Mechanics of Bacterial Interaction and Death on Nanopatterned Surfaces.

Nanopatterned surfaces are believed to kill bacteria through physical deformation, a mechanism that has immense potential against biochemical resistance. Because of its elusive nature, this mechanism is mostly understood through biophysical modeling. Problematically, accurate descriptions of the contact mechanics and various boundary conditions involved in the bacteria-nanopattern interaction remain to be seen. This may underpin conflicting predictions, found throughout the literature, regarding two important aspects of the mechanism-that is, its critical action site and relationship with geometry. Herein, a robust computational analysis of bacteria-nanopattern interaction is performed using a three-dimensional finite element modeling that incorporates relevant continuum mechanical properties, multilayered envelope structure, and adhesion interaction conditions. The model is applied to more accurately study the elusory mechanism and its enhancement via nanopattern geometry. Additionally, micrographs of bacteria adhered on a nanopatterned cicada wing are examined to further inform and verify the major modeling predictions. Together, the results indicate that nanopatterned surfaces do not kill bacteria predominantly by rupture in between protruding pillars as previously thought. Instead, nondevelopable deformation about pillar tips is more likely to create a critical site at the pillar apex, which delivers significant in-plane strains and may locally rupture and penetrate the cell. The computational analysis also demonstrates that envelope deformation is increased by adhesion to nanopatterns with smaller pillar radii and spacing. These results further progress understanding of the mechanism of nanopatterned surfaces and help guide their design for enhanced bactericidal efficiency.

A systematic approach towards biomimicry of nanopatterned cicada wings on titanium using electron beam lithography.

The interaction of bacteria on nanopatterned surfaces has caught attention since the discovery of the bactericidal property of cicada wing surfaces. While many studies focused on the inspiration of such surfaces, nanolithography-based techniques are seldom used due to the difficulties in fabricating highly dense (number of pillars per unit area), geometrical nanostructured surfaces. Here we present a systematic modelling approach for optimising the electron beam lithography parameters in order to fabricate biomimicked nanopillars of varying patterned geometries. Monte Carlo simulation was applied to optimize the beam energy and pattern design prior to the experimental study. We optimized the processing parameters such as exposure factor, write field size, pitch, the different types and thicknesses of the PMMA resist used, and the shape of the feature (circle or a dot) for the fabrication of nanopillars to achieve the best lift-off with repeatable result. Our simulation and experimental results showed that a circle design with a voltage of 30 kV and 602 nm thickness of PMMA 495 A4 as base layers and 65 nm of PMMA 950 A2 as top layer achieves the best results. The antibacterial activity was also validated on the representative fabricated titanium nanopillar surface. The surface with a base diameter of 94.4 nm, spike diameter of 12.6 nm, height of 115.6 nm, density of 43/µm2, aspect ratio of 2.16 and centre to centre distance of 165.8 nm was the optimum surface for antibacterial activity. Such a systematic design approach for fabrication of insect wing-mimicked closely packed nanopillars have not been investigated before which provides an excellent platform for biomedical Ti implants.

Multi-scale surface topography to minimize adherence and viability of nosocomial drug-resistant bacteria.

Toward minimizing bacterial colonization of surfaces, we present a one-step etching technique that renders aluminum alloys with micro- and nano-scale roughness. Such a multi-scale surface topography exhibited enhanced antibacterial effect against a wide range of pathogens. Multi-scale topography of commercially grade pure aluminum killed 97% of Escherichia coli and 28% of Staphylococcus aureus cells in comparison to 7% and 3%, respectively, on the smooth surfaces. Multi-scale topography on Al 5052 surface was shown to kill 94% of adhered E. coli cells. The microscale features on the etched Al 1200 alloy were not found to be significantly bactericidal, but shown to decrease the adherence of S. aureus cells by one-third. The fabrication method is easily scalable for industrial applications. Analysis of roughness parameters determined by atomic force microscopy revealed a set of significant parameters that can yield a highly bactericidal surface; thereby providing the design to make any surface bactericidal irrespective of the method of fabrication. The multi-scale roughness of Al 5052 alloy was also highly bactericidal to nosocomial isolates of E. coli, K. pneumoniae and P. aeruginosa. We envisage the potential application of engineered surfaces with multi-scale topography to minimize the spread of nosocomial infections.

