3D Printing Direct Powder Extrusion in the Production of Drug Delivery Systems: State of the Art and Future Perspectives.

The production of tailored, on-demand drug delivery systems has gained attention in pharmaceutical development over the last few years, thanks to the application of 3D printing technology in the pharmaceutical field. Recently, direct powder extrusion (DPE) has emerged among the extrusion-based additive manufacturing techniques. It is a one-step procedure that allows the direct processing of powdered formulations. The aim of this systematic literature review is to analyze the production of drug delivery systems using DPE. A total of 27 articles have been identified through scientific databases (Scopus, PubMed, and ScienceDirect). The main characteristics of the three types of 3D printers based on DPE have been discussed. The selection of polymers and auxiliary excipients, as well as the flowability of the powder mixture, the rheological properties of the molten material, and the printing temperatures have been identified as the main critical parameters for successful printing. A wide range of drug delivery systems with varied geometries and different drug release profiles intended for oral, buccal, parenteral, and transdermal routes have been produced. The ability of this technique to manufacture personalized, on-demand drug delivery systems has been proven. For all these reasons, its implementation in hospital settings in the near future seems promising.

Extrusion-based technologies for 3D printing: a comparative study of the processability of thermoplastic polyurethane-based formulations.

Thermoplastic polyurethanes (TPU) offer excellent properties for a wide range of dosage forms. These polymers have been successfully utilized in personalized medicine production using fused deposition modeling (FDM) 3D printing (3DP). However, direct powder extrusion (DPE) has been introduced recently as a challenging technique since it eliminates filament production before 3DP, reducing thermal stress, production time, and costs. This study compares DPE and single-screw extrusion for binary (drug-TPU) and ternary (drug-TPU-magnesium stearate [MS]) mixtures containing from 20 to 60% w/w of theophylline. Powder flow, mechanical properties, fractal analysis, and percolation theory were utilized to analyze critical properties of the extrudates. All the mixtures could be processed at a temperature range between 130 and 160 °C. Extrudates containing up to 50% w/w of drug (up to 30% w/w of drug in the case of single-screw extrusion binary filaments) showed toughness values above the critical threshold of 80 kg/mm2. MS improved flow in mixtures where the drug is the only percolating component, reduced until 25 °C the DPE temperature and decreased the extrudate roughness in high drug content systems. The potential of DPE as an efficient one-step additive manufacturing technique in healthcare environments to produce TPU-based tailored on-demand medicines has been demonstrated.

Connecting perception and production in early Catalan-Spanish bilingual children: language dominance and quality of input effects.

This study investigates perception and production of the Catalan mid-vowel /e/-/ɛ/ contrast by two groups of 4.5-year-old Catalan-Spanish bilingual children, differing in language dominance. Perception was assessed with an XAB discrimination task involving familiar words and non-words. Production accuracy was measured using a familiar-word elicitation task. Overall, Catalan-dominant bilingual children outperformed Spanish-dominant bilinguals, the latter showing high variability in production accuracy, while being slightly above chance level in perception. No correlation between perception and production performance could be established in this group. The effect of language dominance alone could not explain the Spanish-dominant participants' performance, but quality of Catalan input (native vs. accented speech) was identified as an important factor behind familiar-word production and the inaccurate representation of the target contrast in the lexicon of the bilinguals' less-dominant language. More fine-grained measurements of experience-related factors are needed for a full understanding of the acquisition of challenging contrasts in bilingual contexts.

3D Printed Fractal-like Structures with High Percentage of Drug for Zero-Order Colonic Release.

