JMIR Research Protocols最新文献

{"title":"Effectiveness and Safety of Tuina Therapy Combined With Yijinjing Exercise for Neck Pain: Protocol for a Systematic Review and Meta-Analysis.","authors":"Shichang Yang, Yuanming Zhong, Qipeng Yuan, Jinxu Wang, Guancheng Wang, Yan Long, Haoran Sun, Jie Si, Jinyu Li","doi":"10.2196/77864","DOIUrl":"10.2196/77864","url":null,"abstract":"<p><strong>Background: </strong>Neck pain with high incidence and recurrence rates significantly impairs patients' quality of life and imposes a considerable economic burden. Traditional Chinese medicine therapies such as Yijinjing exercise and Tuina have shown promising efficacy in alleviating the local symptoms of neck pain. However, there is currently insufficient high-level evidence to robustly support these findings.</p><p><strong>Objective: </strong>This study aims to evaluate the efficacy and safety of combining Yijinjing exercise with Tuina for the treatment of neck pain.</p><p><strong>Methods: </strong>PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Database, VIP Chinese Science and Technology Periodicals Full-Text database, and Wanfang database will be systematically searched for all relevant randomized controlled trials (RCTs) from their inception to September 2025, without language or publication status restrictions. The Cochrane Risk of Bias 2 assessment tool will be used to evaluate the risk of bias in the included studies, and the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) system will be employed to grade the quality of evidence. Heterogeneity will be evaluated through I<sup>2</sup> statistics and Cochran's Q test: a fixed-effect model will be used when I<sup>2</sup><50% and P≥.01. If I<sup>2</sup>≥50% or P<.01, subgroup analysis will be conducted. When heterogeneity still exists, sensitivity analysis or exploratory subgroup analysis will be performed. If it cannot be explained ultimately, the random-effects model will be adopted and the GRADE evidence level will be reduced.</p><p><strong>Results: </strong>As of June 2025, we have completed the preliminary screening of titles and abstracts for 573 studies. The full-text screening is expected to be completed by September 2025, and data analysis is planned to be completed by December 2025. About two-thirds of the studies were published after 2015. Geographically, the samples in the studies were highly concentrated in Asia. The results were comprehensively developed around the core outcomes. The primary outcome was presented by changes in the visual analog scale. The secondary outcomes were evaluated by the neck disability index, self-rating anxiety scale score, mean vertebral artery blood flow velocity, and Cobb angle.</p><p><strong>Conclusions: </strong>If the results of this study confirm the effectiveness of massage combined with Yijinjing, it can provide a direction for the nonpharmaceutical treatment of neck pain. However, some studies have risks of bias such as insufficient standardization of massage operations and difficulty in implementing blinding methods. The expected heterogeneity is significant due to differences in intervention plans and patients' cultural backgrounds, and the original RCTs are few and regionally concentrated, with limited extrapolation of conclusions. In the fut","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"14 ","pages":"e77864"},"PeriodicalIF":1.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collecting and Sharing Person-Centered AI Clinical Summaries Across Frailty Services Provided by the National Health Service and Voluntary, Community, and Social Enterprise: Protocol for a Co-Design and Feasibility Study.","authors":"Kieran Green, Sheena Asthana, Oscar Josue Ponce-Ponte, John Downey, Joanne Watson","doi":"10.2196/68511","DOIUrl":"10.2196/68511","url":null,"abstract":"<p><strong>Background: </strong>Due to its association with multimorbidity, frailty gives rise to multidimensional needs for different services. Too often, patient preferences and service encounter information are not adequately shared.</p><p><strong>Objective: </strong>This developmental study aims to co-design, collect, and analyze encounter data from multiple community and primary-based multidisciplinary teams (MDTs) providing services for people with frailty to develop prototype large language models that can generate clinical and person-centered care summaries.