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Performance of generative pre-trained transformers (GPTs) in Certification Examination of the College of Family Physicians of Canada

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Family medicine and Community Health 2024年第S1期12卷 12-19页

作者： mehdi mousavi Shabnam Shafiee jason m harley Jackie Chi Kit Cheung Samira Abbasgholizadeh Rahimi Department of Family medicine Faculty of MedicineUniversity of SaskatchewanNipawinSaskatchewanCanada Department of Family medicine Saskatchewan Health AuthorityRiverside Health ComplexTurtlefordSaskatchewanCanada Department of Surgery Faculty of Medicine and Health SciencesMcGill UniversityMontrealQuebecCanada Research Institute of the mcGill University Health Centre MontrealQuebecCanada Institute for Health Sciences Education Faculty of Medicine and Health SciencesMcGill UniversityMontrealQuebecCanada mcGill University School of Computer Science MontrealQuebecCanada CIFAR AI Chair Mila-Quebec AI InstituteMontrealQuebecCanada Department of Family medicine McGill UniversityMontrealQuebecCanada mila Quebec AI-Institute MontrealQuebecCanada Faculty of Dentistry medicine and Oral Health Sciences McGill UniversityMontrealQuebecCanada Lady Davis Institute for medical Research Jewish General HospitalMontrealQuebecCanada

Introduction The application of large language models such as generative pre-trained transformers(GPTs)has been promising in medical education,and its performance has been tested for different medical *** study aims to assess the performance of GPTs in responding to a set of sample questions of short-answer management problems(SAmPs)from the certification exam of the College of Family Physicians of Canada(CFPC).method Between August 8th and 25th,2023,we used GPT-3.5 and GPT-4 in five rounds to answer a sample of 77 SAmPs questions from the CFPC *** independent certified family physician reviewers scored AI-generated responses twice:first,according to the CFPC answer key(ie,CFPC score),and second,based on their knowledge and other references(ie,Reviews’score).An ordinal logistic generalised estimating equations(GEE)model was applied to analyse repeated measures across the five *** According to the CFPC answer key,607(73.6%)lines of answers by GPT-3.5 and 691(81%)by GPT-4 were deemed ***’s scoring suggested that about 84%of the lines of answers provided by GPT-3.5 and 93%of GPT-4 were *** GEE analysis confirmed that over five rounds,the likelihood of achieving a higher CFPC Score Percentage for GPT-4 was 2.31 times more than GPT-3.5(OR:2.31;95%CI:1.53 to 3.47;pmilarly,the Reviewers’Score percentage for responses provided by GPT-4 over 5 rounds were 2.23 times more likely to exceed those of GPT-3.5(OR:2.23;95%CI:1.22 to 4.06;p=0.009).Running the GPTs after a one week interval,regeneration of the prompt or using or not using the prompt did not significantly change the CFPC score *** In our study,we used GPT-3.5 and GPT-4 to answer complex,open-ended sample questions of the CFPC exam and showed that more than 70%of the answers were accurate,and GPT-4 outperformed GPT-3.5 in responding to the *** language models such as GPTs seem promising for assisting candidates of the CFPC exam by pr

关键词： Canada prompt education

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Astrocytic calcium waves:unveiling their roles in sleep and arousal modulation

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Neural Regeneration Research 2024年第5期19卷 984-987页

作者： Erxi Wu Dan Qi Damir Nizamutdinov jason H.Huang Department of Neurosurgery and Neuroscience Institute Baylor Scott&White HealthTempleTXUSA Texas A&m University School of medicine TempleTXUSA Texas A&m University School of Pharmacy College StationTXUSA LIVESTRONG Cancer Institutes and Department of Oncology Dell Medical Schoolthe University of Texas at AustinAustinTXUSA Department of Neurosurgery Baylor College of MedicineTempleTXUSA

