Search Results (120)

Wastewater-based epidemiology (WBE) has historically proven to be a powerful surveillance tool, particularly during the SARS-CoV-2 pandemic. Effective WBE depends on the sensitive detection of pathogens in wastewater. However, determining the process limit of detection (PLOD) of WBE through a comprehensive evaluation that accounts for pathogen concentration, nucleic acid extraction, and molecular analysis has rarely been documented. We prepared dilution series with known concentrations of S. Typhi, V. cholerae, rotavirus, and SARS-CoV-2 in surface water and wastewater. Pathogen concentration was performed using Nanotrap particles with the KingFisher™ Apex robotic platform, followed by nucleic acid extraction. Quantitative real-time PCR (qPCR) and digital PCR (dPCR) were used to detect the extracted nucleic acids of the pathogens. The PLODs and recovery efficiencies for each of the four pathogens in surface water and wastewater were determined. Overall, the observed PLODs for S. Typhi, V. cholerae, and rotavirus in surface water and wastewater were approximately 3 log₁₀ loads (2.1–2.8 × 10³/10 mL) using either qPCR or dPCR as the detection method. For SARS-CoV-2, the PLOD in surface water was 2.9 × 10⁴/10 mL with both RT-qPCR and dPCR, one log₁₀ higher than the PLODs of the other three pathogens. In wastewater, the PLOD for SARS-CoV-2 was 2.9 × 10⁴/10 mL using RT-qPCR and 2.9 × 10³/10 mL using dPCR. The mean recovery rates of S. Typhi, V. cholerae, rotavirus, and SARS-CoV-2 for dPCR in both surface water and wastewater were below 10.4%, except for S. Typhi and V. cholerae in wastewater, which showed significantly higher recoveries, from 26.5% at 4.6 × 10⁵/10 mL for S. Typhi to 58.8% at 4.8 × 10⁵/10 mL for V. cholerae. Our study demonstrated that combining qPCR or dPCR analysis with automated Nanotrap particle concentration and nucleic acid extraction using the KingFisher™ platform enables the sensitive detection of S. Typhi, V. cholerae, rotavirus, and SARS-CoV-2 in surface water and wastewater. Full article

Wastewater-based epidemiology (WBE) offers a promising tool for sexually transmitted infection (STI) surveillance, especially in settings where underdiagnosis or social stigma complicates conventional reporting. To assess its utility, we conducted a year-long study examining six STIs, Chlamydia trachomatis, Treponema pallidum, Neisseria gonorrhoeae, human immunodeficiency virus (HIV), hepatitis C virus (HCV), and herpes simplex virus (HSV), in weekly composite samples from the primary influent of a small-sized Midwestern wastewater treatment plant. Pathogen detection and quantification were performed via digital PCR. Among the tested targets, Gonorrhea, HIV, HCV, and HSV were detected at the highest frequencies, often in 40–50% of the samples, while Chlamydia and Syphilis appeared less frequently. Despite the variability in detection patterns, this study demonstrates that even infrequent signals can reveal community-level shedding of poorly reported or asymptomatic infections. Although month-to-month wastewater data were not strongly correlated with corresponding clinical records, which could potentially reflect delayed healthcare seeking and pathogen-specific shedding dynamics, the overall findings underscore WBE’s ability to complement existing surveillance by capturing infections outside traditional healthcare channels. These results not only advance our understanding of STI prevalence and population shedding but also highlight the practical benefits of WBE as an early warning and targeted intervention tool. Full article

Wastewater-based epidemiology (WBE) offers valuable insight into viral circulation at the community level. In this study, we combined digital PCR (dPCR) with molecular typing to investigate the prevalence and diversity of human adenoviruses (HAdVs) in untreated wastewater samples collected throughout Italy. HAdV genomes were detected in over 93% of the 168 samples analyzed, with concentrations up to 4.5 × 10⁶ genome copies per liter. For genotypic characterization, we used nested PCR followed by Sanger and Oxford Nanopore Technologies (ONTs) long-read sequencing. While Sanger sequencing identified three dominant genotypes (HAdV-A12, HAdV-B3, and HAdV-F41), ONT sequencing provided enhanced resolution, confirming all previously identified types and revealing seven additional genotypes: HAdV-B21, HAdV-C5, HAdV-D45, HAdV-D46, HAdV-D49, HAdV-D83, and HAdV-F40. This comprehensive approach highlights the added value of ONT long-read sequencing in uncovering the genetic complexity of adenoviruses in wastewater, particularly in detecting rare or low abundance types that conventional methods may miss. Our findings highlight the value of integrating quantitative and high-resolution molecular tools in WBE to improve surveillance and better understand the epidemiology of viral pathogens circulating in the human population. Full article

