In this study, a biomimetic microfluidic plasma separation device is discussed. The design of the device drew inspiration from in vivo observations of enhanced cell-free layer (CFL) formation downstream of vascular bifurcations. The working principle for the plasma separation was based on the plasma skimming effect in an arteriolar bifurcation, which is modulated by CFL formation. The enhancement of the CFL width was achieved by a local hematocrit reduction near the collection channel by creating an uneven hematocrit distribution at the bifurcation of the channel. The device demonstrated a high purity of separation (~99.9%) at physiological levels of hematocrit (~40%).

BACKGROUND

The aim of this prospective study was to evaluate the influence of sectioning the calcaneofibular ligament (CFL) during an extensile lateral approach during open reduction and internal fixation (ORIF) of calcaneal fractures on ankle joint stability.

METHODS

Forty-two patients with calcaneal fractures that received ORIF were included. Talar tilt stress and anterior drawer radiographs were performed on the operative and contralateral ankles 6 months postoperatively.

RESULTS

The average degree of talar tilt on stress radiographs was 3.4 degrees (range, 0-12 degrees) on the operative side and 3.2 degrees (range, 0-14 degrees) on the contralateral side. The mean anterior drawer on stress radiographs of the CFL incised ankle was 6.1 mm (range, 2.4-11.8 mm) and on the contralateral ankle was 5.7 mm (range, 2.6-8.6 mm). There was no statistically significant difference of talar tilt and anterior drawer between the CFL incised side and the contralateral side (P = .658 and .302, respectively).

CONCLUSIONS

The results suggest that sectioning of the CFL without any repair during ORIF of a calcaneal fracture does not have a negative effect on stability of the ankle. Repair of the CFL is, thus, probably not necessary following extended lateral approach for ORIF of calcaneal fractures.

METHODS

Level II, comparative study.

BACKGROUND

Ankle sprains remain the most common orthopaedic injury. Conducting long-term studies in humans is difficult and costly, so the long-term consequences of an ankle sprain are not entirely known.

OBJECTIVE

To measure knee-joint space after a single surgically induced ankle sprain in mice.

METHODS

Randomized controlled trial.

METHODS

University research laboratory.

METHODS

Thirty male mice (CBA/2J) were randomly placed into 1 of 3 surgical groups: the transected calcaneofibular ligament (CFL) group, the transected anterior talofibular ligament/CFL group, or a sham treatment group. The right ankle was operated on in all mice.

METHODS

Three days after surgery, all of the mice were individually housed in cages containing a solid-surface running wheel, and daily running-wheel measurements were recorded. Before surgery and every 6 weeks after surgery, a diagnostic ultrasound was used to measure medial and lateral knee-joint space in both hind limbs.

RESULTS

Right medial (P = .003), right lateral (P = .002), left medial (P = .03), and left lateral (P = .002) knee-joint spaces decreased across the life span. The mice in the anterior talofibular ligament/CFL group had decreased right medial (P = .004) joint space compared with the sham and CFL groups starting at 24 weeks of age and continuing throughout the life span. No differences occurred in contralateral knee-joint degeneration among any of the groups.

CONCLUSIONS

Based on current data, mice that sustained a surgically induced severe ankle sprain developed greater joint degeneration in the ipsilateral knee. Knee degeneration could result from accommodation to the laxity of the ankle or biomechanical alterations secondary to ankle instability. A single surgically induced ankle sprain could significantly affect knee-joint function.

Lateral ligament tears, also known as high-grade ankle sprains, are common, debilitating, and usually heal slowly. 10-30% of patients continue to suffer from chronic pain and ankle instability even after 3-9 months. Previously, we showed that the recombinant human amelogenin (rHAM⁺ ) induced regeneration of fully transected rat medial collateral ligament (MCL), a common proof-of-concept model. Our aim was to evaluate whether rHAM⁺ can regenerate torn ankle calcaneo-fibular ligament (CFL), an important component of the lateral ankle stabilizers. Right CFLs of Sabra rats were transected and treated with 0, 0.5 or 1µg/µl rHAM⁺ dissolved in propylene glycol alginate (PGA). Results were compared to the normal group, without surgery. Healing was evaluated 12 weeks after treatment by mechanical testing (ratio between the right and left, un-transected ligaments of the same rat), and histology including immunohistochemical staining of collagen I and S100. The mechanical properties, structure, and composition of transected ligaments treated with 0.5μg/μl rHAM⁺ (experimental) were similar to un-transected ligaments. PGA (control) treated ligaments were much weaker, lax and unorganized compared to un-transected ligaments. Treatment with 1μg/μl rHAM⁺ was not as efficient as 0.5μg/μl rHAM⁺ . Normal arrangement of collagen I fibers and of proprioceptive nerve endings, parallel to the direction of the force, was detected in ligaments treated with 0.5μg/μl rHAM⁺ , and scattered arrangement, resembling scar tissue, in control ligaments. In conclusion, we showed that rHAM⁺ induced significant mechanical and structural regeneration of torn rat CFLs, which might be translated into treatment for grade 2-3 ankle sprain injuries. This article is protected by copyright. All rights reserved.

