The Influencing Factors of Implementation in Emergency Medical Service Systems - A Scoping Review.

OBJECTIVES: Emergency medical services (EMS) provide health care in situations with limited time and resources. Challenges arise when introducing novel medications, treatments, or technologies or modifying existing practices in these settings. Effective implementation strategies are pivotal for their success. This study aims to identify and categorize potential facilitators and barriers in the implementation of prehospital EMS through a review of relevant research articles.METHODS: We searched PubMed and EMbase to identify studies published before December 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for our search strategy and scoping review. We included original articles written in English that report on the factors that influence the implementation in prehospital settings. We extracted and categorized the factors into different themes.RESULTS: Out of the 371 retrieved papers, we selected 19 (5%) for inclusion in this review. We extracted 46 influencing factors from the selected articles and categorized them into ten themes: (1) Outer system, (2) Inner system, (3) Practitioner characteristics, (4) Resources, (5) Communication and collaboration, (6) Patient factors, (7) Intervention characteristics, (8) De-implementation of prior practices, (9) Logistical issues, and (10) Quality improvement.CONCLUSIONS: This study examined the literature on EMS implementation factors and proposed a 10-theme EMS model framework. Key factors include training/education, equipment/tools, communication with hospitals, and practitioners' attitudes.

IoT-Based Heartbeat Rate-Monitoring Device Powered by Harvested Kinetic Energy.

Remote patient-monitoring systems are helpful since they can provide timely and effective healthcare facilities. Such online telemedicine is usually achieved with the help of sophisticated and advanced wearable sensor technologies. The modern type of wearable connected devices enable the monitoring of vital sign parameters such as: heart rate variability (HRV) also known as electrocardiogram (ECG), blood pressure (BLP), Respiratory rate and body temperature, blood pressure (BLP), respiratory rate, and body temperature. The ubiquitous problem of wearable devices is their power demand for signal transmission; such devices require frequent battery charging, which causes serious limitations to the continuous monitoring of vital data. To overcome this, the current study provides a primary report on collecting kinetic energy from daily human activities for monitoring vital human signs. The harvested energy is used to sustain the battery autonomy of wearable devices, which allows for a longer monitoring time of vital data. This study proposes a novel type of stress- or exercise-monitoring ECG device based on a microcontroller (PIC18F4550) and a Wi-Fi device (ESP8266), which is cost-effective and enables real-time monitoring of heart rate in the cloud during normal daily activities. In order to achieve both portability and maximum power, the harvester has a small structure and low friction. Neodymium magnets were chosen for their high magnetic strength, versatility, and compact size. Due to the non-linear magnetic force interaction of the magnets, the non-linear part of the dynamic equation has an inverse quadratic form. Electromechanical damping is considered in this study, and the quadratic non-linearity is approximated using MacLaurin expansion, which enables us to find the law of motion for general case studies using classical methods for dynamic equations and the suitable parameters for the harvester. The oscillations are enabled by applying an initial force, and there is a loss of energy due to the electromechanical damping. A typical numerical application is computed with Matlab 2015 software, and an ODE45 solver is used to verify the accuracy of the method.

The global burden, trends, and inequalities of individuals with developmental and intellectual disabilities attributable to iodine deficiency from 1990 to 2019 and its prediction up to 2030.