Background: Emerging and re-emerging infectious diseases (EIDs and Re-EIDs) cause significant economic crises and public health problems worldwide. Epidemics appear to be more frequent, complex, and harder to prevent. Early warning systems can significantly reduce outbreak response times, contributing to better patient outcomes. Improving early warning systems and methods might be one of the most effective responses. This study employs a bibliometric analysis to dissect the global research hotspots and evolutionary trends in the field of infectious disease early warning, with the aim of providing guidance for optimizing public health emergency management strategies. Methods: Publications related to the role of early warning systems in detecting and responding to infectious disease outbreaks from 1999 to 2024 were retrieved from the Web of Science Core Collection (WoSCC) database. CiteSpace software was used to analyze the datasets and generate knowledge visualization maps. Results: A total of 798 relevant publications are included. The number of annual publications has sharply increased since 2000. The USA produced the highest number of publications and established the most extensive cooperation relationships. The Chinese Center for Disease Control & Prevention was the most productive institution. Drake, John M was the most prolific author, while the World Health Organization and AHMED W were the most cited authors. The top two cited references mainly focused on wastewater surveillance of SARS-CoV-2. The most common keywords were “infectious disease”, “outbreak”, “transmission”, “virus”, and “climate change”. The basic keyword “climate” ranked the first and long duration with the strongest citation burst. “SARS-CoV-2”, “One Health”, “early warning system”, “artificial intelligence (AI)”, and “wastewater-based epidemiology (WBE)” were emerging research foci. Conclusions: Over the past two decades, research on early warning of infectious diseases has focused on climate change, influenza, SARS, virus, machine learning, warning signals and systems, artificial intelligence, and so on. Current research hotspots include wastewater-based epidemiology, sewage, One Health, and artificial intelligence, as well as the early warning and monitoring of COVID-19. Research foci in this area have evolved from focusing on climate–disease interactions to pathogen monitoring systems, and ultimately to the “One Health” integrated framework. Our research findings underscore the imperative for public health policymakers to prioritize investments in real-time surveillance infrastructure, particularly wastewater-based epidemiology and AI-driven predictive models, and strengthen interdisciplinary collaboration frameworks under the One Health paradigm. Developing an integrated human–animal–environment monitoring system will serve as a critical development direction for early warning systems for epidemics. Full article

Antimicrobial resistance (AMR) is an emerging global threat that is expanding in many areas of the world. Wastewater-based epidemiology (WBE) is uniquely suited for use in areas of the world where clinical surveillance is limited or logistically slow to identify emerging threats, such as in Sub-Saharan Africa (SSA). Wastewater was analyzed from three urban areas of Kampala, including a local HIV research clinic and two informal settlements. Wastewater extraction was performed using a low-cost, magnetic bead-based protocol that minimizes consumable plastic consumption followed by sequencing on the Oxford Nanopore Technology MinION platform. The majority of the analysis was performed using cloud-based services to identify AMR biomarkers and bacterial pathogens. Assemblies containing AMR pathogens were isolated from all locations. As one example, clinically relevant AMR biomarkers for multiple drug classes were found within Acinetobacter baumannii genomic fragments. This work presents a metagenomic WBE workflow that is compatible with areas of the world without robust water treatment infrastructure. This study was able to identify various bacterial pathogens and AMR biomarkers without shipping water samples internationally or relying on complex concentration methods. Due to the time-dependent nature of wastewater surveillance data, this work involved cross-training researchers in Uganda to collect and analyze wastewater for future efforts in public health development. Full article

