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Karttunen AP, Junnila A, Myöhänen E, Harju E, Xuan C, Okuyucu İN, Heininen J, Kivimäki S, Harju V, Julkunen M, Vähäjärvi P, Mikkonen KS, Tomberg T, Moilanen U, Strachan CJ, Teppo J, Tossavainen M, Peltonen L. Use of dairy industry side-stream lactose for tablet manufacturing - proof of concept study. Int J Pharm 2024; 660:124354. [PMID: 38897486 DOI: 10.1016/j.ijpharm.2024.124354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/14/2024] [Accepted: 06/15/2024] [Indexed: 06/21/2024]
Abstract
During recent years there have been shortages of certain drugs due to problems in raw material supply. These are often related to active ingredients but could also affect excipients. Lactose is one of the most used excipients in tableting and comes in two anomeric and several solid-state forms. The aim of this study was to utilize lactose from a dairy side-stream and compare it against a commercial reference in direct compression. This would be a sustainable option and would secure domestic availability during crises. Two types of lactose, spray-dried and freeze-dried, were evaluated. Lactose was mixed with microcrystalline cellulose in different ratios together with lubricant and glidant, and flowability and tabletability of the formulations was characterized. The fully amorphous and small particle-sized spray-dried lactose flowed inadequately but exhibited good tabletability. The larger particle-sized, freeze-dried lactose exhibited sufficient flow and better tabletability than the commercial reference. However, disintegration and drug release were slower when using the investigational lactose formulations. This was most likely due to remaining milk proteins, especially caseins, in the lactose. Overall, the investigational lactose provides promise for the use of such a side-stream product during crisis situations but enhancing their properties and/or purity would be needed.
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Affiliation(s)
- Anssi-Pekka Karttunen
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland.
| | - Atte Junnila
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Eetu Myöhänen
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Elina Harju
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Chee Xuan
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - İrem Namlı Okuyucu
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland; Department of Pharmaceutical Technology, Institute of Health Sciences, Anadolu University, Eskisehir, Turkiye
| | - Juho Heininen
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Satu Kivimäki
- HAMK Bio Research Unit, Häme University of Applied Sciences (HAMK), Hämeenlinna, Finland
| | - Vilhelmiina Harju
- HAMK Bio Research Unit, Häme University of Applied Sciences (HAMK), Hämeenlinna, Finland
| | - Maarit Julkunen
- HAMK Bio Research Unit, Häme University of Applied Sciences (HAMK), Hämeenlinna, Finland
| | - Päivi Vähäjärvi
- HAMK Bio Research Unit, Häme University of Applied Sciences (HAMK), Hämeenlinna, Finland
| | - Kirsi S Mikkonen
- Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, Helsinki, Finland; Helsinki Institute of Sustainability Science (HELSUS), University of Helsinki, Helsinki, Finland
| | - Teemu Tomberg
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Ulla Moilanen
- HAMK Bio Research Unit, Häme University of Applied Sciences (HAMK), Hämeenlinna, Finland
| | - Clare J Strachan
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Jaakko Teppo
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Marika Tossavainen
- HAMK Bio Research Unit, Häme University of Applied Sciences (HAMK), Hämeenlinna, Finland
| | - Leena Peltonen
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
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Lin Z, Cabello B, Kossor C, Davé R. Facilitating direct compaction tableting of fine cohesive APIs using dry coated fine excipients: Effect of the excipient size and amount of coated silica. Int J Pharm 2024; 660:124359. [PMID: 38901539 DOI: 10.1016/j.ijpharm.2024.124359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 06/06/2024] [Accepted: 06/16/2024] [Indexed: 06/22/2024]
Abstract
The possibility of attaining direct compression (DC) tableting using silica coated fine particle sized excipients was examined for high drug loaded (DL) binary blends of APIs. Three APIs, very-cohesive micronized acetaminophen (mAPAP, 7 μm), cohesive acetaminophen (cAPAP, 23 μm), and easy-flowing ibuprofen (IBU, 53 μm), were selected. High DL (60 wt%) binary blends were prepared with different fine-milled MCC-based excipients (ranging 20- 37 μm) with or without A200 silica coating during milling. The blend flowability (flow function coefficient -FFC) and bulk density (BD) of the blends for all three APIs were significantly improved by 1 wt% A200 dry coated MCCs; reaching FFC of 4.28 from 2.14, 7.82 from 2.96, and > 10 from 5.57, for mAPAP, cAPAP, and IBU blends, respectively, compared to the uncoated MCC blends. No negative impact was observed on the tablet tensile strength (TS) by using dry coated MCCs despite lower surface energy of silica. Instead, the desired tablet TS levels were reached or exceeded, even above that for the blends with uncoated milled MCCs. The novelty here is that milled and silica coated fine MCCs could promote DC tableting for cAPAP and IBU blends at 60 wt% DL through adequate flowability and tensile strength, without having to dry coat the APIs. The effect of the silica amount was investigated, indicating lesser had a positive impact on TS, whereas the higher amount had a positive impact on flowability. Thus, the finer excipient size and silica amounts may be adjusted to potentially attain blend DC processability for high DL blends of fine APIs.
