HPV vaccination, knowledge, and attitudes among young cervical cancer survivors in the Deep South.

INTRODUCTION: Although FDA approved for over 10 years, uptake of the human papillomavirus (HPV) vaccination has been slow, particularly among states in the Deep South with high cervical cancer incidence and mortality. The purpose of this study was to explore variables associated with cervical cancer among survivors who were age-eligible for the HPV vaccine and to assess HPV vaccination history, barriers, perceptions, and other associated behaviors within this cohort. METHODS: A mixed methods strategy was used for the study, first identifying eligible cervical cancer survivors from our institution and abstracting demographic and clinicopathologic medical record data. Twenty-three participants from this cohort then completed semi-structured qualitative telephone interviews regarding HPV vaccination participation, knowledge, and attitudes. Interviews were audio-recorded, transcribed, and analyzed using thematic content analysis. RESULTS: Of the 464 cervical cancer patients treated at our institution from 2011 to 2016, 137 (30%) were under age 40 at diagnosis. Seventy-seven women with invasive disease were identified (median age = 33 years), and 56% had been seen by a gynecologist within 5 years of diagnosis. Forty-six of these women met eligibility criteria for inclusion in the qualitative interview, of which 23 successfully completed (response rate = 50%). Of those interviewed, the majority (84%) reported current access to regular medical care. While 90.9% did not receive any doses of HPV vaccination, 78.3% stated they likely would have been vaccinated if it had it been recommended. Four major themes were identified within the interviews: HPV knowledge, vaccine acceptability, healthcare engagement, and provider communication. CONCLUSIONS: Qualitative interviews revealed significant missed opportunities for prevention since most participants stated they would have been vaccinated if given the option. Substantial gaps in knowledge and mixed understanding HPV's association with cervical cancer were observed, demonstrating potential missed opportunities for education and communication between providers of multiple specialties and their patients.

Analysis of protein phosphorylation by capillary liquid chromatography coupled to element mass spectrometry with 31P detection and to electrospray mass spectrometry.

A method for phosphopeptide identification by capillary liquid chromatography (muLC) interfaced alternatively to element mass spectrometry (inductively coupled plasma mass spectrometry, ICPMS) and to electrospray ionization mass spectrometry (ESI-MS) is described. ICPMS is used for 31P detection and ESI-MS provides the corresponding molecular weight information. Alignment of the two separate muLC runs is performed using the baseline distortion at the elution front, which shows up in both muLC-ICPMS and muLC-ESI-MS. Both a quadrupole and a magnetic sector field mass analyzer were used in combination with ICP. The detection limit achieved for the muLC-ICP-HRMS runs is approximately 0.1 pmol of phosphopeptide injected. Without any further precautions, contamination by phosphate-containing compounds at this level was found to be uncritical. The method is demonstrated for the analysis of a complex mixture of synthetic phosphopeptides and a set of tryptic digests of three phosphoproteins. These include beta-casein, activated human MAP kinase ERK1, and protein kinase A catalytic subunit. The tryptic phosphopeptides of these proteins could all be detected and identified by our new strategy. Analysis of three fractions of protein kinase A catalytic subunit with different phosphorylation status gives direct access to the order in which the phosphorylation of the four phosphorylation sites occurs. The two most important aspects of using muLC-ICPMS with 31P detection for phosphopeptide identification are (i) that a high selectivity is achieved and (ii) that the signal intensity is independent of the chemical form of phosphorus and directly proportional to the molar amount of 31P in the muLC eluate. Thus, muLC-ICPMS with 31P detection is introduced as a new, robust, and specific method in phosphoproteomics.