Category: Statistics

Proc Natl Acad Sci U S A. 2026 Feb 24;123(8):e2522228123. doi: 10.1073/pnas.2522228123. Epub 2026 Feb 17.

ABSTRACT

The presence of high levels of PM_2.5 pollution is a major health threat in India. We evaluate the benefits of reducing ambient PM_2.5 and household air pollution from a 2019 baseline, when over 70% of the population of India was exposed to annual average PM_2.5 of more than 40 μg/m³ and 56% of households burned solid fuels for cooking. We estimate the health benefits from reduced mortality that arise when lowering ambient PM_2.5 to the India standard (40 μg/m³) and to two World Health Organization (WHO) interim standards (25 μg/m³ and 15 μg/m³). The benefits of the ambient standards are moderated by the high levels of household air pollution to which people are exposed due to the concavity of the exposure-response function. We therefore examine the benefits of achieving each standard paired with a 50% reduction in the percentage of households burning solid fuels. Annual mortality reductions from the combined policies exceed 300,000 lives saved for the India standard, 500,000 lives saved for the WHO 25 μg/m³ interim standard, and 675,000 lives saved for the WHO 15 μg/m³ interim standard. The economic benefits of each of these joint policies equal 2.2%, 3.6%, and 4.9% of Indian gross domestic product (GDP), using a Value per Statistical Life of 100 times per capita GDP. Results underscore the importance of considering household air pollution when evaluating ambient standards and the synergistic benefits of combined policies when the exposure-response function is concave.

PMID:41701846 | DOI:10.1073/pnas.2522228123

Proc Natl Acad Sci U S A. 2026 Feb 24;123(8):e2510881123. doi: 10.1073/pnas.2510881123. Epub 2026 Feb 17.

ABSTRACT

Quantum computing improves substantially on known classical algorithms for various important problems, but the nature of the relationship between quantum and classical computing is not yet fully understood. This relationship can be clarified by free models, that add to classical computing just enough physical principles to represent quantum computing and no more. Here, we develop an axiomatization of quantum computing that replaces the standard continuous postulates with a small number of discrete equations, as well as a free model that replaces the standard linear-algebraic model with a category-theoretical one. The axioms and model are based on reversible classical computing, isolate quantum advantage in the ability to take certain well-behaved square roots, and link to various quantum computing hardware platforms. This approach allows combinatorial optimization, including brute force computer search, to optimize quantum computations. The free model may be interpreted as a programming language for quantum computers, that has the same expressivity and computational universality as the standard model, but additionally allows automated verification and reasoning.

PMID:41701823 | DOI:10.1073/pnas.2510881123

Proc Natl Acad Sci U S A. 2026 Mar 3;123(9):e2524764123. doi: 10.1073/pnas.2524764123. Epub 2026 Feb 17.

ABSTRACT

Giant planets and brown dwarfs play a crucial role in star and planet formation as they are situated at the boundary between planets and stars with uncertain formation mechanisms. Previous observational searches for the formation boundary were hampered by the lack of large unified samples of wide-orbit giant planets and substellar companions. A combined analysis of radial velocity and astrometry mitigates this problem and has significantly enlarged the sample. Here, we present a rigorous statistical analysis of the sample of 55 giant planets, brown dwarfs, and low-mass stellar companions orbiting FGK stars. We quantitatively analyze the occurrence rates of brown dwarfs and identify a distinct brown dwarf desert at approximately 30 M_J, with no evidence of disappearance up to 20 au. Unlike previous studies that predicted a declining planet occurrence rate beyond the water-ice line, we identify a population of giant planets and low-mass brown dwarfs in this region. The metallicity and eccentricity trends in our sample suggest that these are the consequences of two different formation scenarios. Our combined population synthesis model successfully accounts for the observed brown dwarf desert, supporting the dual formation hypothesis.

