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The new experimental measurements of beam spin asymmetry were performed for the deeply virtual exclusive π0 production in a wide kinematic region with the photon virtualities Q2 up to 6.6 GeV2 and the Bjorken scaling variable xB in the valence regime. The data were collected by the CEBAF Large Acceptance Spectrometer (CLAS12) at Jefferson Lab with longitudinally polarized 10.6 GeV electrons scattered on an unpolarized liquid-hydrogen target. Sizable asymmetry values indicate a substantial contribution from transverse virtual photon amplitudes to the polarized structure functions. The interpretation of these measurements in terms of the Generalized Parton Distributions (GPDs) demonstrates their sensitivity to the chiral-odd GPD E¯T, which contains information on quark transverse spin densities in unpolarized and polarized nucleons and provides access to the nucleon's transverse anomalous magnetic moment. Additionally, the data were compared to a theoretical model based on a Regge formalism that was extended to the high photon virtualities.

A multidimensional extraction of the structure function ratio σLT′/σ0 from the hard exclusive e→p→e′nπ+ reaction above the resonance region has been performed. The study was done based on beam-spin asymmetry measurements using a 10.6 GeV incident electron beam on a liquid-hydrogen target and the CLAS12 spectrometer at Jefferson Lab. The measurements focus on the very forward regime (t/Q2 ≪ 1) with a wide kinematic range of xB in the valence regime (0.17 < xB < 0.55), and virtualities Q2 ranging from 1.5 GeV2 up to 6 GeV2. The results and their comparison to theoretical models based on Generalized Parton Distributions demonstrate the sensitivity to chiral-odd GPDs and the directly related tensor charge of the nucleon. In addition, the data is compared to an extension of a Regge formalism at high photon virtualities. It was found that the Regge model provides a better description at low Q2, while the GPD model is more appropriate at high Q2.

We report a new measurement of the beam-spin asymmetry, Σ, for the γ→n→K+Σ− reaction using quasi-free neutrons in a liquid-deuterium target. The new dataset includes data at previously unmeasured photon energy and angular ranges, thereby providing new constraints on partial wave analyses used to extract properties of the excited nucleon states. The experimental data were obtained using the CEBAF Large Acceptance Spectrometer (CLAS), housed in Hall B of the Thomas Jefferson National Accelerator Facility (JLab). The CLAS detector measured reaction products from a liquid-deuterium target produced by an energy-tagged, linearly polarised photon beam with energies in the range 1.1 to 2.3 GeV. Predictions from an isobar model indicate strong sensitivity to N(1720)3/2+, Δ(1900)1/2−, and N(1895)1/2−, which corroborates results from a recent combined analysis of all KΣ channels. When our data are incorporated in the fits of partial-wave analyses, one observes significant changes in γ-n couplings of resonances which have small branching ratios to the πN channel.

High-momentum configurations of nucleon pairs at short-distance are probed using measurements of the 12C(e,e′p) and 12C(e,e′pN) reactions (where N is either n or p), at high-Q2 and xB>1.1. The data span a missing-momentum range of 300–1000 MeV/c and are predominantly sensitive to the transition region of the strong nuclear interaction from a Tensor to Scalar interaction. The data are well reproduced by theoretical calculations using the Generalized Contact Formalism with both chiral and phenomenological nucleon-nucleon (NN) interaction models. This agreement suggests that the measured high missing-momentum protons up to 1000 MeV/c predominantly belong to short-ranged correlated (SRC) pairs. The measured 12C(e,e′pN) / 12C(e,e′p) and 12C(e,e′pp) / 12C(e,e′pn) cross-section ratios are consistent with a decrease in the fraction of proton-neutron SRC pairs and increase in the fraction of proton-proton SRC pairs with increasing missing momentum. This confirms the transition from an isospin-dependent tensor NN interaction at ∼400 MeV/c to an isospin-independent scalar interaction at high-momentum around ∼800 MeV/c as predicted by theoretical calculation.

We report measurements of π+ and π0 meson photoproduction from longitudinally spin-polarised protons by an energy tagged (0.73-2.3 GeV) and linearly polarised photon beam. A close to complete solid angle coverage for the reaction products was provided by the CEBAF Large Acceptance Spectrometer at Jefferson Laboratory. The double-polarisation observable G is extracted from Maximum Likelihood fits to the data, enabling the first accurate determination for the reaction γ→p→→π+n, while also significantly extending the kinematic coverage for γ→p→→π0p. This large data set provides an important constraint on the properties and spectrum of excited nucleon states decaying to Nπ in the mass range from 1.4 to 2.2 GeV, as well as for background (non-resonant) photoproduction processes. The considerable improvement achieved in the description of the observable G within the SAID and Bonn-Gatchina approaches after implementation of our data, illustrates that the partial-wave analyses now significantly extend the knowledge on Nπ photoproduction amplitudes at W>1.8 GeV. A partial-wave analysis using the new high-precision data set has a large impact on the extracted properties of high-spin nucleon excited states.

