Citations

Abstract Rural and low-socioeconomic status women face social determinants of health barriers leading to disproportionately low rates of breast cancer screening and markedly reduced participation in clinical trials. To address this gap, we developed the WeCARE (Women’s Engagement for Cancer Awareness, Resources, and Education) intervention using a community-engaged approach. This paper describes how Community Advisory Board feedback informed the development of Mayo Clinic Health System’s WeCARE intervention components. Their input was systematically analyzed using the Consolidated Framework for Implementation Research (CFIR 2.0) to identify determinants of acceptability, appropriateness, and feasibility and to guide actionable refinements to intervention content and delivery.

Introduction Women residing in rural areas or belonging to lower socioeconomic status (SES) strata experience disproportionately low rates of breast cancer screening, contributing to delayed diagnoses and poorer prognoses. In addition, their participation in clinical trials remains markedly limited, reducing opportunities to access preventive and screening interventions. Promoting research preparedness among women before disease onset may empower them to make informed decisions regarding their health and willingness to participate in clinical research with fewer emotional and logistical barriers. Methods and analysis This project applies a community-based participatory research approach to develop and refine the WeCARE (Women’s Engagement for Cancer Awareness, Resources and Education) intervention for women aged 50–74 years who have either never undergone breast cancer screening or have not received screening in the past 5 years and who reside in rural areas or belong to low SES groups. The intervention consists of two components. Component 1 is a single-day, in-person community forum that includes (a) an educational seminar led by an oncologist to address breast cancer risk and screening guidelines, (b) survivor storytelling to enhance emotional engagement and cultural resonance and (c) facilitated navigation to breast cancer screening and future research participation. Component 2 involves structured post-forum follow-up through multiple touchpoints (phone calls and mailed boosters) to reinforce knowledge, address barriers and support screening completion and research enrolment. Quantitative data (eg, screening completion, satisfaction and follow-up engagement) will be summarised using descriptive statistics to assess feasibility and reach on 50 participants. Qualitative feedback from participants will undergo thematic analysis to identify barriers, facilitators and perceived cultural relevance. Integrated mixed-method interpretation will inform iterative refinement of the WeCARE intervention and guide design of subsequent larger trials. Ethics and dissemination Approved by the Mayo Clinic Institutional Review Board (IRB #25–008934). All participants will provide informed consent. Procedures ensure confidentiality, cultural sensitivity and participant safety. Data will be stored in REDCap and disseminated through publications, conferences, local town halls and community reports.

Vaccination is critical to control the ongoing COVID-19 pandemic, but despite the availability of safe and effective vaccine in children over 5 years, vaccination rates remain low. There is paucity of data about vaccine acceptance and factors influencing parents’ hesitancy about the COVID-19 vaccine for young children. Aims and objectives To estimate vaccine acceptance by parents of children 6 months through 4 years, and to evaluate the factors influencing vaccine hesitancy. Methods Electronic survey was sent to parents of children 6 months through 4 years through an online portal account at Mayo Clinic Health System, Northwest-Wisconsin. Data were captured via Research Electronic Data Capture secured data collection software. Bivariate and multivariate regression was used to determine most pertinent factors influencing parents’ decisions against the outcome, ‘Intent to Vaccinate’. Results 39.7% of the parents were ‘very likely’ or ‘somewhat likely ’ to vaccinate their children once the vaccine became available, while 49.8% were not likely or highly unlikely to vaccinate. Routine childhood vaccination, receiving seasonal influenza vaccine, parents' perception of COVID-19 severity in children and safety and effectiveness of the vaccine were all associated with more vaccine acceptance. 71.4% of parents who will likely not vaccinate their children indicated that they are unlikely to change their decision. The need for more research on the vaccine and more information from the PCP office were the most common reasons behind the vaccine decision-making. Conclusions Vaccine hesitancy remains a major issue regarding uptake of the upcoming COVID-19 vaccine. Strong and clear evidence-based recommendations from primary care provider and more information from trusted websites such as Centers for Disease Control and Prevention can decrease vaccine hesitancy in parents. Further research targeted at understanding beliefs and perspectives of parents from different demographics can assist policy-makers in implementing measures to improve vaccination rates in children and tailor our dialogue to match the needs of our patients and families.

AbstractObjectiveSatiety, defined as the duration of the sensation of fullness, is usually measured by validated visual analog scales (VAS) for appetite. Gastric function plays a key role in food intake regulation. However, the association between gastric emptying (GE) and VAS appetite is unknown.MethodsIn this cross‐sectional study, 134 participants (mean [SEM] age = 39 [0.8] years, mean [SEM] BMI = 38 [0.5] kg/m2, 67% females) completed simultaneous measurements of GE and VAS appetite. After a 320‐kcal meal, GE was measured by scintigraphy and appetite by validated 100‐mm VAS for 240 minutes. Satiation was defined as calories consumed to terminate meal and was measured by an ad libitum meal. GE, VAS, and ad libitum meal tests were measured on the same day. Percent of meal retention in the stomach, VAS area under curve (AUC0‐240 min), and overall appetite score (OAS) were calculated. Pearson correlation (ρ) determined the association of GE with VAS appetite and satiation. Appetite components were also analyzed by quartiles based on GE120 min.ResultsGE120 min was correlated with sensation of VAS hungerAUC(0‐240 min) (ρ = 0.24, p = 0.004), fullnessAUC(0‐240 min) (ρ = 0.16, p = 0.05), and OASAUC(0‐240 min) (ρ = 0.20, p = 0.02). Patients with rapid GE120 min had a mean increase in VAS hungerAUC(0‐240 min) by 32 mm/min (15.62%, p = 0.03) compared with normal/slow GE120 min.ConclusionsGE is associated with the sensations of appetite, and rapid GE is associated with increased appetite, which may contribute to weight gain.

