Objective:Serum tumor markers(STMs)are important indicators associated with metastasis in patients with breast cancer(BC).This study focuses on predicting the risk of axillary lymph node metastasis(ALNM)in patients with invasive BC in Xinjiang by combining STMs and clinicopathological factors.Methods:Data from 3,360 patients diagnosed with invasive BC and treated at the Affiliated Cancer Hospital of Xinjiang Medical University between 2015 and 2019 were analyzed,focusing on 11 relevant demographic and clinical factors.Five ma-chine learning(ML)algorithms were used to develop predictive models for ALNM.Their performance was compared using metrics such as area under the curve(AUC),accuracy,Kappa value,and Brier score.The best-performing model was then compared with a nomogram based on Logistic regression(LR)to determine the final model.Shapley additive explanations(SHAP)values were used to rank the importance of factors contributing to ALNM.Results:Of the 3,266 patients studied,1,368(41.89%)developed ALNM.Among the five constructed ML models,eXtreme gradient boosting(XGBoost)demonstrated the best predictive performance with an AUC of 0.768,an accuracy of 0.735,and a Kappa value of 0.450.In both the training and validation sets,the XGBoost model outperformed the LR-based nomogram(training set AUC and Brier score:0.822(0.810～0.820)vs.0.742(0.721～0.763),0.170(0.163～0.177)vs.0.197(0.189～0.204);validation set AUC and Brier score:0.769(0.740～0.770)vs.0.747(0.716～0.779),0.190(0.178～0.202)vs.0.195(0.189～0.204)).Therefore,XGBoost was selec-ted as the final predictive model.SHAP analysis identified T stage,age,molecular subtype,and CEA level as the four most influential factors for ALNM prediction.Conclusions:The XGBoost model effectively predicts the risk of ALNM in patients with invasive BC based on STMs and clinicopathological features,outperforming traditional nomograms.SHAP analysis highlighted T stage as the most critical factor influencing ALNM.

Objective:To explore the impact of noise and dust exposure in the mechanical manufacturing industry on the risk of hypertension and abnormal electrocardiogram in workers, and their combined effects, in order to provide support for the prevention and treatment of occupational related diseases among workers.Methods:In January 2024, A convenience sampling method was used to study 2802 on-the-job workers who underwent occupational health check-ups from January 2023 to December 2023 at a machinery manufacturing enterprise in Baotou, Inner Mongolia. Blood pressure and electrocardiogram results were analyzed in the noise group, dust group, dust noise group and control group according to the exposure factors. For count data, the chi-square test was employed to analyze differences among groups. Additionally, a binary logistic regression model was utilized to assess the impact of dust and noise exposure on the prevalence of hypertension and electrocardiogram abnormalities.Results:The stratified analysis results showed that the differences in hypertension prevalence among the four groups were statistically significant ( P<0.001) in males, age groups >30-40 years, >40-50 years, >50 years, different exposure durations, and different enterprise sizes. For ECG abnormalities, significant differences were observed among the four groups ( P<0.001) in males, the age group >30-40 years, different enterprise sizes, and those with exposure durations ≤15 years. The trend test for hypertension prevalence across different age groups revealed that as age increased, the prevalence of hypertension showed an upward trend in the noise-exposed group, dust-exposed group, and combined dust-noise-exposed group ( χ2=10.76, 4.25, 6.60, P<0.001, 0.039, 0.010) . Binary regression model analyses revealed that the the risk of hypertension in the noise group, dust group and dust noise group was 2.63 times ( OR=2.63, 95% CI: 1.89~3.67, P<0.001) , 2.36 times ( OR=2.36, 95% CI: 1.76~3.16, P<0.001) and 2.69 times ( OR=2.69, 95% CI: 2.14~3.38, P<0.001) . Using ECG abnormalities as the dependent variable and incorporating the statistically significant variables from Table 1 as independent variables into the binary logistic regression model, the results showed no statistically significant differences in the risk of ECG abnormalities in the dust-exposed, noise-exposed, and combined dust-noise-exposed groups compared to the control group ( P> 0.05) . Conclusion:Combined exposure to dust and noise increases the risk of hypertension in workers and has a combined effect.

