Collapse of carbon nanotubes due to local high-pressure from van der Waals encapsulation.

Van der Waals (vdW) assembly of low-dimensional materials has proven the capability of creating structures with on-demand properties. It is predicted that the vdW encapsulation can induce a local high-pressure of a few GPa, which will strongly modify the structure and property of trapped materials. Here, we report on the structural collapse of carbon nanotubes (CNTs) induced by the vdW encapsulation. By simply covering CNTs with a hexagonal boron nitride flake, most of the CNTs (≈77%) convert from a tubular structure to a collapsed flat structure. Regardless of their original diameters, all the collapsed CNTs exhibit a uniform height of ≈0.7 nm, which is roughly the thickness of bilayer graphene. Such structural collapse is further confirmed by Raman spectroscopy, which shows a prominent broadening and blue shift in the Raman G-peak. The vdW encapsulation-induced collapse of CNTs is fully captured by molecular dynamics simulations of the local vdW pressure. Further near-field optical characterization reveals a metal-semiconductor transition in accompany with the CNT structural collapse. Our study provides not only a convenient approach to generate local high-pressure for fundamental research, but also a collapsed-CNT semiconductor for nanoelectronic applications.

Laparoscopically harvested omental flap for immediate breast reconstruction: a retrospective single-center study of 300 cases.

BACKGROUND: The laparoscopically harvested omental flap (LHOF) has been used in partial or total breast reconstruction, but most studies on LHOF were case reports or small case series. However, the clinical feasibility and oncological safety of LHOF in oncoplastic breast surgery remains controversial. This study reported our experience applying LHOF for immediate breast reconstruction. METHODS: Between June 2018 and March 2022, 300 patients underwent oncoplastic breast surgery using LHOF at our institution. Their clinicopathological data, complications, cosmetic outcomes, and oncologic outcomes were evaluated. RESULTS: All patients underwent total breast reconstruction using LHOF after nipple-sparing mastectomy. The median operation time was 230 min (ranging from 155 to 375 min). The median operation time for harvesting the omental flap was 55 min (ranging from 40 to 105 min). The success rate of the laparoscopically harvested pedicled omental flap was over 99.0%. Median blood loss was 70 ml, ranging from 40 to 150 ml. The volume of the flap was insufficient in 102 patients (34.0%). The overall complication rate was 12.3%. Subcutaneous fluid in the breast area (7%) was the most common reconstruction-associated complication, but most cases were relieved spontaneously. The incidence rate of omental flap necrosis was 3.3%. LHOF-associated complications occurred in two cases, including one case of incisional hernia and one case of vascular injury. Cosmetic outcomes were satisfactory in 95.1% of patients on a four-point scale by three-panel assessment and 97.2% using the BCCT.core software. Two local and one systemic recurrence were observed during a median follow-up period of 32 months. CONCLUSIONS: The LHOF for immediate breast reconstruction is a safe and feasible method that involves minimal donor-site morbidity, satisfactory cosmetic outcomes, and promising oncologic safety.

Travel Distance Between Participants in US Telemedicine Sessions With Estimates of Emissions Savings: Observational Study.

BACKGROUND: Digital health and telemedicine are potentially important strategies to decrease health care's environmental impact and contribution to climate change by reducing transportation-related air pollution and greenhouse gas emissions. However, we currently lack robust national estimates of emissions savings attributable to telemedicine. OBJECTIVE: This study aimed to (1) determine the travel distance between participants in US telemedicine sessions and (2) estimate the net reduction in carbon dioxide (CO2) emissions attributable to telemedicine in the United States, based on national observational data describing the geographical characteristics of telemedicine session participants. METHODS: We conducted a retrospective observational study of telemedicine sessions in the United States between January 1, 2022, and February 21, 2023, on the doxy.me platform. Using Google Distance Matrix, we determined the median travel distance between participating providers and patients for a proportional sample of sessions. Further, based on the best available public data, we estimated the total annual emissions costs and savings attributable to telemedicine in the United States. RESULTS: The median round trip travel distance between patients and providers was 49 (IQR 21-145) miles. The median CO2 emissions savings per telemedicine session was 20 (IQR 8-59) kg CO2). Accounting for the energy costs of telemedicine and US transportation patterns, among other factors, we estimate that the use of telemedicine in the United States during the years 2021-2022 resulted in approximate annual CO2 emissions savings of 1,443,800 metric tons. CONCLUSIONS: These estimates of travel distance and telemedicine-associated CO2 emissions costs and savings, based on national data, indicate that telemedicine may be an important strategy in reducing the health care sector's carbon footprint.

