Diverse Radiofrequency Sensitivity and Radiofrequency Effects of Mobile or Cordless Phone near Fields Exposure in Drosophila melanogaster

Introduction

The impact of electromagnetic fields on health is of increasing scientific interest. The aim of this study was to examine how the Drosophila melanogaster animal model is affected when exposed to portable or mobile phone fields.

Methods/Results

Two experiments have been designed and performed in the same laboratory conditions. Insect cultures were exposed to the near field of a 2G mobile phone (the GSM 2G networks support and complement in parallel the 3G wide band or in other words the transmission of information via voice signals is served by the 2G technology in both mobile phones generations) and a 1880 MHz cordless phone both digitally modulated by human voice. Comparison with advanced statistics of the egg laying of the second generation exposed and non-exposed cultures showed limited statistical significance for the cordless phone exposed culture and statistical significance for the 900 MHz exposed insects. We calculated by physics, simulated and illustrated in three dimensional figures the calculated near fields of radiation inside the experimenting vials and their difference. Comparison of the power of the two fields showed that the difference between them becomes null when the experimental cylinder radius and the height of the antenna increase.

Conclusions/Significance

Our results suggest a possible radiofrequency sensitivity difference in insects which may be due to the distance from the antenna or to unexplored intimate factors. Comparing the near fields of the two frequencies bands, we see similar not identical geometry in length and height from the antenna and that lower frequencies tend to drive to increased radiofrequency effects.     

Co-Designed Exposure Protocol in the Study of Idiopathic Environmental Intolerance Attributed to Electromagnetic Fields

The hypothesis of an electromagnetic origin of idiopathic environmental intolerance (IEI) attributed to electromagnetic fields (EMF) has been widely investigated by provocation studies, which consist of deliberately exposing people with IEI-EMF in laboratory settings to particular EMF to observe volunteers’ reactions. In the majority of these studies, reactions have been found to be independent of exposure. However, most of these studies suffer from design and methodological limitations that might bias their findings or reduce their precision. As provocation studies are best suited for isolating the effects of EMF, innovative protocols should be applied. In the ExpoComm project (PNREST Anses, EST/2017/2 RF/19), several innovations have been introduced: the involvement of people with IEI-EMF in the development of the protocol, the attenuation of the anxiogenic nature of the tests, the individualization of the protocol, the validation of the neutral or normal reactivity state before the test, and the use of a cocktail of real, rather than artificially generated, sources. The objective of involving people with IEI-EMF was to increase the relevance and acceptability of the protocol, while respecting technical constraints and scientific quality requirements. This paper describes the protocol resulting from the collaborative process. Bioelectromagnetics. 2020;41:425–437. © 2020 Bioelectromagnetics Society.     

Association between Exposure to Electromagnetic Fields from High Voltage Transmission Lines and Neurobehavioral Function in Children

Background

Evidence for a possible causal relationship between exposure to electromagnetic fields (EMF) emitted by high voltage transmission (HVT) lines and neurobehavioral dysfunction in children is insufficient. The present study aims to investigate the association between EMF exposure from HVT lines and neurobehavioral function in children.

Methods

Two primary schools were chosen based on monitoring data of ambient electromagnetic radiation. A cross-sectional study with 437 children (9 to 13 years old) was conducted. Exposure to EMF from HVT lines was monitored at each school. Information was collected on possible confounders and relevant exposure predictors using standardized questionnaires. Neurobehavioral function in children was evaluated using established computerized neurobehavioral tests. Data was analyzed using multivariable regression models adjusted for relevant confounders.

Results

After controlling for potential confounding factors, multivariable regression revealed that children attending a school near 500 kV HVT lines had poorer performance on the computerized neurobehavioral tests for Visual Retention and Pursuit Aiming compared to children attending a school that was not in close proximity to HVT lines.

Conclusions

The results suggest long-term low-level exposure to EMF from HVT lines might have a negative impact on neurobehavioral function in children. However, because of differences in results only for two of four tests achieved statistical significance and potential limitations, more studies are needed to explore the effects of exposure to extremely low frequency EMF on neurobehavioral function and development in children.     

