PERANGKAT BANTU UNTUK OPTIMASI QUERY PADA ORACLE DENGAN RESTRUKTURISASI SQL

Query merupakan bagian dari bahasa pemrograman SQL (Structured Query Language) yang berfungsi untuk mengambil data (read) dalam DBMS (Database Management System), termasuk Oracle [3]. Pada Oracle, ada tiga tahap proses yang dilakukan dalam pengeksekusian query, yaitu Parsing, Execute dan Fetch. Sebelum proses execute dijalankan, Oracle terlebih dahulu membuat execution plan yang akan menjadi skenario dalam proses excute.Dalam proses pengeksekusian query, terdapat faktor-faktor yang mempengaruhi kinerja query, di antaranya access path (cara pengambilan data dari sebuah tabel) dan operasi join (cara menggabungkan data dari dua tabel). Untuk mendapatkan query dengan kinerja optimal, maka diperlukan pertimbangan-pertimbangan dalam menyikapi faktor-faktor tersebut.  Optimasi query merupakan suatu cara untuk mendapatkan query dengan kinerja seoptimal mungkin, terutama dilihat dari sudut pandang waktu. Ada banyak metode untuk mengoptimasi query, tapi pada Penelitian ini, penulis membuat sebuah aplikasi untuk mengoptimasi query dengan metode restrukturisasi SQL statement. Pada metode ini, objek yang dianalisa adalah struktur klausa yang membangun sebuah query. Aplikasi ini memiliki satu input dan lima jenis output. Input dari aplikasi ini adalah sebuah query sedangkan kelima jenis output aplikasi ini adalah berupa query hasil optimasi, saran perbaikan, saran pembuatan indeks baru, execution plan dan data statistik. Cara kerja aplikasi ini dibagi menjadi empat tahap yaitu mengurai query menjadi sub query, mengurai query per-klausa, menentukan access path dan operasi join dan restrukturisasi query.Dari serangkaian ujicoba yang dilakukan penulis, aplikasi telah dapat berjalan sesuai dengan tujuan pembuatan Penelitian ini, yaitu mendapatkan query dengan kinerja optimal.Kata Kunci : Query, SQL, DBMS, Oracle, Parsing, Execute, Fetch, Execution Plan, Access Path, Operasi Join, Restrukturisasi SQL statement

PERANGKAT BANTU UNTUK OPTIMASI QUERY PADA ORACLE DENGAN RESTRUKTURISASI SQL

Query merupakan bagian dari bahasa pemrograman SQL (Structured Query Language) yang berfungsi untuk mengambil data (read) dalam DBMS (Database Management System), termasuk Oracle [3]. Pada Oracle, ada tiga tahap proses yang dilakukan dalam pengeksekusian query, yaitu Parsing, Execute dan Fetch. Sebelum proses execute dijalankan, Oracle terlebih dahulu membuat execution plan yang akan menjadi skenario dalam proses excute.Dalam proses pengeksekusian query, terdapat faktor-faktor yang mempengaruhi kinerja query, di antaranya access path (cara pengambilan data dari sebuah tabel) dan operasi join (cara menggabungkan data dari dua tabel). Untuk mendapatkan query dengan kinerja optimal, maka diperlukan pertimbangan-pertimbangan dalam menyikapi faktor-faktor tersebut.  Optimasi query merupakan suatu cara untuk mendapatkan query dengan kinerja seoptimal mungkin, terutama dilihat dari sudut pandang waktu. Ada banyak metode untuk mengoptimasi query, tapi pada Penelitian ini, penulis membuat sebuah aplikasi untuk mengoptimasi query dengan metode restrukturisasi SQL statement. Pada metode ini, objek yang dianalisa adalah struktur klausa yang membangun sebuah query. Aplikasi ini memiliki satu input dan lima jenis output. Input dari aplikasi ini adalah sebuah query sedangkan kelima jenis output aplikasi ini adalah berupa query hasil optimasi, saran perbaikan, saran pembuatan indeks baru, execution plan dan data statistik. Cara kerja aplikasi ini dibagi menjadi empat tahap yaitu mengurai query menjadi sub query, mengurai query per-klausa, menentukan access path dan operasi join dan restrukturisasi query.Dari serangkaian ujicoba yang dilakukan penulis, aplikasi telah dapat berjalan sesuai dengan tujuan pembuatan Penelitian ini, yaitu mendapatkan query dengan kinerja optimal.Kata Kunci : Query, SQL, DBMS, Oracle, Parsing, Execute, Fetch, Execution Plan, Access Path, Operasi Join, Restrukturisasi SQL statement

