Elevated risk of multimorbidity post-COVID-19 infection: protective effect of vaccination

BACKGROUND

It is unclear how the coronavirus disease 2019 (Covid-19) pandemic has affected multimorbidity incidence among those with one pre-existing chronic condition, as well as how vaccination could modify this association.

AIM

To examine the association of Covid-19 infection with multimorbidity incidence among people with one pre-existing chronic condition, including those with prior vaccination.

DESIGN

Nested case-control study.

METHODS

We conducted a territory-wide nested case-control study with incidence density sampling using Hong Kong electronic health records from public healthcare facilities and mandatory Covid-19 reports. People with one listed chronic condition (based on a list of 30) who developed multimorbidity during 1 January 2020-15 November 2022 were selected as case participants and randomly matched with up to 10 people of the same age, sex and with the same first chronic condition without having developed multimorbidity at that point. Conditional logistic regression was used to estimate adjusted odds ratios (aORs) of multimorbidity.

RESULTS

In total, 127 744 case participants were matched with 1 230 636 control participants. Adjusted analysis showed that there were 28%-increased odds of multimorbidity following Covid-19 [confidence interval (CI) 22% to 36%] but only 3% (non-significant) with prior full vaccination with BNT162b2 or CoronaVac (95% CI -2% to 7%). Similar associations were observed in men, women, older people aged 65 or more, and people aged 64 or younger.

CONCLUSIONS

We found a significantly elevated risk of multimorbidity following a Covid-19 episode among people with one pre-existing chronic condition. Full vaccination significantly reduced this risk increase.

Eco-friendly fabrication of coco coir composites for hydroponic cultivation: A green chemistry approach

In this study, we report an eco-friendly biocomposite fabrication process for valorizing coconut fibers (coco coir) by transforming them into multi-purpose biocomposites using a pectin-based one-pot aqueous process. In our...

Phytotoxic effect of sub-3-nm crystalline ceria nanoparticles on the hydroponic growth of Daikon radish microgreens

Cerium oxide nanoparticles (ceria NPs) have been widely used in many industrial applications. They have been proposed as a potential remedy for reducing oxidative stress in biological systems. General concerns over the toxicity of engineered ceria NPs have led to studies of their phytotoxicity in plants. Most of these plant growth studies were conducted in soil using grain crops and commercial ceria NPs of sizes from 6 nm to 100's nm. In this paper, we report our evaluation of the phytotoxicity and uptake of sub-3-nm crystalline ceria NPs by exposing Daikon radish (Raphanus sativus var. longipinnatus) microgreens to these NPs with environmentally relevant concentrations under hydroponic growth conditions. Aqueous suspensions of different concentrations of these ceria NPs (0.1 ppm, 1 ppm, and 10 ppm) were applied to these microgreens for the last 7 days of the 12-day growth period. Our results revealed the uptake of cerium by plant roots and the translocation of cerium to the stems and the cotyledons (seed leaves). The accumulation of cerium was found to be maximum at the roots, followed by the cotyledons and the stems of the plants. Even at the lowest concentration (0.1 ppm) of the sub-3-nm ceria NPs, the accumulation of cerium at the roots significantly stunted the root growth. However, these NP treatments did not show significant changes to the distributions of macro-minerals (Mg, K, and Ca) and micro-minerals (Zn and Cu) in the microgreens at the end of the 12-day growth period. The phytotoxic effect of sub-3-nm crystalline ceria nanoparticles on the hydroponic growth of Daikon radish microgreens was studied. The cerium uptake by the plant and its effect on the bioavailability of major macro-minerals and micro-minerals within the plant were examined.

Prevalence of metabolic syndrome in the United States National Health and Nutrition Examination Survey (nhanes) 2011–2018

Background

Metabolic syndrome (MetS) is a cluster of risk factors presaging the development of cardiovascular disease and diabetes. It is a risk factor for severe coronavirus disease 2019 (COVID-19).

Purpose

To estimate the prevalence of MetS in the US National Health and Nutrition Examination Survey (NHANES) 2011–2018.

Methods

This cohort study included 22370 eligible participants aged ≥20 years from the NHANES 2011–2018. MetS was defined as the presence of at least three of these components: central obesity, reduced high-density lipoprotein, elevated triglycerides, elevated blood pressure and elevated fasting blood glucose. The prevalence of MetS was estimated taking into account the complex sampling. The time trend was evaluated using logistic regression. Annual percentage changes (APC) were measured trend in MetS prevalence.

Results

The prevalence of MetS was 36.2% (95% CI, 32.3–40.3), 34.8% (95% CI, 32.3–37.4), 39.9% (95% CI, 36.6–43.2) and 38.3% (95% CI, 35.3–41.3) in 2011–2, 2013–4, 2015–6, 2017–8, respectively (P for trend = 0.08). Among the MetS components, the prevalence of elevated glucose increased from 48.7% (95% CI, 45.9–51.5) in 2011–2 to 64.3% (95% CI, 61.0–67.4) in 2017–8 [P for trend <0.001; APC=11.7, (95% CI, 3.5–21.0)]. The prevalence of MetS in non-Hispanic Asian increased from 21.8% (95% CI, 16.7–28.0) in 2011–2 to 31.2% (95% CI, 27.4–35.3) in 2017–8 [P for trend <0.001; APC=14.6, (95% CI, 2.5–34.8)].

