This research project addresses the following: how topical talk operates in the organisation and management of MSE interactions; and how topical talk operates in the co-ordination of specific service requests and service provisions. It draws on a corpus of audio-recorded and transcribed interactions between general practitioners and persons seeking general medical services in suburban clinics in Brisbane, Australia. The corpus comprised a total of 67 medical service events (henceforth MSEs), audio-taped with the full informed consent of the participants. Many contemporary medical sociological accounts of the operation of topical talk in MSEs, typified by the work of Mishler (1981, 1984) and Waitzkin (1991), remain anchored to the 'professional dominance' thesis (Freidson 1970a; 1970b), arguing for the fundamental conflict between two perspectives - lay and professional. Topical talk has been formulated as one expression of this conflict in 'doctor-centred' communicative 'styles' (Byrne and Long 1976; Silverman 1987). Within such accounts, familiar interactional patterns in MSEs, including the content and structure of topics, have been theorised as instruments of power and control whereby the dominance of specialised medical knowledge and expertise are established and maintained. Mishler's (1984) characterisation of the conflict between a biomedically oriented 'voice of medicine' used by professional physicians (henceforth GPs) and a 'voice of the lifeworld' used by persons seeking medical services (henceforth Ps) is an expression of the 'professional dominance' thesis. The voices are characterised as attesting to a fundamental, theoretically problematic, asymmetry of power relations between GPs and Ps, thereby reinforcing the ideological status of professionals in general and the medical profession in particular. Further, recommendations regarding correctives to 'professional dominance' centre on advice GPs to attend to the primacy of Ps' talk on their experiences of illnesses rather than apparently 'ignoring' or transforming these topics into biomedical accounts of disease. This research project critiques this formulation of topical talk and the traditional theoretical and empirical bases on which it has drawn. This critique arises from the application of ethnomethodological approaches to the study of MSEs. Such approaches, as outlined in Chapters 2 and 3, are characterised by a number of conceptual and analytic premises: First, particular social structural features of social activities and the institutional contexts within which activities occur should not be assumed to be the primary criteria for judging the import and adequacy of situated action. Second, the parties to situated social events mutually constitute those events in the real world. Third, issues of agency are collaborative situated accomplishments such that the management of everyday social activities is accomplished by the people involved who show one another the rationalities of their actions as they assemble the familiar scenic features of those same institutional events (Garfinkel 1967; Sacks 1992a, 1992b). These assumptions have been applied in ethnomethodological analyses of social action, including the analysis of professional service encounters that have critiqued the 'professional dominance' thesis (Eglin and Wideman 1986; Sharrock 1979). The novelty of this study is the analysis of the operation of topic organisation as a phenomenon of order. This study also draws on recommendations within Ethnomethodology (Hester & Eglin 1997b; Watson 1997) that sequential and categorial organisations are mutually informative in the analysis of the rationality of situated social action. One of the particular contributions of this thesis is that it not only jointly applies both conversation analysis and membership categorisation analysis but also extends this recommendation to the inclusion of topic analysis as was originally provided for by Sacks (1992a , 1992b) and Garfinkel and Sacks (1970). Within this study a model of analysis has been constructed that has enabled the analytical consideration of four dimensions of social organisation: local sequential, extended sequential, topical and categorial organisations. The theoretical and empirical concepts of ethnomethodogical analysis have thus been developed and extended within this project. The central findings of this study are that in institutional service events, the 'service topic' is both significant and consequential, and that persons constitute themselves as bona fide incumbents of the categories GP or P by attending to their actions as topically organised. The local adequacy of any particular interactional move (such as questioning-answering, greetings, the design of a topic proposal, etc) is shown to be referenced to the service topic. This study found no evidence of potential or actual "struggles" between the 'voice of the life-world and the voice of medicine'. Rather, this study finds routine recognition on the part of both Ps and GPs of the centrality of the service topic and, thereby, the service task, and no evidence of orientation to distinctive biographical contributions staged in competition with biomedically relevant service topics. It is found that Ps' biographical references were made in the context of an assembled service topic such that particular service tasks, however conventional, were constituted as both relevant and reasonable as medical goods and service for the specific service recipient and provider. At the most general level, it is concluded that the service topic operates as a phenomenon of order in MSEs where order, as defined by Garfinkel and Weider (1992: 202), refers to all of the rationalities evident in the generic features of institutional events and settings, that is, the situated logic and intelligibility as well as the procedures whereby they are constituted as recognisable social events. The thesis concludes with a discussion of the implications of the findings for the theorisation, policy-making, medical education, and practices of GPs and Ps within MSEs. Overall, the significance of this work for researchers into medical interactions is that the relevance of the service topic and its pervasive organisational consequences need to be considered analytically. A major outcome of this thesis is the establishment of a new order of interest within the study of institutional interactions. The project demonstrates the pervasive consequences of service topics and thus provides a step forward in the study of institutional service interactions and ways of theorising their rationality, a step that extends beyond social structural pre-theorisations of power and domination and also beyond interactional accounts of the primary relevance of turn taking structures.

