Chinese Firm Is Cleared to Buy American DNA Sequencing Company

Ramin Rahimian for The New York Times

DNA sequencing machines at Complete Genomics in California. The firm dismissed concerns about its acquisition.

The federal government has given national security clearance to the controversial purchase of an American DNA sequencing company by a Chinese firm.

The Chinese firm, BGI-Shenzhen, said in a statement this weekend that its acquisition of Complete Genomics, based in Mountain View, Calif., had been cleared by the federal Committee on Foreign Investment in the United States, which reviews the national security implications of foreign takeovers of American companies. The deal still requires antitrust clearance by the Federal Trade Commission.

Some scientists, politicians and industry executives had said the takeover represented a threat to American competitiveness in DNA sequencing, a technology that is becoming crucial for the development of drugs, diagnostics and improved crops.

The fact that the $117.6 million deal was controversial at all reflects a change in the genomics community.

A decade ago, the Human Genome Project, in which scientists from many nations helped unravel the genetic blueprint of mankind, was celebrated for its spirit of international cooperation. One of the participants in the project was BGI, which was then known as the Beijing Genomics Institute.

But with DNA sequencing now becoming a big business and linchpin of the biotechnology industry, international rivalries and nationalism are starting to move front and center in any acquisition.

Much of the alarm about the deal has been raised by Illumina, a San Diego company that is the market leader in sequencing machines. It has potentially the most to lose from the deal because BGI might buy fewer Illumina products and even become a competitor. Weeks after the BGI deal was announced, Illumina made its own belated bid for Complete Genomics, offering 15 cents a share more than BGI’s bid of $3.15. But Complete Genomics rebuffed Illumina, saying such a merger would never clear antitrust review.

Illumina also hired a Washington lobbyist, the Glover Park Group, to stir up opposition to the deal in Congress. Representative Frank R. Wolf, Republican of Virginia, was the only member of Congress known to have publicly expressed concern.

BGI and Complete Genomics point out that Illumina has long sold its sequencing machines — including a record-setting order of 128 high-end machines — to BGI without raising any security concerns. Sequencing machines have not been subject to export controls like aerospace equipment, lasers, sensors and other gear that can have clear military uses.

“Illumina has never previously considered its business with BGI as ‘sensitive’ in the least,” Ye Yin, the chief operating officer of BGI, said in a November letter to Complete Genomics that was made public in a regulatory filing. In the letter, Illumina was accused of “obvious hypocrisy.”

BGI and Complete said that Illumina was trying to derail the agreement and acquire Complete Genomics itself in order to “eliminate its closest competitor, Complete.”

BGI is already one of the most prolific DNA sequencers in the world, but it buys the sequencing machines it uses from others, mainly Illumina.

Illumina, joined by some American scientists, said it worried that if BGI gained access to Complete’s sequencing technology, the Chinese company might use low prices to undercut the American sequencing companies that now dominate the industry.

Some also said that with Complete Genomics providing an American base, BGI would have access to more DNA samples from Americans, helping it compile a huge database of genetic information that could be used to develop drugs and diagnostic tests. Some also worried about protection of the privacy of genetic information.

“What’s to stop them from mining genomic data of American samples to some unknown nefarious end?” Elaine R. Mardis, co-director of the genome sequencing center at Washington University in St. Louis, said in an e-mail.

Dr. Mardis could not specify what kind of nefarious end she imagined. But opponents of the deal cited a November article in The Atlantic saying that in the future, pathogens could be genetically engineered to attack particular individuals, including the president, based on their DNA sequences.

BGI and Complete Genomics dismissed such concerns as preposterous.

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YouTube Ban Lifted in Pakistan, for 3 Minutes

ISLAMABAD, Pakistan — A ban on YouTube, which Pakistan imposed after an anti-Islam video caused riots in much of the Muslim world, was lifted Saturday, only to be reinstated — after three minutes — when it was discovered that blasphemous material was still available on the site.

After months of criticism of the ban, the government decided to allow Pakistanis to have access to YouTube again, saying steps had been taken to ensure that offensive content would not be visible. But those efforts apparently failed, and the authorities quickly backtracked.

The ban was imposed on Sept. 17 following violent protests in response to the video, which was made in the United States and ridiculed the Prophet Muhammad. The government then ordered all telecommunications companies to block Internet material deemed offensive to Muslims and urged people to report such material.

But the ban on YouTube came to be seen as censorship, and a growing number of the estimated 25 million Internet users in the country complained.

