bluuebunny/crossref_metadata_2025 huggingface dataset:
A Numerical Investigation of Bolt Underhead Temperature Evolution During Tightening
Authors: Guessous Laila , Barber Gary , Zou Qian , Nassar Sayed
Published: April 2009

The temperature rise that occurs due to frictional heating under the turning fastener head during the tightening process of bolted joints can have a significant effect on surface and thread wear and galling. The subject has received little attention in the scientific literature. In the present study, the spatial and temporal temperature rise in a bolt during the tightening process are numerically investigated for a variety of sliding and loading conditions using finite difference methods. The effect of tightening speed, angle of turn, and frictional energy input is numerically investigated. Tightening speeds were varied between 1 RPM and 3000 RPM and the angle of turn was varied between 15 and 720 degrees past free spinning; this range of turn simulates joint stiffness variation from very hard to very soft joints. Significant temperature rises of the bolt underhead were observed for higher tightening speeds and the potential for localized melting or near-melting temperatures was shown. In the case of lower tightening speeds, the temperature rise was not as dramatic, but temperature increases are then observed along the length of the shank, showing the possibility of contributing to thermally induced galling between the threads. Due to the temperature variations observed in most cases in the underhead and along the bolt shank, this study indicates that such thermal effects should be considered when modeling the wear of bolted joints, particularly in cases involving larger tightening speeds or softer joints.
Visualization and Measurement of Dynamic Water Behavior in PEFC by Neutron Radiography
Authors: Ueda Tadanobu , Takenaka Nobuyuki , Asano Hitoshi , Tanimoto Kazumi , Mochiki Ko-Ichi , Kawabata Yuji , Matsubayashi Masahito
Published: April 2009

Hydrogen gas and air are supplied in saturated moist condition to keep a membrane wet in a PEFC. Condensation may occur in the cathode by the FC reaction, since air is saturated moist condition. The condensed water may affect on the fuel cell performance. It is very important for the design to know the water behaviors. In this study, in-situ visualization of an operating PEFC was carried by neutron radiography with the cell voltage measurements. A JARI standard cell was improved for the visualization with the same performance. Water distribution in the fuel cell could be quantitatively measured from visualized images via some image processing methods. The relationships between the water distributions and cell voltage fluctuations were clearly shown from the visualization and measurement results. The difference in water distribution for three types of gas supply channel was clearly shown.
Comparing Shock, Random and Sine Vibration Loads of the Electronic Equipment
Authors: Wang Frank Fan
Published: April 2009

It is a challenge to correlate different dynamic loads. Often, attempts are made to compare the peak acceleration of sine wave to the root mean square (RMS) acceleration of random vibration and shock. However, peak sine acceleration is the maximum acceleration at one frequency. Random RMS is the square root of the area under a spectral density curve. These are not equivalent. This paper is to discuss a mathematical method to compare different kinds of dynamic damage at the resonant point of the related electronic equipment. The electronic equipment will vibrate at its resonance point when there are dynamic excitations. The alternative excitation at the resonant frequency causes the most damage. This paper uses this theory to develop a method to correlate different dynamic load conditions for electronic equipment. The theory is that if one kind of dynamic load causes the same levels of damaging effects as the other, the levels of vibration can then be related.
Analysis and Characterization of Embedded Resistors for Wideband Applications
Authors: Lu Albert C. W. , Wai L. L. , Fan W. , Wong Stephen C. K. , Yamazaki Toshio , Jarcia Jacinto Jun , Chin Kim H.
Published: April 2009

This paper will describe the high-frequency analysis and characterization of embedded resistors fabricated in organic substrates. Although embedded resistors have been widely used in organic substrates, detailed analysis and characterization at high frequencies have received very limited attention. Majority of previous research work focuses on low frequency performance and manufacturing considerations. In this research work, a novel embedded resistor fabrication technique was employed to allow design on demand implementation of resistors. Analysis and characterization were carried out for frequencies up to 20 GHz, along with a comparison between embedded resistors and discrete surface mount resistors. It can be deduced that the degraded performance in the discrete implementation occurs above 1 GHz and is mainly attributed to surface mount parasitics. Embedded resistors, in contrast, offer significantly better broadband performance up to 20 GHz, in spite of inferior tolerances within 20%. This results show that embedded resistors not only achieve improved area utilization but also greatly improved high-frequency performance.
Multiple-point statistical room correction for audio reproduction: Minimum mean squared error correction filtering
Authors: Lingvall Fredrik , Brännmark Lars-Johan
Published: April 2009