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Affiliation(s)
- Zhixing Lin
- New Jersey Center for Engineered Particulates, New Jersey Institute of Technology, Newark, NJ 07102, USA
| | - Bian Cabello
- New Jersey Center for Engineered Particulates, New Jersey Institute of Technology, Newark, NJ 07102, USA
| | - Christopher Kossor
- New Jersey Center for Engineered Particulates, New Jersey Institute of Technology, Newark, NJ 07102, USA
| | - Rajesh Davé
- New Jersey Center for Engineered Particulates, New Jersey Institute of Technology, Newark, NJ 07102, USA.
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Li Z, Peng W, Zhu L, Liu W, Yang L, Chen L, Naeem A, Zhu W, Feng Y, Ming L. Study on Improving the Performance of Traditional Medicine Extracts with High Drug Loading Based on Co-spray Drying Technology. AAPS PharmSciTech 2023; 24:247. [PMID: 38030948 DOI: 10.1208/s12249-023-02703-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023] Open
Abstract
The purpose of this study is to develop modified particles with different structures to improve the flowability and compactibility of Liuwei Dihuang (LWDH) powder using co-spray drying technology, and to investigate the preparation mechanism of modified particles and their modified direct compaction (DC) properties. Moreover, tablets with high drug loading contents were also prepared. Particles were designed using polyvinylpyrrolidone (PVP K30) and hydroxypropyl methylcellulose (HPMC E3) as shell materials, and sodium bicarbonate (NaHCO3) and ammonium bicarbonate (NH4HCO3) as pore-forming agents. The porous particles (Ps), core-shell particles (CPs), and porous core-shell particles (PCPs) were prepared by co-spray drying technology. The key DC properties and texture properties of all the particles were measured and compared. The properties of co-spray drying liquid were also determined and analyzed. According to the results, Ps showed the least improvement in DC properties, followed by CPs, and PCPs showed a significant improvement. The modifier, because of its low surface tension, was wrapped in the outer layer to form a shell, and the pore-forming agent was thermally decomposed to produce pores, forming core-shell, porous, and porous core-shell composite structures. The smooth surface of the shell structure enhances fluidity, while the porous structure allows for greater compaction space, thereby improving DC properties during the compaction process.
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Affiliation(s)
- Zhe Li
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Institute for Advanced Study, Jiangxi University of Chinese Medicine, Nanchang, 330004, People's Republic of China
| | - Wanghai Peng
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Institute for Advanced Study, Jiangxi University of Chinese Medicine, Nanchang, 330004, People's Republic of China
| | - Lin Zhu
- Macau Centre for Research and Development in Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, People's Republic of China
| | - Wenjun Liu
- Jiangzhong Pharmaceutical Co. Ltd, Nanchang, 330049, People's Republic of China
| | - Lingyu Yang
- Jiangzhong Pharmaceutical Co. Ltd, Nanchang, 330049, People's Republic of China
| | - Lihua Chen
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Institute for Advanced Study, Jiangxi University of Chinese Medicine, Nanchang, 330004, People's Republic of China
| | - Abid Naeem
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Institute for Advanced Study, Jiangxi University of Chinese Medicine, Nanchang, 330004, People's Republic of China
| | - Weifeng Zhu
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Institute for Advanced Study, Jiangxi University of Chinese Medicine, Nanchang, 330004, People's Republic of China
| | - Yi Feng
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Institute for Advanced Study, Jiangxi University of Chinese Medicine, Nanchang, 330004, People's Republic of China
- Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Liangshan Ming
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Institute for Advanced Study, Jiangxi University of Chinese Medicine, Nanchang, 330004, People's Republic of China.
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Shi C, Zhao H, Fang Y, Shen L, Zhao L. Lactose in tablets: Functionality, critical material attributes, applications, modifications and co-processed excipients. Drug Discov Today 2023; 28:103696. [PMID: 37419210 DOI: 10.1016/j.drudis.2023.103696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/06/2023] [Accepted: 06/29/2023] [Indexed: 07/09/2023]
Abstract
Lactose is one of the most widespread excipients used in the pharmaceutical industry. Because of its water solubility and acceptable flowability, lactose is generally added into tablet formulation to improve wettability and undesirable flowability. Based on Quality by Design, a better understanding of the critical material attributes (CMAs) of raw materials is beneficial in guiding the improvement of tablet quality and the development of lactose. Additionally, the modifications and co-processing of lactose can introduce more-desirable characteristics to the resulting particles. This review focuses on the functionality, CMAs, applications, modifications and co-processing of lactose in tablets.
