tbuckley/cabot-search huggingface dataset:
Scaling convolutional neural networks achieves expert level seizure detection in neonatal EEG
Authors: Robert Hogan, Sean R. Mathieson, Aurel Luca, Soraia Ventura, Sean Griffin, Geraldine B. Boylan, John M. O’Toole
Journal: npj Digital Medicine (2025)

Neonatal seizures require urgent treatment, but often go undetected without expert EEG monitoring. We have developed and validated a seizure detection model using retrospective EEG data from 332 neonates. A convolutional neural network was trained and tested on over 50,000 hours (n = 202) of annotated single-channel EEG containing 12,402 seizure events. This model was then validated on two independent multi-reviewer datasets (n = 51 and n = 79). Increasing data and model size improved performance: Matthews correlation coefficient (MCC) and Pearson's correlation (r) increased by up to 50% (15%) with data (model) scaling. The largest model (21m parameters) achieved state-of-the-art on an open-access dataset (MCC = 0.764, r = 0.824, and AUC = 0.982). This model also attained expert-level performance on both validation sets, a first in this field, with no significant difference in inter-rater agreement when the model replaces an expert (∣Δκ∣ < 0.094, p > 0.05).
Outcomes for Children With Congenital Heart Disease Undergoing Ventricular Assist Device Implantation
Authors: Shahnawaz Amdani, Muhammad Farrukh Shezad, Benjamin Kroslowitz, Madeleine Townsend, Anna Joong, Hani Najm, Bradley S Marino, David N Rosenthal, Angela Lorts, Matthew J O'Connor
Journal: Journal of the American College of Cardiology (2025)
Contributors and Solutions to High Out-of-Pocket Costs for Heart Failure Medications
Authors: Emily F Lowe, Denae Gerasta, Madeline Balser, Robert L Page, Elise Tsai, Henry D Biermann, Andrea Mitchell, Denise Chan, Daniel D Matlock, Neal W Dickert, Caroline E Sloan, Larry A Allen
Journal: Journal of the American College of Cardiology (2025)
The Nonsyndromic Ascending Thoracic Aorta in a Population-Based Setting
Authors: Lasse M Obel, Axel C P Diederichsen, Joachim S S Kristensen, Oke Gerke, Katrine L Larsen, Mads Liisberg, Lytfi Krasniqi, Flemming H Steffensen, Lars Frost, Jess Lambrechtsen, Martin Busk, Grazina Urbonaviciene, Kenneth Egstrup, Marek Karon, Lars M Rasmussen, Jes S Lindholt
Journal: Journal of the American College of Cardiology (2025)
Worldwide Chronic Retrieval Experience of Helix-Fixation Leadless Cardiac Pacemakers
Authors: Petr Neuzil, Derek V Exner, Reinoud E Knops, Daniel J Cantillon, Pascal Defaye, Rajesh Banker, Paul Friedman, Chris Hubbard, Stephanie M Delgado, Anuradha Bulusu, Vivek Y Reddy
Journal: Journal of the American College of Cardiology (2025)
Demographic-Based Personalized Left Ventricular Hypertrophy Thresholds for Hypertrophic Cardiomyopathy Diagnosis
Authors: Hunain Shiwani, Rhodri H Davies, Constantin-Cristian Topriceanu, Raffaello Ditaranto, Anjali Owens, Betty Raman, João Augusto, Rebecca K Hughes, Camilla Torlasco, Ben Dowsing, Jessica Artico, George Joy, Inês Miranda, Walter Witschey, Jose F Rodriguez-Palomares, Clara Badia-Molins, Lia Crotti, Mario Cortina-Borja, Michael L Chuang, Raymond Y Kwong, Christopher M Kramer, Warren Manning, Carolyn Y Ho, Peter Kellman, Alun D Hughes, Elena Biagini, Saidi Mohiddin, Luis Lopes, Harold Litt, Victor A Ferrari, Gabriella Captur, James C Moon
Journal: Journal of the American College of Cardiology (2025)
Higher Aircraft Noise Exposure Is Linked to Worse Heart Structure and Function by Cardiovascular MRI
Authors: Constantin-Cristian Topriceanu, Xiangpu Gong, Mit Shah, Hunain Shiwani, Katie Eminson, Glory O Atilola, Calvin Jephcote, Kathryn Adams, Marta Blangiardo, James C Moon, Alun D Hughes, John Gulliver, Alex V Rowlands, Nishi Chaturvedi, Declan P O'Regan, Anna L Hansell, Gabriella Captur
Journal: Journal of the American College of Cardiology (2025)