Neuron-astrocyte interactions are vital for the brain’s *** astrocyte activities is crucial for comprehending the complex neural network,particularly the population-level functions of neurons in different cortical states and associated behaviors in *** on animal sleep and wakefulness have revealed distinct cortical synchrony patterns between ***,outnumbering neurons by nearly fivefold,support and regulate neuronal and synaptic *** research on astrocyte activation during cortical state transitions has emphasized the influence of norepinephrine as a neurotransmitter and calcium waves as key components of ion channel *** summary focuses on a few recent studies investigating astrocyte-neuron interactions in mouse models during sleep,wakefulness,and arousal levels,exploring the involvement of noradrenaline signaling,ion channels,and glutamatergic signaling in different cortical *** findings highlight the significant impact of astrocytes on large-scale neuronal networks,influencing brain activity and *** astrocytic signaling pathways shows promise for treating sleep disorders and arousal *** research is needed to understand astrocytic calcium signaling in different brain regions and its implications for dysregulated brain states,requiring future human studies to comprehensively investigate neuron-astrocyte interactions and pave the way for therapeutic interventions in sleep-and arousal-related disorders.

关键词： arousal astrocyte calcium waves locus coeruleus neuron-astrocyte interaction norepinephrine sleep wakefulness

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Evaluating implicit gender bias at Canadian otolaryngology meetings through use of professional title

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第1期10卷 12-17页

作者： Kylen Van Osch Agnieszka Dzioba Khadija Ahmed Andrew macDonald Jamila Skinner harley Williams Julie E.Strychowsky m.Elise Graham Department of Otolaryngology-Head&Neck Surgery Schulich School of Medicine&DentistryWestern UniversityLondonOntarioCanada Department of Otolaryngology London Health Sciences Centre Children's HospitalLondonOntarioCanada Faculty of medicine Schulich School of Medicine&DentistryWestern UniversityLondonOntarioCanada

Objectives:Increasing numbers of women enter medical school *** number of female physicians in leadership positions has been much slower to *** are also well‐documented differences in the treatment of women as compared to men in professional *** presenters are less likely to be introduced by their professional title(“Doctor”)for grand rounds and conferences,especially with a man performing the *** study reviewed the Canadian Society of Otolaryngology–Head and Neck Surgery(CSOHNS)meetings from 2017 to 2020 to determine the proportion of presenters introduced by their professional title and whether this varied by ***:Recordings from CSOHNS meetings were reviewed and coded for introducer and presenter demographics,including leadership positions and ***‐squared tests of proportion and multivariate logistic regression was used to compare genders and identify factors associated with professional versus unprofessional forms of ***:No significant association was found between professional title use and introducer or presenter *** presenters were introduced with professional title 69.6%of the time,while male presenters were introduced with professional title 67.6%of the time(P=0.69).Residents were introduced with a professional title with the most frequency(75.8%),while attending staff were introduced with a professional title with the least frequency(63.0%)(P=0.02).Conclusions:The lack of gender bias in speaker introductions at recent CSOHNS meetings demonstrates progress in achieving gender equity in *** efforts should continue to define additional forms of unconscious bias that may be contributing to gender inequity in leadership positions.

关键词： attitude of health personnel gender identity Otolaryngology women

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基于TROPOmI NO_(2)、CO及HCHO重构数据的近地面O_(3)浓度估算研究

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遥感学报 2024年第9期28卷 2348-2361页

作者：陈小娟秦凯 Cohen jason 何秦中国矿业大学环境与测绘学院徐州221116

以TROPOmI大气成分产品为代表的卫星遥感数据在近地面臭氧(O_(3))浓度估算中表现出很好的潜力。由于云及反演算法局限性等原因,TROPOmI的大气成分产品存在一定的数据缺失,使得基于此的近地面O_(3)浓度估算数据覆盖度较低。为此,本文采... 详细信息

