The survey found that 82 percent of U.S. adults correctly identified preventing mosquito bites and controlling mosquitoes in and around the home as the best defense against dengue fever and West Nile virus, the two mosquito-borne diseases of greatest concern in the continental United States. That figure has remained remarkably stable over time, essentially unchanged from 81 percent in 2025 and 79 percent in 2024. Nearly two-thirds of Americans, 64 percent, reported routinely taking precautions to avoid mosquito bites, an increase from 61 percent in August 2025 and 59 percent in September 2024. That level of precautionary behavior is consistent with responses recorded in July 2016, during the height of the U.S. outbreak of mosquito-borne Zika virus, when 67 percent of Americans said they routinely took precautions against mosquito bites.

The specific precautions that Americans report taking vary considerably. Among those who said they routinely protect themselves from mosquitoes, 81 percent reported removing standing water from around their homes, a critical measure because standing water serves as the breeding habitat where mosquitoes lay their eggs. Seventy-one percent said they avoid activities or areas that would bring them into contact with mosquitoes, a figure unchanged from the past two years but significantly higher than the 63 percent recorded in July 2016. Sixty-four percent reported wearing insect repellent, statistically unchanged from 2025 but significantly lower than the 72 percent who said so in September 2024 and the 73 percent who reported repellent use in July 2016. Just over half, 55 percent, said they wear long-sleeved shirts or other protective clothing outdoors, while 54 percent reported routinely replacing or repairing window screens, substantially lower than the 64 percent reported in September 2024 and the 67 percent in July 2016. Only 11 percent reported using mosquito netting, a figure that has not changed since July 2016.

The Centers for Disease Control and Prevention recommends a comprehensive approach to mosquito bite prevention: using insect repellent, wearing loose-fitting long-sleeved shirts and pants, taking steps to control mosquitoes both indoors and outdoors, and eliminating standing water where mosquitoes can lay eggs. While the survey demonstrates that most Americans are aware of these general strategies, the picture changes dramatically when people are asked about the specific mechanics of insect repellent use. When asked about applying sunscreen and insect repellent together, only 31 percent of respondents correctly said that the CDC recommends putting on sunscreen first, allowing it to dry, and then applying insect repellent. Nearly half of respondents, 49 percent, said they were unsure in which order to apply the two products. The percentage answering correctly is statistically unchanged from the 33 percent recorded in 2025, suggesting that public knowledge on this point has not improved despite ongoing guidance from federal health agencies.

Knowledge about where insect repellent should and should not be applied is even scarcer. Just 15 percent of respondents correctly said that the CDC recommends not putting insect repellent on skin that is covered by clothing, essentially unchanged from 14 percent in 2025, while 41 percent said they were unsure. A somewhat larger share, 53 percent, correctly knew that insect repellent should not be used on babies younger than 2 months old, statistically unchanged from 54 percent in 2025, though another 42 percent remained uncertain about this guidance. These findings indicate that even among Americans who do use repellent, a substantial portion may be applying it incorrectly or inappropriately, potentially reducing its effectiveness or creating unnecessary exposure.

Confusion also extends to how people choose a repellent in the first place. Only 18 percent of survey respondents correctly identified the CDC recommendation to look for a repellent that is registered with the Environmental Protection Agency, compared with 19 percent in 2025. Nearly half, 45 percent, said they were unsure which type of repellent to look for, while 30 percent incorrectly chose a repellent containing more than 50 percent DEET and 6 percent chose one described as natural. The CDC recommends EPA-registered insect repellents containing active ingredients such as DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-diol, or 2-undecanone. The agency’s guidance notes that concentrations above 50 percent DEET generally do not provide additional protection against mosquito bites, meaning that the 30 percent of Americans who believe higher DEET concentrations are the right choice may be spending more money without gaining additional protection. Patrick E. Jamieson, director of APPC’s Annenberg Health and Risk Communication Institute, which oversees the health survey, said the CDC needs to do a better job of informing the public about how to choose and apply insect repellent.

The survey findings arrive at a time when mosquito-borne disease remains an active public health concern in the United States, even if the immediate threat appears lower than in the previous year. According to the CDC, West Nile virus is the leading cause of mosquito-borne disease in the continental United States, and dengue is also spread through the bites of infected mosquitoes. As of September 8, 2026, the CDC had reported 504 human cases of West Nile virus across 41 states through ArboNET, the agency’s national surveillance system, including 363 cases of the more serious neuroinvasive form of the disease. That total, while significant, is substantially lower than the number of reported cases at the same point in 2025. West Nile virus infection most commonly occurs through the bite of an infected mosquito, and most infected people do not develop symptoms, although some develop febrile illness and a small proportion develop serious disease affecting the central nervous system.

Despite this ongoing disease burden, public worry about mosquito-borne illness remains remarkably low and stable. In August 2026, just 16 percent of U.S. adults said they were worried that they or someone in their family would contract dengue fever or West Nile virus during the next three months, compared with 15 percent who were worried in August 2025 and 15 percent in September 2024. Ken Winneg, APPC’s managing director of survey research, emphasized that despite the drop in West Nile virus cases relative to 2025, taking precautions to prevent mosquito bites and control mosquitoes remains important to upholding community public health. The persistence of low worry alongside generally high awareness of preventive strategies suggests that many Americans view mosquito-borne disease as a distant or abstract threat rather than an immediate personal risk.

Compounding the low level of concern, the survey found that knowledge of West Nile virus symptoms has actually declined over the past year. When respondents were presented with a list of possible symptoms and asked to identify those associated with West Nile virus, 56 percent said they were unsure, an 8-percentage-point increase from 48 percent in August 2025 and statistically unchanged from the 53 percent recorded in September 2024. Among those who did offer answers, fever was selected by more adults than any other symptom, chosen by 39 percent, but that was a significant decline from the 45 percent who selected it in 2025. Similar downward patterns appeared across other correct symptoms relative to 2025: 34 percent selected muscle and joint pain, a 7-point drop from 41 percent the previous year, and 32 percent selected headache, a significant 6-percentage-point drop from 38 percent. Twenty-nine percent selected nausea and vomiting, a 4-point drop from 33 percent that was not statistically significant. No change was seen in the percentage who selected rash, at 22 percent in 2026 versus 23 percent in 2025. Respondents also incorrectly selected two items as West Nile symptoms: dizziness or lightheadedness, incorrectly chosen by 23 percent in 2026, an improvement from 31 percent in 2025, and firm, round painless sores, incorrectly chosen by 9 percent, roughly the same as the 12 percent in 2025.

The overall picture painted by the survey is one of a public that has absorbed the general message about mosquito-borne disease prevention but has not internalized the finer points of the guidance that would make their preventive efforts fully effective. The stability of the headline figures over three consecutive years, and in some cases back to 2016, suggests that these knowledge gaps are structural rather than transient. With more than a third of Americans unsure how to layer sunscreen and repellent, four in ten unsure whether repellent belongs under clothing, fewer than one in five knowing to seek an EPA-registered product, and more than half unable to identify any symptoms of West Nile virus, the survey’s authors argue that clearer, more sustained public communication from the CDC and other health authorities is needed to close the gap between what Americans know in general terms and what they need to know to protect themselves and their families effectively during mosquito season.

The latest wave of the Annenberg Science and Public Health survey was conducted for the Annenberg Public Policy Center by SSRS, an independent research company. Interviews were conducted by web and telephone among a nationally representative probability sample drawn from the SSRS Opinion Panel, with data weighted to represent the U.S. adult population. The survey was fielded August 4 through 17, 2026, among 1,904 U.S. adults, with a margin of sampling error of plus or minus 3.2 percentage points at the 95 percent confidence level. In addition to Winneg and Jamieson, APPC’s ASAPH survey team includes research analysts Laura A. Gibson and Shawn Patterson Jr. The Annenberg Public Policy Center, established in 1993, tracks American public knowledge, beliefs, and behaviors regarding vaccination, Covid-19, flu, RSV, climate, and other consequential health issues through its survey panel.

The research team assembled mortality data from 134 countries and territories, drawing on national statistical offices, population registries, health ministries and a wide network of other primary sources. Rather than relying on the cause-of-death classifications that each government submitted, the study anchored its analysis in excess mortality—the number of deaths recorded above what would have been expected in a normal year, based on pre-pandemic trends from 2015 onward. This methodological choice is central to the study’s power. Official Covid death counts depended on identifying Covid as the specific cause of death, a process vulnerable to gaps in testing availability, diagnostic practices, and reporting conventions that varied enormously across health systems. Excess mortality, by contrast, asks a simpler and harder-to-falsify question: how many people died compared with how many would normally have been expected? By carefully subtracting excess deaths attributable to non-Covid factors—such as reduced traffic fatalities during lockdowns or increased deaths from disrupted healthcare—the researchers constructed an independent estimate of true Covid mortality for each country.

The scale of the gap they uncovered is striking. Across the countries studied, governments collectively reported 5.08 million Covid deaths during 2020 and 2021. The researchers’ excess-mortality-based estimate puts the true figure at approximately 12.47 million—roughly two and a half times the officially acknowledged toll. Using a carefully constructed statistical framework, the authors estimate that between 45 and 55 percent of governments misreported Covid mortality in some form, with underreporting vastly more common than overreporting. The study then went a critical step further. The researchers deliberately avoided the assumption that every reporting gap reflects deliberate manipulation, recognizing that countries differ profoundly in their ability to diagnose illness, register deaths and maintain functioning vital statistics systems. A poor country with fragmented civil registration might simply miss many deaths without any political motive. So the team tested whether standard measures of state capacity could account for the observed discrepancies—and found that capacity explains only a small fraction of the variation. Something else was shaping what governments chose, or managed, to report.

