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  1. Article: Electrospun Drug-Loaded and Gene-Loaded Nanofibres: The Holy Grail of Glioblastoma Therapy?

    Louis, Lynn / Chee, Bor Shin / McAfee, Marion / Nugent, Michael

    Pharmaceutics

    2023  Volume 15, Issue 6

    Abstract: To date, GBM remains highly resistant to therapies that have shown promising effects in other cancers. Therefore, the goal is to take down the shield that these tumours are using to protect themselves and proliferate unchecked, regardless of the advent ... ...

    Abstract To date, GBM remains highly resistant to therapies that have shown promising effects in other cancers. Therefore, the goal is to take down the shield that these tumours are using to protect themselves and proliferate unchecked, regardless of the advent of diverse therapies. To overcome the limitations of conventional therapy, the use of electrospun nanofibres encapsulated with either a drug or gene has been extensively researched. The aim of this intelligent biomaterial is to achieve a timely release of encapsulated therapy to exert the maximal therapeutic effect simultaneously eliminating dose-limiting toxicities and activating the innate immune response to prevent tumour recurrence. This review article is focused on the developing field of electrospinning and aims to describe the different types of electrospinning techniques in biomedical applications. Each technique describes how not all drugs or genes can be electrospun with any method; their physico-chemical properties, site of action, polymer characteristics and the desired drug or gene release rate determine the strategy used. Finally, we discuss the challenges and future perspectives associated with GBM therapy.
    Language English
    Publishing date 2023-06-03
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2527217-2
    ISSN 1999-4923
    ISSN 1999-4923
    DOI 10.3390/pharmaceutics15061649
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: A framework for managing risk-based managed care contracts.

    Nugent, Michael

    Healthcare financial management : journal of the Healthcare Financial Management Association

    2013  Volume 67, Issue 12, Page(s) 82–87

    Abstract: To prepare for managing risk-based contracts with payers and other purchasers, providers should: Identify operational, competitive, and financial risks associated with the relevant patient populations. Improve organizational abilities related to patient ... ...

    Abstract To prepare for managing risk-based contracts with payers and other purchasers, providers should: Identify operational, competitive, and financial risks associated with the relevant patient populations. Improve organizational abilities related to patient care management, which is the key to managing operational risk. Address the competitive risks that can ensue when traditional lines of demarcation between providers and payers are crossed. Adopt strategies and tactics to manage financial risk, beyond buying malpractice and stop-loss insurance.
    MeSH term(s) Contracts ; Economic Competition ; Financial Management, Hospital/economics ; Humans ; Managed Care Programs/economics ; Risk Management/economics ; United States
    Language English
    Publishing date 2013-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605617-9
    ISSN 0735-0732 ; 0018-5639
    ISSN 0735-0732 ; 0018-5639
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Letter to the editor regarding the article "Photobiomodulation therapy for the prevention of acute radiation dermatitis in head and neck cancer patients (DERMISHEAD trial)" by Robijns et al. Radiat Oncol. 2021.

    Donnelly, Olly / Goranova, Rebecca / Nugent, Michael

    Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

    2021  Volume 161, Page(s) 254

    MeSH term(s) Head and Neck Neoplasms/radiotherapy ; Humans ; Low-Level Light Therapy ; Radiodermatitis/etiology ; Radiodermatitis/prevention & control
    Language English
    Publishing date 2021-06-16
    Publishing country Ireland
    Document type Letter ; Comment
    ZDB-ID 605646-5
    ISSN 1879-0887 ; 0167-8140
    ISSN (online) 1879-0887
    ISSN 0167-8140
    DOI 10.1016/j.radonc.2021.06.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Design, development and in vitro quantification of novel electrosprayed everolimus-loaded Soluplus®/Polyvinyl alcohol nanoparticles via stability-indicating HPLC method in cancer therapy.

    Louis, Lynn / Chee, Bor Shin / McAfee, Marion / Nugent, Michael J D

    European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V

    2023  Volume 191, Page(s) 235–246

    Abstract: Everolimus (RAD001) a mammalian target of rapamycin has been hampered by poor solubility, affecting its dissolution rate, a relationship that extends to low bioavailability. Nanoparticles (NP) based on Soluplus (SOL®) and Polyvinyl alcohol (PVA) was ... ...

