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Rotavirus (RV) vaccines have demonstrated substantial effectiveness in reducing the healthcare burden caused by gastroenteritis (RVGE) worldwide. This study aims to understand the differential impact of RV vaccination in reducing RVGE burden in children under 7 years old in China. A Markov Model was used to investigate the health impact of introducing two different RV vaccines into the Chinese population. The analysis was conducted for RV5, a live pentavalent human-bovine reassortant vaccine, and Lanzhou Lamb RV (LLR), a live-attenuated monovalent RV vaccine, separately, by comparing the strategy of each vaccine to no vaccination within a Chinese birth cohort, including 100,000 children modeled until 7 years of age. The vaccination scenario assumed a vaccination coverage of 2.5%, 2.5%, 90% and 5% for doses one, two, three and no vaccine, respectively, for both vaccines. Strategies with RV5, LLR, and no vaccination were associated with 9,895, 49,069, and 64,746 symptomatic RV infections, respectively. RV5 and LLR were associated with an 85% and 24% reduction in the total symptomatic RV infections, respectively, suggesting that the health benefits of RV5 are at least three-fold greater than those associated with the LLR. Further, strategies with RV5 and LLR resulted in an estimated 206 and 59-year increase in quality-adjusted life years (QALYs), respectively. Sensitivity and scenario analyses supported the robustness of the base-case findings. Use of RV vaccine is expected to improve RV-associated health outcomes and its adoption will help alleviate the burden of RVGE in China. RV5 use will result in significantly better health outcomes.

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BACKGROUND: Nipple-sparing mastectomy (NSM) and skin-sparing mastectomy (SSM) are challenging for surgical training among fellow trainees. We developed a surgical training course with novel concept of breast modular resection (BMR) for NSM/SSM procedure, and performed this study to investigate whether BMR could improve surgical outcomes compared to classical procedure resection (CPR). METHODS: The records of 105 breast cancer patients undergoing NSM/SSM with immediate reconstruction performed by fellow trainees were reviewed. Clinicopathological characteristics and surgical outcomes were compared between 2 groups. Laser speckle contrast imaging (LSCI) was performed to intraoperatively evaluate the blood supply of the NAC, and the absolute perfusion unit (PU) values and relative perfusion unit (rPU) values were further compared. RESULTS: Surgical training outcomes of BMR group (N = 52) were insignificantly improved compared to CPR group (N = 53). The rates of NAC necrosis, flap necrosis and implant removal all reduced respectively. Among the 60 NSM patients, the blood loss (P = .011) and surgery time (P < .001) was significantly reduced in BMR group (N = 30) and all the other outcomes were insignificantly improved. Both the absolute PU values and rPU values were significantly higher among patients without NAC necrosis (P < .001). The absolute PU values were significantly higher in BMR group (P = .002). CONCLUSION: Compared to CPR, the BMR-based surgical training course for NSM demonstrated the reduction in complications and operating time, offering a potential streamlined, efficient, and safe method for NSM procedure. LSCI was effective for intraoperative visualized evaluation of NAC blood supply and could provide effective real-time feedback for fellow trainees.

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The selection of photoactive materials and the design of device structures are critical to the photoelectronic performance of photodetectors. This study reports on a vertically structured photodetector device with rapid, stable, and efficient photoelectric performance across the UV-visible broadband range based on the Si++/SiO2/Au/single-layer graphene/CsPbI3 quantum dots (QDs) configuration. In this specific device structure, a relatively high conductivity Si++/SiO2 wafer was used as the substrate, a CsPbI3 QD film with high light absorption was used as the photoactive layer, and a monolayer graphene with high conductivity was inserted between the substrate and the CsPbI3 QD film to form a heterojunction with the QD film. Based on the Frenkel-Poole emission effect arising from the high trap state density within the SiO2 layer, the device exhibited excellent photoelectric performances. Especially at a wavelength of 365 nm, a photocurrent responsivity of 2319 A/W, a specific detectivity of 1.15 × 1014 Jones, an external quantum efficiency of 7883%, and an on/off time of 39/36 ms at a Si++ terminal voltage of -80 V and an optical power density of 84.03 nW/cm2 can be achieved.