The beam spin asymmetry of the exclusive pseudoscalar channel e→p→e′p′η was measured for the first time in the deep-inelastic regime (W>2 GeV/c2 and Q2>1 GeV2/c2) using a longitudinally polarized 5.78 GeV electron beam at Jefferson Lab with the CEBAF Large Acceptance Spectrometer. The data were accumulated in 144 four-dimensional bins of Q2, xB, −t and ϕ over a wide kinematic range, where ϕ is the azimuthal angle between the lepton and hadron scattering planes, The measured azimuthal dependence with large amplitudes of the sin⁡ϕ moments is a clear indication of a substantial contribution to the polarized cross-section from transversely polarized virtual photons. In the framework of generalized parton distributions (GPDs) this contribution is expressed via longitudinal-transverse interference between chiral-even and chiral-odd GPDs. The experimental results are compared to the existing theoretical models demonstrating the sensitivity to the product of chiral-odd and chiral-even GPDs and provide new constraints to the existing GPD parameterizations. Keywords: Nucleon structure, CLAS collaboration, Deeply Virtual Meson Production, Chiral-odd generalized parton distributions

We report the first experimental measurements of the nine 1-fold differential cross sections for the γp→π+π−p reaction, obtained with the CLAS detector at Jefferson Laboratory. The measurements cover the invariant mass range of the final state hadrons from 1.6 GeV

We report a measurement of a beam–target double-polarisation observable (E) for the γ→n→(p)→K+Σ−(p) reaction. The data were obtained impinging the circularly-polarised energy-tagged photon beam of Hall B at Jefferson Lab on a longitudinally-polarised frozen-spin hydrogen deuteride (HD) nuclear target. The E observable for an effective neutron target was determined for centre-of-mass energies 1.70≤W≤2.30 GeV, with reaction products detected over a wide angular acceptance by the CLAS spectrometer. These new double-polarisation data give unique constraints on the strange decays of excited neutron states. Inclusion of the new data within the Bonn-Gatchina theoretical model results in significant changes for the extracted photocouplings of a number of established nucleon resonances. Possible improvements in the PWA description of the experimental data with additional “missing” resonance states, including the N(2120)3/2− resonance, are also quantified.

We present precision measurements of the target and beam-target spin asymmetries from neutral pion electroproduction in deep-inelastic scattering (DIS) using the CEBAF Large Acceptance Spectrometer (CLAS) at Jefferson Lab. We scattered 6-GeV, longitudinally polarized electrons off longitudinally polarized protons in a cryogenic 14NH3 target, and extracted double and single target spin asymmetries for ep→e′π0X in multidimensional bins in four-momentum transfer (1.0

The cross section for coherent ω-meson photoproduction off the deuteron has been measured for the first time as a function of the momentum transfer t=(Pγ−Pω)2 and photon energy Eγ using the CLAS detector at the Thomas Jefferson National Accelerator Facility. The cross sections are measured in the energy range 1.4

We report on the first measurement of cross sections for exclusive deeply virtual pion electroproduction off the proton, ep→e′nπ+, above the resonance region at backward pion center-of-mass angles. The φπ⁎-dependent cross sections were measured, from which we extracted three combinations of structure functions of the proton. Our results are compatible with calculations based on nucleon-to-pion transition distribution amplitudes (TDAs). These non-perturbative objects are defined as matrix elements of three-quark-light-cone-operators and characterize partonic correlations with a particular emphasis on baryon charge distribution inside a nucleon. Keywords: TDA, Exclusive single pion, Eletroproduction, CLAS

Photon beam asymmetry Σ measurements for ω photoproduction in the reaction γ→p→ωp are reported for photon energies from 1.152 to 1.876 GeV. Data were taken using a linearly-polarized tagged photon beam, a cryogenic hydrogen target, and the CLAS spectrometer in Hall B at Jefferson Lab. The measurements obtained markedly increase the size of the database for this observable, extend coverage to higher energies, and resolve discrepancies in previously published data. Comparisons of these new results with predictions from a chiral-quark-based model and from a dynamical coupled-channels model indicate the importance of interferences between t-channel meson exchange and s- and u-channel contributions, underscoring sensitivity to the nucleon resonances included in those descriptions. Comparisons with the Bonn–Gatchina partial-wave analysis indicate the Σ data reported here help to fix the magnitudes of the interference terms between the leading amplitudes in that calculation (Pomeron exchange and the resonant portion of the JP=3/2+ partial wave), as well as the resonant portions of the smaller partial waves with JP=1/2−, 3/2−, and 5/2+. Keywords: Omega photoproduction, Polarization observable, Beam asymmetry

Measurements of the linearly-polarized photon beam asymmetry Σ for photoproduction from the proton of η and η′ mesons are reported. A linearly-polarized tagged photon beam produced by coherent bremsstrahlung was incident on a cryogenic hydrogen target within the CEBAF Large Acceptance Spectrometer. Results are presented for the γp→ηp reaction for incident photon energies from 1.070 to 1.876 GeV, and from 1.516 to 1.836 GeV for the γp→η′p reaction. For γp→ηp, the data reported here considerably extend the range of measurements to higher energies, and are consistent with the few previously published measurements for this observable near threshold. For γp→η′p, the results obtained are consistent with the few previously published measurements for this observable near threshold, but also greatly expand the incident photon energy coverage for that reaction. Initial analysis of the data reported here with the Bonn–Gatchina model strengthens the evidence for four nucleon resonances – the N(1895)1/2−, N(1900)3/2+, N(2100)1/2+ and N(2120)3/2− resonances – which presently lack the “four-star” status in the current Particle Data Group compilation, providing examples of how these new measurements help refine models of the photoproduction process. Keywords: Meson photoproduction, Eta photoproduction, Eta-prime photoproduction, Polarization observable, Photon beam asymmetry

The reaction γp→K⁎+Λ was measured using the CLAS detector for photon energies between the threshold and 3.9 GeV at the Thomas Jefferson National Accelerator Facility. For the first time, spin-density matrix elements have been extracted for this reaction. Differential cross sections, spin density matrix elements, and the Λ recoil polarization are compared with theoretical predictions using the BnGa partial wave analysis. The main result is the evidence for significant contributions from N(1895)1/2− and N(2100)1/2+ to the reaction. Branching ratios for decays into K⁎Λ for these resonances and further resonances are reported. Keywords: Baryon spectroscopy, Meson photoproduction, Polarization observables

