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\"The Balkan Wars, the Rwanda genocide, and the crimes against humanity in Cambodia and Sierra Leone spurred the creation of international criminal tribunals to bring the perpetrators of unimaginable atrocities to justice. When Richard Goldstone, David Crane, Robert Petit, and Luis Moreno-Ocampo received the call - each set out on a unique quest to build an international criminal tribunal and launch its first prosecutions. Never before have the founding International Prosecutors told the behind-the-scenes stories of their historic journey. With no blueprint and little precedent, each was a path-breaker. This book contains the first-hand accounts of the challenges they faced, the obstacles they overcame, and the successes they achieved in obtaining justice for millions of victims\"-- Provided by publisher.

During and after the 9/11 rescue and recovery efforts, World Trade Center (WTC) responders were exposed to environmental hazards that may accelerate aging and increase frailty. This study examines the relationship between polypharmacy and frailty among WTC responders to inform strategies that mitigate medication-related risks in high-risk, aging populations. We included WTC responders aged 50 and older who attended at least one clinical monitoring visit at WTC Health Program between 2017-2019. Frailty was assessed using the WTC-specific Clinical Frailty Index, and associations with polypharmacy (concurrent use of 5 or more medications) and fall-risk increasing drugs (FRIDs) use were evaluated through multivariable logistic regression models adjusting for demographic, employment, health, and WTC exposure data. Among 6,966 WTC responders, 55% met the criteria for polypharmacy and 7.6% used FRIDs. Frailty was independently associated with both polypharmacy (OR 1.15, p < 0.001) and FRID use (OR 1.11, p < 0.001). Older age (OR 1.08, p < 0.001), obesity (OR 1.92, p < 0.001 for BMI ≥ 30), protective service occupations (OR 1.30, p = 0.002), and chronic conditions such as gastroesophageal reflux disease (OR 1.71, p < 0.001), obstructive airway disease (OR 2.24, p < 0.001), and upper respiratory disease (OR 1.85, p < 0.001) were associated with higher odds of polypharmacy. In contrast, male sex (OR 0.81, p = 0.018) and construction occupations (OR 0.73, p = 0.001) were associated with lower odds of polypharmacy. Female sex (OR 1.64, p < 0.001), smoking (current: OR 1.55, p = 0.013; former: OR 1.30, p = 0.014), and mental health conditions such as anxiety (OR 1.66, p = 0.004), depression (OR 2.85, p < 0.001), and post-traumatic stress disorder (OR 1.72, p < 0.001) were associated with higher odds of FRID use. We found a high prevalence of polypharmacy and FRID use among aging WTC responders, with frailty significantly associated with both. Our findings underscore the need to optimize medication management for aging WTC responders, which may impact their healthy aging.

