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This paper proposes a rotary-linear surface-mounted permanent magnet (PM) voice coil motor (RL-SVCM) with PM flux bridges in place of the iron flux bridges in a traditional RL-SVCM for enhancing average torque and force ripple but slight damage of torque ripple and average linear force. The iron flux bridges in a basic RL-SVCM cannot participate in the generation of rotary torque. In contrast, the PM flux bridges in the proposed RL-SVCM can participate in the generation of rotary torque. The magnetic equivalent circuit (MEC) is used to analyze the magnetic circuits of the basic and proposed models. The results explain the reasons for the performance improvements achieved by the proposed motor. The finite element method (FEM) is used to derive the precise output performance of the basic and proposed motors. Additionally, a prototype of the proposed RL-SVCM with PM flux bridges was manufactured for experimental verification. Close agreement between the experimental results and FEM results validates the feasibility of the proposed RL-SVCM.

Background Symmetrical peripheral gangrene (SPG) is an uncommon syndrome showing symmetrical gangrene in acral regions without evidence of large-vessel occlusion or vasculitis. Intravenous vasopressors are frequently used to manage hemodynamically unstable patients. There have been few reports about SPG after using inotropics. However, risk factors for SPG have not been extensively studied. Therefore, the objective of this study was to analyze several cases of SPG and identify risk factors for SPG. Methods From October 2013 to October 2016, 36 patients with SPG after using vasopressors were included in this study. SPG is an extremely rare disease entity. Therefore, this work was designed as a matched case-control study. For the control group, 42 patients (25 men and 17 women) with similar age, admission department, sex, and vasopressor usage in intensive care unit patients during the same period were selected. Retrospective chart review was performed to identify risk factors within the following categories: medical conditions, vasopressor-related factors, and Sequential Organ Failure Assessment scores. Results Differences between the 2 groups concerning medical condition-related variables did not exist. Statistically significant differences were found in intensive care unit duration (P = 0.0011) and survival. All vasopressor-related factors were adjusted according to weights of patients. Weight-compensated mean dose of dopamin significantly (P = 0.028) affected the occurrence of SPG. Weight-compensated peak dose of norpin, dopamin, and epinephrine also significantly contributed to SPG. Conclusions Symmetrical peripheral gangrene is a rare clinical syndrome related with a high mortality and up to 70% of patients who survive require amputation. Several studies have mentioned that there are several factors affecting the result of SPG. Few studies on SPG have been reported and most of them are case reports. In this study, we revealed the influence of vasopressors to the occurrence of SPG, and this was the first matched case-control study based on the analysis of multiple risk factors.

Background Settlements between doctors and patients provide a solution to complicated disputes. However, some disputes may be renewed as a result of negligence by both parties. The purpose of this study was to review the legal issues that may potentially arise during the preparation of settlement agreements and to propose a list of requirements for ensuring the effectiveness of these settlement agreements. Methods Data from 287 civil cases concerning aesthetic surgery that took place between 2000 and 2015 were collected from a court database in South Korea. Factors that influenced the effectiveness of settlement agreements were analyzed. Results Among the 287 court precedents, there were 68 cases of covenant not to sue. Eighteen cases were dismissed because the settlement agreements were recognized as effective, and 50 cases were sent forward for judgment on their merits because the agreements were not recognized as effective. The types of surgery and types of complications were classified by frequency. We evaluated the geographical distribution of the precedents, the settlement timing, and the effectiveness and economic impact of the settlements. We found that there was no statistically significant relationship among these factors. Four major factors that made a settlement agreement legally effective were identified, and the data showed that fee-free reoperations were not considered by the court in determining the compensation amount. Conclusions When preparing a settlement agreement, it is advisable to review the contents of the agreement rather than to take the preparation of a settlement agreement per se to be legally meaningful.

Background In an increasing number of lawsuits doctors lose, despite providing preoperative patient education, because of failure to prove informed consent. We analyzed judicial precedents associated with insufficient informed consent to identify judicial factors and trends related to aesthetic surgery medical litigation. Methods We collected data from civil trials between 1995 and 2015 that were related to aesthetic surgery and resulted in findings of insufficient informed consent. Based on these data, we analyzed the lawsuits, including the distribution of surgeries, dissatisfactions, litigation expenses, and relationship to informed consent. Results Cases were found involving the following types of surgery: facial rejuvenation (38 cases), facial contouring surgery (27 cases), mammoplasty (16 cases), blepharoplasty (29 cases), rhinoplasty (21 cases), body-contouring surgery (15 cases), and breast reconstruction (2 cases). Common reasons for postoperative dissatisfaction were deformities (22%), scars (17%), asymmetry (14%), and infections (6%). Most of the malpractice lawsuits occurred in Seoul (population 10 million people; 54% of total plastic surgeons) and in primary-level local clinics (113 cases, 82.5%). In cases in which only invalid informed consent was recognized, the average amount of consolation money was KRW 9,107,143 (USD 8438). In cases in which both violation of non-malfeasance and invalid informed consent were recognized, the average amount of consolation money was KRW 12,741,857 (USD 11,806), corresponding to 38.6% of the amount of the judgment. Conclusions Surgeons should pay special attention to obtaining informed consent, because it is a double-edged sword; it has clinical purposes for doctors and patients but may also be a litigation strategy for lawyers.

