JMIR Research Protocols

Menopausal syndrome (MPS) results from declining ovarian function and estrogen fluctuations during the menopausal transition, typically presenting with vasomotor, psychological, and metabolic symptoms that impair quality of life. Current treatments, including hormone replacement therapy and nonhormonal medications, are limited by safety concerns and adverse effects. The Liuwei Dihuang (LWDH) pill, a classical traditional Chinese medicine formula, is widely used for kidney-yin deficiency and menopausal symptoms such as hot flashes, insomnia, depression, and anxiety. Preliminary studies suggest favorable efficacy and safety; however, robust real-world evidence, particularly in combination with conventional Western therapy, remains insufficient.

Malnutrition is a prevalent and serious concern in adult survivors of stroke, often worsening their clinical status and leading to a poor prognosis. However, the effectiveness of nutritional interventions in this population remains uncertain. Furthermore, the impact of nutritional support on functional recovery, especially in relation to rehabilitation outcomes, has not been sufficiently investigated.

Older adults represent the fastest-growing group of medical marijuana (MM) users in the United States, with chronic pain being the most common reason for use. Despite this trend, scientific evidence remains limited regarding the short- and long-term effects of MM on critical health outcomes, including cognitive function, physical and mental health, and overall quality of life, in this population. To better inform clinical practice and public policy, there is a clear need for more rigorous longitudinal studies that examine the impact of real-world MM products over time.

Young adults face rising wellness challenges, including prediabetes risk, requiring sustained engagement with preventive health interventions. Digital wellness applications offer promise for promoting healthy lifestyle behaviors, yet high dropout rates and inadequate personalization limit their effectiveness. This paper outlines the technical implementation and formative usability evaluation of MiCARE, a theory-driven progressive web application (PWA) designed to support sustained wellness engagement among young adults through user-centered design.

Frailty is a progressive, dynamic clinical syndrome characterized by reduced physiological reserves and increased vulnerability to stressors, leading to adverse outcomes in older adults. Despite its clinical significance, routine detection of frailty remains challenging owing to subtle presentations and time constraints during assessments. Longitudinal studies are essential for capturing its biological trajectory and identifying early biomarkers.

About 2.4% of Kenyan people (approximately 1.3 million people) are living with HIV. Despite advances in antiretroviral therapy, men continue to experience disproportionately poor engagement in HIV care due to entrenched masculine norms, stigma, and lack of tailored interventions. Mobile health (mHealth) platforms offer a promising strategy to improve care engagement, but evidence on its implementation and impact among men living with HIV is limited.

Long COVID (postacute sequelae of SARS-CoV-2 infection) is a heterogeneous condition with persistent multisystem symptoms and substantial functional burden. Integrative longitudinal studies combining clinical phenotyping, lifestyle factors, and immunobiological markers are needed to clarify determinants of symptom persistence and inform risk stratification and targeted interventions.

The promise of artificial intelligence (AI) in medicine depends on its ability to learn from data that reflect what matters to patients and clinicians in the care process. Most existing models are trained on electronic health records (EHRs), which primarily capture biological measures but rarely the interactions and relationships between patients and clinicians. These relationships, central to how care is understood, negotiated, and delivered, unfold across multiple modalities, including voice, text, and video, yet remain largely absent from current datasets. As a result, AI systems trained solely on EHRs risk perpetuating a narrow biomedical view of medicine and overlooking the lived exchanges that define clinical encounters.

Effective collaborative practice among health care professionals is crucial for addressing intimate partner violence (IPV) during pregnancy. Therefore, the development and evaluation of an evidence-based intervention for health care professionals is required to work toward meeting the key priorities of the National Plan to End Violence Against Women and Children 2022‐2032. The consistency, modality, and effectiveness of IPV-focused education vary, and some midwives lack the confidence to respond effectively to disclosures, often due to limited knowledge, education, and skills. This issue is further amplified in interdisciplinary settings, where a lack of cohesiveness and collaboration can negatively impact the experience for pregnant women seeking or needing support.

Piriformis syndrome is a neuromuscular condition with hip and buttock pain and other symptoms, including referred pain towards the lower back and leg and radiating towards the foot’s medial aspect. Similarly, low back pain caused by piriformis syndrome is undetected or difficult to diagnose because of similar symptoms of lumbar disc herniation, lumbar stenosis, or radiculopathy, as well as neurogenic pain. A study conducted in 2013 found 2910 patients experienced low back pain with sciatica, which is the most common cause of low back pain, because of piriformis muscle stiffness. The prevalence of low back pain in piriformis syndrome is 5%‐36%. It is more commonly seen in women than men.

Established treatments for granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) include the use of immunosuppressive agents for remission induction followed by maintenance therapy. However, patients continue to experience disease progression, organ damage, and adverse events related to current therapies. Avacopan, an oral selective C5a receptor antagonist, was approved by the European Commission in January 2022 for the treatment of adult patients with severe, active GPA or MPA in combination with rituximab (RTX) or cyclophosphamide (CYC). In the pivotal phase 3 ADVOCATE (Avacopan Development in Vasculitis to Obtain Corticosteroid Elimination and Therapeutic Efficacy) study, avacopan was noninferior to prednisone taper in achieving remission at week 26 and superior in sustaining remission at week 52; furthermore, a greater improvement in estimated glomerular filtration rate with avacopan was also observed at week 52. The AvacoStar study will generate data on the benefit and risk and safety profile of avacopan in patients in a real-world context, including in those where treatment may potentially continue beyond 1 year.

The early onset of myopia in children has become a critical public health issue that requires urgent attention. Notably, high myopia-related retinal diseases have emerged as the leading cause of irreversible blindness in adults in certain regions of China. Physiological hyperopia, as a protective factor and one of the strongest predictors of myopia development, plays a key role in delaying the progression of early-onset myopia and reducing the risk of high myopia in adulthood. However, the dynamic changes, critical turning points, and factors contributing to the rapid regression of physiological hyperopia during childhood remain unclear.