JMIR Research Protocols

Cardiac surgery patients are at particular risk of postoperative acute respiratory distress syndrome (ARDS), with an estimated incidence of 5% to 10%. Cardiopulmonary bypass (CPB), ischemia-reperfusion injury, and blood product transfusions are well-recognized contributing factors. Asymptomatic carriage of respiratory viruses has been hypothesized to prime the lungs and potentiate ARDS development when combined with the pulmonary insults of cardiac surgery. However, no study has directly assessed the relationship between preoperative asymptomatic viral carriage and postoperative ARDS.

Food systems strongly affect human and environmental health. Across Europe, they often generate negative public health and environmental outcomes and contribute to inequalities in access to healthy, sustainable food. Addressing these challenges requires understanding the complex dynamics of the interaction of individual behavior within food systems, which involves a combination of internal mechanisms and external influences.

Maintaining and improving motor function is essential in the rehabilitation of children with cerebral palsy (CP). Stretching is traditionally used to prevent muscle tightness and contractures to improve movement patterns in children with CP. Fascial manipulation (FM) is an increasingly used manual therapy method for movement difficulties associated with CP. However, evidence for FM remains limited, and its benefits over conventional stretching are unclear. A pilot randomized controlled trial (RCT) is warranted to assess the feasibility and acceptability of a definitive trial comparing FM with stretching. This study protocol describes a pilot randomized controlled feasibility trial comparing FM and stretching in children with CP to inform the design and conduct of a future definitive RCT.

Contraceptive care is complex, especially for individuals with health conditions (eg, diabetes, depression, and cardiovascular disease) who must consider how and to what extent their condition may be affected by contraception or vice versa. My Health, My Choice (MHMC) is a novel, web-based contraceptive decision support tool designed in English for patients with health conditions and is currently being tested in a cluster randomized controlled trial in the United States. MHMC is not available in Spanish, creating linguistic barriers to trial participation for those who prefer to read and learn in Spanish.

People with intellectual disabilities have a high prevalence of mental health problems, which are often underdiagnosed and treated late due to difficulties in assessment. The limited availability of validated instruments, communication barriers, and reliance on external informants hinder the early detection of symptoms and the monitoring of their progression.

Survivors of breast cancer frequently experience anxiety, stress, and depression during the follow-up and survivorship phases, when access to psychosocial support is often limited. Although psychological interventions have demonstrated effectiveness, their implementation in routine clinical practice remains challenging. Digital mental health interventions offer a promising alternative. However, many existing solutions show limited personalization, engagement, and long-term adherence, partly due to insufficient involvement of end users in their design.

In South Africa, the metastatic response rate for stage 4 high-risk neuroblastoma (HR-NB) to induction chemotherapy is lower than that of similar regimens in well-resourced settings. Augmenting current induction chemotherapy regimens with molecular radiotherapy, without increasing toxicity, is an attractive systemic treatment in radioisotope-avid tumors, especially in a resource-limited setting where stem cell transplantation and immunotherapy are unavailable and costly. Clinical trials of [Lu]Lutetium DOTATATE ([Lu]Lu-DOTATATE) have primarily focused on refractory or relapsed HR-NB, with disappointing results. This study evaluates the feasibility and dose-limiting toxicity grading of adding a single dose of [Lu]Lu-DOTATATE to induction chemotherapy in achieving metastatic remission rates.

The incidence of end-stage renal disease (ESRD) continues to increase globally, including in Indonesia, representing a significant public health burden. Genetic factors, particularly variations in human leukocyte antigen (HLA) alleles, have been suggested to contribute to ESRD susceptibility, either indirectly through their association with underlying immune-mediated diseases or directly through their involvement in immune regulation and renal injury pathways. Studies have shown varying results due to HLA polymorphisms, ethnicity, and environmental influences. HLA polymorphisms are suspected of influencing HLA antibody production, which in turn impacts kidney transplant outcomes. Although ethnicity is one of the factors that determine HLA allele variation in the population, research on HLA alleles has not been widely conducted in Indonesia.

Young children with exposure to or infection with are at high risk of developing tuberculosis disease, and postexposure tuberculosis preventive treatment decreases this risk. Evidence is limited regarding the dosing and safety of the 12-dose once-weekly rifapentine and isoniazid regimen (3HP) for tuberculosis preventive treatment in children younger than 2 years and in children living with HIV.

AI and machine learning (ML) are increasingly being used in health care settings but may reproduce or exacerbate systemic biases. The integration of intersectionality and equity-related concepts offers an analytical framework to guide more reflexive, equity-oriented AI and ML design and implementation, particularly when paired with a coproduction philosophy that meaningfully includes community-based collaborators and knowledge users. However, there is limited synthesis on how intersectionality is conceptualized and operationalized in this context, and the extent to which interdisciplinary collaborators and patient partners are involved in such undertakings is unknown.

Intravenous fluid therapy is widely used in emergency departments (EDs) to treat hypovolemia and hypotension. However, its hemodynamic effects are often modest and short-lived. Intravenous fluid therapy requires a peripheral venous catheter, which increases the risk of complications such as catheter failure and phlebitis. Oral fluid therapy represents a simple, noninvasive alternative that has been shown in physiological studies to expand plasma volume and increase blood pressure. No randomized trial has compared oral with intravenous fluid therapy in a general adult ED population. Evidence regarding the feasibility of randomized comparisons of fluid administration modes and whether oral fluid administration can reliably deliver the prescribed volume remains limited.

Auditory spatial attention (ASA) can be impaired in clinical populations and affects everyday activities, yet it remains understudied and lacks practical assessment tools for clinical use. However, recent technological advances have enabled the development of auditory virtual environments capable of engaging attentional networks while remaining compatible with clinical implementation and supporting the collection of objective physiological measures.