Data-driven classification of left atrial morphology and its predictive impact on atrial fibrillation catheter ablation.

INTRODUCTION: Various left atrial (LA) anatomical structures are correlated with postablative recurrence for atrial fibrillation (AF) patients. Comprehensively integrating anatomical structures, digitizing them, and implementing in-depth analysis, which may supply new insights, are needed. Thus, we aim to establish an interpretable model to identify AF patients' phenotypes according to LA anatomical morphology, using machine learning techniques. METHODS AND RESULTS: Five hundred and nine AF patients underwent first ablation treatment in three centers were included and were followed-up for postablative recurrent atrial arrhythmias. Data from 369 patients were regarded as training set, while data from another 140 patients, collected from different centers, were used as validation set. We manually measured 57 morphological parameters on enhanced computed tomography with three-dimensional reconstruction technique and implemented unsupervised learning accordingly. Three morphological groups were identified, with distinct prognosis according to Kaplan-Meier estimator (p < .001). Multivariable Cox model revealed that morphological grouping were independent predictors of 1-year recurrence (Group 1: HR = 3.00, 95% CI: 1.51-5.95, p = .002; Group 2: HR = 4.68, 95% CI: 2.40-9.11, p < .001; Group 3 as reference). Furthermore, external validation consistently demonstrated our findings. CONCLUSIONS: Our study illustrated the feasibility of employing unsupervised learning for the classification of LA morphology. By utilizing morphological grouping, we can effectively identify individuals at different risks of postablative recurrence and thereby assist in clinical decision-making.

Broadband coherent modulation imaging with no knowledge of the illumination spectrum distribution: publisher's note.

This publisher's note contains a correction to Opt. Lett.48, 3977 (2023)10.1364/OL.495706.

In Situ Test and Numerical Analysis of the Subway-Induced Vibration Influence in Historical and Cultural Reserves.

Although the rapid expansion of urban rail transit offers convenience to citizens, the issue of subway vibration cannot be overlooked. This study investigates the spatial distribution characteristics of vibration in the Fayuan Temple historic and cultural reserve. It involves using a V001 magnetoelectric acceleration sensor capable of monitoring low amplitudes with a sensitivity of 0.298 V/(m/s2), a measuring range of up to 20 m/s2, and a frequency range span from 0.5 to 100 Hz for in situ testing, analyzing the law of vibration propagation in this area, evaluating the impact on buildings, and determining the vibration reduction scheme. The reserve is divided into three zones based on the vertical vibration level measured during the in situ test as follows: severely excessive, generally excessive, and non-excessive vibration. Furthermore, the research develops a dynamic coupling model of vehicle-track-tunnel-stratum-structure to verify the damping effect of the wire spring floating plate track and periodic pile row. It compares the characteristics of three vibration reduction schemes, namely, internal vibration reduction reconstruction, periodic pile row, and anti-vibration reinforcement or reconstruction of buildings, proposing a comprehensive solution. Considering the construction conditions, difficulty, cost, and other factors, a periodic pile row is recommended as the primary treatment measure. If necessary, anti-vibration reinforcement or reconstruction of buildings can serve as supplemental measures.

Anchoring of Metal Complexes on Au25 Nanocluster for Enhanced Photocoupled Electrocatalytic CO2 Reduction.

Atomically precise Au nanoclusters (NCs) with discrete energy levels can be used as photosensitizers for CO2 reduction. However, tight ligand capping of Au NCs hinders CO2 adsorption on its active sites. Here, a new hybrid material is obtained by anchoring of thiol functionalized terpyridine metal complexes (metal=Ru, Ni, Fe, Co) on Au NCs by ligand exchange reactions (LERs). The anchoring of Ru and Ni complexes on Au25 NC (Au25 -Ru and Au25 -Ni) leads to adequate CO2 to CO conversion for photocoupled electrocatalytic CO2 reduction (PECR) in terms of high selectivity, with Faradaic efficiency of CO (FECO ) exceeding 90 % in a wide potential range, remarkable activity (CO production rate up to two times higher than that for pristine Au25 PET18 ) and extremely large turnover frequencies (TOFs, 63012 h-1 at -0.97 V for Au25 -Ru and 69989 h-1 at -1.07 V vs. RHE for Au25 -Ni). Moreover, PECR stability test indicates the excellent long-term stability of the modified NCs in contrast with pristine Au NCs. The present approach offers a novel strategy to enhance PECR activity and selectivity, as well as to improve the stability of Au NCs under light illumination, which paves the way for highly active and stable Au NCs catalysts.

