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AimsA frequently-seen injury pattern in current military experience is traumatic lower limb amputation as a result of improvised explosive devices (IEDs). This injury can coexist with fractures involving the pelvic ring. This study aims to assess the frequency of concomitant pelvic fracture in IED-related lower limb amputation.MethodsA retrospective analysis of the trauma charts, medical notes, and digital imaging was undertaken for all patients arriving at the Emergency Department at the UK military field hospital in Camp Bastion, Afghanistan, with a traumatic lower limb amputation in the six months between September 2009 and April 2010, in order to determine the incidence of associated pelvic ring fractures.ResultsOf 77 consecutive patients with traumatic lower limb amputations, 17 (22%) had an associated pelvic fracture (eleven with displaced pelvic ring fractures, five undisplaced fractures and one acetabular fracture). Unilateral amputees (n=31) had a 10% incidence of associated pelvic fracture, whilst 30 % of bilateral amputees (n=46) had a concurrent pelvic fracture. However, in bilateral, trans-femoral amputations (n=28) the incidence of pelvic fracture was 39%.ConclusionsThe study demonstrates a high incidence of pelvic fractures in patients with traumatic lower limb amputations, supporting the routine pre-hospital application of pelvic binders in this patient group.

System reliability is an integral part of a properly designed deregulated electricity market, even though wholesale energy prices are its most visible piece. This paper discusses the resources, collectively known as the ancillary services, in a power system for maintaining reliability. It then discusses an integrated approach in systematically determining and securing the needed ancillary services and system configuration across multiple time spans, culminating in the cooptimization of energy and ancillary services for security-constrained generator unit commitment in the day-ahead market and security-constrained economic dispatch of the generators in real-time operation. The paper also provides a summary of the ancillary services market in several U.S. power markets and proposes several technical issues for further discussion and research.

This chapter is a review about sugarcane, one of the most important energy crops. It will describe some aspects of the production system, like varieties, pests and diseases, nutrients requirements, mechanical harvest, residue management and water use. After, sugarcane products and co-products are presented, followed by an energy balance of the production of sugarcane ethanol in Brazil. To finish, an analysis of the land use changes in sugarcane areas is made. About varieties, in the last years, beyond traditional cross breeding, molecular marker techniques and genetic engineering have also been used in genetic improvement programmes. Current improvement faces new challenges, where the objective is to use all parts of the plant that are not normally used to produce energy, as straw, leaves, and the residues and not only the juice extracted in grinding. As a result of these genetic programmes the sugarcane sector is a model in the gain of production (tons per hectare; litres per ton) and in the employment of technologies that reduce the use of chemical defensives, as, for instance, the biological control of pests. Those programs were successful in introducing materials resistant or tolerant to the main pests and diseases that affect sugarcane. In addition, it is expected that the use of transgenic cultivars will result in a greater reduction in the use of defensives, though environmental impacts should be better defined. In spite of the success, new pests and diseases, like Telchin licus licus and orange rust, have appeared, posing new challenges. Sugar cane cultivation culture is considered relatively efficient in using nutrients – the mean dose of mineral fertilizer used is 408 kg/ha, similar to that of several other crops with much smaller productions of biomass per area. One important aspect for this rational use of fertilizers is nutrient recycling, common in sugarcane agroindustry, by returning solid and liquid residues, such as filter cakes, ashes, straw, and, especially, vinasse. Also, the biological nitrogen fixation (BNF) has an important role in the nitrogenous nutrition of sugarcane in Brazil, and in the world. In the industry, rational water use has been adopted. The industry requirement for water has dropped from 5 m3 per ton to 1.83 m3 per ton of sugarcane; reaching 1.23 m3 of water per ton. Mills with the best management practices replace only 500 litres of water in the industrial system, with a recycling rate of 96.67 %. The sugarcane production system and the processing of its main products, sugar and alcohol, generates a significant number of co-products that have high added value. In addition to vinasse and filter cake, the bagasse is the co-product most used in the agroindustrial system of sugarcane. It is mainly used to produce energy. Basically all the thermal energy, and about 95% of the electric energy, is produced at the mill with co-generation systems using the bagasse. The estimation of the total fossil energy used in the field operations is 12329.7 MJ ha−1 year−1. Considering that one litre of ethanol produces 21.45 MJ of energy in the combustion, one hectare of sugarcane currently producing an average 6510 L of ethanol could generate 139639.0 MJ of energy, approximately 11 times the fossil energy invested in the agricultural operations. In addition to the energy balance, analysis of the process of land use change must be made. Studies recently conducted show that, in Brazil, sugarcane production is localized and expanding in areas that have been designated for agricultural production since long ago. The projections indicated that sugarcane expansion will continue in those areas. This means that there is no sugarcane expansion in the agricultural frontier. An Agroecological Zoning analysis for Sugarcane showed that the country has about 64.7 million hectares of land that is suitable for the expansion of sugarcane cultivation. And, to supply the market for the conditions in the year 2020, the additional area needed for the production of sugarcane will be of approximately 5.1M ha. Also, it is expected for the year 2020 that there will be a net reduction of approximately 100 kg CO2 eq m−3 of ethanol, in the emissions associated with the land use change in Brazil. Combining these facts, it is observed that sugarcane expansion in Brazil has a great chance of being conducted in a way that is less harmful to the environment, with land use changes that allow for a smaller emission of greenhouse gases and greater sustainability of the adopted production systems.