This paper treats the problem of correction of loudspeaker and room responses using a single source. The objective is to obtain a linear correction filter, which is robust with respect to listener movement within a predefined region-of-interest. The correction filter is based on estimated impulse responses, obtained at several positions, and a linear minimum mean squared error criteria. The impulse responses are estimated using a Bayesian approach that takes both model errors and measurement noise into account, which results in reliable impulse response estimates and a measure of the estimation errors. The correction filter is then constructed by using information from both the estimated impulse response coefficients and their associated estimation errors. Furthermore, in the optimization criteria a time-dependent reflection filter is introduced, which attenuates the high frequency parts of the reflected responses, that is, the parts of the responses that cannot be compensated with a single source system. The resulting correction filter is shown to significantly improve both the temporal and spectral properties of the responses compared to the uncorrected system, and, furthermore, the obtained correction filter has a low level of pre-ringing.
A filtered convolution method for the computation of acoustic wave fields in very large spatiotemporal domains
Authors: Verweij Martin D. , Huijssen Jacob
Published: April 2009

The full-wave computation of transient acoustic fields with sizes in the order of 100×100×100 wavelengths by 100 periods requires a numerical method that is extremely efficient in terms of storage and computation. Iterative integral equation methods offer a good performance on these points, provided that the recurring spatiotemporal convolutions are computed with a coarse sampling and relatively few computational operations. This paper describes a method for the numerical evaluation of very large-scale, four-dimensional convolutions that employs a fast Fourier transformation and that uses a sampling rate close to or at the limit of two points per wavelength and per period. To achieve this, the functions involved are systematically filtered, windowed, and zero-padded with respect to all relevant coordinates prior to sampling. The method is developed in the context of the Neumann iterative solution of the acoustic contrast source problem for an inhomogeneous medium. The implementation of the method on a parallel computer is discussed. The obtained numerical results have a relative root mean square error of a few percent when sampling at two points per wavelength and per period. Further, the results prove that the method enables the computation of transient fields in the order of the indicated size.
Monitoring stress related velocity variation in concrete with a 2×10−5 relative resolution using diffuse ultrasound
Authors: Larose Eric , Hall Stephen
Published: April 2009

Ultrasonic waves propagating in solids have stress-dependent velocities. The relation between stress (or strain) and velocity forms the basis of non-linear acoustics. In homogeneous solids, conventional time-of-flight techniques have measured this dependence with spectacular precision. In heterogeneous media such as concrete, the direct (ballistic) wave around 500 kHz is strongly attenuated and conventional techniques are less efficient. In this manuscript, the effect of weak stress changes on the late arrivals constituting the acoustic diffuse coda is tracked. A resolution of 2×10−5 in relative velocity change is attained which corresponds to a sensitivity to stress change of better than 50 kPa. Therefore, the technique described here provides an original way to measure the non-linear parameter with stress variations on the order of tens of kPa.
A statistical, formant-pattern model for segregating vowel type and vocal-tract length in developmental formant data
Authors: Turner Richard E. , Walters Thomas C. , Monaghan Jessica J. M. , Patterson Roy D.
Published: April 2009

This paper investigates the theoretical basis for estimating vocal-tract length (VTL) from the formant frequencies of vowel sounds. A statistical inference model was developed to characterize the relationship between vowel type and VTL, on the one hand, and formant frequency and vocal cavity size, on the other. The model was applied to two well known developmental studies of formant frequency. The results show that VTL is the major source of variability after vowel type and that the contribution due to other factors like developmental changes in oral-pharyngeal ratio is small relative to the residual measurement noise. The results suggest that speakers adjust the shape of the vocal tract as they grow to maintain a specific pattern of formant frequencies for individual vowels. This formant-pattern hypothesis motivates development of a statistical-inference model for estimating VTL from formant-frequency data. The technique is illustrated using a third developmental study of formant frequencies. The VTLs of the speakers are estimated and used to provide a more accurate description of the complicated relationship between VTL and glottal pulse rate as children mature into adults.
Basic theory and properties of statistically optimized near-field acoustical holography
Authors: Hald Jørgen
Published: April 2009

To avoid the requirement set by standard near-field acoustical holography (NAH) to measure an area that fully covers the source, a set of so-called patch NAH methods has been introduced. One such method is the statistically optimized NAH (SONAH). In this method, the acoustic quantities on a mapping surface near the measurement surface are calculated by using a transfer matrix defined in such a way that all propagating waves and a weighted set of evanescent waves are projected with optimal average accuracy. The present paper gives an overview of the basic theory of SONAH, including a description of phenomena such as spatial aliasing and wave-number domain leakage. A revised and generalized mathematical formulation is given, covering the calculation of all three components of particle velocity and the use of up to six virtual source planes. A set of formulas for the inherent estimation error level of the method is derived and used to visualize the regions of validity of the SONAH predictions for some typical microphone array geometries. The sensitivity of the inherent error level distribution to changes in the parameters of the SONAH algorithm is also investigated.
Perception of allophonic cues to English word boundaries by Japanese second language learners of English
Authors: Ito Kikuyo , Strange Winifred
Published: April 2009

