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INTRODUCTION: Smoking during breast radiotherapy (RT) may be associated with radiation-induced skin injury (RISI). We aimed to determine if a urinary biomarker of tobacco smoke exposure is associated with increased rates of RISI during and after breast RT. PATIENTS AND METHODS: Women with Stage 0-IIIA breast cancer treated with breast-conserving surgery or mastectomy followed by RT to the breast or chest wall with or without regional nodal irradiation were prospectively enrolled on a multicenter study assessing acute/late RISI. 980 patients with urinary cotinine (UCot) measurements (baseline and end-RT) were categorized into three groups. Acute and late RISI was assessed using the ONS Acute Skin Reaction scale and the LENT-SOMA Criteria. RESULTS: Late Grade 2+ and Grade 3+ RISI occurred in 18.2% and 1.9% of patients, respectively-primarily fibrosis, pain, edema, and hyperpigmentation. Grade 2+ late RISI was associated with UCot group (P= 006). Multivariable analysis identified UCot-based light smoker/secondhand smoke exposure (HR 1.79, P= .10) and smoking (HR 1.60, p = .06) as non-significantly associated with an increased risk of late RISI. Hypofractionated breast RT was associated with decreased risk of late RISI (HR 0.51, P=.03). UCot was not associated with acute RISI, multivariable analysis identified race, obesity, RT site/fractionation, and bra size to be associated with acute RISI. CONCLUSIONS: Tobacco exposure during breast RT may be associated with an increased risk of late RISI without an effect on acute toxicity. Smoking cessation should be encouraged prior to radiotherapy to minimize these and other ill effects of smoking.

In this study, we investigate how a third-grade teacher enacted controversial issues discussion about the use of Indigenous people as sports mascots. We highlight how the teacher supported eight students' sensemaking about the issue during small-group instruction. We provide suggestions for controversial issues teaching in elementary social studies.

In this article, the authors share how a third-grade teacher supported students in crafting and researching their own inquiry questions using a process known as the Question Formulation Technique to scaffold students' development of supporting questions. Hughes and Heckart provide the reader with suggestions and resources for supporting student-initiated inquiry. [This article's title is displayed on the URL as: "Teaching Young Learners with the C3 Framework."]

PURPOSE: Long-term outcomes after external beam radiation therapy (EBRT) and radiofrequency ablation (RFA) for medically inoperable early-stage non-small cell lung cancer (NSCLC) are not well known. METHODS AND MATERIALS: Patients with medically inoperable early-stage NSCLC were enrolled in a prospective single-arm, phase 2 study between June 2007 and October 2008 and were treated with RFA followed by EBRT. Radiation was delivered using hypofractionated radiation therapy (HFRT; 70.2 Gy in 26 fractions) or stereotactic body radiation therapy (54 Gy in 3 fractions). RESULTS: Twelve patients were evaluable; 10 patients were treated with HFRT. The cumulative incidence of local progression at 5 years was 16.7% (95% confidence interval [CI], 0-37.8). Median progression-free survival was 37.8 months (95% CI, 11.1 to not reached) and median overall survival was 53.6 months (95% CI, 21.0 to not reached). There were no mortalities within 30 days after RFA and no grade ≥4 toxicity. CONCLUSIONS: The combination of RFA with EBRT appears feasible with favorable long-term local control. However, because SBRT alone has similar or better rates of control, we do not recommend routine combined RFA and EBRT.

Diamine-appended metal-organic frameworks exhibiting step-shaped CO2 adsorption are exceptional candidates for energy-efficient carbon capture. However, there are few studies examining their performance in real-world capture scenarios, in part due to the challenge inherent in modeling their CO2 uptake behavior. Here, we develop a dual-site Sips model to fit experimental CO2 adsorption data for dmpn-Mg2(dobpdc) (dmpn = 2,2-dimethyl-1,3-diaminopropane; dobpdc4- = 4,4′-dioxidobiphenyl-3,3′-dicarboxylate) and develop a linear driving force model for the adsorption kinetics based on available experimental data. These models are used to develop a dynamic, fixed bed, nonisothermal contactor model using shaped particles of the material, which is validated with experimental breakthrough data. We also examine the effects of the high heat of adsorption of the material on CO2 uptake performance and find that heat removal is essential to maximize capture performance. We finally investigate "basic"(no bed cooling during adsorption) and "modified"(bed cooling during adsorption) temperature swing adsorption (TSA) processes using dmpn-Mg2(dobpdc), and their process economics are compared to a state-of-the-art monoethanolamine (MEA) capture system with and without heat recovery. In the absence of heat recovery, the adsorbent systems are more costly than established technology. However, with 85% heat recovery, both adsorbent-based TSA processes are projected to cost less than the MEA system. This work highlights that thermal management is vital for implementation of dmpn-Mg2(dobpdc) as a viable CO2 capture technology. Investigation of other contactor technologies that can provide unique ways to manage system heat represent promising future areas of study.

This study investigates how 19 third-grade students developed their understandings of enslavement during a six-week social studies inquiry. Using Teaching Tolerance's key concepts as my analytic framework, I analyzed the students' pre- and post-concept maps and classwork to understand their learning. The findings show that students conceptualized enslavement as interactions between "individuals"--such as getting whipped by an overseer or forced to work by a master--but did not focus on the "systemic" nature of power and economic gain. Furthermore, students' sensemaking about race was limited to naming enslaved people as African Americans without naming the enslavers as whites. These results point to the need for critical inquiries on enslavement in elementary schools that explicitly focus on systemic race/ism and white supremacy. I provide implications to support antiracist teaching about enslavement in K-5 social studies education and teacher education.