Encapsulation of an Au25 Nanocluster inside a Porphyrin Nanoring Enhances Singlet Oxygen Generation and Photo-Electrocatalytic CO2 Reduction.

The synthesis of molecular host-guest complexes with enhanced performance, relative to those of their components, is a central theme in supramolecular chemistry. Here we explore a host-guest system consisting of an atomically precise gold nanocluster bound inside a zinc porphyrin nanoring. UV-vis absorption and fluorescence titrations with different sized nanorings revealed strong binding between a pyridinethiol-coated Au25 nanocluster and a nanoring consisting of six zinc porphyrin units, and complexation is confirmed by mass spectrometry. Formation of this assembly enhances the stability of the gold nanocluster. The host-guest complex also exhibits remarkable activity and selectivity for photochemical CO2 to CO conversion and singlet oxygen generation.

Very Low Temperature CO Oxidation over Atomically Precise Au25 Nanoclusters on MnO2.

Atomically precise Au25 nanoclusters have garnered significant interest in the field of heterogeneous catalysis due to their remarkable activity and selectivity. However, for the extensively studied reaction of low-temperature CO oxidation, their performance has not been competitive compared to other known gold nanocatalysts. To address this, we deposited Au25(SR)18 (R = CH2CH2Ph) nanoclusters onto a manganese oxide support (Au25/MnO2), resulting in a very stable and highly active catalyst. By optimizing the pretreatment temperature, we were able to significantly enhance the performance of the Au25/MnO2 catalyst, which outperformed most other gold catalysts. Impressively, 100% conversion of CO was achieved at temperatures as low as -50 °C, with 50% conversion being reached below -70 °C. Furthermore, the existence of ligands could also influence the negative apparent activation energy observed at intermediate temperatures. Analysis using X-ray photoelectron spectroscopy (XPS), scanning transmission electron microscopy (STEM), and X-ray diffraction (XRD) techniques indicated that the Au25 nanoclusters remained stable on the catalyst surface even after pretreatment at high temperatures. In-situ modulation excitation spectroscopy (MES) spectra also confirmed that the Au cluster was the active site for CO oxidation, highlighting the potential of atomically precise Au25 nanoclusters as primary active sites at very low temperatures.

Advanced Catalyst for CO2 Photo-Reduction: From Controllable Product Selectivity by Architecture Engineering to Improving Charge Transfer Using Stabilized Au Clusters.

Despite enormous progress and improvement in photocatalytic CO2 reduction reaction (CO2 RR), the development of photocatalysts that suppress H2 evolution reaction (HER), during CO2 RR, remains still a challenge. Here, new insight is presented for controllable CO2 RR selectivity by tuning the architecture of the photocatalyst. Au/carbon nitride with planar structure (p Au/CN) showed high activity for HER with 87% selectivity. In contrast, the same composition with a yolk@shell structure (Y@S Au@CN) exhibited high selectivity of carbon products by suppressing the HER to 26% under visible light irradiation. Further improvement for CO2 RR activity was achieved by a surface decoration of the yolk@shell structure with Au25 (PET)18 clusters as favorable electron acceptors, resulting in longer charge separation in Au@CN/Auc Y@S structure. Finally, by covering the structure with graphene layers, the designed catalyst maintained high photostability during light illumination and showed high photocatalytic efficiency. The optimized Au@CN/Auc /G Y@S structure displays high photocatalytic CO2 RR selectivity of 88%, where the CO and CH4 generations during 8 h are 494 and 198 µmol/gcat., respectively. This approach combining architecture engineering and composition modification provides a new strategy with improved activity and controllable selectivity toward targeting applications in energy conversion catalysis.

Broadband coherent modulation imaging with no knowledge of the illumination spectrum distribution.

Coherent diffraction imaging (CDI) is an alternative way to achieve high-performance imaging without high-quality imaging lenses. Coherent modulation imaging (CMI) improves CDI's algorithmic convergence and applicability to general samples. A high degree of coherence of the source is essential for CDI, which limits its application to ultrafast pulsed sources with an intrinsically broad spectrum. Here, we propose an algorithm to increase the tolerance of CMI to low temporal coherence that tandemly employs the Wiener and Lucy deconvolution approaches. Simulations and visible light experiments demonstrate the effectiveness of our method. This work could pave the way for implementing CMI with attosecond pulsed lasers, laboratory x-ray sources, or electron microscopes.