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Affiliation(s)
- Chuting Shi
- Engineering Research Center of Modern Preparation Technology of Traditional Chinese Medicine of Ministry of Education, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-lun Road, Pudong District, Shanghai 201203, PR China
| | - Haiyue Zhao
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-lun Road, Pudong District, Shanghai 201203, PR China
| | - Ying Fang
- Engineering Research Center of Modern Preparation Technology of Traditional Chinese Medicine of Ministry of Education, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-lun Road, Pudong District, Shanghai 201203, PR China
| | - Lan Shen
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-lun Road, Pudong District, Shanghai 201203, PR China.
| | - Lijie Zhao
- Engineering Research Center of Modern Preparation Technology of Traditional Chinese Medicine of Ministry of Education, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-lun Road, Pudong District, Shanghai 201203, PR China.
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Jin C, Wu F, Hong Y, Shen L, Lin X, Zhao L, Feng Y. Updates on applications of low-viscosity grade Hydroxypropyl methylcellulose in coprocessing for improvement of physical properties of pharmaceutical powders. Carbohydr Polym 2023; 311:120731. [PMID: 37028868 DOI: 10.1016/j.carbpol.2023.120731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 02/05/2023] [Accepted: 02/17/2023] [Indexed: 03/03/2023]
Abstract
Hydroxypropyl methylcellulose (HPMC) is an important polymeric excipient. Its versatility in terms of molecular weights and viscosity grades is the basis for its wide and successful application in the pharmaceutical industry. Low viscosity grades of HPMC (like E3 and E5) have been used as physical modifiers for pharmaceutical powders in recent years due to their unique physicochemical and biological properties (e.g., low surface tension, high Tg, strong hydrogen bonding ability, etc.). Such modification is the co-processing of HPMC with a drug/excipient to create composite particles (CPs) for the purpose of providing synergistic effects of functional improvement as well as of masking undesirable properties of the powder (e.g., flowability, compressibility, compactibility, solubility, stability, etc.). Therefore, given its irreplaceability and tremendous opportunities for future developments, this review summarized and updated studies on improving the functional properties of drugs and/or excipients by forming CPs with low-viscosity HPMC, analyzed and exploited the improvement mechanisms (e.g., improved surface properties, increased polarity, hydrogen bonding, etc.) for the further development of novel co-processed pharmaceutical powders containing HPMC. It also provides an outlook on the future applications of HPMC, aiming to provide a reference on the crucial role of HPMC in various areas for interested readers.
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De Pauw E, Vervaet C, Vanhoorne V. Formation of delta-mannitol by co-spray drying: enhancing the tabletability of paracetamol/mannitol formulations. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chen FC, Liu WJ, Zhu WF, Yang LY, Zhang JW, Feng Y, Ming LS, Li Z. Surface Modifiers on Composite Particles for Direct Compaction. Pharmaceutics 2022; 14:pharmaceutics14102217. [PMID: 36297653 PMCID: PMC9612340 DOI: 10.3390/pharmaceutics14102217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/13/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022] Open
Abstract
Direct compaction (DC) is considered to be the most effective method of tablet production. However, only a small number of the active pharmaceutical ingredients (APIs) can be successfully manufactured into tablets using DC since most APIs lack adequate functional properties to meet DC requirements. The use of suitable modifiers and appropriate co-processing technologies can provide a promising approach for the preparation of composite particles with high functional properties. The purpose of this review is to provide an overview and classification of different modifiers and their multiple combinations that may improve API tableting properties or prepare composite excipients with appropriate co-processed technology, as well as discuss the corresponding modification mechanism. Moreover, it provides solutions for selecting appropriate modifiers and co-processing technologies to prepare composite particles with improved properties.
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Affiliation(s)
- Fu-Cai Chen
- Key Laboratory of Preparation of Modern TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China
| | - Wen-Jun Liu
- Jiangzhong Pharmaceutical Co., Ltd., Nanchang 330049, China
| | - Wei-Feng Zhu
- Key Laboratory of Preparation of Modern TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China
| | - Ling-Yu Yang
- Jiangzhong Pharmaceutical Co., Ltd., Nanchang 330049, China
| | - Ji-Wen Zhang
- Key Laboratory of Preparation of Modern TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Yi Feng
- Key Laboratory of Preparation of Modern TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China
- Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Liang-Shan Ming
- Key Laboratory of Preparation of Modern TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China
- Correspondence: (L.-S.M.); (Z.L.); Tel.: +86-791-8711-9027 (L.-S.M. & Z.L.)
| | - Zhe Li
- Key Laboratory of Preparation of Modern TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China
- Correspondence: (L.-S.M.); (Z.L.); Tel.: +86-791-8711-9027 (L.-S.M. & Z.L.)