Biophysical model of bacterial cell interactions with nanopatterned cicada wing surfaces.

The nanopattern on the surface of Clanger cicada (Psaltoda claripennis) wings represents the first example of a new class of biomaterials that can kill bacteria on contact based solely on their physical surface structure. The wings provide a model for the development of novel functional surfaces that possess an increased resistance to bacterial contamination and infection. We propose a biophysical model of the interactions between bacterial cells and cicada wing surface structures, and show that mechanical properties, in particular cell rigidity, are key factors in determining bacterial resistance/sensitivity to the bactericidal nature of the wing surface. We confirmed this experimentally by decreasing the rigidity of surface-resistant strains through microwave irradiation of the cells, which renders them susceptible to the wing effects. Our findings demonstrate the potential benefits of incorporating cicada wing nanopatterns into the design of antibacterial nanomaterials.

High-spatial-resolution mapping of superhydrophobic cicada wing surface chemistry using infrared microspectroscopy and infrared imaging at two synchrotron beamlines.

The wings of some insects, such as cicadae, have been reported to possess a number of interesting and unusual qualities such as superhydrophobicity, anisotropic wetting and antibacterial properties. Here, the chemical composition of the wings of the Clanger cicada (Psaltoda claripennis) were characterized using infrared (IR) microspectroscopy. In addition, the data generated from two separate synchrotron IR facilities, the Australian Synchrotron Infrared Microspectroscopy beamline (AS-IRM) and the Synchrotron Radiation Center (SRC), University of Wisconsin-Madison, IRENI beamline, were analysed and compared. Characteristic peaks in the IR spectra of the wings were assigned primarily to aliphatic hydrocarbon and amide functionalities, which were considered to be an indication of the presence of waxy and proteinaceous components, respectively, in good agreement with the literature. Chemical distribution maps showed that, while the protein component was homogeneously distributed, a significant degree of heterogeneity was observed in the distribution of the waxy component, which may contribute to the self-cleaning and aerodynamic properties of the cicada wing. When comparing the data generated from the two beamlines, it was determined that the SRC IRENI beamline was capable of producing higher-spatial-resolution distribution images in a shorter time than was achievable at the AS-IRM beamline, but that spectral noise levels per pixel were considerably lower on the AS-IRM beamline, resulting in more favourable data where the detection of weak absorbances is required. The data generated by the two complementary synchrotron IR methods on the chemical composition of cicada wings will be immensely useful in understanding their unusual properties with a view to reproducing their characteristics in, for example, industry applications.

Selective bactericidal activity of nanopatterned superhydrophobic cicada Psaltoda claripennis wing surfaces.

The nanopattern on the surface of Clanger cicada (Psaltoda claripennis) wings represents the first example of a new class of biomaterials that can kill bacteria on contact based solely on its physical surface structure. As such, they provide a model for the development of novel functional surfaces that possess an increased resistance to bacterial contamination and infection. Their effectiveness against a wide spectrum of bacteria, however, is yet to be established. Here, the bactericidal properties of the wings were tested against several bacterial species, possessing a range of combinations of morphology and cell wall type. The tested species were primarily pathogens, and included Bacillus subtilis, Branhamella catarrhalis, Escherichia coli, Planococcus maritimus, Pseudomonas aeruginosa, Pseudomonas fluorescens, and Staphylococcus aureus. The wings were found to consistently kill Gram-negative cells (i.e., B. catarrhalis, E. coli, P. aeruginosa, and P. fluorescens), while Gram-positive cells (B. subtilis, P. maritimus, and S. aureus) remained resistant. The morphology of the cells did not appear to play any role in determining cell susceptibility. The bactericidal activity of the wing was also found to be quite efficient; 6.1 ± 1.5 × 10(6) P. aeruginosa cells in suspension were inactivated per square centimeter of wing surface after 30-min incubation. These findings demonstrate the potential for the development of selective bactericidal surfaces incorporating cicada wing nanopatterns into the design.