That something, the study argues, is the structure of political incentives and the strength of the checks imposed on governments. When the researchers examined institutional constraints, a far stronger pattern emerged. Countries with robust systems of checks and balances—independent judiciaries, free presses, functioning opposition parties and accountable bureaucracies—showed dramatically less underreporting. Misreporting was also lower in countries whose citizens were better positioned to evaluate official information, measured through indicators including educational attainment and internet access. In societies where large numbers of people could observe burial activity, compare local hospital conditions with national claims, and cross-check official statements against independent sources, governments appear to have faced a real cost to publishing misleading figures. The mechanism the authors describe is not necessarily one of dramatic falsification; more often, underreporting likely took the form of passive failure to investigate, delayed or incomplete death certification, or narrowed definitions of what counted as a Covid death. But the aggregate effect was the same: where accountability was weak, the official record diverged sharply from demographic reality.

The study also uncovered two provocative descriptive associations. Countries that held national elections during the pandemic tended to show higher levels of misreporting, a pattern consistent with the incentives incumbent governments face when voters are heading to the polls and bad news carries electoral consequences. Countries with a communist legacy likewise exhibited elevated misreporting, potentially reflecting enduring institutional traditions in which official statistics serve political ends as much as informational ones. The authors are careful to emphasize that these relationships are correlational and descriptive rather than causal—they identify patterns, not proof of mechanism. Even so, the findings fit within a broader body of political economy research showing that governments routinely face temptations to present economic and social statistics favorably, and that what distinguishes accurate reporters from inaccurate ones is not intent alone but the presence or absence of institutions and audiences capable of detecting and punishing distortion.

The methodological contribution of the work deserves particular attention, because it extends well beyond the pandemic. Excess mortality functions as what social scientists call an independent benchmark—a measure generated by demographics and death registration rather than by the political process under scrutiny. When an official claim can be tested against a benchmark produced through a separate channel, the room for undetected manipulation shrinks considerably. This principle has applications far beyond mortality statistics. Claims about economic growth, unemployment, inflation, agricultural yields and environmental conditions all become more verifiable when independent evidence—satellite imagery, night-time lights, trade partner data, household surveys—can be brought to bear. The Covid episode demonstrated this dynamic at global scale under emergency conditions: because demographers and statisticians could reconstruct death totals from civil registries and historical baselines, the gap between claims and reality became measurable, and eventually undeniable.

The consequences of misreported mortality were not confined within national borders. During the pandemic, reported figures shaped international decisions about travel restrictions, border closures, vaccine allocation and the assessment of emerging variants. A country reporting low death counts might be treated as a safe travel partner or a low-risk source of new variants when the underlying reality was far grimmer. The study argues that inaccurate official information ripples outward, complicating international efforts in domains such as foreign aid targeting, climate action and global vaccination campaigns. Policymakers allocating scarce resources rely on the statistics governments provide; when those statistics are systematically distorted, resources flow to the wrong places and collective problems become harder to solve. In an era of fast-moving digital information flows and AI-generated content, the researchers note, the challenge of distinguishing reliable official data from favorable spin has become only more acute.

Importantly, the authors resist the conclusion that official statistics should now be treated with blanket suspicion. The study’s message is more nuanced and, in a sense, more constructive: trust in official information should be earned and maintained through verification, not granted by default or withdrawn wholesale. Governments facing strong institutional and social constraints generally reported accurately, and many countries—even some with limited resources—produced mortality data that closely tracked demographic reality. The lesson is not that governments lie, but that the reliability of what governments say depends on the surrounding ecosystem of accountability. Free media, professional statistical agencies insulated from political interference, transparent methodologies, engaged and informed publics, and independent researchers with access to raw data together form the infrastructure of truthful official communication. Where that infrastructure exists, even a crisis as chaotic as a global pandemic produced largely honest numbers. Where it was absent, the numbers bent toward political convenience.

Covid offered researchers an unusually clean natural experiment: governments across virtually every political system on Earth confronted a broadly comparable shock at roughly the same moment, making cross-national comparison meaningful in a way few crises allow. What the comparison reveals is a window into a much older and larger question—what makes official information trustworthy at all? Karlinsky and Shayo’s answer is that trustworthiness resides less in the technical capacity to count than in the political and social architecture that makes distortion costly. An informed public that can detect falsehood, and institutions that can challenge it, turned out to be better predictors of accurate death reporting than wealth or administrative sophistication. As the world confronts future pandemics, climate-related disasters and economic shocks that will again demand honest, timely data from every government simultaneously, the study’s central finding stands as both a warning and a guide: the numbers will only be as good as the accountability that surrounds them, and investing in strong institutions and informed citizens is, in a very literal sense, an investment in knowing the truth.

News Publication Date: 9-Sep-2026

Web References: https://link.springer.com/article/10.1007/s10887-026-09266-w

References: Karlinsky, A., & Shayo, M. (2026). Manipulation of information in times of crisis: Evidence from Covid excess mortality. Journal of Economic Growth. https://doi.org/10.1007/s10887-026-09266-w

The timing of the review is pointed. As Prime Minister Mark Carney prepares to host the inaugural Canada Investment Summit in Toronto this September, the researchers frame their findings as one of the country’s largest untapped economic and health-care opportunities. Dr. Michelle St. Pierre, a postdoctoral fellow in UBC Okanagan’s Department of Psychology and the review’s corresponding author, distilled the problem in stark terms. One in two primary-care visits in Canada now involves a mental-health concern, yet family doctors themselves report lacking the training, the time, and the team to manage that caseload. The integrated primary care model, in which mental-health specialists including psychologists work as members of the primary-care team rather than as distant referral targets, has been studied and validated for decades across multiple countries. Canada, despite possessing both the scientific evidence base and a trained professional workforce, has not built the model at scale.

The cost of inaction is not abstract. The review marshals some sobering figures. Roughly two in five Canadians living with a mental-health condition report that they are not receiving the care they need. Approximately 6.5 million Canadians lack a family doctor altogether, the highest rate among Canada’s peer countries, which means an enormous segment of the population has no stable point of entry into the health-care system at all. Meanwhile, mental illness drains an estimated $42 billion annually from the Canadian economy in treatment and support costs, and a further $50 billion in lost productivity and absenteeism. Together, those figures approach one hundred billion dollars a year, a sum that dwarfs most line items in national policy debate and yet receives a fraction of the attention devoted to other areas of public investment.

The review’s core subject is integrated primary care, a service-delivery model that embeds mental-health specialists, including registered psychologists, directly within family-practice teams. Rather than referring patients to external practitioners with long wait lists and fragmented communication, integrated models allow patients to receive evidence-based psychological treatment within the same clinic, often from the same building, and frequently in coordination with the physicians who already know their medical histories. The researchers examined studies from Canada, the United States, the United Kingdom, Australia, and New Zealand, and the pattern they found was remarkably consistent across jurisdictions, health systems, and patient populations.

The technical findings cut across four dimensions. First, wait times fall. In one Canadian study cited in the review, the arrival of a psychologist on a primary-care team reduced waits for mental-health services by more than six weeks, a meaningful difference when considering that untreated depression and anxiety typically worsen over time and often escalate into crises requiring emergency care. Second, patients engage. Up to 90 percent of patients referred to co-located mental-health providers complete their treatment, a completion rate that substantially outperforms traditional external referrals. The mechanism behind this is not mysterious. Patients are more likely to follow through when the psychologist is down the hall rather than across town, when scheduling is coordinated with their existing medical appointments, and when the stigma of a separate psychiatric referral is replaced by the normalization of a visit within their trusted family clinic.

Third, clinical outcomes improve measurably. Patients in integrated primary care settings show durable, lasting improvements in depression, anxiety, and the management of chronic diseases. This last element deserves emphasis, because the review is careful not to reduce psychological care to the treatment of diagnosable psychiatric conditions alone. Behavioral factors, including stress, sleep, adherence to medical regimens, and lifestyle change, are deeply implicated in the trajectory of chronic conditions such as diabetes, cardiovascular disease, and obesity. A psychologist embedded in a primary-care team can address the behavioral dimension of these illnesses directly, which no prescription alone can do. Fourth, physicians benefit. Doctors working in fully integrated practices report lower rates of burnout and greater professional satisfaction. Given the well-documented crisis of physician attrition in Canada, with family doctors leaving the profession in alarming numbers, any intervention that demonstrably reduces burnout has system-level value far beyond the individual clinicians it helps.

The economics underpinning all of this are as important as the clinical findings. A Canadian economic analysis cited in the review estimated that every dollar invested in publicly covered psychological services returns approximately two dollars in savings to society. This is a benefit-cost ratio that few public investments can match, and it is achieved through reduced downstream expenditures on emergency care, hospitalization, specialist referrals, disability payments, and the enormous productivity losses associated with untreated mental illness. The argument is not simply that integrated care is humane, though it plainly is. The argument is that it is one of the most fiscally rational interventions available to a government facing simultaneous crises in health-care access and labor productivity.

