Das bei der Sanierung von großen segmentalen Knochendefekten bestehende Risiko einer fremdkörperassoziierten Infektion soll durch die Integration eines Wirkstofffreisetzungssystems in ein bestehendes textiles Knochenimplantat gemindert werden. Durch Immobilisierung des Wirkstoffs in eine degradierbare Polymermatrix wird eine zeitlich verzögerte Freisetzung bewirkt. Als Wirkstofffreisetzungssystem wird die Kombination von Polylactid (PLA) bzw. Poly(Lactid-co-Glycolid) (PLGA) als Matrixpolymer mit dem Antibiotikum Gentamicin als Wirkstoff untersucht, welches durch Beschichtung der textilen Scaffolds mittels Dip-Coating eingebracht werden soll. Es stehen die drei Beschichtungsmethoden „Suspension“, „Emulsion“ und „Schichtaufbau“ zur Auswahl, die jeweils über eigene Parameter zur Beeinflussung des Freisetzungsprofils verfügen. Die Methode „Suspension“ und die damit verbundenen Einflussfaktoren Korngröße, Korngrößenverteilung sowie Masseanteil des Antibiotikums und Schichtdicke der aufgetragenen Polymerschicht wurde als die günstigste herausgearbeitet. Im Teil II dieser Arbeit wird diese soweit optimiert, dass nahezu über den gesamten geforderten Zeitraum die festgelegte notwendige Dosierung aufrechterhalten werden kann. Erste in vitro Versuche weisen auf eine gute Zellverträglichkeit sowie eine ausreichende mikrobielle Wirksamkeit hin. / To reduce the risk of infection in the treatment of long bone defects, a novel embroidered bone implant is to be provided with an antibiotic drug delivery system. Prolonged and controlled drug release can be achieved by coating the thread material with antibiotics incorporated in a degradable polymer matrix. The chosen drug delivery system is composed of polylactide acid (PLA) or poly(lactide-co-glycolide) acid (PLGA) as matrix polymer and the antibiotic gentamicin. It is integrated into the textile structure by dip-coating providing the three different methods suspension, emulsion and layered. Each method bears its appropriate parameters to influence the releasing profile. The suspension-method and its parameters grain size and grain size distribution as well as mass fraction of the antibiotic and the coating thickness could be proved as the most feasible. In part II of this essay the chosen coating set-up gets optimized so that a drug release nearly along the whole required term can be achieved. Preliminary in vitro studies show a good cell tolerance besides a sufficient microbial efficacy.

<div>This study explores the perceptions of critical stakeholders as to the viability of a fully remote apprenticeship delivery system (FRADS), as well as its ability to serve as a functionally equivalent path of inclusion for access-limited populations. One of the first recorded pedagogical models, apprenticeship was also one of the first to be regulated. The effectiveness of the method of training a novice to enter the adult world of work through apprenticeship is undisputed, when it is conducted in a manner approximate to that from which it derived: a process that occurs over time, with continuous interaction between novice and expert. Despite millennia of practice, and a few emerging programs called Virtual Apprenticeships, the critical real-time skills-based mentoring component (on the job instruction/training, or OJI/OJT) of the modern apprenticeship is still only carried out fully in face-to-face programs. With the move to work-from-home (WFH) resulting from the global COVID-19 pandemic of 2020, assessing the viability of a FRADS is timely. This qualitative exploratory study is a first step in the discussion. Bounded by the parameters of the U.S. Certified Apprenticeship Guidelines for Registered Apprenticeships and the constructs of viability and functional equivalence, participants of three critical stakeholder groups—policy makers, service managers, and front-line service workers—offer their pre-pandemic perceptions of the construct of a FRADS. Guided by the work of Jahoda, et al., (1957), Northrop (1949,1959), and Swedberg (2018), this qualitative exploratory methodology identified perceptual data points that are then compared against a framework of viability derived from IEG’s Service Delivery Evaluation Framework (Caceres, et al., 2016). And, because this represents a large systems change (LSC), I included aspects of Weiner’s (2009) Organizational Readiness for Change—valance and efficacy—as additional indicators of potential viability. Stakeholders examined key components of IEG’s evaluative criteria applied to a face-to-face apprenticeship as a functionally equivalent, technology-mediated apprenticeship delivery system. Additional stakeholder perceptions, mid-pandemic, along with a review of scholarly articles, media reports, and Department of Labor statistics concerning the impact of the WFH mandates foreground the gap a purposeful FRADS might fill. Analysis of some of the findings are represented in a preliminary process map. </div>

No description available.

