Development of a Temperature-Recording Vaginal Ring for Monitoring User Adherence

Background: Vaginal ring devices are being actively developed for controlled delivery of HIV microbicides and as multi-purpose prevention technology (MPT) products combining hormonal contraception with prevention of HIV and other sexually transmitted diseases. Presently, there is no reliable method for monitoring user adherence in HIV vaginal ring trials; previous acceptability studies have included some type of participant self-reporting mechanism, which have often been unreliable. More objective, quantitative and accurate methods for assessing adherence are needed.
Methods: A silicone elastomer vaginal ring containing an encapsulated miniature temperature recording device has been developed that can capture and store real-time temperature data during the period of designated use. Devices were tested in both simulated vaginal environments and following vaginal placement in cynomolgus macaques. Various use protocols and data sampling rates were tested to simulate typical patient usage scenarios. Results: The temperature logging devices accurately recorded vaginal temperature in macaques, clearly showing the regular diurnal temperature cycle. When environmental temperature and vaginal temperature was significantly different, the device was able to accurately pinpoint the insertion and removal times. Based on the data collected it was possible to infer removal periods as short as 5 min when the external environmental temperature was 25 °C. Accuracy increased with data sampling rate. Conclusions: This work provides proof-of-concept for monitoring adherence using a vaginal ring device containing an encapsulated temperature logger. The addition of one or more active agents into the ring body is not anticipated to affect the temperature monitoring function. A clinical study to compare self- reported user adherence data with that obtained by the device would be highly informative.

Thermal properties and eutectic behaviour of dapivirine in combination with steroid hormones and other antiretrovirals

Background: Combination drug products can display thermal behaviour that is more complex than for the corresponding single drug products. For example, the contraceptive vaginal ring (VR) Nuvaring contains a eutectic (lowest melting) composition of etonogestrel (ETN) and ethinyl estradiol. Here we report the predisposition of dapivirine (DPV) to form reduced melting/eutectic mixtures when combined with other contraceptive hormones and antiretrovirals, and discuss the implications for development of combination microbicide and multipurpose prevention technology (MPT) products.
Methods: Binary mixtures of DPV with darunavir (DRV), levonorgestrel (LNG), ETN or maraviroc (MVC) were prepared either by physical mixing or by solvent evaporation. Selected binary mixtures were also incorporated into silicone elastomer (SE) VR devices. Thermal behavior of the mixtures was analyzed using differential scanning calorimetry (DSC) operating in standard heating ramp mode (10 °C/min). DSC data were used to construct two component phase diagrams for each binary system.
Results: Drug mixtures typically showed reduced melting transitions for both drug components, with clear evidence for a eutectic mixture at a well-defined intermediate composition. Eutectic temperatures and compositions for the various mixtures were: 40% DPV / 60% ETN - 170°C; 25% DPV / 75% MVC - 172°C; 65% DPV / 35% LNG - 192°C. In each case, the eutectic composition was also detected when the drug mixtures were incorporated into SE VRs. For the DPV/DRV system, the thermal behaviour is complicated by desolvation from the darunavir ethanolate polymorph.
Conclusions: When DPV is combined with small molecular weight hydrophobic drugs, the melting temperature for both drugs is typically reduced to a degree dependent on the composition of the mixture. At specified compositions, a low melting eutectic system results. The formation of eutectic behavior in binary drug systems needs to be carefully characterised in order to define product performance and drug release.

A Combination Vaginal Ring Releasing Dapivirine and Darunavir

Background: Combination microbicide vaginal rings, containing two or more antiretrovirals targeting different steps in the HIV replicative process, may be more effective than single microbicide products at preventing sexual transmission of HIV. Here, we report the preclinical development, including in vitro release and macaque pharmacokinetics, of matrix-type silicone elastomer rings containing dapivirine (DPV; an experimental non-nucleoside reverse transcriptase inhibitor) and darunavir (DRV; a marketed protease inhibitor). Methods: Macaque rings containing 25 mg DPV, 300 mg DRV and 100 mg DPV, and 300 mg DRV were manufactured and characterised by differential scanning calorimetry. In vitro release was assessed into isopropanol/water and simulated vaginal fluid. Macaque vaginal fluid and blood serum concentrations for both antiretrovirals were measured during 28-day ring use. Tissue levels were measured on day 28. Ex vivo challenge studies were performed on vaginal fluid samples and IC50 values calculated.
Results: DRV caused a concentration-dependent reduction in the DPV melting temperature in both solid drug mixes and in the combination ring. In vitro release from rings was dependent on drug loading, the number of drugs present, and the release medium. In macaques, serum concentrations of both
microbicides were maintained between 101-102 pg/mL. Vaginal fluid levels
ranged between 103-104 ng/g and 104-105 ng/g for DPV and DRV, respectively. Vaginal tissue concentrations decreased in rank order: vagina
(1.8×103-3.8×103 ng/g) > cervix (9.4×101-3.9×102 ng/g) > uterus (0-108 ng/g) > rectum (0-40 ng/g). Measured IC50 values (HIV-1 BaL) determined from macaque vaginal fluid samples were < 2 ng/mL for both compounds. Conclusions: Based on these results, and in light of the ongoing clinical progress of the 25mg DPV ring, a combination vaginal ring containing DPV and DRV is a viable second-generation HIV microbicide candidate.