Revealing the three-component structure of water with principal component analysis (PCA) of X-ray spectra.

Combining principal component analysis (PCA) of X-ray spectra with MD simulations, we experimentally reveal the existence of three basic components in water. These components exhibit distinct structures, densities, and temperature dependencies. Among the three, the two major components correspond to the low-density liquid (LDL) and the high-density liquid (HDL) predicted by the two-component model, and the third component exhibits a unique 5-hydrogen-bond configuration with ultra-high local density. As the temperature increases, the LDL component decreases and the HDL component increases, while the third component varies non-monotonically with a peak around 20 °C to 30 °C. The 3D structure of the third component is further illustrated as the uniform distribution of five hydrogen-bonded neighbors on a spherical surface. Our study reveals experimental evidence for water's possible three-component structure, which provides a fundamental basis for understanding water's special properties and anomalies.

Surface metrology by multiple-wavelength coherent modulation imaging.

With the rapid progress of advanced manufacturing, three-dimensional metrology techniques that are able to achieve nanometer spatial resolution and to capture fast dynamics are highly desired, for which a snapshot ability and a common-light-path setup are required. Commonly used off-axis holography and phase-shifting interferometry are short in fulfilling those requirements. We studied the suitability and performance of the coherent modulation imaging (CMI) method for metrology applications. Both transparent and reflective samples are measured in visible light experiments. Thanks to its ability to retrieve separate wavefronts at different wavelengths from a single measurement, CMI allows for attaining an enlarged range of measurement free from phase wrapping by utilizing the concept of synthetic wavelength. The CMI method fulfills well the requirements for advanced metrology and can be implemented at any wavelength. We expect it would be a powerful addition to the pool of advanced metrology tools.

Endogenous ethanol produced by intestinal bacteria induces mitochondrial dysfunction in non-alcoholic fatty liver disease.

BACKGROUND AND AIM: A causal relationship between changes of the gut microbiome and non-alcoholic fatty liver disease (NAFLD) remains unclear. We demonstrated that endogenous ethanol (EnEth) produced by intestinal microbiota is likely a causative agent of NAFLD. METHODS: Two mutants with different alcohol-producing abilities, namely, W14-adh and W14Δadh, were constructed using the clinical high alcohol-producing (HiAlc) Klebsiella pneumoniae strain W14 as a parent. Damage to hepatocytes caused by bacteria with different alcohol-producing capacities was evaluated (EtOH group as positive control). The ultrastructural changes of mitochondria were assessed via transmission electron microscopy (TEM). Hepatic levels of mitochondrial reactive oxygen species (ROS), DNA damage, and adenosine triphosphate were examined. RESULTS: The results illustrated that steatosis was most severe in the W14-adh group, followed by the W14 group, whereas the W14Δadh group had few fatty droplets. TEM and examination of related protein expression revealed that the mitochondrial integrity of HepG2 hepatocytes was considerably damaged in the EtOH and bacteria treatment groups. The impaired mitochondrial function in HepG2 hepatocytes was evidenced by reduced adenosine triphosphate content and increased mitochondrial ROS accumulation and DNA damage in the EtOH and bacteria treatment groups, especially the W14-adh group. Meanwhile, liver injury and mitochondrial damage were observed in the hepatocytes of mice. The livers of mice in the W14-adh group, which had the highest ethanol production, exhibited the most serious damage, similar to that in the EtOH group. CONCLUSIONS: EnEth produced by HiAlc bacteria induces mitochondrial dysfunction in NAFLD.

Identification and molecular characterization of Serratia marcescens phages vB_SmaA_2050H1 and vB_SmaM_2050HW.

Serratia marcescens is a rod-shaped, Gram-negative bacterium causing nosocomially acquired infections. Bacteriophages are natural opponents of their pathogenic bacterial hosts and could be an alternative to traditional antibiotic treatments. In this study, two S. marcescens-specific bacteriophages, vB_SmaA_2050H1 and vB_SmaM_2050HW, were isolated from two different waste samples in China. Phage plaque assays, transmission electron microscopy, host-range determination, and one-step growth curve analyses were performed for both phages. vB_SmaA_2050H1 was classified as belonging to the family Ackermannviridae, and vB_SmaM_2050HW was classified as belonging to the family Myoviridae. One-step growth curve analysis showed that the latent and rise period of vB_SmaA_2050H1 were 80 min and 50 min, respectively, with a burst size of approximately 103 phage particles per infected cell. For vB_SmaM_2050HW, latent and rise periods of 40 min and 60 min, respectively, were determined, with a burst size of approximately 110 phage particles per infected cell. vB_SmaA_2050H1 infected 10 of the 15 (66.67%) S. marcescens strains tested, while vB_SmaM_2050HW infected 12 (80%) of the strains. Whole-genome sequencing and annotation of each of the phage genomes revealed genome sizes of 159,631 bp and 276,025 bp for vB_SmaA_2050H1 and vB_SmaM_2050HW, respectively, with the respective genomes containing 213 and 363 putative open reading frames. Sequence analysis of the genomes revealed that vB_SmaA_2050H1 is a member of the ViI-like family, while vB_SmaM_2050HW is a novel virulent bacteriophage. These findings provide further insights into the genomic structures of S. marcescens bacteriophages.