To preempt the criticism that such models exist only in theory or in foreign health systems with little resemblance to Canada’s, the review’s co-authors point to a working pilot in British Columbia. Since 2023, a registered clinical psychologist has been embedded one day per week in the UBCO Student Health Clinic through the Primary Care Psychologist Program, developed by the review’s co-authors, including Dr. Lesley Lutes, Professor and Director of the Centre for Obesity and Well-Being Research Excellence at UBC Okanagan. The psychologist works alongside the medical team to identify and treat mental-health concerns early, and the program has now become standard practice at the clinic, with rigorous evaluation of patient outcomes ongoing. The university setting provides a natural proving ground, serving a population of students who often face their first serious mental-health challenges precisely when they have left family doctors behind in their hometowns.

Dr. Lutes framed the pilot as proof that the model requires no further scientific validation. What the Primary Care Psychologist Program demonstrates, she said, is that the model is not theoretical. It is, in her words, a staffing decision waiting to be made at scale. This is the crux of the review’s policy argument. Canada does not need a generation of new research, nor does it need to invent a novel clinical methodology, nor does it lack the professional workforce. Registered psychologists already exist in every province and territory, trained in evidence-based interventions, currently operating in fragmented private practices or confined to hospital settings, and often inaccessible to the majority of Canadians because their services are not publicly covered in most provinces. The single decisive variable is whether governments choose to fund the integration.

Dr. Lutes was careful to position the review not as a partisan critique but as an invitation. Our paper is not a critique of any one government, she said. It is an attempt to put the full evidence base on the table so the next conversation can move faster. That framing matters. Health policy in Canada is contested terrain, with provincial jurisdiction over service delivery, federal spending power, and professional Colleges each holding pieces of the puzzle. By assembling three decades of cross-national evidence into a single, accessible case, the researchers are attempting to lower the cost of political action, reducing the excuse that the evidence is scattered, contested, or untested in the Canadian context. The evidence, they demonstrate, is neither scattered nor contested nor untested. It has been accumulating steadily since the early 1990s and it points in one direction.

The broader implications reach beyond the borders of Canada. Health systems in the United States, the United Kingdom, Australia, and New Zealand have each grappled with the same structural problem, the sheer volume of mental-health need flowing into primary care and the inadequacy of fragmented referral models to absorb it. The convergence of findings across these five countries suggests that integrated primary care is not a local idiosyncrasy of one system but a general principle of effective health-service design. For clinicians, the message is that co-location, shared records, and warm handoffs between physicians and psychologists transform outcomes. For policymakers, the message is that funding publicly covered psychological services within primary-care teams pays for itself. For patients, the message is simpler still. Help could sit in the same waiting room as the family doctor they already trust, and the six-week waits, the 90 percent completion rates, and the two-dollar return on every dollar invested are not projections but documented realities waiting for a policy decision.

The study’s central finding is sobering. While 1,222 food contact chemicals are already recognized as hazardous to human health—substances with well-documented links to endocrine disruption, carcinogenicity, reproductive toxicity, and other adverse outcomes—more than 13,000 chemicals remain in a regulatory gray zone. They are used in materials that touch food every day, yet insufficient publicly available data exist to determine whether they are safe. This means that when a consumer picks up a plastic-wrapped sandwich, a canned beverage, or a takeout container, there is a substantial chance the chemicals involved have never been comprehensively evaluated for the breadth of harm they could inflict. Current regulatory frameworks in Europe and North America, the researchers argue, were simply not designed to cope with a universe of chemicals this large and this poorly characterized.

The scale of the challenge becomes clearer when one considers how food contact chemicals are regulated today. Under existing systems, chemicals are typically assessed one at a time, with each substance requiring its own evaluation process, its own dossier of toxicological studies, and its own regulatory determination. Given that comprehensive testing of a single chemical can take years and cost millions of dollars, applying this approach to more than 13,000 data-poor substances would be a bureaucratic and scientific undertaking of generations. Meanwhile, consumers continue to be exposed, and manufacturers continue to bring new materials to market. The one-by-one paradigm, the authors contend, is both inefficient and ineffective—a conclusion that will surprise no one who has followed the slow pace of chemical regulation over the past several decades.

To break this impasse, the research team turned to a strategy that toxicologists have long advocated: structural grouping. Chemicals that share similar molecular architectures often share similar biological activities, because the ways in which molecules interact with receptors, enzymes, and DNA depend on their three-dimensional shapes and functional groups. By analyzing the chemical structures of the more than 15,000 food contact chemicals cataloged in the Food Packaging Forum’s database of food contact chemicals, the scientists identified 38 priority chemical groups—clusters of structurally related substances with a high proportion of known hazardous members. These groups include some of the most controversial chemical families in modern consumer products: ortho-phthalates, the plastic softeners associated with reproductive and developmental harm; per- and polyfluoroalkyl substances, or PFAS, the so-called forever chemicals linked to cancer, immune dysfunction, and thyroid disease; alkyl phenols; organophosphates; isocyanates; and primary aromatic amines, among others.

The power of this grouping approach lies in what it enables regulators and companies to do today, without waiting for exhaustive testing. In total, 3,547 food contact chemicals fall within these 38 priority groups. Because these chemicals are structurally similar to substances already known to be dangerous, they carry an elevated probability of sharing that danger—and they represent prime candidates for what toxicologists call regrettable substitution. This phenomenon, in which a hazardous chemical is replaced by a structurally related but untested alternative that later proves equally or nearly as harmful, has become one of the most frustrating patterns in chemical safety. The textbook example is bisphenol A, the endocrine-disrupting plasticizer that manufacturers increasingly replaced with bisphenol F, a close chemical cousin that subsequent research suggested carried comparable hazards. By flagging entire structural families at once, the new approach is designed to prevent industry from simply hopping from one problematic chemical to the next.

To make this method usable in practice, the researchers have released two publicly accessible tools. The first is the FCCprio List, an evidence-based inventory of known hazardous chemicals found in food contact materials, compiled from publicly available hazard data. Chemicals on this list, the authors suggest, are reasonable candidates for more restricted use in food contact applications. The second is an interactive application called FCCgroup, which allows users—whether regulators, researchers, or company compliance officers—to screen any set of chemicals and quickly determine whether individual substances belong to one of the 38 priority groups. The intent is to democratize hazard screening: rather than requiring specialized expertise to identify potential chemicals of concern, the tool makes structural prioritization available to anyone with an interest in the safety of their supply chain or their products.

The implications for industry are significant. Companies that manufacture or use food packaging materials face a growing thicket of legal restrictions, litigation risks, and consumer scrutiny. A tool that flags potentially hazardous chemicals before they become the target of regulation offers a way to stay ahead of the curve, reformulate products proactively, and avoid the reputational and financial costs of being caught with a regrettable substitute in the portfolio. As Albert Anguera Sempere, a co-author of the study, noted, the app can help companies screen their chemical inventories quickly and identify substances that might pose an avoidable threat to consumer health—an advantage both for risk management and for building consumer trust.

The researchers are careful to frame their approach as a bridge, not a destination. Grouping by structure is a triage tool, not a substitute for proper toxicological evaluation. The ideal outcome, they emphasize, would be for the missing data on food contact chemicals to be generated through rigorous testing, allowing each substance to be assessed on its own merits across the full range of health endpoints. Until that happens—which, at current testing rates, could take decades—the grouping strategy offers an evidence-based way to reduce exposure to the most likely hazards first. In effect, it converts a chaotic, intractable data problem into an ordered queue of priorities, focusing scarce regulatory and scientific resources where they are most likely to protect human health.

The scope of the problem the study addresses extends beyond individual consumer choices. Food contact materials are one of the most intimate and continuous routes of chemical exposure in modern life. Chemicals can migrate from packaging into food through contact, heat, acidity, and time, meaning that even substances used at low concentrations can accumulate in the diet over a lifetime. Recent biomonitoring studies have detected a wide array of food contact chemicals in human blood, urine, and other tissues, underscoring that exposure is not hypothetical. For vulnerable populations—pregnant women, infants, and children, whose developing systems are particularly sensitive to endocrine-active substances—the stakes are especially high. The fact that such a large fraction of these chemicals has never been adequately characterized represents, in the researchers’ view, a systemic failure of existing regulatory architecture.

Dr. Jane Muncke, a co-author of the study, framed the findings bluntly: the research demonstrates just how little is known about so many of the chemicals that consumers are exposed to every day through the packaging on the food they buy. Regulatory approaches in Europe and North America that treat each chemical individually are inefficient and do not sufficiently protect consumers, she argued, and the grouping approach offers decision makers something they can act on immediately, before the slow machinery of full chemical testing catches up. Dr. Helene Wiesinger, the study’s lead author, echoed this sentiment, stressing that replacing known hazardous chemicals with very similar, insufficiently tested alternatives simply perpetuates the problem rather than solving it. The 38 priority groups her team identified, together with the screening method they developed, provide a way to spot potential chemicals of concern quickly and take appropriate action.

