Phthalates Boost Natural Transformation of Extracellular Antibiotic Resistance Genes through Enhancing Bacterial Motility and DNA Environmental Persistence.

The environmental dissemination of extracellular antibiotic resistance genes (eARGs) in wastewater and natural water bodies has aroused growing ecological concerns. The coexisting chemical pollutants in water are known to markedly affect the eARGs transfer behaviors of the environmental microbial community, but the detailed interactions and specific impacts remain elusive so far. Here, we revealed a concentration-dependent impact of dimethyl phthalate (DMP) and several other types of phthalate esters (common water pollutants released from plastics) on the natural transformation of eARGs. The DMP exposure at an environmentally relevant concentration (10 µg/L) resulted in a 4.8-times raised transformation frequency of Acinetobacter baylyi but severely suppressed the transformation at a high concentration (1000 µg/L). The promotion by low-concentration DMP was attributed to multiple mechanisms, including increased bacterial mobility and membrane permeability to facilitate eARGs uptake and improved resistance of the DMP-bounded eARGs (via noncovalent interaction) to enzymatic degradation (with suppressed DNase activity). Similar promoting effects of DMP on the eARGs transformation were also found in real wastewater and biofilm systems. In contrast, higher-concentration DMP suppressed the eARGs transformation by disrupting the DNA structure. Our findings highlight a potentially underestimated eARGs spreading in aquatic environments due to the impacts of coexisting chemical pollutants and deepen our understanding of the risks of biological-chemical combined pollution in wastewater and environmental water bodies.

Wasted Food, Wasted Resources? A Critical Review of Environmental Impact Analysis of Food Loss and Waste Generation and Treatment.

Food loss and waste (FLW) comes with significant environmental impacts and thus prevents a sustainable food system transition. Here we conducted a systematic review of 174 screened studies that assessed the environmental impacts of FLW generation and treatment. We found that the embodied impacts of FLW along the supply chain and impacts from FLW treatment received equal attention, but few studies have included both. The reviewed studies show narrow geographical (mostly conducted in industrialized countries) and food supply chain (mostly focused on the consumption stage) coverage. Life cycle analysis (LCA), material flow analysis (MFA), or their combination are the most commonly used to quantify FLW related environmental impacts. More method standardization, integration, and innovation and better FLW data with regional and stage resolution from a first-hand source are badly needed. Among the various proposed mitigation strategies covering technology, economy, behavior, and policy aspects, process optimization and waste management options are the most discussed. Our review calls for a more holistic environmental impact assessment of FLW generation and treatment and analysis of the trade-offs among different environmental impact categories and between supply chain stages, which would better inform relevant policy on effective environmental impact mitigation strategies toward sustainable food systems.

Engineering Redox Cofactor Balance for Improved 5-Methyltetrahydrofolate Production in Escherichia coli.

5-Methyltetrahydrofolate (5-MTHF) is the sole active form of folate functioning in the human body and is widely used as a nutraceutical. Unlike the pollution from chemical synthesis, microbial synthesis enables green production of 5-MTHF. In this study, Escherichia coli BL21 (DE3) was selected as the host. Initially, by deleting 6-phosphofructokinase 1 and overexpressing glucose-6-phosphate 1-dehydrogenase and 6-phosphogluconate dehydrogenase, the glycolysis pathway flux decreased, while the pentose phosphate pathway flux enhanced. The ratios of NADH/NAD+ and NADPH/NADP+ increased, indicating elevated NAD(P)H supply. This led to more folate being reduced and the successful accumulation of 5-MTHF to 44.57 µg/L. Subsequently, formate dehydrogenases from Candida boidinii and Candida dubliniensis were expressed, which were capable of catalyzing the reaction of sodium formate oxidation for NAD(P)H regeneration. This further increased the NAD(P)H supply, leading to a rise in 5-MTHF production to 247.36 µg/L. Moreover, to maintain the balance between NADH and NADPH, pntAB and sthA, encoding transhydrogenase, were overexpressed. Finally, by overexpressing six key enzymes in the folate to 5-MTHF pathway and employing fed-batch cultivation in a 3 L fermenter, strain Z13 attained a peak 5-MTHF titer of 3009.03 µg/L, the highest level reported in E. coli so far. This research is a significant step toward industrial-scale microbial 5-MTHF production.

