Carotid endarterectomy with patch angioplasty versus primary closure in patients with symptomatic and significant stenosis:a systematic review with meta-analyses and trial sequential analysis of randomized clinical trials

Background: Patch angioplasty in conventional carotid endarterectomy is suggested to reduce the risk of restenosis and recurrent ipsilateral stroke compared with primary closure. A systematic review of randomized clinical trials is needed to compare outcomes (benefits and harms) of both techniques. Methods: Searches (CENTRAL, PubMed/MEDLINE, EMBASE, and other databases) were last updated 3rd of January 2021. We included randomized clinical trials comparing carotid endarterectomy with patch angioplasty versus primary closure of the arterial wall in patients with a symptomatic and significant (> 50%) carotid stenosis. Primary outcomes are defined as all-cause mortality and serious adverse events. Results: We included 12 randomized clinical trials including 2187 participants who underwent 2335 operations for carotid stenosis comparing carotid endarterectomy with patch closure (1280 operations) versus carotid endarterectomy with primary closure (1055 operations). Meta-analysis comparing carotid endarterectomy with patch angioplasty versus carotid endarterectomy with primary closure may potentially decrease the number of patients with all-cause mortality (RR 0.53; 95% CI 0.26 to 1.08; p = 0.08, best-case scenario for patch), serious adverse events (RR 0.73; 95% CI 0.56 to 0.96; p = 0.02, best-case scenario for patch), and the number of restenosis (RR 0.41; 95% CI 0.23 to 0.71; p < 0.01). Trial sequential analysis demonstrated that the required information sizes were far from being reached for these patient-important outcomes. All the patient-relevant outcomes were at low certainty of evidence according to The Grading of Recommendations Assessment, Development, and Evaluation. Conclusions: This systematic review showed no conclusive evidence of a difference between carotid endarterectomy with patch angioplasty versus primary closure of the arterial wall on all-cause mortality, < 30 days mortality, < 30 days stroke, or any other serious adverse events. These conclusions are based on data from 15 to 35 years ago, obtained in trials with very low certainty according to GRADE, and should be interpreted cautiously. Therefore, we suggest conducting new randomized clinical trials patch angioplasty versus primary closure in carotid endarterectomy in symptomatic patients with an internal carotid artery stenosis of 50% or more. Such trials ought to be designed according to the Standard Protocol Items: Recommendations for Interventional Trials statement (Chan et al., Ann Intern Med 1:200–7, 2013) and reported according to the Consolidated Standards of Reporting Trials statement (Schulz et al., 7, 2010). Until conclusive evidence is obtained, the standard of care according to guidelines should not be abandoned. Systematic review registration: PROSPERO CRD42014013416. Review protocol publication 2019 DOI: https://doi.org/10.1136/bmjopen-2018-026419

Concepts for the Representation, Storage, and Retrieval of Spatio-Temporal Objects in 3D/4D Geo-Informations-Systems

The quickly increasing number of spatio-temporal applications in fields like environmental management or geology is a new challenge to the development of database systems. This thesis addresses three areas of the problem of integrating spatio-temporal objects into databases. First, a new representational model for continuously changing, spatial 3D objects is introduced and transferred into a small system of classes within an object-oriented database framework. The model extends simplicial cell complexes to the spatio-temporal setting. The problem of closure under certain operations is investigated. Second, internal data structures are introduced that represent instances of the (user-level) spatio-temporal classes. A new technique provides a compromise between compact storage and efficient retrieval of spatio-temporal objects. These structures correspond to temporal graphs and support updates as well as the maintainance of connected components over time. Third, it is shown how to realise further operations on the new type of objects. Among these operations are range queries, intersection tests, and the Euclidean distance function

Algebraic optimization of recursive queries

Over the past few years, much attention has been paid to deductive databases. They offer a logic-based interface, and allow formulation of complex recursive queries. However, they do not offer appropriate update facilities, and do not support existing applications. To overcome these problems an SQL-like interface is required besides a logic-based interface.\ud \ud In the PRISMA project we have developed a tightly-coupled distributed database, on a multiprocessor machine, with two user interfaces: SQL and PRISMAlog. Query optimization is localized in one component: the relational query optimizer. Therefore, we have defined an eXtended Relational Algebra that allows recursive query formulation and can also be used for expressing executable schedules, and we have developed algebraic optimization strategies for recursive queries. In this paper we describe an optimization strategy that rewrites regular (in the context of formal grammars) mutually recursive queries into standard Relational Algebra and transitive closure operations. We also describe how to push selections into the resulting transitive closure operations.\ud \ud The reason we focus on algebraic optimization is that, in our opinion, the new generation of advanced database systems will be built starting from existing state-of-the-art relational technology, instead of building a completely new class of systems

A survey of parallel execution strategies for transitive closure and logic programs