The study arrives at a moment of heightened global attention to chemical safety. The European Union’s chemicals strategy, ongoing negotiations over a global plastics treaty, and mounting public concern about PFAS contamination have all pushed the question of how to manage tens of thousands of poorly characterized substances to the top of the policy agenda. What this study contributes is a concrete, operational answer to a question that has often felt paralyzing: where to begin? By ranking the universe of food contact chemicals by structural similarity to known hazards, the Food Packaging Forum team has transformed an unmanageable problem into a tractable one—38 groups, 3,547 chemicals, and a clear starting point for regulators, manufacturers, and researchers alike. The study, titled “Prioritizing and Grouping Food Contact Chemicals – From chaos to clarity,” was published online on September 1, 2026, and its authors declare no competing financial interests. The researchers will present their findings and demonstrate the FCCgroup application in a free public webinar, and both the FCCprio List and the app are freely available through the Food Packaging Forum’s website.

News Publication Date: 1-Sep-2026

Web References: Food Packaging Forum Foundation (FCCprio List and FCCgroup app, freely available via the Food Packaging Forum website)

References: Wiesinger, H., Parkinson, L. V., Geueke, B., Anguera Sempere, A., Boucher, J., Cabane, E., Scheringer, M., Muncke, J. (2026). Prioritizing and Grouping Food Contact Chemicals – From chaos to clarity. Environmental Science & Technology. https://doi.org/10.1021/acs.est.5c15186

The distinction at the heart of this year’s theme is one that separates two generations of artificial intelligence tools. The generative AI systems that dominated the previous funding cycles respond to a single prompt: a researcher asks a question, the model produces an answer, and the interaction ends. Agentic workflows operate on an entirely different architectural principle. An agent is given an objective and then plans a sequence of steps, executes those steps by calling external tools and services, inspects the results, revises its plan when necessary, and loops through this cycle until the work is complete. In a research context, that might mean an agent that retrieves datasets from a repository, cleans and reconciles them against institutional records, drafts an analysis, checks its own output against the source material, and then prepares a submission-ready package. Each of those stages involves tool calls, intermediate state, and decisions that were previously made by a human sitting at a keyboard.

Steve Scott, VP Portfolio Development at Digital Science, framed the shift in terms that will resonate with anyone who has watched the AI tooling landscape evolve. “AI tools are increasingly able to act on research, not just describe it,” he said at the launch. “The next breakthroughs will come from agentic workflows, autonomous and multi-step, that researchers, institutions and funders can actually rely on.” His second observation is arguably the more consequential one for the sector. “This is a different category from the generative AI tools we were funding three years ago,” Scott explained. “An agentic workflow plans, executes and reviews multi-step work rather than answering a single prompt.” The distinction matters because autonomy changes the risk profile completely. A chatbot that hallucinates a citation is an inconvenience; an autonomous agent that hallucinates a citation and then acts on it, submitting a flawed manuscript or misclassifying a grant application, embeds that error into the permanent record of research.

This is why the 2026 theme insists on the word “trust,” and why Scott was careful to define what trust means in this context. “Trust in this case means quality rather than detection,” he said. “An agent that shows its working, not a tool that catches bad actors after the fact.” The technical implications of that statement are substantial. Provenance, in the sense intended here, means that every output an agent produces carries a verifiable record of the inputs, data sources, model versions and prompts that produced it. Audit means that the full chain of an agent’s actions, every tool invocation, every intermediate artefact, every decision point, is logged in a form that a human reviewer or institutional compliance system can reconstruct after the fact. Governance means that agents operate within defined permission boundaries, escalate to human judgement at meaningful checkpoints, and remain accountable to identifiable owners within an organisation. A trustworthy agentic workflow is, in engineering terms, a system designed for inspectability rather than opacity.

The focus areas for this year’s grant map those engineering requirements onto the research lifecycle. Trusted authorship and writing refers to agents that assist with drafting, summarising and editing while maintaining an unambiguous account of what was contributed by a human, what was contributed by a machine, and on what basis. Enterprise research workflows covers agents operating at institutional scale, interfacing with the systems that universities and research organisations actually run, from current research information systems to repositories and grant management platforms. Trusted decision agents, perhaps the most delicate of the four categories, addresses systems that support funding and institutional decisions, where the stakes of an unexplainable or unverifiable output are at their highest. Trusted publication workflows rounds out the list, encompassing the journey from manuscript preparation through peer review support to publication, with provenance intact at every stage. Digital Science notes that novel applications of agentic AI benefiting any part of the research lifecycle will be considered, with these four areas serving as indicative rather than exhaustive territory.

The eligibility criteria are deliberately forgiving, which has always been part of the programme’s appeal to early-stage builders. Applicants do not need revenue, a finished build or a complete business plan. A prototype, a working product or a well-formed concept is enough to enter. What the application must articulate is the problem being solved, the approach taken, why the solution fits an agentic and trustworthy workflow, and where the work stands today. That last requirement is telling. In a funding landscape crowded with AI pitches, Digital Science is effectively screening for teams that understand the difference between a demo and a system an institution would actually deploy. The equity-free nature of the award is equally significant for early-stage teams: £25,000 arrives without the recipient surrendering ownership, allowing founders and academic groups to use the capital as validation capital rather than as the beginning of a dilution cycle.

The timing of the theme reflects a broader inflection point in the research technology sector. Tool-calling interfaces and orchestration frameworks have matured to the point where multi-step autonomous systems are technically feasible for small teams, not just large laboratories, and the last two years have seen an explosion of experimental agents across science, from literature-screening assistants to automated data-analysis pipelines. What has lagged behind is the institutional infrastructure of trust. Universities, funders and publishers operate under obligations of research integrity, data protection and auditability that generic consumer AI tools were never designed to satisfy. An agent that cannot explain where a piece of information came from, or that leaves no traceable record of its actions, is functionally unusable inside those environments regardless of how capable its underlying model is. The 2026 Catalyst Grant is, in effect, a bet that the teams who solve the trust problem, rather than the teams who chase raw capability, will define the next generation of research infrastructure.

Scott also pointed to the value the programme delivers beyond the cheque itself, a point that previous cohorts have repeatedly confirmed. “Catalyst Grant’s real value lies beyond the funding itself,” he said. “It’s in the opportunities provided to winning teams: the conversations it starts, practical advice, introductions to other experts in the field, and a sharper idea of what successful innovation looks like.” Over sixteen years, the programme has functioned as an early signal of where research tooling is heading, and its alumni network has become a genuine asset for teams navigating the difficult passage from prototype to product. For researchers and founders working on agentic systems, access to a company whose portfolio spans research information management, altmetrics, data repositories, authoring platforms and patent services offers a vantage point across the entire ecosystem that few accelerators can match.

For those considering an application, the practical details are straightforward. Full eligibility criteria and application instructions are available on the Catalyst Grant website, and questions about the programme can be directed to catalyst@digital-science.com. The award is open globally to individuals, startups and research teams with early-stage ideas, and Digital Science is encouraging applicants and observers to join the conversation on social media under the hashtag #CatalystGrant. The company itself sits at the centre of the ecosystem this year’s theme addresses: its brands include Altmetric, Dimensions, Figshare, IFI CLAIMS Patent Services, metaphacts, Overleaf, ReadCube, Symplectic and Writefull, collectively covering research evaluation, data publication, authoring and institutional workflow management. That breadth gives the 2026 theme particular weight, because the company is not merely observing the shift toward agentic AI; it operates the infrastructure such agents would need to work within. Media enquiries can be directed to David Ellis, Manager of Media and PR at Digital Science. As autonomous systems move from novelty to necessity in research, the question the 2026 Catalyst Grant poses is no longer whether agents will act on science, but whether the people building them can make their actions visible, verifiable and worthy of institutional confidence.

News Publication Date: 1-Sep-2026

Web References: Digital Science Catalyst Grant

References: Digital Science’s 2026 Catalyst Grant seeks agentic AI workflows you can trust. Available at: https://www.digital-science.com/about-us/investment/catalyst-grant/

Sickle cell disease is a single-gene disorder that affects hemoglobin, the oxygen-carrying molecule in red blood cells. A single mutation causes hemoglobin molecules to polymerize under certain conditions, deforming red cells into rigid, crescent shapes that lodge in small blood vessels. The consequences are cascading: vaso-occlusion triggers episodes of excruciating pain, chronic hemolytic anemia, inflammation, and progressive damage to organs including the kidneys, lungs, brain, and spleen. The disease is among the costliest chronic conditions in medicine, measured in both direct health care expenditure and lost human potential, and it disproportionately affects people of African, Mediterranean, Middle Eastern, and South Asian ancestry. Yet for all its molecular simplicity—one gene, one known mutation—the disease behaves with bewildering variability. Some patients endure frequent crises and early organ failure while others, carrying the same genotype, live comparatively well for decades. The reason for this divergence has remained one of the field’s most stubborn mysteries.

The Mount Sinai team, led by principal investigator Sarah McCuskee, MD, Assistant Professor of Emergency Medicine and of Global Health and Health Systems Design, believes the answer may lie substantially outside the genome—in the “exposome,” the cumulative measure of every environmental exposure an individual encounters from moment to moment across a lifetime. “We have heard time and time again from our patients: their lives impact their disease, and vice versa,” Dr. McCuskee said in announcing the award. “But until now, how daily life impacts sickle cell disease hasn’t been studied very much. We are excited to partner with people living with sickle cell disease to understand this better, while applying rigorous scientific methods to make sure our conclusions are impactful.” Her framing captures the project’s central ambition: to treat patient experience not as anecdote but as a valid signal that can be rigorously quantified, measured, and validated.

