Health Technology Assessment India, established in 2017, has assessed diagnostics, medical devices, pharmaceuticals and public health interventions. The authors say these assessments have informed price negotiations, revisions to health benefit packages and the adoption of cost-effective interventions in areas including tuberculosis, cancer, maternal and child health and hepatitis C. They cite a recent study that reported returns on investment from HTA-informed interventions ranging from 8.5:1 to 3,906:1. Those figures concern earlier HTA-informed interventions rather than ADOPT itself, and the commentary does not present them as outcomes of the newer implementation programme. More broadly, the aim is to ensure that technically supported decisions can be translated into choices about what health systems buy, finance and deliver.

The commentary identifies four constraints that have restricted the translation of HTAIn outputs into subnational action. Dissemination of findings and recommendations has sometimes been episodic, making implementation status harder for decision-makers to track. Some technologies recommended on the basis of cost-effectiveness have had limited availability on procurement platforms or government e-marketplaces used by payer agencies. Programme personnel have also raised field-level concerns about feasibility within population-wide health programmes. In addition, the budget impact of cost-effective technologies can influence adoption; the authors cite the phased introduction of pangenotypic sofosbuvir-velpatasvir for hepatitis C in resource-constrained settings as an example. These observations show why the production of an assessment is only one part of making use of its recommendations.

India’s response has combined institutional structures, designated personnel, training and recurring discussion. State HTA committees have been constituted in Punjab, Haryana, Tamil Nadu and Gujarat, while states have designated HTA nodal officers to act as links between the HTAIn Secretariat and state governments. The wider package also includes sensitisation meetings, simpler communication of findings through policy briefs, efforts to incorporate recommendations into state programme implementation plans, and capacity-building through tailored workshops, expert masterclasses and online courses. HTAIn and HTA resource centres have initiated these training activities. The commentary says they provide a foundation for developing officials who can interpret and apply HTA evidence in routine decisions, rather than confining assessment work to specialist teams or occasional policy exercises.

Between May 2025 and July 2026, HTAIn conducted 50 weekly ADOPT virtual sessions involving state HTA nodal officers, state programme officers and representatives from states and union territories. Average attendance was approximately 60 participants per session. A principal investigator presented the findings and recommendations of an HTA study, after which discussion focused on clinical effectiveness, value for money and implementation considerations. Participants used these sessions to assess the relevance, affordability and feasibility of recommended technologies in their own contexts. The engagement therefore functions as a structured route for moving from national recommendations to locally informed conversations. The commentary does not report a controlled comparison showing that these sessions changed adoption rates, clinical outcomes or health-system performance.

ADOPT also convened a national sensitisation meeting with 134 participants from 28 states and eight union territories. Senior state health policymakers, administrators and programme officials used the forum to discuss implementation experiences, barriers and context-specific adaptations across health technologies. In parallel, HTAIn has established five regional ADOPT Centres. Their stated functions are stakeholder engagement, dissemination of HTA evidence, support for integrating that evidence into state planning processes, and documentation of post-implementation experience. These roles are intended to support adoption, scale-up and refinement of recommended technologies. By linking implementation feedback with later assessment and planning activity, the centres are intended to make uptake an iterative process in which experience across health systems can inform further use.

The commentary points to earlier examples showing what can happen when HTA is embedded directly in operational and financing processes. HTA-informed procurement decisions in tuberculosis control and the sickle cell elimination programme were associated with estimated savings of USD 195 million and USD 5.5 million, respectively. HTA evidence has also contributed to health benefit package design and pricing decisions under the government-funded health insurance programme, PM-JAY. These are not evaluations of ADOPT and the reported savings cannot be attributed to its sessions or centres. They instead illustrate the potential of linking assessment evidence to procurement, programme planning and benefit design. Where such institutional links are absent, HTA can remain advisory even when its evidence is considered credible by policymakers.

The authors frame the ADOPT experience as consistent with implementation-science ideas that treat uptake as a process shaped by governance, institutional capacity, stakeholder engagement and cross-learning rather than as a linear sequence. Discussions during ADOPT sessions and state HTA committee meetings indicated that differences in technical capacity, the availability of field implementation data and procurement readiness influenced how far states and union territories could act on recommendations. The initiative supplies forums, personnel and training intended to address those constraints, but it does not remove the need for decisions and execution within each jurisdiction. The commentary provides no adoption rate, controlled estimate of implementation effects or quantified reduction in delays. Its findings primarily document the architecture of an implementation effort and the issues officials identified while examining how national recommendations could be used.

The implementation lessons may also be relevant elsewhere in Southeast Asia, where subnational entities play substantial roles in health service delivery. The commentary proposes three priorities: creating structured platforms that connect evidence producers with policymakers, embedding HTA within routine planning, procurement, financing and benefit-package processes, and strengthening subnational capacity to interpret and apply assessments. India’s five regional ADOPT centres are intended to help identify systemic bottlenecks, facilitate peer learning and support consistent application of recommendations across states and union territories. The programme is presented as one model for addressing the “last mile” of evidence use as countries in the region advance toward universal health coverage. Whether that model produces durable results will depend on continued stakeholder engagement, institutional integration and measurable progress in implementation, outcomes not yet quantified in the commentary.

Subject of Research: A commentary on India’s programme for implementing health technology assessment recommendations in state health systems

Article Title: From evidence to action: bridging the implementation gap for health technology assessment in India

Article References: Bhattacharjee, S., Chanana, N., Gupta, P., Sarkar, S., Venugopal, B., Sahoo, K. C., Sachin, O., Jagadeesh, K. V., Prinja, S., & Rajsekar, K. (2026). From evidence to action: bridging the implementation gap for health technology assessment in India. International Journal of Public Health, 71, Article 1610379. https://doi.org/10.3389/ijph.2026.1610379

Image Credits: AI Generated

DOI: 10.3389/ijph.2026.1610379

Keywords: health technology assessment, India, ADOPT initiative, health policy, stakeholder engagement, procurement, health systems, capacity building, universal health coverage, implementation science, evidence, action

The researchers followed the “6S” evidence model, beginning with high-level systems and summaries and extending to individual studies. They searched international and Chinese-language websites and databases, including the National Institute for Health and Care Excellence, Joanna Briggs Institute resources, the Cochrane Library, PubMed, Embase, Web of Science, CNKI, Wanfang, VIP and SinoMed. Searches ran from the inception of each database through December 19, 2025, using terms for colorectal cancer, laparoscopic or minimally invasive surgery, enhanced recovery, ambulation, mobilization, physiotherapy and early exercise. The initial search retrieved 2,130 records; 1,885 remained after duplicates were removed, and 19 publications ultimately met the inclusion criteria.

