Search results for: aquatic therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2357

Search results for: aquatic therapy

1067 In situ One-Step Synthesis of Graphene Quantum Dots-Metal Free and Zinc Phthalocyanines Conjugates: Investigation of Photophysicochemical Properties

Authors: G. Fomo, O. J. Achadu, T. Nyokong

Abstract:

Nanoconjugates of graphene quantum dots (GQDs) and 4-(tetrakis-5-(trifluoromethyl)-2-mercaptopyridinephthalocyanine (H₂Pc(OPyF₃)₄) or 4-(tetrakis-5-(trifluoromethyl)-2-mercaptopyridinephthalocyaninato) zinc (II) (ZnPc(OPyF₃)₄) were synthesized via a novel in situ one-step route. The bottom-up approach for the prepared conjugates could ensure the intercalation of the phthalocyanines (Pcs) directly onto the edges or surface of the GQDs and or non-covalent coordination using the π-electron systems of both materials. The as-synthesized GQDs and their Pcs conjugates were characterized using different spectroscopic techniques and their photophysicochemical properties evaluated. The singlet oxygen quantum yields of the Pcs in the presence of GQDs were enhanced due to Förster resonance energy transfer (FRET) occurrence within the conjugated hybrids. Hence, these nanoconjugates are potential materials for photodynamic therapy (PDT) and photocatalysis applications.

Keywords: graphene quantum dots, metal free fluorinated phthalocyanine, zinc fluorinated phthalocyanine, photophysicochemical properties

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1066 Preliminary Dosimetric Evaluation of Two New 153Sm Bone Pain Palliative Agents

Authors: H. Yousefnia, S. Zolghadri, N. Amraee, Z. Naseri, Ar. Jalilian

Abstract:

The purpose of this study was to calculate the absorbed dose to each human organ for two new Sm-153 bone-seeking agents in order to evaluate their effectiveness in bone pain palliation therapy. In this work, the absorbed dose of 153Sm-TTHMP and 153Sm-PDTMP to each human organ was evaluated based on biodistribution studies in rats by radiation dose assessment resource (RADAR) method. The highest absorbed dose for 153Sm-TTHMP and 153Sm-PDTMP is observed in trabecular bone with 1.844 and 3.167 mGy/MBq, respectively. Bone/red marrow dose ratio, as the target/critical organ dose ratio, for 153Sm-PDTMP is greater than 153Sm-TTHMP and is compatible with 153Sm-EDTMP. The results showed that these bone-seeking agents, specially 153Sm-PDTMP, have considerable characteristics compared to the most clinically used bone pain palliative radiopharmaceutical, and therefore, can be good candidates for bone pain palliation in patients with bone metastasis; however, further biological studies in other mammals are still needed.

Keywords: internal dosimetry, PDTMP, 153Sm, TTHMP

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1065 Adsorption of Chlorinated Pesticides in Drinking Water by Carbon Nanotubes

Authors: Hacer Sule Gonul, Vedat Uyak

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Intensive use of pesticides in agricultural activity causes mixing of these compounds into water sources with surface flow. Especially after the 1970s, a number of limitations imposed on the use of chlorinated pesticides that have a carcinogenic risk potential and regulatory limit have been established. These chlorinated pesticides discharge to water resources, transport in the water and land environment and accumulation in the human body through the food chain raises serious health concerns. Carbon nanotubes (CNTs) have attracted considerable attention from on all because of their excellent mechanical, electrical, and environmental characteristics. Due to CNT particles' high degree of hydrophobic surfaces, these nanoparticles play critical role in the removal of water contaminants of natural organic matters, pesticides and phenolic compounds in water sources. Health concerns associated with chlorinated pesticides requires the removal of such contaminants from aquatic environment. Although the use of aldrin and atrazine was restricted in our country, repatriation of illegal entry and widespread use of such chemicals in agricultural areas cause increases for the concentration of these chemicals in the water supply. In this study, the compounds of chlorinated pesticides such as aldrin and atrazine compounds would be tried to eliminate from drinking water with carbon nanotube adsorption method. Within this study, 2 different types of CNT would be used including single-wall (SWCNT) and multi-wall (MWCNT) carbon nanotubes. Adsorption isotherms within the scope of work, the parameters affecting the adsorption of chlorinated pesticides in water are considered as pH, contact time, CNT type, CNT dose and initial concentration of pesticides. As a result, under conditions of neutral pH conditions with MWCNT respectively for atrazine and aldrin obtained adsorption capacity of determined as 2.24 µg/mg ve 3.84 µg/mg. On the other hand, the determined adsorption capacity rates for SWCNT for aldrin and atrazine has identified as 3.91 µg/mg ve 3.92 µg/mg. After all, each type of pesticide that provides superior performance in relieving SWCNT particles has emerged.

Keywords: pesticide, drinking water, carbon nanotube, adsorption

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1064 Immunohistochemical Expression of β-catenin and Epidermal Growth Factor Receptor in Adamantinomatous Craniopharyngioma

Authors: Ghada Esheba, Fatimah Alturkistani, Arwa Obaid, Ahdab Bashehab, Moayad Alturkistani

Abstract:

Introduction: Craniopharyngiomas (CPs) are rare epithelial tumors located mainly in the sellar/parasellar region. CPs have been classified histopathologically, genetically, clinically and prognostically into two distinctive subtypes: adamantinomatous and papillary variants. Aim: To examine the pattern of expression of both the β-catenin and epidermal growth factor receptor (EGFR) in surgically resected samples of adamantinomatous CP, and to asses for the possibility of using anti-EGFR in the management of ACP patients. Materials and methods: β-catenin and EGFR immunostaining was performed on paraffin-embedded tissue sections of 18 ACP cases. Result: 17 out of 18 cases (94%) of ACP exhibited strong nuclear/cytoplasmic expression of β-catenin, 15 (83%) of APC cases were positive for EGFR. Conclusion: Nuclear accumulation of β-catenin is a diagnostic hallmark of ACP. EGFR positivity in most cases of ACP could qualify the use of anti-EGFR therapy. 