The biological logic behind the hypothesis is grounded in what preliminary work has already hinted at. Neighborhood and personal exposures are known to activate inflammatory pathways, alter vascular tone, and shift metabolic states—all processes directly implicated in sickle cell pathogenesis. Chronic psychosocial stress elevates cortisol and sympathetic nervous system activity, which can promote vasoconstriction and heighten the likelihood of vaso-occlusive events. Elevated ambient temperature is suspected of influencing blood viscosity and dehydration status, both critical variables in a disease where red cells sickle more readily when blood flow slows or plasma volume falls. Airborne particulate matter, particularly fine particles smaller than 2.5 micrometers, known as PM2.5, penetrates deep into the lungs and drives systemic inflammation through oxidative stress, an especially concerning mechanism for patients whose vasculature is already prone to inflammatory damage. Poor access to nutritious food may compromise the antioxidant defenses and hydration status that help keep sickling episodes at bay. Substandard housing—with inadequate heating, cooling, ventilation, or pest exposure—compounds all of these risks simultaneously.

The new study is among the first prospective investigations of exposures in sickle cell disease ever undertaken, and its methodology reflects the sophistication that such a claim demands. The researchers will pursue two complementary strategies. The first links blood samples previously donated by people with sickle cell disease for research to geospatial data on the exposures those individuals experience, drawing on advanced satellite-based models. These models can estimate ambient concentrations of fine particulate matter, neighborhood-level temperatures, and other environmental variables at fine resolution, allowing investigators to connect each participant’s residential history with molecular readouts of their disease state. The second strategy moves into real time: participants will carry portable air-quality sensors that directly measure the particles they breathe, and they will report on diet and stress levels as they occur. These moment-to-moment exposure data will then be linked to measurements of the body’s energy metabolism and inflammatory markers, giving researchers a dynamic picture of how a specific exposure on a specific day translates into molecular changes in the blood.

This pairing of satellite modeling and personal sensing is methodologically significant. Satellite data offers population-scale coverage and historical depth, but it estimates exposure at the ambient level and can miss what individuals actually encounter indoors, in transit, or in microenvironments like subway platforms and workplaces. Portable sensors capture the true inhaled dose but are limited in duration and cohort size. By triangulating the two approaches and anchoring both to biochemical endpoints—energy metabolism and inflammation—the study can distinguish between exposures that merely correlate with disease activity and those that plausibly drive it. If, for example, a spike in personally measured PM2.5 is followed within days by a rise in inflammatory cytokines and markers of hemolysis, the causal chain becomes far harder to dismiss. That kind of evidence, replicated across participants and seasons, is what regulatory policy and clinical guidance ultimately require.

The collaborative architecture of the project is equally deliberate. The research will be conducted in partnership with the Human Immune Monitoring Center at Mount Sinai, which provides deep immunophenotyping capability; the Institute for Exposomic Research at the Icahn School of Medicine, one of the first institutions in the world organized specifically around exposomic science; and the Center for Sickle Cell Disease, which anchors the clinical and community dimensions of the work. Exposomics—the systematic study of non-genetic drivers of health—has gained momentum in cancer, cardiovascular disease, and neurology, but its application to a monogenic disease like sickle cell is comparatively novel and potentially transformative, because it addresses the variability that the gene itself cannot explain.

Community partnership is not an afterthought in this design but a stated structural principle. When the study concludes, the researchers intend to share results widely, including through publicly available maps of neighborhood exposures co-developed with the New York City sickle cell community. That commitment matters for a disease whose patients have historically faced well-documented barriers in health care—under-treatment of pain, delayed emergency care, and skepticism about the severity of their symptoms. By giving the community access to the same exposure data that researchers use, the project aims to convert an academic finding into an advocacy tool, one that residents, clinicians, and policymakers can use to argue for cooler housing, cleaner air, and better food environments in the neighborhoods where sickle cell patients live.

The translational endpoint is clinical. Dr. McCuskee and her colleagues plan to develop tools based on their findings that will help clinicians counsel patients concretely—not in vague exhortations to “stay healthy,” but with specific, evidence-based guidance about which environmental conditions appear to elevate risk for a given individual, and what mitigations may help. Beyond sickle cell disease, the investigators hope the methods themselves—linking personal sensing, geospatial modeling, and molecular biomarkers—could form a template for investigating other chronic and genetic illnesses in which outcomes vary inexplicably from patient to patient, including cystic fibrosis, certain autoimmune conditions, and cardiovascular disease.

The grant will be distributed over five years, a duration long enough to capture seasonal variation in temperature, air quality, and stress exposures, and to observe whether exposure-driven molecular changes translate into clinical events such as pain crises, emergency department visits, or hospitalizations. If the study delivers on its promise, it could mark a turning point in how medicine understands a disease long defined by its genetics. The mutation in the hemoglobin gene has been known since the middle of the twentieth century; the environmental and social conditions that determine how severely that mutation expresses itself have, by comparison, barely been examined. Mount Sinai’s new program sets out to close that gap, grounded in the conviction that where people live is not background noise to their biology but part of it—and that understanding the two together may finally explain why one gene can produce so many different lives.

The phenomenon at the heart of the study is known in health financing circles as the “missing middle.” In many low- and middle-income countries adopting national health insurance (NHI), the poorest citizens are enrolled through government-subsidized premiums funded by taxation, while formal sector workers contribute through payroll deductions. Informal sector workers fall into a gap: their earnings are typically too high to qualify for subsidies but too low and too irregular to comfortably cover insurance premiums out of pocket. In Kenya at the time of the survey, informal workers were expected to pay a flat monthly premium of 500 Kenyan shillings (about USD 4.00) regardless of income—a sum that many households struggling with competing basic needs simply could not prioritize. Subsequent reforms shifted premiums to an income-based formula of 2.75 percent of income or household asset value, with a floor of KES 300, but the researchers caution this means-testing approach may push premiums even further beyond what many informal workers can afford.

The study drew on an unusually rich data source: a nationally representative cross-sectional household survey of 5,168 informal sector workers aged 18 and above, collected in December 2020 by the German Institute of Development and Sustainability in collaboration with the Friedrich-Ebert-Stiftung, the International Labour Organization, and the Institute for Development Studies at the University of Nairobi. The survey used a clustered, stratified, multi-stage probability design, randomly sampling 2,608 households across regions, counties, districts, and villages, with selection probabilities proportional to adult population size and allocated across the urban-rural divide. The timing is significant: the data were gathered during the post-COVID-19 recovery period and during Kenya’s transition from voluntary to mandatory enrolment, offering a rare real-world snapshot of the structural and economic forces shaping participation at a pivotal policy moment. Informal workers in the sample included small-scale traders, farmers, domestic workers, transport sector employees, and handicraft manufacturers.

The analytical approach was rigorous and multilayered. The researchers first described enrolment levels, then quantified socioeconomic inequality using concentration curves and the Wagstaff concentration index—a measure defined as twice the area between the concentration curve and the line of equality, ranging from −1 to +1, where positive values indicate concentration of enrolment among the rich. Because enrolment is a binary variable bounded between 0 and 1, the team used Wagstaff’s normalized index, which rescales the measure to permit valid comparisons. Finally, the researchers fitted a three-level mixed effects logistic regression model, nesting 5,168 individuals within 47 county clusters, to identify the determinants of enrolment while accounting for variability between geographic units. Four nested models were compared using Akaike’s Information Criterion, and multicollinearity was assessed with variance inflation factors, all of which fell below 2, with an overall VIF of 1.41, indicating no problematic collinearity among the twelve explanatory variables.

The inequality findings were unambiguous. Informal workers in the richest wealth quintile were more than four times as likely to be enrolled as those in the poorest quintile, a relative difference of 4.29, and even the second-richest quintile showed more than double the enrolment rate of the poorest. Education generated equally dramatic disparities: households headed by someone with tertiary or university education were three times as likely to have enrolled members as those with no basic education, an absolute difference of 23.72 percentage points. Workers in the non-agricultural sector were nearly twice as likely to be enrolled compared with the unemployed, with an absolute gap of 14.51 percentage points. Large households of more than six members were significantly less likely to enrol than small households of fewer than four members—a relative ratio of just 0.53—reflecting the reality that per capita income stretches thin across competing needs when a flat premium must be paid for coverage.

The multilevel regression confirmed and refined these patterns. Compared with workers aged 18 to 34, those aged 34 to 54 had 35 percent higher odds of enrolment (adjusted odds ratio 1.35; 95 percent CI 1.13–1.60), and those over 54 had 63 percent higher odds (AOR 1.63; 95 percent CI 1.29–2.07). Non-agricultural employment doubled the odds of enrolment (AOR 1.96; 95 percent CI 1.61–2.40), and household heads with advanced education more than doubled their households’ odds (AOR 2.52; 95 percent CI 2.01–3.15). Wealth showed the largest effect: workers in the wealthiest quintile had nearly four times the odds of enrolment compared with the poorest (AOR 3.87; 95 percent CI 2.97–5.05). Membership in informal microfinance institutions—rotational savings and credit associations and accumulated savings and credit associations—raised the odds of enrolment by 41 to 44 percent, suggesting these community-based financial structures could serve as practical onboarding channels for insurance schemes. Notably, sex showed no significant association with enrolment, and roughly 13 percent of the variation in enrolment was attributable to differences between county clusters.