Colonic drug delivery of drugs is an area of great interest due to the need to treat high prevalence colonic local diseases as well as systemic conditions that may benefit from the advantages associated to this route of drug administration. In the last decade, the use of 3D printing technologies has expanded, offering the possibility of preparing personalized medicines in small batches directly at the point of care. The aim of this work is to design a high drug loaded 3D printed system prepared by a combination of Fused Deposition Modelling (FDM) and Injection Volume Filling (IVF) techniques intended for zero-order colonic drug release. For this purpose, different batches of binary and ternary filaments based on the thermoplastic polyurethane Tecoflex EG-72D (TPU), theophylline anhydrous (AT) as model drug, and magnesium stearate as lubricant have been developed and characterized. Filaments with the highest drug load and the best rheological properties were selected for the manufacture of a printed fractal-like structure based on multiple toroids. This design was proposed to provide high surface area, leading to increased drug release and water uptake in the colonic region. This structure was 3D printed by FDM and then coated in a unique step by IVF technology using the enteric polymer DrugCoat S 12.5. This way, an additional coating process is avoided, reducing costs and production time. Studies of drug release confirmed the ability of the structures to provide a five-hour period of constant drug delivery in the colonic region.

Redox-Responsive Polymersomes as Smart Doxorubicin Delivery Systems.

Stimuli-responsive polymersomes have emerged as smart drug delivery systems for programmed release of highly cytotoxic anticancer agents such as doxorubicin hydrochloride (Dox·HCl). Recently, a biodegradable redox-responsive triblock copolymer (mPEG-PDH-mPEG) was synthesized with a central hydrophobic block containing disulfide linkages and two hydrophilic segments of poly(ethylene glycol) methyl ether. Taking advantage of the self-assembly of this amphiphilic copolymer in aqueous solution, in the present investigation we introduce a solvent-exchange method that simultaneously achieves polymersome formation and drug loading in phosphate buffer saline (10 mM, pH 7.4). Blank and drug-loaded polymersomes (5 and 10 wt.% feeding ratios) were prepared and characterized for morphology, particle size, surface charge, encapsulation efficiency and drug release behavior. Spherical vesicles of uniform size (120-190 nm) and negative zeta potentials were obtained. Dox·HCl was encapsulated into polymersomes with a remarkably high efficiency (up to 98 wt.%). In vitro drug release studies demonstrated a prolonged and diffusion-driven release at physiological conditions (~34% after 48 h). Cleavage of the disulfide bonds in the presence of 50 mM glutathione (GSH) enhanced drug release (~77%) due to the contribution of the erosion mechanism. Therefore, the designed polymersomes are promising candidates for selective drug release in the reductive environment of cancer cells.

3D printed systems for colon-specific delivery of camptothecin-loaded chitosan micelles.

The use of 3D printing technology in the manufacturing of drug delivery systems has expanded and benefit of a customized care. The ability to create tailor-made structures filled with drugs/delivery systems with suitable drug dosage is especially appealing in the field of nanomedicine. In this work, chitosan-based polymeric micelles loaded with camptothecin (CPT) were incorporated into 3D printing systems (printfills) sealed with an enteric layer, aiming to protect the nanosystems from the harsh environment of the gastrointestinal tract (GIT). Polymeric micelles and printfills were fully characterized and, a simulated digestion of the 3D systems upon an oral administration was performed. The printfills maintained intact at the simulated gastric pH of the stomach and, only released the micelles at the colonic pH. From there, the dissolution media was used to recreate the intestinal absorption and, chitosan micelles showed a significant increase of the CPT permeability compared to the free drug, reaching an apparent permeability coefficient (Papp) of around 9×10-6 cm/s in a 3D intestinal cell-based model. The combination of 3D printing with nanotechnology appears to have great potential for the colon-specific release of polymeric micelles, thereby increasing intestinal absorption while protecting the system/drug from degradation throughout the GIT.

3D Printed Drug Delivery Systems Based on Natural Products.

In the last few years, the employment of 3D printing technologies in the manufacture of drug delivery systems has increased, due to the advantages that they offer for personalized medicine. Thus, the possibility of producing sophisticated and tailor-made structures loaded with drugs intended for tissue engineering and optimizing the drug dose is particularly interesting in the case of pediatric and geriatric population. Natural products provide a wide range of advantages for their application as pharmaceutical excipients, as well as in scaffolds purposed for tissue engineering prepared by 3D printing technologies. The ability of biopolymers to form hydrogels is exploited in pressure assisted microsyringe and inkjet techniques, resulting in suitable porous matrices for the printing of living cells, as well as thermolabile drugs. In this review, we analyze the 3D printing technologies employed for the preparation of drug delivery systems based on natural products. Moreover, the 3D printed drug delivery systems containing natural products are described, highlighting the advantages offered by these types of excipients.