OBJECTIVE

To investigate the use of different modes of transport and long-term changes among stroke survivors with cognitive functional limitations (CFLs), and to study differences among sub-groups (decreased/ceased vs. unchanged and increased public transport use) regarding physical functional limitations (PFLs), CFLs, depression, and social activity outside home.

METHODS

Survey of 79 individuals living in the community with CFLs post-stroke (mean 26 months). Well-established and study-specific instruments were used capturing the mode of transport use, CFLs (professionally assessed and self-reported), depression symptoms, and PFLs.

RESULTS

Over one third of the participants reported decreased/ceased use of bus and train, among whom more PFLs were found in comparison with those reporting unchanged use and more depression was found in comparison with those showing increased use. There were no sub-group differences concerning occurrence of CFLs and decrease in social activity. The use of own car or motorbike had largely ceased, most often replaced by Special Transportation Service or travelling by private car or taxi. Yet 27% were still frequent car drivers.

CONCLUSIONS

The results indicate considerably affected use of modes of transport after stroke, and higher frequencies of PFLs and symptoms of depression among those with decreased/ceased public transport use.

Objective: To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping.

Materials and methods: This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student's t test, and Pearson's correlation coefficient.

Results: T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p < 0.05). However, there were no significant differences in T2 values in subtalar and midtarsal joints between patients with isolated ATFL injuries and healthy controls (all p > 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = -0.687, p = 0.007; r = -0.609, p = 0.021, respectively).

Conclusion: CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.

Keywords: Cartilage; Chronic lateral ankle instability; Magnetic resonance imaging; Midtarsal joint; Subtalar joint.

Histological and electron microscopic examinations were made of hepatic biopsies from children in various types of congenital fibrosis of the liver (CFL). A relationship was found between clinico-laboratory evidence of liver dysfunction and severity of ultrastructural changes in hepatic parenchyma in non-complicated and complicated CFL. Signs of active intralobular fibrosis were revealed in cases of complicated CFL. Perisinusoid and perihepatocellular depositions of collagenous fibers lead to isolation of hepatic cells from the blood supply system, which is a cause of dystrophic changes in the liver and affects the function of the organ.

Patients with Low vision are known to experience difficulties in executing activities of daily living and visual search due to reduction in vision. There is a need to translate clinical parameters into a real world that is relevant so as to understand the patient's functional vision; this can be possible with virtual reality (VR). This prospective study included 53 normal and 30 low vision subjects older than 18 years of age in a tertiary care center. The low vision subjects were further classified into peripheral field loss (PFL) and central field loss (CFL). A VR bank environment was developed with multiple tasks that aimed at assessing reading for distance and near, identification of objects against various contrast levels and mobility. Based on the normative data obtained a scoring system was developed to quantify the visual performance between normal and low vision subjects. A significant difference was found in the performance between the normal and low vision subjects in the VR environment. The overall VR performance score was lower in subjects with PFL 56.65 (IQR 19.4) than CFL 63.25 (IQR 10.83); however, both of them were lower compared with normal subjects 87 (IQR 4.6) p < 0.001. These findings suggest that performance of low vision subjects was worse than normal subjects in VR environment and it is important to plan and prioritize assessment and rehabilitation interventions for low vision subjects with a more holistic performance based approach.

