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Heart failure affects millions worldwide with limited treatment options. Here, the authors develop a biodegradable, self-powered vagus nerve stimulator that attenuates cardiac damage at different disease stages without requiring battery replacement or surgical removal.

MedHELM, an extensible evaluation framework including a new taxonomy for classifying medical tasks and a benchmark of many datasets across these categories, enables the evaluation of large language models on real-world clinical tasks.

Extreme heat events are increasing due to climate change, which may reduce insect abundance. This study suggests that insect pests can buffer the impacts of heat waves via fine-scale behavioural thermoregulation, markedly promoting pest population growth and aggravating crop yield losses globally.

Replacing animal feathers and wool with synthetic materials can ameliorate the ethical and environmental issues associated with the production of clothing designed to retain warmth. Here the authors present synthetic nanofibre textiles that combine wearability, comfort, lightness and thermal insulation.

Deposition–dissolution reactions are key to the function of rechargeable batteries, but the limited reversibility of plating/stripping shortens their lifespan. Now, a liquid crystal interphase is shown to control deposition in preferred orientations, enabling dual-electrode-free batteries with enhanced reversibility and increased energy density.

The development of three-dimensional (3D) covalent organic frameworks (COFs) with novel topologies is of both fundamental and practical interest but the construction of highly crystalline 3D COF remains challenging. Here, the authors report highly crystalline 3D COFs with pto and mhq-z topologies by rationally selecting rectangular-planar and trigonal-planar building blocks with appropriate conformational strains.

Catalytic methods to introduce fluorine into the backbone of small-ring heterocycles are challenging due to the problems of strain-induced ring cleavage and defluorination. Now, a copper catalyst mediates insertion of an in situ-generated difluorocarbene into oxygen heterocycles, affording ring-expanded fluorinated pharmacophores. Experimental and computational studies provide insights into the mechanism.

Structurally diverse natural products are a promising source of antibiotics. Here, the authors report the collective asymmetric total synthesis of polycyclic xanthene myrtucommulone D and five related congeners and discover a compound active against both drug-sensitive and drug-resistant Staphylococcus aureus.

Though single-material organic solar cells are attractive for next-generation photovoltaic technologies, designing new materials with ideal properties remains a challenge. Here, the authors report the use of orientation-dependent molecular electrostatics to realise efficient homojunction devices.

Lithium cobalt oxide is widely studied for electrocatalytic applications. Here, the authors develop a technique for delithiating the material in organic electrolyte, and demonstrate that the oxygen evolution catalytic activity is significantly improved after the treatment.

The practical performance of lithium–sulphur batteries is lower than expected because of polysulphide dissolution into the electrolyte over time. Sehet al. show that a yolk–shell nanoarchitecture is able to encapsulate sulphur cathode materials efficiently and thus allows over 1,000 charge/discharge cycles.

Sequencing the genome and microbiome of about 1,500 tick samples from regions across China revealed host–microbe associations in ticks that could have implications for controlling ticks and tick-borne diseases.

Authors perform an in vivo mass spectrometry-based interactome analysis of HOIL-1-interacting protein, a key component of linear ubiquitination assembly complex.

Soil pollution by heavy metals is a problem of global concern, requiring the development of remediation technologies. Here the authors report a method based on asymmetrical alternating current electrochemistry, which enables recycling of soil washing chemicals and eliminates secondary pollution.

As immune checkpoint therapy is more frequently used for cancer, side effects such as Stevens-Johson syndrome / toxic epidermal necrolysis (SJS/TEN) are becoming more common. Here the authors use single cell transcriptomics to implicate TNF and CXCL10 in recruitment of CXCR3⁺ cytotoxic T cell in SJS/TEN skin lesions.

Microcombs are vulnerable to the environmental perturbations. Here, the authors propose a universal mechanism to fully control the microcombs. Based this reconfigurable microsoliton, a wavemeter with a precision of kHz is demonstrated.

In the IMpower151 trial, the drug combination previously shown to be effective in the IMpower150 trial was not significantly effective in a Chinese population.

Through multimodal analyses of human cardiac tissues across different ages, Fan, Zheng, Zhan, Xu, Liu and colleagues reveal that RNA-binding protein ARID5A drives inflammaging by stabilizing the MAVS mRNA and activating the NF-κB–TBK1 pathway, and show that inactivating myocardial ARID5A attenuates cardiac senescence and functional decline.

The unique structure and mechanism of chanoclavine synthase (EasC), a haem catalase that uses superoxide for substrate transformation in ergot alkaloid biosynthesis, are revealed in this study, challenging established catalase mechanisms.

Experimental evidence for charge coupling to ferroelectric soft mode is scarce. Here, the authors find a photogenerated coherent phonon coupling to the electronic transition above the bandgap in the van der Waals ferroelectric semiconductor NbOI2.

