Risk Communication Strategies for Possible Health Risks From Radio-Frequency Electromagnetic Fields (RF-EMF) Emission by Telecommunication Structures.

There is widespread anxiety and speculation about RF-EMF emissions by telecommunication base stations and structures, as it is perceived by some to be unsafe and a threat to public health. Scientists, medical experts, politicians, journalists, and mobile telecommunication company specialists are involved in an active debate on whether people are immune to RF or if we are gambling with our future. Interviews with 31 individuals from 7 stakeholder groups in Malaysia reveal that the residents' main concerns are that the telecommunication companies do not follow guidelines and as a result the telecommunication structures are constructed close to their homes, which they perceive as a threat to public health. Some residents also do not want these structures because of cultural reasons, while some are jealous over rental income received by the landlords. Meanwhile, the authorities entrusted with safe-guarding public health are involved in a blame game as there is no agency that is clearly in charge. The interviews also highlight that the current risk communication initiatives are more reactive rather than proactive, and that the authorities do not speak in one voice. Based on the outcome of the interviews, eleven recommendations are formulated to improve risk communication initiatives in Malaysia. The recommendations stress on repairing, building, and strengthening trust, because trust in agencies, along with credibility, determines risk communication initiatives' effectiveness. These strategies can also be effectively replicated across regions to deal with contestations over RF-EMF emissions and the impact on health.

Telementoring Demonstration in Craniofacial Surgery With HoloLens, Skype, and Three-Layer Facial Models.

BACKGROUND: Telementoring is the technology for providing surgical instruction from a remote place via a network. To demonstrate the use of telementoring in craniofacial surgery, Skype and a mixed reality device HoloLens were adopted, and 3-layer facial models had been developed. METHODS: A resident in hospital A used the model surgery under remote guidance by a mentor surgeon in hospital B 4 times on different dates. The straight-line between hospitals A and B is 250 km. The mentor gave the resident guidance via Skype and HoloLens, communicating by voice, and video of the surgical field, and providing reference data. RESULTS: There was no delay in voice communication and a delay of <0.5 seconds in the video. The resident was able to confirm the main landmarks of the surgical field and to grasp the situation without problems. The mentor could send appropriate instructions by voice, could point out a specific part by telestration function, and could draw lines on the 2-dimentional images pasted on the operator's field of vision. DISCUSSION: With the use of HoloLens, Skype, and the 3-layer models, it was possible to demonstrate telementoring. The risk of personal information leakage due to data interception seems to be very low because its data communication is encrypted with advanced encryption standard. CONCLUSION: This telementoring system has various advantages and many improvable aspects in the field of craniofacial surgery.

Simulation-Based Testing of Pager Interruptions During Laparoscopic Cholecystectomy.

OBJECTIVE: To determine if pager interruptions affect operative time, safety, or complications and management of pager issues during a simulated laparoscopic cholecystectomy. DESIGN: Twelve surgery resident volunteers were tested on a Simbionix Lap Mentor II simulator. Each resident performed 6 randomized simulated laparoscopic cholecystectomies; 3 with pager interruptions (INT) and 3 without pager interruptions (NO-INT). The pager interruptions were sent in the form of standardized patient vignettes and timed to distract the resident during dissection of the critical view of safety and clipping of the cystic duct. The residents were graded on a pass/fail scale for eliciting appropriate patient history and management of the pager issue. Data was extracted from the simulator for the following endpoints: operative time, safety metrics, and incidence of operative complications. The Mann-Whitney U test and contingency table analysis were used to compare the 2 groups (INT vs. NO-INT). SETTING: Level I trauma center; Simulation laboratory. PARTICIPANTS: Twelve general surgery residents. RESULTS: There was no significant difference between the 2 groups in any of the operative endpoints as measured by the simulator. However, in the INT group, only 25% of the time did the surgery residents both adequately address the issue and provide effective patient management in response to the pager interruption. CONCLUSION: Pager interruptions did not affect operative time, safety, or complications during the simulated procedure. However, there were significant failures in the appropriate evaluations and management of pager issues. Consideration for diversion of patient care issues to fellow residents not operating to improve quality and safety of patient care outside the operating room requires further study.

