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Negative affect (NA) is associated with increased urge to smoke cigarettes and smoking relapse. Mindfulness meditation is a practice shown to help individuals manage difficult emotions and is an effective method for helping to reduce/quit smoking. The present study was a laboratory experiment with college student smokers ( N  = 50) who self-reported motivation to smoke for NA reduction. Participants were randomized to a brief mindfulness intervention ( n  = 24) or control condition ( n  = 26) followed by a NA induction. Comparisons of NA and urge to smoke cigarettes between groups was examined at baseline, post-intervention, and post-NA manipulation. We predicted that the mindfulness group would better manage experimentally induced NA and report lower urge to smoke following a NA manipulation compared to the control group. Urge to smoke was not lower post-intervention or post-NA induction among participants in the mindfulness group compared to the control group. The mindfulness group no longer had relationships between NA and urge measures post-intervention, while the control group had positive relationships between NA both QSU-Brief Factors. However, post-NA induction the mindfulness group demonstrated a correlation between NA and all smoking urge measures, while the control group demonstrated no correlations between NA and any of the smoking urge measures. These unexpected findings may be accounted for by the theory that mindfulness involves “decoupling” from NA and urges, promoting increased emotional flexibility rather than direct changes to these internal states. Future studies should determine the necessary dose of mindfulness to produce changes in NA and smoking urges.

BackgroundAdrenal venous sampling (AVS) is recommended before adrenalectomy for patients with primary aldosteronism (PA) over 35 years old. The literature examining contralateral suppression (CoS) on AVS in predicting surgical outcomes is conflicting. We examined the presence of CoS in patients who underwent adrenalectomy while adjusting for clinical and biochemical factors associated with a clinical cure of hypertension (ccHTN).MethodsWe performed a retrospective review of patients with successful AVS who underwent unilateral adrenalectomy for PA at a quaternary referral center. Patients were excluded if they had overt cortisol co-secretion, or inadequate follow-up. We first evaluated the aldosterone resolution score (ARS) in predicting ccHTN in our cohort. Next, the receiver-operator characteristic analysis (ROC) was used to determine the optimal contralateral suppression index (CSI) cutoff to define CoS. We performed univariable and multivariable analyses of factors associated with ccHTN. The primary outcome was ccHTN defined as blood pressure less than 140/90 mmHg, and off blood pressure medications.ResultsOf the 102 patients on bivariable analysis, age, sex, duration of HTN, number of medications, preoperative systolic blood pressure, and creatinine level were associated with ccHTN. ROC analysis of ARS had an AUC of 0.850 (p < 0.001). On multivariable analysis, only ARS remained associated with ccHTN (OR 3.40, 95% CI 1.20–9.61, p = 0.021). CSI was not significantly associated with ccHTN on ROC, bivariable, or multivariable analyses.ConclusionThe presence of CoS was not useful in predicting ccHTN following unilateral adrenalectomy for PA in our cohort. After adjusting for clinical and biochemical factors, ARS remains a useful predictor for ccHTN.

A brief form of the Smoking Consequences Questionnaire–Adult (SCQ-A) was developed as an economical alternative to the 55-item SCQ-A in assessing smoking outcome expectancies in adult, heavy smokers. A total of 25 items (two to three items per each of the 10 SCQ-A scales) were administered to current smokers and ex-smokers. Confirmatory factor analysis was used to determine whether the brief form was better accounted for by a 4- or 10-factor model. Several variants of 9- and 8-factor models also were compared. The 10-factor model, representing the 10 subscales of the full-length SCQ-A, fit the data more adequately than the other models. The Brief SCQ-A (BSCQ-A) scales demonstrated good internal consistency (mean coefficient α=.79) and convergent validity. The BSCQ-A also showed promising validity in distinguishing among current smokers and ex-smokers. In a separate sample of smokers, strong and positive associations were present between corresponding pairs of the SCQ-A and BSCQ-A subscales.

