Poor Sleep Quality Increases Gestational Weight Gain Rate in Pregnant People: Findings from the MADRES Study

Background

Poor sleep quality is associated with weight gain in non-pregnant populations, but evidence in pregnant people is lacking. Our study examined the association between early-to-mid pregnancy sleep quality and weekly gestational weight gain (GWG) rate during mid-to-late pregnancy by pre-pregnancy body mass index (BMI).

Method

Participants were 316 pregnant participants from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) study. During early-to-mid pregnancy, participants reported their sleep quality which was used to construct four categories: very poor, poor, good, and very good. Linear growth curve models examined the association between early-to-mid pregnancy sleep quality and weekly rate of GWG (kg/week) during mid-to-late pregnancy (> 20 weeks gestation), with a three-way cross-level interaction between gestational age, sleep quality, and pre-pregnancy BMI category. Models adjusted for ethnicity by birthplace, hypertensive disorders, perceived stress score, and physical activity level.

Results

Overall, poorer early-to-mid pregnancy sleep quality was associated with increased weekly weight gain during mid-to-late pregnancy. For example, amongst normal weight participants, mid-to-late pregnancy weight gain was, on average, 0.39 kg (95% CI: 0.29, 0.48) per week for those with very good sleep quality, 0.53 kg (95% CI: 0.44, 0.61) per week for those with poor sleep quality, and 0.54 kg (95% CI: 0.46, 0.62) per week for those with very poor sleep quality during early-to-mid pregnancy. This difference in GWG rate was statistically significantly comparing very good to poor sleep (0.14 kg/week, 95% CI: 0.01, 0.26) and very good to very poor sleep (0.15kg/week, 85% CI: 0.02, 0.27). This association between sleep quality and GWG rate did not statistically differ by pre-pregnancy BMI.

Conclusion

Our study found very poor early-to-mid pregnancy sleep quality was associated with higher mid-to-late pregnancy GWG rate. Incorporating pregnancy-specific sleep recommendations into routine obstetric care may be a critical next step in promoting healthy GWG.

Effects of dual use of e-cigarette and cannabis during adolescence on cigarette use in young adulthood

INTRODUCTION

E-cigarette and cannabis use by adolescents are risk factors for smoking initiation. We hypothesised that increasingly common dual use of e-cigarette and cannabis in adolescence leads to more frequent cigarette smoking in young adulthood.

METHODS

Data are from a prospective cohort study in Southern California, where 1164 participants who ever used nicotine products in their lifetime completed surveys in 12th grade (T1:2016), and at 24-month (T2) and 42-month (T3) follow-ups. Past 30-day use (number of days: range=0-30) of cigarettes, e-cigarettes and cannabis, and nicotine dependence, were assessed in each survey. Nicotine dependence for cigarettes and e-cigarettes was assessed using original and modified (for e-cigarette) Hooked on Nicotine Checklists (number of dependent products: range=0-2). Path analysis examined the mediation process via nicotine dependence linking baseline e-cigarette and cannabis use to subsequent increased cigarette use.

RESULTS

Baseline exclusive use of e-cigarettes (baseline prevalence, 2.5%) was associated with 2.61-fold increase in frequency of smoking days at T3 (95% CI 1.04 to 13.1), exclusive cannabis use (26.0%) with 2.58-fold increase (95% CI 1.43 to 4.98), and dual use (7.4%) with 5.84-fold increase (95% CI 3.16 to 12.81), compared with baseline non-users. Nicotine dependence at T2 mediated 10.5% (95% CI 6.3 to 14.7) and 23.2% (95% CI 9.6 to 36.3) of the association of cannabis and dual use, respectively, with increased smoking at T3.

DISCUSSION

Adolescent e-cigarette and cannabis use was associated with more frequent smoking during young adulthood, with larger effects of dual use. Associations were partially mediated through nicotine dependence. Dual use of cannabis and e-cigarettes may contribute to the development of nicotine dependence and increased use of combustible cigarettes.

