Tag: statistics

JMIR Hum Factors. 2026 Apr 23;13:e79930. doi: 10.2196/79930.

ABSTRACT

BACKGROUND: The integration of robots into industrial settings has rapidly advanced, aiming to reduce human involvement in demanding tasks while improving overall efficiency. As collaborative robots (cobots) become more prevalent, assessing the physical strain during joint tasks is essential to promote long-term well-being in the workplace.

OBJECTIVE: This study aimed to investigate how human-robot collaboration influences workers’ postural control and musculoskeletal load during manipulation tasks performed in parallel.

METHODS: Fourteen healthy male participants performed manipulation tasks under 3 conditions: without robotic assistance, with a cobot providing load support (Robot Free [RF]) and a cobot constrained to horizontal movement (Robot Plane [RP]). Center of pressure trajectories were computed, and nonlinear recurrence quantification analysis indicators (recurrence rate [REC], determinism [DET], and their ratio) were calculated in the anteroposterior, mediolateral, and anteroposterior-mediolateral planes.

RESULTS: Statistical analysis showed greater postural sway in robot-assisted conditions compared to Free. Mean distance increased from 1.7 (SD 0.6) cm in Free to 2.4 (SD 0.6) cm in RF (P<.001) and 2.3 (SD 0.6) cm in RP (P<.001). Mean velocity increased from 2.9 (SD 0.9) cm/s in Free to 4.3 (SD 1.4) cm/s in RF and RP. Confidence ellipse area increased from 7.6 (SD 4.1) cm2 in Free to 24.9 (SD 14.2) cm2 in RF and 23.1 (SD 13.4) cm2 in RP. Sway area increased from 1.5 (SD 0.7) cm2/s in Free to 2.9 (SD 1.2) cm2/s in RF and RP. Nonlinear metrics revealed lower recurrence rates in robot-assisted conditions, decreasing from 0.31 (SD 0.08) in Free to 0.2 (SD 0.08) in RF and 0.2 (SD 0.04) in RP in the anteroposterior-mediolateral plane (P<.001), from 0.33 (SD 0.08) in Free to 0.28 (SD 0.07) in RF (P=.02) and 0.16 (SD 0.03) in RP (P=.007) in the mediolateral direction, and from 0.36 (SD 0.07) in Free to 0.3 (SD 0.06) in RF (P=.009) and 0.26 (SD 0.03) in RP (P<.001) in the anteroposterior direction. Determinism remained stable (values close to 1), leading to higher determinism-to-recurrence ratios for robot-assisted conditions, increasing from 3.41 (SD 0.87) in Free to 5.41 (SD 1.69) in RF and 5.51 (SD 1.11) in RP in the anteroposterior-mediolateral plane (P<.001), from 3.11 (SD 0.63) in Free to 3.64 (SD 0.72) in RF (P=.02) and 3.92 (SD 0.48) in RP (P=.007) in the mediolateral direction, and from 2.82 (SD 0.48) in Free to 3.47 (SD 0.57) in RF (P=.009) and 3.46 (SD 0.45) in RP (P<.001) in the anteroposterior direction. No significant differences were found between the robot-assisted conditions.

CONCLUSIONS: Interaction increases postural sway, indicating reduced stability and higher physical demand. This could reflect impaired balance or adaptation. Nonlinear analysis reveals that postural control remains structured. Results also suggest that the mere presence of the cobot is the primary driver of these postural changes.

PMID:42024870 | DOI:10.2196/79930

J Glob Health. 2026 Apr 24;16:04121. doi: 10.7189/jogh.16.04121.

ABSTRACT

BACKGROUND: Weak opioids are often prescribed for osteoarthritis (OA), yet their comparative psychiatric risks are not well established. We aimed to comprehensively compare the composite psychiatric risks associated with codeine and tramadol in patients diagnosed with hip OA.

METHODS: We conducted a nationwide, population-based retrospective cohort study, using Korean Health Insurance Review and Assessment Service database on patients diagnosed with hip OA between 2014 and 2017. We included patients who received either opioid, with a total of 22 651 patients (of whom 4533 codeine and 18 118 tramadol users) after 1:4 propensity score matching (PSM). We applied Cox proportional hazards models to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CIs) for incident psychiatric outcomes.

RESULTS: Codeine use was associated with a significantly lower hazard of composite psychiatric disorders (aHR = 0.86; 95% CI = 0.78-0.96), particularly anxiety (aHR = 0.81; 95% CI = 0.69-0.95), and showed a borderline reduction in sleep disorders (aHR = 0.81; 95% CI = 0.65-1.00, P = 0.048) after adjustment for age, sex, comorbidities, and concomitant medications. Subgroup analyses revealed consistently lower psychiatric risk among patients with a high comorbidity burden (Charlson’s comorbidity index ≥3), cardiovascular disease, or those without concomitant psychotropic medications. Sensitivity analyses using inverse probability treatment weighting and 1:1 PSM demonstrated broadly similar patterns, although statistical significance varied across models. No clear duration-response relationship was observed.