The target and double spin asymmetries of the exclusive pseudoscalar channel e→p→→epπ0 were measured for the first time in the deep-inelastic regime using a longitudinally polarized 5.9 GeV electron beam and a longitudinally polarized proton target at Jefferson Lab with the CEBAF Large Acceptance Spectrometer (CLAS). The data were collected over a large kinematic phase space and divided into 110 four-dimensional bins of Q2, xB, −t and ϕ. Large values of asymmetry moments clearly indicate a substantial contribution to the polarized structure functions from transverse virtual photon amplitudes. The interpretation of experimental data in terms of generalized parton distributions (GPDs) provides the first insight on the chiral-odd GPDs H˜T and ET, and complement previous measurements of unpolarized structure functions sensitive to the GPDs HT and E¯T. These data provide a crucial input for parametrizations of essentially unknown chiral-odd GPDs and will strongly influence existing theoretical calculations based on the handbag formalism.

This paper presents, for the first time, measurements of neutron transparency ratios for nuclei relative to C measured using the (e,e′n) reaction, spanning measured neutron momenta of 1.4 to 2.4 GeV/c. The transparency ratios were extracted in two kinematical regions, corresponding to knockout of mean-field nucleons and to the breakup of Short-Range Correlated nucleon pairs. The extracted neutron transparency ratios are consistent with each other for the two measured kinematical regions and agree with the proton transparencies extracted from new and previous (e,e′p) measurements, including those from neutron-rich nuclei such as lead. The data also agree with and confirm the Glauber approximation that is commonly used to interpret experimental data. The nuclear-mass-dependence of the extracted transparencies scales as Aα with α=−0.289±0.007, which is consistent with nuclear-surface dominance of the reactions.

Results are presented for the first measurement of the double-polarization helicity asymmetry E for the η photoproduction reaction γp→ηp. Data were obtained using the FROzen Spin Target (FROST) with the CLAS spectrometer in Hall B at Jefferson Lab, covering a range of center-of-mass energy W from threshold to 2.15 GeV and a large range in center-of-mass polar angle. As an initial application of these data, the results have been incorporated into the Jülich–Bonn model to examine the case for the existence of a narrow N⁎ resonance between 1.66 and 1.70 GeV. The addition of these data to the world database results in marked changes in the predictions for the E observable from that model. Further comparison with several theoretical approaches indicates these data will significantly enhance our understanding of nucleon resonances. Keywords: Eta photoproduction, Polarization observable, Helicity asymmetry

First results from the longitudinally polarized frozen-spin target (FROST) program are reported. The double-polarization observable E, for the reaction γ→p→→π+n, has been measured using a circularly polarized tagged-photon beam, with energies from 0.35 to 2.37 GeV. The final-state pions were detected with the CEBAF Large Acceptance Spectrometer in Hall B at the Thomas Jefferson National Accelerator Facility. These polarization data agree fairly well with previous partial-wave analyses at low photon energies. Over much of the covered energy range, however, significant deviations are observed, particularly in the high-energy region where high-L multipoles contribute. The data have been included in new multipole analyses resulting in updated nucleon resonance parameters. We report updated fits from the Bonn–Gatchina, Jülich–Bonn, and SAID groups.

Giant icy volcanos (cryovolcanos) on Pluto are unique in the imaged solar system and provide evidence for unexpected, active geology late in Pluto’s history.

We report on a study of the mounds that dominate the appearance of Kuiper Belt Object (486958) Arrokoth's larger lobe, named Wenu. We compare the geological context of these mounds and measure and intercompare their shapes, sizes/orientations, reflectance, and colors. We find the mounds are broadly self-similar in many respects and interpret them as the original building blocks of Arrokoth. It remains unclear why these building blocks are so similar in size—and this represents a new constraint and challenge for solar system formation models. We then discuss the implications of this interpretation.

The topography of Neptune’s large icy moon Triton could reveal important clues to its internal evolution, but has been difficult to determine. New global digital color maps for Triton have been produced as well as topographic data for

Comprehensive pyrolysis models that are integral to computational fire codes have improved significantly over the past decade as the demand for improved predictive capabilities has increased. High fidelity pyrolysis models may improve the design of engineered materials for better fire response, the design of the built environment, and may be used in forensic investigations of fire events. A major limitation to widespread use of comprehensive pyrolysis models is the large number of parameters required to fully define a material and the lack of effective methodologies for measurement of these parameters, especially for complex materials. The work presented here details a methodology used to characterize the pyrolysis of a low-pile carpet tile, an engineered composite material that is common in commercial and institutional occupancies. The studied material includes three distinct layers of varying composition and physical structure. The methodology utilized a comprehensive pyrolysis model (ThermaKin) to conduct inverse analyses on data collected through several experimental techniques. Each layer of the composite was individually parameterized to identify its contribution to the overall response of the composite. The set of properties measured to define the carpet composite were validated against mass loss rate curves collected at conditions outside the range of calibration conditions to demonstrate the predictive capabilities of the model. The mean error between the predicted curve and the mean experimental mass loss rate curve was calculated as approximately 20% on average for heat fluxes ranging from 30 to 70 kW·m−2, which is within the mean experimental uncertainty.

