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Peroxiredoxin 6 (Prdx6) repairs peroxidized membranes by reducing oxidized phospholipids, and by replacing oxidized sn-2 fatty acyl groups through hydrolysis/reacylation by its phospholipase A2 (aiPLA2) and lysophosphatidylcholine acyltransferase activities. Prdx6 is highly expressed in the lung, and intact lungs and cells null for Prdx6 or with single-point mutations that inactivate either Prdx6-peroxidase or aiPLA2 activity alone exhibit decreased viability, increased lipid peroxidation, and incomplete repair when exposed to paraquat, hyperoxia, or organic peroxides. Ferroptosis is form of cell death driven by the accumulation of phospholipid hydroperoxides. We studied the role of Prdx6 as a ferroptosis suppressor in the lung. We first compared the expression Prdx6 and glutathione peroxidase 4 (GPx4) and visualized Prdx6 and GPx4 within the lung. Lung Prdx6 mRNA levels were five times higher than GPx4 levels. Both Prdx6 and GPx4 localized to epithelial and endothelial cells. Prdx6 knockout or knockdown sensitized lung endothelial cells to erastin-induced ferroptosis. Cells with genetic inactivation of either aiPLA2 or Prdx6-peroxidase were more sensitive to ferroptosis than WT cells, but less sensitive than KO cells. We then conducted RNA-seq analyses in Prdx6-depleted cells to further explore how the loss of Prdx6 sensitizes lung endothelial cells to ferroptosis. Prdx6 KD upregulated transcriptional signatures associated with selenoamino acid metabolism and mitochondrial function. Accordingly, Prdx6 deficiency blunted mitochondrial function and increased GPx4 abundance whereas GPx4 KD had the opposite effect on Prdx6. Moreover, we detected Prdx6 and GPx4 interactions in intact cells, suggesting that both enzymes cooperate to suppress lipid peroxidation. Notably, Prdx6-depleted cells remained sensitive to erastin-induced ferroptosis despite the compensatory increase in GPx4. These results show that Prdx6 suppresses ferroptosis in lung endothelial cells and that both aiPLA2 and Prdx6-peroxidase contribute to this effect. These results also show that Prdx6 supports mitochondrial function and modulates several coordinated cytoprotective pathways in the pulmonary endothelium.

Experimental studies of the dynamics of shear flow and turbulence spreading at the edge of tokamak plasmas are reported. Scans of line-averaged density and plasma current are carried out while approaching the Greenwald density limit on the J-TEXT tokamak. In all scans, when the Greenwald fraction f G = n ¯ / n G = n ¯ / ( I p / π a 2 ) increases, a common feature of enhanced turbulence spreading and edge cooling is found. The result suggests that turbulence spreading is a good indicator of edge cooling, indeed better than turbulent particle transport is. The normalized turbulence spreading power increases significantly when the normalized E × B shearing rate decreases. This indicates that turbulence spreading becomes prominent when the shearing rate is weaker than the turbulence scattering rate. The asymmetry between positive/negative (blobs/holes) spreading events, turbulence spreading power and shear flow are discussed. These results elucidate the important effects of interaction between shear flow and turbulence spreading on plasma edge cooling.

