Treatment Practices Research Articles

Age-peculiarities of L-arginine, inosine and meldonium effects on the adult and old rat vascular wall reactivity

Abstract. Cardiovascular diseases are most common in older people. The functional state of the vascular endothelium is important in the pathogenesis of cardiovascular diseases. Numerous physiologically active substances with different mechanisms of action can affect endothelial function L-arginine, inosine and meldonium caught our attention. Combination therapy is a promising direction in treating circulatory system diseases. This work aimed to establish the age-related characteristics of L-arginine, inosine and meldonium and their combination (Melarginine) on the vascular wall reactivity in adult and old rats to substantiate the occurrence of these cases in cardiology and geriatrics. Experiments were carried out on isolated norepinephrine (10-7 mol/l) segments of the thoracic aorta of adult (8-10 months) and old (21-23 months) outbred male rats. It was shown that the vasodilatory effect of L-arginine, inosine and meldonium and their combination (Melarginine) was insignificant. At the same time, the isolated vascular segment relaxation of old rats under the studied substances was significantly greater compared to adult animals. It should be noted that the vasodilatory effect of acetylcholine in old rats was significantly less than in adults. This indicates the practical endothelium preservation in adult animals and its damage in old ones. The greater sensitivity of the vascular wall of old rats to the action of L-arginine, inosine and meldonium and their combination Melarginine indicates their action is directed at restoring endothelial function in old animals. This suggests the feasibility of using Melarginine in geriatric practice for cardiovascular disease treatment in the future. _________________________________________________________________________________________ Keywords: vessel reactivity; ageing; L-arginine; inosine; meldonium; Melarginine

Synergistic cotreatment of cooling tower blowdown and produced waters: Techno-economic, sustainability, and optimization systems analyses

A blowdown and produced water cotreatment train design was preliminarily simulated to explore water-energy nexus synergy. This process model was able to provide results concerning water compositions, chemical demand, and energy intensity. The computational expense associated with this simulation made it intractable to use within optimization algorithms for further informative, comprehensive systems analyses. This work details the efforts of developing a framework suitable for the optimization of computationally demanding wastewater treatment train simulations, specifically demonstrated for the cotreatment train’s process, economic, and sustainability models. The unique challenges of the cotreatment train model motivated a modified surrogate optimization methodology to be developed. Using this framework, worst and best case economic scenarios were optimized to minimize the levelized cost of water (LCOW) employed in a reduced-order model-based simulation. Applying the optimal designs obtained from the surrogate optimization into the original comprehensive simulation resulted in an expected range of LCOW from $2.01 to $4.43m-3. Other established techno-economic and sustainability indicators further inform on process implications. The process was compared to current management practices of blowdown water treatment and produced water injection to discuss the advantages and disadvantages of the proposed cotreatment train designed for water reuse. The cotreatment process was estimated to have lower levelized treatment costs but require more chemicals and energy to manage a higher salinity wastewater than pure blowdown water alone. If sustainable management goals motivate produced water remediation, the cotreatment process can be beneficial for the broader scope of water management.

Drosophila melanogaster as a model organism for screening acetylcholinesterase reactivators

ABSTRACT The widely used insecticide chlorpyrifos (CP) is known to inhibit acetylcholinesterase (AChE) activity attributed to result in various neurological disorders and acetylcholine-dependent organ functions including heart, skeletal muscle, lung, gastrointestinal tract, and central nervous systems. Enzyme reactivators, such as oximes, are known to restore AChE activity and mitigate adverse effects. The identification of compounds that reactivate AChE constitute agents with important therapeutic beneficial effects in cases of pesticide poisoning. However, the screening of novel drugs using traditional models may raise ethical concerns. This study aimed to investigate the potential of Drosophila melanogaster as a model organism for screening AChE reactivators, with a focus on organophosphate poisoning. The efficacy of several oximes, including pralidoxime, trimedoxime, obidoxime, methoxime, HI-6, K027, and K048, against CP-induced AChE activity inhibition in D. melanogaster was determined in silico, in vitro, and in vivo experiments. Molecular docking studies indicated a strong interaction between studied oximes and the active-site gorge of AChE. Data showed that selected oximes (100 μM) are effective in the reactivation of AChE inhibited by CP (10 μM) in vitro. Finally, in vivo investigations demonstrated that selected oximes, pralidoxime and K048 (1.5 ppm), reversed the locomotor deficits, inhibition of AChE activity as well as lowered the mortality rates induced by CP (0.75 ppm). Our findings contribute to utilization of D. melanogaster as a robust model for determination of actions of identified new AChE inhibitory agents with more effective therapeutic properties that those currently in use in the clinical practice in treatment of AChE associated disorders.