Lack of in vitro-in vivo correlation for a UC781-releasing vaginal ring in macaques

This study describes the preclinical development of a matrix-type silicone elastomer vaginal ring device designed to provide controlled release of UC781, a non-nucleoside re- verse transcriptase inhibitor. Testing of both human- and macaque-sized rings in a sink condition in vitro release model demonstrated continuous UC781 release in quantities consid- ered sufficient to maintain vaginal fluid concentrations at levels 82–860-fold higher than the in vitro IC50 (2.0 to 10.4 nM) and therefore potentially protect against mucosal trans- mission of HIV. The 100-mg UC781 rings were well tolerated in pig-tailed macaques, did not induce local inflammation as determined by cytokine analysis and maintained median con- centrations in vaginal fluids of UC781 in the range of 0.27 to 5.18 mM during the course of the 28-day study. Analysis of residual UC781 content in rings after completion of both the in vitro release and macaque pharmacokinetic studies revealed that 57 and 5 mg of UC781 was released, respectively. The pharmacokinetic analysis of a 100-mg UC781 vaginal ring in pig-tailed macaques showed poor in vivo–in vitro correlation, attributed to the very poor solubility of UC781 in vaginal fluid and resulting in a dissolution-controlled drug release mecha- nism rather than the expected diffusion-controlled mechanism.

A Temperature-Monitoring Vaginal Ring for Measuring Adherence

Background

Product adherence is a pivotal issue in the development of effective vaginal microbicides to reduce sexual transmission of HIV. To date, the six Phase III studies of vaginal gel products have relied primarily on self-reporting of adherence. Accurate and reliable methods for monitoring user adherence to microbicide-releasing vaginal rings have yet to be established.

Methods

A silicone elastomer vaginal ring prototype containing an embedded, miniature temperature logger has been developed and tested in vitro and in cynomolgus macaques for its potential to continuously monitor environmental temperature and accurately determine episodes of ring insertion and removal.

Results

In vitro studies demonstrated that DST nano-T temperature loggers encapsulated in medical grade silicone elastomer were able to accurately and continuously measure environmental temperature. The devices responded quickly to temperature changes despite being embedded in different thickness of silicone elastomer. Prototype vaginal rings measured higher temperatures compared with a subcutaneously implanted device, showed high sensitivity to diurnal fluctuations in vaginal temperature, and accurately detected periods of ring removal when tested in macaques.

Conclusions

Vaginal rings containing embedded temperature loggers may be useful in the assessment of product adherence in late-stage clinical trials.

Sustained release of the candidate antiretroviral peptides T-1249 and JNJ54310516-AFP from a rod insert vaginal ring

Administration of biomacromolecular drugs in effective quantities from conventional vaginal rings is hampered by poor drug permeability in the polymers from which rings are commonly constructed. Here, we report the formulation development and testing of rod insert rings for sustained release of the candidate antiretroviral peptides T-1249 and JNJ54310516-AFP (JNJ peptide), both of which have potential as HIV microbicides. Rod inserts were prepared comprising antiviral peptides T-1249 or JNJ peptide in combination with a hydrophilic excipient (sodium chloride, sodium glutamate, lactose or zinc acetate) dispersed at different loadings within a medical grade silicone elastomer. The inserts were tested for weight change and swelling when immersed in simulated vaginal fluid (SVF). Dye migration into the inserts was also assessed visually over 28 days. In vitro release of T-1249 and JNJ peptide from rings containing various insert types was tested. Weight change and degree of swelling of rods immersed in SVF was dependent on the type and concentration of excipient present. The rods displayed the following rank order in terms of weight change: sodium glutamate > zinc acetate ≈ sodium chloride > lactose. The weight change and degree of swelling of the inserts did not correlate with the level of dye uptake observed. In vitro release of T-1249 was improved through addition of lactose, sodium chloride and sodium glutamate, while release of JNJ peptide was improved through addition of sodium chloride or sodium glutamate. Sustained release of hydrophobic peptides can be achieved using a rod insert ring design formulated to include a hydrophilic excipient. Release rates were dependent upon the type of excipient used. The degree of release improvement with different inserts partially reflects their ability to imbibe surrounding fluid and swell in aqueous environments.