Keywords: craniopharyngioma, adamantinomatous, papillary, epidermal growth factor receptor, B-catenin

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1063 A Relational Data Base for Radiation Therapy

Authors: Raffaele Danilo Esposito, Domingo Planes Meseguer, Maria Del Pilar Dorado Rodriguez

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As far as we know, it is still unavailable a commercial solution which would allow to manage, openly and configurable up to user needs, the huge amount of data generated in a modern Radiation Oncology Department. Currently, available information management systems are mainly focused on Record & Verify and clinical data, and only to a small extent on physical data. Thus, results in a partial and limited use of the actually available information. In the present work we describe the implementation at our department of a centralized information management system based on a web server. Our system manages both information generated during patient planning and treatment, and information of general interest for the whole department (i.e. treatment protocols, quality assurance protocols etc.). Our objective it to be able to analyze in a simple and efficient way all the available data and thus to obtain quantitative evaluations of our treatments. This would allow us to improve our work flow and protocols. To this end we have implemented a relational data base which would allow us to use in a practical and efficient way all the available information. As always we only use license free software.

Keywords: information management system, radiation oncology, medical physics, free software

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1062 A Systematic Review of the Transportability of Cognitive Therapy for the Treatment of PTSD among South African Survivors of Rape

Authors: Anita Padmanabhanunni

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Trauma-focused cognitive-treatment (CT) models are among the most efficacious in treating PTSD arising from exposure to rape. However, these treatment approaches are severely under-utilised by South African mental health care practitioners owing to concerns around whether treatments developed in Western clinical contexts are transportable and applicable in routine clinical settings. One way of promoting the use of these efficacious treatments in local contexts is by identifying and appraising the evidence from local outcome studies. This paper presents the findings of a systematic review of research evidence from local outcome studies on the effectiveness of CT in the treatment of rape-related PTSD in South Africa. The study found that whilst limited research has been published in South Africa on the outcome of CT in the treatment of rape survivors, the studies that are available afford insights into the effectiveness of CT.

Keywords: cognitive treatment, PTSD, South Africa, transportability

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1061 Optical Properties of N-(Hydroxymethyl) Acrylamide Polymer Gel Dosimeters for Radiation Therapy

Authors: Khalid A. Rabaeh, Belal Moftah, Ahmed A. Basfar, Akram A. Almousa

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Polymer gel dosimeters are tissue equivalent martial that fabricated from radiation sensitive chemicals which, upon irradiation, polymerize as a function of absorbed radiation dose. Polymer gel dosimeters can uniquely record the radiation dose distribution in three-dimensions (3D). A novel composition of normoxic polymer gel dosimeters based on radiation-induced polymerization of N-(Hydroxymethyl)acrylamide (NHMA) is introduced in this study for radiotherapy treatment planning. The dosimeters were irradiated by 10 MV photon beam of a medical linear accelerator at a constant dose rate of 600 cGy/min with doses up to 30 Gy. The polymerization degree is directly proportional to absorbed dose received by the polymer gel. UV/Vis spectrophotometer was used to investigate the degree of white color of irradiated NHMA gel which is associated to the degree of polymerization of polymer gel dosimeters. The absorbance increases with absorbed dose for all gel dosimeters in the dose range between 0 and 30 Gy. Dose rate , energy of radiation and the stability of the polymerization after irradiation were investigated. No appreciable effects of these parameters on the performance of the novel gel dosimeters were observed.

Keywords: dosimeter, gel, spectrophotometer, N-(Hydroxymethyl)acrylamide

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1060 The Effect of Cigarette Smoking on the Production of 20-Hydroxyeicosatetraenoic Acid in Human Platelet

Authors: Yazun Jarrar

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Smoking has effect on platelet aggregation and the activity of anti-platelet drugs. The chemical 20-hydroxyeicosatetraenoic acid (20-HETE) is a cardiotoxic arachidonic acid metabolite which increases platelet aggregation. In this study, we investigated the influence of cigarette smoking on 20-HETE levels and protein expression of 20-HETE producing enzyme CYP4A11 in isolated platelets from smoker and non-smoker volunteers. The protein expression and 20-HETE levels were analyzed using immunoblot and High-Performance Liquid Chromatography with Mass Spectrometry (HPL-MS) assays. The results showed that 20-HETE level was higher significantly among smokers than non-smokers (t-test, p-value<0.05). The protein expression of CYP4A11 was significantly higher (t-test, p-value<0.05) among the platelets of smokers. We concluded that cigarette smoking increased the level of platelet activator 20-HETE through increasing the protein expression of CYP4A11. These findings may increase the understanding of smoking-drug interaction during antiplatelets therapy.

Keywords: smoking, 20-HETE, CYP4A11, platelet

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1059 Numerical Investigation of Heat Transfer in Laser Irradiated Biological Samplebased on Dual-Phase-Lag Heat Conduction Model Using Lattice Boltzmann Method

Authors: Shashank Patidar, Sumit Kumar, Atul Srivastava, Suneet Singh

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Present work is concerned with the numerical investigation of thermal response of biological tissues during laser-based photo-thermal therapy for destroying cancerous/abnormal cells with minimal damage to the surrounding normal cells. Light propagation through the biological sample is mathematically modelled by transient radiative transfer equation. In the present work, application of the Lattice Boltzmann Method is extended to analyze transport of short-pulse radiation in a participating medium.In order to determine the two-dimensional temperature distribution inside the tissue medium, the RTE has been coupled with Penne’s bio-heat transfer equation based on Fourier’s law by several researchers in last few years.

Keywords: lattice Boltzmann method, transient radiation transfer equation, dual phase lag model

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1058 Ontology-Driven Generation of Radiation Protection Procedures

Authors: Chamseddine Barki, Salam Labidi, Hanen Boussi Rahmouni

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In this article, we present the principle and suitable methodology for the design of a medical ontology that highlights the radiological and dosimetric knowledge, applied in diagnostic radiology and radiation-therapy. Our ontology, which we named «Onto.Rap», is the subject of radiation protection in medical and radiology centers by providing a standardized regulatory oversight. Thanks to its added values of knowledge-sharing, reuse and the ease of maintenance, this ontology tends to solve many problems. Of which we name the confusion between radiological procedures a practitioner might face while performing a patient radiological exam. Adding to it, the difficulties they might have in interpreting applicable patient radioprotection standards. Here, the ontology, thanks to its concepts simplification and expressiveness capabilities, can ensure an efficient classification of radiological procedures. It also provides an explicit representation of the relations between the different components of the studied concept. In fact, an ontology based-radioprotection expert system, when used in radiological center, could implement systematic radioprotection best practices during patient exam and a regulatory compliance service auditing afterwards.

