The effectiveness of cervical rehabilitation interventions for pain in adults with myogenic temporomandibular disorders: A systematic review and meta-analysis.

OBJECTIVE: Little evidence exists for the most effective conservative treatment approach for adults with myogenic temporomandibular disorders (MTMD). We aim to assess the effectiveness of cervical rehabilitation interventions on pain intensity and sensitivity in adults with MTMD compared to comparison intervention such as placebo, sham treatment, education or no intervention. METHODS: For this systematic review and meta-analysis, we searched PubMed, EMBASE, Medline, PEDro databases, forward and backward citations and grey literature studies through PROSPERO, clinical trials and data registries without language or date restrictions between inception and 1 December 2021. We selected randomised controlled trials (RCTs) based on adult populations with MTMD who had a cervical rehabilitation intervention which was defined as any conservative intervention targeting the anatomical structures of the cervical spine. The primary outcome measures for pain were self-reported pain intensity and pain sensitivity through the pressure pain threshold (PPT) of the masseter and temporalis muscles. Secondary outcome measures of maximal mouth opening (on MMO) were included. Included studies were assessed for bias with the Cochrane risk of bias tool for randomised trials. Evidence from RCTs was synthesised to determine treatment effect size as differences between standardised mean difference (SMD) for changes in pain intensity, PPT and MMO comparing adults with MTMD who were treated with cervical rehabilitation interventions compared to a control group. This study is registered on Prospero, number CRD 42021289299. RESULTS: Our general search yielded 2647 studies where seven RCTs met eligibility criteria with low to some concerns in their risk of bias. Pain intensity (five studies, n = 223, SMD -0.98, 95% CI -1.67 to -0.28, I2 = 79%), PPT of the masseter muscle (six studies, n = 395, SMD 0.64, 95% CI 0.43 to 0.86, I2 = 90%) and the temporalis muscles (five studies, n = 295, SMD 0.76, 95% CI 0.07 to 1.45, I2 = 84%) showed large treatment effect estimates favouring cervical rehabilitation interventions compared to no treatment, sham cervical treatment, patient education or non-cervical neuromuscular techniques. Compared to control interventions, one type of cervical rehabilitation intervention, cervical manual therapy alone or in combination with a neck exercise program was associated with statistically significant, large treatment effect estimates on pain intensity (four studies, n = 203, SMD -1.52, 95% CI -2.50 to -0.55). CONCLUSIONS: This review found that in the short-term, cervical rehabilitation interventions especially upper cervical MT alone or in combination with a neck exercise program are effective in improving multiple pain outcomes in adults with MTMD. However, further research is needed to measure the long-term effects of this type of intervention.

Performance characterization of a novel hybrid dosimetry insert for simultaneous spatial, temporal, and motion-included dosimetry for MR-linac.

BACKGROUND: Several (online) adaptive radiotherapy procedures are available to maximize healthy tissue sparing in the presence of inter/intrafractional motion during stereotactic body radiotherapy (SBRT) on an MR-linac. The increased treatment complexity and the motion-delivery interplay during these treatments require MR-compatible motion phantoms with time-resolved dosimeters to validate end-to-end workflows. This is not possible with currently available phantoms. PURPOSE: Here, we demonstrate a new commercial hybrid film-scintillator cassette, combining high spatial resolution radiochromic film with four time-resolved plastic scintillator dosimeters (PSDs) in an MRI-compatible motion phantom. METHODS: First, the PSD's performance for consistency, dose linearity, and pulse repetition frequency (PRF) dependence was evaluated using an RW3 solid water slab phantom. We then demonstrated the MRI4D scintillator cassette's suitability for time-resolved and motion-included quality assurance for adapt-to-shape (ATS), trailing, gating, and multileaf collimator (MLC) tracking adaptations on a 1.5 T MR-linac. To do this, the cassette was inserted into the Quasar MRI4D phantom, which we used statically or programmed with artificial and patient-derived motion. Simultaneously with dose measurements, the beam-gating latency was estimated from the time difference between the target entering/leaving the gating window and the beam-on/off times derived from the time-resolved dose measurements. RESULTS: Experiments revealed excellent detector consistency (standard deviation ≤ $\le$ 0.6%), dose linearity (R2 = 1), and only very low PRF dependence ( ≤ $\le$ 0.4%). The dosimetry cassette demonstrated a near-perfect agreement during an ATS workflow between the time-resolved PSD and treatment planning system (TPS) dose (0%-2%). The high spatial resolution film measurements confirmed this with a 1%/1-mm local gamma pass-rate of 90%. When trailing patient-derived prostate motion for a prostate SBRT delivery, the time-resolved cassette measurements demonstrated how trailing mitigated the motion-induced dose reductions from 1%-17% to 1%-2% compared to TPS dose. The cassette's simultaneously measured spatial dose distribution highlighted the dosimetric gain of trailing by improving the 3%/3-mm local gamma pass-rates from 80% to 97% compared to the static dose. Similarly, the cassette demonstrated the benefit of real-time adaptations when compensating patient-derived respiratory motion by showing how the TPS dose was restored from 2%-56% to 0%-12% (gating) and 1%-26% to 1%-7% (MLC tracking) differences. Larger differences are explainable by TPS-PSD coregistration uncertainty combined with a steep dose gradient outside the PTV. The cassette also demonstrated how the spatial dose distributions were drastically improved by the real-time adaptations with 1%/1-mm local gamma pass-rates that were increased from 8 to 79% (gating) and from 35 to 89% (MLC tracking). The cassette-determined beam-gating latency agreed within ≤ $\le$ 12 ms with the ground truth latency measurement. Film and PSD dose agreed well for most cases (differences relative to TPS dose < $<$ 4%), while film-PSD coregistration uncertainty caused relative differences of 5%-8%. CONCLUSIONS: This study demonstrates the excellent suitability of a new commercial hybrid film-scintillator cassette for simultaneous spatial, temporal, and motion-included dosimetry.