Aircraft noise is a growing concern for communities living near airports. This study aimed to explore the impact of aircraft noise on heart structure and function. Nighttime aircraft noise levels (Lnight) and weighted 24-hour day-evening-night aircraft noise levels (Lden) were provided by the UK Civil Aviation Authority for 2011. Health data came from UK Biobank (UKB) participants living near 4 UK major airports (London Heathrow, London Gatwick, Manchester, and Birmingham) who had cardiovascular magnetic resonance (CMR) imaging starting from 2014 and self-reported no hearing difficulties. Generalized linear models investigated the associations between aircraft noise exposure and CMR metrics (derived using a validated convolutional neural network to ensure consistent image segmentations), after adjustment for demographic, socioeconomic, lifestyle, and environmental confounders. Mediation by cardiovascular risk factors was also explored. Downstream associations between CMR metrics and major adverse cardiac events (MACE) were tested in a separate prospective UKB subcohort (n = 21,360), to understand the potential clinical impact of any noise-associated heart remodeling. Of the 3,635 UKB participants included, 3% experienced higher Lnight (≥45 dB) and 8% higher Lden (≥50 dB). Participants exposed to higher Lnight had 7% (95% CI: 4%-10%) greater left ventricular (LV) mass and 4% (95% CI: 2%-5%) thicker LV walls with a normal septal-to-lateral wall thickness ratio. This concentric LV remodeling is relevant because a 7% greater LV mass associates with a 32% greater risk of MACE. They also had worse LV myocardial dynamics (eg, an 8% [95% CI: 4%-12%] lower global circumferential strain which associates with a 27% higher risk of MACE). Overall, a hypothetical individual experiencing the typical CMR abnormalities associated with a higher Lnight exposure may have a 4 times higher risk of MACE. Findings were clearest for Lnight but were broadly similar in analyses using Lden. Body mass index and hypertension appeared to mediate 10% to 50% of the observed associations. Participants who did not move home during follow-up and were continuously exposed to higher aircraft noise levels had the worst CMR phenotype. Higher aircraft noise exposure associates with adverse LV remodeling, potentially due to noise increasing the risk of obesity and hypertension. Findings are consistent with the existing literature on aircraft noise and cardiovascular disease, and need to be considered by policymakers and the aviation industry.
The intestinal fungus Aspergillus tubingensis promotes polycystic ovary syndrome through a secondary metabolite
Authors: Jiayu Wu, Kai Wang, Xinyu Qi, Shuang Zhou, Shuyun Zhao, Meisong Lu, Qixing Nie, Meng Li, Mengwei Han, Xi Luo, Chuyu Yun, Pengcheng Wang, Rong Li, Chao Zhong, Xiaofei Yu, Wen-bing Yin, Changtao Jiang, Jie Qiao, Yanli Pang
Journal: Cell Host & Microbe (2025)
Double or nothing: Ancient duplications in the amylase locus drove human adaptation
Authors: Shahar Silverman, Diyendo Massilani
Journal: Cell Genomics (2025)

Salivary and pancreatic amylase are encoded by AMY1 and AMY2, respectively, which are located within a single genomic locus that has undergone substantial structural variation, resulting in varying gene copy numbers across species. Using optical genome mapping and long-read sequencing, Yilmaz, Karageorgiou, Kim, et al. achieved nucleotide-level resolution of this locus across different human populations, offering new insights into how copy number variation contributes to human adaptation.
Joanne
Authors: Natalie Perlov Snyder
Journal: JAMA (2025)

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Latine Patients’ Beliefs, Attitudes, and Experience With Psoriasis
Authors: Nathaly Gonzalez, Kamina Wilkerson, Herbert Castillo Valladares, Maria Elena Sanchez-Anguiano, Aileen Y. Chang, Erin H. Amerson
Journal: JAMA Dermatology (2025)

