Einbeziehung der privaten Krankenvollversicherung in den Risikostrukturausgleich der gesetzlichen Krankenversicherung in Deutschland. Abschätzung der quantitativen Auswirkungen

Die Einbeziehung der privaten Krankenversicherung (PKV) in den Risikostrukturausgleich (RSA) der gesetzlichen Krankenversicherung (GKV) wird häufig diskutiert. In der vorliegenden Studie wird anhand einer quantitativen Analyse unter Verwendung der Daten des Sozioökonomischen Panels (SOEP) abgeschätzt, welche Transfersumme aus dem System der PKV in das System der GKV fließen würden, wenn ein übergreifender RSA eingerichtet würde. Die Summe läge bei 9,9 Mrd. Euro pro Jahr unter Annahme der Beitragsbemessungsgrenze des Jahres 2006. Einbezogen wurden dabei nur die Unterschiede auf der Einnahmenseite des RSA. Einschränkend muss gesehen werden, dass unklar bleibt, welche Krankenversicherungsunternehmen be- oder entlastet würden und über welches Verfahren die Transfersumme aufgebracht werden könnte.

Interacting effects of fertilization, mowing and grazing on plant species diversity of 1500 grasslands in Germany differ between regions

The relationship of different types of grassland use with plant species richness and composition (functional groups of herbs, legumes, and grasses) has so far been studied at small regional scales or comprising only few components of land use. We comprehensively studied the relationship between abandonment, fertilization, mowing intensity, and grazing by different livestock types on plant diversity and composition of 1514 grassland sites in three regions in North-East, Central and South-West Germany. We further considered environmental site conditions including soil type and topographical situation. Fertilized grasslands showed clearly reduced plant species diversity (−15% plant species richness, −0.1 Shannon diversity on fertilized grasslands plots of 16 m2) and changed composition (−3% proportion of herb species), grazing had the second largest effects and mowing the smallest ones. Among the grazed sites, the ones grazed by sheep had higher than average species richness (+27%), and the cattle grazed ones lower (−42%). Further, these general results were strongly modulated by interactions between the different components of land use and by regional context: land-use effects differed largely in size and sometimes even in direction between regions. This highlights the importance of comparing different regions and to involve a large number of plots when studying relationships between land use and plant diversity. Overall, our results show that great caution is necessary when extrapolating results and management recommendations to other regions.

A Benzaldehyde Derivative as a Chelating Ligand: Helical Manganese(II) Coordination Polymers Assembling into a Porous Solid

A molecular, porous crystalline material constructed from neutral helical coordination polymers incorporating manganese(II) ions and two types of bridging ligands, namely the deprotonated form of 2-hydroxy-5-methoxy-3-nitrobenzaldehyde (HL) and isobutyrate (iB−), has been obtained and structurally characterized. Structural analysis reveals that within the coordination polymer each benzaldehyde derivative ligates two manganese ions in 6-membered chelating rings, and the isobutyrate ligands cooperatively chelate either two or three manganese ions. The solid state assembly of the resulting polymeric chains of formula [Mn4(L)2(iB)6]n (1), described in the polar space group R3c, is associated with tubular channels occupied by MeCN solvent molecules (1·xMeCN; x ≤ 9). TGA profiles and PXRD measurements demonstrate that the crystallinity of the solid remains intact in its fully desolvated form, and its stability and crystallinity are ensured up to a temperature of 190 °C. Gas adsorption properties of desolvated crystals were probed, but no remarkable sorption capacity of N2 and only a limited one for CO2 could be observed. Magnetic susceptibility data reveal an antiferromagnetic type of coupling between adjacent manganese(II) ions along the helical chains with energy parameters J1 = −5.9(6) cm−1 and J2 = −1.8(9) cm−1.

A multi-center retrospective analysis of treatment effects and quality of life in adult patients with cranial ependymomas

Long term quality of life data of adult patients harboring intracranial ependymomas have not been reported. The role of adjuvant radiation therapy in Grade II ependymomas is unclear and differs from study to study. We therefore sought to retrospectively analyze outcome and quality of life of adult patients that were operated on intracranial ependymomas at four different surgical centers in two countries. All patients were attempted to be contacted via telephone to assess quality of life (QoL) at the time of the telephone interview. The standard EORTC QoL Questionnaire C30 (EORTC QLQ-C30) and the EORTC QLQ-Brain Cancer Module (QLQ-BN20) were used. 64 adult patients with intracranial ependymomas were included in the study. The only factor that was associated with increased survival was age <55 years (p < 0.001). Supratentorial location was correlated with shorter progression free survival than infratentorial location (PFS; p = 0.048). In WHO Grade II tumors local irradiation did not lead to increased PFS (p = 0.888) or overall survival (p = 0.801). Even for incompletely resected Grade II tumors local irradiation did not lead to a benefit in PFS (p = 0.911). In a multivariate analysis of QoL, irradiated patients had significantly worse scores in the item "fatigue" (p = 0.037) than non-irradiated patients. Here we present QoL data of adult patients with intracranial ependymomas. Our data show that local radiation therapy may have long-term effects on patients' QoL. Since in the incompletely resected Grade II tumors local irradiation did not lead to a benefit in PFS in this retrospective study, prospective randomized studies are necessary. In addition to age, supratentorial tumor location is associated with a worse prognosis in adult ependymoma patients.