bluuebunny/crossref_metadata_2025_split huggingface dataset:
An improved method for edge detection based on neighbor distance for processing hemispheric photography
Authors: Liu Yasi , Fan Dayong , Sun Han , Wang Xiangping 
Published: March 2024

Abstract
Hemisphere photos are now widely applied to provide information about solar radiation dynamics, canopy structure and their contribution to biophysical processes, plant productivity and ecosystem properties. The present study aims to improve the original ‘edge detection’ method for binary classification between sky and canopy, which works not well for closed canopies. We supposed such inaccuracy probably is due to the influence of sky pixels on their neighbor canopy pixels. Here, we introduced a new term ‘neighbor distance’, defined as the distance between pixels participated in the calculation of contrast at the edges between classified canopy and sky, into the ‘edge detection’ method. We showed that choosing a suitable neighbor distance for a photo with a specific gap fraction can significantly improve the accuracy of the original ‘edge detection’ method. We developed an ND-IS (Neighbor Distance-Iteration Selection) method that can automatically determine the threshold values of hemisphere photos with high accuracy and reproductivity. It combines the modified ‘edge detection’ method and an iterative selection method, with the aid of an empirical power function for the relationship between neighbor distance and manually verified gap fraction. This procedure worked well throughout a broad range of gap fractions (0.019–0.945) with different canopy compositions and structures, in five forest biomes along a broad gradient of latitude and longitude across Eastern China. Our results highlight the necessity of integrating neighbor distance into the original ‘edge detection’ algorithm. The advantages and limitations of the method, and the application of the method in the field were also discussed.
Child routines moderate a brief behavioral intervention to enhance sleep in school-aged children
Authors: Gebre Azeb , Hawley Nicola , Carskadon Mary A , Raynor Hollie , Jelalian Elissa , Owens Judith , Wing Rena R , Hart Chantelle N 
Published: March 2024

Abstract

Objective
To examine whether child routines (the consistency or variation in children’s daily routines, household responsibilities, discipline routines, and homework routines) moderated the effectiveness of a brief behavioral intervention to enhance sleep in school-aged children.

Methods
Secondary analysis was conducted with a subset of 66 families with short sleeping (≤9.5 hr/day) children, 8–11 years old (female = 68%; mean age = 9.76, SD = 1.02) who completed the Child Routines Inventory at baseline and were then randomized to receive a behavioral sleep intervention (n = 32) or to control (n = 34). Sleep period was objectively measured using wrist actigraphy at baseline and 2 months post-randomization. Moderation analysis was performed using ordinary least squares regression using the PROCESS macro for SPSS.

Results
Controlling for sleep period at baseline, treatment condition was significantly related to the sleep period at 2 months post-randomization, with the intervention group achieving a longer sleep period compared to the usual sleep period group (control) (b = 46.30, p &lt; .01). Intervention response was moderated by child routines (b = 1.43, p &lt; .05). Specifically, the intervention produced the greatest change in sleep period for children who engaged in greater routine behaviors at baseline than those who engaged in fewer routine behaviors.

Conclusions
Families that engage in routine behaviors may be better equipped to adopt the behavioral modifications required to get a good night’s sleep. The findings highlight the importance of working with families to establish routine behaviors to improve responses to behavioral sleep interventions.
FoxO1 as the critical target of puerarin to inhibit osteoclastogenesis and bone resorption
Authors: Feng Yanling , Tang Xulei 
Published: March 2024

Abstract

Background
Elevated reactive oxygen species levels promote excessive osteoclastogenesis and bone resorption. Puerarin, a natural antioxidant, can prevent bone loss through its antioxidant effects; however, the underlying molecular mechanism remains unclear. This study aimed to explore the effects of puerarin on osteoclast differentiation and bone resorption by regulating the PI3K/AKT/FoxO1 signaling pathway.

Materials and methods
An ovariectomized (OVX) rat model of osteoporosis and H2O2-induced oxidative cell model of RAW 264.7 cells were established. The following indices were measured including bone μ-CT scanning and the protein expression levels of FoxO1, p-FoxO1, and catalase were detected using western blotting.