Two researchers independently appraised the literature and extracted data, resolving disagreements by group discussion. AGREE II was used for guidelines, adapted Joanna Briggs Institute criteria for expert consensus statements and systematic reviews, the Critical Appraisal for Summaries of Evidence tool for the evidence summary, and corresponding critical-appraisal criteria for randomized controlled trials. The evidence was then converted into recommendations through the Joanna Briggs Institute grading system, with strength also informed by feasibility, appropriateness, meaningfulness, effectiveness, clinical applicability and safety. Secondary sources were treated as summaries of their underlying primary studies to avoid counting the same evidence more than once.

The resulting pathway treats early mobilization as a progressive, measurable part of enhanced recovery after surgery rather than a single intervention. Its recommended sequence runs from structured exercises in bed to sitting upright, standing at the bedside, assisted walking and independent walking, with activity duration and distance increasing according to recovery. In-bed exercises—including deep breathing, elbow flexion, ankle pumping, knee flexion, hip elevation and turning—should begin within 24 hours after regaining consciousness from anesthesia. Patients should be encouraged to attempt standing or walking within 24 hours of surgery, and from the first postoperative day the pathway calls for at least three hours of activity each day.

Before any activity begins, nurses should assess consciousness, vital signs, pain, muscle strength and the condition of the surgical incision. The synthesized criteria call for activity to be suspended when pain measured on the visual analogue scale exceeds 4, oxygen saturation falls below 90%, heart rate is above 100 or below 40 beats per minute, systolic blood pressure is below 90 mmHg or diastolic pressure below 50 mmHg, or dizziness, marked weakness or orthostatic intolerance develops. These thresholds are explicitly provisional rather than universal safety standards: they largely derive from one randomized trial, and the review assigned the stop criteria a weak recommendation pending validation in larger, multicenter studies.

Preoperative work is presented as a foundation for postoperative participation. Patients and families should receive education about the importance, components and goals of early mobilization, with additional strategies and success stories proposed for people who may have difficulty retaining verbal information. Exercise-based prehabilitation combining aerobic activity, cardiorespiratory exercise and resistance training may improve functional reserve and exercise endurance, although no standardized protocol is supported by the available evidence. Grip strength and the six-minute walk test can describe functional status before surgery, but the review cautions that they should not be presented as established predictors of surgical risk.

The postoperative plan also depends on removing barriers to movement. For patients without high-risk factors, urinary catheters should be removed within 24 hours; for those without risk of urinary retention, removal is recommended within 48 hours. Other drainage tubes should be reviewed promptly and removed when appropriate. Postoperative nausea and vomiting should be prevented, and excessive intravenous fluid should be limited because fluid overload can reduce a patient’s willingness and ability to get out of bed. Nutritional screening before surgery, daily monitoring afterward and early enteral nutrition within 24 hours, together with oral supplements, are recommended to support gastrointestinal recovery and shorten hospital stay.

Pain control is a central enabler of activity, and the review adjusts earlier evidence to reflect the laparoscopic population. Its recommended strategy is multimodal analgesia centered on acetaminophen combined with bilateral transversus abdominis plane blocks. For colon surgery, selective cyclooxygenase-2 inhibitors may be added, whereas nonsteroidal anti-inflammatory drugs should be avoided in rectal surgery; intrathecal morphine may be used as needed for visceral analgesia. The authors also recommend chewing gum three or four times daily for 10 to 15 minutes after surgery. Assessment should combine patient reports with objective measures such as time to first flatus, time to first bowel movement, time to mobilization, daily steps, walking distance, sleep duration, pain, fatigue, complications and quality of life.

The evidence supports a structured approach, but it does not establish that one mobilization dose independently improves every clinical outcome. The included trials were heterogeneous and generally small, and a colorectal trial in which staff facilitated mobilization found substantially greater in-hospital activity without better walking capacity at four weeks or other measured outcomes. The 2025 ERAS Society guidance likewise characterizes evidence for specific mobilization interventions as limited and finds no demonstrated improvement in functional capacity or complications from mobilization on the day of surgery. The review therefore distinguishes between encouraging movement to avoid prolonged immobility and claiming that a particular number of active hours independently produces better outcomes.

Implementation remains a substantial challenge. Age, beliefs about recovery, catheter use, duration of anesthesia, wound pain, preoperative hemoglobin and family support can affect adherence, while staffing shortages and heavy clinical workloads can prevent patients from getting out of bed. A colorectal cohort of 1,170 patients found that 58% did not meet a first-day target of at least six hours out of bed; emergency surgery, older age and intraoperative fluid overload were associated with delayed mobilization, which was in turn linked to more complications and longer hospitalization. Multidisciplinary quality-improvement work in other major abdominal surgery raised mobilization rates substantially and reduced length of stay, but that evidence is indirect. The review’s 23-item framework therefore calls for tailored goals, explicit safety criteria, adequate staffing, patient education and continued measurement rather than reliance on a uniform routine.

Subject of Research: Evidence-based early postoperative mobilization after laparoscopic radical colorectal cancer resection

Article Title: Summary of the best evidence for early mobilization following laparoscopic radical resection for colorectal cancer

Article References: She, R., Jin, X., Shi, Z., Wei, H., Wei, X., & Wu, Z. (2026). Summary of the best evidence for early mobilization following laparoscopic radical resection for colorectal cancer. Frontiers in Medicine, 13, Article 1967502. https://doi.org/10.3389/fmed.2026.1967502

Image Credits: AI Generated

DOI: 10.3389/fmed.2026.1967502

Keywords: colorectal cancer, laparoscopic surgery, early mobilization, enhanced recovery, postoperative care, evidence synthesis, nursing protocols, clinical safety, Summary, best, evidence, early

Sampling in 2024–2025 focused on nests collected between April and June. Fifteen nests were classified as being in the colony-establishment stage and 32 in the colony-growth stage; no propagation- or collapse-stage nests were observed. Seventeen nests contained only V. velutina, one contained a V. basalis queen and undeveloped brood, and 29 contained both species.

In at least 16 of the mixed-species nests, the observations indicated that a V. basalis queen had replaced a V. velutina queen. Earlier records had suggested that V. basalis and V. velutina queens might interact during nest establishment, but the process had not been confirmed. The present study focused on the less-understood founding stage of the two species.

Observations at bird nest boxes in the Guanwu area of Shei-Pa National Park documented V. velutina queens constructing small embryo nests. Most of these colonies were later abandoned, while one retained four V. velutina workers until August. The reasons for abandonment were not established, although human disturbance or competition from other species were considered possible explanations.

Photographic records provided additional evidence of interspecific interactions. At a founding nest discovered beneath a building at the Fushan Research Center in late April 2007, a V. velutina queen guarded the nest, while dead queens of both species were found nearby, suggesting a conflict during establishment. Later footage showed a V. basalis queen approaching and entering the nest and interacting with the resident V. velutina, although the footage did not establish whether a confrontation occurred.

Three other founding nests contained queens of both species, and the first adults recorded in those nests were V. velutina workers. Mixed-species colonies also occurred at the growth stage. One nest collected in 2012 contained five apparent V. basalis workers and 30 apparent V. velutina workers, with more than 30 adult V. basalis subsequently emerging.