Keeping Communications Flowing During Large-scale Disasters: Leveraging Amateur Radio Innovations for Disaster Medicine.

Medical facilities may struggle to maintain effective communications during a major disaster. Natural and man-made disasters threaten connectivity by degrading or crippling Internet, cellular/mobile, and landline telephone services across wide areas. Communications among staff, between facilities, and to resources outside the disaster area may be lost for an extended time. A prototype communications system created by the National Library of Medicine (NLM) provides basic communication services that ensure essential connectivity in the face of widespread infrastructure loss. It leverages amateur radio to provide resilient email service to local users, enabling them to reach intact communications networks outside the disaster zone. Because amateur radio is inexpensive, always available, and sufficiently independent of terrestrial telecommunications infrastructure, it has often augmented telecommunications capabilities of medical facilities. NLM's solution is unique in that it provides end-user to end-user direct email communications, without requiring the intervention of a radio operator in the handling of the messages. Medical staff can exchange email among themselves and with others outside the communications blackout zone. The technology is portable, is deployable on short notice, and can be powered in a variety of ways to adapt to the circumstances of each crisis. (Disaster Med Public Health Preparedness. 2018;12:257-264).

Characterizing and Mapping of Exposure to Radiofrequency Electromagnetic Fields (20-3,000 Mhz) in Chengdu, China.

With radiofrequency exposure caused by electronic applications increasing, some members of the public are worrying about potential health risks. In this paper, methods of performing large-scale radiofrequency exposure evaluation are described. All studied sites were divided into three categories: commercial-area, residential-urban, and residential-rural. Then a series of site investigations were conducted on a car-mounted system in the years 2014 and 2015, aiming to characterize electric field exposure from 12 different radiofrequency sources. The results indicate that the studied environment is safe as indicated by exposure below guidelines and standards. The highest exposure measured in the 2 y of monitoring was from an FM source, 316.23 mV m. Telecommunication sources dominate exposure, contributing the most power density (65-90%). Meanwhile, intergroup differences are discussed and summarized. The spatial distributions of FM and GSM1800 exposure are demonstrated on a map. This study describes an approach for the assessment of the spatiotemporal pattern of radiofrequency exposures in Chengdu and facilitates the identification of any sources causing exposure above relevant guidelines and standards.

Implementation of a Voice Messaging System is Associated With Improved Time-to-Treatment and Overall Survival in Patients With Hepatocellular Carcinoma.

BACKGROUND: The diagnosis and treatment of cancer is a continuum, with multiple steps and interfaces between patients and providers allowing for potential delays in cancer recognition and subsequent treatment. The diagnosis and treatment of hepatocellular carcinoma (HCC) is especially prone to missteps along the continuum, leading to treatment delays due to non-tissue-based diagnosis and multiprovider treatments. The aim of this study was to evaluate outcome measures after implementation of a voice messaging system (VMS) designed to streamline patient referrals to downstream treatment physicians and ultimately reduce delays in HCC treatment, thereby improving outcome measures. METHODS: A retrospective study of outpatients with HCC was conducted in a safety net hospital between February 2008 and January 2012. In February 2010, VMS notification of HCC to the ordering physician and downstream treating physicians was implemented. Patients were divided into 2 groups: (1) preintervention: diagnosis 2 years before implementation or failure of notification following implementation, and (2) postintervention: diagnosis 2 years after implementation. Demographics, tumor characteristics, treatment, and survival were compared. RESULTS: This study included 96 patients diagnosed with HCC: 51 in the preintervention group and 45 in the postintervention group. The main cause of chronic liver disease was HCV infection, and no differences in symptoms, liver dysfunction, tumor characteristics, or treatment were observed between groups. The time from diagnosis to clinic contact (0.5 vs 2.9 months; P=.003) and time from detection to treatment (2.2 vs 5.5 months; P=.005) was significantly shorter after implementation of the VMS. Barcelona Clinic Liver Cancer stage A status (hazard ratio [HR], 3.1; 95% CI, 2, 6), treatment (HR, 1.9; 95% CI, 1, 4), and VMS (HR, 1.8; 95% CI, 1, 3) were independently associated with overall survival. Patients diagnosed after implementation of the VMS had a median survival of 28.5 versus 15.7 months (P=.02). CONCLUSIONS: Implementation of VMS reduces time to treatment and time to clinic visit. Reduction in time to treatment is associated with improved outcome independent of tumor stage, underlying liver function, and treatment.