Conclusions

The prevalence of MetS remained stable during 2011 to 2018. Lifestyle modification is needed, especially among non-Hispanic Asians to prevent the metabolic syndrome and the associated risks of diabetes and cardiovascular disease.

Funding Acknowledgement

Type of funding sources: None.

Formation of dimethyl carbonate via direct esterification of CO2 with methanol on reduced or stoichiometric CeO2(111) and (110) surfaces

CeO2-Catalyzed esterification of CO2, a well-known greenhouse gas, with methanol has been widely recognized as a promising alternative method to produce dimethyl carbonate (DMC). Herein, we performed a comprehensive study of catalytic mechanisms underlying the formation of DMC from CO2 and methanol on both stoichiometric and reduced CeO2(111) and (110) surfaces. To this end, the saddle-point searching algorithm is employed. Specifically, using the monomethyl carbonate (MMC) as the key intermediate, a three-step Langmuir-Hinshelwood (LH) mechanism, including the formation and esterification of monomethyl carbonate and removal of water molecule, is identified for the catalytic DMC formation on either the reduced or the stoichiometric CeO2(111) and (110) surfaces. For both CeO2(111) and (110) surfaces, our study indicates that the presence of oxygen vacancies can markedly lower the activation energy barrier. Different rate-limiting steps are identified, however, for the reduced CeO2(111) and (110) surfaces. Successful identification of the rate-limiting step and the associated active CO2 species will provide atomic-level guidance on selection of metal-oxide-based catalysts toward direct synthesis of DMC from the green-house gas CO2 and methanol.

Hip fractures are preventable: a proposal for osteoporosis screening and fall prevention in older people

Osteoporosis is highly prevalent but underdiagnosed and undertreated in Hong Kong. Fragility fractures associated with osteoporosis often result in loss of independence and increased mortality for home-dwelling patients, imposing a high socio-economic burden on society. This issue requires urgent attention given the rapid growth of the elderly population in Hong Kong by approximately 4.3% each year. To address this situation, a group of experts convened to discuss practical ways to reduce the burden of fractures and formulated three recommendations: first, all men (aged ≥70 years) and women (aged ≥65 years) should receive universal dual-energy X-ray absorptiometry assessment for osteoporosis. Second, all men (aged ≥70 years) and women (aged ≥65 years) with a fracture-risk assessment-derived 10-year risk (hip fracture with bone mineral density) ≥3% should receive ≥3 years of anti-osteoporotic treatment. Third, comprehensive structured assessment (including dual-energy X-ray absorptiometry) should be conducted in older patients with a history of falling. By implementing these recommendations, we estimate that we could prevent 5234 hip fractures in 10 years, an annual incidence reduction of approximately 7%, and save HK$425 million in direct medical costs plus substantial indirect savings. Ample clinical and cost-effectiveness data support these recommendations, and studies in Hong Kong and abroad could serve as models on how to implement them. We are confident that by applying these recommendations rigorously and systematically, a significant reduction in hip fractures in Hong Kong is achievable.

Gas hydrates in confined space of nanoporous materials: new frontier in gas storage technology

Gas hydrates (clathrate hydrates, clathrates, or hydrates) are crystalline inclusion compounds composed of water and gas molecules. Methane hydrates, the most well-known gas hydrates, are considered a menace in flow assurance. However, they have also been hailed as an alternative energy resource because of their high methane storage capacity. Since the formation of gas hydrates generally requires extreme conditions, developing porous material hosts to synthesize gas hydrates with less-demanding constraints is a topic of great interest to the materials and energy science communities. Though reports of modeling and experimental analysis of bulk gas hydrates are plentiful in the literature, reliable phase data for gas hydrates within confined spaces of nanoporous media have been sporadic. This review examines recent studies of both experiments and theoretical modeling of gas hydrates within four categories of nanoporous material hosts that include porous carbons, metal-organic frameworks, graphene nanoslits, and carbon nanotubes. We identify challenges associated with these porous systems and discuss the prospects of gas hydrates in confined space for potential applications.

Mechanistic insights into the acetate-accelerated synthesis of crystalline ceria nanoparticles

Lithium acetate was reported to accelerate the growth of crystalline ceria nanoparticles in ozone-mediated synthesis through promoting alcohol-like condensation reactions.

Growth of carbon dioxide whiskers

We report the growth of carbon dioxide (CO₂) whiskers at low temperatures (−70 °C to −65 °C) and moderate pressure (4.4 to 1.0 bar). Their axial growth was assessed by optical video analysis. The identities of these whiskers were confirmed as CO₂ solids by Raman spectroscopy. A vapor–solid growth mechanism was proposed based on the influence of the relative humidity on the growth.

Carbon dioxide (CO₂) whiskers were reported to grow at low temperatures (−70 °C to −65 °C) and moderate pressure (4.4 to 1.0 bar).