Objective: The objective of this study was to assess the global burden of disease for developmental and intellectual disabilities caused by iodine deficiency from 1990 to 2019. Methods: Using data from the global burden of disease (GBD) 2019, we conducted a cross-country inequity analysis to examine the worldwide burden of developmental and intellectual disabilities caused by the issue of iodine deficiency from 1990 to 2019. Absolute and relative inequality were assessed by the slope index of inequality and the concentration index, respectively. After summarising the latest evidence, we also projected the age-standardized prevalence and years lived with disability (YLD) rates up to 2030 using the BAPC and INLA packages in R statistical software. Results: In 2019, the global age-standardized prevalence and YLD rates for developmental and intellectual disabilities due to iodine deficiency were 22.54 per 100,000 population (95% UI 14.47 to 29.23) and 4.12 per 100,000 population (95% UI 2.25 to 6.4), respectively. From 1990 to 2019, the age-standardized prevalence and YLD rates of developmental and intellectual disabilities due to iodine deficiency decreased significantly. Geographic distribution showed that areas with lower socio-demographic indices (SDI) were the most affected. The correlation between higher SDI and lower prevalence highlights the role of economic and social factors in the prevalence of the disease. Cross-national inequity analysis shows that disparities persist despite improvements in health inequalities. In addition, projections suggest that the disease burden may decline until 2030. Conclusion: This research underscores the necessity for targeted interventions, such as enhancing iodine supplementation and nutritional education, especially in areas with lower SDI. We aim to provide a foundation for policymakers further to research effective preventative and potential alternative treatment strategies.

Asymmetric catalytic synthesis of chiral covalent organic framework composite (S)-DTP-COF@SiO2 for HPLC enantioseparations by normal-phase and reversed-phase chromatographic modes.

A novel CCOF core-shell composite material (S)-DTP-COF@SiO2 was prepared via asymmetric catalytic and in situ growth strategy. The prepared (S)-DTP-COF@SiO2 was utilized as separation medium for HPLC enantioseparation using normal-phase and reversed-phase chromatographic modes, which displays excellent chiral separation performance for alcohols, esters, ketones, and epoxides, etc. Compared with chiral commercial chromatographic columns (Chiralpak AD-H and Chiralcel OD-H columns) and some previously reported chiral CCOF@SiO2 (CC-MP CCTF@SiO2 and MDI-ß-CD-modified COF@SiO2)-packed columns, there are 4, 3, 13, and 15 tested racemic compounds that could not be resolved on the Chiralpak AD-H column, Chiralcel OD-H column, CC-MP CCTF@SiO2 column, and MDI-ß-CD-modified COF@SiO2 column, respectively, which indicates that the resolution effect of (S)-DTP-COF@SiO2-packed column can be complementary to the other ones. The effects of the analyte mass, column temperature, and mobile phase composition on the enantiomeric separation were investigated. The chiral column exhibits good reproducibility after multiple consecutive injections. The RSDs (n = 5) of the peak area and retention time were less than 1.5% for repetitive separation of 2-methoxy-2-phenylethanol and 1-phenyl-1-pentanol. The chiral core-shell composite (S)-DTP-COF@SiO2 exhibited good enantiomeric separation performance, which not only demonstrates its potential as a novel CSP material in HPLC but also expands the range of applications for chiral COFs.

Site engineering of linear conjugated polymers to regulate oxygen adsorption affinity for boosting photocatalytic production of hydrogen peroxide without sacrificial agent.

Artificial photosynthesis of hydrogen peroxide (H2O2) is a hopeful alternative to the industrial anthraquinone process. However, rational fabrication of the photocatalysts for the production of H2O2 without any sacrificial agents is still a formidable challenge. Herein, two kinds of linear conjugated polymers (LCPs) including pyridinic N functionalized polymer (DEB-N2) and pyridinic N non-contained polymer (DEB-N0) were successfully synthesized. DEB-N2 displays enhanced light capturing ability and good dispersion in water, leading to a substantial initial H2O2 generation rate of 3492µmol g-1h-1 as well as remarkable photocatalytic stability in pure water. Furthermore, the temperature programmed desorption (TPD) and density functional theory (DFT) analysis reveal that highly electronegative pyridine-N atoms in DEB-N2 boost the adsorption affinity of oxygen molecules, which facilitates the occurrence of the oxygen reduction reaction, therefore enhancing the performance of photocatalytic H2O2 production. This study unveils that the presence of pyridinic N in DEB-N2 has a significant impact on photocatalytic H2O2 production, suggesting the precise manipulation of the chemical structure of polymer photocatalysts is essential to achieve efficient solar-to-chemical energy conversion.