Coding for stable transmission of W-band radio-over-fiber system using direct-beating of two independent lasers.

We demonstrate experimentally Manchester (MC) coding based W-band (75 - 110 GHz) radio-over-fiber (ROF) system to reduce the low-frequency-components (LFCs) signal distortion generated by two independent low-cost lasers using spectral shaping. Hence, a low-cost and higher performance W-band ROF system is achieved. In this system, direct-beating of two independent low-cost CW lasers without frequency tracking circuit (FTC) is used to generate the millimeter-wave. Approaches, such as delayed self-heterodyne interferometer and heterodyne beating are performed to characterize the optical-beating-interference sub-terahertz signal (OBIS). Furthermore, W-band ROF systems using MC coding and NRZ-OOK are compared and discussed.

Assessment of radio frequency exposures in schools, homes, and public places in Belgium.

Characterization of exposure from emerging radio frequency (RF) technologies in areas where children are present is important. Exposure to RF electromagnetic fields (EMF) was assessed in three "sensitive" microenvironments; namely, schools, homes, and public places located in urban environments and compared to exposure in offices. In situ assessment was conducted by performing spatial broadband and accurate narrowband measurements, providing 6-min averaged electric-field strengths. A distinction between internal (transmitters that are located indoors) and external (outdoor sources from broadcasting and telecommunication) sources was made. Ninety-four percent of the broadband measurements were below 1 V m(-1). The average and maximal total electric-field values in schools, homes, and public places were 0.2 and 3.2 V m(-1) (WiFi), 0.1 and 1.1 V m(-1) (telecommunication), and 0.6 and 2.4 V m(-1) (telecommunication), respectively, while for offices, average and maximal exposure were 0.9 and 3.3 V m(-1) (telecommunication), satisfying the ICNIRP reference levels. In the schools considered, the highest maximal and average field values were due to internal signals (WiFi). In the homes, public places, and offices considered, the highest maximal and average field values originated from telecommunication signals. Lowest exposures were obtained in homes. Internal sources contributed on average more indoors (31.2%) than outdoors (2.3%), while the average contributions of external sources (broadcast and telecommunication sources) were higher outdoors (97.7%) than at indoor positions (68.8%). FM, GSM, and UMTS dominate the total downlink exposure in the outdoor measurements. In indoor measurements, FM, GSM, and WiFi dominate the total exposure. The average contribution of the emerging technology LTE was only 0.6%.

All-optical non-conjugated wavelength multicasting of QPSK signal with capability of phase regeneration.

We propose all-optical one-to-three non-conjugated wavelength multicasting of QPSK signal with capability of phase regeneration, using dual-conjugated-pump phase sensitive amplification (PSA). Based on the seven-wave model, we can obtain phase transfer functions of individual multicasting channel. Different from two multicasting copies, the phase regeneration performance of input signal is determined by the nonlinear phase shift. Moreover, the optimal squeezing points of three multicasting channels have a deviation. Thus, there exists a regeneration performance trade-off among three multicasting channels. Our numerical simulation shows that the error vector magnitude (EVM) of 50 Gb/s QPSK signal can be successfully improved when both nonlinear phase shift and four-state position in its constellation are optimized. The calculated BER curves verify that the OSNR penalties of three multicasting channels are improved by around 1dB at BER = 10(-3).

Analysis of glass-reinforced epoxy material for radio frequency resonator.

A radio frequency (RF) resonator using glass-reinforced epoxy material for C and X band is proposed in this paper. Microstrip line technology for RF over glass-reinforced epoxy material is analyzed. Coupling mechanism over RF material and parasitic coupling performance is explained utilizing even and odd mode impedance with relevant equivalent circuit. Babinet's principle is deployed to explicate the circular slot ground plane of the proposed resonator. The resonator is designed over four materials from different backgrounds which are glass-reinforced epoxy, polyester, gallium arsenide (GaAs), and rogers RO 4350B. Parametric studies and optimization algorithm are applied over the geometry of the microstrip resonator to achieve dual band response for C and X band. Resonator behaviors for different materials are concluded and compared for the same structure. The final design is fabricated over glass-reinforced epoxy material. The fabricated resonator shows a maximum directivity of 5.65 dBi and 6.62 dBi at 5.84 GHz and 8.16 GHz, respectively. The lowest resonance response is less than -20 dB for C band and -34 dB for X band. The resonator is prototyped using LPKF (S63) drilling machine to study the material behavior.