Spartin-mediated lipid transfer facilitates lipid droplet turnover.

Lipid droplets (LDs) are organelles critical for energy storage and membrane lipid homeostasis, whose number and size are carefully regulated in response to cellular conditions. The molecular mechanisms underlying lipid droplet biogenesis and degradation, however, are not well understood. The Troyer syndrome protein spartin (SPG20) supports LD delivery to autophagosomes for turnover via lipophagy. Here, we characterize spartin as a lipid transfer protein whose transfer ability is required for LD degradation. Spartin copurifies with phospholipids and neutral lipids from cells and transfers phospholipids in vitro via its senescence domain. A senescence domain truncation that impairs lipid transfer in vitro also impairs LD turnover in cells while not affecting spartin association with either LDs or autophagosomes, supporting that spartin's lipid transfer ability is physiologically relevant. Our data indicate a role for spartin-mediated lipid transfer in LD turnover.

Multiresistance states in ferro- and antiferroelectric trilayer boron nitride.

Stacking two atomic layers together can induce interlayer (sliding) ferroelectricity that is absent in their naturally occurring crystal forms. With the flexibility of two-dimensional materials, more layers could be assembled to give rise to even richer polarization states. Here, we show that three-layer boron nitride can host ferro- and antiferroelectric domains in the same sample. When used as a tunneling junction, the polarization of these domains could be switched in a layer-by-layer procedure, producing multiple resistance states. Theoretical investigation reveals an important role played by the interaction between the trilayer boron nitride and graphene substrate. These findings reveal the great potential and unique properties of 2D sliding ferroelectric materials.

Spartin-mediated lipid transfer facilitates lipid droplet turnover.

Lipid droplets (LDs) are organelles critical for energy storage and membrane lipid homeostasis, whose number and size are carefully regulated in response to cellular conditions. The molecular mechanisms underlying lipid droplet biogenesis and degradation, however, are not well understood. The Troyer syndrome protein spartin (SPG20) supports LD delivery to autophagosomes for turnover via lipophagy. Here, we characterize spartin as a lipid transfer protein whose transfer ability is required for LD degradation. Spartin co-purifies with phospholipids and neutral lipids from cells and transfers phospholipids in vitro via its senescence domain. A senescence domain truncation that impairs lipid transfer in vitro also impairs LD turnover in cells while not affecting spartin association with either LDs or autophagosomes, supporting that spartin's lipid transfer ability is physiologically relevant. Our data indicate a role for spartin-mediated lipid transfer in LD turnover.

ATG2A-mediated bridge-like lipid transport regulates lipid droplet accumulation.

ATG2 proteins facilitate bulk lipid transport between membranes. ATG2 is an essential autophagy protein, but ATG2 also localizes to lipid droplets (LDs), and genetic depletion of ATG2 increases LD numbers while impairing fatty acid transport from LDs to mitochondria. How ATG2 supports LD homeostasis and whether lipid transport regulates this homeostasis remains unknown. Here we demonstrate that ATG2 is preferentially recruited to phospholipid monolayers such as those surrounding LDs rather than to phospholipid bilayers. In vitro, ATG2 can drive phospholipid transport from artificial LDs with rates that correlate with the binding affinities, such that phospholipids are moved much more efficiently when one of the ATG2-interacting structures is an artificial LD. ATG2 is thought to exhibit 'bridge-like" lipid transport, with lipids flowing across the protein between membranes. We mutated key amino acids within the bridge to form a transport-dead ATG2 mutant (TD-ATG2A) which we show specifically blocks bridge-like, but not shuttle-like, lipid transport in vitro. TD-ATG2A still localizes to LDs, but is unable to rescue LD accumulation in ATG2 knockout cells. Thus, ATG2 has a natural affinity for, and an enhanced activity upon LD surfaces and uses bridge-like lipid transport to support LD dynamics in cells.