Thermoplastic polyurethane as matrix forming excipient using direct and ultrasound-assisted compression.

Thermoplastic polyurethanes (TPU) are block copolymers utilized in a wide variety of applications due to their superior characteristics as resistance, flexibility and biocompatibility. However, the use of TPU as a matrix tablet forming excipient is more limited. For the first time, matrix tablets based on TPU have been developed by direct compression and ultrasound-assisted compression (USAC) allowing a comparison between these two methods. TPU powder has been rheologically characterized according to SeDeM method, demonstrating the suitability of the polymer (Pearlbond™ 523) to be compressed. TPU matrices have shown an inert behavior and a sustained drug release with a very low quantity of excipient. The better drug release control of matrices obtained by USAC has been explained based on the sintering of the TPU particles, resulting in lower porous structures and a quasi-continuum medium instead of particulate systems. The Excipient Efficiency values show the high ability of this TPU to control drug release by both methods. Finally, the estimation of the percolation threshold of TPU by both methods has contributed to the deep knowledge of the systems and allows defining the Design Space of a formulation.

Achieving High Excipient Efficiency with Elastic Thermoplastic Polyurethane by Ultrasound Assisted Direct Compression.

Ultrasound assisted compression (USAC) is a manufacturing technique which applies thermal and mechanical energy to the powder bed, producing tablets with improved characteristics compared to the direct compression process. This technology is ideal for thermoplastic materials, as polyurethanes, whose particles usually undergo a sintering process. Thermoplastic polyurethanes are widely used in sustained drug release systems but rarely seen in tablets due to their elastic properties. The aim of this work is to investigate the ability of USAC to manufacture sustained release matrix tablets based on elastic thermoplastic polyurethanes (TPU), overcoming the limitations of direct compression. The technological and biopharmaceutical characteristics of the TPU matrices have been evaluated, with special focus on the porous structure due to the implications on drug release. For the first time, USAC has been successfully employed for manufacturing elastic thermoplastic polyurethanes-based matrices. TPU tablets show an inert character with a sustained drug release governed by a diffusional mechanism. Initial porosity of matrices was similar in all batches studied, with no influence of drug particle size, and a fractal nature of the pore network has been observed. SEM microphotographs show the continuum medium created by the sintering of the polymer, responsible for the high excipient efficiency.

Printfills: 3D printed systems combining fused deposition modeling and injection volume filling. Application to colon-specific drug delivery.

Three-dimensional printing has become a feasible manufacturing technique for pharmaceutical products providing cheap and accurate freeform systems with a great potential for personalized-dose drugs. Fused Deposition Modeling (FDM) highlights among other 3D technologies due to its low cost and easy to operate but, until now, it has the drawbacks of the low drug loaded and the impossibility to print thermosensitive drugs. So, intermediate processes such as hot melt extrusion are frequently associated with FDM. Here, pharmaceutical dosage forms have been manufactured for the first time with a 3D printer combining two different printing technologies: FDM and injection volume filling (IVF), performing customized extruded scaffolds in which a liquid or semisolid system can be injected at room temperature. A model drug and a pH-sensitive polymer were successfully incorporated during the construction of the extruded backbone of the systems, called printfills (printed systems filled with a liquid or semisolid). SEM microphotographs of printfills show the sealing of the structure in the perimeter and the homogeneity of the colonic film formed in the upper side. Thus, the addition of the pH-sensitive polymer does not need an additional process in a fluidized bed or coating pan. Results from drug release studies performed at different pH confirm the ability of printfills for colon-specific drug delivery. Therefore, IVF technology complements FDM, solving its main limitations providing an easy, automatized and versatile technology to manufacture tailored drug delivery platforms, avoiding other intermediate processes.

First study of the evolution of the SeDeM expert system parameters based on percolation theory: Monitoring of their critical behavior.

