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Hydropower plays a pivotal role in low-carbon electricity generation, yet many projects are situated in regions facing heightened water scarcity risks. This research devised a plant-level Hydropower Water Scarcity Index (HWSI), derived from the ratio of water demand for electricity generation to basin-scale available runoff water. We assessed the water scarcity of 1736 hydropower plants in China for the baseline year 2018 and projected into the future from 2025 to 2060. The results indicate a notable increase in hydropower generation facing moderate to severe water scarcity (HWSI >0.05), rising from 10% in 2018 to 24-34% of the national total (430-630 TWh), with a projected peak in the 2030s-2040s under the most pessimistic scenarios. Hotspots of risk are situated in the southwest and northern regions, primarily driven by decreased river basin runoff and intensified sectoral water use, rather than by hydropower demand expansion. Comparative analysis of four adaptation strategies revealed that sectoral water savings and enhancing power generation efficiency are the most effective, potentially mitigating a high of 16% of hydropower risks in China. This study provides insights for formulating region-specific adaptation strategies and assessing energy-water security in the face of evolving environmental and societal challenges.
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Cambio Climático , Centrales Eléctricas , China , Abastecimiento de AguaRESUMEN
Understanding the impact of heavy precipitation on human mobility is critical for finer-scale urban flood risk assessment and achieving sustainable development goals #11 to build resilient and safe cities. Using â¼2.6 million mobile phone signal data collected during the summer of 2018 in Jiangsu, China, this study proposes a novel framework to assess human mobility changes during rainfall events at a high spatial granularity (500 m grid cell). The fine-scale mobility map identifies spatial hotspots with abnormal clustering or reduced human activities. When aggregating to the prefecture-city level, results show that human mobility changes range between -3.6 and 8.9%, revealing varied intracity movement across cities. Piecewise structural equation modeling analysis further suggests that city size, transport system, and crowding level directly affect mobility responses, whereas economic conditions influence mobility through multiple indirect pathways. When overlaying a historical urban flood map, we find such human mobility changes help 23 cities reduce 2.6% flood risks covering 0.45 million people but increase a mean of 1.64% flood risks in 12 cities covering 0.21 million people. The findings help deepen our understanding of the mobility pattern of urban dwellers after heavy precipitation events and foster urban adaptation by supporting more efficient small-scale hazard management.
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Macrodatos , Inundaciones , Humanos , Ciudades , ChinaRESUMEN
BACKGROUND: Kerion is a severe type of tinea capitis that is difficult to treat and remains a public health problem. OBJECTIVES: To evaluate the epidemiologic features and efficacy of different treatment schemes from real-world experience. METHODS: From 2019 to 2021, 316 patients diagnosed with kerion at 32 tertiary Chinese hospitals were enrolled. We analysed the data of each patient, including clinical characteristics, causative pathogens, treatments and outcomes. RESULTS: Preschool children were predominantly affected and were more likely to have zoophilic infection. The most common pathogen in China was Microsporum canis. Atopic dermatitis (AD), animal contact, endothrix infection and geophilic pathogens were linked with kerion occurrence. In terms of treatment, itraconazole was the most applied antifungal agent and reduced the time to mycological cure. A total of 22.5% of patients received systemic glucocorticoids simultaneously, which reduced the time to complete symptom relief. Furthermore, glucocorticoids combined with itraconazole had better treatment efficacy, with a higher rate and shorter time to achieving mycological cure. CONCLUSIONS: Kerion often affects preschoolers and leads to serious sequelae, with AD, animal contact, and endothrix infection as potential risk factors. Glucocorticoids, especially those combined with itraconazole, had better treatment efficacy.
