医疗保险总额预付试点三级医院患者就医感受调查

目的 调查上海市实行医疗保险总额预付的三级医院中患者的就医感受。方法 经培训的调查员应用结构式调查问卷对上海市10家实行医疗保险总额预付的三级医院的699名患者进行面对面访谈，数据分析主要采用描述性统计。结果 城保患者对门诊医生明显减少处方金额（或处方天数）的感受强于非城保患者，城保和非城保患者的住院就医感受差异无显著统计学意义。结论 医疗保险总额预付对上海三级医院患者就医感受的总体效应似偏弱，而且有限的影响主要集中于门诊而非住院环节。     

Phosphorus eutrophication in the SW Frisian lake district 2. Phosphorus balances and simulation of reduction scenarios

The lakes and interconnecting canals in the S.W. Frisian lake district are highly eutrophic. In the mid-1980's a project on eutrophication and lake restoration research was started. This project was aimed at modelling water transport and phosphorus (P) dynamics and at simulating management scenarios. A simple dynamic P-balance model was used to calculate total phosphorus (TP) balances and to simulate three TP reduction scenarios in each of three lakes: Tjeukemeer, Groote Brekken and Slotermeer. The model covered three periods in 1985, 1986 and 1987. The external loads to Tjeukemeer were highest, moderate to Groote Brekken, and lowest to Slotermeer. The major P sources in the area were discharges from the surrounding polders, used mainly for agriculture, and from IJsselmeer.Despite a 75% TP-reduction in water from the surrounding polders the 0.07 mg l^–1 target level could be reached only occasionally in Tjeukemeer, while in the other two lakes this level was not even approached. The effect of a 75% reduction in water from IJsselmeer was greatest in Groote Brekken (but again approached the target only occasionally), moderate in Tjeukemeer and least in Slotermeer. The simulations showed that only a 75% reduction in both external loads (from polders and from IJsselmeer) will lead to achieving the target level in Tjeukemeer and Groote Brekken during the summer periods. In Slotermeer, a relatively isolated lake, other measures are necessary to reach the target level. The results are confirmed by an approximate theoretical analysis of the effects of load reduction.     

Projecting terrestrial biodiversity intactness with GLOBIO 4

Scenario‐based biodiversity modelling is a powerful approach to evaluate how possible future socio‐economic developments may affect biodiversity. Here, we evaluated the changes in terrestrial biodiversity intactness, expressed by the mean species abundance (MSA) metric, resulting from three of the shared socio‐economic pathways (SSPs) combined with different levels of climate change (according to representative concentration pathways [RCPs]): a future oriented towards sustainability (SSP1xRCP2.6), a future determined by a politically divided world (SSP3xRCP6.0) and a future with continued global dependency on fossil fuels (SSP5xRCP8.5). To this end, we first updated the GLOBIO model, which now runs at a spatial resolution of 10 arc‐seconds (~300 m), contains new modules for downscaling land use and for quantifying impacts of hunting in the tropics, and updated modules to quantify impacts of climate change, land use, habitat fragmentation and nitrogen pollution. We then used the updated model to project terrestrial biodiversity intactness from 2015 to 2050 as a function of land use and climate changes corresponding with the selected scenarios. We estimated a global area‐weighted mean MSA of 0.56 for 2015. Biodiversity intactness declined in all three scenarios, yet the decline was smaller in the sustainability scenario (?0.02) than the regional rivalry and fossil‐fuelled development scenarios (?0.06 and ?0.05 respectively). We further found considerable variation in projected biodiversity change among different world regions, with large future losses particularly for sub‐Saharan Africa. In some scenario‐region combinations, we projected future biodiversity recovery due to reduced demands for agricultural land, yet this recovery was counteracted by increased impacts of other pressures (notably climate change and road disturbance). Effective measures to halt or reverse the decline of terrestrial biodiversity should not only reduce land demand (e.g. by increasing agricultural productivity and dietary changes) but also focus on reducing or mitigating the impacts of other pressures.     

