The chosen few Botticini, Maristella; Eckstein, Zvi
2012, 2012., 20120805, 2012-08-05, 20120101, Volume:
42
eBook, Book
In 70 CE, the Jews were an agrarian and illiterate people living mostly in the Land of Israel and Mesopotamia. By 1492 the Jewish people had become a small group of literate urbanites specializing in ...crafts, trade, moneylending, and medicine in hundreds of places across the Old World, from Seville to Mangalore. What caused this radical change?The Chosen Fewpresents a new answer to this question by applying the lens of economic analysis to the key facts of fifteen formative centuries of Jewish history.
Maristella Botticini and Zvi Eckstein show that, contrary to previous explanations, this transformation was driven not by anti-Jewish persecution and legal restrictions, but rather by changes within Judaism itself after 70 CE--most importantly, the rise of a new norm that required every Jewish male to read and study the Torah and to send his sons to school. Over the next six centuries, those Jews who found the norms of Judaism too costly to obey converted to other religions, making world Jewry shrink. Later, when urbanization and commercial expansion in the newly established Muslim Caliphates increased the demand for occupations in which literacy was an advantage, the Jews found themselves literate in a world of almost universal illiteracy. From then forward, almost all Jews entered crafts and trade, and many of them began moving in search of business opportunities, creating a worldwide Diaspora in the process.
The Chosen Fewoffers a powerful new explanation of one of the most significant transformations in Jewish history while also providing fresh insights to the growing debate about the social and economic impact of religion.
International consensus on a complications list after gastrectomy for cancer Baiocchi, Gian Luca; Giacopuzzi, Simone; Marrelli, Daniele ...
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association,
01/2019, Volume:
22, Issue:
1
Journal Article
Peer reviewed
Open access
Background
Perioperative complications can affect outcomes after gastrectomy for cancer, with high mortality and morbidity rates ranging between 10 and 40%. The absence of a standardized system for ...recording complications generates wide variation in evaluating their impacts on outcomes and hinders proposals of quality-improvement projects. The aim of this study was to provide a list of defined gastrectomy complications approved through international consensus.
Methods
The Gastrectomy Complications Consensus Group consists of 34 European gastric cancer experts who are members of the International Gastric Cancer Association. A group meeting established the work plan for study implementation through Delphi surveys. A consensus was reached regarding a set of standardized methods to define gastrectomy complications.
Results
A standardized list of 27 defined complications (grouped into 3 intraoperative, 14 postoperative general, and 10 postoperative surgical complications) was created to provide a simple but accurate template for recording individual gastrectomy complications. A consensus was reached for both the list of complications that should be considered major adverse events after gastrectomy for cancer and their specific definitions. The study group also agreed that an assessment of each surgical case should be completed at patient discharge and 90 days postoperatively using a Complication Recording Sheet.
Conclusion
The list of defined complications (soon to be validated in an international multicenter study) and the ongoing development of an electronic datasheet app to record them provide the basic infrastructure to reach the ultimate goals of standardized international data collection, establishment of benchmark results, and fostering of quality-improvement projects.
Background
Detecting small nodules that are grossly unidentifiable remains a major challenge in liver resection for cancer. Novel developments in navigation surgery, especially indocyanine green ...(ICG)-based fluorescence imaging, are making a clear breakthrough in addressing this issue. ICG is almost routinely administered during the preoperative stage in hepatobiliary surgery. However, its full potential has yet to be realized, partly because there are no precise guidelines regarding the optimal dose or timing of ICG injections before liver surgery. The main goal of this study was to design an algorithm for the management of ICG injections to achieve optimal liver staining results.
Methods
Twenty-seven consecutive, unselected patients undergoing liver resection for cancer were enrolled and underwent preoperative liver function assessment by the LiMON test. Extra ICG i.v. injections at different doses and timings were performed. In vivo intraoperative analysis of the stain detected by near-infrared fluorescence imaging of the liver and ex vivo analysis of each resected nodule was performed and compared to the pathological analysis.
