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Insights and Recommendations From Moderators and Community Members for Keeping Online Peer Support Safe: Thematic Analysis

Background: Online peer support can help people living with long-term physical health conditions to manage their mental well-being. Although the potential negative events that can occur and risks associated with web-based peer communities are well recognized, our understanding of how best to moderate these spaces is relatively limited, particularly with regard to new communities. Previous work has focused on the experiences of either moderators or community members. Objective: This study aims to explore the perspectives of both members and moderators of a new online peer support community to evaluate the moderation procedures and inform recommendations for best practice. Methods: Community members (n=39) who participated in a research trial of a new online peer community, CommonGround, were interviewed. The moderation team (n=5) was invited to a focus group. Community member interviews explored their opinions of moderation policies and the behavior of the moderation team. The moderator focus group explored their experiences of moderating the community, including perceived benefits, common challenges, and areas for improvement. All interviews and the focus group were conducted online, audio-recorded, and transcribed verbatim. An inductive thematic analysis was conducted to sort the data into overarching themes through an iterative process. Results: Effective moderation was considered critical in creating a safe space that members wanted to engage with and for mitigating any risks, particularly around the spread of medical misinformation. Both moderators and community members felt that the moderation policies and practices were appropriate and applicable to the community. Moderators found navigating the moderation threshold, where they balanced safety against free speech, challenging when determining whether to intervene or not. Being part of a team with mixed clinical expertise helped moderators build confidence in navigating this threshold and also presented other benefits of easy access to support and improving the consistency of their moderation practices. It was suggested that in order for a community to flourish, community members would self-moderate. However, moderators and members felt that the strong community culture and high levels of member engagement that are needed to support self-moderation had not yet evolved. Proposed improvements to moderation included new features to support the efficiency of identifying new content for review and reviewing the rule of anonymity. Conclusions: Moderation is critical in making online peer communities feel safe and engaging. Moderation practices should be co-produced with the target audience to ensure that they are aligned with the community’s unique moderation wants and needs, including clear escalation pathways, transparent communication patterns, and plans to review and update policies or procedures as the community evolves. There should be technological features that promote self-moderation, as the community may shift towards self-moderation as it matures. It is also critical to ensure that moderators feel supported so that they are best placed to support the broader community. Trial Registration: ClinicalTrials.gov NCT06222346; https://clinicaltrials.gov/study/NCT06222346
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A structure-based mRNA vaccine for Nipah virus in healthy adults: a phase 1 trial

Nature Medicine, Published online: 12 March 2026; doi:10.1038/s41591-026-04265-1

In this phase 1, open-label dose-escalation study in healthy adults found that the mRNA vaccine (mRNA-1215), encoding the Nipah virus Malaysian strain chimeric pre-fusion F protein linked to glycoprotein G, was safe and induced elevated immune responses at 1 year of follow-up, indicating that this is a promising vaccine candidate for further development.
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A clinical environment simulator for dynamic AI evaluation

Nature Medicine, Published online: 12 March 2026; doi:10.1038/s41591-026-04252-6

The authors propose a framework for clinical AI evaluation within simulated digital hospital environments that capture the evolving constraints, and cascading effects, of clinical decisions.
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A sorghum pangenome reference improves global crop trait discovery

Nature, Published online: 11 March 2026; doi:10.1038/s41586-026-10229-9

A pangenome reference for the phenotypically diverse crop sorghum aims to help accelerate future efforts to breed crops that are better adapted to changing environments.
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Immune evasive DNA donors and recombinases license kilobase-scale writing

Nature, Published online: 11 March 2026; doi:10.1038/s41586-026-10241-z

INSTALL overcomes fundamental challenges for DNA delivery and integration methods by synergizing immune-stealth nucleic acids with recombinases to enable kilobase-scale integration strategies without viral vectors.
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Natural maternal immunity protects neonates from <i>Escherichia coli</i> sepsis

Nature, Published online: 11 March 2026; doi:10.1038/s41586-026-10225-z

Neonatal sepsis caused by Escherichia coli is associated with reduced transfer of pathogen-specific maternal antibodies and, in a mouse model, can be prevented by maternal preconceptual colonization with probiotic E. coli.
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Ageing promotes metastasis via activation of the integrated stress response

Nature, Published online: 11 March 2026; doi:10.1038/s41586-026-10216-0

Ageing reprograms the evolutionary trajectory of KRAS-driven lung adenocarcinoma, limiting primary tumour growth while promoting metastatic dissemination through epigenetic activation of the integrated stress response, and a therapeutic opportunity in older patients is revealed.
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Impact of using artificial intelligence as a second reader in breast screening including arbitration

Nature Cancer, Published online: 10 March 2026; doi:10.1038/s43018-026-01128-z

Warren et al. used data from a retrospective cohort of 50,000 women attending breast screening. Arbitration between human and AI decisions was performed in a reader study following normal arbitration workflow. After arbitration, replacing the second human reader with AI in a double-read breast screening workflow was noninferior to two human readers.
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