</p><p><strong>Methods: </strong>Engaging stakeholders in 2 primary care networks, we will co-design the large language model to ensure it meets local needs and preferences as well as infrastructure, information governance, and regulation requirements. General practitioners will identify 50 patients with frailty requiring MDT engagement. Three consecutive encounters between the patients and different members of MDTs will then be audio-recorded. Recordings will be transcribed into text for concept design and model pretraining. These data combine stakeholder engagement insights to develop sensitive artificial intelligence (AI) models responding to stakeholders' needs, workflows, and preferences. To generate the person-centered summaries, we will test 2 approaches to modeling the encounter data: graph-based modeling and hierarchical transformers. The AI-generated summaries will be compared to human-written summaries of the same encounter data and assessed for accuracy, quality, fluency, and person-centeredness. They will also be shared with the original MDT members for validation. We will capture inputs, processes, and outcomes across all key phases of the implementation journey to identify capability requirements, determinants of implementation (including key challenges and best practices to overcome them), and the value added by the technology.</p><p><strong>Results: </strong>This protocol aims to review implementation evidence and engage stakeholders in co-design. This work package will aid the development of contextually sensitive, longitudinal, and AI-generated person-centered summarization tools. Model development will aim to achieve longitudinal person-centered summaries tested against MDT standards. If deemed suitable for deployment, optimum ways of integrating these summaries into shared care records will be explored with local key system leaders. Model evaluations will provide conclusive insights into such technologies' benefits and risks. As of August 2025, this study has not yet been funded, nor has ethical approval for the project been obtained. Consequently, dates of data collection and numbers of recruited participants are not applicable at this time.</p><p><strong>Conclusions: </strong>Our protocol provides a robust method of co-designing, evaluating, and implementing a longitudinal AI medical summary tool. Including key stakeholders at multiple stages facilitates an itera","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"14 ","pages":"e68511"},"PeriodicalIF":1.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating and Optimizing Just-in-Time Adaptive Interventions in a Digital Mental Health Intervention (Wysa for Chronic Pain) for Middle-Aged and Older Adults With Chronic Pain: Protocol for a Series of Randomized Trials.","authors":"Abby L Cheng, Joanna Abraham, Sarah M Hartz, Eric B Laber, J Philip Miller","doi":"10.2196/77532","DOIUrl":"10.2196/77532","url":null,"abstract":"<p><strong>Background: </strong>On a population level, digital mental health interventions effectively reduce depression and anxiety symptoms. However, middle-aged and older adults with chronic pain and coexisting depression or anxiety have not been adequately represented in digital mental health studies.</p><p><strong>Objective: </strong>The goal of this study is to refine an existing mobile, digital mental health intervention (Wysa for Chronic Pain) that addresses symptoms of depression, anxiety, and coexisting chronic pain for the unique challenges and technology use patterns of middle-aged and older adults.</p><p><strong>Methods: </strong>Using a mixed methods, human-centered design approach and a series of randomized trials, we will test and iteratively refine just-in-time adaptive interventions (JITAIs) that are designed to increase engagement with a digital mental health intervention. Participants will be aged 45 years or older, endorse at least moderately severe depression or anxiety symptoms (Patient Health Questionnaire-9 or Generalized Anxiety Disorder-7 score ≥10), and have coexisting chronic pain (ie, pain on most days or every day in the past 3 months), and live in the United States. In this open, web-based trial, participants will all receive Wysa for Chronic Pain (by Wysa), which uses a behavioral activation framework and encourages users to work toward pain acceptance. The fully automated intervention also includes cognitive behavioral therapy, mindfulness, and sleep tools, among others. In each trial, participants will be randomized during a maximum 12-week study period to receive versus not receive novel JITAIs that are intended to reduce navigation burden and improve usability (and subsequent engagement and clinical effectiveness). The JITAIs are being designed with iterative user feedback, guided by the Discover, Design/Build, and Test framework and the Behavioral Intervention Technology model. The proximal outcome for each JITAI is related to engagement with Wysa for Chronic Pain after JITAI delivery (compared to when no JITAI is delivered). The primary distal clinical outcome is the Patient Health Questionnaire Anxiety and Depression Scale. Based on statistical analysis that is triangulated with qualitative feedback from a subsample of trial participants, the JITAIs will be iteratively refined and retested in subsequent microrandomized trials until retesting of refined adaptations no longer yields meaningful improvement in immediate engagement or a maximum of 5 total trials have been completed.