Background Behavior change is essential for promoting health and preventing illness; yet, motivating individuals to adopt and maintain healthy behaviors remains a significant challenge. Multiple models have been developed in Psychology and Behavioral Sciences to understand and encourage behavior change, including the Capability, Opportunity, Motivation, Behavior model (COM-B model), the Health Belief Model, the Behavior Change Wheel, the Theoretical Domains Framework (TDF), nudge theory, and Behavior Change Techniques (BCTs). Among these, the Fogg Behavior Model (FBM), developed by Dr. BJ Fogg, offers a specific and valuable framework for facilitating behavior change. This scoping review aims to analyze studies that apply the FBM in health, particularly its impact on changing health-related behaviors. By synthesizing the evidence, this review provides valuable insights into the use and impact of the FBM in promoting behavior change in health, with implications for future research and practice. Objective To investigate the application of the FBM within the health domain, focusing on its role in behavior change interventions. Methods A comprehensive search of multiple databases, including MEDLINE/PubMed, Cochrane Library, Epistemonikos, and PsycINFO, was conducted to identify studies applying the FBM in health-related interventions. The search strategy incorporated terms related to the FBM, health behavior change, and relevant health outcomes, with no restrictions on publication date. Unpublished and grey literature was also searched. Eligibility criteria included studies that applied the FBM in health interventions and reported outcomes. The review followed PRISMA-ScR and SAGER guidelines to ensure comprehensive reporting and consideration of sex and gender variables. Data were synthesized using a narrative approach, summarizing findings descriptively and thematically. Results Six studies met the inclusion criteria, covering sexual and reproductive health, vaccination, chronic disease management, general wellness, and healthcare adherence. The FBM was applied through motivation (anticipation, sensation, belonging), ability enhancement (reducing effort, increasing accessibility, integrating behaviors into routines), and prompts (reminders, calls to action, environmental cues). Effectiveness varied across studies. Gestational weight management reduced gestational diabetes (10.34% vs. 34.48%, p = 0.028), hypertension (3.45% vs. 27.59%, p = 0.030), and cesarean rates (41.38% vs. 72.41%, p = 0.017). HPV vaccination interventions increased intent to vaccinate (63.3–96.7%, p < 0.001), with 30% receiving the first dose within three months. Diabetes self-management improved dietary adherence (p = 0.04), physical activity (p = 0.005), and glucose monitoring (p = 0.02). Parental nutrition interventions increased knowledge (d = 1.07), beliefs (d = 0.61), and behavior change (d = 0.59). A vaginal birth intervention raised intention by 29% (p < 0.05). Conclusions Our scoping review highlights the FBM as an effective framework for promoting health behavior change across various domains. By systematically applying motivation, ability, and prompts, FBM-based interventions demonstrated positive outcomes. However, limitations such as the lack of long-term follow-ups and sex- and gender-disaggregated data indicate areas for future research. Expanding its application to diverse populations, integrating digital health technologies, and addressing structural and cultural barriers will enhance its impact. Strengthening methodological rigor and comparative analyses with other behavior change models will further refine its effectiveness for broader public health applications. Despite its potential, the FBM remains underutilized in public health research. Trial registration Open Science Framework osf.io/jpwxg.

More than 50 000 people participated in the rescue and recovery work that followed the Sept 11, 2001 (9/11) attacks on the World Trade Center (WTC). Multiple health problems in these workers were reported in the early years after the disaster. We report incidence and prevalence rates of physical and mental health disorders during the 9 years since the attacks, examine their associations with occupational exposures, and quantify physical and mental health comorbidities. In this longitudinal study of a large cohort of WTC rescue and recovery workers, we gathered data from 27 449 participants in the WTC Screening, Monitoring, and Treatment Program. The study population included police officers, firefighters, construction workers, and municipal workers. We used the Kaplan-Meier procedure to estimate cumulative and annual incidence of physical disorders (asthma, sinusitis, and gastro-oesophageal reflux disease), mental health disorders (depression, post-traumatic stress disorder [PTSD], and panic disorder), and spirometric abnormalities. Incidence rates were assessed also by level of exposure (days worked at the WTC site and exposure to the dust cloud). 9-year cumulative incidence of asthma was 27·6% (number at risk: 7027), sinusitis 42·3% (5870), and gastro-oesophageal reflux disease 39·3% (5650). In police officers, cumulative incidence of depression was 7·0% (number at risk: 3648), PTSD 9·3% (3761), and panic disorder 8·4% (3780). In other rescue and recovery workers, cumulative incidence of depression was 27·5% (number at risk: 4200), PTSD 31·9% (4342), and panic disorder 21·2% (4953). 9-year cumulative incidence for spirometric abnormalities was 41·8% (number at risk: 5769); three-quarters of these abnormalities were low forced vital capacity. Incidence of most disorders was highest in workers with greatest WTC exposure. Extensive comorbidity was reported within and between physical and mental health disorders. 9 years after the 9/11 WTC attacks, rescue and recovery workers continue to have a substantial burden of physical and mental health problems. These findings emphasise the need for continued monitoring and treatment of the WTC rescue and recovery population. Centers for Disease Control and Prevention and National Institute for Occupational Safety and Health.