Mobile daily diaries to characterize stressors and acute health symptoms in an environmental justice neighborhood

Low-income communities and communities of color face multiple, cumulative environmental and social burdens. Methods development in environmental justice research has largely focused on spatial and quantitative approaches. Less attention has been paid to developing methodologies that help collect information on everyday stressors and quality of life experiences for residents in overburdened communities. Mixed methods approaches can be one way to structure study designs that help consider how residents experience environmental and socioeconomic impacts in a localized community context. In neighborhoods burdened by cumulative stressors, traditional cross-sectional epidemiological research designs can also be challenging, as well as limited or narrow in their application. However, repeat sampling of measures within a vulnerable population can approach a quasi-experimental design and help consider variations within residents in a single neighborhood as well as better parse relationships between exposures and outcomes. Through a community-academic partnership with university partners, local community partners, and a local promotores de salud (community health workers) network, we pilot tested a novel mobile daily diary approach in both English and Spanish in an urban, predominantly immigrant community in South Los Angeles as a potential method to collect information on daily stress, environmental quality, and health status/symptoms. We collected resident responses via a once per day 7-day SMS/text messaging survey. We sought to gather granular data on daily resident experiences of air pollution and environmental hazards. Residents reported acute health symptoms and stressors, with repeat measures demonstrating how residents might rank, categorize, or cope with stressors. We find that residents in environmental justice communities record variation in their daily diary responses and document changes in environmental quality, stressors, and odors. Refining this type of method could enable a more rigorous examination of co-occurrences of environmental quality and acute health symptoms. This approach supports the inclusion of residents in the research process and helps more systematically integrate open-ended environmental health relevant data in environmental justice efforts. Used with measured data such as air monitoring or health measures, mixed methods generated data can help support efforts that aim to alleviate sources of daily stress, alongside efforts to reduce overall pollution burdens. Mobile daily diaries can be one way to capture variable responses to environmental quality, acute health symptoms, and stressors.

Λ-enhanced gray molasses in a tetrahedral laser beam geometry

We report the observation of sub-Doppler cooling of lithium using an irregular-tetrahedral laser beam arrangement, which is produced by a nanofabricated diffraction grating. We are able to capture 11(2)% of the lithium atoms from a grating magneto-optical trap into Λ-enhanced D₁ gray molasses. The molasses cools the captured atoms to a radial temperature of 60(9) μK and an axial temperature of 23(3) μK. In contrast to results from conventional counterpropagating beam configurations, we do not observe cooling when our optical fields are detuned from Raman resonance. An optical Bloch equation simulation of the cooling dynamics agrees with our data. Our results show that grating magneto-optical traps can serve as a robust source of cold atoms for tweezer-array and atom-chip experiments, even when the atomic species is not amenable to sub-Doppler cooling in bright optical molasses.

Accurate Determination of Hubble Attenuation and Amplification in Expanding and Contracting Cold-Atom Universes

In the expanding universe, relativistic scalar fields are thought to be attenuated by "Hubble friction," which results from the dilation of the underlying spacetime metric. By contrast, in a contracting universe this pseudofriction would lead to amplification. Here, we experimentally measure, with fivefold better accuracy, both Hubble attenuation and amplification in expanding and contracting toroidally shaped Bose-Einstein condensates, in which phonons are analogous to cosmological scalar fields. We find that the observed attenuation or amplification depends on the temporal phase of the phonon field, which is only possible for nonadiabatic dynamics. The measured strength of the Hubble friction disagrees with recent theory [Gomez Llorente et al., Phys. Rev. A 100, 043613 (2019)PLRAAN2469-992610.1103/PhysRevA.100.043613 and Eckel et al., SciPost Phys. 10, 64 (2021)SPCHCW2542-465310.21468/SciPostPhys.10.3.064].

A constant pressure flowmeter for extreme-high vacuum

We demonstrate operation of a constant-pressure flowmeter capable of generating and accurately measuring flows as low as 2 × 10^-13 mol/s. Generation of such small flows is accomplished by using a small conductance element with C ≈ 50 nL/s. Accurate measurement then requires both low outgassing materials (< 1 × 10^-15 mol/s) and small volume changes (≈ 70 μL). We outline the present flowmeter's construction, detail its operation, and quantify its uncertainty. The type-B uncertainty is < 0.2 % (k = 1) over the entire operating range. In particular, we present an analysis of its hydraulic system, and quantify the shift and uncertainty due to the slightly compressible oil. Finally, we compare our flowmeter against a NIST standard flowmeter, and find agreement to within 0.5 % (k = 2).

A Bitter-type electromagnet for complex atomic trapping and manipulation

We create a pair of symmetric Bitter-type electromagnet assemblies capable of producing multiple field configurations including uniform magnetic fields, spherical quadruple traps, or Ioffe-Pritchard magnetic bottles. Unlike other designs, our coil allows both radial and azimuthal cooling water flows by incorporating an innovative 3D-printed water distribution manifold. Combined with a double-coil geometry, such orthogonal flows permit stacking of non-concentric Bitter coils. We achieve a low thermal resistance of 4.2(1) °C kW-1 and high water flow rate of 10.0(3) l min-1 at a pressure of 190(10) kPa.