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8
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Binder jetting 3D printing of challenging medicines: from low dose tablets to hydrophobic molecules. Eur J Pharm Biopharm 2021; 170:144-159. [PMID: 34785345 DOI: 10.1016/j.ejpb.2021.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/03/2021] [Accepted: 11/08/2021] [Indexed: 11/20/2022]
Abstract
Increasing access to additive manufacturing technologies utilising easily available desktop devices opened novel ways for formulation of personalized medicines. It is, however, challenging to propose a flexible and robust formulation platform which can be used for fabrication of tailored solid dosage forms composed of APIs with different properties (e.g., hydrophobicity) without extensive optimization. This manuscript presents a strategy for formulation of fast dissolving tablets using binder jetting (BJ) technology. The approach is demonstrated using two model APIs: hydrophilic quinapril hydrochloride (QHCl, logP = 1.4) and hydrophobic clotrimazole (CLO, logP = 5.4). The proposed printing method uses inexpensive well known and easily available FDA approved pharmaceutical excipients. The obtained model tablets had uniform content of the drug, excellent mechanical properties and highly porous structure resulting in short disintegration time and fast dissolution rate. The tablets could be scaled and obtained in predesigned shapes and sizes. The proposed method may find its application in the early stages of drug development where high flexibility of the formulation is required and the amount of available API is limited.
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Parmar PK, Rao SG, Bansal AK. Co-processing of small molecule excipients with polymers to improve functionality. Expert Opin Drug Deliv 2021; 18:907-928. [PMID: 33412936 DOI: 10.1080/17425247.2021.1873946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Polymers have various applications such as binder, film coating agent, stabilizer, drug release modification, and as primary packaging materials. Recently, they have been explored in co-processing technique to improve the functionality of small molecule excipients (SMEs). Co-processing is a concept wherein two or more excipients interact at sub-particle level to provide synergy in functionality and minimize drawbacks of individual excipients. AREA COVERED The present review highlights the application of co-processing to improve the functionality of SMEs using polymers; physicochemical and mechanical properties of polymers for co-processing; advantages of co-processed excipients for different applications; functionality enhancement of co-processed excipients; novel concepts/methods for co-processing; mechanistic insights on co-processing and commercial products available in the market. EXPERT OPINION Most of the SMEs do not possess optimal multifunctional properties like flow, compressibility, compactibility, and disintegration ability, required to compensate for poorly compactable drugs. Some of these drawbacks can be overcome by co-processing of SMEs with polymers. For example, co-processing of a brittle SME and plastic material (polymer) can provide a synergistic effect and result in the generation of single entity multi-functional excipient. Besides, novel co-processed excipients generated using combinations of SMEs and polymers can also generate intellectual property rights.
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Affiliation(s)
- Prashantkumar K Parmar
- Solid State Pharmaceutics Lab, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Mohali, Punjab, India
| | - Srilaxmi G Rao
- Solid State Pharmaceutics Lab, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Mohali, Punjab, India
| | - Arvind K Bansal
- Solid State Pharmaceutics Lab, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Mohali, Punjab, India
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Yu Y, Zhao L, Lin X, Wang Y, Du R, Feng Y. Research on the powder classification and the key parameters affecting tablet qualities for direct compaction based on powder functional properties. ADV POWDER TECHNOL 2021. [DOI: 10.1016/j.apt.2021.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Li Z, Wu F, Hong Y, Shen L, Lin X, Feng Y. The Fundamental and Functional Property Differences Between HPMC and PVP Co-Processed Herbal Particles Prepared by Fluid Bed Coating. AAPS PharmSciTech 2020; 21:201. [PMID: 32676863 DOI: 10.1208/s12249-020-01739-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 06/22/2020] [Indexed: 01/11/2023] Open
Abstract
Core-shell composite particles (CPs) are the most preferred choice for direct compaction (DC), but their application in herbal tablets is limited. Hydroxypropyl methylcellulose (HPMC) and polyvinylpyrrolidone (PVP) are usually employed as the shell materials, but there are few, if any, researches exploring the different effects of HPMC and PVP on the properties of herbal CPs. In this study, the CPs containing HPMC (CP X-H) and CPs containing PVP (CP X-P) were prepared based on herbal powders (X). Their physical properties were characterized comprehensively. The differences in properties between CP X-H and CP X-P were explored, and their mechanism analysis was also performed profoundly. The results demonstrated that (i) CP X-H and CP X-P exhibited similar flowability; (ii) CP X-H generally exhibited better compactibility, larger particle size, and more uniform particle size distribution, and lower bulk density, tap density, and hygroscopicity than CP X-P; (iii) compared with the tablets produced with CP X-P, ones with CP X-H exhibited similar weight variation (%), lower friability, and longer disintegration time. The mechanism analysis manifested that the differences in physical properties between HPMC and PVP were the important and fundamental factors, which led to the differences in structure and surface morphology of particles, and in fundamental properties of CPs. These findings are beneficial to the development of herbal core-shell CPs for DC.