Pluto and Charon exhibit strikingly different surface appearances, despite their similar densities and presumed bulk compositions. Systematic mapping has revealed that much of Pluto’s surface can be attributed to surface-atmosphere interactions and the mobilization of volatile ices by insolation. Many mapped valley systems appear to be the consequence of glaciation involving nitrogen ice. Other geological activity requires or required internal heating. The convection and advection of volatile ices in Sputnik Planum can be powered by present-day radiogenic heat loss. On the other hand, the prominent mountains at the western margin of Sputnik Planum, and the strange, multi-km-high mound features to the south, probably composed of H2O, are young geologically as inferred by light cratering and superposition relationships. Their origin, and what drove their formation so late in Solar System history, is under investigation. The dynamic remolding of landscapes by volatile transport seen on Pluto is not unambiguously evident in the mapping of Charon. Charon does, however, display a large resurfaced plain and globally engirdling extensional tectonic network attesting to its early endogenic vigor.

New Horizons 2015 flyby of the Pluto system has resulted in high-resolution topographic maps of Pluto and Charon, the most distant objects so mapped. DEM’s over ~30% of each object were produced at 100-300 m vertical and 300-800 m spatial resolutions, in hemispheric maps and high-resolution linear mosaics. Both objects reveal more relief than was observed at Triton. The dominant 800-km wide informally named Sputnik Planum bright ice deposit on Pluto lies in a broad depression 3 km deep, flanked by dispersed mountains 3-5 km high. Impact craters reveal a wide variety of preservation states from pristine to eroded, and long fractures are several km deep with throw of 0-2 km. Topography of this magnitude suggests the icy shell of Pluto is relatively cold and rigid. Charon has global relief of at least 10 km, including ridges of 2-3 km and troughs of 3-5 km of relief. Impact craters are up to 6 km deep. Vulcan Planum consists of rolling plains and forms a topographic moat along its edge, suggesting viscous flow.

The authors wish to make the following corrections to this manuscript [1]. During the publishing process, symbols that represented the absorption coefficient in Table 4 and thermal conductivity in Table 5 were changed such that they were inconsistent with the rest of the manuscript. [...]

Purpose Compared to insured individuals who have established pathways for primary and specialist care, uninsured patients often delay seeking medical attention and are more likely to rely on emergency departments or community clinics for low-cost services. This study aims to identify the most prevalent otolaryngology (ENT) diagnoses at a free, student-run community clinic for uninsured patients. Additionally, it seeks to elucidate their management needs in order to inform strategies for enhancing support and care for this vulnerable population. Methods The electronic medical records for a free, student-run community clinic (St. Vincent's Hope Student Clinic in Galveston, Texas) were reviewed. Patient age, sex, chief complaint, date of medical encounter, and encounter diagnoses from April 2021 to May 2024 were recorded; medical diagnoses were then manually stratified into system categories and diagnostic subgroups. Diagnoses unrelated to ENT were excluded and likely represented secondary encounter diagnoses. Results A total of 38 patients were evaluated across 51 total ENT encounters. The average number of encounters per patient per year was 1.34 (1.05-1.63, 95% CI). The most common ENT category was throat (37%), and the most common individual diagnosis was balance problems (11% of total diagnoses). Conclusion The most common ENT system was the throat, followed by ear, nose, and other. Balance problems, reflux, and allergic rhinitis were the most common individual ENT diagnoses. The analysis of data collected for this study may help direct future care and resource allocation at this clinic., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Quinlan et al.)

Introduction: Anandamide (AEA) and 2-arachidonoylglycerol are endogenous agonists of the cannabinoid receptors and regulate and control many cellular functions. Their activities are governed by enzymes and proteins that regulate their synthesis, receptor binding, transport, and degradation, which are known as the endocannabinoid system (ECS). The aim of this study was to investigate the regulation of endocannabinoid activity in the endometrium by studying the RNA and protein expression of the ECS within endometrial cell types and during different menstrual cycle stages and the impact of endometriosis. Materials and Methods: The RNA expression of 70 ECS genes was assessed using RNA sequencing of isolated endometrial epithelial and stromal cells. Subsequent immunofluorescence-stained endometrial samples on ECS components of interest were objectively analyzed via an agnostic and automated image analysis pipeline to extract quantitative information. Differential gene and protein expression was investigated between the two cell types, menstrual cycle phases, and endometriosis cases and controls. Results: Sufficient RNA expression was detected for 45 genes, and 17 (38%) genes were significantly different between epithelial and stromal cells. FAAH RNA was significantly higher in epithelial cells compared with stromal cells. Protein expression analysis of the main synthesizing (NAPE-PLD) and catabolizing (FAAH and NAAA) enzymes of AEA revealed a significantly stronger epithelial expression compared to stromal cells. The RNA and protein expression of CB1 receptors was very low with no significant difference between epithelial and stromal cells. Eleven ECS genes were regulated across the menstrual cycle, and there was no gene with significant difference between endometriosis cases and controls in epithelial cells. Discussion: Differential expression of ECS genes supports a cell type-specific endocannabinoid activity in the endometrium. As endocannabinoids are short-lived signaling molecules, higher RNA and protein expression of FAAH in the epithelial cells suggests an active regulation of endocannabinoid activity in epithelial cells within the endometrium.

Seroprevalence studies on SARS-CoV-2 infections have been often based on study populations with non-random and non-representative samples, limiting the generalizability of their results. In this study, we investigated the representativity and the generalizability of the baseline (collected from October 16th, 2020, to April 18th, 2021) estimate of a pediatric seroprevalence study based in Montréal. We compared the change in the estimates of seroprevalence for two different weighting methods: marginal standardization and raking. The target population was the general pediatric population of Montréal and was based on 2016 Canadian census data. Study results show variation across the multiple weighting scenarios although both weighting methods performed similarly, each possessing its own strengths and weaknesses. However, we prefer raking due to its capacity to simultaneously weight for multiple underrepresented study population characteristics., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.)