Perception of stop aspiration and glottal stop allophonic cues for word juncture in English by Japanese second language (L2) learners of English was examined, extending a study of Spanish L2 learners [Altenberg, E. P. (2005). Second Lang. Res. 21, 325–358]. Thirty Japanese listeners ranging in length of residence (LOR) in the United States (2weeks–12years) were tested on 42 contrasting pairs (e.g., aspiration: keeps talking vs keep stalking, glottal stop: a nice man vs an ice man, and double cues: grape in vs grey pin). Phrases were presented in randomly ordered lists and subjects responded in a two-choice identification task followed by a phrase familiarity test. The Japanese listeners performed more poorly than an American English-speaking control group (N=10), especially on aspiration pairs. Aspiration pairs were differentiated significantly less well (73% correct) by Japanese listeners than were glottal stop pairs (91% correct) and double cue pairs (94% correct); response biases predicted from relative familiarity of phrases were evident only for aspiration pairs. Performance correlated with LOR and suggested that aspiration cues take more immersion experience to learn than glottal stop cues. The patterns of errors were similar, but not identical, to Altenberg’s Spanish data.
Auditory stream formation affects comodulation masking release retroactively
Authors: Dau Torsten , Ewert Stephan , Oxenham Andrew J.
Published: April 2009

Many sounds in the environment have temporal envelope fluctuations that are correlated in different frequency regions. Comodulation masking release (CMR) illustrates how such coherent fluctuations can improve signal detection. This study assesses how perceptual grouping mechanisms affect CMR. Detection thresholds for a 1-kHz sinusoidal signal were measured in the presence of a narrowband (20-Hz-wide) on-frequency masker with or without four comodulated or independent flanking bands that were spaced apart by either 1/6 (narrow spacing) or 1 octave (wide spacing). As expected, CMR was observed for the narrow and wide comodulated flankers. However, in the wide (but not narrow) condition, this CMR was eliminated by adding a series of gated flanking bands after the signal. Control experiments showed that this effect was not due to long-term adaptation or general distraction. The results are interpreted in terms of the sequence of “postcursor” flanking bands forming a perceptual stream with the original flanking bands, resulting in perceptual segregation of the flanking bands from the masker. The results are consistent with the idea that modulation analysis occurs within, not across, auditory objects, and that across-frequency CMR only occurs if the on-frequency and flanking bands fall within the same auditory object or stream.
Judging the similarity of soundscapes does not require categorization: Evidence from spliced stimuli
Authors: Aucouturier Jean-Julien , Defreville Boris
Published: April 2009

This study uses an audio signal transformation, splicing, to create an experimental situation where human listeners judge the similarity of audio signals, which they cannot easily categorize. Splicing works by segmenting audio signals into 50-ms frames, then shuffling and concatenating these frames back in random order. Splicing a signal masks the identification of the categories that it normally elicits: For instance, human participants cannot easily identify the sound of cars in a spliced recording of a city street. This study compares human performance on both normal and spliced recordings of soundscapes and music. Splicing is found to degrade human similarity performance significantly less for soundscapes than for music: When two spliced soundscapes are judged similar to one another, the original recordings also tend to sound similar. This establishes that humans are capable of reconstructing consistent similarity relations between soundscapes without relying much on the identification of the natural categories associated with such signals, such as their constituent sound sources. This finding contradicts previous literature and points to new ways to conceptualize the different ways in which humans perceive soundscapes and music.
Measurement of liquid and solid component parameters in canine vocal fold lamina propria
Authors: Phillips Robert , Zhang Yu , Keuler Megan , Tao Chao , Jiang Jack J.
Published: April 2009

This study aimed to measure solid and liquid component parameters for canine vocal fold lamina propria tissue, as is consistent with the solid and liquid fraction parameters in the context of the biphasic theory. A liquid-displacement apparatus was developed and utilized to estimate volumes of small samples of tissue. Accuracy was determined by calibrations with an object of known mass and density (copper). The experimental apparatus was then used to determine the volume of eight tissue samples, followed by an apparently complete dehydration of the samples, yielding the dry or solid tissue. The mass and volume fractions of the liquid component were sufficiently higher than those of the solid component. These results represent preliminary experimental evidence for the biphasic composition (solid-liquid) of canine lamina propria tissue as predicted in the biphasic theory. This study presents an effective experimental method to estimate some of the biphasic model parameters, and may provide a valuable application in exploring the viscoelastic behaviors of vocal fold lamina propria tissue.
A wave-based finite element analysis for acoustic transmission in fluid-filled elastic waveguides
Authors: Peplow Andrew T.
Published: April 2009

This paper describes an original numerical prediction technique developed for the analysis of coupled vibro-acoustic problems in fluid waveguides. Specifically it is a wave-based method that adopts a spectral element approach. Unlike the conventional element-based methods, this technique uses wave functions that satisfy the governing equations to describe the dynamic variables exactly. One advantage is that fine domain discretizations, used by element-based methods near the fluid-structure interface typically, are no longer required. Hence the resulting model sizes are much smaller than element-based methods yielding a more time-efficient prediction technique that may allow handling of mid-frequency applications. Another advantage is that dispersion relations between propagating and excitation wavenumbers are easily obtained, and an example to show this, as well as a discussion on how the wave-based prediction technique can be used for two coupled vibro-acoustic problems: a cavity with a non-reflecting boundary and a silencer duct problem, is presented. Its beneficial characteristics compared to element-based methods are demonstrated through the validation study and transmission loss examples.
Can temporal fine structure represent the fundamental frequency of unresolved harmonics?
Authors: Oxenham Andrew J. , Micheyl Christophe , Keebler Michael V.
Published: April 2009