Structure-activity relationship of nanostructured ceria for the catalytic generation of hydroxyl radicals

Reactive oxygen species (ROS) are powerful oxidants generated in both biological systems and natural environments. Though enzyme-mimic activity and Fenton-like reactions have been postulated to explain how ceria nanoparticles and ROS are involved in the catalytic decomposition of hydrogen peroxide (H2O2), the corresponding reaction kinetics for this reaction have not yet been completely resolved. Here we present our investigation of the structure-activity relationship of ceria nanostructures for the generation of hydroxyl radicals through the catalytic decomposition of H2O2. Different nanostructured ceria including nanorods (NR), nanocubes (NC), and nanooctahedra (NO), together with commercial ceria, were examined to elucidate the relationship between the morphology and reaction kinetics. The initial relative production rates of hydroxyl radicals over different ceria nanostructures were determined using fluorescence measurements and were applied to obtain the apparent activation energy for their intrinsic activity comparisons. The activity trend of the order: ceria NR > ceria NC > ceria NO > commercial ceria was observed. This trend was rationalized and assessed using activity descriptive factors including the intensity ratio of Raman bands of vibration modes due to atomic defects, the percentage of surface Ce3+ content, and the average coordination number of oxygen anions surrounding each cerium cation in the ceria samples.

Ozone-mediated synthesis of ceria nanoparticles

We report a rapid, room temperature methodology to synthesize fluorite-structured ceria nanoparticles using cerium(iii) salts and ozone in the presence of short chain primary, secondary, and tertiary alcohols. This simple technique produced nanoparticles with higher oxygen vacancy compared to that of bulk ceria.

Crystallographic, vibrational modes and optical properties data of α-DIPAB crystal

The Crystallographic data of the α-DIPAB sample was measured using powder X-ray diffraction (PXRD). The crystal structure was also optimized using density functional based method. The calculations were performed both including van der Waals (vdW) interactions and excluding them to quantify the effects of vdW interaction on the crystal formation. The vibrational modes of DIPAB crystal corresponding to the Bromine deficient samples are calculated and presented. These show the origin of drastic change in dielectric response in Br deficient samples as compared to the ideal stoichiometric DIPAB crystal (Alsaad et al. 2018) [4]. Optical properties of an idealα-DIPAB were calculated using GGA and HSE06 hybrid functional methods implemented in VASP package. We mainly calculated the real and imaginary parts of the frequency-dependent linear dielectric function, as well as the related quantities such as the absorption, reflectivity, energy-loss function, and refractive index of α-DIPAB in the energy window of (0–12) eV.

X-ray absorption study of ceria nanorods promoting the disproportionation of hydrogen peroxide

A quasi in situ X-ray absorption study demonstrated that the disproportionation of hydrogen peroxide (H2O2) promoted by ceria nanorods was associated with a reversible Ce(3+)/Ce(4+) reaction and structural transformations in ceria. The direction of this reversible reaction was postulated to depend on the H2O2 concentration and the fraction of Ce(3+) species in ceria nanorods.

Serum calcium and incident diabetes: an observational study and meta-analysis

The study aimed to prospectively evaluate if serum calcium is related to diabetes incidence in Hong Kong Chinese. The results showed that serum calcium has a significant association with increased risk of diabetes. The result of meta-analysis reinforced our findings.

INTRODUCTION

This study aimed to evaluate the association of serum calcium, including serum total calcium and albumin-corrected calcium, with incident diabetes in Hong Kong Chinese.

METHODS

We conducted a retrospective cohort study in 6096 participants aged 20 or above and free of diabetes at baseline. Serum calcium was measured at baseline. Incident diabetes was determined from several electronic databases. We also searched relevant databases for studies on serum calcium and incident diabetes and conducted a meta-analysis using fixed-effect modeling.

RESULTS

During 59,130.9 person-years of follow-up, 631 participants developed diabetes. Serum total calcium and albumin-corrected calcium were associated with incident diabetes in the unadjusted model. After adjusting for demographic and clinical variables, the association remained significant only for serum total calcium (hazard ratio (HR), 1.32 (95 % confidence interval (CI), 1.02-1.70), highest vs. lowest quartile). In a meta-analysis of four studies including the current study, both serum total calcium (pooled risk ratio (RR), 1.38 (95 % CI, 1.15-1.65); I (2) = 5 %, comparing extreme quantiles) and albumin-corrected calcium (pooled RR, 1.29 (95 % CI, 1.03-1.61); I (2) = 0 %, comparing extreme quantiles) were associated with incident diabetes. Penalized regression splines showed that the association of incident diabetes with serum total calcium and albumin-correlated calcium was non-linear and linear, respectively.

CONCLUSIONS

Elevated serum calcium concentration is associated with incident diabetes. The mechanism underlying this association warrants further investigation.

One-pot conversion of cellobiose to mannose using a hybrid phosphotungstic acid–cerium oxide catalyst

Two-step conversion of cellobiose to mannose using hybrid catalyst.

Cerium oxide as a promoter for the electro-oxidation reaction of ethanol: in situ XAFS characterization of the Pt nanoparticles supported on CeO2 nanoparticles and nanorods

Probing the electrocatalytic activity of Pt-ceria nanoparticles and -nanorods in ethanol oxidation reaction.