Postnatal Environmental Tobacco Smoke Exposure Related to Behavioral Problems in Children

ObjectiveThe purpose of this study was to examine the association between pre and post environmental tobacco smoke (ETS) exposure and behavioral problems in schoolchildren.MethodsIn the cross-sectional 6 cities Study conducted in France, 5221 primary school children were investigated. Pre- and postnatal exposure to secondhand tobacco smoke at home was assessed using a parent questionnaire. Child’s behavioral outcomes (emotional symptoms and conduct problems) were evaluated by the Strengths and Difficulties Questionnaire (SDQ) completed by the parents.ResultsETS exposure during the postnatal period and during both pre- and postnatal periods was associated with behavioral problems in children. Abnormal emotional symptoms (internalizing problems) were related to ETS exposure in children who were exposed during the pre- and postnatal periods with an OR of 1.72 (95% Confidence Interval (CI)= 1.36-2.17), whereas the OR was estimated to be 1.38 (95% CI= 1.12-1.69) in the case of postnatal exposure only. Abnormal conduct problems (externalizing problems) were related to ETS exposure in children who were exposed during the pre- and postnatal periods with an OR of 1.94 (95% CI= 1.51-2.50), whereas the OR was estimated to be 1.47 (95% CI=1.17-1.84) in the case of postnatal exposure only. Effect estimates were adjusted for gender, study center, ethnic origin, child age, low parental education, current physician diagnosed asthma, siblings, preterm birth and single parenthood.ConclusionPostnatal ETS exposure, alone or in association with prenatal exposure, increases the risk of behavioral problems in school-age children.     

Mobile Phone Use,Blood Lead Levels,and Attention Deficit Hyperactivity Symptoms in Children: A Longitudinal Study

Background

Concerns have developed for the possible negative health effects of radiofrequency electromagnetic field (RF-EMF) exposure to children’s brains. The purpose of this longitudinal study was to investigate the association between mobile phone use and symptoms of Attention Deficit Hyperactivity Disorder (ADHD) considering the modifying effect of lead exposure.

Methods

A total of 2,422 children at 27 elementary schools in 10 Korean cities were examined and followed up 2 years later. Parents or guardians were administered a questionnaire including the Korean version of the ADHD rating scale and questions about mobile phone use, as well as socio-demographic factors. The ADHD symptom risk for mobile phone use was estimated at two time points using logistic regression and combined over 2 years using the generalized estimating equation model with repeatedly measured variables of mobile phone use, blood lead, and ADHD symptoms, adjusted for covariates.

Results

The ADHD symptom risk associated with mobile phone use for voice calls but the association was limited to children exposed to relatively high lead.

Conclusions

The results suggest that simultaneous exposure to lead and RF from mobile phone use was associated with increased ADHD symptom risk, although possible reverse causality could not be ruled out.     

The Effect of Combined Exposure of 900 MHz Radiofrequency Fields and Doxorubicin in HL-60 Cells

Human promyelocytic leukemia HL-60 cells were pre-exposed to non-ionizing 900 MHz radiofrequency fields (RF) at 12 µW/cm² power density for 1 hour/day for 3 days and then treated with a chemotherapeutic drug, doxorubicin (DOX, 0.125 mg/L). Several end-points related to toxicity, viz., viability, apoptosis, mitochondrial membrane potential (MMP), intracellular free calcium (Ca²⁺) and Ca²⁺-Mg²⁺ -ATPase activity were measured. The results obtained in un-exposed and sham-exposed control cells were compared with those exposed to RF alone, DOX alone and RF+DOX. The results indicated no significant differences between un-exposed, sham-exposed control cells and those exposed to RF alone while treatment with DOX alone showed a significant decrease in viability, increased apoptosis, decreased MMP, increased Ca²⁺ and decreased Ca²⁺-Mg^2+-ATPase activity. When the latter results were compared with cells exposed RF+DOX, the data showed increased cell proliferation, decreased apoptosis, increased MMP, decreased Ca²⁺ and increased Ca²⁺-Mg²⁺-ATPase activity. Thus, RF pre-exposure appear to protect the HL-60 cells from the toxic effects of subsequent treatment with DOX. These observations were similar to our earlier data which suggested that pre-exposure of mice to 900 MHz RF at 120 µW/cm² power density for 1 hours/day for 14 days had a protective effect in hematopoietic tissue damage induced by subsequent gamma-irradiation.     