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Antifúngicos , Itraconazol , Microsporum , Tiña del Cuero Cabelludo , Humanos , Preescolar , Antifúngicos/uso terapéutico , Masculino , Femenino , Tiña del Cuero Cabelludo/tratamiento farmacológico , Tiña del Cuero Cabelludo/epidemiología , Tiña del Cuero Cabelludo/microbiología , Itraconazol/uso terapéutico , China/epidemiología , Microsporum/aislamiento & purificación , Niño , Lactante , Glucocorticoides/uso terapéutico , Resultado del Tratamiento , Dermatitis Atópica/tratamiento farmacológico , Dermatitis Atópica/epidemiología , Dermatitis Atópica/microbiología , Factores de Riesgo , Adolescente , Adulto , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Current knowledge about public climate change perception mainly covers belief, concern, and attitudes. However, how this discourse is interpreted using individuals' own frame of reference remains largely unknown, particularly in many large emitters from non-Annex I countries such as China. This study, for the first time, performs a nationwide open-ended survey covering 4,037 respondents and collected 12,100 textual answers. Using a semiautomated coding method, we find seven mental images that exclusively represent the Chinese interpretation of the climate change issue, including global warming, distant icons, natural disasters, environmental degradation, cause, solution, and weather. Analysis of influencing factors shows that females, those with lower education levels, lower income, and older individuals tend to connect climate change with natural weather phenomena. Younger and well-educated residents in developed cities are more aware of various consequences and anthropogenic causes of climate change. People with stronger climate change beliefs, policy support, and personal experience of extreme weather are more likely to mention disastrous impacts, carbon emission as causes, and potential solutions. Employing the multilevel regression and post-stratification technique, we map the prevalence of mental images in China at the prefecture-city level. The results reveal significant geographical heterogeneity, with estimated national means ranging from a high of 55% (weather) to a low of 11% (solution). Our findings reveal diverse perspectives and a widespread misconception of climate change in China, suggesting the need for tailored clarification strategies to gain public consent.
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Exposure to ambient and indoor particle matter (PM2.5) leads to millions of premature deaths in China. In recent years, indoor air pollution and premature deaths associated with polluting fuel cooking demonstrate an abrupt decline. However, the driving forces behind the mortality change are still unclear due to the uncertainty in household fuel use prediction. Here, we propose an integrated approach to estimate the fuel use fractions and PM2.5-related deaths from outdoor and indoor sources during 2000-2020 across China. Our model estimated 1.67 and 1.21 million premature deaths attributable to PM2.5 exposure in 2000 and 2020, respectively. We find that the residential energy transition is associated with a substantial reduction in premature deaths from indoor sources, with 100,000 (95% CI: 76,000-122,000) for urban and 265,000 (228,000-300,000) for rural populations during 2000-2020. Economic growth is the dominant driver of fuel use transition and avoids 21% related deaths (357,000, 315,000-402,000) from polluting fuel cooking since 2000, which offsets the adverse impact of ambient emissions contributed by economic growth. Our findings give an insight into the coupled impact of socioeconomic factors in reshaping health burden in exposure pathways.
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Contaminantes Atmosféricos , Contaminación del Aire Interior , Contaminación del Aire , Humanos , Contaminantes Atmosféricos/análisis , Desarrollo Económico , Contaminación del Aire Interior/análisis , China/epidemiología , Culinaria , Material Particulado/análisis , Contaminación del Aire/análisisRESUMEN
The Basel Convention and prior studies mainly focused on the physical transboundary movements of hazardous waste (transporting waste from one region to another for cheaper disposal). Here, we take China, the world's largest waste producer, as an example and reveal the virtual hazardous waste flows in trade (outsourcing waste by importing waste-intensive products) by developing a multiregional input-output model. Our model characterizes the impact of international trade between China and 140 economies and China's interprovincial trade on hazardous waste generated by 161,599 Chinese enterprises. We find that, in 2015, virtual hazardous waste flows in China's trade reached 26.6 million tons (67% of the national total), of which 31% were generated during the production of goods that were ultimately consumed abroad. Trade-related production is much dirtier than locally consumed production, generating 26% more hazardous waste per unit of GDP. Under the impact of virtual flows, 40% of the waste-intensive production and relevant disposal duty is unequally concentrated in three Chinese provinces (including two least-developed ones, Qinghai and Xinjiang). Our findings imply the importance of expanding the scope of transboundary waste regulations and provide a quantitative basis for introducing consumer responsibilities. This may help relieve waste management burdens in less-developed "waste havens".
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Residuos Peligrosos , Abastecimiento de Agua , Comercio , Internacionalidad , ChinaRESUMEN
Municipal solid waste (MSW) incineration has developed rapidly in China. However, the air pollution-related health risks attributable to MSW incinerators are still far from known. In this context, an MSW incineration emission inventory was compiled using plant-level activity data and localized emission factors. Subsequently, Gaussian Plume Model and Risk Quotients Model were utilized to calculate the spatialized hazard index (HI) and carcinogenic risk (CR). Altogether, 76449 tons (t) of NO X, 25725 t of SO2, 16937 t of CO, 9279 t of HCl, 5629 t of particulate matter, 33 t of Cr, 33 t of Pb, 20 t of Hg, 6 t of Cd, 4 t of Ni, 0.4 t of As, and 94 g-toxic equivalent quantity of polychlorinated dibenzo- p-dioxins and polychlorinated dibenzofurans were emitted in 2015. The national average HI was 1.88 × 10-2, which was far lower than the acceptable level (HI ≤ 1). However, the national average CR was 5.71 × 10-6, which was approximately five times higher than the acceptable level (CR ≤ 1 × 10-6). The spatial heterogeneity of health risks was observed. The results enrich spatial dimensions of prior estimates and provide policy implications from the aspects of accelerating technology upgrades, strengthening emission standards, optimizing site selection and enhancing risk communication.
