The New England Journal of Medicine (NEJM) is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It describes itself as the oldest continuously published medical journal in the world.^[1] The journal publishes editorials, papers on original research, review articles, correspondence, and case reports, and has a special section called "Images in Clinical Medicine".

History[link]

January 1814 edition of the Journal.

In September 1811, John Collins Warren, a Boston physician,^[2] along with James Jackson, submitted a formal prospectus to establish the New England Journal of Medicine and Surgery and Collateral Branches of Science as a medical and philosophical journal.^[3] Subsequently, the first issue of the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science was published in January 1812.^[4] The journal was published quarterly.

On April 29, 1823, another publication, the Boston Medical Intelligencer, appeared under the stewardship of Jerome V.C. Smith.^[5][6]

The Intelligencer ran into financial troubles in the spring of 1827, and the editors of the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science purchased it in February 1828 merging the two publications to form the Boston Medical and Surgical Journal,^[7] published weekly.

The Massachusetts Medical Society purchased it in 1921 for $1^[8] and renamed it in 1928 the New England Journal of Medicine.

200th Anniversary in 2012[link]

Notable articles from the course of the New England Journal of Medicine's history include:

• In November 1846, Henry Jacob Bigelow, a Boston surgeon, reported a breakthrough in the search for surgical anesthetics with the first uses of inhaled ether in 1846. This allowed patients to remain sedated during operations ranging from dental extraction to amputation.^[9] "A patient has been rendered completely insensible during an amputation of the thigh, regain consciousness after a short interval," Bigelow wrote. "Other severe operations have been performed without the knowledge of the patients."

• In June 1906, James Homer Wright published an article that described how he stained and studied bone marrow with descriptions of what are now known as megakaryocytes and platelets.^[10]

• In October 1872, a lecture by C.E. Brown-Sequard was published that proposed the then-revolutionary idea that one cerebral hemisphere can influence both sides of the body. The neurologist would go on to describe what is now known as the Brown-Sequard syndrome.^[11]

• In June 1948, Sidney Farber reported promising results in treatment of early childhood leukemia. Based on anecdotal evidence that children with acute leukemia worsened if they were given folic acid, he worked on blocking folic acid metabolism. His team gave 16 infants and children with acute lymphoblastic leukemia a folic acid inhibitor, aminopterin -– 10 showed improvement by clinical and hematologic parameters after three months.^[12] In his article, Farber advised receiving the results cautiously: "It is again emphasized that these remissions are temporary in character and that the substance is toxic and may be productive of even greater disturbances than have been encountered so far in our studies," he wrote. "No evidence has been mentioned in this report that would justify the suggestion of the term 'cure' of acute leukemia in children."

• In November 1952, cardiologist Paul Zoll published an early report on resuscitation of the heart. "The purpose of this report is to describe the successful use in 2 patients of a quick, simple, effective and safe method of arousing the heart from ventricular standstill by an artificial, external, electric pacemaker," he wrote. "For the first time it was possible to keep a patient alive during ventricular asystole lasting for hours to days. This procedure may prove valuable in many clinical situations."^[11]

• In February 1973, NEJM published the first report of polyp removal using a colonoscope and introduced a procedure during screening to reduce cancer risk. The authors reported on 218 patients, from whom they removed 303 polyps (at one or more procedures per patient).^[13]

• In December 1981, two landmark articles^{[14] [15]} described the clinical course of four patients -– first reported in the CDC's June 1981 Morbidity and Mortality Weekly Report -- with the disease that would come to be known as AIDS.

