Sternal Osteomyelitis and Abscess Caused by Elbowing during a Basketball Game

A 15-year-old boy was referred to our hospital for further investigation and treatment of sternal osteomyelitis due to blunt chest trauma, more specifically elbowing during a basketball game 19 days earlier. On an initial presentation, his chest was markedly swollen and chest computed tomography demonstrated a sternal fracture and massive fluid collection in the chest wall. Since his general condition remained fairly good, we initially selected minimal drainage concomitant with antibiotics; if it was unsuccessful, we planned to switch to a more radical debridement procedure. The patient recovered without further invasive intervention and was discharged on postoperative day 26. There is no sign of recurrence six months after operation. This case report indicates that minimal drainage would be a good option for treatment in a phased strategy

Detection of bacterial DNA from central venous catheter removed from patients by next generation sequencing: a preliminary clinical study

Abstract Background Catheter-related infection (CRI) is one of the serious challenges in clinical practice. This preliminary clinical study aimed to examine whether next-generation sequencing (NGS) targeting 16S rDNA, which was PCR-amplified directly from the tip of a central venous catheter (CVC), can be used to identify causative pathogens in CRI, compared to the culture method. Methods Hospitalized patients, from whom a CVC had just been removed, were prospectively enrolled and divided into the CRI-suspected and routine removal groups. DNA was extracted from the sonication fluid of CVC specimens derived from patients. For analysis of bacterial composition by NGS, the V3–V4 fragments of bacterial 16S rDNA were PCR-amplified, followed by index PCR and paired-end sequencing on an Illumina MiSeq device. Conventional culture methods were also performed in the CRI-suspected group. Results Of CVCs collected from the 156 enrolled patients (114 men; mean age 65.6 years), a total of 14 specimens [nine out of 31 patients suspected with CRI and five out of 125 patients without infection symptoms (routine removal group)] were PCR-positive. In five patients with definite CRI, Staphylococcus was the most frequently detected genus by NGS (4/5 specimens), although no pathogens were detected by NGS in the one remaining specimen. The genera identified by NGS were consistent with those from conventional culture tests. There was high agreement between NGS and the culture method in the CRI-suspected group, with sensitivity and specificity values of 80.0% and 76.9%, respectively; meanwhile, the false-positive rate of NGS was as low as 4.0% in the routine removal group. Moreover, several genera, besides the genus identified by culture test, were detected in each patient with definite CRI and surgical site infection (SSI). Additionally, in one patient with SSI, Enterococcaceae were detected not only by NGS but also by abdominal abscess drainage culture. Conclusions NGS targeting 16S rDNA was able to analyze the bacterial composition of CVC specimens and detect causative pathogens in patients with CRI and was therefore suggested as a promising diagnostic tool for CRI

Alkali Metal Salts with Designable Aryltrifluoroborate Anions

Aryltrifluoroborate ([ArBF₃]⁻) has a designable basic anion structure. Various [ArBF₃]⁻-based anions were synthesized to create novel alkali metal salts using a simple and safe process. Nearly 40 novel alkali metal salts were successfully obtained, and their physicochemical characteristics, particularly their thermal properties, were elucidated. These salts have lower melting points than those of simple inorganic alkali halide salts, such as KCl and LiCl, because of the weaker interactions between the alkali metal cations and the [ArBF₃]⁻ anions and the anions’ larger entropy. Moreover, interestingly, potassium cations were electrochemically reduced in the potassium (<i>meta</i>-ethoxyphenyl)­trifluoroborate (K­[<i>m</i>-OEtC₆H₄BF₃]) molten salt at 433 K. These findings contribute substantially to furthering molten salt chemistry, ionic liquid chemistry, and electrochemistry

Additional file 1 of Involvement of CX3CR1+ cells appearing in the abdominal cavity in the immunosuppressive environment immediately after gastric cancer surgery

Supplementary Material 1

Apathy/depression, but not subjective fatigue, is related with cognitive dysfunction in patients with multiple sclerosis

