Possible Approach to Esophageal Lung with Long Tracheobronchial Gap

Esophageal lung is a rare bronchopulmonary foregut malformation characterized by an anomalous origin of one of the main bronchi which arises from the esophagus. Less than 30 cases are reported in the literature. Therefore, there are no standardized guidelines for the treatment of this condition. We report a case of right esophageal lung diagnosed in a neonate. The patient was treated with thoracoscopic closure of the ectopic main bronchus in the neonatal period, followed by delayed pneumonectomy at 5 months of age. No prosthetic substitute was implanted in the ipsilateral hemithorax after pneumonectomy. The patient is now 4 years old and doing well, postpneumonectomy syndrome was never observed. Our strategy and the possible alternatives are discussed here

Cognitive and noncognitive costs of day care at age 0-2 for children in advantaged families

Electronically published December 12, 2019Exploiting admission thresholds to the Bologna day care system, we show using a regression discontinuity (RD) design that one additional day care month at age 0–2 reduces intelligence quotient by 0.5% (4.7% of a standard deviation) at age 8–14 in a relatively affluent population. Themagnitude of this negative effect increases with family income. Similar negative impacts are found for personality traits. These findings are consistent with the hypothesis frompsychology that children in day care experience fewer one-to-one interactions with adults, with negative effects in families where such interactions are of higher quality.We embed this hypothesis in a model that lends structure to our RD design.Margherita Fort, Andrea Ichino, Giulio Zanell

The subconvexity problem for \GL_{2}

Generalizing and unifying prior results, we solve the subconvexity problem for the $L$-functions of \GL_{1} and \GL_{2} automorphic representations over a fixed number field, uniformly in all aspects. A novel feature of the present method is the softness of our arguments; this is largely due to a consistent use of canonically normalized period relations, such as those supplied by the work of Waldspurger and Ichino--Ikeda.Comment: Almost final version to appear in Publ. Math IHES. References updated

Mass equidistribution of Hilbert modular eigenforms

Let F be a totally real number field, and let f traverse a sequence of non-dihedral holomorphic eigencuspforms on GL(2)/F of weight (k_1,...,k_n), trivial central character and full level. We show that the mass of f equidistributes on the Hilbert modular variety as max(k_1,...,k_n) tends to infinity. Our result answers affirmatively a natural analogue of a conjecture of Rudnick and Sarnak (1994). Our proof generalizes the argument of Holowinsky-Soundararajan (2008) who established the case F = Q. The essential difficulty in doing so is to adapt Holowinsky's bounds for the Weyl periods of the equidistribution problem in terms of manageable shifted convolution sums of Fourier coefficients to the case of a number field with nontrivial unit group.Comment: 40 pages; typos corrected, nearly accepted for

Labeling male anorectal malformations: objective evaluation of radiologic imaging before surgery

PurposeProne cross-table lateral x-ray (CTLxR) and colostogram aid surgical planning for anorectal malformations (ARMs) without perineal fistulas. We suggest objective imaging tools to classify ARMs.MethodsThree observers prospectively evaluated CTLxR and colostograms of male ARM patients (2012–2022) without perineal fistulas. The level of the rectal pouch was estimated with pubococcygeal (PC) and ischiatic (I) lines. On CTLxR, we described the “pigeon sign”, defined as the rectal pouch ending with a beak-like image, suspicious for a rectourinary fistula. ARM was defined as rectobulbar when the rectal pouch was below the I line, rectoprostatic when between PC and I lines, and rectovesical when above the PC line. Concordance was assessed with Fleiss' kappa. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the “pigeon sign” were calculated.ResultsThirteen patients were included in this study. The interobserver agreement on CTLxR was 69.2% (k = 0.54) on pouch ending, 84.6% (k = 0.69) on the “pigeon sign”, and 76.9% (k = 0.69) on diagnosis; concordance between observers and intraoperative diagnosis was 66.6% (k = 0.56). The “pigeon sign” had 75% sensitivity, 100% specificity, 100% PPV, and 50% NPV. The interobserver agreement on colostograms was 84.6% (k = 0.77) on pouch ending and 89.7% (k = 0.86) on diagnosis; concordance between observers and intraoperative diagnosis was 92.3% (k = 0.90).ConclusionPC and I lines and the “pigeon sign” are useful tools in examining CTLxR and colostograms. Adequate CTLxR interpretation may modify surgical strategy