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AbstractXylene substances have wide industrial and consumer uses and are currently undergoing dossier and substance evaluation under Registration, Evaluation, Authorization and Restriction of Chemicals (REACH) for further toxicological testing including consideration of an additional neurotoxicological testing cohort to an extended one-generation reproduction toxicity (EOGRT) study. New repeated dose study data on xylenes identify the thyroid as a potential target tissue, and therefore a weight of evidence review is provided to investigate whether or not xylene-mediated changes on the hypothalamus-pituitary-thyroid (HPT) axis are secondary to liver enzymatic induction and are of a magnitude that is relevant for neurological human health concerns. Multiple published studies confirm xylene-mediated increases in liver weight, hepatocellular hypertrophy, and liver enzymatic induction via the oral or inhalation routes, including an increase in uridine 5′-diphospho-glucuronosyltransferase (UDP-GT) activity, the key step in thyroid hormone metabolism in rodents. Only minimal to slight increases in thyroid follicular cell hypertrophy have been observed in some xylene repeated dose studies, with no associated robust or consistent perturbance of thyroid hormone changes across the studies or carried through to offspring indicating adaptive homeostatic maintenance of the HPT axis. Also importantly, in vitro human cell line data from the United States Environmental Protection Agency (US EPA) Toxicity Forecasting (ToxCast) provides supporting evidence of xylene’s inability to directly perturb thyroidal functionality. A further supplemental in-depth metabolomics analysis (MetaMap®Tox) of xylene showed a tentative match to compounds that also demonstrate extra-thyroidal effects on the HPT axis as a consequence of liver enzyme induction. Lastly, the slight HPT axis changes mediated by xylene were well-below the published literature thresholds for developmental neurotoxicological outcomes established for thyroidal changes in animals and humans. In summary, the data and various lines of scientific evidence presented herein individually and collectively demonstrate that xylene’s mediated changes in the HPT axis, via a secondary extra-thyroidal MOA (i.e. liver enzyme induction), do not raise a human health concern with regards to developmental neurotoxicity. As such, the available toxicological data do not support the classification of xylene as a known or suspected endocrine disruptor, specifically through the thyroid modality, per Regulations Commission Delegated Regulation (EU) 2023/707 of 19 December 2022 amending Regulation (EC) No 1272/2008 and do not support the need for a neurotoxicological cohort evaluation in any subsequent EOGRTS. [ABSTRACT FROM AUTHOR]

Introduction: The long-term effects of surgery for subthalamic nucleus deep brain stimulation (STN-DBS) on cognitive aspects of motor control for people with Parkinson's disease (PD) are largely unknown. We compared saccade latency and reach reaction time (RT) pre- and post-surgery while participants with PD were off-treatment. Methods: In this preliminary study, we assessed people with PD approximately 1 month pre-surgery while OFF medication (OFF-MEDS) and about 8 months post-surgery while OFF medication and STN-DBS treatment (OFF-MEDS/OFF-DBS). We examined saccade latency and reach reaction time (RT) performance during a visually-guided reaching task requiring participants to look at and reach toward a visual target. Results: We found that both saccade latency and reach RT significantly increased post-surgery compared to pre-surgery. In addition, there was no significant change in Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III score. Discussion: We found detrimental post-surgical changes to saccade latency and reach RT. We discuss the potential contributions of long-term tissue changes and withdrawal from STN-DBS on this detrimental cognitive effect. [ABSTRACT FROM AUTHOR]

The ECHA guidance on persistence (P) assessment has been updated with respect to non-extractable residues (NER). Unless further characterized, total NER shall be considered as non-degraded parent compound. We investigated how different NER fractions affect degradation half-lives (DegT50) of chemicals and the P assessment. Total NER consist of the fractions sorbed/sequestered (NER I), covalently bound (NER II), and bioNER (incorporated into the biomass, NER III). NER I pose a risk due to potential release, NER II have much lower release potential, and bioNER do not have any. NER I and NER II are considered as xenoNER. Data from 46 degradation tests with 24 substances were analyzed to find DegT50 for four scenarios: (i) extractable parent compound, (ii) parent plus total NER, (iii) parent plus xenoNER, and (iv) parent plus NER I. The microbial turnover to biomass (MTB) model was applied to calculate bioNER, and then xenoNER were calculated as total NER minus bioNER. The half-lives were determined by the fit program CAKE, using single first-order kinetics (SFO) for all fits. We found increasing degradation half-lives for the scenarios: extractable parent only < parent + NER I < parent + xenoNER < parent + total NER. A third of all chemicals show half-lives above the persistence criterion (120 days in OECD 307 and 308, and 40 days in OECD 309) for scenario i, and two thirds with scenario ii and, therefore, would be classified as 'persistent'. For two compounds, the subtraction of bioNER led to a change to 'not persistent'. The inclusion of NER in the P assessment (ECHA 2017, 2023) will thus have significant effects on the DegT50 of compounds and the persistence assessment. Experimental quantification of NER I (scenario iv) significantly reduces half-lives, in comparison to total NER (scenario ii). The results are closer to half-lives for parent only (scenario i) and give the lowest acceptable DegT50 below the vP criteria under the latest guidance. In addition, refining the DegT50 based on modelled bioNER can provide a more realistic option for persistence assessment, without laborious and costly analyses for NER I determination, when considered in the regulatory assessment of persistence. Moreover, bioNER can also be calculated for existing test data. [ABSTRACT FROM AUTHOR]

Introduction: In the Netherlands, since 1996, there is a national cervical cancer (CC) screening programme in place for women aged 30–60 years. The participation of Turkish‐ and Moroccan‐Dutch women is very low. To facilitate their informed decision‐making, we developed a culturally sensitive educational video, and evaluated it through a questionnaire study. Since we used multiple strategies for the recruitment of respondents, we aimed (1) to explore which sampling strategy resulted in which type of respondents, (2) to investigate which sampling strategy and individual characteristics were associated with successful recruitment of other respondents, and (3) to examine similarity between those recruited via respondent‐driven sampling (RDS). Methods: Six sampling strategies were used and compared to explore their recruitment success: (1) RDS (i.e. peer‐to‐peer recruitment), (2) public and private women's Facebook groups, (3) Instagram, (4) researchers' network, (5) offline organizations (e.g., community centres and mosques), and (6) other channels (e.g. flyers, infographics, and information meetings). To do this, χ2 tests, a multivariate logistic regression, and intra class correlations (ICCs) were performed. Results: Overall, 782 Moroccan‐ and 696 Turkish‐Dutch respondents were included in the analysis. Almost 40% filled out the questionnaire via RDS. RDS yields more often older, lower educated, and first‐generation immigrant women than average. Respondents recruited via RDS have more often low CC screening knowledge and make more often uninformed CC screening decisions than average. Social media channels, however, yielded more younger, highly educated, and second‐generation immigrant women than average. Sociodemographic characteristics and attitudes towards CC screening varied more strongly within than between network trees. The probability that paired respondents within a network tree had similar characteristics varied strongly depending on the characteristic. Conclusions: By using RDS and asking respondents to recruit peers, the more hard‐to‐reach individuals (i.e. older, lower educated, and first‐generation immigrants) were reached. By using social media channels, younger, highly educated, and second‐generation individuals can be recruited. RDS yielded more often women with low CC screening knowledge and women making uninformed CC screening decisions. To reach the individuals in need of tailored information or an intervention conform their needs, we recommend to use RDS as an intervention delivery strategy. Patient or Public Contribution: Following RDS, we involved Moroccan‐ and Turkish‐Dutch women in recruiting other Moroccan‐ and Turkish‐Dutch women. Through this recruitment, women were able to fill out our questionnaire, and watch our culturally sensitive educational video to improve their informed decision‐making in regard to the CC screening programme. [ABSTRACT FROM AUTHOR]

