Rural-urban differences and the break-up of Yugoslavia

There has been widespread debate over the possible causes of the break-up of the former Yugoslav federation : but relatively little attention has been paid to the importance of rural-urban differences in this process. The central claim of the article is that the economic, political and social exclusion which some specific segments of the Yugoslav rural population came to experience in relation to the urban-centred “system” can be regarded as having played an important contributory part in the genesis and course of the struggles surrounding the disintegration of Yugoslavia. This broad hypothesis is explored through brief discussions of two case-studies, the Serb krajina in Croatia, and “Herceg-Bosna”. While expressly rejecting single-factor explanations of change, the author argues that in looking for explanations of the phenomenon of secessionism in these cases we need to take into consideration the profound state of economic depression into which these areas had fallen

Modeling resilience and sustainability in ancient agricultural systems

The reasons why people adopt unsustainable agricultural practices, and the ultimate environmental implications of those practices, remain incompletely understood in the present world. Archaeology, however, offers unique datasets on coincident cultural and ecological change, and their social and environmental effects. This article applies concepts derived from ecological resilience thinking to assess the sustainability of agricultural practices as a result of long-term interactions between political, economic, and environmental systems. Using the urban center of Gordion, in central Turkey, as a case study, it is possible to identify mismatched social and ecological processes on temporal, spatial, and organizational scales, which help to resolve thresholds of resilience. Results of this analysis implicate temporal and spatial mismatches as a cause for local environmental degradation, and increasing extralocal economic pressures as an ultimate cause for the adoption of unsustainable land-use practices. This analysis suggests that a research approach that integrates environmental archaeology with a resilience perspective has considerable potential for explicating regional patterns of agricultural change and environmental degradation in the past

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Using Phytolith, Geochemical and Ethnographic Analysis to Inform on Site Construction and Activities in the Neolithic of Southwest Asia:Case Studies from Wadi Faynan 16 and ‘Ain Ghazal, Jordan

This paper explores what can be learned about settlement construction and use in the southwest Asian Neolithic from phytolith, geochemical and ethnographic analysis. This period was targeted because, despite its importance, our understanding of building practices and use of space within settlements is sometimes limited. We chose the sites of WF16 and ‘Ain Ghazal as case studies and compared them with ethnographic samples of known origin from the similarly constructed 20th century village of Al Ma’tan, Jordan. We split our samples into different context categories for example middens, hearths and floors, and found that phytolith and elemental signatures are strongest for categories linked to construction practices rather than activities. Geology, age and the availability of local plant materials are shown to be key sources of signature variability. Fire contexts have particularly distinct activity signatures, which are heavily influenced by fuel choice yet are relatively analogous. We suggest that the use of micro-proxies such as phytoliths and geochemistry should be considered when sampling strategies are devised and integrated with other forms of archaeological evidence to enhance site interpretation