Highlights 2  Microplate assays demonstrated that TCE and CCDE decreased initial biofilm formation  Cell adhesion generally increased when PE was used  Biofilm formation was dependent on the conditioning film concentration  Under flow conditions all conditioning films reduced biofilm formation  Surface conditioning affected the amount and clustering of bacteria on surfaces

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15With resistant bacteria on the increase, there is a need for new combinations of antimicrobials 16 / biocidal agents to help control the transmission of such microorganisms. Particulate forms of 17 graphite, graphene oxide (GO) and metal-hybrid compounds (silver-graphene oxide (AgGO) 18 and zinc oxide graphene oxide (ZnOGO)) were fabricated and characterised. X-Ray diffraction 19 and Diffuse Reflectance Infrared Fourier Transform Spectroscopy demonstrated the 20 composition of the compounds. Scanning Electron Microscopy and Energy Dispersive X-Ray 21 Spectroscopy determined the compounds were heterogeneous and irregular in shape and size 22 and that the level of silver in the AgGO sample was 57.9 wt.% and the ZnOGO contained 72.65 23 wt. % zinc. The compounds were tested for their antimicrobial activity against four prominent 24 bacteria; Escherichia coli, Staphylococcus aureus, Enterococcus faecium and Klebsiella 25 pneumoniae. AgGO was the most effective antimicrobial (Minimum inhibitory concentration 26 E. coli / Enterococcus faecium 0.125 mg mL -1 ; S. aureus / K. pneumoniae 0.25 mg mL -1 ). The 27 addition of Ag enhanced the activity of GO against the bacteria tested, including the generally 28 recalcitrant K. pneumoniae and Enterococcus faecium. These findings demonstrated that GO-29 metal hybrids have the potential to be utilised as novel antimicrobials or biocides in liquid 30 formulations, biomaterials or coatings for use in the treatment of wounds where medically 31 relevant bacteria are becoming increasingly resistant.32

The TiN/25.65at.%Ag coating was antimicrobial against bacteria  The physicochemistry of the bacteria and surfaces influenced bacterial retention  Multifractal analysis (MFA) did not affect the density of the bacteria  MFA demonstrated that surface properties affected bacterial spread and clustering  The surface properties influenced specific species : substratum interactions

Background The rising prevalence of nonalcoholic fatty liver disease (NAFLD) and the more aggressive subtype, nonalcoholic steatohepatitis (NASH), is a global public health concern. Left untreated, NAFLD/NASH can lead to cirrhosis, liver failure, and death. The current standard for diagnosing and staging liver disease is a liver biopsy, which is costly, invasive, and carries risk for the patient. Therefore, there is a growing need for a reliable, feasible, and cost-effective, noninvasive diagnostic tool for these conditions. LiverMultiScan is one such promising tool that uses multi-parametric magnetic resonance imaging (mpMRI) to characterize liver tissue and to aid in the diagnosis and monitoring of liver diseases of various etiologies. Objective The primary objective of this trial (RADIcAL1) is to evaluate the cost-effectiveness of the introduction of LiverMultiScan as a standardized diagnostic test for liver disease in comparison to standard care for NAFLD, in different EU territories. Methods RADIcAL1 is a multi-center randomized control trial with 2 arms conducted in 4 European territories (13 sites, from across Germany, Netherlands, Portugal, and the United Kingdom). In total, 1072 adult patients with suspected fatty liver disease will be randomized to be treated according to the result of the mpMRI in the intervention arm, so that further diagnostic evaluation is recommended only when values for metrics of liver fat or fibro-inflammation are elevated. Patients in the control arm will be treated as per center guidelines for standard of care. The primary outcome for this trial is to compare the difference in the proportion of patients with suspected NAFLD incurring liver-related hospital consultations or liver biopsies between the study arms, from the date of randomization to the end of the study follow-up. Secondary outcomes include patient feedback from a patient satisfaction questionnaire, at baseline and all follow-up visits to the end of the study, and time, from randomization to diagnosis by the physician, as recorded at the final follow-up visit. Results This trial is currently open for recruitment. The anticipated completion date for the study is December 2020. Conclusions This randomized controlled trial will provide the evidence to accelerate decision making regarding the inclusion of mpMRI-based tools in existing NAFLD/NASH clinical care. RADIcAL1 is among the first and largest European health economic studies of imaging technologies for fatty liver disease. Strengths of the trial include a high-quality research design and an in-depth assessment of the implementation of the cost-effectiveness of the mpMRI diagnostic. If effective, the trial may highlight the health economic burden on tertiary-referral hepatology clinics imposed by unnecessary consultations and invasive diagnostic investigations, and demonstrate that including LiverMultiScan as a NAFLD diagnostic test may be cost-effective compared to liver-related hospital consultations or liver biopsies. Trial Registration ClinicalTrials.gov NCT03289897 https://clinicaltrials.gov/ct2/show/NCT03289897 International Registered Report Identifier (IRRID) DERR1-10.2196/19189