Cingulate cGMP-dependent protein kinase I facilitates chronic pain and pain-related anxiety and depression.

ABSTRACT: Patients with chronic pain often experience exaggerated pain response and aversive emotion, such as anxiety and depression. Central plasticity in the anterior cingulate cortex (ACC) is assumed to be a critical interface for pain perception and emotion, which has been reported to involve activation of NMDA receptors. Numerous studies have documented the key significance of cGMP-dependent protein kinase I (PKG-I) as a crucial downstream target for the NMDA receptor-NO-cGMP signaling cascade in regulating neuronal plasticity and pain hypersensitivity in specific regions of pain pathway, ie, dorsal root ganglion or spinal dorsal horn. Despite this, whether and how PKG-I in the ACC contributes to cingulate plasticity and comorbidity of chronic pain and aversive emotion has remained elusive. Here, we uncovered a crucial role of cingulate PKG-I in chronic pain and comorbid anxiety and depression. Chronic pain caused by tissue inflammation or nerve injury led to upregulation of PKG-I expression at both mRNA and protein levels in the ACC. Knockdown of ACC-PKG-I relieved pain hypersensitivity as well as pain-associated anxiety and depression. Further mechanistic analysis revealed that PKG-I might act to phosphorylate TRPC3 and TRPC6, leading to enhancement of calcium influx and neuronal hyperexcitability as well as synaptic potentiation, which results in the exaggerated pain response and comorbid anxiety and depression. We believe this study sheds new light on the functional capability of ACC-PKG-I in modulating chronic pain as well as pain-associated anxiety and depression. Hence, cingulate PKG-I may represent a new therapeutic target against chronic pain and pain-related anxiety and depression.

A Multi-Scale Tool Orientation Generation Method for Freeform Surface Machining with Bull-Nose Tool.

Free-form surface parts are widely used in industries, and they consist of intricate 3D surfaces such as molds, impellers, and turbine blades that possess complex geometrical contours and demand high precision. Proper tool orientation is crucial for ensuring the efficiency and accuracy of five-axis computer numerical control (CNC) machining. Multi-scale methods have received much attention and have been widely used in various fields. They have been proven to be instrumental and can obtain fruitful outcomes. Ongoing research on multi-scale tool orientation generation methods, which aim to acquire tool orientations that satisfy both macro- and micro-scale requirements, is significantly important for improving the machining quality of workpiece surfaces. This paper proposes a multi-scale tool orientation generation method that considers both the machining strip width and roughness scales. This method also ensures a smooth tool orientation and avoids interference in the machining process. First, the correlation between the tool orientation and rotational axis is analyzed, and feasible area calculation and tool orientation adjustment methods are introduced. Then, the paper introduces the calculation method for machining strip widths on the macro-scale and the roughness calculation method on the micro-scale. Besides, tool orientation adjustment methods for both scales are proposed. Next, a multi-scale tool orientation generation method is developed to generate tool orientations that meet the macro- and micro-scale requirements. Finally, to verify the effectiveness of the proposed multi-scale tool orientation generation method, it is applied to the machining of a free-form surface. Experimental verification results have shown that the tool orientation generated by the proposed method can obtain the expected machining strip width and roughness, meeting both macro- and micro-scale requirements. Therefore, this method has significant potential for engineering applications.

Quantitative prediction of potential areas likely to yield Se-rich and Cd-low rice using fuzzy weights-of-evidence method.