At least two modes of pitch perception exist: in one, the fundamental frequency (F0) of harmonic complex tones is estimated using the temporal fine structure (TFS) of individual low-order resolved harmonics; in the other, F0 is derived from the temporal envelope of high-order unresolved harmonics that interact in the auditory periphery. Pitch is typically more accurate in the former than in the latter mode. Another possibility is that pitch can sometimes be coded via the TFS from unresolved harmonics. A recent study supporting this third possibility [Moore et al. (2006a). J. Acoust. Soc. Am. 119, 480–490] based its conclusion on a condition where phase interaction effects (implying unresolved harmonics) accompanied accurate F0 discrimination (implying TFS processing). The present study tests whether these results were influenced by audible distortion products. Experiment 1 replicated the original results, obtained using a low-level background noise. However, experiments 2–4 found no evidence for the use of TFS cues with unresolved harmonics when the background noise level was raised, or the stimulus level was lowered, to render distortion inaudible. Experiment 5 measured the presence and phase dependence of audible distortion products. The results provide no evidence that TFS cues are used to code the F0 of unresolved harmonics.
Modeling cumulative sound exposure around marine seismic surveys
Authors: Erbe Christine , King Andrew R.
Published: April 2009

This article presents a method for reducing the computation time required for estimating cumulative sound exposure levels. Sound propagation has to be computed from every source position to every desired receiver location; so if there are many source positions, then the problem can quickly become computationally expensive. The authors' solution to this problem is to extract all possible source-receiver pathways and to cluster these with a self-organizing neural net. Sound propagation is modeled only for the cluster centroids and extrapolated for the entire geographic region. The tool is illustrated for the example of a marine seismic survey over a tropical coral reef. Resident fish species were expected not to flee the reef, but to stay among the corals for the entire duration of the survey. In such cases, the modeling of cumulative sound exposure levels is sometimes requested as part of environmental impact assessments. The tool developed combines a seismic source model, a near-field sound propagation model, and a far-field sound propagation model. The neural network reduces the computation time by a factor of 55. The cost is an error in modeled received levels of less than −1±3 dB re 1 μPa2 s.
A portable infrasound generator
Authors: Park Joseph , Robertson James
Published: April 2009

The rotary subwoofer is a novel low frequency transducer capable of efficiently generating infrasound from a compact source. A field-deployable version of this device may find application as a calibration source for infrasound arrays of the International Monitoring System (IMS) [(2001). The Global Verification Regime and the International Monitoring System (CTBTO Preparatory Commission Vienna International Centre, Vienna, Austria)]. A prototype tested at the IMS infrasound array I59US demonstrated the ability to insonify all elements of the array from a standoff distance of 3.8km. Signal-to-noise ratios of continuous wave signals ranged from 5to15dB, indicating the utility of this source to transmit controllable infrasound signals over distances of 5km.
Estimating marine sediment attenuation at low frequency with a vertical line array
Authors: Jiang Yong-Min , Chapman N. Ross , Yang Kunde , Ma Yuanliang
Published: April 2009

This paper presents a method of determining the compressional wave attenuation in marine sediment from a short range measurement. The data were collected on a vertical line array at a range of 230 m during the Shallow Water 2006 experiments. The sediment attenuation is extracted from the signal strength ratio of the sea bottom reflection to a sub-bottom reflection at different frequencies from 1.75 to 3.15 kHz. Linear frequency dependence of the attenuation is found from the estimation. The sediment attenuation estimate is lower than the values estimated from the inversions of acoustic field data previously done in the vicinity.
Acupuncture for Resistant Temporo-Mandibular Joint Pain Dysfunction Syndrome
Authors: Ho Victor , Bradley Paul
Published: April 2009

Four patients suffering from Temporo-Mandibular joint Pain Dysfunction Syndrome, who had proved resistant to conventional, conservative therapy, were treated with a combination of manual body-acupuncture, electroacupuncture to points on the face and laser therapy to ear points.

Three of the patients showed marked improvement during the initial four weeks of treatment. The fourth did not complete the treatment course but none the less had improved by the two month follow up. All patients showed sustained relief over a six month period of follow up. It is suggested that acupuncture should be included among the first line, conservative therapies for this problem.
Acupuncture of the Knee
Authors: Camp Virginia
Published: April 2009

Knee pain should never be considered in isolation. It must be effectively investigated and accurately diagnosed where possible, to differentiate the various forms of arthritis, identify causes of inflammation and exclude metabolic and other factors.