MRI and Molecular Characterization of Pediatric High-Grade Midline Thalamic Gliomas: The HERBY Phase II Trial

Background: Diffuse midline gliomas (DMG) are characterized by a high incidence of H3 K27 mutations and poorer outcome. The HERBY trial has provided one of the largest cohorts of pediatric DMGs with available radiologic, histologic-genotypic, and survival data. / Purpose: To define MRI and molecular characteristics of DMG. / Materials and Methods: This study is a secondary analysis of a prospective trial (HERBY; ClinicalTrials.gov identifier, NCT01390948) undertaken between October 2011 and February 2016. Among 121 HERBY participants, 50 had midline nonpontine-based tumors. Midline high-grade gliomas were reclassified into DMG H3 K27 mutant, H3 wild type with enhancer of zest homologs inhibitory protein overexpression, epidermal growth factor receptormutant, or not otherwise stated. The epicenter of each tumor and other radiologic characteristics were ascertained from MRI and correlated with the new subtype classification, histopathologic characteristics, surgical extent, and outcome parameters. Kaplan-Meier curves and log-rank tests were applied to determine and describe survival differences between groups. / Results: There were 42 participants (mean age, 12 years ± 4 [SD]; 23 girls) with radiologically evaluable thalamic-based DMG. Eighteen had partial thalamic involvement (12 thalamopulvinar, six anteromedial), 10 involved a whole thalamus, nine had unithalamic tumors with diffuse contiguous extension, and five had bithalamic tumors (two symmetric, three partial). Twenty-eight participants had DMG H3 K27 mutant tumors; there were no differences in outcome compared with other DMGs (n = 4). Participants who underwent major debulking or total or near-total resection had longer overall survival (OS): 18.5 months vs 11.4 months (P = .02). Enrolled participants who developed leptomeningeal metastatic dissemination before starting treatment had worse outcomes (event-free survival, 2.9 months vs 8.0 months [P = .02]; OS, 11.4 months vs 18.5 months [P = .004]). / Conclusion: Thalamic involvement of diffuse midline gliomas ranged from localized partial thalamic to holo- or bithalamic with diffuse contiguous spread and had poor outcomes, irrespective of H3 K27 subtype alterations. Leptomeningeal dissemination and less than 50% surgical resection were adverse risk factors for survival. / Clinical trial registration no. NCT0139094

Birth cohort-specific trends of sun-related behaviors among individuals from an international consortium of melanoma-prone families