Light-emitting diodes (LEDs) lights are more energy-efficient and provide adequate illumination compared to compact fluorescent (CFL) lamps and incandescent light (ICD) bulbs. However, as new light sources, the LED lights may have a stress effect on broiler chickens. Thus, this study aimed to determine the effects of dietary L-tryptophan (Trp), as an anti-stress agent and different color temperatures of light-emitting diodes on immune responses and growth performance of male broiler chickens. Four hundred and eighty day-old Ross 308 male chicks were used from day 1 to 42. The chicks were randomly distributed into six treatment groups in a 2 × 3 factorial arrangement [0 or 1 g Trp per kg diet along with neutral-white (4286 K), warm-white (2990 K), and incandescent (2790 K) light bulbs] with four replicates of 20 chicks each. Results showed that dietary Trp and Trp×light interaction did not affect growth performance, immune responses, a total number of leukocytes, and different leukocytes count (heterophil, eosinophil, monocyte, and lymphocyte) of male broiler chickens. However, LEDs' different color temperatures significantly affected the feed conversion ratio (FCR) and primary antibody of sheep red blood cell (SRBC). The FCR was the lowest in the warm-white light, and primary SRBC antibody titers of the chicks were the highest. In conclusion, although adding Trp to male broiler diets did not affect the growth performance and immune responses of chickens, the warm-white light improved the FCR and primary SRBC.

Keywords: Chicks; Dietary L-tryptophan; Growth performance; Immune responses; Light.

Efficient light-induced floral stimulation plays a key role in energy conservation and maintaining stable productivity during off-season periods of dragon fruit plants. In this study, we first reported on results of a survey on dragon fruit farmers regarding use of lamps in performing artificially induced flowering process in Vietnam. It was found that the use of incandescent lamp was prevalent in dragon fruit cultivation practices, resulting in heavy electricity consumption, and that low-power compact fluorescent light (CFL) bulbs were not extensively utilized, possibly due to low floral induction performance of domestic CFL bulbs. Arguing that emission spectra of currently used lamps were not consistent with adsorption spectra of phytochromes, whose transformation is responsible for flowering process of dragon fruit, we then proposed three improved CFL lamps (power capacity of 20 W) having emission spectra focused on red and far-red regions. New lamp prototypes were tested in 7 field experiments in three different provinces in Vietnam. One improved CFL bulb (treatment 2) performed relatively well in comparison with the incandescent control lamp (60 W) in six out of seven experiments with regard to some growth indicators (e.g., number of floral stems, number of bubs, number of fruits per plant) and fruit yield. Recent success on commercialization of the improved CFL lamp demonstrates the potential of CFL lamps in floral stimulating irradiation of other crops and plants and in alleviating electricity burden in dragon fruit growing areas.

Keywords: compact fluorescent lamp; dragon fruit; floral stimulation; flowering control; photon flux density.

Objectives: A retrograde fibular medullary screw may be utilized in certain fractures about the ankle. The purpose of this study is to investigate the anatomic considerations of a retrograde medullary screw inserted from a lateral starting point to nearby anatomic structures about the distal fibula.

Methods: Ten fresh-frozen cadaveric lower extremities were utilized. A 1.6-mm Kirschner wire was inserted into the distal fibula from a far-lateral starting point. A 3.2-mm cannulated drill bit was then inserted over the Kirschner wire. After placement of the drill bit, dissection of the lateral ankle was undertaken. The proximity of nearby anatomic structures to the drill bit was measured using calipers. A 4.5-mm cortical screw was then inserted using fluoroscopic guidance. Measurements were then taken again to assess the relationship of the screw head to adjacent structures.

Results: Mean distance from drill bit to nearby structures is as follows: Peroneus longus tendon 4.56 mm, peroneus brevis tendon 6.62 mm, sural nerve 4.13 mm, superior peroneal retinaculum 7.52 mm, inferior peroneal retinaculum 6.61 mm, anterior talofibular ligament (ATFL) 6.1 mm, calcaneofibular ligament (CFL) 6.7 mm. Average distance from 4.5-mm screw head to nearby structures is as follows: peroneus longus tendon 6.79 mm, peroneus brevis tendon 6.73 mm, ATFL 4.16 mm, CFL 5.14 mm, lateral talar process 9.41 mm.

Conclusion: Retrograde medullary fibular screw fixation may be safely carried out through a lateral start point. Anatomic structures about the lateral ankle are nearby but not immediately adjacent to the drill bit.

Keywords: Anatomy; Fibula; Medullary screw; Peroneal tendons; Trauma.

Purpose: The objective of this study was to analyze the visual acuity improvement in patients with low vision using augmented reality device who presented to the low vision care (LVC) clinic at a tertiary eye care center.