Fluorinated amides are prevalent structural motifs in pharmaceuticals and bioactive molecules, but their enantioselective synthesis is challenging. Here, the authors synthesize fluorinated amide compounds with distal chirality (γ to F) using ene-reductases and blue light irradiation.

Diarrhoea is a major cause of morbidity and mortality in China. Here, the authors present results from a large sentinel surveillance scheme from 217 hospitals in all 31 provinces in mainland China, including ~150,000 patients with acute diarrhoea and covering years 2009-2018.

China operates a national surveillance program for acute respiratory infections and sampled over 200,000 patients between 2009–2019. Here, the authors present results from this program and describe patterns by age, pathogen type, presence of pneumonia, and season.

A cross-sectional study of hospitalized patients with COVID-19 and a longitudinal follow-up study of patients with COVID-19 suggest that SARS-CoV2-specific IgG or IgM seroconversion occurs within 20 days post symptom onset.

Methods to stratify patients according to mortality risk are essential to allocate limited heath resources during the COVID-19 crisis. Here, using machine learning methods, the authors present a mortality risk prediction model for COVID-19 that uses patients’ clinical data on admission to stratify patients by mortality risk.

Ge, Zhou, Fu et al. find caspase-2 accumulates in biomolecular condensates with ubiquitin and proteasomal components and functions as a deubiquitinase following stress. Caspase-2-deficient mice accumulate poly-ubiquitinated TDP-43 and show motor defects.

Achieving fairness while preserving privacy in medical imaging tasks remains a significant challenge. Here, the authors present and comprehensively evaluate a federated learning framework to tackle both fairness and privacy issues, using a flexible regularization term to integrate multiple fairness criteria.

The precise control of interlayer stacking mode of 2D materials is a long-standing pursuit. Here, the authors report two 2D copper-organic frameworks that can undergo the reversible interlayer sliding through environmental stimulation.

Hypoxic tumor microenvironment (TME) limits the therapeutic efficacy of anticancer drugs. Here this group reports a ruthenium-based nanocatalyst alleviating hypoxic TME, activating protein transient receptor potential melastatin 2 ion channel, promoting systemic immune response thereby eliciting its therapeutic efficacy against osteosarcoma.

DNA polymerase ζ (Pol ζ) maintains continuity but impairs accuracy during DNA replication. Here, the authors report a mechanism by which human cells precisely control the essential, yet mutagenic, activity of Pol ζ to ensure both continuation and fidelity during DNA replication challenges.

ATF3, a stress mediator, regulates the activities of key cancer-associated proteins by altering their interactions with DNA or other proteins. Here, the authors report that ATF3 also regulates Tip60, a protein acetyltransferase, by promoting its enzymatic activity and increasing its protein stability.

Endovascular thrombectomy (EVT) achieves high recanalization rates in acute stroke, but many patients still experience poor outcomes. Here, the authors show that intravenous edaravone dexborneol (ED) is safe and reduces early hemorrhage but does not significantly improve 90-day functional outcomes in stroke patients after EVT.

Using data-driven disease-progression modelling, Jiang, Wang, Zhou et al. characterized and replicated two distinct ‘trajectories’ of brain atrophy in patients with schizophrenia.

Developing robotic hands that can adapt to real-world dynamics remains a substantial challenge. The authors present an AI system that mimics human-like grasping using full-hand tactile sensing and a sensory–motor feedback mechanism.

Chromosome-level triploid genome assembly of parthenogenetic H. longicornis reveals autopolyploid origin, key embryogenesis genes, and pathogen tolerance in its global expansion context.

The Duf4243 dioxygenases GedK and BTG13 are known to catalyze the aromatic cleavage of bulky tricyclic hydroquinone. Here, the authors discover a distinct Duf4243 dioxygenase PaD that favors small monocyclic hydroquinones from the penicillic-acid biosynthetic pathway and determine the structural basis for its changed substrate specificity.

Sox2 regulates pluripotency in neural progenitor cells (NPC) but how protein stability affects this is unclear. Here, the authors identify changes in ubiquitylation of Sox2 (by CUL4A-DET1-COP1 ligase and OTUD7B deubiquitylase) as controlling protein stability and so the differentiation state of NPCs.

The authors report an inorganic tellurium-selenium-oxygen (TeSeO) alloyed semiconductor for high-mobility p-channel transistors and broadband photodetectors, through the scalable thermal evaporation method combined with post-oxygen implantation.

Here the authors use cryo-electron microscopy to provide insights into fatty acid recycling by an acyl-acyl carrier protein (ACP) synthesizing enzyme, showing a transition from a hexameric to tetrameric form in the process of acyl-ACP production.