Introduction: with regards to tobacco dependence management, there are certain barriers to successful smoking cessation for patients, such as untreated anxiety and depression. Complicating the impact of mental health morbidities on tobacco dependence may be the significant portion of patients whose mental health issues and limited social connections are undiagnosed and unaddressed. We hypothesize that patients with no prior mental health diagnoses who are treated for tobacco dependence have high rates of undiagnosed mental health morbidities. Methods: patients were recruited from a tobacco treatment clinic in 2021. Every patient who came for an inaugural visit without a prior diagnosis of mental health disease was screened for depression, anxiety, social isolation and loneliness. Sociodemographic variables were collected. Results: over a 12-month period, 114 patients were seen at the tobacco treatment clinic. Of these 114 patients, 77 (67.5%) did not have a prior diagnosis of a mental health disease. The mean age was 54.3 ± 11.2 years, 52 (67.5%) were females, and 64 (83.1%) were Black/African American. The mean age of starting smoking was 19.3 ± 5.2 years, and 43 (55.8%) had never attempted to quit smoking in the past. With regards to mental health screening, 32 (41.6%) patients had a score of 9 or greater on the Patient Health Questionnaire (PHQ) 9, 59 (76.6%) had a score of 7 or greater on the Generalized Anxiety Disorder (GAD) 7, 67 (87.0%) were identified with social isolation and 70 (90.1%) for loneliness on screening. Conclusion: there was a high prevalence of undiagnosed mental health morbidities and social disconnection in patients who were actively smoking and were struggling to achieve smoking cessation. While a larger scale study is necessary to reaffirm these results, screening for mental health morbidities and social disconnection may be warranted in order to provide effective tobacco dependence management.

A review of literature on the expression of Annexin 2 in cancer has shown that there is very limited research work on the association of this protein with breast cancer aggressiveness in African Americans. In the present study, TMA breast tissues from African American women were stained with Annexin 2 antibody to determine the association between the molecular subtypes and Annexin 2 protein expression. An annotated case series of 135 breast cancer tissues archived from 2000 to 2010 was acquired from the Howard University Tumor Registry. The association between ANX2 expression and survival by molecular subtypes Luminal A, Luminal B, HER2, and Triple Negative (TN) was assessed using Multinomial regression, chi-square analysis, and Kaplan-Meir graphs (Stata 11). Our findings show a marked association between ANX2 protein expression in Luminal B and HER2 subtypes unadjusted and when adjusted for age. Borderline differences in tumor grade were found in TN only.Univariately, age (<50, 50 + years) and metastases were highly significant for overall survival, disease-free survival and recurrence-free survival. Stage, tumor size, and nodal involvement were of borderline or greater significance for overall and disease-free survival. ANX2 expression was not significant. Kaplan Meier tests of ANX2 showed significant separation of overall survival by ANX2 protein expression in all breast tumor subtypes. In multivariate analyses comparing TN to Luminal A, ANX2 was not important while controlling for age and grade. ANX2 might be a biomarker of aggressiveness and a relevant candidate biomarker in high risk African American women with Luminal B and HER2 breast cancer.

Context: About half of adolescents aged 13 to 17 in United States are not fully vaccinated against human papillomavirus (HPV). As they age into young adulthood, colleges may be an excellent target population nexus for implementing interventions to improve HPV vaccination uptake. Objectives: Our study goal was to generate knowledge about HPV vaccine offerings and awareness programs at colleges to ascertain the extent of campus-facilitated access to HPV immunization and education in 1 state. Design: An electronic survey was designed and emailed to 32 of 47 Maryland colleges for which relevant campus contacts could be identified. Settings: The study took place at Johns Hopkins Bloomberg School of Public Health in consultation with the Maryland Cancer Collaborative and the Maryland Department of Health. Participants: Maryland colleges and universities Main Outcome Measures: HPV vaccine and awareness program offerings on college and university campuses. Results: Twenty Maryland colleges responded. Two colleges offer awareness programs only. Ten colleges offer HPV vaccine, covering about 39% of Maryland college students. Of these, 4 colleges schedule “periodic” campus health clinics or provide an immunization prescription, which is filled at nearby pharmacies. In all colleges, which offer HPV vaccine, immunization is offered to everyone (both men and women) at no out-of-pocket cost. Conclusions: In cooperation with the Maryland Cancer Collaborative, the implementation arm for the Maryland Cancer Control Plan, we showed that college campuses are an excellent target site for implementation of interventions to improve access of college age students to HPV vaccine and awareness programs. We lay the groundwork for recommendations, programs and policies that can improve HPV vaccine offerings among college students thus raising the HPV vaccination rate in young adults. Simple inexpensive alternatives to offering vaccine at college health centers may be periodic campus health clinics and arrangements with nearby pharmacies.

Background: Given the recent findings from pooled studies about a potential inverse association between selenium levels and prostate cancer risk, this cross-sectional study aimed to investigate the association between serum selenium and serum concentrations of sex steroid hormones including estradiol in a nationally representative sample of U.S. men to investigate one mechanism by which selenium may influence prostate cancer risk. Methods: The study included 1,420 men ages 20 years or older who participated in the Third National Health and Nutrition Examination Survey between 1988 and 1994. We calculated age/race–ethnicity-adjusted and multivariable-adjusted geometric mean serum concentrations of total and estimated free testosterone and estradiol, androstanediol glucuronide, and sex hormone binding globulin, and compared them across quartiles of serum selenium. Results: Adjusting for age, race/ethnicity, smoking status, serum cotinine, household income, physical activity, alcohol consumption, and percent body fat, mean total estradiol [e.g., Q1, 38.00 pg/mL (95% confidence interval (CI), 36.03–40.08) vs. Q4, 35.29 pg/mL (95% CI, 33.53–37.14); Ptrend = 0.050] and free estradiol [e.g., Q1, 0.96 pg/mL (95% CI, 0.92–1.01) vs. Q4, 0.90 (95% CI, 0.85–0.95); Ptrend = 0.065] concentrations decreased over quartiles of selenium. Stratification by smoking and alcohol consumption, showed that the latter observation was stronger for never smokers (Pinteraction = 0.073) and those with limited alcohol intake (Pinteraction = 0.017). No associations were observed for the other sex steroid hormones studied. Conclusions: Our findings suggests that a possible mechanism by which selenium may be protective for prostate cancer is related to estrogen. Impact: Further studies of longitudinal measurements of serum and toenail selenium in relation to serum measurements of sex steroid hormones are needed.

[This corrects the article DOI: 10.2196/54126.].