Myocarditis is an inflammation of the myocardium which often follows microbial infections and is a significant cause of sudden unexpected death in the young (<40 years of age) and an underlying cause ...of dilated cardiomyopathy. Although histologically, the disease is usually associated with infiltration of the myocardium with either eosinophils or leukocytes, use of immunosuppression is controversial outside of giant cell myocarditis and has been found to be of limited value in lymphocytic myocarditis. The relatively limited response might reflect the need for host immunity to control persistent virus infection in the heart which may be the predominant cause of the chronic myocarditis and dilated cardiomyopathy. Treating the persistent virus infection with interferon-beta improved cardiac function in a clinical trial. However, classic immunosuppressive drugs, such as cyclosporine A and cyclophosphamide, are not effective against all types of immunity and experimental myocarditis models have shown that certain immunopathogenic forms of the disease are resistant to these immunosuppressive agents. Understanding the molecular mechanisms underlying the pathogenesis of this disease and the various infectious agents which can cause it will be essential for developing effective therapeutic agents.
Understanding and addressing the consequences of partisan animosity requires knowledge of its foundations. To what extent is animosity between partisan groups motivated by dislike for partisan ...outgroups per se, policy disagreement, or other social group conflicts? In many circumstances, including extant experimental research, these patterns are observationally equivalent. In a series of vignette evaluation experiments, we estimate effects of shared partisanship when additional information is or is not present, and we benchmark these effects against shared policy preference effects. Partisanship effects are about 71% as large as shared policy preference effects when each is presented in isolation. When an independently randomized party and policy position are presented together, partisanship effects decrease substantially, by about 52%, whereas policy effects remain large, decreasing by about 10%. These results suggest that common measures of partisan animosity may capture programmatic conflict more so than social identity-based partisan hostility.
We examine the trade-offs associated with using Amazon.com's Mechanical Turk (MTurk) interface for subject recruitment. We first describe MTurk and its promise as a vehicle for performing low-cost ...and easy-to-field experiments. We then assess the internal and external validity of experiments performed using MTurk, employing a framework that can be used to evaluate other subject pools. We first investigate the characteristics of samples drawn from the MTurk population. We show that respondents recruited in this manner are often more representative of the U.S. population than in-person convenience samples—the modal sample in published experimental political science—but less representative than subjects in Internet-based panels or national probability samples. Finally, we replicate important published experimental work using MTurk samples.
We introduce ultraresolving terahertz (THz) near-field microscopy based on THz scattering at atomic force microscope tips. Nanoscale resolution is achieved by THz field confinement at the very tip ...apex to within 30 nm, which is in good agreement with full electro-dynamic calculations. Imaging semiconductor transistors, we provide first evidence of 40 nm (lambda/3000) spatial resolution at 2.54 THz (wavelength lambda=118 microm) and demonstrate the simultaneous THz recognition of materials and mobile carriers in a single nanodevice. Fundamentally important, we find that the mobile carrier contrast can be directly related to near-field excitation of THz-plasmons in the doped semiconductor regions. This opens the door to quantitative studies of local carrier concentration and mobility at the nanometer scale. The THz near-field response is extraordinary sensitive, providing contrast from less than 100 mobile electrons in the probed volume. Future improvements could allow for THz characterization of even single electrons or biomolecules.
Chronic conditions and multimorbidity have become one of the main challenges in health care worldwide. However, data on the burden of multimorbidity are still scarce. The purpose of this study is to ...examine the association between multimorbidity and the health care utilization and costs in the Swiss community-dwelling population, taking into account several sociodemographic factors.
The study population consists of 229'493 individuals aged 65 or older who were insured in 2013 by the Helsana Group, the leading health insurer in Switzerland, covering all 26 Swiss cantons. Multimorbidity was defined as the presence of two or more chronic conditions of a list of 22 conditions that were identified using an updated measure of the Pharmacy-based Cost Group model. The number of consultations (total and divided by primary care physicians and specialists), the number of different physicians contacted, the type of physician contact (face-to-face, phone, and home visits), the number of hospitalisations and the length of stay were assessed separately for the multimorbid and non-multimorbid sample. The costs (total and divided by inpatient and outpatient costs) covered by the compulsory health insurance were calculated for both samples. Multiple linear regression modelling was conducted to adjust for influencing factors: age, sex, linguistic region, purchasing power, insurance plan, and nursing dependency.
Prevalence of multimorbidity was 76.6%. The mean number of consultations per year was 15.7 in the multimorbid compared to 4.4 in the non-multimorbid sample. Total costs were 5.5 times higher in multimorbid patients. Each additional chronic condition was associated with an increase of 3.2 consultations and increased costs of 33%. Strong positive associations with utilization and costs were also found for nursing dependency. Multimorbid patients were 5.6 times more likely to be hospitalised. Furthermore, results revealed a significant age-gender interaction and a socioeconomic gradient.
Multimorbidity is associated with substantial higher health care utilization and costs in Switzerland. Quantified data on the current burden of multimorbidity are fundamental for the management of patients in health service delivery systems and for health care policy debates about resource allocation. Strategies for a better coordination of multimorbid patients are urgently needed.
Massively parallel pyrosequencing of hypervariable regions from small subunit ribosomal RNA (SSU rRNA) genes can sample a microbial community two or three orders of magnitude more deeply per dollar ...and per hour than capillary sequencing of full-length SSU rRNA. As with full-length rRNA surveys, each sequence read is a tag surrogate for a single microbe. However, rather than assigning taxonomy by creating gene trees de novo that include all experimental sequences and certain reference taxa, we compare the hypervariable region tags to an extensive database of rRNA sequences and assign taxonomy based on the best match in a Global Alignment for Sequence Taxonomy (GAST) process. The resulting taxonomic census provides information on both composition and diversity of the microbial community. To determine the effectiveness of using only hypervariable region tags for assessing microbial community membership, we compared the taxonomy assigned to the V3 and V6 hypervariable regions with the taxonomy assigned to full-length SSU rRNA sequences isolated from both the human gut and a deep-sea hydrothermal vent. The hypervariable region tags and full-length rRNA sequences provided equivalent taxonomy and measures of relative abundance of microbial communities, even for tags up to 15% divergent from their nearest reference match. The greater sampling depth per dollar afforded by massively parallel pyrosequencing reveals many more members of the "rare biosphere" than does capillary sequencing of the full-length gene. In addition, tag sequencing eliminates cloning bias and the sequences are short enough to be completely sequenced in a single read, maximizing the number of organisms sampled in a run while minimizing chimera formation. This technique allows the cost-effective exploration of changes in microbial community structure, including the rare biosphere, over space and time and can be applied immediately to initiatives, such as the Human Microbiome Project.
Optical and infrared antennas enable a variety of cutting-edge applications ranging from nanoscale photodetectors to highly sensitive biosensors. All these applications critically rely on the optical ...near-field interaction between the antenna and its 'load' (biomolecules or semiconductors). However, it is largely unexplored how antenna loading affects the near-field response. Here, we use scattering-type near-field microscopy to monitor the evolution of the near-field oscillations of infrared gap antennas progressively loaded with metallic bridges of varying size. Our results provide direct experimental evidence that the local near-field amplitude and phase can be controlled by antenna loading, in excellent agreement with numerical calculations. By modelling the antenna loads as nanocapacitors and nanoinductors, we show that the change of near-field patterns induced by the load can be understood within the framework of circuit theory. Targeted antenna loading provides an excellent means of engineering complex antenna configurations in coherent control applications, adaptive nano-optics and metamaterials.
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