facing serious fiscal distress, is threatened with the loss of more than $126 million in federal grant money, the analysis found.

Even with the automatic cuts, the analysis found, states are still expected to get more federal aid over all this year than they did last year, because of growth in some of the biggest programs that are exempt from the cuts, including Medicaid.

But the cuts still pose a real risk to states, officials said. State budget officials from around the country held a conference call last week to discuss the threatened cuts. “In almost every case the folks at the state level, the budget offices, are pretty much telling the agencies and departments that they’re not going to backfill — they’re not going to make up for the budget cuts,” said Scott D. Pattison, the executive director of the National Association of State Budget Officers, which arranged the call. “They don’t have enough state funds to make up for federal cuts.”

The cuts would not hit all states equally, the Pew Center on the States found. While the federal grants subject to the cuts make up more than 10 percent of South Dakota’s revenue, it found, they make up less than 5 percent of Delaware’s revenue.

Many state officials find themselves frustrated year after year by the uncertainty of what they can expect from Washington, which provides states with roughly a third of their revenues. There were threats of cuts when Congress balked at raising the debt limit in 2011, when a so-called super-committee tried and failed to reach a budget deal, and late last year when the nation faced the “fiscal cliff.”

John E. Nixon, the director of Michigan’s budget office, said that all the uncertainty made the state’s planning more difficult. “If it’s going to happen,” he said, “at some point we need to rip off the Band-Aid.”

Fernanda Santos contributed reporting.

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Chinese Buoys Focus of Latest Dispute With Japan Over Islands

TOKYO – Japan has asked the Chinese government to explain why Chinese ships have strategically placed several buoys in the East China Sea near a group of disputed islands, a Japanese government spokesman said Friday.

The spokesman, Chief Cabinet Secretary Yoshihide Suga, told reporters that ships from China’s State Oceanic Administration, which is similar to the coast guard, had placed the buoys last week in Chinese-controlled waters near the islands, known as the Senkaku in Japan and Diaoyu in Chinese. The uninhabited islands have been controlled by Japan for decades, but are claimed by China and also Taiwan.

Japanese media reported the buoys might be used to track Japanese submarines in waters around the uninhabited islands, where Japanese and Chinese ships have chased each other in recent months. If so, their placement could represent another step in an ominous escalation in the standoff, which began with coast guard and other non-military ships, but has recently begun to involve more heavily armed navy ships.

Tensions over the islands flared up in September, after the Japanese government announced that it would buy three of the five islands from their private owner, setting off violent street protests in China. The Chinese government responded by sending oceanic administration and other non-military ships into Japanese-claimed waters on almost a daily basis.

Earlier this month, tensions seemed to rise when Japan said that a Chinese navy frigate had briefly used a missile-directing radar to make a target of a Japanese military ship. China has denied doing that.

Mr. Suga did not say how far the buoys were located from the islands. He said they were in undisputed waters controlled by China, but had been placed on Feb. 17 less than 1,000 feet from the edge of Japanese-controlled waters.

He said his government had asked China for an explanation, saying it was also possible that the buoys were being used to track ocean currents or weather. However, the Japanese defense minister, Itsunori Onodera, told reporters that the buoys may be used to track nearby vessels.

The sparring over the islands came as South Korea criticized Japan for sending a top government official to ceremonies highlighting Japan’s claim to another set of islands, which are claimed by South Korea. In a statement, the South Korean foreign ministry said, "We strongly protest the Japanese government’s decision to send a government official to such an unjustifiable event."

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NFL exec: HGH testing resolution needed

INDIANAPOLIS (AP) — NFL senior vice president Adolpho Birch says the league and players association need to reach agreement soon on HGH testing.

The NFL and the union agreed in principle to HGH testing when a new 10-year labor agreement was reached in August 2011. But protocols must be approved by both sides and the players have questioned the science in the testing procedures, stalling implementation.

Speaking at the scouting combine Thursday, Birch says the NFL has full confidence in the test and "should have been a year into this by now." He calls the delays "a disservice to all of us."

On Tuesday, the union said in a conference call it favors HGH testing, but only with a strong appeal process. Otherwise, NFLPA spokesman George Atallah said, "it's just a nonstarter."

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