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Category: Ankle; Arthroscopy; Basic Sciences/Biologics; Sports; Trauma Introduction/Purpose: Osteochondral lesions of the talus (OCLT) are common traumatic injuries and can be difficult to treat. Conventional methods consist of arthroscopic debridement and bone marrow stimulation techniques including microfracture, curettage, abrasion chondroplasty and antegrade/retrograde drilling predominantly leading to fibrocartilage formation. These methods have proved effective for small lesions; however, larger lesions with accompanying subchondral bone cysts require more invasive treatment with osteochondral allografts or autologous chondrocyte implantation. These procedures can require harvesting of osteochondral grafts from the knee or malleolar osteotomies, which have associated donor site morbidities and complications of osteotomy healing. We describe an alternative method, an all-arthroscopic technique to treat these large cystic OCLTs, and sought to determine long-term quality of life metrics for a cohort of patients. Methods: From 2010-2012, six patients with difficult to treat OCLTs underwent arthroscopic-assisted implantation of particulated juvenile allograft cartilage with viable chondrocytes (DeNovo NT) along with autogenous bone grafting from the calcaneus by a single surgeon. These lesions all had associated cystic changes requiring bone graft to fill the defect. Other inclusion criteria included at least two of the following: 1) shoulder lesions, 2) lesion size > 200 mm2, 3) failed previous microfracture treatment, or 4) age > 40 with a Body Mass Index (BMI) > 25 kg/m2. These six patients were fully evaluated using physical examination, patient interviews, and outcome score measures. Follow-up was completed at 2 years, 4 years, and between 6-9 years at their most recent visit. Pre-operative and post-operative functional outcome scores were compared with Wilcoxon Signed Ranked Test. Results: Six patients (age: 43.8 + 14.0 years, BMI: 28.4 + 6.7 kg/m2) had average lesion sizes of 188.5 + 50.9 mm2 (range: 125-260 mm2) and most recent follow-up of 8.4 + 1.2 years (range: 6.0-9.3 years). Post-operatively, average VAS pain scores decreased by 4.2 points, 95% CI [1.6-6.8]. FAAM ADL scores improved from 41.8 to 72.5, 95% CI [11.3-50.1]. SF-36 Physical Component Scores also showed significant improvement by 37.8 points, 95% CI [20.8-54.8]. FAAM Sports (p = 0.055) and AOFAS (p = 0.066) scores clinically improved from 13.3 to 39.2 and 57.7 to 86.3, respectively, and approached statistical significance. There were no intraoperative or perioperative complications with calcaneal bone grafting. Conclusion: A small cohort of patients followed over the course of ~8 years after implantation of particulated juvenile allograft cartilage (DeNovo NT) and autogenous calcaneal bone graft for cystic OCLTs had positive post-operative, self-reported functional outcomes. Patients significantly improved compared to pre-operative measures, with no complications observed. This may be an effective long-term treatment for patients with difficult to treat OCLTs.

An experiment searching for a T-violating transverse muon polarization (Pr) in K+ --> pi (0)mu (+)nu decay is underway at the 12-GeV proton synchrotron at KEK (KEK-PS). This search is sensitive to new mechanisms of T or CP violation beyond the Standard Model. The expected sensitivity from 1996-98 data is presented based on the published result from 1996-97 data and the new result from 1998 data.

A measurement of the transverse mu (+) polarization, P-T, in K+ --> pi (0)mu (+)nu decay was performed using stopped kaons. For 1996-1997 data the results are P-T = -0.0042 +/- 0.0049(stat) +/- 0.0009(syst) and Im(xi) = -0.013 +/- 0.016(stat)+/- 0.003(syst), where Im(xi) is T-violating physics parameter.

An experiment E246 at the 12-GeV proton synchrotron at KEK (KEK-PS), which is searching for the T-violating transverse muon polarization (P-mu(perpendicular to)) in K+ --> pi (0)mu (+)nu decay, is described. The search is sensitive to new mechanisms of T or CP violation beyond the Standard Model. The initial results of P-mu(perpendicular to) = -0.0042+/-0.0049(stat.)+/-0.0009(syst.) and the T-violating parameter Im(xi) = -0.013+/- 0.016(stat.) +/- 0.003(syst.) were determined from the data taken in 1996 and 1997.

In a kinematically complete setting, the $K^+ \to \pi^+ \pi^0 \pi^0$ decays of stopped $K^+$ were measured. In the frame work of the Weinberg polynomial expansion, the coefficients up to quadratic terms were deduced. The results are in good agreement with previous measurements and consistent with CP conservation expectations. The empirical $\Delta I=1/2$ rule is violated.

An experiment searching for a T-violating transverse muon polarization (Pr) in K+ --> pi (0)mu (+)nu decay is underway at the 12-GeV proton synchrotron at KEK (KEK-PS). This search is sensitive to new mechanisms of T or CP violation beyond the Standard Model. The expected sensitivity from 1996-98 data is presented based on the published result from 1996-97 data and the new result from 1998 data.

