JMIR Research Protocols

Cleft lip and palate is a complex congenital defect that can present functional and esthetic challenges, particularly in patients with large alveolar clefts for which surgical management is indicated. In contrast to traditional treatment techniques such as autologous bone grafting, newer techniques include unilateral Le Fort I osteotomy advancement and dentoalveolar transport distraction osteogenesis and have been shown to be useful in the treatment of maxillary hypoplasia and large alveolar clefts. These techniques may help improve both esthetic and function in patients with substantial tissue deficiencies as well as in patients with scarring.

A 1-session virtual reality (VR) exposure for public speaking anxiety has been found to be effective in reducing public speaking anxiety. Previous meta-analyses comparing 1-session to several sessions of in vivo exposure for specific phobias did not find a difference in effectiveness. However, due to the specificity of VR exposure and public speaking anxiety, it is unclear how dividing the same amount of exposure tasks into 3 shorter sessions instead of one long session would affect the effectiveness of VR exposure for public speaking.

Systemic lupus erythematosus (SLE) presents substantial life challenges, reflecting the complex and heterogeneous nature of the disease. Pain is common and often one of the earliest manifestations. Skill-based behavioral pain treatments are often inaccessible to patients with SLE, and no SLE-specific evidence exists to guide patient and clinician treatment choices. To fill a pressing evidence gap for SLE pain treatment, the Lupus PROGRESS (Pain Relief With Online Groups That Empower Skill-Based Symptom Reduction) trial will compare a lower-burden evidence-based behavioral pain treatment with online multisession cognitive behavioral therapy (CBT; the gold standard behavioral treatment for chronic pain) while also enhancing diversity and representativeness among patient advisors and study participants.

Breast cancer screening through mammography is essential for early detection and improved survival; however, pain and discomfort during the procedure remain major barriers to women’s participation. Pain perception during mammography is influenced not only by technical factors but also by psychological variables such as anxiety, depression, pain catastrophizing, and personality traits. Despite growing evidence, findings on the role of psychological factors remain inconsistent, and the contribution of personality traits remains largely unexplored, highlighting the need for further investigation.

In India, hanging is the leading method of suicide, and survivors of near-hanging often present with altered sensorium due to cerebral edema from cervical vascular compression and hypoxia. Management typically involves supportive care and antiedema measures, such as mannitol, hypertonic saline, and dexamethasone. Dexamethasone, a corticosteroid that crosses the blood-brain barrier, is commonly used for presumed cerebral edema. However, evidence supporting its efficacy is limited, and there are no clinical guidelines that recommend its routine use. A randomized controlled trial is therefore essential to establish the real-world efficacy of dexamethasone in this setting.

Placental dysfunction underlies major obstetric complications, including preeclampsia, fetal growth restriction, preterm birth, and stillbirth. While early identification of pregnancies at high risk of complications enables preventive interventions, current screening methods based on traditional risk factors have limited accuracy.

Wounds are common and clinically consequential, and consistent assessment is essential for communication, monitoring, and decision-making. Although multiple wound assessment instruments exist, there is no agreement among specialists on which criteria to prioritize during validation processes and evidence synthesis remains insufficient within the Brazilian context.

Sacroiliac joint (SIJ) dysfunction is associated with significant pain, disability, and altered postural control in adults. Manual therapies, including Mulligan mobilization, Maitland mobilization, high-velocity thrust (HVT), and muscle energy technique (MET), are routinely applied for the management of SIJ dysfunction. However, comparative evidence regarding their effects on pain, disability, and center-of-gravity (COG) displacement remains insufficient.

Top surgery refers to various gender-affirming surgical procedures involving breast or chest tissue. Existing research suggests top surgery improves physical, psychological, and social well-being in transgender and gender-diverse individuals (herein “trans”) who desire it. However, most studies have been retrospective, have not used validated outcome measures, and have excluded nonbinary individuals, limiting the robustness of the existing research.

Rehabilitation is beneficial for individuals with cancer across all phases of care, but access remains limited for many survivors, including individuals with melanoma. As new treatment strategies for melanoma are introduced, there is an opportunity to assess perioperative rehabilitation strategies for patients undergoing surgery during and after neoadjuvant treatment.

Patient and public involvement (PPI) is increasingly recognized as an important component of inclusive and patient-centered health research. However, the extent and nature of PPI in autoimmune and inflammatory ocular disease research remain unclear and inconsistently reported.

Preoperative anxiety is common among women undergoing breast cancer surgery and is associated with impaired subjective well-being as well as adverse perioperative outcomes, including increased postoperative pain, nausea and vomiting, and higher analgesic requirements. While preliminary evidence suggests potential benefits of nonpharmacological interventions, including acupuncture, robust clinical evaluation of safe and feasible approaches in perioperative oncology is still needed. The National Acupuncture Detoxification Association (NADA) protocol, a standardized 5-point auricular approach, has been investigated for its potential stress-regulating effects in other clinical contexts but has not yet been systematically evaluated in perioperative breast cancer surgery. To the best of our knowledge, this is the first randomized controlled trial to evaluate whether NADA auricular acupressure, when added to standard preoperative care, reduces perioperative anxiety and pain in women with newly diagnosed breast cancer undergoing therapeutic surgery.