Wastewater-based epidemiology (WBE) has emerged as a transformative approach for community-level health monitoring, particularly during the COVID-19 pandemic. This review critically examines the methodological framework of WBE systems through the following three core components: (1) sampling strategies that address spatial–temporal variability in wastewater systems, (2) comparative performance of different platforms in pathogen detection, and (3) predictive modeling integrating machine learning approaches. We systematically analyze how these components collectively overcome the limitations of conventional surveillance methods through early outbreak detection, asymptomatic case identification, and population-level trend monitoring. While highlighting technical breakthroughs in viral concentration methods and variant tracking through sequencing, the review also identifies persistent challenges, including data standardization, cost-effectiveness concerns in resource-limited settings, and ethical considerations in public health surveillance. Drawing insights from global implementation cases, we propose recommendations for optimizing each operational phase and discuss emerging applications beyond pandemic response. This review highlights WBE as an indispensable tool for modern public health, whose methodological refinements and cross-disciplinary integration are critical for transforming pandemic surveillance from reactive containment to proactive population health management. Full article

Wastewater-based epidemiology (WBE) has been widely employed to track the spread of human pathogens; however, correlating wastewater data with clinical surveillance remains challenging due to population variability and environmental factors affecting wastewater composition. This study evaluated different SARS-CoV-2 normalization methods, comparing static population estimates with dynamic normalization based on common physicochemical parameters: chemical oxygen demand (COD), biochemical oxygen demand (BOD₅), and ammonia (NH₄-N). Wastewater samples were collected from four urban wastewater treatment plants (WWTPs) in northwestern Tuscany (Italy) from February 2021 to March 2023. The correlations between normalized viral loads and clinical COVID-19 cases were highest for static normalization (ρ = 0.405), followed closely by dynamic normalization using COD and BOD₅ (ρ = 0.378 each). Normalization based on NH₄-N was less effective. These findings suggest that chemical parameters, particularly COD and BOD₅, offer a valid alternative for viral normalization when population estimates or flow rate measurements are unavailable. These parameters provide a cost-effective and practical approach for improving WBE reliability, particularly in resource-limited settings. Our results reinforce the importance of normalization in WBE to enhance its representativeness and applicability for public health surveillance. Full article

As measures of wellbeing have matured, wellbeing-related outcomes have become increasingly relevant as inputs to policy-making, with increasing numbers of countries using wellbeing metrics to guide decision-making and inform government budgetary processes that support sustainable development. The concept of the wellbeing economy (WBE) is gaining traction as a serious alternative to ‘business as usual’ in industrial development and may be expected to have increasing relevance in tourism planning, policy development, and assessment. The paper addresses the nature of the WBE, what it is, and what it is expected to achieve for both public- and private-sector stakeholders. The implications for tourism policy, destination development and tourism operations are discussed. Several types of barriers to participation by the tourism industry in the WBE agenda are identified. The final section outlines a future agenda for tourism research and sustainable development based on a wellbeing-informed approach. Full article

Wastewater surveillance has emerged as a cost-effective and equitable approach for tracking the spread of SARS-CoV-2. In this study, we monitored the prevalence of SARS-CoV-2 on a university campus over three years (2021–2023) using wastewater-based epidemiology (WBE). Wastewater samples were collected from 11 manholes on campus, each draining wastewater from a corresponding dormitory building, and viral RNA concentrations were measured using reverse transcription-quantitative PCR (RT-qPCR). Weekly clinical case data were also obtained from the university health center. A strong positive and significant correlation was observed between Grab and Composite sampling methods, supporting their robustness as equally effective approaches for sample collection. Specifically, a strong correlation was observed between Aggie Village 4 Grab and Aggie Village 4 Composite samples (R² = 0.84, p = 0.00) and between Barbee Grab and Barbee Composite samples (R² = 0.80, p = 0.00). Additionally, higher viral RNA copies of SARS-CoV-2 (N1 gene) were detected during the Spring semester compared to the Fall and Summer semesters. Notably, elevations in raw N1 concentrations were observed shortly after the return of college students to campus, suggesting that these increases were predominantly associated with students returning at the beginning of the Fall and Spring semesters (January and August). To account for variations in fecal loading, SARS-CoV-2 RNA concentrations were normalized using Pepper Mild Mottle Virus (PMMoV), a widely used viral fecal biomarker. However, normalization using PMMoV did not improve correlations between SARS-CoV-2 RNA levels and clinical case data. Despite these findings, our study did not establish WBE as a consistently reliable complement to clinical testing in a university campus setting, contrary to many retrospective studies. One key limitation was that numerous off-campus students did not contribute to the campus wastewater system corresponding to the monitored dormitories. However, some off-campus students were still subjected to clinical testing at the university health center under mandated protocols. Moreover, the university health center discontinued reporting cases per dormitory after 2021, making direct comparisons more challenging. Nevertheless, this study highlights the continued value of WBE as a surveillance tool for monitoring infectious diseases and provides critical insights into its application in campus environments. Full article