MCA Parallel Anatomic Scanning MR Imaging-Guided Recanalization of a Chronic Occluded MCA by Endovascular Treatment.

Basi-parallel anatomic scanning has been widely used for assessing the vascular morphology of vertebral basilar arteries. Previous studies have demonstrated its efficacy in evaluating the morphology of the MCA, which we refer to as MCA parallel anatomic scanning MR imaging (MCPAS). In this study, we present our experience with the application of MCPAS in patients with MCA occlusion. Endovascular treatment was performed on the patients with intact MCA morphology visible in on MCPAS, with no intracranial hemorrhage, occlusion, or other complications observed. No severe stenosis or re-occlusion was observed at the 12-month postoperative follow-up. In conclusion, MCPAS is an effective method for assessing the outer contour of an occlusive MCA. Endovascular treatment can be considered a safe and efficient option for patients who show a favorable MCA through MCPAS assessment.

Unmasking Spatial Heterogeneity in Phytotoxicology Mechanisms Induced by Carbamazepine by Mass Spectrometry Imaging and Multiomics Analyses.

Previous studies have highlighted the toxicity of pharmaceuticals and personal care products (PPCPs) in plants, yet understanding their spatial distribution within plant tissues and specific toxic effects remains limited. This study investigates the spatial-specific toxic effects of carbamazepine (CBZ), a prevalent PPCP, in plants. Utilizing desorption electrospray ionization mass spectrometry imaging (DESI-MSI), CBZ and its transformation products were observed predominantly at the leaf edges, with 2.3-fold higher concentrations than inner regions, which was confirmed by LC-MS. Transcriptomic and metabolic analyses revealed significant differences in gene expression and metabolite levels between the inner and outer leaf regions, emphasizing the spatial location's role in CBZ response. Notably, photosynthesis-related genes were markedly downregulated, and photosynthetic efficiency was reduced at leaf edges. Additionally, elevated oxidative stress at leaf edges was indicated by higher antioxidant enzyme activity, cell membrane impairment, and increased free fatty acids. Given the increased oxidative stress at the leaf margins, the study suggests using in situ Raman spectroscopy for early detection of CBZ-induced damage by monitoring reactive oxygen species levels. These findings provide crucial insights into the spatial toxicological mechanisms of CBZ in plants, forming a basis for future spatial toxicology research of PPCPs.

Evolutionarily conserved 12-oxophytodienoate reductase trans-lncRNA pair affects disease resistance in tea (Camellia sinensis) via the jasmonic acid signaling pathway.

Long non-coding RNAs (lncRNAs) have gathered significant attention due to their pivotal role in plant growth, development, and biotic and abiotic stress resistance. Despite this, there is still little understanding regarding the functions of lncRNA in these domains in the tea plant (Camellia sinensis), mainly attributable to the insufficiencies in gene manipulation techniques for tea plants. In this study, we designed a novel strategy to identify evolutionarily conserved trans-lncRNA (ECT-lncRNA) pairs in plants. We used highly consistent base sequences in the exon-overlapping region between trans-lncRNAs and their target gene transcripts. Based on this method, we successfully screened 24 ECT-lncRNA pairs from at least two or more plant species. In tea, as observed in model plants such as Arabidopsis, alfalfa, potatoes, and rice, there exists a trans-lncRNA capable of forming an ECT-lncRNA pair with transcripts of the 12-oxophytodienoate reductase (OPR) family, denoted as the OPRL/OPR pair. Considering evolutionary perspectives, the OPRL gene cluster in each species likely originates from a replication event of the OPR gene cluster. Gene manipulation and gene expression analysis revealed that CsOPRL influences disease resistance by regulating CsOPR expression in tea plants. Furthermore, the knockout of StOPRL1 in Solanum tuberosum led to aberrant growth characteristics and strong resistance to fungal infection. This study provides insights into a strategy for the screening and functional verification of ECT-lncRNA pairs.