In this study, I sought to understand the disciplinary nature of an expert third-grade teacher's practice as she apprenticed students into ways of reading, analyzing, and employing historical evidence. Using a case study methodology, I draw on classroom observation data, teacher interviews, and classroom artifacts to identify instances where the teacher apprenticed the students into practices related to historical thinking concepts. I found the teacher engaged students in disciplinary literacy practices through discussing the constructed nature of historical accounts; allowing students to analyze primary sources using heuristics, tools, and instructional sequence; and engaging students in making claims from evidence over the course of the inquiry. This paper highlights the possibilities for disciplinary literacy instruction in elementary schools.

Background: Radiation therapy is an integral component of treatment that can predispose to carotid artery stenosis (CAS) and increase the risk of cerebrovascular events for head and neck cancer survivors. The utility of screening for CAS with carotid ultrasound in asymptomatic head and neck cancer survivors is unclear. Methods: In this prospective, cross-sectional pilot study, 60 patients who have no evidence of cancer at least 2 years from completion of RT will undergo screening carotid ultrasound to identify patients with high risk of cardiovascular events. Results: Outcomes will include clinically significant CAS, carotid intima-media thickness, acceptability/feasibility of screening, barriers to care and preliminary data on changes to medical management because of screening. Correlative multi-omics analyses will examine biomarkers of CAS after radiation therapy. Conclusion: The results of this study will provide valuable data on the prevalence of CAS and preliminary patient-centered data that will inform the design of a future large-scale, multi-site clinical trial. Clinical Trial Registration:NCT05490875 (ClinicalTrials.gov) Plain Language Summary Patients with head and neck cancer are often treated with radiation therapy. Radiation therapy can cause damage to the blood vessels in the neck. This damage can manifest as narrowing of the blood vessels like the carotid artery, which can lead to stroke. Currently, it is not clear if screening head and neck cancer survivors with ultrasound scans of the carotid arteries is feasible or acceptable to patients. This has also not been formally assessed using a prospective clinical trial. In this study, patients with a history of head and neck cancer who have no evidence of their cancer for at least 2 years since completion of their radiation therapy will be enrolled. They will undergo blood testing and a research ultrasound of the carotid arteries to check for narrowing and other findings that may signal a high risk of stroke or another cardiovascular event. Participants will complete surveys on their experience with the process and how likely they are to accept further screening or additional treatment if something is found. They will also complete surveys on their perception of their personal risk of stroke and barriers to care that would prevent them from getting screening ultrasounds. Patients will be followed for up to 6 months after the ultrasound to check for any changes in their medical care that occurred because of the screening ultrasound. Article highlights Carotid artery stenosis in head & neck cancer survivors treated with radiation therapy Radiotherapy for head and neck (HN) cancer may increase the risk of accelerated atherosclerosis and late carotid artery stenosis (CAS) in 25% of patients, and screening of asymptomatic stenosis may be useful and cost-effective in specific high-risk populations. If clinically significant stenosis is identified, risk reduction strategies such as optimal medical management with or without procedural intervention may reduce the risk of stroke. Data supporting the use of carotid ultrasound (CUS) for HN cancer survivors are sparse, and no guideline currently recommends CUS screening for asymptomatic patients. Carotid ultrasound surveillance for detection of asymptomatic carotid artery stenosis after head & neck radiotherapy CUS allows for cardiovascular risk stratification using stenosis and intima-media thickness measurements. Knowledge gaps with regard to the use of CUS screening in this population include patient acceptability, feasibility, and clinical utility. Rates of change in medical management for screen-detected carotid stenosis in HN cancer survivors have not been assessed in a prospective study. Pilot trial of carotid artery ultrasound in head & neck cancer survivors In this single-institution trial, 60 patients with a history of HN cancer treated with radiotherapy will undergo screening CUS. Patients will be evaluated for CAS (peak systolic velocity by Doppler ultrasonography), and intima-media thickness will be measured. Outcomes include patient acceptability, feasibility, barriers to care and perceived stroke risk among participants. In patients with clinically significant stenosis, the rate of resultant medical interventions (e.g., new medication, additional imaging or intervention) will be determined. Conclusion This prospective study for CUS screening in HN cancer survivors will obtain novel preliminary data to better understand the utility and feasibility of a CUS screening program. Preliminary results will inform future trials focused on the efficacy and cost-effectiveness of carotid artery ultrasound screening in this patient population. Correlative analysis will elucidate novel biomarkers and mechanisms of post-radiotherapy CAS. [ABSTRACT FROM AUTHOR]

PurposeRecent data indicate consolidative radiation therapy improves progression-free survival (PFS) for patients with oligometastatic non-small cell lung cancer (NSCLC). Data on long-term outcomes are limited.Methods and materialsThis prospective, multicenter, single-arm, phase 2 trial was initiated in 2010 and enrolled patients with oligometastatic NSCLC. Oligometastatic disease was defined as a maximum of 5 metastatic lesions for all disease sites, including no more than 3 active extracranial metastatic lesions. Limited mediastinal lymph node involvement was allowed. Patients achieving a partial response or stable disease after 3 to 6 cycles of platinum-based chemotherapy were treated with CRT to the primary and metastatic sites of disease, followed by observation alone. The primary endpoint was PFS, with secondary endpoints of local control, overall survival (OS), and safety.ResultsTwenty-nine patients were enrolled between October 2010 and October 2015, and 27 were eligible for consolidative radiation therapy. The study was closed early because of slow accrual but met its primary endpoint for success, which was PFS >6 months (P