Introduction: Public health concerns over the impact of social media use (SMU) on adolescent health are growing. We investigated the relationship between SMU and sleep health in adolescents in Canada aged 11 to 17 years., Methods: Data from the 2017-2018 Health Behaviour in School-aged Children study were available for 12 557 participants (55.2% female). SMU was categorized by frequency of use (non-active, active and intense) and the presence of addiction-like symptoms (problematic). Mixed effects logistic regression models identified associations between SMU and seven sleep health indicators (insomnia symptoms, daytime wakefulness problems, screen time before bed, meeting sleep duration recommendations, sleep variability and late bedtime on school and non-school days)., Results: Compared to active SMU, non-active SMU was associated with better sleep indicators, except for insomnia symptoms. Intense SMU was associated with greater odds of having poor sleep health indicators (adjusted odds ratio [aORs] from 1.09 to 2.24) and problematic SMU with the highest odds (aORs from 1.67 to 3.24). Associations with problematic SMU were greater among girls than boys, including having a later bedtime on school days (aOR = 3.74 vs. 1.84) and on non-school days (aOR = 4.13 vs. 2.18). Associations between SMU and sleep outcomes did not differ by age group., Conclusion: Intense and problematic SMU were associated with greater odds of poor sleep health among adolescents in Canada, with stronger associations among girls than boys. Further research is needed to understand the mechanisms underlying associations between SMU and sleep to inform public health recommendations., Competing Interests: None to declare. Justin J. Lang is one of this journal’s Associate Scientific Editors, but has recused himself from the review process for this article.

Objective: To evaluate the cost-effectiveness of various topical prophylaxis strategies against posttympanostomy otorrhea using a break-even analysis., Study Design: An economic decision analysis of data collected from purchasing records and the literature., Setting: An academic center., Methods: Costs of various strategies were calculated by querying our institution's pharmacy as well as GoodRX.com drug prices. Posttympanostomy otorrhea rates were acquired from a review of the literature. Costs for treatment of otorrhea were based upon our institution's self-pay patient charges. A break-even analysis was performed to determine the required absolute risk reduction ( ARR ) in otorrhea rate to make prophylactic treatment cost-effective., Results: The most expensive strategy ciprofloxacin/hydrocortisone otic ($626.83) was not cost-effective unless the rate of postoperative otorrhea was greater than 92% or if the cost of otorrhea treatment exceeded $4477.36. The cheapest antibiotic/steroid combination, ciprofloxacin/dexamethasone otic ($72.25) was cost-effective ( ARR 10%). Using a conservative initial otorrhea rate (14%) and weighted cost of treatment ($683.39), the most expensive cost-effective prophylactic intervention possible was $95.67., Conclusion: Prophylaxis against posttympanostomy otorrhea can be cost-effective. Physicians should consider the cost of prophylaxis at their institution as well as the patient's postoperative risk of otorrhea when making treatment decisions., (© 2024 The Author(s). OTO Open published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

Background: Targeted therapies like denosumab have revolutionized multiple myeloma (MM) treatment, improved patient outcomes while introducing long-term complications. This study explores a rare instance of delayed maxillary osteonecrosis post-denosumab therapy, delving into its pathophysiology and management. Methods: A 40-year-old male MM patient who developed a painful palatal lesion post denosumab treatment and diagnosed of maxillary osteonecrosis by computed tomography scan and surgical biopsy is presented. Treatment history, symptom progression, and response to the PENTOCLO protocol were analyzed. Results: Post-denosumab discontinuation osteonecrosis highlights its prolonged impact on bone metabolism. PENTOCLO treatment protocol led to significant improvement. Genetic factors influencing osteonecrosis susceptibility have been discussed and considered. Conclusions: This case underscores the need for vigilance regarding long-term complications in MM survivors, preventive strategies, including regular dental evaluations and reducing invasive dental procedures, are crucial. We advocate for an interdisciplinary approach and further research into tailored prevention and management of osteonecrosis in cancer survivors., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: Sublingual immunotherapy (SLIT) has emerged as a potentially safe and convenient option for allergen immunotherapy for patients with inhalant allergy. Larger studies on the overall side effects and severe reactions anaphylaxis are still lacking. Study Design: Systematic review and meta-analysis. Setting: Author's review was completed in the University of Texas Medical Branch. Methods: A systematic review and meta-analysis of prospective clinical trials focusing on SLIT safety published from January 1, 2001, to December 31, 2021, was conducted. Results: Twenty-six studies were included with analysis of 7827 patients, representing over 2.7 million SLIT doses. All studies focused on single-antigen immunotherapy. The mean duration of treatment was 11.54 months. Local side effects were present in 40.83% of patients [95% confidence interval (CI) 24.78-57.96]. Systemic side effects were encountered in 1.09% of SLIT patients (95% CI 0.57-1.78). Anaphylaxis was reported in 0.13% of patients (95% CI 0.06-0.22). Discontinuation rates due to side effects were low, at 4.32% of patients (95% CI 3.28-5.49). Conclusion: This meta-analysis shows that single-antigen SLIT is well-tolerated, with overall low rates of systemic side effects including anaphylaxis. Although there is a high rate of minor local side effect, the treatment attrition during the first year is low. With growing allergy burden worldwide, SLIT is a convenient and economically feasible option for immunotherapy. Further work is needed to evaluate long-term safety and efficacy of single as well as multi-antigen SLIT, including quality of life assessments., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: Prior studies have demonstrated the adverse effects of upper respiratory infections on the pediatric population, such as increased risk for acute otitis media (AOM). Other studies have noted decreased otitis media complaints during the COVID-19 pandemic. This project aims to identify whether individuals who tested positive for COVID-19 at the Emergency Department (ED) visit had an increased risk of developing severe complications. Additionally, we will study whether vaccination helped decrease following COVID-19 complications., Methods: Utilizing the TriNetX database, we obtained de-identified electronic medical records for children under five and 6-10 years old from 2020-2023 in the United States. The study population was propensity-matched for gender, index age, and comorbidities. Complications within eight weeks of the ED visit were compared between COVID-19 vaccinated and unvaccinated children. Risk ratio was used to measure associations between our groups. A p-value less than or equal to 0.05 was considered significant., Results: After propensity matching, a total of 211,138 children were identified. Within eight weeks after the ED visit, unvaccinated children <5 years old who tested negative for COVID-19 had a 30 % relative risk reduction for AOM, 52 % for sinusitis, 76 % for multisystem inflammatory system (MIS), 17 % for acute respiratory failure, and 37 % for septic shock when compared to those with a positive COVID-19 result (p ≤ 0.05). Unvaccinated 6-10 years old children who tested negative for COVID-19 had an 18 % risk reduction for AOM, 44 % reduction for sinusitis, 63 % reduction for MIS, and 42 % for acute respiratory failure (p ≤ 0.05) compared to those that tested positive for COVID-19. Vaccinated children with positive COVID-19 results have no significant risk of AOM or acute respiratory failure. Additionally, children 6-10 years old with positive COVID-19 results did not have a substantial risk of sinusitis., Conclusion: COVID-19's effects require continued investigation in children. This study showed that there are some increased risks of severe complications following this viral infection., (Copyright © 2024. Published by Elsevier B.V.)