Results
Puerarin strongly alleviated oxidative stress-induced bone loss in OVX rats in vivo owing to its antioxidant effects. Puerarin improved the oxidative stress status of cells and inhibited osteoclast formation in vitro. Moreover, the protein expression of FoxO1 and its downstream target, catalase, was upregulated by puerarin.

Conclusions
Puerarin improved the OPG/RANKL ratio, upregulated the protein expression and transcriptional activity of FoxO1, and suppressed the differentiation of RAW264.7 cells into osteoclasts. FoxO1 is a pivotal target of puerarin to confer anti-osteoporosis effects.
Minimax detection boundary and sharp optimal test for Gaussian graphical models
Authors: Qiu Yumou , Guo Bin 
Published: March 2024

Abstract
In this article, we derive the minimax detection boundary for testing a sub-block of variables in a precision matrix under the Gaussian distribution. Compared to the results on the minimum rate of signals for testing precision matrices in literature, our result gives the exact minimum signal strength in a precision matrix that can be detected. We propose a thresholding test that is able to achieve the minimax detection boundary under certain cases by adaptively choosing the threshold level. The asymptotic distribution of the thresholding statistic for precision matrices is derived. Power analysis is conducted to show the proposed test is powerful against sparse and weak signals, which cannot be detected by the existing Lmax and L2 tests. Simulation studies show the proposed test has an accurate size around the nominal level and is more powerful than the existing tests for detecting sparse and weak signals in precision matrices. Real data analysis on brain imaging data is carried out to illustrate the utility of the proposed test in practice, which reveals functional connectivity between brain regions for Alzheimer’s disease patients and normal healthy people.
Glans penis volume is associated with lifelong premature ejaculation
Authors: Ates Erhan , Gok Mustafa , Kazici Hakan Gorkem , Kol Arif , Sahin Tuna , Erol Haluk 
Published: March 2024

Abstract

Background
Although premature ejaculation (PE) is the most common male sexual dysfunction, the underlying mechanisms are not fully understood.

Aim
The study sought to evaluate the possible associations among glans penis volume and tissue stiffness measured using penile ultrasonography and penile shear wave elastography (SWE) with PE.

Methods
Men 18 to 65 years of age with normal International Index of Erectile Function scores (&gt;25) and who were diagnosed with PE between June 2021 and June 2022 were enrolled. The Premature Ejaculation Diagnostic Tool score and intravaginal ejaculation latency times were recorded. Healthy volunteers constituted the control group. The study group was divided into lifelong PE (LLPE) and acquired PE (AqPE) subgroups. In all groups, the glans penis volume was measured via penile ultrasonography and tissue stiffness of the glans penis, penile frenulum, postcircumcision mucosal cuff, and penile shaft were measured via SWE. The findings of the groups were compared using appropriate statistical methods.

Outcomes
The outcomes included ultrasonographic and elastographic measurements of the glans penis.

Results
Data on 140 men, including 70 PE patients and 70 healthy volunteers, were evaluated. Of the patients, 20 had LLPE and 50 had AqPE. The median glans penis volume was significantly greater in the LLPE group (14.1 [range, 6.6-19] mm3) compared with the AqPE group (11.7 [range, 5.1-27] mm3) and control group (11.4 [range, 6.1-32] mm3) (P = .03). According to the Youden index, the best cutoff value for glans penis volume in LLPE compared with non-LLPE (AqPE + control) was 12.65 mm3 (area under the curve, 0.684; 95% confidence interval, 0.556-0.812; P = .009). The risk of having LLPE in those with a glans penis volume ≥12.65 mm3 was 3.326 (95% confidence interval, 1.234-8.965) times higher than the non-LLPE group (P = .014). There were no significant differences between the groups in the SWE evaluation of glans penis, penile frenulum, mucosal cuff, and penile shaft tissue stiffness.

Clinical Implications
The high incidence of PE in those with high glans penis volume may make glans penis volume a predictor for the development of LLPE.

Strengths and Limitations
This was the first study to show that PE is more common in individuals with a high glans penis volume. It was also the first to perform a penile elastographic evaluation in patients with PE. The most important limitation was that we did not evaluate glans penile nerve function with a test, but rather we made an indirect inference about the density of free nerve endings based on increased glans penile volume.

