The effects of radiofrequency electromagnetic fields exposure on human self-reported symptoms: A systematic review of human experimental studies.

BACKGROUND: The technological applications of radiofrequency electromagnetic fields (RF-EMF) have been steadily increasing since the 1950s exposing large proportions of the population. The World Health Organization (WHO) is assessing the potential health effects of exposure to RF-EMF. OBJECTIVES: To systematically assess the effects of exposure to RF-EMF on self-reported non-specific symptoms in human subjects and to assess the accuracy of perceptions of presence or absence of RF-EMF exposure. METHODS: Eligibility criteria: experimental studies carried out in the general population and in individuals with idiopathic environmental intolerance attributed to EMF (IEI-EMF), in any language. INFORMATION SOURCES: Medline, Web of Science, PsycInfo, Cochrane Library, Epistemonikos, Embase and EMF portal, searched till April 2022. Risk of Bias (ROB): we used the RoB tool developed by OHAT adapted to the topic of this review. SYNTHESIS OF RESULTS: we synthesized studies using random effects meta-analysis and sensitivity analyses, where appropriate. RESULTS: Included studies: 41 studies were included, mostly cross over trials and from Europe, with a total of 2,874 participants. SYNTHESIS OF RESULTS: considering the primary outcomes, we carried out meta-analyses of 10 exposure-outcomes pairs. All evidence suggested no or small non-significant effects of exposure on symptoms with high (three comparisons), moderate (four comparisons), low (one comparison) and very low (two comparisons) certainty of evidence. The effects (standard mean difference, where positive values indicate presence of symptom being exposed) in the general population for head exposure were (95% confidence intervals) 0.08 (-0.07 to 0.22) for headache, -0.01 (-0.22 to 0.20) for sleeping disturbances and 0.13 (-0.51 to 0.76) for composite symptoms; and for whole-body exposure: 0.09 (-0.35 to 0.54), 0.00 (-0.15 to 0.15) for sleeping disturbances and -0.05 (-0.17 to 0.07) for composite symptoms. For IEI-EMF individuals SMD ranged from -0.19 to 0.11, all of them with confidence intervals crossing the value of zero. Further, the available evidence suggested that study volunteers could not perceive the EMF exposure status better than what is expected by chance and that IEI-EMF individuals could not determine EMF conditions better than the general population. DISCUSSION: Limitations of evidence: experimental conditions are substantially different from real-life situations in the duration, frequency, distance and position of the exposure. Most studies were conducted in young, healthy volunteers, who might be more resilient to RF-EMF than the general population. The outcomes of interest in this systematic review were symptoms, which are self-reported. The available information did not allow to assess the potential effects of exposures beyond acute exposure and in elderly or in chronically ill people. It cannot be ruled out that a real EMF effect in IEI-EMF groups is masked by a mix with insensitive subjects. However, studies on symptoms reporting and/or field perceptions did not find any evidence that there were particularly vulnerable individuals in the IEI-EMF group, although in open provocation studies, when volunteers were informed about the presence or absence of EMF exposure, such differences were consistently observed. INTERPRETATION: available evidence suggests that acute RF-EMF below regulatory limits does not cause symptoms and corresponding claims in the everyday life are related to perceived and not to real EMF exposure status.

Research on an Equivalent Heat Source Model of the AC Arc in the Short Gap of a Copper-Core Cable and a Fire Risk Assessment Method.

The magnetohydrodynamics (MHD) model of the alternating current (AC) arc is complex, so a simplified equivalent heat source (EHS) model can be used to replace the complex model in studying the AC arc's thermal characteristics and cable fire risk. A 2D axisymmetric AC arc MHD simulation model in the short gap of a copper-core cable is established in this paper. The AC arc voltage and current obtained by the model are consistent with experiments. The AC arc's heat source distribution obtained by the MHD model is fitted to obtain the heat source function Q of the AC arc. Q is divided into 16 independent segmented heat sources, and a correction matrix is constructed to optimize the segmented heat sources. A neural network and a genetic algorithm give the prediction model and the optimal correction matrix of the segmented heat source. The EHS model optimized by the optimal correction matrix can obtain a minimum temperature error of 5.8/4.4/4.2% with the MHD model in different AC arc peak currents 2/4/6 A. The probability of a cable fire is calculated by using AC arc's optimized EHS model when different numbers of AC arcs are generated randomly in AC half-waves. The EHS model can replace the complex MHD model to study the thermal characteristics of AC arcs and quickly calculate the probability of a cable fire caused by random AC arcs.