Introduction: This study tests the utilization of Bluetooth noise-canceling headphones in improving the quality of eye exams in patients with hearing loss. This prospective study was approved on ethical standards by the University of Texas Medical Branch (UTMB) Institutional Review Board (Approval No. 22-0079) and registered with the National Institutes of Health (NCT05420038)., Methods: UTMB patients above 55 years of age were screened for hearing loss using soundcheck audiometry. Twenty-nine subjects answered pre-recorded ophthalmic exam questions that solicited precise responses. As controls, subjects were randomly administered half of the questions via headphones and half via a smartphone at normal speech volume (60 decibels). Points were awarded for responses demonstrating comprehension, and a post-exam survey was collected., Results: Collectively, the mean score was 1.79 with headphones versus 0.96 with control on the Amsler grid segment and 1.90 with headphones versus 0.97 with control on education questions (p=0.001). Between red zone and yellow zone hearing loss patients, the more severe red zone group answered significantly better in both Amsler (1.78 versus 0.50; p=0.0003) and education questions (1.88 versus 0.44; p<0.0001) with headphones. The yellow zone group answered better with headphones overall but failed to reach significance. Post-exam survey indicated that 28 of 29 patients (97%) preferred the headphones during ophthalmic exams., Conclusion: Patients with hearing loss demonstrated better comprehension with Bluetooth headphones. These low-cost devices show great promise at improving effective, compassionate communication between providers and hearing loss patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Glanzer et al.)

Background: Liposarcomas originating in the supraclavicular fossa are exceptionally rare, with only a few documented cases in the medical literature. Methods: We present a unique case involving a remarkably large indolent, atypical lipomatous tumor or well-differentiated liposarcoma situated in the right supraclavicular region, measuring 18 cm × 18 cm × 17 cm. To our knowledge, this represents the largest liposarcoma found in the supraclavicular fossa reported in the literature. This unique case highlights the effective management of a remarkably large supraclavicular liposarcoma through complete surgical resection. Result and Conclusion: Our findings further support the existing consensus that complete surgical removal is often curative for well-differentiated liposarcoma., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background and Objectives: Coronavirus disease 2019 (COVID-19) posed a significant threat to adolescents' sexual and reproductive health. In this study, we examined population-level pregnancy and sexual health-related care utilization among adolescent females in Ontario, Canada during the pandemic and evaluated relationships between these outcomes and key sociodemographic characteristics., Methods: This was a population-based, repeated cross-sectional study of >630 000 female adolescents (12-19 years) during the prepandemic (January 1, 2018-February 29, 2020) and COVID-19 pandemic (March 1, 2020-December 31, 2022) periods. Primary outcome was pregnancy; secondary outcomes were contraceptive management visits, contraception prescription uptake, and sexually transmitted infection (STI) management visits. Poisson models with generalized estimating equations for clustered count data were used to model pre-COVID-19 trends and forecast expected rates during the COVID-19 period. Absolute rate differences between observed and expected outcome rates for each pandemic month were calculated overall and by urbanicity, neighborhood income, immigration status, and region., Results: During the pandemic, lower-than-expected population-level rates of adolescent pregnancy (rate ratio 0.87; 95% confidence interval [CI]:0.85-0.88), and encounters for contraceptive (rate ratio 0.82; 95% CI:0.77-0.88) and STI management (rate ratio 0.52; 95% CI:0.51-0.53) were observed. Encounter rates did not return to pre-pandemic rates by study period end, despite health system reopening. Pregnancy rates among adolescent subpopulations with the highest pre-pandemic pregnancy rates changed least during the pandemic., Conclusions: Population-level rates of adolescent pregnancy and sexual health-related care utilization were lower than expected during the COVID-19 pandemic, and below-expected care utilization rates persist. Pregnancy rates among more structurally vulnerable adolescents demonstrated less decline, suggesting exacerbation of preexisting inequities., (Copyright © 2024 by the American Academy of Pediatrics.)