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Background: Breast cancer stands as a globally significant contributor to both incidence rates and mortality among women. Approximately 10-15 % of women will face a diagnosis of an advanced yet potentially treatable stage of the disease. When individuals diagnosed with locally advanced breast cancer (LABC) exhibit resistance to preoperative chemotherapy and experience tumor progression, they unfortunately forfeit the opportunity for surgical intervention, thereby diminishing the prospects for a radical cure. Method: We conducted a prospective, single-arm cohort study aimed at evaluating the feasibility of locally modified radical resection for LABC with skin invasion. The primary endpoints encompassed overall survival (OS) and disease-free survival (DFS), whereas the secondary endpoint focused on the quality of life (QoL) among breast cancer patients. Results: Between March 2018 and December 2022, a total of 38 eligible patients were enrolled in this study. The Kaplan-Meier estimates for 1-year, 3-year, and 5-year DFS among all patients were 69.8 %, 53.3 %, and 37.5 %, respectively. Correspondingly, the OS rates were 100.0 %, 85.6 %, and 68.0 %. Both univariate and multivariate analyses revealed that patients with a history of neoadjuvant chemotherapy who exhibited stable or progressive disease had inferior DFS outcomes. Notably, patients demonstrated clinically meaningful and statistically significant enhancements in functional status and overall QoL. However, no notable improvement was observed in specific symptom domains. Conclusion: Patients with locally advanced breast cancer, specifically those presenting with T4 tumors, who undergo surgical intervention followed by postoperative adjuvant therapy, can attain favorable prognostic outcomes and experience an enhanced quality of life.

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Guanine deaminase (GD)plays important roles in the diagnosis of liver function. However, there is no totally rapid and simple for the eatimation of GD activity in clinical application. Herein, we have constructed an enzymatic assay system with highly sensitive and strong stability for quantification of GD activity by highly double enzyme-coupling (xanthine oxidase and uric acid oxidase) and adding compound stabilizer in GD kit. In this study, we validated parameters, including reagent blank, sensitivity, accuracy, inter-batch difference, intra-batch difference, linear range. Furthermore, composite stabilizers, containing gentamicin sulfate, bovine serum albumin, and mannitol, were selected to improve stability of GD kit during long-term storage. The experimental results showed that the absorbance of the reagent blank was <0.2, the mean recovery rate was 103 %, the inter-batch and intra-batch diffeerence were <15 %, The linearity range was 0 U/L-50 U/L (R2 > 0.99). All indicators met the kit requirements for clinical applications. When gentamicin sulfate, bovine serum albumin, and mannitol were used as a stabilizer, the kit remained stable for 12 months without significant loss of enzymatic activity. These results indicated that GD kit possesses high sensitivity and strong stability, which can be used for routine biochemical applications and is of great significance for the diagnosis and differential diagnosis of liver diseases.

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Uncontrolled bleeding and excessive blood loss stand as the leading causes of death in complex surgeries, civilian traumas, and military operations. Sponges have been used for developing efficiency hemostats, but most commonly used hemostatic sponges possess only one single coagulation mechanism or lack inherent blood clotting ability. Herein, we proposed simple yet innovative approaches for creating novel hemostatic composite sponges with dual hemostatic effects. Bacterial cellulose (BC) was first introduced into polyvinyl alcohol (PVA) matrix to develop a BC/PVA (CP) sponge featuring a unique cellulose-embedded porous network structure and desirable properties. Subsequently, thrombin was immobilized on CP through an easy method that combines physical adsorption and covalent binding to fabricate thrombin-carrying CP (TCP) composite sponges. The resulting composites boasted a highly porous structure, outstanding liquid-absorption capacity, low hemolysis rate, and superior biocompatibility. In vitro clotting tests revealed that TCP displayed potent coagulation capabilities, a rapid blood absorption rate, and the ability to stimulate and activate blood components along with the coagulation cascade. In vivo hemostatic assessments further confirmed that TCP offered high hemostatic efficiency and multifaceted hemostatic effects, making it suitable for the management of acute and severe bleeding.