Cast selection and non-union rates for acute scaphoid fractures treated conservatively: a systematic review and meta-analysis.

Cast selection for conservatively treated acute scaphoid fractures remains controversial. Cast options include short arm versus long arm, and those that include the thumb or leave it free. We sought to investigate the role of how cast choice affects nonunion rates after conservative management of scaphoid fractures. We searched PubMed, Embase, and Google Scholar from inception through July 14, 2020, according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. We extracted information of interest, including cast type, and non-union rates at the end of the treatment period. We then performed a meta-analysis using the random-effects model. We identified seven relevant studies. Non-union was observed in 15 out of 156 (9.6%) with short-arm cast and 13 out of the 124 (10.5%) with long-arm cast (OR = 0.79, 95% CI [0.19, 3.26], p = 0.74). Non-union was observed in 18 out of 174 (10.3%) with thumb immobilization cast and 18 out of the 179 (10.1%) without thumb immobilization (OR = 0.97, 95% CI [0.49, 1.94], p = 0.69). In our study, short arm casting was proven non-inferior to long arm casting. Similarly, casts without thumb immobilization were equally as effective as casts with thumb immobilization in terms of non-union rates for acute scaphoid fractures treated non-operatively.

Natural bactericidal surfaces: mechanical rupture of Pseudomonas aeruginosa cells by cicada wings.

Natural superhydrophobic surfaces are often thought to have antibiofouling potential due to their self-cleaning properties. However, when incubated on cicada wings, Pseudomonas aeruginosa cells are not repelled; instead they are penetrated by the nanopillar arrays present on the wing surface, resulting in bacterial cell death. Cicada wings are effective antibacterial, as opposed to antibiofouling, surfaces.

Spatial variations and temporal metastability of the self-cleaning and superhydrophobic properties of damselfly wings.

Self-cleaning surfaces found in nature show great potential for application in many fields, ranging from industry to medicine. The ability for a surface to self-clean is intimately related to the wetting properties of the surface; for a surface to possess self-cleaning ability it must exhibit extremely high water contact angles and low water adhesion. While investigating the self-cleaning properties of damselfly wings, significant spatial variations in surface wettability were observed. Within an area of 100 µm × 100 µm of the wing surface the water contact angle was found to vary up to 17.8°, while remaining consistently superhydrophobic. The contributions of both surface chemistry and topography to the hydrophobicity of the wings were assessed in an effort to explain these variations. Synchrotron-sourced Fourier-transform infrared microspectroscopy revealed that some of the major components of the wing were aliphatic hydrocarbons and esters, which are attributable to epicuticular lipids. The wing topography, as determined by optical profilometry and atomic force microscopy (AFM), also showed only minor levels of heterogeneity arising from irregular ordering of surface nanostructures. The measured contact angle of a single droplet of water was also found to decrease over time as it evaporated, reaching a minimum of 107°. This is well below the threshold value for superhydrophobicity (i.e., 150°), demonstrating that when the surface is in contact with water for a prolonged period, the damselfly wings lose their superhydrophobicity and subsequently their ability to self-clean. This decrease in hydrophobicity over time can be attributed to the surface undergoing a transition from the Cassie-Baxter wettability state toward the Wenzel wettability state.

Nanomechanical tribological characterisation of nanostructured titanium alloy surfaces using AFM: A friction vs velocity study.