Background/Objectives: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition that causes anterior knee pain, often linked to increased joint stress. Rehabilitation typically includes education, strength training, and functional exercises. Recently, telerehabilitation has become a promising alternative, particularly useful in improving access to care in rural areas. This study compares the effects of supervised (SE), web-based (WBE), and self-guided (SGE) exercise programs on pain, functionality, and fear of movement (kinesiophobia) in individuals with PFPS. Materials and Methods: Sixty female patients with PFPS participated in this randomized controlled trial. They were randomly assigned to one of three groups: SE, WBE, or SGE. Each program lasted six weeks, with exercises adjusted based on individual tolerance. Outcomes were assessed using the Kujala Anterior Knee Pain Scale, the visual analog scale (VAS) for pain, the Timed Up and Go Test (TUG) for mobility, and the Tampa Kinesiophobia Scale. Results: All groups showed significant improvements in pain, functionality, and kinesiophobia (p < 0.05). The SE group achieved the greatest improvements across all measures, reducing pain and kinesiophobia while enhancing functionality (p < 0.017). The WBE group also showed significant improvements, outperforming the SGE group in all outcomes (p < 0.017). The SGE group demonstrated the least improvement but still achieved positive changes. Conclusions: Supervised exercise programs were the most effective in managing PFPS symptoms. However, the web-based programs also provided substantial benefits, making them a viable option when in-person supervision is not feasible. Future research should aim to enhance digital interventions for broader accessibility and engagement. Trial Registration: The study protocol was also registered on ClinicalTrials.gov (NCT06625086). Full article

Tire additives, extensively utilized as industrial raw materials, may enter aquatic environments through various pathways during production, usage, or disposal processes. Research has shown that these additives pose potential threats to human health. However, the information regarding human exposure to 1,3-diphenylguanidine (DPG), 1,3-di-o-tolylguanidine (DTG), and 1,2,3-triphenylguanidine (TPG) (collectively referred to as DPGs) remains limited. The objective of this research was to evaluate human exposure to DPG and its derivatives by analyzing urine and wastewater samples. DPG, DTG, and TPG were frequently detected in urine samples, with median concentrations of 0.19, 0.06, and 0.03 ng/L, respectively. The median urinary concentration of DPG was significantly higher in children than in the general population (p < 0.05). Nevertheless, higher concentrations of DPGs were detected in wastewater, with median values of 20.7 ng/L (DPG), 0.13 ng/L (DTG), and 0.85 ng/L (TPG). The per capita mass loads of ∑DPGs in wastewater treatment plants (WWTPs) were significantly higher on weekdays than weekends, whereas domestic WWTPs exhibited slightly lower average loads on weekdays compared to weekends. Additionally, urine–wastewater collaborative monitoring revealed that urinary excretion contributed only 28% to the total mass load of ∑DPGs in municipal wastewater, indicating it is not the main source in southern China. Consequently, the wastewater-based epidemiology (WBE) approach based on the analysis of parent compounds is unsuitable for assessing human exposure to DPGs. These results aid in developing an efficient surveillance system for understanding human exposure trends to DPGs. Full article

Business groups comprise independently owned firms based on different types of owner solidarity, such as kinship, ethnicity, religion, or political identity. However, research has been slow to account for how the adverse effects of ethnic solidarity influence BG-affiliate firm performance. We investigate the interplay of owner ethnicity and their firms’ innovation and export performance. We find variations in affiliates’ performance based on their self-identified ethnicities by analyzing data from the World Bank’s Enterprise Surveys (WBES) across 20 sub-Saharan African countries. Notably, long-established migrant communities, including Indian, Middle Eastern, and European entrepreneurs, experienced waning performance within the BG structure. In contrast, group-affiliated firms led by Chinese entrepreneurs show significant outperformance compared to their African counterparts and minority group affiliates. This study contributes to a novel understanding of the heterogeneous relationship between ethnic solidarity and BG-affiliated firms’ performance across sub-Saharan Africa. Full article