• In April 2001, Druker et al. reported a targeted therapy for chronic myelogenous leukemia. Based on the knowledge that BCR-ABL, a constitutively activated tyrosine kinase, causes CML, the authors tested with success an inhibitor of this tyrosine kinase in patients who had failed first-line therapy. The finding helped begin the era of designing cancer drugs to target specific molecular abnormalities.^[16]

Website[link]

On April 25, 1996, NEJM announced their new website, which published each week the abstracts for research articles and the full text of editorials, cases, and letters to the editor. After print publishing for 184 years this was the NEJM's first use of the Internet for electronic publication.^[17]

The website was launched several months earlier in 1996, but the editors wanted proof that weekly electronic publication would work. Only then was an announcement approved for publication on the editorial page. Two years later, online publication extended to include the full text of all articles.^[18]

Since its launch, NEJM has added to its website:

• Videos in Clinical Medicine, peer-reviewed educational videos to teach procedures requiring skilled techniques and specialized physical examination.^[19]
• Interactive Medical Cases, which mimic a clinical encounter by presenting the patient's history with results of the physical examination and laboratory and radiographic tests. Multiple-choice questions throughout test the taker's knowledge.^[20]
• NEJM Archive, the entire collection of the journal's published material.

Influence[link]

The website for the George Polk Awards noted that its 1977 award to the New England Journal of Medicine "provided the first significant mainstream visibility for a publication that would achieve enormous attention and prestige in the ensuing decades."^[21]

The journal usually has the highest impact factor of the journals of clinical medicine (including the Journal of the American Medical Association, and The Lancet); in 2006, the impact factor was 51, according to the Journal Citation Reports, the first research journal to break 50.^{[not specific enough to verify][Full citation needed]}

Ingelfinger Rule[link]

The New England Journal of Medicine requires that articles it publishes not have been published or released elsewhere. Referred to as the Ingelfinger Rule, this policy protects the originality of content.

The rule was first described in a 1969 editorial by Franz Ingelfinger, the editor-in-chief at that time.^[22] Most medical journals have similar rules in place.

Vioxx correction controversy[link]

In the early 2000s, the New England Journal of Medicine was involved in a controversy around problems with research on the drug Vioxx. A study was published in the journal in November 2000 which noted an increase in myocardial infarction amongst those taking Vioxx.^[23] According to Richard Smith, the former editor of the British Medical Journal, concerns about the correctness of that study were raised with the journal's editor, Jeff Drazen, as early as August 2001. That year, both the US Food and Drug Administration and the Journal of the American Medical Association also cast doubt on the validity of the data interpretation that had been published in the NEJM.^[24] Merck withdrew the drug from market in September 2004. In December 2005, NEJM published an expression of concern about the original study following discovery that the authors knew more about certain adverse events than they disclosed at the time of publication. From the Expression of Concern: "Until the end of November 2005, we believed that these were late events that were not known to the authors in time to be included in the article published in the Journal on November 23, 2000. It now appears, however, from a memorandum dated July 5, 2000, that was obtained by subpoena in the Vioxx litigation and made available to the Journal, that at least two of the authors knew about the three additional myocardial infarctions at least two weeks before the authors submitted the first of two revisions and 4 1/2 months before publication of the article."^[25] During the five-year period between publication and Expression of Concern, it has been estimated that Merck paid NEJM as much as US$836,000 for article reprints that Merck used for promotional purposes.^[26] The journal was publicly rebuked for its response to the research issues in editorials appearing in publications including the British Medical Journal^[24] and the Journal of the Royal Society of Medicine.^[27]

Open access policy[link]

NEJM provides delayed free online access to its research articles (it does so six months after publication, and maintains that access dating back to 1990).^[28] This delay does not apply to readers from the least developed countries, for whom the content is available at no charge for personal use.^[29]

NEJM also has two podcast features, one with interviews of doctors and researchers that are publishing in the journal, and another summarizing the content of each issue. Other offerings include Continuing Medical Education, Videos in Clinical Medicine (showing videos of medical procedures), and the weekly Image Challenge.

Editors[link]

• Walter Prentice Bowers, 1921–1937
• Robert Nason Nye, 1937–1947
• Joseph Garland, 1947–1967
• Franz J. Ingelfinger, 1967–1977
• Arnold S. Relman, 1977–1991
• Jerome P. Kassirer, 1991–1999
• Marcia Angell, 1999–2000
• Jeffrey M. Drazen, 2000–present

See also[link]

• List of medical journals

References[link]

External links[link]

• Official website

This article has multiple issues. Please help improve it or discuss these issues on the talk page. It does not cite any references or sources. Please help improve it by adding citations to reliable sources. Tagged since August 2009. It is written like an advertisement and needs to be rewritten from a neutral point of view. Tagged since August 2009. It may contain original research. Tagged since August 2009. Its tone or style may not reflect the formal tone used on Wikipedia. Tagged since August 2009.