Sensitive and rapid detection of Zika virus by loop-mediated isothermal amplification.

Zika virus (ZIKV) is a mosquito-borne flavivirus, which is a pathogen affecting humans in Africa, Asia, and America. It is necessary to detect ZIKV with a rapid and sensitive molecular method to guide timely treatment. In this study, a loop-mediated isothermal amplification (LAMP) assay was described, which is an attractive option as a fast, sensitive, and specific method for ZIKV detection using the NS5 protein coding region and the envelope protein (EP) coding region as target sequences. Two different techniques, a calcein/Mn2+ complex chromogenic method and real-time turbidity monitoring, were employed. The specificity and sensitivity of the LAMP assay were determined. The assay's detection limit was 0.5 × 10-9 pmol/µl DNA for NS5 protein coding region and 1.12 × 10-11 pmol/µl DNA for E coding region, respectively, which is a 100-fold increase in sensitivity compared with real-time reverse transcription-polymerase chain reaction (RT-PCR) and conventional PCR. All 12 non-ZIKA respiratory pathogens tested were negative for LAMP detection, indicating the high specificity of the primers for ZIKV. In conclusion, a visual detection LAMP assay was developed, which could be a useful tool for primary quarantine purposes and clinical screening, especially in situations where resources are poor and in point-of-care tests.

Understanding of Strain Effects in the Electrochemical Reduction of CO2 : Using Pd Nanostructures as an Ideal Platform.

Tuning the surface strain of heterogeneous catalysts represents a powerful strategy to engineer their catalytic properties by altering the electronic structures. However, a clear and systematic understanding of strain effect in electrochemical reduction of carbon dioxide is still lacking, which restricts the use of surface strain as a tool to optimize the performance of electrocatalysts. Herein, we demonstrate the strain effect in electrochemical reduction of CO2 by using Pd octahedra and icosahedra with similar sizes as a well-defined platform. The Pd icosahedra/C catalyst shows a maximum Faradaic efficiency for CO production of 91.1 % at -0.8 V versus reversible hydrogen electrode (vs. RHE), 1.7-fold higher than the maximum Faradaic efficiency of Pd octahedra/C catalyst at -0.7 V (vs. RHE). The combination of molecular dynamic simulations and density functional theory calculations reveals that the tensile strain on the surface of icosahedra boosts the catalytic activity by shifting up the d-band center and thus strengthening the adsorption of key intermediate COOH*. This strain effect was further verified directly by the surface valence-band photoemission spectra and electrochemical analysis.

Characterization of phiCFP-1, a virulent bacteriophage specific for Citrobacter freundii.

Citrobacter freundii, a Gram-negative bacterium, causes many opportunistic infections. Bacteriophage phiCFP-1 was isolated and characterized by its ability to lyse the multidrug-resistant clinical C. freundii strain P10159. Transmission electron microscopy showed that the phage has an icosahedral head and a short tail, making it a Podoviridae family member. In a single-step growth experiment, phiCFP-1 exhibited an eclipse period of 20 min and a burst size of 100 particles per cell. Its genome assembled as a circular molecule when genomic sequencing was completed. However, based on genome content and organization, it was categorized as a classic T7-related phage, and such phages are known to have linear genomes with direct terminal repeats. With the quick and simple method established herein, the 38,625-bp linear double-stranded DNA with 229-bp direct terminal repeats was accurately identified. The genome contained 43 putative open reading frames and no tRNA genes. Using a proteomics-based approach, seven viral and two host proteins from purified phiCFP-1 particles were identified. Comparative genomics and recombination analyzes revealed close genetic relatedness among phiCFP-1, phiYeO3-12/vB_YenP_AP5 (from Yersinia enterocolitica O3), and phiSG-JL2 (from Salmonella enterica).