Full-scale multisampling and empirical modeling of DBPs in water and air of indoor pools.

Disinfection by-products (DBPs) are formed in the water in swimming pools due to reactions between disinfectants (chlorine, bromine, ozone) and the organic matter introduced by bathers and supply water. High concentrations of DBPs are also reported in the air of indoor swimming pools. Based on a robust multisampling program, the levels and variations of DBPs in the air (trichloramine [TCAM] and trihalomethanes [THMs]) and water (THM) were assessed, as well as their precursors (total organic carbon, water temperature, pH, free, and total chlorine) and proxies (CO2 and relative humidity) in four indoor chlorinated swimming pools. High-frequency sampling was conducted during one high-attendance day for each pool. This study focused on parameters that are easy to measure in order to develop models for predicting levels of THMs and TCAM in the air. The results showed that the number of bathers had an important impact on the levels of THMs and TCAM, with a two-to-three-fold increase in air chloroform (up to 110 µg/m3) and a two-to-four-fold increase in TCAM (up to 0.52 mg/m3) shortly after pools opened. The results of this study for the first time showed that CO2 and relative humidity can serve as proxies for monitoring variations in airborne THMs and TCAM. Our results highlight the good predictive capacity of the developed models and their potential for use in day-to-day monitoring. This could help optimize and control DBPs formation in the air of indoor swimming pools and reduce contaminant exposure for both pool employees and users.

Performance of the HYPERSCINT scintillation dosimetry research platform for the 1.5 T MR-linac.

Objective.Adaptive radiotherapy techniques available on the MR-linac, such as daily plan adaptation, gating, and dynamic tracking, require versatile dosimetric detectors to validate end-to-end workflows. Plastic scintillator detectors (PSDs) offer great potential with features including: water equivalency, MRI-compatibility, and time-resolved dose measurements. Here, we characterize the performance of the HYPERSCINT RP-200 PSD (MedScint, Quebec, CA) in a 1.5 T MR-linac, and we demonstrate its suitability for dosimetry, including in a moving target.Approach.Standard techniques of detector testing were performed using a Beamscan water tank (PTW, Freiburg, DE) and compared to microDiamond (PTW, Freiburg, DE) readings. Orientation dependency was tested using the same phantom. An RW3 solid water phantom was used to evaluate detector consistency, dose linearity, and dose rate dependence. To determine the sensitivity to motion and to MRI scanning, the Quasar MRI4Dphantom (Modus, London, ON) was used statically or with sinusoidal motion (A= 10 mm,T= 4 s) to compare PSD and Semiflex ionization chamber (PTW, Freiburg, DE) readings. Conformal beams from gantry 0° and 90° were used as well as a 15-beam 8 × 7.5 Gy lung IMRT plan.Main results.Measured profiles, PDD curves and field-size dependence were consistent with the microDiamond readings with differences well within our clinical tolerances. The angular dependence gave variations up to 0.8% when not irradiating directly from behind the scintillation point. Experiments revealed excellent detector consistency between repeated measurements (SD = 0.06%), near-perfect dose linearity (R2= 1) and a dose rate dependence <0.3%. Dosimetric effects of MRI scanning (≤0.3%) and motion (≤1.3%) were minimal. Measurements were consistent with the Semiflex (differences ≤1%), and with the treatment planning system with differences of 0.8% and 0.4%, with and without motion.Significance.This study demonstrates the suitability of the HYPERSCINT PSD for accurate time-resolved dosimetry measurements in the 1.5 T MR-linac, including during MR scanning and target motion.

