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This paper investigates a new ventilation cooling technology for modular permanent magnet (PM) machines. Air is pumped into the stator flux gaps and rotor ducts. A significant temperature reduction for the modular machines can be observed by introducing ventilated air. The flux gaps within the modular machines provide extra coolant path, notably modify the flow profile. Moreover, the flux gaps also provide additional contact area between machines and coolant, improving heat transfer rate. Comparative study between different machine configurations, including different inlet and outlet areas, different topologies of shaft, and different stator topologies have been investigated. Their influences on machine cooling have been investigated using computational fluid dynamics (CFD) modelling. Furthermore, since the coolant (air) will pass through the stator-rotor annular gap, i.e., airgap, as well as rotor ducts, the rotor speed will influence the cooling efficiency of the ventilation cooling system. This influence comes from shock loss, friction loss, and combining flow phenomenon. A series of experiments have been conducted to validate the CFD simulations.

ABSTRACTIntroductionAtopic dermatitis (AD) is an inflammatory skin condition that affects millions of pediatric and adult patients with well-studied impact on morbidity and quality of life. Management occurs in a stepwise fashion beginning with preventative measures before immunomodulators are introduced. However, challenges remain in treatment of moderate-to-severe atopic dermatitis that is refractory to first- and second-line treatments and there are only few topical anti-inflammatory options, especially for pediatric patients.Areas coveredNew medications are required to address these gaps as lesions may persist despite treatment or patients may discontinue treatment due to actual or anticipated adverse effects of mainstay medications. Emerging research into the pathophysiology of AD and the immune system at large has provided opportunities for novel interventions aimed at stopping AD mechanisms at new checkpoints. Clinical trials for 36 agents currently in phase 2 or phase 3 are evaluated with particular focus on the studies for, B244, CBP-201, tapinarof, lebrikizumab, nemolizumab, amlitelimab, and rocatinlimab as they explore novel pathways and have some of the most promising results.Expert opinionThese clinical trials contribute to the evolution of AD treatment toward greater precision based on salient pathways with a particular focus on moderate-to-severe AD to enhance efficacy and minimize adverse effects.

Compared with conventional non-modular machines, the flux gaps in alternate stator teeth of the modular machines can increase the winding factor and provide flux focusing effect and hence can increase the torque/power density. In addition, the flux gaps can be used as cooling channels to improve the thermal performance. This article investigates an advanced cooling approach using ferrofluid (FF) as coolant to fill in the cavity around end windings and flux gaps. The multiphysics modeling in this article has shown that the influence of the flux gaps on machine thermal performances comes from two aspects: 1) the gravitational effect, the flux gaps allow more self-circulating coolant to transfer heat to the housing. This helps to reduce machine temperature by around 5 °C for a flux gap width of 2 mm; and 2) the magnetic body force, i.e., the thermomagnetic effect. This is very effective in non-modular machine cooling, but its efficiency slightly deteriorates in the modular machines. This is because the self-circulation of FF in the flux gaps due to the gravitational effect has been negatively affected by the thermomagnetic effect.

This article investigates an advanced thermal management method adopting ferrofluid (FF) for improving the end-winding cooling of permanent magnet (PM) machines. An oil-based liquid with nano-sized ferromagnetic particles (which is known as FF) is used to fill in the cavity around the end windings. This is to establish an effective heat flux path between the end winding that is often regarded as hot spot in electrical machines and the external cooling system, i.e., water jacket, to improve the cooling performance of the PM machines. This improvement does not only result from the higher thermal conductivity and thermal expansion of the nanofluid with metal particles but also from strong thermomagnetic convection generated by the magnetic body force of the ferromagnetic particles within the FF. Multiphysics models considering the interaction between the electromagnetic field, the heat transfer, and the fluid dynamics have been built to study the thermal performances of a PM machine under different load conditions. Several factors affecting the thermomagnetic convection, such as the temperature-dependent magnetization curve of the FF, the concentration, and different ferromagnetic materials as well as different current densities, have been investigated to analyze their influences on cooling performance. One major finding is that, compared with other coolant without magnetic body force, the FF can significantly reduce machine peak temperature, e.g., by around ${36.4}~^{\circ }\text{C}$ when the current density is $\boldsymbol {22.1}~\text {A} / {\text {mm}}^{ \boldsymbol {2}}$ .