ENGL is a German company that makes high-end tube amplifiers for electric guitars. Over the years ENGL has succeeded in becoming a global player in this market. Currently the company competes with leading makes such as Marshall and Mesa Boogie.

Notable users include: Ritchie Blackmore, Chris Broderick, Phil Campbell, Marty Friedman, Craig Goldy, Jeff Loomis, Steve Morse, Rudolph Schenker, Paul Stanley and Glenn Tipton.

Current amplifier models[link]

Steve Morse[link]

The Steve Morse Signature 100 E656 is a 3 channel amp designed for and with Steve Morse, lead guitarist of Deep Purple. The amp is based on the ENGL Invader, omitting the two high gain channels to feature one extremely versatile lead channel. All three channels on the Steve Morse have an individual equaliser. The lead channel gives extended control over the midrange by means of two sets of mid controls; high mid 1, high mid 2, low mid 1 and low mid 2. The two sets are individually switchable and combined with the tone switch that allows for 8 different equaliser settings within the same channel.
Furthermore, the amp features two parallel effects loops, a noise gate, two master volume controls, tone- and gain switches for all channels.

Blackmore[link]

The full name of the Blackmore is the Ritchie Blackmore Signature E650. The design is based on the ENGL Savage 120 with modified voicing to suit the style of former Deep Purple guitarist Ritchie Blackmore.
The amplifier head features 2 channels with footswitchable gainboost (similar to the Engl Screamer): clean, crunch, lead and heavy lead. There is a shared passive 3 band equalizer, mid contour switch, bright switch and 2 master volume controls.
There is one effects loop post preamp with a control for adjusting between serial and parallel operation.
The power amp section is a 100 watt class A/B design featuring one ECC 83 and four 5881 tubes. The preamp section features a further three ECC 83 tubes. It was the only signature model produced by ENGL, until very recently with the new Steve Morse Signature 100 Head. Ironically, Steve Morse replaced Ritchie Blackmore in the legendary band, Deep Purple. There is also a very rare "slowhand" version of this amp which uses EL34s instead of 6L6s, which is some times referred to as the Engl Blackmore (Slow Hand Motion edition).

Classic[link]

There are 3 models in the Classic range.
Classic Head E 355 C
Classic Combo 2 x 10" E 350 C
Classic Combo 2 x 12" E 358 C

Fireball[link]

The Fireball E 625 is a 2 channel 60 watt guitar amplifier head. The design takes a no frills approach with less control options compared to similar products in the ENGL range. Its lead and clean channels share a gain control and 3-band equalizer, which can make optimizing the sound of each channel at the same time difficult. It is favored by some, however, for its simplicity and ease of use, while retaining the tone that ENGL is known for. The amp is equipped with 4xECC83 Preamp tubes and 2x6L6GC tubes in Poweramp. Despite offering a clean mode, the main intent of the Fireball was aimed at the heavy metal guitar market. The clean and lead gain control also serves as a primary volume and by turning this control to zero, silences the amplifier completely.

Invader[link]

The Invader features 4 independent channels, each capable of producing a wide range of tones, differing from traditional designs of having dedicated clean and lead channels.

The power amp design is 150 watt produced by six EL34 tubes with a depth and presence control, although a 100W version is also available.

The preamp features separate gain and volume controls for each of the 4 channels, each featuring a dedicated 3 band passive eq, powered by four ECC 83 tubes.

The amp also features 2 parallel effects loops and a noise gate.