Mapping sustainable supply chain innovation: A comprehensive bibliometric analysis.

This comprehensive bibliometric study investigates Sustainable Supply Chain Innovation (SSCI) research, examining its evolution, identifying key contributors, and unveiling emerging trends. Analyzing 1158 English-language SSCI articles using the robust Scopus dataset exposes noteworthy journals, authors, institutions, and global contributions. The findings suggest a consistent increase in research output since 1999, with a notable surge in the past decade. Network analysis and density-based spatial clustering identified six SSCI research clusters: Sustainability and Responsibility in Business, Navigating Innovation and Disruption, Sustainable Business Strategies, Environmental Sustainability and Innovation, Sustainable Food Systems and Environmental Impact, and Sustainable Business Dynamics. These clusters highlight the diverse nature of the evolving Sustainability and Supply Chain Management (SCM) field, contributing to a thorough understanding of the SSCI research landscape and emphasizing interconnections between sustainability and SCM themes, potentially leading to more comprehensive theoretical models. Furthermore, this understanding aids businesses in anticipating emerging trends and implementing optimal practices in SSCI. Moreover, recognizing active institutions and global contributors provides practical insights for fostering strategic collaborations.

Global Health Commodities Supply Chain in the Era of COVID-19 Pandemic: Challenges, Impacts, and Prospects: A Systematic Review.

Background: The COVID-19 pandemic led to the most substantial health crisis in the 21st Century. This pandemic interrupted the supply of essential commodities for human beings. Among the essential commodities for human survival, disruption of the supply of essential health commodities has become a global concern. Objective: The study aimed to systematically analyze published articles on the challenges, impacts, and prospects of the global health commodities' supply chain in the era of the COVID-19 pandemic. Methods: A standard searching strategy was conducted in seven research databases to retrieve pertinent articles. Finally, 459 articles were retrieved for further screening, and only 13 articles were selected for final synthesis. Results: Almost 38.5% of the studies targeted the supply chain of health commodities used to treat HIV, TB, and malaria. Lockdown policies, travel restrictions, lack of transportation, low manufacturing capacity, and rising costs were the significant challenges indicated for the supply interruption of essential health commodities and COVID-19 vaccines. Findings indicated that the supply interruption of essential health commodities leads to a devastating impact on global health. Conclusion: Global medicine shortages due to the pandemic crisis can have a devastatingly harmful impact on patient outcomes and might result in a devastatingly long-lasting effect on the health of the world community. Supply-related challenges of the COVID-19 vaccine affect countries' ambitions for achieving herd immunity quickly. Monitoring the pandemic's effect on the health commodities' supply system and designing a short-term and long-term resilient health supply chain system that can cope with current and future health catastrophes is pivotal.

Tracking the changes of dissolved organic matter throughout the city water supply system with optical indices.

Dissolved organic matter (DOM) is important in determining the drinking water treatment and the supplied water quality. However, a comprehensive DOM study for the whole water supply system is lacking and the potential effects of secondary water supply are largely unknown. This was studied using dissolved organic carbon (DOC), absorption spectroscopy, and fluorescence excitation-emission matrices-parallel factor analysis (EEM-PARAFAC). Four fluorescent components were identified, including humic-like C1-C2, tryptophan-like C3, and tyrosine-like C4. In the drinking water treatment plants, the advanced treatment using ozone and biological activated carbon (O3-BAC) was more effective in removing DOC than the conventional process, with the removals of C1 and C3 improved by 17.7%-25.1% and 19.2%-27.0%. The absorption coefficient and C1-C4 correlated significantly with DOC in water treatments, suggesting that absorption and fluorescence could effectively track the changes in bulk DOM. DOM generally remained stable in each drinking water distribution system, suggesting the importance of the treated water quality in determining that of the corresponding network. The optical indices changed notably between distribution networks of different treatment plants, which enabled the identification of changing water sources. A comparison of DOM in the direct and secondary water supplies suggested limited impacts of secondary water supply, although the changes in organic carbon and absorption indices were detected in some locations. These results have implications for better understanding the changes of DOM in the whole water supply system to help ensure the supplied water quality.

A multi-objective optimization approach for green supply chain network design for the sea cucumber (Apostichopus japonicus) industry.

