38 research outputs found
Narrow-band imaging versus white light for the detection of proximal colon serrated lesions: a randomized, controlled trial
Background
The value of narrow-band imaging (NBI) for detecting serrated lesions is unknown.
Objective
To assess NBI for the detection of proximal colon serrated lesions.
Design
Randomized, controlled trial.
Setting
Two academic hospital outpatient units.
Patients
Eight hundred outpatients 50 years of age and older with intact colons undergoing routine screening, surveillance, or diagnostic examinations.
Interventions
Randomization to colon inspection in NBI versus white-light colonoscopy.
Main Outcome Measurements
The number of serrated lesions (sessile serrated polyps plus hyperplastic polyps) proximal to the sigmoid colon.
Results
The mean inspection times for the whole colon and proximal colon were the same for the NBI and white-light groups. There were 204 proximal colon lesions in the NBI group and 158 in the white light group (P = .085). Detection of conventional adenomas was comparable in the 2 groups.
Limitations
Lack of blinding, endoscopic estimation of polyp location.
Conclusion
NBI may increase the detection of proximal colon serrated lesions, but the result in this trial did not reach significance. Additional study of this issue is warranted. (Clinical trial registration number: NCT01572428.
Different paths to the modern state in Europe: the interaction between domestic political economy and interstate competition
Theoretical work on state formation and capacity has focused mostly on early modern Europe and on the experience of western European states during this period. While a number of European states monopolized domestic tax collection and achieved gains in state capacity during the early modern era, for others revenues stagnated or even declined, and these variations motivated alternative hypotheses for determinants of fiscal and state capacity. In this study we test the basic hypotheses in the existing literature making use of the large date set we have compiled for all of the leading states across the continent. We find strong empirical support for two prevailing threads in the literature, arguing respectively that interstate wars and changes in economic structure towards an urbanized economy had positive fiscal impact. Regarding the main point of contention in the theoretical literature, whether it was representative or authoritarian political regimes that facilitated the gains in fiscal capacity, we do not find conclusive evidence that one performed better than the other. Instead, the empirical evidence we have gathered lends supports to the hypothesis that when under pressure of war, the fiscal performance of representative regimes was better in the more urbanized-commercial economies and the fiscal performance of authoritarian regimes was better in rural-agrarian economie