Preparation and characterization of Pt/Pt:CeO2−x nanorod catalysts for short chain alcohol electrooxidation in alkaline media

Multi-functional anode catalysts composed of platinum (Pt) nanoparticles electrodeposited on 2 wt% Pt decorated ceria (Pt:CeO_2−x) nanorod supports were shown to enhance the alkaline electrocatalytic oxidation of short chain alcohols.

Randomized clinical trial of chronic pain after the transinguinal preperitoneal technique compared with Lichtenstein's method for inguinal hernia repair

Background

Preliminary experience has suggested that preperitoneal mesh positioning causes less chronic pain than Lichtenstein's technique for inguinal hernia repair. Therefore, a randomized clinical trial was conducted with the aim of evaluating the incidence of postoperative chronic pain after transinguinal preperitoneal (TIPP) mesh repair versus Lichtenstein's technique.

Methods

Patients with a primary unilateral inguinal hernia were randomized to either TIPP or Lichtenstein's repair in two training hospitals. The primary outcome was the number of patients with chronic pain after surgery. Secondary outcomes were adverse events. Follow-up was scheduled after 14 days, 3 months and 1 year. Patients and outcome assessors were blinded.

Results

A total of 302 patients were randomized to TIPP (143) or Lichtenstein (159) repair. Baseline characteristics were comparable in the two groups. Some 98·0 per cent of the patients were included in the analysis (141 in the TIPP group and 155 in the Lichtenstein group). Significantly fewer patients in the TIPP group had continuous chronic pain 1 year after surgery: five patients (3·5 per cent) versus 20 patients (12·9 per cent) in the Lichtenstein group (P = 0·004). An additional 12 patients (8·5 per cent) in the TIPP group and 60 (38·7 per cent) in the Lichtenstein group experienced pain during activity (P = 0·001). There were two patients with recurrence in the TIPP group and four in the Lichtenstein group, but no significant differences were found in other severe adverse events between the groups.

Conclusion

Fewer patients had continuous chronic pain at 1 year after the TIPP mesh inguinal hernia repair compared with Lichtenstein's repair. Registration number: ISRCTN93798494 (http://www.controlled-trials.com).

Controlling E. coli adhesion on high-k dielectric bioceramics films using poly(amino acid) multilayers

The influence of high-k dielectric bioceramics with poly(amino acid) multilayer coatings on the adhesion behavior of Escherichia coli (E. coli) was studied by evaluating the density of bacteria coverage on the surfaces of these materials. A biofilm forming K-12 strain (PHL628), a wild-type strain (JM109), and an engineered strain (XL1-Blue) of E. coli were examined for their adherence to zirconium oxide (ZrO(2)) and tantalum oxide (Ta(2)O(5)) surfaces functionalized with single and multiple layers of poly(amino acid) polyelectrolytes made by the layer-by-layer (LBL) deposition. Two poly(amino acids), poly(l-arginine) (PARG) and poly(l-aspartic acid) (PASP), were chosen for the functionalization schemes. All three strains were found to grow and preferentially adhere to bare bioceramic film surfaces over bare glass slides. The bioceramic and glass surfaces functionalized with positively charged poly(amino acid) top layers were observed to enhance the adhesion of these bacteria by up to 4-fold in terms of bacteria surface coverage. Minimal bacteria coverage was detected on surfaces functionalized with negatively charged poly(amino acid) top layers. The effect of different poly(amino acid) coatings to promote or minimize bacterial adhesion was observed to be drastically enhanced with the bioceramic substrates than with glass. Such observed enhancements were postulated to be attributed to the formation of higher density of poly(amino acids) coatings enabled by the high dielectric strength (k) of these bioceramics. The multilayer poly(amino acid) functionalization scheme was successfully applied to utilize this finding for micropatterning E. coli on bioceramic thin films.

Discriminative value of FRAX for fracture prediction in a cohort of Chinese postmenopausal women

We followed 2,266 postmenopausal Chinese women for 4.5 years to determine which model best predicts osteoporotic fracture. A model that contains ethnic-specific risk factors, some of which reflect frailty, performed as well as or better than the well-established FRAX model.

INTRODUCTION

Clinical risk assessment, with or without T-score, can predict fractures in Chinese postmenopausal women although it is unknown which combination of clinical risk factors is most effective. This prospective study sought to compare the accuracy for fracture prediction using various models including FRAX, our ethnic-specific clinical risk factors (CRF) and other simple models.

METHODS

This study is part of the Hong Kong Osteoporosis Study. A total of 2,266 treatment naïve postmenopausal women underwent clinical risk factor and bone mineral density assessment. Subjects were followed up for outcome of major osteoporotic fracture and receiver operating characteristic (ROC) curves for different models were compared. The percentage of subjects in different quartiles of risk according to various models who actually fractured was also compared.

RESULTS

The mean age at baseline was 62.1 ± 8.5 years and mean follow-up time was 4.5 ± 2.8 years. A total of 106 new major osteoporotic fractures were reported, of which 21 were hip fractures. Ethnic-specific CRF with T-score performed better than FRAX with T-score (based on both Chinese normative and National Health and Nutrition Examination Survey (NHANES) databases) in terms of AUC comparison for prediction of major osteoporotic fracture. The two models were similar in hip fracture prediction. The ethnic-specific CRF model had a 10% higher sensitivity than FRAX at a specificity of 0.8 or above.