Quantum-Based Photonic Sensors for Pressure, Vacuum, and Temperature Measurements: A Vison of the Future with NIST on a Chip

The NIST on a Chip (NOAC) program's central idea is the idea that measurement technology can be developed to enable metrology to be performed "outside the National Metrology Institute" by the creation of deployed and often miniaturized standards. These standards, when based on fundamental properties of nature, are directly tracible to the international system of units known as the SI. NIST is also developing quantum-based standards for SI traceability known as QSI, or Quantum based International System of units. Specifically, this paper will cover NIST efforts in the area of thermodynamic metrology to develop NOAC standards for pressure, vacuum and temperature measurements.

A radiofrequency voltage-controlled current source for quantum spin manipulation

We present a wide-bandwidth, voltage-controlled current source that is easily integrated with radiofrequency magnetic field coils. Our design uses current feedback to compensate for the frequency-dependent impedance of a radiofrequency antenna. We are able to deliver peak currents greater than 100 mA over a 300 kHz to 54 MHz frequency span. The radiofrequency current source fits onto a printed circuit board smaller than 4 cm² and consumes less than 1.3 W of power. It is suitable for use in deployable quantum sensors and nuclear magnetic resonance systems.

Confinement of an alkaline-earth element in a grating magneto-optical trap

We demonstrate a compact magneto-optical trap (MOT) of alkaline-earth atoms using a nanofabricated diffraction grating chip. A single input laser beam, resonant with the broad ¹S₀ → ¹P₁ transition of strontium, forms the MOT in combination with three diffracted beams from the grating chip and a magnetic field produced by permanent magnets. A differential pumping tube limits the effect of the heated, effusive source on the background pressure in the trapping region. The system has a total volume of around 2.4 l. With our setup, we have trapped up to 5 × 10^{6 88}Sr atoms at a temperature of ∼6 mK, and with a trap lifetime of ∼1 s. Our results will aid the effort to miniaturize quantum technologies based on alkaline-earth atoms.

Biomedical REAl-Time Health Evaluation (BREATHE): toward an mHealth informatics platform

OBJECTIVE

To describe a configurable mobile health (mHealth) framework for integration of physiologic and environmental sensors to be used in studies focusing on the domain of pediatric asthma.

MATERIALS AND METHODS

The Biomedical REAl-Time Health Evaluation (BREATHE) platform connects different sensors and data streams, contextualizing an individual's symptoms and daily activities over time to understand pediatric asthma's presentation and its management. A smartwatch/smartphone combination serves as a hub for personal/wearable sensing devices collecting data on health (eg, heart rate, spirometry, medications), motion, and personal exposures (eg, particulate matter, ozone); securely transmitting information to BREATHE's servers; and interacting with the user (eg, ecological momentary assessments). Server-side integration of electronic health record data and spatiotemporally correlated information (eg, weather, traffic) elaborates on these observations. An initial panel study involving pediatric asthma patients was conducted to assess BREATHE.

RESULTS

Twenty subjects were enrolled, during which BREATHE accrued seven consecutive days of continuous data per individual. The data were used to confirm knowledge about asthma (use of controller inhalers, time-activity behaviors, personal air pollution exposure), and additional analyses provided insights into within-day associations of environmental triggers and asthma exacerbations. Exit surveys focusing on mHealth usability, while positive, noted several translational challenges.

DISCUSSION

Based on these promising results, a longitudinal panel study to evaluate individual microenvironments and exposures is ongoing. Lessons learned thus far reflect the need to address various usability aspects, including convenience and ongoing engagement.

CONCLUSION

BREATHE enables multi-sensor mHealth studies, capturing new types of information alongside an evolving understanding of personal exposomes.

Single-beam Zeeman slower and magneto-optical trap using a nanofabricated grating

We demonstrate a compact (0.25 L) system for laser cooling and trapping atoms from a heated dispenser source. Our system uses a nanofabricated diffraction grating to generate a magnetooptical trap (MOT) using a single input laser beam. An aperture in the grating allows atoms from the dispenser to be loaded from behind the chip, increasing the interaction distance of atoms with the cooling light. To take full advantage of this increased distance, we extend the magnetic field gradient of the MOT to create a Zeeman slower. The MOT traps approximately 10^{6 7}Li atoms emitted from an effusive source with loading rates greater than 10⁶ s^-1. Our design is portable to a variety of atomic and molecular species and could be a principal component of miniaturized cold-atom-based technologies.

