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This paper aims to study the application of high-tolerance and flexible indigenous bacteria and fungi, along with the co-metabolism in recycled paper and cardboard mill (RPCM) wastewater treatment (WWT).

The molecular characterization of isolated indigenous bacteria and fungi was performed by 16S rRNA and 18S rRNA gene sequencing, respectively. Glucose was used as a cometabolic substrate to enhance the bioremediation process.

The highest removal efficiency was achieved for both chemical oxygen demand (COD) and color [78% COD and 45% color removal by Pseudomonas aeruginosa RW-2 (MZ603673), as well as approximately 70% COD and 48% color removal by Geotrichum candidum RW-4 (ON024394)]. The corresponding percentages were higher in comparison with the efficiency obtained from the oxidation ditch unit in the full-scale RPCM WWT plant.

Indigenous P. aeruginosa RW-2 and G. candidum RW-4 demonstrated effective capability in RPCM WWT despite the highly toxic and low biodegradable nature, especially with the assistance of glucose.

Applying the value-attitude-behavior (VAB) model, this study investigated how perceived utilitarian and hedonic values (i.e. novelty and emotion) affect individuals' attitudes toward medical hotels and how these attitudes, in turn, influence their intentions to stay at medical hotels. The current study also explored the moderating impact of overall health status on the relationships between perceived utilitarian, novelty and emotional values and attitudes toward medical hotels.

The data collected from 351 individuals who spent a night in a hospital to undergo medical treatment was used in conducting structural equation modeling to evaluate the research model and test the study hypotheses.

The study results revealed that perceived utilitarian, novelty and emotional values exerted a positive influence on individuals’ attitudes toward medical hotels, consequently enhancing their intention to stay. Additionally, significant moderating impacts of overall health status on the associations between perceived utilitarian, novelty and emotional values and attitudes toward medical hotels were observed.

The study findings provide useful guidance for professionals, such as operators, marketers and managers in medical hotels. These insights can improve operational and marketing strategies, benefiting both the industry and healthcare accommodation seekers.

This study is among the first to empirically assess a theoretical model that explored the influence of individuals' value perceptions within the realm of medical hotel establishments.