BackgroundThe use of tumor-infiltrating T lymphocytes (TIL) that recognize cancer neoantigens has led to lasting remissions in metastatic melanoma and certain cases of metastatic epithelial cancer. For the treatment of the latter, selecting cells for therapy typically involves laborious screening of TIL for recognition of autologous tumor-specific mutations, detected through next-generation sequencing of freshly resected metastatic tumors. Our study explored the feasibility of using archived formalin-fixed, paraffin-embedded (FFPE) primary tumor samples for cancer neoantigen discovery, to potentially expedite this process and reduce the need for resections normally required for tumor sequencing.MethodWhole-exome sequencing was conducted on matched primary and metastatic colorectal cancer samples from 22 patients. The distribution of metastatic tumor mutations that were confirmed as neoantigens through cognate TIL screening was evaluated in the corresponding primary tumors. Mutations unique to primary tumors were screened for recognition by metastasis-derived TIL and circulating T lymphocytes.ResultsWe found that 25 (65.8%) of the 38 validated neoantigens identified in metastatic tumors from 18 patients with colorectal cancer were also present in matched primary tumor samples. This included all 12 neoantigens encoded by putative cancer driver genes, which are generally regarded as superior targets for adoptive cell therapy. The detection rate for other neoantigens, representing mutations without an established role in cancer biology, was 50% (13/26). Gene products encoding neoantigens detected in the primary tumors were not more likely to be clonal or broadly distributed among the analyzed metastatic lesions compared with those undetected in the primary tumors. Additionally, we found that mutations detected only in primary tumor samples did not elicit recognition by metastatic tumor-derived TIL but could elicit specific recognition by the autologous circulating memory T cells.ConclusionsOur findings indicate that primary FFPE tumor-derived screening libraries could be used to discover most neoantigens present in metastatic tumors requiring treatment. Furthermore, this approach can reveal additional neoantigens not present in resected metastatic tumors, prompting further research to understand their clinical relevance as potential therapeutic targets.

Introduction/Objectives: Despite the introduction of lung cancer screening using low dose computed tomography (LDCT), overall screening rates in the U.S. remain low, with certain populations including Black and rural communities experiencing additional disparities. The primary objective of this study was to understand the facilitators of lung cancer screening initiation and retention in Alabama reported by people at risk from mostly rural, mostly Black populations in Jefferson County—including the urban center of Birmingham—and 6 rural counties: Choctaw, Dallas, Greene, Hale, Marengo, and Sumter. Methods: We conducted semi-structured telephone interviews with 58 people who underwent lung cancer screening between December 2019 and January 2022. Participant responses were recorded by the interviewer for analysis. Open-ended responses were coded to identify emergent themes. Results: The most reported influences to initiate screening were information or suggestion from a Community Health Advisor (CHAs) or the supervising county coordinator, suggestion from a friend, or consideration of a personal history of smoking. Most participants reported multiple influences. Physicians were not very influential in decisions to initiate screening, but they were extremely influential in participants’ intent to continue screening, both positively and negatively. Knowing the recommended timeline for their annual scans was also a predictor of intention to continue screening. Participants screened during the COVID-19 state of emergency expressed less certainty about dates of next scans and more ambivalence about intention to continue screening. Conclusions: This study shows the benefit of using multiple methods to support increased awareness of and interest in lung cancer screening, particularly when educational messaging through CHAs is used. Clear guideline-based messages from healthcare providers about recommended screening is important for increasing retention. COVID-19 related implementation challenges impacted screening recruitment and retention. Future research is warranted to further explore use of CHAs in lung cancer screening.

Mindfulness is a multi-faceted construct, and research suggests that certain components (e.g., Acting with Awareness, Nonjudging) are associated with less problematic alcohol use. Recent research has examined whether specific drinking motives mediate the relationship between facets of mindfulness and alcohol use. The current study sought to extend this research by examining whether certain drinking motives would mediate the relationship between facets of mindfulness and problematic alcohol use in a sample of 207 college students classified as engaging in problematic drinking. Participants completed the Five Facet Mindfulness Questionnaire (FFMQ), Drinking Motives Questionnaire-Revised (DMQ-R), and Alcohol Use Disorders Identification Test (AUDIT). Results indicated that lower levels of Coping motives significantly mediated the relationship between greater Acting with Awareness and lower AUDIT score and between greater Nonjudging and lower AUDIT score. Lower levels of Conformity motives significantly mediated the relationship between greater Acting with Awareness and lower AUDIT score. These findings offer insight into specific mechanisms through which mindfulness is linked to less problematic drinking, and also highlight associations among mindfulness, drinking motives, and alcohol use among a sample of problematic college student drinkers. Future research should determine whether interventions that emphasize Acting with Awareness and Nonjudging facets of mindfulness and/or target coping and conformity motives could be effective for reducing problematic drinking in college students.