Association between the experience of exertional heat illness (EHI) and living conditions of collegiate student athletes.

Exertional heatstroke (EHS), a severe form of exertional heat illness (EHI), is the third leading cause of death in athletes; thus, early detection and prevention of EHI can help prevent EHS, which is a life-threatening condition. This study aimed to clarify the association between the cognizance of experiencing EHI and living conditions and specific EHI symptoms among collegiate athletes. This study was conducted in October 2022 by administering a questionnaire to 237 male collegiate athletes. Of the 215 (90.7%) respondents, 197 (91.6%) provided valid responses; among them, 88 (44.7%) responded they had experienced EHI, while 109 (55.3%) had not. A history of medical examinations due to EHI, having experienced headaches during summer activities, and having read the EHI manual were factors indicating cognizance of EHI. The number of times meals containing a staple food, main dish, and side dish were eaten in a day was a factor in preventing EHI. Early detection of EHI is important for its prevention, and it is important that athletes themselves have knowledge of symptoms and can correctly self-diagnose EHI. Emphasizing the potential of a well-balanced dietary intake has the potential to prevent EHI is crucial.

UV filter ethylhexyl salicylate affects cardiovascular development by disrupting lipid metabolism in zebrafish embryos.

Ethylhexyl salicylate (EHS) is an organic UV filter commonly used in sunscreens to protect people from the UV radiation. The widespread use of EHS will enter the aquatic environment along with human activities. EHS readily accumulates in adipose tissue as a lipophilic compound, but its toxic effects on lipid metabolism and cardiovascular system of aquatic organisms have not been studied. This study investigated the effects of EHS on lipid metabolism and cardiovascular development during zebrafish embryogenesis. The results showed that EHS caused defects such as pericardial edema, cardiovascular dysplasia, lipid deposition, ischemia, and apoptosis in zebrafish embryos. In addition, qPCR and whole-mount in situ hybridization (WISH) results indicated that EHS treatment significantly altered the expression of genes related to cardiovascular development, lipid metabolism, erythropoiesis, and apoptosis. The hypolipidemic drug rosiglitazone was able to alleviate the cardiovascular defects caused by EHS, indicating that EHS affected cardiovascular development by disrupting lipid metabolism. In addition, severe ischemia caused by cardiovascular abnormalities and apoptosis were observed in the EHS-treated embryos, which was likely to be the main cause of embryonic mortality. In conclusion, this study shows that EHS has toxic effects on lipid metabolism and cardiovascular formation. Our findings provide new evidence for assessing UV filter EHS toxicity and contribute to raising awareness of the safety risks of EHS.

Design and performance analysis of a rectenna system for charging a mobile phone from ambient EM waves.

Advances in information technology have dramatically enhanced mobile phones. Power capacity is one of the most significant limitations of a mobile phone. As a result, efficient energy management in such devices is critical everywhere. The goal of this research is to find a way to charge electronic devices wirelessly using radio frequency (RF) electromagnetic (EM) waves (Rectenna using energy detection-based spectrum sensing). Mechanical deformations cause frequency detuning, which lowers the effectiveness of antennas and rectennas that would otherwise allow wireless communication and RF energy harvesting in the far field. A rectenna based on a stretchable multiband antenna is designed as a self-powered system to perform reliably and integrate RF power received across its multiband despite mechanical deformations. Depending on what the battery needs, the proposed multiband antenna will work at 900 MHz, 1800 MHz, 2100 MHz, and 2.45 GHz as both an RF transducer and an RF energy harvester. Depending on the received RF power density (high), the receiving RF wave will be utilized for both communication and RF energy harvesting (RF-EH) when the battery's current voltage is less than 20% (referred to as "low voltage"). Otherwise, the received RF wave will be used only for RF-EH. The installed multiband rectifiers function perfectly in terms of efficiency and bandwidth. This proposed technique would reduce the charging crisis by 60-90% depending on the location of the mobile phone or receiver of ambient EM signals. This paper could help researchers in the field of RF energy-based wireless charging systems.

