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Femoral neck system (FNS) is a novel fixed-angle gliding device combining a sliding bolt and an anti-rotational screw to treat femoral neck fractures. It was proven to have comparable biomechanical strength to sliding hip screws. Tip-to-apex distance (TAD) is an established assessment for fixation quality in sliding hip screws. The purpose of our study was to evaluate whether TAD can be used in FNS implant to predict fixation failure. Seventy-six patients receiving FNS fixation for intra-capsular hip fracture were included. TAD was measured from post-operative radiographs and clinical outcomes were collected with a mean follow-up of 14.1 months. The mean TAD for patients who experienced fixation failure was 20.7 mm, versus 19.7 mm for those who did not (p = 0.395). Subgroup analysis among fractures with good reduction quality, defined as no varus angulation, less than 5 degrees of retroversion, and less than 4 mm cortical translation, did not demonstrate statistically significant difference in the mean TAD between failure and non-failure group (20.7 mm vs 19.5 mm, p = 0.68). We conclude that in our study of modest sample size, there was not demonstrable association between TAD and fixation failure in intra-capsular neck of femur patients treated with FNS. [ABSTRACT FROM AUTHOR]

Difficulty in visualizing anatomical structures has been identified as a challenge in anatomy learning and the emergence of three‐dimensional printed models (3DPMs) offers a potential solution. This study evaluated the effectiveness of 3DPMs for learning the arterial supply of the head and neck region. One hundred eighty‐four undergraduate medical students were randomly assigned to one of four learning modalities including wet specimen, digital model, 3DPM, and textbook image. Posttest scores indicated that all four modalities supported participants' knowledge acquisition, most significantly in the wet specimen group. While the participants rated 3DPMs lower for helping correct identification of structures than wet specimens, they praised 3DPMs for their ability to demonstrate topographical relationships between the arterial supply and adjacent structures. The data further suggested that the biggest limitation of the 3DPMs was their simplicity, thus making it more difficult for users to recognize the equivalent structures on the wet specimens. It was concluded that future designs of 3DPMs will need to consider the balance between the ease of visualization of anatomical structures and the degree of complexity required for successful transfer of learning. Overall, this study presented some conflicting evidence of the favorable outcomes of 3DPMs reported in other similar studies. While effective for anatomy learning as a standalone modality, educators must identify the position 3DPM models hold relative to other modalities in the continuum of undergraduate anatomy education in order to maximize their advantages for students. [ABSTRACT FROM AUTHOR]

Objective: Investigating what contributes to perceptions of ambiguity in stepfamily relationships among adolescents, and which strategies adolescents use to deal with ambiguity. Background: Relational losses or acquisitions marked by ambiguity (i.e., ambiguous losses and gains) are taxing as they often evade resolution. The frequent assumption that family relationships in postdivorce stepfamilies are per se ambiguous has only received limited empirical foundation. Little is known about how adolescents experience ambiguity, how and why ambiguity emerges, and what strategies adolescents develop to deal with ambiguity. Method: Semi‐structured interviews with 30 Dutch adolescents (aged 16–20) living in diverse postdivorce stepfamilies were conducted. The data were analyzed using open, axial, and selective coding. Results: Relationships with stepparents, stepsiblings, and biological parents were especially likely to be experienced as ambiguous. Two key categories of reasons emerged that helped to explain the emergence of ambiguity: information (i.e., incomplete or contradictory knowledge about family relationships), and relationality (i.e., the ways in which family relationships were assessed and compared to each other). Results point towards potential chains of ambiguity in stepfamilies, and show that respondents compared their relations with constructed archetypes of stepparents. Respondents used three strategies to deal with ambiguity: (a) improving relationships, (b) accepting ambiguity, and (c) creating distance. Conclusion: Ambiguity was common in postdivorce stepfamilies, yet mostly confined to relationships between adolescents and stepparents, stepsiblings, and biological parents. This suggests that, in stepfamilies, ambiguous gain might occur more frequently than ambiguous loss. The negative feelings associated with ambiguity might explain why many adolescents perceive living in stepfamilies as burdensome. [ABSTRACT FROM AUTHOR]

Despite the potential importance of kin to divorced parents in particular, prior research rarely studied how kinship patterns vary between married and divorced parents, nor within-group variations depending upon postdivorce residence arrangements and repartnering. We estimated mixed-effects logistic regression models using data from samples of Dutch married (N = 1,336) and divorced parents (N = 3,464) to predict the extent to which parents considered various blood relatives and (former) in-laws kin (i.e. parents, siblings, aunts/uncles, nieces/nephews, and cousins) and investigated differences within the divorced group per residence arrangements and repartnering. We found that married and divorced parents barely differed in the extent to which they considered blood relatives kin, but differences were large for (former) in-laws, and particularly great when parents did not reside with their biological child. Repartnered divorced parents were less likely to consider their former in-laws kin than single divorced parents but considered their new in-laws kin to high extents. For both blood relatives and (former) in-laws, parents were most often, and cousins least often considered kin. These results indicate that kinship patterns only differ for in-laws between married and divorced parents. Resident children may lead parents to consider former in-laws kin, whereas repartnering leads to exclusion of former in-laws. [ABSTRACT FROM AUTHOR]

Introduction: Our prototype wireless full-HD Augmented Reality Head-Mounted Display (AR-HMD) aims to eliminate surgeon head turning and reduce theater clutter. Learning and performance versus TV Monitors (TVM) is evaluated in simulated knee arthroscopy. Methods: 19 surgeons and 19 novices were randomized into either the control group (A) or intervention group (B) and tasked to perform 5 simulated loose-body retrieval procedures on a bench-top knee arthroscopy simulator. A cross-over study design was adopted whereby subjects alternated between devices during trials 1-3, deemed the "Unfamiliar" phase, and then used the same device consecutively in trials 4-5, to assess performance in a more "Familiarized" state. Measured outcomes were time-to-completion and incidence of bead drops. Results: In the unfamiliar phase, HMD had 67% longer mean time-to-completion than TVM (194.7 ± 152.6s vs 116.7 ± 78.7s, P <.001). Once familiarized, HMD remained inferior to TVM, with 48% longer completion times (133.8 ± 123.3s vs 90.6 ± 55s, P =.052). Cox regression revealed device type (OR = 0.526, CI 0.391-0.709, P <.001) and number of procedure repetitions (OR = 1.186, CI 1.072-1.311, P =.001) are significantly and independently related to faster time-to-completion. However, experience is not a significant factor (OR = 1.301, CI 0.971-1.741, P =.078). Bead drops were similar between the groups in both unfamiliar (HMD: 27 vs TVM: 22, P =.65) and familiarized phases (HMD: 11 vs TVM: 17, P =.97). Conclusion: Arthroscopic procedures continue to be better performed under conventional TVM. However, similar quality levels can be reached by HMD when given more time. Given the theoretical advantages, further research into improving HMD designs is advocated. [ABSTRACT FROM AUTHOR]