The deep understanding of products and processes has become a requirement for pharmaceutical industries to follow the Quality by Design principles promoted by the regulatory authorities. With this aim, SeDeM expert system was developed as a useful preformulation tool to predict the likelihood to process drugs and excipients through direct compression. SeDeM system is a step forward in the rational development of a formulation, allowing the normalisation of the rheological parameters and the identification of the weaknesses and strengths of a powder or a powder blend. However, this method is based on the assumption of a linear behavior of disordered systems. As percolation theory has demonstrated, powder blends behave as non-linear systems that can suffer abrupt changes in their properties near to geometrical phase transitions of the components. The aim of this paper was to analyze for the first time the evolution of the SeDeM parameters in drug/excipient powder blends from the point of view of the percolation theory and to compare the changes predicted by SeDeM with the predictions of Percolation theory. For this purpose, powder blends of lactose and theophylline with varying concentrations of the model drug have been prepared and the SeDeM analysis has been applied to each blend in order to monitor the evolution of their properties. On the other hand, percolation thresholds have been estimated for these powder blends where critical points have been found for important rheological parameters as the powder flow. Finally, the predictions of percolation theory and SeDeM have been compared concluding that percolation theory can complement the SeDeM method for a more accurate estimation of the Design Space.

Towards a rational basis for selection of excipients: Excipient Efficiency for controlled release.

There are many factors influencing the drug release behaviour from a pharmaceutical formulation as the particle size of the drug and excipient, porosity of the system or geometrical phase transitions of the components. Therefore, the choice of the adequate excipient to achieve a specific drug release profile is mainly based on the experience and the trial and error method. Taking into account the directives towards the application of the "Quality by Design" approach, in this study the Excipient Efficiency (EE), a parameter able to quantify the capability of an excipient to control the drug release, has been developed. EE was initially calculated dividing the total porosity of the system by its diffusional release rate constant. The influence of several factors on this parameter has been evaluated. As a result, the final parameter has been corrected based on the drug solubility and the excipient particle size. EE provides a rational basis for identifying the most adequate excipients for a concrete formulation.

Use of ethyl lactate to extract bioactive compounds from Cytisus scoparius: Comparison of pressurized liquid extraction and medium scale ambient temperature systems.

An important trend in the extraction of chemical compounds is the application of new environmentally friendly, food grade solvents. Ethyl lactate (ethyl 2-hydroxypropanoate), produced by fermentation of carbohydrates, is miscible with both hydrophilic and hydrophobic compounds being a potentially good solvent for bioactive compounds. Despite its relatively wide use as a general solvent, the utilization of ethyl lactate as an extraction solvent has only recently been considered. Here, we evaluate the possible use of ethyl lactate to extract phenolic compounds from wild plants belonging to Cytisus scoparius, and we compare the characteristics of the extracts obtained by Pressurized Solvent Extraction (the total phenolics content, the antioxidant activity and the concentration of the major polyphenols) with those of other extracts obtained with methanol. In order to explore the industrial production of the ethyl lactate Cytisus extract, we also evaluate medium scale ambient temperature setups. The whole plant and the different parts (flowers, branches, and seed pods) were evaluated separately as potential sources of polyphenols. All extracts were analyzed by LC-MS/MS for accurate identification of the major polyphenols. Similar phenolic profiles were obtained when using ethyl lactate or methanol. The main bioactives found in the Cytisus extract were the non-flavonoid phenolic compounds caffeic and protocatechuic acids and 3,4-dihydroxybenzaldehyde; the flavonoids rutin, kaempferol and quercetin; the flavones chrysin, orientin and apigenin; and the alkaloid lupanine. Regarding the comparison of the extraction systems, although the performance of the PLE was much better than that of the ambient-temperature columns, the energy consumption was also much higher. Ethyl lactate has resulted an efficient extraction solvent for polyphenols from C. scoparius, yielding extracts with high levels of plant phenolics and antioxidant activity. The antimicrobial activity of these extracts was also tested, showing antibacterial activity against Gram +ve bacteria. Qualitatively similar extracts were obtained either by using PLE or medium-scale-ambient-temperature systems, these last rendering larger volumes of extract with lower energy cost. Good results have been obtained with whole plant extracts; nevertheless, extracts enriched in a particular polyphenol can be obtained from different parts of the plant.