In China, aquatic supply chain network design does not include the green concept or the coordination of environmental and economic performance. Sea cucumber (Apostichopus japonicus) is an aquatic product of high economic value; however, studies on sea cucumber supply chain network optimization are lacking. This study is the first to design the sea cucumber supply chain and construct an optimization model. Considering the characteristics of the sea cucumber industry, LCA for Experts software and the CML-IA-Aug. 2016-world method were used to assess each aquaculture model's global warming potential (GWP), as the environmental performance indicator. In addition, multi-objective genetic algorithm (MOGA) coupled with Modified Technique for Order of Preference by Similarity to Ideal Solution (M-TOPSIS) integrates yield production, economic benefits, and environmental performance. The results demonstrated that cage seed rearing (CSR) combined bottom sowing aquaculture (BSA) represents the best production strategy upstream of the sea cucumber supply chain. In the downstream, the best proportion of sales channels in supermarkets, boutique stores and online shops accounted for 14.79 %, 58.02 % and 27.19 % of the production, respectively. The proposed optimization scenario 4 (S4) can increase product profit by 27.88 % and reduce GWP by 56.89 %. The following improvement measures are proposed: using sea cucumber aquaculture industry standards (cleaner production and green supplier selection) to regulate the behavior of enterprises, adopting an ecological and green production strategy, eliminating high-energy consumption and high emission production practices, and promoting widespread adoption of green consumption concepts. Finally, these measures may improve the sea cucumber supply chain, achieve coordinated environmental and economic performance development in the sea cucumber industry, and provide guidance for green optimization of other aquatic product supply chains in China.

How halogenated aromatic compounds affect the electron supply and consumption in glucose supported denitrification?

Halogenated aromatic compounds possess bidirectional effects on denitrifying bio-electron behavior, providing electrons and potentially interfering with electron consumption. This study selected the typical 4-chlorophenol (4-CP, 0-100 mg/L) to explore its impact mechanism on glucose-supported denitrification. When COD(glucose)/COD(4-CP)=28.70-3.59, glucose metabolism remained the dominant electron supply process, although its removal efficiency decreased to 73.84-49.66 %. When COD(glucose)/COD(4-CP)=2.39-1.43, 4-CP changed microbial carbon metabolism priority by inhibiting the abundance of glucose metabolizing enzymes, gradually replacing glucose as the dominant electron donor. Moreover, 5-100 mg/L 4-CP reduced adenosine triphosphate (ATP) by 15.52-24.67 % and increased reactive oxygen species (ROS) by 31.13-63.47 %, causing severe lipid peroxidation, thus inhibiting the utilization efficiency of glucose. Activated by glucose, 4-CP dechlorination had stronger electron consumption ability than NO2--N reduction (NO3--N > 4-CP > NO2--N), combined with the decreased nirS and nirK genes abundance, resulting in NO2--N accumulation. Compared with the blank group (0 mg/L 4-CP), 5-40 mg/L and 60-100 mg/L 4-CP reduced the secretion of cytochrome c and flavin adenine dinucleotides (FAD), respectively, further decreasing the electron transfer activity of denitrification system. Micropruina, a genus that participated in denitrification based on glucose, was gradually replaced by Candidatus_Microthrix, a genus that possessed 4-CP degradation and denitrification functions after introducing 60-100 mg/L 4-CP.

Modeling and analysis of a tourism supply chain considering service level and advertising in the context of regular epidemic prevention and control under COVID-19.

In the context of regular epidemic prevention and control, this paper considers a two-stage tourism supply chain consisting of a scenic spot that attracts tourists through advertising and a travel agency that invests in service improvement and epidemic prevention. By establishing theoretical game models of a tourism supply chain, we investigate how the service level and advertising level can affect the retail price, product service level, and profits of the supply chain. The results show that the service level of travel agencies could improve consumers' preferences, expand the market demand for tourism products, and improve the efficiency of the supply chain to achieve a win-win situation and increase the profits of the scenic spot and the travel agency. The retailer price, service level, promotion level, and supply chain profit all increase as the service coefficient and advertising coefficient increase, and the speed of the increase is higher for the centralized model than for other models. Some valuable information could be provided for supply chain enterprises to develop collaborative strategies and promote tourism supply chain management practices.

[Prevalence of and risk factors for perceived absence of breast milk supply in Chinese lactating women in 2013].

