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Constraints and Challenges: As medicine has been shown throughout this paper, there are a number of issues that need to be resolved before nanotechnology may be routinely employed in radiation oncology departments
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Clinical trials are one kind of research that has been conducted to evaluate the efficacy of NP-mediated diagnosis and/or treatment and quantify the therapeutic benefit to patients
However, a number of additional obstacles must be addressed before clinical trials may be developed
There are many criteria that must be met for NPs to be considered therapeutically relevant
All of these characteristics are essential for any therapeutic or imaging agent (whether imaging- or therapy-related)
These characteristics have been studied in vitro and in vivo, and the results have indicated that it is difficult to predict them based on individual particle qualities
They result from the interplay between several factors, including particle size, shape, material, and coating
Because of this interplay, optimizing NP properties in isolation is probably not feasible; instead, particles should be subjected to rigorous in vitro and in vivo preclinical testing that takes into consideration all of these effects before they are used in clinical studies
Producing NPs on a practical scale is also a major challenge
The vast majority of studies either create their own NP formulations in-house or utilize commercial particles produced at a sufficiently high scale for laboratory testing
These preparations may be rather expensive; for example, raw unconjugated nanoparticles can cost as much as $10,000/gram of gold, and particles that have been functionalized to the customer's specifications can cost much more
It is important to think about how revolutionary nanoparticles may be effectively scaled up while developing new approaches
On the other hand, showing clinical proof of concept should get the attention of big pharmaceutical companies and give them more reason to compete
Individual and population health in the twenty-first centuryPublic health promotes, protects, and preserves the health of groups or populations, while clinical medicine targets individual health
To maximize the benefits and minimize potential harm for the greatest number of people, nanomedicine applications and impacts must be explored through the lens of public health
Nanotechnology applications are intriguing owing to their unique properties and phenomena
Engineering materials on this scale enables novel medical therapies such as the development of nanoparticle-based drugs with improved specificity, resulting in fewer side effects for patients
3 Other advances are being made in medical devices and instrumentation for less invasive surgical procedures, leading to shorter recovery times and a lower risk of postoperative complications
These breakthroughs will increase life expectancy, enhance quality of life, and cut healthcare costs
Nanotechnology research is happening globally in cardiology, neurology, and other medical disciplines
Targeted drug delivery systems use nanoparticles, and carbon nanotubes make imaging modalities better at diagnosing diseases
4 Public health-focused research is vital to progressing in the area and producing useful medical solutions
In the US
the Food and Drug Administration (FDA) has not specified explicit standards for artificial nanomaterials in consumer items
There is rising worry about probable health and safety issues and a lack of knowledge to foresee and minimize them
More study is needed to analyze the life-cycle of manmade nanomaterials and their influence on health and safety
Nanotechnology must be properly advanced by communicating risks and advantages to stakeholders
Nanomedicine will encounter several obstacles from regulatory authorities, public organizations, insurance firms, and others
Early collaboration amongst people interested in promoting nanomedicine should be encouraged
Public health professionals should shape nanomedicine research, clinical, and population-based applications
Their tasks include collecting and interpreting epidemiology data on nanoenabled medications and pressing for more research funding
Nanomedicine and public health can work together to help people's health more than either could do on its own
This article aims to educate the public, business, government, and academia on public health ideas that should be included in nanomedicine research, development, and implementation
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Nanomedicine will influence public health
Public health is "the science and art of preventing disease, prolonging life, and promoting health and efficiency through organized community effort
" This includes community-wide or population-based interventions like public sanitation, infectious disease control, and clinical preventive services including early screening and detection
Public health promotes the health of a community via coordinated activities that benefit organizations and individuals
According to the Association of Schools of Public Health, public health has five basic disciplines:
Infection factors and distribution are studied in epidemiology, whereas biostatistics quantifies them
Health policy and management employs information from medical and public health to produce legislation, rules, and recommendations
Social and community behavior studies individuals' through organizational level health outcomes
7 Environmental health focuses on how the physical and social environment affects human health, as well as how humans affect their surrounding environment
8 With the knowledge gained from these core disciplines, public health professionals can look at, understand, and predict how nanomedicine will affect the health of a population
Public health technology has changed history