Purpose: Disparities in youth COVID-19 vaccine acceptance and uptake have been documented in several countries, yet few studies have explored the attitudes and perceptions underlying vaccine-related decision-making among adolescent populations with unique sociocultural, environmental, and/or structural contexts that may influence vaccine uptake., Methods: This study used data from surveys and semistructured interviews collected between January and March 2022 as part of an ongoing community-based research project in two ethnoculturally diverse, lower income neighborhoods of Montreal, Canada. Youth researchers designed and conducted interviews with unvaccinated adolescents, and thematic analysis was employed to explore attitudes and perceptions underlying vaccine-related decisions and opinions about vaccine passports. Survey data were used to describe sociodemographic and psychological determinants of COVID-19 vaccination., Results: Among 315 survey participants aged 14-17 years, most (74%) were fully vaccinated against COVID-19. Prevalence ranged from 57% among Black adolescents to 91% among South and/or Southeast Asian adolescents (34% difference, 95% confidence interval: 20-49). Qualitative and quantitative findings highlighted several misconceptions about the safety, effectiveness, and necessity of COVID-19 vaccines and adolescents' desire for trusted sources of information to address their concerns. Vaccine passports likely increased uptake, yet adolescents were strongly resistant to the policy, and for some, it may have fueled distrust of government and scientific institutions., Discussion: Strategies that increase the trustworthiness of institutions and foster genuine partnership with underserved youth may improve vaccine confidence and help ensure an effective, proequity recovery from COVID-19., (Copyright © 2023 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

The polarized cross-section ratio σ&#95;{LT^{'}}/σ&#95;{0} from hard exclusive π^{-}Δ^{++} electroproduction off an unpolarized hydrogen target has been extracted based on beam-spin asymmetry measurements using a 10.2  GeV/10.6  GeV incident electron beam and the CLAS12 spectrometer at Jefferson Lab. The study, which provides the first observation of this channel in the deep-inelastic regime, focuses on very forward-pion kinematics in the valence regime, and photon virtualities ranging from 1.5  GeV^{2} up to 7  GeV^{2}. The reaction provides a novel access to the d-quark content of the nucleon and to p→Δ^{++} transition generalized parton distributions. A comparison to existing results for hard exclusive π^{+}n and π^{0}p electroproduction is provided, which shows a clear impact of the excitation mechanism, encoded in transition generalized parton distributions, on the asymmetry.

Identifying tissue-specific molecular signatures of active regulatory elements is critical to understanding gene regulatory mechanisms. In this study, transcription start sites (TSS) and enhancers were identified using Cap analysis of gene expression (CAGE) across endometrial stromal cell (ESC) samples obtained from women with ( n = 4) and without endometriosis ( n = 4). ESC TSSs and enhancers were compared to those reported in other tissue and cell types in FANTOM5 and were integrated with RNA-seq and ATAC-seq data from the same samples for regulatory activity and network analyses. CAGE tag count differences between women with and without endometriosis were statistically tested and tags within close proximity to genetic variants associated with endometriosis risk were identified. Over 90% of tag clusters mapping to promoters were observed in cells and tissues in FANTOM5. However, some potential cell-type-specific promoters and enhancers were also observed. Regions of open chromatin identified using ATAC-seq provided further evidence of the active transcriptional regions identified by CAGE. Despite the small sample number, there was evidence of differences associated with endometriosis at 210 consensus clusters, including IGFBP5, CALD1 and OXTR . ESC TSSs were also located within loci associated with endometriosis risk from genome-wide association studies. This study provides novel evidence of transcriptional differences in endometrial stromal cells associated with endometriosis and provides a valuable cell-type specific resource of active TSSs and enhancers in endometrial stromal cells.

Objectives: To use serological testing to assess the pre-Omicron seroprevalence, seroconversion, and seroreversion of infection-induced SARS-CoV-2 antibodies in children and adolescents in Montréal, Canada., Design: This analysis is from a prospective cohort study of children aged 2-17 years (at baseline) that included blood spots for antibody detection. The serostatus of participants was determined by enzyme-linked immunosorbent assays using the receptor-binding domain from the spike protein and the nucleocapsid protein as antigens. We estimated seroprevalence, seroconversion rates, and the likelihood of seroreversion at 6 months and 1 year., Results: The baseline (October 2020 to April 2021) seroprevalence was 5.8% (95% confidence interval [CI] 4.8-7.1), which increased to 10.5% (May to September 2021) and 11.0% (November 2021 to March 2022) for the respective follow-ups (95% CI 8.6-12.7; 95% CI 8.8-13.5). The crude rate of seroconversion over the study period was 12.8 per 100 person-years (95% CI 11.0-14.7). The adjusted hazard rates of seroconversion by child characteristics showed higher rates in children who were female, whose parent identified as a racial or ethnic minority, and in households with incomes in the lowest tercile of our study population. The likelihood of remaining seropositive at 6 months was 68% (95% CI 60-77%) and dropped to 42% (95% CI 32-56%) at 1 year., Conclusion: Serological studies continue to provide valuable contributions for infection prevalence estimates and help us better understand the dynamics of antibody levels after infection., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Deeply virtual Compton scattering (DVCS) allows one to probe generalized parton distributions describing the 3D structure of the nucleon. We report the first measurement of the DVCS beam-spin asymmetry using the CLAS12 spectrometer with a 10.2 and 10.6 GeV electron beam scattering from unpolarized protons. The results greatly extend the Q^{2} and Bjorken-x phase space beyond the existing data in the valence region and provide 1600 new data points measured with unprecedented statistical uncertainty, setting new, tight constraints for future phenomenological studies.