The thesis is focused on the research of stability of controlled drug release systems based on a blend of plasticized starch/polycaprolactone (TPS/PCL) that served as a carrier. Antibiotic vancomycin was used as a model drug, and its release from TPS/PCL pellets into aqueous environment was followed by UV-spectroscopy and the obtained time dependences were treated by a simple kinetic model. Moreover, the simultaneous release of starch particles to the surrounding liquid phase was studied by static and dynamic light scattering as well as transmission electron microscopy (TEM) in order to obtain information on the stability of biodegradable matrix and on the structure of the products of the pellet decomposition on a nanoscale level. Key words: vancomycin, starch, drug delivery system, polycaprolactone (PCL), particle release, dynamic light scattering (DLS), static light scattering (SLS)

No description available.

Objectif : Comparer les dispositifs de délivrance automatisée d’insuline open-source (DDAI-OS) et les DDAI commerciaux hybrides sur le contrôle glycémique, la qualité de vie rapportée, et la sécurité chez des adultes avec diabète de type 1 (DT1). Méthodes : Étude prospective, observationnelle, de non-infériorité, comparative et en vie réelle, incluant 78 adultes canadiens avec un DT1 et utilisant un DDAI ≥ 3 mois. Quatre semaines de mesure continue du glucose ont permis d’évaluer le % temps passé dans la cible de glucose (%TIR, 3,9-10,0 mmol/L). Les indicateurs de qualité de vie ont été évalués par des échelles de mesure validées. Les mesures de sécurité sont le temps passé en hypoglycémie, la survenue d’hypoglycémie sévère ou d’acido-cétose et les problèmes techniques. Résultats : Les participants du groupe DDAI-OS étaient non inférieurs au groupe DDAI commercial sur le %TIR (78,3% [SD 11,0] vs. 71,2% [SD 10,9], différence moyenne 7,2% [95% CI 1,9% à 12,5%], p<0.001), même après ajustement sur plusieurs facteurs confondants. Le groupe DDAI-OS a passé plus de temps en hypoglycémie (<3,9 mmol/L) (3,9% [SD 3,1] vs. 1,8% [SD 1,3], p<0.001) et a rapporté moins de peur de l’hypoglycémie. Aucun épisode d’hypoglycémie sévère ou d’acido-cétose n’a été rapporté, avec un nombre de problèmes techniques similaires entre les deux groupes. Conclusion : Les DDAI-OS hybrides sont sécuritaires et non inférieurs aux DDAI commerciaux hybrides en termes de %TIR chez des adultes vivant avec un DT1 dans des conditions de vie réelle. Nos résultats soutiennent que les DDAI-OS peuvent être considérés pour la gestion du DT1. / Background: Comparison between unregulated open-source (OS) automated insulin delivery (AID) systems and commercial AID (C-AID) systems remains scarce. Objective: Compare both AID systems regarding glucose management, patient-reported outcomes (PROs), and safety among adults with type 1 diabetes (T1D) in real-life conditions. Design: Prospective, observational, non-inferiority, comparative, real-world study. Setting: On-site (a diabetes clinic in Montreal) and online (a T1D registry and social media platforms) across Canada. Participants: 78 adults with T1D, having used an AID system for ≥ 3 months, and living in Canada (26 OS-AID and 52 C-AID users). Measurements: 4-week’s data from a blinded continuous glucose monitor were used to assess effectiveness (primary outcome: 24h time in range % [TIR%], with a non-inferiority margin of 5%). Other outcomes included PRO measures using validated scales. Safety outcomes included time spent in hypoglycemia, severe hypoglycemia, diabetic ketoacidosis (DKA), and technical issues. Results: OS-AIDs were non-inferior to C-AIDs regarding 24h TIR% (78.3% [SD 11.0] vs. 71.2% [SD 10.9], mean difference 7.2% [95% CI 1.9% to 12.5%], p<0.001), even after adjusting for various confounding factors. OS-AIDs spent more time in hypoglycemia (<3.9 mmol/L) than C-AIDs (3.9% [SD 3.1] vs. 1.8% [SD 1.3], p<0.001) and reported less fear of hypoglycemia. No severe hypoglycemia or DKA was reported in either group, with a similar occurrence rate of technical issues between groups. Conclusion: OS-AIDs are safe and non-inferior to C-AIDs for TIR% among adults with T1D in real-world settings. Our findings support that both OS-AID and C-AID systems can be considered for T1D management.