“This is purely a naked power play by the government and one that we should resist,” an editorial in The Express Tribune, an English-language daily newspaper in Karachi, Pakistan, said Friday. “This is about controlling our behavior and denying us access to the Internet.”

“We need to make it clear that we do not wish to regress to a dark age when a centralized authority controlled all access to information,” the editorial, observing the 100th day of the ban, went on to say. “Retreating to such an era would essentially mean that we were no longer living in a democracy.”

By Friday evening, Rehman Malik, the country’s interior minister, indicated that the ban would be lifted over the weekend. Mr. Malik said firewalls by government technicians were being installed to block pornographic and blasphemous material.

On Saturday, the Pakistan Telecommunication Authority directed local Internet service providers to make YouTube accessible. But by the afternoon, Geo, a private television news network that wields immense influence, reported that anti-Islam and blasphemous material was still available on YouTube. The criticism was led by Ansar Abbasi, a right-leaning journalist who often speaks out on morality and religion.

Yielding to the criticism, Prime Minister Raja Pervez Ashraf then ordered providers to again block access to the video-sharing site.

The flip-flop drew an immediate rebuke from users and led to a flurry of jokes on Twitter about the government’s dithering and backtracking.

“YouTube is a huge convenience for users, who benefit from it for educational as well as entertainment purposes,” Zubair Kasuri, the editor of Flare, a Karachi-based telecommunications magazine, said in a telephone interview. Mr. Kasuri expressed surprise over the government’s failure to install an effective firewall mechanism despite having months to do so.

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Envoy to Syria Warns of Descent to Warlord ‘Hell’

BEIRUT, Lebanon — The international envoy to Syria, Lakhdar Brahimi, drew a grim portrait on Sunday of the country’s future in the absence of a political solution, warning of a state carved up by warlords and a death toll that would rapidly surge, while conceding that there was little sign that the antagonists intended to negotiate.

Muzaffar Salman/Reuters

A rebel soldier firing at pro-government forces on Sunday in Aleppo, Syria. In Homs, civilians fled a district torn by fighting.

At a news conference at Arab League headquarters in Cairo, Mr. Brahimi said the violence, which has already killed tens of thousands of people, could claim 100,000 lives over the next year.

“People are talking about a divided Syria being split into a number of small states like Yugoslavia,” he said.

“This is not what is going to happen. What will happen is Somalization — warlords,” Mr. Brahimi said, according to a transcript of his remarks. Without a peace deal, he added, Syria would be “transformed into hell.”

Mr. Brahimi’s comments reflected a deepening pessimism after his apparently unsuccessful attempt over the past week to mediate the crisis by shuttling between opposition figures and the Syrian president, Bashar al-Assad. The envoy indicated that Mr. Assad had made no response to peace proposals, which included a plan to create a transitional government. In another sign of the impasse, the leader of a large opposition coalition all but rebuffed an invitation by Russia, one of Syria’s closest allies, to discuss solutions to the crisis.

On Saturday, nearly a week after Mr. Brahimi traveled to Damascus, the Syrian capital, Russia’s foreign minister said there was “no possibility” of persuading Mr. Assad to leave the country, which Syrian opposition groups have insisted is a precondition for any peace talks.

The envoy’s warnings came as activists in Syria reported a new exodus of civilians from the central city of Homs, adding untold numbers of internal refugees to the millions Mr. Brahimi said had already been displaced by the war. Over the past three days, hundreds and perhaps thousands of residents have fled fighting in the Deir Ba’alba district of Homs after government troops stormed the restive neighborhood, according to activists in Talbiseh, north of Homs, where many of the refugees were being received.

Some residents have blamed rebel fighters for the incursion, saying the army moved in after the insurgents inexplicably quit the neighborhood. In Syria’s other cities, residents have frequently been angered by the tendency of rebel fighters to occupy a neighborhood and then attack government troops before abruptly withdrawing and leaving civilians to bear the brunt of the army’s brutal retaliation.

It was unclear how many people had been killed in the fighting in the district. One young witness said he believed a neighbor had been killed. Two videos purportedly from Deir Ba’alba showed the bodies of about a dozen men who had apparently been executed with gunshots to the head. But there was no confirmation of claims made on Saturday by an antigovernment group, the Local Coordination Committees, that hundreds had been killed.

One resident of Deir Ba’alba, a 14-year-old boy reached by Skype in Talbiseh, said he had fled with his parents at 1:30 a.m. Sunday. The family had grown accustomed to sporadic fighting and gunfire, and usually fled to a relative’s house elsewhere in Homs. “But this time, it was heavy shelling,” the teenager said. “I could hear the asphalt cracking under the tanks.”