Postoperative infections are rare after plastic surgery; however, when present, they can affect the aesthetic outcome. Currently, many malpractice lawsuits are associated with surgical site infection. The present study aimed to analyze malpractice claims associated with surgical site infection in the field of plastic surgery through a review of Korean precedents. We analyzed the type of procedure, associated complications, and legal judgment in these cases. Most claimants were women, and claims were most often related to breast surgery. The common complications related to surgical site infection were deformity, scar, and asymmetry. Among the 40 cases, 34 were won by the plaintiff, and the mean claim settlement was 2,832,654 KRW (USD 2,636.6). The reasons for these judgements were as follows: 1) immediate bacterial culture tests were not performed and appropriate antibiotics were not used; 2) patients were not transferred to a high-level hospital or the infection control department was not consulted; 3) surgical site infection control measures were not appropriate; and 4) surgical procedures were performed without preoperative explanation about surgical site infection. The number of claims owing to surgical site infection after surgery is increasing. Infection handling was one of the key factors that influenced the judgement, and preoperative explanation about the possibility of infection is important. The findings will help surgeons achieve high patient satisfaction and reduce liability concerns., Graphical Abstract

We herein propose a novel high-torque-density flux-switching permanent magnet machine (FSPMM) which adopted phase-group concentrated-coil (PGCC) winding and a cogging torque reduction technique. The PGCC winding was applied to increase the torque density. In order to maximize the torque of the FSPMM that utilizes the PGCC windings, the performance according to stator slots/rotor poles combinations were compared. A machine which had 12 stator slots and 13 rotor poles (12S13P) was selected for its top average torque value. However, the 12S13P PGCC FSPMM contains high cogging torque that must be reduced. The cogging torque reduction technique is applied, and the parameters used in the technique are further optimized to achieve the target average torque, while suppressing the cogging torque as much as possible. The optimization process was performed with a collaboration of the genetic algorithm and Kriging method. The analysis results of the optimized design exhibited huge reductions in the cogging torque and eventually in the torque ripple from the initial machine, with reasonable average torque reduction. The entire work was evaluated experimentally using a manufactured prototype.

Background: Human placental extract (HPE), prepared from the placentas of healthy, postpartum females, displays various physiological activities, including antioxidative properties. In this study, a dorsal skin flap model was used to investigate the effect of HPE on flap viability in rats. Materials and methods: Forty male Sprague-Dawley rats underwent random-pattern skin flap surgeries. The animals were randomly divided among a control group and three treatment groups (localized injection (LI), 10 mg/kg/d localized HPE injections; low-dose treatment (LT), 10 mg/kg/d systemic HPE injections; high-dose treatment (HT), 40 mg/kg/d systemic HPE injections). Surviving skin flap areas were measured 7 days after surgery and tissue samples were stained with hematoxylin and eosin; vascular endothelial growth factor expression was determined immunohistochemically. To evaluate the antioxidant and antiapoptotic effects of HPE, malondialdehyde, glutathione peroxidase, and caspase-3 levels were examined. Result...

This paper proposes flux switching permanent magnet machines (FSPMMs) with improved performance for robot applications. The phase-group concentrated-coil (PGCC) windings are adopted for high torque density. The influence of the combinations of stator-rotor poles on machine performance are studied, and the model with 12 slots and 13 poles (12S13P) is chosen for the highest torque. Then, to reduce cogging torque and torque ripple, the pole-arc and stator pole width of the 12S13P FSPMM are optimized by the Kriging method and genetic algorithm with the aid of finite element method.

A sialo-cutaneous fistula is a communication between the skin and a salivary gland or duct discharging saliva. Trauma and iatrogenic complications are the most common causes of this condition. Treatments include aspiration, compression, and the administration of systemic anticholinergics; however, their effects are transient and unsatisfactory in most cases. We had a case of a patient who developed an iatrogenic sialo-cutaneous fistula after wide excision of squamous cell carcinoma in the parotid region that was not treated with conventional management, but instead completely resolved with the injection of botulinum toxin. Based on our experience, we recommend the injection of botulinum toxin into the salivary glands, especially the parotid gland, as a conservative treatment option for sialo-cutaneous fistula.

A Virtual Inhabitant is a kind of believable agent proposed to endow attractive features of human-controlled characters, especially the diverse behaviors, to the computer-controlled characters. To behave diversely, goal production module of a Virtual Inhabitant should be designed to produce wide variety of goals semi-automatically which are fit for general situations in contrast to the previous character’s goal production models which are devised for handling very restricted situation based on fixed form goal description methods such as script, state-machine. In this paper, we elaborate the goal production module by categorizing diverse drive stimuli, devising extending and matching methods for those stimuli, and introducing additional methods for supporting the features stressed in psychological field and habitual/routine behavior of a Virtual Inhabitant. We expect that the proposed goal production module can be used for the characters in the open-ended games, on-line games, virtual communities, and so on.