OBJECTIVE: To investigate the prevalence and influencing factors of postpartum perceived absence of breast milk supply among Chinese mothers in 2013. METHODS: This is a cross-sectional study based on the data collected from children and mothers under 2 years of age in 2013 as part of the nutrition and health surveillance of Chinese residents. In this study, multistage stratified cluster sampling method was used to select subjects from 55 countires/districts in 30 provinces in China. The perceived absence of breast milk supply was defined as the mother's self-reported absence of breast milk and failure to breastfeed. Breastfeeding knowledge, maternal breastfeeding knowledge and general characteristics were collected through a structured questionnaire. Univariate analysis and Logistic regression were used to analyze the factors associated with perceived absence of breast milk supply. RESULTS: A total of 12091 mothers were included in the study, including 419 in the perceived non-breastfeeding group, the prevalence of perceived absence of breast milk supply was 3.5%. Multivariate Logistic regression showed maternal age(OR=1.04, 95%CI 1.02-1.06), postpartum hemorrhage(OR=2.03, 95%CI 1.30-3.16), and belief that breastfeeding should continue beyond 12 months of age(OR=0.27, 95%CI 0.17-0.45), not knowing how to breastfeed(OR=3.31, 95%CI: 2.31-4.74) were the main influencing factors for perceived absence of breast milk supply after delivery. CONCLUSION: Age, postpartum hemorrhage and knowledge level of breastfeeding are the main risk factors for perceived absence of breast milk supply, and knowledge level of breastfeeding is a modifiable factor.

Key Factors Impacting a Medical Ventilator Supply Chain During the COVID- 19 Pandemic: Lessons for Pandemic Preparedness.

OBJECTIVES: Future pandemics may cause more severe respiratory illness in younger age groups than COVID-19, requiring many more mechanical ventilators. This publication synthesizes the experiences of diverse contributors to Medtronic's mechanical ventilator supply chain during the pandemic, serving as a record of what worked and what didn't, while identifying key factors affecting production ramp-up in this healthcare crisis. METHOD: In-depth, one-on-one interviews (n = 17) were held with key Medtronic personnel and suppliers. Template analysis was used, and interview content was analyzed for signals, initiatives, actions, and outcomes, as well as influencing forces. RESULTS: Key findings revealed many factors limiting ventilator production ramp-up. Supply chain strengths and weaknesses were identified. Political factors played a role in allocating ventilators and also supported production. Commercial considerations were not priority, but economic awareness was essential to support suppliers. Workers were motivated and flexible. Component shortages, space, production processes, and logistics were challenges. Legally based pressures were reported e.g., import and export restrictions. CONCLUSION: Crisis response alone is not enough; preparation is essential. Coordinated international strategies are more effective than individual country responses. Supply chain resilience based on visibility and flexibility is key. This research can help public health planners and the medical device industry prepare for future healthcare crises.

Digital Traceability in Agri-Food Supply Chains: A Comparative Analysis of OECD Member Countries.

In an era marked by globalization and rapid technological advancements, the agri-food sector confronts both unprecedented challenges and opportunities. Among these, digital traceability systems have emerged as pivotal in enhancing operational efficiencies, ensuring food safety, and promoting transparency throughout the supply chain. This study presents a comparative analysis of digital traceability adoption and its impact across member countries of the Organization for Economic Co-operation and Development (OECD). By utilizing a multidimensional analytical framework, this study investigates national regulations, legal frameworks, and key food commodities affected by digital traceability implementations. It systematically assesses the efficacy of these systems in meeting consumer transparency expectations, regulatory compliance, and the overarching goal of sustainable agri-food supply chains. Through case studies and empirical evidence, the paper elucidates the complex interplay between technological innovation and regulatory environments, offering insights into best practices and potential integration barriers. Ultimately, this comprehensive investigation contributes to the scholarly discourse on digital traceability, providing actionable recommendations for policymakers, industry stakeholders, and academia to navigate the complexities of modern agri-food systems.

A multi-criteria model of supply chain sustainability assessment and improvement for sugarcane agroindustry.

