{
  "abstract": "We developed and validated PANDA, a deep-learning model for pediatric arousal detection in polysomnography. PANDA uses a U-Net-style encoder-decoder architecture trained on 10-channel PSG signals with 17.5 min contextual windows and 2 Hz arousal outputs. The model was trained on 9150 PSGs from 7604 subjects, validated on 2455 PSGs from 2000 subjects, and evaluated on a held-out Boston Children’s Hospital test set of 3804 recordings from 3000 subjects. To reduce reference-label noise, we constructed a rigorously adjudicated 200-PSG platinum set and quantified inter-rater reliability before and after adjudication. Performance was assessed using sample-wise agreement, event-wise arousal-index agreement, and external validation on CHAT and PATS. On routine labels, PANDA achieved mean subject-wise Cohen’s κ = 0.45 compared with κ = 0.26 for CAISR. Agreement increased to κ = 0.87 on platinum labels, consistent with reduced scoring variability after expert adjudication. PANDA also showed closer event-wise agreement with reference arousal index and lower bias than CAISR across internal and external cohorts. External validation yielded κ = 0.46 on CHAT and κ = 0.38 on PATS, improving to κ = 0.57 and κ = 0.50 after cohort-specific calibration. PANDA enables scalable pediatric arousal detection with improved consistency and reduced manual scoring time.",
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  "affiliations": [
    "Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA USA",
    "Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA USA",
    "Harvard Medical School, Boston, MA USA",
    "Emory University School of Medicine, Atlanta, GA USA",
    "Department of Epidemiology and Biostatistics, University of California, San Francisco, CA USA",
    "California Pacific Medical Center Research, San Francisco, CA USA",
    "Stanford University, Palo Alto, CA USA",
    "Kaiser Permanente, San Bernardino County Sleep Disorders Center, San Bernardino, CA USA",
    "Department of Neurology and Emory Sleep Center, Emory University School of Medicine, Atlanta, GA USA",
    "Georgia Institute of Technology, Atlanta, GA USA",
    "Pediatric Sleep Center, Boston Children’s Hospital, Boston, MA USA",
    "Department of Medicine, Division of Pulmonary Critical Care & Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA USA"
  ],
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  "authors": [
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      "name": "Arnav Gupta"
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      "name": "Ayush Tripathi"
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      "name": "Wolfgang Ganglberger"
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      "name": "Samuel Waters"
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    {
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        2
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      "name": "Haoqi Sun"
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      "name": "Samaneh Nasiri"
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      "name": "Katie L. Stone"
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      "name": "Emmanuel Mignot"
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      "name": "Dennis Hwang"
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      "name": "Matthew A. Reyna"
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      "name": "Lynn Marie Trotti"
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      "name": "Gari D. Clifford"
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    {
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      "name": "Kiran Maski"
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      "name": "Umakanth Katwa"
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      "name": "Robert J. Thomas"
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    {
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      "name": "M. Brandon Westover"
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  "bibtex": "https://research.draconitic.com/paper/cdh5xtnt77sap.bib",
  "cited_by": 0,
  "doi": "10.1038/s41746-026-02967-x",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13737120/",
  "id": "cdh5xtnt77sap",
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  "landing_url": "https://doi.org/10.1038/s41746-026-02967-x",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
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  "pdf_url": "https://www.nature.com/articles/s41746-026-02967-x_reference.pdf",
  "pmcid": "PMC13737120",
  "pmid": "42414584",
  "published": "2026-07-07",
  "publisher": "Nature Publishing Group",
  "ris": "https://research.draconitic.com/paper/cdh5xtnt77sap.ris",
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      "origin": "openalex:2805|EEG and Brain-Computer Interfaces",
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  "title": "PANDA pediatric arousal neural detection architecture",
  "title_text": "PANDA pediatric arousal neural detection architecture",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:22:24Z",
  "url": "https://research.draconitic.com/paper/cdh5xtnt77sap",
  "venue": "NPJ Digital Medicine",
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