CONCLUSION

CRF related to frailty and differences in lifestyle between populations are likely to be important in fracture prediction. Further work is required to determine which and how CRF can be applied to develop a fracture prediction model in our population.

Ethnic difference of clinical vertebral fracture risk

Vertebral fractures are the most common osteoporotic fractures. Data on the vertebral fracture risk in Asia remain sparse. This study observed that Hong Kong Chinese and Japanese populations have a less dramatic increase in hip fracture rates associated with age than Caucasians, but the vertebral fracture rates were higher, resulting in a high vertebral-to-hip fracture ratio. As a result, estimation of the absolute fracture risk for Asians may need to be readjusted for the higher clinical vertebral fracture rate.

INTRODUCTION

Vertebral fractures are the most common osteoporotic fractures. Data on the vertebral fracture risk in Asia remain sparse. The aim of this study was to report the incidence of clinical vertebral fractures among the Chinese and to compare the vertebral-to-hip fracture risk to other ethnic groups.

METHODS

Four thousand, three hundred eighty-six community-dwelling Southern Chinese subjects (2,302 women and 1,810 men) aged 50 or above were recruited in the Hong Kong Osteoporosis Study since 1995. Baseline demographic characteristics and medical history were obtained. Subjects were followed annually for fracture outcomes with a structured questionnaire and verified by the computerized patient information system of the Hospital Authority of the Hong Kong Government. Only non-traumatic incident hip fractures and clinical vertebral fractures that received medical attention were included in the analysis. The incidence rates of clinical vertebral fractures and hip fractures were determined and compared to the published data of Swedish Caucasian and Japanese populations.

RESULTS

The mean age at baseline was 62 ± 8.2 years for women and 68 ± 10.3 years for men. The average duration of follow-up was 4.0 ± 2.8 (range, 1 to 14) years for a total of 14,733 person-years for the whole cohort. The incidence rate for vertebral fracture was 194/100,000 person-years in men and 508/100,000 person-years in women, respectively. For subjects above the age of 65, the clinical vertebral fracture and hip fracture rates were 299/100,000 and 332/100,000 person-years, respectively, in men, and 594/100,000 and 379/100,000 person-years, respectively, in women. Hong Kong Chinese and Japanese populations have a less dramatic increase in hip fracture rates associated with age than Caucasians. At the age of 65 or above, the hip fracture rates for Asian (Hong Kong Chinese and Japanese) men and women were less than half of that in Caucasians, but the vertebral fracture rate was higher in Asians, resulting in a high vertebral-to-hip fracture ratio.

CONCLUSIONS

The incidences of vertebral and hip fractures, as well as the vertebral-to-hip fracture ratios vary in Asians and Caucasians. Estimation of the absolute fracture risk for Asians may need to be readjusted for the higher clinical vertebral fracture rate.

Phase stabilization in nitrogen-implanted nanocrystalline cubic zirconia

The phase stability of nanocrystallites with metastable crystal structures under ambient conditions is usually attributed to their small grain size. It remains a challenging problem to maintain such phase integrity of these nanomaterials when their crystallite sizes become larger. Here we report an experimental-modelling approach to study the roles of nitrogen dopants in the formation and stabilization of cubic ZrO(2) nanocrystalline films. Mixed nitrogen and argon ion beam assisted deposition (IBAD) was applied to produce nitrogen-implanted cubic ZrO(2) nanocrystallites with grain sizes of 8-13 nm. Upon thermal annealing, the atomic structure of these ZrO(2) films was observed to evolve from a cubic phase, to a tetragonal phase and then a monoclinic phase. Our X-ray absorption near edge structure study on the annealed samples together with first-principle modelling revealed the significance of the interstitial nitrogen in the phase stabilization of nitrogen implanted cubic ZrO(2) crystallites via the soft mode hardening mechanism.

Defect engineering in cubic cerium oxide nanostructures for catalytic oxidation

Traditional nanostructured design of cerium oxide catalysts typically focuses on their shape, size, and elemental composition. We report a different approach to enhance the catalytic activity of cerium oxide nanostructures through engineering high density of oxygen vacancy defects in these catalysts without dopants. The defect engineering was accomplished by a low pressure thermal activation process that exploits the nanosize effect of decreased oxygen storage capacity in nanostructured cerium oxides.

Formation of a porous cerium oxide membrane by anodization

A two-step synthetic process is reported to fabricate porous ceria membranes by anodization of cerium metal foils with subsequent calcination. "Ribbon-like" structures were found to form the backbones of these porous frameworks. The hydrophobic nature of these membranes was revealed by water contact angle measurements.