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Contaminantes Atmosféricos , Contaminación del Aire , China , Dibenzofuranos Policlorados , Incineración , Exposición por Inhalación , Residuos SólidosRESUMEN
An all-optical photonic microwave phase shifter that can realize a continuous 0°-360° phase shift is presented. The phase-shifting operation is implemented by controlling the phase of the two RF phase-modulation sidebands while keeping the optical carrier phase fixed. The use of two RF modulation sidebands, instead of a single sideband used in most conventional phase shifters, has the advantage of high-output RF signal power, and consequently high signal-to-noise ratio performance. Experimental results demonstrate the full -180° to +180° phase shift over a wide microwave frequency range from 11 to 26.5 GHz, and 14 dB increase in the output RF signal power compared to a conventional phase shifter.
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Advancing the synergetic control of climate change and environmental crisis is crucial for achieving global sustainable development goals. This study evaluates synergetic governance levels over climate change and four environmental issues at the provincial level in China from 2009 to 2020. Our findings reveal significant progress in China's coordinated efforts to mitigate carbon emissions, reduce air pollutants, and conserve water resources. However, there remains room for improvement in managing solid waste and protecting ecological systems and overall progress in synergetic governance has slowed since 2015. Employing a random forest model, we identify socio-economic factors with great influence on synergetic climate change and environmental governance, such as energy intensity, service sector development, electronic equipment manufacturing, and transportation. Additionally, we reveal nonlinear relationships between some factors and performance of environmental subsystems, including both plateau effects (e.g. output in the smelting of ferrous metals) and U-shaped patterns (e.g. output in the manufacturing of metal products), possibly attributed to constraints in end-of-pipe treatment capacities and complexities in supply chain networks. Furthermore, through hierarchical clustering analysis, we classify provinces into four groups and provide tailored recommendations for policymakers to enhance synergetic governance levels in their respective regions. The framework established in this study also serves as a valuable reference for countries seeking to develop practical and context-specific solutions to mitigate climate and environmental risks.
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With the soaring generation of hazardous waste (HW) during industrialization and urbanization, HW illegal dumping continues to be an intractable global issue. Particularly in developing regions with lax regulations, it has become a major source of soil and groundwater contamination. One dominant challenge for HW illegal dumping supervision is the invisibility of dumping sites, which makes HW illegal dumping difficult to be found, thereby causing a long-term adverse impact on the environment. How to utilize the limited historic supervision records to screen the potential dumping sites in the whole region is a key challenge to be addressed. In this study, a novel machine learning model based on the positive-unlabeled (PU) learning algorithm was proposed to resolve this problem through the ensemble method which could iteratively mine the features of limited historic cases. Validation of the random forest-based PU model showed that the predicted top 30% of high-risk areas could cover 68.1% of newly reported cases in the studied region, indicating the reliability of the model prediction. This novel framework will also be promising in other environmental management scenarios to deal with numerous unknown samples based on limited prior experience.
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Industrial enterprises are major sources of contaminants, making their regulation vital for sustainable development. Tracking contaminant generation at the firm-level is challenging due to enterprise heterogeneity and the lack of a universal estimation method. This study addresses the issue by focusing on hazardous waste (HW), which is difficult to monitor automatically. We developed a data-driven methodology to predict HW generation using wastewater big data which is grounded in the availability of this data with widespread application of automatic sensors and the logical assumption that a correlation exists between wastewater and HW generation. We created a generic framework that used representative variables from diverse sectors, exploited a data-balance algorithm to address long-tail data distribution, and incorporated causal discovery to screen features and improve computation efficiency. Our method was tested on 1024 enterprises across 10 sectors in Jiangsu, China, demonstrating high fidelity (R² = 0.87) in predicting HW generation with 4,260,593 daily wastewater data.