Methods: A prospective study of 100 patients with low vision who were referred to the LVC clinic between July and December 2018 was done. Demographic data and visual acuity improvement assessed using augmented reality (AR) technology paired with Samsung Gear headset were documented.

Results: Out of 100 patients, 74 were male and 26 were female. The median age of the overall patients was 36 (25.5) years. In 100 patients, 21% patients were found to have central field loss (CFL), 35% patients have peripheral field loss (PFL), and 44% patients were found to have overall blurred vision (OBV). Majority of the subjects with CFL (47%) and OBV (37%) has a moderate visual impairment and in PFL group (26%), severe visual impairment was more. Cone dystrophy (9%) was found to be the major cause of CFL group, retinitis pigmentosa (22%) in the case of PFL group, and optic atrophy (10%) in the case of OBV group. The median distance visual acuity 0.9 log MAR improved to 0.2 log MAR (P < 0.0001) and median near visual acuity 0.4 log MAR improved to 0.1 log MAR with a P value of < 0.0001 using AR device.

Conclusion: The use of an AR device can help patients with low vision to improve their residual vision for better visual performance.

Keywords: Augmented reality; Low vision care; Samsung Gear; central field loss; overall blurred vision; peripheral field loss.

Light-emitting diode (LED) light bulbs are becoming more prevalent in layer production as unlike CFLs they are dimmable and are even more energy-efficient than CFLs. There is also discussion on whether the spectrum of light that is produced by the bulb can affect production, stress, and behavior of laying hens. To investigate if differences between how the bulb that produce different wavelengths of light affect these factors, we raised White Leghorn hens under either a bulb that produced white light with the addition of red light (Once, Inc, AgriShift MLL; RED) or a bulb that produced only white light (Overdrive, L10NA19DIM 3000 K; WHITE). Each treatment consisted of 36 White Leghorn hens, and the experiment was replicated three times for a total of 108 hens per treatment. Production parameters including % hens in lay, feed conversion, average egg weight, total eggs per hen, eggshell breaking strength, and Haugh units were measured. Hen fear response during tonic immobility and inversion was documented at 3 time points during the study (18, 42, and 72 wk of age). Stress susceptibility was also quantified using plasma corticosterone, heterophil to lymphocyte ratio, and composite asymmetry score at the same time points as the fear testing. No production parameters were affected by lighting type (P > 0.05). Lighting type did not affect tonic immobility or inversion response (P > 0.05). By 42 wk of age and continuing on until 72 wk of age, the RED treatment had lower plasma corticosterone concentrations, lower heterophil to lymphocyte ratios, and lower composite asymmetry scores than the WHITE treatment (P < 0.05). The results indicate that including red light in the spectrum of light layers are reared under can lower stress susceptibility but had no effect on fear response or production parameters when compared to white light.

Objective To compare three surgical techniques for lateral ankle ligament reconstruction using finite element (FE) models. Methods A three-dimensional FE model of the left foot of a healthy volunteer and lateral collateral ligament injury models were developed. Three tendons [one-half of the autologous peroneus longus tendon (PLT), one-half of the peroneus brevis tendon (PBT), and an allogeneic tendon] were used for lateral collateral ligament reconstruction. The ankle varus stress and anterior drawer tests were performed to compare the three surgical techniques. Results The ankle varus stress test showed that the equivalent stresses of the anterior talofibular ligament (ATFL) (84.00 MPa) and calcaneofibular ligament (CFL) (27.01 MPa) were lower in allogeneic tendon reconstruction than in the other two techniques but similar to those of normal individuals (138.48 and 25.90 MPa, respectively). The anterior drawer test showed that the equivalent stresses of the ATFL and CFL in autologous PLT reconstruction (31.31 and 28.60 MPa, respectively) and PBT reconstruction (31.47 and 29.07 MPa, respectively) were lower than those in allogeneic tendon reconstruction (57.32 and 52.20 MPa, respectively). Conclusions The allogeneic tendon reconstruction outcome was similar to normal individuals. Allogeneic tendon reconstruction may be superior for lateral ankle ligament reconstruction without considering its complications.