CONCLUSIONS: Codeine was associated with lower hazards of anxiety and sleep disorders in several analyses. These findings suggest that strengthening opioid stewardship through structured psychiatric risk assessment and individualised prescribing may enhance patient safety. Further controlled studies incorporating detailed clinical data are warranted to validate these associations and to better define their implications for long-term opioid management and policy development.

PMID:42024864 | DOI:10.7189/jogh.16.04121

JMIR Public Health Surveill. 2026 Apr 23;12:e85244. doi: 10.2196/85244.

ABSTRACT

BACKGROUND: Acute respiratory infections (ARIs) remain a significant global health challenge and are the second leading cause of disease burden and mortality. Early warning systems (EWS) play a key role in detecting clinical deterioration, alerting health care providers (HCPs), and supporting pandemic surveillance. While existing literature highlights HCPs’ positive experiences with EWS in confirming clinical assessments and guiding escalation, perspectives on how these systems can be optimized for ARI management remain underexplored.

OBJECTIVE: As Canada continues to develop and operationalize EWS for outbreak and pandemic preparedness, this study aims to explore the experiences and insights of primary care providers, emergency department (ED) physicians, and researchers regarding the use of EWS for ARI management in Canada.

METHODS: Eleven participants, including primary care providers, ED physicians, and researchers from urban and rural settings across 5 Canadian provinces (Ontario, Newfoundland and Labrador, Quebec, British Columbia, and Manitoba), were recruited in 2024. All participants regularly managed patients with ARIs or played key roles in pandemic response. A codebook thematic analysis was conducted to identify patterns and themes, with subthemes organized under broader thematic categories. Data saturation was assessed during the analysis phase. The study adhered to the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines.

RESULTS: Among the 11 participants, there was approximately equal representation across gender and age groups, and more than 90% had over ten years of experience in ARI management. Three overarching themes emerged. First, participants demonstrated general awareness of the use of EWS in ARI management, including outbreak detection, screening and triage support, and informing clinical decision-making. Technologies and surveillance tools used during the COVID-19 pandemic were frequently referenced; however, understanding of specific EWS and their application to ARI management was often limited. Second, participants identified key attributes of an effective EWS as accuracy, timeliness, integration, and equity, emphasizing the need for seamless integration into existing Canadian health care workflows without increasing administrative burden. Third, anticipated challenges were described across 4 stages of EWS development, including initiation (funding and privacy concerns), implementation (outdated data systems and limited legislation), use (staff shortages and capacity constraints), and evaluation (lack of standardized and innovative evaluation approaches).

CONCLUSIONS: This study engaged 11 experienced HCPs and researchers who were directly involved in patient care and public health response to ARI outbreaks and qualitatively explored their perspectives on EWS for ARI management and pandemic preparedness. The findings identified 3 overarching themes regarding the general knowledge, desired attributes, and anticipated challenges of EWS in ARI management, highlighting the importance of co-designing EWS with clinicians, researchers, and other key stakeholders to improve their effectiveness and integration into clinical practice and pandemic preparedness across Canada.

PMID:42024857 | DOI:10.2196/85244

JCO Glob Oncol. 2026 Apr;12(4):e2500483. doi: 10.1200/GO-25-00483. Epub 2026 Apr 23.

ABSTRACT

PURPOSE: In 2023, the G7 Cancer Initiative was launched by Australia, Canada, France, Germany, Japan, the United Kingdom, and the United States with the aim of enhancing global cancer control, and with poor-prognosis cancers as a priority. To facilitate effective collaboration among G7 Cancer, we aimed to address the lack of standardized definitions and coordinated initiatives across countries.

METHODS: We examined how the G7 Cancer Initiative countries defined poor-prognosis cancers, objectively classified them, quantified their burden, and assessed national response strategies. A review of national cancer plans was conducted together with an expert email survey to evaluate definitions and classifications. Poor-prognosis cancers were identified based on 5-year net survival (NS) below 30% and a mortality-to-incidence (M/I) ratio over 0.75 using CONCORD-3 and Global Cancer Observatory 2022 data.

RESULTS: Pancreatic cancer was consistently categorized as a poor-prognosis cancer, while some countries also included liver, esophageal, stomach, and some brain cancers. For lung cancer, classification varied depending on the definition used. These six cancers accounted for a major share of cancer deaths, with lung (18%-23%) and pancreatic (6%-10%) cancers contributing the most. National strategies differed, with Australia, France, and Japan implementing specific policies for poor-prognosis cancers, while others addressed them indirectly or not at all.

