Against the backdrop of US–China superpower rivalry in the Indo-Pacific, this article assesses the visions and strategies of the region's middle powers, which remain under-examined at present. First, it briefly traces the boundaries of this research by reviewing the contested nature of the Indo-Pacific concept and the definitional complexities of middle power theory. Second, it provides a novel comparative framework to analyse Australia, South Korea and Indonesia as the region's major middle powers, exploring their goals and strategies. The framework consists of: 1) middle power categorization; 2) interconnectedness with the two superpowers; 3) vision for the Indo-Pacific; 4) resulting regional posture; and 5) capacity to implement the country's goals. Third, it assesses the ensuing implications of this analysis for the region's strategic landscape. It finds that Canberra is now firmly aligned with Washington in balancing against China, as epitomized by the Quad and AUKUS; Seoul is cautiously increasing cooperation with the US, though potentially only to protract its strategic ambiguity; and Jakarta is pursuing strategic autonomy for itself and ASEAN, with the ambitious but precarious goal of creating a ‘third way’ for the Indo-Pacific. Consequently, middle powers seem unlikely to provide an alternative platform for the region's direction in the near future, due to a number of internal divisions. By shedding light on such understudied aspects, this article addresses a gap in the scholarly literature and provides a novel contribution to the understanding of both the diverse roles of middle powers and the Indo-Pacific's evolving strategic landscape.
Aim:To present the case of a 14-year-old boy with bilateral stage IV keratoconus, treated with a combined MARK + CXL intervention, without the need for a corneal transplantation.Results:The left eye displays considerable improvements, with a follow-up of 13.5 years: Kmax is decreased by 5.53 D, Kmed is decreased by 1.95 D and thinnest pachymetry is increased by 106 µm. The right eye shows equally remarkable parameters, with a follow-up of 9.5 years: Kmax is decreased by 8.16 D, Kmed is decreased by 0.38 D and thinnest pachymetry is increased by 52 µm. Keratoconus has been halted and the patient has a binocular best corrected visual acuity of -0.079 LogMAR (12/10).Conclusion:The MARK + CXL combined intervention, known as the “Rome Protocol”, was successful in halting a bilateral stage IV keratoconus and improving visual acuity in a very young patient, with long-term follow-up. Conservative treatments should always be privileged when treating very young patients with developed stages of the pathology.
Australia is often described as a 'good international citizen' (GIC), which is intertwined to its status of 'quintessential' middle power. However, a number of elements might undermine both notions. This research reviews the concept of GIC and contributes to this niche of IR theory by providing a dedicated definitional framework, which consists of: i) the respect of the international law; ii) multilateralism; iii) the pursuing of humanitarian and idealist objectives; iv) an active support for the rules-based order; and v) a congruous identity matched by consistent domestic policies. After assessing the country's foreign and domestic policies against this, it finds that Australia has damaged its GIC credentials due to a number of reasons, including: the hard-line policies against seaborne asylum seekers; the participation in missions that are not sanctioned by the UN; the transformation of its global multilateralism into a selective regionalism; the budget cuts to foreign aid; a controversial attitude towards climate change mitigation; and a preference for the US-led global order over a rules-based international society. Far from criticising the country's foreign policy in its entirety, it argues that in the 21st century Australia behaves as a 'neutral international citizen', and a traditional but not 'quintessential' middle power.
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