Numerical simulation of hydraulic characteristics and pollutant transport in the channels with different ice coverages.

In winter, rivers at high latitudes often freeze and an ice cover emerges at the free surface of the river. According to the coverage degree of the ice cover, rivers can be divided into free-flowing, partially frozen, and completely frozen. The presence of ice cover can greatly alter the hydraulic conditions of rivers, complicating the transport of pollutants in river channels. The distribution of pollutants in rivers with different ice coverages was simulated using the Detached Eddy Simulation (DES) model in this paper. The velocity distribution, the pollutant diffusion coefficient distribution, the turbulent kinetic energy distribution, and the vortex distribution with different ice coverages were analyzed. The velocity in the ice cover zone is at a lower rate than in the open flow zone. With the increase of the ice coverage, the turbulent kinetic energy of the ice cover area in partially frozen conditions gradually increases, which makes the water flow turbulence increase. The diffusion coefficient of pollutants in the ice cover area is greater than that in the open flow area, so pollutants disperse more quickly in the ice cover area. The turbulence energy and the diffusion coefficient have similar distribution characteristics beneath the ice cover. The presence of the ice cover promotes the movement of the vortex from the open flow area to the ice cover area, which may be the reason for the larger turbulence energy and the diffusion coefficient. The simulation results can provide a reference for ice disasters and water quality remediation.

Effects of Fast-Tempo and Binaural Beat Therapy Music during Warm-Up on Repeated Sprint Ability Test Performance among Young Soccer Players.

This prospective crossover study aimed to investigate the effect of binaural beat therapy music on soccer player performance. Between July 2023 and December 2023, 45 athletes (31 females/14 males, mean age = 20.47 ± 0.99) wore Bluetooth earphones through which one of the following was given during initial 20 min warm-up exercises before undergoing repeated sprint ability tests: no music/fast-tempo music/fast-tempo music with background binaural beat therapy music. Heart rate change after warm-up exercises/repeated sprint ability (RSA) tests and the time to finish RSA tests were recorded. Despite no significant difference in heart rate increase after warm-up between the two genders regardless of intervention, larger increases after RSA tests were found in males following any of the three interventions (all p < 0.01) with the most notable difference observed after fast-tempo music (p < 0.0001). A significant effect size (r = 0.2) correlated with fast-tempo music during warm-up in either gender. Binaural beat therapy music during warm-up reached a significant effect size only when all participants were considered, suggesting limited benefits.

Immunogenicity of 4-dose Essen intramuscular regimen for rabies post-exposure prophylaxis: A multi-center cross-sectional study in China.

BACKGROUND: The 4-dose Essen intramuscular (IM) regimen for rabies post-exposure prophylaxis (PEP) has been recommended by Advisory Committee on Immunization Practices (ACIP) and World Health Organization (WHO), but the large-sample clinical evidence is still limited. METHOD: Rabies virus neutralizing antibodies of 11,752 patients were detected from 409 rabies prevention clinics in 27 provinces in China. Patients with serum collected before or no later than 1 h after injection on the day of the fifth dose (day 28) of 5-dose Essen regimen were included in Group A to observe the immune efficacy of 4-dose Essen IM regimen, and patients with serum collected 14-28 days after injection of the fifth dose were included in Group B to observe the immune efficacy of 5-dose Essen IM regimen. RESULTS: Finally, 2351 cases met the inclusion and exclusion criteria, including 2244 cases in Group A and 107 cases in Group B. The antibody titer of Group A was higher than that of Group B [12.21 (4.15, 32.10) IU/ml vs. 9.41 (3.87, 27.38) IU/ml] (P = 0.002). In Group A, the median antibody titers were 4.01IU/ml, 11.63IU/ml and 29.46IU/ml in patients vaccinated with purified hamster kidney cell vaccine (PHKCV), purified Vero cell vaccine (PVRV), and human diploid cell rabies vaccine (HDCV), respectively, with statistical significance (P < 0.001). CONCLUSIONS: The 4-dose Essen IM regimen could provide satisfactory immune effect, and HDCV induced higher antibody titer than PHKCV or PVRV.

