JMIR Research Protocols

Type 2 respiratory failure (T2RF) is a common and high-risk presentation in the emergency department (ED). Noninvasive positive pressure ventilation (NIPPV) is a standard first-line therapy for T2RF, particularly in acute exacerbations of chronic obstructive pulmonary disease and cardiogenic pulmonary edema. However, NIPPV has limitations, including discomfort, claustrophobia, air leaks, skin injury, and aspiration that may compromise tolerance and lead to treatment failure or escalation to endotracheal intubation. High-velocity nasal insufflation (HVNI), particularly via a single-prong asymmetric cannula configuration, has been proposed to enhance dead-space washout and improve patient comfort. Despite growing interest, robust evidence of evaluation of HVNI in heterogeneous, all-cause T2RF populations in the ED remains limited.

Autonomic nervous system (ANS) dysregulation is increasingly linked to concussion. However, studies examining the relationship between concussion and ANS measures, such as heart rate (HR), HR variability (HRV), and pupillary light reflex (PLR), are limited by small sample sizes, inconsistent control of confounders, and methodological heterogeneity, thereby limiting clinical translation.

Stroke is a leading cause of death and disability globally. India, like other low- and middle-income countries, faces rising stroke cases with significant regional variations and burden. Successful management of acute stroke requires timely recognition, quick transportation to a definitive health care facility, and specialized care for reducing mortality and morbidity. Stroke care in India is predominantly urban-oriented, private sector–dominant, with a shortage of trained or specialist personnel and limited access to infrastructure. There is a need to develop stroke care systems across various levels of health care delivery that are comprehensive and standardized for timely intervention, management, and referral.

Neuropathic pain (NP) remains difficult to manage because conventional pharmacological therapies often have limited efficacy and intolerable side effects. Noninvasive neuromodulation techniques have emerged as potential alternatives with fewer adverse effects. Meta-analyses of randomized controlled trials suggest that high-frequency repetitive transcranial magnetic stimulation over the primary motor cortex has analgesic effects; however, its efficacy is modest and restricted by the inability to stimulate deeper brain regions. Low-intensity transcranial focused ultrasound stimulation (TUS) is a novel approach that enables precise targeting of deep brain structures and modulation of neural activity. Although promising in preclinical and preliminary human studies, its long-term therapeutic efficacy for NP remains unknown.

Sickle cell disease (SCD) is the most common monogenic disorder in humans and occurs predominantly among individuals who identify as Black or African American in the United States. In earlier work, we found that developmental delays were present in more than 50% of children with SCD before the age of 3 years, yet none had been diagnosed or referred to intervention services. Children whose caregivers participated in a home-based caregiver education program demonstrated improved scores on standardized developmental measures. When developmental delays go unidentified, children miss a critical opportunity for intervention during a period of rapid neurological change. Yet few, if any, studies have described the incidence and severity of developmental delays among children with SCD compared to controls.

Access to health care remains a critical issue in protracted forced displacement contexts globally. In Cox’s Bazar, Bangladesh, the co-existence of Rohingya refugees and the host community for many years has generated complex health care dynamics. While humanitarian interventions have increased service availability for refugees, barriers still persist, and disparities in health care access between refugees and host populations exist.

Currently, the treatment of cognitive dysfunction after acute traumatic brain injury (TBI) remains a challenge, and novel therapeutic methods are urgently needed. Median nerve stimulation (MNS) is a noninvasive neuromodulation technique that has recently shown positive effects in promoting recovery from coma after acute brain injury. It has been shown to improve cognition in healthy volunteers, and may be a potential therapeutic approach for cognitive dysfunction in patients with acute TBI.

Gynecological cancers pose significant physical, psychological, and social challenges for those affected. Although psychosocial interventions are components of holistic cancer care, access can be limited by specialized practitioner expertise, wait times, gender-biased care, and accessibility constraints. These barriers highlight a recognized need for alternative, timely, and nonclinical approaches that can complement existing services and relieve system pressures.

Mental health disorders (MHDs) represent a growing global challenge and pose a significant risk to public health. Alongside developments in the field of large language models (LLMs), conversational mental health chatbots (CMHBs) have emerged and are increasingly being used by individuals in self-directed and independent ways for mental health support. Although users’ perspectives on CMHBs have been extensively examined and systematically synthesized, relatively little research has focused on how health care professionals (HCPs) perceive these tools. To develop a more comprehensive understanding of the implications of using CMHBs, the perspectives of HCPs should also be considered. As HCPs’ views are informed by their clinical expertise and professional responsibility, they may point to underexplored implications related to the safety, ethical use, and implementation of these tools.

Crisis helplines are a vital component of a robust public health approach to suicide prevention as they are often free, accessible, and provide immediate support to individuals in distress. AI presents an opportunity for novel applications to support and improve crisis line services across a variety of functions, including assessing suicide risk, identifying issues, tracking responder behaviors, and providing prompts and reminders. However, the use of AI in the crisis sector also raises critical questions regarding safety, ethics, privacy, efficacy, feasibility, and acceptability among interest holders. The extent to which AI is currently being explored and implemented in crisis line contexts is unknown.

Survivors of childhood cancer have an increased risk of cardiovascular disease (CVD), but that risk may be reduced by healthy lifestyle behaviors.

Progressive neurological diseases (PNDs) such as Parkinson disease and multiple sclerosis cause profound motor and nonmotor symptom burdens that significantly impair health-related quality of life. Beyond physical challenges, patients face profound psychospiritual distress driven by prognostic uncertainty, loss of autonomy, and existential concerns. While palliative care can address these multidimensional needs, it remains underused in neurological populations, where conventional care predominantly focuses on motor symptom management.