Background: Individuals from melanoma-prone families have similar or reduced sun-protective behaviors compared to the general population. Studies on trends in sun-related behaviors have been temporally and geographically limited. Methods: Individuals from an international consortium of melanoma-prone families (GenoMEL) were retrospectively asked about sunscreen use, sun exposure (time spent outside), sunburns, and sunbed use at several timepoints over their lifetime. Generalized linear mixed models were used to examine the association between these outcomes and birth cohort defined by decade spans, after adjusting for covariates. Results: A total of 2407 participants from 547 families across 17 centers were analyzed. Sunscreen use increased across subsequent birth cohorts, and although the likelihood of sunburns increased until the 1950s birth cohort, it decreased thereafter. Average sun exposure did not change across the birth cohorts, and the likelihood of sunbed use increased in more recent birth cohorts. We generally did not find any differences in sun-related behavior when comparing melanoma cases to non-cases. Melanoma cases had increased sunscreen use, decreased sun exposure, and decreased odds of sunburn and sunbed use after melanoma diagnosis compared to before diagnosis. Conclusions: Although sunscreen use has increased and the likelihood of sunburns has decreased in more recent birth cohorts, individuals in melanoma-prone families have not reduced their overall sun exposure and had an increased likelihood of sunbed use in more recent birth cohorts. These observations demonstrate partial improvements in melanoma prevention and suggest that additional intervention strategies may be needed to achieve optimal sun-protective behavior in melanoma-prone families.This work was supported by: the European Commission under the 6th and 7th Framework Programme [LSH-CT-2006-018702] to JNB; Cancer Research UK Programme Awards (C588/A4994 and C588/ A10589) to DTB/JNB; a Cancer Research UK Project Grant (C8216/A6129) to DTB/JNB; the US National Institutes of Health [R01 CA83115 (PAK, DEE, DTB)], the National Health and Medical Research Council of Australia [NHMRC 107359, 402761, 633004, 566946, 211172, 1093017, 1147843 (AC)]; the Cancer Council New South Wales (project grant 77/00, 06/10); the Cancer Institute New South Wales [CINSW 05/TPG/1-01, 10/TPG/1-02], 15/CDF/1-14 (AC); CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior); FAPESP (Fundação para o Amparo da Pesquisa do Estado de São Paulo) – SP, Brazil # 2007/04313-2; the Cancer Research Foundations of Radiumhemmet and the Swedish Cancer Society; the Paulsson Trust, Lund University; grant support from the Swedish Cancer Society and European Research Council Advanced Grant (ERC-2011-294576); the research at the Melanoma Unit in Barcelona is partially funded by Spanish Fondo de Investigaciones Sanitarias grants PI15/ 00716 and PI15/00956; CIBER de Enfermedades Raras of the Instituto de Salud Carlos III, Spain, co-financed by European Regional Development Fund “A way to achieve Europe” ERDF; AGAUR 2014_SGR_603 of the Catalan Government, Spain; Diagnoptics; a grant from “Fundació La Marató de TV3” 201331-30, Catalonia, Spain; a grant from “Fundación Científica de la Asociación Española Contra el Cáncer” GCB15152978SOEN, Spain, and CERCA Programme / Generalitat de Catalunya. Part of the work was carried out at the Esther Koplowitz Center, Barcelona; Italian Ministry of Health RF-2016- 02362288 to PG; the Comisión Honoraria de Lucha Contra el Cáncer, CSIC, Fundación Manuel Pérez, Montevideo, Uruguay; Francisco Cuellar is supported by a scholarship awarded by CONACYT, Mexico (152256/158706)

Skin examination behavior: the role of melanoma history, skin type, psychosocial factors, and region of residence in determining clinical and self-conducted skin examination