Keywords: knowledge, ontology, radiation protection, radiology

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1057 Traditional Herbal Medicine Used to Treat Infertility in Women by Traditional Practitioner of Malwa Region of Madhya Pradesh, India

Authors: Shweta Shriwas, Sumeet Dwivedi

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Knowledge of use of traditional medicine is as old as human civilization in almost every system of medicine. Traditional practitioner viz., vaidhayas, ojha, hakim have their own herbal therapy in the treatment of infertility among women’s. Infertility is very common in developed and developing countries due to busy life style of women’s. The present study was initiated with an aim to identify medicinal plants resources from traditional practitioners of Malwa region of Madhya Pradesh to treat infertility. An ethnomedicinal study of Malwa region viz., Indore, Dewas, Ratlam, Ujjain, Dhar, Mandsour and Neemuch of Madhya Pradesh, India comprising fifty-seven study site was conducted during Jan-217 to June-2017. During the course of present investigation, the traditional use of medicinal plants for infertility in women was revealed by traditional practitioner. The botanical name, family, local name, part used, habit along with mode of their administration and dose duration were enumerated.

Keywords: herbal medicine, infertility, traditional, Malwa, Madhya Pradesh

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1056 Spawning Induction and Early Larval Development of the Penshell Atrina maura (Sowerby, 1835) under Controlled Conditions in Ecuador

Authors: Jose Melena, Rosa Santander, Tanya Gonzalez, Richard Duque, Juan Illanes

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Ecuador is one of the countries with the greatest aquatic biodiversity worldwide. In particular, there are at least a dozen native marine species with great aquaculture potential locally. This research concerns one of those species. It has proposed to implement experimental protocols in order to induce spawning and to generate the early larval development of the penshell Atrina maura under controlled conditions. Bioassays were carried out with one adult batch (n= 26) with an average valvar length of 307,6 ± 9,4 mm, which were collected in the Puerto El Morro Mangrove (2° 42' 33'' S, 80° 14' 28'' W), Guayas Province. During a short acclimation stage, five adults of penshell A. maura were sacrificed in order to determine their sexual maturity degree and to estimate their sex ratio. Dissection showed that three were ripe females (60%) and two were ripe males (40%). Later, three groups (n= 7 by each) were tested with two treatments in order to induce the broodstock spawning: thermal stress, osmotic shock, and one control. Spawning induction was achieved by the immersion in water to 0 g L⁻¹ per 1 h and immersion in sea water to 34 g L⁻¹ per 1 h. After the delivery of gametes, it was achieved 1,35 × 10⁶ viable zygotes. As results, fertilized eggs had 60 µm diameter; while first and second cell divisions were observed to 1 h post-fertilization, with individual average length of 65 ± 4 µm and polar body. Latter cell divisions, including gastrula stage, appeared at 9 h post-fertilization, with individual average length of 71 ± 4 µm; and trochophore stage at 16 h post-fertilization with individual average length of 75 ± 5 µm. In addition, veliger stage was registered at 20 h post-fertilization with individual average length of 81 ± 5 µm. Umboned larvae appeared at day 8 post-fertilization, with individual average length of 145 ± 6 µm. These pioneering results in Ecuador can strengthen the local conservation process of the overexploited A. maura and to encourage its production for commercial purposes.

Keywords: Atrina maura, Ecuador, larval development, spawning induction

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1055 Magnetic Properties and Cytotoxicity of Ga-Mn Magnetic Ferrites Synthesized by the Citrate Sol-Gel Method

Authors: Javier Sánchez, Laura Elena De León Prado, Dora Alicia Cortés Hernández

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Magnetic spinel ferrites are materials that possess size, magnetic properties and heating ability adequate for their potential use in biomedical applications. The Mn0.5Ga0.5Fe2O4 magnetic nanoparticles (MNPs) were synthesized by sol-gel method using citric acid as chelating agent of metallic precursors. The synthesized samples were identified by X-Ray Diffraction (XRD) as an inverse spinel structure with no secondary phases. Saturation magnetization (Ms) of crystalline powders was 45.9 emu/g, which was higher than those corresponding to GaFe2O4 (14.2 emu/g) and MnFe2O4 (40.2 emu/g) synthesized under similar conditions, while the coercivity field (Hc) was 27.9 Oe. The average particle size was 18 ± 7 nm. The heating ability of the MNPs was enough to increase the surrounding temperature up to 43.5 °C in 7 min when a quantity of 4.5 mg of MNPs per mL of liquid medium was tested. Cytotoxic effect (hemolysis assay) of MNPs was determined and the results showed hemolytic values below 1% in all tested cases. According to the results obtained, these synthesized nanoparticles can be potentially used as thermoseeds for hyperthermia therapy.

Keywords: manganese-gallium ferrite, magnetic hyperthermia, heating ability, cytotoxicity

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1054 Leaching of Metal Cations from Basic Oxygen Furnace (BOF) Steelmaking Slag Immersed in Water

Authors: Umashankar Morya, Somnath Basu

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Metalloids like arsenic are often present as contaminants in industrial effluents. Removal of the same is essential before the safe discharge of the wastewater into the environment. Otherwise, these pollutants tend to percolate into aquifers over a period of time and contaminate drinking water sources. Several adsorbents, including metal powders, carbon nanotubes and zeolites, are being used for this purpose, with varying degrees of success. However, most of these solutions are not only costly but also not always readily available. This restricts their use, especially among financially weaker communities. Slag generated globally from primary steelmaking operations exceeds 200 billion kg every year. Some of it is utilized for applications like road construction, filler in reinforced concrete, railway track ballast and recycled into iron ore agglomeration processes. However, these usually involve low-value addition, and a significant amount of the slag still ends up in a landfill. However, there is a strong possibility that the constituents in the steelmaking slag may immobilize metalloid contaminants present in wastewater through a combination of adsorption and precipitation of insoluble product(s). Preliminary experiments have already indicated that exposure to basic oxygen steelmaking slag does reduce pollutant concentration in wastewater. In addition, the slag is relatively inexpensive and available in large quantities and in several countries across the world. Investigations on the mechanism of interactions at the water-solid interfaces have been in progress for some time. However, at the same time, there are concerns about the possibility of leaching of metal ions from the slag particles in concentrations greater than what exists in the water bodies where the “treated” wastewater would eventually be discharged. The effect of such leached ions on the aquatic flora and fauna is yet uncertain. This has prompted the present investigation, which focuses on the leaching of metal ions from steelmaking slag particles in contact with wastewater, and the influence of these ions on the removal of contaminant species. Experiments were carried out to quantify the leaching behavior of different ionic species upon exposure of the slag particles to simulated wastewater, both with and without specific metalloid contaminants.