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Objective.Steady-state visual evoked potentials (SSVEPs) in response to flickering stimuli are popular in brain-computer interfacing but their implementation in virtual reality (VR) offers new opportunities also for clinical applications. While traditional SSVEP target selection relies on single-frequency stimulation of both eyes simultaneously, further called congruent stimulation, recent studies attempted to improve the information transfer rate by using dual-frequency-coded SSVEP where each eye is presented with a stimulus flickering at a different frequency, further called incongruent stimulation. However, few studies have investigated incongruent multifrequency-coded SSVEP (MultiIncong-SSVEP).Approach.This paper reports on a systematical investigation of incongruent dual-, triple-, and quadruple-frequency-coded SSVEP for use in VR, several of which are entirely novel, and compares their performance with that of congruent dual-frequency-coded SSVEP.Main results.We were able to confirm the presence of a summation effect when comparing monocular- and binocular single-frequency congruent stimulation, and a suppression effect when comparing monocular- and binocular dual-frequency incongruent stimulation, as both tap into the binocular vision capabilities which, when hampered, could signal amblyopia.Significance.In sum, our findings not only evidence the potential of VR-based binocularly incongruent SSVEP but also underscore the importance of paradigm choice and decoder design to optimize system performance and user comfort.

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BACKGROUND: With the aging population, the increasing prevalence of chronic non-communicable diseases, and the diversified needs for primary health care (PHC) medicines, it is necessary to rethink the functional role of the supply of PHC medicines. This study aims to evaluate the supply of PHC medicines and the status of meeting PHC medicine needs. METHODS: The mixed-methods study was conducted to evaluate the supply of PHC medicines in Shandong Province. In the quantitative study, survey questionnaires were distributed to county hospitals, township hospitals, and patients, and a prescription review was performed in township hospitals. In the qualitative study, semi-structured interviews were conducted with the pharmacy managers, physicians, and patients in county hospitals, township hospitals, and village clinics. A senior pharmacist from a tertiary hospital who has rich experience on the indications for medicine use, accompanied us on a visit to inspect the PHC pharmacies to survey medicine equipment with a professional perspective. RESULTS: Quantitative analysis revealed that 211 county hospitals and 1,581 township hospitals participated in the survey, revealing the median annual frequency of medicine shortages of 5.0 times for county hospitals and 2.0 times for township hospitals. Of the 6,323 patient medication surveys, after excluding 152 patients not involved in medication use, 945 (15.3%) indicated medicine shortages, with half of these attributable to institutions lacking required medicines (52.8%). On average, the prescription qualified rate of 37 township hospitals was 72.2%. Four final themes emerged during the qualitative data analysis: (1) Supply of PHC medicines; (2) Solutions to the shortage of off-list medicines; (3) Appropriateness of PHC medicines list; (4) Pharmacist workforce development and pharmacy services. CONCLUSIONS: The discrepancy between patients' need for PHC medicine and present medicine supply is noteworthy. It is suggested that governments should optimize the existing lists to adequately meet patient medicine needs and prioritize medicines for chronic diseases, which is also particularly important for developing countries. Integrated health care may be a novel strategy to establish unified medicines list and achieve uniform pharmaceutical services in PHC.

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It has been a long-standing challenge to develop high-performance solid-state hydrogen storage materials operated under near-ambient conditions. In this work, we propose a new strategy of using noble gases for space holding to design porous titanium carbides with abundant open metal sites for hydrogen storage. By using machine learning and graph theory-assisted universal structure searching methods, we obtain 28 porous titanium carbides from three precursors (TiC dimer, C atom, and Kr atom) under 30 GPa of pressure. The stability and hydrogen storage performance of the resulting structures are further assessed and validated through density function theory and grand canonical Monte Carlo simulations with a DFT-fitted force field. Finally, p-TiC2 is identified as a promising quasi-molecular hydrogen storage material with capacity of 4.0 wt % and 106.0 g/L at 230 K and 16 bar.

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Soil degradation, characterized by the deterioration of soil physical and chemical properties, nutrient loss, and an increase in toxic substances, is a key ecological concern in mining activities. This study explores the use of waste black shale from mining development as an additive to loess to enhance soil properties for reclamation in mining areas. The research includes resistivity and organic carbon content tests on modified reclaimed loess with varying black shale and water contents. Additionally, the electrical properties of these modified soils are investigated across different AC frequencies. The results highlight the significance of soil plasticity and a 1.5% black shale content in influencing reclaimed loess's electrical properties. Moisture content and black shale influence changes in soil conductive paths and resistivity. The abundance of clay minerals in black shale plays a crucial role in altering soil electrical resistivity due to the adsorption of cations in water and the directional transport under an electric field. Considering soil's three-phase composition and diffuse bilayer structure, the study elucidates the mechanism behind changes in the electrical properties of improved reclaimed loess, accounting for water and black shale content. This research demonstrates the feasibility of using black shale as a soil additive and emphasizes the non-destructive assessment potential of electrical resistivity test (ERT) measurements for modified reclaimed soils.