The sustainability of the sugarcane agro-industry supply chain plays a crucial role in providing economic benefits, minimizing social and environmental impacts, and optimizing resource utilization. This research aims to analyze the sustainability performance of the sugarcane agro-industry supply chain using multi-criteria assessment and formulate strategies for sustainability improvement. The study proposes a multi-criteria assessment model with twenty-eight indicators and four dimensions of sustainability: economic, social, environmental, and resources, which were developed based on previous research. The fuzzy inference system (FIS) and multi-dimensional scaling (MDS) methods were utilized to analyze the multi-criteria indicators of sustainability performance in each dimension and overall supply chain. The Adaptive Neuro Fuzzy Inference System (ANFIS) model was used to aggregate multi-dimension sustainability to achieve overall sustainability performance. A fuzzy cognitive map (FCM) framework was developed to formulate strategies for improving the sustainability performance of the supply chain. The research was verified at two sugar mill locations in Java Island, Indonesia. The FIS and MDS models successfully analyzed the sustainability performance of the two sugar agro-industries, showing an average value of "quite sustainable". The overall sustainability performance using the ANFIS model for mill A and B were 57.2 and 61.9, respectively. Series of FGDs combined with the FCM model successfully formulated five clusters of strategies as initiatives in improving the sustainability performance, namely raw material provision, harvesting and post-harvest activities, production process optimization, IT-based technology implementation, and institutional aspects. This present work seeks to contributes to the development of multi-criteria of sustainability performance for the food industry's supply chain. It also proposes a comprehensive framework for analyzing and improving sustainable supply chain performance under uncertainty using a combination of conventional and fuzzy assessment modeling approach. A practical initiative strategy in sustainability improvement is revealed for the sugarcane agroindustry's supply chain.

Multi-scenario flexible contract coordination for determining the quantity of emergency medical suppliers in public health events.

Determining the optimal number of emergency medical suppliers for the government to contract with in the context of public health events poses a challenging problem. Having too many suppliers can result in increased costs, while having too few suppliers can potentially expose the government to supply risks. Striking the right balance between these two factors is crucial in ensuring efficient and reliable emergency response and management. This study examines the process of determining the appropriate number of suppliers in emergency medical supply chain. By incorporating option contracts and employing the total cost of government procurement as the objective function, the analysis focuses on the impact of relevant parameters on the optimal number of suppliers. Furthermore, the study investigates the optimal supplier quantities under different types of option contracts. The proposed decision model for determining the optimal number of suppliers in this paper considers three key factors: the supply risk associated with emergency medical supplies, the reserve cost of government procurement, and the responsiveness of emergency medical supplies. Additionally, a method is introduced for selecting the quantity of emergency medical suppliers based on flexible contracts. This approach offers a scientific foundation for the government to effectively address the challenge of supplier quantity selection when faced with risks related to shortages, expiration, and the combination of both.

Super-resolution imaging for in situ monitoring sub-cellular micro-dynamics of small molecule drug.

Small molecule drugs play a pivotal role in the arsenal of anticancer pharmacological agents. Nonetheless, their small size poses a challenge when directly visualizing their localization, distribution, mechanism of action (MOA), and target engagement at the subcellular level in real time. We propose a strategy for developing triple-functioning drug beacons that seamlessly integrate therapeutically relevant bioactivity, precise subcellular localization, and direct visualization capabilities within a single molecular entity. As a proof of concept, we have meticulously designed and constructed a boronic acid fluorescence drug beacon using coumarin-hemicyanine (CHB). Our CHB design includes three pivotal features: a boronic acid moiety that binds both adenosine triphosphate (ATP) and adenosine diphosphate (ADP), thus depleting their levels and disrupting the energy supply within mitochondria; a positively charged component that targets the drug beacon to mitochondria; and a sizeable conjugated luminophore that emits fluorescence, facilitating the application of structured illumination microscopy (SIM). Our study indicates the exceptional responsiveness of our proof-of-concept drug beacon to ADP and ATP, its efficacy in inhibiting tumor growth, and its ability to facilitate the tracking of ADP and ATP distribution around the mitochondrial cristae. Furthermore, our investigation reveals that the micro-dynamics of CHB induce mitochondrial dysfunction by causing damage to the mitochondrial cristae and mitochondrial DNA. Altogether, our findings highlight the potential of SIM in conjunction with visual drug design as a potent tool for monitoring the in situ MOA of small molecule anticancer compounds. This approach represents a crucial advancement in addressing a current challenge within the field of small molecule drug discovery and validation.

Conscientious objection - a cross-sectional, vignette-based, mixed methods exploration of Australian pharmacists' perspectives.