Surgical treatment, including arthroscopy and joint replacement, is a very effective option and should now be considered at an earlier stage before severe deformity has occurred. Non-steroidal anti-inflammatory drugs should generally be avoided except in topical form. Intra-articular steroid injection may often be used after diagnostic aspiration of the joint.

Acupuncture is very acceptable to patients but must be viewed as part of an overall treatment plan. It is effective in acute and anterior knee pain. In chronic pain it should logically be used where the diagnosis is known and where joint aspiration is not necessary, and it is the treatment of choice for advanced rheumatoid patients who are inadequately controlled on other therapy - 60% have lasting benefit. The drawback is that clinics may be overwhelmed by the demand for repeated courses of treatment, since the relief is often excellent but rarely permanent.
Surrounding the Dragon
Authors: Redfearn Ted
Published: April 2009

The technique of surrounding an injured area with needles is a well tried and effective method of providing analgesia and reducing tissue oedema and inflammation. Here the author describes his own experience of self administered acupuncture for post-operative relief.
Regulations Governing the Use of Laser Equipment
Authors: White Adrian
Published: April 2009

Anyone using a medical laser must contact the local Laser Protection Adviser, and is likely to have to register his premises as a Nursing Home.
Elective Project in a Chinese Hospital
Authors: Wong Christopher K M
Published: April 2009

This is the story behind the award winning project on acupuncture anaesthesia in China, undertaken as a student elective from the University of Wales. Chinese hospital life is acutely observed, as is the process of living in one of the most densely populated countries on earth.
Acupuncture, Chi and a Credible Model for Treatment
Authors: Wood Clive
Published: April 2009

The concept of chi and the system of meridians in which it travels is not essential to explain the therapeutic action of acupuncture, for example in the treatment of pain. Neurophysiological explanations, whilst still not wholly adequate, will eventually provide an accurate and adequate account of the processes involved. In contrast, scientific studies attempting to validate the existence of acupuncture meridians have been uniformly unsuccessful. Why then does this vitalistic concept persist in many acupuncture practices, even in the Western world? The answer is that it provides a credible model of the patient's symptoms and of the treatment procedure. Acceptance of this shared model strengthens the therapeutic relationship and is likely to facilitate the treatment process.
Acupuncture Research: Where Are the Problems?
Authors: Ernst Edzard
Published: April 2009

In spite of its long history and widespread use, acupuncture has failed to demonstrate its clinical effectiveness convincingly. This article is aimed at discussing some of the problems related to acupuncture research that might have contributed to this overt discrepancy. These are the effects of investigator bias, the abundance of derivatives of traditional acupuncture, the lack of standardisation of treatment and selection of acupoints, and the difficulty in blinding the investigator, patient or therapist, as well as the problems related to the choice of an appropriate placebo. Such, mostly methodological difficulties, can and must be overcome if the controversy regarding the clinical effectiveness of acupuncture is to be solved.
Oral Acupuncture
Authors: Gleditsch Jochen
Published: April 2009

The oral mucosa offers non traditional acupoints, forming an acupuncture microsystem that may be used for treatment of disease throughout the body. Through palpation of tender spots this system can be an aid to diagnosis, or by injection of tiny volumes of normal saline or local anaesthetic it can be used as an effective treatment. Oral acupuncture has been clinically tested over a period of 25 years and has proved effective for a variety of diseases. Additionally, relationships with internal organs and body acupoints have been demonstrated.
The “Very Point” Technique: A Needle Based Point Detection Method
Authors: Gleditsch Jochen
Published: April 2009

An acupuncture point detection technique is described in which the needle to be used in therapy acts as a guide for the point detection. The needle is dabbed tangentially onto the area around the point until a loss of resistance is felt and the patient reports an electrical sensation. This method can be used particularly well in two areas of the hand: along the outer edges of the thumb and little finger. These partial acupuncture microsystems are described with therapeutic indications for their points.
Eciwo Biology and the Future of Medicine
Authors: Schjelderup Vilhelm
Published: April 2009

Acupuncture microsystems have proved clinically successful, despite being apparently based on little more than empirical descriptions of point relationships with the body as a whole. ECIWO biology (which stands for Embryo Containing Information of the Whole Organism) suggests a coherent hypothesis to explain the microsystems, which are credited with providing a natural, stimulatory control for pathology throughout the body.
Complications of Acupuncture
Authors: Rampes Hagen , James Richard
Published: April 2009

Acupuncture as a treatment modality is now more widely used by the medical profession. It behoves both practitioners and patients to be aware of possible complications, the majority of which can be avoided with cautious and prudent use of this ancient therapy.

