The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

Harrison's Principles of Internal Medicine

Background
Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. Treatments for neck pain are varied, as are perceptions of benefit. Acupuncture has been used as an alternative to more conventional treatment for musculoskeletal pain. This review summarises the most current scientific evidence on the effectiveness of acupuncture for acute, subacute and chronic neck pain. This update replaces our 2006 Cochrane review update on this topic.

Objectives
To determine the effects of acupuncture for adults with neck pain, with focus on pain relief, disability or functional measures, patient satisfaction and global perceived effect.

Search methods
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Manual, Alternative and Natural Therapy Index System (MANTIS), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the Index to Chiropractic Literature (ICL) from their beginning to August 2015. We searched reference lists, two trial registers and the acupuncture database Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS) in China to 2005.

Selection criteria
We included published trials that used random assignment to intervention groups, in full text or abstract form. We excluded quasi-randomised controlled trials (RCTs).

Data collection and analysis
Two review authors made independent decisions for each step of the review: article inclusion, data abstraction and assessment of quality of trial methods. We assessed study quality by using the Cochrane Back Review Group 'Risk of bias' tool. We used consensus to resolve disagreements, and when clinical heterogeneity was absent, we combined studies by using random-effects meta-analysis models.

Main results
Of the 27 included studies, three represented individuals with whiplash-associated disorders (WADs) ranging from acute to chronic (205 participants), five explored chronic myofascial neck pain (186 participants), five chronic pain due to arthritic changes (542 participants), six chronic non-specific neck pain (4011 participants), two neck pain with radicular signs (43 participants) and six subacute or chronic mechanical neck pain (5111 participants).

For mechanical neck pain, we found that acupuncture is beneficial at immediate-term follow-up compared with sham acupuncture for pain intensity; at short-term follow-up compared with sham or inactive treatment for pain intensity; at short-term follow-up compared with sham treatment for disability; and at short-term follow-up compared with wait-list control for pain intensity and neck disability improvement. Statistical pooling was appropriate for acupuncture compared with sham for short-term outcomes due to statistical homogeneity (P value = 0.83; I2 = 20%). Results of the meta-analysis favoured acupuncture (standardised mean difference (SMD) -0.23, 95% confidence interval (CI) -0.20 to -0.07; P value = 0.0006). This effect does not seem sustainable over the long term. Whether subsequent repeated sessions would be successful was not examined by investigators in our primary studies.

Acupuncture appears to be a safe treatment modality, as adverse effects are minor. Reported adverse effects include increased pain, bruising, fainting, worsening of symptoms, local swelling and dizziness. These studies reported no life-threatening adverse effects and found that acupuncture treatments were cost-effective.

Since the time of our previous review, the quality of RCTs has improved, and we have assessed many of them as having low risk of bias. However, few large trials have provided high-quality evidence.

Authors' conclusions
Moderate-quality evidence suggests that acupuncture relieves pain better than sham acupuncture, as measured at completion of treatment and at short-term follow-up, and that those who received acupuncture report less pain and disability at short-term follow-up than those on a wait-list. Moderate-quality evidence also indicates that acupuncture is more effective than inactive treatment for relieving pain at short-term follow-up.

Acupuncture for neck disorders

This paper describes a fault diagnosis system for automotive generators using discrete wavelet transform (DWT) and an artificial neural network. Conventional fault indications of automotive generators generally use an indicator to inform the driver when the charging system is malfunction. But this charge indicator tells only if the generator is normal or in a fault condition. In the present study, an automotive generator fault diagnosis system is developed and proposed for fault classification of different fault conditions. The proposed system consists of feature extraction using discrete wavelet analysis to reduce complexity of the feature vectors together with classification using the artificial neural network technique. In the output signal classification, both the back-propagation neural network (BPNN) and generalized regression neural network (GRNN) are used to classify and compare the synthetic fault types in an experimental engine platform. The experimental results indicate that the proposed fault diagnosis is effective and can be used for automotive generators of various engine operating conditions.

An automotive generator fault diagnosis system using discrete wavelet transform and artificial neural network

A flux-based technique is proposed for the on-line detection, localization and discrimination of stator and rotor turn-to-turn faults in synchronous generators, using the measured air-gap rotational magnetic field. Simple magnetic field sensors (MFSs) are installed in the stator slots at different regions, and the corresponding induced voltages are measured. Several differential voltages are then obtained to give a picture of the rotational magnetic field symmetricity, whose distortions indicate the presence of the stator or rotor faults. The proposed diagnostic technique is presented in detail and validated initially by simulation results obtained with a finite element simulation package and afterwards through the experimental tests. The obtained results demonstrate that the proposed technique can be used to detect and discriminate stator and rotor turn-to-turn faults with appropriate sensitivity. In addition, the region of the stator turn-to-turn faults can be identified as well.