PMID:41701813 | DOI:10.1073/pnas.2524764123

Turk Gogus Kalp Damar Cerrahisi Derg. 2026 Feb 17. doi: 10.4274/tjtcs.2026.28320. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to determine the relationship between near-infrared spectroscopy (NIRS) changes and shunt use, and the role of wakefulness in detecting early neurological events during carotid endarterectomy (CEA) surgeries performed under local anesthesia (LA) while the patient was awake.

METHODS: Patients who underwent CEA under LA were included in the study. All data were obtained retrospectively from patient files in our institution’s archives. Shunt use, decreases in NIRS values, internal carotid artery (ICA) closure technique, and clamping time were recorded during the procedure. Patients were divided into two groups: Those with and those without contralateral total occlusion (CTO). These groups were compared in terms of decrease rates in NIRS values and shunt use.

RESULTS: Present study included 635 patients (68% male, mean age: 66.7±5.6 years). One hundred thirty-four (21.1%) of the patients had bilateral ICA stenosis of 70% or greater. The patients were divided into two groups: With and without CTO. CTO was detected in 97 (15.3%) patients. In all groups, shunts were applied to patients with a 30% or more decrease in NIRS values. In the CTO group, percentage decreases in NIRS values were greater and statistically significant (p<0.001), except for decreases below 10% (p<0.001). Shunt usage in the CTO group was found to be statistically significant (p=0.042). However, shunt use was associated with a decrease in NIRS rather than the presence of CTO (r=0.747, p<0.001). The most common complications in the postoperative period were voice disorder and hoarseness at a rate of 20.8%.

CONCLUSION: With carotid surgery performed under LA, significant neurological deficits were detected early and necessary revisions were performed. We also found that a decrease in NIRS values is significant for shunt use, and a decrease of more than 30% in NIRS could be note worthy for shunt use.

PMID:41700460 | DOI:10.4274/tjtcs.2026.28320

Am J Hosp Palliat Care. 2026 Feb 17:10499091261427444. doi: 10.1177/10499091261427444. Online ahead of print.

ABSTRACT

BackgroundIn palliative care, drug delivery methods must be simple, rapid and acceptable especially in homecare settings to relatives as non-professional caregivers. This study compared intranasal (IN) and subcutaneous (SC) administration performed by medical laypersons under standardized conditions.Methods31 volunteers without medical training participated in a non-randomised crossover study. After receiving instructions, participants performed both SC and IN administration in a simulated environment using placebo medication. Primary endpoints were preparation and administration time. Secondary endpoints included perceived ease, comfort, safety and handling difficulties. Data were collected using structured questionnaires. Statistical analyses used paired t-tests and binomial testing.ResultsAll participants (27 female, median age range 50-60 years) completed both procedures. Mean administration time: 4:49 minutes (SD 1:20) for SC, 1:16 minutes (SD 0:20) for IN (p < .001, d = 2.97). >90% preferred IN and rated it as easier (30/31, 97%), more comfortable (30/31, 97%), faster (30/31, 97%) and safer (21/31, 68%). SC was consistently rated more complex (30/31, 97%) and cumbersome (30/31, 97%). Handling errors were more frequent with SC application. Nearly half of participants (15/31) had prior SC experience, while all had personal experience with nasal sprays, though not in administering them to another adult. Participants emphasized the importance of training for safe and accurate administration.ConclusionMedical laypersons strongly preferred IN over SC administration. IN was significantly faster, more acceptable and associated with fewer handling problems. These findings support IN administration as a practical and caregiver-friendly alternative in palliative care.Clinical Trial NumberNot applicable.Trial Identification173-02, protocol Version 02, 03.11.2022.

PMID:41700441 | DOI:10.1177/10499091261427444

Public Health Res (Southampt). 2026 Feb;14(2):1-22. doi: 10.3310/AKHD0407.

ABSTRACT

BACKGROUND: Childhood obesity is a major public health concern worldwide, yet the best way to prevent it remains unknown.

