Posttraumatic Arthrosis and Triquetral Nonunion Associated With Pisotriquetral Subluxation in Adolescent Female Softball Players.

Impaction fracture subluxation of the pisotriquetral joint producing arthrosis and ulnar triquetral osteochondral nonunion is a cause for ulnar wrist pain in batting athletes. Two cases of adolescent female softball players managed successfully with pisiform and triquetral fragment excision are reported.

Faith as a Mechanism for Health Promotion among Rural African American Prostate Cancer Survivors: A Qualitative Examination.

Conceptualized using critical race theory as a theoretical underpinning, this study analyzed the lived experiences of older, rural, African American male prostate cancer (hereafter referenced as PrCA) survivors' faith and health promotion practices within Northeast Louisiana. Qualitative data from journaling, observations, and semi-structured interviews were obtained from ten older, African American male PrCA survivors residing in four rural parishes of Louisiana. The data analysis employed a two-stage approach known as Polkinghorne's analysis of narratives and narrative analysis using an art-based methodological approach. Framed as composite character counterstories, survivors' narratives revealed how survivors made sense of and gave meaning to their PrCA diagnosis, treatment, recovery, and survivorship. Specifically, their counterstories indicate that centering and honoring the unique and often taken-for-granted perspectives of older, rural, African American male PrCA survivors offered a deeper understanding of the multiple factors influencing their quality of life, as well as the sociostructural mechanisms impacting their survivorship care. Faith was examined as both a secular and sacred source of support that these men viewed as central to the acceptance of their diagnosis, treatment, recovery, and survivorship.

In Situ Sensing of Reactive Oxygen Species on Dye-Stained Single DNA Molecules under Illumination.

Reactive oxygen species (ROS) are a necessary evil in many biological systems and have been measured with fluorescent probes at the ensemble levels both in vitro and in vivo. Measuring ROS generated from a single molecule is important for mechanistic studies, yet measuring ROS near a dye-labeled single-molecule under illumination has been challenging. Here, we use CellROX, a group of ROS probes, to sense ROS near dye-stained DNA that has been flow-stretched and immobilized on a surface. ROS is responsible for the photodamage of DNA molecules under this circumstance. In this report, we confirmed the ROS sensing reaction in bulk solutions and optimized the conditions for single-molecule experiments including the selection of substrates, dye concentrations, probes in the CellROX series, excitation lasers, and emission filter-sets. We observed a correlation between ROS and the dye-labeled DNA and localized the ROS-activated CellROX probe molecules at both the ensemble level and the single-molecule level.

Single-Particle Organolead Halide Perovskite Photoluminescence as a Probe for Surface Reaction Kinetics.

Photoluminescence (PL) of organolead halide perovskites (OHPs) is sensitive to OHPs' surface conditions and is an effective way to report surface states. Literature has reported that at the ensemble level, the PL of photoexcited OHP nanorods declines under an inert nitrogen (N2) atmosphere and recovers under subsequent exposure to oxygen (O2). At the single-particle level, we observed that OHP nanorods photoblink at rates dependent on both the excitation intensity and the O2 concentration. Combining the two sets of information with the charge-trapping/detrapping mechanism, we are able to quantitatively evaluate the interaction between a single surface defect and a single O2 molecule using a new kinetic model. The model predicts that the photodarkening of OHP nanorods in the N2 atmosphere has a different mechanism than conventional PL quenching, which we call photo-knockout. This model provides fundamental insights into the interactions of molecular O2 with OHP materials and helps design a suitable OHP interface for a variety of applications in photovoltaics and optoelectronics.

Game Changers: A Critical Race Theory Analysis of the Economic, Social, and Political Factors Impacting Black Fatherhood and Family Formation.