Keywords: slag, water, metalloid, heavy metal, wastewater

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1053 Genetically Modified Organisms

Authors: Mudrika Singhal

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The research paper is basically about how the genetically modified organisms evolved and their significance in today’s world. It also highlights about the various pros and cons of the genetically modified organisms and the progress of India in this field. A genetically modified organism is the one whose genetic material has been altered using genetic engineering techniques. They have a wide range of uses such as transgenic plants, genetically modified mammals such as mouse and also in insects and aquatic life. Their use is rooted back to the time around 12,000 B.C. when humans domesticated plants and animals. At that humans used genetically modified organisms produced by the procedure of selective breeding and not by genetic engineering techniques. Selective breeding is the procedure in which selective traits are bred in plants and animals and then are domesticated. Domestication of wild plants into a suitable cultigen is a well known example of this technique. GMOs have uses in varied fields ranging from biological and medical research, production of pharmaceutical drugs to agricultural fields. The first organisms to be genetically modified were the microbes because of their simpler genetics. At present the genetically modified protein insulin is used to treat diabetes. In the case of plants transgenic plants, genetically modified crops and cisgenic plants are the examples of genetic modification. In the case of mammals, transgenic animals such as mice, rats etc. serve various purposes such as researching human diseases, improvement in animal health etc. Now coming upon the pros and cons related to the genetically modified organisms, pros include crops with higher yield, less growth time and more predictable in comparison to traditional breeding. Cons include that they are dangerous to mammals such as rats, these products contain protein which would trigger allergic reactions. In India presently, group of GMOs include GM microorganisms, transgenic crops and animals. There are varied applications in the field of healthcare and agriculture. In the nutshell, the research paper is about the progress in the field of genetic modification, taking along the effects in today’s world.

Keywords: applications, mammals, transgenic, engineering and technology

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1052 Reverse Osmosis Application on Sewage Tertiary Treatment

Authors: Elisa K. Schoenell, Cristiano De Oliveira, Luiz R. H. Dos Santos, Alexandre Giacobbo, Andréa M. Bernardes, Marco A. S. Rodrigues

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Water is an indispensable natural resource, which must be preserved to human activities as well the ecosystems. However, the sewage discharge has been contaminating water resources. Conventional treatment, such as physicochemical treatment followed by biological processes, has not been efficient to the complete degradation of persistent organic compounds, such as medicines and hormones. Therefore, the use of advanced technologies to sewage treatment has become urgent and necessary. The aim of this study was to apply Reverse Osmosis (RO) on sewage tertiary treatment from a Waste Water Treatment Plant (WWTP) in south Brazil. It was collected 200 L of sewage pre-treated by wetland with aquatic macrophytes. The sewage was treated in a RO pilot plant, using a polyamide membrane BW30-4040 model (DOW FILMTEC), with 7.2 m² membrane area. In order to avoid damage to the equipment, this system contains a pleated polyester filter with 5 µm pore size. It was applied 8 bar until achieve 5 times of concentration, obtaining 80% of recovery of permeate, with 10 L.min-1 of concentrate flow rate. Samples of sewage pre-treated on WWTP, permeate and concentrate generated on RO was analyzed for physicochemical parameters and by gas chromatography (GC) to qualitative analysis of organic compounds. The results proved that the sewage treated on WWTP does not comply with the limit of phosphorus and nitrogen of Brazilian legislation. Besides this, it was found many organic compounds in this sewage, such as benzene, which is carcinogenic. Analyzing permeate results, it was verified that the RO as sewage tertiary treatment was efficient to remove of physicochemical parameters, achieving 100% of iron, copper, zinc and phosphorus removal, 98% of color removal, 91% of BOD and 62% of ammoniacal nitrogen. RO was capable of removing organic compounds, however, it was verified the presence of some organic compounds on de RO permeate, showing that RO did not have the capacity of removal all organic compounds of sewage. It has to be considered that permeate showed lower intensity of peaks in chromatogram in comparison to the sewage of WWTP. It is important to note that the concentrate generate on RO needs a treatment before its disposal in environment.

Keywords: organic compounds, reverse osmosis, sewage treatment, tertiary treatment

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1051 Challenges of Water License in Agriculture Sector in British Columbia: An Exploratory Sociological Inquiry

Authors: Mandana Karimi, Martha McMahon

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One of the most important consequences of water scarcity worldwide is the increase in conflicts over water issues, reduced access to clean water, food shortages, energy shortages, and reduced economic development. The extreme weather conditions in British Columbia are because of climate change, which is leading to water scarcity becoming a serious issue affecting British Columbians, aquatic ecosystems, the BC water policy, agriculture, and the economy. In light of climate change and water stress, the British Columbia government introduced a new water legislation in 2016 named the Water Sustainability Act to manage water resources in British Columbia. So, this study aimed to present a deep understanding emanating from the political and social dimensions of the new water policy in BC in the agriculture sector and which sociological paradigm governs the current water policy (WSA) in BC. Policy analysis based on the water problem representation approach was used to present the problem and solutions identified by the water policy in the agricultural sector in BC. The results of the policy analysis highlighted that the Water Sustainability Act is governed by a positivist and modernist approach because the groundwater license is the measurable situation to access the adequate quantity of water for the farmers. In addition, by the positivist paradigm water resources are conceptualized as a commodity to be bought and sold. Under the positivist approach, the measurable parameter of groundwater is also applied based on the top-down approach for water management to show the use of water resources for economic development. In addition, the findings of the policy analysis suggest that alternative paradigms, such as relational ontology, ecofeminism, and indigenous knowledge, could be applied in introducing water policies to shift from the positivist or modernist paradigm. These new paradigms present the potential for environmental policies like the Water Sustainability Act, based on partnership, and collaboration and with an explicit emphasis on protecting water for nature.

Keywords: water governance, Water Sustainability Act, water policy, small-scale farmer, policy analysis

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1050 Improved Approach to the Treatment of Resistant Breast Cancer