Les neurotoxiques organophosphorés (NOP) sont extrêmement toxiques et peu volatils. Dans des conditions normales de température et de pression, ils peuvent pénétrer rapidement la peau sous forme liquide et exercer leurs effets délétères. En milieu civil ou militaire, leur utilisation potentielle est toujours redoutée. Le développement de dispositifs de protection cutanée vis-à-vis de ces agents est donc d’un intérêt majeur pour les armées et la sécurité civile. Dans ce contexte, les objectifs de ce travail ont été de formuler et évaluer la stabilité et l’efficacité de topiques protecteurs cutanés (TP) vis-à-vis des NOP. Le premier objectif a consisté à mettre au point des TP de compositions et de formes galéniques différentes (émulsions, gels) puis à valider leurs stabilités physicochimiques. Cent trente TP ont été formulés et 30 ont montré une stabilité physicochimique satisfaisante. Le second objectif a été d’évaluer l’efficacité des TP les plus prometteurs vis-à-vis des composés organophosphorés. Actuellement il n’existe pas de standardisation de ce type d’étude. Par conséquent, l’utilisation de plusieurs tests in vitro et in vivo (membranes biologiques ou synthétiques, NOP ou simili), dont la pertinence et la fiabilité ont été déterminées, nous a permis d’établir une logique de criblage pour l’évaluation de l’efficacité des TP. Parmi les 13 formulations testées, les résultats ont montré qu’un gel hydro-alcoolique apporte une protection cutanée significative et supérieure aux produits de référence testés vis-à-vis du VX, un NOP d’intérêt / Prevention of exposure to the neurotoxic organophosphorus compounds (OP) that are quickly absorbed in the skin is a major concern both for pesticide users and soldiers. Skin barrier creams are being developed to complement or replace uncomfortable chemical protective suits. The objectives of this work were to formulate and assess physicochemical stability and protective efficacy of topical skin protectant (TSP) against OP compounds. The first objective was to formulate several different TSP (emulsions, gel) and validate their physicochemical stability.The second objective was to determine the consistency of results from in vitro tests and the importance of the formulation composition in the skin protective efficacy. Quick evaluation of formulations efficacy mainly relies on in vitro tests which lead to consistent, complementary and relevant results. Our results indicated that the least effective formulations could be quickly identified by performing in vitro permeation tests with silicone membrane and by evaluating interfacial interactions between formulations and OP. We showed that a hydrogel containing specific hydrophilic polymers was by far the most effective of the formulations evaluated against VX, OP compounds, skin permeation in vitro

Background: Pimecrolimus cream (Elidel®, SDZ ASM 981), a non-steroid inhibitor of inflammatory cytokines, is effective in the treatment of atopic dermatitis (AD). We assessed whether early treatment of AD signs/symptoms reduces the need for topical corticosteroids. Objective: To investigate the efficacy and safety of pimecrolimus cream 1% in the long-term management of adult AD. Methods: 192 adults with moderate to severe AD were randomised (1:1) for twice daily (b.i.d.) treatment of early signs or symptoms of AD with either pimecrolimus cream 1% or vehicle cream (control group) to prevent progression to flares. Treatment was given as needed for 24 weeks. In the event of flares, a moderately potent corticosteroid (prednicarbate 0.25% cream) was permitted as rescue medication in both groups. The percentage of days on which a topical corticosteroid was used to treat disease flares was the main outcome measure. Results: Corticosteroid medication was used on 14.2% (95% confidence interval, CI: 8.3–21.1) of the days of the 24-week treatment period in the pimecrolimus group and on 37.2% (95% CI: 30.4–44.0) of the days in the control group (p < 0.001). In total, 44.8% (43/96) of patients in the pimecrolimus group did not experience a flare compared with 18.8% (18/96) of patients in the control group. The median time to first flare was 144 days in the pimecrolimus group and 26 days in the control group (p < 0.001). Pimecrolimus treatment was also associated with improvement in signs and symptoms of AD, pruritus, patients’ self-assessment and quality of life. Conclusions: Pimecrolimus cream 1% b.i.d. is an effective, well-tolerated, long-term treatment for AD in adults, substantially reducing the number of flares compared to a conventional therapy and consequently reducing or eliminating the need for corticosteroid treatment. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Da topische Glucocorticoide im Vergleich zur parenteralen Anwendung weniger systemische (Neben)Wirkungen haben können, werden sie bevorzugt in der Human- und Veterinärmedizin eingesetzt. Jedoch konnte bei vielen Untersuchungen gezeigt werden, dass topische Glucocorticoide je nach Applikationsdauer, -ort, Wirkstoffpotenz, -dosis und Behandlungsfläche ausgeprägte messbare Reaktionen wie Suppression der HHNA und der Immunzellen hervorrufen können. Beim Pferd wurden jedoch dahingehend bisher keine Untersuchungen durchgeführt. Da Glucocorticoide im Pferdesport auch dopingrelevant sind wurde der Frage nachgegangen, ob nach der dermalen Applikation eines niederpotenten Glucocorticoidpräparates auf die Haut gesunder Pferde systemische Effekte auftreten können und ob ein, nach perkutaner Resorption auftretender, Wirkstoffspiegel im Blut gemessen werden kann. Im Rahmen dieser Dissertation standen 10 erwachsene, klinisch gesunde Versuchspferde zur Verfügung. Die Versuchsdurchführung erfolgte in 3 Phasen. Vor Behandlungsbeginn (Tag 0) wurden von jedem Pferd die Kontrolldaten erfasst. Die Applikation der Dexamethasonformulierung erfolgte über einen Zeitraum von 10 Tagen. 