Conclusion
Glans penis volume was a significant predictor for LLPE. However, there are no associations between PE and the glans penis, postcircumcision mucosal cuff, penile frenulum, or penile shaft tissue stiffness and development.
Amplified PTSD Symptoms From Self-Attributed Moral Transgressions Are Linked to Internalized Moral Identity During Military Deployment
Authors: Sowden Walter J , Jones Rachell L 
Published: March 2024

ABSTRACT

Introduction
Military personnel frequently experience stressful, morally challenging situations that can lead to posttraumatic stress disorder (PTSD). The relationships between moral identity, transgressive acts, and symptoms related to posttraumatic stress disorder (i.e., posttraumatic stress symptoms; PTSS) among U.S. Army Soldiers were assessed.

Materials and Methods
A convenience cohort of 1,547 soldiers completed a survey assessing moral identity and PTSS before deployment. A subset of 505 soldiers completed another survey assessing transgressive acts and PTSS during deployment. Exploratory and confirmatory factor analyses were conducted to determine the underlying factor structure of the measures of moral identity and transgressive acts. Generalized linear modeling, robustness checks, and sensitivity analysis were used to evaluate the predictive relationships.

Results
Moral identity did not directly predict PTSS during deployment. However, self-attributed and betrayal-based transgressive acts were significant predictors. Specifically, self-attributed transgressive acts and PTSS were moderated by internalized moral identity; individuals with a higher internalized moral identity experienced more severe PTSS following self-attributed transgressive acts. These findings were consistent across various model checks, including covariate adjustments, data imputation, and the application of a data quality filter.

Conclusions
The study highlights the significant role of self-attributed moral transgressions during deployment in the development of PTSS among military service members—especially in those with a strong internalized moral identity. This finding suggests a “target of opportunity” for the development of intervention strategies that mitigate PTSS by addressing the moral dimensions of military service.
Cumulative Blast Impulse Is Predictive for Changes in Chronic Neurobehavioral Symptoms Following Low Level Blast Exposure during Military Training
Authors: McEvoy Cory , Crabtree Adam , Case John , Means Gary E , Muench Peter , Thomas Ronald G , Ivory Rebecca A , Mihalik Jason , Meabon James S 
Published: March 2024

ABSTRACT

Introduction
Cumulative low-level blast exposure during military training may be a significant occupational hazard, increasing the risk of poor long-term outcomes in brain function. US Public Law 116-92 section 717 mandates that US Department of Defense agencies document the blast exposure of each Service member to help inform later disability and health care decisions. However, which empirical measures of training blast exposure, such as the number of incidents, peak overpressure, or impulse, best inform changes in the neurobehavioral symptoms reflecting brain health have not been established.

Materials and Methods
This study was approved by the US Army Special Operations Command, the University of North Carolina at Chapel Hill, and the VA Puget Sound Health Care System. Using methods easily deployable across different organizational structures, this study sought to identify and measure candidate risk factors related to career occupational blast exposure predictive of changes in neurobehavioral symptom burden. Blast dosimetry-symptom relationships were first evaluated in mice and then tested in a military training environment. In mice, the righting time neurobehavioral response was measured after exposure to a repetitive low-level blast paradigm modeled after Special Operations training. In the military training environment, 23 trainees enrolled in a 6-week explosive breaching training course, 13 instructors, and 10 Service member controls without blast exposure participated in the study (46 total). All participants provided weekly Neurobehavioral Symptom Inventory (NSI) surveys. Peak blast overpressure, impulse, total number of blasts, Time in Low-Level Blast Occupation, and Time in Service were analyzed by Bayesian analysis of regression modeling to determine their probability of influence on the post-training symptoms reported by participants.

Results
We tested the hypothesis that cumulative measures of low-level blast exposure were predictive of changes in neurobehavioral symptoms. In mice, repetitive blast resulted in reduced righting times correlated with cumulative blast impulse. In Service members, peak blast overpressure, impulse, total number of blasts, Time in Low-Level Blast Occupation, and Time in Service all showed strong evidence of influence on NSI scores after blast exposure. However, only models including baseline NSI scores and cumulative blast impulse provided significant predictive value following validation.