Single-beam Zeeman slower and magneto-optical trap using a nanofabricated grating

We demonstrate a compact (0.25 L) system for laser cooling and trapping atoms from a heated dispenser source. Our system uses a nanofabricated diffraction grating to generate a magnetooptical trap (MOT) using a single input laser beam. An aperture in the grating allows atoms from the dispenser to be loaded from behind the chip, increasing the interaction distance of atoms with the cooling light. To take full advantage of this increased distance, we extend the magnetic field gradient of the MOT to create a Zeeman slower. The MOT traps approximately 10^{6 7}Li atoms emitted from an effusive source with loading rates greater than 10⁶ s^-1. Our design is portable to a variety of atomic and molecular species and could be a principal component of miniaturized cold-atom-based technologies.

Light-induced atomic desorption of lithium

We demonstrate loading of a Li magneto-optical trap using light-induced atomic desorption. The magnetooptical trap confines up to approximately 4 × 104 7Li atoms with loading rates up to approximately 4 × 103 atoms per second. We study the Li desorption rate as a function of the desorption wavelength and power. The extracted wavelength threshold for desorption of Li from fused silica is approximately 470 nm. In addition to desorption of lithium, we observe light-induced desorption of background gas molecules. The vacuum pressure increase due to the desorbed background molecules is ≲ 50 % and the vacuum pressure decreases back to its base value with characteristic timescales on the order of seconds when we extinguish the desorption light. By examining both the loading and decay curves of the magneto-optical trap, we are able to disentangle the trap decay rates due to background gases and desorbed lithium. Our results show that light-induced atomic desorption can be a viable Li vapor source for compact devices and sensors.

Note: A 3D-printed alkali metal dispenser

We demonstrate and characterize a source of Li atoms made from direct metal laser sintered titanium. The source's outgassing rate is measured to be 5(2) × 10-7 Pa L s-1 at a temperature T = 330 °C, which optimizes the number of atoms loaded into a magneto-optical trap. The source loads ≈1077Li atoms in the trap in ≈1 s. The loaded source weighs 700 mg and is suitable for a number of deployable sensors based on cold atoms.

A rapidly expanding Bose-Einstein condensate: an expanding universe in the lab

We study the dynamics of a supersonically expanding ring-shaped Bose-Einstein condensate both experimentally and theoretically. The expansion redshifts long-wavelength excitations, as in an expanding universe. After expansion, energy in the radial mode leads to the production of bulk topological excitations - solitons and vortices - driving the production of a large number of azimuthal phonons and, at late times, causing stochastic persistent currents. These complex nonlinear dynamics, fueled by the energy stored coherently in one mode, are reminiscent of a type of "preheating" that may have taken place at the end of inflation.

Do animal exhibitors support and follow recommendations to prevent transmission of variant influenza at agricultural fairs? A survey of animal exhibitor households after a variant influenza virus outbreak in Michigan

Influenza A viruses circulate in swine and can spread rapidly among swine when housed in close proximity, such as at agricultural fairs. Youth who have close and prolonged contact with influenza-infected swine at agricultural fairs may be at increased risk of acquiring influenza virus infection from swine. Animal and human health officials have issued written measures to minimize influenza transmission at agricultural exhibitions; however, there is little information on the knowledge, attitudes, and practice (KAP) of these measures among animal exhibitors. After an August 2016 outbreak of influenza A(H3N2) variant (“H3N2v”) virus infections (i.e., humans infected with swine influenza viruses) in Michigan, we surveyed households of animal exhibitors at eight fairs (including one with known H3N2v infections) to assess their KAP related to variant virus infections and their support for prevention measures. Among 170 households interviewed, most (90%, 151/167) perceived their risk of acquiring influenza from swine to be low or very low. Animal exhibitor households reported high levels of behaviours that put them at increased risk of variant influenza virus infections, including eating or drinking in swine barns (43%, 66/154) and hugging, kissing or snuggling with swine at agricultural fairs (31%, 48/157). Among several recommendations, including limiting the duration of swine exhibits and restricting eating and drinking in the animal barns, the only recommendation supported by a majority of households was the presence of prominent hand-washing stations with a person to monitor hand-washing behaviour (76%, 129/170). This is a unique study of KAP among animal exhibitors and highlights that animal exhibitor households engage in behaviours that could increase their risk of variant virus infections and have low support for currently recommended measures to minimize infection transmission. Further efforts are needed to understand the lack of support for recommended measures and to encourage healthy behaviours at fairs.