The research of high-quality agricultural products rich in selenium and low in cadmium (Se-rich and Cd-low, respectively) is related directly to the value of agricultural products and people's food safety. Now it is still challenging to carry out development planning for Se-rich rice. By fuzzy weights-of-evidence method, the geochemical soil survey data of Se and Cd from 27,833 surface soil samples and 804 rice samples was used to predict the probability of areas, in Hubei Province, China, that will likely yield (a) Se-rich and Cd-low rice, (b) Se-rich and Cd-normal rice and (c) Se-rich and Cd-high rice. The areas predicted to likely yield Se-rich and Cd-high rice, Se-rich and Cd-normal rice, and high quality (i.e., Se-rich and Cd-low) rice cover 6542.3 km2 (5.9 %), 35,845.9 km2 (32.6 %), 12,379.7 km2 (11.3 %), respectively, of the surveyed region. According to the predictive distribution probability mapping of Se and Cd, this paper gives preliminary suggestions on the use of endogenous and exogenous Se, and Cd-reduction measures in planting Se-rich rice in different regions of Hubei Province. This study provides a new perspective for rational rice planting of Se-rich agricultural products, and it lays a foundation for the effective implementation of a geochemical soil investigation engineering project, which is of great significance for improving the economic value of Se-rich agricultural products and sustainable utilization of Se land resources.

Introduction of defects in hexagonal boron nitride for vacancy-based 2D memristors.

Two-dimensional (2D) materials have become potential resistive switching (RS) layers to prepare emerging non-volatile memristors. The atomically thin thickness and the highly controllable defect density contribute to the construction of ultimately scaled memory cells with stable switching behaviors. Although the conductive bridge random-access memory based on 2D hexagonal boron nitride has been widely studied, the realization of RS completely relying on vacancies in 2D materials has performance superiority. Here, we synthesize carbon-doped h-BN (C-h-BN) with a certain number of defects by controlling the weight percentage of carbon powder in the source. These defects can form a vacancy-based conductive filament under an applied electric field. The memristor displays bipolar non-volatile memory with a low SET voltage of 0.85 V and shows a long retention time of up to 104 s at 120 °C. The response times of the SET and RESET process are less than 80 ns and 240 ns, respectively. The current mapping by conductive atomic force microscopy demonstrates the electric-field-induced current tunneling from defective sites of the C-h-BN flake, revealing the defect-based RS in the C-h-BN memristor. Moreover, C-h-BN with excellent flexibility can be applied to wearable devices, maintaining stable RS performance in a variety of bending environments and after multiple bending cycles. The vacancy-based 2D memristor provides a new strategy for developing ultra-scaled memory units with high controllability.

Large gap two-dimensional topological insulators with the coexistence of a significant Rashba effect and piezoelectricity in functionalized PbGe monolayers.

In recent years, two-dimensional (2D) multifunctional materials have become a research hotpot for their wide application range. In this work, PbGe(CN)2 and PbGe(C2H)2 are predicted to realize the piezoelectricity, quantum spin Hall (QSH) insulator, and Rashba effects simultaneously. The topological bandgaps of PbGe(CN)2 and PbGe(C2H)2 are 0.418 and 0.405 eV, respectively, which are much larger than the recently reported value of 0.165 eV for InTeO that can also attain both the piezoelectricity and QSH insulator (PQSHI) effects. The in-plane and out-of-plane piezoelectric effects coexist in both PbGe(CN)2 and PbGe(C2H)2 with the in-plane piezoelectric coefficients d11 of 8.823 and 2.913 pm V-1 and out-of-plane piezoelectric coefficients d31 of 0.638 and 0.608 pm V-1. It is worth noting that there are significant Rashba SOC effects in PbGe(CN)2 and PbGe(C2H)2 and their Rashba splitting parameters are 2.576 and 2.184 eV Å, respectively. The prominent Rashba effects, which don't exist in other PQSHI materials, make PbGe(CN)2 and PbGe(C2H)2 more suitable for application in spintronic devices. Besides, the topological properties can remain robust under the uniaxial strain within the range of -6% to 6%. Our results imply that PbGe(CN)2 and PbGe(C2H)2 qualify as potential candidates for low-power, highly sensitive piezoelectric devices, such as pressure sensors for converting mechanical energy into electrical energy.