A second apparently abandoned nest contained eight V. basalis and four V. velutina workers, together with larvae, pupae and mold-covered empty cells. To identify immature wasps, the researchers developed a multiplex PCR assay using species-specific primers targeting the mitochondrial COI region. The assay produced an approximately 657-base-pair fragment for V. basalis and a 375-base-pair fragment for V. velutina.

Blind analysis of the growth-stage nest N_46 identified all 70 tested broods—20 eggs, 20 larvae and 30 pupae—as V. basalis, consistent with a complete reproductive takeover by that species. Brood mapping in a second growth-stage nest, N_47, provided a temporal sequence of reproduction. Of 70 samples examined, 43 yielded reliable species assignments after ambiguous results were excluded.

All 18 newly laid eggs identified were V. basalis, whereas the more developed larvae and pupae were predominantly V. velutina. The arrangement of eggs, capped cells and brood indicated that V. basalis had laid eggs in cells reused or newly constructed after the original colony developed. This pattern supports a takeover in which the V. basalis queen subsequently dominated reproductive output.

Across the sampled nests, the number of V. velutina decreased after usurpation while the number of V. basalis increased over time. The authors therefore interpret the combined field and molecular evidence as showing that a V. basalis queen can take over a developing V. velutina nest and produce offspring that become dominant. They suggest that this behavior may increase V. basalis reproductive success, but also note risks to both species because injury or death of a queen can lead to failure of the entire colony.

The evidence is nevertheless strengthened by repeated observations of interspecific coexistence, changes in queen and worker composition, and brood-level molecular results that distinguish the reproductive contributions of the two species. The findings support classifying V. basalis as a facultative social parasite of V. velutina during the founding stage, while the frequency and consequences of the behavior across the full colony cycle remain unresolved.

Subject of Research: Nest usurpation and facultative social parasitism in Vespa hornets

Article Title: Evidence of nest usurpation of Vespa velutina in the founding stage by V. basalis reveals it as a facultative social parasite ( Hymenoptera , Vespidae )

Article References: Lu, S.-S., Hu, Y.-H., Shiao, M.-T., & Sung, I.-H. (2025). Evidence of nest usurpation of Vespa velutina in the founding stage by V. basalis reveals it as a facultative social parasite (Hymenoptera, Vespidae). Journal of Hymenoptera Research, 98, 779-794. https://doi.org/10.3897/jhr.98.162472

Image Credits: AI Generated

DOI: 10.3897/jhr.98.162472

Keywords: Vespa basalis, Vespa velutina, nest usurpation, social parasitism, Taiwan, hornet nests, multiplex PCR, brood identification, colony founding, Evidence, nest, usurpation

Phytotelmata are generally non-permanent aquatic micro-ecosystems in plants. In teasels, opposite leaves clasp the stem and form cup-like structures that collect rainwater and sediment. These cavities are small and persist for only about three to four months, making them overlooked and relatively short-lived sampling environments.

The investigators collected water and sediment from leaf axils on five plants at each of two sites, near the villages of Demjata and Kapušany. Sampling took place at the end of each of five 14-day collection periods in 2021, using sterile containers to prevent contamination from other sources. The 50 sampled teasels contained 171 functioning phytotelmata, from which 4,596 millilitres of water and sediment were collected in total.

After the initial observation, samples were examined in a sterile Petri dish under a stereomicroscope. Positive samples were photographed and measured, and 3 millilitres from each positive sample were analysed in 0.5-millilitre increments after thorough mixing. The reported concentrations were converted to values for one millilitre of sample. The Leica M205MC stereomicroscope, paired with a digital camera and used at magnifications from 7.8 to 160 times, could capture and measure particles with a minimum size of 1 micrometre.

Positive phytotelmata accounted for 3.5% of the 171 samples examined. They were recorded during two consecutive sampling periods, from 29 June to 12 July and from 13 to 26 July 2021, at different levels on the plants and at both localities. The six positive samples yielded estimated concentrations of 101.75 to 408.87 microplastic particles per millilitre, based on the analysed three-millilitre subsamples and their conversion to a one-millilitre basis.

The particles were predominantly fibres in blue, black, red and white, measuring 141 micrometres to 2.4 millimetres in length. Blue and orange fragments were also present, with diameters of 9 to 81 micrometres. The fibres and fragments were identified and measured microscopically; the study did not report chemical polymer identification, and the researchers did not experimentally trace the particles to a specific contamination source.

Suspended atmospheric microplastics were proposed as the most probable contamination pathway because fibres and fragments were also dominant in samples of atmospheric microplastics cited by the authors. The researchers also identified transport by snails as a second possible route, either through particles carried on or within their bodies or through ingestion and later dispersal. Living or drowned snails and their excrement were frequently observed in the teasel cavities, while the authors reported no contamination sources other than the atmosphere in the surrounding soil, vegetation and landscape at the two sites. These pathway explanations remained hypotheses rather than source-tracing results.

The low proportion of positive cavities may be related to the density of surrounding vegetation and to the position and orientation of the water-filled leaf axils, according to the study. The authors proposed testing whether the contamination pathway affects the usefulness of phytotelmata as indicators of microplastic pollution and whether their microplastic concentrations reflect environmental concentrations. They also suggested investigating whether the sequence of phytotelmata on individual teasels could reveal temporal differences in contamination during the growing season.

The study has a limited geographic scope and covers only two Slovak localities, 50 plants and one growing season. It was an observational field sampling study with incidental detection of microplastics rather than a controlled experiment, and it did not establish that the particles came from atmospheric deposition, snails or another specific source. The results therefore demonstrate the presence of microplastics in sampled teasel phytotelmata, while their origin, temporal dynamics and usefulness as environmental indicators require further testing.

Subject of Research: Field detection of microplastics in Slovak teasel phytotelmata and proposed contamination pathways

Article Title: The first evidence of microplastics in plant-formed fresh-water micro-ecosystems: Dipsacus teasel phytotelmata in Slovakia contaminated with MPs

Article References: Fogašová, K., Manko, P., & Oboňa, J. (2022). The first evidence of microplastics in plant-formed fresh-water micro-ecosystems: Dipsacus teasel phytotelmata in Slovakia contaminated with MPs. BioRisk, 18, 133-143. https://doi.org/10.3897/biorisk.18.87433

Image Credits: AI Generated

DOI: 10.3897/biorisk.18.87433

Keywords: microplastics, phytotelmata, teasel, Dipsacus, freshwater micro-ecosystems, Slovakia, atmospheric deposition, snail transport, environmental monitoring, first, evidence, plant-formed

The authors followed PRISMA-ScR guidance and screened electronic databases and grey literature. They included 24 peer-reviewed primary articles examining human, livestock, wildlife and vector populations. Serosurveys in domestic livestock reported overall seroprevalence ranging from 3.3% to 33.3% across regions and species, with most study estimates clustering between 5% and 30%. Higher values were reported in northern pastoral regions characterized by transhumance, wetlands and cross-border animal movement.