Objective: To assess the effects of an evidence‐based family caregiver training program (implementation of Helping Invested Families Improve Veteran Experiences Study [iHI‐FIVES]) in the Veterans Affairs healthcare system on Veteran days not at home and family caregiver well‐being. Data Sources and Study Setting: Participants included Veterans referred to home‐ and community‐based services with an identified caregiver across 8 medical centers and confirmed family caregivers of eligible Veterans. Study Design: In a stepped wedge cluster randomized trial, sites were randomized to a 6‐month time interval for starting iHI‐FIVES and received standardized implementation support. The primary outcome, number of Veteran "days not at home," and secondary outcomes, changes over 3 months in measures of caregiver well‐being, were compared between pre‐ and post‐iHI‐FIVES intervals using generalized linear models including covariates. Data Collection/Extraction Methods: Patient data were extracted from the electronic health record. Caregiver data were collected from 2 telephone‐based surveys. Principal Findings: Overall, n = 898 eligible Veterans were identified across pre‐iHI‐FIVES (n = 327) and post‐iHI‐FIVES intervals (n = 571). Just under one fifth (17%) of Veterans in post‐iHI‐FIVES intervals had a caregiver enroll in iHI‐FIVES. Veteran and caregiver demographics in pre‐iHI‐FIVES intervals were similar to those in post‐iHI‐FIVES intervals. In adjusted models, the estimated rate of days not at home over 6‐months was 42% lower (rate ratio = 0.58 [95% confidence interval: 0.31–1.09; p = 0.09]) post‐iHI‐FIVES compared with pre‐iHI‐FIVES. The estimated mean days not at home over a 6‐month period was 13.0 days pre‐iHI‐FIVES and 7.5 post‐iHI‐FIVES. There were no differences between pre‐ and post‐iHI‐FIVES in change over 3 months in caregiver well‐being measures. Conclusions: Reducing days not at home is consistent with effectiveness because more time at home increases quality of life. In this study, after adjusting for Veteran characteristics, we did not find evidence that implementation of a caregiver training program yielded a reduction in Veteran's days not at home. [ABSTRACT FROM AUTHOR]

The essential use concept aims to better protect consumers, vulnerable groups, and the environment from the most harmful chemicals by phasing out uses considered non-essential for society. Given the lack of empirical research evaluating this novel approach for chemical management in real-world settings, the aims of the present analysis were to 1) investigate if the information provided in applications for authorisation under REACH allowed for the identification of non-essential uses of substances of very high concern (SVHCs), and 2) identify data gaps, challenges and potential needs for revising the assessment criteria to effectively implement the essential use concept in the REACH authorisation. In total, 100 uses covering 11 SVHCs were analysed. 4-(1,1,3,3-tetramethylbutyl) phenol (OPnEO) and chromium trioxide were among the most frequently used substances, covering 42% and 35% of the analysed uses. Using the current essential use criteria, 55% of all analysed uses were categorised as essential, while 10% were categorised as non-essential. Potentially, authorisations would not have been granted for the identified non-essential uses under REACH if the concept had been implemented at the time. However, for 35% of the uses it was not possible to assess their essentiality and these uses were therefore categorised as "complex." These challenges were due to the multiple purposes of the technical function, lack of detailed information on the spectrum of end-uses, and difficulties in interpreting the essential use criteria. Consequently, for a successful implementation of the essential use concept, we recommend the European Commission to develop guidance for applicants and refine the essential use criteria to ensure a transparent and resource-efficient authorisation procedure under REACH. [ABSTRACT FROM AUTHOR]

In Europe, Directive 2010/63/EU aims to protect animals used for scientific purposes and reduce their use, asking institutions to commit in this direction. At the same time, the REACH regulation (EC 2006/1907) is based on the concept that it is important to develop alternative methods to test the toxicity of chemical substances. The intentions are good, but the results in terms of reducing animal use are limited. Following a publication by the American Environmental Protection Agency (EPA), scientific development has turned towards new horizons with the use of New Approach Methodologies (NAMs), which aim to study the mechanisms of chemical substances primarily using biological material of human origin. Today, the main institutions are all committed to building greater knowledge of these NAMs in order to make them robust and reliable for regulatory use. [ABSTRACT FROM AUTHOR]

The demand for alternatives to animal testing has increased, but there has been no significant progress in developing alternatives for repeated-dose toxicity tests despite their importance in chemical risk assessment. A comprehensive analysis of existing toxicity studies is the first step toward understanding toxicity and developing alternatives. However, such an analysis has yet to be performed for industrial chemicals. Therefore, we collected and organized publicly available repeated-dose subacute toxicity studies in male rats and constructed a database consisting of more than 2000 toxicity studies with about 500 toxicity-related findings. We then analyzed the no observed effect and lowest observed effect levels, toxicity-related findings, and organ categories in the database. The analyses revealed commonly and uncommonly observed toxicity-related findings and organ categories, as well as toxicity-related findings and organ categories with low and high median lowest observed effect levels. In addition, we extracted the toxicity studies registered in the Japanese and European chemical regulatory systems and conducted the same analysis for these datasets as the entire database. The results suggest that commonly observed toxicity-related findings were similar, but some toxicity-related findings differed in the frequency of observations between the two datasets. HIGHLIGHTS: More than 2000 repeated-dose subacute toxicity studies of industrial chemicals in male rats were collected and organized. The distributions of study NOELs and the medians of the LOELs of about 400 toxicity-related findings were examined. Commonly and uncommonly observed, and low-LOEL toxicity-related findings differed from those of safety failures in drug development. REACH-contained substances had relatively larger LOELs than CSCL substances. Some toxicity-related findings differed in the frequency of observations between CSCL and REACH datasets. [ABSTRACT FROM AUTHOR]

There is a growing emphasis on reducing the gap between research and routine practice. Dissemination and Implementation (D&I) science offers theories, models, and frameworks to enhance the implementation, impact, and sustainment of new programs and interventions. Few training opportunities are available that help leaders, researchers, clinicians, and staff (implementers) translate original research into practice settings in a more timely and effective manner without requiring significant time away from their primary clinical duties. To address these needs, we designed a virtual Designing for Dissemination and Implementation (D4D&I) Learning Hub that offered foundational D&I knowledge and opportunities for skill building. We developed the D4D&I Learning Hub curricula to train novice participants in the multicomponent D4D&I implementation strategy bundle when implementing new programs or innovations. The components of the D4D&I strategy bundle include (i) Pre-implementation assessment for proactive planning and multilevel contextual assessment, (ii) Multilevel partner engagement to learn what is important to end-users and obtain buy-in, (iii) Implementation and adaptations guided by a pre-implementation assessment while retaining program fidelity, and (iv) Program evaluation. We utilized a virtual e-learning platform, expert trainers, mentorship, and a Virtual Learning Collaborative to deliver the six-module curricula to support participants' growth and success. We used quantitative and qualitative methods informed by the Kirkpatrick Evaluation Model to evaluate the D4D&I Learning Hub. Thirty-one participants completed the D4D&I Learning Hub across four cohorts. Participants found the D4D&I curricula relevant and favorable, indicating they acquired the intended knowledge and skills. In presentations of their key takeaways, participants cited a greater understanding of how to apply various D&I theories, models, and frameworks to their research, engage multilevel partners during all phases of implementation and evaluation, and assess fidelity and adaptations. Participants planned to incorporate the acquired D&I knowledge and skills in future publications, grant applications, and when implementing new programs and projects in clinical settings. The D4D&I Learning Hub provides foundational education for novice participants of D&I science. It promotes designing, disseminating, implementing, and evaluating effective programs in clinical settings. This article discusses the development and implementation of the D4D&I Learning Hub. In addition, we evaluated the first four cohorts using the Kirkpatrick Evaluation Model. [ABSTRACT FROM AUTHOR]