World Trade Center (WTC) rescue and recovery workers were exposed to a complex mix of pollutants and carcinogens. The purpose of this investigation was to evaluate cancer incidence in responders during the first 7 years after 11 September 2001. Cancers among 20,984 consented participants in the WTC Health Program were identified through linkage to state tumor registries in New York, New Jersey, Connecticut, and Pennsylvania. Standardized incidence ratios (SIRs) were calculated to compare cancers diagnosed in responders to predicted numbers for the general population. Multivariate regression models were used to estimate associations with degree of exposure. A total of 575 cancers were diagnosed in 552 individuals. Increases above registry-based expectations were noted for all cancer sites combined (SIR = 1.15; 95% CI: 1.06, 1.25), thyroid cancer (SIR = 2.39; 95% CI: 1.70, 3.27), prostate cancer (SIR = 1.21; 95% CI: 1.01, 1.44), combined hematopoietic and lymphoid cancers (SIR = 1.36; 95% CI: 1.07, 1.71), and soft tissue cancers (SIR = 2.26; 95% CI: 1.13, 4.05). When restricted to 302 cancers diagnosed ≥ 6 months after enrollment, the SIR for all cancers decreased to 1.06 (95% CI: 0.94, 1.18), but thyroid and prostate cancer diagnoses remained greater than expected. All cancers combined were increased in very highly exposed responders and among those exposed to significant amounts of dust, compared with responders who reported lower levels of exposure. Estimates should be interpreted with caution given the short follow-up and long latency period for most cancers, the intensive medical surveillance of this cohort, and the small numbers of cancers at specific sites. However, our findings highlight the need for continued follow-up and surveillance of WTC responders.

Background The disasters at Seveso, Three Mile Island, Bhopal, Chernobyl, the World Trade Center (WTC) and Fukushima had historic health and economic sequelae for large populations of workers, responders and community members. Methods Comparative data from these events were collected to derive indications for future preparedness. Information from the primary sources and a literature review addressed: i) exposure assessment; ii) exposed populations; iii) health surveillance; iv) follow-up and research outputs; v) observed physical and mental health effects; vi) treatment and benefits; and vii) outreach activities. Results Exposure assessment was conducted in Seveso, Chernobyl and Fukushima, although none benefited from a timely or systematic strategy, yielding immediate and sequential measurements after the disaster. Identification of exposed subjects was overall underestimated. Health surveillance, treatment and follow-up research were implemented in Seveso, Chernobyl, Fukushima, and at the WTC, mostly focusing on the workers and responders, and to a lesser extent on residents. Exposure-related physical and mental health consequences were identified, indicating the need for a long-term health care of the affected populations. Fukushima has generated the largest scientific output so far, followed by the WTCHP and Chernobyl. Benefits programs and active outreach figured prominently in only the WTC Health Program. The analysis of these programs yielded the following lessons: 1) Know who was there; 2) Have public health input to the disaster response; 3) Collect health and needs data rapidly; 4) Take care of the affected; 5) Emergency preparedness; 6) Data driven, needs assessment, advocacy. Conclusions Given the long-lasting health consequences of natural and man-made disasters, health surveillance and treatment programs are critical for management of health conditions, and emergency preparedness plans are needed to prevent or minimize the impact of future threats.

Abstract Background Following the September 11, 2001, attacks on the World Trade Center (WTC), thousands of workers were exposed to an array of toxins known to cause adverse health effects, including cancer. This study evaluates cancer incidence in the WTC Health Program General Responder Cohort occurring within 12 years post exposure. Methods The study population consisted of 28 729 members of the General Responder Cohort enrolled from cohort inception, July 2002 to December 31, 2013. Standardized incidence ratios (SIRs) were calculated with cancer case inclusion and follow-up starting post September 11, 2001 (unrestricted) and, alternatively, to account for selection bias, with case inclusion and follow-up starting 6 months after enrollment in the WTC Health Program (restricted). Case ascertainment was based on linkage with six state cancer registries. Under the restricted criterion, hazard ratios were estimated using multivariable Cox proportional hazards models for all cancer sites combined and for prostate cancer. Results Restricted analyses identified 1072 cancers in 999 responders, with elevations in cancer incidence for all cancer sites combined (SIR = 1.09, 95% confidence interval [CI] = 1.02 to 1.16), prostate cancer (SIR = 1.25, 95% CI = 1.11 to 1.40), thyroid cancer (SIR = 2.19, 95% CI = 1.71 to 2.75), and leukemia (SIR = 1.41, 95% CI = 1.01 to 1.92). Cancer incidence was not associated with any WTC exposure index (composite or individual) for all cancer sites combined or for prostate cancer. Conclusion Our analyses show statistically significant elevations in cancer incidence for all cancer sites combined and for prostate and thyroid cancers and leukemia. Multivariable analyses show no association with magnitude or type of exposure.