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12
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McDonagh AF, Tajber L. Crystallo-co-spray drying as a new approach to manufacturing of drug/excipient agglomerates: Impact of processing on the properties of paracetamol and lactose mixtures. Int J Pharm 2020; 577:119051. [PMID: 31981704 DOI: 10.1016/j.ijpharm.2020.119051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/13/2020] [Accepted: 01/15/2020] [Indexed: 10/25/2022]
Abstract
The novel process of crystallo-co-spray drying of paracetamol and α-lactose monohydrate was investigated by varying the spray dryer inlet temperature and inlet feed solvent composition. A crystalline agglomerate was obtained with no change to the physical structure of either component throughout both investigations and with possible interactions between the hydroxyl groups of the α-lactose monohydrate and the amide and hydroxyl groups of the paracetamol detected. The percentage soluble fraction of the components in the inlet feed had the largest influence on the morphology of the final dried agglomerate. Low excipient soluble fraction resulted in an increase in paracetamol surface coating and high excipient soluble fraction produced agglomerates of highly mixed components. The use of crystallo-co-spray drying can serve as a method of producing an agglomerated blend of crystalline co-spray dried components leading to possible opportunities for process intensification with the reduction of process steps such as blending, agglomeration, drying and milling into one single stage.
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Affiliation(s)
- Alan F McDonagh
- Synthesis and Solid State Pharmaceutical Centre, School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, Ireland
| | - Lidia Tajber
- Synthesis and Solid State Pharmaceutical Centre, School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, Ireland.
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13
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Erdemir D, Daftary V, Lindrud M, Buckley D, Lane G, Malsbury A, Tao J, Kopp N, Hsieh DS, Nikitczuk W, Engstrom JD. Design and Scale-up of a Co-processing Technology to Improve Powder Properties of Drug Substances. Org Process Res Dev 2019. [DOI: 10.1021/acs.oprd.9b00354] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Li Z, Zhou M, Wu F, Shen L, Lin X, Feng Y. Direct compaction properties of Zingiberis Rhizoma extracted powders coated with various shell materials: Improvements and mechanism analysis. Int J Pharm 2019; 564:10-21. [PMID: 30974193 DOI: 10.1016/j.ijpharm.2019.04.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 03/19/2019] [Accepted: 04/07/2019] [Indexed: 02/08/2023]
Abstract
Direct compaction (DC) attracts more and more attention for tablet manufacturing; however, its application in natural plant product (NPP) tablets is still extremely limited. In this study, 8 kinds of composite particles (CPs) based on the Zingiberis Rhizoma extracted powder (ZR) (a natural plant product powder with poor DC properties) were prepared with different shell materials, including hydroxypropyl methylcellulose (HPMC), polyvinylpyrrolidone (PVP), dextran, inulin, mannitol, silica, and their combinations. Their physical properties and compacting parameters were characterized comprehensively. The results demonstrated that (i) fluid bed coating was not a simple process of superposition and transmission of the physical properties of raw materials; and (ii) all the shell materials studied could improve the DC properties of problematic ZR to some degree and the combination of 7% HPMC and 1% silica showed to be the best to markedly improve both the compactibility and flowability of ZR. As a whole, by virtue of the design of core-shell particles, qualified tablets with high ZR loadings were successfully produced via continuous DC in this study. These findings are beneficial to boosting the development of natural plant tablets through DC.
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Affiliation(s)
- Zhe Li
- College of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China; Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China
| | - Miaomiao Zhou
- College of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China; Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China
| | - Fei Wu
- College of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China; Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China.
| | - Lan Shen
- College of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China
| | - Xiao Lin
- College of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China.