Human seroprevalence was consistently lower than 20% and was largely confined to occupationally exposed groups. The review’s authors interpret this pattern as suggesting that human infections may be under-recognized because of non-specific clinical presentation and limited routine diagnostics. Entomological evidence implicated mosquitoes, predominantly Culex species, as well as biting midges in the genus Culicoides. The review also identified evidence of wildlife exposure and concluded that these findings support a complex, ecologically resilient transmission system capable of sustaining year-round circulation independently of extreme climatic events.

The abstract identifies diagnostic invisibility, fragmented surveillance and weak integration across human, animal and environmental health as major constraints on characterizing Rift Valley fever in Nigeria. Documented control interventions were also described as scarce. The review notes advances in molecular diagnostics, participatory epidemiology and integrated One Health responses in other African countries, but the abstract does not report the effectiveness of such measures in Nigeria. Because this is a synthesis of varied primary studies rather than a single longitudinal analysis, the reported evidence supports an interpretation of sustained inter-epidemic circulation without providing a quantitative estimate of national incidence. The review concludes that the burden of Rift Valley fever is underestimated and calls for integrated, multisectoral surveillance and proactive control strategies.

Subject of Research: Scoping review of Rift Valley fever epidemiology and inter-epidemic transmission in Nigeria

Article Title: Evidence of inter-epidemic transmission of Rift Valley Fever virus circulation in Nigeria: a scoping review

Article References: Oyekan, O. A., Igah, O. E., Bakam, J. D., Ogunmolawa, O. R., Wungak, Y. S., Oyekan, O. D., Ehizibolo, D. O., Adedeji, A. J., Ularamu, H. G., & Meseko, C. A. (2026). Evidence of inter-epidemic transmission of Rift Valley Fever virus circulation in Nigeria: a scoping review. BMC Public Health. https://doi.org/10.1186/s12889-026-29876-8

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DOI: 10.1186/s12889-026-29876-8

Keywords: Rift Valley fever, Nigeria, scoping review, inter-epidemic transmission, zoonosis, seroprevalence, livestock, mosquito vectors, One Health, surveillance, Evidence, inter-epidemic

The review, which searched PubMed and EMBASE for studies published from 19 September 2020 through 19 September 2024, focused on interventions and implementation strategies used in primary care in Australia, Canada, the European Union, the United Kingdom and the United States. Primary care was defined as the first point of contact for non-emergency patients, including consultations with general practitioners, nurses, allied health professionals and pharmacists. Two reviewers independently screened records, extracted study characteristics and assessed reported abstinence outcomes, verification methods and intervention components. Because the designs, populations and outcomes varied substantially, the researchers used narrative synthesis rather than formal meta-analysis.

Of 2,166 records screened, 30 peer-reviewed studies met the inclusion criteria. Thirteen were conducted in the United States and 13 in the European Union, while evidence from the United Kingdom, Australia and Canada was comparatively limited. Twenty-two were randomised or non-randomised controlled trials, and eight used other quasi-experimental designs. Most evaluated smoking cessation rather than vaping cessation. Point-prevalence and prolonged abstinence were commonly reported, and nine studies also used biochemical validation, such as carbon monoxide testing, to support their findings. This breadth makes the review useful for mapping real-world approaches, although the absence of a formal quality assessment and the marked heterogeneity limit the strength of any overall estimate.

Counselling was the most frequently studied cessation component, appearing in 26 studies; 18 reported statistically significant improvements in smoking abstinence. Twelve used behavioural-cognitive approaches intended to strengthen problem-solving, coping and self-efficacy, while nine incorporated motivational interviewing. The level of support varied considerably, from brief advice during lung-cancer screening or after spirometry to repeated sessions with follow-up. Six behavioural-cognitive studies reported significant cessation improvements. A pharmacist-led programme that combined motivational and behavioural support produced 12-month abstinence of 20.7%, with better outcomes among participants who received pharmacotherapy and engaged with more pharmacist consultations or telephone sessions. In another study, motivational coaching, financial support and nicotine replacement therapy increased six-month abstinence to 17%, compared with 9% in the comparison group.

Alternative delivery channels also showed promise. Six of eight studies examining telephone, text and other remote counselling methods reported positive or partly positive results. A cognitive-behavioural therapy app combined self-monitoring, feedback and medication support, yielding seven-day abstinence of 44.5% at four weeks after the quit date, compared with 28.7% after very brief advice; the reported relative risk was 1.55, with a 95% confidence interval of 1.23 to 1.96. A chatbot intervention produced long-term nicotine abstinence of 26.0%, compared with 18.8% in standard primary care, although the confidence interval for the odds ratio included the null value. These findings suggest that digital tools can extend primary care capacity, but they do not mean that every app or chatbot is equally effective. The studies differed in content, support, comparison conditions and outcome definitions.

Pharmacotherapy was assessed in 18 studies, of which 13 reported effectiveness in promoting abstinence. Five examined bupropion or varenicline, and three of these found significantly higher abstinence rates with varenicline than with placebo, nicotine replacement therapy or cytisine. Multi-component care was especially common: 16 of the 18 pharmacotherapy studies combined medication with behavioural support, and 11 found combination therapy more effective than a single component or usual care. In one pharmacist-led or coordinated programme, 12-month cessation reached 54.3% in the intervention group, compared with 37.1% in controls. The pattern is consistent across much of the review: medication appeared most useful when it was not delivered as an isolated offer but embedded in a service that included advice, follow-up or structured opportunities to try quitting.

Financial measures were also among the more promising approaches. Six studies examined monetary support, including three that eliminated the cost of medication. In one low-dose computed tomography screening programme, four face-to-face counselling sessions, educational materials and cost-free nicotine replacement therapy were associated with a one-year quit rate of 15.5% and significant improvements in smoking-related behaviours. Another digital intervention supplied nicotine gum or patches free of charge and reported seven-day point-prevalence abstinence of 44.5%, compared with 28.7% after very brief advice. Contingency-management studies also reported higher abstinence: varenicline plus counselling with attendance-based payments produced week-26 abstinence of 15.7%, versus 6.5% with placebo, while a programme for Medicaid-enrolled pregnant women increased biochemically confirmed abstinence at six months postpartum from 9.2% to 14.7%. Financial coaching that linked quitting with budgeting and benefits referrals produced self-reported six-month abstinence of 17%, versus 9% with usual care.

Embedding cessation support into existing clinical moments produced mixed but generally encouraging results. Seven studies examined integration with low-dose computed tomography screening or post-spirometry feedback. Only one of the screening studies reported a significant short-term improvement, with a one-year abstinence rate of 15.5%. By contrast, four of five studies involving immediate, personalised support after spirometry found significantly higher smoking cessation than standard advice alone. The difference may reflect how cessation care was delivered: feedback alone was not the intervention under evaluation, whereas immediate support created a direct route into treatment. Two studies tested opt-out models, in which patients were automatically enrolled or offered cessation support unless they declined. One formed part of a successful screening programme, but the other increased quit attempts and use of cessation aids without changing self-reported abstinence at six months.