There have been many isolated reports of complications of acupuncture in the literature. We surveyed the literature identifying all articles referring to complications of acupuncture. Our findings are presented and discussed.
Acupuncture in the Normal General Practice Consultation: An Assessment of Clinical and Cost Effectiveness
Authors: Downey Paul
Published: April 2009

An audit of the effectiveness of acupuncture was carried out to ascertain whether short courses of acupuncture therapy in a normal general practice surgery setting were appropriate and effective. Clinical effectiveness was measured in terms of improvement in patient symptomatology, and the cost-effectiveness was assessed by asking, “What would have been offered if acupuncture was not used?” Fifty consecutive cases were analysed over a six month period.
Acupuncture for Chronic Pain in a Chinese Out-Patient Clinic
Authors: Seth Emma
Published: April 2009

During a student elective to China, the use of acupuncture in the treatment of chronic pain was investigated at a university teaching hospital. Sixteen patients in two groups: Osteoarthritis and others, answered questionnaires on their pain and its response to treatment. Acupuncture was found to provide effective pain relief and improved mobility in most patients for a period of 24 hours. This benefit was most marked in those who had had electroacupuncture.
Modern Chinese Use of Tcm as Seen on a Student Elective
Authors: Jones Martin , Murray Stuart
Published: April 2009

The authors, medical students of Bristol University, spent their elective period of almost six weeks during September and October 1993 in the Acupuncture Department of the First Teaching Hospital of Beijing Medical University. The aim of the elective was to see traditional Chinese medicine (TCM) in clinical practice, especially in conjunction with western medicine, and to try to learn the fundamentals of the theory and practice of TCM. This report details the teaching received and discusses the modern Chinese attitudes to medical treatment and TCM in particular.
A Review of the Use of Acupuncture in General Practice
Authors: Watkins Sarah
Published: April 2009

This is a practice audit reviewing the outcome of acupuncture treatment over a two month period. A questionnaire was used to determine the benefit obtained by patients following acupuncture and also to investigate any change in attitude towards the treatment brought about by “sharp end” experience.

Improvement was claimed by 85% of responders to the questionnaire, with 57% finding that benefit lasted more than 5 days. Initially 50% of patients were sceptical about acupuncture, but after treatment 91% had become enthusiasts.
Acupuncture in the Management of Postoperative Nausea and Vomiting in Patients Receiving Morphine via a Patient-Controlled Analgesia System
Authors: McConaghy Paul , Bland David , Swales Hilary
Published: April 2009

This single-blind, randomised, controlled trial was undertaken to assess the efficacy of acupuncture (ACP) at the PC.6 (Neiguan) point in the management of established postoperative nausea and vomiting (PONV) in patients receiving parenteral morphine via a Patient-Controlled Analgesia System (PCAS). Eighty patients were recruited on the first postoperative day and 30 were treated with ACP after developing PONV lasting more than 10min. Patients were randomly allocated to receive ACP bilaterally at either PC.6 or at a dummy point near the elbow, with manual stimulation for a total of 4min. Only patients with no knowledge of ACP antiemesis were studied, and each patient was thus unaware of the group to which they were allocated. Patients treated with PC.6 ACP had a greater mean improvement in their visual analogue score for nausea (p<0.05). All patients in the PC.6 group improved their score by 20% or more, while only one third in the control group did so (p<0.001). In the PC.6 group 53% of patients did not require any further antiemetic while receiving PCAS morphine. All patients in the control group required further antiemetic treatment (p<0.001). No adverse effects were recorded.
Practising Acupunture Today: A Postal Questionnaire of Medical Practitioners
Authors: Dale Jennifer
Published: April 2009

This article summarises the main findings, as they pertain to physician acupuncturists of the British Medical Acupuncture Society (BMAS), of a general survey of British acupuncture practitioners carried out in 1995. The issues covered include: who uses acupuncture in the National Health Service (NHS), and in what settings; how much acupuncture is used in both the NHS and private practice; how much time is spent with patients; and the different ways in which General Practitioners fit acupuncture sessions into their general practice. Brief consideration is also given to conditions treated and style of acupuncture practised. Some possible implications of the findings for the expansion of provision within the NHS are raised.
Acupuncture's Place within Mainstream Medicine
Authors:   British Medical Acupuncture Society
Published: April 2009

This is a discussion paper reviewing the evidence for acupuncture in the fields of its current Western medical use. It is proven by controlled trials to be effective in pain relief, for dysmenorrhoea, and in nausea and vomiting. It has been found clinically useful in a wide variety of other areas including allergy bladder dysfunction, drug dependency and stroke.

There is an increasing body of evidence that acupuncture is a cost-effective treatment option, and its use has become widespread in pain clinics, hospital rheumatology and physiotherapy departments, and in general practice. Medical acupuncture is now based firmly on modern physiological principles, and an understanding of the opioid and other neurotransmitters involved in needle stimulation has made clinically useful acupuncture practice readily accessible to medical practitioners.
Survey of Adverse Events following Acupuncture
Authors: White Adrian , Hayhoe Simon , Ernst Edzard
Published: April 2009

Volunteers are sought who will commit themselves to report the incidence of adverse effects in their acupuncture practice over a period of two years. The Department of Complementary Medicine of Exeter University is co-ordinating a survey of 30,000 acupuncture treatments. From the resulting data a complication rate of serious and minor side effects will be compiled. It is hoped that meticulous recording could demonstrate circumstances leading to adverse effects and identify unrecorded complications of acupuncture.