Welcome to the 25th anniversary edition of PLEXUS, UC Irvine School of Medicine’s annual student-organized Journal of Medical Humanities & Arts. To mark this celebratory milestone, it is with great pleasure that I present to you NAVIGATE. In the ever-evolving landscape of medicine, the ability to navigate through challenges and unforeseen obstacles is paramount. NAVIGATE serves as a timely invitation for our colleagues to reflect on the distances traversed and to envision the new horizons that lie ahead. We sought to highlight the constellation of tools utilized when we feel lost and to acknowledge the beacons that steer our actions. The subsequent pages offer its readers profoundinsights into the extraordinary journeys undertaken by the greater UCI Health community. We hope it delivers a sense of direction, solace, and clarity to all readers.As we celebrate our 25th anniversary, wehonor the visionaries, contributors, and readers that have propelled us forward on this remarkable voyage. Their collective support fuels our efforts to serve as a creative outlet for the community, catalyze meaningful discussions, and apply the tenets of medical humanities to foster a cohort of compassionate healers.We extend our deepest gratitude to our faculty advisors Dr. Juliet McMullin and Dr. TanNguyen for their invaluable guidance and for sharing their expertise within the field. We thank the UCISOM Medical Humanities & Arts Program and the UCI Department of Family Medicine for their unwavering support. I invite you to embark on this exploration with us, and witness the intricate tapestry of our contributors’ lived experiences that defines our shared journey in healthcare.Bon voyage,Christopher SahagianEditor-in-ChiefCreative Review — Caroline GeeCreative Review — Huan NguyenCreative Review — Sana ShahDesign — Nicole ParkerDesign — Britney WengFaculty Advisor — Dr. Juliet McMullinFaculty Advisor — Dr. Tan NguyenStaff Advisor — Leonora Naser-Saravia{Front Cover): NEW HEIGHTS Britney Weng, MS1San Pedro de Atacama, Chile(Inner Cover): TRAVERSING  Britney Weng, MS1Chile Route 23

The COVID-19 pandemic underscored the promise of monoclonal antibody-based prophylactic and therapeutic drugs1-3 and revealed how quickly viral escape can curtail effective options4,5. When the SARS-CoV-2 Omicron variant emerged in 2021, many antibody drug products lost potency, including Evusheld and its constituent, cilgavimab4-6. Cilgavimab, like its progenitor COV2-2130, is a class 3 antibody that is compatible with other antibodies in combination4 and is challenging to replace with existing approaches. Rapidly modifying such high-value antibodies to restore efficacy against emerging variants is a compelling mitigation strategy. We sought to redesign and renew the efficacy of COV2-2130 against Omicron BA.1 and BA.1.1 strains while maintaining efficacy against the dominant Delta variant. Here we show that our computationally redesigned antibody, 2130-1-0114-112, achieves this objective, simultaneously increases neutralization potency against Delta and subsequent variants of concern, and provides protection in vivo against the strains tested: WA1/2020, BA.1.1 and BA.5. Deep mutational scanning of tens of thousands of pseudovirus variants reveals that 2130-1-0114-112 improves broad potency without increasing escape liabilities. Our results suggest that computational approaches can optimize an antibody to target multiple escape variants, while simultaneously enriching potency. Our computational approach does not require experimental iterations or pre-existing binding data, thus enabling rapid response strategies to address escape variants or lessen escape vulnerabilities.

Even though the most prevalent category of disability served in the U.S. school system is specific learning disabilities (SLD), practitioners are often unfamiliar with the indicators associated with a specific LD such as dysgraphia and dyslexia. Misconceptions or an absence of understanding of the behavioral indicators related to dysgraphia and dyslexia puts children at risk for poor academic or social success due to a lack of intervention or late or missed diagnosis. Practitioners can utilize the Dysgraphia and Dyslexia Behavioral Indicator Checklist to identify these indicators in students' writing samples, design appropriate instructional intervention(s), and refer them for proper assessment.

Abstract: The self-organization is one of the most interesting phenomena in the non-equilibrium complex system, generating ordered structures of different sizes and durations. In tokamak plasmas, various self-organized phenomena have been reported, and two of them, coexisting in the near-marginal (interaction dominant) regime, are avalanches and the E × B staircase. Avalanches mean the ballistic flux propagation event through successive interactions as it propagates, and the E × B staircase means a globally ordered pattern of self-organized zonal flow layers. Various models have been suggested to understand their characteristics and relation, but experimental researches have been mostly limited to the demonstration of their existence. Here we report detailed analyses of their dynamics and statistics and explain their relation. Avalanches influence the formation and the width distribution of the E × B staircase, while the E × B staircase confines avalanches within its mesoscopic width until dissipated or penetrated. Our perspective to consider them the self-organization phenomena enhances our fundamental understanding of them as well as links our findings with the self-organization of mesoscopic structures in various complex systems.

