tbuckley/cabot-search huggingface dataset:
A hybrid multi model artificial intelligence approach for glaucoma screening using fundus images
Authors: Parmanand Sharma, Naoki Takahashi, Takahiro Ninomiya, Masataka Sato, Takehiro Miya, Satoru Tsuda, Toru Nakazawa
Journal: npj Digital Medicine (2025)

Abstract Glaucoma, a leading cause of blindness, requires accurate early detection. We present an AI-based Glaucoma Screening (AI-GS) network comprising six lightweight deep learning models (total size: 110 MB) that analyze fundus images to identify early structural signs such as optic disc cupping, hemorrhages, and nerve fiber layer defects. The segmentation of the optic cup and disc closely matches that of expert ophthalmologists. AI-GS achieved a sensitivity of 0.9352 (95% CI 0.9277–0.9435) at 95% specificity. In real-world testing, sensitivity dropped to 0.5652 (95% CI 0.5218–0.6058) at ~0.9376 specificity (95% CI 0.9174–0.9562) for the standalone binary glaucoma classification model, whereas the full AI-GS network maintained higher sensitivity (0.8053, 95% CI 0.7704–0.8382) with good specificity (0.9112, 95% CI 0.8887–0.9356). The sub-models in AI-GS, with enhanced capabilities in detecting early glaucoma-related structural changes, drive these improvements. With low computational demands and tunable detection parameters, AI-GS promises widespread glaucoma screening, portable device integration, and improved understanding of disease progression.
Six early CPAP-usage behavioural patterns determine peak CPAP adherence and permit tailored intervention, in patients with obstructive sleep apnoea
Authors: Julia Dielesen, Lesedi J Ledwaba-Chapman, Pragna Kasetti, Noori Fatima Husain, Timothy C Skinner, Martino F Pengo, Teresa Whiteman, Koula Asimakopoulou, Simon Merritt, David Jones, Peter Dickel, Siddiq Pulakal, Neil R Ward, Justin Pepperell, Joerg Steier, S Amanda Sathyapala
Journal: Thorax (2025)

Background High rates of non-adherence to continuous positive airway pressure (CPAP) in obstructive sleep apnoea hamper good clinical outcomes. Current recommendations assumes two behaviours (adherence and non-adherence) and days 7–90 follow-up post-CPAP initiation mitigates against non-adherence. Objectives To investigate associations between early CPAP-usage behaviours and (1) CPAP adherence at month 3 of treatment and (2) sleep centres’ treatment pathways (the procedures patients undergo that may affect barriers or facilitators of CPAP adherence). Methods We conducted growth mixture modelling (GMM) on retrospective data from 1000 patients at 5 UK sleep centres. Night 1 to month 3 telemonitored CPAP-usage data were downloaded from 200 patients per centre who started CPAP in 2019 (100) or 2020 (100). Adherence was defined using accepted criteria (mean CPAP-usage ≥4 hours/night for ≥70% of nights). Results GMM identified six distinct CPAP-usage behaviour patterns over month 1. In four (54% of patients), CPAP-usage increased or decreased, in two (remaining 46%), CPAP-usage/non-usage was consistent. 62% of the cohort were non-adherent by month 3, despite pathways following current recommendations. 98% of patients who were non-adherent by month 3 were already non-adherent by month 1. Regression analysis with a separate dataset demonstrated that early CPAP-usage behaviour explained 86% of the variance in CPAP non-adherence at month 3. Conclusions These data, supported by previous work, indicate that recommended day 30–90 follow-up is too late to prevent CPAP non-adherence. Determining CPAP-usage behavioural pattern in week 2 identifies risk of CPAP non-adherence at month 3 and permits the possibility of tailored interventions.
Gut microbial-derived N-acetylmuramic acid alleviates colorectal cancer via the AKT1 pathway
Authors: Mengyao Hu, Yi Xu, Yuqing Wang, Zhenhe Huang, Lei Wang, Fanan Zeng, Bowen Qiu, Zefeng Liu, Peibo Yuan, Yu Wan, Shuang Ge, Dian Zhong, Siyu Xiao, Rongrong Luo, Jiaqi He, Meiling Sun, Xiaoduan Zhuang, Nannan Guo, Chunhui Cui, Jie Gao, Hongwei Zhou, Xiaolong He
Journal: Gut (2025)