2 mal täglich wurden 50 g einer 0,017 %igen Dexamethasonemulsion auf eine definierte Hautfläche (30 x 50 cm) aufgetragen. Die Blutentnahmen zur Gewinnung der Proben erfolgten am 2., 6., 8., und 10. Tag der Behandlung. Die Nachbehandlungsphase erstreckte sich über einen Zeitraum von 20 Tagen ohne die Dexamethasonanwendung. Hier erfolgte die Probengewinnung an den Tagen 3, 7, 11, 14 und 20 nach Absetzen der Behandlung. Aus den gewonnenen Plasmaproben wurden die Konzentrationen von Cortisol, Insulin, T3 und T4 mittels Radioimmunoassay bestimmt, sowie die ACTH-Konzentrationen mittels Chemilumineszenz-Enzymimmunometrischem Assay. Darüber hinaus wurden die hämatologischen und blutchemischen Parameter gemessen. Die Funktion des negativen Feetback-Mechanismus der Hypothalamus-Hypophysen-Nebennierenrinden-Achse wurde mittels eines ACTH-Stimulationstests überprüft. Während der Behandlung konnte eine ausgeprägte Suppression der Nebennierenrindenfunktion, gekennzeichnet durch die signifkante Abnahme der basalen Cortisolkonzentration, auf weniger als 10 % der Ausgangswerte vor der Behandlung gemessen werden. Auch der ACTH-Stimulationstest am 8. Behandlungstag zeigte einen signifikant geringeren Anstieg des Kortisolspiegels (< 50 %) als vor der Behandlung. Weiterhin kam es während der dermalen Verabreichung von Dexamethason zu einer progressiven, signifikanten Zunahme des Serumglucosespiegels bis um das 1,5 fache des Kontrollwertes. Parallel dazu stieg der Plasmainsulinspiegel um das 3-fache des Ausgangswertes vor Behandlungsbeginn. Die Plasmakonzentration von T3 zeigte einen leichten behandlungsbedingten Abfall, wohingegen der Plasma-T4-Spiegel einen deutlichen Rückgang auf 50 % des Ausgangswertes zeigte. Die endokrinologischen Veränderungen waren nach Absetzen der Behandlung alle reversibel. Weiterhin kam es zu einer signifikanten Reduktion der eosinophilen Granulozyten und der Lymphozyten, während die Zahl der Neutrophilen zunahm. Plasmakonzentrationen von Dexamethason konnten mit einem Maximalwert am 8. Tag der Behandlung (1542,10 ± 567 pg/ml) gemessen werden. Diese Ergebnisse belegen, dass bei der dermalen Applikation von Dexamethason eine perkutane Wirkstoffresorption in einem Umfang stattfindet, dass die typischen systemischen Glucocorticoidwirkungen auftreten. Es kann somit auch davon ausgegangen werden, dass die topische Verabreichung schwach wirksamer Glucocorticoidformulierungen eine gewisse Dopingrelevanz besitzt.

Les nanomatériaux représentent un créneau de recherche en plein essor dans de nombreuxdomaines. Leurs propriétés inédites leur confèrent de nombreux avantages mais soulèvent égalementdes interrogations quant à leur profil toxicologique. Parmi leurs applications possibles, lesnanomatériaux sont intégrés au sein de topiques protecteurs : dans le secteur militaire, afin de limiterla pénétration cutanée des agents chimiques de guerre et dans le secteur cosmétique, notammentdans les produits de protection solaire. Ce travail porte sur l'intérêt du dioxyde de cérium pur ou dopéau calcium dans ces deux applications. Dans un premier temps, les nanoparticules ont étésynthétisées par une méthode hydrothermale, assistée de la voie micro-ondes. La caractérisation pardifférentes méthodes a permis d'identifier la phase cristalline du CeO2 et a montré que lesnanoparticules présentaient une taille de 3 nm, pouvant être augmentée jusqu'à 95 nm en fonction dutraitement thermique appliqué. Par la suite, l'efficacité des nanoparticules seules puis incorporées ausein de topiques à effets barrières vis-à-vis de la pénétration du paraoxon, agent organophosphoré, aété testée. Une émulsion H/E constituée de 10 % de cérine a permis de réduire de façon significativela pénétration du toxique. Enfin, la photoprotection et la sécurité d'emploi du CeO2 ont été comparéesà celles des filtres solaires, et notamment à celles de l'oxyde de zinc (ZnO) fréquemment rencontrédans les produits de protection solaire. Le CeO2, en améliorant la protection dans le domaine des UVBet en ne présentant aucun effet antiprolifératif ou génotoxique sur une lignée cellulaire dekératinocytes humains, représente une alternative particulièrement intéressante au ZnO. / Nanomaterials represent a growing niche research in many fields. Their unusual properties provide many benefits, but also raise questions about their toxicological profile. Among their applications, nanomaterials are integrated into topical skin protectant: in the military sector, in order to reduce skin penetration of chemical warfare agents and in the cosmetics industry, especially in sunscreen products. This work focuses on the interest of pure or calcium doped cerium dioxide in these two applications. Initially, the nanoparticles were synthesized by a microwave-hydrothermal method. Characterization by different methods has identified the crystalline phase of CeO2 and has showed that the nanoparticles had a size of 3 nm, which could be increased up to 95 nm depending on the heat treatment applied. Thereafter, the effectiveness of nanoparticles alone and then incorporated in a topical barrier cream over the penetration of paraoxon, organophosphorus agent was tested. An O/W emulsion, consisting of 10 % ceria, has reduced significantly the penetration of the toxic. Finally, photoprotection and safety of CeO2 were compared with sunscreens, and in particular with zinc oxide (ZnO), frequently encountered in sunscreen products. CeO2, improving protection in the UVB range and showing no antiproliferative or genotoxic effect on human keratinocyte cell line, is a particularly attractive alternative to ZnO.