Effect of Exposure to a Radiofrequency Electromagnetic Field on Body Temperature in Anesthetized and Non-Anesthetized Rats

Exposure to a radiofrequency (RF) signal at a specific absorption rate (SAR) of 4 W/kg can increase the body temperature by more than 1 °C. In this study, we investigated the effect of anesthesia on the body temperature of rats after exposure to an RF electromagnetic field at 4 W/kg SAR. We also evaluated the influence of body mass on rats’ body temperature. Rats weighing 225 and 339 g were divided into sham- and RF-exposure groups. Each of the resulting four groups was subdivided into anesthetized and non-anesthetized groups. The free-moving rats in the four RF-exposure groups were subjected to a 915 MHz RF identification signal at 4 W/kg whole-body SAR for 8 h. The rectal temperature was measured at 1-h intervals during RF exposure using a small-animal temperature probe. The body temperatures of non-anesthetized, mobile 225 and 339 g rats were not significantly affected by exposure to an RF signal. However, the body temperatures of anesthetized 225 and 339 g rats increased by 1.9 °C and 3.3 °C from baseline at 5 and 6 h of RF exposure, respectively. Three of the five 339 g anesthetized and exposed rats died after 6 h of RF exposure. Thus, anesthesia and body mass influenced RF exposure-induced changes in the body temperature of rats. Bioelectromagnetics. 2020;41:104–112. © 2019 Bioelectromagnetics Society.     

Effect of Mobile Phone Exposure on Apoptotic Glial Cells and Status of Oxidative Stress in Rat Brain

The aim of this study was to investigate the effects of mobile phone exposure on glial cells in brain. The study carried out on 31 Wistar Albino adult male rats. The rat heads in a carousel exposed to 900 MHz microwave. For the study group (n:14), rats exposed to the radiation 2h per day (7 days in a week) for 10 months. For the sham group (n:7), rats were placed into the carousel and the same procedure was applied except that the generator was turned off. For the cage control (n:10), nothing applied to rats in this group. In this study, rats were euthanized after 10 months of exposure periods and brains were removed.

Brain tissues were immunohistochemically stained for the active (cleaved) caspase-3, which is a well-known apoptosis marker, and p53. The expression of the proteins was evaluated by a semi-quantitative scoring system. However, total antioxidative capacity (TAC), catalase, total oxidant status (TOS), and oxidative stress index were measured in rat brain.

Final score for apoptosis in the exposed group was significantly lower than the sham (p < 0.001) and the cage control groups (p < 0.01). p53 was not significantly changed by the exposure (p > 0.05). The total antioxidant capacity and catalase in the experimental group was found higher than that in the sham group (p < 0.001, p < 0.05). In terms of the TOS and oxidative stress index, there was no statistically significant difference between exposure and sham groups (p > 0.05).

In conclusion, the final score for apoptosis, total antioxidant capacity and catalase in rat brain might be altered by 900 MHz radiation produced by a generator to represent exposure of global systems for mobile communication (GSM) cellular phones.     

电磁场暴露海马神经元自由基和胞内Ca2+的变化

电磁场对健康影响的研究包括流行病调查、人体与动物、细胞、生化与分子生物、生物物理等5个层次,电磁生物效应最初是通过物理作用产生化学反应,继而产生后续生物反应.自由基、电磁能量和生物钙是分属于化学、物理学和生物学的3个概念,研究它们之间的关系对于认识电磁生物效应的原初作用具有意义.选择海马神经元,观察在0.1mT、0.5mT和1.0mT电磁场暴露48h,海马神经元ROS水平和胞内Ca2+浓度的变化.实验结果表明:暴露于0.1mT,0.5mT和1.0mT电磁场海马神经元的ROS水平和Ca2+浓度都比对照组有显著性提高(P<0.01).暴露于0.1mT和0.5mT电磁场的ROS水平和暴露于0.1mT电磁场的Ca2+浓度与自由基清除剂+电磁场(Trolox+EMF)组比较没有差异(P>0.05),暴露于1.0mT电磁场的ROS水平和暴露于0.5mT和1.0mT电磁场的Ca2+浓度比Trolox+EMF组有显著性提高(P<0.01).表明电磁场可以促进细胞自由基的产生,并且ROS水平与胞内Ca2+浓度有正相关性.     