Background Gut microbial metabolites are recognised as critical effector molecules that influence the development of colorectal cancer (CRC). Peptidoglycan fragments (PGFs) produced by microbiota play a crucial role in maintaining intestinal homeostasis, but their role in CRC remains unclear. Objective Here, we aimed to explore the potential contribution of PGFs in intestinal tumourigenesis. Design The relative abundance of peptidoglycan synthase and hydrolase genes was assessed by metagenomic analysis. Specific PGFs in the faeces and serum of CRC patients were quantified using targeted mass spectrometry. The effects of PGF on intestinal tumourigenesis were systematically evaluated using various murine models of CRC and organoids derived from CRC patients. Downstream molecular targets were screened and evaluated using proteome microarray, transcriptome sequencing and rescue assays. Results Metagenomic analysis across seven independent cohorts (n=1121) revealed a comprehensive reduction in peptidoglycan synthase gene relative abundance in CRC patients. Targeted mass spectrometry identified significant depletion of a specific PGF, N-acetylmuramic acid (NAM) in CRC patients, which decreased as tumours progressed (p&lt;0.001). NAM significantly inhibits intestinal tumourigenesis in various models, including Apc Min/+ , AOM/DSS-treated and MC38 tumour-bearing mice. Additionally, NAM inhibits the growth of patient-derived CRC organoids in a concentration-dependent manner. Mechanistically, NAM inhibits the activation of AKT1 by directly binding to it and blocking its phosphorylation, which is a partial mediator of NAM’s anticancer effects. Conclusion The PGF NAM protects against intestinal tumourigenesis by targeting the AKT1 signalling pathway. NAM may serve as a novel potential preventive and therapeutic biomarker against CRC.
Glucagon-like peptide-1 receptor agonist use is associated with a lower risk of major adverse liver-related outcomes: a meta-analysis of observational cohort studies
Authors: Ciro Celsa, Grazia Pennisi, Adele Tulone, Giacinta Ciancimino, Marco Vaccaro, Giuseppe Infantino, Gabriele Di Maria, David J Pinato, Giuseppe Cabibbo, Marco Enea, Alessandro Mantovani, Herbert Tilg, Giovanni Targher, Calogero Cammà, Salvatore Petta
Journal: Gut (2025)

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown promising effects on liver histology in phase 2 trials enrolling patients with metabolic dysfunction-associated steatotic liver disease. However, the impact of GLP-1RAs on the long-term risk of major adverse liver-related outcomes (MALOs) remains uncertain. We performed a meta-analysis of observational cohort studies to quantify the magnitude and direction of the association between GLP-1RA use and MALOs in people with type 2 diabetes (T2D). We systematically searched eligible cohort studies comparing GLP-1RA new users versus users of other glucose-lowering medications. The primary outcome was the cumulative incidence rates of MALOs. Secondary outcomes included hepatic decompensation events, hepatocellular carcinoma (HCC) and liver-related mortality. Random-effects models were used to calculate incidence rate ratios (IRRs). 11 retrospective cohort studies with aggregate data on 1 467 220 patients with T2D (647 903 GLP-1RA new users, 819 317 non-users) were included. GLP-1RA use was significantly associated with a lower risk of MALOs (IRR 0.71, 95% CI 0.57 to 0.88) and hepatic decompensation (IRR 0.70, 95% CI 0.52 to 0.94). Association with reduced risk of HCC was also observed (IRR 0.82, 95% CI 0.61 to 1.11). Compared with other antidiabetic medications, GLP-1RAs showed superior effectiveness versus SGLT2 inhibitors in preventing MALOs (IRR 0.93, 95% CI 0.87 to 0.99), versus DPP-4 inhibitors in preventing hepatic decompensation (IRR 0.74, 95% CI 0.66 to 0.83) and versus insulin therapy in preventing HCC (IRR 0.32, 95% CI 0.13 to 0.80). GLP-1RA use is associated with a lower risk of liver-related complications and hepatic decompensation in people with T2D. These findings suggest a role of GLP-1RAs in preventing liver-related complications beyond their beneficial cardiometabolic effects.
Trends in Cervical Precancers Identified Through Population-Based Surveillance — Human Papillomavirus Vaccine Impact Monitoring Project, Five Sites, United States, 2008–2022
Authors: Julia W. Gargano, Ruth Stefanos, Rebecca M. Dahl, Jessica L. Castilho, Erica A. Bostick, Linda M. Niccolai, Ina U. Park, Sheelah Blankenship, Monica M. Brackney, Kameny Chan, Emily L. Delikat, Sara Ehlers, Kimberly Gonzalez Barrera, RaeAnne Kurtz, James I. Meek, Erin Whitney, Marissa Vigar, Elizabeth R. Unger, Lauri E. Markowitz, Deborah Adeyemi, Anjola-Oluwa A. Ajayi, Nicole R. Andersen, Bradley Beauchamp, Sarah E. Clarke, Emilio DeBess, Kyle Higgins, Tiffanie M. Markus, Troy D. Querec, Michael Silverberg
Journal: MMWR Morbidity and Mortality Weekly Report (2025)

