US Rural youth face elevated firearm risk and mental health challenges

Handgun carrying and firearm exposure are linked to suicide risk and behavioral outcomes, according to Rutgers researchers

Rutgers University

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Rural youth experience higher rates of firearm exposure, handgun carrying and associated mental health risks, according to Rutgers researchers.

Their study, published in Trauma, Violence, and Abuse, examined recent literature on rural youth firearm exposure and its association with health risk behaviors and outcomes, including violence and suicide.

The rural youth remain significantly understudied compared to their urban counterparts, despite facing distinct and growing risks related to firearm exposure. According to the study, suicide rates among rural youth have outpaced those in urban areas for years, with firearms now the leading cause of death in these communities. Additionally, American Indian and Alaska Native youth experience disproportionately high rates of suicide across age groups, highlighting critical disparities in risk and outcomes.

“Many manuscripts in this review find that handgun carrying was associated with increased risk behaviors, such as violence and early substance use, and mental health outcomes such as suicide ideation,” said Catherine Heitz, a doctoral candidate at Rutgers University–Camden and the New Jersey Gun Violence Research Center at the Rutgers School of Public Health.

Using an integrative, systematic review of peer-reviewed literature, researchers examined studies published between 2014 and 2024 on rural youth firearm exposure. Nineteen studies were included and grouped into three themes: violence exposure, handgun carrying and suicide.

“There is a significant association between rurality and gun use in the form of handgun carrying and suicide, as well as firearms and violence – with and without firearms – and adverse mental health symptoms such as sadness and hopelessness in rural youth,” Heitz said.

Researchers recommend holistic, community-based interventions that incorporate culturally appropriate approaches, safe firearm storage practices, and school-based education focused on mental health and suicide prevention.

 “Culturally competent programs with reliable messengers, accessible resources and acceptable interventions are needed to address disparate rates of firearm carrying and injury in rural American Indian and Alaska Native youth,” Heitz said.

Heitz added future research should focus on expanding representation across diverse rural populations, particularly underserved groups and developing targeted, culturally responsive interventions to reduce firearm-related harm and improve mental health outcomes among rural youth.

This paper includes researchers Daniel Semenza, director of research from the New Jersey Gun Violence Research Center at Rutgers University, and others from collaborating institutions.

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Journal

Behavioral Medicine

DOI

10.1080/08964289.2026.2653519 

Method of Research

Systematic review

Subject of Research

People

Article Title

Community Violence Intervention (CVI) in a Semi-Rural Region: Implementation and Operation Considerations

 

Giants that vanished 10,000 years ago triggered ripple effects that are still felt today, and here’s where

Study reveals striking differences in the structure of mammal food webs from one continent to the next

Michigan State University

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Tens of thousands of years ago, many of the world’s biggest mammals disappeared. New research reveals where the ripple effects are still being felt in terms of who eats whom today.

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Credit: Chia Hsieh, Michigan State University

Between 50,000 and 10,000 years ago, many of the world’s largest mammals disappeared. Picture creatures like saber-toothed cats with 7-inch fangs and elephant-sized sloths. Woolly mammoths whose curved tusks grew longer than 12 feet. Even a 3-ton wombat the size of a car. After roaming the Earth for millions of years, most large-bodied mammals — especially those weighing over a ton — were wiped out. Vanished.

A new study reveals how their disappearance fundamentally reshaped food webs for the species that remain today, and why the changes were more pronounced in some parts of the world than others, particularly in the Americas.

The results will appear April 27 in the journal Proceedings of the National Academy of Sciences.

When any species goes extinct, it’s not just the animal that vanishes — the web of relationships among the surviving species often shifts in complex ways too.

When predators disappear, their prey can multiply unchecked, causing a series of cascading effects, said senior author Lydia Beaudrot, an assistant professor of integrative biology and member of the Ecology, Evolution & Behavior program at Michigan State University.

Beaudrot had a hunch based on some of her previous research that the extinction of large mammals tens of thousands of years ago could have had long-lasting effects on food webs — the often complex networks of who eats whom.

“But there weren’t that many data points,” she said.