Previous reports suggest that the major complications of acupuncture have an incidence of between 1:10,000 and 1:100,000, which is classified as very low. This survey aims to give an accurate assessment of the risk of major complication and to determine the range and incidence of any other unintended and non-therapeutic ill-effects following acupuncture, no matter how minor. It constitutes the first such investigation into the safety of acupuncture.
A Comparative Study of Two Methods of Acupuncture Treatment for Neck and Shoulder Pain
Authors: Hansen John A
Published: April 2009

Patients with chronic neck and/or shoulder pain were sequentially allocated into two groups to be treated with acupuncture using the same needle positions and depth, but with varying time of stimulation. One group (15 patients) had treatment sessions lasting 20min, and the second group (13 patients) had treatment for only 5min. A visual analogue score (VAS) was used to measure the levels of pain before treatment, at the end of a ten week course of weekly acupuncture treatments and again after 6 months.

The results showed that patients in both groups had a good response, both short and long term, to acupuncture, and that there was no significant difference in benefit between the groups at the end of their course of treatment or after 6 months. However, this may not necessarily mean that the shorter time of stimulation can be used in preference to the more traditional longer treatment sessions, as there was an imbalance between groups in the pre-treatment VAS and the trial size was inadequate to give a reliable result.

There was good clinical tolerance and most patients were able to continue working during the course of treatment. There thus seems no benefit to be gained by advising patients to take sick leave during acupuncture treatment for neck and shoulder pain.
Epicondylitis Treated by Local Corticosteroid Injection
Authors: Bourne I H J
Published: April 2009

Tennis and golfer's elbow (lateral and medial epicondylitis) are readily treated with local injection of long-acting corticosteroid. In a clinical series of patients who had already failed to respond to oral drug treatment, rest and physiotherapy thus acting as their own controls, 63% recorded an excellent result after corticosteroid injection and a further 26% had a good result. Inspection of anatomical specimens shows that the common extensor origin at the lateral epicondyle is variable in size and shape and that the male and female humeri are very different in character at this area. Epicondylitis is much more common in the female: 19 out of 27 in this clinical series.

A technique is described for selecting the most tender spot, at which the injection should be sited. This is rarely at the epicondyle itself. Also, when the lesion is recurrent, tenderness is usually noted at a new site. For an average-sized tender lesion, a 1 ml injection of the mixture methylprednisolone 40mg and lignocaine 10mg per ml is ideal; however in order to reduce the incidence of skin atrophy, superficial lesions should receive a smaller volume of more dilute suspension.
Cardiac and Non-Cardiac Chest Wall Pain
Authors: Baldry Peter
Published: April 2009

The various causes of anterior chest wall pain are reviewed with particular reference to the clinical manifestations of coronary artery disease (CAD), costochondritis and the myofascial pain syndrome.

Attention is drawn to the manner in which myofascial pain syndrome in the anterior chest wall may arise as a result of primary trauma or anxiety-induced activation of myofascial trigger point (MTrP) nociceptors and also as a result of the secondary activation of MTrPs situated in a zone of cardiac pain referral, and how myofascial pain syndrome may develop in patients with mitral valve prolapse.

It is explained that, because of an appreciable incidence of concomitant costochondritis and CAD pain and of MTrP and CAD pain, and because dry needling in both myofascial pain syndrome and costochondritis may relieve underlying CAD pain, it is not infrequently necessary in cases of anterior chest wall pain to carry out a detailed cardiological assessment including electrocardiographic exercise testing and radionuclide cineangiography.
Review of Acupuncture for Schizophrenia
Authors: Beecroft Nicholas , Rampes Hagen
Published: April 2009

There is a paucity of scientific data on the use of acupuncture or low-power laser treatment in schizophrenia. The authors have conducted a literature search, identifying eight papers on the subject: all were significantly flawed, most seriously so. The papers suggest that acupuncture and low-power laser treatment may be as effective as chlorpromazine in schizophrenia. However no scientifically sound conclusions can be drawn. Better designed research is required before acupuncture can be considered a suitable treatment for schizophrenia.
A Questionnaire on Medical Acupuncture Practice
Authors: Hayhoe Simon , Box Hillary
Published: April 2009

Members of a medical acupuncture society were circulated by postal questionnaire to enquire into their acupuncture practice. Over half the replies were from general practitioners, with one third from anaesthetists. Most were using acupuncture for musculo-skeletal and general pain, but a large variety of conditions were reported as responding well by small numbers of practitioners, while others regarded these same conditions as being resistant to treatment. It is suggested that this was due to inadequate training, particularly for non painful disease which requires a more traditional and less Westernised approach. The British Medical Acupuncture Society has since modified its teaching structure to take account of this finding.