1950 MHz射频电磁场对SRA01/04细胞周期和凋亡的影响

目的：研究显示射频电磁场与白内障的发生关系密切,为了评价晶状体上皮细胞在射频电磁场诱导的白内障发生中的作 用,本实验探讨了1950 MHz射频电磁场暴露对人眼晶状体上皮细胞株（SRA01/04）细胞周期与凋亡的影响。方法：将处于对数生 长期的SRA01/04 细胞暴露或假暴露于频率为1950 MHz,比吸收率（SAR）为2.79 W/kg 的射频电磁场中,每天暴露1 h,每周暴露 5 天,连续暴露4 周。暴露结束后立即收集细胞,显微镜下观察细胞形态变化,噻唑蓝（MTT）法检测细胞存活力,流式细胞仪 （FCM）检测细胞周期与凋亡。结果：与假辐照组相比,暴露组细胞形态未见明显变化;细胞存活力、细胞周期分布及细胞凋亡率亦 无显著改变（P>0.05）。结论：1950 MHz射频电磁场暴露4 周对SRA01/04 细胞的形态、活力、周期以及凋亡均无明显影响,提示在 本实验条件下1950 MHz 射频电磁场不会诱发白内障的发生。     

Biochemical Modifications and Neuronal Damage in Brain of Young and Adult Rats After Long-Term Exposure to Mobile Phone Radiations

This study investigated the effect of exposure to mobile phone radiations on oxidative stress and apoptosis in brain of rats. Rats were allocated into six groups (three young and three adult). Groups 1 and 4 were not subjected to the radiation source and served as control groups. In groups 2 and 5, the mobile phones were only connected to the global system for mobile communication, while in groups 3 and 6, the option of calling was in use. Microwaves were generated by a mobile test phone (SAR = 1.13 W/kg) during 60 days (2 h/day). Significant increments in conjugated dienes, protein carbonyls, total oxidant status, and oxidative stress index along with a significant reduction of total antioxidant capacity levels were evident after exposure. Bax/Bcl-2 ratio, caspase-3 activity, and tumor necrosis factor-alpha level were enhanced, whereas no DNA fragmentation was detected. The relative brain weight of young rats was greatly affected, and histopathological examination reinforced the neuronal damage. The study highlights the detrimental effects of mobile phone radiations on brain during young and adult ages. The interaction of these radiations with brain is via dissipating its antioxidant status and/or triggering apoptotic cell death.     

Environmental Lead Exposure among Preschool Children in Shanghai,China: Blood Lead Levels and Risk Factors

Objective

To determine blood lead levels and to identify related risk factors among children in Shanghai; to explore the lead change trend of children after industrial transformation and to provide data for policy development to control environmental lead pollution in Shanghai.

Methods

A stratified-clustered-random sampling method was used. A tungsten atomizer absorption spectrophotometer was employed to determine blood lead levels.

Results

The arithmetic mean, geometric mean and median of blood lead levels of 0- to 6-year-old children from Shanghai were 22.49 µg/L, 19.65 µg/L and 19.5 µg/L, including 0.26% (6/2291) with concentrations ≥100 µg/L and 2.7% (61/2291) with concentrations ≥50 µg/L. Boys'' levels (23.57 µg/L) were greater than those of girls (21.2 µg/L). The blood lead levels increased with age. This survey showed that the Chongming district was the highest and Yangpu district was the lowest, this result is completely opposite with the earlier survey in Shanghai. Risk factors for lead contamination included housing environment, parents'' education levels, social status, hobbies, and children''s nutritional status.

Conclusions

The blood lead levels of children in Shanghai were lower than the earlier data of Shanghai and those of published studies in China, but higher than the blood lead levels of developed countries. The blood lead levels of urban districts are higher than the central districts with the industrial transformation. Society and the government should take an active interest in childhood lead poisoning of urban areas.     