Access to scientific data can enable independent reuse and verification; however, most data are not available and become increasingly irrecoverable over time. This study aimed to retrieve and preserve important datasets from 160 of the most highly-cited social science articles published between 2008–2013 and 2015–2018. We asked authors if they would share data in a public repository—the Data Ark—or provide reasons if data could not be shared. Of the 160 articles, data for 117 (73%, 95% CI [67%–80%]) were not available and data for 7 (4%, 95% CI [0%–12%]) were available with restrictions. Data for 36 (22%, 95% CI [16%–30%]) articles were available in unrestricted form: 29 of these datasets were already available and 7 datasets were made available in the Data Ark. Most authors did not respond to our data requests and a minority shared reasons for not sharing, such as legal or ethical constraints. These findings highlight an unresolved need to preserve important scientific datasets and increase their accessibility to the scientific community.

1 Nitric oxide (NO) is a potent inhibitor of platelet activation, that inhibits the agonist‐induced increase in cytosolic Ca2+ concentration through both cGMP‐dependent and independent pathways. However, the NO‐related (NOx) species responsible for cGMP‐independent signalling in platelets is unclear. We tested the hypothesis that extracellular NO, but not NO+ or peroxynitrite, generated in the extracellular compartment is responsible for cGMP‐independent inhibition of platelet activation via inhibition of Ca2+ signalling. 2 Concentration–response curves for diethylamine diazeniumdiolate (DEA/NO; a spontaneous NO generator), S‐nitroso‐N‐valerylpenicillamine (SNVP; an S‐nitrosothiol) and 3‐morpholinosydnonomine (SIN‐1; a peroxynitrite generator) were generated in platelet‐rich plasma (PRP) and washed platelets (WP) in the presence and absence of a supramaximal concentration of the soluble guanylate cyclase inhibitor, ODQ (20 μM). All three NOx donors displayed cGMP‐independent inhibition of platelet aggregation in PRP, but only DEA/NO exhibited cGMP‐independent inhibition of aggregation in WP. 3 Analysis of NO generation using an isolated NO‐electrode revealed that cGMP‐independent effects coincided with the generation of substantial levels of extracellular NO (>40 nM) from the NOx donors. 4 Reconstitution of WP with plasma factors indicated that the copper‐containing plasma protein, caeruloplasmin (CP), catalysed the release of NO from SNVP, while Cu/Zn superoxide dismutase (SOD) unmasked NO generated from SIN‐1. The increased generation of extracellular NO correlated with a switch to cGMP‐independent effects with both NOx donors. 5 Analysis of Fura‐2 loaded WP revealed that only DEA/NO inhibited Ca2+ signalling in platelets via a cGMP‐independent mechanism. However, preincubation of SNVP and SIN‐1 with CP and SOD, respectively, induced cGMP‐independent inhibition of intraplatelet Ca2+ trafficking by the NOx donors. 6 Taken together, our data suggest that extracellular NO (>40 nM) is required for cGMP‐independent inhibition of platelet activation. Plasma constituents may play an important pharmacological role in activating cGMP‐independent signalling by S‐nitrosothiols or peroxynitrite generators. British Journal of Pharmacology (2005) 144, 849–859. doi:10.1038/sj.bjp.0706110