以TROPOmI大气成分产品为代表的卫星遥感数据在近地面臭氧(O_(3))浓度估算中表现出很好的潜力。由于云及反演算法局限性等原因,TROPOmI的大气成分产品存在一定的数据缺失,使得基于此的近地面O_(3)浓度估算数据覆盖度较低。为此,本文采用经验正交函数分解插值法(DINEOF)对TROPOmI NO_(2)、CO、HCHO原始数据产品进行缺失像元重构,并基于重构数据产品采用极限梯度提升算法(XGBoost)估算了中国大陆地区2019年—2021年高覆盖度的日最大8 h平均O_(3)浓度(mDA8 O_(3))。对比研究了DINEOF方法对TROPOmI NO_(2)、CO、HCHO原始数据产品的缺失像元进行重构后再建模估算O_(3)的方法(方案1),使用TROPOmI NO_(2)、CO、HCHO原始数据产品并对其缺失像元赋空值并输入其他特征变量来建模估算O_(3)的方法(方案2),有TROPOmI NO_(2)、CO、HCHO原始数据产品的建模结果和无TROPOmI NO_(2)、CO、HCHO原始数据产品,只有其他特征变量的建模结果相结合的方法(方案3),均可提升O_(3)模型估算结果的覆盖度。实验表明:方案1的结果最好,其十折交叉验证R^(2)=0.86,RmSE=15.86μg/m^(3),模型精度和方案2基本一致且高于方案3,在重构区域的模型精度最高(训练集R^(2)=0.82,RmSE=15.57μg/m^(3)),且当重构区域出现O_(3)重污染时(浓度大于160μg/m^(3)),能明显改善模型高值低估现象,结果的空间分布更合理。方案1估算的2019年—2021年近地面mDA8 O_(3)的平均覆盖度从33.6%提升到97.2%,使用TROPOmI NO_(2)、CO、HCHO重构数据产品建模估算O_(3)可提升模型性能和模型结果的覆盖度。

关键词：遥感近地面O_(3) TROPOmI DINEOF XGBoost 数据重构

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4-1BB transcriptomic expression patterns across malignancies:Implications for clinical trials of 4-1BB agonists

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Cancer Communications 2024年第10期44卷 1168-1172页

作者： Yuji Uehara Shumei Kato Daisuke Nishizaki Hirotaka miyashita Suzanna Lee mary K.Nesline Sarabjot Pabla Jeffrey m.Conroy Paul DePietro Heidi Ko jason K.Sicklick Razelle Kurzrock Department of Thoracic Oncology and Respiratory medicine Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan Department of Precision Cancer medicine Center for Innovative Cancer TreatmentTokyo Medical and Dental UniversityTokyoJapan Center for Personalized Cancer Therapy and Division of Hematology and Oncology Department of MedicineUniversity of California San DiegoMoores Cancer CenterLa JollaCaliforniaUnited States Dartmouth Cancer Center Hematology and Medical OncologyLebanonNew HampshireUnited States Labcorp Oncology DurhamNorth CarolinaUnited States OmniSeq Incorporation BuffaloNew YorkUnited States Division of Surgical Oncology Department of SurgeryCenter for Personalized Cancer TherapyUniversity of California San DiegoLa JollaCaliforniaUnited States medical College of Wisconsin Cancer Center and Genomic Sciences and Precision medicine Center Medical College of WisconsinMilwaukeeWisconsinUnited States Department of Oncology Medical College of Wisconsin Cancer CenterMilwaukeeWisconsinUnited States Department of Oncology University of NebraskaOmahaNebraskaUnited States

4-1BB,a member of the tumor necrosis factor receptor superfamily,is an important co-stimulatory molecule regulating the activity of immune cells across a range of physiological and pathological processes,which culminates in a potent immune response(Figure 1A and B)[1,2].Numerous clinical trials have been conducted utilizing 4–1BB agonists(Supplemental Table S1);however,previous and ongoing 4-1BB agonist trials are being conducted without biomarker selection,which potentially explains their modest ***,several studies suggest the potential value of utilizing transcriptomics in addition to genomics to identify the unique immunologic signature of individual tumors[3–7].

