JMIR Research Protocols

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.

Conversational artificial intelligence (AI) technologies are increasingly positioned as a response to social isolation, loneliness, and unmet psychosocial needs across health and care contexts. Non-embodied AI-based digital companions have attracted growing attention for their potential to support companionship, social interaction, communication, and psychosocial well-being among older adults, including people living with dementia. However, the evidence base remains underexplored. Terminology is inconsistently applied, systems are variably defined, and studies are distributed across disciplinary silos, limiting critical investigation of how these technologies are conceptualized, designed, and evaluated.

The incidence of femoral neck fractures (FNFs) is increasing, primarily due to an aging population and an increased incidence of high-energy trauma. Although fixation with three cannulated screws (TCS) is the most commonly used surgical technique, it has limitations, including suboptimal operative accuracy and dependence on repeated intraoperative fluoroscopy. In response, advanced navigation systems have been developed to improve surgical precision and outcomes.

With a 5-year survival rate of less than 10% in most regions worldwide, pancreatic ductal adenocarcinoma (PDAC) has been considered as one of the deadliest tumor diseases. In addition, the incidence of acute and chronic pancreatitis is also increasing worldwide. Both diseases—tumorous and inflammatory—involve pronounced stromal changes, including stellate cell activation, fibrosis, immune cell recruitment, and a proinflammatory microenvironment that is able to drive malignant progression. Vitamin C is increasingly coming into focus as a treatment option, as it has the potential to act both as an antioxidant and anti-inflammatory agent on pancreatitis tissue and as a cytotoxic and modulatory agent on tumor-relevant signaling pathways in PDAC. While the influence of vitamin C on tumor cells has been extensively studied and classified, there is a lack of consideration in the context of stromal and epithelial cells in PDAC and benign/inflammatory pancreatic diseases.

Musicians are at high risk for playing-related musculoskeletal disorders due to prolonged static postures and asymmetrical movements. Despite the prevalence of these disorders, objective ergonomic assessments in orchestral settings are limited.

Clinical guidelines recommend a stepped-care strategy for patients with hip and knee osteoarthritis that begins with nonoperative approaches, including education, pain medication, and self-care. However, the implementation of stepped-care remains limited. Digital self-management interventions have the potential to support patients in applying lifestyle advice and self-care strategies, but current tools often provide generic support without long-term continuity. Artificial intelligence offers new opportunities to deliver personalized, just-in-time self-management interventions for people with osteoarthritis. The development of such artificial intelligence algorithms is limited due to a lack of rich, longitudinal datasets.

Among US teenagers, 79% of HIV infections are attributable to male-to-male sexual contact; yet, few interventions have been shown to effectively reduce sexual risk among gay and bisexual adolescents (GBA). Parent communication about sex is associated with adolescent sexual risk, and interventions to improve parent communication have been shown to successfully reduce sexual risk among heterosexual samples. However, no interventions designed specifically for parents of GBA have been tested in clinical trials. Parents and Adolescent Talking About Healthy Sexuality (PATHS) is a web-based intervention we created for parents of GBA that aims to improve parent communication about sexuality and HIV and increase parent behaviors supportive of GBA sexual health.