Background: Laparoscopic liver resection (LLR) of high difficulty score is technically challenging. There is a lack of clinical evidence to support its applicability in terms of the long-term survival benefits. This study aims to compare clinical outcomes between LLR and the open liver resection of high difficulty score for hepatocellular carcinoma (HCC). Materials and Methods: From 2010 to 2020, using Iwate criteria, 424 patients underwent liver resection of high difficulty score by the laparoscopic (n= 65) or open (n= 359) approach. Propensity score (PS) matching was performed between the two groups. Short-term and long-term outcomes were compared between PS-matched groups. Univariate and multivariate analyses were performed to identify prognostic factors affecting survival. Results: The laparoscopic group had significantly fewer severe complications (3% vs. 10.8%), and shorter median hospital stays (6 days vs. 8 days) than the open group. Meanwhile, the long-term oncological outcomes were comparable between the two groups, in terms of the tumor recurrence rate (40% vs. 46.1%), the 5-year overall survival rate (75.4% vs. 76.2%), and the 5-year recurrence-free survival rate (50.3% vs. 53.5%). The high preoperative serum alpha-fetoprotein level, multiple tumors, and severe postoperative complications were the independent poor prognostic factors associated with worse overall survival. The surgical approach (Laparoscopic vs. Open) did not influence the survival. Conclusion: LLR of high difficulty score for selected patients with HCC has better short-term outcomes than the open approach. More importantly, it can achieve similar long-term survival outcomes as the open approach.

The experiential teaching method draws on research‐based principles of adult education. The integration of academic learning and practice provides students opportunities to increase their knowledge while developing capabilities to meet the International Union for Health Promotion and Education (IUHPE) Core Competencies and Professional Standards. Community Health Promotion is a second‐year subject offered in the Bachelor of Health Sciences at La Trobe University. The project‐based curriculum, delivered over 12 weeks, consists of theoretical material which students apply through hands‐on project planning, implementation and evaluation; projects are carried out on campus. To bridge academic content and project practicalities the Victorian government's Integrated Health Promotion Resource Kit is used as a foundational teaching resource. Students are supported by teaching staff and a project sponsor throughout the project cycle. Assessment tasks comprised of problem definition and priority setting, project planning and critical reflection on project implementation. The experiential learning approach enables students, in a self‐directed yet collaborative manner, to develop skills aligned with health promotion competencies. Students were able to safely “experiment” and apply health promotion theory while actively developing project management and partnerships skills, reflecting on their practice and communicating project findings. Students consistently provide feedback articulating the value they place on the purposeful and scaffolded transition of classroom learning to real‐life environments which they recognised as building their competencies and enhancing their employability skills. Experiential learning through small‐group projects prepares students for the health promotion workforce in a low‐risk, high‐impact educational setting while contributing to promoting the ethos of a health‐promoting university. The authentic assessments provide students with the opportunity to develop competency within several domains of the IUHPE Core Competencies and Professional Standards.

