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To maximize the morpho-functional recovery on the totally degloved foot while not excessively introducing the technical complexity of microsurgery, we present a regionalized reconstruction, in which the highly functional subunit (weight-bearing area and ankle-around area) is covered by free skin flaps, and the less functional subunit (dorsum) by skin graft.From June 2011 to December 2017, 10 patients who had total degloving injury on foot underwent reconstruction based on regionalized coverage. As the shape of combined flaps resemble a boat sock in high-heeled shoe, we name it as "Boat Sock" flaps. Complication like vascular compromise, partial or total flap loss, Equinus deformity and delayed plantar ulceration were documented elaborately. Secondary surgeries were also recorded. Foot function was evaluated by Maryland foot score at the last follow up.Twenty-one free skin flaps were used for "Boat sock" coverage on highly functional subunits. Flap dimension ranged from 19×5cmThis regionalized coverage by "Boat Sock" flaps and skin graft could serve as a standard procedure for reconstruction of the totally degloved foot, by offering the benefits of multi-plane coverage, a well-contoured ankle, an abrasion-tolerant planta, and eclectic surgical complexities.

We propose a highly efficient and accurate numerical scheme named Truncated Atomic Plane Wave (TAPW) method to determine the subband structure of Twisted Bilayer Graphene (TBG) inspired by BM model. Our method utilizes real space information of carbon atoms in the moir\'e unit cell and projects the full tight binding Hamiltonian into a much smaller subspace using atomic plane waves. We present accurate electronic band structures of TBG in a wide range of twist angles together with detailed moir\'e potential and screened Coulomb interaction at the first magic angle using our new method. Furthermore, we generalize our formalism to solve the problem of low frequency moir\'e phonons in TBG.

Introduction Coverage of circumferential wounds on limbs is a challenging reconstructive job. Here, we propose a skin flap-based algorithm to reconstruct circumferential wound with the chain-linked design and combined transplantation of ALTP and DIEP flap, which could achieve full-coverage and simultaneously primary donor-site closure. Patient and methods From December 2007 to December 2018, 14 patients with circumferential would on upper or lower limbs underwent reconstruction with ALTP or DIEP flap, by the technique of combined transplantation or chain-linked design, or both. The wound was classified into five different types according to the width compared to the donor site (overall magnitudes and regularity), which was separately reconstructed by five different wound decomposition and corresponding flap design. Flap survivorship, complication on recipient or donor site and any secondary surgeries have been recorded. Results 14 patients were successfully treated with 22 flaps, including seven patients reconstructed with one flap (4 bi-pedicled, 2 tri-pedicled), 6 patients reconstructed with two flaps (1 in mono-pedicled, 5 in multi-pedicled), one with 3 flaps and skin grafts. Only one donor site was not directly closed, and one experienced dehiscence but finally healed. All flaps survived uneventfully but three had minor edge necrosis and later treated with skin graft. Conclusion The algorithm is practical in circumferential wound resurfacing on limbs for allowing flexible design, sufficient coverage, and low donor site morbidity.

This study aimed to examine health information technology-related incidents and identify risks associated with multiple patients’ management. Sources of information comprised interviews with healthcare professionals and three small sets of local voluntary incident reports using two sampling strategies, purposive and snowball sampling. Incident reports, in the form of free-text narratives, were aggregated for analysis using the Health Information Technology Classification System and thematic analysis. Of 95 incidents, 176 issues were identified, comprising 77% ( n = 136) technical issues, and 23% ( n = 40) use or human-related issues. Human issues were over two times more likely to harm patients (OR 2.25, 95% CI 1.01 - 4.98) than technical issues. Incidents that affected multiple patients’ care accounted for 70% ( n = 66) of the total sample, and large-scale events comprised 39% ( n = 26) of the incidents that affected multiple patients' care. Systematically identifying and characterizing such incidents should be prioritized for health information technology implementations.

Acrylonitrile wastewater was an organic wastewater with strong toxicity and poor biodegradability. Therefore, electro-catalytic technology became a promising acrylonitrile wastewater treatment technology because of no secondary pollution, wide application range and low water quality requirements. The optimal Mn-Sn modified Ru-Ir electrode material was synthesized by thermal method and applied in electro-catalytic treatment of acrylonitrile wastewater. The electrode materials were characterized by SEM, TEM, XRD, XPS and electrochemical characterization. SEM, TEM, XRD and XPS indicated that Mn and Sn were capable of incorporating and replacing the part of Ru or Ir and could alter the microstructure of Ru-Ir and the types of Mn and Sn oxides, raising the oxygen evolution potential (OEP) and voltampere charge. When the molar ratio of Mn-Sn was 1:1, OEP, voltampere charge and exchange current density could reach 1.303 V, 1.51 C/cm2 and 6.29×10-4 A/cm2, respectively. The co-doping of Mn-Sn had significant influence on the electrocatalytic performance of Ru-Ir electrode materials. The optimum synthesis conditions of Mn-Sn modified Ru-Ir electrode were as follows: the molar ratio of Mn-Sn was 1:1, calcination time was 4.0 hours, calcination temperature was 450℃, and solvent was water. Under certain conditions, the removal rate of acrylonitrile with Mn-Sn modified Ru-Ir electrode was 100%. Mn-Sn modified Ru-Ir electrode had high oxygen evolution potential and good removal effect of acrylonitrile, which was higher than that of ruthenium iridium electrode and RuO2 electrode.