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Global climate change will significantly impact the biodiversity of freshwater ecosystems, both directly and indirectly via the exacerbation of impacts from other stressors. Pesticides form a prime example of chemical stressors that are expected to synergize with climate change. Aquatic exposures to pesticides might change in magnitude due to increased runoff from agricultural fields, and in composition, as application patterns will change due to changes in pest pressures and crop types. Any prospective chemical risk assessment that aims to capture the influence of climate change should properly and comprehensively account for the variabilities and uncertainties that are inherent to projections of future climate. This is only feasible if they probabilistically propagate extensive ensembles of climate model projections. However, current prospective risk assessments typically make use of process‐based models of chemical fate that do not typically allow for such high‐throughput applications. Here, we describe a Bayesian network model that does. It incorporates a two‐step univariate regression model based on a 30‐day antecedent precipitation index, circumventing the need for computationally laborious mechanistic models. We show its feasibility and application potential in a case study with two pesticides in a Norwegian stream: the fungicide trifloxystrobin and herbicide clopyralid. Our analysis showed that variations in pesticide application rates as well as precipitation intensity lead to variations in in‐stream exposures. When relating to aquatic risks, the influence of these processes is reduced and distributions of risk are dominated by effect‐related parameters. Predicted risks for clopyralid were negligible, but the probability of unacceptable future environmental risks due to exposure to trifloxystrobin (i.e., a risk quotient >1) was 8%–12%. This percentage further increased to 30%–35% when a more conservative precautionary factor of 100 instead of 30 was used. Integr Environ Assess Manag 2024;20:384–400. © 2023 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC). Key Points: A Bayesian network (BN) model was presented that allows the high‐throughput incorporation of local climate projections into the environmental risk assessment of pesticides in aquatic ecosystems.Predictions for the fungicide trifloxystrobin and the herbicide clopyralid showed that variations in pesticide application rates and precipitation intensity lead to variations in in‐stream exposures.Predicted risks for clopyralid were negligible, but there was an 8%–12% probability of unacceptable future risks due to trifloxystrobin exposure (at a precautionary factor of 30), increasing to 30%–35% when a more precautionary factor of 100 was used.The BN model is set up to facilitate future inclusion of climate‐dependent pesticide applications and large ensembles of local climate projections, downscaled from global climate models. [ABSTRACT FROM AUTHOR]

Background: The Omnipod® 5 Automated Insulin Delivery (AID) System was shown to be safe and effective following 3 months of use in people with type 1 diabetes (T1D); however, data on the durability of these results are limited. This study evaluated the long-term safety and effectiveness of Omnipod 5 use in people with T1D during up to 2 years of use. Materials and Methods: After a 3-month single-arm, multicenter, pivotal trial in children (6–13.9 years) and adolescents/adults (14–70 years), participants could continue system use in an extension phase. HbA1c was measured every 3 months for up to 15 months; continuous glucose monitor metrics were collected for up to 2 years. Results: Participants (N = 224) completed median (interquartile range) 22.3 (21.7, 22.7) months of AID. HbA1c was reduced in the pivotal trial from 7.7% ± 0.9% in children and 7.2% ± 0.9% in adolescents/adults to 7.0% ± 0.6% and 6.8% ± 0.7%, respectively, (P < 0.0001), and was maintained at 7.2% ± 0.7% and 6.9% ± 0.6% after 15 months (P < 0.0001 from baseline). Time in target range (70–180 mg/dL) increased from 52.4% ± 15.6% in children and 63.6% ± 16.5% in adolescents/adults at baseline to 67.9% ± 8.0% and 73.8% ± 10.8%, respectively, during the pivotal trial (P < 0.0001) and was maintained at 65.9% ± 8.9% and 72.9% ± 11.3% during the extension (P < 0.0001 from baseline). One episode of diabetic ketoacidosis and seven episodes of severe hypoglycemia occurred during the extension. Children and adolescents/adults spent median 96.1% and 96.3% of time in Automated Mode, respectively. Conclusion: Our study supports that long-term use of the Omnipod 5 AID System can safely maintain improvements in glycemic outcomes for up to 2 years of use in people with T1D. Clinical Trials Registration Number: NCT04196140 [ABSTRACT FROM AUTHOR]

BACKGROUND: Schools are important arenas for the promotion of critical health literacy (CHL) among adolescents. Key domains of CHL are information appraisal, understanding social determinants of health, and abilities to act on determinants of health. In this paper, we examine the psychometric properties of the Critical Health Literacy for Adolescents Questionnaire (CHLA‐Q). METHODS: A cross‐sectional survey study was performed at 5 schools in Norway. Respondents included 522 pupils aged 13‐15 years old. Confirmatory factor analysis (CFA) was conducted to examine the structural validity. Internal reliability was assessed using ordinal Cronbach's alpha. RESULTS: The estimated model had acceptable closeness of fit. Five of 6 scales displayed adequate internal reliability. CONCLUSION: The results indicate acceptable fit of the CHLA‐Q framework and that 5 of the 6 scales are applicable to inform future research and interventions. More research is needed on measurement of the second domain of CHL. [ABSTRACT FROM AUTHOR]