Abstract: We report on comprehensive experimental studies of turbulence spreading in edge plasmas. These studies demonstrate the relation of turbulence spreading and entrainment to intermittent convective density fluctuation events or bursts (i.e. blobs and holes). The non-diffusive character of turbulence spreading is thus elucidated. The turbulence spreading velocity (or mean jet velocity) manifests a linear correlation with the skewness of density fluctuations, and increases with the auto-correlation time of density fluctuations. Turbulence spreading by positive density fluctuations is outward, while spreading by negative density fluctuations is inward. The degree of symmetry breaking between outward propagating blobs and inward propagating holes increases with the amplitude of density fluctuations. Thus, blob-hole asymmetry emerges as crucial to turbulence spreading. These results highlight the important role of intermittent convective events in conveying the spreading of turbulence, and constitute a fundamental challenge to existing diffusive models of spreading.

Work shows that sexually-diverse individuals face high rates of early life adversity and in turn increased engagement in behavioral outcomes traditionally associated with adversity, such as sexual risk taking. Recent theoretical work suggests that these associations may be attributable to heightened sexual reward sensitivity among adversity-exposed women. We aimed to test these claims using a combination of self-report and EEG measures to test the relationship between early adversity, sexual reward sensitivity (both self-reported and EEG measured) and sexual risk taking in a sexually diverse sample of cis-gender women (N = 208) (Mage = 27.17, SD = 6.36). Results showed that childhood SES predicted self-reported sexual reward sensitivity which in turn predicted numbers of male and female sexual partners. In contrast we found that perceived childhood unpredictability predicted neurobiological sexual reward sensitivity as measured by EEG which in turn predicted male sexual partner number. The results presented here provide support for the notion that heightened sexual reward sensitivity may be a pathway through which early life adversity augments future sexual behavior, and underscores the importance of including greater attention to the dynamics of pleasure and reward in sexual health promotion.

Ecological and evolutionary theories have proposed that species traits should be important in mediating species responses to contemporary climate change; yet, empirical evidence has so far provided mixed evidence for the role of behavioral, life history, or ecological characteristics in facilitating or hindering species range shifts. As such, the utility of trait-based approaches to predict species redistribution under climate change has been called into question. We develop the perspective, supported by evidence, that trait variation, if used carefully can have high potential utility, but that past analyses have in many cases failed to identify an explanatory value for traits by not fully embracing the complexity of species range shifts. First, we discuss the relevant theory linking species traits to range shift processes at the leading (expansion) and trailing (contraction) edges of species distributions and highlight the need to clarify the mechanistic basis of trait-based approaches. Second, we provide a brief overview of range shift-trait studies and identify new opportunities for trait integration that consider range-specific processes and intraspecific variability. Third, we explore the circumstances under which environmental and biotic context dependencies are likely to affect our ability to identify the contribution of species traits to range shift processes. Finally, we propose that revealing the role of traits in shaping species redistribution may likely require accounting for methodological variation arising from the range shift estimation process as well as addressing existing functional, geographical, and phylogenetic biases. We provide a series of considerations for more effectively integrating traits as well as extrinsic and methodological factors into species redistribution research. Together, these analytical approaches promise stronger mechanistic and predictive understanding that can help society mitigate and adapt to the effects of climate change on biodiversity.