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Pollution from untreated wastewater discharges depletes clean water supply for humans and the environment. It poses adverse economic impacts by determining agricultural yields, manufacturing productivity, and ecosystem functionality. Current studies mainly focus on quantity-related water scarcity assessment. It is unknown how low water quality amplifies local water stress and induces cascading economic risks globally. In this study, we estimated both quality and quantity-related water scarcity index (WSI), local economic water scarcity risk (WSR), and cascading virtual WSR evident in global trade markets across 40 major economies from 1995 to 2010. We find developing countries, e.g., India and China, witnessed fast growth in both quantity and quality-related WSI. Major developed economies, e.g., the US and Germany, experienced a modest increase in water stress but alleviated quality-related risks. Local economic risk (WSR) grew from $116B to $380B, with quality-related risks rising from 20 % to 30 %. Virtual economic WSR in global supply chains increased from $39B to $160B, with quality-related risks increasing from 19 % to 27 %. China became the top exporter of economic WSR, ranked above the US, France, and Japan, and the second-largest position as an importer, trailing only the US. We finally conducted scenario modeling by 2030, assuming different progresses on SDG 6 targets. The findings suggest that only the most ambitious progress in both water quality enhancement and efficiency improvement helps to alleviate â¼20 % economic WSR globally. Our findings underscore the necessity for strategies that integrate management of untreated wastewater flows, improved water use efficiency, and diversification of supply chain networks to enhance global economic resilience to water challenges in the future.
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Ecosistema , Desarrollo Sostenible , Humanos , Deshidratación , Estudios Retrospectivos , Aguas Residuales , Abastecimiento de Agua , Contaminación del Agua , ChinaRESUMEN
Piles (kinds of geotechnical structures) are used for resisting various lateral loads including earthquakes and inclined loads. Hence, these structures' behavior under lateral load should be studied. Therefore, this investigation studies the lateral deflection (LD) of piles under different situations. 192 physical models were carried out by consideration of the most important factor on the lateral deflection amounts in dried sandy soils. Besides, a model of the Elman Neural Network (ENN) - Improved Arithmetic Optimizer (IAO) algorithm was suggested for predicting the piles' lateral deflection. For the intention of comparison, the Elman Neural Network model and Particle Swarm Optimization - Artificial Neural Network were utilized in lateral deflection amounts estimation. For evaluating the proposed model validity, some parameters like Variance Account For, determination coefficient, and Root Mean Squared Error were estimated. The results showed the ENN-IAO method is more reliable for lateral deflection prediction in a small-scale pile in comparison to the ENN method and PSO-ANN model.
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Previous studies have done more research on the relationship between carbon emission reduction, energy consumption, and economic growth in specific countries or regions, which rarely consider the issue of heterogeneity between countries or regions, and also lack the refinement of energy consumption categories. Using panel data from 2000 to 2017, this paper divided the top 28 global carbon emission countries into developed countries and developing countries, and explores co-integration and causality between renewable energy consumption, non-renewable energy consumption, economic growth, and carbon emission. Results suggested that there is a two-way causal relationship between carbon emissions and economic growth in all economies. There is a two-way causal relationship between economic growth in developed countries and consumption of renewable and non-renewable energy, while there is no significant relationship between economic growth and energy consumption in developing countries. There is a two-way causal relationship between carbon emissions and renewable energy in all economies, but there are significant differences; there is a two-way causal relationship between carbon emissions in developed countries and non-renewable energy, and only one-way causality exists in developing countries.
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Gases de Efecto Invernadero , Carbono , Dióxido de Carbono/análisis , Desarrollo Económico , Energía RenovableRESUMEN
Pollution exacerbates a region's water scarcity by making water unfit for different uses and reducing freshwater availability. Local water scarcity may lead to economic output losses, and the risk can be transmitted to downstream sectors through reduced input supplies. Previous studies focus on quantity-based water scarcity assessment. It is still unknown how water quality constraints may amplify economic risks of local water-use sectors and distant economies. Here we introduce an integrated method and assess the impacts of both quantity and quality-based local physical water scarcity risks (LWSR) and virtual water scarcity risks (VWSR) in domestic trade system in China. We find in 2017 quality-based LWSR and VWSR in China are â¼593 and â¼240 billion US$. Inclusion of water pollution constraints almost doubles the risks of economic losses due to insufficient clean water supply. We then identify critical regions and sectors that are highly risky or vulnerable to the supply chains. We find water pollution makes risky VWSR exporters more centralized in a few Northern provinces where available freshwater resources are already limited, e.g. the agriculture sector in Hebei province. VWSR importers span broadly, but water pollution increases concentrations of upstream suppliers that face local water scarcity for most provinces, decreasing overall resilience of China's domestic trade network. Our results underscore the needs to alleviate overall scarcity risks by conserving physical water resources and improving water quality simultaneously.