| | - Yi Feng
- Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China
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Overcoming Poor Tabletability of Bulky Absorption Enhancers by Spray Drying Technology. J Pharm Sci 2019; 108:2128-2135. [PMID: 30721708 DOI: 10.1016/j.xphs.2019.01.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/18/2019] [Accepted: 01/28/2019] [Indexed: 11/21/2022]
Abstract
Absorption enhancers are often a major component of solid oral peptide formulations as compared to the active pharmaceutical ingredient and excipients. This commonly results in poor tabletability that is hard to mitigate in direct compaction by addition of small amounts of excipients. To improve the tabletability of bulky absorption enhancers, the model absorption enhancers, sodium cholate and deoxycholic acid, were co-spray-dried with hydroxypropyl methylcellulose E5, where the percentage of absorption enhancers was not lower than 90% (w/w). The physicochemical properties of the resulting powders were assessed by laser diffraction, scanning electron microscopy, X-ray powder diffraction, thermogravimetric analysis, and differential scanning calorimetry. The powders were compressed into tablets, and the tabletability was evaluated. Co-spray drying with 10% of hydroxypropyl methylcellulose significantly improved the tabletability of the both absorption enhancers. Moreover, it was demonstrated that small particle size and amorphous state rather than high moisture content contributed to the improved tabletability of the spray-dried powders. The study suggests that spray drying technology can be promising to overcome the poor tabletability of oral peptide formulation consisting of large amounts of absorption enhancers.
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16
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Li Z, Wu F, Zhao L, Lin X, Shen L, Feng Y. Evaluation of fundamental and functional properties of natural plant product powders for direct compaction based on multivariate statistical analysis. ADV POWDER TECHNOL 2018. [DOI: 10.1016/j.apt.2018.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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17
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18
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Erdemir D, Rosenbaum T, Chang SY, Wong B, Kientzler D, Wang S, Desai D, Kiang S. Novel Co-processing Methodology To Enable Direct Compression of a Poorly Compressible, Highly Water-Soluble Active Pharmaceutical Ingredient for Controlled Release. Org Process Res Dev 2018. [DOI: 10.1021/acs.oprd.8b00204] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Deniz Erdemir
- Drug Product Science and Technology, Bristol Myers Squibb, 1 Squibb Drive, New Brunswick, New Jersey 08903, United States
| | - Tamar Rosenbaum
- Drug Product Science and Technology, Bristol Myers Squibb, 1 Squibb Drive, New Brunswick, New Jersey 08903, United States
| | - Shih-Ying Chang
- Drug Product Science and Technology, Bristol Myers Squibb, 1 Squibb Drive, New Brunswick, New Jersey 08903, United States
| | - Benjamin Wong
- Drug Product Science and Technology, Bristol Myers Squibb, 1 Squibb Drive, New Brunswick, New Jersey 08903, United States
| | - Donald Kientzler
- Drug Product Science and Technology, Bristol Myers Squibb, 1 Squibb Drive, New Brunswick, New Jersey 08903, United States
| | - Steve Wang
- Drug Product Science and Technology, Bristol Myers Squibb, 1 Squibb Drive, New Brunswick, New Jersey 08903, United States
| | - Divyakant Desai
- Drug Product Science and Technology, Bristol Myers Squibb, 1 Squibb Drive, New Brunswick, New Jersey 08903, United States
| | - San Kiang
- Drug Product Science and Technology, Bristol Myers Squibb, 1 Squibb Drive, New Brunswick, New Jersey 08903, United States
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19
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Dong Q, Zhou M, Lin X, Shen L, Feng Y. Differences in fundamental and functional properties of HPMC co-processed fillers prepared by fluid-bed coating and spray drying. Eur J Pharm Sci 2018; 119:147-158. [PMID: 29626592 DOI: 10.1016/j.ejps.2018.04.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 03/20/2018] [Accepted: 04/02/2018] [Indexed: 11/29/2022]
Abstract
This study aimed to develop novel co-processed tablet fillers based on the principle of particle engineering for direct compaction and to compare the characteristics of co-processed products obtained by fluid-bed coating and co-spray drying, respectively. Water-soluble mannitol and water-insoluble calcium carbonate were selected as representative fillers for this study. Hydroxypropyl methylcellulose (HPMC), serving as a surface property modifier, was distributed on the surface of primary filler particles via the two co-processing methods. Both fundamental and functional properties of the products were comparatively investigated. The results showed that functional properties of the fillers, like flowability, compactibility, and drug-loading capacity, were effectively improved by both co-processing methods. However, fluid-bed coating showed greater advantages over co-spray drying in some aspects, which was mainly attributed to the remarkable differences in some fundamental properties of co-processed powders, like particle size, surface topology, and particle structure. For example, the more irregular surface and porous structure induced by fluid-bed coating could contribute to better compaction properties and lower lubricant sensitivity due to the increasing contact area and mechanical interlocking between particles under pressure. More effective surface distribution of HPMC during fluid-bed coating was also a contributor. In addition, such a porous agglomerate structure could also reduce the separation of drug and excipients after mixing, resulting in the improvement in drug loading capacity and tablet uniformity. In summary, fluid-bed coating appears to be more promising for co-processing than spray drying in some aspects, and co-processed excipients produced by it have a great prospect for further investigations and development.