IntroductionIn South Asia, younger women have high rates of unmet need for family planning and low empowerment. Life skills interventions can equip young women with agency, but the effectiveness of these interventions in reproductive and sexual autonomy and contraception has not been examined.Methods and analysisA two-arm, parallel, cluster randomised controlled trial will evaluate the impact of TARANG (Transforming Actions for Reaching and Nurturing Gender Equity and Empowerment), a life skills and reproductive health empowerment group-based intervention for newly married women, compared with usual services in the community in rural and tribal Rajasthan, India. TARANG will also provide light-touch sessions to husbands and mothers-in-law of newly married women. We will test the impact of TARANG in 80 village clusters among 800 eligible households comprising newly married women aged 18-25 years who are at risk of pregnancy but do not want a pregnancy within 1 year at the time of enrolment, their husbands and mothers-in-law who consent to participate. Women in the intervention villages will receive 14 sessions over a 6-month period, while husbands and mothers-in-law will receive 1 and 4 sessions (respectively) each. Three rounds of surveys will be collected over 18 months. Control villages will receive the intervention after the endline surveys. Primary outcomes include rate of unintended pregnancy and modern contraceptive use. We plan to start recruitment of participants and data collection in April 2024. We will estimate unadjusted and adjusted intention-to-treat effects using survival analysis and mixed models.Ethics and disseminationStudy protocols have been reviewed and approved by the human subjects review boards at the University of California, San Francisco, and the Centre for Media Studies, India (IRB00006230) and ACE Independent Ethics Committee, Bangalore (NET0062022). Results will be disseminated in international peer-reviewed journals and conferences, to stakeholders including local government and non-governmental organisations, and directly to the communities and individuals that participated in the intervention.Trial registration numberNCT06024616.

Abstract: In this work, we propose a reduced model with a dynamical critical gradient to study the formation, propagation, and conversion of the transport barriers. In contrast to the commonly adopted static critical gradient, an evolving critical gradient self-consistently softens the profile stiffness, so as to facilitate the generation of transport barriers. This is especially crucial to the internal transport barrier (ITB) formation. Numerically, we show that the inhomogeneity of turbulent and neoclassical diffusivities can induce the global wave front propagation of the transport barrier. When the heating power ramps quickly, the ITB propagates unidirectionally to the edge region and converts into an edge transport barrier. For slow power ramping, the propagating ITB will bifurcate into bidirectional wavefronts and finally convert into a steady double transport barrier state. Our model uncovers the vital role of a dynamical ‘profile-stiffness’ in depicting the global dynamics of the transport barrier.

Marine cloud brightening (MCB) is the deliberate injection of aerosol particles into shallow marine clouds to increase their reflection of solar radiation and reduce the amount of energy absorbed by the climate system. From the physical science perspective, the consensus of a broad international group of scientists is that the viability of MCB will ultimately depend on whether observations and models can robustly assess the scale-up of local-to-global brightening in todays climate and identify strategies that will ensure an equitable geographical distribution of the benefits and risks associated with projected regional changes in temperature and precipitation. To address the physical science knowledge gaps required to assess the societal implications of MCB, we propose a substantial and targeted program of research-field and laboratory experiments, monitoring, and numerical modeling across a range of scales.

Abstract: Viable magnetic fusion devices necessitate combining good confinement with effective power flux handling. A major concern for ITER, and devices beyond, is the divertor heat load width, which sets peak boundary heat loads on the plasma-facing materials. Current estimates of the heat flux width are narrow for future reactors. Here, we demonstrate how pedestal turbulence can expand into, or entrain, the stable scrape-off-layer and so broaden the heat flux width beyond these neoclassical predictions. Employing combined theoretical, computational, and experimental approaches, we focus on quiescent high confinement discharges on the DIII-D tokamak, but the results are of broader significance. Our findings uncover common trends in the edge turbulence intensity flux, the pressure perturbation skewness, and the turbulence mixing length, which together determine the heat flux width. This research demonstrates the physics of scrape-off-layer broadening by turbulence and highlights the promise of a turbulent pedestal for successful core-edge integration in ITER and future fusion devices.