Real-world evaluation of multimodal treatment practice in older oesophageal cancer patients.

Elderly-specific data for multimodal treatment of oesophageal cancer (EC) is lacking. This study aimed to evaluate the safety and efficacy of multimodal treatment in older EC patients and to compare the impact of neoadjuvant chemotherapy (NCT) and neoadjuvant chemoradiotherapy (NCRT). Patients diagnosed with oesophageal squamous cell carcinoma or adenocarcinoma who received NCT/NCRT were identified in the National Cancer Database (NCDB, 2004-2015). First, we compared baseline and post-treatment characteristics between younger (<70 years) and older patients (≥70 years). Logistic regression was used to investigate risk factors of postoperative mortality. Second, we evaluated the effect of neoadjuvant chemotherapy on postoperative mortality and overall survival in the older cohort. Inverse probability of treatment weights and multivariable analyses were used to compensate for differences in baseline covariates. We 1st compared outcomes of neoadjuvant therapy plus oesophagectomy in 14778 eligible EC patients. The older group experienced higher rates of postoperative mortality at 30 days (5.8%) and 90 days (13.5%) compared to younger patients. Postoperative mortality was significantly related to the Charlson-Deyo score and treatment-related factors including neoadjuvant therapy type and minimally invasive technique. Second, among the 3141 older patients (with a median follow-up of 57.8 months and 2029 deaths), those receiving NCT obtained significantly lower postoperative mortality and improved overall survival compared with NCRT (inverse probability of treatment weights-adjusted P = 0.05; hazard ratio 0.85; 95% Cl 0.72-0.99). Neoadjuvant therapy plus oesophagectomy carries increased short-term mortality risk in older EC patients. NCT in older EC patients showed lower postoperative mortality but no statistically significant differences in overall survival, with a point estimate favouring NCT compared to the NCRT group, making NCT a potential option for consideration in specific cases.

Expert views on screening for tuberculosis infection in patients commencing treatment with a biologic agent.

Many biologic agents cause some degree of immunosuppression, which can increase the risk of reactivation of tuberculosis infection (TBI). This risk is variable between individual biologics. We aimed to assess current (and recommended) clinical practice of TBI screening and treatment among patients initiating treatment with biologic agents. An online questionnaire was distributed via email to members of the Global Tuberculosis Network and associated professional organisations to seek insights into the screening for and treatment of TBI in patients treated with biologics. A total of 163 respondents in 27 countries answered at least one question. For all biologics described in the questionnaire, respondents advised increasing screening relative to current practice. Observed and supported TBI screening rates in patients treated with TNF-a inhibitors were high, especially for older TNF-a inhibitors. Most participants supported TBI screening in patients treated with B- or T-cell inhibitors but not in those treated with interleukin inhibitors. Guideline awareness was higher for TNF-a inhibitors than for other biologic classes (79% vs. 34%). Although respondents stated that TBI screening rates are lower than what they consider ideal, there was a tendency to recommend TBI screening in patients treated with biologics not known to be associated with an increased risk of TBI. As a result, there is a potential risk of over-screening and over-treatment of TBI, potentially causing harm, in patients treated with biologics other than TNF-a inhibitors. There is a need to research the risk of TBI associated with biologics and for guidelines to address the spectrum of TBI risk across all types of biologics.

