Background Recovery trajectories support early identification of delayed recovery and can inform personalized management or phenotyping of risk profiles in patients. The objective of this study was to investigate the trajectories in pain severity and functional interference following non-catastrophic musculoskeletal (MSK) trauma in an international, mixed injury sample. Methods A prospective longitudinal cohort of n= 241 was formed from patients identified within 4 weeks of trauma, from attendance at emergency or urgent care centres located in London, ON, Canada, or Chicago, IL, USA. Pain interference was measured via the Brief Pain Inventory (London cohort) or the Neck Disability Index (Chicago cohort). Pain severity was captured in both cohorts using the numeric pain rating scale. Growth mixture modeling and RM ANOVA approaches identified distinct trajectories of recovery within pain interference and pain severity data. Results For pain interference, the 3 trajectories were labeled accordingly: Class 1 = Rapid recovery (lowest intercept, full or near full recovery by 3 months, 32.0% of the sample); Class 2 = Delayed recovery (higher intercept, recovery by 12 months, 26.7% of the sample); Class 3 = Minimal or no recovery (higher intercept, persistently high interference scores at 12 months, 41.3% of the sample). For pain severity, the 2 trajectories were labeled: Class 1 = Rapid recovery (lower intercept, recovery by 3 months, 81.3% of the sample); and Class 2 = Minimal or no recovery (higher intercept, flat curve, 18.7% of the sample). The “Minimal or No Recovery” trajectory could be predicted by female sex and axial (vs. peripheral) region of trauma with 74.3% accuracy across the 3 classes for the % Interference outcome. For the Pain Severity outcome, only region (axial trauma, 81.3% accuracy) predicted the “Minimal or No Recovery” trajectory. Conclusions These results suggest that 3 meaningful recovery trajectories can be identified in an international, mixed-injury sample when pain interference is the outcome, and 2 recovery trajectories emerge when pain severity is the outcome. Females in the sample or people who suffered axial injuries (head, neck, or low back) were more likely to be classed in poor outcome trajectories.

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BackgroundRecovery trajectories support early identification of delayed recovery and can inform personalized management or phenotyping of risk profiles in patients. The objective of this study was to investigate the trajectories in pain severity and functional interference following non-catastrophic musculoskeletal (MSK) trauma in an international, mixed injury sample. MethodsA prospective longitudinal cohort (n= 241) was formed from patients identified within four weeks of trauma, from attendance at emergency or urgent care centres located in London, ON, Canada, or Chicago, IL, USA. Pain interference was measured via the Brief Pain Inventory (London cohort) or the Neck Disability Index (Chicago cohort). Pain severity was captured in both cohorts using the numeric pain rating scale. Growth mixture modeling and RM repeated measures ANOVA approaches identified distinct trajectories of recovery within pain interference and pain severity data. ResultsFor pain interference, the three trajectories were labeled accordingly: Class 1 = Rapid recovery (lowest intercept, full or near full recovery by 3 months, 32.0% of the sample); Class 2 = Delayed recovery (higher intercept, recovery by 12 months, 26.7% of the sample); Class 3 = Minimal or no recovery (higher intercept, persistently high interference scores at 12 months, 41.3% of the sample). For pain severity, the two trajectories were labeled: Class 1 = Rapid recovery (lower intercept, recovery by 3 months, 81.3% of the sample); and Class 2 = Minimal or no recovery (higher intercept, flat curve, 18.7% of the sample). The “Minimal or No Recovery” trajectory could be predicted by female sex and axial (vs. peripheral) region of trauma with 74.3% accuracy across the 3 classes for the % Interference outcome. For the Pain Severity outcome, only region (axial trauma, 81.3% accuracy) predicted the “Minimal or No Recovery” trajectory. ConclusionsThese results suggest that three meaningful recovery trajectories can be identified in an international, mixed-injury sample when pain interference is the outcome, and two recovery trajectories emerge when pain severity is the outcome. Females in the sample or people who suffered axial injuries (head, neck, or low back) were more likely to be classed in poor outcome trajectories. Trial registrationNational Institutes of Health - clinicaltrials.gov (NCT02711085; Retrospectively registered Mar 17, 2016)