The concept and theory of potential vorticity in drift wave turbulence are extended to the case of an inhomogeneous magnetic field. A one-field magnetic potential vorticity conserving equation is derived via the use of conservative gyrokinetics. The similarity between the corresponding systems for drift wave turbulence and shallow water theory is discussed in detail. Zonal flow physics in an inhomogeneous magnetic field is discussed. In particular, a Charney–Drazin type nonacceleration theorem is derived from the novel system, which conserves magnetic potential vorticity. Extensions of the turbulent equipartition theory to the transport of magnetic potential vorticity are proposed.

Hydra has a tubular bilayered epithelial body column with a dome-shaped head on one end and a foot on the other. Hydra lacks a permanent mouth: its head epithelium is sealed. Upon neuronal activation, a mouth opens at the apex of the head which can exceed the body column diameter in seconds, allowing Hydra to ingest prey larger than itself. While the kinematics of mouth opening are well characterized, the underlying mechanism is unknown. We show that Hydra mouth opening is generated by independent local contractions that require tissue-level coordination. We model the head epithelium as an active viscoelastic nonlinear spring network. The model reproduces the size, timescale and symmetry of mouth opening. It shows that radial contractions, travelling inwards from the outer boundary of the head, pull the mouth open. Nonlinear elasticity makes mouth opening larger and faster, contrary to expectations. The model correctly predicts changes in mouth shape in response to external forces. By generating innervated : nerve-free chimera in experiments and simulations, we show that nearest-neighbour mechanical signalling suffices to coordinate mouth opening. Hydra mouth opening shows that in the absence of long-range chemical or neuronal signals, short-range mechanical coupling is sufficient to produce long-range order in tissue deformations.

BACKGROUND: Leveraging the Accelerating Medicines Partnership (AMP) Lupus Nephritis (LN) dataset, we evaluated longitudinal patterns, rates, and predictors of response to standard-of-care therapy in patients with lupus nephritis. METHODS: Patients from US academic medical centers with class III, IV, and/or V LN and a baseline urine protein/creatinine (UPCR) ratio ≥ 1.0 (n = 180) were eligible for this analysis. Complete response (CR) required the following: (1) UPCR  50% reduction in UPCR; (2) normal serum creatinine or, if abnormal, ≤ 125% of baseline; and (3) prednisone dose ≤ 15 mg/day. RESULTS: Response rates to the standard of care at week 52 were CR = 22.2%; PR = 21.7%; non-responder (NR) = 41.7%, and not determined (ND) = 14.4%. Only 8/180 (4.4%) patients had a week 12 CR sustained through week 52. Eighteen (10%) patients attained a week 12 PR or CR and sustained their responses through week 52 and 47 (26.1%) patients achieved sustained PR or CR at weeks 26 and 52. Week 52 CR or PR attainment was associated with baseline UPCR > 3 (ORadj = 3.71 [95%CI = 1.34-10.24]; p = 0.012), > 25% decrease in UPCR from baseline to week 12 (ORadj = 2.61 [95%CI = 1.07-6.41]; p = 0.036), lower chronicity index (ORadj = 1.33 per unit decrease [95%CI = 1.10-1.62]; p = 0.003), and positive anti-dsDNA antibody (ORadj = 2.61 [95%CI = 0.93-7.33]; p = 0.069). CONCLUSIONS: CR and PR rates at week 52 were consistent with the standard-of-care response rates observed in prospective registrational LN trials. Low sustained response rates underscore the need for more efficacious therapies and highlight how critically important it is to understand the molecular pathways associated with response and non-response.