Electronic health records produced consistently positive process or outcome signals across all five studies that examined them. These systems could record tobacco use systematically, prompt clinicians to follow evidence-based steps, display best-practice alerts, refer patients automatically to quitlines or e-health programmes, and support proactive outreach by care managers. One EHR-embedded Ask, Advise and Connect programme found six-month abstinence of 7.6% among patients receiving treatment in Spanish-speaking settings, compared with 3.7% in English-speaking settings. A paediatric implementation that transferred tablet-based screening data into the electronic record and prompted counselling and referral was followed by more than a two-fold reduction in population-level tobacco use. Another registry-based system increased treatment reach, with odds ratios of 2.0 to 3.0, and smoking cessation rates, with reported odds ratios ranging from 2.2 to 10.5. The review supports EHR integration as an implementation strategy, but it does not isolate the contribution of every technical feature.

Provider education alone was the least convincing strategy. All five studies evaluated some combination of training and process improvement, and two reported better delivery of the Ask, Advise, Assess, Assist and Arrange framework. One recorded a rise in the proportion of participants reducing smoking from 5.5% before training to 41.8% afterwards. Another found more quit attempts and a 12-month cessation rate of 46%, compared with 20%, although no effect was evident at six months. The remaining studies did not significantly improve six-month prolonged abstinence, and offering smoking cessation as the default through an encounter decision aid did not affect self-reported abstinence at six months. The distinction between process and clinical outcomes matters: training can make clinicians more likely to follow cessation protocols without necessarily producing a durable increase in successful quits. More intensive behavioural, pharmacological and system-level strategies were generally associated with better outcomes than education by itself.

The clearest finding is therefore not a single winning technology, but a pattern of coordinated care. Primary care appears most effective when it systematically identifies tobacco use, offers counselling, supplies or facilitates medication, reduces financial barriers and creates an active referral or follow-up pathway. The review offers a detailed map of the components with the most support, but it cannot establish that all packages will work in every health system. The search excluded lower-middle-income settings, included diverse study designs, did not conduct formal meta-analysis and provided no quality assessment. Most importantly, its smoking evidence cannot simply be assumed to apply to vaping cessation. With only two studies involving e-cigarette users and limited reporting of vaping-specific abstinence, dedicated behavioural, educational and implementation research remains necessary.

Subject of Research: A 2026 scoping review of smoking and vaping cessation interventions and implementation strategies in primary care

Article Title: Evidence for Embedding Smoking and Vaping Cessation Support in Primary Care: A Scoping Review

Article References: Wang, S., Rojas, I., Dean, E., Hoek, A. C., & Pettigrew, S. (2026). Evidence for Embedding Smoking and Vaping Cessation Support in Primary Care: A Scoping Review. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-026-10835-3

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DOI: 10.1007/s11606-026-10835-3

Keywords: smoking cessation, vaping cessation, primary care, systematic scoping review, behavioural counselling, pharmacotherapy, electronic health records, financial incentives, opt-out care, spirometry feedback, Evidence, Embedding

Researchers followed PRISMA 2020 guidance and searched PubMed, Embase, the Cochrane Library, Scopus and Web of Science from each database’s inception through March 20, 2026. Eligible studies evaluated EFT in participants with clinically significant PTSD symptoms. The team synthesized study characteristics, methodological quality and findings descriptively, with the evidence organized by study design, comparator, population and outcome. Overlap among the three included systematic reviews was quantified with the Corrected Covered Area, or CCA. The review protocol was registered in PROSPERO as CRD420261380106.

Most EFT protocols consisted of four to 10 sessions. Across randomized trials, results consistently favored EFT over passive controls. The findings were less conclusive when EFT was compared directly with active trauma-focused therapies: five primary studies compared EFT with eye movement desensitization and reprocessing, cognitive behavioral therapy or narrative exposure therapy, and most reported no statistically significant difference between the treatment groups. Thus, the review identified favorable evidence against passive comparators but could not establish that EFT is more effective than established active treatments for PTSD.

Studies without random assignment provided weaker evidence for causal conclusions. The two non-randomized comparative studies and three uncontrolled before-and-after studies generally reported improvements after EFT, but their designs restricted causal inference. Quality assessments reflected these limitations: randomized trials raised some concerns to a high risk of bias, non-randomized studies were rated as having moderate risk of bias, and uncontrolled studies were rated as fair. The three systematic reviews with meta-analysis were evaluated with AMSTAR 2 and received ratings ranging from critically low to low, indicating weaknesses in their methodological quality.

The reviews also drew extensively on overlapping primary studies. Their reported CCA was 0.46, which the researchers classified as very high overlap and interpreted as substantial redundancy in the underlying evidence. The number of published reviews therefore did not correspond to an equally large number of independent replications. The authors described the literature as a small but growing evidence base concentrated in randomized trials and systematic reviews with meta-analysis, with limited independent replication and substantial overlap across reviews. They identified adequately powered, methodologically rigorous comparative trials as a priority for strengthening the evidence and determining whether EFT provides benefits beyond active, established trauma-focused therapies.

Subject of Research: Evidence mapping of Emotional Freedom Techniques for PTSD across randomized, non-randomized and uncontrolled clinical studies

Article Title: Evidence mapping of Emotional Freedom Techniques for post-traumatic stress disorder: a systematic review

Article References: Ang, L., Kim, J., & Do, J.-H. (2026). Evidence mapping of Emotional Freedom Techniques for post-traumatic stress disorder: a systematic review. BMC Psychiatry. https://doi.org/10.1186/s12888-026-08786-4

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08786-4

Keywords: Emotional Freedom Techniques, post-traumatic stress disorder, systematic review, evidence mapping, randomized controlled trials, trauma-focused therapy, EMDR, cognitive behavioral therapy, narrative exposure therapy, risk of bias, Evidence, mapping

The field observation was made at midday in October 2023 during a survey designed to assess the presence of newt species at the lake. Near the end of that survey, researchers noticed a rodent carcass at the shallow end of the lake bank. On closer inspection, they saw two male and one female alpine newt nibbling at the carcass, removing small pieces and swallowing them. The animals were therefore not merely investigating the object: the observed behaviour involved active consumption of the carcass tissue.

Researchers took steps to exclude an alternative explanation before recording the animals as scavengers. They removed the carcass with a kick net fitted with 0.5-millimetre mesh and examined it for aquatic invertebrates or worms that might have attracted the newts independently of the rodent tissue. The inspection found no evidence of hidden invertebrates. In the researchers’ assessment, the absence of those organisms meant that the carcass itself was the most likely object drawing the alpine newts to the site. This was an observational check rather than a controlled experiment, so it does not establish every possible cause of the newts’ behaviour.