Powerball[link]

The Powerball E 645 is a 100 watt amp with four channels (Clean/Crunch/Lo-Lead/Hi-lead) These are divided into 2 main channels (channel 1-clean/crunch, channel 2-Lo-Lead/Hi-Lead), each with its own gain control and 3 band e.q (4 band in the case of channel one as it has independent treble controls for the clean and crunch modes) the 4 channels all have their own master volume, added to 2 master volumes (switchable only by footswitch) and the bottom and bright controls (adding bass or treble boosts respectively) for clean/crunch channels and independent bottom controls for the Lo-Lead and Hi-Lead channels. Poweramp presence and depth controls are also included, tailoring the poweramps high and low frequency response respectively. Furthermore, there is the option to switch between open mode, less pronounced mids giving a more vintage sound, and focused mode, a much tighter, more mid-rich sound - noticeably more modern sounding, that affect all channels (independent mid controls for these 2 modes are given on channel 2 - Lo-Lead/Hi-Lead).

It is equipped with 4 6L6 tubes and 4 ECC83 tubes.

As of mid 2010, ENGL officially released the new Powerball II, replacing the original Powerball, ENGL's best selling amplifier to date. The key differences with the Powerball II is that it now comes with a black (powder coated like) finish for the dial face and a black grill with a red (instead of orange) power switch. The biggest functional differences are that each channel now has its own gain control whereas the old Powerball only had two, one for the clean and crunch and a second for the lo lead and hi lead channels. Also, the Powerball II now takes a different footswith (Z-9) using a normal quarter inch stereo lead. The Powerball II is designed to offer further tonal versatility than the original Powerball.

Savage 120[link]

Another seminal ENGL Amplifier head, and the basis for the Ritchie Blackmore signature amplifier. It is much more versatile than its successor the Blackmore, with much greater control over the 4 channels as they are divided into 2 main channels (channel 1 – clean/crunch 1, channel 2 – crunch 2/lead) each with eq controls, a common ENGL theme, also present on the SE and Powerball models. The 2 main channels each have their own gain control, as well as a further control for the crunch 1 and lead channels, to add extra gain and shape the tone further. There is also a further boost on the lead channel available. There are 2 switchable master volumes and 2 switchable presence controls. There is also a HiBalance control, tailoring the high frequency response even further in relation to the control on the relevant treble setting. powered by: preamp: v1-ECC83/7025 F.Q, v2/v3/v4-ECC83/12AX7 selected, v5/v6-ECC83/12AX7 standard poweramp: v7/v8-6550 Matched pair Despite the ENGL being rated at 120 watts, this can only be achieved at peak power rating however, the pair of 6550 power amp valves peak at approximately 40 watts each making an 80 watt amplifier.^{[clarification needed]}

Screamer[link]

The ENGL Screamer 50 is a 50 watt all tube guitar amplifier. The amp sports the typical Engl heavy duty grill front and classic 'chicken head' knobs. The front panel comprises, left to right, input socket, Clean volume, Bright switch, Lead volume, Bass, Middle, Treble, Lead Presence, Reverb Lead Volume, Gain Lo/Hi switch, Clean/Lead switch, Master volume, Standby and Power switches. The rear panel contains inputs for digital (e.g. Engl Z4 footswitch) and analogue footswitchs to control channel selection, reverb and, in the case of the Z4, a 'Solo' volume boost. Next to these are the input/output for a parallel effects loop with wet/dry mix knob, a variety of external speaker output sockets including a series configuration output section for 1 x 16ohm speaker or 2 x 8ohm and a parallel configuration output section for 1 x 8ohm speaker or 2 x 16ohm speaker as well as a Balanced D.I. Output panel. The amp has 2 channels but each has 2 separate 'voices' available through the switches on the front panel or a footswitch attachment. All four channel voicings share the same 3 band equalizer (Bass, Middle & Treble). The preamp consists of 3x ECC83 valves and the powerstage valves are 1x ECC83 & 2x 5881(6L6). The amplifier is available in head and combo versions, the combo being open-backed with one 12" Celestion Vintage 30 speaker.

Sovereign[link]

This section requires expansion.