IMPORTANCE: Laparoscopic and robotic techniques have both been well adopted as safe options in selected patients undergoing hepatectomy. However, it is unknown whether either approach is superior, especially for major hepatectomy such as right hepatectomy or extended right hepatectomy (RH/ERH). OBJECTIVE: To compare the outcomes of robotic vs laparoscopic RH/ERH. DESIGN, SETTING, AND PARTICIPANTS: In this case-control study, propensity score matching analysis was performed to minimize selection bias. Patients undergoing robotic or laparoscopic RH/EHR at 29 international centers from 2008 to 2020 were included. INTERVENTIONS: Robotic vs laparoscopic RH/ERH. MAIN OUTCOMES AND MEASURES: Data on patient demographics, tumor characteristics, and short-term perioperative outcomes were collected and analyzed. RESULTS: Of 989 individuals who met study criteria, 220 underwent robotic and 769 underwent laparoscopic surgery. The median (IQR) age in the robotic RH/ERH group was 61.00 (51.86-69.00) years and in the laparoscopic RH/ERH group was 62.00 (52.03-70.00) years. Propensity score matching resulted in 220 matched pairs for further analysis. Patients’ demographics and tumor characteristics were comparable in the matched cohorts. Robotic RH/ERH was associated with a lower open conversion rate (19 of 220 [8.6%] vs 39 of 220 [17.1%]; P = .01) and a shorter postoperative hospital stay (median [IQR], 7.0 [5.0-10.0] days; mean [SD], 9.11 [7.52] days vs median [IQR], 7.0 [5.75-10.0] days; mean [SD], 9.94 [8.99] days; P = .048). On subset analysis of cases performed between 2015 and 2020 after a center’s learning curve (50 cases), robotic RH/ERH was associated with a shorter postoperative hospital stay (median [IQR], 6.0 [5.0-9.0] days vs 7.0 [6.0-9.75] days; P = .04) with a similar conversion rate (12 of 220 [7.6%] vs 17 of 220 [10.8%]; P = .46). CONCLUSION AND RELEVANCE: Robotic RH/ERH was associated with a lower open conversion rate and shorter postoperative hospital stay compared with laparoscopic RH/ERH. The difference in open conversion rate was associated with a significant decrease for laparoscopic but not robotic RH/ERH after a center had mounted the learning curve. Use of robotic platform may help to overcome the initial challenges of minimally invasive RH/ERH.

Food allergy (FA) is a growing issue worldwide. The United Kingdom (UK) and United States (US) are high-income, industrialized countries with reported increases in FA prevalence over the past few decades. This review compares delivery of FA care in the UK and US and each country’s response to the heightened demand and disparities for FA services. In the UK, allergy specialists are scarce and general practitioners (GPs) provide most allergy care. While the US has more allergists per capita than the UK, there is still a shortage of allergy services owing to the greater reliance on specialist care for FA in America and wide geographic variation in access to allergist services. At this time, generalists in these countries lack the specialty training and equipment to optimally diagnose and manage FA. Moving forward, the UK aims to enhance training for GPs so they may provide better quality frontline allergy care. In addition, the UK is implementing a new tier of semi-specialized GPs and increasing cross-center collaboration through clinical networks. The UK and US aim to increase the number of FA specialists, which is critical at a time of rapidly expanding management options for allergic and immunologic diseases requiring clinical expertise and shared decision-making to select appropriate therapies. While these countries aim to actively grow their supply of quality FA services, further efforts to build clinical networks, and perhaps, recruit international medical graduates and expand telehealth services, are necessary to reduce disparities in access to care. For the UK in particular, this will require additional support from the leadership of the centralized National Health Service, which remains challenging.

La scintigraphie aux leucocytes marqués (SLM) a démontré son apport dans le diagnostic de l’endocardite sur prothèse valvulaire (EPV) en complément de l’échocardiographie. Dans cette étude, 47 patients consécutifs avec une EPV et un SLM positif traités médicalement ont été identifiés rétrospectivement. En cas d’EPV, un traitement chirurgical est souvent recommandé, mais associé à un risque élevé. Il apparaît donc important de parvenir à identifier les patients avec une EPV susceptibles d’évoluer favorablement avec un traitement médical. Les objectifs de cette étude étaient de tester la valeur pronostique de l’intensité du signal sur la SLM chez des patients avec une EPV traités médicalement et de caractériser l’évolution du signal dans les prothèses valvulaires en SLM sous traitement par antibiotiques.