Tipologia, instalação, funcionamento e manutenção dos diversos tipos de aparelhos de apoio em obras de arte

Trabalho Final para a obtenção do grau de Mestre em Engenharia Civil

Tipologia, instalação, funcionamento e manutenção de diversos tipos de juntas de dilatação em obras de arte

Dissertação para obtenção do grau de Mestre em Engenharia Civil na Área de Especialização de Estruturas

Studies on the Toughening of Epoxy Resins

This thesis aims to develop new toughened systems for epoxy resin via physical and chemical modifications. Initially the synthesis of DGEBA was carried out and the properties compared with that of the commercial sample. Subsequently the modifier resins to be employed were synthesized. The synthesized resin were characterized by spectroscopic method (FTIR and H NMR), epoxide equivalent and gel permeation chromatography. Chemical modification involves the incorporation of thermoset resins such a phenolics, epoxy novolacs, cardanol epoxides and unsaturated polyester into the epoxy resin by reactive belnding. The mechanical and thermal properties of the blends were studied. In the physical modification route, elastomers, maleated elastomers and functional elastomers were dispersed as micro-sized rubber phase into the continuous epoxy phase by a solution blending technique as against the conventional mechanical blending technique. The effect of matrix toughening on the properties of glass reinforced composites and the effect of fillers on the properties of commercial epoxy resin were also investigated. The blends were characterized by thermo gravimetric analysis, differential scanning calorimetry, dynamic mechanical analysis, scanning electron microscopy and mechanical property measurements. Among the thermoset blends, substantial toughening was observed in the case of epoxy phenolic novolacs especially epoxy para cresol novolac (ECN). In the case of elastomer blending , the toughest blends were obtained in the case of maleic anhydride grafted NBR. Among functional elastomers the best results were obtained with CTBN. Studies on filled and glass reinforced composites employing modified epoxy as matrix revealed an overall improvement in mechanical properties

Swelling behaviour of isora/natural rubber composites in oils used in automobiles

Natural rubber/isora fibre composites were cured at various temperatures. The solvent swelling characteristics of natural rubber composites containing both untreated and alkali treated fibres were investigated in aromatic and aliphatic solvents like toluene, and n-hexane. The diffusion experiments were conducted by the sorption gravimetric method. The restrictions on elastomer swelling exerted by isora fibre as well as the anisotropy of swelling of the composite have been confirmed by this study. Composite cured at 100°C shows the lowest percentage swelling. The uptake of aromatic solvent is higher than that of aliphatic solvent for the composites cured at all temperatures. The effect of fibre loading on the swelling behaviour of the composite was also investigated in oils like petrol, diesel, lubricating oil etc. The % swelling index and swelling coefficient of the composite were found to decrease with increase in fibre loading. This is due to the increased hindrance exerted by the fibres at higher fibre loadings and also due to the good fibre-rubber interactions. Maximum uptake of solvent was observed with petrol followed by diesel and then lubricating oil. The presence of bonding agent in the composites restrict the swelling considerably due to the strong interfacial adhesion. At a fixed fibre loading, the alkali treated fibre composite showed lower percentage swelling compared to the untreated one.

New oligomer-bound antioxidants for improved flex crack resistance and ozone resistance

New oligomer-bound antioxidants have been prepared by condensation reaction. The efficiency and permanence of these oligomer- bound paraphenylene diamines as antioxidants has been compared with conventional amine type antioxidants in NR, SBR, IIR and NBR and in elastomer blends like NR/BR and NR/SBR. The oligomer-bound antioxidants are found to impart improved ozone, flex resistance and mechanical properties to the vulcanizates of NR, SBR, IIR and NBR and to blends of NR/BR and NR/ SBR in comparison with those containing conventional antioxidants.

Characterization of Short Nylon-6 Fiber/Acrylonitrile Butadiene Rubber Composite by Thermogravimetry

The thermal degradation of short nylon-6 fiber reinforced acrylonitrile butadiene rubber (NBR) composites with and without epoxy-based bonding agent has been studied by thermogravimetric analysis (TGA). It was found that the onset of degradation shifted from 330.5 to 336.1°C in the presence of short nylon fiber, the optimum fiber loading being 20 phr. The maximum rate of degradation of the composites was lower than that of the unfilled rubber compound, and it decreased with increase in fiber concentration. The presence of epoxy resin-based bonding agent in the virgin elastomer and the composites improved the thermal stability. Results of kinetic studies showed that the degradation of NBR and the short nylon fiber reinforced composites followed first-order kinetics.