Importance In the US, Latine patients disproportionately experience severe psoriasis, limited access to care, and poor disease-related quality of life. However, little is known about psoriasis in this growing US population. Objectives To explore Latine patients’ perception of their illness and their attitudes toward and experiences with the health care system, treatment, and research. Design, Setting, and Participants In this qualitative study, a thematic analysis was performed of in-depth, semistructured interviews of 30 Latine adults with moderate to severe psoriasis at an outpatient dermatology clinic in an urban safety-net hospital. All patients included had psoriasis diagnosed by a dermatologist and were defined as having moderate to severe psoriasis if systemic treatment was offered at any time during their disease course. Interviews were held between July 7 and August 3, 2022. Data saturation was used to determine sample size. Main Outcomes and Measures Interviews were conducted in English or Spanish, audio recorded, transcribed verbatim, and translated. Transcripts were then coded through an iterative process, and themes were identified through thematic analysis. Results Among 30 participants included, the mean (SD) age was 50 (11) years, 20 (67%) were male, and 22 (73%) preferred Spanish. Among 15 participants who disclosed their country of origin or ancestry, 7 (23%) were from Mexico; 4 (13%), Guatemala; 2 (7%), El Salvador; 1 (3%), Honduras; 1 (3%), Nicaragua; and 1 (3%), Peru. Six interrelated themes describing participant experiences were identified: (1) illness perception of psoriasis, (2) reliance on sociofamilial connections for medical decision-making, (3) impact of psoriasis on work life, (4) barriers to accessing quality dermatologic care, (5) receptiveness to prescription and nonprescription treatments, and (6) positive perception and interest toward research. Conclusions and Relevance The findings of this study highlight the impact of psoriasis on Latine individuals, the efforts made by this population to overcome health disparities, their positive perception toward biologic medications, and their interest in participating in biomedical research. Future investigations should assess educational interventions and further explore the preferences of Latine patients toward biologic medications and biomedical research.
Practical Guide to Artificial Intelligence, Chatbots, and Large Language Models in Conducting and Reporting Research
Authors: Tyler J. Loftus, Adil Haider, Gilbert R. Upchurch
Journal: JAMA Surgery (2025)

This Guide to Statistics and Methods provides an overview of the limitations and opportunities in applying large language models in such tasks as extracting surgical risk factors from clinical notes, learning from text inputs for decision support, and serving as educational tools.
Physician Payment Incentives and Active Surveillance in Low-Risk Prostate Cancer
Authors: Arnav Srivastava, Samuel R. Kaufman, Addison Shay, Mary Oerline, Xiu Liu, Monica Van Til, Susan Linsell, Corinne Labardee, Christopher Dall, Kassem S. Faraj, Avinash Maganty, Tudor Borza, Kevin Ginsburg, Brent K. Hollenbeck, Vahakn B. Shahinian
Journal: JAMA Network Open (2025)

Importance Active surveillance in men with less aggressive prostate cancer is inconsistently used despite clinical guidelines. Renumeration generally favors treatment over conservative management and may contribute to the variable adoption of active surveillance, which suggests that value-based payment incentives may promote guideline-concordant care. Objective To describe the adoption of active surveillance in low-risk prostate cancer, following the initiation of a novel payment incentive sponsored by a commercial payer to support its use. Design, Setting, and Participants This cohort study included men with prostate cancer diagnosed between 2015 to 2021 with data registered with the Michigan Urological Surgery Improvement Collaborative (MUSIC), a statewide quality-improvement collaborative of practicing urologists. Eligible participants were men with newly diagnosed low-risk or low-volume, favorable intermediate-risk prostate cancer who were eligible for active surveillance. Data were analyzed from January 2015 through December 2021. Exposure Health insurance payment incentive established between June 9, 2017, and September 30, 2018, to encourage active surveillance adoption within MUSIC. Upon meeting the target (ie, at least 72% of men with low-risk disease consider or initiate surveillance), the insurer would provide enhanced reimbursement on claims covered by preferred provider organization plans independent of diagnosis. Main Outcomes and Measures Active surveillance adoption relative to the preincentive period among men with low-risk prostate cancer. Secondary analyses examined practices by baseline surveillance use and proportion of patients with eligible insurance plans, as well as patients with favorable intermediate-risk disease. Results We identified 15 273 patients (median [IQR] age, 65 [59-70] years), of whom 10 457 (68.5%) had low-risk disease. The percentage of these men electing for surveillance increased, from 54.4% in 2015 (729 of 1340 men) to 84.1% in 2021 (1089 of 1295 men). Relative to the preincentive period, the payment incentive was not associated with increased surveillance use among patients with low-risk disease (odds ratio [OR], 0.96; 95% CI, 0.75-1.24) during its application. Secondary analyses similarly did not demonstrate an association between the payment incentive and active surveillance adoption. Conclusions and Relevance A payment incentive was not associated with increased active surveillance adoption in men with low-risk prostate cancer relative to the preincentive period. Value-based reimbursement incentives may require tailored implementation that considers existing reimbursement policy and practice characteristics to improve prostate cancer care quality.
Cost-Effectiveness of a Polypill for Cardiovascular Disease Prevention in an Underserved Population
Authors: Ciaran N. Kohli-Lynch, Andrew E. Moran, Dhruv S. Kazi, Kirsten Bibbins-Domingo, Neil Jordan, Dustin French, Yiyi Zhang, Thomas J. Wang, Brandon K. Bellows
Journal: JAMA Cardiology (2025)