Authors: Lola T. Alimkhodjaeva, Lola T. Zakirova, Soniya S. Ziyavidenova

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Background: Breast cancer (BC) is still one of the urgent oncology problems. The essential obstacle to the full anti-tumor therapy implementation is drug resistance development. Taking into account the fact that chemotherapy is main antitumor treatment in BC patients, the important task is to improve treatment results. Certain success in overcoming this situation has been associated with the use of methods of extracorporeal blood treatment (ECBT), plasmapheresis. Materials and Methods: We examined 129 women with resistant BC stages 3-4, aged between 56 to 62 years who had previously received 2 courses of CAF chemotherapy. All patients additionally underwent 2 courses of CAF chemotherapy but against the background ECBT with ultrasonic exposure. We studied the following parameters: 1. The highlights of peripheral blood before and after therapy. 2. The state of cellular immunity and identification of activation markers CD23 +, CD25 +, CD38 +, CD95 + on lymphocytes was performed using monoclonal antibodies. Evaluation of humoral immunity was determined by the level of main classes of immunoglobulins IgG, IgA, IgM in serum. 3. The degree of tumor regression was assessed by WHO recommended 4 gradations. (complete - 100%, partial - more than 50% of initial size, process stabilization–regression is less than 50% of initial size and tumor advance progressing). 4. Medical pathomorphism in the tumor was determined by Lavnikova. 5. The study of immediate and remote results, up to 3 years and more. Results and Discussion: After performing extracorporeal blood treatment anemia occurred in 38.9%, leukopenia in 36.8%, thrombocytopenia in 34.6%, hypolymphemia in 26.8%. Studies of immunoglobulin fractions in blood serum were able to establish a certain relationship between the classes of immunoglobulin A, G, M and their functions. The results showed that after treatment the values of main immunoglobulins in patients’ serum approximated to normal. Analysis of expression of activation markers CD25 + cells bearing receptors for IL-2 (IL-2Rα chain) and CD95 + lymphocytes that were mediated physiological apoptosis showed the tendency to increase, which apparently was due to activation of cellular immunity cytokines allocated by ultrasonic treatment. To carry out ECBT on the background of ultrasonic treatment improved the parameters of the immune system, which were expressed in stimulation of cellular immunity and correcting imbalances in humoral immunity. The key indicator of conducted treatment efficiency is the immediate result measured by the degree of tumor regression. After ECBT performance the complete regression was 10.3%, partial response - 55.5%, process stabilization - 34.5%, tumor advance progressing no observed. Morphological investigations of tumor determined therapeutic pathomorphism grade 2 in 15%, in 25% - grade 3 and therapeutic pathomorphism grade 4 in 60% of patients. One of the main criteria for the effect of conducted treatment is to study the remission terms in the postoperative period (up to 3 years or more). The remission terms up to 3 years with ECBT was 34.5%, 5-year survival was 54%. Carried out research suggests that a comprehensive study of immunological and clinical course of breast cancer allows the differentiated approach to the choice of methods for effective treatment.

Keywords: breast cancer, immunoglobulins, extracorporeal blood treatment, chemotherapy

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1049 Owning (up to) the 'Art of the Insane': Re-Claiming Personhood through Copyright Law

Authors: Mathilde Pavis

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From Schumann to Van Gogh, Frida Kahlo, and Ray Charles, the stories narrating the careers of artists with physical or mental disabilities are becoming increasingly popular. From the emergence of ‘pathography’ at the end of 18th century to cinematographic portrayals, the work and lives of differently-abled creative individuals continue to fascinate readers, spectators and researchers. The achievements of those artists form the tip of the iceberg composed of complex politico-cultural movements which continue to advocate for wider recognition of disabled artists’ contribution to western culture. This paper envisages copyright law as a potential tool to such end. It investigates the array of rights available to artists with intellectual disabilities to assert their position as authors of their artwork in the twenty-first-century looking at international and national copyright laws (UK and US). Put simply, this paper questions whether an artist’s intellectual disability could be a barrier to assert their intellectual property rights over their creation. From a legal perspective, basic principles of non-discrimination would contradict the representation of artists’ disability as an obstacle to authorship as granted by intellectual property laws. Yet empirical studies reveal that artists with intellectual disabilities are often denied the opportunity to exercise their intellectual property rights or any form of agency over their work. In practice, it appears that, unlike other non-disabled artists, the prospect for differently-abled creators to make use of their right is contingent to the context in which the creative process takes place. Often will the management of such rights rest with the institution, art therapist or mediator involved in the artists’ work as the latter will have necessitated greater support than their non-disabled peers for a variety of reasons, either medical or practical. Moreover, the financial setbacks suffered by medical institutions and private therapy practices have renewed administrators’ and physicians’ interest in monetising the artworks produced under their supervision. Adding to those economic incentives, the rise of criminal and civil litigation in psychiatric cases has also encouraged the retention of patients’ work by therapists who feel compelled to keep comprehensive medical records to shield themselves from liability in the event of a lawsuit. Unspoken transactions, contracts, implied agreements and consent forms have thus progressively made their way into the relationship between those artists and their therapists or assistants, disregarding any notions of copyright. The question of artists’ authorship finds itself caught in an unusually multi-faceted web of issues formed by tightening purse strings, ethical concerns and the fear of civil or criminal liability. Whilst those issues are playing out behind closed doors, the popularity of what was once called the ‘Art of the Insane’ continues to grow and open new commercial avenues. This socio-economic context exacerbates the need to devise a legal framework able to help practitioners, artists and their advocates navigate through those issues in such a way that neither this minority nor our cultural heritage suffers from the fragmentation of the legal protection available to them.

Keywords: authorship, copyright law, intellectual disabilities, art therapy and mediation

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1048 Traditional Medicines Used for the Enhancement of Male Sexual Performance among the Indigenous Populations of Madhya Pradesh, India

Authors: A. N. Sharma

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A traditional medicine comprises a knowledge system, practices related to the cure of various ailments that developed over generations by indigenous people or populations. The indigenous populations developed a unique understanding with wild plants, herbs, etc., and earned specialized knowledge of disease pattern and curative therapy-though hard experiences, common sense, trial, and error methods. Here, an attempt has been made to study the possible aspects of traditional medicines for the enhancement of male sexual performance among the indigenous populations of Madhya Pradesh, India. Madhya Pradesh state is situated more or less in the central part of India. The data have been collected from the 305 Bharias of Patalkot, traditional health service providers of Sagar district, and other indigenous populations of Madhya Pradesh. It may be concluded that sizable traditional medicines exist in Madhya Pradesh, India, for the enhancement of male sexual performance, which still awaits for scientific exploration and intensive pharmaceutical investigations.

Keywords: Bharias, indigenous, Madhya Pradesh, sexual performance, traditional medicine

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1047 The Role of Dentists in the Management of Obstructive Sleep Apnoea

Authors: David Parmenter, Brian Millar

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Obstructive sleep apnoea is a common condition which is generally under-diagnosed. Poorly managed obstructive sleep apnoea carries serious health risks and can greatly impact on the sufferer's quality of life. This publication covers the aetiology, symptoms, and treatment of sleep apnoea. The treatment of Obstructive Sleep Apnoea is an emerging field, and the useful role of the Dental Team is relatively unknown, therefor this paper will highlight the role of the dental team in its treatment. The concept of mandibular advancement appliances, along with the clinical and laboratory stages for constructing them, are documented. It is the hope of the author that this publication will educate healthcare professionals on the role of dental practitioners in the multidisciplinary team for treating sleep apnoea. Objective: Individuals should be more aware of the demographic of patients at risk of sleep apnoea, how it is diagnosed and which group of sleep apnoea patients are suitable to refer for mandibular appliance therapy. Individuals should also be aware of what a mandibular advancement appliance is and how it helps treat obstructive sleep apnoea.

