The origins and development of Zuwīla, Libyan Sahara: an archaeological and historical overview of an ancient oasis town and caravan centre

Zuwīla in southwestern Libya (Fazzān) was one of the most important early Islamic centres in the Central Sahara, but the archaeological correlates of the written sources for it have been little explored. This paper brings together for the first time a detailed consideration of the relevant historical and archaeological data, together with new AMS radiocarbon dates from several key monuments. The origins of the settlement at Zuwīla were pre-Islamic, but the town gained greater prominence in the early centuries of Arab rule of the Maghrib, culminating with the establishment of an Ibāḍī state ruled by the dynasty of the Banū Khaṭṭāb, with Zuwīla its capital. The historical sources and the accounts of early European travellers are discussed and archaeological work at Zuwīla is described (including the new radiocarbon dates). A short gazetteer of archaeological monuments is provided as an appendix. Comparisons and contrasts are also drawn between Zuwīla and other oases of the ash-Sharqiyāt region of Fazzān. The final section of the paper presents a series of models based on the available evidence, tracing the evolution and decline of this remarkable site

[PP. 27.24] DIAGNOSTIC ACCURACY AND DIAGNOSTIC GAIN OF CRITERIA TO INTERPRET UNILATERALLY SELECTIVE ADRENAL VEIN SAMPLING (AVS) RESULTS

Objective: 10–20% of AVS performed in Excellence centers for primary aldosteronism (PA) are not bilaterally selective. The ratio of cortisol-corrected aldosterone concentration between adrenal vein and inferior vena cava (unilateral ratio, UR) has been proposed to interpret unilaterally selective AVS [1]:UR<0.5could suggest unilateral PA on the opposite side; UR >5.5 could suggest unilateral PA on the same side, and UR 0.5–5.5 would be inconclusive. Design and method: This retrospective study evaluates the diagnostic value of the UR on AVS data collected over10 years in a referral centre. French AVS-consensus criteria (selectivity index >2, lateralisation ratio >4) were used for AVS interpretation. We first assessed the numbers of cases with left and right UR both <0.5 or both >5.5, because in these cases the interpretation of unilaterally selective AVS will depend only on the side of successful adrenal vein cannulation, not on the side of the disease. We then assessed the sensitivity, specificity and PPV of these criteria for the diagnosis of unilateral PA. Cases with left and right UR both <0.5 or both >5.5 were counted as false positives for these calculations. We finally assessed the diagnostic impact of using the unilateral criteria in case of unilaterally selective AVS. Results: -537AVS were performed from 2001–2010, 64(12%) were not bilaterally selective using the reference criteria (28unilaterally selective and 36 bilaterally non-selective), 287 (53%) were diagnostic of bilateral PA, 99 (18%) of left PA and 87 (16%) of right PA [Table 1]. -Among 473 bilaterally selective AVS, 7 (1.5%) had left and right UR both <0.5 and 32 (7%) had left and right UR both >5.5 [Table 2]. -Sensitivity of UR <0.5 to detect unilateral PA was 55%, specificity 91%, PPV79%. -Sensitivity of UR >5.5 was 51%, specificity71%, PPV53% [Table3]. -Using these criteria to interpret 28 unilaterally selective AVS led to diagnose 2right PA but 0left PA with a contralateral UR <0.5, 10 right PA and 6left PA with an ipsilateral UR >5.5, the remaining 10 cases staying inconclusive. However, among the 16 unilateral PA diagnosed with an ipsilateral UR >5.5, we must expect 8 false positives