Introduction: Contingency management involves rewarding individuals based on objective evidence of behavioral changes. This study explores preferences for financial incentives in vaping cessation programs. Methods: A discrete choice experiment (DCE) was conducted among young adult current e-cigarette users aged 19-29. DCE attributes (and levels) included reward amount ($100, $300), reward schedule (consistent value, escalating value), reward procedure (gain-framed, loss-framed), vaping education modules (yes, no), text messaging support (yes, no), and cost ($30, $100). Participants were randomized into one of the four blocks, each containing four choice sets. Each choice set presented two hypothetical vaping cessation programs. Choice data (n × choice sets × alternative programs = 154 × 4 × 2 = 1,232 observations) were analyzed using generalized estimation equation models. Results: Participants showed a preference for vaping cessation programs offering a higher reward amount (odds ratio [OR] = 11.5; 95% CI,7.0-19.2), gain-framed rewards for sustained abstinence (OR = 1.4; 95% CI,1.0-1.8), text messaging support (OR = 1.9; 95% CI,1.4-2.5), and a lower program cost (OR = 2.6; 95% CI,1.8-3.8). Interaction tests showed significant effects of the rewards procedure among daily e-cigarette users (adjusted OR [AOR] = 2.1; 95% CI,1.3-3.5), but not some-day users; and among those with no quit attempts in the past six months (AOR = 2.7; 95% CI,1.5-4.7), but not those with previous quit attempts. Female participants preferred text messaging support (AOR = 3.6; 95% CI,2.3-5.4), whereas male participants did not show this preference. Conclusion: A multifaceted vaping cessation intervention augmented with financial incentives might improve participation and engagement among young adults. Future studies should investigate how these attributes can enhance program reach and vaping abstinence outcomes in real-world settings. [ABSTRACT FROM AUTHOR]

Abstract Background As a result of the COVID-19 pandemic, we implemented a novel nurse-led symptom monitoring and virtual telehealth program for patients with advanced cancer on palliative care. Aims To evaluate the reach, effectiveness, adoption, implementation, maintenance and acceptability of our program. Methods This was a prospective study carried out in a cohort of patients with advanced cancer over the period of 3rd June 2020 to 22nd October 2021. Demographic characteristics, cancer diagnosis, and functional status of patients were collected upon recruitment. Patients were asked to complete a patient-reported outcome measure (the Integrated Palliative Care Outcome Scale, IPOS) prior to the first palliative care consult and subsequently every week for the duration of their participation in the program (12 weeks). The IPOS measures the severity of physical symptoms, emotional concerns, information, and financial needs. Participants’ utilization of healthcare services by participants 3 months before, during and 3 months after the telemedicine program was reviewed. At the end of the program, a client satisfaction questionnaire (CSQ-4) to survey participants’ experience with the telehealth program and their willingness to pay for this program was administered. Results Reach: The recruitment to adoption ratio of the program was 0.71. Acceptability:: Participants expressed satisfactory experience. Effectiveness: We noted that the severity of patients’ symptoms and number of emergency department visits decreased over time with nurse support. Adoption: we received referrals from 23 oncologists, yielding an adoption rate of 70%. Implementation: Of the 99 patients recruited for the program, 88.9% of them managed to complete their initial video consults as planned. 16% of them failed to complete the program due to factors such as patient demising. Maintenance: The declining rate of IPOS completion throughout the study period (98.9% at week 1 to 60.8% at week 12) demonstrated the difficulties in sustaining regular administration of self-reported patient outcome measures. Conclusion The telemedicine program was effective and acceptable. We noted challenges in sustaining the administration of patient reported outcome measures over time. Further studies on how we can improve the sustainability of symptom monitoring in a telehealth program for patients with advanced illnesses, under palliative care, should be conducted.

Falls are the most common cause of injury in older people, with consequences for the individual and society. With an increasing population of older people, falls and related costs are expected to increase. It is crucial to identify scalable and cost-effective interventions and subsequently reduce fall-related costs. The aim was to evaluate the cost-effectiveness of the Safe Step digital fall preventive exercise intervention over a period of 12 years and, in addition, to evaluate the impact of increased recruitment cost and decreased intervention effect. The intervention was evaluated in an observational study in a municipality context targeting community-dwelling older people of age 70 +. A Markov model with five states was used to model the cost-effectiveness of the Safe Step intervention and evaluate quality-adjusted life years (QALYs) and fall-related costs from a societal perspective. By using data from a meta-analysis as basis for the estimated intervention effect, the Safe Step intervention was compared with a no-intervention alternative. The results showed that the Safe Step intervention dominated no intervention. In the sensitivity analysis with the most conservative estimate of intervention effect, the ICER was €7 616 per QALY gained. Hence, Safe Step showed to be a cost-saving fall preventive intervention in older people at risk of falling and potentially cost-effective even with a low estimated intervention effect. Future studies on efficacy of fall preventive digital interventions will contribute in precising effect estimates and enhance the validity of these cost-effectiveness results. [ABSTRACT FROM AUTHOR]

Background: As a result of the COVID-19 pandemic, we implemented a novel nurse-led symptom monitoring and virtual telehealth program for patients with advanced cancer on palliative care. Aims: To evaluate the reach, effectiveness, adoption, implementation, maintenance and acceptability of our program. Methods: This was a prospective study carried out in a cohort of patients with advanced cancer over the period of 3rd June 2020 to 22nd October 2021. Demographic characteristics, cancer diagnosis, and functional status of patients were collected upon recruitment. Patients were asked to complete a patient-reported outcome measure (the Integrated Palliative Care Outcome Scale, IPOS) prior to the first palliative care consult and subsequently every week for the duration of their participation in the program (12 weeks). The IPOS measures the severity of physical symptoms, emotional concerns, information, and financial needs. Participants' utilization of healthcare services by participants 3 months before, during and 3 months after the telemedicine program was reviewed. At the end of the program, a client satisfaction questionnaire (CSQ-4) to survey participants' experience with the telehealth program and their willingness to pay for this program was administered. Results: Reach: The recruitment to adoption ratio of the program was 0.71. Acceptability:: Participants expressed satisfactory experience. Effectiveness: We noted that the severity of patients' symptoms and number of emergency department visits decreased over time with nurse support. Adoption: we received referrals from 23 oncologists, yielding an adoption rate of 70%. Implementation: Of the 99 patients recruited for the program, 88.9% of them managed to complete their initial video consults as planned. 16% of them failed to complete the program due to factors such as patient demising. Maintenance: The declining rate of IPOS completion throughout the study period (98.9% at week 1 to 60.8% at week 12) demonstrated the difficulties in sustaining regular administration of self-reported patient outcome measures. Conclusion: The telemedicine program was effective and acceptable. We noted challenges in sustaining the administration of patient reported outcome measures over time. Further studies on how we can improve the sustainability of symptom monitoring in a telehealth program for patients with advanced illnesses, under palliative care, should be conducted. [ABSTRACT FROM AUTHOR]

During infectious disease epidemics, accurate diagnostic testing is key to rapidly identify and treat cases, and mitigate transmission. When a novel pathogen is involved, building testing capacity and scaling testing services at the local level can present major challenges to healthcare systems, public health agencies, and laboratories. This mixed methods study examined lessons learned from the scale-up of SARS-CoV-2 testing services in New York City (NYC), as a core part of NYC's Test & Trace program. Using quantitative and geospatial analyses, the authors assessed program success at maximizing reach, equity, and timeliness of SARS-CoV-2 diagnostic testing services across NYC neighborhoods. Qualitative analysis of key informant interviews elucidated key decisions, facilitators, and barriers involved in the scale-up of SARS-CoV-2 testing services. A major early facilitator was the ability to establish working relationships with private sector vendors and contractors to rapidly procure and manufacture necessary supplies locally. NYC residents were, on average, less than 25 min away from free SARS-CoV-2 diagnostic testing services by public transport, and services were successfully directed to most neighborhoods with the highest transmission rates, with only one notable exception. A key feature was to direct mobile testing vans and rapid antigen testing services to areas based on real-time neighborhood transmission data. Municipal leaders should prioritize fortifying supply chains, establish cross-sectoral partnerships to support and extend testing services, plan for continuous testing and validation of assays, ensure open communication feedback loops with CBO partners, and maintain infrastructure to support mobile services during infectious disease emergencies. [ABSTRACT FROM AUTHOR]