Comparison of early period sexual function parameters between surgical repair and conservative treatment after penile fracture / Comparación de los parámetros de función sexual en el período temprano entre la reparación quirúrgica y el tratamiento conservador después de una fractura de pene

Introduction and objectives: Comparison of early period sexual function parameters in patients who had surgical repair and conservative follow-up after penile fracture and the evaluation of surgical intervention time on these parameters were planned in this study. Materials and methods: Total of 26 patients who were treated for penile fracture were evaluated. 19 patients had surgical repair and 7 patients had conservative treatment.Sexual function and erectile dysfunction (ED) degree of the patients before penile fracture and in the 12th week after fracture were evaluated with 5-question International Index of Erectile Function (IIEF-5) questionnaire, Erection Hardness Score (EHS), Sexual Encounter Profile(SEP) 2 and SEP 3. Parameters showing sexual function before and after the fracture were compared. Results: In both groups, a significant change was detected in IIEF-5 score, EHS, SEP-2 and SEP-3 parameters of the patients measured after penile fracture compared to the values before the fracture (all parameters, p<0.05). No difference was detected in the parameters measured before and after the fracture among surgical repair and conservative treatment groups (all parameters p>0.05). Mean time passing until the surgery after fracture was measured as 9.6±6.85h in 19 patients who had surgery. Conclusion: A difference wasn’t detected in sexual parameters in conservative treatment and surgical repair groups in this study. As a significant decrease was observed in sexual function parameters even in conservative treatment cases without sudden detumescence and tunica albuginea rupturing, we think that quick surgical exploration would be useful in cases considered to have penile fracture. (AU)

Introducción y objetivos: En este estudio se planificó la comparación de los parámetros de función sexual en el período temprano en pacientes sometidos a reparación quirúrgica y seguimiento conservador después de una fractura de pene y la evaluación del tiempo de intervención quirúrgica sobre estos parámetros. Materiales y métodos: Se evaluaron un total de 26 pacientes que fueron tratados por fractura de pene: 19 fueron sometidos a reparación quirúrgica y 7 tuvieron un seguimiento conservador. La función sexual y el grado de disfunción eréctil de los pacientes antes de la fractura de pene y en la semana 12 después de la fractura se evaluaron con el cuestionario International Index of Erectile Function de 5 preguntas (IIEF-5), el Erection Hardness Score (EHS), y el Sexual Encounter Profile (SEP) 2 y SEP 3. Se compararon los parámetros que muestran la función sexual antes y después de la fractura. Resultados: En ambos grupos se detectó un cambio significativo en la puntuación IIEF-5 y los parámetros EHS, SEP 2 y SEP 3 de los pacientes medidos después de la fractura de pene en comparación con los valores antes de la fractura (todos los parámetros, p<0,05). No se detectaron diferencias en los parámetros medidos antes y después de la fractura entre los grupos de reparación quirúrgica y tratamiento conservador (todos los parámetros p>0,05). El tiempo medio transcurrido hasta la cirugía después de la fractura se midió como 9,6±6,85h en los 19 pacientes intervenidos. Conclusión: No se detectaron diferencias en los parámetros sexuales entre los grupos de observancia conservadora y reparación quirúrgica en este estudio. Como se observó una disminución significativa de los parámetros de función sexual incluso en casos de seguimiento conservador sin detumescencia súbita y desgarro de la túnica albugínea, pensamos que la exploración quirúrgica rápida sería útil en los casos en los que se considere que tienen fractura de pene. (AU)

Use of the benchmark-dose (BMD) approach to derive occupational exposure limits (OELs) for genotoxic carcinogens: N-nitrosamines.