In 2006, human papillomavirus (HPV) vaccine was first recommended in the United States to prevent cancers and other diseases caused by HPV; vaccination coverage increased steadily through 2021, and increasing numbers of young women had received HPV vaccine as children or adolescents. Since 2008, CDC has monitored incidence of precancerous lesions (cervical intraepithelial neoplasia [CIN] grades 2-3 and adenocarcinoma in situ [AIS], collectively CIN2+), which are detected through cervical cancer screening and can be used as an intermediate outcome for monitoring vaccination impact, via the five-site Human Papillomavirus Vaccine Impact Monitoring Project. This analysis describes trends in incidence of CIN2+ and CIN3+ (i.e., CIN grade 3 and AIS) lesions during 2008-2022. Among women aged 20-24 years who were screened for cervical cancer, rates during 2008-2022 decreased for CIN2+ by 79%, and for CIN3+ by 80%. In the same period, CIN3+ rates among screened women aged 25-29 years decreased by 37%. These data are consistent with considerable impact of HPV vaccination for preventing cervical precancers among women in the age groups most likely to have been vaccinated, and support existing recommendations to vaccinate children at the routinely recommended ages as a cancer prevention measure.
Avian Influenza A(H5) Subtype in Wastewater — Oregon, September 15, 2021–July 11, 2024
Authors: Rebecca Falender, Tyler S. Radniecki, Christine Kelly, Paul Cieslak, David Mickle, Harrison Hall, Ryan Scholz, Melissa Sutton
Journal: MMWR Morbidity and Mortality Weekly Report (2025)

Wastewater surveillance is an important tool in the surveillance of emerging pathogens and has been leveraged during the highly pathogenic avian influenza (HPAI) A(H5N1) virus outbreak in cattle and poultry in the United States. Interpretation of avian influenza A(H5) subtype detections in wastewater requires an understanding of human and animal contributors to the sewershed because current testing does not distinguish between human and animal sources. Potential animal contributors include wild birds, farms with poultry or dairy cattle outbreaks, and dairy processing facilities. Retrospective analysis of 551 influenza A virus-positive wastewater surveillance samples from 20 sites in Oregon during September 15, 2021-July 11, 2024, revealed 21 avian influenza A(H5) subtype detections across 12 communities. Avian influenza A(H5) subtype detections in wastewater began approximately 6 weeks before Oregon's first HPAI outbreak in domestic poultry, 7 weeks before Oregon's first avian influenza A(H5) detection in wild birds, and 2 years before the first HPAI A(H5N1) outbreak in dairy cattle in the United States (Oregon has not detected HPAI A(H5N1) in dairy cattle or milk). No association was found between detection of avian influenza A(H5) in a community's wastewater and history of an HPAI A(H5) outbreak among poultry in the county or presence of dairy processing facilities or dairy farms within the sewershed. Avian influenza A(H5) was detected most frequently in two communities with important wild bird habitats. Animal inputs, including from wild birds, should be considered when interpreting avian influenza A(H5) subtype detections in wastewater.
Eye Movement Desensitisation and Reprocessing with and without Dialectical Behaviour Therapy for Posttraumatic Stress Disorder and Comorbid Borderline Personality Disorder Symptoms: A Randomised Controlled Trial
Authors: Aishah Cecile Snoek, Arne van den End, Aartjan T. F. Beekman, Jack Dekker, Inga Aarts, Matthijs Blankers, Chris Vriend, Odile A. van den Heuvel, Nick Lommerse, Kathleen Thomaes
Journal: Psychotherapy and Psychosomatics (2025)