As he and his family left, the boy saw the body of a neighbor, a woman, lying on the ground, he said. His mother tried to convince the boy that the neighbor was alive. “I’m sure I saw her dead,” he said. “Her neck was bleeding. She was unveiled. It was the first time I saw our neighbor unveiled.”

One fighter from Homs said the retreat had come after the rebel military council for Homs failed to provide ammunition for its fighters in Deir Ba’alba. “They asked for supplies 48 hours before the invasion,” the fighter said. “Their call was not answered. I don’t know why.”

Civilians had begged the fighters not to leave, or at least to leave their weapons behind, two fighters said. Another fighter from Homs, calling the withdrawal “suicidal,” said the rebels had left civilians “to face their destiny alone.”

“We don’t know what happened to them,” he said.

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Senate Leaders Racing to Beat Fiscal Deadline

WASHINGTON — Senate leaders and their aides spent Saturday searching for a formula to extend tax cuts for most Americans that could win bipartisan support in the Senate and final approval in the fractious House by the new year, hoping to prevent large tax increases and budget cuts that could threaten the fragile economy.

As part of the last-minute negotiations, the lawmakers were haggling over unemployment benefits, cuts in Medicare payments to doctors, taxes on large inheritances and how to limit the impact of the alternative minimum tax, a parallel income tax system that is intended to ensure the rich pay a fair share but that is increasingly encroaching on the middle class.

President Obama said that if talks between the Senate leaders broke down, he wanted the Senate to schedule an up-or-down vote on a narrower measure that would extend only the middle-class tax breaks and unemployment benefits. The Senate majority leader, Harry Reid of Nevada, said he would schedule such a vote on Monday absent a deal.

If Congress is unable to act before the new year, Washington will effectively usher in a series of automatic tax increases and a program of drastic spending cuts that economists say could pitch the country back into recession.

The president and lawmakers put those spending cuts in place this year as draconian incentives that would force them to confront the nation’s growing debt. Now, lawmakers are trying to keep them from happening, though it seemed most likely on Saturday that the cuts, known as sequestration, would be left for the next Congress, to be sworn in this week.

“We just can’t afford a politically self-inflicted wound to our economy,” Mr. Obama said Saturday in his weekly address. “The housing market is healing, but that could stall if folks are seeing smaller paychecks. The unemployment rate is the lowest it’s been since 2008, but already families and businesses are starting to hold back because of the dysfunction they see in Washington.”

The fear of another painful economic slowdown appears to have accelerated deal-making on Capitol Hill with just 48 hours left before the so-called fiscal cliff arrives. Weeks of public sniping between Mr. Reid, the Democratic leader, and Senator Mitch McConnell of Kentucky, the Republican leader, ebbed on Friday evening with pledges of cooperation and optimism from both.

On Saturday, though, that sentiment was put to the test as 98 senators waited for word whether their leaders had come up with a proposal that might pass muster with members of both parties. The first votes in the Senate, if needed, are scheduled for Sunday afternoon.

“It’s a little like playing Russian roulette with the economy,” said Senator Mark Warner, Democrat of Virginia. “The consequences could be enormous.”

Members of Congress were mostly absent from the Capitol on Saturday, after two days of Senate votes on other matters and a day before both chambers were to reconvene. However, senior aides were working on proposals in their offices or at their homes.

Speaker John A. Boehner stopped by the Capitol briefly to see his chief of staff on Saturday afternoon. Mr. McConnell spent much of the day in his office.

Aides to Mr. Reid were expecting to receive offers from Mr. McConnell’s staff, but no progress was reported by midday. Even if the talks took a positive turn, Senate aides said, no announcement was expected before the leaders briefed their caucuses on Sunday.

The chief sticking point among lawmakers and the president continued to be how to set tax rates for the next decade and beyond. With the Bush-era tax cuts expiring, Mr. Obama and Democrats have said they want tax rates to rise on income over $250,000 a year, while Republicans want a higher threshold, perhaps at $400,000.

Democrats and Republicans are also divided on the tax on inherited estates, which currently hits inheritances over $5 million at 35 percent. On Jan. 1, it is scheduled to rise to 55 percent beginning with inheritances exceeding $1 million.

The political drama in Washington over the weekend was given greater urgency by the fear that the economic gains of the past two years could be lost if no deal is reached.

Some of the consequences of Congressional inaction would be felt almost at once on Tuesday, in employee paychecks, doctors’ offices and financial markets. Analysts said the effect would be cumulative, building over time.