CONCLUSION: To enhance cancer outcomes for poor-prognosis cancers, the G7 Cancer Initiative should coordinate efforts through joint programs focused on early detection, treatment, and policy alignment. Standardized definitions and collaborative action are essential to strengthening the global poor-prognosis cancer response.

PMID:42024847 | DOI:10.1200/GO-25-00483

Am J Public Health. 2026 Apr 23:e1-e4. doi: 10.2105/AJPH.2026.308443. Online ahead of print.

ABSTRACT

Objectives. To estimate the mortality burden attributable to daily mean temperatures during the heat season (April through October) in Maricopa County, Arizona. Methods. We examined the effects of heat exposure on 126 854 deaths that occurred in Maricopa County during the 2019 to 2023 heat seasons. Using a quasi-Poisson regression with distributed lag nonlinear models, we estimated the cumulative relative risk (relative to 77°F) between population-weighted daily mean temperatures and all-cause mortality over a lag period of 3 days. Results. At 99°F (the 95th percentile of the population-weighted daily mean temperature), we observed an 11% (95% confidence interval [CI] = 7%, 16%) increase in daily all-cause mortality relative to 77°F. Overall, 3036 (95% empirical CI = 968, 4887) deaths were attributable to heat, which is 57% more deaths than identified through epidemiological heat surveillance. Conclusions. The mortality burden increases with increasing population-weighted daily mean temperatures, indicating that the effects of heat on mortality can be indirect and incompletely captured by routine surveillance. Public Health Implications. Statistical approaches can help estimate the mortality burden associated with heat exposure, complementing countywide surveillance efforts that provide actionable insights into enhancing heat prevention strategies. (Am J Public Health. Published online ahead of print April 23, 2026:e1-e4. https://doi.org/10.2105/AJPH.2026.308443).

PMID:42024837 | DOI:10.2105/AJPH.2026.308443

Am J Public Health. 2026 Apr 23:e1-e10. doi: 10.2105/AJPH.2026.308465. Online ahead of print.

ABSTRACT

Objectives. To examine the association of abortion bans with changes in maternal, pregnancy-related, and pregnancy-associated mortality. Methods. Using national vital statistics data (2016-2023), we used a Bayesian panel model to examine maternal, pregnancy-related, and pregnancy-associated mortality in 14 US states that implemented abortion bans by the end of 2022. Models accounted for temporal trends and state-specific factors. Results. Among the 14 states with abortion bans, there was some evidence of a potential 9.2% (95% credible interval [CI] = -1.6, 20.7) increase in the number of pregnancy-associated deaths above expectation, equivalent to 68 (95% CI = -13, 147) excess deaths; the rate was also higher than expected, with 3.3 (95% CI = -2.6, 9.0) additional deaths per 100 000 live births. Relative changes in pregnancy-related mortality were similar in magnitude but had greater uncertainty. There was no detectable increase in maternal mortality. Conclusions. Abortion bans may be associated with an increase in pregnancy-associated and pregnancy-related mortality, although data limitations and chance variation in these rare outcomes constrain the certainty of these and other findings. (Am J Public Health. Published online ahead of print April 23, 2026:e1-e10. https://doi.org/10.2105/AJPH.2026.308465).

PMID:42024836 | DOI:10.2105/AJPH.2026.308465

Am J Public Health. 2026 Apr 23:e1-e4. doi: 10.2105/AJPH.2026.308522. Online ahead of print.

ABSTRACT

Objectives. To investigate the effects of recreational cannabis laws (RCLs) on the rate of Medicare fee-for-service enrollees with cannabis-related disorders (CRDs) and claims involving CRDs. Methods. We used Medicare fee-for-service inpatient and outpatient claims from 2010 to 2022 to compare CRD outcomes in US states with and without effective RCLs and open recreational cannabis dispensaries (RCDs) using difference-in-difference models. We estimated the impact of RCLs and RCDs on the overall rate of Medicare enrollees with CRD per 10 000 enrollees and the rate of claims with CRD per 10 000 enrollees at the state‒year level (n = 663). Results. We found statistically significant increases in CRD outcomes following RCLs (19.73 patients per 10 000 enrollees [P < .001]; 20.56 claims per 10 000 enrollees [P = .005]) and RCDs (14.14 patients per 10 000 enrollees [P < .001]; 13.98 claims per 10 000 enrollees [P = .004]). Conclusions. Given that RCLs were associated with increased rates of CRD diagnoses and claims including CRD among Medicare fee-for-service enrollees, states considering implementation of RCLs should consider the negative harms of legalization, particularly for older adults. (Am J Public Health. Published online ahead of print April 23, 2026:e1-e4. https://doi.org/10.2105/AJPH.2026.308522).