Perhaps the most intriguing finding concerns the behavioral spillover of healthcare experience. Workers from households in which at least one member reported a positive experience at their most recent health facility visit—assessed across reception, staff competency, ease of accessing services, and waiting time—were about 45 to 49 percent more likely to be enrolled than those from households reporting negative experiences (AOR 1.49; 95 percent CI 1.22–1.73). The researchers argue that positive encounters with the health system, whether through insured or uninsured channels, build trust and enhance the perceived value of financial protection in household discussions about whether premiums are worth paying. This interpretation aligns with experimental evidence from Ghana, where a randomized trial demonstrated that improving service quality increased insurance enrolment among initially uninsured households. People, in short, invest in insurance only to the extent that they trust the return on that investment, making health system quality itself a determinant of insurance uptake.

The study also examined Kenya’s “Afya Care” pilot, a one-year free healthcare policy launched in December 2018 that removed user fees in four counties. Concentration curves suggested the pilot improved equity in enrolment among the poorest 20 percent of informal workers, with the curve for exposed workers even crossing the line of equality at the lowest quintile—though this effect was not statistically significant overall (CIX 0.20, p = 0.341). The regression found a positive but nonsignificant association between exposure to the free care policy and enrolment (AOR 1.75; 95 percent CI 0.88–3.46), possibly because premium subsidies for poor households were introduced in pilot counties before national scale-up. The researchers place these results in a global context, noting that targeted subsidies have proven effective elsewhere: Ghana exempts elderly people, children under 18, and pregnant women; Rwanda subsidizes community-based insurance through formal sector contributions; Gabon created a dedicated fund for the poor; and several Asian countries, including Thailand, Vietnam, and Indonesia, have implemented subsidized coverage arrangements for informal and vulnerable populations.

The authors are careful to acknowledge limitations. The cross-sectional design precludes causal inference, and the 2020 data predate subsequent economic shifts, including inflation and evolving labor dynamics. Questions on health service utilization were asked only as follow-ups to illness episodes, limiting their analytical use. Nevertheless, given the absence of more recent datasets specifically targeting informal workers, the team argues the findings remain highly relevant, particularly since structural characteristics—employment informality, information access, trust—are likely to persist regardless of macroeconomic conditions. They call for future research on retention and the stability of enrolment, which are critical to the sustainability of insurance pools, and on the feasibility of leveraging community health volunteers and microfinance institutions as awareness and enrolment channels.

The implications extend well beyond Kenya. With informal workers forming the overwhelming majority of employment across much of sub-Saharan Africa, and with countries from Tanzania to Zambia struggling with the same enrolment gaps—rates ranging from under 10 percent in Tanzania to 57 percent in Ghana—the “missing middle” represents one of the central obstacles to achieving Sustainable Development Goal Target 3.8 by 2030. The researchers recommend differential premium levels, expanded targeted subsidies reaching beyond the ultra-poor, and awareness campaigns delivered through nontraditional channels such as community health volunteers and microfinance groups. They also flag the demographic challenge posed by adverse selection: with more than half of informal workers under 35, schemes must find innovative ways—such as digital applications combining education and enrolment—to attract younger, healthier members and balance the risk pool. Without such measures, they warn, the transition to mandatory national health insurance risks formalizing a system that, on paper promises universal protection, but in practice continues to concentrate coverage among those who need it least.

The new journal itself is devoted to metascience, sometimes called metaresearch or "research on research," a field that treats the scholarly enterprise itself as an object of study. Rather than investigating questions within a particular discipline, metascientists examine how research is conducted, reviewed, published, communicated, and used, with the aim of raising the quality and efficiency of science and strengthening the transparency and integrity of the scholarly publishing ecosystem. The field has gained considerable traction over the past decade, with high-profile replication projects, systematic examinations of statistical practice, and studies of peer review reliability demonstrating that the processes underpinning published knowledge can themselves be measured, audited, and improved. JMIR Metascience and Research Integrity frames its mission around ethical challenges, best practices, and evidence-based research standards, positioning the new section on misinformation as a natural extension of that agenda: if metascience can diagnose weaknesses in research practice, it can equally be applied to the corruption of the communication channels through which research travels.

The rationale for the section rests on a growing concern: the integrity of the scientific record depends not only on rigorous research practices but also on the trustworthiness of the channels through which knowledge is communicated and disseminated. According to the announcement, misinformation, disinformation, and malinformation in scholarly publishing now represent a growing threat to the credibility of science. The publisher draws a deliberate distinction between these phenomena and the more familiar category of public health misinformation, which typically circulates among lay audiences. Scholarly misinformation, in this framing, arises from within the academic ecosystem itself, generated through compromised peer review, manipulated data, misleading abstracts, predatory publishing, citation manipulation, paper mills, and the irresponsible or outright fraudulent use of artificial intelligence tools across the research life cycle. The distinction matters because scholarly misinformation can carry the implicit imprimatur of peer review and institutional affiliation, lending it an authority that public misinformation lacks and making it harder for readers—including experienced clinicians and researchers—to detect.

The consequences, the announcement warns, extend well beyond academic debates. Erosion of public trust in science is one downstream effect, but the risks are more concrete: misleading content in the literature could inform harmful real-world decisions in clinical practice or health policy. A clinician who acts on a fabricated or manipulated study, or a policy maker who cites a compromised systematic review, may cause direct harm to patients or populations. This clinical and policy dimension is especially salient for JMIR Publications, whose portfolio is anchored by digital health research, including the well-known Journal of Medical Internet Research. In fields where published findings are quickly translated into apps, clinical protocols, telehealth interventions, and guideline recommendations, the lag between publication of a flawed or fabricated paper and its practical application can be vanishingly short, magnifying the stakes of every integrity failure.

The publisher also emphasizes how changes in the speed and scale of scholarly production have amplified these vulnerabilities. Evolving publishing models, such as preprints and open peer review, together with modern dissemination tools and culture—including social media and journalistic media—may serve as new avenues for an influx of unvalidated AI-generated material. The result, according to the call, is an increased risk of accelerating the spread of information that has not been adequately vetted. Even when such content is harmless, its rapid circulation is problematic; when it is intentionally misleading, it shades into disinformation and malinformation. The concern reflects broader anxieties in the publishing world, where generative tools have made it cheaper and faster than ever to produce fluent, plausible-sounding manuscripts at industrial scale, straining the capacity of editors and volunteer reviewers to distinguish legitimate submissions from manufactured ones. At the same time, the announcement notes a countervailing trend: the scholarly publishing community is actively developing governance models, detection tools, educational frameworks, and policy interventions to counter these threats, and it is precisely this emerging body of work that the new section hopes to capture.

The call for papers outlines a broad set of topics that prospective authors might address. One cluster focuses on mechanisms: how inaccurate or misleading content enters and persists in the scientific literature in the first place. Understanding these pathways—whether through fraudulent manuscripts produced by commercial paper mills, peer review rings, image and data manipulation, or abstracts that overstate findings—underpins any serious effort at mitigation. Paper mills in particular have moved to the forefront of publishing-sector concern in recent years, with major publishers retracting thousands of articles linked to coordinated manuscript production operations, and with industry bodies convening cross-publisher working groups to share intelligence on suspicious submissions. The announcement treats this mechanistic understanding as a first-order research question, not merely background for policy discussion, implying that empirical studies of how corruption operates are as welcome as proposals for stopping it.

A second cluster concerns response and remediation. The journal invites work on the accurate detection, investigation, correction, and retraction of misinformation in published literature, including through postpublication review and other existing or novel policies and approaches. This encompasses some of the most contested terrain in contemporary publishing: the slow pace of retractions, the reluctance of journals to correct high-profile papers, the burden placed on volunteer sleuths who flag suspicious work, and the design of institutional processes that can investigate concerns fairly and efficiently. The explicit inclusion of "novel" approaches suggests openness to proposals for new infrastructures, not just evaluations of current practice—potentially encompassing automated screening tools, standardized investigation protocols, or rethinking how responsibility for postpublication correction is distributed among journals, institutions, and independent watchdogs.

The announcement also directs attention to scholarly content that falls outside formal peer review. Preprints have become an increasingly prominent part of the publishing landscape, particularly since their rapid adoption during public health emergencies, and the call specifically solicits work on misinformation in non–peer-reviewed scholarly content and its implications for public understanding of science. Because preprints are often indexed, covered by journalists, and shared widely on social media before any expert vetting occurs, they occupy a contested middle ground: valuable for speed and openness, but vulnerable to the amplification of claims that later prove wrong or were never properly qualified. Relatedly, the call invites examination of publishing practices themselves—predatory publishing, research assessment incentives, and other system and industry influences—as vectors for misinformation, recognizing that the pressures of "publish or perish" and metrics-driven evaluation can create demand for fraudulent or low-quality output. Studies linking assessment reform, such as moves away from journal-based metrics toward narrative CVs and research quality frameworks, could find a natural home here.

Governance and infrastructure form a third thematic pillar. The journal seeks submissions on policy and infrastructure-based solutions to mitigate misinformation in scholarly publishing, including the roles of publishers, editors, funders, and institutions. This framing acknowledges that no single actor controls the publishing ecosystem: funders shape research incentives, institutions oversee researchers, editors and publishers control venues and review processes, and infrastructure providers underpin the databases and platforms through which papers circulate. Effective responses, the call implies, will require coordinated action across these stakeholders rather than isolated interventions—an approach consistent with recent industry efforts to coordinate responses to paper mills and peer review manipulation across competing publishers who might otherwise have little incentive to share sensitive information.