Keywords: sleep apnoea, snoring, sleep appliances, mandibular advancement appliance

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1046 Malaria Menace in Pregnancy; Hard to Ignore

Authors: Nautiyal Ruchira, Nautiyal Hemant, Chaudhury Devnanda, Bhargava Surbhi, Chauhan Nidhi

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Introduction: South East Asian region contributes 2.5 million cases of malaria each year to the global burden of 300 to 500 million of which 76% is reported from India. Government of India launched a national program almost half a century ago, still malaria remains a major public health challenge. Pregnant women are more susceptible to severe malaria and its fetomaternal complications. Inadequate surveillance and under-reporting underestimates the problem. Aim: Present study aimed to analyze the clinical course and pattern of malaria during pregnancy and to study the feto-maternal outcome. Methodology: This is a prospective observational study carried out at Himalayan Institute of Medical Sciences – a tertiary care center in the sub-Himalayan state of Uttarakhand, Northern India. All the pregnant women with malaria and its complications were recruited in the study during 2009 to 2014 which included referred cases from the state of western Uttar Pradesh. A thorough history and clinical examination were carried out to assess maternal and fetal condition. Relevant investigations including haemogram, platelet count, LFT, RFT, and USG was done. Blood slides and rapid diagnostic tests were done to diagnose the type of malaria.The primary outcomes measured were the type of malaria infection, maternal complications associated with malaria, outcome of pregnancy and effect on the fetus. Results: 67 antenatal cases with malaria infection were studied. 71% patients were diagnosed with plasmodium vivax infection, 25% cases were plasmodium falciparum positive and in 3% cases mixed infection was found. 38(56%) patients were primigravida and 29(43%) were multiparous. Most of the patients had already received some treatment from their local doctors and presented with severe malaria with the complications. Thrombocytopenia was the commonest manifestation seen in 35(52%) patients, jaundice in 28%, severe anemia in 18%, and severe oligohydramnios in 10% and renal failure in 6% cases. Regarding pregnancy outcome there were 44 % preterm deliveries, 22% had IUFD and abortions in 6% cases.20% of newborn were low birth weight and 6% were IUGR. There was only one maternal death which occurred due to ARDS in falciparum malaria. Although Plasmodium vivax was the main parasite considering the severity of clinical presentation, all the patients received intensive care. As most of the patients had received chloroquine therapy hence they were treated with IV artesunate followed by oral artemesinin combination therapy. Other therapies in the form of packed RBC’s and platelet transfusions, dialysis and ventilator support were provided when required. Conclusion: Even in areas with annual parasite index (API) less than 2 like ours, malaria in pregnancy could be an alarming problem. Vivax malaria cannot be considered benign in pregnancy because of high incidence of morbidity. Prompt diagnosis and aggressive treatment can reduce morbidity and mortality significantly. Increased community level research, integrating ANC checkups with the distribution of insecticide-treated nets in areas of high endemicity, imparting education and awareness will strengthen the existing control strategies.

Keywords: severe malaria, pregnancy, plasmodium vivax, plasmodium falciparum

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1045 Decreasing the Oxidative Stress in Autistic Children: A Randomized Double-Blind Controlled Study With Palm Dates Fruit

Authors: Ammal Mokhtar Metwally, Amal Elsaied, Ghada A. Abdel-Latef, Ebtissam M. Salah El-Din, Hanaa R. M. Attia

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The link between various diet therapies and autism is controversial and limited. Nutritional interventions aim to increase antioxidant levels suggesting a positive effect on the improvement of autism severity. In this study, the effectiveness of a 90-day Dates fruits consumption fruits (a non-pharmacological and risk-free option) on alleviating autism severity symptoms in individuals with ASD was investigated. The study examined also whether the baseline or improvements of some of the clinical and laboratory characteristics of the subjects affected their response to dates fruits intake on the severity of ASD symptoms. Methodology: This study involved a randomized controlled, double-blind 3-month dates fruits intake. 131 Egyptian children aged 3-12 years with confirmed ASD were enrolled in the study. cases were randomized in one of the three groups as follows; 1st regimen: Group I on 3 dates’ fruits/day (47 cases), 2nd regimen: Group II on 5 dates’ fruits/day (42 cases), and 3rd regimen: group III; nondates group (42 cases). ASD severity was assessed using both the Diagnostic and statistical manual of mental disorders, 5th ed. (DSM-V) criteria and the Childhood Autism Rating Scale (CARS) analysis. The following measures were assessed before and after the regimens: blood levels of three oxidative markers; Malondialdehyde (MDA), glutathione peroxidase (GPX1), and superoxide dismutase (SOD), nutritional, dietary assessment & anthropometric measurements Results: A significant reduction in the mean score of autism was detected based on CARS scores for those on dates’ regimens compared to those on non-dates (p < 0.01). Participants on 5 dates’ fruits/day for three months showed the highest improvement for autism severity based on both CARS and DSM5 compared to those in 3 dates’ fruits/day and non-dates groups. Responders to dates fruits intake as reflected on the Improvement of autism severity based on CARS diagnosis was detected among 78.7 % and 62.9 % based on CARS and DSM5 diagnosis, respectively. Responders had significant improvement in BMI z score and in the ratio levels of both MDA/SOD and MDA/GPX. Conclusion: The positive results of this study suggest that palm dates fruits could be recommended for children with ASD as adjuvant therapy on a daily regular basis to achieve consistent improvement of autism symptoms Objective: Investigate the effectiveness of a 90-day Dates fruits consumption fruits on alleviating autism severity symptoms in individuals with ASD and explore the clinical and laboratory characteristics of the subjects affected their response to dates fruits intake. Methodology: The study was a randomized controlled, double-blind for 3-month. 131 autistic Egyptian children aged 3-12 years were enrolled in one of the three groups; 1st: on 3 dates’ fruits/day (47 cases), 2nd: Group II on 5 dates’ fruits/day (42 cases), and 3rd: group III; nondates group (42 cases). Conclusion: The positive results of this study suggest that palm dates fruit (a non-pharmacological and risk-free option) could be recommended for children with ASD as adjuvant therapy on a daily regular basis to achieve consistent improvement of autism symptoms.