Fundação de Amparo a Pesquisa do Estado de Alagoas / O presente trabalho propõe-se a analisar a construção do tópico discursivo em histórias em quadrinhos (HQ) escritas por uma díade de alunas recém-alfabetizados de um 2º ano do Ensino Fundamental de uma escola da rede pública da cidade de Maceió. Inserido no campo de estudo da Genética Textual, e assumindo como base teórico-metodológica as investigações sobre processos de escritura em ato e manuscritos escolares proposta por Calil (2008, 2009), considerando as reflexões sobre as relações entre texto em quadrinhos (LINS, 2008), as propriedades de centração e organicidade constitutivas do tópico discursivo, conforme indicado por Koch et al.(1996), e as noções da Linguística Textual acerca da Referenciação (KOCK, 2006; KOCH & ELIAS, 2010), nosso objeto de perquirição está voltado para a análise das filmagens de processos de escritura em ato, bem como dos manuscritos, quando uma dupla (Ana e Maria, ambas com 08 anos de idade) de discentes escreviam propostas de produção de HQ. Este processo e seu manuscrito estabeleceram-se a partir do diálogo entre as alunas, enquanto criavam e escreviam, em dois processos de escritura distintos, historinhas da Turma da Mônica sem os textos escritos, o que poderia acompanhar os quadrinhos oferecidos como suporte. Com o apoio do programa de computador ELAN, pudemos descrever e associar, cronologicamente, um complexo sistema semiótico composto pelas imagens captadas (movimentos de corpo, gestos, mãos, expressões faciais, posição da caneta e direções do olhar), o que foi falado e combinado e, por fim, pelo que ficou escrito em cada quadrinho. Dentre os aspectos mais importantes que ocorreram durante o estabelecimento do tópico discursivo pela díade no primeiro processo/manuscrito está a preponderância da perspectiva enunciativa enquanto-leitoras-de-imagens sobre a perspectiva enunciativa enquanto-autoras-da-narrativa-em-quadrinhos , representada através da interação gráfico-visual entre os personagens; e no segundo processo/manuscrito, houve alternância entre uma e outra perspectiva, prevalecendo, no texto final após interferências do professor que conduzira a aula , o segundo posicionamento. Por fim, nossa análise advoga a necessidade de se refletir e diferenciar a constituição do tópico discursivo em HQ a partir da recepção, quando os alunos, professores (e pesquisadores) assumem a posição de leitores e a constituição do tópico discursivo em HQ a partir da produção, quando os alunos assumem a posição de escreventes, sendo necessário um empreendimento lingüístico-cognitivo para se construir a perspectiva dos personagens que falam e não a do narrador que descreve.

Hierarchical Bayesian Models and Matrix factorization methods provide an unsupervised way to learn latent components of data from the grouped or sequence data. For example, in document data, latent component corn-responds to topic with each topic as a distribution over a note vocabulary of words. For many applications, there exist sparse relationships between the domain entities and the latent components of the data. Traditional approaches for topic modelling do not take into account these sparsity considerations. Modelling these sparse relationships helps in extracting relevant information leading to improvements in topic accuracy and scalable solution. In our thesis, we explore these sparsity relationships for di errant applications such as text segmentation, topical analysis and entity resolution in dyadic data through the Bayesian and Matrix tri-factorization approaches, propos-in scalable solutions. In our rest work, we address the problem of segmentation of a collection of sequence data such as documents using probabilistic models. Existing state-of-the-art Hierarchical Bayesian Models are connected to the notion of Complete Exchangeability or Markov Exchangeability. Bayesian Nonpareil-metric Models based on the notion of Markov Exchangeability such as HDP-HMM and Sticky HDP-HMM, allow very restricted permutations of latent variables in grouped data (topics in documents), which in turn lead to com-mutational challenges for inference. At the other extreme, models based on Complete Exchangeability such as HDP allow arbitrary permutations within each group or document, and inference is significantly more tractable as a result, but segmentation is not meaningful using such models. To over-come these problems, we explored a new notion of exchangeability called Block Exchangeability that lies between Markov Exchangeability and Com-plate Exchangeability for which segmentation is meaningful, but inference is computationally less expensive than both Markov and Complete Exchange-ability. Parametrically, Block Exchangeability contains sparser number of transition parameters, linear in number of states compared to the quadratic order for Markov Exchangeability that is still less than that for Complete Exchangeability and for which parameters are on the order of the number of documents. For this, we propose a nonparametric Block Exchangeable model (BEM) based on the new notion of Block Exchangeability, which we have shown to be a superclass of Complete Exchangeability and subclass of Markov Exchangeability. We propose a scalable inference algorithm for BEM to infer the topics for words and segment boundaries associated with topics for a document using the collapsed Gibbs Sampling procedure. Empirical results show that BEM outperforms state-of-the-art nonparametric models in terms of scalability and generalization ability and shows nearly the same segmentation quality on News dataset, Product review dataset and on a Synthetic dataset. Interestingly, we can tune the scalability by varying the block size through a parameter in our model for a small trade-o with segmentation quality. In addition to exploring the association between documents and words, we also explore the sparse relationships for dyadic data, where associations between one pair of domain entities such as (documents, words) and as-associations between another pair such as (documents, users) are completely observed. We motivate the analysis of such dyadic data introducing an additional discrete dimension, which we call topics, and explore sparse relation-ships between the domain entities and the topic, such as of user-topic and document-topic respectively. In our second work, for this problem of sparse topical analysis of dyadic data, we propose a formulation using sparse matrix tri-factorization. This formulation requires sparsity constraints, not only on the individual factor matrices, but also on the product of two of the factors. To the best of our knowledge, this problem of sparse matrix tri-factorization has not been stud-ide before. We propose a solution that introduces a surrogate for the product of factors and enforces sparsity on this surrogate as well as on the individual factors through L1-regularization. The resulting optimization problem is e - cogently solvable in an alternating