Importance The Southern Community Cohort Study (SCCS) Polypill Trial showed that a cardiovascular polypill (a single pill containing a statin and 3 half-standard dose antihypertensive medications) effectively controls cardiovascular disease (CVD) risk factors in a majority Black race and low-income population. The cost-effectiveness of polypill treatment in this population has not been previously studied. Objective To determine the cost-effectiveness of the cardiovascular polypill. Design, Setting, and Participants A discrete-event simulation version of the well-established CVD policy model simulated clinical and economic outcomes of the SCCS Polypill Trial from a health care sector perspective. A time horizon of 10 years was adopted. Polypill treatment was priced at $463 per year in the base-case analysis. Model input data were derived from the National Health and Nutrition Examination Survey, Medical Expenditure Panel Survey, pooled longitudinal cohort studies, the SCCS Polypill Trial, and published literature. Two cohorts were analyzed: an SCCS Polypill Trial–representative cohort of 100 000 individuals and all trial-eligible non-Hispanic Black US adults. Study parameters and model inputs were varied extensively in 1-way and probabilistic sensitivity analysis. Exposures Polypill treatment or usual care. Main Outcome and Measures Primary outcomes were direct health care costs (US dollar 2023) and quality-adjusted life-years (QALYs), both discounted 3% annually, and the incremental cost per QALY gained. Results In the trial-representative cohort of 100 000 individuals (mean [SD] age, 56.9 [5.9] years; 61 807 female [61.8%]), polypill treatment was projected to yield a mean of 1190 (95% uncertainty interval, 287-2159) additional QALYs compared with usual care, at a cost of approximately $10 152 000. Hence, polypill treatment was estimated to cost $8560 per QALY gained compared with usual care and was high value (&amp;amp;lt;$50 000 per QALY gained) in 99% of simulations. Polypill treatment was estimated to be high value when priced at $559 or less per year and cost saving when priced at $443 or less per year. In almost all sensitivity analyses, polypill treatment remained high value. In a secondary analysis of 3 602 427 trial-eligible non-Hispanic Black US adults (mean [SD] age, 55.4 [7.6] years; 2 006 597 female [55.7%]), polypill treatment was high value, with an estimated cost of $13 400 per QALY gained. Conclusions and Relevance Results of this economic evaluation suggest that polypill treatment could be a high value intervention for a low-income, majority Black population with limited access to health care services. It could additionally reduce health disparities.
Carbon Footprint Analysis of an Outpatient Dermatology Practice at an Academic Medical Center
Authors: Genevieve S. Silva, Alex Waegel, Joshua Kepner, Greg Evans, William Braham, Misha Rosenbach
Journal: JAMA Dermatology (2025)