Objective:To explore the relationship between work engagement, job burnout, and mental health among full-time and part-time student management staff in universities in Xinjiang, and to provide a scientific basis for developing differentiated mental health intervention measures.Methods:By using the method of cluster random sampling, 1267 student management staff from five universities in Urumqi were selected as the research subjects from March 2020 to December 2021. Data collection was conducted using the Utrecht Work Engagement Scale (UWES-9) , the Maslach Burnout Inventory-General Survey (MBI-GS) , and the Symptom Checklist-90 (SCL-90) . Spearman rank correlation analysis was used to explore the relationship among work engagement, job burnout and mental health. Multivariate logistic regression was adopted to analyze the influencing factors of mental health, and the mediating effect of job burnout was analyzed through the mediating effect test.Results:The detection proportions of job burnout and psychological disorders were 80.5% (525/652) and 38.5% (251/652) among full-time personnel, and 75.3% (463/615) and 30.2% (186/615) among part-time personnel, respectively. Spearman rank correlation analysis showed that work engagement was negatively correlated with psychological disorders ( rs=-0.720, -0.760, P<0.001) and job burnout ( rs=-0.776, -0.700, P<0.001) in both full-time and part-time personnel, while job burnout was positively correlated with psychological disorders ( rs=0.804, 0.718, P<0.001) . Multivariate logistic regression analysis indicated that high work engagement (full-time: OR=0.05, 95% CI: 0.02-0.18; part-time: OR=0.02, 95% CI: 0.01-0.04) was a protective factor for mental health ( P<0.001) , whereas job burnout (full-time: OR=10.85, 95% CI: 3.50-33.58; part-time: OR=3.71, 95% CI: 1.76-7.76) was a risk factor for mental health ( P<0.001) . Mediating effect tests demonstrated that job burnout played a partial mediating effect between work engagement and mental health, with mediating effect proportions of 57.3% and 27.9% for full-time and part-time personnel, respectively. Conclusion:The detection proportions of job burnout and psychological disorders among full-time and part-time student management staff in Xinjiang universities are relatively high, and job burnout acts as a mediating variable between work engagement and mental health. Universities should enhance the work engagement level of student management staff to prevent and alleviate job burnout, and thereby improving their mental health status.

Objective:To investigate the temporal correlation between occupational stress and elevated blood pressure among petroleum workers in Xinjiang.Methods:Based on the Occupational Health Study Cohort of Petroleum Workers (OHSPIW), 1600 petroleum workers in Xinjiang who underwent occupational health examinations from May to June 2015 and December 2017 were selected as the research subjects. The occupational stress of workers was evaluated using the Occupational Roles Questionnaire (ORQ) in the Occupational Stress Inventory-Revised (OSI-R). The blood pressure measurement data of physical examination results were collected. The relationship between the ORQ total score and blood pressure was analyzed using Spearman rank correlation, and the causal time-series relationship between occupational stress and elevated blood pressure over time was analyzed by cross-lagged path analysis modelling.Results:In the baseline data of petroleum workers, the systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 124.00 (119.00, 128.00) and 77.00 (73.00, 82.00) mmHg respectively, with an ORQ total score of 164.00 (154.00, 174.00) points. In the follow-up data, the SBP and DBP were 126.00 (123.00, 128.00) and 78.00 (75.00, 82.00) mmHg respectively, and the ORQ total score was 168.00 (157.00, 181.00) points. The results of the correlation analysis showed that the ORQ total score of petroleum workers was positively correlated with the levels of SBP and DBP ( P<0.05), and the ORQ total score at follow-up was negatively correlated with the baseline levels of SBP and DBP ( P<0.05). The results of the cross-lagged path analysis showed that the path coefficients from the baseline ORQ total score of petroleum workers to the follow-up SBP and DBP levels were statistically significant ( ρ=0.06, 0.06, P=0.032, 0.011). In terms of time sequence, the increase in the ORQ total score preceded the increase in the SBP and DBP levels. Conclusion:The occupational stress of petroleum workers is related to blood pressure, and the increase of occupational stress precedes the change of blood pressure. This correlation may increase the risk of hypertension among petroleum workers.