N-Nitrosamines are potent carcinogens and considered non-threshold carcinogens in various regulatory domains. However, recent data indicate the existence of a threshold for genotoxicity, which can be adequately demonstrated. This aspect has a critical impact on selecting the methodology that is applied to derive occupational exposure limits (OELs). OELs are used to protect workers potentially exposed to various chemicals by supporting the selection of appropriate control measures and ultimately reducing the risk of occupational cancer. Occupational exposures to nitrosamines occur during manufacturing processes, mainly in the rubber and chemical industry. The present study derives OELs for inhaled N-nitrosamines, employing the benchmark dose (BMD) approach if data are adequate and read-across for nitrosamines without adequate data. Additionally, benchmark dose lower confidence limit (BMDL) is preferred and more suitable point-of-departure (PoD) to calculate human health guidance values, including OEL. The lowest OEL (0.2 µg/m3 ) was derived for nitrosodiethylamine (NDEA), and nitrosopiperidine (NPIP) (OEL = 0.2 µg/m3 ), followed by nitrosopyrrolidine (NPYR) (0.4 µg/m3 ), nitrosodimethylamine (NDMA), nitrosodimethylamine (NMEA), and nitrosodipropylamine (NDPA) (0.5 µg/m3 ), nitrosomorpholine (NMOR) (OEL = 1 µg/m3 ), and nitrosodibutylamine (NDBA) (OEL = 2.5 µg/m3 ). Limits based on "non-threshold" TD50 slope calculation were within a 10-fold range. These proposed OELs do not consider skin absorption of nitrosamines, which is also a possible route of entry into the body, nor oral or other environmental sources. Furthermore, we recommend setting a limit for total nitrosamines based on the occupational exposure scenario and potency of components.

Dariusz Leszczynski responds to comments of Maël Dieudonné on Leszczynski's review of the scientific evidence on the individual sensitivity to electromagnetic fields (EHS).

While Dieudonné has praised thoroughness of Leszczynski's review of EHS studies, he was critical of the final conclusions. Leszczynski strongly disagrees with argumentation of Dieudonné that EHS issue is settled and that biomarker research is unnecessary because it is expensive and might produce false positives. Leszczynski's opinion is that his review has demonstrated how very poor scientifically and inadequate statistically is the to-date executed research on EHS. Dieudonné's approach of using such poor science to justify claim that EHS issue is settled and there is no causality link between EHS and EMF exposures, is completely unjustified and simply false.

Comparison of early period sexual function parameters between surgical repair and conservative treatment after penile fracture.

INTRODUCTION AND OBJECTIVES: Comparison of early period sexual function parameters in patients who had surgical repair and conservative follow-up after penile fracture and the evaluation of surgical intervention time on these parameters were planned in this study. MATERIALS AND METHODS: Total of 26 patients who were treated for penile fracture were evaluated. 19 patients had surgical repair and 7 patients had conservative treatment. Sexual function and erectile dysfunction (ED) degree of the patients before penile fracture and in the 12th week after fracture were evaluated with 5-question International Index of Erectile Function (IIEF-5) questionnaire, Erection Hardness Score (EHS), Sexual Encounter Profile(SEP) 2 and SEP 3. Parameters showing sexual function before and after the fracture were compared. RESULTS: In both groups, a significant change was detected in IIEF-5 score, EHS, SEP-2 and SEP-3 parameters of the patients measured after penile fracture compared to the values before the fracture (all parameters, p<0.05). No difference was detected in the parameters measured before and after the fracture among surgical repair and conservative treatment groups (all parameters p>0.05). Mean time passing until the surgery after fracture was measured as 9.6±6.85h in 19 patients who had surgery. CONCLUSION: A difference wasn't detected in sexual parameters in conservative treatment and surgical repair groups in this study. As a significant decrease was observed in sexual function parameters even in conservative treatment cases without sudden detumescence and tunica albuginea rupturing, we think that quick surgical exploration would be useful in cases considered to have penile fracture.

Time course of health complaints attributed to RF-EMF exposure and predictors of electromagnetic hypersensitivity over 10 years in a prospective cohort of Dutch adults.