Chiral three-dimensional organic-inorganic lead iodide hybrid semiconductors.

Chiral hybrid metal halides (CHMHs) have received a considerable amount of attention in chiroptoelectronics, spintronics, and ferroelectrics due to their superior optoelectrical properties and structural flexibility. Owing to limitations in synthesis, the theoretical prediction of room-temperature stable chiral three-dimensional (3D) CHFClNH3PbI3 has not been successfully prepared, and the optoelectronic properties of such structures cannot be studied. Herein, we have successfully constructed two pairs of chiral 3D lead iodide hybrids (R/S/Rac-3AEP)Pb2I6 (3R/S/Rac, 3AEP = 3-(1-aminoethyl)pyridin-1-ium) and (R/S/Rac-2AEP)Pb2I6 (2R/S/Rac, 2AEP = 2-(1-aminoethyl)pyridin-1-ium) through chiral introduction and ortho substitution strategies, and obtained bulk single crystals of 3R/S/Rac. The 3R/S exhibits optical activity and bulk photovoltaic effect induced by chirality. The 3R crystal device exhibits stable circularly polarized light performance at 565 nm with a maximum anisotropy factor of 0.07, responsivity of 0.25 A W-1, and detectivity of 3.4 × 1012 jones. This study provides new insights into the synthesis of chiral 3D lead halide hybrids and the development of chiral electronic devices.

Omni-dimensional dynamic convolution feature coordinate attention network for pneumonia classification.

Pneumonia is a serious disease that can be fatal, particularly among children and the elderly. The accuracy of pneumonia diagnosis can be improved by combining artificial-intelligence technology with X-ray imaging. This study proposes X-ODFCANet, which addresses the issues of low accuracy and excessive parameters in existing deep-learning-based pneumonia-classification methods. This network incorporates a feature coordination attention module and an omni-dimensional dynamic convolution (ODConv) module, leveraging the residual module for feature extraction from X-ray images. The feature coordination attention module utilizes two one-dimensional feature encoding processes to aggregate feature information from different spatial directions. Additionally, the ODConv module extracts and fuses feature information in four dimensions: the spatial dimension of the convolution kernel, input and output channel quantities, and convolution kernel quantity. The experimental results demonstrate that the proposed method can effectively improve the accuracy of pneumonia classification, which is 3.77% higher than that of ResNet18. The model parameters are 4.45M, which was reduced by approximately 2.5 times. The code is available at https://github.com/limuni/X-ODFCANET .

Two C-terminal isoforms of Aplysia tachykinin-related peptide receptors exhibit phosphorylation-dependent and independent desensitization mechanisms.

Diversity, a hallmark of G protein-coupled receptor (GPCR) signaling, partly stems from alternative splicing of a single gene generating more than one isoform for a receptor. Additionally, receptor responses to ligands can be attenuated by desensitization upon prolonged or repeated ligand exposure. Both phenomena have been demonstrated and exemplified by the deuterostome tachykinin (TK) signaling system, although the role of phosphorylation in desensitization remains a subject of debate. Here, we describe the signaling system for tachykinin-related peptides (TKRPs) in a protostome, mollusk Aplysia. We cloned the Aplysia TKRP precursor, which encodes three TKRPs (apTKRP-1, apTKRP-2a, and apTKRP-2b) containing the FXGXR-amide motif. In situ hybridization and immunohistochemistry showed predominant expression of TKRP mRNA and peptide in the cerebral ganglia. TKRPs and their post-translational modifications were observed in extracts of CNS ganglia using mass spectrometry. We identified two Aplysia TKRP receptors (TKRPRs), named apTKRPR-A and apTKRPR-B. These receptors are two isoforms generated through alternative splicing of the same gene and differ only in their intracellular C-termini. Structure-activity relationship analysis of apTKRP-2b revealed that both C-terminal amidation and conserved residues of the ligand are critical for receptor activation. C-terminal truncates and mutants of apTKRPRs suggested that there is a C-terminal phosphorylation-independent desensitization for both receptors. Moreover, apTKRPR-B also exhibits phosphorylation-dependent desensitization through the phosphorylation of C-terminal Ser/Thr residues. This comprehensive characterization of the Aplysia TKRP signaling system underscores the evolutionary conservation of the TKRP and TK signaling systems, while highlighting the intricacies of receptor regulation through alternative splicing and differential desensitization mechanisms.