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Locally advanced breast cancer (LABC) is challenging with limited treatment options. This study investigates the feasibility and long-term outcomes of upfront surgery compared to neoadjuvant chemotherapy (NAC) in a real-world cohort. This retrospective study analyzed 243 inoperable LABC patients (excluding T3N1M0) that underwent upfront surgery (n = 187) or NAC (n = 56) in matched groups. Disease-free survival (DFS) and overall survival (OS) are primary outcomes. Secondary outcomes included NAC response rate and subgroup analyses based on age, tumor stage, and treatment response. Survival was estimated using Kaplan-Meier methods with log-rank tests for comparisons. Cox proportional hazards models were used for subgroup analyses. With a median follow-up of 60.9 months, no significant difference emerged in 5-year OS (upfront surgery: 89.6%, NAC: 81.9%, p = .12) or 5-year DFS rates (73.0% vs. 67.1%, p = .24). Subgroup analyses revealed upfront surgery offered significantly better OS for patients under 60 (HR = 0.32; 95% CI: 0.10-0.96; p = .0429) and stage IIIA disease (HR = 0.22; CI: 0.06-0.86; p = .03). Upfront surgery showed a trend towards improved OS for tumors under 5 cm (HR = 0.37; 95% CI: 0.13-1.03; p = .056). Patients with progressive disease (PD) or stable disease (SD) after NAC had significantly worse DFS (HR = 0.27; 95% CI: 0.09-0.79; p = .017) and OS (HR = 0.09; 95% CI: 0.02-0.48; p = .004) compared to responders. Upfront surgery may be viable for LABC patients, particularly younger patients, those with stage IIIA disease, or smaller tumors. NAC response can inform treatment decisions. These findings highlight the need for personalized LABC treatment considering patient characteristics and NAC response.

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Alzheimer's disease (AD) is the most common form of neurodegeneration which currently has no effective treatment. Ferroptosis is a new style of programmed cell death and is widely implicated in the pathogenesis and progression of AD. Decursin has been shown widely neuroprotective effects but poorly understood about the underlying mechanisms between decursin and ferroptosis in AD. Here, the protective effect of decursin and the underlying mechanism under glutamate treatment in SH-SY5Y cells was investigated. SH-SY5Y cells were cultured with glutamate in the presence or absence of decursin. The safe concentrations of decursin on SH-SY5Y cells were measured via CCK-8. Furthermore, LDH content, antioxidant enzyme activities including GPx, CAT and SOD, MDA contents, GSH levels, ROS formation, MMP, mitochondria ultrastructure morphology change, and intracellular Fe2+ levels were measured to investigate the influence of decursin and Fer-1 on ferroptosis in glutamate-treated SH-SY5Y cells. Moreover, the expressions of ferroptosis-related proteins were determined by Western blot. As a result, glutamate-induced cell survival was markedly elevated and morphological change was improved by decursin administrated in SH-SY5Y cells. Furthermore, decursin could reversed the decreased antioxidant enzyme activities, GSH levels, GPX4n and FTH1 expression, as well as the increased iron levels, LDH, MDA, ROS formation, and MMP, which showed similar effects to Fer-1, the specific ferroptosis inhibitor. Therefore, the inhibitory effect of decursin on ferroptosis probably was partially governed by FTH1 expression to regulate the cellular iron homeostasis. Additionally, decursin facilitated the translocation of Nrf2 from the cytoplasm to the nucleus. Taken together, our data for the first time suggest that decursin could ameliorate neurotoxicity induced by glutamate by attenuating ferroptosis via alleviating cellular iron levels by up-regulating FTH1 expression which is attributing to its promotion of Nrf2 translocation into the nucleus in SH-SY5Y neuroblastoma cells. Hence, decursin might be a novel and promising therapeutic option for AD. In addition, our study also provided some new clues to potential target for the intervention and therapy of AD.