An early barometer would probably be the financial markets, where skittish investors, as they have during previous Congressional cliffhangers, could send the stock market lower on fears of another prolonged period of economic distress.

In 2011, the political battles over whether to raise the nation’s borrowing limit prompted Standard & Poor’s to downgrade its rating of American debt, suggesting a higher risk of default. The Dow Jones industrial average fell 635 points in a volatile day of trading after the downgrade.

This month, traders have again nervously watched the political maneuvering in Washington, and the markets have jumped or dropped at tidbits of news from the negotiations. Two weeks ago, Ben S. Bernanke, the chairman of the Federal Reserve Board, predicted that if lawmakers failed to reach a deal, “the economy will, I think, go off the cliff.”

Immediately — regardless of whether a deal is reached — every working American’s taxes will go up because neither party is fighting to extend a Social Security payroll tax cut that has been in place for two years.

Robert Pear and Jennifer Steinhauer contributed reporting.

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Elwood V. Jensen, Pioneer in Breast Cancer Treatment, Dies at 92

Tony Jones/Cincinnati Enquirer, via Associated Press

Elwood V. Jensen in 2004.

Elwood V. Jensen, a medical researcher whose studies of steroid hormones led to new treatments for breast cancer that have been credited with saving or extending hundreds of thousands of lives, died on Dec. 16 in Cincinnati. He was 92.

The cause was complications of pneumonia, his son, Thomas Jensen, said.

In 2004 Dr. Jensen received the Albert Lasker Basic Medical Research Award, one of the most respected science prizes in the world.

When Dr. Jensen started his research at the University of Chicago in the 1950s, steroid hormones, which alter the functioning of cells, were thought to interact with cells through a series of chemical reactions involving enzymes.

However, Dr. Jensen used radioactive tracers to show that steroid hormones actually affect cells by binding to a specific receptor protein inside them. He first focused on the steroid hormone estrogen.

By 1968, Dr. Jensen had developed a test for the presence of estrogen receptors in breast cancer cells. He later concluded that such receptors were present in about a third of those cells.

Breast cancers that are estrogen positive, meaning they have receptors for the hormone, can be treated with medications like Tamoxifen or with other methods of inhibiting estrogen in a patient’s system, like removal of the ovaries. Women with receptor-rich breast cancers often go into remission when estrogen is blocked or removed.

By the mid-1980s, a test developed by Dr. Jensen and a colleague at the University of Chicago, Dr. Geoffrey Greene, could be used to determine the extent of estrogen receptors in breast and other cancers. That test became a standard part of care for breast cancer patients.

Scientists like Dr. Pierre Chambon and Dr. Ronald M. Evans, who shared the 2004 Lasker prize with Dr. Jensen, went on to show that many types of receptors exist. The receptors are crucial components of the cell’s control system and transmit signals in an array of vital functions, from the development of organs in the womb to the control of fat cells and the regulation of cholesterol.

Dr. Jensen’s work also led to the development of drugs that can enhance or inhibit the effects of hormones. Such drugs are used to treat prostate and other cancers.

Elwood Vernon Jensen was born in Fargo, N.D., on Jan. 13, 1920, to Eli and Vera Morris Jensen. He majored in chemistry at what was then Wittenberg College in Springfield, Ohio, and had begun graduate training in organic chemistry at the University of Chicago when World War II began.

Dr. Jensen wanted to join the Army Air Forces, but his poor vision kept him from becoming a pilot. During the war he synthesized poison gases at the University of Chicago, exposure to which twice put him in the hospital. His work on toxic chemicals, he said, inspired him to pursue biology and medicine.

Dr. Jensen studied steroid hormone chemistry at the Swiss Federal Institute of Technology on a Guggenheim Fellowship after the war. While there, he climbed the Matterhorn, one of the highest peaks in the Alps, even though he had no mountaineering experience. He often equated his successful research to the novel approach taken by Edward Whymper, the first mountaineer to reach the Matterhorn’s summit. Mr. Whymper went against conventional wisdom and scaled the mountain’s Swiss face, after twice failing to reach the summit on the Italian side.

Dr. Jensen joined the University of Chicago as an assistant professor of surgery in 1947, working closely with the Nobel laureate Charles Huggins. He became an original member of the research team at the Ben May Laboratory for Cancer Research (now the Ben May Department for Cancer Research) in 1951, and became the director after Dr. Huggins stepped down.

He came to work at the University of Cincinnati in 2002, and continued to do research there until last year.

His first wife, the former Mary Collette, died in 1982. In addition to his son, Dr. Jensen is survived by his second wife, the former Hiltrud Herborg; a daughter, Karen C. Jensen; a sister, Margaret Brennan; two grandchildren; and three great-grandchildren.