PMID:42024835 | DOI:10.2105/AJPH.2026.308522

Health Aff (Millwood). 2026 Apr 23:101377hlthaff202501665. doi: 10.1377/hlthaff.2025.01665. Online ahead of print.

ABSTRACT

Extreme heat events have been demonstrated to increase emergency department (ED) visits, hospitalizations, and mortality, but evidence of their impacts on the associated costs and on outpatient use is more limited. We used 2016-23 health insurance claims from a large, national insurer and national temperature and humidity data to conduct a regression analysis on the relationship between extreme heat exposure and ED, inpatient, and outpatient use and cost in the commercial insurance, Medicaid, and Medicare Advantage (MA) populations. One additional day with a heat index of 100°F or hotter within a week was associated with increased ED use and cost across nearly all coverage populations and age groups. Extreme heat was associated with significant increases in inpatient use for children with commercial coverage (1.4 percent), members ages 18-64 with Medicaid coverage (0.47 percent), and MA members (0.5 percent) but was not associated with statistically significant increases in inpatient cost for any population group. It was not associated with increases in outpatient use or cost in any population group. MA members had the highest annual cost due to extreme heat. These findings provide evidence to inform population health management strategies, seasonal preparedness planning, and policy interventions to mitigate heat-related morbidity and health care costs.

PMID:42024824 | DOI:10.1377/hlthaff.2025.01665

Science. 2026 Apr 23;392(6796):395-400. doi: 10.1126/science.aeb0673. Epub 2026 Apr 23.

ABSTRACT

Translating the conductivity of individual carbon nanotubes into practical, macroscopic conductors remains a challenge. We report highly aligned fibers of double-walled carbon nanotubes intercalated with chains of tetrachloroaluminate anions (AlCl₄^–) in the intertube channels. The AlCl₄^– intercalant acts as a noncovalent dopant, accepting 0.65 electrons per anion, mostly from the outer nanotube layer. Combined with a 17% intercalant volume fraction, it produces an increase in room-temperature conductivity to values as high as 24.5 mega-Siemens per meter, which is 41% of that of copper. Specific conductivity values reach 17,345 Siemens-meter squared per kilogram, which is superior to that of metals. These fibers are five times stronger and half the weight of conventional overhead cables while remaining stable in dry conditions and retaining 80% of their conductivity protected from moisture by a cable polymer sheath.

PMID:42024735 | DOI:10.1126/science.aeb0673

J Bone Joint Surg Am. 2026 Apr 23. doi: 10.2106/JBJS.25.00667. Online ahead of print.

ABSTRACT

BACKGROUND: Understanding drivers of supply and labor cost variation in orthopaedic surgery is crucial to provide value-based care. Time-driven activity-based costing (TDABC) is a more accurate methodology for capturing costs of care than traditional methods. Anterior cruciate ligament reconstruction (ACLR) is one of the most performed outpatient procedures within orthopaedic surgery. The purpose of this study was to characterize the cost composition of ACLR and identify factors that drive cost variation.

METHODS: Cost data for supplies and time-based personnel usage were extracted from electronic health records and were used to calculate costs using TDABC. TDABC methodology was applied to calculate the cost of personnel usage by multiplying the duration and associated cost per minute. Descriptive statistics and mixed-effects modeling were used to determine cost drivers.

RESULTS: This study included 861 patients who underwent ACLR at 8 hospitals. The mean patient age (and standard deviation) was 31.1 ± 11.6 years. Of the 861 patients, 350 were male and 511 were female; 85.6% of patients were White, 8.1% were Asian, and 3.4% were Black. There was 3.2-fold variation in supply costs ($2,950) and 1.6-fold variation in labor costs ($940) between the 10th and 90th percentiles. Overall, supply costs accounted for 58.2% of total costs, whereas labor costs comprised the remaining 41.8%. The intraoperative phase was the greatest generator of total cost (89.7%). After adjusting for surgeon and hospital variability, variation in total cost was most effectively explained by graft type, primary surgery status, and meniscal repair (conditional R2 = 0.84; marginal R2 = 0.27). On subanalysis, patients undergoing allograft ACLR had significantly higher total costs, implant costs, and age compared with those undergoing ACLR with any autograft type (all p < 0.01).

CONCLUSIONS: The most notable drivers of labor and supply cost variation were graft type, surgeon, surgery center, primary surgery status, and concomitant meniscal repair. Understanding modifiable cost drivers may aid health systems in designing value-based pathways, implant formularies, and surgeon education programs. Future studies may integrate cost with outcome measures for a more holistic view of value.

LEVEL OF EVIDENCE: Economic and Decision Analysis Level III. See Instructions for Authors for a complete description of levels of evidence.

PMID:42024715 | DOI:10.2106/JBJS.25.00667