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The effectiveness of single-session gamma knife radiosurgery (GKRS) for small metastatic brain tumors has been proven, but hypofractionated GKRS (hfGKRS) for large brain metastases (BM) from the linear quadratic (LQ) model is uncertain. The purpose of this study was to investigate volume changes large BM after hfGKRS from the LQ model and predict volume changes using artificial neural network (ANN). We retrospectively investigated the clinical findings of 28 patients who underwent hfGKRS with large BM (diameter >3 cm or volume >10 cc). A total of 44 tumors were extracted from 28 patients with features. We randomly divided 30 large brain tumors as training set and 14 large brain tumors as test set. To predict the volume changes after hfGKRS, we used ANN models (single-layer perceptron (SLP) and multi-layer perceptron (MLP)). The volume reduction was 96% after hfGKRS for large BM from the LQ model. ANN model predicted volume changes with 70% and 80% accuracy for SLP and MLP, respectively. Even in large BM, hfGKRS from the LQ model could be a good treatment option. Additionally, the MLP model could predict volume changes with 80% accuracy after hfGKRS for large BM.
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http://dx.doi.org/10.1097/MD.0000000000030964 | DOI Listing |
Br J Anaesth
September 2025
Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, WA, Australia; Division of Emergency Medicine, Anaesthesia and Pain Medicine, The University of Western Australia, Perth, WA, Australia; Institute for Paediatric Perioperative Excellence, The University of Western Austr
Background: Obstructive sleep apnoea (OSA) has been thought to increase the risk of respiratory depression from opioids. The primary aim of this study was to assess whether preoperative hypoxaemia by sleep study pulse oximetry imparts greater opioid sensitivity.
Methods: A multicentre observational cohort study with in-cohort dose randomisation was performed in children 2-8 yr of age with OSA undergoing adenotonsillectomy.
J Cardiol
September 2025
Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Epidemiology, Disease Control, and Prevention, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan. Electronic address:
Background: Guidelines recommend biomarker-based screening for pre-heart failure (pre-HF) among at-risk populations. Although the asymptomatic nature of pre-HF necessitates proactive screening, real-world implementation remains understudied. This retrospective study analyzed data from a regional pre-HF screening initiative, integrated into annual health screenings, to evaluate: (1) the prevalence of elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, (2) associated echocardiographic findings, and (3) adherence across the screening-to-consultation pathway.
View Article and Find Full Text PDFLancet Respir Med
September 2025
Effi-Stat, Paris, France.
Background: Among people with cystic fibrosis, sweat chloride and lung function response to elexacaftor-tezacaftor-ivacaftor (ETI) is variable. We hypothesised that the presence of two versus one ETI-responsive CFTR variant could predict response variability.
Methods: In this analysis of two real-world observational studies, data from a French national cohort of adults (aged ≥18 years) with cystic fibrosis and at least one F508del variant treated with ETI and the French compassionate programme for ETI in people (aged ≥6 years) with cystic fibrosis without F508del were used to examine sweat chloride concentrations (SCCs) after ETI initiation, and the absolute change in SCC and percentage of predicted forced expiratory volume in 1 s (ppFEV) following ETI initiation.
Sports Med
September 2025
Harvard Medical School, Boston, USA.
Background: Physical training influences competitive marathon performance, including training volume and training frequency changes (TFCs) pre-race. Training intensity distribution (i.e.
View Article and Find Full Text PDFHealth Serv Res
September 2025
Division of Clinical Informatics and Digital Transformation, Director, Center for Clinical Informatics and Improvement Research, University of California - San Francisco, San Francisco, CA, San Francisco, California, USA.
Objective: To analyze national rates of team-based ordering and evaluate changes in key outcomes following adoption.
Study Setting And Design: We conducted an observational pre-post intervention-comparison study of 249,463 ambulatory physicians across 401 organizations using the Epic EHR. Our intervention was the adoption of team-based ordering, measured as the proportion of orders involving team support.