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OBJECTIVE: Various population pharmacokinetic (PPK) models have been established to help determine the appropriate dosage of docetaxel, however, no clear consensus on optimal dosing has been achieved. The purpose of this study is to perform an external evaluation of published models in order to test their predictive performance, and to find an appropriate PPK model for Chinese breast cancer patients. METHODS: A systematic literature search of docetaxel PPK models was performed using PubMed, Web of Science, China National Knowledge Infrastructure, and WanFang databases. The predictive performance of eleven identified models was evaluated using prediction-based and simulation-based diagnostics on an independent dataset (112 docetaxel concentrations from 56 breast cancer patients). The -2×log (likelihood) and Akaike information criterion were also calculated to evaluate model fit. RESULTS: The median prediction error of eight of the eleven models was less than 10%. The model fitting results showed that the three-compartment model of Bruno et al. had the best prediction performance and that the three compartment model of Wang et al. had the best simulation effect. Furthermore, although the covariates that significantly affect PK parameters were different between them, seven models demonstrated that docetaxel PK parameters were influenced by liver function. CONCLUSIONS: Three compartment PPK models may be predictive of optimal docetaxel dosage for Chinese breast cancer patients. However, for patients with impaired liver function, the choice of which model to use to predict the blood concentration of docetaxel still requires great care.

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Objectives: This study aimed to assess and compare the effect of an 8-week high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT) programme on body composition and cardiovascular metabolic outcomes of sedentary adolescents in China. Methods: Eighteen sedentary normal-weight adolescents (age: 18.5 ± 0.3 years, 11 females) were randomized into three groups. HIIT group protocol consisted of three sessions/week for 8-week of "all out" sprints to reach 85%-95% of HRmax, and MICT group protocol undertook three sessions/week for 8-week of continuous running to reach 65%-75% of HRmax. The control group resumed normal daily activities without any intervention. Blood pressure and body composition were measured, and fasting blood samples were obtained at baseline and 48 h post-trial. Mixed-design ANOVA analysis was employed followed by post hoc t-tests and Bonferroni alpha-correction was used to evaluate interaction, between-group, and within-group differences, respectively. Results: Results indicated that HIIT and MICT similarly affected body fat mass (p = 0.021, ES = 0.19; p = 0.016, ES = 0.30, respectively), body fat percentage (p = 0.037, ES = 0.17; p = 0.041, ES = 0.28, respectively), visceral fat area (p = 0.001, ES = 0.35; p = 0.003, ES = 0.49, respectively) of body composition. A positive outcome was observed for waist/hip ratio (p = 0.033, ES = 0.43) in HIIT, but not MICT (p = 0.163, ES = 0.33). No significant differences were found between groups for any clinical biomarkers. However, pairwise comparison within the group showed a significant decrease in systolic blood pressure (p = 0.018, ES = 0.84), diastolic blood pressure (p = 0.008, ES = 1.76), and triglyceride (p = 0.004, ES = 1.33) in HIIT, but no significant differences were found in the MICT and Control group. Conclusion: Both 8-week HIIT and MICT programmes have similar positive effects on reducing body fat mass, fat percentage, and visceral fat area. However, sedentary adolescents may have limited scope to decrease insulin resistance after these 8-week interventions. Notably, the 8-week HIIT intervention was highly effective in increasing cardiometabolic health compared to the MICT. The exercise intensity threshold value and metabolic outcomes of high-intensity interval sprints should be explored further to extend the long-term benefit in this cohort.

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Enteroviruses (EVs and RVs) are prevalent worldwide and cause various diseases in humans, of which the VP1-pocket is a target of antivirals, with a lipid molecule as a pocket factor to stabilize the virion. However, the characterization of the structure of the VP1-pocket in EVs is poor. Here, we compared the published capsid crystals of EVs and RVs and proposed a structural framework for the VP1-pocket: Frame 1-4, which is located at the CD loop, GH loop, and C-terminus, presenting with an outward opening appearance or not. The non-outward viral strains-CVB3, Echo 11, RV-A81, and RV-B70-are more thermally stable, with a breakpoint temperature (B.T.) of 51~62 °C for genome releasing, which is 4~10 °C higher than its outward temperature of 41~47 °C, and infectivity preservation when treated at 50 °C for 3 min. Its outward versus non-outward opening is correlated significantly with the B.T. for genome release (r = -0.90; p = 0.0004) and infectivity (r = -0.82, p = 0.0039). The energy of Frames 1, 2, and 4, including Van der Waals attractive and repulsive interactions and hydrogen bonds, showed significant correlations with the B.T. (r = -0.67, 0.75, and -0.8; p = 0.034, 0.013, and 0.006, respectively). These characters of the VP1-pocket could be predictors for virion thermostability and aid in the development of vaccines or antivirals.

