JMIR Research Protocols

Frailty and prefrailty are highly prevalent conditions among older adults and are associated with increased functional decline, fall risk, hospitalization, and mortality. Multicomponent supervised exercise programs have demonstrated efficacy in improving physical performance and mitigating frailty, particularly when adapted to older adults’ functional capacity. However, evidence regarding Vivifrail-based interventions for frail and prefrail older adults in Brazil remains limited.

Advanced HIV disease remains a major global health concern, with nearly 40.8 million people living with HIV as of 2024. Antiretroviral therapy has improved outcomes, but its success depends on timely intervention, adherence, and retention in care. AI, including machine learning and deep learning, offers promising tools for prognostic modeling that could support clinical decision-making and personalized treatment. Existing syntheses, however, have been largely narrative and have not systematically evaluated the performance, risk of bias, reporting quality, or clinical readiness of AI-based prognostic models, leaving a critical gap in understanding their validity and applicability.

The global consumption of electronic and electrical products has increased the generation of electronic waste (e-waste), which poses environmental and public health concerns. In Vietnam, informal e-waste processing, characterized by unregulated collection and dismantling, is widespread and exposes workers to hazardous substances. However, data on the health status of e-waste workers remain limited, and exposure to phthalates, which are endocrine-disrupting chemicals widely used in electronics, has not yet been evaluated.

Relapse following drug rehabilitation remains a major mental health challenge in Indonesia. Although rehabilitation programs emphasize individual recovery, postdischarge outcomes are strongly influenced by the family as the primary microsocial environment. However, family mental readiness before discharge from rehabilitation has not been systematically explored, particularly in ways that support structured and scalable postrehabilitation care.

Hospital professionals face mental health challenges caused by the high demands of their work. Mindfulness meditation (MM) is a nonpharmacological practice with promising effects in promoting mental health and well-being across various hospital professionals. However, the benefits obtained from its implementation in the context of real work in hospital departments are understudied.

Establishment of the gut microbiome during the first years of life is critically important for long-term health and development. In preterm infants, microbial colonization is disrupted due to their developmental immaturity and the myriad of pre- and postnatal exposures. Unfortunately, this places them at an elevated risk for adverse health outcomes into childhood (eg, asthma and impaired neurodevelopment). Understanding the developmental trajectory of the microbiome in preterm infants, the factors predicting these microbial patterns, and the links to childhood health can offer opportunities to develop interventions and optimize health.

3D printing is an advanced, computer-aided design (CAD)–guided, layer-by-layer manufacturing technology with strong potential for producing patient-specific drug products. Integrating AI with pharmaceutical 3D printing can accelerate formulation development, improve process robustness and quality, and enable efficient personalization across the preprinting, printing, and postprinting stages. However, evidence remains dispersed across technologies, dosage forms, and AI approaches, making it difficult to obtain a comprehensive understanding of current research and knowledge gaps.

Nurses rely on current and relevant evidence to provide safe, high-quality care to patients and families. To do this, nurses need support to participate in research and evidence-based practice (EBP) activities. Despite the well-documented benefits of nurses’ engagement in research and EBP, few actually do so in the clinical setting. This creates a knowledge-to-practice gap in which nursing evidence is not generated and existing evidence is often not applied in practice, jeopardizing the quality of care and patient outcomes.

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.