'How To Save A Life' (HTSAL) was a mass media campaign on drug-related death prevention which ran in Scotland from August 2021 to January 2022. It aimed to increase awareness of how to respond to an opioid overdose, and the uptake of take-home naloxone (THN). The objective of this study was to determine the reach and engagement with the campaign. Methods included a descriptive analysis of data from media sources, the campaign website, and an online naloxone training course. A quantitative content analysis was conducted on media articles. The campaign generated 57,402,850 non-unique impressions (the total number of times the campaign was seen or heard), and unique reach (the number of people who were exposed to the campaign) figures of 2,621,450. Engagement with the campaign was positive, and 96% of print/digital media articles had a positive view of the campaign. There were 40,714 visits to the campaign website, leading to 8,107 clicks to the free naloxone training course, and 3,141 clicks to order a free naloxone kit. This study showed that mass media campaigns on drug policy topics can achieve high levels of reach and engagement. There was a clear progression from viewing campaign materials, to visiting the campaign website, to completing naloxone training. Our research suggests that mass media campaigns can be used to disseminate harm reduction messages to the general public. [ABSTRACT FROM AUTHOR]

Holding still and aiming reaches to spatial targets may depend on distinct neural circuits. Using automated homecage training and a sensitive joystick, we trained freely moving mice to contact a joystick, hold their forelimb still, and then reach to rewarded target locations. Mice learned the task by initiating forelimb sequences with clearly resolved submillimeter-scale micromovements followed by millimeter-scale reaches to learned spatial targets. Hundreds of thousands of trajectories were decomposed into millions of kinematic submovements, while photoinhibition was used to test roles of motor cortical areas. Inactivation of both caudal and rostral forelimb areas preserved the ability to produce aimed reaches, but reduced reach speed. Inactivation specifically of contralateral caudal forelimb area (CFA) additionally impaired the ability to aim corrective submovements to remembered locations following target undershoots. Our findings show that motor cortical inactivations reduce the gain of forelimb movements but that inactivation specifically of contralateral CFA impairs corrective movements important for reaching a target location. NEW & NOTEWORTHY: To test the role of different cortical areas in holding still and reaching to targets, this study combined home-cage training with optogenetic silencing as mice engaged in a learned center-out-reach task. Inactivation specifically of contralateral caudal forelimb area (CFA) impaired corrective movements necessary to reach spatial targets to earn reward. [ABSTRACT FROM AUTHOR]

The main purpose of this study was to evaluate the feasibility of an online psychological intervention for individuals with gambling-related problems, supported by ecological momentary assessments and interventions (EMAs and EMIs), along with weekly phone-calls, before conducting a randomized controlled trial. Participants were required to complete 3 of the 8 modules of the program based on cognitive-behavioral therapy (CBT) and extensions and innovations of CBT. The study measured the outcomes of feasibility (i.e., reach, appropriateness, technology literacy and technology usability, fidelity, and adherence). In terms of reach, 19.8% (n = 11) of the initial population met the inclusion criteria and completed the three modules (mean age = 41; 90.9% men). The perceived appropriateness and the technology usability after the first use were both excellent, fidelity and adherence to the online treatment (73.3%) were adequate. Adherence to the EMAs and the weekly phone calls were more modest (54.51% and 66.67%, respectively). The results of the present study show that an online treatment for gambling problems enhanced by EMA and EMI might be feasible but challenges were noted in terms of reach and adherence to these assessments and calls. These challenges are important to consider for future trials and the scalability of treatments for individuals with gambling disorders. [ABSTRACT FROM AUTHOR]

This article analyzes the politics of scale in global development by focusing on a sanitation program in western Kenya. It follows the daily work of a nongovernmental organization that seeks to provide access to chlorine dispensers to millions of people for the purpose of disinfecting water. By engaging with literatures on development and infrastructure, this article proposes reach as an analytic that jointly attends to the aspirations, labors, and uncertain outcomes embedded in scale work. An ethnography of reach emphasizes the temporality of off‐grid infrastructures to capture the ambivalent relationships between aspirations and results and between standardization and adaptation, as well as the unstable nature of care. This proves useful to theorizing expansion as potentially generative of, rather than only inimical to, the good life—thereby troubling the vision of scale making as replication often used to understand development projects and their consequences. [ABSTRACT FROM AUTHOR]

Sediments are an integral component of aquatic systems, linking multiple water uses, functions, and services. Contamination of sediments by chemicals is a worldwide problem, with many jurisdictions trying to prevent future pollution (prospective) and manage existing contamination (retrospective). The present review assesses the implementation of sediment toxicity testing in environmental regulations globally. Currently, the incorporation of sediment toxicity testing in regulations is most common in the European Union (EU), North America, and Australasian regions, with some expansion in Asia and non‐EU Europe. Employing sediment toxicity testing in prospective assessments (i.e., before chemicals are allowed on the market) is most advanced and harmonized with pesticides. In the retrospective assessment of environmental risks (i.e., chemicals already contaminating sediments), regulatory sediment toxicity testing practices are applied inconsistently on the global scale. International harmonization of sediment toxicity tests is considered an asset and has been successful through the widespread adoption and deployment of Organisation for Economic Co‐operation and Development guidelines. On the other hand, retrospective sediment assessments benefit from incorporating regional species and protocols. Currently used toxicity testing species are diverse, with temperate species being applied most often, whereas test protocols are insufficiently flexible to appropriately address the range of environmental contaminants, including nanomaterials, highly hydrophobic contaminants, and ionized chemicals. The ever‐increasing and ‐changing pressures placed on aquatic resources are a challenge for protection and management efforts, calling for continuous sediment toxicity test method improvement to insure effective use in regulatory frameworks. Future developments should focus on including more subtle and specific toxicity endpoints (e.g., incorporating bioavailability‐based in vitro tests) and genomic techniques, extending sediment toxicity testing from single to multispecies approaches, and providing a better link with ecological protection goals. Environ Toxicol Chem 2024;43:1697–1716. © 2024 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC. [ABSTRACT FROM AUTHOR]

BACKGROUND: Financial barriers in substance use disorder service systems have limited the widespread adoption-i.e., provider-level reach-of evidence-based practices (EBPs) for youth substance use disorders. Reach is essential to maximizing the population-level impact of EBPs. One promising, but rarely studied, type of implementation strategy for overcoming barriers to EBP reach is financing strategies, which direct financial resources in various ways to support implementation. We evaluated financing strategies for the Adolescent Community Reinforcement Approach (A-CRA) EBP by comparing two US federal grant mechanisms, organization-focused and state-focused grants, on organization-level A-CRA reach outcomes. METHOD: A-CRA implementation took place through organization-focused and state-focused grantee cohorts from 2006 to 2021. We used a quasi-experimental, mixed-method design to compare reach between treatment organizations funded by organization-focused versus state-focused grants (164 organizations, 35 states). Using administrative training records, we calculated reach as the per-organization proportion of trained individuals who received certification in A-CRA clinical delivery and/or supervision by the end of grant funding. We tested differences in certification rate by grant type using multivariable linear regression models that controlled for key covariates (e.g., time), and tested threats to internal validity from our quasi-experimental design through a series of sensitivity analyses. We also drew on interviews and surveys collected from the treatment organizations and (when relevant) interviews with state administrators to identify factors that influenced reach. RESULTS: The overall certification rates were 27 percentage points lower in state-focused versus organization-focused grants (p = .01). Sensitivity analyses suggested these findings were not explained by confounding temporal trends nor by organizational or state characteristics. We did not identify significant quantitative moderators of reach outcomes, but qualitative findings suggested certain facilitating factors were more influential for organization-focused grants (e.g., strategic planning) and certain barrier factors were more impactful for state-focused grants (e.g., states finding it difficult to execute grant activities). DISCUSSION: As the first published comparison of EBP reach outcomes between financing strategies, our findings can help guide state and federal policy related to financing strategies for implementing EBPs that reduce youth substance use. Future work should explore contextual conditions under which different financing strategies can support the widespread implementation of EBPs for substance use disorder treatment.

