Developing an Australian Melanoma Clinical Outcomes Registry (MelCOR): a protocol paper

Introduction Australia has the highest incidence of melanoma in the world with variable care provided by a diverse range of clinicians. Clinical quality registries aim to identify these variations in care and provide anonymised, benchmarked feedback to clinicians and institutions to improve patient outcomes. The Australian Melanoma Clinical Outcomes Registry (MelCOR) aims to collect population-wide, clinical-level data for the early management of cutaneous melanoma and provide anonymised feedback to healthcare providers. Methods and analysis A modified Delphi process will be undertaken to identify key clinical quality indicators for inclusion in the MelCOR pilot. MelCOR will prospectively collect data relevant to these quality indicators, initially for all people over the age of 18 years living in Victoria and Queensland with a melanoma diagnosis confirmed by histopathology, via a two-stage recruitment and consent process. In stage 1, existing State-based cancer registries contact the treating clinician and provide an opportunity for them to opt themselves or their patients out of direct contact with MelCOR. After stage 1, re-identifiable clinical data are provided to the MelCOR under a waiver of consent. In stage 2, the State-based cancer registry will approach the patient directly and invite them to opt in to MelCOR and share identifiable data. If a patient elects to opt in, MelCOR will be able to contact patients directly to collect patient-reported outcome measures. Aggregated data will be used to provide benchmarked, comparative feedback to participating institutions/clinicians. Ethics and dissemination Following the successful collection of pilot data, the feasibility of an Australia-wide roll out will be evaluated. Key quality indicator data will be the core of the MelCOR dataset, with additional data points added later. Annual reports will be issued, first to the relevant stakeholders followed by the public. MelCOR is approved by the Alfred Ethics Committee (58280/127/20)

Data Collection Methodology For Dynamic Temperature Model Testing And Corroboration

This article describes a data collection approach for determining the significance of individual heat fluxes within streamswith an emphasis on testing (i.e. identification of possible missing heat fluxes), development, calibration and corroborationof a dynamic temperature model. The basis for developing this approach was a preliminary temperature modelling effort onthe Virgin River in southwestern Utah during a low-flow period that suggested important components of the energy balancemight be missing in the o riginal standard surface-flux temperat ure model. Possible missing heat fluxes were identi fied as bedconduction, hyporheic exchange, dead zone warming and exchange and poor representation of the amount of solar radiationentering the water column. To identify and estimate the relative importance of the missing components, a comprehensive datacollection eff ort was developed and implemented. In particular, a method for measuring shortwave radiation behaviour inthe water column and an in situ method for separating out bed conduction and hyporheic influences were established. Theresulting data and subsequent modelling effort indicate that hyporheic and d ead zone heat fluxes are important, whereas solarradiation reflection at the water surface was found to be insignificant. Although bed conduction can be significant in certainrivers, it was found to have little effect on the overall heat budget for this section of the Virg in River. Copyright 2009 JohnWiley & Sons, Ltd

Stereoselective palladium-catalyzed functionalization of homoallylic alcohols: a convenient synthesis of di- and trisubstituted isoxazolidines and β-amino-δ-hydroxy esters

Enantiopure, Boc-protected alkoxyamines 12 and 13, derived from the readily available homoallylic alcohols 4 via a reaction that involves either inversion or retention of configuration, undergo a diastereoselective Pd-catalyzed ring-closing carbonylative amidation to produce isoxazolidines 16/17 (≤50:1 diastereoisomer ratio (d.r.)) that can be readily converted into the N-Boc-protected esters of β-amino-δ-hydroxy acids and their γ-substituted homologues 37. The key carbonylative cyclization proceeds through an unusual syn addition of the palladium and the nitrogen nucleophile across the C[DOUBLE BOND]C bond (19→21), as revealed by the reaction of 15, which afforded isoxazolidine 18 with high diastereoselectivity