Plasma-deposited AgOx-doped TiOx coatings enable rapid antibacterial activity based on ROS generation

Abstract To enable a rapid-acting antibacterial mechanism without the release of biocidal substances, TiO2 catalysts have been considered based on the generation of reactive oxygen species (ROS). Doping with dissimilar metals generates electron-hole pairs with narrow band gaps promoting the production of ROS. Here, plasma technology is investigated to deposit Ag nano islets on defective TiOx films, stabilized by plasma postoxidation suppressing Ag ion release. Importantly, ROS generation is maintained upon storage in the dark yet with diminishing efficacy; however, it can be restored by exposure to visible light. The rapid-acting antibacterial properties are found to strongly correlate with ROS generation, which can even be maintained by functionalization with hydrophobic plasma polymer films. The cytocompatible coatings offer promising applications for implants and other medical devices

Suture slippage in knotless suture anchors as a potential failure mechanism in rotator cuff repair

PURPOSE: To quantify the strength of suture fixation of knotless suture anchors in relation to the anchors' pullout strength and to compare these results with the static friction between different sutures and anchor materials. METHODS: Suture slippage within the anchor and pullout strength of 4 different knotless suture anchor models were assessed in a bovine bone model. Furthermore, the peak force before onset of slippage of different sutures trapped between increasingly loaded 4-mm rods made of commonly used anchor material (polyetheretherketone, poly-L-lactide acid, metal) was assessed. RESULTS: In all but 1 of the tested anchors, there was a relevantly lower load needed for slippage of the sutures than to pull out the anchor from bone. The mean load to anchor pullout ranged between 156 and 269 N. The load to suture slippage ranged between 66 and 109 N. All sutures were better held between the metal rods (mean, 21; 95% confidence interval [CI], 19.2 to 23.3) than with polyetheretherketone rods (mean, 17; 95% CI, 15.7 to 18.1) or poly-L-lactide acid rods (mean, 18; 95% CI, 17.6 to 18.4). CONCLUSIONS: In the case of suture anchors that hold the sutures by clamping, the hold of the suture in the anchor may be far lower than the pullout strength of the anchor from bone, because the sutures just slip out from the anchor through the clamping mechanism. This is well explained by the low static friction achieved between the tested sutures and the test rods made of anchor materials. CLINICAL RELEVANCE: The use of knotless suture anchors appears quick and easy to perform; however, most of the anchor systems could not even reach half of the anchor pullout strength from bone before suture slippage occurred

In vitro biodegradation of polyester-based plastic materials by selected bacterial cultures

A simple and rapid in vitro test was designed for the assessment of the biodegradation of polyester-based plastics by selected biodegrading bacterial strains. Variovorax paradoxus LMG 16137 was used for the degradation of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) and Acidovorax avenae subsp. avenae LMG 17238 for the synthetic-based polyesters poly(epsilon -caprolactone) (PCL), poly(butylene succinate-co-butylene adipate), and a starch-PCL blend. Degradation by the bacteria was studied in liquid medium with the plastics (films, granules, and injection-molded test bars) as sole sources of carbon. Degradation was followed through gravimetry, growth of the culture, and tensile testing. The effects of incubation time, inoculum density, aeration, incubation temperature, and pH of the medium on the mass loss were investigated and conditions optimized. The test allowed to obtain reproducible results on the mass loss of plastic samples in less than 3 weeks and yielded excellent partially degraded samples for further analysis

Non-destructive three-dimensional evaluation of a polymer sponge by micro-tomography using synchrotron radiation

X-ray micro-tomography, a non-destructive technique is used to uncover the complex 3-D micro-architecture of a degradable polymer sponge designed for bone augmentation. The measurements performed at HASYLAB at DESY are based on a synchrotron radiation source resulting in a spatial resolution of about 5.4 microm. In the present communication we report the quantitative analysis of the porosity and of the pore architecture. First, we elucidate that synchrotron radiation at the photon energy of 9 keV has an appropriate cross section for this low-weight material. Modifications in sponge micro-architecture during measurement are not detected. Second, the treatment of the data, an amount of 2.5 Gbyte to generate binary data is described. We compare the 3-D with the 2-D analysis in a quantitative manner. The obtained values for the mean distance to material within the sponge calculated from 2-D and 3-D data of the whole tomogram differ significantly: 12.5 microm for 3-D and 17.6 microm for 2-D analysis. If the pores exhibit a spherical shape as frequently found, the derived mean pore diameter, however, is overestimated only by 6% in the 2-D image analysis with respect to the 3-D evaluation. This approach can be applied to different porous biomaterials and composites even in a hydrated state close to physiological conditions, where any surface preparation artifact is avoided

