Through-and-through gunshot wounds of the foot present the unique problem of needing to fill a defect while at the same time providing coverage of the dorsum and plantar surface of the foot. A series of 5 patients from 2 institutions is presented. These patients all sustained gunshot wounds that penetrated the forefoot, leaving a rim of uninjured soft tissue and bone around the periphery. All patients were reconstructed with free-tissue transfers, but no bone grafting was required to replace missing bone. One patient did have an arthrodesis and wedge osteotomy to help with walking mechanics. Soft-tissue reconstruction only is adequate to restore the foot sufficiently to allow the patient to walk satisfactorily.

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Safety analysis computer codes are designed to simulate phenomena relevant to the assessment of normal and transient behaviour in nuclear power plants. In order to do so, models of relevant phenomena are developed and a set of such models constitutes a computer code. In accident or transient analysis the values of certain output parameters (margin parameters) are used to characterize the severity of the event. The accuracy of the computer code in calculating these margin parameters is usually obtained through validation and variation in the margin parameter is estimated through the propagation of variation in the code input. A method for estimating code uncertainty respect to a specific output parameter has been developed. The methodology has the following basic elements: (1) specification and ranking of phenomena that govern the behaviour of the output parameter for which an uncertainty range is required; (2) identification of models within the code that represent the relevant phenomena; (3) determination of the governing parameters for the phenomenological models and Identification of uncertainty ranges for the governing model parameters from validation or scientific basis, if available; (4) decomposition of the governing model parameters into related parameters; (5) identification of uncertainty ranges for the modelling parameters for use in Best Estimate Analysis; (6) design and execution of a case matrix; and (7) estimation of the code uncertainty through quantification of the variability in output parameters arising from uncertainty in modelling parameters. This methodology has been employed using simulations of Large Break Loss of Coolant Accident (LOCA) tests in the RD-14M test facility to calculate the uncertainty in the TUF thermal hydraulics code calculation of the coolant void fraction. The uncertainty has been estimated with and without plant parameters (parameters specific to the RD-14M test loop). The TUF coolant void fraction uncertainty without plant parameters was determined to be 0.08 while the uncertainty with plant parameters included was determined to be 0.11. The uncertainty value without plant parameters included is comparable to the uncertainty in the measurements (0.09). The uncertainty value with plant parameters included is larger than the variation in the bias (0.10) of the TUF calculation of void fraction. From these findings, it can be concluded that the estimated accuracy of the TUF code calculation of void fraction is consistent with the available experimental data.

The COVID-19 pandemic illuminated how essential summer and after-school programs are for youth and their families. Policymakers took note of the needs and the evidence base, and prioritized stimulus funding to expand access and accelerate learning. American Rescue Plan (ARP) and Elementary and Secondary School Emergency Relief (ESSER) funds were quickly released to schools through different mechanisms, initially prioritizing speed over infrastructure design. The funds were intended to fuel robust school–community partnerships to provide students who suffered from pandemic-related learning and developmental setbacks with comprehensive, high-quality programming; yet the timeline for planning and implementation often hindered progress toward that vision. This article discusses the challenges to scaling critical services, the strategies that states and partners are putting into place, and opportunities to strengthen relationships and infrastructure at the national, state, and regional or local level.