Short Isora Fibre Reinforced Natural Rubber Composites

The present study deals with the short isora fibre reinforced natural rubber composites. In recent years there has been a tremendous advancement in the field of science and technology of short fibre reinforced polymer composites. The low density, high strength, high stiffness to weight ratio, excellent durability and design flexibility are the primary reasons for their use in many diversified fields such as air crafts, automobiles, marine industry etc. Compared to the various natural and synthetic fibres used as reinforcement for elastomer composites isora fibre is superior in many aspects. `Isora' is a natural lignocellulosic fibre which is easily available in South India especially in Kerala. The fibre is separated from the bark of the Helicteres isora plant by retting process. This fibre has excellent mechanical properties and is easily amenable to physical and chemical modifications. The study shows that composites with poor interfacial bonding tend to dissipate more energy than that with to interfacial bonding. The mechanical loss also can be related to interfacial bonding. The effect of chemical treatment of isora fibre on damping was also studied. Both in the low and high temperature region which indicates that this composite posseses low damping and hence good interfacial bonding characteristics. Hence these composites are better candidates for high damping applications. Composites with longitudinally oriented fibres showed high storage modulus than transversely oriented ones due to the effective stress transfer between fibre and matrix.

An Inter-digital Capacitive Electrode Modified as a Pressure Sensor

Inter-digital capacitive electrodes working as electric field sensors have been developed for touch panel applications. Evaluation circuits to convert variations in electric fields in such sensors into computer compatible data are commercially available. We report development of an Interdigital capacitive electrode working as a sensitive pressure sensor in the range 0-120 kPa. Essentially it is a touch/proximity sensor converted into a pressure sensor with a suitable elastomer buffer medium acting as the pressure transmitter. The performance of the sensor has been evaluated and reported. Such sensors can be made very economical in comparison to existing pressure sensors. Moreover, they are very convenient to be fabricated into sensor arrays involving a number of sensors for distributed pressure sensing applications such as in biomedical systems.

Synthesis and Characterisation of Thermoplastic Ionomers based on Natural Rubber

Chemically modified novel thermo-reversible zinc sulphonated ionomers based on natural rubber (NR), radiation induced styrene grafted natural rubber (RI-SGNR), and chemically induced styrene grafted natural rubber (CI-SGNR) were synthesized using acetyl sulphate/zinc acetate reagent system. Evidence for the attachment of sulphonate groups has been furnished by FTIR spectra. which was supplanted by FTNMR results. Estimation of the zinc sulphonate group was done using spectroscopic techniques such as XRFS and ICPAES. The TGA results prove improvement in the therrno-oxidative stability of the modified natural rubber. Both DSC and DMTA studies show that the incorporation of the ionic groups affect the thermal transition of the base polymer. Retention of the improved physical properties of the novel ionomers even after three repeated cycles of mastication and molding at 120 degree C may be considered as the evidence for the reprocessabiJity of the ionomer. Effect of both particulate (carbon black. silica & zinc stearate) and fibrous fillers (nylon & glass) on the properties of the radiation induced styrene grafted natural rubber ionomer has been evaluated. Incorporation of HAF carbon black results in maximum improvement in physical properties. Silica reinforces the backbone chain and weakens the ionic associations. Zinc stearate plays the dual role of reinforcement and ptasticization. The nylon and glass filled lonorner compounds show good improvement in the physical properties in comparison with the neat ionomer. Dispersion and adhesion of the fillers in the ionomer matrix has been amply supported by their SEM micrographs. Microwave probing of the electrical behavior of the 26.5 ZnSRISGNR ionomer reveals that the maximum relative complex conductivity and the complex permittivity appear at the frequency of 2.6 GHz. The complex conductivity of the base polymer increases from 1.8x 10.12 S/cm to 3.3xlO·4 S/cm. Influence of fillers on the dielectric constant and conductivity of the new ionic thermoplastic elastomer has been studied. The ionomer I nylon compound shows the highest microwave conductivity. Use of the 26.5 ZnS-RISGNR ionomer as a compatibilizer for obtaining the technologically compatible blends from the immiscible SBR/NBR system has been verified. The heat fugitive ionic cross-linked natural rubber may be, therefore, useful as an alternative to vulcanized rubber and thermoplastic elastomer