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Affiliation(s)
- QianQian Dong
- College of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China; Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China
| | - MiaoMiao Zhou
- College of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China
| | - Xiao Lin
- College of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China; Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China.
| | - Lan Shen
- College of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China
| | - Yi Feng
- Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China
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20
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Li Z, Zhao L, Lin X, Shen L, Feng Y. Direct compaction: An update of materials, trouble-shooting, and application. Int J Pharm 2017; 529:543-556. [PMID: 28720538 DOI: 10.1016/j.ijpharm.2017.07.035] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 07/08/2017] [Accepted: 07/10/2017] [Indexed: 01/25/2023]
Abstract
Direct compaction (DC) is the preferred choice for tablet manufacturing; however, only less than 20% of active pharmaceutical ingredients could be compacted via DC as its high requirement for functional properties of materials. Materials with improper functionalities could lead to serious troubles during DC manufacturing, such as content non-uniformity, sticking, and capping, all of which profoundly affect the properties of final products and, thus, severely restrict the practical application of DC. With undoubted importance, these seem to be unexpectedly ignored by reviewers but not researchers in terms of many original research articles published recently. Therefore, as an informative supplement and update, this review mainly focused on trouble-shooting and application situation of DC, together with several newly reported materials.
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Affiliation(s)
- Zhe Li
- College of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China; Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China
| | - LiJie Zhao
- Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China
| | - Xiao Lin
- College of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China; Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China.
| | - Lan Shen
- College of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China
| | - Yi Feng
- Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China
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21
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Kääriäinen TO, Kemell M, Vehkamäki M, Kääriäinen ML, Correia A, Santos HA, Bimbo LM, Hirvonen J, Hoppu P, George SM, Cameron DC, Ritala M, Leskelä M. Surface modification of acetaminophen particles by atomic layer deposition. Int J Pharm 2017; 525:160-174. [PMID: 28432020 DOI: 10.1016/j.ijpharm.2017.04.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 04/12/2017] [Accepted: 04/13/2017] [Indexed: 12/25/2022]
Abstract
Active pharmaceutical ingredients (APIs) are predominantly organic solid powders. Due to their bulk properties many APIs require processing to improve pharmaceutical formulation and manufacturing in the preparation for various drug dosage forms. Improved powder flow and protection of the APIs are often anticipated characteristics in pharmaceutical manufacturing. In this work, we have modified acetaminophen particles with atomic layer deposition (ALD) by conformal nanometer scale coatings in a one-step coating process. According to the results, ALD, utilizing common chemistries for Al2O3, TiO2 and ZnO, is shown to be a promising coating method for solid pharmaceutical powders. Acetaminophen does not undergo degradation during the ALD coating process and maintains its stable polymorphic structure. Acetaminophen with nanometer scale ALD coatings shows slowed drug release. ALD TiO2 coated acetaminophen particles show cytocompatibility whereas those coated with thicker ZnO coatings exhibit the most cytotoxicity among the ALD materials under study when assessed in vitro by their effect on intestinal Caco-2 cells.
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Affiliation(s)
- Tommi O Kääriäinen
- Laboratory of Inorganic Chemistry, University of Helsinki, P.O. Box 55 (A.I.Virtasen aukio 1), FI-00014 Helsinki, Finland; Department of Chemistry and Biochemistry and Department of Mechanical Engineering, University of Colorado, Boulder, CO 80309, United States; NovaldMedical Ltd Oy, Telkäntie 5, 82500 Kitee, Finland.