Turn to Turn Fault Detection, Discrimination, and Faulty Region Identification in the Stator and Rotor Windings of Synchronous Machines Based on the Rotational Magnetic Field Distortion

An overview of various faults detection methods in synchronous generators

Introduction This study aims to assess the feasibility of acupuncture as an add-on intervention for patients with non-emergent acute musculoskeletal pain and primary headache in an emergency department (ED) setting. Methods and analysis A total of 40 patients who present to the ED and are diagnosed to have acute non-specific neck pain, ankle sprain or primary headache will be recruited by ED physicians. An intravenous or intramuscular injection of analgesics will be provided as the initial standard pain control intervention for all patients. Patients who still have moderate to severe pain after the 30 min of initial standard ED management will be considered eligible. These patients will be allocated in equal proportions to acupuncture plus standard ED management or to standard ED management alone based on computer-generated random numbers concealed in opaque, sealed, sequentially numbered envelopes. A 30 min session of acupuncture treatment with manual and/or electrical stimulation will be provided by qualified Korean medicine doctors. All patients will receive additional ED management at the ED physician9s discretion and based on each patient9s response to the allocated intervention. The primary outcome will be pain reduction measured at discharge from the ED by an unblinded assessor. Adverse events in both groups will be documented. Other outcomes will include the patient-reported overall improvement, disability due to neck pain (only for neck-pain patients), the treatment response rate, the use of other healthcare resources and the patients’ perceived effectiveness of the acupuncture treatment. A follow-up telephone interview will be conducted by a blinded assessor 72±12 h after ED discharge. Ethics and dissemination Written informed consent will be obtained from all participants. The study has been approved by the Institutional Review Boards (IRBs). The results of this study will guide a full-scale randomised trial of acupuncture in an ED context. Trial registration number ClinicalTrials.gov: NCT02013908.

https://bmjopen.bmj.com/content/bmjopen/4/6/e004994.full.pdf

Acupuncture as analgesia for non-emergent acute non-specific neck pain, ankle sprain and primary headache in an emergency department setting: a protocol for a parallel group, randomised, controlled pilot trial

This paper describes a method for detecting the shorted-turn of the rotor windings based on the discrete wavelet transform in the cylindrical synchronous generator. Multi-resolution analysis based on discrete wavelet transform provides a set of decomposed signals in independent frequency bands, which contain the independent dynamic information due to the orthogonality of wavelet function. In the proposed method, detecting the shorted-turn of the rotor windings is based on the decomposition of the rotor currents, where wavelet coefficients of these signals have been extracted. Comparing these extracted coefficients is used for diagnosing the healthy condition from faulty conditions. Experimental results show the effectiveness of the proposed method for detecting the shorted-turn of rotor windings in the cylindrical synchronous generator.

Detection of shorted-turns in the rotor winding of cylindrical synchronous generators using discrete wavelet transform

Now a days, frequency of abnormally high temperatures like heat wave by global warming and climate change is increasing constantly and the number of patient with heat related illness are jumping rapidly. In this study, we chose the case day for the heat wave in Busan area(Busan and Yangsan), 2013 which it was the most hottest year during 21th century. And then, we analysed the weather condition using automatic synoptic observing system(ASOS) data. Also, four indices, heat index(HI), wet bulb globe temperature(WBGT), Man-ENvironment heat EXchange model(MENEX)’s results like Physiological subjective temperature(PST), Physiological strain(PhS), were calculated to evaluate the thermal comfort and stress quantitatively. However, thermal comfort was different as the each station and thermal comfort index during same time. Busan’s thermal indices (HI: hot, WBGT: sweltering, PST: very hot, PhS: very hot) indicated relatively higher than Yansan’s (HI: very hot, WBGT: sweltering, PST: very hot, PhS: sweltering). It shows that Busan near coast is relatively more comfortable than Yangsan located in inland.

Evaluation of Thermal Environments during the Heat Waves of Summer 2013 in Busan Metropolitan Area

Comparative Effectiveness of Hwangryunhaedok-tang Pharmacopuncture, Essential Bee Venom Pharmacopuncture and Jungsongouhyul Pharmacopuncture for Cervical Pain caused by Traffic Accidents: A Retrospective Observational Study

The Retrospective Analysis of Traffic Accident Inpatients in Korean and Western Medicine Hospital

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