So Beaudrot and colleagues set about developing methods for synthesizing more data at larger spatial scales. For the new study, a team led by Beaudrot and first author Chia Hsieh analyzed recent data on predator-prey relationships at 389 sites across tropical and subtropical regions of the Americas, Africa and Asia.

The study included more than 440 species of mammals including bears, wolves, elephants and lions.

Food webs throughout the world all have the same basic trophic levels: animals that eat and are in turn eaten by others. However, the number and types of species vary greatly between different areas.

Overall, they found that food webs today have fewer, smaller prey in the Americas than in Africa and Asia.

And when they looked at prey characteristics such as body mass and activity patterns, they found that predators in the Americas stuck to prey with a narrower range of traits, with less overlap among them.

The differences among regions didn’t just stem from current factors such as weather or the seasons, said Hsieh, who is a Presidential Postdoctoral Fellow in MSU’s Ecology, Evolution, and Behavior program.

Rather, they found that differences in the severity of past extinctions played a significant role.

Each region suffered their share of losses. But the Americas got hit the hardest, losing more than three-quarters of all mammals over 100 pounds during the last 50,000 years.

For example, South America was once home to several giant deer. Their extinction left fewer prey for predators such as saber-toothed cats and dire wolves, essentially flattening and thinning out the food web.

“A lot of the lower part of the food web was lost,” Hsieh said.

Just why the most massive mammals disappeared is still a subject of debate.

Some scientists say climate and environmental stresses played a role in the loss of mammoths and other giants. Others say the spread of humans out of Africa to other parts of the world is to blame for their demise.

But whatever their cause, the new study confirms that their disappearance has had long-lasting consequences.

The research is important because it helps scientists understand the potential long-term impacts of species facing extinction today.

Around the planet, nearly half of all mammals weighing more than 20 pounds are considered vulnerable, endangered or critically endangered by the International Union for the Conservation of Nature (IUCN).

As a next step, Beaudrot said, the team plans to look at whether historical extinctions could make certain communities more vulnerable going forward.

“By studying the past, we can also try to understand what to expect in the future,” Hsieh said.

This research was supported by the U.S. National Science Foundation (DEB-2213568), Rice University, and a Michigan State University Presidential Postdoctoral Fellowship in Ecology, Evolution, and Behavior.

CITATION: "Historical legacies shape continental variation in contemporary mammal food webs," Chia Hsieh, Evan C. Fricke, Wei-Hao Lee, Daniel Gorczynski, Lydia Beaudrot. Proceedings of the National Academy of Sciences, April 27, 2026. DOI: 10.1073/pnas.2519938123

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Journal

Proceedings of the National Academy of Sciences

DOI

10.1073/pnas.2519938123 

Method of Research

Data/statistical analysis

Subject of Research

Animals

Article Title

Historical legacies shape continental variation in contemporary mammal food webs

Article Publication Date

27-Apr-2026

 

Deforestation policies are failing to protect against a potentially bigger threat to the Brazilian Amazon

University of Cambridge

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Antonio has spent the past seven years running toward fires that most others run from. A firefighter in the Brazilian Amazon since 2019, he works inside the Chico Mendes Extractive Reserve, one of the most biodiverse places on Earth.

But things are changing, and fast. “2024 was the most extreme year for fires,” Antonio said. “I had never seen anything like it. The forest burned like dry pasture – it was frightening for those of us who risk our lives to protect it.”

What Antonio and his fellow firefighters are witnessing on the ground has been backed up by a new study. An international team of researchers, led by the University of Cambridge, have found that the policies that helped reduce deforestation in the Brazilian Amazon over the past two decades have mostly failed to stop forest degradation: a slower and potentially more dangerous form of destruction. Their results are published in the Proceedings of the National Academy of Sciences.

Unlike deforestation, where whole areas of forests are cleared for farming, industry or infrastructure, a degraded forest still has trees standing. However, it has been so damaged by fire, illegal logging, fragmentation, droughts and over-hunting that it has lost much of its ecological value. The forest floor, stripped of shade and moisture, becomes a tinderbox.