Conclusions
These results indicate that measures of cumulative blast impulse may have utility in predicting changes in NSI scores. Such paired dosimetry-symptom measures are expected to be an important tool in safely guiding Service members’ occupational exposure and optimizing force readiness and lethality.
Modeling Risk for Lower Extremity Musculoskeletal Injury in U.S. Military Academy Cadet Basic Training
Authors: Hearn Darren W , Kerr Zachary Yukio , Wikstrom Erik A , Goss Donald L , Cameron Kenneth L , Marshall Stephen W , Padua Darin A 
Published: March 2024

ABSTRACT

Introduction
Sport and tactical populations are often impacted by musculoskeletal injury. Many publications have highlighted that risk is correlated with multiple variables. There do not appear to be existing studies that have evaluated a predetermined combination of risk factors that provide a pragmatic model for application in tactical and/or sports settings.

Purpose
To develop and test the predictive capability of multivariable risk models of lower extremity musculoskeletal injury during cadet basic training at the U.S.Military Academy.

Materials and Methods
Cadets from the class of 2022 served as the study population. Sex and injury history were collected by questionnaire. Body Mass Index (BMI) and aerobic fitness were calculated during testing in the first week of training. Movement screening was performed using the Landing Error Scoring System during week 1 and cadence was collected using an accelerometer worn throughout initial training. Kaplan–Meier survival curves estimated group differences in time to the first musculoskeletal injury during training. Cox regression was used to estimate hazard ratios (HRs) and Akaike Information Criterion (AIC) was used to compare model fit.

Results
Cox modeling using HRs indicated that the following variables were associated with injury risk : Sex, history of injury, Landing Error Scoring System Score Category, and Physical Fitness Test (PT) Run Score. When controlling for sex and history of injury, amodel including aerobic fitness and BMI outperformed the model including movement screening risk and cadence (AIC: 1068.56 vs. 1074.11) and a model containing all variables that were significant in the univariable analysis was the most precise (AIC: 1063.68).

Conclusions
In addition to variables typically collected in this tactical setting (Injury History, BMI, and aerobic fitness), the inclusion of kinematic testing appears to enhance the precision of the risk identification model and will likely continue to be included in screening cadets at greater risk.
Efficacy of 1% Clotrimazole Powder Monotherapy for Treating Tinea Cruris: A Comparative Randomized Study
Authors: Ongsri Punyawee , Bangchang Nanchaya Na , Saengthong-Aram Phuwakorn , Leeyaphan Charussri , Pattanaprichakul Penvadee , Bunyaratavej Sumanas 
Published: March 2024

ABSTRACT

Introduction
A rise in tinea cruris among Thai Naval Cadets has been observed. Clotrimazole powder has been shown to be effective as an adjunct treatment for tinea cruris; however, its efficacy as a monotherapy is limited.

Objectives
The aim is to determine the efficacy of 1% clotrimazole cream versus 1% clotrimazole powder in treating tinea cruris.

Material and Methods
A randomized trial was conducted at the Thai Naval Rating School, Chonburi, Thailand. Naval rating cadets with suspected tinea cruris were randomly assigned to one of two groups: 1% clotrimazole cream or 1% clotrimazole powder, and they were instructed to apply the related medication to the affected lesion twice daily for 4 weeks. Clinical and symptomatic evaluations were carried out at 4 and 8 weeks.

Results
All 17 and 14 participants who received 1% clotrimazole cream and powder, respectively, were included. After 4 weeks, the clinical cure rates were 76.5% in the cream group and 85.7% in the powder group (P = .664). All participants were clinically cured within 8 weeks. The self-evaluation of itch severity using a visual analog scale (VAS) revealed no significant difference between the two groups (P = .343). The dermatology quality of life index decreased as clinical improvement was achieved in both the clotrimazole cream and powder groups (6.0 vs. 7.5 score reductions, respectively; P = .765). The score for sweat reduction was higher in the 1% clotrimazole powder group compared to the cream group (5.0 vs. 4.0, respectively; P = .006).