Vaccines have eradicated or reduced dangerous infectious illnesses worldwide
Side effects and hazards have influenced vaccination development and use
As shown by the hepatitis B vaccination, nanotechnology may improve medical practice and community health
Two billion individuals worldwide have hepatitis B
Noncompliance with the dosage schedule is a major concern, especially in third world nations, making the vaccination less effective or useless
The vaccination may now be given in one dose and still be effective
One group is looking at how well different PLGA microspheres work to give the hepatitis B vaccine in a single dose
10 This type of preventive care for hepatitis B makes it possible to vaccinate a larger population against a significant public health threat—an infectious disease that causes 600,000 deaths a year
Nanomedicine might drastically alter chronic illness treatment in the U
and worldwide
Traditional cancer treatments such as chemotherapy, surgery, and radiation therapy are taxing on patients because they damage both cancerous and healthy cells
12 The National Cancer Institute (NCI) recognizes the potential of nanotechnology to improve cancer diagnosis
The NCI supports nanotechnology-based medications and cures via clinical studies
The FDA has approved a number of drugs that use nanotechnology to treat cancer
These include Abraxane® for breast cancer and Doxil® for ovarian cancer
14, 15 Using carbon nanotubes and nanofibers, nanopatterned extracellular matrices, and dendritic nanopolymers, advances in regenerative medicine are being made to help with other major causes of illness and death in the US
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These disciplines' research has revealed correlations between exposures and health outcomes that have influenced medicine and public health practices
Epidemiology studies environmental exposures that may cause a disease or novel medical interventions that may lower illness occurrence
Epidemiologists will examine the effect nanomedicine applications have on health outcomes and population health
This includes post-market safety and efficacy studies of nanoenabled drugs21
Epidemiologic monitoring will enable researchers to measure nanotechnology's effect on population health
It's crucial to ask, "Does this technology enhance health outcomes?" This technique improves health outcomes for whom? In the age of personalized medicine, we must verify nanotechnology's application to people and groups based on physical, medicinal, and biological traits
Advances in personalized medicine through lab-on-a-chip nanoarray technologies will help quantify and understand how nanomedicine applications affect health outcomes 22, 23
National and international epidemiology data and trend information will advance our understanding of the "big picture" impact of these technologies and reveal how they are advancing national and international health
As nanomedicine applications become more popular in clinical care, information on their health outcomes will assist insurance companies in performing cost-benefit comparisons between new and established medical therapies
This may lower healthcare costs
Surveillance data will indicate medical research areas that require nanotechnology
Communicating with federal authorities about gaps will ensure money is provided to the most impactful locations
Epidemiologic monitoring will show whether nanomedicine uses are evenly distributed across people in different locations
Future uses of nanotechnology in medicine and health will be based on these factors and the legal, social, and moral effects of those uses
Nanomedicine will alter regulatory authorities and healthcare delivery systems
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The FDA protects public health by ensuring that biological products, cosmetics, national food supplies, medical supplies, and drugs are safe
Currently, the FDA has not developed specific regulations for products containing nanomaterials; however, many products containing engineered nanomaterials fall under their jurisdiction
Sunscreens and prescription medications raise public and legislative attention
In 2006, the International Center for Technology Assessment and other consumer organizations sued the FDA over a perceived "lack of effort" in regulating nanomaterial-containing products
In response, the FDA constituted a "Nano Task Force"
Nanotechnology: A Report of the US
The FDA Task Force details how the FDA is tackling items containing manufactured nanosized particles
26 Ultimately, the paper argues that they do not have enough health and safety knowledge to handle nanosized particles differently from bigger particles of the same material composition
In its findings, the FDA advises case-by-case labeling of nanoparticle-containing goods
Despite concerns from advocacy organizations like the Consumers Union, they have not changed their system of reviewing nanomaterial-containing items
More toxicological data is needed to successfully regulate new goods
Responsible nanotechnology advancement requires balancing consumer protection and innovation
The FDA isn't the only agency struggling to regulate nanomaterials
The EPA and OSHA are also under pressure to oversee the safe development of nanotechnology
Nanomaterial standards are a difficulty for these authorities
The diversity of nanomaterials doesn't fit chemical nomenclature
Material safety datasheets employ a defined naming scheme to transmit health and safety information
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A global and consistent naming system is needed to design nanomaterial rules
These government agencies also have information gaps about the environmental and human health implications of manmade nanomaterials
Health and safety research lags behind nanotechnology product development