</p><p><strong>Results: </strong>Institutional review board approval was obtained on April 11, 2025. The first participant was enrolled on June 2, 2025, and recruitment is expected to conclude in 2026.</p><p><strong>Conclusions: </strong>Completion of this project will result in iteratively refined JITAIs that are designed to improve usability and engagement with a digital mental health intervention by middle-aged and older adults wit","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"14 ","pages":"e77532"},"PeriodicalIF":1.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Artery Disease Prevalence in an Executive Population at a Tertiary Medical Center: Protocol for a Retrospective Cohort Study.","authors":"Murali Duggirala, Basant Katamesh, Ann Vincent, Ivana Croghan, Brian Dougan, Jayanth Adusumalli, Ryan Hurt, Sanjeev Nanda, Donna Lawson, Amirala Pasha","doi":"10.2196/72451","DOIUrl":"10.2196/72451","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) is a leading cause of global morbidity and mortality. Although CAD prevalence in the general population is well-documented, its occurrence among executive patients remains largely unexplored. An executive is an individual in a major leadership role, such as a C-suite officer, senior manager, board member, trustee, founder, or business owner, responsible for high-level decision-making and strategic direction. These roles often involve demanding schedules and significant stress. Despite their influence and better access to health care, this demographic faces unique challenges such as demanding work schedules, chronic stress, frequent travel, and reduced control over lifestyle. To address executives' unique health needs, many health care organizations offer specialized programs emphasizing preventive cardiovascular care, using advanced tools such as lipid panels, stress tests, and coronary calcium scans not typically included in primary care, to detect risks early and to promote long-term wellness.</p><p><strong>Objective: </strong>This protocol aims to design a study to determine the prevalence of CAD in executive patients and compare it to the established prevalence in the US general population with the overarching goal of improving screening and care of CAD among executive patients.</p><p><strong>Methods: </strong>This protocol proposes a retrospective review of medical records for patients with CAD seen at the Mayo Clinic's Executive Health Program from January 1, 2020, to December 31, 2023, with the aim of determining the prevalence of CAD in executive patients. The primary outcome is CAD prevalence, which will be identified through clinical diagnoses in the electronic medical records. Secondary outcomes include demographics, cardiovascular medications, social determinants of health, laboratory and diagnostic results, coronary calcium scores, and treatment interventions. The prevalence of CAD will be calculated as the proportion of patients with a documented CAD diagnosis relative to the total number of patients in the study cohort.</p><p><strong>Results: </strong>A total of 24,272 patients were seen in the executive health clinic between January 1, 2020, and December 31, 2023. After applying the inclusion criteria, 6466 executive patients were eligible, with 3290 identified as having a potential CAD diagnosis pending confirmation through a detailed chart review.</p><p><strong>Conclusions: </strong>In this protocol, we outline a research design and methodology to address a critical gap in understanding the prevalence of CAD among executive patients. This demographic is often overlooked despite their unique risk factors such as high stress and lifestyle choices.</p><p><strong>International registered report identifier (irrid): </strong>DERR1-10.2196/72451.</p>","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"14 ","pages":"e72451"},"PeriodicalIF":1.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing Public Health Vending Machines in Rural Communities: Protocol for a Study Using a Community-Based Participatory Approach.","authors":"Meghan Guter, Lauren Harrell, Kathleen L Egan, Reese Hiatt, Lori Ann Eldridge","doi":"10.2196/64913","DOIUrl":"10.2196/64913","url":null,"abstract":"<p><strong>Background: </strong>Drug-related overdoses impact communities all over the United States. In the past 2 decades, over 28,000 people have died of a drug overdose in North Carolina (NC). Research has shown that there has been an increase in overdose deaths throughout NC, particularly in rural areas. To reduce overdose rates, health care interventions should be expanded. Naloxone distribution is one intervention to combat overdose rates. Naloxone is a medication designed to reverse an opioid overdose rapidly. Public health vending machines (PHVMs) are a strategy recently implemented in some US communities to expand access to harm reduction supplies. Examples of locations where PHVMs have been installed include public health departments, libraries, county detention centers, and law enforcement offices.