Relationship between red cell distribution width and early renal injury in patients with gestational diabetes mellitus.

Previous studies found that red cell distribution width was related to adverse cardiovascular events. However, few studies reported the relationship between red cell distribution width and early-stage renal injury in pregnant women with gestational diabetes mellitus. Using a cross-sectional design, 334 pregnant women with gestational diabetes mellitus were enrolled according to the criterion of inclusion and exclusion. Demographic and clinical examination data were collected. Depended on the urine albumin, study population were divided into case group (n = 118) and control group (n = 216). Compared with control group, the case group tend to be higher red cell distribution width level (13.6 ± 0.9 vs.12.5 ± 0.6, p < 0.001). The red cell distribution width was positively associated with albuminuria creatinine ratio (r = 0.567, p < 0.001). Multiple logistic regressions showed that red cell distribution width was still associated with early-stage renal injury after adjusting for many other potential cofounders. Compared with the first quartile, the risk ratio of the second, the third and the fourth quartile were 1.38 (95%CI: 1.06-1.80), 1.57 (95%CI: 1.21-2.97), 2.71 (95%CI: 2.08-3.54), respectively. Besides, systolic blood pressure, estimated glomerular filtration rate, uric acid and blood urea nitrogen were also significantly associated with renal injury in gestational diabetes mellitus patients. The elevated red cell distribution width level might be a predictor of early-stage renal injury in pregnant women with gestational diabetes mellitus. As an easy and routine examination index, red cell distribution width may provide better clinical guidance when combined with other important indices.

Parental burnout of parents of primary school students: an analysis from the perspective of job demands-resources.

Objective: Based on the theory of Job Demands-Resources, this study has been set out to examine how parenting demands, parenting resources affect parental burnout of primary school students' parents. Methods: An online survey with four scales (Parenting Stress Scale, Perceived Family Support Scale, Psychological Resilience Scale and Parental Burnout Scale) was completed by 600 parents of students from three primary schools in Central China. Structural equation models were implemented. Results: Parenting stress had a positive impact on parental burnout (ß = 0.486, p < 0.001). Both perceived family support (ß = -0.228, p < 0.001) and psychological resilience (ß = -0.332, p = 0.001) had a negative impact on parental burnout. Perceived family support played a moderating role between parenting stress and parental burnout (ß = -0.121, p < 0.001). Psychological resilience also played a moderating role between parenting stress and parental burnout (ß = -0.201, p < 0.001). Psychological resilience partially mediated the relationship between perceived family support and parental burnout. The total effect was -0.290, with 95% CI (-0.350, -0.234). Direct effect was -0.228, with 95% CI (-0.283, -0.174), and indirect effect was -0.062, with 95% CI (-0.092, -0.037). Conclusion: Parental burnout may be reduced by increasing family support and self-improvement of psychological resilience. In the same way, the impact of parenting stress on parental burnout may be buffered under high-pressure situations.

Engineering ligand chemistry on Au25 nanoclusters: from unique ligand addition to precisely controllable ligand exchange.

Au25 nanoclusters (NCs) protected by 18 thiol-ligands (Au25SR18, SR is a thiolate ligand) are the prototype of atomically precise thiolate-protected gold NCs. Studies concerning the alteration of the number of surface ligands for a given Au25SR18 NC are scarce. Herein we report the conversion of hydrophobic Au25PET18 (PET = 2-phenylethylthiolate) NCs to Au25SR19 [Au25PET18(metal complex)1] induced by ligand exchange reactions (LERs) with thiolated terpyridine-metal complexes (metal complex, metal = Ru, Fe, Co, Ni) under mild conditions (room temperature and low amounts of incoming ligands). Interestingly, we found that the ligand addition reaction on Au25PET18 NCs is metal dependent. Ru and Co complexes preferentially lead to the formation of Au25SR19 whereas Fe and Ni complexes favor ligand exchange reactions. High-resolution electrospray ionization mass spectrometry (HRESI-MS) was used to determine the molecular formula of Au25SR19 NCs. The photophysical properties of Au25PET18(Ru complex)1 are distinctly different from Au25PET18. The absorption spectrum is drastically changed upon addition of the extra ligand and the photoluminescence quantum yield of Au25PET18(Ru complex)1 is 14 times and 3 times higher than that of pristine Au25PET18 and Au25PET17(Ru complex)1, respectively. Interestingly, only one surface ligand (PET) could be substituted by the metal complex when neutral Au25PET18 was used for ligand exchange whereas two ligands could be exchanged when starting with negatively charged Au25PET18. This charge dependence provides a strategy to precisely control the number of exchanged ligands at the surface of NCs.