Objective:To understand the factors influencing new infections of 9-valent vaccine-type human papillomavirus (9-valent type HPV) among men who have sex with men (MSM) in Urumqi City and to construct a prediction model of individual dynamics of new infections of 9-valent type HPV among MSM.Methods:In this study, a snowball method was adopted to recruit MSM in Urumqi City to establish a dynamic cohort, and participants were followed up every 6 months from 2016 to 2023, and perianal exfoliated cells were collected for HPV genotyping; joint models were established using the number of same-sex sexual partners in the last six months and the number of anal intercourse in the last one week as longitudinal variables, respectively, and joint models were utilized to analyze the influence factors of 9-valent HPV new infections in MSM individuals were analyzed by the joint model; the predictive efficacy of the model in the follow-up period was evaluated by using the time-dependent receiver operating characteristic area under the curve (AUC) values. Based on the prediction model, two study participants were randomly selected for individual dynamic prediction of new-onset HPV infections of 9-valent type types.Results:MSM with at least two follow-up visits 579 individuals were included in the analysis. The results of the two joint models showed that being divorced/widowed [hazard ratio ( HR)=1.544, 95% CI: 1.033-2.233], having a sexual behavior style of being the inserted party ( HR=1.366, 95% CI: 1.053-1.764), and having a history of STDs ( HR=1.659, 95% CI: 1.057-2.558) increased the 9-valent types of new HPV infections risk. The results of the shared parameter of the joint model of the number of same-sex partners in the last six months showed that each 2.72 increase in the number of same-sex partners in the last six months was associated with a 28.2% increase in the risk of new 9-valent HPV infections in MSM individuals ( HR=1.282, 95% CI: 1.065-1.540). The time-dependent AUC results showed that the joint model for the number of same-sex sexual partners in the last six months (0.808 0) predicted better performance than the joint model for the number of anal intercourse in the last one week (0.750 0). The joint model based on the number of same-sex sexual partners in the last six months for the prediction of MSM individual dynamics was consistent with the real situation. Conclusion:The joint model based on the number of same-sex sexual partners in the last six months, sexual behavior, history of STDs, and other risk factors has high accuracy in predicting the risk of new MSM 9-valent HPV infections in Urumqi City, which can provide a scientific basis for the prediction of individual dynamics of new MSM 9-valent HPV infections.

Objective:To analyze the pangenome, pan drug resistance genes, pan virulence genes, pan replicons, and others of the plasmids carried by hypervirulent Klebsiella pneumoniae (hvKP) in the world and their evolutionary trends over time, and provide evidence for more comprehensive understanding of the evolution of genetic diversity, drug resistance genes, and virulence genes of the plasmids. Methods:From the National Center for Biotechnology Information database, a total 1 738 plasmids were screened from 524 strains with completed genome sequences in 2 136 strains of hvKP carrying plasmids. Through pangenome, pan drug resistance gene, and pan-virulence gene composition and functional analyses, the curves of pangenome size and new gene size against plasmid isolation time were established, revealing the diversity of the plasmid pangenome and its evolutionary patterns.Results:The homologous genes, homologous drug resistance genes, homologous virulence genes, and replicons of the plasmids carried by hvKP comprised of 12 906, 149, 107 and 89 types, respectively. The fitting curves for the number of new genes, new drug resistance genes and new replicons increased with the increase of plasmids in an open state, while the curve for novel virulence genes was in a closed state. A obvious increase in new drug resistance genes was observed during 2018-2019. Among the newly added drug resistance genes during 2021-2023, beside those conferring aminoglycoside resistance, they were mainly new subtypes conferring carbapenem resistance.Conclusions:The pangenome of plasmids carried by hvKP exhibited high diversity, with the plasmid pan genes, pan drug resistance genes, and pan replicon types gradually expanding, while the pan virulence genes remains stable. The increase in novel drug resistance genes in specific years and the emergence of new carbapenem-resistant gene subtypes during 2021-2023 suggested the need for strengthened drug resistance surveillance and prevention efforts, with particular attention to carbapenem resistance.