Keywords: autism spectrum disorders, palm dates fruits, CARS, DSM5, oxidative markers

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1044 Neural Network Based Decision Trees Using Machine Learning for Alzheimer's Diagnosis

Authors: P. S. Jagadeesh Kumar, Tracy Lin Huan, S. Meenakshi Sundaram

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Alzheimer’s disease is one of the prevalent kind of ailment, expected for impudent reconciliation or an effectual therapy is to be accredited hitherto. Probable detonation of patients in the upcoming years, and consequently an enormous deal of apprehension in early discovery of the disorder, this will conceivably chaperon to enhanced healing outcomes. Complex impetuosity of the brain is an observant symbolic of the disease and a unique recognition of genetic sign of the disease. Machine learning alongside deep learning and decision tree reinforces the aptitude to absorb characteristics from multi-dimensional data’s and thus simplifies automatic classification of Alzheimer’s disease. Susceptible testing was prophesied and realized in training the prospect of Alzheimer’s disease classification built on machine learning advances. It was shrewd that the decision trees trained with deep neural network fashioned the excellent results parallel to related pattern classification.

Keywords: Alzheimer's diagnosis, decision trees, deep neural network, machine learning, pattern classification

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1043 A Combined Fiber-Optic Surface Plasmon Resonance and Ta2O5: rGO Nanocomposite Synergistic Scheme for Trace Detection of Insecticide Fenitrothion

Authors: Ravi Kant, Banshi D. Gupta

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The unbridled application of insecticides to enhance agricultural yield has become a matter of grave concern to both the environment and the human health and, thus pose a potential threat to sustainable development. Fenitrothion is an extensively used organophosphate insecticide whose residues are reported to be extremely toxic for birds, humans and aquatic life. A sensitive, swift and accurate detection protocol for fenitrothion is, thus, highly demanded. In this work, we report an SPR based fiber optic sensor for the detection of fenitrothion, where a nanocomposite arrangement of Ta2O5 and reduced graphene oxide (rGO) (Ta₂O₅: rGO) decorated on silver coated unclad core region of an optical fiber forms the sensing channel. A nanocomposite arrangement synergistically integrates the properties of involved components and consequently furnishes a conducive framework for sensing applications. The modification of the dielectric function of the sensing layer on exposure to fenitrothion solutions of diverse concentration forms the sensing mechanism. This modification is reflected in terms of the shift in resonance wavelength. Experimental variables such as the concentration of rGO in the nanocomposite configuration, dip time of silver coated fiber optic probe for deposition of sensing layer and influence of pH on the performance of the sensor have been optimized to extract the best performance of the sensor. SPR studies on the optimized sensing probe reveal the high sensitivity, wide operating range and good reproducibility of the fabricated sensor, which unveil the promising utility of Ta₂O₅: rGO nanocomposite framework for developing an efficient detection methodology for fenitrothion. FOSPR approach in cooperation with nanomaterials projects the present work as a beneficial approach for fenitrothion detection by imparting numerous useful advantages such as sensitivity, selectivity, compactness and cost-effectiveness.

Keywords: surface plasmon resonance, optical fiber, sensor, fenitrothion

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1042 Parent’s Preferences about Technology-Based Therapy for Children and Young People on the Autism Spectrum – a UK Survey

Authors: Athanasia Kouroupa, Karen Irvine, Sivana Mengoni, Shivani Sharma

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Exploring parents’ preferences towards technology-based interventions for children on the autism spectrum can inform future research and support technology design. The study aimed to provide a comprehensive description of parents’ knowledge and preferences about innovative technology to support children on the autism spectrum. Survey data were collected from parents (n = 267) internationally. The survey included information about the use of conventional (e.g., smartphone, iPod, tablets) and non-conventional (e.g., virtual reality, robot) technologies. Parents appeared to prefer conventional technologies such as tablets and dislike non-conventional ones. They highlighted the positive contribution technology brought to the children’s lives during the pandemic. A few parents were equally concerned that the compulsory introduction of technology during the pandemic was associated with elongated time on devices. The data suggested that technology-based interventions are not widely known, need to be financially approachable and achieve a high standard of design to engage users.

Keywords: autism, intervention, preferences, technology

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1041 Portable Glove Controlled Video Game for Hand Rehabilitation

Authors: Vinesh Janarthanan, Mohammad H. Rahman

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There are numerous neurological conditions that may result in a loss of motor function. Such conditions may include cerebral palsy, Parkinson’s disease, stroke or multiple sclerosis. Due to impaired motor function, specifically in the hand and arm, living independently becomes tremendously more difficult. Rehabilitation programs are the main method to treat these kinds of disabled individuals. However, these programs require longtime commitment from the clinicians/therapists, demand person to person caring, and typically the treatment duration is usually very long. Aside from the treatment received from the therapist, the continuation of neuroplasticity at home is essential to maximizing development and restoring the biological function. To contribute in this area, we have researched and developed a portable and comfortable hand glove for fine motor skills rehabilitation. The glove provides interactive home-based therapy to engage the patient with simple games. The key to this treatment is the repetition of moving the hand and being capable of positioning the hand in various ways.

Keywords: home based, wearable sensors, glove, rehabilitation, motor function, video games

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1040 Ovarian Stimulation and Oocyte Cryopreservation for Fertility Preservation in Adolescent Females at the Royal Children’s Hospital: A Case Series

Authors: Kira Merigan

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BACKGROUND- Fertility preservation (FP) measures are increasingly recognised as an important consideration for children and adolescents planned to undergo potentially damaging gonadotoxic therapy. Worldwide, there are very few documented cases of FP in young females by way of ovarian stimulation and oocyte cryopreservation.AIM – To report a case series of mature oocyte cryopreservation in 5post-pubertal adolescents aged 14-17 years old, with varied medical conditions requiring gonadotoxic treatment. SETTING-These cases took place via a multidisciplinary team approach at The Royal Children’s Hospital, a large tertiary centre in Melbourne, Australia. INTERVENTION– Ovarian stimulation and oocyte collection was performed as detailed in each case. RESULTS –Across the 5 patients, 3-28 oocytes were retrieved. We report pre-treatment workup, complications, and delays to treatment. CONCLUSION- Oocyte cryopreservation may be a safe alternative to ovarian tissue cryopreservation (OTC) in the adolescent population

Keywords: fertility preservation, adolescent, ovarian stimulation, oocyte cryopreservation

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1039 Magnetic Carriers of Organic Selenium (IV) Compounds: Physicochemical Properties and Possible Applications in Anticancer Therapy