Hybrid Cerenkov-scintillation detector validation using Monte Carlo simulations.

Objective.This study aimed at investigating through Monte Carlo simulations the limitations of a novel hybrid Cerenkov-scintillation detector and the associated method for irradiation angle measurements.Approach.Using Monte Carlo simulations, previous experimental irradiations of the hybrid detector with a linear accelerator were replicated to evaluate its general performances and limitations. Cerenkov angular calibration curves and irradiation angle measurements were then compared. Furthermore, the impact of the Cerenkov light energy dependency on the detector accuracy was investigated using the energy spectra of electrons travelling through the detector.Main results.Monte Carlo simulations were found to be in good agreement with experimental values. The irradiation angle absolute mean error was found to be less than what was obtained experimentally, with a maximum value of 1.12° for the 9 MeV beam. A 0.4% increase of the ratio of electrons having an energy below 1 MeV to the total electrons was found to impact the Cerenkov light intensity collected as a function of the incident angle. The effect of the Cerenkov intensity variation on the measured angle was determined to vary according to the slope of the angular calibration curve. While the contribution of scattered electrons with a lower energy affects the detector accuracy, the greatest discrepancies result from the limitations of the calculation method and the calibration curve itself.Significance.A precise knowledge of the limitations of the hybrid detector and the irradiation angle calculation method is crucial for a clinical implementation. Moreover, the simulations performed in this study also corroborate hypotheses made regarding the relations between multiple Cerenkov dependencies and observations from the experimental measurements.

Spatial and temporal variability of contaminants of emerging concern in a drinking water source.

The spatial-temporal behaviour of contaminants of emerging concern (CECs) are not well-documented in drinking water sources, including in Quebec, Canada. In this study, a set of seven contaminants, which are more frequently reported in water sources, were monitored from May 2016 to August 2017 at ten locations within an urbanized watershed (lakes and rivers) in Quebec, Canada. Samples were collected between a wastewater plant discharge (upstream) and the intake of a drinking water plant (downstream). The results showed that three (acetaminophen, salicylic acid, caffeine) out of seven CECs were consistently detected at a range of up to a few hundred ng L-1 at all sampling stations throughout the sampling period with a detection frequency between 51% and 94%. Upstream of two wastewater plant discharge locations, six CECs were measured above the detection limit compared to other locations where only three CECs (acetaminophen, salicylic acid, caffeine) were detected. Most of the CEC concentrations were higher (a few ng L-1) during late winter in comparison with the summer, in both years 2016 and 2017. The results highlight that the wastewater effluents and septic system effluents are significant sources of CECs that are released into the surface water. Moreover, the results help to identify the spatio-temporal patterns, which is a crucial element to understand the fate of CECs in water sources submitted to extreme weather conditions during the year. This research also provides baseline data for CEC occurrence at different points across lakes, rivers, and tributaries which will be useful for future ecotoxicological studies.

External beam irradiation angle measurement using a hybrid Cerenkov-scintillation detector.

Objective.In this study, we propose a novel approach designed to take advantage of the Cerenkov light angular dependency to perform a direct measurement of an external beam irradiation angle.Approach.A Cerenkov probe composed of a 10 mm long filtered sensitive volume of clear PMMA optical fibre was built. Both filtered and raw Cerenkov signals from the transport fibre were collected through a single 1 mm diameter transport fibre. An independent plastic scintillation detector composed of 10 mm BCF12 scintillating fibre was also used for simultaneous dose measurements. A first series of measurements aimed at validating the ability to account for the Cerenkov electron energy spectrum dependency by simultaneously measuring the deposited dose, thus isolating signal variations resulting from the angular dependency. Angular calibration curve for fixed dose irradiations and incident angle measurements using electron and photon beams where also achieved.Main results.The beam nominal energy was found to have a significant impact on the shapes of the angular calibration curves. This can be linked to the electron energy spectrum dependency of the Cerenkov emission cone. Irradiation angle measurements exhibit an absolute mean error of 1.86° and 1.02° at 6 and 18 MV, respectively. Similar results were obtained with electron beams and the absolute mean error reaches 1.97°, 1.66°, 1.45° and 0.95° at 9, 12, 16 and 20 MeV, respectively. Reducing the numerical aperture of the Cerenkov probe leads to an increased angular dependency for the lowest energy while no major changes were observed at higher energy. This allowed irradiation angle measurements at 6 MeV with a mean absolute error of 4.82°.Significance.The detector offers promising perspectives as a potential tool for future quality assurance applications in radiotherapy, especially for stereotactic radiosurgery (SRS), magnetic resonance image-guided radiotherapy (MRgRT) and brachytherapy applications.