Results
(i) The success rate of ICG injections in terms of liver staining was 92.6%; (ii) in the absence of or with 7 or more days from a previous ICG injection, the best dose to inject before the operation was 0.2 mg/kg, and the best timing was between 24 and 48 h before the scheduled surgery; and (iii) the ICG fluorescence patterns observed in the tumors were total fluorescence staining (41% of the cases), partial fluorescence staining (15%), rim fluorescence staining surrounding the tumor (30%), and no staining (15%).
Conclusions
This study is a building block for the characterization of liver nodules and the search for additional surface lesions undetected by preoperative radiological work-up—a crucial task for the successful treatment of liver cancer at an early stage using a safe, minimally invasive, and inexpensive technique.
Empirical work on contracts typically regresses contract choice on observed principal and agent characteristics. If (i) some of these characteristics are unobserved or partially observedand(ii) there ...are incentives whereby particular types of agents end up contracting with particular types of principals, estimated coefficients on the observed characteristics may be misleading. We address thisendogenous matchingproblem using a data set on agricultural contracts between landlords and tenants in early Renaissance Tuscany. Controlling for endogenous matching has an impact on parameters of interest, and tenants’ risk aversion appears to have influenced contract choice.
AIM To analyze the clinicopathological characteristics of patients with both node-negative gastric carcinoma and diagnosis of recurrence during follow-up. METHODS We enrolled 41 patients treated with ...curative gastrectomy for p T2-4 a N0 gastric carcinoma between 1992 and 2010,who developed recurrence(Group 1). We retrospectively selected this group from the prospectively collected database of 4 centers belonging to the Italian Research Group for Gastric Cancer,and compared them with 437 p T2-4 a N0 patients without recurrence(Group 2). We analyzed lymphatic embolization,microvascular infiltration,perineural infiltration,and immunohistochemical determination of p53,Ki67,and HER2 in Group 1 and in a subgroup of Group 2(Group 2 bis) of 41 cases matched with Group 1 according to demographic and pathological characteristics. RESULTS T4 a stage and diffuse histotype were associated with recurrence in the group of p N0 patients. In-depth pathological analysis of two homogenous groups of p N0 patients,with and without recurrence during longterm follow-up(groups 1 and 2 bis),revealed two striking patterns: lymphatic embolization and perineural infiltration(two parameters that pathologists can easily report),and p53 and Ki67,represent significant factors for recurrence.CONCLUSION The reported pathological features should be considered predictive factors for recurrence and could be useful to stratify node-negative gastric cancer patients for adjuvant treatment and tailored follow-up.
Abstract
Maritime insurance developed in medieval Europe is the ancestor of all forms of insurance that appeared subsequently. We address the question of why modern insurance was first invented in ...medieval Europe, and neither earlier nor elsewhere. Drawing from insights from the literature on uncertainty aversion, we show that medieval merchants had to bear more frequently natural risks (they traveled longer distances) and new human risks with unknown probabilities (they faced unpredictable attacks by corsairs due to increased political fragmentation and commercial competition in Europe). The increased demand for protection in medieval seaborne trade met the supply of protection by a small group of wealthy merchants with a broad information network who could pool risks and profit from selling protection through a novel business device: the insurance contract. A new market—the market for insurance—was then born. Next, analyzing more than 7,000 insurance contracts redacted by notaries and about 100 court proceedings housed in the archives of Barcelona, Florence, Genoa, Palermo, Prato, and Venice, we study the main features of medieval trade, the type of risks faced by merchants, and the characteristics of insurance contracts and markets from 1340 to 1500.The empirical analysis delivers two main findings. First, risks related to human activities (e.g., attacks by corsairs) seem to have had a relatively greater impact on insurance premia compared to natural risks (proxied by seasonal risks). Second, distance mattered but the route seems to have had a greater impact on insurance premia. Specific routes (e.g., in the Tyrrhenian and the western Mediterranean) were more plagued by human risks, which were harder to avoid for the majority of merchants who did not have a broad information network compared to the few wealthy merchants, who became the key players in selling insurance in the early stages of the development of insurance markets.
Abstract
Economists increasingly highlight the role that human capital formation, institutions and cultural transmission may play in shaping health, knowledge and wealth. We study one of the most ...remarkable instances in which religious norms and childcare practices had a major impact: the history of the Jews in central and eastern Europe from 1500 to 1930. We show that while birth rates were about the same, infant and child mortality among Jews was much lower and accounted for the main difference in Jewish versus non-Jewish natural population growth. Jewish families routinely adopted childcare practices that recent medical research has shown as enhancing children's well-being.