Objectives:To calculate the age-standardized incidence rate, disability-adjusted life years (DALY) rate, and mortality rate of chronic obstructive pulmonary disease (COPD) among individuals aged ≥60 years globally from 1990 to 2019, and analyze their trends. To assess the impact of population growth, changes in age structure, and epidemiological changes on global changes in COPD incidence, DALYs, and deaths among individuals aged ≥60 years.Methods:The data were derived from the 2019 Global Burden of Disease study. The Joinpoint regression model was used to calculate the average annual percentage change (AAPC) and its 95% uncertainty interval ( UI). Through decomposition analysis, the changes in the number of COPD cases, DALYs, and deaths among individuals aged ≥60 years globally were attributed to three main factors: population growth, changes in age structure, and epidemiological changes. The contributions of these different factors were analyzed to identify the important factor driving the changes. Results:From 1990 to 2019, the age-standardized incidence rate, DALY rate, and mortality rate of COPD in the global population aged ≥60 years all showed a decreasing trend, with AAPCs of -0.12% (95% UI: -0.13%--0.11%), -1.69% (95% UI: -1.80%--1.58%), and -1.77% (95% UI: -1.89%--1.64%), respectively. The overall contributions of population growth, changes in age structure, and epidemiological changes to the changes in the number of COPD cases, DALYs, and deaths in the global population aged ≥60 years were 5.631 million (112.55%), 14.315 million person-years (33.08%), and 799 400 (35.76%), respectively. Specifically, the contributions of population growth were 5.643 million (112.80%), 39.774 million person-years (91.92%), and 2.078 million (92.93%) for incidence, DALYs, and deaths, respectively. The contributions of changes in age structure were 3.228 million (6.45%), 2.231 million person-years (5.15%), and 265 600 (11.88%) for incidence, DALYs, and deaths, respectively. The contributions of epidemiological changes were -335 200 (-6.70%), -27.690 million person-years (-64.00%), and -1.544 million (-69.05%) for incidence, DALYs and deaths, respectively. Conclusions:Globally, from 1990 to 2019, the age-standardized incidence, DALY rate, and mortality of COPD in individuals aged ≥60 years showed a general downward trend while the combined factors, including contribution of population growth, age structure, and epidemiological features, showed positive impacts on the changes in the number of COPD cases, DALYs, and deaths among individuals aged ≥60 years. The largest impact was on the number of cases. Specifically, population growth had the highest contribution ratio to the changes in COPD incidence, DALYs, and deaths among individuals aged ≥60 years, while epidemiological changes had a negative contribution.

Objective To investigate the relationship between the public's risk perception,behavioral patterns,and emotional responses during major public health emergencies,and to analyze the interaction mech-anisms.Methods Both paper and electronic questionnaires were used to collect data on sociodemographic characteristics,lifestyle habits,and psychological status from residents of different occupations and age groups living in Urumqi from January 2021 to December 2022.Pearson correlation analysis and mediation effect anal-ysis were then conducted.Results People with different sociological characteristics exhibited varying risk per-ceptions,behavioral patterns,and emotional responses during public health emergencies.Risk perception was positively correlated with emotional responses(r=0.190,P<0.001);anxiety was positively correlated with emotional responses(r=0.585,P<0.001)and risk perception(r=0.176,P<0.001);depression was posi-tively correlated with emotional responses(r=0.540,P<0.001)and anxiety(r=0.732,P<0.001).Behav-ioral patterns were negatively correlated with risk information(r=-0.329,P<0.001),emotional responses(r=-0.091,P<0.001),risk perception(r=-0.030,P=0.049);anxiety was negatively correlated with risk information(r=-0.046,P=0.003)and behavioral patterns(r=-0.065,P<0.001).Depression was also negatively correlated with risk perception(r=-0.148,P<0.001),and behavioral patterns(r=-0.092,P<0.001).Conclusion People with different sociological characteristics exhibit differences in risk perception,behavioral patterns,and emotional responses during public health emergencies,and there are com-plex correlations among these factors.Especially in emergencies such as pandemics,risk perception significant-ly influences individual behavioral patterns and mental health,with emotional responses playing an important mediating role.

