The future of pediatric pulmonology: A survey of division directors, assessment of current research funding, and discussion of workforce trends

Adequacy of the US workforce in pediatric pulmonology has been a source of serious concern within the field for some time, as it has been for several pediatric subspecialties. Contributing factors have been thought to include low fill rates of fellowship training programs, aging, and retirement rates of the subspecialist population, and the perception of insufficient numbers of specialists in some regions to meet clinical care needs. Several approaches to assessing workforce needs have already been described, and stakeholder groups are currently working on additional analyses. Although the recent report by Harris et al. captured a broad snapshot of workforce perceptions of 485 pediatric pulmonologists, this study (reporting data collected in 2014) did not address the future scope of practice

Differences in pre-pregnancy diet quality by occupation among employed women

Objective: Maternal risk factors for pregnancy outcomes are known to vary by employment status. We evaluated whether pre-pregnancy diet quality varies by occupation in a population-based sample.Design: We analysed interview data from 7341 mothers in a national case-control study of pregnancy outcomes. Self-reported job(s) held during the 3 months before pregnancy were classified using Standard Occupational Classification (SOC) codes. Usual diet in the year before conception was assessed with a semi-quantitative FFQ and evaluated using the Diet Quality Index for Pregnancy (DQI-P). Using logistic regression, we calculated adjusted OR and 95 % CI to estimate associations between low diet quality (defined as the lowest quartile of DQI-P scores) and occupation types.Setting: The National Birth Defects Prevention Study: Arkansas, California, Georgia, Iowa, Massachusetts, North Carolina, New Jersey, New York, Texas, Utah.Participants: Employed mothers of infants born between 1997 and 2011.Results: No occupation was strongly associated with low diet quality. Moderate but relatively imprecise associations were observed for women employed in management (OR: 1·3; 95 % CI: 1·1, 1·7); arts, design, entertainment, sports and media (OR: 1·4; 95 % CI: 0·9, 2·1); protective service (OR 1·3; 95 % CI: 0·7, 2·5) and farming, fishing, and forestry occupations (OR: 0·5; 95 % CI: 0·2, 1·1).Conclusions: Our analyses suggest that women in certain occupations may have lower diet quality in the months before pregnancy. Further research is needed to determine whether certain occupations could benefit from interventions to improve diet quality in the workplace for women of reproductive age

Removal of a single photon by adaptive absorption

We present a method to remove, using only linear optics, exactly one photon from a field-mode. This is achieved by putting the system in contact with an absorbing environment which is under continuous monitoring. A feedback mechanism then decouples the system from the environment as soon as the first photon is absorbed. We propose a possible scheme to implement this process and provide the theoretical tools to describe it

Information and noise in quantum measurement

Even though measurement results obtained in the real world are generally both noisy and continuous, quantum measurement theory tends to emphasize the ideal limit of perfect precision and quantized measurement results. In this article, a more general concept of noisy measurements is applied to investigate the role of quantum noise in the measurement process. In particular, it is shown that the effects of quantum noise can be separated from the effects of information obtained in the measurement. However, quantum noise is required to ``cover up'' negative probabilities arising as the quantum limit is approached. These negative probabilities represent fundamental quantum mechanical correlations between the measured variable and the variables affected by quantum noise.Comment: 16 pages, short comment added in II.B., final version for publication in Phys. Rev.

Strongly focused light beams interacting with single atoms in free space

We construct 3-D solutions of Maxwell's equations that describe Gaussian light beams focused by a strong lens. We investigate the interaction of such beams with single atoms in free space and the interplay between angular and quantum properties of the scattered radiation. We compare the exact results with those obtained with paraxial light beams and from a standard input-output formalism. We put our results in the context of quantum information processing with single atoms.Comment: 9 pages, 9 figure

Correlates of intake of folic acid–containing supplements among pregnant women

This study describes the timing and correlates of folic acid supplement intake among pregnant women

Entanglement transfer from dissociated molecules to photons

We introduce and study the concept of a reversible transfer of the quantum state of two internally-translationally entangled fragments, formed by molecular dissociation, to a photon pair. The transfer is based on intracavity stimulated Raman adiabatic passage and it requires a combination of processes whose principles are well established.Comment: 5 pages, 3 figure

Antioxidant Consumption is Associated with Decreased Odds of Congenital Limb Deficiencies