Dr. Jensen’s wife was found to have breast cancer in 2005. She had the tumor removed, he said in an interview, but tested positive for the estrogen receptor and was successfully treated with a medication that prevents estrogen synthesis.

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Well: Exercise and the Ever-Smarter Human Brain

Anyone whose resolve to exercise in 2013 is a bit shaky might want to consider an emerging scientific view of human evolution. It suggests that we are clever today in part because a million years ago, we could outrun and outwalk most other mammals over long distances. Our brains were shaped and sharpened by movement, the idea goes, and we continue to require regular physical activity in order for our brains to function optimally.

Phys Ed

Gretchen Reynolds on the science of fitness.

The role of physical endurance in shaping humankind has intrigued anthropologists and gripped the popular imagination for some time. In 2004, the evolutionary biologists Daniel E. Lieberman of Harvard and Dennis M. Bramble of the University of Utah published a seminal article in the journal Nature titled “Endurance Running and the Evolution of Homo,” in which they posited that our bipedal ancestors survived by becoming endurance athletes, able to bring down swifter prey through sheer doggedness, jogging and plodding along behind them until the animals dropped.

Endurance produced meals, which provided energy for mating, which meant that adept early joggers passed along their genes. In this way, natural selection drove early humans to become even more athletic, Dr. Lieberman and other scientists have written, their bodies developing longer legs, shorter toes, less hair and complicated inner-ear mechanisms to maintain balance and stability during upright ambulation. Movement shaped the human body.

But simultaneously, in a development that until recently many scientists viewed as unrelated, humans were becoming smarter. Their brains were increasing rapidly in size.

Today, humans have a brain that is about three times larger than would be expected, anthropologists say, given our species’ body size in comparison with that of other mammals.

To explain those outsized brains, evolutionary scientists have pointed to such occurrences as meat eating and, perhaps most determinatively, our early ancestors’ need for social interaction. Early humans had to plan and execute hunts as a group, which required complicated thinking patterns and, it’s been thought, rewarded the social and brainy with evolutionary success. According to that hypothesis, the evolution of the brain was driven by the need to think.

But now some scientists are suggesting that physical activity also played a critical role in making our brains larger.

To reach that conclusion, anthropologists began by looking at existing data about brain size and endurance capacity in a variety of mammals, including dogs, guinea pigs, foxes, mice, wolves, rats, civet cats, antelope, mongooses, goats, sheep and elands. They found a notable pattern. Species like dogs and rats that had a high innate endurance capacity, which presumably had evolved over millenniums, also had large brain volumes relative to their body size.

The researchers also looked at recent experiments in which mice and rats were systematically bred to be marathon runners. Lab animals that willingly put in the most miles on running wheels were interbred, resulting in the creation of a line of lab animals that excelled at running.

Interestingly, after multiple generations, these animals began to develop innately high levels of substances that promote tissue growth and health, including a protein called brain-derived neurotrophic factor, or BDNF. These substances are important for endurance performance. They also are known to drive brain growth.

What all of this means, says David A. Raichlen, an anthropologist at the University of Arizona and an author of a new article about the evolution of human brains appearing in the January issue of Proceedings of the Royal Society Biology, is that physical activity may have helped to make early humans smarter.

“We think that what happened” in our early hunter-gatherer ancestors, he says, is that the more athletic and active survived and, as with the lab mice, passed along physiological characteristics that improved their endurance, including elevated levels of BDNF. Eventually, these early athletes had enough BDNF coursing through their bodies that some could migrate from the muscles to the brain, where it nudged the growth of brain tissue.

Those particular early humans then applied their growing ability to think and reason toward better tracking prey, becoming the best-fed and most successful from an evolutionary standpoint. Being in motion made them smarter, and being smarter now allowed them to move more efficiently.

And out of all of this came, eventually, an ability to understand higher math and invent iPads. But that was some time later.

The broad point of this new notion is that if physical activity helped to mold the structure of our brains, then it most likely remains essential to brain health today, says John D. Polk, an associate professor of anthropology at the University of Illinois at Urbana-Champaign, and co-author, with Dr. Raichlen, of the new article.

And there is scientific support for that idea. Recent studies have shown, he says, that “regular exercise, even walking,” leads to more robust mental abilities, “beginning in childhood and continuing into old age.”

Of course, the hypothesis that jogging after prey helped to drive human brain evolution is just a hypothesis, Dr. Raichlen says, and almost unprovable.