ABSTRACT Introduction In the Netherlands, since 1996, there is a national cervical cancer (CC) screening programme in place for women aged 30–60 years. The participation of Turkish‐ and Moroccan‐Dutch women is very low. To facilitate their informed decision‐making, we developed a culturally sensitive educational video, and evaluated it through a questionnaire study. Since we used multiple strategies for the recruitment of respondents, we aimed (1) to explore which sampling strategy resulted in which type of respondents, (2) to investigate which sampling strategy and individual characteristics were associated with successful recruitment of other respondents, and (3) to examine similarity between those recruited via respondent‐driven sampling (RDS). Methods Six sampling strategies were used and compared to explore their recruitment success: (1) RDS (i.e. peer‐to‐peer recruitment), (2) public and private women's Facebook groups, (3) Instagram, (4) researchers' network, (5) offline organizations (e.g., community centres and mosques), and (6) other channels (e.g. flyers, infographics, and information meetings). To do this, χ2 tests, a multivariate logistic regression, and intra class correlations (ICCs) were performed. Results Overall, 782 Moroccan‐ and 696 Turkish‐Dutch respondents were included in the analysis. Almost 40% filled out the questionnaire via RDS. RDS yields more often older, lower educated, and first‐generation immigrant women than average. Respondents recruited via RDS have more often low CC screening knowledge and make more often uninformed CC screening decisions than average. Social media channels, however, yielded more younger, highly educated, and second‐generation immigrant women than average. Sociodemographic characteristics and attitudes towards CC screening varied more strongly within than between network trees. The probability that paired respondents within a network tree had similar characteristics varied strongly depending on the characteristic. Conclusions By using RDS and asking respondents to recruit peers, the more hard‐to‐reach individuals (i.e. older, lower educated, and first‐generation immigrants) were reached. By using social media channels, younger, highly educated, and second‐generation individuals can be recruited. RDS yielded more often women with low CC screening knowledge and women making uninformed CC screening decisions. To reach the individuals in need of tailored information or an intervention conform their needs, we recommend to use RDS as an intervention delivery strategy. Patient or Public Contribution Following RDS, we involved Moroccan‐ and Turkish‐Dutch women in recruiting other Moroccan‐ and Turkish‐Dutch women. Through this recruitment, women were able to fill out our questionnaire, and watch our culturally sensitive educational video to improve their informed decision‐making in regard to the CC screening programme.

IntroductionThe long-term effects of surgery for subthalamic nucleus deep brain stimulation (STN-DBS) on cognitive aspects of motor control for people with Parkinson’s disease (PD) are largely unknown. We compared saccade latency and reach reaction time (RT) pre- and post-surgery while participants with PD were off-treatment.MethodsIn this preliminary study, we assessed people with PD approximately 1 month pre-surgery while OFF medication (OFF-MEDS) and about 8 months post-surgery while OFF medication and STN-DBS treatment (OFF-MEDS/OFF-DBS). We examined saccade latency and reach reaction time (RT) performance during a visually-guided reaching task requiring participants to look at and reach toward a visual target.ResultsWe found that both saccade latency and reach RT significantly increased post-surgery compared to pre-surgery. In addition, there was no significant change in Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III score.DiscussionWe found detrimental post-surgical changes to saccade latency and reach RT. We discuss the potential contributions of long-term tissue changes and withdrawal from STN-DBS on this detrimental cognitive effect.

The essential use concept aims to better protect consumers, vulnerable groups, and the environment from the most harmful chemicals by phasing out uses considered non-essential for society. Given the lack of empirical research evaluating this novel approach for chemical management in real-world settings, the aims of the present analysis were to 1) investigate if the information provided in applications for authorisation under REACH allowed for the identification of non-essential uses of substances of very high concern (SVHCs), and 2) identify data gaps, challenges and potential needs for revising the assessment criteria to effectively implement the essential use concept in the REACH authorisation. In total, 100 uses covering 11 SVHCs were analysed. 4-(1,1,3,3-tetramethylbutyl) phenol (OPnEO) and chromium trioxide were among the most frequently used substances, covering 42% and 35% of the analysed uses. Using the current essential use criteria, 55% of all analysed uses were categorised as essential, while 10% were categorised as non-essential. Potentially, authorisations would not have been granted for the identified non-essential uses under REACH if the concept had been implemented at the time. However, for 35% of the uses it was not possible to assess their essentiality and these uses were therefore categorised as “complex.” These challenges were due to the multiple purposes of the technical function, lack of detailed information on the spectrum of end-uses, and difficulties in interpreting the essential use criteria. Consequently, for a successful implementation of the essential use concept, we recommend the European Commission to develop guidance for applicants and refine the essential use criteria to ensure a transparent and resource-efficient authorisation procedure under REACH.

Abstract Background In Northwestern Switzerland, recent legislation tackles the needs of community-dwelling older adults by creating Information and Advice Centers (IACs). IACs are a new service in the community that aims to assess the needs and provide information on age-related issues to community-dwelling older adults and their families. Previous studies reported difficulties in reaching community-dwelling older adults for community-based programs. We aimed to: 1) systematically identify implementation strategies to promote the IAC among community care providers, older adults and informal caregivers; 2) monitor the delivery of these strategies by the IAC management; and 3) describe the impact of those strategies on reach of community-dwelling older adults. This study was conducted as part of the TRANS-SENIOR project. Methods As part of the INSPIRE feasibility assessment, we conducted a pre-test post-test study between March and September 2022. The sample included 8,840 older adults aged 65 + visiting/calling or being referred to the IAC for the first time. Implementation strategies were selected using implementation mapping and organized in bundles for each group of community care providers and older adults/caregivers. Our evaluation included: estimation of fidelity to the delivery of implementation strategies and bundles by the IAC management and their coverage; referral source of older adults to the IAC; and impact of the strategies on reach of the IAC on the 65 + population living in the care region. Adaptations to the strategies were documented using the FRAME-IS. Descriptive statistics were calculated and reported. Results Seven implementation strategies were selected and organized in bundles for each community care provider and older adults and their caregivers. The lowest fidelity score was found in implementation strategies selected for nursing homes whereas the highest score corresponded to strategies targeting older adults and caregivers. “Informational visits” was the strategy with the lowest coverage (2.5% for nursing homes and 10.5% for hospitals and specialized clinics). The main referral sources were self-referrals and referrals by caregivers, followed by nursing homes. The IAC reach among the 65 + population was 5.4%. Conclusion We demonstrated the use of implementation mapping to select implementation strategies to reach community-dwelling older adults. The reach was low suggesting that higher fidelity to the delivery of the strategies, and reflection on the causal pathway of the implementation strategies might be needed.

Abstract Background In response to the COVID-19 challenge and the consequent concerns and misconceptions about potential mother-to-child virus transmission, the United Nations Children’s Fund (UNICEF), in collaboration with the Ethiopian Ministry of Health, launched a 3-month nationwide media campaign to promote appropriate and safe breastfeeding practices using national and regional television and radio channels, as well as social media. This study assesses the reach and impact of a media campaign in Ethiopia on improving mothers’, partners’/caregivers’, and the public’s awareness of and practices related to appropriate and safe breastfeeding. Methods A two-round mobile survey was conducted using random digit dialing (RDD) and an interactive voice response (IVR) system. In order to assess the impact of the media campaign, the study compared outcomes related to awareness, perceptions, and safe breastfeeding practices using post-intervention comparison data across levels of exposure (exposed vs. unexposed to the campaign). A propensity score matching (PSM) analysis was performed using a two sample test of proportions to estimate the impact of the media campaign. Results Among the 3170 mobile subscribers who completed the survey questions, half (50%) reported that they had seen or heard media advertisements about appropriate breastfeeding, the importance of continuing breastfeeding during the COVID-19 pandemic, and how to safely breastfeed a baby when a mother is suspected or confirmed with COVID-19. The PSM analysis showed that exposure to the media campaign was significantly associated with awareness and perceptions of the importance of continuing appropriate breastfeeding during the pandemic among the general public (proportion difference, 0.16; 95% CI, 0.12–0.19; p