“There’s still a forest there, but it’s so damaged that the carbon it once stored starts leaking, the animals have disappeared, and new grass species colonise the forest edges,” said lead author Federico Cammelli from Cambridge’s Department of Geography and the Conservation Research Institute. “Tropical forest fires are low intensity, flames often go undetected under the canopy, but after one or two years, trees die while standing, and the forest transforms into a cemetery of dead standing trees.”

Earlier research found that between 2001 and 2018, net carbon emissions from forest degradation in the Brazilian Amazon were comparable or even higher than those from deforestation itself. By 2050, degradation could affect the entire Brazilian Amazon, but it has barely featured in the policies meant to protect it.

Brazil has made real progress on deforestation. The first phase of the government’s Plan for Prevention and Control of Deforestation in the Amazon, launched in the mid-2000s, reduced tree clearing by an estimated 60 to 80 percent. Agreements in the private sector – including a moratorium on soybeans from deforested land, and a commitment from meat packers not to source cattle from newly deforested areas – also contributed to the region’s success.

However, the researchers found that four major policies meant to reduce deforestation across three Brazilian states did not reduce degradation.

When deforestation slows down, some degradation slows as well, since forests suffer less from so-called edge effects where cleared areas touch intact woodland. “However, we found no conclusive evidence that any of the supply chain policies, like the soy moratorium or the cattle agreements, tackled other big drivers of anthropogenic degradation, like fires, logging and fragmentation,” said Cammelli.

In one case, the research suggests, even successful deforestation policies can make degradation worse. The G4 cattle agreement, signed by Brazil’s four biggest meat packers, appeared to be linked to an increase in timber extraction: possibly because as cattle ranching became more regulated, some businesses switched to the less-regulated logging sector.

Back in Chico Mendes, Antonio sees some of the consequences of these gaps in policy. He said the dry season now lasts longer each year, forests are growing more fragile, and the rains arrive with sudden violence, washing out bridges and blocking roads.

He is not optimistic that the law is keeping up. “Environmental laws should be stricter, and offenders should be properly published,” he said. “If we lose the forest, we indirectly lose our lives.”

Cammelli said that political will is vital. An update to Brazilian environmental policy published in 2023 includes forest degradation among the criteria for targeting environmental law enforcement towards municipalities with poor environmental records, along requirements to reduce deforestation specifically.

“Fires often spread over many properties and entail complex liabilities: who is responsible for ignition, who for fire spread? They are best addressed at the landscape scale. The timber sector remains poorly regulated, and much can be done to crack down illegal logging,” he said.

The researchers are calling for a fundamental shift in how governments, companies and regulators think about how to best protect forests.

The EU Deforestation Regulation, which bans imports of products linked to forest destruction, defines degradation too narrowly, the researchers say, and largely overlooks the fire damage and fragmentation caused by soybean and beef production. The researchers are urging the EU to expand their definition of degradation.

Despite commitments on deforestation, the researchers found no publicly documented examples of companies operating in the Brazilian Amazon that had set concrete targets for specifically addressing forest degradation.

“Avoiding deforestation and degradation is so much more important for climate and nature than restoring what’s already gone,” said senior author Professor Rachael Garrett, also from Cambridge’s Department of Geography and Conservation Research Institute. “There are certain things you can’t get back.”

“Every year,” said Antonio, “the forest and wildlife become more vulnerable.”

The research was supported in part by the European Union and the Swiss National Science Foundation.

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Journal

Proceedings of the National Academy of Sciences

DOI

10.1073/pnas.2507793123 

Article Title

Deforestation-focused policies do not reduce degradation in the Brazilian Amazon

Article Publication Date

1-May-2026

 

Location, location, location: How the Nile helped an ancient Sudanese city thrive for centuries

University of Michigan

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Panoramic view of Jebel Barkal (ancient Napata), a UNESCO World Heritage site in northern Sudan, with its sandstone outcrop and royal pyramids.

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Credit: Gregory Tucker

ANN ARBOR—The ancient city of Napata, located in what is now Sudan, was a major urban and cultural center of Kush, an ancient empire in Nubia.