The carcass was then returned to the water at a different site, closer to the lake’s overflow point. Within minutes, three female alpine newts approached it and started eating the decomposing flesh again. The second group’s response to the relocated carcass further supported the interpretation that the animals were exploiting the carcass itself. The sympatric Macedonian newt, Triturus macedonicus, showed no interest in the carcass. The observation therefore records a difference in feeding behaviour between two newt species at the same lake, although it does not explain why the species responded differently.

Lake Kosmeou is a small, spring-fed water body in Greece’s Metsovo Province. It is slightly more than 100 metres long and more than 60 metres wide, with depths ranging from approximately half a metre to two metres, and it is continuously supplied by low-output springs. The carcass was encountered at the shallow end of the lake bank, where the newts were observed feeding. The setting is part of a range of environments occupied by alpine newts across Europe, including permanent or ephemeral water bodies such as lakes, troughs and puddles. In Greece, the species has been recorded at elevations between 659 and 2,350 metres.

The alpine newt is a small, polyphagous and opportunistic predator whose feeding relationships vary substantially across daily, seasonal and spatial scales. Studies conducted in countries including Romania, Italy, Czechia, Austria and Greece have examined its diet, feeding habits and predatory behaviour. Much of this work has involved flushing the stomach contents of numerous captured animals, a method that has helped document the composition of its diet. The species feeds principally on invertebrates belonging to groups such as crustaceans, stoneflies, springtails, isopods, beetles, flies and true bugs. Tadpoles and larvae of the fire salamander, Salamandra salamandra, have also been recorded as prey.

Alpine newts have additionally been observed consuming their own eggs and those of other amphibians without discriminating among them. Shed skin from the animals themselves or from conspecifics has been found in stomach contents as a regular non-prey item. Plant material and inorganic particles from substrate sediment have also been reported, with both interpreted as accidental ingestion during feeding. These findings portray the species as a flexible generalist that can exploit a wide range of food sources. However, the available literature had contained no account of an alpine newt, or another newt species, feeding on an animal prey item belonging to the class Mammalia. The rodent observation fills that specific gap in the available dietary record.

Scavenging is generally described as a way of overcoming food scarcity, and it occurs across many carnivorous vertebrates. Vultures are the only obligate scavengers identified in the cited background research, while animals including coyotes and freshwater turtles are facultative scavengers that capitalise on opportunities as they arise. No amphibian is known to be an obligate scavenger, although facultative scavenging has been recorded in several frog species and in one salamander species. Among newts, the earlier record cited in the study involved several crested newts, Triturus cristatus, consuming a fish carcass. The Greek observation therefore extends the recorded scavenging behaviour of newts from a fish carcass in another species to a rodent carcass in the alpine newt.

The researchers said the finding indicates that alpine newts are generalists and opportunists able to adopt an energy-efficient foraging strategy when food is limited. That interpretation is consistent with the species’ multiphasic life cycle: adults shift between terrestrial and aquatic phases, their activity changes over daily and seasonal cycles, and they occur in high-altitude lakes where prey availability can be scarce or unpredictable. The carcass-feeding observation does not establish how frequently scavenging occurs, whether it has measurable effects on population survival, or whether the behaviour is widespread across the species’ European range. It is a single field observation, but it documents a distinct foraging mode that previous diet surveys had not captured.

Scavenging can also increase nutrient recycling and contribute to food-web stability, according to the background research cited by the study. In harsh environments, flexibility in foraging may be particularly valuable when normal prey is unavailable. For the alpine newt, the finding adds a new dimension to the species’ natural history and may help researchers identify habitats in which flexible access to alternative foods matters. That relevance is heightened by the loss of suitable aquatic habitats and breeding sites associated with agriculture and agrochemical pollution. The study does not directly demonstrate that carcass feeding has caused a population decline or that scavenging offsets habitat loss, but it documents an additional food-related behaviour that may be useful for understanding how the species responds to variable conditions in the environments it occupies.

Subject of Research: First field record of alpine newts scavenging a rodent carcass in a Greek subalpine lake.

Article Title: First evidence of scavenging behaviour in Ichthyosaura alpestris (Laurenti, 1768)

Article References: Daftsios, T., Iakovidis, D., Gogolos, N., & Sagonas, K. (2024). First evidence of scavenging behaviour in Ichthyosaura alpestris (Laurenti, 1768). Herpetozoa, 37, 137-140. https://doi.org/10.3897/herpetozoa.37.e123069

Image Credits: AI Generated

DOI: 10.3897/herpetozoa.37.e123069

Keywords: alpine newt, Ichthyosaura alpestris, scavenging behaviour, rodent carcass, facultative scavenging, Lake Kosmeou, amphibian ecology, animal behaviour, opportunistic feeding, Greece, First, evidence

The research team, led by Ye Ni and Zhaolei Sun of Kangwon National University in South Korea, together with colleagues from Zunyi Normal University and Henan Normal University in China, surveyed 457 Chinese adolescents aged 10 to 18 who had completed a six-week music-based immersive technology experience. Using structural equation modeling, the researchers found that engagement with the immersive music experience was significantly and positively associated with adolescents’ perceived alleviation of anxiety symptoms. More intriguingly, the experience was also positively associated with the three psychological constructs, and each of these, in turn, was positively associated with perceived anxiety relief.

What makes this study particularly compelling is its mediation analysis. The researchers used a bootstrapping procedure with 1,000 resamples to test whether cognitive restructuring, self-acceptance, and self-efficacy statistically mediated the association between the immersive music experience and perceived anxiety alleviation. All three pathways were significant, with confidence intervals that excluded zero. In other words, adolescents who reported deeper engagement with the immersive music experience also tended to report greater capacity to reframe negative thoughts, more accepting attitudes toward themselves, and stronger beliefs in their ability to cope with challenges—and these psychological resources were statistically linked to their perceived relief from anxiety symptoms.

The immersive sessions themselves were carefully structured. Participants attended one 30-to-40-minute session per week for six consecutive weeks, delivered through PICO Neo 3 Pro standalone VR headsets with a stereoscopic 360-degree visual environment, a refresh rate of up to 90 Hz, and an approximate field of view of 98 degrees. Audio was delivered through over-ear headphones connected to the headset. The software environment, built in Unity, synchronized preselected 360-degree visual scenes—including natural landscapes, slow-moving abstract patterns, and interactive elements that responded to the music—with Chinese traditional music tracks and short guided verbal prompts.

Each session followed a standardized five-component structure: a brief orientation and comfort check, an opening breathing and attentional-settling segment, the main immersive music-and-visual experience lasting 20 to 25 minutes, short guided reflection prompts distributed across the session, and a closing transition period. The guided prompts were deliberately non-diagnostic and non-therapeutic in wording, designed to encourage calm attention, emotional awareness, and reflective appraisal. Examples included instructions to notice one’s breathing and let attention settle with the music, to observe worrying thoughts as they come and go, to look at one difficulty from another angle, and to accept the present moment without judging oneself.