Antioxidant White Grape Seed Phenolics: Pressurized Liquid Extracts from Different Varieties.

Grape seeds represent a high percentage (20% to 26%) of the grape marc obtained as a byproduct from white winemaking and keep a vast proportion of grape polyphenols. In this study, seeds obtained from 11 monovarietal white grape marcs cultivated in Northwestern Spain have been analyzed in order to characterize their polyphenolic content and antioxidant activity. Seeds of native (Albariño, Caiño, Godello, Loureiro, Torrontés, and Treixadura) and non-native (Chardonnay, Gewurtzträminer, Pinot blanc, Pinot gris, and Riesling) grape varieties have been considered. Low weight phenolics have been extracted by means of pressurized liquid extraction (PLE) and further analyzed by LC-MS/MS. The results showed that PLE extracts, whatever the grape variety of origin, contained large amounts of polyphenols and high antioxidant activity. Differences in the varietal polyphenolic profiles were found, so a selective exploitation of seeds might be possible.

Physicochemical stability of captopril and enalapril extemporaneous formulations for pediatric patients.

The prevalence of hypertension among children has been increasing. Community and Hospital Pharmacists are often challenged to provide an oral liquid extemporaneous formulation for pediatric patients, because there are no appropriate dosage drugs to the specific needs of the child. The objective of this study is to choose and develop suitable pediatric extemporaneous formulations for captopril and enalapril maleate and to determine their physicochemical stability. A survey was carried out to evaluate the extent of dispensation of these drugs in Hospitals in Spain. Stability studies of formulations have been studied according to ICH normative at 5, 25 and 40 °C. Three samples from each temperature were withdrawn and assessed for stability on days 0, 15, 30, 50 and 90 using a high-performance liquid chromatography (HPLC) mass spectrometer assay. Rheological studies were carried out to ensure the maintenance of the physical characteristics of these non-Newtonian fluids. Captopril and enalapril maleate formulations used the pure drug and were stable during 50 days at 5 °C. We have developed easy antihypertensive oral liquid extemporaneous formulations for pediatric patients with physical and chemical stability higher than those provided by the majority of Hospitals.

Vermicomposting grape marc yields high quality organic biofertiliser and bioactive polyphenols.

Grape is the largest fruit crop in the world, and most (80%) of the harvested fruit is used to make wine. The main by-product of the wine industry is called grape marc, which consists of the stalks, skin, pulp and seeds that remain after pressing the grapes. The aim of this study was to evaluate whether grape marc could be processed by vermicomposting on an industrial scale to yield both a high-quality organic, polyphenol-free fertiliser and grape seeds (as a source of bioactive polyphenols). Vermicomposting reduced the biomass of grape marc substantially (by 58%), mainly as a result of the loss of volatile solids. After 2 weeks, the process yielded a nutrient-rich, microbiologically active and stabilised peat-like material that was easily separated from the seeds by sieving. Although the polyphenol content of the seeds was considerably reduced, this disadvantage was outweighed by the ease of separation of the seeds. Separation of the seeds also eliminated the polyphenol-associated phytotoxicity from the vermicompost. The seeds still contained useful amounts of polyphenols, which could be directly extracted for use in the pharmaceutical, cosmetic and food industries. The procedure described is effective, simple and economical, and could easily be scaled up for industrial application.

Consonants, vowels and levels of specification in the phonological representations of the first lexicon: a review / Consonantes, vocales y niveles de especificación en las representaciones fonológicas del léxico inicial: una revisión

A review of the main studies on the format of lexical representation in the initial stages of language development is presented. Current investigations reveal a significant level of phonological specificity in the representation of words in the first lexicon, even before age two years. These results can be explained from a theoretical framework that posits the existence of multiple levels of encoding and suggests differences in accessing the represented information as a function of task demands or vocabulary size. The existence of possible differences in the degree of specification of vowels and consonants represented in the lexicon is an area of current debate. This article discusses the present state of this debate in the light of re-cent findings from research with different languages, in populations with different linguistic environments (monolingual and bilingual) and from experimental approaches that involve varying degrees of cognitive demands