Contact resistance and phase slips in mesoscopic superfluid atom transport

We have experimentally measured transport of superfluid, bosonic atoms in a mesoscopic system: a small channel connecting two large reservoirs. Starting far from equilibrium (superfluid in a single reservoir), we observe first resistive flow transitioning at a critical current into superflow, characterized by oscillations. We reproduce this full evolution with a simple electronic circuit model. We compare our fitted conductance to two different microscopic phenomenological models. We also show that the oscillations are consistent with LC oscillations as estimated by the kinetic inductance and effective capacitance in our system. Our experiment provides an attractive platform to begin to probe the mesoscopic transport properties of a dilute, superfluid, Bose gas.

Subwavelength-width optical tunnel junctions for ultracold atoms

We propose a method for creating far-field optical barrier potentials for ultracold atoms with widths that are narrower than the diffraction limit and can approach tens of nanometers. The reduced widths stem from the nonlinear atomic response to control fields that create spatially varying dark resonances. The subwavelength barrier is the result of the geometric scalar potential experienced by an atom prepared in such a spatially varying dark state. The performance of this technique, as well as its applications to the study of many-body physics and to the implementation of quantum-information protocols with ultracold atoms, are discussed, with a focus on the implementation of tunnel junctions.

Resistive flow in a weakly interacting Bose-Einstein condensate

We report the direct observation of resistive flow through a weak link in a weakly interacting atomic Bose-Einstein condensate. Two weak links separate our ring-shaped superfluid atomtronic circuit into two distinct regions, a source and a drain. Motion of these weak links allows for creation of controlled flow between the source and the drain. At a critical value of the weak link velocity, we observe a transition from superfluid flow to superfluid plus resistive flow. Working in the hydrodynamic limit, we observe a conductivity that is 4 orders of magnitude larger than previously reported conductivities for a Bose-Einstein condensate with a tunnel junction. Good agreement with zero-temperature Gross-Pitaevskii simulations and a phenomenological model based on phase slips indicate that the creation of excitations plays an important role in the resulting conductivity. Our measurements of resistive flow elucidate the microscopic origin of the dissipation and pave the way for more complex atomtronic devices.

Limit on the electron electric dipole moment using paramagnetic ferroelectric Eu0.5Ba0.5TiO3

We report on the results of a search for the electron electric dipole moment d(e) using paramagnetic ferroelectric Eu(0.5)Ba(0.5)TiO(3). The electric polarization creates an effective electric field that makes it energetically favorable for the spins of the seven unpaired 4f electrons of the Eu(2+) to orient along the polarization, provided that d(e) ≠ 0. This interaction gives rise to sample magnetization, correlated with its electric polarization, and is therefore equivalent to a linear magnetoelectric effect. A SQUID magnetometer is used to search for the resulting magnetization. We obtain d(e) = (-1.07 ± 3.06(stat) ± 1.74(syst)) × 10(-25) ecm, implying an upper limit of |d(e)|<6.05 × 10(-25) ecm (90% confidence).

Note: A high dynamic range, linear response transimpedance amplifier

We have built a high dynamic range (nine decade) transimpedance amplifier with a linear response. The amplifier uses junction-gate field effect transistors (JFETs) to switch between three different resistors in the feedback of a low input bias current operational amplifier. This allows for the creation of multiple outputs, each with a linear response and a different transimpedance gain. The overall bandwidth of the transimpedance amplifier is set by the bandwidth of the most sensitive range. For our application, we demonstrate a three-stage amplifier with transimpedance gains of approximately 10(9)Ω, 3 × 10(7)Ω, and 10(4)Ω with a bandwidth of 100 Hz.

A multiferroic material to search for the permanent electric dipole moment of the electron

We describe the first-principles design and subsequent synthesis of a new material with the specific functionalities required for a solid-state-based search for the permanent electric dipole moment of the electron. We show computationally that perovskite-structure europium barium titanate should exhibit the required large and pressure-dependent ferroelectric polarization, local magnetic moments and absence of magnetic ordering at liquid-helium temperature. Subsequent synthesis and characterization of Eu(0.5)Ba(0.5)TiO(3) ceramics confirm the predicted desirable properties.