Lead-doped scintillator dosimeters for detection of ultrahigh dose-rate x-rays.

Objective.Lead-doped scintillator dosimeters may be well suited for the dosimetry of FLASH-capable x-ray radiotherapy beams. Our study explores the dose rate dependence and temporal resolution of scintillators that makes them promising in the accurate detection of ultrahigh dose-rate (UHDR) x-rays.Approach.We investigated the response of scintillators with four material compositions to UHDR x-rays produced by a conventional x-ray tube. Scintillator output was measured using the HYPERSCINT-RP100 dosimetry research platform. Measurements were acquired at high frame rates (400 fps) which allowed for accurate dose measurements of sub-second radiation exposures from 1 to 100 ms. Dose-rate dependence was assessed by scaling tube current of the x-ray tube. Scintillator measurements were validated against Monte Carlo simulations of the probe geometries and UHDR x-ray system. Calibration factors converting dose-to-medium to dose-to-water were obtained from simulation data of plastic and lead-doped scintillator materials.Main Results.The results of this work suggest that lead-doped scintillators were dose-rate independent for UHDR x-rays from 1.1 to 40.1 Gy s-1and capable of measuring conventional radiotherapy dose-rates (0.1 Gy s-1) at extended distance from the x-ray focal spot. Dose-to-water measured with a 5% lead-doped scintillator detector agreed with simulations within 0.6%.Significance.Lead-doped scintillators may be a valuable tool for the accurate real-time dosimetry of FLASH-capable UHDR x-ray beams.

Technical note: Characterization and practical applications of a novel plastic scintillator for online dosimetry for an ultrahigh dose rate (FLASH).

PURPOSE: Although flash radiation therapy (FLASH-RT) is a promising novel technique that has the potential to achieve a better therapeutic ratio between tumor control and normal tissue complications, the ultrahigh pulsed dose rates (UHPDR) mean that experimental dosimetry is very challenging. There is a need for real-time dosimeters in the development and implementation of FLASH-RT. In this work, we characterize a novel plastic scintillator capable of temporal resolution short enough (2.5 ms) to resolve individual pulses. METHODS: We characterized a novel plastic dosimeter for use in a linac converter to deliver 16-MeV electrons at 100-Gy/s UHPDR average dose rates. The linearity and reproducibility were established by comparing relative measurements with a pinpoint ionization chamber placed at 10-cm water-equivalent depth where the electrometer is not saturated by the high dose per pulse. The accuracy was established by comparing the plastic scintillator dose measurements with EBT-XD Gafchromic radiochromic films, the current reference dosimeter for UHPDR. Finally, the plastic scintillator was compared against EBT-XD films for online dosimetry of two in vitro experiments performed at UHPDR. RESULTS: Relative ion chamber measurements were linear with plastic scintillator response within ≤1% over 4-20 Gy and pulse frequencies (18-180 Hz). When characterized under reference conditions with NIST-traceability, the plastic scintillator maintained its dose response under UHPDR conditions and agreed with EBT-XD film dose measurements within 4% under reference conditions and 6% for experimental online dosimetry. CONCLUSION: The plastic scintillator shows a linear and reproducible response and is able to accurately measure the radiation absorbed dose delivered by 16-MeV electrons at UHPDR. The dose is measured accurately in real time with a greater level of precision than that achieved with a radiochromic film.

Temporal and spatial variations in the levels of prominent airborne disinfection by-products at four indoor swimming pools.

Exposure to airborne disinfection by-products, especially trichloramine and trichloromethane, may cause various adverse health effects for the workers and users of indoor swimming pools. This study aims to evaluate the spatial and temporal variations in trichloramine and trichloromethane concentrations within and between swimming pools. Workplace measurements were carried out at four indoor swimming pools in Quebec (Canada) during the cold season. To fully represent daily operating conditions, sampling started 2 hr before the swimming pool opened and continued until 2 hr after closing. To quantify trichloramine and trichloromethane concentrations, 304 air samples have been collected. Temperature, humidity, and CO2 were measured-simultaneously every 2 hr. The results showed that both trichloramine and trichloromethane concentrations varied significantly in time. The observed daily variations in trichloramine and trichloromethane concentrations suggest that the common practice of collecting a single 2-hr air sample does not represent daily pool trichloramine and trichloromethane contamination levels and, consequently, does not represent the true exposure and health risks for workers that are present for a full 8-hr shift. This study recommends a new 8-hr sampling strategy or a full-shift strategy using a cassette with three impregnated filters as a valid and cost-effective solution for comparing time-weighted average (TWA) concentrations to permissible trichloramine exposure limits.