Steric and electrostatic complementarity in the assembly of two-dimensional virus arrays

A highly ordered assembly of biological molecules provides a powerful means to study the organizational principles of objects at the nanoscale. Two-dimensional cowpea mosaic virus arrays were assembled in an ordered manner on mica using osmotic depletion effects and a drop-and-dry method. The packing of the virus array was controlled systematically from rhombic packing to hexagonal packing by modulating the concentrations of poly(ethylene glycol) surfactant in the virus solutions. The orientation and packing symmetry of the virus arrays were found to be tuned by the concentrations of surfactants in the sample solutions. A phenomenological model for the present system is proposed to explain the assembly array morphology under the influence of the surfactant. Steric and electrostatic complementarity of neighboring virus capsids is found to be the key factors in controlling the symmetry of packing.

Estrogen receptor alpha CA dinucleotide repeat polymorphism is associated with rate of bone loss in perimenopausal women and bone mineral density and risk of osteoporotic fractures in postmenopausal women

The association between a newly identified CA repeat polymorphism of the estrogen receptor alpha gene (ESR1) with osteoporosis was investigated. Postmenopausal women with <18 CA repeats had low BMD, increased rate of bone loss and increased fracture risk.

INTRODUCTION

Studies have shown that intronic dinucleotide repeat polymorphisms in some genes are associated with disease risk by modulating mRNA splicing efficiency. D6S440 is a newly identified intronic CA repeat polymorphism located downstream of the 5'-splicing site of exon 5 of ESR1.

METHODS

The associations of D6S440 with bone mineral density (BMD), rate of bone loss and fracture risk were evaluated in 452 pre-, 110 peri- and 622 postmenopausal southern Chinese women using regression models.

RESULTS

Post- but not premenopausal women with less CA repeats had lower spine and hip BMD. The number of CA repeats was linearly related to hip BMD in postmenopausal women (beta=0.008; p=0.004). Postmenopausal women with CA repeats <18 had higher risks of having osteoporosis (BMD T-score< -2.5 at the spine: OR 2.46, 95% CI 1.30-4.65; at the hip: OR 3.79(1.64-8.74)) and low trauma fractures (OR 2.31(1.29-4.14)) than those with >or= 18 repeats. Perimenopausal women with <18 CA repeats had significantly greater bone loss in 18 months at the hip than those with >or= 18 repeats (-1.96% vs. -1.61%, p = 0.029).

CONCLUSIONS

ESR1 CA repeat polymorphism is associated with BMD variation, rate of bone loss and fracture risk, and this may be a useful genetic marker for fracture risk assessment.

Lotus effect in engineered zirconia

Patterned micro- and nanostructured surfaces have received increasing attention because of their ability to tune the hydrophobicity and hydrophilicity of their surfaces. However, the mechanical properties of these studied surfaces are not sufficiently robust for load-bearing applications. Here we report transparent nanocrystalline ZrO 2 films possessing combined properties of hardness and complete wetting behavior, which are expected to benefit tribology, wear reduction, and biomedical applications where ultrahydrophilic surfaces are required. This ultrahydrophilic behavior may be explained by the Wenzel model.

Structural study of titanium oxide films synthesized by ion beam-assisted deposition

The application of titanium dioxide (TiO(2)) films as surgical implant coatings for antibiotic attachment depends crucially on their available surface area and thus their surface morphology and crystallinity. Here, we report our fabrication of high Wenzel ratio TiO(2) films targeted to increase the film surface area using the ion beam-assisted deposition (IBAD) technique at high-deposition temperatures (approximately 610 degrees C). The modulation of the films' surface morphology was accomplished by varying the chemical identity of the concurrent ion beams bombarded on the films during the e-beam evaporation process. Atomic force microscopy (AFM) and scanning electron microscopy (SEM) were employed to investigate the surface morphology of the as-deposited films. X-ray diffractometry (XRD) revealed that these nanocrystalline films primarily consist of anatase phase TiO(2). Wenzel ratio, the ratio of the actual surface area to the projected area, of IBAD films prepared with argon, oxygen, and nitrogen ion beams was measured to be 1.52, 1.31 and 1.49, respectively. The effect of the differences in chemical reactivity and ion size of these three type ion beams are discussed to explain the present results.

Establishment of influenza A virus (H6N1) in minor poultry species in southern China

An H6N1 virus, A/teal/Hong Kong/W312/97 (W312), was isolated during the "bird flu" incident in Hong Kong in 1997. Genetic analysis suggested that this virus might be the progenitor of the A/Hong Kong/156/97 (HK/97) H5N1 virus, as seven of eight gene segments of those viruses had a common source. Continuing surveillance in Hong Kong showed that a W312-like virus was prevalent in quail and pheasants in 1999; however, the further development of H6N1 viruses has not been investigated since 2001. Here we report influenza virus surveillance data collected in southern China from 2000 to 2005 that show that H6N1 viruses have become established and endemic in minor poultry species and replicate mainly in the respiratory tract. Phylogenetic analysis indicated that all H6N1 isolates had W312-like hemagglutinin and neuraminidase genes. However, reassortment of internal genes between different subtype virus lineages, including H5N1, H9N2, and other avian viruses, generated multiple novel H6N1 genotypes in different types of poultry. These novel H6N1/N2 viruses are double, triple, or even quadruple reassortants. Reassortment between a W312-like H6N1 virus and an A/quail/Hong Kong/G1/97 (HK/97)-like H9N2 virus simultaneously generated novel H6N2 subtype viruses that were persistent in poultry. Molecular analyses suggest that W312-like viruses may not be the precursors of HK/97 virus but reassortants from an HK/97-like virus and another unidentified H6 subtype virus. These results provide further evidence of the pivotal role of the live poultry market system of southern China in generating increased genetic diversity in influenza viruses in this region.