Family has always been one of the strongest institutions in the African American community. However, over the past 30 years, massive changes have occurred within the structure of African American families, resulting in many fathers living apart from their children. Applying the basic tenets of Critical Race Theory (CRT) and Michelle Alexander's notion of Racialized "Game Changing," this article examines the social, political, and economic factors that have worked to undermine normative Black fatherhood involvement and family formation patterns over time. Two of the major arguments-the slavery argument and the cultural argument-offered in the empirical research literature in an attempt to explain the shifts that have occurred within Black families historically are also examined, followed by an in-depth discussion and analysis of factors that underlie the changes in Black family structure and formation over time. The article concludes with a set of policy recommendations for strengthening Black fatherhood and family formation in the 21st century.

Reusable Chemically-Micropatterned Substrates via Sequential Photoinitiated Thiol-Ene Reactions as Template for Perovskite Thin-Film Microarrays.

Patterning semiconducting materials are important for many applications such as microelectronics, displays, and photodetectors. Lead halide perovskites are an emerging class of semiconducting materials that can be patterned via solution-based methods. Here we report an all-benchtop patterning strategy by first generating a patterned surface with contrasting wettabilities to organic solvents that have been used in the perovskite precursor solution then spin-coating the solution onto the patterned surface. The precursor solution only stays in the area with higher affinity (wettability). We applied sequential sunlight-initiated thiol-ene reactions to functionalize (and pattern) both glass and conductive fluorine-doped tin oxide (FTO) transparent glass surfaces. The functionalized surfaces were measured with the solvent contact angles of water and different organic solvents and were further characterized by XPS, selective fluorescence staining, and selective DNA adsorption. By simply spin-coating and baking the perovskite precursor solution on the patterned substrates, we obtained perovskite thin-film microarrays. The spin-coated perovskite arrays were characterized by XRD, AFM, and SEM. We concluded that patterned substrate prepared via sequential sunlight-initiated thiol-ene click reactions is suitable to fabricate perovskite arrays via the benchtop process. In addition, the same patterned substrates can be reused several times until a favorable perovskite microarray is acquired. Among a few conditions we have tested, DMSO solvent and modified FTO surfaces with alternatively carboxylic acid and alkane is the best combination to obtain high-quality perovskite microarrays. The solvent contact angle of DMSO on carboxylic acid-modified FTO surface is nearly zero and 65±3° on octadecane modified FTO surface.

Benefits of sonography in diagnosing suspected uncomplicated acute diverticulitis.

OBJECTIVES: Despite evidence demonstrating equivalent accuracy of sonography and computed tomography (CT) in the workup of mild/uncomplicated acute diverticulitis, CT is overwhelmingly performed as the initial diagnostic test, particularly in the acute setting. Our study evaluated potential radiation and turnaround time savings associated with performing sonography instead of CT as the initial diagnostic examination in the workup of suspected uncomplicated acute diverticulitis. METHODS: We retrospectively reviewed medical records from January 2010 to December 2012 for patients presenting with clinical symptoms of acute diverticulitis. Patients were categorized as a whole and subgrouped by age (>40 and <40 years). A modified Hinchey classification (Am Surg 1999; 65:632-636) was used to stage the severity of the disease. The effective radiation dose was calculated by multiplying the dose length product from the scanner by the standard conversion coefficient (k= 0.0021 mSv/mGy × cm). The turnaround time for patients was calculated as the time the examination was ordered by the emergency department physician or staff to the time the report was finalized. RESULTS: Our study included 253 patients (172 male and 81 female; mean age ± SD, 50.2 ± 11.7 years; 132 >40 years and 121 <40 years). The distribution of patients by the modified Hinchey classification was 210 (stages 0 and 1a), 26 (stages 1b and 2), 17 (stages 3 and 4), 0 (fistula), and 0 (obstruction). The estimated CT radiation dose per patient was 21 ± 5.2 mSv. Mean turnaround times for CT and sonography were 138.5 ± 76.9 and 51.3 ± 44 minutes, respectively. CONCLUSIONS: Sonography is a lower-cost, faster, and radiation-free alternative that measures up to the diagnostic standards of CT for management of suspected mild or uncomplicated acute diverticulitis.

Remodeling potential of phalangeal distal condylar malunions in children.