An important feature of database technology of the nineties is the use of parallelism for speeding up the execution of complex queries. This technology is being tested in several experimental database architectures and a few commercial systems for conventional select-project-join queries. In particular, hash-based fragmentation is used to distribute data to disks under the control of different processors in order to perform selections and joins in parallel. With the development of new query languages, and in particular with the definition of transitive closure queries and of more general logic programming queries, the new dimension of recursion has been added to query processing. Recursive queries are complex; at the same time, their regular structure is particularly suited for parallel execution, and parallelism may give a high efficiency gain. We survey the approaches to parallel execution of recursive queries that have been presented in the recent literature. We observe that research on parallel execution of recursive queries is separated into two distinct subareas, one focused on the transitive closure of Relational Algebra expressions, the other one focused on optimization of more general Datalog queries. Though the subareas seem radically different because of the approach and formalism used, they have many common features. This is not surprising, because most typical Datalog queries can be solved by means of the transitive closure of simple algebraic expressions. We first analyze the relationship between the transitive closure of expressions in Relational Algebra and Datalog programs. We then review sequential methods for evaluating transitive closure, distinguishing iterative and direct methods. We address the parallelization of these methods, by discussing various forms of parallelization. Data fragmentation plays an important role in obtaining parallel execution; we describe hash-based and semantic fragmentation. Finally, we consider Datalog queries, and present general methods for parallel rule execution; we recognize the similarities between these methods and the methods reviewed previously, when the former are applied to linear Datalog queries. We also provide a quantitative analysis that shows the impact of the initial data distribution on the performance of methods

Context-Free Path Querying by Matrix Multiplication

Graph data models are widely used in many areas, for example, bioinformatics, graph databases. In these areas, it is often required to process queries for large graphs. Some of the most common graph queries are navigational queries. The result of query evaluation is a set of implicit relations between nodes of the graph, i.e. paths in the graph. A natural way to specify these relations is by specifying paths using formal grammars over the alphabet of edge labels. An answer to a context-free path query in this approach is usually a set of triples (A, m, n) such that there is a path from the node m to the node n, whose labeling is derived from a non-terminal A of the given context-free grammar. This type of queries is evaluated using the relational query semantics. Another example of path query semantics is the single-path query semantics which requires presenting a single path from the node m to the node n, whose labeling is derived from a non-terminal A for all triples (A, m, n) evaluated using the relational query semantics. There is a number of algorithms for query evaluation which use these semantics but all of them perform poorly on large graphs. One of the most common technique for efficient big data processing is the use of a graphics processing unit (GPU) to perform computations, but these algorithms do not allow to use this technique efficiently. In this paper, we show how the context-free path query evaluation using these query semantics can be reduced to the calculation of the matrix transitive closure. Also, we propose an algorithm for context-free path query evaluation which uses relational query semantics and is based on matrix operations that make it possible to speed up computations by using a GPU.Comment: 9 pages, 11 figures, 2 table

AiiDA: Automated Interactive Infrastructure and Database for Computational Science

Computational science has seen in the last decades a spectacular rise in the scope, breadth, and depth of its efforts. Notwithstanding this prevalence and impact, it is often still performed using the renaissance model of individual artisans gathered in a workshop, under the guidance of an established practitioner. Great benefits could follow instead from adopting concepts and tools coming from computer science to manage, preserve, and share these computational efforts. We illustrate here our paradigm sustaining such vision, based around the four pillars of Automation, Data, Environment, and Sharing. We then discuss its implementation in the open-source AiiDA platform (http://www.aiida.net), that has been tuned first to the demands of computational materials science. AiiDA's design is based on directed acyclic graphs to track the provenance of data and calculations, and ensure preservation and searchability. Remote computational resources are managed transparently, and automation is coupled with data storage to ensure reproducibility. Last, complex sequences of calculations can be encoded into scientific workflows. We believe that AiiDA's design and its sharing capabilities will encourage the creation of social ecosystems to disseminate codes, data, and scientific workflows.Comment: 30 pages, 7 figure

Temporalized logics and automata for time granularity

Suitable extensions of the monadic second-order theory of k successors have been proposed in the literature to capture the notion of time granularity. In this paper, we provide the monadic second-order theories of downward unbounded layered structures, which are infinitely refinable structures consisting of a coarsest domain and an infinite number of finer and finer domains, and of upward unbounded layered structures, which consist of a finest domain and an infinite number of coarser and coarser domains, with expressively complete and elementarily decidable temporal logic counterparts. We obtain such a result in two steps. First, we define a new class of combined automata, called temporalized automata, which can be proved to be the automata-theoretic counterpart of temporalized logics, and show that relevant properties, such as closure under Boolean operations, decidability, and expressive equivalence with respect to temporal logics, transfer from component automata to temporalized ones. Then, we exploit the correspondence between temporalized logics and automata to reduce the task of finding the temporal logic counterparts of the given theories of time granularity to the easier one of finding temporalized automata counterparts of them.Comment: Journal: Theory and Practice of Logic Programming Journal Acronym: TPLP Category: Paper for Special Issue (Verification and Computational Logic) Submitted: 18 March 2002, revised: 14 Januari 2003, accepted: 5 September 200