University of Michigan archaeologists and earth scientists examined the land underlying the city to determine what geological processes might have led to the city's successful settlement. Their findings suggest Napata, which flourished from about 800 BCE to 100 CE, owed its staying power to a relatively stable Nile, which deposited millennia of clay and built up a thick and fertile floodplain, creating a landscape that reduced flood risk while maintaining access to water.

The U-M study, led by archaeologist Geoff Emberling, geomorphologist Jan Peeters and El-Hassan Ahmed Mohammed, who along with Emberling directs the Jebel Barkal Archaeological Project, is published in the Proceedings of the National Academy of Sciences. The Napata site is one of The Klinsky Expeditions, a series of five archaeological field projects funded by U-M alum Steve Klinsky.

"Scholars have looked at the association between changes in climate and local environment and their impact on societies, including their political development and economic systems," said Emberling, a research scientist at the U-M Kelsey Museum of Archaeology. "But this hasn't been done in Sudan, and we've missed a key tool to help us not only understand the rise and fall of individual settlements, but also the broader history of the rise and fall of the Empire of Kush. This is really the first systematic geomorphological study in Sudan that relates to these ancient cultures."

Kush was an important player in the ancient world, Emberling said. The empire was mentioned in the Bible, by the Greek historian Herodotus, and interacted with Egypt, the Assyrians, Greeks, Persians and with the Roman Empire. After the Egyptian empire collapsed at around 1200 BCE, the Kushite dynasty came into power, based at what's now called Jebel Barkal, whose ancient name was Napata. There, at the foot of an ancient sandstone outcrop, the Kushites built palaces, pyramids and temples. Now, Jebel Barkal is a UNESCO World Heritage Site.

"They were part of that whole world system, yet because of a history of relatively lower investment in research in Sudan, some very basic questions haven't been addressed," Emberling said. "We might think we know all we need to know about the Nile because there's been a fair amount of research in Egypt. But in Sudan, the way the Nile works is different."

The gentling of the Nile

In Sudan, the geology of the region creates rapids, waterfalls and islands along the Nile that disrupt travel and fragment settlements, according to Emberling. To understand the geology underlying Jebel Barkal, Peeters led a research team including a group of local Sudanese that drilled 26 sediment cores across the river valley in which the city is situated. 

The team collected samples every 10 centimeters, with the boreholes eventually reaching between five and 13 meters deep. Using a technique called optically stimulated luminescence dating, which dates samples by determining the last time sand grains were exposed to light, the researchers were able to peer into 12,500 years of Nile history.

For the first 8,000 years of this period, the Nile carved its own valley, according to Peeters. Then, about 4,000 years ago, the valley leveled out, allowing the river to start depositing sediment and building up the valley floor. From that time period on, the river has been relatively stable—composing a layer of fertile clay and silt about 10 meters thick. 

The researchers say another geologic feature, the Nile's Fourth Cataract, also helped the river slow and allowed it to drop sediment at the site where Napata would eventually thrive. The cataracts of the Nile are stretches of islands and fast-moving rapids. The Fourth Cataract lies just upstream of Jebel Barkal, and Peeters surmises that much of the river's energy dissipates over the stretch of this cataract, allowing the river to deposit sediment and become relatively stable for 4,000 years.

"Where sediments accumulate shapes where people can live, farm, and carry out cultural and religious practices,” Peeters said. 

The precarity of war

The researchers say this work is ongoing, even as Sudan experiences its current war. Sudanese archaeologists, members of Sudan's antiquities department, known as the National Corporation for Antiquities and Museums, have been carrying out work at Jebel Barkal, guided by Emberling and others abroad.

"Despite all the difficulties and hardship of Sudan, because of the ongoing war, research is continuing through the efforts of our local collaborators," Peeters said. "Their work is central to the project, which places strong emphasis on community engagement and collaboration with Sudanese researcher.

Co-authors include Timotheus Winkels, Pawel Wolf, Tim Skuldbøl, Elizabeth Chamberlain, Saskia Büchner-Matthews and Sami Elamin.

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Journal

Proceedings of the National Academy of Sciences

DOI

10.1073/pnas.2529986123 

Article Title

Holocene Nile dynamics shaped the physical and cultural landscape of ancient Nubia

Article Publication Date

27-Apr-2026

JMIR report: Can digital twins fix hospital patient bottlenecks?