关键词： clinical utilizing Figure

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CD8+T cell metabolic flexibility elicited by CD28-ARS2 axisdriven alternative splicing of PKm supports antitumor immunity

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Cellular & molecular Immunology 2024年第3期21卷 260-274页

作者： G.Aaron Holling Colin A.Chavel Anand P.Sharda mackenzie m.Lieberman Caitlin m.James Shivana m.Lightman jason H.Tong Guanxi Qiao Tiffany R.Emmons Thejaswini Giridharan Shengqi Hou Andrew m.Intlekofer Richard m.Higashi Teresa W.m.Fan Andrew N.Lane Kevin H.Eng Brahm H.Segal Elizabeth A.Repasky Kelvin P.Lee Scott H.Olejniczak Department of Immunology Roswell Park Comprehensive Cancer CenterBuffaloNY 14263USA Department of medicine Roswell Park Comprehensive Cancer CenterBuffaloNY 14263USA Human Oncology and Pathogenesis Program Memorial Sloan Kettering Cancer CenterNew YorkNY 10065USA Center for Environmental Systems Biochemistry Department of Toxicology and Cancer Biology and Markey Cancer CenterLexingtonKY 40536USA Department of Cancer Genetics and Genomics Roswell Park Comprehensive Cancer CenterBuffaloNY 14263USA Present address:University of Colorado Boulder BoulderCO 80309USA Present address:Dana Farber Cancer Institute BostonMA 02215USA Present address:massachusetts Institute of Technology BostonMA 02139USA Present address:melvin and Bren Simon Comprehensive Cancer Center Indiana University School of MedicineIndianapolisIN 46202USA

metabolic flexibility has emerged as a critical determinant of CD8+T-cell antitumor activity,yet the mechanisms driving the metabolic flexibility of T cells have not been *** this study,we investigated the influence of the nuclear cap-binding complex(CBC)adaptor protein ARS2 on mature T *** doing so,we discovered a novel signaling axis that endows activated CD8+T cells with flexibility of glucose ***2 upregulation driven by CD28 signaling reinforced splicing factor recruitment to pre-mRNAs and affected approximately one-third of T-cell activation-induced alternative splicing *** these effects,the CD28-ARS2 axis suppressed the expression of the m1 isoform of pyruvate kinase in favor of PKm2,a key determinant of CD8+T-cell glucose utilization,interferon gamma production,and antitumor effector ***,PKm alternative splicing occurred independently of CD28-driven PI3K pathway activation,revealing a novel means by which costimulation reprograms glucose metabolism in CD8+T cells.

关键词： Immunometabolism mRNA splicing CD8 T cells ARS2 PKm2

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Systematic Radio Telescope Alignment Using Portable Fringe Projection Profilometry

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Nanomanufacturing and metrology 2024年第1期7卷 75-85页

作者： Joel Berkson Justin Hyatt Nathan Julicher Byeongjoon Jeong Isaac Pimienta Rachel Ball Wyatt Ellis jason Voris Diego Torres‑Barajas Daewook Kim James C.Wyant College of Optical Sciences University of Arizona1630 E.University Blvd.TucsonAZ 85721USA Department of Astronomy at Steward Observatory University of Arizona933 N Cherry Ave.TucsonAZ 85721USA

In 2019,the Event Horizon Telescope(EHT)released the first-ever image of a black hole event *** are now aiming for higher angular resolutions of distant targets,like black holes,to understand more about the fundamental laws of gravity that govern our *** achieve this higher resolution and increased sensitivity,larger radio telescopes are needed to operate at higher frequencies and in larger *** like the next-generation Very Large Array(ngVLA)and the Square-Kilometer Array(SKA)require building hundreds of telescopes with diameters greater than 10 ms over the next *** has a twofold *** telescope surfaces need to be more accurate to operate at higher frequencies,and the logistics involved in maintaining a radio telescope need to be simplified to support them properly in large *** of these problems can be solved with improved methods for surface metrology that are faster and more accurate with a higher *** leads to faster and more accurate panel alignment and,therefore,a more productive *** this paper,we present the use of binocular fringe projection profilometry as a solution to this problem and demonstrate it by aligning two panels on a 3-m radio telescope *** measurement takes only 10 min and directly delivers feedback on the tip,tilt,and piston of each panel to create the ideal reflector shape.