    Abstract Everolimus (RAD001) a mammalian target of rapamycin has been hampered by poor solubility, affecting its dissolution rate, a relationship that extends to low bioavailability. Nanoparticles (NP) based on Soluplus (SOL®) and Polyvinyl alcohol (PVA) was fabricated by electrospraying (ES) for the delivery of RAD001 to improve anti-tumour efficacy. Electrospraying with established experimental conditions produced PVA-SOL®-RAD001 NP with 71 nm mean diameter, smaller particle size distribution and >90 % encapsulation efficiency. Various polymer-drug concentrations exposed to various freeze-thaw (F/T) cycles were studied for NP optimisation and to enhance its mechanical properties. The optimised NP formulation demonstrated complete encapsulation as well as a sustained and pH dependent drug release profile for in vitro release test. In addition, to specifically study the degradation profile of RAD001 and to quantify RAD001 in the fabricated NP, a new HPLC method was developed and validated. The purpose and novelty of the HPLC method was also to ensure that RAD001 can be detected at low amounts where other conventional characterisation methods are unable to detect. The developed HPLC method was accurate, precise, robust and sensitive with LOD and LOQ values of 4.149 and 12.575 μg/mL. In conclusion, the novel developed HPLC system can be applied for the quantification of different chemotherapeutic agents and the novel electrosprayed hydrogel NP is a potential drug delivery system to increase solubility and bioavailability of RAD001 in cancer therapy.
    Language English
    Publishing date 2023-09-14
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1065368-5
    ISSN 1873-3441 ; 0939-6411
    ISSN (online) 1873-3441
    ISSN 0939-6411
    DOI 10.1016/j.ejpb.2023.09.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Machine Learning for Process Monitoring and Control of Hot-Melt Extrusion: Current State of the Art and Future Directions.

    Munir, Nimra / Nugent, Michael / Whitaker, Darren / McAfee, Marion

    Pharmaceutics

    2021  Volume 13, Issue 9

    Abstract: In the last few decades, hot-melt extrusion (HME) has emerged as a rapidly growing technology in the pharmaceutical industry, due to its various advantages over other fabrication routes for drug delivery systems. After the introduction of the 'quality by ...

    Abstract In the last few decades, hot-melt extrusion (HME) has emerged as a rapidly growing technology in the pharmaceutical industry, due to its various advantages over other fabrication routes for drug delivery systems. After the introduction of the 'quality by design' (QbD) approach by the Food and Drug Administration (FDA), many research studies have focused on implementing process analytical technology (PAT), including near-infrared (NIR), Raman, and UV-Vis, coupled with various machine learning algorithms, to monitor and control the HME process in real time. This review gives a comprehensive overview of the application of machine learning algorithms for HME processes, with a focus on pharmaceutical HME applications. The main current challenges in the application of machine learning algorithms for pharmaceutical processes are discussed, with potential future directions for the industry.
    Language English
    Publishing date 2021-09-09
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2527217-2
    ISSN 1999-4923
    ISSN 1999-4923
    DOI 10.3390/pharmaceutics13091432
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Engaging purchasers in value improvement.

    Nugent, Michael E

    Healthcare financial management : journal of the Healthcare Financial Management Association

    2013  Volume 67, Issue 8, Page(s) 70–74

    Abstract: Health systems that wish to engage employers and other healthcare purchasers directly in initiatives to improve health should consider a number of steps, including: Setting a reasonable goal around a critical mass of covered lives the health system could ...

    Abstract Health systems that wish to engage employers and other healthcare purchasers directly in initiatives to improve health should consider a number of steps, including: Setting a reasonable goal around a critical mass of covered lives the health system could attract and maintain through such an approach. Finding likeminded customers and partners. Anticipating competitive responses from the market. Creating a distinctive brand.
    MeSH term(s) Cooperative Behavior ; Delivery of Health Care ; Health Benefit Plans, Employee ; Quality Improvement ; United States ; Value-Based Purchasing
    Language English
    Publishing date 2013-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605617-9
    ISSN 0735-0732 ; 0018-5639
    ISSN 0735-0732 ; 0018-5639
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Utility of preoperative colour flow Doppler assessment of perforator anatomy in medial sural artery perforator (MSAP) free flaps.