BACKGROUND: Cognitive impairment could affect quality of life for patients with multiple sclerosis (MS), and cognitive function may be correlated with several factors such as depression and fatigue. This study aimed to evaluate cognitive function in Japanese patients with MS and the association between cognitive function and apathy, fatigue, and depression. METHODS: The Brief Repeatable Battery of Neuropsychological tests (BRB-N) was performed in 184 Japanese patients with MS and 163 healthy controls matched for age, gender, and education. The Apathy Scale (AS), Fatigue Questionnaire (FQ), and Beck Depression Inventory Second Edition (BDI-II) were used to evaluate apathy, fatigue, and depression, respectively. Student’s t-test was used to compare MS patients and healthy controls. Correlations between two factors were assessed using the Pearson correlation test, and multiple regression analysis was used to evaluate how much each factor affected the BRB-N score. RESULTS: In all BRB-N tests, patients with MS scored significantly lower than controls, and the effect size of symbol digit modalities test was the highest among the 9 tests of the BRB-N. Patients with MS had higher AS (p < 0.001), FQ (p < 0.0001), and BDI-II (p < 0.0001) scores than controls. In patients with MS, scores on most of the BRB-N tests correlated with scores on the AS and BDI-II; however, there was little correlation between scores on the BRB-N tests and those on the FQ. CONCLUSIONS: Cognitive function was impaired, particularly information-processing speed, and decreased cognitive function was correlated with apathy and depression in Japanese patients with MS. Despite the association between cognitive variables and depression/apathy, cognitive function was impaired beyond the effect of depression and apathy. However, subjective fatigue is not related with cognitive impairment. Taken together, this suggests that different therapeutic approaches are needed to improve subjective fatigue and cognition, and thereby quality of life, in patients with MS

EMPRESS. VIII. A New Determination of Primordial He Abundance with Extremely Metal-Poor Galaxies: A Suggestion of the Lepton Asymmetry and Implications for the Hubble Tension

The primordial He abundance $Y_P$ is a powerful probe of cosmology. Currently, $Y_P$ is best determined by observations of metal-poor galaxies, while there are only a few known local extremely metal-poor ($<0.1 Z_\odot$) galaxies (EMPGs) having reliable He/H measurements with HeI$\lambda$10830 near-infrared (NIR) emission. Here we present deep Subaru NIR spectroscopy and He/H determinations for 10 EMPGs, combining the existing optical data and the Markov chain Monte Carlo algorithm. Adding the existing 3 EMPGs and 51 moderately metal-poor ($0.1-0.4 Z_\odot$) galaxies with reliable He/H estimates, we obtain $Y_P=0.2379^{+0.0031}_{-0.0030}$ by linear regression in the (He/H)-(O/H) plane, where our observations increase the number of EMPGs from 3 to 13 anchoring He/H of the most metal-poor gas in galaxies. Although our $Y_P$ measurement and previous measurements are consistent, our result is slightly (~ 1$\sigma$) smaller due to our EMPGs. Including the existing primordial deuterium $D_P$ constraints, we estimate the effective number of neutrino species to be $N_{eff}=2.41^{+0.19}_{-0.21}$ showing a > 2 $\sigma$ tension with the Standard Model value ($N_{eff}=3.046$), which may be a hint of an asymmetry in electron-neutrino $\nu_e$ and anti-electron neutrino $\bar{\nu}_e$. Allowing the degeneracy parameter of electron-neutrino $\xi_e$ to vary as well as $N_{eff}$ and the baryon-to-photon ratio $\eta$, we obtain $\xi_e$ = $0.05^{+0.03}_{-0.03}$, $N_{eff}=3.22^{+0.33}_{-0.30}$, and $\eta\times10^{10}=6.13^{+0.04}_{-0.04}$ from the $Y_P$ and $D_P$ measurements with a prior of $\eta$ taken from Planck Collaboration et al. (2020). Our constraints suggest a $\nu_e - \bar{\nu}_e$ asymmetry and allow for a high value of $N_{eff}$ within the 1$\sigma$ level, which could mitigate the Hubble tension.Comment: 19 pages, 7 figures, submitted to Ap