Objective: To examine the frequency and correlates of skin examination behaviors in an international sample of individuals at varying risk of developing melanoma. Design: A cross-sectional, web-based survey. Setting: Data were collected from the general population over a 20-month period on behalf of the Melanoma Genetics Consortium (GenoMEL). Participants: A total of 8178 adults from Northern (32%), Central (33%), and Southern (14%) Europe, Australia (13%), and the United States (8%). Main outcome measures: Self-reported frequency of skin self-examination (SSE) and clinical skin examination (CSE). Results: After adjustment for age and sex, frequency of skin examination was higher in both Australia (odds ratio [OR]SSE=1.80 [99% CI, 1.49-2.18]; ORCSE=2.68 [99% CI, 2.23-3.23]) and the United States (ORSSE=2.28 [99% CI, 1.76-2.94]; ORCSE=3.39 [99% CI, 2.60-4.18]) than in the 3 European regions combined. Within Europe, participants from Southern Europe reported higher rates of SSE than those in Northern Europe (ORSSE=1.61 [99% CI, 1.31-1.97]), and frequency of CSE was higher in both Central (ORCSE=1.47 [99% CI, 1.22-1.78]) and Southern Europe (ORCSE=3.46 [99% CI, 2.78, 4.31]) than in Northern Europe. Skin examination behavior also varied according to melanoma history: participants with no history of melanoma reported the lowest levels of skin examination, while participants with a previous melanoma diagnosis reported the highest levels. After adjustment for region, and taking into account the role of age, sex, skin type, and mole count, engagement in SSE and CSE was associated with a range of psychosocial factors, including perceived risk of developing melanoma; perceived benefits of, and barriers to, skin examination; perceived confidence in one's ability to engage in screening; and social norms. In addition, among those with no history of melanoma, higher cancer-related worry was associated with greater frequency of SSE. Conclusions: Given the strong association between psychosocial factors and skin examination behaviors, particularly among people with no history of melanoma, we recommend that greater attempts be made to integrate psycho-education into the fabric of public health initiatives and clinical care, with clinicians, researchers, and advocacy groups playing a key role in guiding individuals to appropriate tools and resources

Constitutional Microsatellite Instability, Genotype, and Phenotype Correlations in Constitutional Mismatch Repair Deficiency

peer reviewed[en] BACKGROUND & AIMS: Constitutional mismatch repair deficiency (CMMRD) is a rare recessive childhood cancer predisposition syndrome caused by germline mismatch repair variants. Constitutional microsatellite instability (cMSI) is a CMMRD diagnostic hallmark and may associate with cancer risk. We quantified cMSI in a large CMMRD patient cohort to explore genotype-phenotype correlations using novel MSI markers selected for instability in blood. METHODS: Three CMMRD, 1 Lynch syndrome, and 2 control blood samples were genome sequenced to >120× depth. A pilot cohort of 8 CMMRD and 38 control blood samples and a blinded cohort of 56 CMMRD, 8 suspected CMMRD, 40 Lynch syndrome, and 43 control blood samples were amplicon sequenced to 5000× depth. Sample cMSI score was calculated using a published method comparing microsatellite reference allele frequencies with 80 controls. RESULTS: Thirty-two mononucleotide repeats were selected from blood genome and pilot amplicon sequencing data. cMSI scoring using these MSI markers achieved 100% sensitivity (95% CI, 93.6%-100.0%) and specificity (95% CI 97.9%-100.0%), was reproducible, and was superior to an established tumor MSI marker panel. Lower cMSI scores were found in patients with CMMRD with MSH6 deficiency and patients with at least 1 mismatch repair missense variant, and patients with biallelic truncating/copy number variants had higher scores. cMSI score did not correlate with age at first tumor. CONCLUSIONS: We present an inexpensive and scalable cMSI assay that enhances CMMRD detection relative to existing methods. cMSI score is associated with mismatch repair genotype but not phenotype, suggesting it is not a useful predictor of cancer risk

Radiological evaluation of newly diagnosed non-brainstem pediatric high-grade glioma in the HERBY phase II trial