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal.

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

The past few years have witnessed significant work being directed towards drug delivery systems with layer-by layer (LbL) technique prominently featured as one of the most sought after approach. However, majority of the studies were focused on the fabrication of microcapsules which produced numerous drawbacks resulting in reduced applicability. This has spurred research into nanocapsules which has proved to overcome most of the drawbacks that plagued microcapsules by being able to evade the reticulo-endothelial system, exhibit enhanced permeability and retention in tumours etc. The capsules fabricated by the LbL technique requires a suitable combination of cationic and anionic polyelectrolytes which ensures that it is able to effectively protect the cargo it encapsulates as well as enhance its bio-applications. With numerous advantages such as biocompatibility and biodegradability to name a few, chitosan has proved to be an ideal cationic polyelectrolyte. Thus, this thesis focuses on the various therapeutic applications of LbL fabricated chitosan based nanocapsules. The first work focuses on the targeted delivery of the somatostatin analogue, Octreotide conjugated nanocapsules to over expressed somatostatin receptors. These LbL fabricated nanocapsules composed of chitosan and dextran sulfate (CD) encapsulate the anti cancer drug, doxorubicin and are found to attain site specificity as well as enhanced anti-proliferative activity. The results indicated that the nanocapsules were biocompatible and when conjugated with octreotide was found to have an enhanced internalization into SSTR expressing cells, thereby making it a viable strategy for the treatment of tumors that has an over expression of somatostatin receptors such as pancreatic carcinoma, breast carcinoma etc. The objective of the second work was to develop an efficient drug delivery system such as CD nanocapsules for encapsulation of Ciprofloxacin in order to combat infection by Salmonella, an intracellular and intra-phagosomal pathogen. In vitro and in vivo experiments showed that this delivery system can be used effectively to clear Salmonella infection. The increased retention of ciprofloxacin in tissues delivered by CD nanocapsules as compared to the conventional delivery proved that the same therapeutic effect was obtained with reduced dosage and frequency of Ciprofloxacin administration. The third work deals with the probiotic, Saccharomyces boulardii which is found to be effective against several gastrointestinal diseases but had limited clinical application due to its sensitivity to acidic environment. However, encapsulation of S. boulardii with chitosan and dextran sulfate ensured enhanced viability and selective permeability on exposure to acidic and alkaline conditions experienced during gastro intestinal transit. The final work involves the fabrication of novel pH responsive nanocapsules composed of chitosan-heparin which facilitate the intracellular delivery of a model anti-cancer drug, doxorubicin.

