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Wave transmission reciprocity is broken by exploiting the synchronization of two coupled self-oscillators. The underlying principle is that illumination from one port drives the in phase, while illumination from the other port drives the antiphase synchronization state. Because of its self-adjustment the system is operationally stable. An experimental demonstration with aeroacoustic cavities is presented. They behave as weakly nonlinear limit cycles when driven by a constant airflow, leading to self-oscillations that can couple to the surrounding waveguides via two ports. Incident waves from one port trigger antiphase synchronization, causing destructive interference and low transmission, while waves from the opposite port induce in-phase synchronization, resulting in high transmission. This directional dependence effectively breaks reciprocity, where the operational bandwidth is defined by the synchronization region and can be broader than resonance-based methods. Experimental results show robust nonreciprocal behavior with respect to parameter changes. Moreover, a modified temporal coupled mode theory is proposed, explaining the system's nonlinear dynamics and scattering properties in a quantitative manner. This synchronization-based approach offers a new avenue for directional wave control, complementing traditional reciprocity breaking techniques and offering an intrinsic loss compensation emanating from the self-oscillation of meta-atoms.

Hemosuccus pancreaticus is an uncommon but potentially life-threatening cause of upper gastrointestinal bleeding. We report the case of a 47-year-old man with a history of alcohol use disorder and alcohol use disorder and a previous episode of alcohol-induced acute pancreatitis who presented with melena, severe microcytic anemia, and recurrent epigastric pain. Upper endoscopy demonstrated blood emerging from the major papilla alternating with bile, raising suspicion for hemosuccus pancreaticus. Contrast-enhanced computed tomography revealed a large pseudoaneurysm of the pancreatoduodenal artery within the pancreatic head, likely secondary to chronic inflammatory changes. The patient underwent successful endovascular coil embolization, resulting in complete cessation of bleeding and an uneventful recovery. This case highlights the role of upper endoscopy in early recognition of hemosuccus pancreaticus and underscores the effectiveness of endovascular therapy in managing pseudoaneurysm-related hemorrhage. O hemosuccus pancreaticus é uma causa rara, mas potencialmente fatal, de hemorragia digestiva alta. Apresenta-se o caso de um homem de 47 anos, com antecedentes de perturbação do uso de álcool e um episódio de pancreatite aguda induzida por álcool, que recorreu ao serviço de urgência por melenas, dor epigástrica recorrente e anemia microcítica grave. A endoscopia digestiva alta evidenciou saída intermitente de sangue pela papila major, alternando com saída de bílis, achado sugestivo de hemosuccus pancreaticus. A tomografia computorizada revelou um pseudoaneurisma da artéria pancreatoduodenal, localizado na cabeça do pâncreas, provavelmente secundário a alterações inflamatórias crónicas. O doente foi submetido com sucesso a embolização endovascular com coils, não se tendo verificado recidiva hemorrágica nem outras complicações. Este caso destaca o papel da endoscopia alta no reconhecimento precoce do hemosuccus pancreaticus, bem como a eficácia da abordagem endovascular no seu tratamento.

Aging is the primary risk factor for most chronic diseases and is accompanied by the progressive accumulation of senescent cells within tissues. While cellular senescence initially serves as a protective mechanism that limits the proliferation of damaged cells, its persistent presence contributes to tissue dysfunction through the secretion of a broad spectrum of inflammatory and profibrotic mediators. The resulting chronic low-grade inflammation, oxidative stress, immune dysregulation, and impaired regenerative capacity are increasingly recognized as hallmarks of age-related pathology. Chronic pulmonary diseases, including chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis, increase markedly with age and are increasingly regarded as manifestations of accelerated lung aging. Their development and progression are further exacerbated by obesity and type 2 diabetes mellitus, two highly prevalent metabolic disorders characterized by chronic metabolic stress, mitochondrial dysfunction, systemic inflammation, and enhanced accumulation of senescent cells. Emerging evidence suggests that cellular senescence represents a common biological denominator linking metabolic and pulmonary disease. Through persistent inflammatory and profibrotic signaling, senescent cells establish a self-perpetuating cycle of chronic inflammation, extracellular matrix remodeling, fibrosis, endothelial dysfunction, and impaired tissue repair, thereby driving progressive deterioration of both metabolic and pulmonary function. The recognition of cellular senescence as one of the important drivers of both chronic pulmonary and metabolic diseases has stimulated growing interest in therapeutic strategies aimed at reducing senescent-cell burden or attenuating its detrimental effects. Current approaches include both novel senotherapies specifically targeting cellular senescence, as well as established therapies used in metabolic diseases that have recently been shown to exert senescence-modulating effects. Although clinical evidence remains limited, targeting cellular senescence offers a unique opportunity to address the underlying biology of aging rather than individual disease manifestations. This review highlights the emerging role of cellular senescence as a mechanistic link between chronic pulmonary diseases and metabolic disorders and discusses its potential as a therapeutic target.