We report results of Λ hyperon production in semi-inclusive deep-inelastic scattering off deuterium, carbon, iron, and lead targets obtained with the CLAS detector and the Continuous Electron Beam Accelerator Facility 5.014 GeV electron beam. These results represent the first measurements of the Λ multiplicity ratio and transverse momentum broadening as a function of the energy fraction (z) in the current and target fragmentation regions. The multiplicity ratio exhibits a strong suppression at high z and an enhancement at low z. The measured transverse momentum broadening is an order of magnitude greater than that seen for light mesons. This indicates that the propagating entity interacts very strongly with the nuclear medium, which suggests that propagation of diquark configurations in the nuclear medium takes place at least part of the time, even at high z. The trends of these results are qualitatively described by the Giessen Boltzmann-Uehling-Uhlenbeck transport model, particularly for the multiplicity ratios. These observations will potentially open a new era of studies of the structure of the nucleon as well as of strange baryons.

We report the first measurements of deep inelastic scattering spin-dependent azimuthal asymmetries in back-to-back dihadron electroproduction in the deep inelastic scattering process. In this reaction, two hadrons are produced in opposite hemispheres along the z axis in the virtual photon-target nucleon center-of-mass frame, with the first hadron produced in the current-fragmentation region and the second in the target-fragmentation region. The data were taken with longitudinally polarized electron beams of 10.2 and 10.6 GeV incident on an unpolarized liquid-hydrogen target using the CLAS12 spectrometer at Jefferson Lab. Observed nonzero sinΔϕ modulations in ep→e^{'}pπ^{+}X events, where Δϕ is the difference of the azimuthal angles of the proton and pion in the virtual photon and target nucleon center-of-mass frame, indicate that correlations between the spin and transverse momenta of hadrons produced in the target- and current-fragmentation regions may be significant. The measured beam-spin asymmetries provide a first access in dihadron production to a previously unexplored leading-twist spin- and transverse-momentum-dependent fracture function. The fracture functions describe the hadronization of the target remnant after the hard scattering of a virtual photon off a quark in the target particle and provide a new avenue for studying nucleonic structure and hadronization.

Participatory approaches are increasingly popular in public health, but remain little used to address adolescent health issues. However, adolescent participation in research has enormous potential for identifying solutions to health issues that concern them. In Senegal, a youth-led participatory action research (YPAR) project was implemented in four communities where teams of adolescents were trained to conduct a research project and identify solutions to address adolescent sexual and reproductive health and rights (ASRHR) issues. This article presents the results of the project evaluation, which aimed to explore the potential of YPAR to address ASRHR issues and inform future YPAR projects. Observations and interviews were carried out during results dissemination meetings in each of the communities. The evaluation of the project demonstrated the potential of YPAR to identify relevant solutions, while promoting positive and meaningful adolescent participation. Despite some difficulties, such as community resistance, the youth researchers were able to successfully complete their research project, while developing their confidence and self-esteem. The adolescents were convinced that they could act as agents of positive social change. This project has shown that it is possible and relevant to involve adolescents in research projects, and that this approach has significant potential in global health.

We present the first measurement of dihadron angular correlations in electron-nucleus scattering. The data were taken with the CLAS detector and a 5.0 GeV electron beam incident on deuterium, carbon, iron, and lead targets. Relative to deuterium, the nuclear yields of charged-pion pairs show a strong suppression for azimuthally opposite pairs, no suppression for azimuthally nearby pairs, and an enhancement of pairs with large invariant mass. These effects grow with increased nuclear size. The data are qualitatively described by the gibuu model, which suggests that hadrons form near the nuclear surface and undergo multiple scattering in nuclei.These results show that angular correlation studies can open a new way to elucidate how hadrons form and interact inside nuclei.

Introduction: Endometriosis is a common gynaecological disease associated with pelvic pain and subfertility. There are no non-invasive diagnostic tests, medical management requires suppression of oestrogens and surgical removal is associated with risk. Endometriosis is a complex genetic disease with variants in at least 27 genetic regions associated with susceptibility. Previous research has implicated a variety of biological mechanisms in multiple cell types. Endometrial and endometriotic epithelial cells acquire somatic mutations at frequency higher than expected in normal tissue. Stromal cells have altered adhesive capacity and immune cells show altered cytotoxicity. Understanding the functional consequences of these genetic variants on each cell type requires the collection of patient symptoms, clinical and genetic data and disease-relevant tissue in an integrated program., Methods and Analysis: The aims of this study are to collect tissue associated with endometriosis, chart the genetic architecture related to endometriosis in this tissue, isolate and propagate patient-specific cellular models, understand the functional consequence of these genetic variants and how they interact with environmental factors in pathogenesis and treatment response.We will collect patient information from online questionnaires prior to surgery and at 6 and 12 months postsurgery. Treating physicians will document detailed surgical data. During surgery, we will collect blood, peritoneal fluid, endometrium and endometriotic tissue. Tissue will be used to isolate and propagate in vitro models of individual cells. Genome wide genotyping and gene expression data will be generated. Somatic mutations will be identified via whole genome sequencing., Ethics and Dissemination: The study has been approved and will be monitored by the Metro North Human Research Ethics committee (HREC) and research activities at the University of Queensland (UQ) will be overseen by the UQ HREC with annual reports submitted. Research results will be published in peer-reviewed journals and presented at conferences were appropriate. This study involves human participants and was approved by RBWH Human Research Ethics Committee; HREC/2019/QRBW/56763.The University of Queensland; 2017002744. Participants gave informed consent to participate in the study before taking part., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)