Occult Bacteremia Caused by Enterococcus-Associated Pyuria in an Elderly Man.

We report a case of Enterococcus-associated pyelonephritis in a 74-year-old Parkinson's patient. He showed constipation, a mild fever, and altered consciousness. Blood cultures revealed Gram-positive cocci (GPC), prompting vancomycin treatment. Urinary Gram staining confirmed pyelonephritis, underscoring its diagnostic utility in elderly patients with vague symptoms. Enterococcus faecalis infections can be insidious, with the potential for organ abscesses and persistent fever. Due to nuanced presentations of Gram-positive infections versus Gram-negative ones, diagnosis can be delayed, risking sepsis. Gram-staining urine is vital, especially in older patients, as untreated Gram-positive bacteremia elevates mortality. Given our aging population and their comorbidities, Gram staining's role in quick antibiotic administration is crucial. Hence, its integration into community hospitals is advocated. This case emphasizes early detection and treatment of GPC infections in the elderly and endorses Gram staining for prompt diagnosis of Enterococcus-associated pyelonephritis.

An iPad application-based intervention for improving post-stroke depression symptoms in a convalescent rehabilitation ward: A pilot randomized controlled clinical trial protocol.

BACKGROUND: Post-stroke depression (PSD) is a neuropsychiatric sequela that causes serious adverse effects on the prognosis of stroke patients. Our developed iPad application is a very innovative approach designed to improve participants' depressive symptoms by presenting positive words stimuli in a video. Although this application has fewer side effects than existing pharmacological and non-pharmacological interventions and is likely less burdensome for patients and caregivers, its efficacy for PSD has not been investigated. Here we present a pilot randomized controlled trial (RCT) protocol to investigate the therapeutic potential of this application intervention for PSD patients. METHODS: This study is designed as a 5-week, single-center, open-label, parallel-group, pilot RCT. Thirty-two patients with PSD will be randomly assigned to a combination of the iPad application and usual rehabilitation or usual rehabilitation alone (1:1 allocation ratio). The iPad application intervention lasts 3 min a day, and the usual rehabilitation lasts 3 h a day. The primary outcome is the change from baseline in The Center for Epidemiologic Studies Depression Scale score at the end of the 5-week intervention. DISCUSSION: This pilot RCT is the first study to investigate the potential of iPad application interventions to reduce depressive symptoms in PSD patients. This pilot RCT determines whether this is a viable and effective intervention and informs the design for a full-scale trial. If our hypothesis is correct, this trial can provide evidence to augment the standard practice of iPad application interventions to improve depressive symptoms in patients with PSD.

Maternal Separation as Early-Life Stress Causes Enhanced Allergic Airway Responses by Inhibiting Respiratory Tolerance in Mice.

Epidemiologic studies indicate that exposure to psychosocial stress in early childhood is a risk factor of adult-onset asthma, but the mechanisms of this relationship are poorly understood. Therefore, we examined whether early-life stress increases susceptibility to adult-onset asthma by inhibiting the development of respiratory tolerance. Neonatal BALB/c female mice were aerosolized with ovalbumin (OVA) to induce immune tolerance prior to immune sensitization with an intraperitoneal injection of OVA and the adjuvant aluminum hydroxide. Maternal separation (MS) was applied as an early-life stressor during the induction phase of immune tolerance. The mice were challenged with OVA aerosol in adulthood, and allergic airway responses were evaluated, including airway hyper-responsiveness to inhaled methacholine, inflammatory cell infiltration, bronchoalveolar lavage fluid levels of interleukin (IL)-4, IL-5, and IL-13, and serum OVA-specific IgE. We then evaluated the effects of MS on the development of regulatory T (Treg) cells in bronchial lymph nodes (BLN) and on splenocyte proliferation and cytokine expression. In mice that underwent MS and OVA tolerization, the allergic airway responses and OVA-induced proliferation and IL-4 expression of splenocytes were significantly enhanced. Furthermore, exposure to MS was associated with a lower number of Treg cells in the BLN. These findings suggest that exposure to early-life stress prevents the acquisition of respiratory tolerance to inhaled antigen due to insufficient Treg cell development, resulting in Th2-biased sensitization and asthma onset. We provide the evidence for inhibitory effects of early-life stress on immune tolerance. The present findings may help to clarify the pathogenesis of adult-onset asthma.

Tracking background-oriented schlieren for observing shock oscillations of transonic flying objects.

A detailed understanding of the in-flight behavior of high-speed flying objects is useful in the forensic investigation of crime scenes. In particular, for transonic flying objects with associated unsteady shock waves, long-duration and high-resolution measurements are desirable but difficult with conventional optical visualization methods. In this study, we propose a tracking background-oriented schlieren (BOS) method that uses a mirror-based high-speed optical axis controller and a striped retroreflective background. We combine prediction instruction including a compensator for the flight trajectory, high-speed visual feedback by silhouette recognition, and reference image generation from only a measurement image in the BOS visualization process. Experimentally, we successfully observe the shock oscillations of an actual high-speed flying object.

Uniformity Study of Two-Functional Luminescent Dyes Adsorbed over an Anodized Aluminum Coating for Motion-Capturing Pressure- and Temperature-Sensitive Paint Imaging.

The pressure- and temperature-sensitive paint (PSP/TSP) technique, for steady-state and unsteady-state measurements, is becoming widespread. However, unsteady quantitative measurement is still difficult because non-uniform distribution of the probes over a test model may cause errors in the results. We focus on the dipping method that applies two luminophores into a binding material to improve sensitivity uniformity over a model surface. A bullet-shaped axisymmetric test model with motion-capturing TSP was used to evaluate the sensitivity uniformity, and three dipping methods (static, convectional, and rotational) were examined. The average peak ratios in the longitudinal direction were 1.17-1.46 for static, 1.38-1.51 for convectional, and 1.42-1.45 for rotational dipping. The standard deviations in the transverse direction were the smallest for rotational (0.022-0.033), relative to static (0.086-0.104), and convectional (0.044-0.065) dipping.