The success of source protection in ensuring safe drinking water is centered around being able to understand the hazards present in the catchment then plan and implement control measures to manage water quality risk to levels which can be controlled through downstream barriers. The programs in place to manage source protection are complex sociotechnical systems involving policy, standards, regulators, technology, human factors and so on. This study uses System Theoretic Process Analysis (STPA) to analyze the operational hazards of a typical drinking water source protection (DWSP) program and identify control measures to ensure safe operations. To validate the results a questionnaire was developed and distributed to specialists in DWSP in Taiwan, Australia and Greece. Using Principle Components Analysis (PCA) of the questionnaire responses, the study identified four critical success factors (CSFs) for DWSP. The four factors identified are ‘Policy and Government Agency Support of Source Protection’, ‘Catchment Risk Monitoring and Information’, ‘Support of Operational Field Activities’ and ‘Response to Water Quality Threats’. The results of this study provide insight into the approach of grouping of source protection measures to identify a series of targeted CSF for operational source protection programs. Using CSF can aide catchment management agencies in ensuring that the risk level in the catchment is managed effectively and that threats to public health from drinking water are managed appropriately.

Globally, public acceptance of waste-to-energy (WtE) incinerators is a crucial factor in implementing national waste-to-energy policies. This study adds to the literature on anti-incinerator sentiment by drawing upon an extended psychological-emotional model that integrates place-, trust-, and fairness-based pathways. A total of 338 residents in the Asuwei area in North Beijing completed a survey on a proposal to construct a WtE incinerator in the vicinity. Hierarchical regression analyses indicate that place attachment positively enhances anti-incinerator sentiment through direct effects, as well as through moderation and mediation effects between risk perception and opposing willingness. Further, institutional trust negatively moderates the impact of perceived risk on anti-incinerator sentiment, in addition to directly reducing perceived risk. Trust also influences anti-incinerator sentiment via risk perception, attesting to the effectiveness of a casual model of trust. Likewise, fairness perception acts as another determinant of opposing sentiment, similar to trust. We further reveal that procedural fairness plays a more significant role in predicting anti-incinerator sentiment than does distributional fairness. These findings demonstrate the importance of using a range of instrumental and more affective strategies to promote social acceptance of renewable energy infrastructure.

Washing machines are one of the tools that bring great convenience to people's daily lives. However, washing machines that have been used for a long time often develop issues such as odor and mold, which can pose health hazards to consumers. There exists a conspicuous gap in our understanding of the microorganisms that inhabit the inner workings of washing machines. In this study, samples were collected from 22 washing machines in Shanghai, China, including both water eluted from different parts of washing machines and biofilms. Quantitative qualitative analysis was performed using fluorescence PCR quantification and microbial communities were characterized by high throughput sequencing (HTS). It showed that the microbial communities in all samples were predominantly composed of bacteria, and they have a strong adhesion ability in the washing machine environment. HTS results showed that in the eluted water samples, the bacteria mainly included Pseudomonas, Enhydrobacter, Brevibacterium and Acinetobacter. On the contrary, in biofilm samples, Enhydrobacter and Brevibacterium were the predominant bacterial microorganisms. Correlation analysis results revealed that microbial colonies in washing machines were significantly correlated with years of use and the type of detergent used to clean the washing machine. As numerous pathogenic microorganisms can be observed in the results, effective preventive measures and future research are essential to mitigate these health problems and ensure the continued safe use of these household appliances.

Surgical methods for treating spasmodic torticollis include denervation and myotomy (DAM) of the affected muscles, and deep brain stimulation (DBS). This study reports on the long-term efficacy, prognostic factors, safety, and hospitalization costs following these two procedures. We collected data from 94 patients with spasmodic torticollis, of whom 41 and 53 were treated with DAM and DBS, respectively, from June 2008 to December 2020 at the Chinese People’s Liberation Army General Hospital. We used the Tsui scale and the global outcome score of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) to evaluate the preoperative and postoperative clinical condition in all patients. We also determined the cost of hospitalization, prognostic factors, and serious adverse events following the two surgical procedures. The mean follow-up time was 68.83 months (range = 13–116). Both resection surgery and DBS showed good results in terms of Tsui (Z = -5.103, P = 0.000; Z = -6.210, P = 0.000) and TWSTRS scores (t = 8.762, P = 0.000; Z = -6.308, P = 0.000). Compared with the DAM group, the preoperative (47.71, range 24–67.25) and postoperative (18.57, range 0–53) TWSTRS scores in the DBS group were significantly higher (Z = -3.161, P = 0.002). We found no correlation between prognostic factors and the patient age, gender, or disease duration for either surgical procedure. However, prognostic factors were related to the length of the postoperative follow-up period in the DBS surgery group (Z = -2.068, P = 0.039; Z = -3.287, P = 0.001). The mean hospitalization cost in the DBS group was 6.85 times that found in the resection group (Z = -8.284, P = 0.000). The total complication rate was 4.26%. We found, both resection surgery and DBS, showed good results in the patients with spasmodic torticollis. Although DBS had a greater impact on the quality of life and the degree of pain relief, it was more expensive. Prognostic factors were related to the length of the postoperative follow-up period in patients who underwent DBS surgery.

The value of QuantiFERON in the diagnosis of tuberculosis and in the monitoring of the response to anti-tuberculosis treatment is unclear. The aims of this study were to evaluate the accuracy of the QuantiFERON-TB Gold In-Tube (QFT-GIT) test in the diagnosis of tuberculosis and in the monitoring of the response to anti-tuberculosis treatment in patients with active pulmonary tuberculosis (PTB). Between January 2013 and December 2015, 128 cases with active PTB and 128 controls with no mycobacterial infection, matched by age (within 3 years) and by the week that they visited Tainan Chest Hospital, were enrolled in the study. Serial testing by QFT-GIT at baseline and after 2 and 6 months of treatment was performed. At these time points, a comparison of the performance of QFT-GIT with that of sputum culture status among study subjects was conducted. Compared to baseline, 116 (87.2%) cases showed a decreased response, whereas 17 (12.8%) showed persistent or stronger interferon-gamma (IFN-γ) responses at 2 months. Their IFN-γ responses declined significantly from baseline to 2 months (median, 6.32 vs. 4.12; P < 0.005). The sensitivity values of the QFT-GIT test for the detection of pulmonary tuberculosis at cut-off points of 0.35 IU/ml, 0.20 IU/ml, and 0.10 IU/ml were 74.4%, 78.2%, and 80.5%, respectively. The specificity values at cut-off points of 0.35 IU/ml, 0.20 IU/ml, and 0.10 IU/ml were 66.2%, 63.9%, and 57.1%, respectively. Our results support the QFT-GIT assay as a potential tool for diagnosing tuberculosis and for monitoring the efficacy of anti-tuberculosis treatment.