Oxygenation Defects, Ventilatory Ratio, and Mechanical Power During Severe Pediatric Acute Respiratory Distress Syndrome: Longitudinal Time Sequence Analyses in a Single-Center Retrospective Cohort.

OBJECTIVES: Our understanding of pediatric acute respiratory distress syndrome is based on information from studies reporting intermittent, serial respiratory data. We have analyzed a high-resolution, longitudinal dataset that incorporates measures of hypoxemia severity, metrics of lung mechanics, ventilatory ratio, and mechanical power and examined associations with survival after the onset of pediatric acute respiratory distress syndrome. DESIGN: Single-center retrospective cohort, 2013-2018. SETTING: Tertiary surgical/medical PICU. PATIENTS: Seventy-six cases of severe pediatric acute respiratory distress syndrome, determined according to the Pediatric Acute Lung Injury Consensus Conference criteria. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The high-resolution database included continuous monitoring of ventilatory data (0.03 Hz) for up to 14 days after the diagnosis of pediatric acute respiratory distress syndrome or until extubation or death (n = 26). In the 12,128 hours of data during conventional mechanical ventilation, we used generalized estimating equations to compare groups, accounting for any effect of time. We identified an association between survival and faster rate of improvement in delta pressure (peak inspiratory pressure minus positive end-expiratory pressure; p = 0.028). Nonsurvival was associated with higher daily Pediatric Logistic Organ Dysfunction-2 scores (p = 0.005) and more severe hypoxemia metrics (p = 0.005). Mortality was also associated with the following respiratory/pulmonary metrics (mean difference [95% CI]): positive end-expiratory pressure level (+2.0 cm H2O [0.8-3.2 cm H2O]; p = 0.001), peak inspiratory pressure level (+3.0 cm H2O [0.5-5.5 cm H2O]; p = 0.022), respiratory rate (z scores +2.2 [0.9-3.6]; p = 0.003], ventilatory ratio (+0.41 [0.28-0.55]; p = 0.0001], and mechanical power (+5 Joules/min [1-10 Joules/min]; p = 0.013). Based on generalized linear mixed modeling, mechanical power remained associated with mortality after adjustment for normal respiratory rate, age, and daily Pediatric Logistic Organ Dysfunction-2 score (+3 Joules/breath [1-6 Joules/breath]; p = 0.009). CONCLUSIONS: Mortality after severe pediatric acute respiratory distress syndrome is associated with the severity of organ dysfunction, oxygenation defects, and pulmonary metrics including dead space and theoretical mechanical energy load.

Probabilistic framework for assessing ecological risk of Contaminants of Emerging Concern: Application to a Canadian lake system.

Contaminants of Emerging Concern (CECs) in natural water pose risks to ecosystems. The concentration of CECs varies spatially and temporally, and their estimated ecotoxicities differ widely by toxicological studies. This study extensively reviewed literature on ecological risk assessment and proposed a probabilistic framework for assessing ecological risk and its uncertainties (aleatory and epistemic). The framework integrated Adverse Outcome Pathway in risk assessment and was applied to a Canadian lake system for seven CECs: salicylic acid, acetaminophen, caffeine, carbamazepine, ibuprofen, drospirenone, and sulfamethoxazole. Altogether 264 water samples were collected and analyzed from 15 sites May 2016 to September 2017. Phytoplankton, zooplankton, and fish were also sampled and analyzed. The results show ecological risk estimates (Risk Quotient, RQ) varied considerably indicating a range of uncertainty. Based on the conservative estimate, the central tendency estimate of the ecological risk of mixture compounds was medium (RQ = 0.6) including drospirenone. However, the reasonably maximum estimate of the risk was high (RQ = 1.4) for mixture compounds including drospirenone. The high risk is primarily due to drospirenone as its individual risk was high (RQ = 1.1) to fish. The specific site and time of high drospirenone exposure was identified for implementing control measures. Classification of ecotoxicity values based on environmental parameters such as climate and water quality, can reduce uncertainty in the risk estimate.