</p><p><strong>Objective: </strong>This protocol aims to develop a community-engaged approach to implementing PHVMs as a health care delivery option for harm reduction supplies in 5 rural counties in NC.</p><p><strong>Methods: </strong>This study will use a community-based participatory approach in which we partnered with the NC Harm Reduction Coalition and Community Impact NC to engage with substance use prevention providers and community members in 5 rural counties in NC to improve naloxone access. We will collect qualitative interview data from people with lived experience of substance use to identify the optimal placement of PHVMs and items to be stocked in PHVMs. To do this, we will hire 1 local community member with lived experience of substance use from each county to be an interviewer who will recruit, conduct interviews, and collect data from other community members with lived experience of substance use. Interviewers will be trained to recruit participants, conduct interviews, and collect and analyze data. Developing a protocol for training interviewers includes an interview training presentation with an adapted collaborative institutional training initiative portion.</p><p><strong>Results: </strong>Data will be collected from 2024 to 2025. The findings will inform the implementation of PHVMs to improve harm reduction access and assist in decreasing overdose deaths.</p><p><strong>Conclusions: </strong>This study will use in a community-based participatory approach to improve naloxone access in rural communities. Community partners will assist the academic team in developing a sustainability plan for each county and an implementation toolkit for other communities to use.</p><p><strong>International registered report identifier (irrid): </strong>PRR1-10.2196/64913.</p>","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"14 ","pages":"e64913"},"PeriodicalIF":1.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Digital Solutions to Improve Access to Comprehensive Primary Health Care Services in Remote Indigenous Communities: Protocol for a Participatory Action Research Project.","authors":"Vishnu Khanal, Emily Saurman, Deborah J Russell, Nicki Newton, Karina Coombes, Alexandar Puruntatameri, Sarah Norris, Amy von Huben, Tamsin Cockyane, Paul Burgess, John Wakerman, Timothy Shaw","doi":"10.2196/68892","DOIUrl":"10.2196/68892","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Aboriginal and Torres Strait Islander (Indigenous) peoples living in remote Australia experience a heavy burden of ill health and multiple barriers to accessing health care. Digital health technologies (DHTs) have the potential to help overcome some of these challenges and increase access to comprehensive primary health care (CPHC), thereby improving equity of health outcomes. However, little is known about the community and provider preferences for the use of digital technologies for improving health and wellness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The study aims to co-design, implement, and evaluate how DHTs can improve access to CPHC in remote Indigenous communities in the Northern Territory (NT), Australia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This multiphased project will take a participatory action research approach to co-design and optimize digital health solutions with local community members and health service staff in 2 communities. Our mixed methods approach will include pre- and postimplementation focus group discussions, interviews, quantitative analysis of CPHC utilization administrative data, and surveys administered by Indigenous community-based researchers to understand the use of digital devices and connectivity, eHealth literacy, preferences for different attributes of DHTs using best-worst scaling, and consumer satisfaction and experiences with DHT interventions. Priority DHTs will be selected for implementation based on consumer and health staff preferences. Focus group discussions and interview data will explore community and health service staff preferences, experiences, and satisfaction with implemented DHTs. A realist approach will be taken to identify how DHT interventions work, for whom, and in what circumstances, so that the understanding of why some interventions work while others do not is expanded. Economic analyses will be conducted to calculate the incremental costs and benefits of implemented DHT interventions. The scalability of digital health solutions will be tested in two additional communities. Project partners include key funding, service, and support agencies in the NT and nationally.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;As of November 2024, we have selected two implementation sites. Digital health initiatives are underway at the implementation sites, and evaluation activities are progressing. The initial findings from these sites have informed our scalability assessment in an additional two sites.