Apigenin attenuates atherosclerosis and non-alcoholic fatty liver disease through inhibition of NLRP3 inflammasome in mice.

Apigenin (APN), a flavone found in several plant foods with various biological properties such as anti-obesity, anti-inflammation and other abilities, alleviates atherosclerosis and non-alcoholic fatty liver disease (NAFLD) induced by a high fat diet (HFD) in mice. However, the underlying mechanisms have not been fully understood. In this study, we investigated the role of NLRP3 in anti-atherosclerosis and anti-NAFLD effect of APN in mouse models with NLRP3 deficiency. Atherosclerosis and NAFLD models were established by treatment of low density lipoprotein receptor-deficient (Ldlr-/-) mice and NLRP3-/- Ldlr-/- mice with a HFD diet (20% fat and 0.5% cholesterol) with or without APN. En face lipid accumulation analysis, plasma lipid levels, hepatic lipid accumulation and inflammation were analyzed and quantified. For in vitro experiments, HepG2 cells were stimulated by LPS plus oleic acid (OA) in the absence or presence of APN (50 µM). Lipid accumulation and the effect of APN on the NLRP3/NF-κB signaling pathway were investigated. APN administration partly reversed atherosclerosis and hepatic lipid accumulation, and decreased body weight and plasma lipid levels in Ldlr-/- mice when fed a HFD. Compared with Ldlr-/- mice, NLRP3-/- Ldlr-/- mice showed more severe atherosclerosis and hepatic lipid accumulation. Treating the HepG2 cells with APN reduced lipid accumulation. APN also inhibited activation of the NLRP3/ NF-κB signaling pathway stimulated by OA together with LPS. Our results indicate that APN supplementation prevents atherosclerosis and NAFLD via NLRP3 inhibition in mice, and suggest that APN might be a potential therapeutic agent for the prevention of atherosclerosis and NAFLD.

Association between the systemic immune-inflammation index and the efficacy of neoadjuvant chemotherapy, prognosis in HER2 positive breast cancer-a retrospective cohort study.

Background: The prognosis of patients who can achieve a complete response after neoadjuvant chemotherapy could be significantly improved. Thus, accurately predicting the efficacy of neoadjuvant chemotherapy is of great clinical significance. Currently, previous indicators such as neutrophil to lymphocyte ratio was poor in predicting the efficacy and prognosis of neoadjuvant chemotherapy in human epidermal growth factor receptor 2 (HER2) positive breast cancer patients. Methods: The data of 172 HER2 positive breast cancer patients admitted to the Nuclear 215 Hospital of Shaanxi Province from January 2015 to January 2017 were retrospectively collected. After neoadjuvant chemotherapy, the patients were divided into the complete response group (n=70) and the non-complete response group (n=102). The clinical characteristics and systemic immune-inflammation index (SII) levels of the two groups were compared. The patients were followed-up for 5 years post-surgery to observe whether recurrence or metastasis occurred after the operation by clinic visit combined with telephone calls. Results: The SII of the complete response group was significantly lower than that of the non-complete response group (587.43±175.97 vs. 821.82±231.58; P=0.000). The SII was valuable in predicting which HER2 positive breast cancer patients would fail to achieve a pathological complete response, and the area under the curve (AUC) was 0.773 [95% confidence interval (CI): 0.705-0.804; P=0.000]. A SII >755.10 was an adverse factor for HER2 positive breast cancer patients achieving a pathological complete response after neoadjuvant chemotherapy [P=0.000; relative risk (RR): 0.172 (95% CI: 0.082-0.358)]. The SII level was valuable in predicting recurrence within 5 years of surgery, and had an AUC of 0.828 (95% CI: 0.757-0.900; P=0.000). A SII >755.10 was a risk factor for recurrence within 5 years of surgery [P=0.001; RR: 4.945 (95% CI: 1.949-12.544)]. The SII level was valuable in predicting metastasis within 5 years of surgery, and had an AUC of 0.837 (95% CI: 0.756-0.917; P=0.000). A SII >755.10 was a risk factor for metastasis within 5 years of surgery [P=0.014, RR: 4.553 (95% CI: 1.362-15.220)]. Conclusions: The SII was associated with the prognosis and efficacy of neoadjuvant chemotherapy in HER2 positive breast cancer patients.