Recent research has shown that body image stimuli increase negative affect and smoking urges among female smokers. Mindfulness (paying attention to present-moment experience with an attitude of nonjudgmental acceptance) may be a useful technique to minimize the influence of body dissatisfaction on negative affect, smoking urges, and smoking behavior. This study investigated whether mindfulness influences how female college smokers respond to a body image challenge. The study used a 2 × 2 factorial design with body image challenge (trying on a bathing suit vs. looking at a purse) crossed with instructions (mindfulness vs. silence). Female smokers (n = 64; M (age) = 20.03 [± 1.77], 87.5% Caucasian) were randomly assigned to one of four conditions: Purse + Silence (n = 16), Body Image + Silence (n = 15), Purse + Mindfulness (n = 15), and Body Image + Mindfulness (n = 18).

Introduction: Many smokers believe that smoking helps them to control their weight, and concerns about weight gain can interfere with smoking cessation. As researchers typically assess general weight concerns, a measure specific to smoking-related weight concerns is needed. Methods: The Smoking-related Weight and Eating Episodes Test (SWEET) was created by generating items from 4 content domains: Hunger, Craving, Overeating, and Body Image. Female undergraduate smokers (N = 280) rated their postcessation weight gain concern and completed the SWEET, Fagerström Test for Nicotine Dependence, Brief Smoking Consequences Questionnaire-Adult, Eating Attitudes Test (EAT)-26, Bulimia Test-Revised (BULIT-R), and Body Shape Questionnaire. Results: Factor analysis of the initial items suggested a 4-factor solution, suggesting 4 subscales: Smoking to suppress appetite, smoking to prevent overeating, smoking to cope with body dissatisfaction, and withdrawal-related appetite increases. Based on these results, the SWEET subscales were revised and shortened. The resulting 10-item SWEET showed excellent internal consistency (total α = .94; mean α = .86) and evidence of validity by predicting smoking frequency, eating pathology, and body image concerns (ps < .05). Smoking frequency, eating pathology, and body image concerns were significantly predicted by the SWEET while controlling for existing measures of postcessation weight gain concern. Conclusions: The SWEET appears to be a reliable and valid measure of tendencies to smoke in response to body image concern and nicotine withdrawal and as a way to control appetite and overeating.

The Brief Alcohol Screening and Intervention for College Students (BASICS) reduces alcohol use and alcohol-related problems among undergraduates, yet variability in outcomes exists. Identifying individual difference variables related to outcomes could inform efforts to improve treatment protocols. The current study evaluated the role of social anxiety during BASICS. High socially anxious (HSA; n = 26) and low socially anxious (LSA; n = 44) heavy-drinking undergraduates were randomly assigned to BASICS (n = 38) or an assessment-only control (n = 32). HSA patients reported higher baseline alcohol consumption (typical drinks, weekly quantity, and frequency). BASICS significantly decreased weekly alcohol consumption and alcohol-related problems relative to the control group. Social anxiety moderated outcomes such that in the BASICS condition; HSA patients reported heavier typical drinks at posttest, even after controlling for referral status, baseline typical drinks, and trait anxiety. This was not the case in the control group. HSA patients may benefit from social anxiety-specific interventions during BASICS.

The relationship between cigarette smoking and depressive symptoms is well established. Dispositional mindfulness has been associated with lower depressive symptoms, lower smoking dependence, and higher odds of smoking cessation. Given that mindfulness is multi-faceted, the current study examined which facets of mindfulness might mediate the relationship between depressive symptoms and smoking behavior. Participants ( n  = 72) completed the Smoking Consequences Questionnaire (SCQ), Center for Epidemiologic Studies Depression Scale (CESD), and Kentucky Inventory of Mindfulness Skills (KIMS; subscales-Observe, Describe, Acting with Awareness, Accepting without Judgment) and indicated number of cigarettes smoked per day (CPD). Simple mediation models (followed by multiple mediation when more than one facet was significant) tested whether mindfulness facets mediated the relationship between CESD and smoking behavior (CPD and SCQ subscales). Results indicated that (1) lower depressive symptoms were associated with higher Accepting without Judgment, which was related to lower Negative Reinforcement expectancies, (2) lower depressive symptoms were associated with increased Describe, which was associated with greater perceived Negative Consequences, (3) lower depressive symptoms were associated with higher Accepting without Judgment, which was associated with lower Negative Consequences expectancies, and (4) higher depressive symptoms were associated with higher scores on Observe, which related to both greater Positive Reinforcement and Negative Consequences expectancies. Greater Accepting without Judgment and Describe aspects of mindfulness may serve as protective factors in the relationship of depressive symptoms and smoking.