Non-AIDS defining malignancies in the combination ART era: immunological and socio-behavioral risk factors

Background: Since the advent of combination antiretroviral therapy (cART), non-AIDS defining malignancies (NADM) have become increasingly important. We examined risk factors for NADM, including immunological, virological and socio-behavioral characteristics. Methods: We linked the Swiss HIV Cohort Study (SHCS) with cancer registries to identify incident cancers between 1996 and 2012. We analyzed four common NADM: anal, lung, prostate, and liver cancer. We calculated standardized incidence ratios (SIRs) and assessed the effect of time-updated CD4 and CD8 count, CD4/CD8 ratio, and HIV viral load (copies/ml) in Cox regression models. We lagged time-dependent variables for 12, 24, and 36 months and captured cumulative exposures using simple moving averages (SMA). In multivariable models, we also considered HIV transmission group, smoking, and chronic hepatitis B or C infection as potential predictors of NADM incidence. Results. Between 1996 and 2012, 563 HIV-infected individuals developed NADM, including 70 anal, 49 lung, 44 prostate, and 36 liver cancers. Compared with the general population, the SHCS exhibited higher rates of anal (SIR 76.1, 95% Confidence interval (CI) 60.2-96.2), lung (SIR 1.98, 1.50-2.62), and liver cancer (SIR 7.28, 5.25-10.1) but similar rates of prostate cancer (SIR 1.03, 0.76-1.38). Anal cancer was associated with low CD4 cell count, high CD8 cell count, men who have sex with men, and smoking. For lung cancer, the CD8 cell count was the only significant predictor identified among the immunological and virological factors. CD4 cell count, and chronic hepatitis B and C infection were predictive of liver cancer incidence. We found no evidence of any of the immunological factors being associated with prostate cancer. Conclusions: The importance of immunodeficiency (indexed by CD4 count) and immune senescence (indexed by CD8 count) differs across NADM. Immunodeficiency was an important risk factor for anal and liver cancer whereas immune senescence was associated with lung cancer and anal cancer

Prediction of hip fracture risk by quantitative ultrasound in more than 7000 Swiss women > or =70 years of age: comparison of three technologically different bone ultrasound devices in the SEMOF study.

To compare the prediction of hip fracture risk of several bone ultrasounds (QUS), 7062 Swiss women > or =70 years of age were measured with three QUSs (two of the heel, one of the phalanges). Heel QUSs were both predictive of hip fracture risk, whereas the phalanges QUS was not. INTRODUCTION: As the number of hip fracture is expected to increase during these next decades, it is important to develop strategies to detect subjects at risk. Quantitative bone ultrasound (QUS), an ionizing radiation-free method, which is transportable, could be interesting for this purpose. MATERIALS AND METHODS: The Swiss Evaluation of the Methods of Measurement of Osteoporotic Fracture Risk (SEMOF) study is a multicenter cohort study, which compared three QUSs for the assessment of hip fracture risk in a sample of 7609 elderly ambulatory women > or =70 years of age. Two QUSs measured the heel (Achilles+; GE-Lunar and Sahara; Hologic), and one measured the heel (DBM Sonic 1200; IGEA). The Cox proportional hazards regression was used to estimate the hazard of the first hip fracture, adjusted for age, BMI, and center, and the area under the ROC curves were calculated to compare the devices and their parameters. RESULTS: From the 7609 women who were included in the study, 7062 women 75.2 +/- 3.1 (SD) years of age were prospectively followed for 2.9 +/- 0.8 years. Eighty women reported a hip fracture. A decrease by 1 SD of the QUS variables corresponded to an increase of the hip fracture risk from 2.3 (95% CI, 1.7, 3.1) to 2.6 (95% CI, 1.9, 3.4) for the three variables of Achilles+ and from 2.2 (95% CI, 1.7, 3.0) to 2.4 (95% CI, 1.8, 3.2) for the three variables of Sahara. Risk gradients did not differ significantly among the variables of the two heel QUS devices. On the other hand, the phalanges QUS (DBM Sonic 1200) was not predictive of hip fracture risk, with an adjusted hazard risk of 1.2 (95% CI, 0.9, 1.5), even after reanalysis of the digitalized data and using different cut-off levels (1700 or 1570 m/s). CONCLUSIONS: In this elderly women population, heel QUS devices were both predictive of hip fracture risk, whereas the phalanges QUS device was not