BACKGROUND: The combination of monalizumab (anti-NKG2A/CD94) and durvalumab (anti-programmed death ligand-1) may promote antitumor immunity by targeting innate and adaptive immunity. This phase 1/2 study of monalizumab and durvalumab evaluated safety, antitumor activity, and pharmacodynamics in patients with advanced solid tumors. MAIN BODY: Immunotherapy-naïve patients aged ≥18 years with advanced disease, Eastern Cooperative Oncology Group performance status of 0-1, and 1-3 prior lines of systemic therapy in the recurrent/metastatic setting were enrolled. In part 1 (dose escalation), patients received durvalumab 1500 mg every 4 weeks (Q4W) with increasing doses of monalizumab Q2W/Q4W (n=15). Dose expansion in part 1 included patients with cervical cancer (n=15; durvalumab 1500 mg Q4W and monalizumab 750 mg Q2W) or metastatic microsatellite stable (MSS)-colorectal cancer (CRC) (n=15; durvalumab 1500 mg Q4W and monalizumab 750 mg Q4W). In part 2 (dose expansion), patients with MSS-CRC (n=40), non-small cell lung cancer (NSCLC; n=20), MSS-endometrial cancer (n=40), or ovarian cancer (n=40) received durvalumab 1500 mg Q4W and monalizumab 750 mg Q2W. The primary endpoint was safety. Secondary endpoints included antitumor activity per Response Evaluation Criteria In Solid Tumors version 1.1 (RECIST v1.1). Exploratory analyses included assessment of T-cell and natural killer (NK) cell activation and proliferation in peripheral blood and the tumor microenvironment (TME). The study enrolled 185 patients (part 1, 45; part 2, 140). No dose-limiting toxicities were observed and the maximum tolerated dose was not reached. In part 2, the most common treatment-related adverse events were fatigue (12.1%), asthenia (9.3%), diarrhea (9.3%), pruritus (7.9%), and pyrexia (7.1%). In the expansion cohorts, response rates were 0% (cervical), 7.7% (MSS-CRC), 10% (NSCLC), 5.4% (ovarian), and 0% (MSS-endometrial). Sustained NK cell activation, CD8+ T-cell proliferation, increased serum levels of CXCL10 (C-X-C motif chemokine ligand 10) and CXCL11, and increased tumor infiltration of CD8+ and granzyme B+ cells were observed. CONCLUSIONS: Although efficacy was modest, monalizumab plus durvalumab was well tolerated and encouraging immune activation was observed in the peripheral blood and TME. TRIAL REGISTRATION NUMBER: NCT02671435.

BOUT++ turbulence simulations were performed to investigate the impact of turbulence spreading on the edge localized mode (ELM) size and divertor heat flux width $({\lambda _q})$ broadening in small ELM regimes. This study is motivated by EAST experiments. BOUT++ linear simulations of a pedestal radial electric field (Er) scan show that the dominant toroidal number mode (n) shifts from high-n to low-n, with a narrow mode spectrum, and the maximum linear growth rate increases as the pedestal Er well deepens. The nonlinear simulations show that as the net E × B pedestal flow increases, the pressure fluctuation level and its inward penetration beyond the top of the pedestal both increase. This leads to a transition from small ELMs to large ELMs. Both inward and outward turbulence spreading are sensitive to the scrape-off-layer (SOL) plasma profiles. The inward turbulence spreading increases for the steep SOL profiles, leading to increasing pedestal energy loss in the small ELM regime. The SOL width $({\lambda _q})$ is significantly broadened progressing from the ELM-free to small ELM regime, due to the onset of strong radial turbulent transport. The extent of the SOL width $({\lambda _q})$ broadening depends strongly on outward turbulence spreading. The fluctuation energy intensity flux ${\varGamma _\varepsilon }$ at the separatrix can be enhanced by increasing either pedestal Er flow shear or local SOL pressure gradient. The ${\lambda _q}$ is broadened as the fluctuation energy intensity flux ${\varGamma _\varepsilon }$ at the last close flux surface (LCFS) increases. Local SOL E × B flow shear will restrain outward turbulence spreading and the associated heat flux width broadening. Operating in H-mode with small ELMs has the potential to solve two critical problems: reducing the ELM size and broadening the SOL width.