Statistical analysis of reduced pair correlation functions of capillaries in the prostate gland

Blood capillaries are thread-like structures that may be considered as an example of a spatial fibre process in three dimensions. At light microscopy, the capillary profiles appear as a planar point process on sections. It has recently been shown that the observed pair correlation function g(r) of the centres of the fibre profiles on two-dimensional sections may be used to estimate the reduced pair correlation function of stationary and isotropic fibre processes in three dimensions. In the present study, we explored how this approach may be extended to statistical analysis of reduced g-functions of capillaries from multiple specimens of different groups and with replicated observations. The methods were applied to normal prostatic tissue compared with prostate cancer. Confidence intervals for the mean reduced g-functions of groups were estimated for fixed r-values parametrically using the t-distribution, and by bootstrap methods. Each estimated reduced g-function was furthermore characterized in terms of its first maximum and minimum. The mean length of capillaries per unit tissue volume was significantly higher in prostate cancer tissue than in normal prostate tissue. Significant differences between the mean reduced g-functions of malignant and benign lesions could be demonstrated for two domains of r-values. In general, bootstrap-based confidence intervals were slightly wider than parametrically estimated confidence intervals. Falsely negative lower bounds of the intervals, which sometimes arose using the parametric approach, could be avoided by the bootstrap method. Testing of group mean values for significant differences by the bootstrap method yielded more conservative results than multiple t-tests. The functional value of the first maximum of the reduced g-function and a global statistical parameter of short-range ordering was significantly reduced in the carcinoma group. Prostate cancer tissue is more densely supplied with capillaries than normal prostate tissue and the three-dimensional arrangement of the vessels differs with respect to interaction at various distance ranges. In the local approach used here, bootstrap methods can be used as a robust statistical tool for the computation of confidence intervals and group comparisons of mean reduced g-functions at specific ranges of interaction.

Synergistic antiallergic activity of combined histamine H1- and cysteinyl leukotriene1-receptor blockade in human bronchus

Mast cell histamine (HA) and cysteinyl leukotrienes (CysLT) account for most of the early phase bronchospasm in asthma. However, activation of the smooth muscle CysLT1-receptor plays a major role in asthmatic bronchospasms. CysLT-receptor antagonists or CysLT-synthesis inhibitors are efficacious in asthma but do not completely abolish asthmatic bronchospasms. A recent clinical study showed that combined antagonists loratadine (H1) and zafirlukast (CysLT1) were more effective against allergic bronchospasms than either drug alone. We examined the combined efficacy of H1- and CysLT1-receptor antagonists in allergic human bronchus. The H1- and CysLT1-receptor antagonists chlorpheniramine (CTM; 1 microM) and MK-571 (0.03 microM), were tested alone and in combination, against anti-human IgE antibody (Ab)-induced contractions of passively sensitized isolated human bronchus. Ab-induced allergic contractions were reduced 15% and 36% by CTM (1 microM) and MK-571 (0.03 microM), respectively. Combined CTM (1 microM) and MK-571 (0.03 microM) significantly inhibited the Ab response by 87%. Mechanistic investigations in isolated human bronchus and cultured human cord blood mast cells suggest that H1- and CysLT-receptor interactions likely occur at the airway smooth muscle level. CTM and MK-571 synergistically inhibited human allergic bronchospasm in the present in vitro model. The mechanism underlying this synergistic activity requires further investigation.

[The value of aspiration cytology within the scope of triple diagnosis of palpable breast changes]

The diagnostic value of aspiration cytology and the overall diagnostic quality of the so-called triple test (aspiration cytology, mammography and physical examination) in the evaluation of palpable breast masses were investigated in a retrospective study. 608 histologically evaluated cancers and 224 benign lesions were investigated. A main purpose of the study was to find out whether the triple diagnostic test can replace surgical biopsy and thereby reduce the number of unnecessary biopsies. All lesions triple-diagnosed as malignant were histologically proved to be malignant, i.e. there were no false positive results. The rate of false negative results was found to be within the range reported for false negative results in fresh frozen sections. Based on these results we state that the dogmatic statement "every palpable mass in the breast must be excised" should be replaced by the recommendation "every palpable mass must be assessed and clarified". A great number of retrospectively unnecessary biopsies can be avoided by a systematic use of the triple diagnosis. The diagnostic safety of this method is close to that of open biopsy. In all cases where positive or negative concordant triplets are found, histological confirmation by biopsy can be avoided. Patients with benign lesions can be thoroughly followed up by repeated physical and radiological examinations. Patients with triple diagnostic malignant results can be adequately treated. Lesions for which triple diagnosis yields neither benign nor malignant, must be biopsied: This is also necessary in all cases with suspicious findings in mammography without a palpable mass, if the equipment for stereotactic or ultrasound- guided biopsies is not available.(ABSTRACT TRUNCATED AT 250 WORDS)