Importance There is growing awareness of the US health sector’s substantial contribution to the country’s greenhouse gas (GHG) emissions, exacerbating the health threats from climate change. Reducing health care’s environmental impact requires understanding its carbon emissions, but there are few published audits of health systems and fewer comprehensive emissions analyses at the clinic or department level. Objective To quantify the annual GHG emissions from a large outpatient dermatology practice, compare relative sources of emissions, and identify actionable targets. Design and Setting This quality improvement study involving a comprehensive carbon footprint analysis (scopes 1-3) of a large (nearly 30 000 visits/y), outpatient medical dermatology practice within the University of Pennsylvania’s academic medical complex was conducted following the GHG Protocol Corporate and Corporate Value Chain reporting standards for fiscal year 2022 (ie, July 2021 through June 2022). Data were obtained through energy metering, manual audits, electronic medical records, and administrative data. Exposure Data were converted into metric tons of carbon dioxide equivalent (tCO 2 e), allowing comparison of global-warming potential of emitted GHGs. Main Outcomes and Measures Primary outcomes were tCO 2 e by scope 1 (direct emissions), scope 2 (indirect, purchased energy), and scope 3 (indirect, upstream/downstream sources), as well as by individual categories of emission sources within each scope. Results Scope 3 contributed most to the clinic’s carbon footprint, composing 165.5 tCO 2 e (51.1%), followed by scope 2 (149.9 tCO 2 e [46.3%]), and scope 1 (8.2 tCO 2 e [2.5%]). Within scope 3, the greatest contributor was overall purchased goods and services (120.3 tCO 2 e [72.7% of scope 3]), followed by patient travel to and from the clinic (14.2 tCO 2 e [8.6%]) and waste (13.1 tCO 2 e [7.9%]). Steam and chilled water were the largest contributors to scope 2. Clinic energy use intensity was 185.4 kBtu/sqft. Conclusions and Relevance In this quality improvement study, the composition of emissions at the clinic level reflects the importance of scope 3, paralleling the health sector overall. The lower-resource intensity of the clinic compared to the average energy requirements of the total clinical complex led to a relatively large contribution from scope 2. These findings support efforts to characterize high-yield emissions-reduction targets and allow for identification of actionable, clinic-level steps that may inform broader health system efforts.
Academic Detailing Interventions and Evidence-Based Prescribing
Authors: Benjamin N. Rome, Ellen Dancel, Alexander Chaitoff, Dominick Trombetta, Shuvro Roy, Paul Fanikos, Jayda Germain, Jerry Avorn
Journal: JAMA Network Open (2025)

Importance Academic detailing (interactive educational outreach) is a widely used strategy to encourage evidence-based prescribing by clinicians. Objective To evaluate academic detailing programs targeted at improving prescribing behavior and describe program aspects associated with positive outcomes. Evidence Review A systematic search of MEDLINE from April 1, 2007, through December 31, 2022, was performed for randomized trials and nonrandomized studies of academic detailing interventions to improve prescribing. Academic detailing was defined as evidence-based medication education outreach delivered interactively to individuals or small groups of prescribers. Only studies that measured prescribing outcomes were included. Two investigators independently assessed studies for risk of bias using validated assessment tools. Among all studies rated as having low risk of bias and randomized trials rated as having moderate risk of bias, the absolute change in the proportion of patients using the targeted medications and the proportion of studies that led to significant changes in 1 or more prescribing outcome were determined. The data analysis was performed between January 25, 2022, and November 4, 2024. Findings The 118 studies identified varied by setting (eg, inpatient, outpatient) and academic detailing delivery (eg, individual vs groups of prescribers). The most common therapeutic targets were antibiotic overuse (32 studies [27%]), opioid prescribing (24 studies [20%]), and management of mental health conditions (16 studies [14%]) and cardiovascular disease (13 studies [11%]). Most studies (66 [56%]) combined academic detailing with other interventions (eg, audit and feedback, electronic health record reminders). Among 36 studies deemed to have the lowest risk of bias, 18 interventions (50%; 95% CI, 33%-67%) led to significant improvements in all prescribing outcomes, and 7 (19%; 95% CI, 8%-36%) led to significant improvements in 1 or more prescribing outcomes. The median absolute change in the proportion of patients using the targeted medication or medications was 4.0% (IQR, 0.3%-11.3%) in the intended direction. Conclusions and Relevance In this systematic review of academic detailing interventions addressing evidence-based prescribing, most interventions led to substantial changes in prescribing behavior, although the quality of evidence varied. These findings support the use of academic detailing to bring about more evidence-based prescribing in a variety of clinical settings.