Population-based patient care study for breast cancer

Background: Different approaches for an effective quality management are funded by the Ministry of Health to verify, to assess and, if necessary to optimize the quality of health care using the tracer diagnoses of breast, rectal, and lung cancer in eight regions in Germany. The conception of these observational studies and initial findings are shown here, using breast cancer in the region of Munich (population 2.4 million) as an example. Patients and Methods: The study started on April 1, 1996. The recruitment phase for all primary boast cancer patients in this region is planned for 2 years with a 3-5-year follow-up. Established documentation sheets are used to document basic medical information of each patient, along with the original reports (pathology: radiotherapy, doctors' reports, etc.), follow-up reports and quality of life questionnaires (QLQ, including the EORTC QLQ C30). Results: In 1996, the Munich region has a crude incidence of 125/100,000 women (world standard 71.5). After almost complete documentation the incidence is 10-15% higher. In the period from April 1 1996 to June 30, 1997 1,360 patients have been recruited into the study. 79% of the patients were 50 years of age or older. pT stages are distributed as follows: pTIS 5%, pT1 54%, pT2 32%, pT3 4%, pT4 6%. 4.5% had primary metastases. Breast-conserving therapy (BCT) was performed in 57% of patients. Five of the 46 departments involved recruited more than 50 patients each within these 14 months. These larger departments treat 59% of all patients. The proportion of older patients and pT4 stages is significantly higher in the smaller departments. BCT is performed significantly more often in the larger departments. First results of quality of life show dependencies on age, but no differences between mastectomy and BCT 3 months after operation. Not only the addressed patients (response rate to QLQ over 80%) but also almost all hospitals and many physicians are milling to support and to partake in quality assurance. 35 hospitals, 46 surgical departments. 80 heads of department and surgically: active general practioners, 330 general practioners. 7 radiotherapy departments, and 13 pathology departments have so far documented for this study. Conclusions: An effective quality management in oncology needs a modern cancer registry which uses documentation sheets as well as original reports and organizes the complicated infrastructure for an interdisciplinary cooperation. To be able to evaluate the health care reality it is necessary to carry out a data analysis and assess each individual case. A feedback of the results have to be available for each physician and each department. The cost of this information management is approximately 0.3% of the health care cost for this group of patients

AVIRIS ground data-processing system

The Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) has been under development at JPL for the past four years. During this time, a dedicated ground data-processing system has been designed and implemented to store and process the large amounts of data expected. This paper reviews the objectives of this ground data-processing system and describes the hardware. An outline of the data flow through the system is given, and the software and incorporated algorithms developed specifically for the systematic processing of AVIRIS data are described

Positional Coincidence between the High-latitude Steady Unidentified Gamma-ray Sources and Possibly Merging Clusters of Galaxies

We report an evidence for the first time that merging clusters of galaxies are a promising candidate for the origin of high galactic-latitude, steady unidentified EGRET gamma-ray sources. Instead of using past optical catalogs of eye-selected clusters, we made a matched-filter survey of galaxy clusters over 4\arcdeg \times 4\arcdeg areas around seven steady unidentified EGRET sources at |b|>45\arcdeg together with a 100 \sq \arcdeg area near the South Galactic Pole as a control field. In total, 154 Abell-like cluster candidates and 18 close pairs/groups of these clusters, expected to be possibly merging clusters, were identified within estimated redshift $z_{est}\leq 0.15$. Five among the seven EGRET sources have one or two cluster pairs/groups (CPGs) within 1\arcdeg from them. We assess the statistical significance of this result by several methods, and the confidence level of the real excess is maximally 99.8% and 97.8% in a conservative method. In contrast, we found no significant correlation with single clusters. In addition to the spatial correlation, we also found that the richness of CPGs associated with EGRET sources is considerably larger than those of CPGs in the control field. These results imply that a part of the steady unidentified EGRET sources at high-latitude are physically associated with close CPGs, not with single clusters. We also discuss possible interpretations of these results. We argue that, if these associations are real, they are difficult to explain by hadronic processes, but best explained by the inverse-Compton scattering by high energy electrons accelerated in shocks of cluster formation, as recently proposed.Comment: 9 pages, 2 PostScript figures, uses emulateapj5.sty, added new analysis and discussion, ApJ accepte