A distinctive feature of the study was its use of culturally relevant Chinese music, including guqin, erhu, and bamboo flute. The research team grounded this choice in music cultural psychology, arguing that culturally congruent music may strengthen emotional engagement and cognitive receptivity. The pentatonic scale, slow tempo, and flowing melodies characteristic of traditional Chinese music are often associated with relaxation, attentional focus, and meditative states. Before the formal six-week program began, the team collected feedback from 32 adolescents comparable in age and school background to the main participants, who rated candidate music excerpts for perceived familiarity, emotional comfort, calmness, and suitability for an immersive experience. This feedback, combined with expert review by specialists in psychology, music therapy, and immersive technology, informed the final selection of musical materials.

The measurement instruments were adapted from established validated scales, with each core construct measured using three items rated on a five-point Likert scale. The research team subjected these items to a multi-step refinement process involving a panel of six expert reviewers—two researchers in adolescent psychology, one in psychometrics, one music therapy specialist, one immersive technology specialist, and one secondary-school mental health educator—who independently evaluated construct relevance, clarity, developmental appropriateness, cultural appropriateness, and contextual fit. Items were revised when at least two reviewers raised similar concerns. The final questionnaire was administered in Chinese following a rigorous translation and back-translation procedure, and internal consistency was assessed using Cronbach’s alpha, with all scales demonstrating satisfactory reliability.

The statistical analysis was thorough. The research model demonstrated excellent fit indices, with a CMIN/DF of 1.526, a comparative fit index of 0.984, and a root mean square error of approximation of 0.033. All factor loadings exceeded 0.600, and the average variance extracted for each latent variable surpassed the accepted threshold of 0.5, indicating robust convergent validity. The discriminant validity was also adequate, as the square root of the average variance extracted for each construct exceeded the correlation coefficients among the latent variables. Harman’s single-factor test indicated that common method bias was not a significant concern, with the first unrotated factor explaining only 29.270 percent of the variance, well below the 50 percent threshold.

The direct path results revealed that the immersive music experience was significantly and positively associated with perceived anxiety alleviation, cognitive restructuring, self-acceptance, and self-efficacy. The standardized coefficients ranged from 0.125 for the direct association with perceived anxiety alleviation to 0.285 for the association with cognitive restructuring. The mediation pathways were also significant, with the self-efficacy pathway showing the largest confidence interval, suggesting that adolescents’ belief in their own coping abilities may be a particularly important psychological resource linking immersive music engagement to perceived anxiety relief.

The researchers are careful to note that this study was observational and cross-sectional, not an intervention trial. There was no control group, and all main study variables were collected at a single time point after the six-week experience. The dependent construct measured adolescents’ perceived alleviation of anxiety symptoms rather than clinical anxiety severity or objectively verified symptom change. The SCARED screening instrument was administered before the experience to characterize anxiety-related experiences in the sample, but it was not used to establish psychiatric diagnoses and was not included as the dependent variable in the structural equation model. The researchers explicitly state that the findings do not permit conclusions about therapeutic efficacy, symptom reduction, treatment effectiveness, temporal ordering, or causal mediation.

Despite these limitations, the theoretical implications are significant. The study extends existing research on music therapy and immersive technology by examining their integration within the context of adolescent mental health. Previous studies on music therapy have primarily focused on traditional auditory or clinical settings, while immersive technology has often been applied in educational or simulation-based contexts. By examining the immersive music experience as a culturally and technologically enriched experience, this research broadens the theoretical discussion on how multisensory music-based experiences may be associated with adolescents’ perceived emotional and psychological states. The findings also contribute to existing models of adolescent mental health by highlighting the potential importance of cognitive and self-related psychological resources in understanding perceived anxiety-related experiences.

The practical implications are equally noteworthy. The researchers suggest that schools may consider incorporating music-based and immersive digital experiences into broader well-being activities, psychological education programs, or extracurricular mental health initiatives. Such activities may provide engaging and interactive contexts in which students can reflect on their emotions, develop more adaptive ways of thinking, strengthen self-understanding, and build confidence in coping with difficulties. However, the researchers emphasize that these applications should be implemented as supportive or preventive activities rather than as substitutes for professional psychological or psychiatric treatment.

The researchers also acknowledge important technological and institutional considerations. The feasibility and accessibility of immersive technology may vary depending on hardware availability, technical support, cost, space management, supervision, and adolescents’ acceptance of head-mounted devices. Some adolescents may experience cybersickness, visual fatigue, discomfort, or low acceptance of head-mounted devices. The cost of VR headsets, software maintenance, content development, and staff training may create unequal opportunities for implementation across regions or institutions. The researchers caution that the findings should be interpreted within the specific technological and institutional context of this study and should not be generalized uncritically to all schools, community settings, or lower-resource environments.

The cultural specificity of the Chinese traditional music materials represents another important consideration. The emotional and reflective responses observed in this study may have been influenced by Chinese adolescents’ familiarity with these musical elements and the cultural meanings attached to them. As a result, the findings should not be assumed to apply equally to adolescents from other cultural backgrounds or to immersive music experiences based on other musical traditions. Future studies could examine whether similar associations are observed when the immersive music experience is adapted with culturally relevant music materials for adolescents in different cultural contexts.

Looking ahead, the researchers call for longitudinal and experimental designs to examine how perceived anxiety-related symptoms and related psychological constructs may change over time. Future research should also include broader psychological and contextual variables such as personality traits, family support, digital literacy, baseline mental health status, and prior exposure to music-based or immersive experiences. The researchers suggest combining self-report measures with qualitative interviews, behavioral observations, physiological indicators such as heart rate variability and cortisol levels, standardized anxiety measures, and clinician-rated or parent-reported indicators to enhance the robustness and validity of the findings.

For now, this study offers a tantalizing glimpse into how the convergence of music, culture, and immersive technology may support adolescent mental health. The finding that cognitive restructuring, self-acceptance, and self-efficacy statistically mediate the association between immersive music engagement and perceived anxiety relief suggests that the experience may work not by directly treating anxiety, but by cultivating the psychological resources that adolescents need to manage it themselves. As anxiety rates continue to rise among adolescents worldwide, approaches that combine emotional engagement with the cultivation of adaptive psychological resources may prove increasingly valuable—and this research provides a preliminary empirical foundation for exploring that possibility.