Greater spatial access to care is associated with lower mortality for emergency general surgery.

BACKGROUND: Emergency general surgery (EGS) diseases are time-sensitive conditions that require urgent surgical evaluation, yet the effect of geographic access to care on outcomes remains unclear. We examined the association of spatial access with outcomes for common EGS conditions. METHODS: A retrospective analysis of twelve 2014 State Inpatient Databases, identifying adults admitted with eight EGS conditions, was performed. We assessed spatial access using the spatial access ratio (SPAR)-an advanced spatial model that accounts for travel distance, hospital capacity, and population demand, normalized against the national mean. Multivariable regression models adjusting for patient and hospital factors were used to evaluate the association between SPAR with (a) in-hospital mortality and (b) major morbidity. RESULTS: A total of 877,928 admissions, of which 104,332 (2.4%) were in the lowest-access category (SPAR, 0) and 578,947 (66%) were in the high-access category (SPAR, ≥1), were analyzed. Low-access patients were more likely to be White, male, and treated in nonteaching hospitals. Low-access patients also had higher incidence of complex EGS disease (low access, 31% vs. high access, 12%; p < 0.001) and in-hospital mortality (4.4% vs. 2.5%, p < 0.05). When adjusted for confounding factors, including presence of advanced hospital resources, increasing spatial access was protective against in-hospital mortality (adjusted odds ratio, 0.95; 95% confidence interval, 0.94-0.97; p < 0.001). Spatial access was not significantly associated with major morbidity. CONCLUSION: This is the first study to demonstrate that geospatial access to surgical care is associated with incidence of complex EGS disease and that increasing spatial access to care is independently associated with lower in-hospital mortality. These results support the consideration of spatial access in the development of regional health systems for EGS care. LEVEL OF EVIDENCE: Prognostic and Epidemiologic; Level III.

Iron plaque effects on selenium and cadmium stabilization in Cd-contaminated seleniferous rice seedlings.

Dietary intake of selenium (Se)-enriched rice has benefit for avoiding Se-deficient disease, but there is a risk of excessive cadmium (Cd) intake. Through hydroponic culture and adsorption-desorption experiments, this paper focused on Se and Cd uptake in rice seedlings associated with the interactive effects of Se (Se4+ or Se6+), Cd, and iron (Fe) plaque. The formation of Fe plaque was promoted by Fe2+ and inhibited by Cd but not related with Se species. Shoot Se (Se4+ or Se6+) uptake was not affected by Fe plaque in most treatments, except that shoot Se concentrations were decreased by Fe plaque when Se4+ and Cd co-exposure. Shoot Cd concentrations were always inhibited by Fe plaque, regardless of Se species. Inhibiting Cd adsorption onto root surface (Se4+  + Cd) or increased Cd retention in Fe plaque (Se6+  + Cd) is an important mechanism for Fe plaque to reduce Cd uptake by rice. However, we found that DCB Cd concentrations (Cd adsorbed by Fe plaque) were not always positively correlated with Fe plaque amounts and always negatively correlated with the distribution ratios of Cd mass in root to that in Fe plaque (abbreviated as DRCMRF; r = - 0.942**); meanwhile, with the increase of DCB Fe concentration, the directions of variations of DCB Cd concentration and DRCMRF were affected by Se species. It indicated that the root system is also an important factor to affect DCB Cd concentration and inhibit Cd uptake, which is mediated by Se species. This paper provides a new understanding of Fe plaque-mediated interactive effect of Se and Cd uptakes in rice, which is beneficial for the remediation of Cd-contaminated and Cd-contaminated seleniferous areas.

Discovery of Type II Interlayer Trions.