From the end of the second century CE, Judaism enforced a religious norm requiring fathers to educate their sons. We present evidence supporting our thesis that this change had a major influence on ...Jewish economic and demographic history. First, the high individual and community cost of educating children in subsistence farming economies (2nd to 7th centuries) prompted voluntary conversions of Jews that account for a share of the reduction from 4.5 to 1.2 million. Second, the Jewish farmers who invested in education gained the comparative advantage and incentive to enter skilled occupations during the urbanization in the Abbasid empire in the Near East (8th and 9th centuries) and they did select themselves into these occupations. Third, as merchants the Jews invested even more in education-a precondition for the mailing network and common court system that endowed them with trading skills demanded all over the world. Fourth, the Jews generated a voluntary diaspora within the Muslim Empire and later to Western Europe. Fifth, the majority of world Jewry lived in the Near East when the Mongol invasions in the 1250s brought this region back to a subsistence farming economy in which many Jews found it difficult to enforce the religious norm, and hence converted, as it had happened centuries earlier.
Why Dowries? Botticini, Maristella; Siow, Aloysius
The American economic review,
09/2003, Volume:
93, Issue:
4
Journal Article
Peer reviewed
The standard economic model of dowries, implicit in the seminal work of Gary S. Becker (1981), assumes that dowries (and brideprices) are used as pecuniary transfers to clear the marriage market. The ...standard economic model of dowries faces two potential objections. First, if the main purpose of dowries is to clear the marriage market, how do marriage markets clear in societies without dowry or brideprice? Second, the standard model of dowries cannot account for why in many dotal societies the timing of intergenerational transfers is gender specific, with parents assigning dowries to their daughters and leaving bequests to their sons. A theory of dowries that is consistent with the standard model without being open to the two objections discussed above is presented. When dowries become an inefficient source of bridal wealth, they will wither. Unlike the standard economic model, it is argued that there is no connection between the disappearance of dowries and the appearance of brideprices.
ABSTRACT
Background
Indocyanine green (ICG) has been recently introduced in clinical practice as a fluorescent tracer. Lymphadenectomy is particularly challenging in gastric cancer surgery, owing to ...the complex anatomical drainage.
Aim
The primary outcomes of this study were the feasibility and usefulness of ICG-guided lymphadenectomy in gastric cancer surgery, considering both the success rate and improved understanding of the surgical anatomy of nodal basins. The secondary outcome was the diagnostic ability of ICG to predict the presence of nodal metastases.
Patients and methods
We conducted a single-center prospective trial comprising 13 patients with gastric cancer. ICG was injected the afternoon prior to surgery or intraoperatively via the submucosal or subserosal route. Standard lymphadenectomy was performed in all patients, according to patient age and tumor stage, as usual, but after standard lymphadenectomy the residual ICG + nodes were harvested and analyzed. Each nodal station and each dissected node was recorded and classified as ICG + or ICG− (both in vivo and back table evaluation was utilized for classification). After pathological analysis, each nodal station and each dissected node was recorded as metastatic or nonmetastatic (E&E staining).
Results
The feasibility rate was 84.6% (11/13). The mean number of dissected lymph nodes per patient was 37.9. Focusing on the 11 patients in whom ICG-guided nodal navigation was successfully performed, 81 lymph node stations were removed, for a total of 417 lymph nodes. Sixty-six stations (81.48%), comprising a total of 336 lymph nodes, exhibited fluorescence. No IC− node was metastatic; all 54 metastatic nodes were ICG + . A total of 282 ICG + nodes were nonmetastatic. In two cases, some nodes outside D2 areas were harvested, being ICG + (1 case of metastatic node).
Conclusions
Fluorescence lymphography–guided lymphadenectomy is a promising new technique that combines a high feasibility rate with considerable ease of use. Regarding its diagnostic value, the key finding from this prospective series is that no metastatic nodes were found outside fluorescent lymph node stations. Further studies are needed to investigate whether this technique can help surgeons performing standard lymphadenectomy and selecting cases for D2 + lymphadenectomy.
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