MonetDB/XQuery - Consistent & Efficient Updates on the Pre/Post Plane

Relational XQuery processors aim at leveraging mature relational DBMS query processing technology to provide scalability and efficiency. To achieve this goal, various storage schemes have been proposed to encode the tree structure of XML documents in flat relational tables. Basically, two classes can be identified: (1) encodings using fixed-length surrogates, like the preorder ranks in the pre/post encoding [5] or the equivalent pre/size/level encoding [8], and (2) encodings using variable-length surrogates, like, e.g., ORDPATH [9] or P-PBiTree [12]. Recent research [1] showed a clear advantage of the former for efficient evaluation of XPath location steps, exploiting techniques like cheap node order tests, positional lookup, and node skipping in staircase join [7]. However, once updates are involved, variable-length surrogates are often considered the better choice, mainly as a straightforward implementation of structural XML updates using fixed-length surrogates faces two performance bottlenecks: (i) high physical cost (the preorder ranks of all nodes following the update position must be modified—on average 50% of the document), and (ii) low transaction concurrency (updating the size of all ancestor nodes causes lock contention on the document root)

Morphology of buried interfaces in ion-assisted magnetron sputter deposited 11B4C-containing Ni/Ti multilayer neutron optics investigated by grazing incidence small angle scattering

Multilayer neutron optics require precise control of interface morphology for optimal performance. In this work, we investigate the effects of different growth conditions on the interface morphology of Ni/Ti based multilayers, with a focus on incorporating low-neutron-absorbing 11B4C and using different ion assistance schemes. Grazing incidence small angle X-ray scattering was used to probe the structural and morphological details of buried interfaces, revealing that the layers become more strongly correlated and the interfaces form mounds with increasing amounts of 11B4C. Applying high flux ion assistance during growth can reduce mound formation but lead to interface mixing, while a high flux modulated ion assistance scheme with an initial buffer layer grown at low ion energy and the top layer at higher ion energy prevents intermixing. The optimal condition was found to be adding 26.0 at.% 11B4C combined with high flux modulated ion assistance. A multilayer with a period of 48.2 {\AA} and 100 periods was grown under these conditions, and coupled fitting to neutron and X-ray reflectivity data revealed an average interface width of only 2.7 {\AA}, a significant improvement over the current state-of-the-art commercial Ni/Ti multilayers. Overall, our study demonstrates that the addition of 11B4C and the use of high flux modulated ion assistance during growth can significantly improve the interface morphology of Ni/Ti multilayers, leading to improved neutron optics performance.Comment: 14 page

Systematic assessment of the growth plates of the wrist in young gymnasts: Development and validation of the Amsterdam MRI assessment of the Physis (AMPHYS) protocol

Objectives To develop and validate a protocol for MRI assessment of the distal radial and ulnar periphyseal area in gymnasts and non-gymnasts. Methods Twenty-four gymnasts with wrist pain, 18 asymptomatic gymnasts and 24 non-gymnastic controls (33 girls) underwent MRI of the wrist on a 3T scanner. Sequences included coronal proton density-weighted images with and without fat saturation, and three-dimensional water-selective cartilage scan and T2 Dixon series. Skeletal age was determined using hand radiographs. Three experienced musculoskeletal radiologists established a checklist of possible (peri)physeal abnormalities based on literature an

Defining the Critical Hurdles in Cancer Immunotherapy

ABSTRACT: Scientific discoveries that provide strong evidence of antitumor effects in preclinical models often encounter significant delays before being tested in patients with cancer. While some of these delays have a scientific basis, others do not. We need to do better. Innovative strategies need to move into early stage clinical trials as quickly as it is safe, and if successful, these therapies should efficiently obtain regulatory approval and widespread clinical application. In late 2009 and 2010 the Society for Immunotherapy of Cancer (SITC), convened an "Immunotherapy Summit" with representatives from immunotherapy organizations representing Europe, Japan, China and North America to discuss collaborations to improve development and delivery of cancer immunotherapy. One of the concepts raised by SITC and defined as critical by all parties was the need to identify hurdles that impede effective translation of cancer immunotherapy. With consensus on these hurdles, international working groups could be developed to make recommendations vetted by the participating organizations. These recommendations could then be considered by regulatory bodies, governmental and private funding agencies, pharmaceutical companies and academic institutions to facilitate changes necessary to accelerate clinical translation of novel immune-based cancer therapies. The critical hurdles identified by representatives of the collaborating organizations, now organized as the World Immunotherapy Council, are presented and discussed in this report. Some of the identified hurdles impede all investigators, others hinder investigators only in certain regions or institutions or are more relevant to specific types of immunotherapy or first-in-humans studies. Each of these hurdles can significantly delay clinical translation of promising advances in immunotherapy yet be overcome to improve outcomes of patients with cancer