PurposeMicrodosimetry is a vital tool for assessing the microscopic patterns of energy deposition by radiation, which ultimately govern biological effect. Solid‐state, silicon‐on‐insulator microdosimeters offer an approach for making microdosimetric measurements with high spatial resolution (on the order of tens of micrometers). These high‐resolution, solid‐state microdosimeters may therefore play a useful role in characterizing proton radiotherapy fields, particularly for making highly resolved measurements within the Bragg peak region. In this work, we obtain microdosimetric measurements with a solid‐state microdosimeter (MicroPlus probe) in a clinical, spot‐scanning proton beam of small spot size.MethodsThe MicroPlus probe had a 3D single sensitive volume on top of silicon oxide. The sensitive volume had an active cross‐sectional area of 250 μm × 10 μm and thickness of 10 μm. The proton facility was a synchrotron‐based, spot‐scanning system with small spot size (σ ≈ 2 mm). We performed measurements with the clinical beam current (≈1 nA) and had no detected pulse pile‐up. Measurements were made in a water‐equivalent phantom in water‐equivalent depth (WED) increments of 0.25 mm or 1.0 mm along pristine Bragg peaks of energies 71.3 MeV and 159.9 MeV, respectively. For each depth, we measured lineal energy distributions and then calculated the dose‐weighted mean lineal energy, . The measurements were repeated for two field sizes: 4 × 4 cm2 and 20 × 20 cm2.ResultsFor both 71.3 MeV and 159.9 MeV and for both field sizes, increased with depth toward the distal edge of the Bragg peak, a result consistent with Monte Carlo calculations and measurements performed elsewhere. For the 71.3 MeV, 4 × 4 cm2 beam (range at 80% distal falloff, R80 = 3.99 cm), we measured keV/μm at WED = 2 cm, and keV/μm at WED = 3.95 cm. For the 71.3 MeV, 20 × 20 cm2 beam, we measured keV/μm at WED = 2.6 cm, and keV/μm at WED = 3 cm. For the 159.9 MeV, 4 × 4 cm2 beam (R80 = 17.7 cm), keV/μm at WED = 5 cm, and keV/μm at WED = 17.6 cm. For the 159.9 MeV, 20 × 20 cm2 beam, keV/μm at WED = 5 cm, and keV/μm at WED = 17.6 cm.ConclusionsWe performed microdosimetric measurements with a novel solid‐state, silicon‐on‐insulator microdosimeter in a clinical spot‐scanning proton beam of small spot size and unmodified beam current. For all of the proton field sizes and energies considered, the measurements of were in agreement with expected trends. Furthermore, we obtained measurements with a spatial resolution of 10 μm in the beam direction. This spatial resolution greatly exceeded that possible with a conventional gaseous tissue‐equivalent proportional counter and allowed us to perform a high‐resolution investigation within the Bragg peak region. The MicroPlus probe is therefore suitable for applications in proton radiotherapy.

PurposeThis work aims to characterize a proton pencil beam scanning (PBS) and passive double scattering (DS) systems as well as to measure parameters relevant to the relative biological effectiveness (RBE) of the beam using a silicon on insulator (SOI) microdosimeter with well‐defined 3D sensitive volumes (SV). The dose equivalent downstream and laterally outside of a clinical PBS treatment field was assessed and compared to that of a DS beam.MethodsA novel silicon microdosimeter with well‐defined 3D SVs was used in this study. It was connected to low noise electronics, allowing for detection of lineal energies as low as 0.15 keV/μm. The microdosimeter was placed at various depths in a water phantom along the central axis of the proton beam, and at the distal part of the spread‐out Bragg peak (SOBP) in 0.5 mm increments. The RBE values of the pristine Bragg peak (BP) and SOBP were derived using the measured microdosimetric lineal energy spectra as inputs to the modified microdosimetric kinetic model (MKM). Geant4 simulations were performed in order to verify the calculated depth‐dose distribution from the treatment planning system (TPS) and to compare the simulated dose‐mean lineal energy to the experimental results.ResultsFor a 131 MeV PBS spot (124.6 mm R90 range in water), the measured dose‐mean lineal energy increased from 2 keV/μm at the entrance to 8 keV/μm in the BP, with a maximum value of 10 keV/μm at the distal edge. The derived RBE distribution for the PBS beam slowly increased from 0.97 ± 0.14 at the entrance to 1.04 ± 0.09 proximal to the BP, then to 1.1 ± 0.08 in the BP, and steeply rose to 1.57 ± 0.19 at the distal part of the BP. The RBE distribution for the DS SOBP beam was approximately 0.96 ± 0.16 to 1.01 ± 0.16 at shallow depths, and 1.01 ± 0.16 to 1.28 ± 0.17 within the SOBP. The RBE significantly increased from 1.29 ± 0.17 to 1.43 ± 0.18 at the distal edge of the SOBP.ConclusionsThe SOI microdosimeter with its well‐defined 3D SV has applicability in characterizing proton radiation fields and can measure relevant physical parameters to model the RBE with submillimeter spatial resolution. It has been shown that for a physical dose of 1.82 Gy at the BP, the derived RBE based on the MKM model increased from 1.14 to 1.6 in the BP and its distal part. Good agreement was observed between the experimental and simulation results, confirming the potential application of SOI microdosimeter with 3D SV for quality assurance in proton therapy.