PURPOSE: Distal condylar phalangeal (DCP) fractures in children are uncommon, but their periarticular location makes them problematic. Malunions are particularly difficult to treat. These fractures are generally thought to have a poor remodeling potential because their location is far from the phalangeal physis. We present 8 cases of DCP malunion in children with a mean 5-year follow-up demonstrating consistent remodeling. METHODS: In this study, DCP fractures were defined as those occurring at or distal to the collateral ligament recess of the proximal or middle phalanx in skeletally immature patients. Radiographic parameters examined at the time of established malunion and at final follow-up included coronal and sagittal plane deformity and translational malalignment of the distal fragment in relation to the proximal shaft. Range of motion was measured, and a brief questionnaire was implemented to establish patient satisfaction. RESULTS: We examined 8 patients with a minimum 1-year follow-up (mean, 5.3 y). Average age at injury was 8.8 years (range, 2-14 y). In the sagittal plane, fractures remodeled from an initial mean deformity of 30.9° to 0.0°; in the coronal plane, from 10.5° to 3.9°. Fracture translation in the sagittal plane corrected, as well, from a mean 57.5% at injury to 0.0% at final follow-up. There was no functionally limiting loss of motion of the digit in any patient. Subjectively, only 2 patients complained of cosmetic deformity, both of which were coronal plane deformities of the small finger. CONCLUSIONS: In this case series, DCP malunions in children remodeled significantly and completely in the sagittal plane, and all patients had good final range of motion. Furthermore, patients were satisfied with nonsurgical treatment at long-term follow-up. This series describes the remodeling potential of DCP fractures in children, lending support to the previously reported cases. These findings support treating late-presenting pediatric DCP malunions nonsurgically. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Precious African American memories, post-racial dreams & the American nation.

This interdisciplinary essay explores a fundamental paradox at the heart of American race relations since the 1960s: "the changing same." The more things change; the more they remain the same. Combining historical and social-scientific evidence with autobiographical reflections, this discussion critically probes the paradoxical decline and persistence of two dimensions of our enduring racial quagmire: racial inequality and white supremacy. The essay argues that these powerful and interrelated elements of America's continuing racial dilemma demand a massive democratic movement to alleviate both at once. This wide-ranging struggle to realize the promise of American democracy requires more than just a revitalized African American Freedom Struggle that is both intraracial and interracial. Progress toward resolving the seemingly intractable problem of racial inequality in the United States demands far more than intensified efforts to alleviate economic inequality; it requires alleviating white supremacy as well.

Building community-engaged health research and discovery infrastructure on the South Side of Chicago: science in service to community priorities.

OBJECTIVE: To describe the roles community members can and should play in, and an asset-based strategy used by Chicago's South Side Health and Vitality Studies for, building sustainable, large-scale community health research infrastructure. The Studies are a family of research efforts aiming to produce actionable knowledge to inform health policy, programming, and investments for the region. METHODS: Community and university collaborators, using a consensus-based approach, developed shared theoretical perspectives, guiding principles, and a model for collaboration in 2008, which were used to inform an asset-based operational strategy. Ongoing community engagement and relationship-building support the infrastructure and research activities of the studies. RESULTS: Key steps in the asset-based strategy include: 1) continuous community engagement and relationship building, 2) identifying community priorities, 3) identifying community assets, 4) leveraging assets, 5) conducting research, 6) sharing knowledge and 7) informing action. Examples of community member roles, and how these are informed by the Studies' guiding principles, are provided. CONCLUSIONS: Community and university collaborators, with shared vision and principles, can effectively work together to plan innovative, large-scale community-based research that serves community needs and priorities. Sustainable, effective models are needed to realize NIH's mandate for meaningful translation of biomedical discovery into improved population health.

Evaluation of the Speed-oligo® Mycobacteria assay for identification of Mycobacterium spp. from fresh liquid and solid cultures of human clinical samples.