    Steel, Ben J / Mehta, Darpan / Nugent, Michael / Wilson, Ajay / Burns, Andrew

    Oral and maxillofacial surgery

    2022  Volume 27, Issue 4, Page(s) 655–659

    Abstract: Purpose: It is known that the vascular perforators upon which the medial sural artery perforator (MSAP) flap is based are subject to considerable variation. This study seeks to evaluate the use of colour flow Doppler (CFD) as an imaging technique to ... ...

    Abstract Purpose: It is known that the vascular perforators upon which the medial sural artery perforator (MSAP) flap is based are subject to considerable variation. This study seeks to evaluate the use of colour flow Doppler (CFD) as an imaging technique to establish the presence of suitable vessels, the discriminatory findings from that imaging, the rate of flap abandonment and flap complications.
    Methods: All patients undergoing MSAP in our institution since 2015 had a pre-operative CFD using a standardised technique. A prior group of 22 patients not having CFD acted as a control group. Data were  collected prospectively.
    Results: Fourteen patients had CFD. In one patient, no suitable vessels were found. In 13 patients, vessels of suitable size and position were identified, which then correlated precisely with operative findings. Three had suitable vessels in one leg only. No flaps in the CFD group were abandoned. One flap in the CFD group was partially lost. One flap in the prior control group was abandoned.
    Conclusions: CFD provided reliable discriminatory information to decide on flap suitability/which leg and correlated precisely with operative findings, with no flap abandonment. Flap survival rate was very high.
    MeSH term(s) Humans ; Free Tissue Flaps/surgery ; Color ; Perforator Flap/blood supply ; Leg/blood supply ; Leg/surgery ; Arteries/diagnostic imaging ; Arteries/surgery
    Language English
    Publishing date 2022-08-18
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2406731-3
    ISSN 1865-1569 ; 1865-1550
    ISSN (online) 1865-1569
    ISSN 1865-1550
    DOI 10.1007/s10006-022-01108-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Factors determining postoperative length of stay and time to resumption of feeding following free flap reconstruction for oral cancer.

    Denholm, Katrina A / Steel, Ben J / Wilson, Ajay / Nugent, Michael / Burns, Andy

    The British journal of oral & maxillofacial surgery

    2022  Volume 60, Issue 9, Page(s) 1240–1245

    Abstract: Microvascular free tissue transfer reconstruction following resection of oral cancer is commonly chosen as the first line of treatment due to its superior functional outcomes. Multiple patient and surgical factors impact the length of postoperative stay, ...

    Abstract Microvascular free tissue transfer reconstruction following resection of oral cancer is commonly chosen as the first line of treatment due to its superior functional outcomes. Multiple patient and surgical factors impact the length of postoperative stay, and the time taken for patients to recommence oral feeding. This study aimed to identify factors that increase the length of stay and time to resumption of feeding. We retrospectively evaluated 100 cases from March 2015 to October 2020, and identified variables associated with increased length of stay (LOS) and time to resumption of feeding in univariate and multivariate analyses. Factors found to be associated with increased LOS in multivariate analysis were increasing age, elective tracheostomy, tumours originating from the floor of the mouth and mandible, a longer operating time, and use of fibular free flaps (p<0.05). Tracheostomy, increasing age, and female gender were strongly associated with delays in resumption of some types of oral feeding, and an integrated critical care unit (ICCU) stay of two or more days was associated with a longer time to resumption of free fluids. This information can be used to anticipate extensions to typical LOS, to produce cost analyses, develop individual patient risk stratification, manage patient expectations, and target the use of enhanced recovery programmes.
    MeSH term(s) Humans ; Female ; Free Tissue Flaps/surgery ; Length of Stay ; Retrospective Studies ; Treatment Outcome ; Reconstructive Surgical Procedures ; Mouth Neoplasms/surgery ; Postoperative Complications/surgery
    Language English
    Publishing date 2022-07-22
    Publishing country Scotland
    Document type Journal Article
    ZDB-ID 605685-4
    ISSN 1532-1940 ; 0266-4356
    ISSN (online) 1532-1940
    ISSN 0266-4356
    DOI 10.1016/j.bjoms.2022.07.003
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  9. Article ; Online: Author reply.