Agricultural waste-based biochars for sustainable removal of heavy metals from stabilized landfill leachate.

In this work, biochars were used as adsorbents to remove Cu, Cd, and Zn ions in a real stabilized leachate from a controlled landfill. Oak fruit shells biochar (OFSBC) and date palm fibers biochar (DPFBC) were obtained by pyrolysis of oak fruit shells and date palm fibers at 700°C and 400°C, respectively. OFSBC and DPFBC showed well-developed structures and high specific surface areas (520.16 m2/g and 470.46 m2/g, respectively). Equilibrium adsorption of heavy metal ions on DPFBC and OFSBC occurred after 4h and 2h of stirring. The removal efficiencies of Cu, Cd, and Zn ions were 97.01%, 94.40%, and 80.59% with DPFBC and 90.10%, 88.33%, and 76.16% using OFSBC, respectively. The Avrami fractional order model was appropriate for describing kinetic adsorption. Increasing the dose of adsorbent improves heavy metal ion retention. Thermodynamic tests have proven the spontaneous and endothermic adsorption of these heavy metals. The electrostatic attraction, ion exchange, complexation, metal-π bending, and surface precipitation and pore filling were regarded as the most predominant heavy metal retention mechanisms from the landfill leachate onto the biochar surface. Separately, the DPFBC showed the best performance than OFSBC regarding the improvement of leachate quality. Chemical oxygen demand (COD), biological oxygen demand (BOD5), ammoniacal nitrogen (NH3-N), and phosphorus (P) were respectively removed at an efficiency of 53.57%, 29.17%, 36.07%, and 37.5%, respectively. Thus, the results allow highlighting that the adsorption on DPFBC and OFSBC can be an effective alternative in the practice of landfill leachate treatment.

Identification, mapping, and self-reported practice patterns of village doctors in Sitakunda subdistrict, Bangladesh.

Informally trained health care providers, such as village doctors in Bangladesh, are crucial in providing health care services to the rural poor in low- and middle-income countries. Despite being one of the primary vendors of antibiotics in rural Bangladesh, village doctors often have limited knowledge about appropriate antibiotic use, leading to varied and potentially inappropriate dispensing and treatment practices. In this study, we aimed to identify, map, and survey village doctors in the Sitakunda subdistrict of Bangladesh to understand their distribution, practice characteristics, clinical behaviours, access to technologies, and use of these technologies for clinical decision-making. Using a 'snowball' sampling method, we identified and mapped 411 village doctors, with 371 agreeing to complete a structured survey. The median distance between a residential household and the closest village doctor practice was 0.37 km, and over half of the practices (51.2%) were within 100 m of the major highway. Village doctors were predominately male (98.7%), with a median age of 39. After completing village doctor training, 39.4% had completed an internship, with a median of 15 years of practice experience. Village doctors reported seeing a median of 84 patients per week, including a median of five paediatric diarrhoea cases per week. They stocked a range of antibiotics, with ciprofloxacin and metronidazole being the most prescribed for diarrhoea. Most had access to phones with an internet connection and used online resources for clinical decision-making and guidance. The findings provide insights into the characteristics and practices of village doctors and point to the potential for internet and phone-based interventions to improve patient care and reduce inappropriate antibiotic use in this health care provider group.

Safe water treatment practices: A qualitative study on point-of-use chlorination in Nigeria

Safe water treatment practices: A qualitative study on point-of-use chlorination in Nigeria

A quantitative survey of correctional mental health professionals on current healthcare and treatment practices for transgender incarcerated persons.

There is a need for updated survey literature collected from correctional mental health professionals working within prison settings. Up to date research can add to the literature addressing the best practices for mental health treatment of the transgender incarcerated population in order to provide health care professionals and correctional staff with more effective, efficient, and widely understood intervention practices to facilitate the well-being and safety of this population. Guided by three research aims, 50 mental health professionals from 21 states throughout the United States were surveyed in this quantitative survey regarding their work with the transgender incarcerated population. Results are discussed in terms of implications for the type of care and coordination of care provided by correctional mental health professionals.