Conclusion
Monotherapy with 1% clotrimazole powder showed comparable efficacy to 1% clotrimazole cream. Furthermore, the powder treatment reduced sweat more effectively compared to the cream.
Exploring Knowledge, Skills, and Abilities Needed for Army Pharmacist Readiness Using the Nominal Group Technique
Authors: Costantino Ryan C , Jung Eulho , Soh Michael , Samuel Anita 
Published: March 2024

ABSTRACT

Introduction
The purpose of this study was to conduct a general educational needs assessment to identify deficiencies in current Army pharmacy education while projecting future educational requirements based on changes in pharmacy practice and evolving demands of military medicine.

Materials and Methods
Twelve pharmacists participated in a facilitated discussion using the nominal group technique. Data were analyzed using quantitative and qualitative methods to establish consensus. Member checking was used to verify and validate the findings.

Results
Participants generated 190 knowledge, skill, and ability (KSA) statements over 3 sessions. Twenty-one statements achieved consensus. Four consensus statements were skills, 7 were knowledge, and 10 were abilities. KSAs were categorized into pharmaceutical care, military, logistics, or legal domain based on a thematic analysis.

Conclusions
With modernized, relevant KSAs, the Army can measure and train a ready pharmacy force. Individual Critical Tasks augmented with KSAs are one potential approach we recommend as a strategy to improve Army pharmacist health profession education.
Occult Lung Cancer–Associated Autoimmune Encephalitis Presenting as Acute Psychosis
Authors: McCarter Shelly K , Shen K Robert , Wylam Mark E 
Published: March 2024

ABSTRACT
During deployment, a 52-year-old male developed acute behavioral changes. Though initially considered to have PTSD and related agitation and confusional state, his evaluation was consistent with acute encephalopathy. Magnetic resonance imaging of the brain showed T2 hyperintensities, and CSF analysis was positive for anti-N-methyl-D-aspartate receptor antibody. A nuclear protein in testis carcinoma midline carcinoma was discovered in the lung. Immunotherapy and surgical resection led to steady improvement prior to adjuvant chemotherapy. Autoimmune encephalitis due to anti-N-methyl-D-aspartate receptor antibodies is increasingly being recognized as causal of acute behavioral change.
The Military–Civilian Partnership Quality Improvement Program Concept: A Process to Improve Data Collection and Outcomes Assessment
Authors: Fox Justin P , Earnest Ryan E , Sams Valerie 
Published: March 2024

ABSTRACT

Introduction
Military–Civilian Partnerships (MCPs) are vital for maintaining the deployment readiness of military health care physicians. However, tracking their clinical activity has proven to be challenging. In this study, we introduce a locally driven process aimed at the passive collection of external clinical workload data. This process is designed to facilitate an assessment of MCP physicians’ deployment readiness and the effectiveness of individual MCPs.

Materials and Methods
From March 2020 to February 2023, we conducted a series of quality improvement projects at the Wright Patterson Medical Center (WPMC) to enhance our data collection efforts for MCP physicians. Our methodology encompassed several steps. First, we assessed our existing data collection processes and their outcomes to identify improvement areas. Next, we tested various data collection methods, including self-reporting, a web-based smart phone application, and an automated process based on billing or electronic health record data. Following this, we refined our data collection process, incorporating the identified improvements and systematically tracking outcomes. Finally, we evaluated the refined process in 2 different MCPs, with our primary outcome measure being the collection of monthly health care data.

Results
Our examination at the WPMC initially identified several weaknesses in our established data collection efforts. These included unclear responsibility for data collection within the Medical Group, an inadequate roster of participating MCP physicians, and underutilization of military and community resources for data collection. To address these issues, we implemented revisions to our data collection process. These revisions included establishing clear responsibility for data collection through the Office of Military–Civilian Partnerships, introducing a regular “roll call” to match physicians to MCP agreements, passively collecting data each month through civilian partner billing or information technology offices, and integrating Office of Military–Civilian Partnership efforts into regular executive committee meetings. As a result, we observed a 4-fold increase in monthly data capture at WPMC, with similar gains when the refined process was implemented at an Air Force Center for the Sustainment of Trauma and Readiness Skills site.

Conclusions
The Military–Civilian Partnership Quality Improvement Program concept is an effective, locally driven process for enhancing the capture of external clinical workload data for military providers engaged in MCPs. Further examination of the Military–Civilian Partnership Quality Improvement Program process is needed at other institutions to validate its effectiveness and build a community of MCP champions.