Se presenta una revisión de las principales investigaciones sobre el formato de representación léxica en etapas iniciales del desarrollo lingüístico. Los resultados actuales, revelan un importante nivel de especificación fonológica en las representaciones del primer léxico, antes incluso de los dos años. Estos resultados se explican desde un marco teórico que plantea la existencia de múltiples niveles de codificación y sugiere diferencias en el acceso a la información representada en función de las demandas de la tarea o del nivel de vocabulario alcanzado. Un área de debate actual se sitúa en torno a la existencia de posibles diferencias en el grado de especificación de las vocales y consonantes representadas en el léxico. Este artículo analiza el estado actual de este debate teniendo en cuenta los resultados recientes obtenidos en investigaciones realizadas en distintas lenguas, con poblaciones de diferente entorno lingüístico (monolingüe y bilingüe) y metodologías experimentales que suponen distinto grado de exigencia cognitiva

Effect of experimental parameters in the pressurized solvent extraction of polyphenolic compounds from white grape marc.

A method based on pressurized solvent extraction (PSE) to determine main polyphenolic compounds in the grape marc obtained as a byproduct of the white winemaking process has been developed. As response variables in the optimisation process include main individual polyphenols, as well as spectrophotometric indexes. The optimised PSE procedure implies the use of 1 g of sample, without preliminary clean-up step, sea sand as dispersant, temperature of 105 °C, methanol (63%) in water as solvent, and 5 min of extraction time (2 static cycles). The performance of the proposed method has been assessed in terms of recovery (91-105%), linearity (R(2)>0.995) and precision. The applicability of the method was demonstrated by the analysis of bagasse samples collected from 12 wineries located in Galicia (NW Spain). Data of the in vitro antioxidant activities of the PSE extracts are also discussed.

Rapid gains in segmenting fluent speech when words match the rhythmic unit: evidence from infants acquiring syllable-timed languages.

The ability to extract word-forms from sentential contexts represents an initial step in infants' process toward lexical acquisition. By age 6 months the ability is just emerging and evidence of it is restricted to certain testing conditions. Most research has been developed with infants acquiring stress-timed languages (English, but also German and Dutch) whose rhythmic unit is not the syllable. Data from infants acquiring syllable-timed languages are still scarce and limited to French (European and Canadian), partially revealing some discrepancies with English regarding the age at which word segmentation ability emerges. Research reported here aims at broadening this cross-linguistic perspective by presenting first data on the early ability to segment monosyllabic word-forms by infants acquiring Spanish and Catalan. Three different language groups (two monolingual and one bilingual) and two different age groups (8- and 6-month-old infants) were tested using natural language and a modified version of the HPP with familiarization to passages and testing on words. Results revealed positive evidence of word segmentation in all groups at both ages, but critically, the pattern of preference differed by age. A novelty preference was obtained in the older groups, while the expected familiarity preference was only found at the younger age tested, suggesting more advanced segmentation ability with an increase in age. These results offer first evidence of an early ability for monosyllabic word segmentation in infants acquiring syllable-timed languages such as Spanish or Catalan, not previously described in the literature. Data show no impact of bilingual exposure in the emergence of this ability and results suggest rapid gains in early segmentation for words that match the rhythm unit of the native language.

Drug diffusion from disperse systems with a hydrophobically modified polysaccharide: Enhancer vs Franz cells.

This study assesses the capacity of a new hydrophobically modified polysaccharide -hydroxypropyl cellulose-methyl methacrylate - to control drug release in semisolid formulations. The dispersed systems contain the new polymer, Igepal CO520 as surfactant and theophylline as model drug at three concentrations (0.5, 1 and 1.5%, w/w). Drug release study shows that the systems containing 0.5% (w/w) of drug have faster release and higher diffusion coefficient than the other two concentrations. These results can be explained by two different structures ("relaxed" and "structured") found from a rheological point of view. Also, this paper compares two different devices for testing drug release and diffusion. It has been obtained more reliable and reproducible results with Enhancer Cell respect to Franz diffusion cell. In both cases, Fickian diffusion was the mechanism predominant for all systems. Finally, the utility of this polymer has been demonstrated to make three-dimensional gel structure and control theophylline release from systems in topical application.