Acupuncture is more popular with middle aged patients and, while medical referrals are common, most patients self-refer on the recommendation of friends and relations, but not until they have tried other therapies. Once they have experienced acupuncture they are more likely to come for initial treatment with any future problems.

The majority (75%) of medical acupuncturists see less than 250 patients a year, and almost 50% see less than 100. Most seem to be conventional doctors who use acupuncture for particular problems in suitable patients. The authors believe that practising acupuncture from a firm base in conventional medicine is likely to give the greatest benefit to patients.
The Effect of Timing of Pc.6 Acupuncture on Post-Operative Vomiting following Major Gynaecological Surgery
Authors: Yentis SM , Vashisht S
Published: April 2009

We have studied whether the antiemetic effect of PC.6 (Neiguan) acupuncture at the wrist in preventing post-operative nausea and vomiting is affected by the timing of its administration in fifty patients undergoing major gynaecological surgery. Patients were randomly assigned to receive PC.6 acupuncture either five minutes before induction of anaesthesia (Group 1), five minutes after induction of anaesthesia (Group 2) or when awake in the recovery room post-operatively (Group 3). There were no significant differences in emetic sequelae amongst the three groups, with respective incidences of vomiting of 29%, 24% and 25% within the first 6 hours post-operatively. In order to have an 80% power of detecting a difference between groups of the magnitude found, over 3600 patients would need to be studied. We conclude that general anaesthesia does not affect the antiemetic action of PC.6 acupuncture.
The Use of Acupuncture in Dentistry: A Systematic Review
Authors: Rosted Palle
Published: April 2009

Published controlled studies on the analgesic effect of acupuncture in dentistry are still relatively few, but those which fulfil predefined methodological criteria are reviewed to assess if acupuncture is effective in this field. A literature search identified 74 papers published between 1966 and 1996, and 48 are reviewed. Only 15 of the papers fulfil a number of predefined criteria: having a reference group, randomisation, blinding, appropriate statistics, sufficient follow-up, etc. Of the 15 papers only one study meets more than 85% of the criteria, five meet 70–84%, three studies meet 60–69%, and six do not reach 60% of the predefined criteria and are thus considered unreliable.

Eleven out of the 15 studies were in favour of acupuncture and showed standard acupuncture to be more effective than placebo, non-standard (sham) acupuncture, or showed it to be able to produce better or similar results to an accepted treatment procedure. The higher the standard of the paper, the more likely it was to have a positive result in favour of acupuncture: all those in the excellent or good categories gave a favourable result Acupuncture proved effective in 73% of the reviewed papers for the treatment of Temporomandibular dysfunction or as an analgesic, and should be considered as a reasonable alternative or supplement to current dental practice in these areas.
Acupuncture: An Alternative Treatment for Post Dural-Puncture Headaches following Obstetric Epidural Or Spinal
Authors: Perera S Mahendra
Published: April 2009

Six obstetric patients were treated with acupuncture for post dural-puncture headaches. Five had had epidurals for pain relief in labour and one a spinal for an elective lower segment caesarean section; all had developed a post dural-puncture headache, although in the epidural group not all had had an obvious CSF leak. After explaining the options available for treatment of post dural-puncture headache, verbal consent was obtained to perform acupuncture. Minimal needling was done using 0.25 by 30mm sterile disposable needles. The points were chosen from: LR.3, bilateral cervical articular pillar (CAP) as described by Felix Mann, and GB.12,14,20 and 21. The CAP points and LR.3 were needled in all patients; other points were chosen according to the site of headache and the location of tender points. Four patients had complete relief of symptoms from the onset of treatment. They were given a second treatment one or two days later and then discharged home. Two patients had only a transient relief lasting about four hours. They were not given a second acupuncture treatment, but were blood-patched with a successful outcome.
Reproductive Medicine: Research Projects in Acupuncture
Authors: Stener-Victorin Elisabet
Published: April 2009

Two studies are briefly reported in which electroacupuncture is found to be beneficial in aspects of infertility treatment. They are the first in a series planned to investigate acupuncture in this area of gynaecology.

1. A high impedance in the blood flow of the uterine arteries has been shown to reduce the pregnancy rate of in-vitro fertilisation treatment. So ten healthy, but infertile, women with a high uterine artery pulsatility index were treated with electroacupuncture twice a week over a period of four weeks. There was a significant reduction (p<0.0001) in pulsatility index that was maintained for a further two weeks.

2. Twenty-four women with polycystic ovary syndrome were treated with electroacupuncture over a period of three months. Ovulation patterns were observed by daily recording of basal body temperature over nine months, including three months before treatment and three after. The main outcome was that electroacupuncture induced regular ovulation in more than a third of the women. The women were found to fall into two categories: a group in whom regular ovulation was induced following electroacupuncture who were less androgenic and had less metabolic disturbance, and a group who were more affected by the syndrome and who did not respond to treatment.