Introduction: Comorbidity between posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD) is prevalent. Despite evidence-based therapies, high rates of non-response and dropout persist. This study therefore aimed to examine whether the concurrent application of eye movement desensitization and reprocessing (EMDR) for PTSD and dialectical behavior therapy (DBT) for BPD yields better results than EMDR alone. Methods: Patients with a PTSD diagnosis and at least four BPD symptoms were randomly assigned to EMDR (n = 63) or concurrent EMDR-DBT (n = 61). Over one year, changes in PTSD symptoms were measured using the Clinician-Administered PTSD Scale for DSM-5. Secondary outcomes included BPD symptoms, global functioning and quality of life. Results: Both treatments led to large reductions in PTSD symptoms, without significant differences after one year (p = .312, d = -0.23, 95% CI = -0.6, 0.1). Both treatments also yielded large and comparable reductions in BPD symptoms and improved quality of life. Global functioning improved only in the EMDR condition according to one measure (WHODAS 2.0), while the other measure (OQ-45) showed improvements in both groups. Additionally, patients in the EMDR-DBT condition were twice as likely to drop out from EMDR treatment compared to those in the EMDR-only condition. Conclusion: Stand-alone EMDR demonstrated safety and efficacy in alleviating PTSD and BPD symptoms, as well as enhancing quality of life. These findings support the use of EMDR as a strong therapeutic option for patients with PTSD and comorbid BPD symptoms. Further research is needed to assess longer-term outcomes beyond one year.
Academic Community Partnership in Acute Promyelocytic Leukemia and Early Mortality
Authors: Anand P. Jillella, Sandra J. Lee, Jessica K. Altman, Selina M. Luger, Martin S. Tallman, James M. Foran, Danielle Bradshaw, Lisa Y. Law, Locke J. Bryan, Abdallah Abou Zahr, Kebede H. Begna, Alexander E. Perl, Joseph J. L. Vadakara, Rubina Qamar, Raymond C. Bergan, Michael J. Fisch, Ruth C. Carlos, Lynne I. Wagner, Vamsi K. Kota, Mark R. Litzow
Journal: JAMA Oncology (2025)

Importance Acute promyelocytic leukemia (APL) is an acute illness that presents with cytopenia, infections, and disseminated intravascular coagulation. Achieving remission has been shown to make a major difference in patient outcomes; however, early death rates in the first month have been as high as 30% due to acute presentation, comorbidities, the rarity of APL, and clinician inexperience. Objective To develop treatment strategies that would decrease estimated 1-month mortality from 30% to below 15%. Design, Setting, and Participants In this nonrandomized clinical trial, a treatment algorithm that focused on supportive care was used to prevent early death in patients with APL treated at academic and community health centers between August 2017 and July 2021. Because of the rarity of the disease, expert support was available 24/7 from 7 designated APL experts at 6 participating academic lead centers, and included an additional 293 community centers. When a patient presented with APL, an expert was contacted and a consensus treatment plan was developed using the algorithm and expert suggestions. There were no exclusion criteria and all patients with a confirmed diagnosis of APL regardless of age or comorbid conditions were enrolled. Expert support was provided throughout induction. Initial data analysis was conducted May 2023. Main Outcomes and Measures One-month mortality; additional objectives were to compare outcomes in academic and community centers and assess 1-year and overall survival. Results A total of 201 patients were enrolled from 43 centers; 62 at lead centers and 139 from 37 community centers. The median age was 53 years (range, 18-91 years), with 72 patients (35.8%) who were aged 60 years or older; 105 patients (52.2%) were male. Fifty-two patients (26.4%) were diagnosed with high-risk APL. The 1-month mortality rate was 6 deaths of 201 patients (3.0%; 95% CI, 1.1%-6.4%) after adjusting for 1 interim analysis. In a secondary analysis using the Kaplan-Meier method, the 1-month overall survival (OS) rate was 97.0% (95% CI, 93.5%-98.6%) and the 1-year OS rate was 94.5% (95% CI, 90.3%-96.9%). Conclusions and Relevance In this nonrandomized clinical trial, use of an algorithm combined with expert support resulted in a dramatic decrease in early death in academic and community centers. Population-wide survival improved in this highly curable disease, which suggests that implementing an accessible support system with APL experts for comanagement is the most logical next step. Trial Registration ClinicalTrials.gov Identifier: NCT03253848
A 25-Year-Old With Verrucous Pustules and Fevers
Authors: Carlos Seas, Paloma Rosanna Seas, Pedro Legua
Journal: JAMA (2025)

A man taking no regular medications had 1 month of small painless facial papules progressing over 1 week to vesicles and pustules. He reported unprotected sex with multiple partners and recent exposure to a person with active tuberculosis; rapid plasma reagin titer was normal; results of HIV and fluorescent treponemal antibody absorption tests were positive. What is the diagnosis and what would you do next?
Prevalence and Control of Diabetes Among US Adults, 2013 to 2023
Authors: Kosuke Inoue, Michael Liu, Rahul Aggarwal, Lucas X. Marinacci, Rishi K. Wadhera
Journal: JAMA (2025)