An experiment E246 at the 12-GeV proton synchrotron at KEK (KEK-PS), which is searching for the T-violating transverse muon polarization (P-mu(perpendicular to)) in K+ --> pi (0)mu (+)nu decay, is described. The search is sensitive to new mechanisms of T or CP violation beyond the Standard Model. The initial results of P-mu(perpendicular to) = -0.0042+/-0.0049(stat.)+/-0.0009(syst.) and the T-violating parameter Im(xi) = -0.013+/- 0.016(stat.) +/- 0.003(syst.) were determined from the data taken in 1996 and 1997.

A measurement of the transverse mu (+) polarization, P-T, in K+ --> pi (0)mu (+)nu decay was performed using stopped kaons. For 1996-1997 data the results are P-T = -0.0042 +/- 0.0049(stat) +/- 0.0009(syst) and Im(xi) = -0.013 +/- 0.016(stat)+/- 0.003(syst), where Im(xi) is T-violating physics parameter.

With the rise of religious plurality and the global public resurgence of religion, deep social unrest and even fatal violence have resulted in a compelling need for plural societies to construct a framework of ‘public civility’. Recently, secularist frameworks such as multiculturalism and legal pluralism have been put forward. Yet, insofar as these approaches are considered non-moral, they are relativistic, and thereby lack the resources needed to ground a universal public civility. Also, approaches to building a ‘just society’ within both Catholic social thought and Islamic jurisprudence have been made specifically on the basis of ‘the common good’. The problem with these approaches is that the so-called ‘common good’ is internally defined such that the ‘good’ is ineluctably uncommon. A more promising basis on which to construct a universal framework of public civility is found in the classical notion of ‘the human good’.The argument proceeds in three main stages: (1) a critical assessment of ideological and sociological forces which have resulted in the fragmentation of modern society and the decline of public life; (2) a delineation of ‘the human good’ on the basis of which I construct a framework of public civility between Catholic and Islamic traditions; and (3) an illustration of the proposed framework in Mindanao, Philippines which represents one of the longest standing internal conflicts in history.The main contention is that Catholic and Islamic political theologies enhance the construction of public civility when reframed in terms of ‘the human good’ in contrast to ‘the common good’. In support of this thesis, I explore the Catholic doctrine of the imago dei and the Islamic notion of fiṭra as prospective conceptual counterparts to the idea of ‘the human good’. I conclude by analyzing the cosmopolitan scope of a framework of public civility as based on ‘the human good’.

Introduction It has still not been clearly established whether the cognitive deficits of idiopathic normal pressure hydrocephalus (iNPH) are caused by a disturbance in cerebrospinal fluid (CSF) dynamics or an underlying metabolic disturbance. Objective To identify the possible associations between biochemical markers, the neuroimaging characteristics, and cognitive deficits of patients undergoing investigations for possible iNPH. Methods A CSF sample obtained during a lumbar puncture from 10 patients with iNPH was analyzed for several biochemical markers (lactate, 8-isoprostane, vascular endothelial growth factor [VEGF], neurofilament heavy protein, glial fibrillary acidic protein, amyloid beta 1-42, and total tau). All patients underwent a battery of neuropsychological testing and imaging as part of their selection process for their suitability for CSF diversion surgical procedure. Volumetric analysis of imaging was carried out measuring the ventricular volume (VV), intracranial volume (ICV), periventricular lucencies, deep white matter hyperintensities, and white matter (WM) volume, as well as their ratios. Results A significant negative correlation of preoperative symptom duration and total tau levels ( R = −0.841, P = .002) was found. There was a significant positive correlation ( R = 0.648, P = .043) between the levels of VEGF and the VV/ICV ratio. There was a significant positive correlation of the levels of glial fibrillary acidic protein and the VV/deep white matter hyperintensities ratio ( R = 0.828, P = .006). A significant negative correlation was observed between the levels of neurofilament heavy protein and the VV/ICV ratio ( R = −0.657, P = .039) and the WM volume ( R = −0.778, P = .023). Lactate levels were lower for patients performing in the normal range on the Recognition Memory Test for faces. Patients who performed better in the Recognition Memory Test words test had higher ICV volumes. All the patients in this study showed below normal performance when the subcortical function was assessed. Conclusion The positive correlation of VEGF with the severity of ventriculomegaly may indicate that this is because of the transmantle pressure gradient; this response may not be because of hypoxia but represents an attempt at neuroregeneration. The degree of reactive gliosis correlates inversely with the severity of WM lesions. Neuronal degeneration is negatively correlated with the volume of the WM in these patients. The small association of volumetry and the cognitive profile of these patients may be consistent with a direct biochemical disturbance being responsible for the cognitive deficit observed. Ongoing studies with set protocols for neuropsychological assessment and volumetric analysis are warranted to further elucidate on the preliminary results of the current study.