The impact of introducing patient co-payments in Germany on the use of IVF and ICSI:a price-elasticity of demand assessment

BACKGROUND: Authorities concerned by rising healthcare costs have a tendency to target reproductive treatments because of the perception that infertility is a low priority. In 2004 German health authorities introduced a 50% co-payment for patients, in an effort to save cost. We explored the impact of this pricing policy on the utilization of reproductive treatments in Germany. METHODS: Using aggregated annual in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycle data in Germany, we evaluated the relationship between changes in the number of cycles in relation to changes in costs faced by consumers following the introduction of a patient co-payment from 'no fees' to (sic)1500-2000 by estimating the short-run price-elasticity of demand. The impact of introducing patient co-payments for IVF/ICSI on the likelihood of switching to other low-cost fertility treatments was evaluated using the cross-price elasticity methodology. RESULTS: The reduction in demand for IVF and ICSI cycles in the year following the introduction of patient co-payments resulted in elasticities of -0.41 and -0.34, respectively. The price-elasticity for the combined reduction of IVF/ICSI in relation to the co-payment was estimated to be -0.36. The cross-price elasticity for clomifene was close to zero (-0.01) suggesting that demand for these interventions are independent of each other and no substitution occurred. CONCLUSIONS: We report price elasticities for IVF and ICSI of -0.41 and -0.34 after introducing a (sic)1500-2000 co-payment. These findings likely represent short-run elasticities that are likely to vary over time as factors that influence the supply and demand for fertility treatments change

Nanowire-based very-high-frequency electromechanical resonator

Fabrication and readout of devices with progressively smaller size, ultimately down to the molecular scale, is critical for the development of very-high-frequency nanoelectromechanical systems (NEMS). Nanomaterials, such as carbon nanotubes or nanowires, offer immense prospects as active elements for these applications. We report the fabrication and measurement of a platinum nanowire resonator, 43 nm in diameter and 1.3 µm in length. This device, among the smallest NEMS reported, has a fundamental vibration frequency of 105.3 MHz, with a quality factor of 8500 at 4 K. Its resonant motion is transduced by a technique that is well suited to ultrasmall mechanical structures

Hooge's Constant of Carbon Nanotube Field Effect Transistors

The 1/f noise in individual semiconducting carbon nanotubes (s-CNT) in a field effect transistor configuration has been measured in ultra-high vacuum and following exposure to air. The amplitude of the normalized current spectral noise density is independent of source-drain current, indicating the noise is due to mobility rather than number fluctuations. Hooge's constant for s-CNT is found to be 9.3 plus minus 0.4x10^-3. The magnitude of the 1/f noise is substantially degreased by exposing the devices to air

Keeping Your Eyes Continuously on the Ball While Running for Catchable and Uncatchable Fly Balls

When faced with a fly ball approaching along the sagittal plane, fielders need information for the control of their running to the interception location. This information could be available in the initial part of the ball trajectory, such that the interception location can be predicted from its initial conditions. Alternatively, such predictive information is not available, and running to the interception location involves continuous visual guidance. The latter type of control would predict that fielders keep looking at the approaching ball for most of its flight, whereas the former type of control would fit with looking at the ball during the early part of the ball's flight; keeping the eyes on the ball during the remainder of its trajectory would not be necessary when the interception location can be inferred from the first part of the ball trajectory. The present contribution studied visual tracking of approaching fly balls. Participants were equipped with a mobile eye tracker. They were confronted with tennis balls approaching from about 20 m, and projected in such a way that some balls were catchable and others were not. In all situations, participants almost exclusively tracked the ball with their gaze until just before the catch or until they indicated that a ball was uncatchable. This continuous tracking of the ball, even when running close to their maximum speeds, suggests that participants employed continuous visual control rather than running to an interception location known from looking at the early part of the ball flight.</p

Electrochemistry of potentially bioreductive alkylating quinones : Part 1. Electrochemical properties of relatively simple quinones, as model compounds of mitomycin- and aziridinylquinone-type antitumour agents

The influence of methyl-, hydroxy and amino substituents on the electrochemical behaviour of simple 1,4-naphtho-and 1,4-benzoquinones, model compounds of many quinoid antitumour agents, in aqueous media was studied. Significant changes in electrochemical behaviour were observed, potentially the result of a change in the electron density of the quinone moiety, pre- or post-protonation of substituents, hydrogen bond formation, tautomerization reactions and steric interactions between the quinone moiety and substituents. The information obtained was of benefit in the elucidation of the reduction mechanisms of quinoid antitumour agents such as aziridnylquinones and mitomycins

Correlated tunneling in intramolecular carbon nanotube quantum dots

We investigate correlated electronic transport in single-walled carbon nanotubes with two intramolecular tunneling barriers. We suggest that below a characteristic temperature the long range nature of the Coulomb interaction becomes crucial to determine the temperature dependence of the maximum G_max of the conductance peak. Correlated sequential tunneling dominates transport yielding the power-law G_max ~ T^{\alpha_{end-end}-1}, typical for tunneling between the ends of two Luttinger liquids. Our predictions are in agreement with recent measurements

A peptide mimic of the chemotaxis inhibitory protein of Staphylococcus aureus: towards the development of novel anti-inflammatory compounds

Complement factor C5a is one of the most powerful pro-inflammatory agents involved in recruitment of leukocytes, activation of phagocytes and other inflammatory responses. C5a triggers inflammatory responses by binding to its G-protein-coupled C5a-receptor (C5aR). Excessive or erroneous activation of the C5aR has been implicated in numerous inflammatory diseases. The C5aR is therefore a key target in the development of specific anti-inflammatory compounds. A very potent natural inhibitor of the C5aR is the 121-residue chemotaxis inhibitory protein of Staphylococcus aureus (CHIPS). Although CHIPS effectively blocks C5aR activation by binding tightly to its extra-cellular N terminus, it is not suitable as a potential anti-inflammatory drug due to its immunogenic properties. As a first step in the development of an improved CHIPS mimic, we designed and synthesized a substantially shorter 50-residue adapted peptide, designated CHOPS. This peptide included all residues important for receptor binding as based on the recent structure of CHIPS in complex with the C5aR N terminus. Using isothermal titration calorimetry we demonstrate that CHOPS has micromolar affinity for a model peptide comprising residues 7–28 of the C5aR N terminus including two O-sulfated tyrosine residues at positions 11 and 14. CD and NMR spectroscopy showed that CHOPS is unstructured free in solution. Upon addition of the doubly sulfated model peptide, however, the NMR and CD spectra reveal the formation of structural elements in CHOPS reminiscent of native CHIPS