The Sovereign E365 and E368 are essentially combo versions of the Savage. The E365 is a 60w version featuring a 12" Celestion Vintage 30 speaker and the E368 is the 120w version with two 12" Celestion Vintage 30 speakers.

Special Edition[link]

The ENGL Special Edition (E670) features 4 Independent channels: Clean, Crunch, Lead 1 and Lead 2, with modern/classic mode and "mega-low punch" options. It has 3 FX loops (1 Serial 2 Parallel) and a built-in noise gate. The poweramp section can operate in either 100w or 50w mode, running on either EL34 or 6L6 tubes depending on the model. It also features Master A/B, Presence A/B and Speaker A/B switches, and a Deep Boost button. The Special Edition also includes MIDI-Programmable functions for storing almost any combination of settings.

Thunder[link]

The ENGL Thunder 50 is a 50 watt all tube amplifier available in head or 1x12" speaker open back combo form. HEAD: Its a 3 channel amplifier (clean/crunch/lead) but all channels share gain and e.q. controls and only crunch and lead channels have volume controls, clean is effectively always at maximum and can only be controlled relative to the crunch and lead channels via the master volume. Front panels controls are: Gain knob, crunch/lead selector button, bass knob, middle knob, treble knob/crunch volume knob, lead volume knob, clean/crunch selector button, master volume. Channel switching is done via the 2 selector buttons, the clean/lead controls the basic channel switching: from clean in the out position-LED is not lit-to crunch or lead in the in position-LED is lit- (crunch if the crunch/lead selector is out-LED is not lit- and lead if the crunch/lead selector is in-LED is lit).

COMBO: The combo is available in 2 models, the 'drive' model, specifications as above, and the reverb version which sacrifices the crunch volume control for a spring reverb control, all other specs are identical. The combos use 1 12" Celestion Vintage 30 speaker. There also was a limited 'Scott Moffatt Signature' version of the Thunder Drive, featuring 6L6GC tubes in the power stage instead of the stock 5881's. This version has become rare, although it is still (wrongly) advertised in many places.

Footswitching can be done via a 2-way button footswitch (Engl make the Z-3 and Z-4 footswitches, the Z-3 being constructed of plastic and the more expensive Z-4 using a metal casing and also using status LEDs for both footswitch functions) the 2 footbuttons each correspond to a selector switch on the amp faceplate.

Current Cabinets[link]

Most ENGL cabinets are covered in grey and black with the ENGL logo at the grill. Standard and Pro cabinets can be found as slanted and straight. All cabinets are loaded with Celestion speakers.

Standard models[link]

Can be found in 1x12, 2x12 and 4x12 versions. All cabinets are loaded with Celestion v60 speakers. The baffle board of the Standard cabinets are made of Siberian birch, the rest of the cabinet is made of particleboard.

Pro models[link]

Same as the Standard cabinet models, except that they are fully made of Siberian birch and loaded with the Celestion Vintage 30 speakers. Pro cabinets are more expensive than the Standard cabinet because of the more expensive V30 speakers and the usage of more expensive wood.

XXL Pro models[link]

This be essentially the same cabinet as the 4x12 Pro model, only larger.

Classic models[link]

2x10 and 4x10 cabinets. Loaded with Celestion Vintage 10 speakers. White color cabinet.

Discontinued amplifier models[link]

Squeeze 30[link]

A two-channel, all tube, 30 watt combo amplifier with a single 12" Celestion Greenback speaker. The pre-amp uses three 12AX7AC4 HG valves and the power stage has two EL84-MRs.

Squeeze 50[link]

A two-channel, all tube, 50 watt combo amplifier with a single 12" Celestion Greenback speaker and reverb. This model also has 2 channels, ECS - Emergency Circuit System and a fx-loop.

The combo design has black panels and there is no standby-switch. It was the basis for the Road amp (see below)

The pre-amp uses 1x ECC 83 FQ, 1x ECC 83 ST, 1x ECC 83 SE valves in the preamp stage and the power stage has two 6LC GCs.

