Background: Online health forums are used widely, yet evidence of their effectiveness is inconsistent. Evidence-based forum design guidance grounded in theory and lived experience could improve the efficacy and outcomes of these forums for the many people using them worldwide. Objective: This study aimed to draw on the experience of online forum users and staff, and insights from existing research on technology design and self-determination theory, to generate a set of theoretically grounded guidelines for safe and well-being–supportive online forums. Methods: We conducted 54 semistructured interviews (36 forum users and 18 forum staff) and 4 design workshops with forum staff, combined with input from a multidisciplinary research team. Principles of qualitative framework analysis were used to adapt a preexisting framework for well-being–supportive technology to the context of online health forums. Results: The resulting design guidelines are framed around 4 overarching principles relating to the psychological needs for autonomy, competence, and relatedness as defined by self-determination theory, and the additional need for safety in online forums. Each principle is presented alongside pragmatic design heuristics and specific implementation strategies. Conclusions: User experiences of online health forums are mixed. We have drawn on self-determination theory to propose evidence-informed guidelines for service development and refinement, adaptable to specific user groups across diverse settings. International Registered Report Identifier (IRRID): RR2-https://doi.org/10.1136/bmjopen-2023-075142

Background: Accurate measurements of children’s digital technology use are essential for understanding its potential implications on health and well-being. Wearable cameras can provide such measurements, but image coding is a high burden for researchers. Machine learning–based object-recognition models have the potential to reduce this burden by identifying images containing technology. Objective: This study aims to evaluate the performance of an object recognition model, the Square Eyes model, as a screening tool for identifying technologies in wearable camera images among children for further human review, as well as to examine the potential influence of face-blurring methods on the model’s performance. Methods: This study used data collected on 48 children (aged 3‐14 y) during an approximately 1-hour laboratory session. The children performed various technology-related tasks while wearing a camera. A total of 221,226 images were coded by humans and processed through the Square Eyes model. The performance of the Square Eyes model as a screening tool was evaluated by (1) assessing agreement between the model and human coding; (2) evaluating the N-back algorithm, an algorithm embedded in the model aimed to flag images requiring human review; and (3) examining the potential influence of facial-blurring on model performance. Results: Humans detected technology in 92,745 (41.9%) images, and the Square Eyes model detected technologies with an overall accuracy of 78.0%. When considering specific technologies, agreement between the model and human coders was the highest for (n=19,148, 54.3%) and (n=8492, 44.5%) and lowest for smaller devices such as (n=2600, 31.3%) and (n=3685, 25.1%). The model’s N-back algorithm effectively flagged images that required further human review, with only 7144 (3.2%) images that were not flagged for screening containing a human-coded technology. An explorative analysis indicated that using a square face-blurring with border could have reduced the model’s ability to accurately detect technologies. Conclusions: The Square Eyes model demonstrated overall satisfying accuracy in detecting technologies and successfully flagged images that required further review by humans. These findings suggest that the model could be used as an effective screening tool for reducing the burden of human coding. However, the model could be improved to more accurately detect smaller devices, and the form of facial blurring in images should be considered.

Background: Chinese men who have sex with men living with HIV (MSMLWH) experience substantial psychological distress driven by minority stress and HIV-related challenges. However, culturally tailored digital mental health interventions that address HIV-specific maladaptive cognitive schemas and culturally specific psychosocial stressors remain scarce in China. Objective: This study aimed to systematically adapt an evidence-based cognitive behavioral therapy (CBT) intervention Effective Skills to Empower Effective Men (ESTEEM) into a WeChat (Tencent) Mini-Program–based intervention (iESTEEM) specifically for Chinese MSMLWH and to evaluate its preliminary feasibility and usability. Methods: We used a three-phase user-centered design approach guided by the Assessment, Decision, Adaptation, Production, Topical Experts, Integration, Training, and Testing (ADAPT-ITT) framework. The study proceeded in three phases: (1) a qualitative needs assessment using semistructured interviews with 20 MSMLWH (mean age 23.25, SD 3.08 years); (2) systematic intervention adaptation and platform development, including theater testing (n=5); and (3) a 2-week pilot study involving 10 MSMLWH and five counselors to evaluate feasibility, usability, and acceptability through focus groups and objective platform analytics. Results: Phase 1 identified 3 major themes of psychological distress: persistent health anxiety fueled by catastrophizing, intersectional stigma internalization, the disclosure dilemma, and intimacy barriers rooted in defectiveness and shame schemas. Participants also prioritized anonymity and bite-sized learning. Guided by these findings, iESTEEM was developed as a counselor-assisted, privacy-preserving WeChat Mini-Program incorporating HIV-specific scenarios, multimodal learning modules, and a back-end risk-alert system. During the 2-week pilot, participants logged into the platform 14.1 (SD 6.7) times per person and completed 134.3 (SD 103.1) minutes of learning activities; all participants accessed module 1, and 90% (9/10) accessed modules 2‐5. Anxiety scores decreased from 8.9 (SD 2.3) to 7.2 (SD 3.0), whereas depression scores remained stable. All participants expressed a willingness to continue using the program and to recommend it to peers. Participants and counselors endorsed its contextual relevance, privacy protections, and clinical utility. Conclusions: This study provides a theory- and evidence-informed model for culturally adapting digital mental health interventions for highly stigmatized populations. By integrating lesbian, gay, bisexual, transgender, and queer (LGBTQ)-affirmative CBT principles, HIV-specific adaptations, and a privacy-preserving, counselor-assisted WeChat Mini-Program, iESTEEM demonstrated promising preliminary feasibility, acceptability, and engagement among Chinese MSMLWH. These findings support the potential of culturally tailored digital interventions to expand access to psychological support for this stigmatized population in resource-constrained settings. Ongoing randomized controlled trials will further evaluate its efficacy, implementation outcomes, and mechanism of action. Trial Registration: Chinese Clinical Trial Registry ChiCTR2400080263; https://www.chictr.org.cn/showproj.html?proj=216926