Assessing routing strategies for cognitive radio sensor networks.

Interest in the cognitive radio sensor network (CRSN) paradigm has gradually grown among researchers. This concept seeks to fuse the benefits of dynamic spectrum access into the sensor network, making it a potential player in the next generation (NextGen) network, which is characterized by ubiquity. Notwithstanding its massive potential, little research activity has been dedicated to the network layer. By contrast, we find recent research trends focusing on the physical layer, the link layer and the transport layers. The fact that the cross-layer approach is imperative, due to the resource-constrained nature of CRSNs, can make the design of unique solutions non-trivial in this respect. This paper seeks to explore possible design opportunities with wireless sensor networks (WSNs), cognitive radio ad-hoc networks (CRAHNs) and cross-layer considerations for implementing viable CRSN routing solutions. Additionally, a detailed performance evaluation of WSN routing strategies in a cognitive radio environment is performed to expose research gaps. With this work, we intend to lay a foundation for developing CRSN routing solutions and to establish a basis for future work in this area.

A subcarrier-pair based resource allocation scheme using proportional fairness for cooperative OFDM-based cognitive radio networks.

The paper presents a joint subcarrier-pair based resource allocation algorithm in order to improve the efficiency and fairness of cooperative multiuser orthogonal frequency division multiplexing (MU-OFDM) cognitive radio (CR) systems. A communication model where one source node communicates with one destination node assisted by one half-duplex decode-and-forward (DF) relay is considered in the paper. An interference-limited environment is considered, with the constraint of transmitted sum-power over all channels and aggregate average interference towards multiple primary users (PUs). The proposed resource allocation algorithm is capable of maximizing both the system transmission efficiency and fairness among secondary users (SUs). Besides, the proposed algorithm can also keep the interference introduced to the PU bands below a threshold. A proportional fairness constraint is used to assure that each SU can achieve a required data rate, with quality of service guarantees. Moreover, we extend the analysis to the scenario where each cooperative SU has no channel state information (CSI) about non-adjacent links. We analyzed the throughput and fairness tradeoff in CR system. A detailed analysis of the performance of the proposed algorithm is presented with the simulation results.

Multi-span transmission using phase and amplitude regeneration in PPLN-based PSA.

We demonstrated multi-span transmission using a periodically poled LiNbO(3) (PPLN) based phase sensitive amplifier (PSA). An in-line PSA with a carrier recovery and phase locking system is implemented as a repeater amplifier in a recirculating loop. We achieved a PSA gain as high as + 18 dB and a high external gain of + 12 dB for the in-line PSA as a black box. The impairments caused by phase noise resulting from fiber nonlinearity and intensity noise caused by the amplified spontaneous emission (ASE) of an optical amplifier are largely suppressed using the phase and amplitude regeneration capabilities of the PSA. The ultra long-haul transmission of a 28-Gb/s binary phase shift keying (BPSK) signal over 5400 km was achieved with phase and amplitude regeneration.

Energy-efficient cognitive radio sensor networks: parametric and convex transformations.

Designing energy-efficient cognitive radio sensor networks is important to intelligently use battery energy and to maximize the sensor network life. In this paper, the problem of determining the power allocation that maximizes the energy-efficiency of cognitive radio-based wireless sensor networks is formed as a constrained optimization problem, where the objective function is the ratio of network throughput and the network power. The proposed constrained optimization problem belongs to a class of nonlinear fractional programming problems. Charnes-Cooper Transformation is used to transform the nonlinear fractional problem into an equivalent concave optimization problem. The structure of the power allocation policy for the transformed concave problem is found to be of a water-filling type. The problem is also transformed into a parametric form for which a ε-optimal iterative solution exists. The convergence of the iterative algorithms is proven, and numerical solutions are presented. The iterative solutions are compared with the optimal solution obtained from the transformed concave problem, and the effects of different system parameters (interference threshold level, the number of primary users and secondary sensor nodes) on the performance of the proposed algorithms are investigated.

