JMIR Research Protocols

Elder orphans have been described as a growing vulnerable population of isolated older adults with limited social and caregiving support. There is a lack of consistency in the terminology and definitions of elder orphans. This lack of consistency impedes research and implementation of services for elder orphans, who are predisposed to isolation, loneliness, unmet care needs, and a decline in health outcomes. It is imperative for elder orphans to plan for their health and well-being as they age in the community.

Polycystic ovary syndrome (PCOS) affects 9% to 12% of reproductive-age women worldwide, with higher prevalence reported in India. Its pathophysiology involves insulin resistance, hyperandrogenism, and chronic low-grade inflammation, increasingly linked to gut dysbiosis and lipopolysaccharide-driven toll-like receptor 4 signaling. Elevated calprotectin and suppressed acylated ghrelin (AGH) reflect this inflammatory-metabolic disruption. While metformin remains standard therapy, it does not address underlying gut dysbiosis. , with its antibacterial and immunomodulatory properties, is a promising but untested gut-targeted adjunct. This trial evaluates whether combining metformin with supplementation improves metabolic and inflammatory outcomes beyond either therapy alone.

Human papillomavirus (HPV)–negative head and neck cancers, often linked to tobacco and alcohol exposure, have a poor prognosis and high recurrence rates. Circulating tumor DNA (ctDNA) is a promising biomarker for detecting minimal residual disease and monitoring treatment response. Recent studies show that ctDNA can detect recurrence earlier than clinical or radiological methods. Prospective trials are needed to validate its clinical utility.

Restrictive practices, including restraint and seclusion, are used across aged care, mental health, and disability support settings to manage behaviors of concern. These practices are associated with substantial ethical, psychological, and physical harms. Digital health technologies, including real-time monitoring systems and AI-enabled predictive analytics, are increasingly used to detect early behavioral escalation. However, detection or prediction alone does not reduce restrictive practices. It remains unclear how these technologies are translated into care actions, decision-making, and measurable outcomes in real-world settings.

The Otago Exercise Program (OEP), traditionally delivered at home by a physical therapist, is an evidence-based intervention proven to reduce falls and fall-related injuries in older adults. Despite its effectiveness, widespread adoption has been limited by the personnel and resource demands required for program delivery. Exploring alternative delivery methods, including remote platforms and community-based programs, may help overcome implementation barriers and expand access to this program.

Adults with hematological malignancies who develop febrile neutropenia (FN) face elevated risks of sepsis, intensive care admission, and treatment interruptions. Early sepsis detection is challenging, as classical clinical signs are often attenuated or delayed in this population. Current risk stratification tools demonstrate limitations when applied to adults with FN. A tailored, nurse-led scoring system integrating clinical, laboratory, and physiological predictors may enhance early sepsis identification.

Postoperative delirium is common among older adults after major surgery, especially those with cognitive impairment, and is associated with prolonged hospitalization, functional decline, mortality, and subsequent cognitive deterioration. Nonpharmacologic delirium-prevention strategies are recommended but are difficult to deliver reliably in high-acuity environments because they require repeated staff-intensive interactions, consistent patient engagement, and integration into complex intensive care unit (ICU) workflows.

Postpartum fatigue (PPF) is clinically defined as persistent physical and mental exhaustion emerging after childbirth that cannot be fully relieved by rest. It is distinct from postpartum depression and has a prevalence of 76.13% among Chinese women within the first postpartum week. Existing evidence suggests that maternal PPF may alter salivary oxytocin concentrations, disturb maternal caregiving behaviors, and subsequently interfere with multiple dimensions of infant emotional development, including emotional expression, emotional regulation, and emotional recognition. Objective psychophysiological measurements, such as eye-tracking and galvanic skin response, have been validated for assessing infant emotional responses. Nevertheless, most existing studies focus merely on maternal mental well-being. Local longitudinal evidence clarifying this sequential mechanistic chain remains limited, and targeted early screening and intervention strategies for PPF-affected mother-infant dyads are insufficient.

The Ending the HIV Epidemic (EHE) initiative remains a national priority in the United States, aiming to reduce new HIV infections by 90% by 2030. As we cross the initiative’s midpoint, there is renewed commitment to strengthening the HIV workforce’s capacity to plan, implement, and sustain effective HIV prevention, treatment, and care interventions. Despite substantial improvement in HIV outcomes, uneven implementation of evidence-based interventions reflects persistent gaps between available evidence and its translation into locally actionable practice. Achieving EHE goals requires tailoring implementation to the diverse sociostructural conditions shaping HIV outcomes across jurisdictions. Research increasingly highlights the value of integrated, contextual data to strengthen public health decision-making. Linking indicators spanning multiple conceptual domains across various geographic levels can support a robust understanding of the distinct drivers of HIV outcomes, yet existing data systems remain fragmented. A harmonized, multisource, multilevel database is therefore essential to support targeted, needs-based, and data-driven implementation under the EHE initiative. We present a reproducible protocol detailing the transferable methodology of building and maintaining such a resource.

On December 20, 2024, a vehicle-ramming attack occurred at the Magdeburg Christmas market, resulting in 6 fatalities and more than 300 injuries. Mass violence incidents have the potential to cause long-lasting psychosocial consequences for directly and indirectly affected individuals. However, the outcomes can vary depending on relevant risk and protective factors. To improve the psychosocial aftercare of mass violence incidents in Germany, more research is essential.

The postnatal period is a critical phase for maternal and newborn survival, during which many preventable complications and deaths occur, yet postnatal care (PNC) use remains low in Ethiopia. Care-seeking and postpartum practices are shaped by knowledge and also by interacting cognitive, interpersonal, sociocultural, and environmental determinants, including perceived risk, self-efficacy, family influence, social norms, and culturally embedded beliefs. Existing educational interventions largely prioritize information provision and insufficiently address these determinants, limiting the translation of knowledge into timely PNC use and safe maternal and newborn care practices.

Sexual assault can have devastating consequences for survivors, including posttraumatic stress disorder (PTSD) and alcohol misuse. Interventions provided in the initial months following a sexual assault can prevent the development of chronic problems. Early interventions that are brief, accessible, and focused on shared vulnerabilities may improve efficacy.