The call additionally reaches beyond the present system toward speculative and evaluative futures. It welcomes well-argued, evidence-based thought pieces that imagine a future scholarly publishing ecosystem capable of mitigating misinformation in the published literature. And it broadens the lens beyond the scholarly record itself, inviting research on the impact of social media, science communication, and the amplification of misleading scientific claims beyond academia. Notably, the announcement highlights the potential impact of zero-click search—search interfaces that answer queries directly on results pages—on access to scientific material, an example of how changes in information infrastructure can alter how, and how accurately, the public encounters science. As search behavior shifts away from clicking through to original sources, the contextual cues that help readers evaluate a claim's provenance—journal identity, study limitations, corrections—may be stripped away, a dynamic the section appears eager to see studied empirically.

In terms of submission formats, the journal is casting a wide net. Original research, systematic reviews, scoping reviews, policy analyses, balanced viewpoints, research letters, and tutorials are all welcome. The publisher states particular interest in work that proposes, evaluates, or critically examines solutions and mitigation strategies developed by stakeholders across the publishing ecosystem, signaling that the section is intended to be solution-oriented rather than purely diagnostic. This orientation toward evidence-based remedies distinguishes the call from more purely aspirational integrity statements, and suggests the editors want submissions that test interventions rather than merely describe problems. Full details of the call for papers are available on the journal's website.

JMIR Publications, headquartered at 130 Queens Quay East in Toronto, describes itself as a leading open access publisher of digital health research and a champion of open science, with a focus on author advocacy and research amplification. It positions itself as a technology organization with publishing at its core, offering tools and resources that support researchers throughout the dissemination process. Its portfolio spans a range of peer-reviewed journals beyond JMIR Metascience and Research Integrity, and it maintains a presence on platforms including X, LinkedIn, YouTube, Facebook, Bluesky, and Instagram. Media inquiries can be directed to the publisher's communications team.

The launch of this section reflects a broader moment in scholarly publishing, in which concerns about paper mills, manipulated peer review, and AI-generated text have moved from the margins to the center of discussions about research integrity. Publishers, funders, and researcher communities have increasingly treated these issues not as isolated scandals but as systemic challenges requiring systemic evidence—a shift that metascience, with its emphasis on empirical study of the research enterprise, is well positioned to serve.

The need for such a tool is grounded in a sobering global record. Between 1994 and 2015, weather-related disasters killed more than 1.5 million people and affected over 4 billion worldwide, a burden that has grown as climate change intensifies floods, droughts, and storms. The COVID-19 pandemic, which had produced more than 777 million cases and 7 million deaths by early 2022, exposed deep vulnerabilities in health systems, from fragile supply chains to overstretched workforces and slow coordination between levels of government. So did the 2013–2016 West African Ebola outbreak, which caused over 28,000 cases and 11,000 deaths and demonstrated how quickly an epidemic can overwhelm under-resourced health services and spread across borders when surveillance and response structures are weak. Low-income nations shoulder a disproportionate share of this burden, bearing up to 91 percent of weather-related disaster mortality, a figure that reflects not only geography but also differences in infrastructure, housing quality, early warning systems, and the capacity of health services to absorb shocks. In Ethiopia, home to roughly 130 million people, threats ranging from malaria and emerging infectious diseases to floods, droughts, and conflict-related disruptions make emergency management a persistent national priority, yet the country’s preparedness efforts have been constrained by workforce shortages, limited funding, weak governance, and poor infrastructure. These constraints mirror those reported across much of sub-Saharan Africa, where public health emergency management is a relatively young professional discipline and formal training pipelines remain limited.

Existing approaches to evaluating emergency preparedness, the researchers argue, have serious shortcomings. Many assessment tools focus narrowly on specific hazards or single sectors rather than offering an integrated view of a program’s overall effectiveness. Others emphasize implementation processes over programmatic outcomes, or lack empirical grounding in their development and validation, producing inconsistent and fragmented evaluations. Without standardized metrics, findings from one assessment cannot reliably be compared with those from another, and managers have little objective basis for deciding where to direct scarce funds. Local assessments in Ethiopia have revealed deficiencies in workforce, infrastructure, resources, and intersectoral collaboration, while studies of vector control in South Asia and the Middle East and global disease surveillance efforts have documented poor monitoring, fragmentation between sectors, and resource constraints. The International Health Regulations monitoring framework and the Joint External Evaluation process provide country-level benchmarks, but the study team argued that a granular, program-level instrument was still missing. To overcome these problems, the team set out to build a standardized instrument capable of capturing readiness, response capabilities, and overall effectiveness across a range of emergency scenarios.

The study, conducted from July 2023 to June 2024, was guided by Donabedian’s Structure-Process-Outcome framework, a classic health services model that separates evaluation into the resources and infrastructure available (structure), the activities carried out (process), and the results achieved (outcome). Developed originally to evaluate the quality of medical care, the framework has been widely applied across health systems research because it offers a logical chain of accountability: adequate structures enable sound processes, which in turn produce better outcomes. Applying this model to emergency management, the team designed the tool to measure structural elements such as resources and workforce capacity, process elements such as multi-sectoral coordination and resource allocation, and outcome-oriented concepts such as community resilience and response effectiveness. Although the study did not directly measure health outcomes, the framework allows the researchers to link improvements in structures and processes to anticipated gains in public health resilience, creating a theory-driven rationale for how better inputs and practices should translate into saved lives and reduced disruption.

Instrument development unfolded in deliberate stages. A team of eight subject matter experts conducted an extensive literature review to identify existing frameworks, core preparedness domains, and validated assessment tools, defining pertinent domains and items for the new instrument. A focused desk review in the town of Adama consolidated this evidence, appraised conceptual coherence, and distilled the material into a preliminary framework. A two-day consultative workshop in Hawassa then brought together twelve experts from every region of Ethiopia, including officials from the Ethiopian Public Health Institute and the Ministry of Health, who refined the draft items through Q-sort procedures, focus groups, and iterative consensus-building. Q-sorting, a technique in which participants sort statements into ranked categories, helped the group surface disagreements about item wording and relevance in a structured way, while the focus groups allowed frontline perspectives to shape the draft. The process deliberately embedded Ethiopian perspectives at every step, ensuring the tool’s cultural relevance and local applicability rather than simply adapting a questionnaire designed abroad. Item generation ultimately produced 60 items: 15 addressing overall implementation status, 15 evaluating individual-level capacities and attitudes, and 30 assessing organizational characteristics.

Because Ethiopia’s emergency management workforce operates largely in Amharic, the questionnaire underwent rigorous translation. Four independent translators produced forward translations from English to Amharic, and two additional language experts translated each version back into English. Back-translation is a standard safeguard in cross-cultural instrument development because it exposes ambiguities: if the backward version drifts from the original meaning, the forward translation likely does too. Comparisons between the back-translations and the original found no discrepancies, and no modifications were required, establishing linguistic equivalence before formal testing began.

Validity assessment proceeded on several fronts. For face validity, 30 Ethiopian public health emergency management professionals with at least a master’s degree and five years of experience rated each item for clarity and comprehensibility on a 4-point scale; items achieving a Face Validity Index of at least 0.80 were retained. For content validity, eight qualified experts independently rated each item’s relevance on a 4-point Likert scale, with scores of 1–2 coded as irrelevant and 3–4 as relevant. Following recommendations from seminal instrument-development literature, items with an Item-level Content Validity Index below 0.83 were eliminated; the threshold reflects a statistical adjustment for small expert panels, which naturally limits how closely ratings can agree. Eight of the original 60 items fell below this threshold and were removed, and recomputation confirmed that the remaining 52 items achieved scale-level content validity scores exceeding 0.83.

Construct validity was tested through exploratory factor analysis using survey responses from 260 public health emergency management professionals recruited across Ethiopia’s national, regional, zonal, and district levels, with support from regional health bureaus. This multi-level recruitment was important because emergency management responsibilities differ sharply between a ministry office in the capital and a district health post, and a valid instrument must function across that spectrum. The sample achieved a 100 percent response rate with no missing data, an unusual and valuable result for survey research. Participants were predominantly male (73.9 percent), relatively young (45.4 percent aged 20 to 30), and split between bachelor’s (53.85 percent) and master’s degrees (46.15 percent); half worked in health facilities, and 50.4 percent were based in Addis Ababa. The data proved highly suitable for factor analysis: the Kaiser–Meyer–Olkin measure of sampling adequacy rose from 0.831 in the first analysis to 0.840 after refinement, Bartlett’s Test of Sphericity was highly significant, and item communalities ranged from 0.526 to 0.808. Values of this kind indicate that the items share enough common variance for meaningful underlying dimensions to be extracted.