Medical-grade titanium alloys used for orthopaedic implants are at risk from infections and complications such as wear and tear. We have recently shown that hydrothermally etched (HTE) nanostructures (NS) formed on the Ti6AlV4 alloy surfaces impart enhanced anti-bacterial activity which results in inhibited formation of bacterial biofilm. Although these titanium alloy nanostructures may resist bacterial colonisation, their frictional properties are yet to be understood. Orthopaedic devices are encapsulated by bone and muscle tissue. Contact friction between orthopaedic implant surfaces and these host tissues may trigger inflammation, osteolysis and wear. To address these challenges, we performed simulation of the contact behaviour between a smooth control Ti6Al4V alloy and HTE surfaces against a hardwearing SiO2 sphere using Atomic Force Microscopy (AFM) in Lateral Force Microscopy mode. The friction study was evaluated in both air and liquid environments at high (5 Hz) and low (0.5 Hz) scan velocities. Lower scan velocities demonstrated opposing friction force changes between the two mediums, with friction stabilising at higher velocities. The friction measured on the NS alloy surfaces was reduced by ~20% in air and ~80% in phosphate buffered saline, in comparison to the smooth control surface, displaying a non-linear behaviour of the force applied by the AFM tip. Changes in friction values and cantilever scan velocities on different substrates are discussed with respect to the Stribeck curve. Reduced friction on nanostructured surfaces may improve wear resistance and aid osseointegration.

Traumatic Complex Scaphoid Dislocation With Radial Carpal Disruption: A Case Report.

Background. Scaphoid dislocation with radial carpal disruption constitutes an extremely rare injury, and there are no clear guidelines for treatment. This article reviews a delayed presentation of this injury and its surgical management.

Surgical Management of Bronchobiliary Fistula After Thoracoabdominal Trauma.

Bronchobiliary fistulas are exceedingly rare pathological connections between the biliary and the bronchial systems, which result from hepatobiliary neoplasms, abscesses, or thoracoabdominal trauma. Prompt recognition, diagnosis, and intervention is essential in order to prevent the high morbidity and mortality associated with this disease process. Multiple management strategies have been described in the literature; however, the optimal course has not been well defined. We present a case of a 31-year-old male who developed a bronchobiliary fistula 1 month after thoracoabdominal trauma. After conservative management with biliary stenting failed, he successfully underwent latissimus sparing right posterolateral thoracotomy, complete fistulectomy, right lower lobe wedge resection, and diaphragmatic reconstruction with subsequent resolution of his symptoms.

Preventing Peri-implantitis: The Quest for a Next Generation of Titanium Dental Implants.

Titanium and its alloys are frequently the biomaterial of choice for dental implant applications. Although titanium dental implants have been utilized for decades, there are yet unresolved issues pertaining to implant failure. Dental implant failure can arise either through wear and fatigue of the implant itself or peri-implant disease and subsequent host inflammation. In the present report, we provide a comprehensive review of titanium and its alloys in the context of dental implant material, and how surface properties influence the rate of bacterial colonization and peri-implant disease. Details are provided on the various periodontal pathogens implicated in peri-implantitis, their adhesive behavior, and how this relationship is governed by the implant surface properties. Issues of osteointegration and immunomodulation are also discussed in relation to titanium dental implants. Some impediments in the commercial translation for a novel titanium-based dental implant from "bench to bedside" are discussed. Numerous in vitro studies on novel materials, processing techniques, and methodologies performed on dental implants have been highlighted. The present report review that comprehensively compares the in vitro, in vivo, and clinical studies of titanium and its alloys for dental implants.

The influence of nanoscopically thin silver films on bacterial viability and attachment.