BACKGROUND: Some individuals attribute health complaints to radiofrequency electromagnetic field (RF-EMF) exposure. This condition, known as idiopathic environmental intolerance attributed to RF-EMFs (IEI-RF) or electromagnetic hypersensitivity (EHS), can be disabling for those who are affected. In this study we assessed factors related to developing, maintaining, or discarding IEI-RF over the course of 10 years, and predictors of developing EHS at follow-up using a targeted question without the condition of reporting health complaints attributed to RF-EMF exposure. METHODS: Participants (n = 892, mean age 50 at baseline, 52 % women) from the Dutch Occupational and Environmental Health Cohort Study AMIGO filled in questionnaires in 2011/2012 (T0), 2013 (T1), and 2021 (T4) where information pertaining to perceived RF-EMF exposure and risk, non-specific symptoms, sleep problems, IEI-RF, and EHS was collected. We fitted multi-state Markov models to represent how individuals transitioned between states ("yes", "no") of IEI-RF. RESULTS: At each time point, about 1 % of study participants reported health complaints that they attributed to RF-EMF exposure. While this percentage remained stable, the individuals who reported such complaints changed over time: of nine persons reporting health complaints at T0, only one reported IEI-RF at both T1 and T4, and two newly reported health complaints at T4. Overall, participants had a 95 % chance of transitioning from "yes" to "no" over a time course of 10 years, and a chance of 1 % of transitioning from "no" to "yes". Participants with high perceived RF-EMF exposure and risk had a general tendency to move more frequently between states. CONCLUSIONS: We observed a low prevalence of IEI-RF in our population. Prevalence did not vary strongly over time but there was a strong aspect of change: over 10 years, there was a high probability of not attributing symptoms to RF-EMF exposure anymore. IEI-RF appears to be a more transient condition than previously assumed.

A clinical study of different doses and frequencies of Sildenafil in the treatment of erectile dysfunction / 现代泌尿外科杂志

【Objective】 To evaluate the efficacy and safety of different doses and frequencies of oral Sildenafil in the treatment of erectile dysfunction (ED). 【Methods】 The randomized,open clinical trial included 120 ED patients who met the inclusion and exclusion criteria. The patients were randomly divided into the following groups:on-schedule (25 mg/day),on-demand (50 mg,taken irregularly half an hour before each sexual life),new regular group (25 mg/day,50 mg more before each sexual life),regular group (100 mg/time,twice/week). All treatments lasted for 8 weeks. The follow-up indexes included the five-item International Index of Erectile Function (IIEF-5),Erection Hardness Scale (EHS) and Sexual Encounter Profile (SEP2/3). The adverse reactions were recorded. 【Results】 The IIEF-5 scores of the four groups were significantly higher than those after baseline treatment (P0.05). In terms of effective rate,at the 16th week,there were significant differences between the on-demand group (10.7%) and new regular group (62.1%),and between the on-demand group (10.7%) and regular group (50.0%) (P<0.001). In terms of EHS, the percentage of grade 4 patients in regular group was significant higher than that in the on-demand group at the 8th week and 16th week (all P<0.05). In terms of positive rate of SEP-3,there was a significant difference between the on-demand group and regular group (P=0.042) at the 16th week. In the course of treatment,there were transient adverse reactions such as headache,blurred vision,stuffy nose and back pain,which did not affect the treatment. 【Conclusion】 All of the four treatment methods of oral sildenafil showed good efficacy. Both regular group and new regular group maintained good clinical efficacy during the follow-up,which is better than that of the on-demand group. The new regular scheme can be used as a new,safe and effective treatment option.

The lack of international and national health policies to protect persons with self-declared electromagnetic hypersensitivity.

Electromagnetic hypersensitivity (EHS), known also as an idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) or a microwave sickness, is not considered by the World Health Organization (WHO) as being caused by the exposures to electromagnetic fields (EMF). EHS is not recognized as a disease anywhere in the world. Some studies have roughly estimated that 1-10% of the population might experience some form of EHS. However, because of the lack of diagnostic criteria for EHS, these estimates might be either under- or over-estimates. Because the vast majority of human population is exposed to EMF, the possibility of developing EHS from the EMF is a substantial public health issue that should be dealt with globally, even if the individual risk of developing EHS might be small. The WHO recognizes that the symptoms experienced by the EHS persons might be severe and might significantly hamper everyday life. However, after a broad analysis of international and national documents, there seems to be currently no effort to develop health policies for the dealing with EHS, no matter what causes it. National governments, follow the opinions of the WHO and the EMF safety standards setting organizations, the International Commission on Non-Ionizing Radiation Protection (ICNIRP) and the Institute of Electrical and Electronics Engineers - International Committee on Electromagnetic Safety (IEEE-ICES), are not developing any practical health policy advisories for self-declared EHS sufferers. However, symptoms experienced by the self-declared EHS persons affect their well-being and, according to the Constitution of the WHO, are a health problem. Hence, independently of what causes EHS symptoms, this admitted well-being-impairment should be dealt with globally by developing an uniform health policy. Furthermore, WHO, ICNIRP and IEEE-ICES should be advocating and supporting research that would generate a reliable scientific evidence on what are the possible cause(s) of EHS. Without such research there is not possible to develop diagnostic methods as well as any possible mitigation approaches. There is an urgent need for the WHO to advocate for the national governments to urgently develop a comprehensive and common EHS health policy.