But it is compelling, says Harvard’s Dr. Lieberman, who has worked with the authors of the new article. “I fundamentally agree that there is a deep evolutionary basis for the relationship between a healthy body and a healthy mind,” he says, a relationship that makes the term “jogging your memory” more literal than most of us might have expected and provides a powerful incentive to be active in 2013.

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YouTube Ban Lifted in Pakistan, for 3 Minutes

ISLAMABAD, Pakistan — A ban on YouTube, which Pakistan imposed after an anti-Islam video caused riots in much of the Muslim world, was lifted Saturday, only to be reinstated — after three minutes — when it was discovered that blasphemous material was still available on the site.

After months of criticism of the ban, the government decided to allow Pakistanis to have access to YouTube again, saying steps had been taken to ensure that offensive content would not be visible. But those efforts apparently failed, and the authorities quickly backtracked.

The ban was imposed on Sept. 17 following violent protests in response to the video, which was made in the United States and ridiculed the Prophet Muhammad. The government then ordered all telecommunications companies to block Internet material deemed offensive to Muslims and urged people to report such material.

But the ban on YouTube came to be seen as censorship, and a growing number of the estimated 25 million Internet users in the country complained.

“This is purely a naked power play by the government and one that we should resist,” an editorial in The Express Tribune, an English-language daily newspaper in Karachi, Pakistan, said Friday. “This is about controlling our behavior and denying us access to the Internet.”

“We need to make it clear that we do not wish to regress to a dark age when a centralized authority controlled all access to information,” the editorial, observing the 100th day of the ban, went on to say. “Retreating to such an era would essentially mean that we were longer living in a democracy.”

By Friday evening, Rehman Malik, the country’s interior minister, indicated that the ban would be lifted over the weekend. Mr. Malik said firewalls by government technicians were being installed to block pornographic and blasphemous material.

On Saturday, the Pakistan Telecommunication Authority directed local Internet service providers to make YouTube accessible. But by the afternoon, Geo, a private television news network that wields immense influence, reported that anti-Islam and blasphemous material was still available on YouTube. The criticism was led by Ansar Abbasi, a right-leaning journalist who often speaks out on morality and religion.

Yielding to the criticism, Prime Minister Raja Pervez Ashraf then ordered providers to again block access to the video-sharing site.

The flip-flop drew an immediate rebuke from users and led to a flurry of jokes on Twitter about the government’s dithering and backtracking.

“YouTube is a huge convenience for users, who benefit from it for educational as well as entertainment purposes,” Zubair Kasuri, the editor of Flare, a Karachi-based telecommunications magazine, said in a telephone interview. Mr. Kasuri expressed surprise over the government’s failure to install an effective firewall mechanism despite having months to do so.

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Drone War Spurs Pakistan Militants to Deadly Reprisals

ISLAMABAD, Pakistan — They are dead men talking, and they know it. Gulping nervously, the prisoners stare into the video camera, spilling tales of intrigue, betrayal and paid espionage on behalf of the United States. Some speak in trembling voices, a glint of fear in their eyes. Others look resigned. All plead for their lives.

“I am a spy and I took part in four attacks,” said Sidinkay, a young tribesman who said he was paid $350 to help direct C.I.A. drones to their targets in Pakistan’s tribal belt. Sweat glistened on his forehead; he rocked nervously as he spoke. “Stay away from the Americans,” he said in an imploring voice. “Stay away from their dollars.”

Al Qaeda and the Taliban have few defenses against the American drones that endlessly prowl the skies over the bustling militant hubs of North and South Waziristan in northwestern Pakistan, along the Afghan border. C.I.A. missiles killed at least 246 people in 2012, most of them Islamist militants, according to watchdog groups that monitor the strikes. The dead included Abu Yahya al-Libi, the Qaeda ideologue and deputy leader.

Despite the technological superiority of their enemy, however, the militants do possess one powerful countermeasure.

For several years now, militant enforcers have scoured the tribal belt in search of informers who help the C.I.A. find and kill the spy agency’s jihadist quarry. The militants’ technique — often more witch hunt than investigation — follows a well-established pattern. Accused tribesmen are abducted from homes and workplaces at gunpoint and tortured. A sham religious court hears their case, usually declaring them guilty. Then they are forced to speak into a video camera.

The taped confessions, which are later distributed on CD, vary in style and content. But their endings are the same: execution by hanging, beheading or firing squad.

In Sidinkay’s last moments, the camera shows him standing in a dusty field with three other prisoners, all blindfolded, illuminated by car headlights. A volley of shots rings out, and the three others are mowed down. But Sidinkay, apparently untouched, is left standing. For a tragic instant, the accused spy shuffles about, confused. Then fresh shots ring out and he, too, crumples to the ground.

