JMIR Research Protocols

Climate change threatens population health through temperature extremes, air pollution, and altered infectious disease patterns. Emergency departments (EDs) are sensitive indicators of climate-related health impacts; however, comprehensive multicenter investigations integrating meteorological factors, air quality, and infectious disease surveillance across different health care provision levels remain scarce in Germany, particularly in maritime climate regions.

Snakebite envenoming (SBE) is a neglected tropical disease with substantial morbidity and mortality. India accounts for nearly 50% of global snakebite deaths, yet the disease remains underreported due to a lack of standardized documentation and phenotypic classification. Current diagnosis is syndromic and lacks uniform data capture protocols.

Despite robust evidence supporting the efficacy of antiobesity medications (AOMs), their use remains limited and inequitable across populations. Patient, provider, and system-level barriers constrain equitable AOM use in eligible persons, limiting the cumulative health benefits realized by eligible patients.

Postmortem pink teeth are an uncommon finding resulting from color changes within dental tissues. They have been reported in several death contexts, including drowning, but neither their presence nor their intensity is specific to a cause of death. Inconsistent photographic, radiological, and histological methods have limited comparisons across studies.

Mild cognitive impairment (MCI) may represent a prodromal stage of Alzheimer disease, but interventions to delay progression remain limited. Genistein is a phytoestrogenic isoflavone with potential effects on several pathways implicated in Alzheimer disease. We previously showed that genistein reverses cognitive decline and lowers brain amyloid β (Aβ) in the Aβ precursor protein/presenilin 1 double transgenic (AβPP/PS1) model of Alzheimer disease.

Shock is a life-threatening condition that can lead to multiorgan failure and death. Vasopressors are needed for the treatment of vasoplegic (distributive) shock. Angiotensin II (AT II) is a novel vasopressor. Approximately two-thirds of patients respond to AT II, and one-third do not. AT II is part of the renin-angiotensin-aldosterone system (RAAS). Renin is the limiting enzyme of the RAAS, and among other mechanisms, its concentration is regulated by AT II concentration through a negative feedback loop. It might be an indicator of response to AT II therapy.

In Australian residential aged care, infection prevention and control (IPC) Lead nurses (IPC Leads) are a key part of the IPC program. IPC Leads are often the main IPC contacts and provide support to staff to improve IPC and resident outcomes. To enhance their competence and self-efficacy, IPC Leads need to engage in ongoing role development. Connecting with other IPC Leads, learning together, and sharing ideas and resources could also be beneficial. Communities of practice (CoPs) have been shown to improve self-efficacy and job satisfaction by fostering belonging, peer learning, and problem-solving. Drawing on social learning theory, CoPs encourage learning with and from one another to explore and iteratively develop practice. This study draws on the CoP literature and builds on our previous pilot of a CoP for IPC Leads in 1 state of Australia, which found promising impacts on confidence and practice change.

Wearable technologies are rapidly transforming the health care landscape by enabling the tracking of real-time physiological and behavioral data used in healthy lifestyle interventions. Despite their widespread adoption in the consumer market, scientific validation of their impact on the brain remains limited, and factors influencing effects on cognition and adherence are not fully understood. This gap is critical, as consumers, health care providers, and researchers depend on these data to unlock the potential of wearables for cognitive support.

Virtual patients (VPs) are considered cost-effective and convenient tools for clinical training. The research team developed a smartphone-based VP tailored to the needs of primary health care physicians in rural China. The VP demonstrated high levels of feasibility and acceptability in this group in a previous study.

Family peers (FPs) have lived experience of parenting a child with mental health needs and specialized training to support other caregivers. They provide informational, emotional, affirmational, and instrumental support and are reimbursable by Medicaid in many states. While there have been positive results of FP support in randomized trials, there is little understanding of the mechanisms through which FP support improves caregiver and child outcomes. While observational coding is considered the gold standard for measuring psychosocial interventions, it has not been acceptable to FPs. This makes it necessary to explore other strategies for measuring intervention delivery.

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.