We demonstrate anisotropic optical films based on liquid crystalline polymer (LCP) using a capillary force lithography (CFL). The fabricated optical films can be used as both an optical component and a self-aligning capability of liquid crystal molecules introduced on the film. Additionally, HA or PA LC can be induced on same material by controlling the water repellency of LCP surface. Moreover, surface anchoring transitions could be controlled by variation of pattern sizes and surface treatment. In this point of view, one thin optical film can act both retarder and alignment layer and then shows good retardation, LC alignment, and transmittance at the same time.

Accumulation of metals is a concern with continuous application of swine slurry to agricultural soils. Solid-liquid separation is a promising approach for reducing phosphorus and total metal loadings with swine manure application to farmlands. However, very little work has been performed on the partitioning of different metal fractions in swine slurry to separated solids and liquids. This study examined the distribution of various metal fractions in raw manures (RM), their separated liquids (SL), and separated solids (SS). The three separation techniques used were centrifuge without flocculant (CNF), centrifuge with flocculant (CFL), and rotary press with flocculant (RFL). Concentrations of Cd, Cu, Zn, Ni, and Se in manure and separates were determined by a modified Sposito's sequential chemical fractionation scheme to extract water-soluble, exchangeable, organically bound, carbonate-precipitated, and residual fractions. The greatest concentrations of metals were recovered in the residual fraction, with the organically bound and carbonate-precipitated concentrations much greater than water-soluble and exchangeable fractions. Separation index () (i.e., percentage partitioned to SS) ranged from 13 to 66%, 9 to 87%, 16 to 93%, and 23 to 96% for water-soluble, exchangeable, organically bound, and carbonate-precipitated fractions, respectively. The values in general, were significantly ( < 0.05) greater for flocculant-based separation techniques than for CNF. For organically bound and carbonate-precipitated fractions, the greatest was obtained with the RFL for most metals. Our results suggest that applying the SL from RFL separation would minimize metal loading to farmlands compared with SL from CNF and CFL techniques. However, further validation is required using more sources of manure and different flocculants.

A unique metal-free aerobic oxidation of primary amines via visible light photocatalytic double carbon-carbon bonds cleavage and multi carbon-hydrogen bonds oxidation was observed. Aerobic oxidation of primary amines could be controlled to afford acids by using dioxane with 18 W CFL, and lactones by using DMF with 8 W green LEDs, respectively. A plausible mechanism was proposed based on control experiments. This observation showed direct evidences for the fragmentation in the aerobic oxidation of aliphatic primary amines.

Sluggish CO2 reduction on the cathodes of solid oxide electrolysis cells (SOECs) greatly affects electrolysis performance. However there is no study investigating the cathode functional layer (CFL), where the reduction occurs. Cathode supports equipped with fast gas diffusion channels were employed as a platform to investigate the CFL, including porosity, NiO/(Y2O3)0.08Zr0.92O2 (YSZ) ratio and thickness. The porosity was adjusted by pore former content, and the higher porosity generated a higher electrolysis current density while the porosity improvement is limited by fabrication process. The three-dimensional microstructure of the CFL with different NiO/YSZ ratios was reconstructed by distance correlation functions (DCFs) to estimate three-phase boundary (TPB) density, which can explain the optimal NiO/YSZ weight ratio of 60:40 for CO2 electrolysis. Increasing CFL thickness can provide more active sites until the optimal thickness of 35μm. Further increasing the thickness results in gas diffusion limitation. Based on the channeled cathode supports, the cathode functional layer was optimized according to CO2 electrolysis performance.

OBJECTIVE

In Belgium, combination chemotherapy of cisplatin and 5-fluorouracil + leucovorin (CFL) according to the modified de Gramont schedule is the treatment of choice in second line for metastatic pancreatic cancer. We retrospectively analyzed survival data in 2 Belgian centers in a nonselected population.

METHODS

Between January 2004 and October 2011, 48 patients with histologically proven recurrent or unresectable pancreatic adenocarcinoma who had received CFL as second-line treatment were identified. We retrospectively analyzed the following parameters: progression-free survival (PFS1 and PFS2) for each line (after the start of first and second line), overall survival (OS), and growth modulation index.

RESULTS

The median PFS1 was 5.4 months (95% confidence interval [CI], 4.1-6.6). The median PFS2 was 3.6 months (95% CI, 2-5.2). The median OS was 12 months (95% CI, 9.3-14.7). Twenty-three percent of patients had a growth modulation index >1.33.

CONCLUSIONS

We show an OS of 12 months with gemcitabine in first-line and CFL in second-line therapy for pancreatic cancer. Sequential therapy with good OS and good quality of life may be preferred to strong upfront therapy in an incurable disease such as pancreatic cancer.