In-line phase sensitive amplifier based on PPLN waveguides.

We demonstrate a χ(2)-based in-line PSA with a carrier-recovery and phase-locking system for a phase shift keying (PSK) signal. By doubling the signal phase using a wavelength conversion technique, the carrier was recovered from a PSK signal. The carrier phase was synchronized to a local oscillator using optical injection locking. Phase sensitive amplification with a wide phase sensitive dynamic range of 20 dB was achieved using degenerate parametric amplification in a periodically poled LiNbO(3) (PPLN) waveguide. The phase regeneration effect was examined for a degraded signal by means of constellation analyses and bit-error rate measurements. The in-line PSA also operated successfully as a repeater amplifier in a 160 km fiber link without a power penalty. Finally, we demonstrate the regeneration of non-linear impairments induced by fiber non-linearity.

Edible crabs "go west": migrations and incubation cycle of Cancer pagurus revealed by electronic tags.

Crustaceans are key components of marine ecosystems which, like other exploited marine taxa, show seasonable patterns of distribution and activity, with consequences for their availability to capture by targeted fisheries. Despite concerns over the sustainability of crab fisheries worldwide, difficulties in observing crabs' behaviour over their annual cycles, and the timings and durations of reproduction, remain poorly understood. From the release of 128 mature female edible crabs tagged with electronic data storage tags (DSTs), we demonstrate predominantly westward migration in the English Channel. Eastern Channel crabs migrated further than western Channel crabs, while crabs released outside the Channel showed little or no migration. Individual migrations were punctuated by a 7-month hiatus, when crabs remained stationary, coincident with the main period of crab spawning and egg incubation. Incubation commenced earlier in the west, from late October onwards, and brooding locations, determined using tidal geolocation, occurred throughout the species range. With an overall return rate of 34%, our results demonstrate that previous reluctance to tag crabs with relatively high-cost DSTs for fear of loss following moulting is unfounded, and that DSTs can generate precise information with regards life-history metrics that would be unachievable using other conventional means.

Photonic chirped radio-frequency generator with ultra-fast sweeping rate and ultra-wide sweeping range.

A high-performance photonic sweeping-frequency (chirped) radio-frequency (RF) generator has been demonstrated. By use of a novel wavelength sweeping distributed-feedback (DFB) laser, which is operated based on the linewidth enhancement effect, a fixed wavelength narrow-linewidth DFB laser, and a wideband (dc to 50 GHz) photodiode module for the hetero-dyne beating RF signal generation, a very clear chirped RF waveform can be captured by a fast real-time scope. A very-high frequency sweeping rate (10.3 GHz/µs) with an ultra-wide RF frequency sweeping range (~40 GHz) have been demonstrated. The high-repeatability (~97%) in sweeping frequency has been verified by analyzing tens of repetitive chirped waveforms.

Medical teleconferencing with high-definition video presentation on the 'usual' Internet.

Although medical teleconferences on advanced academic networks have been common (Telemed J E Health 15:112-117, 1; Asian J Endosc Surg 3:185-188, 2; Surg Today 41:1579-1581, 3; Telemedicine development center of Asia. http://www.aqua.med.kyushu-u.ac.jp/eg/index.html . Accessed 6 March 2013, 4), reports regarding 'usual' Internet teleconferences or tele-lectures employing a telecommunication system for business use are very rare. Medical teleconferences and tele-lectures on the Internet were held three times between our institutions and other institutions, using the 'HD Com' made by Panasonic (HD Com. http://panasonic.biz/com/visual/ . Accessed 6 March 2013, 5), which is a high-definition telecommunication system for business tele-meeting. All of our medical telecommunications were successfully completed without any troubles. This system allows for all kinds of presentations using personal computers to be made from each station, so that discussions with high-definition surgical video presentation, which has recently been developed, could be effortlessly established despite the distance between institutions. Unlike telecommunication using advanced academic networks, this system can run without any need for specific engineering support, on the usual Internet. Medical telecommunication employing this system is likely to become common among ordinary hospitals in the near future.