Nature, Published online: 14 September 2026; doi:10.1038/s41586-026-11124-z

Encoded and non-genetic protein variants expand human functional proteome

Nature, Published online: 14 September 2026; doi:10.1038/d41586-026-02847-0

Fresh evidence reveals that the interplay of several factors could affect the ability of these trees to grow.

Nature, Published online: 14 September 2026; doi:10.1038/d41586-026-02852-3

Patchy legislation means that animals are routinely taken from their natural habitats and sold in other countries. Fresh national and international measures could help to stop this exploitation.

Nature, Published online: 14 September 2026; doi:10.1038/d41586-026-02829-2

Philanthropists are stepping up support for research in a country where scientists have relied on the government alone for funding.

Nature Biotechnology, Published online: 14 September 2026; doi:10.1038/s41587-026-03308-9

Modified nanopore simultaneously identifies diverse biomolecules and their modifications.

npj Digital Medicine, Published online: 14 September 2026; doi:10.1038/s41746-026-03196-y

BenchECG and xECG: a benchmark and baseline for ECG foundation models

npj Digital Medicine, Published online: 14 September 2026; doi:10.1038/s41746-026-03246-5

A scoping review of artificial intelligence-enabled wearables for medication adherence

npj Digital Medicine, Published online: 14 September 2026; doi:10.1038/s41746-026-03225-w

Data-driven identification of repurposable drugs for ALS

npj Digital Medicine, Published online: 14 September 2026; doi:10.1038/s41746-026-03204-1

Training and validation of a 12-lead ECG-based deep-learning model for myocardial infarction subtypes

npj Digital Medicine, Published online: 14 September 2026; doi:10.1038/s41746-026-03214-z

While clinical trials are the gold standard for determining causative side effects from treatment, some trials are too logistically or ethically challenging to complete. Many side effects of treatments are learned from retrospective analyses; however, these can be confounded by other random variables. Causal and explainable machine learning tools are promising for teasing apart confounders from real treatment side effects in observational data.

npj Digital Medicine, Published online: 14 September 2026; doi:10.1038/s41746-026-03239-4

Prospective validation of machine learning models predicting Gram negative bacteremia in ICU versus clinical scores

npj Digital Medicine, Published online: 14 September 2026; doi:10.1038/s41746-026-03187-z

Multi-Agent collaboration as a complementary architecture for AI-generated medical examination items

Nature Medicine, Published online: 14 September 2026; doi:10.1038/s41591-026-04622-0

In this Comment, we argue for a global health system that recognizes and supports countries as the primary agents of action, oriented around global public goods and collective action, and served by a leaner set of global and regional institutions. We present a potential vision for the functions and distribution of labor in the system to inform ongoing reform discussions and draw critique, dissent and amendment.

Nature Medicine, Published online: 14 September 2026; doi:10.1038/s41591-026-04639-5

Trust in clinical artificial intelligence (AI) cannot be benchmarked into existence. It must be earned through rigorous prospective studies in real-world clinical settings, where the hardest lessons often concern the humans and systems around the AI, not the technology itself.

Cell Death Discovery, Published online: 14 September 2026; doi:10.1038/s41420-026-03328-z

HAT1 regulates glioblastoma cell proliferation and membrane lipid remodeling through ALDH2

Cell Death Discovery, Published online: 14 September 2026; doi:10.1038/s41420-026-03333-2

Hepatic Usp2 orchestrates de novo lipogenesis through G3bp2 stabilization and β-catenin activation

Oncogene, Published online: 12 September 2026; doi:10.1038/s41388-026-03985-5

Development and preclinical evaluation of a decoy DLL4-encoding oncolytic HSV-1 for high-grade glioma