Adaptation of the Russian Version of the Elkins Hypnotizability Scale.

Until now, there has been an acute shortage of valid and reliable tools in Russia for making an accurate and highly differentiable assessment of hypnotizability. However, numerous studies confirm the high efficiency, reliability, and accuracy of the Elkins Hypnotizability Scale (EHS), allowing it to claim the title of the new gold standard for assessing hypnotizability. In the present study, the original English-language version of the EHS was translated into Russian. One hundred and five volunteers from Moscow (42% male; 58% female), aged 19 to 44, underwent a hypnotizability assessment procedure according to the EHS protocol. The Russian version of the EHS, like the original, requires an average of 28 minutes to administer and score by a trained assessor. The results showed that the Russian version of the EHS has good internal consistency and does not contain unnecessary elements. Alpha Cronbach values (0.76), and the item-total correlations (rs = 0.44-0.64) are satisfactory.

Outcomes of laparoscopic repair in complicated groin hernia: A single institutional based cohort study in Nepal.

Introduction: Laparoscopic hernia repairs have comparable recurrence rate with less persisting pain and numbness and quicker return to usual activities as compared to open mesh repair. The excellent outcomes of minimally invasive surgery encourage us to extend the laparoscopic technique to complicated groin hernia. Method: A total of 22 patients with complicated groin hernia who presented to our institute from September 2017 to September 2018 were included in this prospective cohort study. Inclusion criteria were patients with age greater than 18 years and clinically diagnosed as complicated groin hernia. Patients with peritonitis, those with previous abdominal surgery and unfit for general anesthesia were excluded from our study. Results: The most common age group was 51-60 (31.8%) years.17 cases were repaired with totally laparoscopic approach (12 TEP, 5 TAPP). Laparoscopic repair with additional procedure was needed in 3 cases and 2 cases were converted to open for completion of the procedure. The mean operating time was 154.8 ± 51.6 (range: 90 to 230) minutes. The average length of hospital stay was 3.8 ± 3 (range: 1 to 12) days. Bleeding from the inferior epigastric and testicular vessels were the major intra-operative complication (11.8%). Seroma and surgical site infection were seen in 2 (11.8%) patients. Conclusion: Laparoscopic approach in cases of complicated groin hernia can achieve desirable patient outcomes without major complications, provided good patient selection and expertise. The evidence for laparoscopic repair as the choice of procedure in complicated groin hernia can be established from further comparative studies.

Hypnotizability and psychopathology of patients with personality disorders.

Assessment of hypnotizability is useful in research and predicting the effects of hypnosis in clinical practice. There are few contemporary scientific reports examining the relationship between hypnotizability and psychopathological personality dimensions. The current study explores the connections between abnormal personality in psychiatric patients and the hypnotizability level. Fifty-five patients with anxiety and personality disorders who previously completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were invited to undergo the Elkins Hypnotizability Scale - Clinical Form (EHS-CF). The hypnotizability scores comprise a normal distribution but shifted toward low scores. Twenty-seven patients were included in the low hypnotizability (LOW) group, and 28 patients in the medium to high (MID-HIGH) group. The number of participants with high scores on the Psychopathic Deviate and Paranoia MMPI-2 clinical scales was significantly higher in the LOW than in the MID-HIGH group. Patterns of associations between hypnotizability and psychopathology differed in the two groups. The results indicate that moderate hypnotizability should be considered a normal trait that has no meaningful relationship with psychopathology, but certain dysfunctional symptoms of personality disorders may entail resistance and a defensive attitude toward the hypnotherapy, resulting in a tendency to obtain lower hypnotizability.

Transarterial Chemoembolization (TACE) Combined With Sorafenib versus TACE in Patients With BCLC Stage C Hepatocellular Carcinoma - A Retrospective Study.