No Increased DNA Damage Observed in the Brain,Liver, and Lung of Fetal Mice Treated With Ethylnitrosourea and Exposed to UMTS Radiofrequency Electromagnetic Fields

The widespread use of mobile phones and Wi-Fi-based communication devices makes exposure to radiofrequency electromagnetic fields (RF-EMF) unavoidable. Previous experiments have revealed the tumor-promoting effects of non-ionizing RF-EMF in adult carcinogen-treated mice in utero. To extend these investigations, we tested whether these effects are due to the co-carcinogenicity of RF-EMF which would manifest as elevated DNA damage. Similar to previous experiments, pregnant mice were exposed to RF-EMF (Universal Mobile Telecommunication System [UMTS] standard, approximately 1,960 MHz) from day 7 post-conception (p.c.) at 0 (sham), 0.04, and 0.4 W/kg SAR. At day 14 p.c., the mice were injected with the carcinogen ethylnitrosourea (ENU, 40 mg/kg). At three time-points specifically 24, 36, and 72 h later, the pregnant females were sacrificed and the fetuses (n = 24–57) were removed. A dye (cy3) specific for adenyl adducts was used to detect DNA damage by fluorescence microscopy in the brain, liver, and lung of each fetus. Compared to control (0 W/kg SAR), exposure to RF-EMF had no effect on the formation of DNA adducts in the inspected tissues. We conclude that increased adenyl formation of DNA by RF-EMF exposure is not a valid explanation for the previously reported tumor-promoting effects of RF-RMF. Our findings may help to gain a deeper insight into the biological effects of RF-EMF exposure in the context of malignancy. © 2020 The Authors. Bioelectromagnetics published by Wiley Periodicals LLC on behalf of Bioelectromagnetics Society     

Natural Light Exposure,Sleep and Depression among Day Workers and Shiftworkers at Arctic and Equatorial Latitudes

Objectives

This study aimed to investigate the relationship between individual natural light exposure, sleep need, and depression at two latitudes, one extreme with a few hours of light per day during winter, and the other with equal hours of light and darkness throughout the year.

Methods

This cross-sectional study included a sample of Brazilian workers (Equatorial, n = 488 workers) and a Swedish sample (Arctic, n = 1,273).

Results

The reported mean total natural light exposure per 4-week cycle differed significantly between the Equatorial and Arctic regions. However, shiftworkers from both sites reported similar hours of natural light exposure. Short light exposure was a predictor for insufficient sleep.

Conclusion

Reduced exposure to natural light appears to increase the perception of obtaining insufficient sleep. Arctic workers were more prone to develop depression than Equatorial workers.     

Induction of Apoptosis and Necrosis in Cancer Cells by Electric Fields,Electromagnetic Fields,and Photodynamically Active Quinoids

Bioelectrochemical and electromagnetic methods are widely known to modify or even inhibit biochemical processes. In this respect apoptosis induction and necrosis of cancer cells (e.g. K-562, U-973 or HL-60) are of considerable interest as an adjuvant therapy. The synergistic combination with photodynamic activity is a novel possibility to enhance the efficacy of electromagnetic methods, as shown for quinoid drugs reacting as photodynamic Type 1 radicals. Some of these light reactions were applied to electroporated cancer cells producing the highest percentage of necrosis for cells in suspension. In order to avoid metallic electrodes for such single pulse application a non-invasive treatment it was demonstrated that using pulsating electromagnetic fields (50 Hz) one is able to cause necrosis itself. Moreover this effect is strengthened in the presence of quinoid anthracyclines and actinomycin-C. Additional exposure using visible light yields a maximum lethality. Hence this non-invasive treatment will be of advantage for future development as an adjuvant therapy.     

Association Between Mobile Phone Radiation Exposure and the Secretion of Melatonin and Cortisol,Two Markers of the Circadian System: A Review

The extremely important use of mobile phones in the world, at all ages of life, including children and adolescents, leads to significant exposure of these populations to electromagnetic waves of radiofrequency. The question, therefore, arises as to whether exposure to these radiofrequencies (RFs) could lead to deleterious effects on the body's biological systems and health. In the current article, we review the effects, in laboratory animals and humans, of exposure to RF on two hormones considered as endocrine markers: melatonin, a neurohormone produced by the pineal gland and cortisol, a glucocorticosteroid synthesized by the adrenal glands. These two hormones are also considered as markers of the circadian system. The literature search was performed using PubMed, Medline, Web of Sciences (ISI Web of Knowledge), Google Scholar, and EMF Portal. From this review on RF effects on cortisol and melatonin, it appears that scientific papers in the literature are conflicting, showing effects, no effects, or inconclusive data. This implies the need for additional research on higher numbers of subjects and with protocols perfectly controlled with follow‐up studies to better determine whether the chronic effect of RF on the biological functioning and health of users exists (or not). Bioelectromagnetics. 2021;42:5–17. © 2020 Bioelectromagnetics Society     