Sustainable intensification of crop residue exploitation for bioenergy: Opportunities and challenges

Crop residue exploitation for bioenergy can play an important role in climate change mitigation without jeopardizing food security, but it may be constrained by impacts on soil organic carbon (SOC) stocks, and market, logistic and conversion challenges. We explore opportunities to increase bioenergy potentials from residues while reducing environmental impacts, in line with sustainable intensification. Using the case study of North Rhine‐Westphalia in Germany, we employ a spatiotemporally explicit approach combined with stakeholder interviews. First, the interviews identify agronomic and environmental impacts due to the potential reduction in SOC as the most critical challenge associated with enhanced crop residue exploitation. Market and technological challenges and competition with other residue uses are also identified as significant barriers. Second, with the use of agroecosystem modelling and estimations of bioenergy potentials and greenhouse gas emissions till mid‐century, we evaluate the ability of agricultural management to tackle the identified agronomic and environmental challenges. Integrated site‐specific management based on (a) humus balancing, (b) optimized fertilization and (c) winter soil cover performs better than our reference scenario with respect to all investigated variables. At the regional level, we estimate (a) a 5% increase in technical residue potentials and displaced emissions from substituting fossil fuels by bioethanol, (b) an 8% decrease in SOC losses and associated emissions, (c) an 18% decrease in nitrous oxide emissions, (d) a 37% decrease in mineral fertilizer requirements and emissions from their production and (e) a 16% decrease in nitrate leaching. Results are spatially variable and, despite improvements induced by management, limited amounts of crop residues are exploitable for bioenergy in areas prone to SOC decline. In order to sustainably intensify crop residue exploitation for bioenergy and reconcile climate change mitigation with other sustainability objectives, such as those on soil and water quality, residue management needs to be designed in an integrated and site‐specific manner.     

Dynamics of solute/matric stress interactions with climate change abiotic factors on growth,gene expression and ochratoxin A production by Penicillium verrucosum on a wheat-based matrix

Penicillium verrucosum contaminates temperate cereals with ochratoxin A (OTA) during harvesting and storage. We examined the effect of temperature (25 vs 30 ^oC), CO₂ (400 vs 1000 ppm) and matric/solute stress (-2.8 vs -7.0 MPa) on (i) growth, (ii) key OTA biosynthetic genes and (iii) OTA production on a milled wheat substrate. Growth was generally faster under matric than solute stress at 25 ^oC, regardless of CO₂ concentrations. At 30 ^oC, growth of P. verrucosum was significantly reduced under solute stress in both CO₂ treatments, with no growth observed at -2.8 MPa (=0.98 water activity, a_w) and 1000 ppm CO₂. Overall, growth patterns under solute stress was slower in elevated CO₂ than under matric stress when compared with existing conditions. The otapksPV gene expression was increased under elevated CO₂ levels in matric stress treatments. There was fewer effects on the otanrpsPV biosynthetic gene. This pattern was paralleled with the production of OTA under these conditions. This suggest that P. verrucosum is able to actively grow and survive in both soil and on crop debris under three way interacting climate-related abiotic factors. This resilience suggests that they would still be able to pose an OTA contamination risk in temperate cereals post-harvest.     

Effects of heat and drought stress on post‐illumination bursts of volatile organic compounds in isoprene‐emitting and non‐emitting poplar

Over the last decades, post‐illumination bursts (PIBs) of isoprene, acetaldehyde and green leaf volatiles (GLVs) following rapid light‐to‐dark transitions have been reported for a variety of different plant species. However, the mechanisms triggering their release still remain unclear. Here we measured PIBs of isoprene‐emitting (IE) and isoprene non‐emitting (NE) grey poplar plants grown under different climate scenarios (ambient control and three scenarios with elevated CO₂ concentrations: elevated control, periodic heat and temperature stress, chronic heat and temperature stress, followed by recovery periods). PIBs of isoprene were unaffected by elevated CO₂ and heat and drought stress in IE, while they were absent in NE plants. On the other hand, PIBs of acetaldehyde and also GLVs were strongly reduced in stress‐affected plants of all genotypes. After recovery from stress, distinct differences in PIB emissions in both genotypes confirmed different precursor pools for acetaldehyde and GLV emissions. Changes in PIBs of GLVs, almost absent in stressed plants and enhanced after recovery, could be mainly attributed to changes in lipoxygenase activity. Our results indicate that acetaldehyde PIBs, which recovered only partly, derive from a new mechanism in which acetaldehyde is produced from methylerythritol phosphate pathway intermediates, driven by deoxyxylulose phosphate synthase activity.     