Best practices for treatment of adolescent SUDs

Best practices for treatment of adolescent SUDs

Advancements in Biopolymer‐Derived Graft Copolymers: A Comprehensive Review on Their Application in Sustainable Wastewater Treatment

ABSTRACTRising concerns over water pollution and the depletion of non‐renewable resources have propelled the exploration of eco‐friendly and sustainable wastewater treatment alternatives. Biopolymer‐derived graft copolymers emerge as a promising solution, offering biodegradability, cost‐effectiveness, versatility, and enhanced functionality. This review provides a comprehensive overview of the latest developments in utilizing these copolymers as eco‐friendly flocculants for wastewater treatment. It covers synthesis methods for functionalized biopolymer‐based flocculants, diverse flocculation mechanisms, and their efficacy in solid–liquid separation. The article explores applications for removing pollutants, emphasizing biodegradability, cost‐effectiveness, and versatility. Special attention is given to the environmental impact, critically analyzing how these copolymers contribute to sustainable water treatment practices. The review also discusses potential future prospects and advancements in addressing global water pollution challenges using biopolymer‐derived graft copolymers.

SATURN: assessing the feasibility of utilising existing registries for real-world evidence data collection to meet patients, regulatory, health technology assessment and payer requirements

BackgroundSATURN (Systematic Accumulation of Treatment practices and Utilisation, Real world evidence, and Natural history data) for the rare condition osteogenesis imperfecta (OI) has the objective to create a common core dataset by utilising existing, well-established data sources to meet the needs of the various stakeholders (physicians, registry/dataset owners, patients and patient associations, OI community leaders, European [EU] policymakers, regulators, health technology assessments [HTA]s, and healthcare systems including payers). This paper describes the steps taken to assess the feasibility of one existing OI registry (i.e., the Registry of OI [ROI]) as a candidate for SATURN. The same methodology will be applied to other existing OI registries in the future and this same concept could be utilised for other rare disease registries.MethodsThe approach to assessing the feasibility of the ROI registry consisted of three steps: (1) an assessment of the registry characteristics using the Registry Evaluation and Quality Standards Tool (REQueST); (2) a gap analysis comparing SATURN required Core Variables to those being captured in the registry’s Case Report Form (CRF); and (3) a compliance check on the data exchange process following the Title 21 of Code of Federal Regulations (CFR) Part 11/EudraLex Annex 11 Compliance Checklist. The first registry that SATURN has assessed is the ROI database at the Istituto Ortopedico Rizzoli (IOR) in Italy.ResultsThe results from the ROI REQueST have demonstrated satisfactory complete responses in terms of methodology, essential standards, interpretability, and interoperability—readiness for data linkage, data sources, and ethics to meet the needs of data customers. However, the ROI data is from a tertiary referral centre which may limit the ability to understand the full patient journey. The gap analysis has revealed that an exact or logical match between SATURN requested variables and the ROI current variables exists for the following items: patient characteristics, treatment of OI (medical and surgical) and treatment of pain (with the exception of frequency of treatment and reasons for discontinuation), fracture history and bone density. However, data on safety was missing. The compliance check has implied that the ROI implemented appropriate controls for the web-based platform (i.e., Genotype–phenotype Data Integration Platform [GeDI]) that is involved in processing the electronic patient data, and GeDI is a validated/compliant application that follows relevant 21 CFR Part 11/EudraLex Annex 11 regulations.ConclusionsThis robust feasibility process highlights potential limitations and opportunities to develop and to refine the collaboration with the ROI as the SATURN programme moves forward. It also ensures that the existing datasets in the rare condition OI are being maximised to respond to the needs of patients, data customers and decision-makers. This feasibility process has allowed SATURN to build a compliant methodology that aligns with the requirements from the European Medicines Agency (EMA) and HTAs. More data variables will continue to be developed and refined along the way with more registries participating in SATURN. As a result, SATURN will become a meaningful and truly collaborative core dataset, which will also contribute to advancing understanding of OI diagnosis, treatment, and care.