Drinking Money and Pulling Women: Mobile Phone Talk,Gender, and Agency in Vanuatu

This paper examines aspects of gendered discourse around mobile phones in Vanuatu, focusing especially on the talk of high-ranking men from the northern Raga-speaking region of Pentecost Island. Rather than being restricted to the technologies or their direct capacities alone, it is argued that the local reception of new technologies such as mobile phones should be contextualised in terms of broader dialogues of change, and should also take into account the visual and discursive expressions of culture that accompanies them, including in the form of marketing. Examination of the ‘impact’ of such new technologies should also include taking account of broader local meanings and messages that become associated with them. As the ethnography presented here suggests, while mobile phones themselves certainly provide a useful tool for furthering positive social change, such as in the empowerment of women, the meanings and narratives that surround them may by marked contrast entail more negative entrenchments of unequal relations of power.     

A Dietary-Wide Association Study (DWAS) of Environmental Metal Exposure in US Children and Adults

Background

A growing body of evidence suggests that exposure to toxic metals occurs through diet but few studies have comprehensively examined dietary sources of exposure in US populations.

Purpose

Our goal was to perform a novel dietary-wide association study (DWAS) to identify specific dietary sources of lead, cadmium, mercury, and arsenic exposure in US children and adults.

Methods

We combined data from the National Health and Nutrition Examination Survey with data from the US Department of Agriculture''s Food Intakes Converted to Retail Commodities Database to examine associations between 49 different foods and environmental metal exposure. Using blood and urinary biomarkers for lead, cadmium, mercury, and arsenic, we compared sources of dietary exposure among children to that of adults.

Results

Diet accounted for more of the variation in mercury and arsenic than lead and cadmium. For instance we estimate 4.5% of the variation of mercury among children and 10.5% among adults is explained by diet. We identified a previously unrecognized association between rice consumption and mercury in a US study population – adjusted for other dietary sources such as seafood, an increase of 10 g/day of rice consumption was associated with a 4.8% (95% CI: 3.6, 5.2) increase in blood mercury concentration. Associations between diet and metal exposure were similar among children and adults, and we recapitulated other known dietary sources of exposure.

Conclusion

Utilizing this combination of data sources, this approach has the potential to identify and monitor dietary sources of metal exposure in the US population.     

Effect of Village Health Team Home Visits and Mobile Phone Consultations on Maternal and Newborn Care Practices in Masindi and Kiryandongo,Uganda: A Community-Intervention Trial

IntroductionThe World Health Organisation recommends home visits conducted by Community Health Workers (in Uganda known as Village Health Teams—VHTs) in order to improve maternal and newborn health. This study measured the effect of home visits combined with mobile phone consultations on maternal and newborn care practices.MethodIn a community intervention trial design 16 health centres in Masindi and Kiryandongo districts, Uganda were randomly and equally allocated to one of two arms: control and intervention arms. Eight control health centres received the usual maternal and newborn educational messages offered by professional health workers and eight intervention health centres that received an intervention package for maternal care and essential newborn care practices. In the intervention arm VHTs made two prenatal and one postnatal home visit to households. VHTs were provided with mobile phones to enable them make regular telephone consultations with health workers at the health centre serving the catchment area. The primary outcome was health facility delivery. Other outcomes included antenatal attendances, birth preparedness, cord and thermal care and breastfeeding practices. Analysis was by intention-to-treat.ResultsA total of 1385 pregnant women were analysed: 758 and 627 in the control and intervention arms respectively. Significant post-intervention differences were: delivery place [adjusted Odds Ratio aOR: 17.94(95%CI: 6.26–51.37); p<0.001], cord care [aOR: 3.05(95%CI: 1.81–5.12); p<0.001] thermal care [aOR: 7.58(95%CI: 2.52–22.82); p<0.001], and timely care-seeking for newborn illness [aOR: 4.93(95%CI: 1.59–15.31); p = 0.006].ConclusionVHTs can have an effect in promoting proper cord and thermal care for the newborn and improve timely care-seeking for health facility delivery and newborn illness, because they could answer questions and refer patients correctly. However, VHTs should be supported by professional health workers through the use of mobile phones.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT02084680","term_id":"NCT02084680"}}NCT02084680