We evaluated the ability of a novel DNA strip assay (Speed-oligo® Mycobacteria) to differentiate mycobacterial species. It is based on polymerase chain reaction targeting 16S rRNA and 16S-23S rRNA regions and double-reverse hybridization on a dipstick using probes bound to colloidal gold and to the membrane. We blindly tested its capacity to identify 182 acid-fast bacilli grown on fresh liquid (BacT/Alert, MGIT) and solid (Lowenstein-Jensen) cultures (from Spanish mycobacteriology laboratories), previously identified by means of Genotype(®) Mycob.CM/AS or Gen-Probe(®) AccuprobeMTC, and 11 collection strains of mycobacteria-related organisms. Discrepancies were resolved by 16S rRNA sequencing. Results were interpreted by identification of 7 specific bands for the following: Mycobacterium sp., M. fortuitum, Mycobacterium avium-intracellulare complex, Mycobacterium tuberculosis complex, Mycobacterium kansasii, M. gordonae, and M. abscessus-chelonae complex. No cross-reactivity was observed with any mycobacteria-related organism. Concordant results were obtained for 177/182 bacilli (97.2%). There was only 1 major discrepancy, misidentification of Mycobacterium marinum as M. kansasii, verified by sequencing.

African American adolescent males' views on doctors and the health care system.

OBJECTIVE: African American adolescent males have disproportionately high rates of morbidity and mortality and low levels of primary care use. To optimize health care for this group, there is a need to understand their views on doctors and health care, reasons for foregone care, and preferences regarding provision of health care. METHODS: This was a pilot survey of African American adolescent males attending community groups in Chicago. RESULTS: A majority of respondents agreed with declarative statements about doctors being considerate, truthful, and respectful (63%, 80%, and 80%, respectively). A majority also indicated that the health care system informs them of ways to stay healthy (65%), but fewer agreed that it meets the needs of adolescents and minorities (44% and 33%, respectively). Race/gender concordance with physicians did not seem to be a high priority. Significant reasons for foregone care included conflict with school hours, parents not having time, and lack of transportation. Despite access issues, only a minority of participants wanted health care services co-located with other aspects of their daily lives (school, community centers, church, and barbershops). CONCLUSION: African American adolescent males may view doctors and the health care system positively. Eliminating barriers to care and ensuring positive interactions may create opportunities to improve health issues afflicting these at-risk adolescents.

Necrosis caused by intra-arterial injection of promethazine: case report.

Promethazine injections have led to necrosis and gangrene of the distal upper extremity when inadvertently injected into an artery. There have been few case reports of this alarming complication in the literature. We report on 2 cases of intra-arterial promethazine injection that led to amputation.

According to him: barriers to healthcare among African-American men.

OBJECTIVES: We sought to elicit barriers to health and primary healthcare use among African-American men residing in a low-income, urban area. METHODS: We conducted a qualitative study of African-American men using focused group interviews. A purposive sampling technique was used to recruit 8 select subgroups: adolescents (age 16-18), trauma survivors, HIV-positive men, homeless men, men who have sex with men (MSM), substance abusers, church affiliated men and a mixed sample (N=71). Focus groups were moderated by trained, African-American male focus group leaders. RESULTS: Qualitative analysis of focused group transcripts yielded 2 major categories-intrinsic barriers and extrinsic barriers. Within the intrinsic barriers category, 5 subcategories emerged: lack of health awareness, fear, healthcare as needed, medical mistrust and fatalism. Extrinsic barriers included cost/benefit, clinic experience, and cultural and linguistic differences. Participants also offered solutions to address key barriers. CONCLUSIONS: African-American men identified key intrinsic and extrinsic barriers to health and primary healthcare, including lack of health awareness and providers' cultural and linguistic differences. These barriers constitute important areas of future research and intervention to address African-American men's health and willingness to seek healthcare.

Cutaneous Rosai-Dorfman disease of the forearm: case report.

Sinus histiocytosis with massive lymphadenopathy, also known as Rosai-Dorfman disease (RDD), is a rare non-neoplastic pathologic condition that frequently pursues a prolonged clinical course marked by exacerbations and remissions. Cutaneous RDD is even less common than cases involving lymph nodes. We present the case of a patient with long-standing Crohn's disease who developed cutaneous RDD in the forearm.

Pisotriquetral dysfunction following limited and total wrist arthrodesis.