| | - Marianna Kemell
- Laboratory of Inorganic Chemistry, University of Helsinki, P.O. Box 55 (A.I.Virtasen aukio 1), FI-00014 Helsinki, Finland
| | - Marko Vehkamäki
- Laboratory of Inorganic Chemistry, University of Helsinki, P.O. Box 55 (A.I.Virtasen aukio 1), FI-00014 Helsinki, Finland
| | - Marja-Leena Kääriäinen
- Department of Chemistry and Biochemistry and Department of Mechanical Engineering, University of Colorado, Boulder, CO 80309, United States; NovaldMedical Ltd Oy, Telkäntie 5, 82500 Kitee, Finland
| | - Alexandra Correia
- Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, FI-00014 Helsinki, Finland
| | - Hélder A Santos
- Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, FI-00014 Helsinki, Finland
| | - Luis M Bimbo
- Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, FI-00014 Helsinki, Finland
| | - Jouni Hirvonen
- Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, FI-00014 Helsinki, Finland
| | - Pekka Hoppu
- NovaldMedical Ltd Oy, Telkäntie 5, 82500 Kitee, Finland
| | - Steven M George
- Department of Chemistry and Biochemistry and Department of Mechanical Engineering, University of Colorado, Boulder, CO 80309, United States
| | - David C Cameron
- R&D Centre for Low-Cost Plasma and Nanotechnology Surface Modification, Masaryk University, Kotlářská 267/2, 611 37 Brno, Czech Republic
| | - Mikko Ritala
- Laboratory of Inorganic Chemistry, University of Helsinki, P.O. Box 55 (A.I.Virtasen aukio 1), FI-00014 Helsinki, Finland
| | - Markku Leskelä
- Laboratory of Inorganic Chemistry, University of Helsinki, P.O. Box 55 (A.I.Virtasen aukio 1), FI-00014 Helsinki, Finland
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Composite particles based on particle engineering for direct compaction. Int J Pharm 2017; 519:272-286. [DOI: 10.1016/j.ijpharm.2017.01.030] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 12/22/2016] [Accepted: 01/14/2017] [Indexed: 02/04/2023]
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23
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Influence of particle properties on powder bulk behaviour and processability. Int J Pharm 2017; 518:138-154. [DOI: 10.1016/j.ijpharm.2016.12.045] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 12/16/2016] [Accepted: 12/19/2016] [Indexed: 11/18/2022]
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24
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Vanhoorne V, Van Bockstal PJ, Van Snick B, Peeters E, Monteyne T, Gomes P, De Beer T, Remon J, Vervaet C. Continuous manufacturing of delta mannitol by cospray drying with PVP. Int J Pharm 2016; 501:139-47. [DOI: 10.1016/j.ijpharm.2016.02.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 01/31/2016] [Accepted: 02/01/2016] [Indexed: 11/26/2022]
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Teżyk M, Milanowski B, Ernst A, Lulek J. Recent progress in continuous and semi-continuous processing of solid oral dosage forms: a review. Drug Dev Ind Pharm 2015; 42:1195-214. [PMID: 26592545 DOI: 10.3109/03639045.2015.1122607] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Continuous processing is an innovative production concept well known and successfully used in other industries for many years. The modern pharmaceutical industry is facing the challenge of transition from a traditional manufacturing approach based on batch-wise production to a continuous manufacturing model. OBJECTIVE The aim of this article is to present technological progress in manufacturing based on continuous and semi-continuous processing of the solid oral dosage forms. METHODS Single unit processes possessing an alternative processing pathway to batch-wise technology or, with some modification, an altered approach that may run continuously, and are thus able to seamlessly switch to continuous manufacturing are briefly presented. Furthermore, the concept of semi-continuous processing is discussed. Subsequently, more sophisticated production systems created by coupling single unit processes and comprising all the steps of production, from powder to final dosage form, were reviewed. Finally, attempts of end-to-end production approach, meaning the linking of continuous synthesis of API from intermediates with the production of final dosage form, are described. RESULTS There are a growing number of scientific articles showing an increasing interest in changing the approach to the production of pharmaceuticals in recent years. Numerous scientific publications are a source of information on the progress of knowledge and achievements of continuous processing. These works often deal with issues of how to modify or replace the unit processes in order to enable seamlessly switching them into continuous processing. A growing number of research papers concentrate on integrated continuous manufacturing lines in which the production concept of "from powder to tablet" is realized. Four main domains are under investigation: influence of process parameters on intermediates or final dosage forms properties, implementation of process analytical tools, control-managing system responsible for keeping continuous materials flow through the whole manufacturing process and the development of new computational methods to assess or simulate these new manufacturing techniques. The attempt to connect the primary and secondary production steps proves that development of continuously operating lines is possible. CONCLUSION A mind-set change is needed to be able to face, and fully assess, the advantages and disadvantages of switching from batch to continuous mode production.
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Affiliation(s)
- Michał Teżyk
- a Gedeon Richter Polska Sp. z o.o. , Grodzisk Mazowiecki , Poland ;,b Department of Pharmaceutical Technology , Faculty of Pharmacy, Poznan University of Medical Sciences , Poznan , Poland
| | - Bartłomiej Milanowski
- b Department of Pharmaceutical Technology , Faculty of Pharmacy, Poznan University of Medical Sciences , Poznan , Poland
| | - Andrzej Ernst
- a Gedeon Richter Polska Sp. z o.o. , Grodzisk Mazowiecki , Poland
| | - Janina Lulek
- b Department of Pharmaceutical Technology , Faculty of Pharmacy, Poznan University of Medical Sciences , Poznan , Poland
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Cai X, Yang JH, Zhang JL, Ma DX, Wang YP. Liquid Carbon Dioxide as Anti-Solvent Coating Aluminum Hydride. PROPELLANTS EXPLOSIVES PYROTECHNICS 2015. [DOI: 10.1002/prep.201500070] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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