This study uses data from the National Health and Nutrition Examination Survey to evaluate trends in the prevalence and control of diabetes among US adults overall and by age and sex between 2013 and 2023.
Megakaryocytes transfer mitochondria to bone marrow mesenchymal stromal cells to lower platelet activation
Authors: Chengjie Gao, Yitian Dai, Paul A. Spezza, Paul Boasiako, Alice Tang, Giselle Rasquinha, Hui zhong, Bojing Shao, Yunfeng Liu, Patricia A. Shi, Cheryl A. Lobo, Xiuli An, Anqi Guo, William B. Mitchell, Deepa Manwani, Karina Yazdanbakhsh, Avital Mendelson
Journal: Journal of Clinical Investigation (2025)

Newly produced platelets acquire a low activation state but whether the megakaryocyte plays a role in this outcome has not been fully uncovered. Mesenchymal stem cells (MSCs) were previously shown to promote platelet production and lower platelet activation. We found healthy megakaryocytes transfer mitochondria to MSCs mediated by Connexin 43 (Cx43) gap junctions on MSCs, which leads to platelets at a low energetic state with increased LYN activation, characteristic of resting platelets. On the contrary, MSCs have a limited ability to transfer mitochondria to megakaryocytes. Sickle cell disease (SCD) is characterized by hemolytic anemia and results in heightened platelet activation, contributing to numerous disease complications. Platelets in SCD mice and human patient samples had a heightened energetic state with increased glycolysis. MSC exposure to heme in SCD led to decreased Cx43 expression and a reduced ability to uptake mitochondria from megakaryocytes. This prevented LYN activation in platelets and contributed to increased platelet activation at steady state. Altogether, our findings demonstrate an effect of hemolysis in the microenvironment leading to increased platelet activation in SCD. These findings have the potential to inspire new therapeutic targets to relieve thrombosis-related complications of SCD and other hemolytic conditions.
Continuity of Prescription Medication Use Among Adults Leaving State Prison
Authors: Laura Dague, Cici McNamara, Ryan Westergaard, Kevin A. Look, Marguerite Burns
Journal: JAMA Network Open (2025)

Importance Identifying prescription needs of adults returning from prison can inform intervention design to mitigate high morbidity and mortality during reentry to the community. Objective To characterize the prevalence and factors associated with continuity of medication use for treatment of chronic illness among adults returning to the community from prison. Design, Setting, and Participants This retrospective cohort study linked administrative records and prescription claims from the Wisconsin Department of Corrections and the Medicaid program. The study included all adults (aged 18-64 years) released from a Wisconsin state correctional facility between April 1, 2015, and June 30, 2017, after incarceration of at least 31 days who enrolled in Medicaid within the month of release. Analyses were conducted between May 2022 and May 2024. Exposure Receipt of a prescription medication commonly used for treatment of certain chronic conditions during the last 3 months of incarceration. Main Outcomes and Measures The primary outcome was medication continuity, which was defined as having a prescription medication claim in the first 6 months after release that was within the same chronic condition therapeutic class as the medication received during the last 3 months of incarceration. Results This cohort study included 13 792 individual releases representing 12 960 individuals from the Wisconsin state prison system who immediately enrolled in Medicaid upon release. These individuals had a mean (SD) age of 35.5 (10.5) years; 89.5% were male. In terms of race, 38.5% of individuals were Black and 57.2% were White. For one-third of individual Medicaid-enrolled releases (4302 [31.2%]), the individual received a prescription medication for a chronic condition. Prescription continuity was observed for 51.7%, with variability across drug class ranging from less than 20.0% to 71.6%. Classes with the highest continuity (eg, thyroid agents) were also those that treated serious chronic conditions, although gaps between realized and clinically recommended care remained. Continuity varied by race, sex, and age. Individuals with continuity were more likely to have had an outpatient visit in the 6 months following release than those without continuity (93.9% vs 55.6%; P &amp;amp;lt; .001) despite similar Medicaid enrollment. Conclusions and Relevance In this study, prescription continuity between prison release and the community was limited, even for drugs with high clinical need and relevance for population health and especially among individuals who did not receive outpatient care in the 6 months post incarceration. These findings suggest that effective transitional care interventions may need to include increased emphasis on connecting with clinicians.