JMIR Research Protocols

Emerging adults (EAs), typically ranging from 18 to 29 years, navigate a transitional period marked by rapid developmental, social, and psychological change. Despite heightened vulnerability to mental health (MH) concerns during this stage, service systems are often fragmented, with gaps between adolescent and adult care streams that leave many EAs without developmentally appropriate support. In response, developing approaches such as transdiagnostic stratification, which structures care around shared symptom processes and informs treatment intensity, and digital measurement-based care (dMBC), based on routine patient-reported outcome measures (PROMs), have gained traction but remain challenging to implement consistently. This reinforces the need for rapid learning health system (RLHS) approaches that leverage continuous data and feedback for ongoing improvement, as well as co-design (CD) methods that meaningfully integrate EA perspectives into service improvement.

HIV incidence among adolescent girls and young women (AGYW) aged 15-24 years in Eastern and Southern Africa remains unacceptably high. Unprotected sex increases the risk of HIV and other sexually transmitted infections and unintended pregnancies, reflecting an unmet need for effective contraception among AGYW. Long-acting injectable preexposure prophylaxis (LAI-PrEP) and long-acting reversible contraception (LARC) offer effective, durable protection against HIV and unintended pregnancy. However, uptake and persistence remain suboptimal due to low awareness, fear of side effects, stigma, limited decision-making autonomy, and poor integrated reproductive health and HIV prevention services. Evidence on community-driven and behaviorally informed strategies to support integrated rollout and uptake of LAI-PrEP and LARC among AGYW in Uganda remains limited.

Total joint arthroplasty (TJA) is among the most common elective surgeries performed in the United States, and recent advances in perioperative care have shortened hospital stays and streamlined recovery. Yet, even brief periods of mechanical ventilation and anesthesia measurably weaken respiratory muscle function in the early postoperative period. Preoperative inspiratory strength training (IST) has been shown to reduce postoperative pulmonary complications in patients undergoing major cardiothoracic surgery, but whether these benefits extend to shorter procedures such as TJA, where hospital stays are already brief, remains unknown.

Early epidemiological studies suggested that pre- and postmenopausal women receiving estrogen therapy were less likely to develop severe disease or die from COVID-19 infection. Potential mechanisms include estrogen-mediated immunomodulation and 17β-estradiol–induced downregulation of angiotensin-converting enzyme type 2 (ACE2), the cellular receptor for SARS-CoV-2.

Persistent disparities in diversity, equity, and inclusion (DEI) remain across US residency programs despite recent accreditation requirements. In this context, DEI disparities refer to inequities in the representation, recruitment, advancement, and educational experiences of individuals from underrepresented and marginalized groups. Numerous specialty-specific studies have evaluated DEI content on residency program websites, but these studies differ in their methodologies, assessed content, and reporting practices. There is currently no comprehensive synthesis of how DEI content is presented across the different existing literature in multiple residency specialties. Therefore, a scoping review is needed to map the existing literature.

Despite increasing recognition of adolescents’ and young adults’ mental health needs, many young people continue to experience barriers in accessing timely, acceptable, and responsive mental health and psychosocial support (PSS) services. There is a need for contextually relevant and youth-responsive approaches that meaningfully engage young people, caregivers, and service providers in implementation strategy development. The study aims to co-design a mental health and PSS implementation strategy for adolescents and young adults in KwaZulu-Natal (KZN), South Africa, using a human-centered design (HCD) approach.

Large language models (LLMs) are increasingly applied in health care for clinical decision-making, education, and patient communication. However, bias in LLM outputs may exacerbate health care disparities and compromise trust. Despite rapid adoption, there is limited synthesis of how bias is identified, measured, and mitigated in medical applications of LLMs.

Ethics of care lies at the heart of the nursing profession. Grounded in the work of Gilligan and Tronto, it emphasizes relationships and responsiveness to the needs of those receiving care. Although Tronto’s framework specifies 5 elements of care, no systematic synthesis has yet examined how each element is expressed through observable behavioral indicators in the nursing context.

Smoking is the leading risk factor for postoperative complications and is associated with longer hospital stays, reoperations, and 30-day mortality. Smoking rates among patients undergoing major elective surgery are high (22.3%‐43.0%). It is urgent to identify efficacious, strategically timed smoking cessation interventions for patients undergoing surgery.

Obsessive-compulsive disorder (OCD) is a disabling mental disorder, characterized by obsessions, compulsions, and substantial morbidity. Approximately 50% of adults with OCD fail to achieve satisfactory outcomes from first-line treatments, such as exposure therapy with response prevention (ERP), with or without medication. This leads to chronic social, educational, and occupational impairment. While invasive procedures such as deep brain stimulation are available for severe, treatment-refractory cases, a need remains for less invasive alternatives. Repetitive transcranial magnetic stimulation (rTMS), a noninvasive intervention, shows promise in reducing OCD symptoms. Unlike in depression, rTMS is not yet reimbursed for OCD in the Dutch healthcare system.

Accurate assessment of surgical margins is essential in the treatment of squamous cell carcinoma (SCC) of the upper aerodigestive tract or of cutaneous origin and of basal cell carcinoma (BCC). Intraoperative frozen section analysis is the current reference standard but is time-consuming and requires coordination between surgical and pathology teams. Ex vivo reflectance confocal microscopy offers rapid, real-time evaluation of surgical margins and may provide diagnostic information comparable to frozen section analysis while enabling the development of a reference atlas for tumor visualization.

The African continent has witnessed a notable shift in its economic landscape, marked by a significant rise in unemployment and a parallel surge in informal trading activities. In response to economic challenges, a substantial number of women within the informal trading sector in African countries have ventured beyond their home settings to engage in trading, aiming to alleviate poverty within their households. However, this pursuit is often characterized by conditions of poverty and socioeconomic difficulties. These women frequently lack access to fundamental health care and social protection services, and they operate within environments that are suboptimal for health and safety. This highlights a gap in knowledge regarding their challenges and barriers in accessing health care and an opportunity for better understanding.