Subject of Research: Music-based immersive technology experience and adolescents’ perceived alleviation of anxiety symptoms: cross-sectional evidence on the mediating roles of cognitive restructuring, self-acceptance, and self-efficacy

Article Title: Music-based immersive technology experience and adolescents’ perceived alleviation of anxiety symptoms: cross-sectional evidence on the mediating roles of cognitive restructuring, self-acceptance, and self-efficacy

Article References: Ni, Y., Sun, Z., Li, Z., Piao, E., & Zhang, J. (2026). Music-based immersive technology experience and adolescents’ perceived alleviation of anxiety symptoms: cross-sectional evidence on the mediating roles of cognitive restructuring, self-acceptance, and self-efficacy. Frontiers in Psychiatry, 17, Article 1917295. https://doi.org/10.3389/fpsyt.2026.1917295

Image Credits: AI Generated

DOI: 10.3389/fpsyt.2026.1917295

Keywords: Music-based, immersive, technology, experience, adolescents, perceived, alleviation, anxiety, symptoms, cross-sectional, evidence, mediating

The research team assembled annual time-series data spanning 1970 to 2025, covering per capita apparent steel consumption alongside GDP per capita, the gross fixed capital formation rate, industrial value added as a share of GDP, the urban population growth rate and international iron ore prices. Rather than relying on a single analytical tradition, the authors constructed an integrated framework that combines classical econometrics with machine learning. At its core sits the Autoregressive Distributed Lag-Error Correction Model, or ARDL-ECM, a technique prized for its ability to disentangle long-run equilibrium relationships from short-run fluctuations within the same estimation. Two machine learning models, a quadratic polynomial ridge regression and a dynamic Support Vector Regression, were then deployed to cross-validate the econometric findings from the perspective of predictive performance and relative variable importance.

The methodological care begins before any coefficients are estimated. Because several candidate variables, including construction value added and industrial value added, are highly correlated with one another, the team ran variance inflation factor tests to detect multicollinearity. When all variables were entered simultaneously, VIF values exceeded the critical threshold of 10, so the authors selected industrial value added including construction as the main industrial proxy and built an alternative specification, replacing it with the sum of manufacturing and construction value added, to test whether conclusions depended on a particular indicator. Unit root testing with the ADF and KPSS procedures, supplemented by the Zivot-Andrews test that allows for one endogenously determined structural break, confirmed that every variable was integrated of order zero or one, with no I(2) series, satisfying the preconditions for ARDL modeling.

The bounds test delivered the study’s first headline result. For both the main and robustness models, the computed F-statistics of 5.796 and 5.573 exceeded the upper critical bound of 4.871 at the 1 percent significance level, rejecting the null hypothesis of no cointegration. In plain terms, India’s per capita steel demand is not drifting randomly; it is stably linked to economic development, investment, industrialization, urbanization and price factors in a long-run equilibrium. This finding guards against spurious regression, a notorious pitfall when non-stationary time series are regressed directly on one another.

Within that equilibrium, one variable towered above the rest. GDP per capita carried a long-run coefficient of 2.180, significant at the 1 percent level, meaning that a 1 percent rise in per capita GDP is associated with an average long-run increase of roughly 2.18 percent in per capita steel demand. Because both variables are expressed in logarithms, this coefficient reads directly as an elasticity. The gross fixed capital formation rate also showed a significant positive long-run relationship, with a coefficient of 0.035 at the 5 percent level, consistent with the steel-hungry nature of roads, railways, energy projects, housing and industrial construction. Industrial value added as a share of GDP was positive but statistically insignificant in the long run, a result the authors attribute to the indicator’s breadth, which mixes sectors of very different steel intensity.

Two relationships stood out for their sign. The urban population growth rate showed a negative conditional relationship with per capita steel demand, marginally significant at the 10 percent level in the long run and significantly negative in the short run. The authors are careful to stress that this indicator measures the annual growth rate of the urban population, not the level of urbanization, so it cannot be read as evidence that urbanization suppresses steel demand. Meanwhile, international iron ore prices carried a negative but statistically insignificant coefficient in every specification, suggesting that upstream raw material prices, which do not capture domestic steel prices, exchange rates or trade policies, have limited explanatory power for India’s final steel consumption.

Perhaps the most elegant finding concerns the error correction term. Estimated at minus 0.496 in the baseline model and minus 0.495 in the robustness model, both significant at the 1 percent level, it reveals a remarkably consistent adjustment mechanism: when India’s steel demand deviates from its long-run equilibrium level in a given year, roughly 49.6 percent of that deviation is corrected in the following year. Short-run shocks, whether from investment swings or industrial fluctuations, may jolt demand temporarily, but the system gravitates back toward the trajectory dictated by economic fundamentals. Short-run coefficients told a parallel story, with GDP per capita changes showing a significant positive effect of 1.231 and annual changes in investment and industrial value added also significantly positive.

The machine learning validation added an independent layer of evidence. Hyperparameters were selected strictly within the training period using an expanding-window time-series cross-validation procedure, with observations from 1970 to 2011 for estimation and 2012 to 2025 reserved as an untouched out-of-sample test set. The dynamic SVR, equipped with a linear kernel and a lagged steel demand term, achieved the strongest out-of-sample performance, with an R-squared of 0.81, a root mean square error of 5.337 kilograms per person and a mean absolute percentage error of 5.87 percent. The quadratic polynomial ridge regression, which expands the inputs into squared and interaction terms to capture nonlinearities, performed respectably but trailed the SVR on most metrics.

Variable importance rankings from the ridge model echoed the econometrics with striking fidelity. GDP per capita ranked first with a relative importance of 41.1 percent, the gross fixed capital formation rate second at 25.8 percent, together explaining 66.9 percent of the variation in steel demand. Iron ore prices ranked last at just 1.5 percent, mirroring their statistical insignificance in the ARDL-ECM. In the dynamic SVR, the lagged steel demand level dominated with 74.3 percent relative importance, underscoring the strong annual persistence of steel consumption, which evolves along existing trends tied to sustained economic activity rather than changing drastically from one year to the next.

The authors frame their findings as conditional statistical relationships and predictive importance rather than strict causal effects, noting that economic development, capital formation and steel demand may all be shaped by reforms, industrial policies and macroeconomic cycles. The implications, however, are hard to ignore. With India’s steel demand projected by the World Steel Association to grow around 9 percent in 2025 and 2026, and to rise by 75 million tons by 2026 compared with 2020, the study suggests that the trajectory of the world’s next steel giant will be written primarily by economic growth and investment activity, not by raw material prices. As China restructures and the global supply-demand system rebalances, the numbers behind India’s ascent are now anchored by evidence that survives both econometric scrutiny and machine learning cross-validation.

Subject of Research: Science

Article Title: Core driving determinants of India’s steel demand: evidence from ARDL-ECM and machine learning cross-validation

Article References: Zhang, X., Fan, F., & Li, L. (2026). Core driving determinants of India’s steel demand: evidence from ARDL-ECM and machine learning cross-validation. Frontiers in Earth Science, 14, Article 1883390. https://doi.org/10.3389/feart.2026.1883390

Image Credits: AI Generated

DOI: 10.3389/feart.2026.1883390

Keywords: Core, driving, determinants, India, steel, demand, evidence, ARDL-ECM, machine, learning, cross-validation, scientific research