This funding gap is being caused by limited government funding to agencies like NIOSH, FDA, and EPA
NIOSH got 0
4% of NNI's 2009 budget
Other agencies that make rules are also asking for more money to fill information gaps about health and safety and teach policymakers
Nanomedicine will impact healthcare delivery
High-sensitivity and specificity screening techniques might enhance prognoses and save healthcare expenses
Insurance providers may initially reject paying for nanomedicine treatments
New technologies are typically more costly than conventional medical techniques, and coverage is often contested
Time and adequate data will show the advantages of novel nanomedicine applications in illness prevention, diagnosis, and therapy
Healthcare providers and delivery systems may encounter cost problems when they purchase new equipment and learn about nanomedicine breakthroughs for clinical use
All parties should collaborate to overcome actual and imagined hurdles
Public health experts will work with the people who make the technology to make sure implementers understand the risks, costs, and benefits
Perceptions of risks and advantages impact health choices despite factual data
With books like Engines of Creation by Eric Drexler and Prey by Michael Crichton proposing that nanorobots will take over the world, nanotechnology has been given a negative spin in some eyes
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29,30 Current studies suggest that there is skepticism among the public about the safety of nanotechnology
31 Nanomedicine may fall under this category
In history, several developing technologies have failed owing to bad public and societal perception
Noncompliance with vaccinations due to fear of adverse health effects is another example of how perception can influence medical decision making and population health
34 Stakeholders in nanomedicine must be proactive in communicating with the public in a clear, consistent, and transparent manner
Strategic risk communication is vital, particularly given nanotechnology's stigma and dread
Understanding the environmental and human health consequences of engineered nanomaterials, products, and byproducts is crucial
While over 1000 nanoenabled consumer products are already on the market, knowledge gaps exist regarding their fate and transport within humans, the environment, and ecosystems
35Other concerns include nanosilver's antibacterial properties and propensity to affect wastewater treatment
Analysis of the whole life-cycle of engineered nanomaterials, from raw materials to disposal, is important for advancing nanotechnology responsibly
As the number of nanomaterial-containing products on the market rises, so does concern about their environmental impact
Different nanoparticles employed for medicinal therapies will have different environmental entry sites dependent on their application, function, and disposal
This includes excreted nanoenabled medicinal products, innovative imaging agents, and end-of-life medical equipment
The FDA and EPA publish instructions on how to dispose of leftover prescriptions since certain drugs might modify wastewater treatment
42, 43 It's important to understand how nanopharmaceuticals will affect water treatment
Continued study is needed to comprehend nanomaterials' full environmental effects
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Public health experts, medical practitioners, and scientific researchers creating and implementing nanomedicine applications should be familiar with evolving technology ideas and principles
This will push research in a direction that best impacts public health and allow for better communication and cooperation between business, government, and academia
Nanomedicine advancement will need multidisciplinary cooperation among numerous specialists
Public health personnel must understand nanotechnology to apply nanomedicine to healthcare systems
Nanomedicine is an emerging science with important public health implications
This can be done by publishing nanomedicine articles for the public health audience, incorporating nanomedicine sessions into major conferences like the American Public Health Association annual conference, and offering seminars and workshops to educate public health professionals about nanomedicine
Strategic planners in government, business, and academia should grasp nanomedicine's public health implications
Clinicians will need training to use nanomedical technology efficiently
Radiology, infectious disease, and cancer applications are rushing from R&D to commercialization
These medical specializations require more training and education than others, but all will be affected in the future
Medical education and training modules need to be made by a group that understands both basic research and clinical medicine and can put them together
All groups require cyclical training and education
Public health professionals must learn about nanotechnology and its medical achievements to educate researchers and doctors about its influence on population health
This will require cross-discipline and sector cooperation to more efficiently translate technology to patient care, improving individual and population health
Conclusion
Nanomedicine has boundless health-improvement potential
Public health skills are needed to improve individual and population health
This effect on nanomedicine will help figure out where the most technical progress needs to be made, where money should go, and how people and the environment should be protected
Expanding cross-disciplinary training for researchers, healthcare providers, and public health professionals in business, government, and academia is key to promoting nanomedicine
Collaborative nanomedicine research and teaching will advance the science and improve public health
Nanomedicine research and development will improve global health
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