The Development of Security Community in Croatia: Leading the Pack

Of the former Yugoslav republics, Croatia is in an enviable position. After years of difficult reforms and restructuring, its efforts are paying off. The country recently assumed a seat on the UN Security Council, it joined NATO and there is an expectation of forthcoming EU membership. Through these steps, the country has begun to integrate into the well-established Euro-Atlantic community. This article explores the depths of this integration through the theoretical lens of security community. We draw conclusions regarding security community in Croatia to provide lessons for NATO’s New Strategic Concept. Ultimately, we argue that NATO must remember that there remain security concerns in the European neighborhood, even in apparent successes like Croatia

Developing Security Community in the Western Balkans: The Role of the EU and NATO

This paper examines how external third-parties, such as international organizations, can play a role in facilitating the development of security community and international integration within post-conflict societies. The formation of a security community includes the emergence of trust, belongingness, and reconciliation, along with internalizing the notion of resolving conflicts in a peaceful manner. This paper studies the roles of the EU and NATO in potentially fostering a regional security community in the Western Balkans. Both organizations have become heavily involved and invested in the region attempting to extend to the area the well established security community that exists among Europe and its Trans-Atlantic partners, while all the countries of the Western Balkan region have expressed a desire to join European institutions and become a part of the Euro-Atlantic community. But what are the implications of external encouragement of security community? The socialization of individual countries, rather than the region as a whole, contributes more to each country’s self-perception as a member state rather than as a part of a regional community. This study offers unique insight into how and why feelings of trust and a sense of community can be encouraged by external actors – and how and why trust and community can filter down to the most local level within post-conflict societies. Such insight will further interests in enhancing conflict resolution and post-conflict reconstruction

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease

Sensitivity of SARS-CoV-2 RNA polymerase chain reaction using a clinical and radiological reference standard: Clinical sensitivity of SARS-CoV-2 PCR.

ObjectivesDiagnostic tests for SARS-CoV-2 are important for epidemiology, clinical management, and infection control. Limitations of oro-nasopharyngeal real-time PCR sensitivity have been described based on comparisons of single tests with repeated sampling. We assessed SARS-CoV-2 PCR clinical sensitivity using a clinical and radiological reference standard.MethodsBetween March-May 2020, 2060 patients underwent thoracic imaging and SARS-CoV-2 PCR testing. Imaging was independently double- or triple-reported (if discordance) by blinded radiologists according to radiological criteria for COVID-19. We excluded asymptomatic patients and those with alternative diagnoses that could explain imaging findings. Associations with PCR-positivity were assessed with binomial logistic regression.Results901 patients had possible/probable imaging features and clinical symptoms of COVID-19 and 429 patients met the clinical and radiological reference case definition. SARS-CoV-2 PCR sensitivity was 68% (95% confidence interval 64-73), was highest 7-8 days after symptom onset (78% (68-88)) and was lower among current smokers (adjusted odds ratio 0.23 (0.12-0.42) pConclusionsIn patients with clinical and imaging features of COVID-19, PCR test sensitivity was 68%, and was lower among smokers; a finding that could explain observations of lower disease incidence and that warrants further validation. PCR tests should be interpreted considering imaging, symptom duration and smoking status

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

Background Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions. 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-19 Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospital with COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients were randomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once per day by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatment groups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment and were twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants and local study staff were not masked to the allocated treatment, but all others involved in the trial were masked to the outcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treat population. 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%) were eligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was 65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomly allocated 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 (median 10 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, no significant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilation or 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 other prespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restricted to patients in whom there is a clear antimicrobial indication. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research