The factor analyses led to further item pruning. An initial extraction identified 16 factors explaining 65.31 percent of variance, but two items on implementation status failed to load meaningfully on any dimension and were dropped. A second analysis flagged five additional poor-fitting items concerning work factors, resource availability, and information sharing. After their removal, the final structure settled at 15 dimensions comprising 45 items, together explaining 74.8 percent of the variance, comfortably above the 60 percent threshold the authors cite as evidence of good construct validity. The retained dimensions spanned implementation status, individual capacity building, individual reinforcement and engagement, individual attitudes, and a suite of community-level factors including information sharing, integration, planning, delegation, resource availability, leadership, monitoring and evaluation, coordination, infrastructure, and the legal framework. This blend of individual and organizational dimensions is notable: many existing tools evaluate either personal competencies or institutional systems, but rarely both in a single instrument. Internal consistency was strong, with an overall Cronbach’s alpha of 0.863 and all subscales exceeding 0.70, the conventional benchmark indicating that items within each subscale reliably measure the same concept.

The study’s authors are candid about its limitations. Validation occurred in a single country, so generalizability elsewhere requires further testing; factor structures and item meanings can shift when a questionnaire crosses cultural and linguistic boundaries. The youthful age profile of many pilot participants raises questions about the depth of professional experience represented, and the team acknowledges potential biases arising from stakeholder input and the need for cultural adaptation in other contexts. They also reflect on methodological lessons, noting that rigid adherence to numerical cutoffs during content review may have overlooked nuanced qualitative perspectives on borderline items; more transparent documentation of expert debates and divergent rationales, they suggest, would strengthen future validation efforts.

Even so, the implications extend well beyond Ethiopia. The tool’s emphasis on multi-sectoral coordination, resource allocation, funding transparency, workforce capacity, and provision of essential supplies addresses weaknesses commonly identified in developing countries, and its structured approach can be adapted through local translation and contextualization for other low- and middle-income settings, including regions contending with climate change, urbanization, or conflict. The researchers recommend operationalizing the instrument within national preparedness plans, using it for ongoing monitoring and benchmarking to guide investments, and testing its responsiveness over time in longitudinal and implementation studies. Repeated application could reveal whether training programs, funding increases, or governance reforms actually move the needle on preparedness, an evidence link that has been difficult to establish with existing tools. By standardizing the measurement of capacities and gaps, they argue, the tool can help policymakers prioritize resources, strengthen resilience, and mount more coordinated responses when the next crisis arrives.

The stakes are enormous. According to the researchers, cooling and heating now account for almost half of global energy consumption, a share that keeps climbing as heatwaves intensify, cities swell and server farms multiply. Meanwhile, many common refrigerants are themselves potent greenhouse gases that contribute to global warming when they escape into the atmosphere. The technology carrying this burden is the vapor-compression cycle, in which an electricity-driven compressor transfers heat carried by a refrigerant from one location to another — the same basic principle that has served fridges, air conditioners and industrial chillers since the early twentieth century. Elastocaloric solid-state cooling has long been considered one of the most credible alternatives. It relies on a remarkable property of shape-memory alloys: they tend to cool down once a previously applied mechanical load is released. No fluids, no compressor, no fluorinated chemistry — just a metal that changes its crystal structure on command. But until now, even these futuristic systems shared one trait with their ancestors: an electric motor did the heavy lifting.

The physics behind the cooling effect is as striking as it is elegant. When a superelastic shape-memory alloy is mechanically stressed, its crystal lattice abruptly reorganizes from the austenite phase into the martensite phase — a diffusionless reshuffling of atoms that releases latent heat and warms the material. The decisive moment comes when the load is released. The lattice snaps back, the reverse transformation absorbs latent heat from the surroundings, and the material’s temperature plunges by several degrees Celsius within a fraction of a second. Cycled rapidly between loading and unloading, a thin strip of nickel-titanium becomes a heat pump built from solid metal: no refrigerant to leak, no compressor oil, no evaporation and condensation. Among the family of so-called caloric effects — magnetocaloric, electrocaloric and barocaloric — the elastocaloric effect is prized for the magnitude of its temperature change and for relying on nickel-titanium, an alloy that medicine and industry have manufactured at scale for decades.

Yet one stubborn caveat has shadowed elastocaloric cooling from the beginning: something still has to do the squeezing. Every elastocaloric system demonstrated to date has depended on an electrically driven actuator to generate the force that triggers the phase transformation — meaning that even a “solid-state” cooler ultimately needed a motor, and therefore grid electricity, to run. That electrical umbilical cord has left the technology blind to its most tantalizing fuel: abundant low-temperature heat. Industrial waste streams, vehicle exhaust, engine coolant and rooftop solar-thermal collectors all deliver heat in enormous quantities, and cooling demand peaks precisely when the sun blazes — but heat cannot turn an electric motor. The question that has hovered over the field is disarmingly simple: could the actuator itself be driven by heat, so that a cooling system could feed on the very warmth that would otherwise be thrown away? The KIT-led team has now answered it in experiment for the first time.

Their solution is a piece of materials choreography. The prototype couples two ultra-thin nickel-titanium films with complementary functions. The first film works as a heat-responsive actuator built on the classic shape-memory effect: once it is heated up, it starts to shrink, converting thermal energy directly into mechanical work — a genuine pulling force generated without any electric motor in the loop. That motion immediately transfers to the second film, which serves as the elastocaloric refrigerant. Under cyclic loading and unloading, the second film undergoes reversible alterations in its crystal structure that generate cold. In one stroke, heat replaces the electric actuator that previously stood at the heart of every elastocaloric cooling system. “The crucial innovation is that we combine two complementary functions of shape memory alloys, with one film converting heat into mechanical work and the other film converting this work into cold,” said Dr. Jingyuan Xu, who leads the Young Investigator Group of the ZEco Thermal Lab at KIT’s Institute of Microstructure Technology (IMT). “This way, we’re establishing a new approach to drive solid-state cooling, thereby opening up exciting possibilities for the use of waste heat and solar energy.”

The measurements that matter have now been delivered. At an actuator temperature of 86 degrees Celsius — a level comfortably within reach of solar-thermal collectors, engine coolant loops and countless industrial processes — the prototype achieved a temperature difference of 4 degrees Celsius on the component level, while the temperature change inside the elastocaloric refrigerant itself amounted to nearly 13 degrees Celsius. Those figures, the researchers emphasize, represent the first experimental proof that a heat-driven elastocaloric system can genuinely produce cold rather than merely exist on paper. The setup also operated reliably when fed by an external heat source providing 130 degrees Celsius, demonstrating that the concept can digest real-world heat sources rather than laboratory idealizations. “The decisive moment for us was when we were able to measure the cold that had indeed been generated by a heat-driven system,” said Yi-Ting Hsiau, lead author of the study and a doctoral researcher at the IMT. “This showed us that the principle doesn’t just work in theory.”

Conceptually, the device is a heat engine fused with a solid-state heat pump: the actuator film is the engine, converting a temperature difference into mechanical work, while the elastocaloric film is the pump, spending that work to absorb heat from the cold side. Because the working substance is a solid rather than a pressurized gas, there is nothing to leak, no fluorinated chemistry to regulate and no compressor to lubricate, maintain or eventually fail. And because the trigger is thermal, the system can in principle be attached directly to a waste-heat pipe or placed beneath a solar absorber, converting energy that would otherwise simply warm the atmosphere into useful refrigeration. The researchers are careful to frame the current device as a feasibility study rather than an optimized machine — but as a demonstration that heat can replace the electric actuator driving solid-state cooling, it is a first.

The application landscape is correspondingly broad. Processors in computers could, in a sense, cool themselves: the chips that need cooling also radiate the waste heat that would drive the elastocaloric cycle, a self-regulating loop for servers and data centers whose thermal appetite grows with every exabyte. In automobiles, sensitive electronics could be cooled using heat drawn from the drivetrain rather than by taxing the vehicle’s electrical system. Solar-driven air conditioning is an equally natural fit, since the same sunshine that heats a building supplies the energy to cool it, aligning cooling supply with cooling demand hour by hour. In every case the principle is the same: warmth that already exists does the work, and no fresh electricity needs to be spent.

Nobody involved presents the prototype as market-ready. The published device was designed explicitly as a feasibility study and is deliberately not optimized for maximum cooling capacity; the temperature spans it achieved, while scientifically decisive, remain far below what a domestic air conditioner must deliver. The path forward — already under way in the lab — is parallelization: connecting multiple shape-memory film pairs side by side, multiplying cooling power much as individual photovoltaic cells are tiled into solar panels. Scaling up will also mean confronting the fatigue that shape-memory alloys suffer under relentless mechanical cycling and engineering heat exchangers that can feed ultrathin films efficiently. The study was conducted in collaboration with the University of Tsukuba in Japan, which the researchers say paves the way for heat-driven solid-state cooling fit for practical use. Funding came from the Carl Zeiss Foundation through the CZS Nexus project, the Baden-Württemberg Foundation’s elite postdocs program, and the Hector Fellow Academy.

For Xu, the milestone is a starting line rather than a finish line. “We believe that this is only the beginning,” Xu said. “By scaling up this technology we want to develop compact cooling systems that leverage abundantly available heat sources for sustainable cooling.” If that ambition holds, the implications stretch far beyond a laboratory bench in Karlsruhe. Cooling is quietly becoming one of the defining energy problems of a warming century, and a machine that turns discarded heat directly into cold attacks the crisis from both ends — trimming electricity demand while putting neglected thermal energy to work. For a hundred years, cooling has been the story of electricity pushing heat around through chemical refrigerants. Two ribbons of nickel-titanium, driven by nothing more exotic than waste heat or sunlight, have now demonstrated a different ending: heat itself, set against heat, becomes cold.