In terms of interlayer trions, electronic excitations in van der Waals heterostructures (vdWHs) can be classified into Type I (i.e., two identical charges in the same layer) and Type II (i.e., two identical charges in the different layers). Type I interlayer trions are investigated theoretically and experimentally. By contrast, Type II interlayer trions remain elusive in vdWHs, due to inadequate free charges, unsuitable band alignment, reduced Coulomb interactions, poor interface quality, etc. Here, the first observation of Type II interlayer trions is reported by exploring band alignments and choosing an atomically thin organic-inorganic system-monolayer WSe2 /bilayer pentacene heterostructure (1L + 2L HS). Both positive and negative Type II interlayer trions are electrically tuned and observed via PL spectroscopy. In particular, Type II interlayer trions exhibit in-plane anisotropic emission, possibly caused by their unique spatial structure and anisotropic charge interactions, which is highly correlated with the transition dipole moment of pentacene. The results pave the way to develop excitonic devices and all-optical circuits using atomically thin organic-inorganic bilayers.

Disparities in Spatial Access to Emergency Surgical Services in the US.

Importance: Hospitals with emergency surgical services provide essential care for a wide range of time-sensitive diseases. Commonly used measures of spatial access, such as distance or travel time, have been shown to underestimate disparities compared with more comprehensive metrics. Objective: To examine population-level differences in spatial access to hospitals with emergency surgical capability across the US using enhanced 2-step floating catchment (E2SFCA) methods. Design, Setting, and Participants: A cross-sectional study using the 2015 American Community Survey data. National census block group (CBG) data on community characteristics were paired with geographic coordinates of hospitals with emergency departments and inpatient surgical services, and hospitals with advanced clinical resources were identified. Spatial access was measured using the spatial access ratio (SPAR), an E2SFCA method that captures distance to hospital, population demand, and hospital capacity. Small area analyses were conducted to assess both the population with low access to care and community characteristics associated with low spatial access. Data analysis occurred from February 2021 to July 2022. Main Outcomes and Measures: Low spatial access was defined by SPAR greater than 1.0 SD below the national mean (SPAR <0.3). Results: In the 217 663 CBGs (median [IQR] age for CBGs, 39.7 [33.7-46.3] years), there were 3853 hospitals with emergency surgical capabilities and 1066 (27.7%) with advanced clinical resources. Of 320 million residents, 30.8 million (9.6%) experienced low access to any hospital with emergency surgical services, and 82.6 million (25.8%) to advanced-resource centers. Insurance status was associated with low access to care across all settings (public insurance: adjusted rate ratio [aRR], 1.21; 95% CI, 1.12-1.25; uninsured aRR, 1.58; 95% CI, 1.52-1.64). In micropolitan and rural areas, high-share (>75th percentile) Hispanic and other (Asian; American Indian, Alaska Native, or Pacific Islander; and 2 or more racial and ethnic minority groups) communities were also associated with low access. Similar patterns were seen in access to advanced-resource hospitals, but with more pronounced racial and ethnic disparities. Conclusions and Relevance: In this cross-sectional study of access to surgical care, nearly 1 in 10 US residents experienced low spatial access to any hospital with emergency surgical services, and 1 in 4 had low access to hospitals with advanced clinical resources. Communities with high rates of uninsured or publicly insured residents and racial and ethnic minority communities in micropolitan and rural areas experienced the greatest risk of limited access to emergency surgical care. These findings support the use of E2SFCA models in identifying areas with low spatial access to surgical care and in guiding health system development.

Evidence of transgenerational effects on autism spectrum disorder using multigenerational space-time cluster detection.