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Knowledge translation is integral to the study design, which involves partnering with consumers, CPHC service providers, and a range of key stakeholders to inform health service providers and policy makers about which DHTs work for which groups of consumers, and under what circumstances, to improve access to CPHC. This unique study will accommodate consumer and provider preferences regarding the use of DHTs to improve CPHC access and address the lack of kn","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"14 ","pages":"e68892"},"PeriodicalIF":1.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Associated Risk Factors of Self-Harm Among Health Care Workers: Protocol for Systematic Review and Meta-Analysis.","authors":"Nor Asiah Muhamad, Nur Hasnah Maamor, 'Izzah 'Athirah Rosli, Tengku Puteri Nadiah Tengku Baharudin Shah, Nurul Hidayah Jamalluddin, Fatin Norhasny Leman, Nik Athirah Farhana Nik Azhan, Shiao Ling Ling, Norliza Chemi, Suria Hussin, Fariza Yahya, Norli Abdul Jabbar, Nurashikin Ibrahim","doi":"10.2196/67059","DOIUrl":"10.2196/67059","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Self-harm is a major public health concern, with prevalence increasing worldwide, particularly after the COVID-19 pandemic and associated lockdown restrictions. Health care workers (HCWs) face various challenges, such as pressures of social and familial responsibilities, a lack of integration within the profession, heavier workload, bullying at the workplace, and limited support in the workplace, that impact their mental health and often lead to self-harm.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aim to synthesize the evidence on the pooled prevalence of self-harm worldwide and identify risk factors for self-harm among HCWs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We will conduct a systematic review of observational and experimental studies that investigated the overall prevalence of self-harm among HCWs. We will search the PubMed, PsycINFO, Embase, and CINAHL databases for eligible articles from inception until March 2025 using specific search terms developed using the population, exposure, comparison, and outcome framework. Study selection and reporting will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and the Meta-Analysis of Observational Studies in Epidemiology guidelines. We will contact the corresponding author via email if the required data are not available in the article. After completing the article search, duplicate records will be removed. Titles and abstracts will then be screened according to the inclusion and exclusion criteria, followed by retrieval of the full texts for detailed screening. All the required data for the review, such as names of authors, publication year, prevalence of self-harm, type of profession, associated risk factors to self-harm, and others, will be extracted using a standardized data extraction form. The quality of the studies will be assessed using the Joanna Briggs Institute guidelines based on the study design. Random-effects meta-analysis will be used to derive the pooled prevalence using Stata (version 17.0) software. We will conduct a subgroup meta-analysis on sex, regions, and the type of profession (physicians or nurses). We will also examine the association of risk factors of self-harm with sociodemographic factors to observe their relationship. Both analyses will be performed using RevMan software. Publication bias will be examined using the funnel plot and Egger test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Data analysis is expected to be completed by August 2025, and manuscript preparation is expected to be completed by October 2025. This review is expected to be completed and published by January 2026.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;We will provide a comprehensive synthesis of the overall prevalence of self-harm among HCWs. We will also provide important information to develop effective strategies for preventing and managing self-harm among HCWs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;PROSPERO CRD42024581791; https://www.crd.york.a","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"14 ","pages":"e67059"},"PeriodicalIF":1.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Synchronous Telerehabilitation Versus Face-to-Face Physical Therapy in Older Adults Who Are Frail: Protocol for a Randomized Controlled Trial.","authors":"Igor Cigarroa, Daniel Reyes-Molina, Felipe Vargas-Rios, Gustavo López-Alarcón, Sergio Jara-Aceituno, Cristobal Riquelme-Hernández, Rafael Zapata-Lamana, María Antonia Parra-Rizo","doi":"10.2196/72318","DOIUrl":"10.2196/72318","url":null,"abstract":"<p><strong>Background: </strong>Older adults who are frail face significant barriers to physical activity, and innovative solutions such as synchronous telerehabilitation (STR) may provide a viable alternative to traditional face-to-face programs. However, less is known about its effectiveness compared to a face-to-face program.