The main result of this paper is a new and direct proof of the natural transformation from the surgery exact sequence in topology to the analytic K-theory sequence of Higson and Roe. Our approach makes crucial use of analytic properties and new index theorems for the signature operator on Galois coverings with boundary. These are of independent interest and form the second main theme of the paper. The main technical novelty is the use of large scale index theory for Dirac type operators that are perturbed by lower order operators.
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