Chapter–I Introduction Shock waves appear in nature whenever the different elements in a fluid approach one another with a velocity larger than the local speed of sound. Shock waves are essentially non-linear waves that propagate at supersonic speeds. Such disturbances occur in steady transonic or supersonic flows, during explosions, earthquakes, tsunamis, lightening strokes and contact surfaces in laboratory devices. Any sudden release of energy (within few μs) will invariably result in the formation of shock wave since it is one of the efficient mechanisms of energy dissipation observed in nature. The dissipation of mechanical, nuclear, chemical, and electrical energy in a limited space will result in the formation of a shock wave. However, it is possible to generate micro-shock waves in laboratory using different methods including controlled explosions. One of the unique features of shock wave propagation in any medium (solid, liquid or gases) is their ability to instantaneously enhance pressure and temperature of the medium. Shock waves have been successfully used for disintegrating kidney stones, non-invasive angiogenic therapy and osteoporosis treatment. In this study, we have generated a novel method to produce micro-shock waves using micro-explosions. Different biological applications were developed by further exploring the physical properties of shock waves. Chapter – II Bacterial transformation using micro-shock waves In bacteria, uptake of DNA occurs naturally by transformation, transduction and conjugation. The most widely used methods for artificial bacterial transformation are procedures based on CaCl2 treatment and electroporation. In this chapter, controlled micro-shock waves were harnessed to develop a unique bacterial transformation method. The conditions have been optimized for the maximum transformation efficiency in E. coli. The highest transformation efficiency achieved (1 × 10-5 transformants per cell) was at least 10 times greater than the previously reported ultrasound mediated transformation (1 × 10-6 transformants per cell). This method has also been successfully employed for the efficient and reproducible transformation of Pseudomonas aeruginosa and Salmonella Typhimurium. This novel method of transformation has been shown to be as efficient as electroporation with the added advantage of better recovery of cells, economical (40 times cheaper than commercial electroporator) and growth-phase independent transformation. Chapter – III Needle-less vaccine delivery using micro-shock waves Utilizing the instantaneous mechanical impulse generated behind the micro-shock wave during controlled explosion, a novel non-intrusive needleless vaccine delivery system has been developed. It is well established, that antigens in the epidermis are efficiently presented by resident Langerhans cells, eliciting the requisite immune response, making them a good target for vaccine delivery. Unfortunately, needle free devices for epidermal delivery have inherent problems from the perspective of patient safety and comfort. The penetration depth of less than 100 µm in the skin can elicit higher immune response without any pain. Here the efficient utilization of the device for micro-shock wave mediated vaccination was demonstrated. Salmonella enterica serovar Typhimurium vaccine strain pmrG-HM-D (DV-STM-07) was delivered using our device in the murine salmonellosis model and the effectiveness of the delivery system for vaccination was compared with other routes of vaccination. The device mediated vaccination elicits better protection as well as IgG response even in lower vaccine dose (ten-fold lesser), compare to other routes of vaccination. Chapter – IV In vitro and in vivo biofilm disruption using shock waves Many of the bacteria secrete highly hydrated framework of extracellular polymer matrix on encountering suitable substrates and get embedded within the matrix to form biofilm. Bacterial colonization in biofilm form is observed in most of the medical devices as well as during infections. Since these bacteria are protected by the polymeric matrix, antibiotic concentration of more than 1000 times of the MIC is required to treat these infections. Active research is being undertaken to develop antibacterial coated medical implants to prevent the formation of biofilm. Here, a novel strategy to treat biofilm colonization in medical devices and infectious conditions by employing shock waves was developed. Micro-shock waves assisted disintegration of Salmonella, Pseudomonas and Staphylococcus biofilm in urinary catheters was demonstrated. The biofilm treated with micro-shock waves became susceptible to antibiotics, whereas the untreated was resistant. Apart from medical devices, the study was extended to Pseudomonas lung infection model in mice. Mice exposed to shock waves responded well to ciprofloxacin while ciprofloxacin alone could not rescue the mice from infection. All the mice survived when antibiotic treatment was provided along with shock wave exposure. These results clearly demonstrate that shock waves can be used along with antibiotic treatment to tackle chronic conditions resulting from biofilm formation in medical devices as well as biological infections. Chapter – V Shock wave responsive drug delivery system for therapeutic application Different systems have been used for more efficient drug delivery as well as targeted delivery. Responsive drug delivery systems have also been developed where different stimuli (pH, temperature, ultrasound etc.) are used to trigger the drug release. In this study, a novel drug delivery system which responds to shock waves was developed. Spermidine and dextran sulfate was used to develop the microcapsules using layer by layer method. Ciprofloxacin was loaded in the capsules and we have used shock waves to release the drug. Only 10% of the drug was released in 24 h at pH 7.4, whereas 20% of the drug was released immediately after the particles were exposed to shock waves. Almost 90% of the drug release was observed when the particles were exposed to shock waves 5 times. Since shock waves can be used to induce angiogenesis and wound healing, Staphylococcus aureus skin infection model was used to show the effectiveness of the delivery system. The results show that shock wave can be used to trigger the drug release and can be used to treat the wound effectively. A brief summary of the studies that does not directly deal with the biological applications of shock waves are included in the Appendix. Different drug delivery systems were developed to check their effect in Salmonella infection as well as cancer. It was shown for the first time that silver nanoparticles interact with serum proteins and hence the antimicrobial properties are affected. In a nutshell, the potential of shock waves was harnessed to develop novel experimental tools/technologies that transcend the traditional boundaries of basic science and engineering.