OBJECTIVE(S): To determine what types of intervention strategy are most effective at preventing the development of obesity in children aged 5-18 years, as measured by change in body mass index, and to determine whether interventions work differentially in children with different characteristics associated with inequities.

DESIGN: Systematic reviews and statistical evidence syntheses.

ELIGIBILITY CRITERIA: Randomised controlled trials of dietary and/or activity interventions that aimed to prevent overweight or obesity in children and young people aged 5-18 years and reported outcomes at least 12 weeks after baseline. Non-randomised evidence was identified through an overview of systematic reviews. Sources of inequity of interest were those defined by the PROGRESS (place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, social capital) acronym: place, race/ethnicity, occupation (of parents), gender/sex, religion, education (of parents), socioeconomic status and social capital.

DATA SOURCES: Updating of an existing Cochrane Review, searching bibliographic databases up to February 2023, including MEDLINE, EMBASE, PsycInfo® (American Psychological Association, Washington, DC, USA) and Cochrane Central Register of Controlled Trials on the Cochrane Library, international trial registers and grey literature databases, and examining reference lists. Results subgrouped by inequity factors were sought directly from trialists.

REVIEW METHODS: Cochrane Reviews followed standard Cochrane procedures. The main statistical synthesis was informed by a novel analytic framework developed iteratively through discussions with children and young people, schoolteachers and public health professionals. Methodology was developed to analyse the data using multilevel metaregression. To examine the impact of inequity factors, we performed a two-stage meta-analysis of interactions, based on subgroup-level aggregate data collected directly from the trialists. We collected available information on intervention costs.

RESULTS: We included 172 trials in ages 5-11 and 74 in ages 12-18. In the main synthesis, of 204 trials from both reviews, we found interventions were effective on average (mean difference in standardised body mass index -0.037, 95% credible interval -0.053 to -0.022, which would correspond to a reduction in a proportion of 2.3% with obesity to a proportion of approximately 2.1%). Larger effects were associated with physical activity rather than dietary interventions, after 12 months of follow-up and in the older age group. The overview of non-randomised evidence included 24 systematic reviews, yielding mixed results. The investigation of inequity did not identify substantial differences in effectiveness according to place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, social capital characteristics, and there was very limited information about costs.

LIMITATIONS: We were able to examine only the interventions that had been evaluated in studies identified for inclusion in the systematic reviews, which does not cover all possible intervention approaches.

CONCLUSIONS: Interventions to prevent obesity in children aged 5-18 have a small beneficial effect on body mass index on average but with considerable variation. A novel re-analysis of existing randomised trials failed to identify general intervention characteristics driving this variation. No evidence was identified to suggest that interventions increase (or decrease) health inequities.

FUTURE WORK: Future studies of the effects of interventions to prevent childhood obesity should routinely collect baseline characteristics around potential inequities.

FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR131572.

PMID:41700427 | DOI:10.3310/AKHD0407

Glob Health Action. 2026 Dec;19(1):2628362. doi: 10.1080/16549716.2026.2628362. Epub 2026 Feb 17.

ABSTRACT

BACKGROUND: Ragging is an initiation ritual in Sri Lankan universities where senior students harass newcomers. This practice leads to severe consequences such as depression, increased dropouts, and suicide, yet research on this issue remains scarce.

OBJECTIVE: This thesis aimed to explore ragging through the perspectives of students and university affiliates and to assess the prevalence of Major Depressive Disorder (MDD) among students.

METHODS: Study I was a cross-sectional survey (n = 623) among second- and third-year students from the Faculties of Medicine and Technology to determine the prevalence of ragging and its health consequences. Study II utilized focus group discussions (n = 17) with students to explore the social dynamics and motivations of ragging. Study III included focus group discussions (n = 7) and interviews (n = 11) with university staff to understand their attitudes towards ragging. Study IV surveyed second-year students (n = 637) from three faculties using the Patient Health Questionnaire to assess the prevalence of MDD.