DR-70 (fibrinogen-fibrin degradation products) as a prognostic biomarker in dogs with neoplasms.

Fibrinogen-fibrin degradation products (DR-70) are derived from tumor cells or metastases. Our previous study reported the diagnostic values in dogs with tumors, but no research has yet to be conducted to establish DR-70 as a prognostic marker. Herein, we investigated changes in DR-70 concentrations and disease courses in dogs with tumors. Overall survival time (OST) analysis was performed in 195 dogs with tumors, stratified with a recommended cut-off (1.514 µg/mL). Continual DR-70 measurements were performed during the medical interventions of 27 dogs with neoplasms. Clinical conditions and medical records were retrospectively reviewed. According to a cut-off value, dogs with plasma DR-70 concentrations above 1.514 µg/mL had shorter survival rates than those with concentrations below this threshold. In cases with complete or partial remission in response to treatment, the DR-70 concentration was decreased compared with that at the first visit, whereas it was increased in patients with disease progression. Our study suggested that changes in DR-70 concentration can be used as a prognostic biomarker for canine neoplasms. Furthermore, increased plasma DR-70 levels might be associated with shorter survival, and DR-70 concentrations may reflect responses to medical intervention.

Control approach and evaluation framework of scaling in drinking water distribution systems: A review.

The United Nations Sustainable Development Goals call for innovative proposals to ensure access to clean water and sanitation. While significant strides have been made in enhancing drinking water purification technologies, the role of drinking water distribution systems (DWDS) in maintaining water quality safety has increasingly become a focal point of concern. The presence of scale within DWDS can impede the secure and efficient functioning of the drinking water supply system, posing risks to the safety of drinking water quality. Previous research has identified that the primary constituents of scale in DWDS are insoluble minerals, such as calcium and magnesium carbonate. Elevated levels of hardness and alkalinity in the water can exacerbate scale formation. To address the scaling issue, softening technologies like induced crystallization, nanofiltration/reverse osmosis, and ion exchange are currently in widespread use. These methods effectively mitigate the scaling in DWDS by reducing the water's hardness and alkalinity. However, the application of softening technologies not only alters the hardness and alkalinity but also induces changes in the fundamental characteristics of water quality, leading to transition effects within the DWDS. This article reviews the impact of various softening technologies on the intrinsic properties of water quality and highlights the merits of electrochemical characteristic indicators in the assessment of water quality stability. Additionally, the paper delves into the factors that influence the transition effects in DWDS. It concludes with a forward-looking proposal to leverage artificial intelligence, specifically machine learning and neural networks, to develop an evaluation and predictive framework for the stability of drinking water quality and the transition effects observed in DWDS. This approach aims to provide a more accurate and proactive method for managing and predicting the impacts of water treatment processes on distribution system integrity and water quality over time.

A study on the relationship between yoga exercise intervention and the comprehensive well-being of female college students.