Objective: Advanced-stage hepatocellular carcinoma is a heterogeneous group with limited treatment options. TACE has been advocated recently by various study groups. The purpose of this study was to evaluate if TACE in combination with sorafenib, as well as TACE alone, was safe and efficacious in treating BCLC stage C HCC. Methods: A retrospective evaluation of the clinical data of 78 patients with BCLC stage C HCC who received either TACE-sorafenib (TS) combination therapy or TACE monotherapy as their first treatment was done. The two groups were compared in terms of radiological tumor response 1 month after the intervention. The two groups were also compared in terms of time to progression (TTP), overall survival (OS), and adverse events. Results: The disease control rate (44.9% and 25.8%, respectively, P = 0.09) was higher in the TS combination group than in the TACE monotherapy group after 1 month of treatment. The TS combination group had significantly superior TTP and OS than the TACE group (TTP was 4.6 and 3.1 months, respectively, P = 0.001), and OS was 10.1 and 7.8 months, respectively, P < 0.001). The TACE-S group had a greater cumulative survival time at 6 months, 9 months, and 1 year than the TACE group (97.9%, 51.1%, 25.7% vs. 90.4%, 51.6%, and 0%, respectively). Conclusion: TS combination therapy in advanced-stage (BCLC-C) HCC significantly improved disease control rate, TTP, and OS compared with TACE alone, without any significant increase in adverse reactions.

Why electrohypersensitivity and related symptoms are caused by non-ionizing man-made electromagnetic fields: An overview and medical assessment.

Much of the controversy over the cause of electrohypersensitivity (EHS) lies in the absence of recognized clinical and biological criteria for a widely accepted diagnosis. However, there are presently sufficient data for EHS to be acknowledged as a distinctly well-defined and objectively characterized neurologic pathological disorder. Because we have shown that 1) EHS is frequently associated with multiple chemical sensitivity (MCS) in EHS patients, and 2) that both individualized disorders share a common pathophysiological mechanism for symptom occurrence; it appears that EHS and MCS can be identified as a unique neurologic syndrome, regardless their causal origin. In this overview we distinguish the etiology of EHS itself from the environmental causes that trigger pathophysiological changes and clinical symptoms after EHS has occurred. Contrary to present scientifically unfounded claims, we indubitably refute the hypothesis of a nocebo effect to explain the genesis of EHS and its presentation. We as well refute the erroneous concept that EHS could be reduced to a vague and unproven "functional impairment". To the contrary, we show here there are objective pathophysiological changes and health effects induced by electromagnetic field (EMF) exposure in EHS patients and most of all in healthy subjects, meaning that excessive non-thermal anthropogenic EMFs are strongly noxious for health. In this overview and medical assessment we focus on the effects of extremely low frequencies, wireless communications radiofrequencies and microwaves EMF. We discuss how to better define and characterize EHS. Taken into consideration the WHO proposed causality criteria, we show that EHS is in fact causally associated with increased exposure to man-made EMF, and in some cases to marketed environmental chemicals. We therefore appeal to all governments and international health institutions, particularly the WHO, to urgently consider the growing EHS-associated pandemic plague, and to acknowledge EHS as a mainly new real EMF causally-related pathology.

Design and implementation of hybrid consensus mechanism for IoT based healthcare system security.

Nowadays, blockchain is emerging as a worthwhile technology for managing sensitive data in electronic healthcare system. It plays an important role in healthcare, medical research and insurance sectors. The consensus algorithms used in blockchain technology for the selection of a new block, provide high-level of security to IoT devices. However, the reliability problem still exists. In the present paper, a blockchain based hybrid consensus mechanism (HCM) is implemented in electronic healthcare system (EHS) to overcome trustworthiness issues. The aim of the proposed HCM is to maintain reputation module on the basis of the block activities. In this context, EHS is designed in four layers namely: system layer, inter-network layer, blockchain layer, and cloud layer. Moreover, HCM consists of five algorithms for creation, validation, fork handling (if any), Merkle tree construction and reward/punishment module respectively. Dev C++ software platform is used for the simulation of the above mentioned HCM algorithms excluding Merkle tree construction which is simulated using conditional contrast high itemset tree. It is observed that all the blocks use same methodology to be the part of a new blockchain network. Moreover, the CPU and memory consumption in the implementation of HCM is always below two percent and about fifty percent respectively as shown in the latency graph. The basic security goal (confidentiality, integrity and availability) is guaranteed with the help of the height of the Merkel tree as well. The performances of the proposed HCM and Proof of X-repute (PoXR) blockchain consensus algorithms are compared with respect to various parameters such as final difficulty, reward and punishment provisions etc. HCM shows superior performance as the final earned reputation is calculated for each block along with the reward and punishment modules during the deployment of blockchain network. In addition, a simple concept of Merkle-tree is opted for providing reward and punishment rather than a set of complex mathematical equations as used in PoXR consensus algorithm.