JMIR Publications

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Mark Crawford, JMIR Correspondent

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Credit: Mark Crawford

(Toronto, April 27, 2026) JMIR Publications today released a new featured report in its News and Perspectives section detailing the transformative rise of Digital Twin (DT) technology in health care management. The article, "How Digital Twins Can Improve Health System Operations," written by Mark Crawford, explores how virtual replicas of entire hospital ecosystems are allowing administrators to test high-risk operational changes in a safe, digital environment before implementing them in the real world.

Originally pioneered by NASA to simulate spacecraft conditions, Digital Twins have evolved into sophisticated, AI-driven platforms. Unlike traditional static models, these live virtual mirrors maintain a continuous data exchange with the physical hospital, allowing for real-time updates and predictive insights into staff workflows, supply chain fluctuations, and patient pathways.

Slashing Bottlenecks and Predicting Surges

The report highlights significant operational wins for health systems currently utilizing DT technology:

• Emergency Department Efficiency: Implementation of DTs has led to reported drops in ER wait times of 20% to 40% and increases in overall patient throughput of up to 20%.

• Surgical Optimization: Orthopedic systems are using digital simulations to model the trade-offs of different block scheduling and staffing allocations, optimizing surgical blocks without risking patient care.

• Winter Surge Preparedness: Children’s Mercy Hospital in Kansas City utilized DT technology to predict the timing of a winter viral surge within a single week of its actual occurrence, allowing for precise capacity planning for flu and RSV spikes.

The Multi-Billion Dollar Shift to Proactive Planning

The global digital twin health care market is projected to reach US $60 billion by 2030, reflecting a massive industry shift from reactive crisis management to proactive system design. Experts interviewed in the report, including representatives from GE HealthCare, Siemens Healthineers, and AnyLogic, emphasize that the true value of a Digital Twin lies in its ability to capture system-wide interactions, ensuring that fixing a bottleneck in one department doesn't accidentally create a crisis in another.

Avoiding the Data Trap

While the potential is vast, the report warns that success depends on data integrity. Crawford notes that DTs can produce misleading conclusions if built on weak assumptions or outdated inputs. Furthermore, successful deployment requires a "shared definition of reality" across an entire organization, from the CEO to the night shift nurse, to ensure that virtual insights translate into effective real-world action.

"When you feed real-time data into a live operational model, the platform starts being a live decision support system," the report concludes. "That is a transformational step."

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Please cite as:

Crawford M. How Digital Twins Can Improve Health System Operations. J Med Internet Res 2026;28:e98113

URL: https://www.jmir.org/2026/1/e98113

DOI: 10.2196/98113

 

About JMIR Publications News and Perspectives

JMIR Publications is a leading open access publisher of digital health research. The News and Perspectives section is the newest addition to its portfolio, established to bring the rigor and integrity of academic publishing to scientific journalism. The section features well-researched, expert-driven content from the Scientific News Editor, Kayleigh-Ann Clegg, PhD, and a network of specialist JMIR Publications Correspondents to keep the digital health community informed, inspired, and ahead of the curve.

 

About JMIR Publications

JMIR Publications is a leading open access publisher of digital health research and a champion of open science. With a focus on author advocacy and research amplification, JMIR Publications partners with researchers to advance their careers and maximize the impact of their work. As a technology organization with publishing at its core, we provide innovative tools and resources that go beyond traditional publishing, supporting researchers at every step of the dissemination process. Our portfolio features a range of peer-reviewed journals, including the renowned Journal of Medical Internet Research. 

To find out more about JMIR Publications, visit jmirpublications.com or connect with them on Bluesky, X, LinkedIn, YouTube, Facebook, and Instagram.

 

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The content of this communication is licensed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, published by JMIR Publications, is properly cited.

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Journal

Journal of Medical Internet Research

DOI

10.2196/98113 

Method of Research

Commentary/editorial

Subject of Research

People

Article Title

How Digital Twins Can Improve Health System Operations

Article Publication Date

24-Apr-2026