Background: Due to the influence of theories, tools, and methodologies in studying well-being, sports science has predominantly focused on subjective well-being, with less attention given to psychological well-being and even less to the integrated study of comprehensive well-being. This study aims to analyze the relationship between yoga exercise intervention and the comprehensive well-being of college students and to explore the mechanism of a yoga exercise intervention to improve the comprehensive well-being of female college students. Methods: With 92 female college students as subjects, the "Comprehensive Well-being Scale" was used, and research methods such as yoga exercise intervention, questionnaire surveys, qualitative analysis, expert interviews, and statistical analysis were employed to investigate the role of a yoga exercise intervention on the comprehensive well-being of female college students. Results: Among the nine dimensions of comprehensive well-being, the three dimensions of subjective well-being and the two dimensions of psychological well-being (health concern and personality growth) of female college students were significantly improved. Additionally, four other dimensions of psychological well-being also showed significant improvement. Furthermore, the improvement in the life satisfaction of female college students' subjective well-being was mainly achieved through yoga meditation, while partner yoga posture practice could help individuals gradually form a stable pattern of altruistic behavior. Conclusion: Yoga exercise intervention can improve the comprehensive well-being of female college students and can be an effective counseling method for college students' mental health education.

Controlling Noncollinear Ferromagnetism in van der Waals Metal-Organic Magnets.

Van der Waals (vdW) magnets both allow exploration of fundamental 2D physics and offer a route toward exploiting magnetism in next generation information technology, but vdW magnets with complex, noncollinear spin textures are currently rare. We report here the syntheses, crystal structures, magnetic properties and magnetic ground states of four bulk vdW metal-organic magnets (MOMs): FeCl2(pym), FeCl2(btd), NiCl2(pym), and NiCl2(btd), pym = pyrimidine and btd = 2,1,3-benzothiadiazole. Using a combination of neutron diffraction and bulk magnetometry we show that these materials are noncollinear magnets. Although only NiCl2(btd) has a ferromagnetic ground state, we demonstrate that low-field hysteretic metamagnetic transitions produce states with net magnetization in zero-field and high coercivities for FeCl2(pym) and NiCl2(pym). By combining our bulk magnetic data with diffuse scattering analysis and broken-symmetry density-functional calculations, we probe the magnetic superexchange interactions, which when combined with symmetry analysis allow us to suggest design principles for future noncollinear vdW MOMs. These materials, if delaminated, would prove an interesting new family of 2D magnets.

Seasonal distribution of human-to-human pathogens in airborne PM2.5 and their potential high-risk ARGs.

Airborne microorganisms, an emerging global health threat, have attracted extensive studies. However, few attentions have been paid to the seasonal distribution of airborne pathogens, in particular their associations with antibiotic resistance genes (ARGs). To this end, two-week daily PM2.5 samples were consecutively collected from Nanchang in four seasons, and the human-to-human pathogens were screened based on high-throughput sequencing. The results showed that there were 20 pathogenic taxa in PM2.5 in Nanchang, and the highest relative abundance of pathogens was observed in winter (5.84%), followed by summer (3.51%), autumn (2.66%), and spring (1.80%). Although more than half of pathogenic taxa were shared by the four seasons, the analysis of similarities showed that pathogenic community was shaped by season (r = 0.16, p < 0.01). Co-occurrence network analysis disclosed significant interactions among pathogens in each season. Moreover, some dominant pathogens such as Plesiomonas shigelloides, Bacteroides fragilis, and Escherichia-Shigella were hub pathogens. In addition, PICRUSt2 predicted that there were 35 high-risk ARG subtypes in PM2.5, and the pathogens had strongly positive correlations with these ARGs. Even some pathogens like Plesiomonas shigelloides, Bacteroides fragilis, Aeromonas, Citrobacter, may be multi-drug resistant pathogens, including beta-lactam, aminoglycosides, chloramphenicol and multi-drug resistances, etc. Both air pollutants and meteorological conditions contributed to the seasonal variation of airborne pathogenic bacteria (r = 0.15, p < 0.01), especially CO, O3, PM2.5, temperature and relative humidity. This study furthers our understanding of airborne pathogens and highlights their associations with ARGs.