minimization framework over sub-problems involving individual factors using the well-known FISTA algorithm. For the sub-problems that are constrained, we use a projected variant of the FISTA algorithm. We also show that our formulation leads to independent sub-problems towards solving a factor matrix, thereby supporting parallel implementation leading to a scalable solution. We perform experiments over bibliographic and product review data to show that the proposed framework based on sparse tri-factorization formulation results in better generalization ability and factorization accuracy compared to baselines that use sparse bi-factorization. Even though the second work performs sparse topical analysis for dyadic data, ending sparse topical associations for the users, the user references with di errant names could belong to the same entity and those with same names could belong to different entities. The problem of entity resolution is widely studied in the research community, where the goal is to identify real users associated with the user references in the documents. Finally, we focus on the problem of entity resolution in dyadic data, where associations between one pair of domain entities such as documents-words and associations between another pair such as documents-users are ob.-served, an example of which includes bibliographic data. In our nil work, for this problem of entity resolution in bibliographic data, we propose a Bayesian nonparametric `Sparse entity resolution model' (SERM) exploring the sparse relationships between the grouped data involving grouping of the documents, and the topics/author entities in the group. Further, we also exploit the sparseness between an author entity and the associated author aliases. Grouping of the documents is achieved with the stick breaking prior for the Dirichlet processes (DP). To achieve sparseness, we propose a solution that introduces separate Indian Bu et process (IBP) priors over topics and the author entities for the groups and k-NN mechanism for selecting author aliases for the author entities. We propose a scalable inference for SERM by appropriately combining partially collapsed Gibbs sampling scheme in Focussed topic model (FTM), the inference scheme used for parametric IBP prior and the k-NN mechanism. We perform experiments over bibliographic datasets, Cite seer and Rexa, to show that the proposed SERM model imp-proves the accuracy of entity resolution by ending relevant author entities through modelling sparse relationships and is scalable, when compared to the state-of-the-art baseline

A pele é exposta a inúmeros agentes, dentre os quais destaca-se a radiação ultravioleta (RUV), que pode energizar os cromóforos celulares da pele e estes reagindo com o oxigênio molecular podem resultar na geração das espécies reativas de oxigênio (EROs). Nestas circunstâncias, mesmo possuindo um sistema de defesa antioxidante, a concentração de radicais livres pode aumentar, rompendo o equilíbrio pró oxidante/antioxidante, levando ao estresse oxidativo na pele. Neste contexto, o uso tópico de formulações adicionadas de substâncias naturais tem sido um eficiente modo para enriquecer o sistema protetor cutâneo endógeno, reduzindo os danos oxidativos causados pela RUV na pele. Sendo assim, o presente trabalho teve como objetivo estudar o potencial fotoquimioprotetor do extrato e da fração de média polaridade de Inga edulis e desenvolver formulações estáveis física e quimicamente a fim de selecionar a que prover melhor liberação, penetração e retenção dos componentes do extrato e/ou da fração na epiderme viável. A partir do perfil cromatográfico foi possível observar que o extrato possui compostos comuns à fração e alguns deles foram identificados, sendo o composto vicenina-2 o escolhido para ser monitorado nos estudos de penetração e retenção cutânea. Dentre as formulações estudadas a formulação a base de Hostacerin SAF® adicionada da fração foi a que proveu a maior penetração/retenção do composto vicenina-2 e de compostos antioxidantes na epiderme viável e também foi considerada estável por todos os parâmetros avaliados no estudo de estabilidade preliminar. A fração de Inga edulis, veiculada por esta formulação, mostrou alta atividade antioxidante frente aos métodos estudados, apresentou baixa citotoxidade em cultura celular de fibroblastos, sendo a quantidade citotóxica estabelecida muito acima da quantidade de vicenina-2 retida na epiderme viável. A fração também apresentou fotoestabilidade frente a altas doses de radiação UVA e UVB quanto à citotoxidade, capacidade de reduzir o radical sintético DPPH? e de sequestrar o ânion superóxido in vitro. Assim, a formulação gel-creme com Hostacerin SAF® adicionada de 1% da fração de média polaridade do Inga edulis mostrou ser muito promissora e deve ser melhor estudada, visando futura aplicação como formulação fotoquimiopreventiva. / The skin is exposed to numerous agents, among which stands out the ultraviolet radiation (UVR) that can energize the chromophores of cell skin and these react with molecular oxygen resulting in the generation of reactive oxygen species (ROS). In these circumstances, the endogenous antioxidant defense system would be impaired leading to a pro oxidant state named oxidative stress. In this context, the topical formulations added with natural substances has been an efficient way to aid endogenous skin protective system, minimizing the oxidative damage caused by UV rays. Thus, the aim of the present work was to study the potential photochemopreventive activity of the extract and medium polarity fraction of Inga edulis and develop formulations physically and chemically stable in order to select the penetration and retention of the components of the extract and / or fraction oin the viable epidermis. The chromatographic profiles showed that the some compounds of the extract are also present in the fraction and some of them were identified. The compound vicenin-2 was chosen to be monitored in studies of cutaneous penetration and retention. Among the formulations studied, the formulation Hostacerin SAF® added to the fraction provided the highest penetration / retention of the compound vicenin-2 and antioxidant compounds in viable epidermis and also was considered stable at all parameters evaluated in the study of preliminary stability. The fraction of Inga edulis, conveyed by this formulation, showed strong antioxidant activity in the methods studied and showed low cytotoxicity in cell culture of fibroblasts. The cytotoxicity concentration was greater than the amount of vicenin-2 retained in viable epidermis. The fraction also showed photostability when it was exposed to high doses of UVA and UVB. The irradiated fraction showed no change in cytotoxicity and antioxidant activity. Thus, the formulation Hostacerin SAF® added with 1% of medium polarity fraction of Inga edulis proved very promising and should be further studied for a future application in photochemoprevention.