The value of biodiversity experiments

Recent biodiversity experiments have investigated the relationship between diversity and ecosystem functioning by synthesizing plant communities from pools of species that have been experimentally manipulated to vary numbers and types of species present while holding abiotic factors constant. Biodiversity experiments therefore focus on a previously under-explored aspect of global change: the feedback from diversity to environment. Consequences of random manipulation of species communities may not correspond well to those of specific extinction sequences observed in the past in response to extinction drivers that cause highly non-random loss. However, random manipulation provides a good starting point given that existing communities could undergo many alternative orders of species loss in the future in response to a variety of different potential extinction drivers. Further, the effects of some extinction drivers are currently poorly understood and therefore difficult to predict (e.g. climate change) and it may be premature to dismiss the predictions of random scenarios as irrelevant to all real examples of species loss. The first generations of biodiversity experiments have provided valuable, and sometimes unexpected, discoveries about the general nature of the relationship between diversity and ecosystem functioning. These discoveries could not have been made using observational studies. We propose that different examples of extinction loss in the real or a potential future world form a continuum from situations where the results of the first-generation biodiversity experiments will be highly relevant to less relevant. At the one extreme are examples where the effects of biodiversity on ecosystem functioning will be overwhelmed by direct effects of the extinction driver on processes (e.g. chronic eutrophication). At the other extreme are situations where ecosystem processes are not strongly affected by direct effects of the extinction driver and where the effects of species loss on functioning may be more important (e.g. habitat fragmentation). Given the unprecedented uncertainty about the future of biodiversity and the functioning of ecosystems, a general approach with randomly varying species pools was the right place to start in order to provide a general foundation. The new challenge is to test for effects of biodiversity on functioning in real-world examples of species loss.

Zusammenfassung

Biodiversitätsversuche zeichnen sich dadurch aus, dass natürliche Artenpools experimentell reduziert werden und anschließend der Zusammenhang zwischen der Artenzahl und Ökosystemfunktionen unter konstanten abiotischen Umweltbedingungen untersucht wird. Dadurch unterscheiden sich Biodiversitätsexperimente grundsätzlich von anderen Versuchen, die die Biodiversität als Zielvariable behandeln und stattdessen die abiotische Umwelt manipulieren. Die Auswahl der Arten für die reduzierten Artenpools in Biodiversitätsexperimenten erfolgte bisher meist zufällig, während natürliche Aussterbefaktoren wie Eutrophierung nicht alle Arten gleichermassen gefährden. Für verschiedene Aussterbefaktoren ist aber so wenig bekannt, dass ein zufälliges Aussterbeszenario die beste gegenwärtig verfügbare Option ist. Dies trifft insbesondere für mögliche zukünftige Aussterbeprozesse zu, die durch globale Umweltveränderungen (Klima, biologische Invasionen) oder Habitatsfragmentierung ausgelöst werden könnten. Die erste Generation von Biodiversitätsexperimenten mit zufälligen Aussterbeszenarien hat wertvolle, teilweise unerwartete, generelle Zusammenhänge zwischen Artenzahl und Ökosystemfunktionen aufgedeckt. Diese Zusammenhänge ließen sich durch vergleichende Studien nicht erkennen. In Zukunft sollten Biodiversitätsexperimente dennoch vermehrt Aussterbeszenarien simulieren, die in der realen Umwelt mit größter Wahrscheinlichkeit auftreten.