BACKGROUND: Transgenerational epigenetic risks associated with complex health outcomes, such as autism spectrum disorder (ASD), have attracted increasing attention. Transgenerational environmental risk exposures with potential for epigenetic effects can be effectively identified using space-time clustering. Specifically applied to ancestors of individuals with disease outcomes, space-time clustering characterized for vulnerable developmental stages of growth can provide a measure of relative risk for disease outcomes in descendants. OBJECTIVES: (1) Identify space-time clusters of ancestors with a descendent with a clinical ASD diagnosis and matched controls. (2) Identify developmental windows of ancestors with the highest relative risk for ASD in descendants. (3) Identify how the relative risk may vary through the maternal or paternal line. METHODS: Family pedigrees linked to residential locations of ASD cases in Utah have been used to identify space-time clusters of ancestors. Control family pedigrees of none-cases based on age and sex have been matched to cases 2:1. The data have been categorized by maternal or paternal lineage at birth, childhood, and adolescence. A total of 3957 children, both parents, and maternal and paternal grandparents were identified. Bernoulli space-time binomial relative risk (RR) scan statistic was used to identify clusters. Monte Carlo simulation was used for statistical significance testing. RESULTS: Twenty statistically significant clusters were identified. Thirteen increased RR (> 1.0) space-time clusters were identified from the maternal and paternal lines at a p-value < 0.05. The paternal grandparents carry the greatest RR (2.86-2.96) during birth and childhood in the 1950's-1960, which represent the smallest size clusters, and occur in urban areas. Additionally, seven statistically significant clusters with RR < 1 were relatively large in area, covering more rural areas of the state. CONCLUSION: This study has identified statistically significant space-time clusters during critical developmental windows that are associated with ASD risk in descendants. The geographic space and time clusters family pedigrees with over 3 + generations, which we refer to as a person's geographic legacy, is a powerful tool for studying transgenerational effects that may be epigenetic in nature. Our novel use of space-time clustering can be applied to any disease where family pedigree data is available.

Mitoguardin-2-mediated lipid transfer preserves mitochondrial morphology and lipid droplet formation.

Lipid transport proteins at membrane contacts, where organelles are closely apposed, are critical in redistributing lipids from the endoplasmic reticulum (ER), where they are made, to other cellular membranes. Such protein-mediated transfer is especially important for maintaining organelles disconnected from secretory pathways, like mitochondria. We identify mitoguardin-2, a mitochondrial protein at contacts with the ER and/or lipid droplets (LDs), as a lipid transporter. An x-ray structure shows that the C-terminal domain of mitoguardin-2 has a hydrophobic cavity that binds lipids. Mass spectrometry analysis reveals that both glycerophospholipids and free-fatty acids co-purify with mitoguardin-2 from cells, and that each mitoguardin-2 can accommodate up to two lipids. Mitoguardin-2 transfers glycerophospholipids between membranes in vitro, and this transport ability is required for roles both in mitochondrial and LD biology. While it is not established that protein-mediated transfer at contacts plays a role in LD metabolism, our findings raise the possibility that mitoguardin-2 functions in transporting fatty acids and glycerophospholipids at mitochondria-LD contacts.

Associated factors with patient-reported unmet food needs among emergency department adult patients - A social need perspective.

Food insecurity is a complex problem affected by a number of factors from individual to societal. While individual-level demographic information and population-level social determinants of health (SDoH) are commonly used to identify patients at risk of food insecurity and to direct resources, a more comprehensive understanding of food insecurity requires integrating multi-level data. Our goal is to identify factors associated with food insecurity using patient, health system, and population level data. Between January 2019 and April 2020, we screened adult patients visiting an academic health sciences emergency department in Utah using a 10-item social needs screener. Patients' demographic data were linked to their screener responses. ZIP Code-level food-related SDoH such as accessibility to food providers, measured by geographic information systems methods, were assigned to patients. We then applied multilevel logistic regression modeling to identify factors associated with unmet food needs at two different levels-individual and ZIP Code. Unmet food needs were identified by asking patients if they felt there was not enough money for food in the last month, which grossly represents food insecurity. On a sample of 2,290 patients, 21.61% reported unmet food needs. Patient-reported housing, medical care, and utility needs along with Supplemental Nutrition Assistance Program participation and primary care provider utilization were highly associated with unmet food needs. Our efforts to identify the population at risk of food insecurity should be centered around patient-reported social needs. Our results suggest that addressing food insecurity in health care settings should include assessing social needs in primary care.