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Inseguridad Hídrica , Abastecimiento de Agua , China , Calidad del Agua , Recursos HídricosRESUMEN
OBJECTIVE: To investigate the effect of transurethral resection of the prostate (TURP) in the treatment of advanced prostate cancer with bladder outlet obstruction (BOO). METHODS: We included in this study 43 cases of advanced prostate cancer with BOO treated by TURP, and analyzed their IPSS, maximum urinary flow rate and relevant risk factors pre-operatively and at 3 and 12 months after TURP. RESULTS: Compared with the baseline, IPSS and the maximum urinary flow rate of the patients showed significant differences 3 months after surgery ([19.60 +/- 0.41] score vs. [9.58 +/- 0.33] score, [4.93 +/- 0.68] ml/s vs. [8.96 +/- 0.47] ml/s, P < 0.05), but not at 12 months ([15.73 +/- 0.66] score, [5.67 +/- 0.44] ml/s). In multiple regression analysis, a good outcome was associated with pre-operative acute urinary retention, while poor prognosis with hormone-refractory prostate cancer. CONCLUSION: In the treatment of advanced hormone-refractory prostate cancer with BOO, TURP can reduce IPSS and increase the maximum urinary flow rate in the early period after surgery, but its long-term effect is not so desirable. Meanwhile the operation itself may bring about relevant complications and reduce the patient's quality of life.
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Neoplasias de la Próstata/cirugía , Resección Transuretral de la Próstata , Anciano , Anciano de 80 o más Años , Estudios de Factibilidad , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Obstrucción del Cuello de la Vejiga Urinaria/cirugíaRESUMEN
Aspergillus fumigatus is an important opportunistic fungal pathogen. Patients treated with chemotherapeutic agent such as cyclophosphamide are susceptible to invasive pulmonary aspergillosis. Dectin-1 is a pattern recognition receptor critically involved in immune responses to A. fumigatus. Therefore, we tested whether cyclophosphamide treatment could cause alterations in dectin-1 expression in the lung, which could contribute to invasive pulmonary Aspergillus infections in patients. We established a murine A. fumigatus infectious model to investigate the kinetics of dectin-1 expression in lung tissues in the presence or absence of cyclophosphamide treatment. During infection, dectin-1 expression was strikingly increased in immunocompetent mice infected with A. fumigatus as compared to those in a non-infected control group. In vitro macrophages stimulated with heat-inactivated A. fumigatus conidia expressed a significantly elevated level of dectin-1. Infected mice treated with cyclophosphamide showed decreased levels of dectin-1 and a higher fungal burden in the lung than the infected mice without cyclophosphamide treatment. These results suggest that dectin-1 is involved in host defense against A. fumigatus infection and that suppression of dectin-1 expression caused by cyclophosphamide may contribute to susceptibility to infections caused by this fungus in the immunocompromised host.
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Aspergilosis/metabolismo , Aspergillus fumigatus/fisiología , Ciclofosfamida/farmacología , Inmunosupresores/farmacología , Pulmón/efectos de los fármacos , Proteínas de la Membrana/biosíntesis , Proteínas del Tejido Nervioso/biosíntesis , Análisis de Varianza , Animales , Aspergilosis/inmunología , Modelos Animales de Enfermedad , Regulación de la Expresión Génica/efectos de los fármacos , Inmunocompetencia , Lectinas Tipo C , Pulmón/metabolismo , Pulmón/microbiología , Masculino , Proteínas de la Membrana/genética , Proteínas de la Membrana/inmunología , Ratones , Ratones Endogámicos BALB C , Microscopía Fluorescente , Proteínas del Tejido Nervioso/genética , Proteínas del Tejido Nervioso/inmunología , Estadísticas no ParamétricasRESUMEN
The increase in microbial resistance to conventional antimicrobial agents is driving research for the discovery of new antibiotics and antifungal agents. The greatest challenge in this endeavor is to find antimicrobial agents with broad antimicrobial activity and low toxicity. Antimicrobial peptides, for example, RNases, are one of the promising areas. The production of RNases increases during infection, but their role is still being explored. Whereas the enzymatic activity of RNases is well documented, their physiological function is still being investigated. This study aimed to evaluate the antimicrobial activity of RNase 1, 2, 5, and 8 against E. coli strains, S. aureus, Streptococcus thermophilus, P. aeruginosa, Candida albicans, and Candida glabrata. The results demonstrated that RNases have a strain-specific antimicrobial activity. RNase 1 had the highest antimicrobial activity compared to other RNases. All the microorganisms screened had varying levels of susceptibility to RNases, except P. aeruginosa and E. coli DR115. RNase 1 showed dose-dependent activity against C. albicans. The RNase killed Candida albicans by lowering the mitochondrial membrane potential but did not damage the cell membrane. We concluded that strain-specific antimicrobial activity is one of the physiological roles of RNases.