This review addresses the issue of replacing manufactured microplastics in seed coatings used in agriculture. Firstly, it focuses on the policy and regulatory actions taken on microplastics at a global level. There is no consensus within the scientific community on the definition of a microplastic and, more generally, on the classification of plastic debris. Nevertheless, several decision schemes have been proposed in an attempt to define the notion of microplastics. The different criteria relevant to this definition, such as the size, physical state, chemical structure, origin, and persistence of microplastics, are discussed, with a comparison being made between the REACH regulation and the scientific literature. Seed production and processing are also discussed, with the functions of seed coatings being explained in order to gain a better understanding of the properties to be considered in a substitution strategy for currently used microplastics. The main challenges are multiple; substitutes must provide the same performance as microplastics: (i) improving the adherence of the treatment to the seed, (ii) distributing the treatment more evenly over the seed, (iii) reducing the amount of dust-off when handling treated seed, and (iv) improving the seed flowability, which is particularly important during the sowing stage, all while preserving the physiological properties of the seed. Substitute polymers are proposed according to the desired performance and functional properties: two main chemical families of biopolymers were identified in the literature: polysaccharides and proteins. Among them, 13 and 6 polymers, respectively, complied with REACH regulation, demonstrating adhesion, dust reduction performances, and preservation of seed physiological quality in particular. This work aims to guide future studies on microplastic substitution in seed coatings, and to highlight research needs in this area. It is based on an analysis and discussion of the literature, identifying and listing potential substitutes. [ABSTRACT FROM AUTHOR]

This article examines the implementation, participation rates, and potential determinants of participation in the digital addiction prevention program "ready4life." A two-arm cluster-randomized trial recruited German vocational students via class-based strategies. Intervention group received 16 weeks of in-app coaching; the control group received health behavior information, with coaching offered after 12 months. Potential determinants of participation were analyzed based on class and individual characteristics. Out of 525 contacted schools, 35 participated, enrolling 376 classes. Implementation during the pandemic required flexible adjustments, with 49.7% of introductions conducted in person, 43.1% digitally via online streaming, and 7.2% received a video link via email. Despite challenges, 72.3% of the vocational students downloaded the app, and 46.7% gave informed consent. Participation rates were highest among (associate) professionals, vocational grammar school classes, classes introduced by females, younger individuals, members of the project team, and classes introduced face-to-face. Female gender, lower social competencies, lifetime cannabis use, higher problematic internet use, and higher perceived stress were associated with higher individual participation. The study highlights the importance of proactive outreach and personalized interventions for addiction prevention programs in vocational schools. While reached students aligned with the aims of the app, tailored recruitment strategies could enhance engagement among under-represented groups. The trial was registered in the German Clinical Trials Register (DRKS): DRKS00022328; registration date 09.10.2020. [ABSTRACT FROM AUTHOR]

Within the last decades, a new way of policymaking has become increasingly prominent: civic hackathons. However, in education policy research, hackathons have not been broadly addressed so far. With this article, we contribute to closing this research gap by empirically investigating the educational #wirfürschule (#wfs) Hackathons that took place in Germany between June 2020 and 2021 as well as their organizing initiative #wfs. As a methodological framework, we hereby draw on social topology. This methodology offers a promising toolbox to get hold of the multiple dynamics and digital platforms of hackathons as well as to address the nuances of such new education policy practices. By applying a topological lens, the aim of this article is to analyze how the spacetimes enacted in, through and around the #wfs Hackathons contribute to new relational ways of policymaking and power shifts in education governance. As our analysis showed, the #wfs Hackathons operated through enabling relational proximity and presence as well as through creating relational distance, by enacting spacetimes that reconfigured traditional policy sites, actors and categories, while supporting new authorities in education policy. [ABSTRACT FROM AUTHOR]

In 2006, the revised chemicals management legislation mandated that manufacturers of hazardous chemical substances conduct risk assessments for the entire substance life cycle. Additionally, they must communicate use-specific safe handling advice (exposure scenarios) to their customer, as annex to the Safety Data Sheet (SDS). Despite significant efforts to develop workable solutions for chemical mixtures, this goal has not yet been fully achieved. Therefore, a Cefic research project (LRI B23) was commissioned on how to ensure meaningful health risk communication for workers across supply chains. The research project determined that risk-based safe use advice generated by manufacturers, often does not reach the intended end-user and was seen as not tailored to specific user needs. Recipients of the advice are also not prepared to act based on information developed by suppliers. From an industry perspective, the complexity of supply chains and substance life cycles are considered major barriers for effective safe use communication. Exposure scenarios for substance use in industrial work environments are often perceived as adding little value compared to existing safe use arrangements required by other health, safety, and environmental legislation applicable to employers and duty-holders. To attain meaningful use-specific safe handling advice for workers, including those at non-industrial premises who may benefit most from such advice, knowledge transfer and close collaboration between manufacturers and formulators remain key elements, supported by enhanced regulatory appreciation. [ABSTRACT FROM AUTHOR]

This study looks into the effectiveness of the authorisation procedure as a regulatory instrument within the framework of the European REACH regulation. It highlights its impact on enhancing occupational safety and health for both applicants and companies utilising the substances. This procedure encompasses manufacturers, importers, and downstream users of substances, as well as representatives of foreign manufacturers who are also eligible to seek authorisation. When applying for authorisation, the ECHA Risk Assessment Committee (RAC) assesses the risks associated with the intended uses of the substance, including the appropriateness and effectiveness of the Occupational Conditions (OCs) and Risk Management Measures (RMMs) described in the application and the risks posed by potential alternatives. If the RAC determines that the OCs/RMMs are inadequate for managing or controlling the risk, or if the measures to protect workers are deemed insufficient, it may recommend additional measures to enhance occupational safety and health or environmental protection. The 398 processed Applications for Authorisation (AfA) that have been submitted to date were examined to determine these recommended measures, categorised as Conditions for use, Monitoring arrangements, and Recommendations for Review Reports. Overall, a significant improvement concerning occupational safety and health seems necessary, as indicated by the large number of measures recommended by the ECHA Committee for Risk Assessment (RAC) and ECHA Committee for Socio-economic Analysis (SEAC) or supplemented by the European Commission. In addition to the proposed measures, a short assessment provided by the committees as to whether the operational conditions and risk management measures are adequate in controlling the risks is also included in the study. [ABSTRACT FROM AUTHOR]

People usually reach for objects to place them in some position and orientation, but the placement component of this sequence is often ignored. For example, reaches are influenced by gaze position, visual feedback, and memory delays, but their influence on object placement is unclear. Here, we tested these factors in a task where participants placed and oriented a trapezoidal block against two-dimensional (2-D) visual templates displayed on a frontally located computer screen. In experiment 1, participants matched the block to three possible orientations: 0° (horizontal), +45° and −45°, with gaze fixated 10° to the left/right. The hand and template either remained illuminated (closed-loop), or visual feedback was removed (open-loop). Here, hand location consistently overshot the template relative to gaze, especially in the open-loop task; likewise, orientation was influenced by gaze position (depending on template orientation and visual feedback). In experiment 2, a memory delay was added, and participants sometimes performed saccades (toward, away from, or across the template). In this task, the influence of gaze on orientation vanished, but location errors were influenced by both template orientation and final gaze position. Contrary to our expectations, the previous saccade metrics also impacted placement overshoot. Overall, hand orientation was influenced by template orientation in a nonlinear fashion. These results demonstrate interactions between gaze and orientation signals in the planning and execution of hand placement and suggest different neural mechanisms for closed-loop, open-loop, and memory delay placement. NEW & NOTEWORTHY: Eye-hand coordination studies usually focus on object acquisition, but placement is equally important. We investigated how gaze position influences object placement toward a 2-D template with different levels of visual feedback. Like reach, placement overestimated goal location relative to gaze and was influenced by previous saccade metrics. Gaze also modulated hand orientation, depending on template orientation and level of visual feedback. Gaze influence was feedback-dependent, with location errors having no significant effect after a memory delay. [ABSTRACT FROM AUTHOR]