Effectiveness of remotely delivered speech therapy in persons with Parkinson's disease – a randomised controlled trial

Increasing evidence supports the merits of speech therapy in Parkinson's disease, but the current practice of multiple in-house treatments is demanding for patients. We therefore assessed the effectiveness of remotely delivered and personalised speech therapy on improving quality of life and speech quality in persons with Parkinson's disease. We performed a single blinded randomised controlled trial (the PERSPECTIVE study), comparing 8 weeks of personalised remote speech therapy to no intervention (waiting list design). Patients with reduced speech intelligibility were included, regardless of disease stage or dysarthria severity. Patients were assigned randomly (1:1) to the intervention or control group. Measurements took place at baseline and after 8 weeks (both groups), and after 32 weeks (intervention group only). Patients were treated remotely by 20 experienced speech therapists. The primary outcome was disease-related quality of life at 8 weeks, assessed with the Parkinson's Disease Questionnaire 39 (PDQ-39). Data were analysed using analysis of covariance based on the intention-to-treat principle. This trial is registered in ClinicalTrials.gov, NCT03963388. Between March 1, 2019, and March 27, 2021, 214 patients were enrolled in the intervention group (n=109) or control group (n=105). At the primary timepoint, the adjusted mean difference in PDQ-39 was-2.0 in favour of the intervention group (95% CI-4.0 to 0.1); p=0.056). The intervention group scored better on the communication index score of the PDQ-39 (post hoc analysis), with an adjusted mean difference of-5.3 (95% CI-9.4 to-1.2; p=0.011). We found no between-group differences on any other PDQ-39 domain. Follow-up measurements showed a significant reduction of the PDQ-39 compared to the primary timepoint with a difference of 2.40 (95%CI 0.77-4.02; p=0.004). Personalised remote speech therapy improved communication-related quality of life, but not overall quality of life. Michael J. Fox Foundation, Gatsby Foundation, and Health∼Holland.

Notalgia Paresthetica Dermatologist Report of Symptom Burden and Treatment: Results from a Physician Survey.

Notalgia paresthetica (NP) is a sensory neuropathy characterized by chronic pruritus, skin pain, and other pathologic sensations affecting the mid-to-upper back. NP may be under-recognized and under-diagnosed, with limited data available on its symptom presentation and treatment patterns. NP-DERM was an internet-based survey of dermatologists (n = 650) from 8 different countries on their perspectives on NP symptoms and current treatment practices. Dermatologists typically treated a median of 12 patients with NP per month. Dermatologists reported that itch (pruritus) was the most common symptom for their patients with NP, followed by hyperpigmentation and sensitive skin. The most burdensome NP symptom was pruritus, followed by burning or hot sensation, and painful or raw skin. The most prescribed treatments included non-medicated skin care, topical corticosteroids, oral antihistamines, medicated topicals, and gabapentin or pregabalin. Physicians reported low satisfaction with available treatments. The most common reason for physicians to discontinue patients' therapy was lack of response.

Survey of international pediatric nutritional supportive care practices: a report from the Pediatric Study Group of the Multinational Association of Supportive Care in Cancer (MASCC)