Defining the critical hurdles in cancer immunotherapy

Scientific discoveries that provide strong evidence of antitumor effects in preclinical models often encounter significant delays before being tested in patients with cancer. While some of these delays have a scientific basis, others do not. We need to do better. Innovative strategies need to move into early stage clinical trials as quickly as it is safe, and if successful, these therapies should efficiently obtain regulatory approval and widespread clinical application. In late 2009 and 2010 the Society for Immunotherapy of Cancer (SITC), convened an "Immunotherapy Summit" with representatives from immunotherapy organizations representing Europe, Japan, China and North America to discuss collaborations to improve development and delivery of cancer immunotherapy. One of the concepts raised by SITC and defined as critical by all parties was the need to identify hurdles that impede effective translation of cancer immunotherapy. With consensus on these hurdles, international working groups could be developed to make recommendations vetted by the participating organizations. These recommendations could then be considered by regulatory bodies, governmental and private funding agencies, pharmaceutical companies and academic institutions to facilitate changes necessary to accelerate clinical translation of novel immune-based cancer therapies. The critical hurdles identified by representatives of the collaborating organizations, now organized as the World Immunotherapy Council, are presented and discussed in this report. Some of the identified hurdles impede all investigators; others hinder investigators only in certain regions or institutions or are more relevant to specific types of immunotherapy or first-in-humans studies. Each of these hurdles can significantly delay clinical translation of promising advances in immunotherapy yet if overcome, have the potential to improve outcomes of patients with cancer

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Imaging of critical limb ischemia

This thesis aims to improve diagnostic evaluation, treatment selection, endovascular intervention, and outcome assessment in patients with PAD with a focus on CLI. If the patient is referred for endovascular intervention, the patient will be exposed to intravascular iodinated contrast. Since this contrast can affect renal function, we studied whether the endovascular procedure can confidently be performed with the use of two lower iodinated contrast concentrations, comparing 240 and 140 mg iodine/ml with the standard concentration of 300 mg iodine/ml. The data from this study indicated that using lower concentrations should be a standard operating procedure. In a cohort consisting of CLI patients were followed for one year after an infrainguinal revascularization. In this cohort the treatment strategy was that patients with poor condition due to comorbidities, unfavorable anatomy for surgery, no venous material for bypass or old age would primarily be treated endovascularly. Compared to other cohort studies and trials, the patients in our cohort showed equal or even slightly better clinical outcomes, indicating that an endovascular first strategy is justified. In this thesis we also present several systematic reviews which show that: 1. CTA or CE-MRA can confidently be performed in patients with CLI or IC; 2. drug-eluting balloons and stents have no clear additional value over non-drug-eluting balloons and stents for femoropopliteal and tibial arterial lesions; 3. patient-reported outcome measures for evaluating quality of life and functional status in patients with intermittent claudication is not well evaluated

Alkaline Earth Metal Imido Complexes with Doubly Deprotonated Amidine and β‐Diketimine Ligands

Double deprotonation of the amidine DIPP‐N=C(tBu)‐NH2 or β‐diketimine DIPP‐N=C(Me)‐C(H)=C(Me)‐NH2 (DIPP = 2,6‐diisopropylphenyl) with strong benzylcalcium or strontium bases gave metal imido complexes with the anions DIPP‐N=C(tBu)‐N2– (Am2–) and DIPP‐N=C(Me)‐C(H)=C(Me)‐N2– (BDI2–) which crystallized as tetrameric complexes with typical Ca4N4 or Sr4N4 cubane frameworks. Crystal structures of [(Am)Ca·THF]4, [(BDI)Ca·THF]4 and the first Sr imido complex [(Am)Sr·THF]4 are presented. Calculated geometries of [(Am)Ca·THF]4 and [(BDI)Ca·THF]4 (B3PW91/6‐311++G**) are in good agreement with the crystal structures. Also complexes with monoanionic ligands (Am‐H)– and (BDI‐H)– are reported. Charge delocalization in the ligand backbone is discussed. Ligand–metal bonds are calculated to be circa 90 % ionic; the NPA charges on Ca is circa +1.8. The negative charge on the ligand is delocalized over the ligand backbone but there is still considerable electron density on the terminal N (–1.4). Despite this high negative charge, the reactivity of these complexes is generally low due to the strongly bound cubane core. Reaction of [(Am)Ca·THF]4 with phenyl cyanide gave the [(Am)Ca·PhCN]4, clearly demonstrating its low reactivity. Attempts to break the tetrameric cluster in smaller aggregates by addition of 18‐crown‐6 led to protonation and isolation of (Am‐H)2Ca·(18‐crown‐6). Reaction of [(Am)Ca·THF]4 with iPrN=C=NiPr gave after addition a complex with a unique amido‐guanidinate ligand

Synthesis and characterization of 11B4C containing Ni/Ti multilayers using combined neutron and X-ray reflectometry

The performance of multilayers in optical components, such as those used in neutron scattering instruments, is crucially dependent on the achievable interface width. We have shown how the interface width of Ni/Ti multilayers can be improved using the incorporation of B4C to inhibit the formation of nanocrystals and limit interdiffusion and intermetallic reactions at the interfaces. A modulated ion-assistance scheme was used to prevent intermixing and roughness accumulation throughout the layer stack. In this work we investigate the incorporation of low-neutron-absorbing 11B4C for Ni/Ti neutron multilayers. Combined fitting of neutron reflectivity and X-ray reflectivity measurements shows an elimination of accumulated roughness for the 11B4C containing multilayers with a mean interface width of 4.5 Å, resulting in an increase in reflectivity at the first Bragg peak by a factor of 2.3 and 1.5 for neutron and X-ray measurements, respectively