La bioéquivalence, une mesure de substitution de l'innocuité et de l'efficacité à différents stades du processus de développement des médicaments, est tout particulièrement importante lors du développement d'un médicament générique. Entre autres critères, la bioéquivalence garantit que les médicaments génériques sont équivalents aux produits innovateurs ou de références approuvés en termes d’efficacité clinique et d’innocuité tout en contournant le long cours et le coût élevé des essais chez les animaux et des essais cliniques chez les patients exigés pour les médicaments innovants. Malgré les avancées dans le développement d'approches robustes au cours des dernières décennies, la pratique actuelle de la bioéquivalence fait toujours l'objet de controverses. Le but de cette thèse est d'explorer certaines de ces controverses et de les aborder en proposant des approches nouvelles et alternatives. L'une des questions les plus controversées dans la pratique actuelle de la bioéquivalence est l'extrapolation des résultats d'études de bioéquivalence d'une population à une autre. La majorité des études de bioéquivalence portant sur des formes pharmaceutiques orales efficaces par voie systémique reposent sur les critères de pharmacocinétique obtenus chez des sujets sains, alors que la population cible est constituée de patients. Ceci est basé sur l'hypothèse que si deux produits sont bioéquivalents dans une population, ils devraient l'être dans une autre. L'extrapolation des résultats des études de bioéquivalence ne se limite pas à celle des sujets sains aux patients. Depuis 2007, une proportion croissante d'études de bioéquivalence pharmacocinétique portant sur des soumissions génériques nord-américaines ou européennes a été réalisée auprès de populations géographiques/ethniques autres que celles visées, en raison du coût moins élevé de ces études en dehors de l'Amérique du Nord et de l'Europe. Dans le premier volet de cette thèse, nous avons examiné si les résultats de la bioéquivalence obtenus dans une population géographique ou ethnique pouvaient être extrapolés à une autre. À cette fin, nous avons extrait les résultats des études de bioéquivalence pharmacocinétique disponibles publiquement et provenant de soumissions génériques à Santé Canada et à la Food and Drug Administration des États-Unis. Pour dix médicaments différents, nous avons calculé l'effet d’un repas normalisé sur le produit de référence et comparé les résultats obtenus chez deux populations ethniques, les indiens et les nord-américains. Cette approche novatrice est basée sur le raisonnement suivant: si l'effet d’un repas sur le produit de référence est le même chez les populations indienne et nord-américaine, le produit générique et sa référence qui se sont révélés bioéquivalents dans la population indienne devraient également l'être dans la population nord-américaine. Pour 90% des médicaments à l'étude, une différence statistiquement significative a été détectée entre les deux populations après un repas. Pour 30% de ces médicaments, la différence s'est révélée d'une pertinence clinique possible. Les résultats de cette étude ont mis en évidence que l’extrapolation des résultats de bioéquivalence d’une population à l’autre devrait possiblement être reconsidérée pour certains médicaments. Les défis dans le contexte de la bioéquivalence ne se limitent pas toujours aux études pivots où la performance d’un produit générique est comparée à celle de la référence. En effet, une étude pilote peut être menée afin d’établir un protocole d’étude approprié pour cette étude pivot. Par conséquent, les résultats inexacts provenant d'une étude pilote, tels qu'une estimation imprécise du moment ou de la durée d’administration optimale de la dose lors de la comparaison du produit testé par rapport à la référence, pourront affecter négativement les résultats de l’étude de bioéquivalence. Ceci est particulièrement crucial pour les produits indiqués pour un usage topique dermatologique dont les corticostéroïdes constituent un cas d’espèce. En effet, leur bioéquivalence est démontrée par une mesure pharmacodynamique, le blanchiment cutané, à différents temps après application topique. L’intensité du blanchiment est comparée entre le produit générique et le produit de référence à une durée d’administration spécifique d’une dose donnée, la DD50, soit la durée associée à 50% de l’effet maximal observé. Par conséquent, cette durée d’administration de la dose doit d’abord être déterminée dans le cadre d’une étude pilote. L’agence réglementaire américaine recommande l’utilisation d’une approche populationnelle basée sur la modélisation non linéaire à effets mixtes pour l'estimation de la DD50 et ce, quelle que soit la méthode d'analyse. Étant donné qu’il existe différents types de méthodes d’analyse non linéaire à effets mixtes, chaque commanditaire peut en choisir une différente. Dans le deuxième volet de cette thèse, nous avons examiné si les mêmes estimations de DD50 pouvaient être obtenues en utilisant différentes méthodes non linéaires à effets mixtes. À cette fin, nous avons ajusté les données de blanchiment de la peau d’onze études avec deux méthodes non linéaires à effets mixtes différentes : le maximum de vraisemblance avec maximisation de l’espérance (MLEM) et l'estimation conditionnelle de premier ordre (FOCE). Les résultats ont favorisé MLEM, compte tenu d’une meilleure puissance discriminative pour l’estimation de la DD50 de population et d’une meilleure minimisation de la variabilité interindividuelle. Bien que l'approche de la bioéquivalence fondée sur la pharmacocinétique ait contribuée de manière significative au développement de versions génériques de haute qualité des formes pharmaceutiques orales indiquées pour un effet systémique, la disponibilité de versions génériques pour les produits dermatologiques topiques demeure limitée et ce, par manque de méthodes acceptées par les agences réglementaires pour l'évaluation de la bioéquivalence de ces produits. Dans le troisième volet de cette thèse, une nouvelle approche pour l’évaluation de la bioéquivalence de formulations de crème topique d’acyclovir a été développée en utilisant une analyse basée sur un modèle de données d’exposition locales récupérées à partir d’échantillons de peau abrasée prélevés à une seule durée d’administration de la dose, la DD50 à l’aide de bandes adhésives. Un seul échantillonnage de peau effectué à la DD50 a non seulement assuré que les données pharmacocinétiques étaient recueillies à la durée d’administration de la dose ayant le meilleur pouvoir discriminant pour détecter une différence au niveau