Prevalence and genetic diversity of coronaviruses in bats from China

Coronaviruses can infect a variety of animals including poultry, livestock, and humans and are currently classified into three groups. The interspecies transmissions of coronaviruses between different hosts form a complex ecosystem of which little is known. The outbreak of severe acute respiratory syndrome (SARS) and the recent identification of new coronaviruses have highlighted the necessity for further investigation of coronavirus ecology, in particular the role of bats and other wild animals. In this study, we sampled bat populations in 15 provinces of China and reveal that approximately 6.5% of the bats, from diverse species distributed throughout the region, harbor coronaviruses. Full genomes of four coronavirues from bats were sequenced and analyzed. Phylogenetic analyses of the spike, envelope, membrane, and nucleoprotein structural proteins and the two conserved replicase domains, putative RNA-dependent RNA polymerase and RNA helicase, revealed that bat coronaviruses cluster in three different groups: group 1, another group that includes all SARS and SARS-like coronaviruses (putative group 4), and an independent bat coronavirus group (putative group 5). Further genetic analyses showed that different species of bats maintain coronaviruses from different groups and that a single bat species from different geographic locations supports similar coronaviruses. Thus, the findings of this study suggest that bats may play an integral role in the ecology and evolution of coronaviruses.

Physical Controls on Directed Virus Assembly at Nanoscale Chemical Templates

Viruses are attractive building blocks for nanoscale heterostructures, but little is understood about the physical principles governing their directed assembly. In situ force microscopy was used to investigate organization of Cowpea Mosaic Virus engineered to bind specifically and reversibly at nanoscale chemical templates with sub-30 nm features. Morphological evolution and assembly kinetics were measured as virus flux and inter-viral potential were varied. The resulting morphologies were similar to those of atomic-scale epitaxial systems, but the underlying thermodynamics was analogous to that of colloidal systems in confined geometries. The 1D templates biased the location of initial cluster formation, introduced asymmetric sticking probabilities, and drove 1D and 2D condensation at sub-critical volume fractions. The growth kinetics followed a t(1/2) law controlled by the slow diffusion of viruses. The ability of poly(ethylene glycol) (PEG) to induce the lateral expansion of virus clusters away from the 1D templates suggests a significant role for weak interactions.

Evolution and adaptation of H5N1 influenza virus in avian and human hosts in Indonesia and Vietnam

Highly pathogenic avian influenza virus H5N1 is endemic in poultry in East and Southeast Asia with disease outbreaks recently spreading to parts of central Asia, Europe and Africa. Continued interspecies transmission to humans has been reported in Vietnam, Thailand, Cambodia, Indonesia and China, causing pandemic concern. Here, we genetically characterize 82 H5N1 viruses isolated from poultry throughout Indonesia and Vietnam and 11 human isolates from southern Vietnam together with sequence data available in public databases to address questions relevant to virus introduction, endemicity and evolution. Phylogenetic analysis shows that all viruses from Indonesia form a distinct sublineage of H5N1 genotype Z viruses suggesting this outbreak likely originated from a single introduction that spread throughout the country during the past two years. Continued virus activities in Indonesia were attributed to transmission via poultry movement within the country rather than through repeated introductions by bird migration. Within Indonesia and Vietnam, H5N1 viruses have evolved over time into geographically distinct groups within each country. Molecular analysis of the H5N1 genotype Z genome shows that only the M2 and PB1-F2 genes were under positive selection, suggesting that these genes might be involved in adaptation of this virus to new hosts following interspecies transmission. At the amino acid level 12 residues were under positive selection in those genotype Z viruses, in the HA and PB1-F2 proteins. Some of these residues were more frequently observed in human isolates than in avian isolates and are related to viral antigenicity and receptor binding. Our study provides insight into the ongoing evolution of H5N1 influenza viruses that are transmitting in diverse avian species and at the interface between avian and human hosts.

H5N1 influenza: a protean pandemic threat

Infection with avian influenza A virus of the H5N1 subtype (isolates A/HK/212/03 and A/HK/213/03) was fatal to one of two members of a family in southern China in 2003. This incident was preceded by lethal outbreaks of H5N1 influenza in waterfowl, which are the natural hosts of these viruses and, therefore, normally have asymptomatic infection. The hemagglutinin genes of the A/HK/212/03-like viruses isolated from humans and waterfowl share the lineage of the H5N1 viruses that caused the first known cases of human disease in Hong Kong in 1997, but their internal protein genes originated elsewhere. The hemagglutinin of the recent human isolates has undergone significant antigenic drift. Like the 1997 human H5N1 isolates, the 2003 human H5N1 isolates induced the overproduction of proinflammatory cytokines by primary human macrophages in vitro, whereas the precursor H5N1 viruses and other H5N1 reassortants isolated in 2001 did not. The acquisition by the viruses of characteristics that enhance virulence in humans and waterfowl and their potential for wider distribution by infected migrating birds are causes for renewed pandemic concern.