PurposeMalnutrition is common in children with cancer. While multiple validated malnutrition screens exist, there is no universal, standardized approach to screen or diagnose malnutrition. The Multinational Association of Supportive Care in Cancer (MASCC) Pediatric Study Group is focused on oncologic supportive care for children and young adults. This subgroup designed and administered a pilot study to characterize global malnutrition screening, diagnosis, and treatment practices for pediatric patients with cancer after identifying variations in malnutrition practice patterns within its members.MethodsA novel, exploratory survey was iteratively developed and distributed in early 2020 to 45 MASCC Pediatric Study Group members. The survey included multiple questions with standard patient presentations and nutritional scenarios, and the respondents selected the answer that best reflected the care patients would receive at their institution.ResultsA validated screening tool to assess for malnutrition was routinely used by 15 of 26 respondents (58%). No single validated screen was used by more than 24% of responders, and 11 of 26 (42%) reported not having a standard malnutrition treatment screen. When the same patient was presented with the survey using different malnutrition indicators, patient care plans varied greatly. This was particularly true for z-scores compared to weight percentiles.ConclusionsDevelopment of consensus recommendations for screening practices, preferred malnutrition indicators, and treatment guidelines could help reduce the underdiagnosis of malnutrition and subsequent variation in its management and ought to be a focus of the global pediatric cancer supportive care community.

Adjunctive use of mindfulness-based mobile application in depression: randomized controlled study.

Mindfulness-based interventions (MBI) are effective in relapse prevention in Major Depressive Disorder (MDD). Internet-based interventions have been demonstrated to be effective in the treatment of MDD. Consequently, the integration of MBI through mobile applications emerges as a promising supplementary intervention for MDD, contributing to the augmentation of mental health services, particularly within ambulatory care contexts. The current randomized controlled study is designed to evaluate the efficacy of adjunctive MBI delivered via a mobile app in mitigating symptom severity and stress levels. This assessment involves a comparison with standard treatment practices in an ambulatory setting among individuals diagnosed with MDD. A total of 83 patients diagnosed with MDD (depressive episode, recurrent depression or depressive phase of bipolar disorder) were randomly allocated to the intervention (41 patients) or control condition (42 patients). The intervention consisted of the daily use of the mindfulness mobile application "Headspace" for thirty days. The control condition was treatment as usual (TAU) only. The symptom severity has been assessed by the Beck Depression Inventory (BDI-II) as well as the Hamilton Depression Rating Scale (HDRS-17). Blood pressure and resting heart rate have been assessed as secondary outcome. Upon hospital discharge, the mean scores on the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS) signaled partial remission of MDD in both treatment arms. In both groups, a subsequent decrease in both self-reported and expert-rated scores was evident after a 30-day period. However, the decrease in depression severity as measured by HDRS was significantly higher in the MBI group compared to the control group after 30days. For secondary outcomes, systolic blood pressure was lower in the intervention group compared to control group. The total drop-out rate was 29%. Short term mindfulness intervention via mobile application (30days) can be beneficial as adjunctive therapy to treatment as usual in patients with MDD.

Water Treatment Practices and Misperceived Social Norms among Women Living with Young Children in Rural Uganda.

Access to water safe for consumption is critical for health and well-being, yet substantial structural barriers often necessitate household action to make water safer. Social norms about water treatment practices are understudied as a driver of personal water treatment practice. This study assesses reported and perceived water treatment practices among women in a rural, water insecure setting. We used cross-sectional data from a population-based study of women living with children under 5 years old across eight villages in southwest Uganda. Participants reported their typical household water treatment practices and what they perceived to be the common practices among most other women with young children in their own village. Modified multivariable Poisson regression models estimated the association between individual behavior and perceptions. Of 274 participants (78% response rate), 221 (81%) reported boiling water and 228 (83%) reported taking at least one action to make water safer. However, 135 (49%) misperceived most women with young children in their village not to boil their water, and 119 (43%) misperceived most to take no action. Participants who misperceived these norms were less likely to practice safe water treatment (e.g., for boiling water, adjusted relative risk = 0.80; 95% CI 0.69-0.92, P = 0.002), adjusting for other factors. Future research should assess whether making actual descriptive norms about local water treatment practices visible and salient (e.g., with messages such as "most women in this village boil their drinking water") corrects misperceived norms and increases safe water treatment practices by some and supports consistent safe practices by others.