des formulations, mais a également permis de diminuer considérablement le nombre d'échantillons à analyser. Et surtout, cette nouvelle approche a permis de générer un profil pharmacocinétique au niveau même de la peau. Ce faisant, nous avons pu utiliser l'analyse compartimentale populationnelle et contourner les nombreuses hypothèses et calculs sophistiqués requis par les méthodes précédentes. Notre approche a également permis de générer de nouveaux paramètres pharmacocinétiques permettant de décrire la vitesse et le degré d’exposition cutanée pour l'évaluation de la biodisponibilité et de la bioéquivalence topiques. Finalement, cette méthode a le potentiel de discerner une formulation bioéquivalente d’une autre qui ne l’est pas. / Bioequivalence is a surrogate measure of safety and efficacy in different stages of drug development process with the most pronounced significance in the development of generic drugs. Bioequivalence, among other standards, ensures that generic drugs are equivalent to their approved innovator or reference products in terms of clinical efficacy and safety while circumventing the lengthy-time course and high cost of animal and clinical trials in patients required for innovator drugs. Despite the advancements in development of robust bioequivalence approaches over the past decades, there are still controversies in the current practice of bioequivalence. The aim of this thesis is to explore some of these controversies and address them by putting forward new and alternative approaches. One of the most controversial issues in the current practice of bioequivalence is the extrapolation of bioequivalence study results from one population to another. The majority of bioequivalence studies for systemic effective oral dosage forms are conducted based on pharmacokinetic endpoints in healthy volunteers whilst the targeted population is patients. This is based on the assumption that if two products are bioequivalent in one population, they should be bioequivalent in another one. The extrapolation of bioequivalence study results is not limited to that from healthy volunteers to patients. Since 2007, an ever-increasing proportion of pharmacokinetic bioequivalence studies for North American or European generic submissions have been performed in geographical/ethnic populations other than the intended ones, due to the lower cost of these studies outside North America and Europe. In the first part of this thesis, we investigated whether the bioequivalence results obtained in one geographical or ethnic population can be extrapolated to another one. To this purpose, we extracted pharmacokinetic bioequivalence studies results from generic submissions to Health Canada and the US Food and Drug Administration. We calculated food effect for ten different reference drug products and compared the results for each product between two ethnic populations, Indians and North Americans. This is based on the reasoning that if food effect is found to be the same between the Indian and North American populations, then the generic product and its reference that were found to be bioequivalent in the Indian population should also be bioequivalent in North American population. For 90% of the study drugs, statistically significant difference was detected in the food effect between two populations. For 30% of these drugs, the difference was found to be of possible clinical relevance. The results of this study raised a flag for extrapolating the bioequivalence results from one population to another. Challenges in the context of bioequivalence are not always limited to the pivotal studies where the performance of a generic product is compared to that of Reference. Prior to pivotal bioequivalence studies, a pilot study may be conducted to establish an appropriate study design for the pivotal bioequivalence study. Therefore, inaccurate results from a pilot study, such as inaccurate estimation of time point or dose duration for comparison of test versus reference, can affect the bioequivalence outcomes adversely. An example to this case is the comparison of the extent of skin blanching, the pharmacological effect of generic versus reference products of topical dermatological corticosteroids at specific dose duration, DD50, where the effect is half maximal. This dose duration should initially be determined in a pilot study. The US FDA 1995 Guidance document recommends the use of non-linear mixed effect population modeling for the estimation of DD50, irrespective of the method of analysis. Given the availability of different types of non-linear mixed effect modeling methods, each sponsor could choose a different one. In the second part of this thesis we investigated whether the same DD50 estimates can be obtained when different non-linear mixed effect modeling methods are used. To this purpose, we fitted the skin blanching data from eleven studies with two different non-linear mixed effect modeling methods, the Maximum Likelihood Expectation Maximization (MLEM) and the First Order Conditional Estimation (FOCE). The results favored MLEM given its lower population DD50 estimates that would locate in a more discriminative portion of the Emax curve and better minimization of inter-individual variability. Although the pharmacokinetic-based bioequivalence approach has contributed significantly to the development of high-quality generic versions of systemic effective oral dosage form, the availability of generic versions of topical dermatological products remains constrained due to the limited methods accepted for bioequivalence evaluation of these products. In the third part of this thesis, a novel approach for the bioequivalence assessment of topical acyclovir cream formulations was developed based on the model-based analysis of local exposure data recovered from tape stripping of the skin at a single dose duration, DD50. Conducting the stripping procedure only at DD50 not only ensured that the PK data was collected at the dose duration that is most discriminative of formulation differences, but it also decreased the number of samples to be analyzed significantly. More importantly, our novel approach in generating the local PK profile in the skin (dermatopharmacokinetic profile) and the implementation of population compartmental analysis circumvented the numerous assumptions and sophisticated calculations that were inherent to previous methods, while yielding the PK parameters relevant for topical bioavailability and bioequivalence assessment (rate and extent of exposure to the skin). This method successfully concluded bioequivalence and its absence.