Category: Lesser Toes Introduction/Purpose: Recent surgical techniques have focused on anatomic repair of lesser toe metatarsophalangeal (MTP) plantar plate tears. MTP instability has been implicated in a number of common toe deformities as well as metatarsalgia. Recently, a study demonstrated that the microvasculature of the normal plantar plate is densest at the proximal and distal attachments. The purpose of this study was to compare the intact plantar plate microvasculature network to the microvasculature network of plantar plates in the presence of toe deformity using similar perfusion and nano-CT imaging methods. Methods: Eight fresh frozen human cadaveric lower extremities with lesser toe deformities including hammertoe or crossover toe were perfused using a barium solution. The soft tissues of each foot were counterstained with phosphomolybdic acid (PMA). Then using nano-CT imaging the second through fourth toe metatarsophalangeal joints of 8 feet were imaged. These images were then reconstructed, plantar plate tears were identified, and eleven toes remained. The plantar plate microvasculature for these eleven toes was analyzed and calculation of vascular density along the plantar plate was performed. Using ANOVA analysis this experimental group was compared to a control group of 35 toes from cadaveric feet without deformity and the vascular density compared between quartiles of plantar plate length proximal to distal. Results: Demonstrated in Figure 1, of the torn plantar plates the average percent vascular density (vascular volume/tissue volume) in the first quartile of length (proximal to distal) is 0.365 (SD 0.058) compared to 0.281 (SD 0.036) for intact plantar plates; in the second quartile it is 0.300 (SD 0.044) vs 0.175 (SD 0.025); third quartile it is 0.326 (SD 0.051) vs 0.117 (SD 0.015); and fourth (most distal) quartile is 0.600 (SD 0.183) vs 0.319 (SD 0.082) respectively. Using ANOVA testing all differences were found to be significant to p<0.001. Conclusion: Torn plantar plates demonstrate increased vascular density throughout the length of the plantar plate with an increase in density most notable in the region at or just proximal to the attachment to the proximal phalanx. The clinical significance of the increased vascularity of torn plantar plates is unknown at this time. However, the increase in vasculature may suggest that the plantar plate is a structure that is attempting to heal.

In his 2006 text, Towards an Understanding of Africology, Dr. Victor O. Okafor, professor of african american studies at eastern Michigan University, contends that what was once called Black studies, africology, has evolved into a legitimate methodology and pedagogy within academia, despite its detractors. Okafor also challenges some of the arguments of the naysayers while presenting a document symbolic of the interdisciplinary nature of the "school." This text, as presented by Okafor, is an undergraduate-and graduatelevel introductory work designed "to enhance awareness of the significant role of Black Studies in the academy . . . and to clear up lingering criticisms about the desirability and legitimacy of the discipline" (p. xi).His first chapter, "an Overview of Primary Historical Themes," is a brief historical survey of the influential pre-european contact african civilizations as well as very brief introductions concerning the various resistance strategies of the african world, concluding with decolonization and the american civil rights movement, thus establishing a classical reference point as the methodology insists, as articulated by Dr. C. Tsehloane Keto in Vision and Time, a 2001 updated version of his 1995 publication Vision, Identity and Time.The second chapter, "The Roots of africology," is a discussion concerning the institutionalization of Black studies in 1968 at San Francisco State University; because of student activism, it is now offered as a doctoral curriculum in some of america's top schools. He also emphasizes the important milestone of his alma mater Temple University's groundbreaking doctoral program in 1988. He discusses africology's outgrowth of the civil rights movement that was contemporary with Black power and Black consciousness. The challenges and opposition to the concept of Black studies, paired with White guilt and "political correctness" within the power structure, are not understated in Okafor's presentation. Placing the development of africology within its proper historical context enhanced Okafor's ability to link the movements to Olaudah equiano, David Walker, W. e. B. Du Bois, pan-africanism, and others.The third chapter, "africology: a Discipline or a Collection of 'Black' Courses?" tackles that very question. Ultimately, he establishes that it is indeed a discipline with an established and evolving methodology and 92 Journal of Black Studies

Nationality in dress is the visual manifestation of a communal cultural identity, often idealistic and nostalgic but rarely conforming to individual realities. Most historians of dress are uncomfortable with such a concept, which lends itself all too easily to stereotype and fails to include another crucial factor in social identity, that of class. No discussion of British society, culture, or history can escape the issue of social class, which proves to be an underlining theme in these recent publications. Local distinction in sartorial style is a phenomenon countering the globalization of clothing manufacture that has resulted in the "homogenization" of contemporary fashion and a worldwide flood of standardized jeans, T-shirts, etc. Both books under review examine how British garment industries created fashions to be sold within Britain and beyond and discuss how what appealed to Britons might or might not sell to the Americans, French, and Japanese, whose concept of "Britishness" proved to be something quite different.Alison Goodrum's The National Fabric is the less satisfying of the two books, retaining large chunks of what appears to be an undigested Ph.D. thesis, particularly chapter two. The excessive theorizing, in keeping with much literature on the subject of cultural studies, will be of little interest to readers outside the field of fashion history, and specialists in dress and culture will have read it all before in every other fashion book published by Berg. The title is slightly misleading; the book is not a general assessment of dress, nationality, and globalization in Britain, but an examination of these in the context of two specific companies and how each one's interpretation of "Britishness" sells within and outside Britain. Mulberry, under the direction of Roger Saul, has based its aesthetic on a stereotype of the British upper class in the 1930s: the tweeds, the leather, the tailoring, the floral dresses, the "huntin', fishin', shootin' " gear (77). Goodrum's analysis illustrates that although such a look has had huge and perennial appeal to foreign markets, it has been less reliable commercially on the home front, for within Britain the attraction of such elitist nostalgia is limited. Mulberry had great success in the

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