Relationship of phospholipase C- and phospholipase D-mediated phospholipid remodeling pathways to respiratory burst activation in human neutrophils stimulated by Candida albicans hyphae

Neutrophil (PMN) oxidant release, a key component of defenses against disseminated candidiasis, was preceded by oxidant generation after stimulation by Candida albicans hyphae. Opsonized or unopsonized hyphae triggered phospholipase D (PLD) activation within 5 or 30 s, respectively, forming 1-O-alkyl-phosphatidic acid (alkyl-PA) or 1-O-alkyl-phosphatidyl-ethanol in the presence of ethanol. Ethanol, which competitively lowers phosphatidic acid (PA) production, caused dose-dependent inhibition of superoxide (O2-) generation after hyphal stimulation but altered neither baseline-unstimulated O2- production nor responses to phorbol myristate acetate. PA rises evoked by unopsonized hyphae began 2 min before significant O2- release, also preceding both phospholipase C activation and cytosolic Ca2+ rises. Diacylglycerol (DAG) rose in two distinct phases after stimulation by opsonized or unopsonized hyphae, peaking briefly after 60 or 120 s, respectively, followed by prolonged secondary rises. Initial DAG rises preceded inositol triphosphate elevations evoked by unopsonized hyphae. Though PA rose before DAG, no dephosphorylation of PA to form 1-O-alkyl-DAG was noted. Propranalol, which increases PA accumulation by inhibiting PA phosphohydrolase, lowered PMN O2- responses to hyphae. Early DAG rises temporally overlapped respiratory burst initiation but PMN responses to hyphae were unchanged by a DAG kinase inhibitor, R59022, which blocks phosphorylation of DAG to PA and enhances DAG accumulation. Thus, neither PA nor DAG accumulation individually accounted for triggering PMN O2- responses to hyphae. PLD activation and PA production may facilitate PMN fungicidal responses to hyphae but play an indirect role in initiating the respiratory burst.

Phosphatidylcholine hydrolysis by phospholipase D determines phosphatidate and diglyceride levels in chemotactic peptide-stimulated human neutrophils. Involvement of phosphatidate phosphohydrolase in signal transduction

Human neutrophils have been labeled in 1-O-alkyl-phosphatidylcholine (alkyl-PC) with 32P by incubation with alkyl-[32P]lysoPC. Upon stimulation with the chemotactic peptide, formylMet-Leu-Phe (fMLP), these 32P-labeled cells produce 1-O-alkyl-[32P]phosphatidic acid (alkyl-[32P]PA) and, in the presence of ethanol, 1-O-alkyl-[32P]phosphatidylethanol (alkyl-[32P]PEt). Because the cellular ATP contains no 32P, alkyl-[32P]PA and alkyl-[32P]PEt must be formed from alkyl-[32P]PC by phospholipase D (PLD)-catalyzed hydrolysis and transphosphatidylation, respectively. Analyses of the sn-1 bonds by selective hydrolysis and mass measurements reveal that the PA and PEt formed during stimulation contain both ester and ether bonds with distributions similar to that in the endogenous PC. Furthermore, in neutrophils labeled in alkyl-[32P]PC, the specific activities of the diradyl-PA and diradyl-PEt formed during stimulation are similar to that of diradyl-PC. These results demonstrate that the fMLP-induced PLD utilizes diradyl-PC as the major substrate. It is further concluded that, at early times (30 s), PA and PEt are both formed almost exclusively by PLD. Following stimulation with fMLP, neutrophils double-labeled in alkyl-PC by incubation with [3H]alkyl-lysoPC and alkyl-[32P]lysoPC generate [3H]alkyl-DG and [32P]orthophosphate [( 32P]PO4) with superimposable kinetics, indicating degradation of PA by a phosphohydrolase. Generation of [3H]alkyl-DG and [32P]PO4 lags behind PA formation and parallels the decline in PA accumulation. In addition, generation of both [3H]alkyl-PA and [3H]alkyl-DG requires extracellular Ca2+ and cytochalasin B. Furthermore, the phosphohydrolase inhibitor, propranolol, decreases both [3H]alkyl-DG and [32P]PO4 while increasing [3H]alkyl-PA and not altering [3H]alkyl-PEt. Moreover, the decreases in DG are accounted for by increases in PA. These results demonstrate that PLD-derived alkyl-PA is degraded by a phosphohydrolase to produce alkyl-DG. DG formed during stimulation contains both ester and ether-linked species and this DG formation is inhibited completely by propranolol. Upon stimulation, alkyl-[32P]PC-labeled neutrophils do not produce [32P]phosphocholine, suggesting that PC is not hydrolyzed by phospholipase C. In addition, PA is formed in amounts sufficient to account for all of the DG formed during stimulation. It is concluded that the DG formed during fMLP stimulation is derived almost exclusively from PC via the PLD/PA phosphohydrolase pathway.

