JMIR Research Protocols

Diseases during childhood and adolescence such as cancer or attention-deficit/hyperactivity disorder (ADHD) can have an impact on brain development and place children and adolescents at increased risk for cognitive long-term problems. Most cognitive trainings currently available have limited efficacy and show limited transfer to nontrained tasks and everyday functioning. We developed a novel intervention (Mio-Training) aiming to increase metacognitive abilities at the intersection between exercise psychology and cognitive science to strengthen the cognitive development of pediatric patients with atypical brain development in the long term.

Diabetic foot osteomyelitis (DFO) is a common complication and major cause of morbidity among people with diabetes mellitus. There has been growing acceptance of primarily nonsurgical (conservative) management of DFO based on antibiotics alone. However, the most appropriate duration of antibiotic therapy for DFO remains controversial. Current guidelines recommend antibiotic duration of up to 6 weeks for DFO. Although there has been growing interest in a shorter duration of antibiotic therapy, in absence of sufficient evidence, the extent to which the duration of antibiotic therapy can be shortened remains debatable. Determination of the optimal duration of antibiotic therapy would improve the outcomes of treatment of DFO while limiting side effects.

Despite active national initiatives, the low prevalence of modern contraception in Pakistan remains unchanged, leading to high rates of unintended pregnancies and poor maternal and neonatal outcomes. Conventional directive counseling does not sufficiently cater to women’s needs, whereas structured client-centered strategies like GATHER (greet, ask, tell, help, explain, return) and the balanced counseling strategy (BCS) may improve outcomes. Existing literature assessing the comparative effectiveness of these strategies in the Pakistani population lacks evidence.

Although the overall number of cervical cancer cases is declining worldwide, the incidence of this type of cancer is increasing in regions with low human papillomavirus (HPV) vaccination and cancer screening rates. In such regions, screening pregnant women can help improve the overall screening rate. Worldwide, cervical cancer screening is shifting from cervical cytology to HPV testing, which reduces the incidence of cervical cancer and, when negative, allows for longer screening intervals. Although HPV-based screening has been shown to be at least as effective as cytology screening for lesion detection in the general population, its performance during pregnancy remains poorly characterized due to the exclusion of pregnant women in previous clinical trials.

Due to climate change, the population and health care systems face an increasing burden of weather-related health risks. Emergency departments (EDs) are one of the first points of contact for acute and emergency care and insights into population health. Previous research has demonstrated that climate change-based weather phenomena have an impact on ED usage and morbidity. However, research shows inconsistent results for some weather phenomena and disease groups, and no corresponding evidence is yet available for Germany.

South Africa has the largest HIV epidemic in the world; in KwaZulu-Natal Province, over 40.8% of adults aged 15 years and older are living with HIV. Despite this, South Africa is home to only 3% of the world’s health care workers. Nurses constitute the largest group of providers in South Africa and experience high levels of burnout, which can contribute to negative patient outcomes for people living with HIV, including reduced treatment adherence. Nurse-centered interventions that offset these effects are urgently needed.

Preterm birth (PTB), or birth before 37 weeks of gestation, remains a significant public health issue in the United States, particularly in Detroit, Michigan. Growing evidence suggests that volatile organic compounds (VOCs), aromatic or chlorinated organic compounds that vaporize readily, may influence PTB risk. However, much of this prior work is limited by indirect VOC exposure estimates (eg, assignment based on maternal residential address), single-point or cumulative exposure estimates during pregnancy, or limited consideration of potential mechanistic factors.

Metabolic syndrome (MetS) is defined by the presence of at least 3 out of 5 clinical risk factors, including abdominal obesity, elevated blood pressure, high fasting glucose, elevated triglycerides, and low high-density lipoprotein cholesterol. Individuals with MetS face significantly increased risks of cardiovascular disease, type 2 diabetes, and all-cause mortality.

Primary biliary cholangitis (PBC) management remains limited by reliance on static biochemical markers, fragmented assessment of symptom burden, and inadequate noninvasive risk stratification for clinically significant portal hypertension (CSPH). Existing tools fail to integrate longitudinal laboratory trends, elastography, and patient-reported outcomes, and translation of risk assessment into guideline-concordant clinical action remains inconsistent.

Cardiac myxomas (CMs) are the commonest benign primary cardiac tumors, most frequently originating from the left atrium and occasionally from the right atrium. Despite being histologically benign, CMs can cause myriad serious embolic complications, including stroke, acute coronary syndrome, limb ischemia, and visceral infarction. While previous studies have explored risk factors for embolization, there is a lack of papers comprehensively summarizing the frequency, anatomical distribution, clinical patterns, and management of CM-related embolization.

SMS text messages have been used as part of health intervention research for over a quarter of a century. Given the ease of reaching people via SMS text message, these interventions are important for all groups, including Hispanic individuals. SMS text messaging interventions continue to show promise for improving health in this population. Several reviews have addressed aspects of designing Hispanic-focused digital health interventions. Emphasis has been placed on the linguistic and cultural relevance of SMS text messages in these studies. However, a gap exists in the literature on how SMS text messages are developed and adapted for use in health interventions with Hispanic communities across the life span.

Pediatric-onset multiple sclerosis (POMS) is a chronic, progressive neurologic condition requiring lifelong management and coordinated transition from pediatric to adult care. Evidence-based guidelines identify transition readiness assessment as a core component of successful transition; however, most POMS clinics do not formally assess readiness, and existing tools do not address POMS-specific challenges, such as fluctuating disability, complex treatment regimens, and cognitive impairment. This gap underscores the need for a transition readiness measure tailored to POMS.