</p><p><strong>Objective: </strong>This study aims to compare the effectiveness of an STR program versus a face-to-face physical therapy (FPT) program in the primary outcomes (lower body strength and cardiorespiratory fitness) and secondary outcomes (upper limb strength, dynamic balance, static balance, number of steps, functional status, and quality of life) in older adults who are frail.</p><p><strong>Methods: </strong>In a randomized, blinded, parallel-group controlled trial, all older adults who are frail and aged ≥60 years of both sexes from the Los Angeles Comprehensive Center for Older Adults will be invited to participate. A total of 58 older adults who are frail (aged ≥60 years) meeting the eligibility criteria will be randomly assigned to either an STR group (n=29, 50%) or an FPT group (n=29, 50%). Participants will engage in 1-hour multicomponent exercise sessions twice weekly for 12 weeks. The telerehabilitation group will participate via videoconferencing, supervised remotely by technical staff, while the face-to-face group will attend in-person sessions. Outcomes will include lower limb strength (sit-to-stand test), cardiorespiratory fitness (2-minute step test), upper limb strength (grip strength test), balance (Timed Up and Go, and single-leg stance), quality of life (36-item brief health survey), functional status (functional independence measure), and daily steps (pedometer).</p><p><strong>Results: </strong>Recruitment will be conducted from April to May 2025. The intervention will run from June to August 2025, follow-up assessments will be completed by September 2025, and data analysis will be finalized by December 2025. Manuscript drafting and submission are planned for March 2026. We hypothesize that STR will yield equal or superior improvements in both primary and secondary outcomes compared to FPT in older adults who are frail.</p><p><strong>Conclusions: </strong>STR is emerging as a viable and effective alternative to in-person physical therapy for older adults with frailty. This approach has the potential to improve physical condition and functional and quality of life indicators, overcoming geographical and logistical barriers and optimizing therapeutic resources.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT06784245; https://clinicaltrials.gov/study/NCT06784245.</p><p><strong>International registered report identifier (irrid): </strong>PRR1-10.2196/72318.</p>","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"14 ","pages":"e72318"},"PeriodicalIF":1.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12485262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Hair Trace Element Content and Children's Growth and Development: Protocol for a Cross-Sectional Surveillance Study.","authors":"Gulnara Batyrova, Gulmira Umarova, Yeskendir Umarov, Gulaim Taskozhina, Victoria Kononets, Rabbil Batyrov","doi":"10.2196/72207","DOIUrl":"10.2196/72207","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Western Kazakhstan, a major industrial region, faces environmental challenges from the release of toxic elements due to intensive industrial activities. The combined impact of anthropogenic factors, trace element deficiencies, and harsh climatic conditions contributes to the deterioration of child health and growth.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to investigate the elemental profile of the child population in the western region of Kazakhstan.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 2279 school-aged children (aged 5 to 18 years) who are permanent residents of the Aktobe, Mangystau, Atyrau, and West Kazakhstan regions will be included in the study using a cluster sampling method. The elemental composition of their hair will be analyzed using inductively coupled plasma mass spectrometry on an Agilent 8900 inductively coupled plasma mass spectrometer (Agilent Technologies). Children's physical growth will be assessed according to the World Health Organization (2007) growth standards and characterized using the following z score values: body weight for age for children aged younger than 10 years, height for age, and BMI for age. The cutoff points of z score values make it possible to diagnose thinness, stunting, overweight, or obesity. Multiple linear regression analysis will be applied to assess the association between chemical element content in hair and z score measures of children's physical growth, as well as associations with gender, age, sociodemographic factors, and residential status. Reference values for chemical element content in biological substrates of the western Kazakhstan population will be established using 95% coverage intervals with 95% CIs following International Union of Pure and Applied Chemistry recommendations. The chemical element content will be reflected in a web-based atlas.