These macabre recordings offer a glimpse into a little-seen side of the drone war in Waziristan, a paranoid shadow conflict between militants and a faceless American enemy in which ordinary Pakistanis have often become unwitting victims.

Outside the tribal belt, the issue of civilian casualties has dominated the debate about American drones. At least 473 noncombatants have been killed by C.I.A.-directed strikes since 2004, according to monitoring groups — a toll frequently highlighted by critics of the drones like the Pakistani politician Imran Khan. Still, strike accuracy seems to be improving: just seven civilian deaths have been confirmed in 2012, down from 68 the previous year, according to the Bureau of Investigative Journalism, which has been critical of the Obama administration’s drone campaign.

And civilian lives are threatened by militants, too. As the American campaign has cut deeply into the commands of both the Taliban and Al Qaeda, drone-fearing militants have turned to the local community for reprisals, mounting a concerted campaign of fear and intimidation that has claimed dozens of lives and further stressed the already fragile order of tribal society.

The video messages from accused spies are intended to send a stark message, regardless of whether innocents are among those caught up in the deadly dragnet. The confessions are delivered at gunpoint, and usually follow extensive torture, including hanging from hooks for up to a month, human rights groups say.

“In every civilized society, the penalty for spying is death,” said a senior commander with the Pakistani Taliban, speaking on the condition of anonymity from Waziristan.

Although each of myriad militant factions in Waziristan operates its own death squads, by far the most formidable is the Ittehad-e-Mujahedeen Khorasan, a shadowy group that experts consider to be Al Qaeda’s local counterintelligence wing. Since it emerged in 2009, the group, which is led by Arab and Uzbek militants, has carefully cultivated a sinister image through video theatrics and the ruthless application of violence.

Black-clad Khorasan militants, their faces covered in balaclavas, roam across North Waziristan in jeeps with tinted windows. In one video clip from 2011, Khorasan fighters are seen searching traffic under a cluster of palm trees outside Mir Ali, a notorious militant hub. Then they move into the town center, distributing leaflets to shoppers, before executing three men outside a gas station.

“Spies, your days are numbered because we are carrying out raids,” chants the video soundtrack.

Thought to number dozens of militants, the Khorasan cooperates closely with the Afghan warlord Jalaluddin Haqqani, who is based in North Waziristan. A sister organization in Afghanistan has been responsible for 250 assassinations and executions, according to American military intelligence.

Reporting was contributed by Ihsanullah Tipu Mehsud from Islamabad; Ismail Khan from Peshawar, Pakistan; Zia ur-Rehman from Karachi, Pakistan; and Scott Shane and Eric Schmitt from Washington.

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The New Old Age Blog: United States Lags in Alzheimer's Support

This month, the United States Senate Special Committee on Aging released a report examining how five nations — the United States, Australia, France, Japan and Britain — are responding to growing numbers of older adults with Alzheimer’s disease and dementia.

Every country has a strategy, but some are much further ahead than others. Notably, France began addressing Alzheimer’s disease and dementia in 2001 and is in the midst of carrying out its third national plan. (Scroll down at this link to find the English version of the 2008-2012 French plan.)

By contrast, the United States released its first national plan to address Alzheimer’s in May.

The Senate report highlights several trends under way in all five countries, including efforts to coordinate research more effectively, diagnose Alzheimer’s disease more reliably and improve training in dementia care by medical practitioners.

Most relevant to readers of this blog is another trend with increasing international scope: an accelerating effort to keep patients with Alzheimer’s disease and other forms of dementia at home and arrange for care and treatment there, rather than in institutions.

Anyone who’s followed reader response to Jane Brody’s column this week on aging in place knows the burden that this can place on families, especially if government support for home-based services (companions or home health aides who help with bathing, dressing, toileting and other tasks), adult day care or respite care is scarce or nonexistent, as is the case for most middle-class families in the United States.

Is care at home for patients with Alzheimer’s necessarily more humane? Only if caregivers have the resources — financial, physical and emotional — to handle this draining, exhausting, immeasurably difficult job. And only if the institutions that serve people with more advanced forms of Alzheimer’s disease and other types of dementia are so poorly financed, staffed and operated that we wouldn’t feel comfortable leaving loved ones in their care.

Three charts in the new Senate report underscore the extent to which the United States differs from other countries in what is expected of family caregivers. The first, on Page 60, shows countries’ support for paid long-term care services for residents age 65 and older. This includes all residents who need long-term care, including those with Alzheimer’s disease, other forms of dementia and other disabling chronic illnesses. Not included are services provided by unpaid family caregivers.