    Narayana, Sumudu / Nugent, Michael / Woodman, Richard / Larkin, Michael / Ramachandran, Jeyamani / Muller, Kate / Wigg, Alan

    Internal medicine journal

    2022  Volume 52, Issue 8, Page(s) 1458

    Language English
    Publishing date 2022-08-13
    Publishing country Australia
    Document type Letter ; Comment
    ZDB-ID 2045436-3
    ISSN 1445-5994 ; 1444-0903
    ISSN (online) 1445-5994
    ISSN 1444-0903
    DOI 10.1111/imj.15841
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Measuring quality of hepatitis B care in a remote Australian Aboriginal community: opportunities for improvement.

    Narayana, Sumudu / Nugent, Michael / Woodman, Richard / Larkin, Michael / Ramachandran, Jeyamani / Muller, Kate / Wigg, Alan

    Internal medicine journal

    2022  Volume 52, Issue 8, Page(s) 1347–1353

    Abstract: Background: Chronic hepatitis B (CHB) infection remains a significant public health issue for Indigenous Australians, in particular for remote communities.: Aim: To evaluate the spectrum of hepatitis B virus (HBV) care provided to a remote Aboriginal ...

    Abstract Background: Chronic hepatitis B (CHB) infection remains a significant public health issue for Indigenous Australians, in particular for remote communities.
    Aim: To evaluate the spectrum of hepatitis B virus (HBV) care provided to a remote Aboriginal community. Measures studied included screening, seroprevalence, vaccination rates and efficacy, and HCC risk and surveillance adherence.
    Methods: A retrospective audit of HBV care received by all permanent residents currently attending a remote Aboriginal Health service. This study was endorsed by both the local Aboriginal Health service and the Aboriginal Health Council of South Australia.
    Results: A total of 208 patients attended the clinic, of whom 52% (109) were screened for HBV. Of these, 12% (13) had CHB and 20% (22) had evidence of past infection. Similarly, of the 208 attending patients, complete vaccination was documented in 48% (99). Of the 33 patients with post-vaccination serology, 24% (8) had subtherapeutic (<10 IU/mL) levels of HBsAb. Subtherapeutic HBsAb was independently associated with higher Charlson Comorbidity scores (odds ratio = 17.1; 95% confidence interval 1.2-243.3; P = 0.036). Definitive breakthrough infection was identified in 6% (2) patients. One HBsAg positive patient was identified as needing HCC surveillance, but had not undertaken HCC surveillance.
    Conclusion: Opportunities to improve the quality of CHB care through increased HBV vaccination, screening and adherence to HCC surveillance were identified. High rates of subtherapeutic vaccine responses and documented breakthrough infection raises concerns about the effectiveness of current CHB vaccines in this population.
    MeSH term(s) Humans ; Australia/epidemiology ; Carcinoma, Hepatocellular/diagnosis ; Health Services, Indigenous ; Hepatitis B ; Hepatitis B Antibodies ; Hepatitis B Surface Antigens ; Hepatitis B Vaccines/therapeutic use ; Hepatitis B virus ; Hepatitis B, Chronic/diagnosis ; Hepatitis B, Chronic/epidemiology ; Hepatitis B, Chronic/prevention & control ; Liver Neoplasms/diagnosis ; Retrospective Studies ; Seroepidemiologic Studies ; Australian Aboriginal and Torres Strait Islander Peoples ; Quality of Health Care
    Chemical Substances Hepatitis B Antibodies ; Hepatitis B Surface Antigens ; Hepatitis B Vaccines
    Language English
    Publishing date 2022-05-31
    Publishing country Australia
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2045436-3
    ISSN 1445-5994 ; 1444-0903
    ISSN (online) 1445-5994
    ISSN 1444-0903
    DOI 10.1111/imj.15349
    Database MEDical Literature Analysis and Retrieval System OnLINE

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