Characterization of an x-ray tube-based ultrahigh dose-rate system for in vitro irradiations.

PURPOSE: To present an x-ray tube system capable of in vitro ultrahigh dose-rate (UHDR) irradiation of small < 0.3 mm samples and to characterize it by means of a plastic scintillation detector (PSD). METHODS AND MATERIALS: A conventional x-ray tube was modified for the delivery of short UHDR irradiations. A beam shutter system with a sample holder was designed and installed in a close proximity of an x-ray tube window to enable <1 s irradiations at UHDR. The dosimetry was performed with a small 0.5-mm long 0.5-mm in diameter PSD irradiated with 80, 100, and 120 kVp beams and beam currents of 1-37.5 mA. The PSD signal was recorded at frame rates of 20 and 50 fps for shutter exposure between 100 and 1125 ms. Irradiation reproducibility was studied with the PSD. The x-ray tube irradiation setup was modeled with Monte Carlo (MC) and dose on a surface of a phantom was also measured with films. The effect of dose delivery uncertainty to 300-µm spheroids due to positioning and spheroid size was evaluated. RESULTS: MC simulations showed good agreement with PSD measurements acquired at both frame rates of 20 and 50 fps in terms of beam temporal profile. PSD-measured dose exhibited excellent linearity as a function of instantaneous dose rate from 3.1 to 118.0 Gy/s as well as shutter exposure time from 100 and 1125 ms for all investigated beam energies. PSD absorbed dose for the 80, 100, and 120 kVp beams agreed with MC simulations to within 5%. The total delivered doses ranged from 0.4 Gy for a 1-mA, 80 kVp beam, and 100 ms shutter exposure to 166.9 Gy for a 37.5-mA, 80 kVp beam, and a 1125 ms exposure. PSD irradiation reproducibility was < 0.5%. Simulated and measured dose fall off agreed and it was steep along the axis of the shutter slit (1%/0.1 mm) and with depth (2%/0.1 mm at 1-mm depth). Spheroid positioning uncertainty of 300 µm resulted in dose difference of < 3% for x and y shifts but up to 7% uncertainty for a z-shift parallel to the beam axis. A 16% difference in spheroid size resulted in <5% dose difference in spheroid absorbed dose. CONCLUSIONS: We have presented a cost-effective x-ray tube-based system with a beam shutter designed for in vitro UHDR delivery and reaching dose rates of up to 118.0 Gy/s. The described shutter system can be easily implemented at other institutions, which might enable new researchers to investigate the radiobiology of UHDR irradiations in vitro.

Tracking domestic wastewater and road de-icing salt in a municipal drinking water reservoir: Acesulfame and chloride as co-tracers.

Developing strategies to identify the origins of contaminants in watersheds is crucial for source water protection. The use of multiple tracers improves the ability to identify contamination events originating from various land use activities. The objective of this study was to evaluate the use of acesulfame and chloride as co-tracers to represent the impact of pollution originating from wastewater and road de-icing on water quality in a municipal drinking water source. The study included a two-year sampling and water quality analysis program in numerous locations within a drinking water reservoir comprising a lake (upstream) and a river (downstream) which supply raw water to a municipal water treatment plant. Results showed that the spatial variability of acesulfame and chloride within the watershed of the lake-river systems depends on the location of contaminant sources, mainly municipal wastewater and septic tank discharges (for acesulfame) and the presence of small tributaries of the lake and river (for chloride). Temporal variability of the tracers under study differed according to the sampling location and was mainly affected by seasonal conditions. Correlation analyses between the two tracers in lake and river waters (in terms of concentrations and loads) made it possible to pinpoint the probable origins of contamination. The assessment of the spatio-temporal variability of these co-tracers within the lake-river watersheds allowed for the delineation of priority intervention zones as a decision-making tool for municipal authorities in improving drinking water source protection.

Comparative optic and dosimetric characterization of the HYPERSCINT scintillation dosimetry research platform for multipoint applications.