Purpose: The HERBY trial evaluated the benefit of the addition of the antiangiogenic agent Bevacizumab (BEV) to radiotherapy/temozolomide (RT/TMZ) in pediatric patients with newly diagnosed non-brainstem high-grade glioma (HGG). The work presented here aims to correlate imaging characteristics and outcome measures with pathologic and molecular data.Experimental Design: Radiological, pathologic, and molecular data were correlated with trial clinical information to retrospectively re-evaluate event-free survival (EFS) and overall survival (OS).Results: One-hundred thirteen patients were randomized to the RT/TMZ arm (n = 54) or the RT/TMZ+BEV (BEV arm; n = 59). The tumor arose in the cerebral hemispheres in 68 patients (Cerebral group) and a midline location in 45 cases (Midline group). Pathologic diagnosis was available in all cases and molecular data in 86 of 113. H3 K27M histone mutations were present in 23 of 32 Midline cases and H3 G34R/V mutations in 7 of 54 Cerebral cases. Total/near-total resection occurred in 44 of 68 (65%) Cerebral cases but in only 5 of 45 (11%) Midline cases (P < 0.05). Leptomeningeal metastases (27 cases, 13 with subependymal spread) at relapse were more frequent in Midline (17/45) than in Cerebral tumors (10/68, P < 0.05). Mean OS (14.1 months) and EFS (9.0 months) in Midline tumors were significantly lower than mean OS (20.7 months) and EFS (14.9 months) in Cerebral tumors (P < 0.05). Pseudoprogression occurred in 8 of 111 (6.2%) cases.Conclusions: This study has shown that the poor outcome of midline tumors (compared with cerebral) may be related to (1) lesser surgical resection, (2) H3 K27M histone mutations, and (3) higher leptomeningeal dissemination

Genome-wide meta-analysis identifies five new susceptibility loci for cutaneous malignant melanoma.

Thirteen common susceptibility loci have been reproducibly associated with cutaneous malignant melanoma (CMM). We report the results of an international 2-stage meta-analysis of CMM genome-wide association studies (GWAS). This meta-analysis combines 11 GWAS (5 previously unpublished) and a further three stage 2 data sets, totaling 15,990 CMM cases and 26,409 controls. Five loci not previously associated with CMM risk reached genome-wide significance (P < 5 × 10(-8)), as did 2 previously reported but unreplicated loci and all 13 established loci. Newly associated SNPs fall within putative melanocyte regulatory elements, and bioinformatic and expression quantitative trait locus (eQTL) data highlight candidate genes in the associated regions, including one involved in telomere biology.[Please see the Supplementary Note for acknowledgments.]This is the author accepted manuscript. The final version is available from NPG via http://dx.doi.org/10.1038/ng.337

Particulate matter exposure during pregnancy is associated with birth weight, but not gestational age, 1962-1992: a cohort study

<p>Abstract</p> <p>Background</p> <p>Exposure to air pollutants is suggested to adversely affect fetal growth, but the evidence remains inconsistent in relation to specific outcomes and exposure windows.</p> <p>Methods</p> <p>Using birth records from the two major maternity hospitals in Newcastle upon Tyne in northern England between 1961 and 1992, we constructed a database of all births to mothers resident within the city. Weekly black smoke exposure levels from routine data recorded at 20 air pollution monitoring stations were obtained and individual exposures were estimated via a two-stage modeling strategy, incorporating temporally and spatially varying covariates. Regression analyses, including 88,679 births, assessed potential associations between exposure to black smoke and birth weight, gestational age and birth weight standardized for gestational age and sex.</p> <p>Results</p> <p>Significant associations were seen between black smoke and both standardized and unstandardized birth weight, but not for gestational age when adjusted for potential confounders. Not all associations were linear. For an increase in whole pregnancy black smoke exposure, from the 1^st(7.4 μg/m³) to the 25^th(17.2 μg/m³), 50^th(33.8 μg/m³), 75^th(108.3 μg/m³), and 90^th(180.8 μg/m³) percentiles, the adjusted estimated decreases in birth weight were 33 g (SE 1.05), 62 g (1.63), 98 g (2.26) and 109 g (2.44) respectively. A significant interaction was observed between socio-economic deprivation and black smoke on both standardized and unstandardized birth weight with increasing effects of black smoke in reducing birth weight seen with increasing socio-economic disadvantage.</p> <p>Conclusions</p> <p>The findings of this study progress the hypothesis that the association between black smoke and birth weight may be mediated through intrauterine growth restriction. The associations between black smoke and birth weight were of the same order of magnitude as those reported for passive smoking. These findings add to the growing evidence of the harmful effects of air pollution on birth outcomes.</p