RESULTS: Study I found that 59% of students experienced ragging, 54% reported health consequences, and most sought help from friends and family. Ragging prevalence varied by faculty and year of study. Study II revealed that ragging was used to establish power and address social inequalities. Study III identified themes of normalization, fear of reprisal, and resistance among staff. Study IV showed that 31% of students experienced MDD. MDD prevalence was associated with students’ ethnicity.

CONCLUSION: Ragging is a pervasive issue with significant mental health consequences. Effective interventions require a multisectoral approach to create a safe and supportive university environment, enabling all students to thrive.

PMID:41700420 | DOI:10.1080/16549716.2026.2628362

Oral Dis. 2026 Feb 17. doi: 10.1111/odi.70252. Online ahead of print.

ABSTRACT

BACKGROUND: Oropharyngeal dysphagia is a common issue among community-dwelling older adults and is associated with adverse health outcomes. This study examined whether the number of remaining teeth mediates the association between age and oropharyngeal dysphagia (OD) risk.

METHODS: This cross-sectional study included 413 community-dwelling older adults (≥ 60 years) recruited from community health centers in Sulawesi, Indonesia. OD risk was assessed using a validated screening questionnaire. Oral examinations were conducted by trained nurses. Mediation analysis estimated the indirect, direct, and total effects of age on OD risk, adjusting for sex, educational level, hypertension, and diabetes mellitus.

RESULTS: Participants’ mean age was 69.9 years, with 15.3 remaining teeth. Mediation analysis revealed a significant indirect association between age and OD risk, mediated through the number of remaining teeth (adjusted β = 0.076, 95% CI: 0.034-0.114, p < 0.001). In contrast, the direct effect of age was not statistically significant. The total effect of age on OD risk remained significant.

CONCLUSION: The number of remaining teeth statistically mediated the association between age and OD risk. Although causal inference is limited by the cross-sectional design, these findings highlight oral health as a potentially modifiable factor for reducing OD risk among older adults.

PMID:41700387 | DOI:10.1111/odi.70252

Blood Coagul Fibrinolysis. 2026 Feb 17. doi: 10.1097/MBC.0000000000001418. Online ahead of print.

ABSTRACT

INTRODUCTION: The functional integrity of stored whole blood (WB) is critical for maintaining hemostatic potential during transfusion. While storage-related changes in coagulation components are known, comparative evaluation using viscoelastic and sonorheometric platforms remains limited. This in vitro study explores time-dependent changes in clotting dynamics during WB storage using rotational thromboelastometry (ROTEM) and sonic estimation of elasticity via resonance (SEER) sonorheometry (Quantra).

METHODS: WB from eight healthy donors was stored at 1-6 °C in citrate-phosphate-dextrose anticoagulant and sampled on Days 0, 1, 3, 7, 14, and 21. ROTEM parameters included INTEM/EXTEM/FIBTEM clotting time and amplitude; Quantra parameters included clotting time (CT), total clot stiffness (CS), platelet contribution (PCS), and fibrinogen contribution (FCS). Nonparametric statistics and effect sizes were used to assess temporal changes and agreement between platforms.

RESULTS: In this pilot in-vitro model (n = 8) we observed progressive prolongation of clotting time and reduction in clot stiffness were observed across both platforms, as early as 1-3 days into storage. PCS declined significantly, while FCS showed modest reductions. ROTEM and Quantra demonstrated strong correlations in matched parameters, with consistent fixed biases noted in Bland-Altman analysis and a proportional bias with fibrinogen between the two methods.

DISCUSSION: Our experimental in vitro study of stored WB exhibits steady, time-dependent hemostatic deterioration, particularly in platelet function and clot initiation. These in-vitro observations reveal early declines in platelet-driven clot stiffness in our model and are hypothesis-generating for further laboratory and clinical evaluation.

PMID:41700373 | DOI:10.1097/MBC.0000000000001418