Background: Approximately 1 in 2000 infants is born with a limb deficiency in the US. Research has shown that women's periconceptional diet and use of vitamin supplements can affect risk of birth defects. We investigated whether maternal consumption of nutritional antioxidants was associated with occurrence of transverse limb deficiency (TLD) and longitudinal limb deficiencies (LLD). Methods: We analysed case–control data from mothers and their singleton infants with TLD (n = 566), LLD (n = 339), or no malformation (controls; n = 9384) in the National Birth Defects Prevention Study (1997–2009). Using a modified food frequency, we estimated usual pre-pregnancy antioxidant consumption by total fruit and vegetable consumption (in grams) grouped into tertiles, and cumulative antioxidant score (ranging from 1 to 10) based on consumption of three antioxidants: beta-carotene, lycopene, and lutein. We estimated odds ratios (OR) adjusted for maternal age, race/ethnicity, education, smoking, alcohol use, body mass index, and total energy. Results: Compared to women in the lowest tertile of fruit and vegetable consumption, women in the highest tertile were less likely to have infants with TLD (OR 0.74, 95% CI 0.57, 0.96) or LLD (OR 0.82, 95% CI 0.59, 1.13). Compared to the lowest antioxidant consumption score of 1, those with the highest score of 10 had ORs of 0.68 (95% CI 0.48, 0.95) for TLD and 0.77 (95% CI 0.50, 1.17) for LLD. Conclusions: Dietary intake of antioxidants was associated with reduced odds of limb deficiencies. These findings add further evidence for women's periconceptional diet reducing occurrence of some birth defects

Sociodemographic, health behavioral, and clinical risk factors for anotia/microtia in a population-based case-control study

Objective: Anotia and microtia are congenital malformations of the external ear with few known risk factors. We conducted a comprehensive assessment of a wide range of potential risk factors using data from the National Birth Defects Prevention Study (NBDPS), a population-based case-control study of non-chromosomal structural birth defects in the United States. Methods: Mothers of 699 infants with anotia or microtia (cases) and 11,797 non-malformed infants (controls) delivered between 1997 and 2011 were interviewed to obtain information about sociodemographic, health behavioral, and clinical characteristics. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated with logistic regression. Results: Infants with anotia/microtia were more likely to be male (aOR, 1.29; 95% CI, 1.10–1.50) and from a multifetal pregnancy (aOR, 1.68; 95% CI, 1.16–2.42). Cases were also more likely to have parents of Hispanic ethnicity (maternal aOR, 3.19; 95% CI, 2.61–3.91; paternal aOR, 2.11; 95% CI, 1.54–2.88), and parents born outside the United States (maternal aOR, 1.29; 95% CI, 1.06–1.57; paternal aOR, 1.92; 95% CI, 1.53–2.41). Maternal health conditions associated with increased odds of anotia/microtia included obesity (aOR, 1.31; 95% CI, 1.06–1.61) and pre-pregnancy diabetes (type I aOR, 9.89; 95% CI, 5.46–17.92; type II aOR, 4.70; 95% CI, 2.56–8.63). Reduced odds were observed for black mothers (aOR, 0.57; 95% CI, 0.38–0.85) and mothers reporting daily intake of folic acid-containing supplements (aOR, 0.59; 95% CI, 0.46–0.76). Conclusion: We identified several risk factors for anotia/microtia, some which have been previously reported (e.g., diabetes) and others which we investigate for perhaps the first time (e.g., binge drinking) that warrant further investigation. Our findings point to some potentially modifiable risk factors and provide further leads toward understanding the etiology of anotia/microtia

Survival of infants with spina bifida and the role of maternal prepregnancy body mass index

Objective: To investigate first-year survival of infants born with spina bifida, and examine the association of maternal prepregnancy body mass index (BMI) with infant mortality. Methods: This is a retrospective cohort study of 1,533 liveborn infants with nonsyndromic spina bifida with estimated dates of delivery from 1998 to 2011 whose mothers were eligible for the National Birth Defects Prevention Study (NBDPS). NBDPS data were linked to death records to conduct survival analyses. Kaplan–Meier survival functions estimated mortality risk over the first year of life. Cox proportional hazards models estimated hazard ratios (HRs) for maternal prepregnancy BMI categorized as underweight ('18.5), normal (18.5–24.9), overweight (25–29.9), and obese (≥30). Results: Infant mortality risk among infants with spina bifida was (4.4% [3.52, 5.60%]). Infants with multiple co-occurring defects, very preterm delivery, multiple gestation, high-level spina bifida lesions, or non-Hispanic Black mothers had an elevated risk of infant mortality. Maternal prepregnancy underweight and obesity were associated with higher infant mortality (15.7% [7.20, 32.30%] and 5.82% [3.60, 9.35%], respectively). Adjusted HR estimates showed underweight and obese mothers had greater hazard of infant mortality compared to normal weight mothers (HR: 4.5 [1.08, 16.72] and 2.6 [1.36, 8.02], respectively). Conclusion: The overall risk of infant mortality for infants born with spina bifida was lower than most previously reported estimates. Infants born with spina bifida to mothers who were underweight or obese prepregnancy were at higher risk of infant mortality. This study provides additional evidence of the importance of healthy maternal weight prior to pregnancy