关键词： metrology Fringe projection profilometry Off-axis alignment Radio astronomy Radio antenna

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观测约束下的煤矿区吸光气溶胶特性模拟研究

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光学学报 2024年第18期44卷 253-263页

作者：关萝尧 Cohen jason Blake 秦凯王硕 Tiwari Pravash 中国矿业大学环境与测绘学院中国矿业大学碳中和研究院

利用黑碳仪、光学粒度仪和太阳光度计在山西省长治市煤矿区开展连续实地观测，结合“核-壳”假设下的米散射模型，对煤矿区吸光气溶胶光学特性进行建模，提出一种基于多源地基观测快速反演吸光气溶胶单次散射反照率（SSA）的方法，并通... 详细信息

利用黑碳仪、光学粒度仪和太阳光度计在山西省长治市煤矿区开展连续实地观测，结合“核-壳”假设下的米散射模型，对煤矿区吸光气溶胶光学特性进行建模，提出一种基于多源地基观测快速反演吸光气溶胶单次散射反照率（SSA）的方法，并通过使用吸收Angstrom指数对模拟结果进行约束，分析了不同混合状态下吸光气溶胶光学特性的变化规律。结果表明：1）煤矿区吸光气溶胶粒径分布与污染条件相关，重度污染条件下粒径较大，中度污染条件下粒径较小，其中不同污染条件均在0.28～0.3μm等较小粒径区间内存在峰值，这表明排放源对粒径分布有重要影响；2）基于“核-壳”假设的米散射模型可以模拟不同混合状态下吸光气溶胶的SSA，以440 nm粒径为例，在均匀假设下SSA为0.43～0.72，在非均匀假设下SSA为0.41～0.65，这表明使用多波段、多粒径信息可以更准确地获取吸光气溶胶光学特性；3）吸收Angstrom指数只能在部分粒径区间与SSA相匹配，且无法应用至较大粒径区间，表明通过吸收Angstrom指数评估吸光气溶胶SSA的方法会产生偏差，应综合考虑粒径分布、混合状态和波长对其产生的影响。

关键词：单次散射反照率吸光气溶胶米散射模型煤矿区

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Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIGHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： jason Philip Appleton Lisa J Woodhouse Craig S Anderson Sandeep Ankolekar Lesley Cala mark Dixon Timothy J England Kailash Krishnan Grant mair Keith W muir John Potter Christopher I Price marc Randall Thompson G Robinson Christine Roffe Else C Sandset Jeffrey L Saver Angela Shone Aloysius Niroshan Siriwardena Joanna m Wardlaw Nikola Sprigg Philip m Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George Institute China at Peking University Health Science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for Clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and Comprehensive Stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate Services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-Lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or mann-Whitney difference(mWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(mWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** IS ALREADY KNOWN ON THIS TOPIC⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those w

关键词： Glasgow nitrate random

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Stereotactic radiosurgery for haemorrhagic cerebral cavernous malformation:a multi-institutional,retrospective study

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Stroke & Vascular Neurology 2024年第3期9卷 221-229,I0130,I0131页