<p>Bed bugs (<i>Cimex lectularius</i> L.) are globally important human ectoparasites. Their management necessitates the use of multiple control techniques. Plant-derived essential oils are extracts from aromatic plants that represent one of the alternative control measures for bed bug control, in addition to mechanical options and synthetic pesticides. However, there is limited information available on the efficacy and toxicology of plant essential oils against bed bugs. This project was designed with the aim to provide in-depth information on efficacy, toxicology and mode-of-action of essential oils and their insecticidal constituents in bed bugs. Initially, I evaluated topical and fumigant toxicity of fifteen essential oil components against adult male bed bugs of the Harlan strain (an insecticide susceptible strain). Neurological effects of the six most toxicologically active compounds were also determined. In both topical and fumigant bioassays, carvacrol and thymol were the most active compounds. Spontaneous electrical activity measurements of the bed bug nervous system demonstrated neuroinhibitory effects of carvacrol, thymol and eugenol, whereas linalool and bifenthrin (a pyrethroid class insecticide) produced excitatory effects. Further, I evaluated the efficacy and neurological impacts of a mixture of three neuroinhibitory compounds; carvacrol, eugenol and thymol in 1:1:1 ratio against adult male bed bugs of the Harlan strain. This mixture of monoterpenoids as well as the mixture of synthetic insecticides exhibited a synergistic affect in topical bioassays. In electrophysiology experiments, the monoterpenoid mixture led to higher neuroinhibitory effects, whereas a mixture of synthetic insecticides caused higher neuroexcitatory effects in comparison to single compounds. </p> <p>In the next objective of my dissertation, I compared the efficacy of five plant essential oils (thyme, oregano, clove, geranium and coriander), their major components (thymol, carvacrol, eugenol, geraniol and linalool) and EcoRaider^® (commercial product) between pyrethroid susceptible (Harlan) and field collected (Knoxville) bed bug populations. Initially, I found that the Knoxville strain was 72,893 and 291,626 fold resistant to topically applied deltamethrin (a pyrethroid class insecticide) compared to the susceptible Harlan strain at the LD₂₅ and LD₅₀ lethal dose levels, respectively. Synergist bioassays and detoxification enzyme assays showed that the Knoxville strain possesses significantly higher activity of cytochrome P450 and esterase enzymes. Further, Sanger sequencing revealed the presence of the L925I mutation in the voltage gated sodium channel gene. The Knoxville strain, however, did not show any resistance to plant essential oils, their major components or EcoRaider^® in topical bioassays (resistance ratios of ~ 1). In the final objective, I evaluated the efficacy of binary mixtures of above-mentioned essential oils or their major components or EcoRaider^® with deltamethrin in susceptible and resistant bed bugs. In topical application bioassays, binary mixtures of essential oils or their major components or EcoRaider^® and deltamethrin at the LD₂₅ dose caused a synergistic increase in toxicity in resistant bed bugs. Further, I studied the inhibitory effects of major essential oil components on detoxification enzyme activities (cytochrome P450s, esterases and glutathione transferases). Detoxification enzyme assays conducted using protein extracts from bed bugs pre-treated with essential oil constituents showed that these compounds significantly inhibited cytochrome P450 activity in the resistant strain, but esterase and glutathione transferase activity were unaffected. No inhibition of detoxification enzyme activities was observed in the Harlan strain bed bugs pre-treated with essential oil constituents.</p> <p>In conclusion, my dissertation research has created the foundation for utilization of natural products for bed bug management by (i) describing the efficacy of plant essential oils and their components against bed bugs, (ii) discovering synergistic interactions between essential oil components at the nervous system level, (iii) determining susceptibility of deltamethrin-resistant bed bugs to plant essential oils and their constituents and (iv) identifying synergistic effects of essential oils or their components on toxicity of pyrethroid insecticides and underlying mechanisms of this synergistic interaction. </p> <br>