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After recruitment of participants, data will be collected between September 2023 and March 2025. Data processing and analysis will be completed in September 2025. Publication of the results is expected in December 2025. An analysis will be conducted to determine the differences in the levels of elements in groups of boys and girls, urban and rural children, and groups of children of different ages. According to the results of multiple regression analysis, chemical elements influencing the indicators of the physical development of children will be identified.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The identified associations between trace and macroelement content and children's growth indicators will allow for the development of region-specific public health measures, such as nutritional supplements, environmental remediation, and policies aimed at reducing exposure to toxic elements. In addition, identifying differences between rural and urban populations could inform the development of targeted prevention strategies. The developed web-based atlas of trace and macroelem","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"14 ","pages":"e72207"},"PeriodicalIF":1.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12485260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a Web-Based Executive Function Training Program to Induce Healthier Food Choices and Increase Valuation of Fruits and Vegetables in Adults: Protocol for a Randomized Controlled Trial.","authors":"James N Roemmich, Alese M Nelson, Eric Stice, Julie M Hess, Daniel G Palmer, Shanon L Casperson","doi":"10.2196/66394","DOIUrl":"10.2196/66394","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Executive function (EF) is a set of explicit (top-down) cognitive abilities theorized to assist in conscious control of eating behavior. However, it is unclear whether EF training can improve valuation and consumption of nutrient-dense foods while concurrently altering attitudes toward and perceptions of nutrient-poor foods and their consumption.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The primary objective is to determine the efficacy of a web-based EF training program designed to concurrently improve attitudes toward and perceptions and consumption of nutrient-dense foods (fruits and vegetables) while worsening those of nutrient-poor foods (ie, candy and fried snacks).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Participants include a nationally representative US sample (N=500) of men and women aged 18 to 70 years with a BMI between 18.5 and 38 kg/m&lt;sup&gt;2&lt;/sup&gt;. Potential participants are recruited through an open link to a prescreening questionnaire. Qualified participants are sent an electronic version of the informed consent form to sign. After consenting, they are invited to create an account on our semiautomated web-based platform and randomized to EF training via a suite of 4 web-based games that promote responding to fruits and vegetables, inhibit responses to nutrient-poor foods, and train attention toward the former and away from the latter or sham training that involves images of flowers and songbirds (control). Training occurs at least twice per week. EF is tested before and after 8 weeks of training. Dietary intake is measured before and after the 8-week intervention. Group and sex differences in frequency of participants violating inhibitory signals will be assessed using log-linear models. Linear mixed-effects models will test whether web-based EF training improves EF as measured via response inhibition and attention during computer-based gameplay. The independent and interactive associations between inhibitory and attentional learning and consumption of nutrient-poor foods will be tested using mixed model regression. If random assignment results in baseline imbalances across conditions on any variables, they will be used as covariates in the mixed models. We will use both an intention-to-treat analysis using (restricted) maximum likelihood estimation and a completer analysis to understand the results from those participants who completed the training at least twice per week.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;As of June 1, 2025, overall, 899 individuals have applied to participate in the study. Of 899 applicants, 763 (84.9%) qualified and 630 (70.1%) consented. There have been 386 withdrawals due to noncompliance with study requirements (n=342, 88.6%) or identification as a bot (n=35, 9.1%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The association between improved EF and healthy eating behaviors may be key to improving diet quality. If effective, this web-based EF training program will provide a platform that can be made wi","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"14 ","pages":"e66394"},"PeriodicalIF":1.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12485253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}