This study introduces the HYPERSCINT research platform (HYPERSCINT-RP100, Medscint Inc., Quebec, Canada), the first commercially available scintillation dosimetry platform capable of multi-point dosimetry through the hyperspectral approach. Optic and dosimetric performances of the system were investigated through comparison with another commercially available solution, the Ocean Optics QE65Pro spectrometer. The optical characterization was accomplished by measuring the linearity of the signal as a function of integration time, photon detection efficiency and spectral resolution for both systems under the same conditions. Dosimetric performances were then evaluated with a 3-point plastic scintillator detector (mPSD) in terms of signal to noise ratio (SNR) and signal to background ratio (SBR) associated with each scintillator. The latter were subsequently compared with those found in the literature for the Exradin W1, a single-point plastic scintillator detector. Finally, various beam measurements were realized with the HYPERSCINT platform to evaluate its ability to perform clinical photon beam dosimetry. Both systems were found to be comparable in terms of linearity of the signal as a function of the intensity. Although the QE65Pro possesses a higher spectral resolution, the detection efficiency of the HYPERSCINT is up to 1000 time greater. Dosimetric measurements shows that the latter also offers a better SNR and SBR, surpassing even the SNR of the Exradin W1 single-point PSD. While doses ranging from 1 to 600 cGy were accurately measured within 2.1% of the predicted dose using the HYPERSCINT platform coupled to the mPSD, the Ocean optics spectrometer shows discrepancies up to 86% under 50cGy. Similarly, depth dose, full width at half maximum region of the beam profile and output factors were all accurately measured within 2.3% of the predicted dose using the HYPERSCINT platform and exhibit an average difference of 0.5%, 1.6% and 0.6%, respectively.

Occurrence and seasonality of raw and drinking water contaminants of emerging interest in five water facilities.

The goal of this work was to investigate the occurrence of contaminants of emerging interest (CEI) in source surface water (SW; river water) and drinking water (DW; tap water) from five drinking water treatment plants (DWTPs) in the Province of Québec, Canada. A total of 28 sampling campaigns were conducted to collect SW and DW samples from each DWTP from June 2016 to July 2017. The seven targeted CEI, including acetaminophen, salicylic acid, caffeine, carbamazepine, ibuprofen, sulfamethoxazole and drospirenone, were analyzed using solid-phase extraction-ultra pressure liquid chromatography-mass spectrometry (SPE-UPLC-MS/MS) for all collected water samples. The selected CEI were detected in all SW and DW samples, with the exception of drospirenone, which occurred in amounts that were below the limit of detection in one DWTP in June and July 2016. In all the SW samples, caffeine was detected and had the highest median concentration range (12.3-91.0 ng/L), followed by acetaminophen (7.9-85.0 ng/L) and salicylic acid (21.6-39.0 ng/L). In the DW samples, salicylic acid was detected and had the highest median concentration range (20.5-50 ng/L), followed by caffeine (5.2-21.8 ng/L), and acetaminophen (5.0-7.7 ng/L). Carbamazepine, ibuprofen, and sulfamethoxazole primarily occurred in amounts between the limit of detection and limit of quantification in SW and occurred below the limit of detection in DW. All the DWTPs exhibited a similar trend in the removal of CEI, which include acetaminophen (≤97.6%), followed by caffeine (71.0-86.5%) and salicylic acid (<50.0%). Varying levels of efficiencies were observed among the removal strategies for CEI under study, which were mainly associated with the contaminant concentration in SW in the case of acetaminophen, and with the treatment processes in the case of caffeine and salicylic acid.

Effects of domestic handling of drinking water on halogenated acetaldehydes.

Halogenated acetaldehydes (HALs) are widely considered to be the third largest group of identified disinfection by-products (DBPs) by weight in drinking water. In this study, we evaluated various scenarios for the domestic handling of drinking water and their effects on HALs. Two drinking water systems (DS1 and DS2) were selected for this case study. First, tap water samples that were collected in DS1 at different time and from different locations were subjected to three domestic handling scenarios: boiling, domestic filtration using a point-of-use device with a new filter followed by refrigeration, and refrigeration in a covered glass pitcher. In the last two scenarios, the maximum storage (refrigeration) time was 24 h. Second, two water samples each from DS1 and DS2 were collected to investigate the effects that heating water to different temperatures has on HALs. According to the results, boiling the water effectively removed most HALs except dichloroacetaldehyde (DCAL), which increased. In contrast to the variable behaviors of HALs after boiling, all HALs were consistently and significantly reduced by domestic filtration. However, the overall removal efficiency of HALs from filtration (65%) was considerably lower than that from boiling (85%). Finally, refrigeration had no significant impact on the overall concentration of total HALs. However, chloral hydrate levels increased in unfiltered water after refrigeration, likely due to the reaction of chlorine residuals and precursors present in water. Therefore, boiling and domestic filtering of tap water may be recommended for the removal of HALs prior to consuming tap water.

Perception of tap water quality: Assessment of the factors modifying the links between satisfaction and water consumption behavior.