Toxic chemicals and epigenetic biomarkers associated with cancer have been used successfully in clinical diagnostic screening of feces and urine from individuals, but they have been underutilized in a global setting. We analyzed peer-reviewed literature to achieve the following: (i) compile epigenetic biomarkers of disease, (ii) explore whether research locations are geographically aligned with disease hotspots, and (iii) determine the potential for tracking disease-associated epigenetic biomarkers. Studies (n = 1145) of epigenetic biomarkers (n = 146) in urine and feces from individuals have established notable diagnostic potential for detecting and tracking primarily gastric and urinary cancers. Panels with the highest sensitivity and specificity reported more than once were SEPT9 (78% and 93%, respectively) and the binary biomarker combinations GDF15, TMEFF2, and VIM (93% and 95%), NDRG4 and BMP3 (98% and 90%), and TWIST1 and NID2 (76% and 79%). Screening for epigenetic biomarkers has focused on biospecimens from the U.S., Europe, and East Asia, whereas data are limited in regions with similar/higher disease incidence rates (i.e., data for New Zealand, Japan, and Australia for colorectal cancer). The epigenetic markers discussed here may aid in the future monitoring of multiple cancers from individual- to population-level scales by leveraging the emerging science of wastewater-based epidemiology (WBE). Full article

The main objectives of this study were to develop an optimized green extraction process to obtain high contents of oleuropein and flavonoids from olive leaves. A deep eutectic solvent (DES) combined with wall-breaking extraction (WBE) was employed. A DES composed of choline chloride and ethylene glycol in a 1:2 molar ratio with 30% moisture content outperformed lactic acid and methanol as extraction solvents. The optimal conditions, determined by response surface methodology, were 30% moisture content, 140 s of wall-breaking time, and a 230 mL/g liquid–solid ratio. Under these conditions, 88.87 mg/g DM oleuropein, 4.57 mg/g DM luteolin-7-O-glucoside, and 114.31 mg RE/g total flavonoids were obtained. Among three olive varieties (Arbosana, Arbequina, and Picholine) cultivated in China, young Picholine leaves exhibited the highest contents. The Picholine-enriched extract demonstrated higher antioxidant activity (ABTS^•+ 155.10 mg/mL, DPPH^• 44.58 mg/mL) compared to other DES-based extracts, although it was lower than that of purified compounds. Furthermore, the CCK-8 assay revealed significant inhibition of Eca-109 human esophageal cells by the Picholine-enriched extract at 25 µg/mL for 24 h, compared to Het-1A cells. This process effectively recovers bioactive compounds from olive by-product, and shows potential for applications in nutritional supplements, cosmetics, and the food industry. Full article

This review examines existing studies on wheat bran extracts (WBEs) to provide an overview of their functional properties, including antioxidant and enzyme-inhibitory activities, highlighting their potential as natural alternatives for applications in both the food and cosmetic industries. Despite variations in extraction techniques, WBEs consistently demonstrated a significant presence of phenolic compounds and antioxidant activity. In the food industry, WBEs are valued for their nutritional richness, including dietary fiber, proteins, and bioactive compounds such as arabinoxylans. These compounds improve food texture, stability, and baking properties. Additionally, WBEs have demonstrated antimicrobial potential, enhanced product quality, and serve as natural preservatives. Furthermore, WBEs exhibit significant inhibitory effects against collagenase and elastase, suggesting promising anti-aging potential. In the cosmetics sector, WBEs have gained attention due to their emulsion stability, skin-whitening properties, antimicrobial effects, and antioxidant capacities. They have the potential to enhance the stability of cosmetic emulsions, improve skin hydration, and inhibit enzymes linked to skin aging, positioning WBEs as potentially natural alternatives to synthetic ingredients in skincare and anti-aging products. Our recent pilot study also supports that WBEs enhance antioxidant defenses against oxidative stress in rats, highlighting their potential role in anti-aging interventions. To further elucidate the efficacy and bioavailability of the beneficial bioactive compounds in WBEs for both food and cosmetic applications, more comprehensive in vivo studies are required in the future. Full article