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In this study, two types of composites, polybutylene terephthalate (PBT) and epoxy resin (ER), reinforced with 20% of glass fiber (GF) are used as the comparative research objects. Their mechanical properties after thermal aging at 85~145 °C are evaluated by tensile strength and fracture morphology analysis. The results show that the composites have similar aging laws. The tensile strength of GF/PBT and GF/ER decrease gradually with the increase of aging temperature, while their elastic moduli are independent of the thermal treatment temperature. Scanning electron microscopy study of the fracture surface shows that separation of glass fiber from PBT and ER matrix becomes more obvious at higher aging temperature. The fibers on the matrix surface appear clear and smooth, and the whole pulled out GFs can be observed. As a main mechanical strength degradation mechanism, the deterioration of interface adhesion between the matrix and GF is discussed. A large difference in coefficients of thermal expansion of the matrix and GF is a main factor of the mechanical degradation.

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With the rapid development of modern industry, it is urgently needed to measure the biotoxicity of complex chemicals. Microbial electrochemical biotoxicity sensors are an attractive technology; however, their application is usually limited by their stability and reusability after measurements. Here, we improve their performance by encapsulating the electroactive biofilm with polydopamine (PDA), and we evaluate the improvement by different concentrations of heavy metal ions (Cu2+, Ag+, and Fe3+) in terms of inhibition ratio (IR) and durability. Results indicate that the PDA-encapsulated sensor exhibits a more significant detection concentration than the control group, with a 3-fold increase for Cu2+ and a 1.5-fold increase for Ag+. Moreover, it achieves 15 more continuous toxicity tests than the control group, maintaining high electrochemical activity even after continuous toxicity impacts. Images from a confocal laser scanning microscope reveal that the PDA encapsulation protects the activity of the electroactive biofilm. The study, thus, demonstrates that PDA encapsulation is efficacious in improving the performance of microbial electrochemical biotoxicity sensors, which can extend its application to more complex media.

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Broadband photodetectors that can decipher the wavelength (λ) and intensity (I) of an unknown incident light are urgently demanded. Photothermoelectric (PTE) detectors can achieve ultrabroadband photodetection surpassing the bandgap limitation; however, their practical application is severely hampered by the lack of deciphering strategy. In this work, we report a variable elimination method to decipher λ and I of the incident lights based on an integrated Ag2Se film-based PTE detector. Nanostructured Ag2Se films with controlled thickness are synthesized using an ion sputtering of Ag and a room-temperature selenization method and then assembled into a detector. Under identical illumination, Ag2Se films of different thicknesses produce varying output photothermal voltages, influenced by factors including λ. By establishing a direct relationship between the photothermal voltage and the absorption of Ag2Se films of varied thickness, we successfully eliminate variables independent of λ, thus determining λ. Subsequently, I is determined by the calibrated responsivity relationship using obtained λ. Our PTE detector achieves a broadband spectrum from 400 to 950 nm and high accuracy, with deviations as low as ∼2.63 and ∼0.53% for deciphered λ and I, respectively. This method allows for self-powered broadband decipherable photodetection without a complex device architecture or computational assistance, which could boost the research enthusiasm and promote the commercialization of PTE broadband detectors.

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PURPOSE: A practical noninvasive method is needed to identify lymph node (LN) status in breast cancer patients diagnosed with a suspicious axillary lymph node (ALN) at ultrasound but a negative clinical physical examination. To predict ALN metastasis effectively and noninvasively, we developed an artificial intelligence-assisted ultrasound system and validated it in a retrospective study. METHODS: A total of 266 patients treated with sentinel LN biopsy and ALN dissection at Peking Union Medical College & Hospital(PUMCH) between the year 2017 and 2019 were assigned to training, validation and test sets (8:1:1). A deep learning model architecture named DeepLabV3 + was used together with ResNet-101 as the backbone network to create an ultrasound image segmentation diagnosis model. Subsequently, the segmented images are classified by a Convolutional Neural Network to predict ALN metastasis. RESULTS: The area under the receiver operating characteristic curve of the model for identifying metastasis was 0.799 (95% CI: 0.514-1.000), with good end-to-end classification accuracy of 0.889 (95% CI: 0.741-1.000). Moreover, the specificity and positive predictive value of this model was 100%, providing high accuracy for clinical diagnosis. CONCLUSION: This model can be a direct and reliable tool for the evaluation of individual LN status. Our study focuses on predicting ALN metastasis by radiomic analysis, which can be used to guide further treatment planning in breast cancer.

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