Objective To investigate the correlation and lag effect between atmospheric particulate matter and the risk of hospitalization for chronic kidney disease(CKD).Methods The daily hospitalization data for CKD in 9 hospitals in Urumqi from Jan.1,2019,to Dec.31,2020,and the air pollution and meteorological data during the same period were collected.The relationship between PM2.5 and PM10 concentrations and CKD incidence was analyzed after controlling for long-term trends,meteorological factors,and potential confounding factors such as the"day of the week effect"by using the generalized additive model(GAM).The effects of single-day lag of 0-7 d(lag0-lag7)and cumulative lag of 0-7 d(lag01-lag07)were analyzed,and subgroup analyses were conducted for gender,age,and season.On the basis of the single pollutant model,other pollutants were included(at most 2 pollutants were included at a time),and a double pollutant model was constructed to evaluate the stability of the model.Results For every 10 μg/m3 increase in PM2.5 concentration,the highest risk of CKD hospitalization occured when lagged alone at lag2(relative risk[RR]=1.014,95％confidence interval[CI]1.006-1.023)and lagged cumulatively at lag04(RR=1.018,95％CI 1.007-1.029).For every 10 μg/m3 increase in PM10 concentration,the risk of CKD hospitalization was highest when lagged alone at lag0 and lagged cumulatively at lag07(RR=1.012,95％CI 1.007-1.017;RR=1.024,95％CI 1.016-1.032).In gender stratification,for every 10 μg/m3 increase in PM2.5 concentration,the cumulative lag at lag04 indicated that males had the highest risk of CKD hospitalization(RR=1.023,95％CI 1.008-1.038);for every 10 μg/m3 increase in PM10 concentration,the highest risk of CKD hospitalization was observed in males when lagged alone at lag0(RR=1.013,95％CI 1.006-1.020),and in females when lagged alone at lag1(RR=1.013,95％CI 1.006-1.020).In age stratification,for every 10 μg/m3 increase in PM2.5 concentration,the risk of CKD hospitalization was highest in people 65 years old with single-day lag at lag3 and cumulative lag at lag04(RR=1.016,95％CI 1.007-1.026;RR=1.022,95％CI 1.010-1.035);for every 10 μg/m3 increase in PM10 concentration,the cumulative lag at lag07 indicated that individuals aged＜65 years old and ≥65 years old had the highest risk of CKD hospitalization(RR=1.027,95％CI 1.017-1.037;RR=1.015,95％CI 1.001-1.028).In seasonal stratification,for every 10 μg/m3 increase in PM2.5 concentration during the cold season,the risk of CKD hospitalization was highest when lagged alone at lag3 and lagged cumulatively at lag07(RR=1.020,95％CI 1.011-1.029;RR=1.025,95％CI 1.011-1.038).For every 10 μg/m3 increase in PM10 concentration during the cold season,the risk of CKD hospitalization was highest when lagged alone at lag2(RR=1.013,95％CI 1.007-1.019).For every 10 μg/m3 increase in PM10 concentration during the warm season,the risk of CKD hospitalization was highest when lagged alone at lag7(RR=1.015,95％CI 1.006-1.024).In the dual pollutant model,the effects of PM2.5 adjusting PM10,SO2,O3 and CO,and PM10 adjusting NO2,SO2,O3,and CO on the risk of CKD hospitalization were still significant(P＜0.05).Conclusion The increase in atmospheric particulate matter concentrations of PM2.5 and PM10 can lead to an increased risk of CKD,and there is a lag effect.Men,people under the age of 65 years old,and those in cold seasons(heating periods)are more sensitive to exposure to PM2.5 and PM10.

AIM:C57BL/6J mice were transplanted with fecal microbiota from a patient with maturity-onset diabetes of the young(MODY)or a healthy control.This study aimed to investigate the effects of fecal microbiota trans-plantation(FMT)on glucose and lipid metabolism,intestinal flora composition,and short-chain fatty acids(SCFAs)me-tabolism in mice,thereby providing an experimental foundation for understanding the role of gut microbiota in MODY.METHODS:A total of 36 male C57BL/6 mice were randomly allocated into three groups,including:control(CON)group(receiving PBS),normal individual-FMT(NF)group(intervened with normal human fecal microbiota)and MODY patient-FMT(MF)group(intervened with MODY patient fecal microbiota),and the mice were performed fecal microbio-ta,transplantation through oral gavage for 8 weeks.Glucose tolerance was assessed using an oral glucose tolerance test(OGTT),while insulin sensitivity was evaluated through an intraperitoneal insulin tolerance test(ITT).Blood biochemi-cal indicators were measured using ELISA,the composition of the gut microbiota was analyzed using 16S rRNA sequenc-ing,and the concentration of fecal short-chain fatty acids(SCFAs)was determined by gas chromatography-mass spec-trometry(GC-MS).RESULTS:The mice in MF group showed impaired glucose tolerance and reduced insulin sensitivi-ty.The FMT altered the composition of gut microbiota in mice,leading to significant differences in microbial diversity among groups.Specifically,the distribution of 18 bacterial species varied significantly among the three groups,with a no-table reduction in SCFA-producing bacteria observed in the MF group.Analyses of fecal SCFAs revealed that acetic acid levels were significantly lower in the MF group(P<0.05).CONCLUSION:The FMT reduces production of SCFAs by altering gut microbiota composition in mice,which was likely related to impaired glucose tolerance and decreased insulin sensitivity.