Polymers that combine exceptional stretchability with high mechanical robustness are essential for advanced applications. To ensure their reliability, it is critical to integrate damage tolerance, which suppresses crack propagation and prevents catastrophic failure under extreme deformation. However, overcoming the intrinsic trade-off between stretchability and strength remains a formidable challenge in polymer science, particularly when damage tolerance is also required. Here, we show the scalable fabrication of super-stretchable polymers exhibiting exceptional mechanical robustness and remarkable damage tolerance, achieved by cross-linking soft polymer chains through synergistic urea-based hydrogen bonding and hydrophobic interactions. These polymers exhibit record-high elongations up to ∼100,000 times their original length while maintaining an extensional true stress of 35.0 MPa at a strain of 33.6, and an extraordinary fracture energy exceeding 374.8 kJ m-2. The extreme stretchability of these polymers arises from the successive breakage, chain slippage, and reformation of noncovalent cross-links. Meanwhile, mechanical robustness and pronounced strain hardening are sustained by a strain-induced transition of urea hydrogen bonds from double to quadruple configurations, together with the progressive orientation of polymer chains. These reversibly cross-linked polymers, featuring intrinsic self-healing and reprocessability, open broad opportunities for extremely deformable polymer materials where robustness, reliability, and sustainability are paramount.

Nuclear magnetic resonance (NMR) spectroscopy serves as a fundamental analytical technique finding valuable applications across chemistry, biology, and materials science, yet its widespread utility is frequently constrained by its inherently low sensitivity and concomitant noise, making noise reduction a critical processing step. Existing denoising methods typically impose a difficult trade-off, namely, traditional iterative algorithms are interpretable and widely adoptable but time-consuming, while deep learning approaches achieve fast denoising and better performance at the cost of generalizability and interpretability. To break this dilemma, we propose a denoising protocol, namely CCA-NMR, to unlock clean signals in noisy NMR spectra. This protocol exploits the idea of blind source separation to separate noise and real signals based on autocorrelation coefficients, delivering good noise reduction, fast computational time, and decent universality. Owing to these advantages, it enables reliable sensitivity benefits and recovers genuine peaks obscured by noise, thus reducing the necessary experimental acquisition times and facilitating subsequent quantitative analysis. Its performance is evidenced through experimental validation across a diverse range of NMR platforms, including relaxation and diffusion Laplace NMR, multidimensional protein NMR, and time-resolved NMR during real-time electrocatalytic reactions. As a consequence, these findings substantially expand the practical applicability of NMR spectroscopy, and indicate its considerable potential for broad chemical and biomedical applications.

Altermagnets are symmetry-defined magnetic phases that combine momentum-dependent spin splitting with zero net magnetization, offering promising opportunities for spintronics. However, their realization is strongly constrained by rigorous symmetry requirements. Exploiting the shared antiparallel magnetic order and vanishing net magnetization between antiferromagnets and altermagnets, we propose a general chemically driven strategy based on asymmetric ligand modification to transform pristine two-dimensional antiferromagnetic metal-organic frameworks into altermagnetic candidates. Using chromium phthalocyanine (CrPc) as a proof-of-concept model, we show that asymmetric modification lowers the local site symmetry at magnetic Cr centers and generates momentum-dependent spin splitting and anisotropic spin densities, as revealed by first-principles calculations. Oxygen-modified CrPc derivatives further illustrate the chemical tunability of this symmetry-control principle. Our work expands the design space of organic altermagnetic candidates and establishes a chemically grounded route for engineering symmetry-governed magnetic functionality in reticular materials.

LGBTQ+ people experience bias, stigma, and discrimination during interactions with healthcare providers. Highly-scripted systems limit how people share critical information about themselves, their values, and their goals of care. Practicing person-centered communication and narrative-eliciting skills, instead of imposing scripts, opens safer spaces for patients and caregivers to assert their truths.

Cancer pain affects 60%-80% of patients with advanced cancer, and approximately 30% of patients experience inadequate pain control. Although the World Health Organization (WHO) three-step analgesic ladder has substantially improved pain management, inadequate analgesia, opioid-related adverse effects, and refractory pain continue to pose significant clinical challenges. This narrative review critically evaluates recent advances in cancer pain management, including novel analgesics, optimized opioid formulations, nanomedicine, invasive interventions (intrathecal drug delivery, neuromodulation, and neurolysis), and complementary integrative therapies, aiming to provide up-to-date insights for clinicians and researchers. Novel analgesics targeting μ-opioid receptor bias, ion channels, and multitarget strategies have shown preclinical promise. Improved opioid formulations and nanomedicine-based approaches may enhance drug delivery and reduce toxicity. Fourth-step interventions, including intrathecal drug delivery, neuromodulation, and neurolysis, provide targeted options for selected patients with refractory cancer pain. Integrative therapies, including mind-body interventions, acupuncture, massage, music therapy, and game-based approaches, may improve symptom burden and quality of life, although evidence for direct analgesic effects remains limited. Cancer pain management is evolving toward a multimodal and increasingly personalized framework. Despite substantial progress, many emerging therapies lack robust cancer-specific validation. High-quality clinical trials, standardized treatment protocols, and improved translational strategies are needed to establish evidence-based precision cancer pain management.

Gaming disorder (GD) and learning burnout (LB) are critical issues impacting adolescents, with GD recognized by the World Health Organization as a behavioral addiction and LB contributing to academic disengagement. While prior research has examined bivariate relationships, such as GD's negative correlation with academic performance and physical education performance, or LB's association with poor grades, no study has integrated all four variables into one model to explore their dynamic interactions longitudinally. A cross-lagged panel network (CLPN) model was applied to longitudinal data from 811 Chinese middle school students collected at two time points. GD and LB showed minimal direct effects on academic performance or physical education performance. Instead, academic performance and physical education performance acted as protective factors, significantly alleviating LB, particularly among boys. These two protective factors were mutually reinforcing. Cognitive exhaustion (a core component of LB) and GD functioned as reciprocal risk factors. Interventions for adolescent maladjustment should prioritize addressing learning burnout through academic and physical avenues rather than overemphasizing gaming disorder, with tailored strategies for different genders.

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