Iatrogenic pediatric unilateral vocal cord paralysis after cardiac surgery: a review.

Unilateral vocal cord paralysis (UVCP) is a growing area of research in pediatrics as it spans across many specialties including otolaryngology, cardiology, general surgery, respirology, and speech language pathology. Iatrogenic injury is the most common cause of UVCP, however there is a wide range of data reporting the prevalence, symptom burden, and best treatment practice for this condition. The literature included systematic reviews and meta-analyses, retrospective studies and limited prospective studies. Overall, the literature lacked consistency in the diagnosis, treatment, and long-term outcomes of patients with UVCP. Many articles conflated bilateral vocal cord paralysis (BVCP) with UVCP and had limited data on the natural history of the condition. There was no consensus on objective and subjective measurements to evaluate the condition or best indications for requiring surgical intervention. Thyroplasty, injection medialization (IM) and recurrent laryngeal nerve reinnervation (RLNR) were the reported surgical interventions used to treat UVCP, however there was limited data on short and long-term surgical outcomes in children. More research is needed to determine the true prevalence, natural history, indications for surgical intervention and long-term outcomes for pediatric patients with this condition.

Utilization of Traditional Healing Practices for Cancer Treatment: Benefits, Risks, and Integration with Modern Medicine

Traditional healing practices in Africa, characterized by the use of locally available plants, minerals, and spiritual rituals, have historically played a significant role in managing diseases, including cancer. Despite the overshadowing effect of Western medicine during the colonial period, traditional practices continue to be integral to many communities, providing culturally relevant and accessible treatments. This review explores the utilization of traditional healing practices in cancer treatment, focusing on the benefits, risks, and integration with modern medicine. Traditional cancer treatments, including herbal remedies, spiritual interventions, and physical therapies, offer potential benefits like improved symptom management and emotional support. However, challenges like lack of standardization, scientific validation, and potential interactions with conventional treatments pose significant risks. The integration of traditional and modern medical approaches is emerging as a trend, aiming to improve treatment outcomes and patient quality of life. This requires careful consideration of safety, efficacy, and standardization. Effective integration involves developing collaborative care models, regulatory frameworks, and interdisciplinary partnerships. Future directions include advancing research to understand traditional remedies’ mechanisms, improving quality control, and exploring hybrid therapies. By fostering collaboration between traditional healers, researchers, and modern healthcare professionals, and addressing ethical and safety concerns, traditional practices can be harnessed while enhancing overall cancer care. Keywords: Traditional Healing, Cancer Treatment, Benefits, Risks, Modern Medicine

Building Clinical Care Capacity for Patients With Special Pathogens in Advance of the Next Outbreak.

In response to the growing number of outbreaks of emerging infectious diseases, the US Administration for Strategic Preparedness and Response (ASPR) has embarked on a plan to improve and expand special pathogen patient care capabilities. To achieve this, ASPR is developing a coordinated network of Regional Emerging Special Pathogen Treatment Centers (RESPTCs) to serve as state-of-the-art facilities staffed by a highly trained workforce to care for and manage special pathogen patients across the lifespan. The RESPTC network represents the operational arm of a broader US National Special Pathogen System of care to prevent and prepare for the next infectious disease outbreak. RESPTCs are strategically located in every region across the country and form a network linking local and regional healthcare partners to enhance national preparedness through training in best practices for detection, isolation, and treatment of individuals suspected of or known to be infected with a special pathogen. This local, regional, and national network is also designed to lead a coordinated response that includes the dissemination of accurate and trustworthy information to responders and the public. The overarching goal of the RESPTCs is to serve as a valuable resource for clinical care, training, and material support to meet current and future major infectious diseases challenges. In this case study, 2 new RESPTCs, MedStar Washington Hospital Center and the University of North Carolina, describe their experiences related to designing a biocontainment unit, creating clinical teams, building staff resiliency, receiving mentoring from regional RESPTC partners, and developing opportunities for innovation.