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Interacciones Huésped-Patógeno , Inmunidad Innata , Ribonucleasas/química , Ribonucleasas/metabolismo , Membrana Celular , Enfermedades Transmisibles/etiología , Enfermedades Transmisibles/metabolismo , Resistencia a la Enfermedad/inmunología , Susceptibilidad a Enfermedades , Interacciones Huésped-Patógeno/inmunología , Isoenzimas , Potencial de la Membrana MitocondrialRESUMEN
Honey is thought to act against microbes and regulates microbiota balance, and this is mainly attributed to the enzymatic production of hydrogen peroxide, high osmolarity, and nonperoxidase factors, for example, lysozyme and botanical sources of nectar, while the effect of honey's probiotic is recently considered. The study of honey as source of beneficial microbes is understudied. The purpose of this study was to screen for the beneficial microorganisms in honey with antagonistic property against important pathogens and the mechanism of antimicrobial activity and thus play a beneficial role as probiotics. The results showed that one out of the fourteen bacterial isolates had antimicrobial activity and was identified as Bacillus Sp. A2 by 16S rRNA sequence and morphology. Antimicrobial activity of the isolate against C. albicans, E. coli, and S. aureus was confirmed by Agar well diffusion and liquid coculture assays, and the propagation of those microbes was significantly inhibited after treatment with the isolate Bacillus sp. A2 (p < .05) in comparison with untreated negative control and positive control (fluconazole, chloramphenicol, L. plantarum). The morphological changes including the distorted shape with indentations and leakages (SEM), damaged cell membrane, and cell wall with the disintegration and attachment of the Bacillus sp. A2 (TEM) in treated C. albicans were observed. Meanwhile, reactive oxygen species accumulation and decreased mitochondrial membrane potential were detected in treated C. albicans. These results revealed that the isolate Bacillus sp. A2 from honey has significant antimicrobial activity (p < .05) against C. albicans in comparison with untreated negative control and positive control L. plantarum, which depends on the accumulation of reactive oxygen species, mitochondrial damage, and the cell apoptosis. We concluded that the Bacillus sp. A2 possess the antimicrobial property, which may contribute to regulation of host's microbiota as a beneficial microbe or probiotic.
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Methotrexate has been widely used in the treatment of osteosarcoma, intracranial lymphomas and leukemia. However, patients are also at high risk of opportunist pathogens such as Aspergillus spp. infection for their deeply depressed immunity. The optimal choice of antifungal agents during the infection of Aspergillus for these patients is necessary to be explored. In this study, we investigated the interactions between antifungals and methotrexate against Aspergillus in vitro. A total of 23 clinical isolates of Aspergillus spp. were studied. Microdilution checkerboard technique was performed to evaluate the interaction of methotrexate with voriconazole, itraconazole, terbinafine and amphotericin B. The highest rate of synergy was obtained for the combination of terbinafine and methotrexate, which exhibited synergy against 60.9% (14/23) of strains. No interaction was detected for the combinations of methotrexate plus itraconazole or amphotericin B against 95.7% (22/23) or 100% of strains, respectively. Although voriconazole exhibited indifferent against 87% (20/23) of strains when combined with methotrexate, antagonism effect was found against 13% (3/23) of strains. The positive interactions of terbinafine and methotrexate were also certified by disk diffusion assay. In addition, we observed the morphological changes for the interaction of methotrexate with terbinafine against Aspergillus. Further inhibition and distortion of growth were found after the combination of terbinafine and methotrexate compared with the drugs treated alone. Clinical studies are warranted to further elucidate optimal treatments for the immunocompromised patients with Aspergillus infection.