Perception of tap water is subject to a wide range of factors and interactions. These include risk perception, tap water quality and organoleptic perceptions, microbiological and chemical quality, prior experiences, information sources, trust in water companies and other groups, and perceived control and contextual factors, among others. The objective of this study is to assess the factors that influence and determine citizen behavior regarding drinking water. A phone survey was conducted among 1014 citizens living in the city of Québec, Canada. Five different domestic water consumption profiles were elaborated according to the citizens' preferences and behavior. Descriptive statistics and mediation analyses were carried out to analyse the survey results and assess the factors modifying the links between satisfaction and water consumption behavior. Results show that drinking water quality could be loosely linked with overall satisfaction with tap water. The water consumption profile was strongly linked with satisfaction levels related to the taste, odor and color of tap water. We observed that the association between an individual's tap water satisfaction and water consumption behavior was mediated by the water treatment strategies applied at home (filtering, cooling), knowledge about drinking water quality and its production, and risk perception. The mediating effects were shown to be significant mainly among bottled-water-only and tap-water-only consumers. Future interventions that aim to encourage the population's use of tap water as a primary source should prioritize cooling and filtering tap water in their messaging, in order to improve population satisfaction. The reduction of risk perception through targeted information campaigns is also of primary importance for decreasing the number of citizens who exclusively drink bottled water.

Near real-time notification of water quality impairments in recreational freshwaters using rapid online detection of ß-D-glucuronidase activity as a surrogate for Escherichia coli monitoring.

Waterborne disease outbreaks associated with recreational waters continue to be reported around the world despite existing microbiological water quality monitoring frameworks. Most regulations resort to the use of culture-based enumeration of faecal indicator bacteria such as Escherichia coli to protect bathers from gastrointestinal illness risks. However, the long sample-to-result time of standard culture-based assays (minimum 18-24 h) and infrequent regulatory sampling (weekly or less) do not enable detection of episodic water quality impairments and associated public health risks. The objective of this study was to assess the suitability of an autonomous online technology measuring ß-D-glucuronidase (GLUC) activity for near real-time monitoring of microbiological water quality in recreational waters and for the resulting beach management decisions. GLUC activity and E. coli concentrations were monitored at three freshwater sites in Quebec, Canada (sites Qc1-3) and one site in New Zealand (site NZ) between 2016 and 2018. We found site-dependent linear relationships between GLUC activity and E. coli concentrations and using confusion matrices, we developed site-specific GLUC activity beach action values (BAVs) matching the regulatory E. coli BAVs. Using the regulatory E. coli BAV as the gold standard, rates of false alarms (unnecessary beach advisories using GLUC activity BAV) and failures to act (failure to trigger advisories using GLUC activity) ranged between 0 and 32% and between 3 and 10%, respectively, which is comparable to the rates reported in other studies using qPCR-defined BAVs. However, a major benefit of the autonomous enzymatic technology is the real-time reporting of threshold exceedances, while temporal trends in GLUC activity can assist in understanding the underlying dynamics of faecal pollution and potential health risks. Our study is the first to describe the applicability of online near real-time monitoring of microbiological water quality as a tool for improved beach management and public health protection.

Synergistic effects of quenching agents and pH on the stability of regulated and unregulated disinfection by-products for drinking water quality monitoring.

Quenching agents (QAs) are widely used in order to prevent the additional formation of disinfection by-products (DBPs) during the sample holding time. In addition, DBP levels are usually stabilized by adjusting the pH of water samples. Previous studies have mostly focused on the individual effects of QAs or of pH on the stability of DBPs in water samples. Considering that disinfectant quenching and pH adjustments are applied simultaneously during routine analyses, it is more appropriate to evaluate the stability of DBPs with all the chemicals (e.g., disinfectants, QAs, buffers) present in the water. This study investigated the synergistic effects of different QAs (ascorbic acid, ammonium chloride, or no quenching) and pH adjustment (3-9) strategies on the stability of different classes of DBPs (i.e., trihalomethanes (THMs), halogenated acetaldehydes (HALs), haloacetonitriles (HANs), haloketones (HKs), and halonitromethane (HNM)). Sample preservation conditions that did not include a QA were shown to be inadequate for GC-ECD analysis, due to interference problems. Ammonium chloride was found to be effective for most DBPs. However, some HALs continued to form in the presence of chloramine, which is a by-product of dechlorination using ammonium chloride. Conversely, using ascorbic acid efficiently inactivated residual chlorine, providing a clean chromatographic baseline. Based on the results of this study, we recommend the use of ascorbic acid for quenching and sulfuric acid for acidifying (pH 3.5) samples. Considering the instability of some DBPs in water matrices over long periods (i.e., 14 days), samples should be processed as soon as possible after collection.