Background: In Northwestern Switzerland, recent legislation tackles the needs of community-dwelling older adults by creating Information and Advice Centers (IACs). IACs are a new service in the community that aims to assess the needs and provide information on age-related issues to community-dwelling older adults and their families. Previous studies reported difficulties in reaching community-dwelling older adults for community-based programs. We aimed to: 1) systematically identify implementation strategies to promote the IAC among community care providers, older adults and informal caregivers; 2) monitor the delivery of these strategies by the IAC management; and 3) describe the impact of those strategies on reach of community-dwelling older adults. This study was conducted as part of the TRANS-SENIOR project. Methods: As part of the INSPIRE feasibility assessment, we conducted a pre-test post-test study between March and September 2022. The sample included 8,840 older adults aged 65 + visiting/calling or being referred to the IAC for the first time. Implementation strategies were selected using implementation mapping and organized in bundles for each group of community care providers and older adults/caregivers. Our evaluation included: estimation of fidelity to the delivery of implementation strategies and bundles by the IAC management and their coverage; referral source of older adults to the IAC; and impact of the strategies on reach of the IAC on the 65 + population living in the care region. Adaptations to the strategies were documented using the FRAME-IS. Descriptive statistics were calculated and reported. Results: Seven implementation strategies were selected and organized in bundles for each community care provider and older adults and their caregivers. The lowest fidelity score was found in implementation strategies selected for nursing homes whereas the highest score corresponded to strategies targeting older adults and caregivers. "Informational visits" was the strategy with the lowest coverage (2.5% for nursing homes and 10.5% for hospitals and specialized clinics). The main referral sources were self-referrals and referrals by caregivers, followed by nursing homes. The IAC reach among the 65 + population was 5.4%. Conclusion: We demonstrated the use of implementation mapping to select implementation strategies to reach community-dwelling older adults. The reach was low suggesting that higher fidelity to the delivery of the strategies, and reflection on the causal pathway of the implementation strategies might be needed. [ABSTRACT FROM AUTHOR]

This study developed inclusive apparel design (IAD) framework to systematically analyse diverse clothing needs of people with different capabilities in reach, dexterity, and mobility, including people living with disabilities. The research critically examined two accessible design approaches, inclusive design framework and universal design framework, focusing on their similarities and distinctions as well as suitability for developing apparel products that cater to the needs of people with different capabilities in reach, dexterity, and mobility. Based on the analysis, three levels of difficulty in using clothing were proposed: (a) from no to minimal difficulty; (b) moderate difficulty; and (c) severe difficulty. For the three levels of difficulty, the IAD framework outlines three respective design strategies: (a) user-aware design, (b) modular design, and (c) special-purpose design. IAD framework can be used to guide future research and practitioner applications to meet the clothing needs of ability-diverse consumers. [ABSTRACT FROM AUTHOR]

Background: In response to the COVID-19 challenge and the consequent concerns and misconceptions about potential mother-to-child virus transmission, the United Nations Children's Fund (UNICEF), in collaboration with the Ethiopian Ministry of Health, launched a 3-month nationwide media campaign to promote appropriate and safe breastfeeding practices using national and regional television and radio channels, as well as social media. This study assesses the reach and impact of a media campaign in Ethiopia on improving mothers', partners'/caregivers', and the public's awareness of and practices related to appropriate and safe breastfeeding. Methods: A two-round mobile survey was conducted using random digit dialing (RDD) and an interactive voice response (IVR) system. In order to assess the impact of the media campaign, the study compared outcomes related to awareness, perceptions, and safe breastfeeding practices using post-intervention comparison data across levels of exposure (exposed vs. unexposed to the campaign). A propensity score matching (PSM) analysis was performed using a two sample test of proportions to estimate the impact of the media campaign. Results: Among the 3170 mobile subscribers who completed the survey questions, half (50%) reported that they had seen or heard media advertisements about appropriate breastfeeding, the importance of continuing breastfeeding during the COVID-19 pandemic, and how to safely breastfeed a baby when a mother is suspected or confirmed with COVID-19. The PSM analysis showed that exposure to the media campaign was significantly associated with awareness and perceptions of the importance of continuing appropriate breastfeeding during the pandemic among the general public (proportion difference, 0.16; 95% CI, 0.12–0.19; p < 0.0001) and mothers with children under 2 years old or their partners (proportion difference, 0.06; 95% CI, 0.01–0.12, p = 0.01). Conclusions: The nationwide media campaign promoting safe breastfeeding practices in the context of COVID-19 reached half of the target breastfeeding mothers and the general public and had a significant impact on awareness and perceptions about the importance of continuing appropriate and safe breastfeeding practices. Future media campaigns should ensure that the intensity and frequency of media spots are appropriate to achieve adequate exposure, message recall, and influence infant and young child feeding behaviors. [ABSTRACT FROM AUTHOR]

There is growing evidence indicating the substantial contribution of man-made products to an increase in the risk of diseases of civilization. In this article, the Belgian Scientific Registration, Evaluation, Authorization and Restriction of Chemicals (REACH) Committee gives a critical view on the working of REACH. The current regulatory framework needs to further evolve taking into account data generated using modern science and technology. There is a need for improved assessment process not only before but also after entering the market. Objectivity, transparency, and the follow-up after market access can be optimized. Additionally, no guidance documents exist for regulation of mixture effects. Further, the lengthiness before regulatory action is a big concern. Decision-making often takes several years leading to uncertainties for both producers and end users. A first proposed improvement is the implementation of independent toxicity testing, to assure objectivity, transparency, and check and improve compliance. A "no data, no market" principle could prevent access of hazardous chemicals to the market. Additionally, the introduction of novel testing could improve information on endpoints such as endocrine disrupting abilities, neurotoxicity, and immunotoxicity. An adapted regulatory framework that integrates data from different sources and comparing the outputs with estimates of exposure is required. Fast toxicology battery testing and toxicokinetic testing could improve speed of decision-making. Hereby, several improvements have been proposed that could improve the current REACH legislation. [ABSTRACT FROM AUTHOR]

As of December 2023, the use of common solvent N,N‐dimethyl formamide (DMF) will be restricted in the European Union because of its reproductive health hazard. Industrial facilities must comply with stricter exposure limits, and researchers are recommended to find alternative solvents. Here we explain the restrictions on DMF, which disciplines are affected, and how to substitute DMF to keep research and development commercially relevant. [ABSTRACT FROM AUTHOR]

Structure-based grouping of chemicals for targeted testing and read-across is an efficient way to reduce resources and animal usage. For substances of unknown or variable composition, complex reaction products, or biological materials (UVCBs), structure-based grouping is virtually impossible. Biology-based approaches such as metabolomics could provide a solution. Here, 15 steam-cracked distillates, registered in the EU through the Lower Olefins Aromatics Reach Consortium (LOA), as well as six of the major substance constituents, were tested in a 14-day rat oral gavage study, in line with the fundamental elements of the OECD 407 guideline, in combination with plasma metabolomics. Beyond signs of clinical toxicity, reduced body weight (gain), and food consumption, pathological investigations demonstrated the liver, thyroid, kidneys (males only), and hematological system to be the target organs. These targets were confirmed by metabolome pattern recognition, with no additional targets being identified. While classical toxicological parameters did not allow for a clear distinction between the substances, univariate and multivariate statistical analysis of the respective metabolomes allowed for the identification of several subclusters of biologically most similar substances. These groups were partly associated with the dominant (> 50%) constituents of these UVCBs, i.e., indene and dicyclopentadiene. Despite minor differences in clustering results based on the two statistical analyses, a proposal can be made for the grouping of these UVCBs. Both analyses correctly clustered the chemically most similar compounds, increasing the confidence that this biological approach may provide a solution for the grouping of UVCBs. [ABSTRACT FROM AUTHOR]

Process‐based river restoration seeks to restore processes such as channel‐floodplain connectivity that create and maintain river corridor functions. Process‐based restoration can fail to produce the desired results if geomorphic context is not effectively incorporated into restoration design. Geomorphic context of a river reach refers to the controls on contemporary river form and process. Controls at the catchment‐ to reach‐scale include geologic history, biophysical characteristics, legacies of past human alterations, position within the river network, river corridor geometry, base level stability, disturbance regime, and contemporary human alterations of the river corridor. We conceptualize a river corridor as reflecting the interactions among fluxes of material and the geomorphic context. We discuss how an understanding of geomorphic context can be used to select a restoration approach and provide examples of how restoration can fail to achieve desired outcomes when geomorphic context is not considered. Within the toolbox of methods used to implement process‐based restoration, we differentiate the alteration of inputs to the river corridor and fluxes of material through the corridor from alteration of form and/or connectivity within the river corridor. Historical, biotic, geologic/geomorphic, and reference sites can be used to inform process‐based restoration targets. Restoration is strongly influenced by human perceptions of what is appropriate and achievable at a site and diverse communities influencing restoration at a site may differ in their perceptions. Geomorphically based conceptual guidelines, such as the River Styles Framework, provide an effective platform for incorporating an understanding of geomorphic context into process‐based river restoration. [ABSTRACT FROM AUTHOR]