Phospholipase D in homogenates from HL-60 granulocytes: implications of calcium and G protein control

Occupancy of chemotactic peptide receptors leads to rapid initiation of phospholipase D (PLD) activity in intact dimethylsulfoxide-differentiated HL-60 granulocytes (Pai, J.-K, Siegel, M.I., Egan, R.W., and Billah, M.M. (1988) J. Biol. Chem. 263, 12472). To gain further insight into the activation mechanisms, PLD has been studied in cell lysates from HL-60 granulocytes, using 1-0-alkyl-2-oleoyl-[32P]phosphatidylcholine (alkyl-[32P]PC), 1-0-[3H]alkyl-2-oleoyl-phosphatidylcholine [( 3H]alkyl-PC) and [14C]arachidonyl-phospholipids as substrates. In the presence of Ca2+ and GTP gamma S, post-nuclear homogenates degrade alkyl-[32P]PC to produce 1-0-alkyl-[32P]phosphatidic acid (alkyl-[32P]-PA), and in the presence of ethanol, also 1-0-alkyl-[32P]phosphatidylethanol (alkyl-[32P]PEt). By comparing the 3H/32P ratios of PA and PEt to that of PC, it is concluded that PA and PEt are formed exclusively by a PLD that catalyzes both hydrolysis and transphosphatidylation between PC and ethanol. Furthermore, PC containing either ester- or ether-linkage at the sn-1 position is degraded in preference to phosphatidylethanolamine and phosphatidylinositol by PLD in HL-60 cell homogenates. It is concluded that HL-60 granulocytes contain a PC-specific PLD that requires both Ca2+ and GTP for activation.

Metabolism of platelet-activating factor (1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine) by human promyelocytic leukemic HL60 cells. Stimulated expression of phospholipase A2 and acetyltransferase requires differentiation

Human promyelocytic leukemia (HL60) cells can be induced to differentiate into mature granulocytes by exposure to dimethyl sulfoxide. The addition of N-formylMet-Leu-Phe or the Ca2+ ionophore A23187 to these differentiated cells generated 15-30 pmol of platelet-activating factor (1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine (alkylacetyl-GPC)/10(6) cells as quantified by platelet aggregation assays. Under identical conditions, uninduced cells produced little alkylacetyl-GPC. Upon the addition of ionophore A23187, differentiated cells, and not uninduced ones, released [14C]arachidonate from prelabeled phospholipids including ether-linked phosphatidylcholines, formed both 3H-labeled 1-O-alkyl-2-lyso-sn-glycero-3-phosphocholine (alkyllyso-GPC) and [3H]alkylacetyl-GPC from endogenous 3H-labeled 1-O-alkyl-2-(long chain) acyl-sn-glycero-3-phosphocholine (alkylacyl-GPC), and incorporated exogenously added [3H]acetate or [3H]alkyllyso-GPC into alkylacetyl-GPC. These results are suggestive that both phospholipase A2 and acetyltransferase activities are involved in alkylacetyl-GPC biosynthesis by HL60 cells and that these activities appear during differentiation. However, when measured in cell extracts, the activities of phospholipase A2 and acetyltransferase of uninduced cells were virtually indistinguishable from those of differentiated cells. Uninduced cells exhibited enhanced incorporation of [3H]alkyllyso-GPC or [3H]alkylacetyl-GPC into alkylacyl-GPC and of [14C]arachidonate and [14C]oleate into various phospholipids including phosphatidylcholine. However, such enhanced expression of acylation reactions could not account for the lack of accumulation of arachidonate or of alkylacetyl-GPC by uninduced cells. Furthermore, analyses of phospholipid classes by phosphorus determination showed no significant alterations in phospholipid composition of HL60 cells during differentiation. Together these data are suggestive that mechanisms regulating the activation of phospholipase A2 and acetyltransferase activities are defective in uninduced cells and that an increased concentration of cytosolic free Ca2+ alone is not a sufficient requirement for these mechanisms.