Alien Registration- Rogan, Bernard B. (Portland, Cumberland County)

https://digitalmaine.com/alien_docs/25654/thumbnail.jp

The Potential Clinical and Economic Value of Primary Tumour Identification in Metastatic Cancer of Unknown Primary Tumour: A Population-Based Retrospective Matched Cohort Study.

PurposeSeveral genomic tests have recently been developed to identify the primary tumour in cancer of unknown primary tumour (CUP). However, the value of identifying the primary tumour in clinical practice for CUP patients remains questionable and difficult to prove in randomized trials.ObjectiveWe aimed to assess the clinical and economic value of primary tumour identification in CUP using a retrospective matched cohort study.MethodsWe used the Manitoba Cancer Registry to identify all patients initially diagnosed with metastatic cancer between 2002 and 2011. We defined patients as having CUP if their primary tumour was found 6 months or more after initial diagnosis or never found during the course of disease. Otherwise, we considered patients to have metastatic cancer from a known primary tumour (CKP). We linked all patients with Manitoba Health databases to estimate their direct healthcare costs using a phase-of-care approach. We used the propensity score matching technique to match each CUP patient with a CKP patient on clinicopathologic characteristics. We compared treatment patterns, overall survival (OS) and phase-specific healthcare costs between the two patient groups and assessed association with OS using Cox regression adjustment.ResultsOf 5839 patients diagnosed with metastatic cancer, 395 had CUP (6.8%); 1:1 matching created a matched group of 395 CKP patients. CUP patients were less likely to receive surgery, radiation, hormonal and targeted therapy and more likely to receive cytotoxic empiric chemotherapeutic agents. Having CUP was associated with reduced OS (hazard ratio [HR] 1.31; 95% confidence interval 1.1-1.58), but this lost statistical significance with adjustment for treatment differences. CUP patients had a significant increase in the mean net cost of initial diagnostic workup before diagnosis and a significant reduction in the mean net cost of continuing cancer care.ConclusionIdentifying the primary tumour in CUP patients might enable the use of more effective therapies, improve OS and allow more efficient allocation of healthcare resources

Distinguishing Land Change from Natural Variability and Uncertainty in Central Mexico with MODIS EVI, TRMM Precipitation, and MODIS LST Data

Precipitation and temperature enact variable influences on vegetation, impacting the type and condition of land cover, as well as the assessment of change over broad landscapes. Separating the influence of vegetative variability independent and discrete land cover change remains a major challenge to landscape change assessments. The heterogeneous Lerma-Chapala-Santiago watershed of central Mexico exemplifies both natural and anthropogenic forces enacting variability and change on the landscape. This study employed a time series of Enhanced Vegetation Index (EVI) composites from the Moderate Resolution Imaging Spectoradiometer (MODIS) for 2001–2007 and per-pixel multiple linear regressions in order to model changes in EVI as a function of precipitation, temperature, and elevation. Over the seven-year period, 59.1% of the variability in EVI was explained by variability in the independent variables, with highest model performance among changing and heterogeneous land cover types, while intact forest cover demonstrated the greatest resistance to changes in temperature and precipitation. Model results were compared to an independent change uncertainty assessment, and selected regional samples of change confusion and natural variability give insight to common problems afflicting land change analyses

Radiation hardness qualification of PbWO_4 scintillation crystals for the CMS Electromagnetic Calorimeter

Ensuring the radiation hardness of PbWO_4 crystals was one of the main priorities during the construction of the electromagnetic calorimeter of the CMS experiment at CERN. The production on an industrial scale of radiation hard crystals and their certification over a period of several years represented a difficult challenge both for CMS and for the crystal suppliers. The present article reviews the related scientific and technological problems encountered