A mouse model of exertional heatstroke-related acute kidney injury.

Background: Acute kidney injury (AKI) is a common complication of exertional heat stroke (EHS) with a complex pathogenesis. We established a stable mouse model of EHS-related AKI (EHS-AKI). Methods: C57BL/6 male mice were divided into 6 groups: Saline Control group, Glycerol Control group, Saline + Sham heat exercise (SHE) group, Saline + Heat exercise (HE) group, Glycerol + SHE group, and Glycerol + HE group. Samples from the Saline Control group and the Glycerol Control group were taken 6 h after the intramuscular injection of saline (4 mL/kg) or glycerol (4 mL/kg) to provide a baseline for comparisons with the other 4 groups. The other 4 groups of mice started exercise 6 h after the intramuscular injection of saline or glycerol, and were sacrificed to collect samples after exercise. Finally, serum and the pathology of kidney and muscle tissues were quantified. Results: There were no differences in the creatinine (Cr), blood urea nitrogen (BUN), creatine kinase (CK), and myoglobin (MYO) levels, but the interleukin 6 (IL-6) level was more increased (P<0.05) in the Glycerol Control group than the Saline Control group at the baseline. The IL-6 levels of the Glycerol + HE group were also higher than those of the Saline + HE groups at 6 and 12 h (P<0.05). The Cr levels at 12 h and 1 day, the BUN levels at 6 h, 12 h, 1 day, and 2 days in the Glycerol+ HE group were higher than the baseline levels (P<0.05). And the renal pathological scores at 6 h, 12 h, 1 day, 2 days, or 3 days were 0.79, 1.29, 1.58, 0.85, and 0.77. However, there was only slight renal pathological injury in the Saline + HE group at 12 h, and 1 day, and the scores were 0.13, and 0.41. The CK level in each group all peaked at 6 h after exercise and higher than the baseline (P<0.05). However, there was no difference in the MYO levels of each group compared to the baseline. Conclusions: We established a stable mouse model of EHS-AKI by conducting a heat exercise after the intramuscular injection of glycerol. Our findings lay the foundation for follow-up clinical and basic research.

A green TLC densitometric method for the simultaneous detection and quantification of naphazoline HCl, pheniramine maleate along with three official impurities.

Impurity profiling of a pharmaceutical compound is now taking great attention during quality assessment of pharmaceuticals, as presence of small amount of impurities may affect safety and efficacy. In this work, a novel TLC chromatographic method coupled with densitometric detection was established for the simultaneous quantification of naphazoline HCl, pheniramine maleate and three of their official impurities, namely; naphazoline impurity B, pheniramine impurities; A & B. Chromatographic separation was carried out on TLC aluminum silica plates F254, as a stationary phase, using methanol: ethyl acetate: 33.0% ammonia (2.0: 8.0: 1.0, by volume), as a mobile phase. Plates were examined at 260.0 nm and International Council for Harmonisation (ICH) guidelines were followed for method's validation. Important factors, such as; composition of mobile phase and detection wavelengths were optimized. Linearity was achieved over the ranges of 2.0-50.0 µg band-1 for naphazoline, 10.0-110.0 µg band-1 for pheniramine, 0.1-10.0 µg band-1 for naphazoline impurity B and 2.0-50.0 µg band-1 for both pheniramine impurities. The proposed method was assessed in terms of accuracy, precision and robustness where satisfactory results (recovery % ≈ 100% and RSD < 2) were obtained. The method was also applied for the simultaneous determination of naphazoline HCl and pheniramine maleate, in Naphcon-A® eye drops, with respective recoveries of 101.36% and 100.94%. Method greenness was evaluated and compared to the reported HPLC one via environmental, health and safety tool. The developed method has much potential over the reported one of being simple, selective, economic and time saving for the analysis of the five cited compounds.