SHCal13 Southern Hemisphere calibration, 0–50,000 years cal BP

The Southern Hemisphere SHCal04 radiocarbon calibration curve has been updated with the addition of new data sets extending measurements to 2145 cal BP and including the ANSTO Younger Dryas Huon pine data set. Outside the range of measured data, the curve is based upon the Northern Hemisphere data sets as presented in IntCal13, with an interhemispheric offset averaging 43 ± 23 yr modeled by an autoregressive process to represent the short-term correlations in the offset

Dynamic Covalent Synthesis of Crystalline Porous Graphitic Frameworks

Porous graphitic framework (PGF) is a two-dimensional (2D) material that has emerging energy applications. An archetype contains stacked 2D layers, the structure of which features a fully annulated aromatic skeleton with embedded heteroatoms and periodic pores. Due to the lack of a rational approach in establishing in-plane order under mild synthetic conditions, the structural integrity of PGF has remained elusive and ultimately limited its material performance. Here, we report the discovery of the unusual dynamic character of the C=N bonds in the aromatic pyrazine ring system under basic aqueous conditions, which enables the successful synthesis of a crystalline porous nitrogenous graphitic framework with remarkable in-plane order, as evidenced by powder X-ray diffraction studies and direct visualization using high-resolution transmission electron microscopy. The crystalline framework displays superior performance as a cathode material for lithium-ion batteries, outperforming the amorphous counterparts in terms of capacity and cycle stability. Insertion of well-defined, evenly spaced nanoscale pores into the two-dimensional (2D) layers of graphene invokes exciting properties due to the modulation of its electronic band gaps and surface functionalities. A bottom-up synthesis approach to such porous graphitic frameworks (PGFs) is appealing but also remains a great challenge. The current methods of building covalent organic frameworks rely on a small collection of thermodynamically reversible reactions. Such reactions are, however, inadequate in generating a fully annulated aromatic skeleton in PGFs. With the discovery of dynamic pyrazine formation, we succeeded in applying this linking chemistry to obtain a crystalline PGF material, which has displayed high electrical conductivity and remarkable performance as a cathode material for lithium-ion batteries. We envision that the demonstrated success will open the door to a wide array of fully annulated 2D porous frameworks, which hold immense potential for clean energy applications. We report the unusual dynamic characteristics of the C=N bonds in the pyrazine ring promoted under basic aqueous conditions, which enables the successful synthesis of two-dimensional porous graphitic frameworks (PGFs) featuring fully annulated aromatic skeletons and periodic pores. The PGF displayed high electrical conductivity and remarkable performance as a cathode material for lithium-ion batteries, far outperforming the amorphous counterparts in terms of capacity and cycle stability

Very High Energy gamma-rays from electron/positron Pair Halos

In this paper we study the formation of giant electrons-positron pair halos around the powerful high energy extragalactic sources. We investigate the dependence of radiation of pair halos, in particular the spectral and angular distributions on the energy spectrum of the primary gamma-rays, the redshift of the source, and the flux of the extragalactic background light.Comment: 17 pages, 17 figures, published in Volume No. 18, Issue No. 06 of "International Journal Of Modern Physics D

Comparison of laboratory calibrations of the Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) at the beginning and end of the first flight season

Spectral and radiometric calibrations of the Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) were performed in the laboratory in June and November, 1987, at the beginning and end of the first flight season. Those calibrations are described along with changes in instrument characteristics that occurred during the flight season as a result of factors such as detachment of the optical fibers to two of the four AVIRIS spectrometers, degradation in the optical alignment of the spectrometers due to thermally-induced and mechanical warpage, and breakage of a thermal blocking filter in one of the spectrometers. These factors caused loss of signal in three spectrometers, loss of spectral resolution in two spectrometers, and added uncertainty in the radiometry of AVIRIS. Results from in-flight assessment of the laboratory calibrations are presented. A discussion is presented of improvements made to the instrument since the end of the first flight season and plans for the future. Improvements include: (1) a new thermal control system for stabilizing spectrometer temperatures, (2) kinematic mounting of the spectrometers to the instrument rack, and (3) new epoxy for attaching the optical fibers inside their mounting tubes