Authors: E. Mosiniewicz-Szablewska, P. Suchocki, P. C. Morais

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Despite the significant progress in cancer treatment, there is a need to search for new therapeutic methods in order to minimize side effects. Chemotherapy, the main current method of treating cancer, is non-selective and has a number of limitations. Toxicity to healthy cells is undoubtedly the biggest problem limiting the use of many anticancer drugs. The problem of how to kill cancer without harming a patient can be solved by using organic selenium (IV) compounds. Organic selenium (IV) compounds are a new class of materials showing a strong anticancer activity. They are first organic compounds containing selenium at the +4 oxidation level and therefore they eliminate the multidrug-resistance for all tumor cell lines tested so far. These materials are capable of selectively killing cancer cells without damaging the healthy ones. They are obtained by the incorporation of selenous acid (H2SeO3) into molecules of fatty acids of sunflower oil and therefore, they are inexpensive to manufacture. Attaching these compounds to magnetic carriers enables their precise delivery directly to the tumor area and the simultaneous application of the magnetic hyperthermia, thus creating a huge opportunity to effectively get rid of the tumor without any side effects. Polylactic-co-glicolic acid (PLGA) nanocapsules loaded with maghemite (-Fe2O3) nanoparticles and organic selenium (IV) compounds are successfully prepared by nanoprecipitation method. In vitro antitumor activity of the nanocapsules were evidenced using murine melanoma (B16-F10), oral squamos carcinoma (OSCC) and murine (4T1) and human (MCF-7) breast lines. Further exposure of these cells to an alternating magnetic field increased the antitumor effect of nanocapsules. Moreover, the nanocapsules presented antitumor effect while not affecting normal cells. Magnetic properties of the nanocapsules were investigated by means of dc magnetization, ac susceptibility and electron spin resonance (ESR) measurements. The nanocapsules presented a typical superparamagnetic behavior around room temperature manifested itself by the split between zero field-cooled/field-cooled (ZFC/FC) magnetization curves and the absence of hysteresis on the field-dependent magnetization curve above the blocking temperature. Moreover, the blocking temperature decreased with increasing applied magnetic field. The superparamagnetic character of the nanocapsules was also confirmed by the occurrence of a maximum in temperature dependences of both real ′(T) and imaginary ′′ (T) components of the ac magnetic susceptibility, which shifted towards higher temperatures with increasing frequency. Additionally, upon decreasing the temperature the ESR signal shifted to lower fields and gradually broadened following closely the predictions for the ESR of superparamagnetoc nanoparticles. The observed superparamagnetic properties of nanocapsules enable their simple manipulation by means of magnetic field gradient, after introduction into the blood stream, which is a necessary condition for their use as magnetic drug carriers. The observed anticancer and superparamgnetic properties show that the magnetic nanocapsules loaded with organic selenium (IV) compounds should be considered as an effective material system for magnetic drug delivery and magnetohyperthermia inductor in antitumor therapy.

Keywords: cancer treatment, magnetic drug delivery system, nanomaterials, nanotechnology

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1038 Breast Cancer Therapy-Related Cardiac Dysfunction Identifying in Kazakhstan: Preliminary Findings of the Cohort Study

Authors: Saule Balmagambetova, Zhenisgul Tlegenova, Saule Madinova

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Cardiotoxicity associated with anticancer treatment, now defined as cancer therapy-related cardiac dysfunction (CTRCD), accompanies cancer patients and negatively impacts their survivorship. Currently, a cardio-oncological service is being created in Kazakhstan based on the provisions of the European Society of Cardio-oncology (ESC) Guidelines. In the frames of a pilot project, a cohort study on CTRCD conditions was initiated at the Aktobe Cancer center. One hundred twenty-eight newly diagnosed breast cancer patients started on doxorubicin and/or trastuzumab were recruited. Echocardiography with global longitudinal strain (GLS) assessment, biomarkers panel (cardiac troponin (cTnI), brain natriuretic peptide (BNP), myeloperoxidase (MPO), galectin-3 (Gal-3), D-dimers, C-reactive protein (CRP)), and other tests were performed at baseline and every three months. Patients were stratified by the cardiovascular risks according to the ESC recommendations and allocated into the risk groups during the pre-treatment visit. Of them, 10 (7.8%) patients were assigned to the high-risk group, 48 (37.5%) to the medium-risk group, and 70 (54.7%) to the low-risk group, respectively. High-risk patients have been receiving their cardioprotective treatment from the outset. Patients were also divided by treatment - in the anthracycline-based 83 (64.8%), in trastuzumab- only 13 (10.2%), and in the mixed anthracycline/trastuzumab group 32 individuals (25%), respectively. Mild symptomatic CTRCD was revealed and treated in 2 (1.6%) participants, and a mild asymptomatic variant in 26 (20.5%). Mild asymptomatic conditions are defined as left ventricular ejection fraction (LVEF) ≥50% and further relative reduction in GLS by >15% from baseline and/or a further rise in cardiac biomarkers. The listed biomarkers were assessed longitudinally in repeated-measures linear regression models during 12 months of observation. The associations between changes in biomarkers and CTRCD and between changes in biomarkers and LVEF were evaluated. Analysis by risk groups revealed statistically significant differences in baseline LVEF scores (p 0.001), BNP (p 0.0075), and Gal-3 (p 0.0073). Treatment groups found no statistically significant differences at baseline. After 12 months of follow-up, only LVEF values showed a statistically significant difference by risk groups (p 0.0011). When assessing the temporal changes in the studied parameters for all treatment groups, there were statistically significant changes from visit to visit for LVEF (p 0.003); GLS (p 0.0001); BNP (p<0.00001); MPO (p<0.0001); and Gal-3 (p<0.0001). No moderate or strong correlations were found between the biomarkers values and LVEF, between biomarkers and GLS. Between the biomarkers themselves, a moderate, close to strong correlation was established between cTnI and D-dimer (r 0.65, p<0.05). The dose-dependent effect of anthracyclines has been confirmed: the summary dose has a moderate negative impact on GLS values: -r 0.31 for all treatment groups (p<0.05). The present study found myeloperoxidase as a promising biomarker of cardiac dysfunction in the mixed anthracycline/trastuzumab treatment group. The hazard of CTRCD increased by 24% (HR 1.21; 95% CI 1.01;1.73) per doubling in baseline MPO value (p 0.041). Increases in BNP were also associated with CTRCD (HR per doubling, 1.22; 95% CI 1.12;1.69). No cases of chemotherapy discontinuation due to cardiotoxic complications have been recorded. Further observations are needed to gain insight into the ability of biomarkers to predict CTRCD onset.

Keywords: breast cancer, chemotherapy, cardiotoxicity, Kazakhstan

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