Outcome for children with MN is excellent at all ages, with little indication for adjuvant chemotherapy. Children presenting at <3 months of age, should be treated by primary nephrectomy. In those presenting aged >3 months, alternative diagnoses should be considered, especially in the presence of surgical risk factors.

OBJECTIVE To document the functional outcome of patients with prenatally detected posterior urethral valves (PUV) in the second decade of life, and to evaluate the possible impact of prenatal diagnosis on the long‐term outcome of this condition PATIENTS AND METHODS We analysed the functional outcome of 25 patients with prenatally detected PUV born between 1984 and 1996, whose mean (range) age at follow‐up was 17.7 (10–23) years. The findings were compared with those in 17 patients (mean age 16.1 years) who had presented clinically to our unit during the same period. The duration of follow‐up in both groups was ≥10 years. Late outcomes were also compared with published data for PUV. Outcome measures included; death, incidence of end‐stage renal failure (ESRF), age at transplantation and the most the recently available plasma creatinine level in untransplanted patients. We also examined any possible association between functional outcome and early predictors, including nadir plasma creatinine level at <1 year and vesico‐ureteric reflux (VUR). RESULTS Three patients died (12%), two as neonates and one aged 3 years. Of five patients who had been shunted in utero, four died or developed early‐onset renal failure. In the 23 prenatally detected patients who survived the neonatal period, four (17%) had a renal transplant at a mean (range) age of 6.5  (3.0–12.0) years. Of 19 patients with prenatally detected PUV who had not been transplanted in the first 12 years of life, only one (5%) developed new‐onset ESRF at 10.0–23.4 years whilst 11 (58%) of these patients had normal creatinine values. In the untransplanted patients there was a statistically significant correlation between age and plasma creatinine level, but no correlation between late functional outcome and nadir creatinine in the first year of life, or bilateral VUR. CONCLUSIONS Prenatal diagnosis had little impact on mortality or ESRF in the first decade of life. This appears to be largely predetermined by renal dysplasia and the severity of intrauterine obstruction. However, the functional outcome of patients with prenatally detected PUV aged 10–23 years was considerably better than published long‐term data and the outcome of clinically presenting patients in our study. These findings suggest that the long‐term prognosis of PUV of intermediate severity might be improved by prenatal diagnosis.

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This paper presents performance improvement of dual stator axial-flux spoke type permanent magnet vernier machine (DSAFST-PMVM), which has the capability to generate high torque at a lower speed due to magnetic gearing effect. Flux focusing effect is created by means of dual stator single rotor topology with spoke type permanent magnets. It is best suitable for high-performance industrial applications such as servo motors, robot arms, wind power, electric vehicles, and elevator applications. A PM shape is proposed in this paper which has notches in such a way that it produces discrete skew effect which reduces the cogging torque and torque ripples. Optimization of magnet shape is done to make the optimized model more competitive than the proposed and basic models. Main parameters such as back emf, cogging torque, torque ripples, electromagnetic torque, VTHD, airgap flux densities, flux density distribution, power factor, and power of the machine are compared among the basic model, proposed model, and optimized models. The comparative analysis is done by using the time stepped 3D finite element method.INDEX TERMS Axial flux, cogging torque, dual stator axial flux machine, flux focusing effect, magnetic gearing effect, torque ripples, vernier machine, finite element method.

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