A visible-light-promoted merged gold/photoredox catalyzed ipso-arylative cyclization has been reported. For instance, the reaction of aryl-alkynoates and N-arylpropiolamides with aryldiazonium salts in the presence of catalytic amounts of [(4-OCH3)C6H4]3PAuCl and Ru(bpy)3(PF6)2 under irradiation using a 32 W CFL bulb gave arylated spirocarbocycles in moderate to good yields.

OBJECTIVE

To study therapeutic effects of lateral ankle ligaments reconstruction for the treatment of chronic lateral instability of the ankle joint.

METHODS

From July 2005 to January 2008, among 13 patients with chronic lateral instability of the ankle joint, 10 patients were male and 3 patients were female, ranging in age from 24 to 45 years,with an average of 33 years. Anterior talo-fibular ligament (ATFL) and calcanea-fibular ligament (CFL) were anatomy reconstructed with a split peroneus brevis tendon graft for all patients. The ankle scoring system was used to evaluate ankle joint function before and after operation, which including stability, pain, locomotor activity and X-ray films.

RESULTS

All the patients were followed up ranged from 6 to 32 months, averaged 16.4 months. The postoperative scores of the ankles increased in respect to stability, pain and locomotor activity. The total average score increased from preoperative (43.54+/-7.04) to postoperative (73.38+/-4.17). There was significant difference between preoperative scores and postoperative scores (P<0.01). All the patients were satisfied with the results.

CONCLUSIONS

Anatomy reconstruct of the ATFL and CFL with a split peroneus brevis tendon graft (Sammarco method) is a practical method for lateral ankle instability and promise good results especially for patients complained of instability.

OBJECTIVE

How do families with children conceived using donor sperm operate as the children grow up?

CONCLUSIONS

Families with children aged 5-13 years conceived through anonymous donor sperm function well, when compared with other family types with children of the same developmental stage.

BACKGROUND

Previous studies on family relationships after donor sperm conception have been reassuring. However, these studies have suffered from methodological limitations due to small sample sizes, respondent biases and absence of appropriate controls.

METHODS

This study was an observational study comparing 79 'donor insemination' (DI) families with 987 'couple' families, 364 'single mother' and 112 'step-father' families as part of the Australian Institute of Family Studies Children and Family Life (CFL) study. CFL involved the collection of data on family functioning and child wellbeing from all resident parents through a Family and Child Questionnaire for the 'primary' parent (FACQ-P1) and a Family Relationship Questionnaire (FRQ-P2) for the 'other' parent.

METHODS

All questionnaires were coded with the identity known only to the researchers. The outcomes studied included parent psychological adjustment, family functioning, couple relationship, parenting and parent-child relationship. Family types were compared, separately for mothers' and fathers' reports. The results presented are the estimated means for each family type based on the final model for each outcome: post hoc comparisons between family types are reported with 95% confidence limits.

RESULTS

With all of the outcomes considered, there was not one result where the DI families showed poorer functioning on average than the comparison groups.

CONCLUSIONS

The final sample size of DI families is 79 with an excellent response rate of nearly 80%. However, there remains some scope for response bias.

CONCLUSIONS

This study further reassures us that families conceived with anonymous donor sperm do not function any differently from other family types.

The purpose of this study was to identify the ideal start site for a retrograde intramedullary fibular cortical screw based on its relationship to the surrounding soft tissue structures and to assess for damage to the surrounding soft tissue structures caused during placement of the screw. Four fresh frozen cadavers underwent fluoroscopic placement of a 3.5 mm cortical screw utilizing a standardized protocol. No damage to the peroneal tendons were noted in any cadaver with the foot in an inverted and plantarflexed position. The closest structure to the center of the screw head was the anterior talofibular ligament anteriorly (3.33 mm range: 3-4 mm) and the calcaneofibular ligament posteriorly (2.66 mm, range: 2-3 mm). Two screws violated the malleolar fossa medially and were noted to impinge on the lateral process of the talus. The ideal start site for a 3.5 mm intramedullary fibular screw is at the midline on the lateral radiograph and 3.0 mm lateral to the malleolar fossa on the AP radiograph. This avoids damage to the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) and prevents impingement on the lateral process of the talus. (Journal of Surgical Orthopaedic Advances 30(2):078-081, 2021).