Munster Technological University (MTU) responded to the COVID-19 pandemic's educational challenges with the creation of the Reach Initiative. This initiative, a comprehensive academic mentoring and coaching programme, was developed at MTU in response to the unique challenges of the COVID-19 pandemic. Primarily targeting first and second year students, this initiative was designed to support their academic and non-academic needs during the transition to online Emergency Remote Teaching (ERT). The programme involved the recruitment and training of Academic Mentors (members of academic staff) from various disciplines who provided tailored individual support to the students. A key component of this study is a survey conducted to evaluate the initiative's impact. The survey aimed to understand students' challenges during the pandemic and assess the effectiveness of the Reach Initiative as a support mechanism. The findings revealed significant engagement with the programme, indicating its importance in providing both academic guidance and emotional support. Students reported benefiting from the initiative in various ways, including improved understanding of academic content, better access to university resources, and enhanced emotional well-being. The conclusion highlights the critical role of academic mentoring in supporting students during unprecedented times. It underscores the need for such initiatives in higher education, particularly during crises that disrupt traditional learning environments. The Reach Initiative not only facilitated academic success but also contributed positively to the students' overall university experience during the pandemic. [ABSTRACT FROM AUTHOR]

This paper studies the statistical query (SQ) complexity of estimating d-dimensional submanifolds in R n . We propose a purely geometric algorithm called manifold propagation, that reduces the problem to three natural geometric routines: projection, tangent space estimation, and point detection. We then provide constructions of these geometric routines in the SQ framework. Given an adversarial STAT (τ) oracle and a target Hausdorff distance precision ε = Ω (τ 2 / (d + 1)) , the resulting SQ manifold reconstruction algorithm has query complexity O ~ (n ε - d / 2) , which is proved to be nearly optimal. In the process, we establish low-rank matrix completion results for SQ's and lower bounds for randomized SQ estimators in general metric spaces. [ABSTRACT FROM AUTHOR]

Brachial plexus birth injury (BPBI) results in upper extremity (UE) movement limitations. Current assessments of UE function used to inform clinical decision-making only evaluate a limited set of static postures and/or movements and have been criticized for being insensitive to certain meaningful differences in function. Reachable workspace provides a numeric and visual assessment of global UE movement ability by quantifying the regions in space that patients can reach with their hands, and it can be collected using real-time feedback to elicit a best-effort acquisition of function. This study evaluated the ability of a real-time feedback reachable workspace tool to assess UE movement in BPBI. Twenty-two children with BPBI participated. Reachable workspace data were collected with three-dimensional motion capture using real-time visual feedback to measure UE reaching ability in all regions surrounding the body. All outer, far-from-body points reached by the hand were recorded and analyzed by region. A two-way, within-subjects analysis of variance was used to assess interlimb differences in percentage workspace reached and median reach distance for each of the six regions. The affected limb had significantly less percentage workspace reached than the unaffected limb for all six regions (mean interlimb differences by region, 5.7%–38.6%). The affected limb had significantly less median reach distance than the unaffected limb for all six regions (mean interlimb differences by region, 3.1%–36.8%). The workspace approach was capable of detecting UE movement impairments of the BPBI-affected limb. The reported deficits in workspace on the affected limb correspond to common movement impairments in BPBI, such as limitations in shoulder elevation, external rotation, extension, and elbow extension. The real-time feedback reachable workspace tool is sufficiently robust for assessing UE movement impairments in children with BPBI. [ABSTRACT FROM AUTHOR]

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The phenomenon of disinformation has been extensively studied, with its roots traced to shifts in the media economy, declining trust, and rising political polarization and populism. Although there is a growing research on disinformation, the issues of its dissemination and reach remain contested. This study investigates the reach and dissemination channels of selected disinformation narratives in Serbia. Through a survey-based approach (N=800), the research examines seven such cases identified through fact-checking portals: alleged Russian aid superiority, alleged Ukrainian biolabs, purported Western cultural censorship, supposed Soros’s global influence, claimed Serbian-Sanskrit connections, alleged Western origins of COVID-19, and misrepresented UN policies on sexuality. The findings reveal a significant reach of these narratives, with four out of seven being recognized by over half of the respondents. Variations in exposure and belief across different narratives potentially stem from factors such as ideological alignment, plausibility, timing, and the presence of counter- narratives. A “market” of disinformation exists on TV, digital news services, and social media, while traditional press and radio play an almost negligible role in disseminating these narratives. This research adds to the growing body of work examining disinformation in illiberal contexts. It provides initial observations on how false information circulates in a media environment where political control is prevalent and media independence is under pressure, pointing to areas for future research in this complex field.

Abstract Objective: Food-based dietary guidelines (FBDG) are an important resource to improve population health; however, little is known about the types of strategies to disseminate them. This study sought to describe dissemination strategies and content of dissemination plans that were available for FBDG. Design: A cross-sectional audit of FBDG with a published English-language version sourced from the United Nations FAO repository. We searched for publicly available dissemination strategies and any corresponding plans available in English language. Two authors extracted data on strategies, which were grouped according to the Model for Dissemination Research Framework (including source, audience, channel and message). For guidelines with a dissemination plan, we described goals, audience, strategies and expertise and resources according to the Canadian Institute for Health Research guidance. Setting: FBDG from fifty-three countries mostly from high-income (n 28, 52·8 %), and upper-middle income (n 18, 34 %) areas were included. Participants: n/a. Results: The source of guidelines was most frequently health departments (79·2 %). The message included quantities and types of foods, physical activity recommendations and 88·7 % included summarised versions of main messages. The most common channels were infographics and information booklets, and the main end-users were the public. For twelve countries (22·6 %), we were able to source an English-language dissemination plan, where none met all recommendations outlined by the Canadian Institute for Health Research. Conclusions: The public was the most frequently identified end-user and thus most dissemination strategies and plans focused on this group. Few FBDG had formal dissemination plans and of those there was limited detailed provided.

Abstract Background Parenting programs have the potential to improve population health, if widely disseminated. However, wide-scale dissemination is challenging. Also, more knowledge is needed of whether parenting programs are effective for the variability of families in the general population. Methods This study aimed to investigate who the universal parenting program All Children in Focus (ABC) reaches when offered in routine care in Sweden. A second aim was to investigate if the outcomes were predicted by factors related to family background, group leader experience, and homework completion. Questionnaires were collected before and after ABC from 1420 parents. Hierarchical regression analyses were performed to examine predictors of disruptive child behavior, parenting practices, and satisfaction. Results ABC was available in about 40% of Swedish municipalities and reached a fairly representative population sample, with the exception that fewer fathers than mothers participated. The examined predictors explained a small proportion of the variance in the outcomes (2.5, 3.5 and 14.7%, respectively). Still, the effect on disruptive child behavior was statistically significantly larger for parents born in Sweden, with higher education, and older children. The effect on parenting practices was also larger for parents born in Sweden, for mothers, and for those practicing homework more frequently. Most examined predictors showed no statistically significant association with child and parenting outcomes. Parents were generally satisfied with ABC and the significant predictors of satisfaction had little practical meaning. Conclusions A fairly representative group of parents across Sweden were reached by ABC. Background variables, homework completion, and group leaders’ experience explained a small proportion of variance in the outcomes. Meanwhile, the slightly lower intervention effects found for preschool children and parents born abroad calls for further investigation, since even small differences in effects can have an impact at a population level. The study also points to the importance of stressing homework completion and to increase the reach of universal parenting interventions to some underrepresented groups.