Isolation and characterization of viruses related to the SARS coronavirus from animals in southern China

A novel coronavirus (SCoV) is the etiological agent of severe acute respiratory syndrome (SARS). SCoV-like viruses were isolated from Himalayan palm civets found in a live-animal market in Guangdong, China. Evidence of virus infection was also detected in other animals (including a raccoon dog, Nyctereutes procyonoides) and in humans working at the same market. All the animal isolates retain a 29-nucleotide sequence that is not found in most human isolates. The detection of SCoV-like viruses in small, live wild mammals in a retail market indicates a route of interspecies transmission, although the natural reservoir is not known.

Fabrication of assembled virus nanostructures on templates of chemoselective linkers formed by scanning probe nanolithography

We have developed a multistep route to the fabrication of virus assembled nanostructures with chemoselective protein-to-surface linkers synthesized by an efficient solid-phase method. These linkers were used to create patterns of 30-to-50-nm-width-lines by scanning probe nanolithography. Genetically modified cow pea mosaic virus with unique cysteine residues at specific locations on their capsomers were assembled through covalent linkage on these patterns. The morphology of the assembled structures on these line patterns characterized by atomic force microscopy was found to be strongly influenced by the intervirion interactions.

Direct imaging of human SWI/SNF-remodeled mono- and polynucleosomes by atomic force microscopy employing carbon nanotube tips

Chromatin-remodeling complexes alter chromatin structure to facilitate, or in some cases repress, gene expression. Recent studies have suggested two potential pathways by which such regulation might occur. In the first, the remodeling complex repositions nucleosomes along DNA to open or occlude regulatory sites. In the second, the remodeling complex creates an altered dimeric form of the nucleosome that has altered accessibility to transcription factors. The extent of translational repositioning, the structure of the remodeled dimer, and the presence of dimers on remodeled polynucleosomes have been difficult to gauge by biochemical assays. To address these questions, ultrahigh-resolution carbon nanotube tip atomic force microscopy was used to examine the products of remodeling reactions carried out by the human SWI/SNF (hSWI/SNF) complex. We found that mononucleosome remodeling by hSWI/SNF resulted in a dimer of mononucleosomes in which approximately 60 bp of DNA is more weakly bound than in control nucleosomes. Arrays of evenly spaced nucleosomes that were positioned by 5S rRNA gene sequences were disorganized by hSWI/SNF, and this resulted in long stretches of bare DNA, as well as clusters of nucleosomes. The formation of structurally altered nucleosomes on the array is suggested by a significant increase in the fraction of closely abutting nucleosome pairs and by a general destabilization of nucleosomes on the array. These results suggest that both the repositioning and structural alteration of nucleosomes are important aspects of hSWI/SNF action on polynucleosomes.

Structural and functional imaging with carbon nanotube AFM probes

Atomic force microscopy (AFM) has great potential as a tool for structural biology, a field in which there is increasing demand to characterize larger and more complex biomolecular systems. However, the poorly characterized silicon and silicon nitride probe tips currently employed in AFM limit its biological applications. Carbon nanotubes represent ideal AFM tip materials due to their small diameter, high aspect ratio, large Young's modulus, mechanical robustness, well-defined structure, and unique chemical properties. Nanotube probes were first fabricated by manual assembly, but more recent methods based on chemical vapor deposition provide higher resolution probes and are geared towards mass production, including recent developments that enable quantitative preparation of individual single-walled carbon nanotube tips [J. Phys. Chem. B 105 (2001) 743]. The high-resolution imaging capabilities of these nanotube AFM probes have been demonstrated on gold nanoparticles and well-characterized biomolecules such as IgG and GroES. Using the nanotube probes, new biological structures have been investigated in the areas of amyloid-beta protein aggregation and chromatin remodeling, and new biotechnologies have been developed such as AFM-based haplotyping. In addition to measuring topography, chemically functionalized AFM probes can measure the spatial arrangement of chemical functional groups in a sample. However, standard silicon and silicon nitride tips, once functionalized, do not yield sufficient resolution to allow combined structural and functional imaging of biomolecules. The unique end-group chemistry of carbon nanotubes, which can be arbitrarily modified by established chemical methods, has been exploited for chemical force microscopy, allowing single-molecule measurements with well-defined functionalized tips.

Energy gaps in "metallic" single-walled carbon nanotubes

Metallic single-walled carbon nanotubes have been proposed to be good one-dimensional conductors. However, the finite curvature of the graphene sheet that forms the nanotubes and the broken symmetry due to the local environment may modify their electronic properties. We used low-temperature atomically resolved scanning tunneling microscopy to investigate zigzag and armchair nanotubes, both thought to be metallic. "Metallic" zigzag nanotubes were found to have energy gaps with magnitudes that depend inversely on the square of the tube radius, whereas isolated armchair tubes do not have energy gaps. Additionally, armchair nanotubes packed in bundles have pseudogaps, which exhibit an inverse dependence on tube radius. These observed energy gaps suggest that most "metallic" single-walled nanotubes are not true metals, and they have implications for our understanding of the electronic properties and potential applications of carbon nanotubes.