The physicochemical and bactericidal properties of thin silver films have been analysed. Silver films of 3 and 150 nm thicknesses were fabricated using a magnetron sputtering thin-film deposition system. X-ray photoelectron and energy dispersive X-ray spectroscopy and atomic force microscopy analyses confirmed that the resulting surfaces were homogeneous, and that silver was the most abundant element present on both surfaces, being 45 and 53 at.% on the 3- and 150-nm films, respectively. Inductively coupled plasma time of flight mass spectroscopy (ICP-TOF-MS) was used to measure the concentration of silver ions released from these films. Concentrations of 0.9 and 5.2 ppb were detected for the 3- and 150-nm films, respectively. The surface wettability of the films remained nearly identical for both film thicknesses, displaying a static water contact angle of 95°, while the surface free energy of the 150-nm film was found to be slightly greater than that of the 3-nm film, being 28.8 and 23.9 mN m(-1), respectively. The two silver film thicknesses exhibited statistically significant differences in surface topographic profiles on the nanoscopic scale, with R (a), R (q) and R (max) values of 1.4, 1.8 and 15.4 nm for the 3-nm film and 0.8, 1.2 and 10.7 nm for the 150-nm film over a 5 × 5 µm scanning area. Confocal scanning laser microscopy and scanning electron microscopy revealed that the bactericidal activity of the 3-nm silver film was not significant, whereas the nanoscopically smoother 150-nm silver film exhibited appreciable bactericidal activity towards Pseudomonas aeruginosa ATCC 9027 cells and Staphylococcus aureus CIP 65.8 cells, obtaining up to 75% and 27% sterilisation effect, respectively.

Acute Ulnar Neurapraxia and Carpal Tunnel Syndrome in the Context of a Distal Radius Fracture.

Distal radius fractures, carpal tunnel syndrome, and ulnar nerve compression are common causes of symptoms that result in patients presenting for hand evaluation. This is a unique case of a distal radius fracture leading to both carpal tunnel syndrome and ulnar nerve compression requiring urgent operative management.

Trends in Bactericidal Nanostructured Surfaces: An Analytical Perspective.

Since the discovery of the bactericidal properties of cicada wing surfaces, there has been a surge in the number of studies involving antibacterial nanostructured surfaces (NSS). Studies show that there are many parameters (and thus, thousands of parameter combinations) that influence the bactericidal efficiency (BE) of these surfaces. Researchers attempted to correlate these parameters to BE but have so far been unsuccessful. This paper presents a meta-analysis and perspective on bactericidal NSS, aiming to identify trends and gaps in the literature and to provide insights for future research. We have attempted to synthesize data from a wide range of published studies and establish trends in the literature on bactericidal NSS. Numerous research gaps and findings based on correlations of various parameters are presented here, which will assist in the design of efficient bactericidal NSS and shape future research. Traditionally, it is accepted that BE of NSS depends on the bacterial Gram-stain type. However, this review found that factors beyond Gram-stain type are also influential. Furthermore, it is found that despite their higher BE, hydrophobic NSS are less commonly studied for their bactericidal effect. Interestingly, the impacts of surface hydrophobicity and roughness on the bactericidal effect were found to be influenced by a Gram-stain type of the tested bacteria. In addition, cell motility and shape influence BE, but research attention into these factors is lacking. It was found that hydrophobic NSS demonstrate more promising results than their hydrophilic counterparts; however, these surfaces have been overlooked. Confirming the common belief of the influence of nanofeature diameter on bactericidal property, this analysis shows the feature aspect ratio is also decisive. NSS fabricated on silicon substrates perform better than their titanium counterparts, and the success of these silicon structures maybe attributed to the fabrication processes. These insights benefit engineers and scientists alike in developing next-generation NSS.

Antiviral and Antibacterial Nanostructured Surfaces with Excellent Mechanical Properties for Hospital Applications.