Road 50 watt[link]

This is the same design as the Squeeze 50 above, but had 50 watts (EL34) with 3 channels.

They both came out at the same time.

Savage Special Edition[link]

The ENGL Savage Special Edition boasts a number of efficient features and operating modes: four channels, Clean, Crunch 1, Crunch 2 and Lead, which are assigned to two main channels, each featuring an individual voicing section. Four gain controls and a separate volume control for each channel allow for precision-tuning between channels. The Rough/Smooth mode selector for the Crunch 2 and Lead channels generates two completely different types of overdrive which produce two distinctive tonal variations: Rough for loads of upper-end grit and powerful bottom-end; Smooth for creamy mids with plenty of punch. This feature combined with the four channels lets you access six individual sound modes! Additionally, diverse switching functions allow you to shape the main channels' tonal characteristics to your taste. Furthermore, the two poweramp operating modes, Triode and Pentode, and the option of switching between two different speaker cabinets both enhance this amp's tonal spectrum. The poweramp's two voicing sections and two master volume controls have proven to be both practical and effective. These, along with the channels and a several other features, can be selected and accessed via the front panel, a footswitch or a MIDI switching system. By means of the ENGL MIDI Interface (optional), these features can be controlled via a MIDI pedal board and the settings for switching functions can be programmed in up to 99 memory locations. This amp also features a number of signal paths: a passive parallel/serial FX loop for each main channel or a switchable master FX loop, a variable balanced line out featuring speaker simulation and an overload LED, as well as selectable 4, 8 and 16 Z speaker outputs for numerous cabinet connection options. Yet another handy tool is the "ENGL Impedance Test and Cable Check System"; This unique feature helps you to check speakers´ impedances and cables equipped with 1/4" plugs. The integrated ECS (Emergency Circuit System) protects the amp from damage due to power tube defects/failure and allows the amp to continue to function at reduced power until the failed tube can be replaced. This model is discontinued and is now rare. It is powered by: v1-ECC83/7025 F.Q, v2/v3/v4/v5 -ECC83/12AX7 selected, v6-ECC83/12AX7 standard, V7, V8, V9, V10 -> 5881s or 6L6 GCs

External links[link]

• ENGL Homepage
• Celestion Guitar Speakers
• US ENGL Dealer
• Engl Amps unofficial resource site
• Musician's Friend

Look up MED or med in Wiktionary, the free dictionary.

MED or med may refer to:

Medicine[link]

• Medicine (or medical)
• Medication, often used in the plural "meds"
• Title of Medic, the first Physician degree in Argentina
• Medical Extrication Device, a device for extricating an injured patient from an accident site, such as the Kendrick Extrication Device
• Minimal Erythemal Dose, the minimum dose of radiation that produces skin erythema

Technology[link]

• Multi Effect Distillation, see Distillation
• UTA MED a type of diesel multiple unit railcar of Northern Ireland Railways
• Manhattan Engineer District, US project to develop a nuclear bomb during WWII (colloquially known as the Manhattan Project)
• Music EDitor, by Tejio Kinnunen, predecessor of OctaMED
• Media Endpoint Discovery, an enhancement of the Ethernet data communications Link Layer Discovery Protocol
• Multi-Exit Discriminator, a network traffic routing protocol in the Border Gateway Protocol
• .med filename extension, used for:
  • tracker modules created by OctaMED
  • MEDLINE documents
  • backup files created by WordPerfect's Macro Editor

Other[link]

• Master of Education (M.Ed), a postgraduate academic degree
• Mediterranean Sea
• Macmillan English Dictionary, by Macmillan Publishers
• Ministry of Economic Development (New Zealand)
• Michael Eric Dyson (born 1958), an American academic, author, and radio host
• M.E.D. (rapper), American Hip hop artist signed to Stones Throw Records
• Marine Equipment Directive 96/98/EC (M.E.D. 96/98/EC), an authorization by the European Unionof equipment and products for the marine industry

See also[link]

This disambiguation page lists articles associated with the same title. If an internal link led you here, you may wish to change the link to point directly to the intended article.