Background: Conscientious objection (CO) in healthcare is a controversial topic. Some perceive CO as freedom of conscience, others believe their professional duty-of-care overrides personal-perspectives. There is a paucity of literature pertaining to pharmacists' perspectives on CO. Aim: To explore Australian pharmacists' decision-making in complex scenarios around CO and reasons for their choices. Method: A cross-sectional, qualitative questionnaire of pharmacists' perspectives on CO. Vignette-based questions were about scenarios related to medical termination, emergency contraception, IVF surrogacy for a same-sex couple and Voluntary Assisted Dying (VAD) Results: Approximately half of participants (n = 223) believed pharmacists have the right to CO and most agreed to supply prescriptions across all vignettes. However, those who chose not to supply (n = 20.9%), believed it justifiable, even at the risk of patients failing to access treatment. Strong self-reported religiosity had a statistically significant relationship with decisions not to supply for 3 of 4 vignettes. Three emergent themes included: ethical considerations, the role of the pharmacist and training and guidance. Conclusion: This exploratory study revealed perspectives of Australian pharmacists about a lack of guidance around CO in pharmacy. Findings highlighted the need for future research to investigate and develop further training and professional frameworks articulating steps to guide pharmacists around CO.

Passive Self-Sustained Thermoelectric Devices Powering the 24 h Wireless Transmission via Radiation-Cooling and Selective Photothermal Conversion.

The rapid development of the Internet of Things has triggered a huge demand for self-sustained technology that can provide a continuous electricity supply for low-power electronics. Here, a self-sustained power supply solution is demonstrated that can produce a 24 h continuous and unipolar electricity output based on thermoelectric devices by harvesting the environmental temperature difference, which is ingeniously established utilizing radiation cooling and selective photothermal conversion. The developed prototype system can stably maintain a large temperature difference of about 1.8 K for a full day despite the real-time changes in environmental temperature and solar radiation, thereby driving continuous electricity output using the built-in thermoelectric device. Specifically, the large output voltage of >102 mV and the power density of >4.4 mW m-2 could be achieved for a full day, which are outstanding among the 24 h self-sustained thermoelectric devices and far higher than the start-up values of the wireless temperature sensor and also the light-emitting diode, enabling the 24 h remote data transmission and lighting, respectively. This work highlights the application prospects of self-sustained thermoelectric devices for low-power electronics.

Knowledge, attitude and behaviours towards food sustainability in a group of Italian consumers. A cross-sectional study.

Sustainability is crucial for transforming the food system, addressing environmental and nutrition issues and depends on consumer perceptions and values. This cross-sectional study investigates the relationship between sustainability attitudes, knowledge, and eating behaviours. Nearly half reported high level of knowledge regarding food sustainability while 24% expressed high attitude towards food sustainability. Women reported higher levels of knowledge and attitude towards food sustainability. Logistic regression analyses, adjusted for age, sex, and education, revealed that using public transport, biking, or walking was significantly associated with higher odds of having a more positive overall attitude towards food sustainability (OR = 1.77). The overall knowledge score was a strong predictor of a positive overall attitude score (OR = 2.11). Examining individual knowledge-related items, almost all were associated with higher levels of knowledge, except those regarding food and environment interaction. These findings underline a complex scenario where consumers' awareness and knowledge highly influence the applicability of sustainable food choices.

Risk factors for Cryptosporidium contamination in Minnesota public supply wells.

In a recent monitoring study of Minnesota's public supply wells, Cryptosporidium was commonly detected with 40% of the wells having at least one detection. Risk factors for Cryptosporidium occurrence in drinking water supply wells, beyond surface water influence, remain poorly understood. To address this gap, physical and chemical factors were assessed as potential predictors of Cryptosporidium occurrence in 135 public supply wells in Minnesota. Univariable analysis, regression techniques, and classification trees were used to analyze the data. Many variables were identified as significant risk factors in univariable analysis and several remained significant throughout the succeeding analysis techniques. These factors fell into general categories of well use and construction, aquifer characteristics, and connectedness to the land surface, well capture zones, and land use therein, existence of potential contaminant sources within 200-feet of the well, and variability in the chemical and isotopic parameters measured during the study. These risk categories, and the specific variables and threshold values we have identified, can help guide future research on factors influencing Cryptosporidium contamination of wells and can be used by environmental health programs to develop risk-based sampling plans and design interventions that reduce associated health risks.