With the rise of bacterial and viral infections including the recent outbreak of coronavirus, the requirement for novel antimicrobial strategies is also rising with urgency. To solve this problem, we have used a wet etching technique to fabricate 23 nm wide nanostructures randomly aligned as ridges on aluminum (Al) 6063 alloy surfaces. The surfaces were etched for 0.5, 1, and 3 h. The surfaces were characterized using scanning electron microscopy, energy-dispersive X-ray spectroscopy, contact angle goniometry, nanoindentation and atomic force microscopy. Strains of the Gram negative bacteria Pseudomonas aeruginosa and the Gram positive bacteria Staphylococcus aureus were used to evaluate the bacterial attachment behavior. For the first time, common respiratory viruses, respiratory syncytial virus (RSV) and rhinovirus (RV), were investigated for antiviral activity on nanostructured surfaces. It was found that the etched Al surfaces were hydrophilic and the nanoscale roughness enhanced with the etching time with Rrms ranging from 69.9 to 995 nm. Both bacterial cells of P. aeruginosa and S. aureus were physically deformed and were nonviable upon attachment after 3 h on the etched Al 6063 surface. This nanoscale surface topography inactivated 92 and 87% of the attached P. aeruginosa and S. aureus cells, respectively. The recovery of infectious RSV was also reduced significantly within 2 h of exposure to the nanostructured surfaces compared to the smooth Al control surfaces. There was a 3-4 log10 reduction in the viability counts of rhinovirus after 24 h on the nanostructured surfaces. The nanostructured surfaces exhibited excellent durability as the surfaces sustained 1000 cycles of 2000 µN load without any damage. This is the first report that has shown the combined antibacterial and antiviral property of the nanostructured surface with excellent nanomechanical properties that could be potentially significant for use in hospital environments to stop the spread of infections arising from physical surfaces.

Antiviral Nanostructured Surfaces Reduce the Viability of SARS-CoV-2.

In this letter, we report the ability of the nanostructured aluminum Al 6063 alloy surfaces to inactivate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There was no recoverable viable virus after 6 h of exposure to the nanostructured surface, elucidating a 5-log reduction compared to a flat Al 6063 surface. The nanostructured surfaces were fabricated using wet-etching techniques which generated nanotextured, randomly aligned ridges approximately 23 nm wide on the Al 6063 alloy surfaces. In addition to the excellent mechanical resilience properties previously shown, the etched surfaces have also demonstrated superior corrosion resistance compared to the control surfaces. Such nanostructured surfaces have the potential to be used in healthcare environment such as hospitals and public spaces to reduce the surface transmission of SARS-CoV-2 and combat COVID-19.

A nanopillar array on black titanium prepared by reactive ion etching augments cardiomyogenic commitment of stem cells.

A major impediment in the clinical translation of stem cell therapy has been the inability to efficiently and reproducibly direct differentiation of a large population of stem cells. Thus, we aimed to engineer a substrate for culturing stem cells to efficiently induce cardiomyogenic lineage commitment. In this work, we present a nanopillar array on the surface of titanium that was prepared by mask-less reactive ion etching. Scanning electron and atomic force microscopy revealed that the surface was covered by vertically aligned nanopillars each of ≈1 µm with a diameter of ≈80 nm. The nanopillars supported the attachment and proliferation of human mesenchymal stem cells (hMSCs). Cardiomyogenic lineage commitment of the stem cells was more enhanced on the nanopillars than on the smooth surface. When co-cultured with neonatal rat cardiomyocytes, the cyclic pattern of calcium transport observed distinctly in cells differentiated on the arrays compared to the cells cultured on the smooth surface was the functional validation of differentiation. The use of small molecule inhibitors revealed that integrins namely, α2ß1 and αvß3, are essential for cardiomyogenesis on the nanostructured surface, which is further mediated by FAK, Erk and Akt cell signaling pathways. This study demonstrates that the nanopillar array efficiently promotes the cardiomyogenic lineage commitment of stem cells via integrin-mediated signaling and can potentially serve as a platform for the ex vivo differentiation of stem cells toward cell therapy in cardiac tissue repair and regeneration.

Mimicking Insect Wings: The Roadmap to Bioinspiration.

Insect wings possess unique, multifaceted properties that have drawn increasing attention in recent times. They serve as an inspiration for engineering of materials with exquisite properties. The structure-function relationships of insect wings are yet to be documented in detail. In this review, we present a detailed understanding of the multifunctional properties of insect wings, including micro- and nanoscale architecture, material properties, aerodynamics, sensory perception, wettability, optics, and antibacterial activity, as investigated by biologists, physicists, and engineers. Several established modeling strategies and fabrication methods are reviewed to engender novel ideas for biomimetics in diverse areas.