The present study shows that enalapril prevents the excessive remodeling of the left ventricle after acute myocardial infarction. This randomized and double blind clinical study analysed 50 patients with an inferior myocardial infarction. The effect of enalapril was evaluated through cardiac volumes, ejection fraction, neurohormonal levels and incidence of the left ventricle disfunction after acute myocardial infarction. The patients treated with enalapril showed a significant reduction on the values of nor-epinefrine, angiotensine II, natriuretic hormone and vasopressine, four weeks after initiation of treatment. The ejection fraction and the level of the wall movement was more favourable, four weeks after infarction, in the group treated with enalapril. The incidence of congestive heart failure and arrhythmias was lower in the group treated with enalapril. So, we conclude that enalapril is a drug that prevents the excessive remodelling of the left ventricle after an acute myocardial infarction.

Some endodontists use iodoform in Sealapex in order to rend it more radiopac. This procedure is empiric and for this reason we decided to observe, histologically, if the iodoform introduces some modification in the biological properties of Sealapex. Thirty root canals of dogs' teeth were overinstrumented and filled, by lateral condensation technique, with gutta percha points and Sealapex, with or without iodoform. The iodoform was added in two different proportions: 30 mg or 112 mg for one centimeter of the base and one centimeter of the catalyst of Sealapex. The pieces were removed for histological studies, 6 months after the treatment. The histological results showed that Sealapex encourages apical closure by cementum deposition and that the addition of iodoform does not change that biological property.

The subject of this work is to observe if the employment of a cream (ENDO-PTC) during the root canal preparation contributes or not to the condensation of debris in the apical region. Twenty root canals of dogs teeth were divided into two experimental groups: in the first one, the biomechanical preparation was carried out up to the n. 50 Kerr file by using irrigation and aspiration with sodium hypochlorite. In the second experimental group the canal negotiation was done in the same way but using a cream (ENDO-PTC) with sodium hypochlorite as a lubrication substance. A final irrigation and aspiration with sodium hypochlorite was also done in this group. The animal was killed and the pieces prepared for histological analysis. The histological results show us that the employment of a cream during the negotiation of the root canal contributes to a higher condensation of debris in the apical area.

The object of the present work was to observe whether the condensation of a plug of infected dentin in the apical region, before the filling of a root canal, could show results similar to those found in the absence of contamination. The histologic analysis of the periapical tissues of dogs' teeth containing infected apical plugs showed results that were totally unfavorable, when compared to cases in which the plugs were absent. Such data do not encourage the use of dentin plugs for cases of contaminated root canals, at least until other experiments can better clarify the problem.

Root canals of dog premolar teeth were negotiated and overfilled with calcium hydroxide paste. After 30 days, half of the treated teeth were refilled up to the apical limit. Root canals not filled were considered as the control group. Ninety days after the first treatment, histologic analysis showed more favorable results in the refilled root canals. The overfilling elicits calcium hydroxide resorption and the ingrowth of periapical connective tissue into the root canal.

The use of a real-time digital simulator In the checkout of comprehensive digital automatic controls for a power plant is described. The paper describes the simulator, and it's Interface with the automatic controls. A few examples of the use of the sTmulator are given.

Although prototypes of advanced fuel fusion plants may be many years off, it is useful to consider the ways in which such devices may be integrated within electric power production and distribution systems. This discussion examines some of the characteristics of the electric power supply systems which impact the application of new energy sources. One of the probable advantages of nuclear fusion plants is greater freedom for plant site selection when compared to nuclear fission LWR plants and coal fired fossil-steam plants. Should direct conversion prove feasible, a “clean” fusion energy plant might be located underground within urban centers. Fusion-steam plants might also be located within urban areas and uses found for the significant quantities of heat which must be released at relatively low temperatures. Although early design considerations may not warrant detailed analyses of technical plant and transmission requirements, broad economic assessments pertaining to point of application and demand requirements upon the energy source should be incorporated in evaluations of advanced fuel fusion processes.

Root canals of dog premolar teeth were instrumented beyond the apices and enlarged up to the size of a No. 40 or 80 file and filled with calcium hydroxide up to the foramen. Ninety days later the histologic data showed more favorable results with the root canals instrumented until file No. 80.

Root canals of dog premolar teeth with or without debris were filled with calcium hydroxide with or without pressure. The histologic results, 90 days after treatment, showed better results in the specimens without debris. More favorable results were obtained with the pressure filling when debris was present in small amounts.

The object of the present work was to observe whether the condensation of a plug of infected dentin in the apical region, before the filling of a root canal, could show results similar to those found in the absence of contamination. The histologic analysis of the periapical tissues of dogs' teeth containing infected apical plugs showed results that were totally unfavorable, when compared to cases in which the plugs were absent. Such data do not encourage the use of dentin plugs for cases of contaminated root canals, at least until other experiments can better clarify the problem.