PURPOSE: We report a series of pisotriquetral arthritis cases following wrist and intercarpal arthrodesis, offer an anatomic and biomechanical rationale, and introduce intraoperative considerations to avoid this potential complication. METHODS: Nine patients with pisotriquetral arthritis requiring pisiform excision following wrist and intercarpal arthrodesis were retrospectively evaluated at 2 institutions. Five paired cadaver wrists were tested for alterations in pressure and kinematics of the pisotriquetral joint following four-corner and total wrist fusions. RESULTS: Nine patients were successfully treated with pisiform excision for pisotriquetral arthritis following wrist and intercarpal fusions. Biomechanical cadaver testing demonstrated profound alterations in pisotriquetral kinematics and pressure changes in measured degrees of wrist position following wrist and intercarpal fusions. CONCLUSIONS: Patients undergoing four-corner and/or wrist arthrodesis should be assessed for pisotriquetral discomfort before surgery, including a physical examination and a 30 degrees supinated radiograph to look for degenerative changes. Attempts should be made intraoperatively to ensure that the proximal row is not fused in an extended position. After surgery, if discomfort develops and conservative treatment fails, then pisiform excision can successfully alleviate the pain.

African-American men's perceptions of health: a focus group study.

African-American men are disproportionately affected by preventable medical conditions, yet they underutilize primary care health services. Because healthcare utilization is strongly dependent on health beliefs, the purpose of this qualitative study was to identify and explore African-American men's perceptions of health and health influences. We conducted eight focus group interviews with select subgroups of African-American men, including adolescents, trauma survivors, HIV-positive men, homeless men, men who have sex with men, substance abusers, church-affiliated men and a mixed sample (N=71). Definitions of health, beliefs about health maintenance and influences on health were elicited. Participants' definitions of health went beyond the traditional "absence of disease" definition and included physical, mental, emotional, economic and spiritual well-being. Being healthy also included fulfilling social roles, such as having a job and providing for one's family. Health maintenance strategies included spirituality and self-empowerment. Stress was cited as a dominant negative influence on health, attributed to lack of income, racism, "unhealthy" neighborhoods and conflict in relationships. Positive influences included a supportive social network and feeling valued by loved ones. This study provides insight into African-American men's general health perceptions and may have implications for future efforts to improve healthcare utilization in this population.

Fathers in child welfare: caseworkers' perspectives.

Five focus groups substantially agreed about the lack of paternal participation in child welfare services and the reasons for low paternal involvement. The groups had considerable disagreement about whether child welfare professionals should address this issue. Some caseworkers believed that all fathers and mothers should be treated identically with respect to services to be offered and time frames for services; other caseworkers thought that the special circumstances of some fathers, such as lack of child care experience, called for service approaches that differ from those for mothers. Another disagreement was whether more fathers would be more involved if services were gender sensitive, that is, if agencies provided male caseworkers for fathers and had father-only services. Much of the debate focused on pragmatic considerations (would gender-sensitive services improve paternal participation and outcomes?), although some participants were concerned about equity (would such services give fathers an advantage in disputed custody cases?).

Gas gangrene and necrotizing fasciitis in the upper extremity.

Necrotizing soft tissue infections encompass a wide variety of clinical syndromes resulting from introduction of various pathogens into injured or devitalized tissue. The extent of microbial involvement in such tissue may range from simple contamination to overt and progressive local tissue necrosis, which, if untreated, may lead to septicemia and death. Early differentiation among these infections is not always possible, as there are overlapping classification criteria. These infections exist along a continuum of clinical severity with different etiological agents and associated medical conditions. The often subtle clues heralding the presence of a necrotizing soft tissue infection must be sought so that expeditious surgical debridement and broad-spectrum antibiotic management are initiated. Although experience enables the clinician to make a specific diagnosis based on early findings, aggressive and proper treatment of suspected infections remains the priority. The purpose of the article is to provide an overview of necrotizing soft tissue infections in the upper extremity, focusing on gas gangrene, or clostridial myonecrosis, and necrotizing fasciitis, to facilitate early diagnosis and optimal management of these lethal diseases.