作者： Chloe Dumot Georgios mantziaris Sam Dayawansa Zhiyuan Xu Stylianos Pikis Selcuk Peker Yavuz Samanci Gokce D Ardor Ahmed m Nabeel Wael A Reda Sameh R Tawadros Khaled Abdelkarim Amr m N El-Shehaby Reem m Emad Eldin Ahmed H Elazzazi Nuria martínez moreno Roberto martínezÁlvarez Roman Liscak Jaromir may David mathieu Jean-Nicolas Tourigny manjul Tripathi Akshay Rajput Narendra Kumar Rupinder Kaur Piero Picozzi Andrea Franzini Herwin Speckter Wenceslao Hernandez Anderson Brito Ronald E Warnick Juan Alzate Douglas Kondziolka Greg N Bowden Samir Patel jason Sheehan Department of Neurological Surgery Hospices Civils de LyonLyonFrance Department of Neurological Surgery University of VirginiaCharlottesvilleVirginiaUSA Department of Neurosurgery Koc University School of MedicineIstanbulTurkey Gamma-knife Center Nasser institute HospitalCairoEgypt Neurosurgery Department Benha UniversityBenhaEgypt Departments of Neurosurgery Ain Shams UniversityCairoEgypt Department of Clinical Oncology Ain Shams UniversityCairoEgypt Department of Radiation Oncology National Cancer InstituteCairo UniversityGizaEgypt Faculty of medicine Extended Modular ProgramAin Shams UniversityCairoEgypt Department of Radiosurgery Rúber Internacional HospitalMadridSpain Department of Stereotactic and Radiation Neurosurgery Na Homolce HospitalPragueCzech Republic Neurosurgery Centre de recherche du CHUSUniversitéde SherbrookeSherbrookeQuebecCanada Neurosurgery PGIMERChandigarhChandigarhIndia Radiation Therapy PGIMERChandigarhChandigarhIndia Neurosurgery IRCCS Istituto Clinico HumanitasRozzanoMilanItaly Dominican Gamma Knife Center and Radiology Department CEDIMATSanto DomingoDominican Republic Gamma Knife Center Mayfield ClinicThe Jewish Hospital-Mercy HealthCincinnatiOhioUSA Neurosurgery NYU Langone HealthNew YorkNew YorkUSA Neurosurgery University of AlbertaEdmontonAlbertaCanada Division of Radiation Oncology Department of OncologyUniversity of AlbertaEdmontonAlbertaCanada

Background Cerebral cavernous malformations(CCms)frequently manifest with *** radiosurgery(SRS)has been employed for CCm not suitable for *** effect on reducing haemorrhage risk is still *** aim of this study was to expand on the safety and efficacy of SRS for haemorrhagic *** This retrospective multicentric study included CCm with at least one haemorrhage treated with single-session *** annual haemorrhagic rate(AHR)was calculated before and after *** event analysis and Cox regression were used to evaluate factors associated with *** radiation effects(AREs)and occurrence of new neurological deficits were *** The study included 381 patients (median age:37.5 years(Q1–Q3:25.8–51.9))with 414 *** AHR from diagnosis to SRS excluding the first haemorrhage was 11.08 per 100 CCm-years and was reduced to 2.7 per 100 CCm-years after *** recurrent event analysis,SRS,HR 0.27(95%CI 0.17 to 0.44),pmorrhage,and the presence of developmental venous anomaly(DVA)with an increased risk,HR 1.60(95%CI 1.07 to 2.40),p=*** cumulative risk of first haemorrhage after SRS was 9.4%(95%CI 6%to 12.6%)at 5 years and 15.6%(95%CI%9 to 21.8%)at 10 *** doses>13 Gy,HR 2.27(95%CI 1.20 to 4.32),p=0.012 and the presence of DVA,HR 2.08(95%CI 1.00 to 4.31),p=0.049 were factors associated with higher probability of post-SRS ***-SRS haemorrhage was symptomatic in 22 out of 381(5.8%)patients,presenting with transient(15/381)or permanent(7/381)neurological *** occurred in 11.1%(46/414)CCm and was responsible for transient neurological deficit in 3.9%(15/381)of the patients and permanent deficit in 1.1%(4/381)of the *** doses>13 Gy and CCm volume>0.7 cc were associated with increased risk of ARE.

关键词： doses haemorrhagic diagnosis

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