Look at where the United States ranks compared with Australia, Japan, France and the 30 other developed countries that belong to the Organization for Economic Cooperation and Development. Paid support for long-term care is much less in our country than in theirs.

The second chart, on Page 64, gives a sense of how much paid support for long-term care is provided in people’s homes. Again, the data is not specific to Alzheimer’s disease or dementia, although these are primary reasons older adults need long-term care.

And again, the United States falls short in terms of the amount of paid care it provides in home settings, even though older people tend to prefer these settings over institutions.

The third chart, on Page 75, brings results in the other two down to the level of families. When paid long-term care support is scarce or unavailable, you would expect a heavier load to fall on unpaid caregivers, and this is what the chart shows. Look at the number of caregivers in the United States who put in 10 to 19 hours a week (34.2 percent) or 20 hours or more a week (30.5 percent), and compare those with similar figures for France, Australia and Britain, all of which provide more paid long-term care than we do. Where are informal caregivers working the hardest? Right here at home in the United States.

For me, the take-away is clear. Other countries with which the United States is closely aligned have embraced long-term care as an essential social responsibility while we have not. Unless and until we do so, caregivers here will be among the most harried, stressed and burdened among wealthy, developed countries in the world.

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The New Old Age Blog: United States Lags in Alzheimer's Support

This month, the United States Senate Special Committee on Aging released a report examining how five nations — the United States, Australia, France, Japan and Britain — are responding to growing numbers of older adults with Alzheimer’s disease and dementia.

Every country has a strategy, but some are much further ahead than others. Notably, France began addressing Alzheimer’s disease and dementia in 2001 and is in the midst of carrying out its third national plan. (Scroll down at this link to find the English version of the 2008-2012 French plan.)

By contrast, the United States released its first national plan to address Alzheimer’s in May.

The Senate report highlights several trends under way in all five countries, including efforts to coordinate research more effectively, diagnose Alzheimer’s disease more reliably and improve training in dementia care by medical practitioners.

Most relevant to readers of this blog is another trend with increasing international scope: an accelerating effort to keep patients with Alzheimer’s disease and other forms of dementia at home and arrange for care and treatment there, rather than in institutions.

Anyone who’s followed reader response to Jane Brody’s column this week on aging in place knows the burden that this can place on families, especially if government support for home-based services (companions or home health aides who help with bathing, dressing, toileting and other tasks), adult day care or respite care is scarce or nonexistent, as is the case for most middle-class families in the United States.

Is care at home for patients with Alzheimer’s necessarily more humane? Only if caregivers have the resources — financial, physical and emotional — to handle this draining, exhausting, immeasurably difficult job. And only if the institutions that serve people with more advanced forms of Alzheimer’s disease and other types of dementia are so poorly financed, staffed and operated that we wouldn’t feel comfortable leaving loved ones in their care.

Three charts in the new Senate report underscore the extent to which the United States differs from other countries in what is expected of family caregivers. The first, on Page 60, shows countries’ support for paid long-term care services for residents age 65 and older. This includes all residents who need long-term care, including those with Alzheimer’s disease, other forms of dementia and other disabling chronic illnesses. Not included are services provided by unpaid family caregivers.

Look at where the United States ranks compared with Australia, Japan, France and the 30 other developed countries that belong to the Organization for Economic Cooperation and Development. Paid support for long-term care is much less in our country than in theirs.

The second chart, on Page 64, gives a sense of how much paid support for long-term care is provided in people’s homes. Again, the data is not specific to Alzheimer’s disease or dementia, although these are primary reasons older adults need long-term care.

And again, the United States falls short in terms of the amount of paid care it provides in home settings, even though older people tend to prefer these settings over institutions.

The third chart, on Page 75, brings results in the other two down to the level of families. When paid long-term care support is scarce or unavailable, you would expect a heavier load to fall on unpaid caregivers, and this is what the chart shows. Look at the number of caregivers in the United States who put in 10 to 19 hours a week (34.2 percent) or 20 hours or more a week (30.5 percent), and compare those with similar figures for France, Australia and Britain, all of which provide more paid long-term care than we do. Where are informal caregivers working the hardest? Right here at home in the United States.

For me, the take-away is clear. Other countries with which the United States is closely aligned have embraced long-term care as an essential social responsibility while we have not. Unless and until we do so, caregivers here will be among the most harried, stressed and burdened among wealthy, developed countries in the world.

Read More..