Page size aware cache prefetching

The increase in working set sizes of contemporary applications outpaces the growth in cache sizes, resulting in frequent main memory accesses that deteriorate system per- formance due to the disparity between processor and memory speeds. Prefetching data blocks into the cache hierarchy ahead of demand accesses has proven successful at attenuating this bottleneck. However, spatial cache prefetchers operating in the physical address space leave significant performance on the table by limiting their pattern detection within 4KB physical page boundaries when modern systems use page sizes larger than 4KB to mitigate the address translation overheads. This paper exploits the high usage of large pages in modern systems to increase the effectiveness of spatial cache prefetch- ing. We design and propose the Page-size Propagation Module (PPM), a µarchitectural scheme that propagates the page size information to the lower-level cache prefetchers, enabling safe prefetching beyond 4KB physical page boundaries when the accessed blocks reside in large pages, at the cost of augmenting the first-level caches’ Miss Status Holding Register (MSHR) entries with one additional bit. PPM is compatible with any cache prefetcher without implying design modifications. We capitalize on PPM’s benefits by designing a module that consists of two page size aware prefetchers that inherently use different page sizes to drive prefetching. The composite module uses adaptive logic to dynamically enable the most appropriate page size aware prefetcher. Finally, we show that the proposed designs are transparent to which cache prefetcher is used. We apply the proposed page size exploitation techniques to four state-of-the-art spatial cache prefetchers. Our evalua- tion shows that our proposals improve single-core geomean performance by up to 8.1% (2.1% at minimum) over the original implementation of the considered prefetchers, across 80 memory-intensive workloads. In multi-core contexts, we report geomean speedups up to 7.7% across different cache prefetchers and core configurations.This work is supported by the Spanish Ministry of Science and Technology through the PID2019-107255GB project, the Generalitat de Catalunya (contract 2017-SGR-1414), the European Union Horizon 2020 research and innovation program under grant agreement No 955606 (DEEP-SEA EU project), the National Science Foundation through grants CNS-1938064 and CCF-1912617, and the Semiconductor Research Corporation project GRC 2936.001. Georgios Vavouliotis has been supported by the Spanish Ministry of Economy, Industry, and Competitiveness and the European Social Fund under the FPI fellowship No. PRE2018-087046. Marc Casas has been partially supported by the Grant RYC2017-23269 funded by MCIN/AEI/10.13039/501100011033 and ESF ‘Investing in your future’.Peer ReviewedPostprint (author's final draft

Spatial Locality Speculation to Reduce Energy in Chip-Multiprocessor Networks-on-Chip

As processor chips become increasingly parallel, an efficient communication substrate is critical for meeting performance and energy targets. In this work, we target the root cause of network energy consumption through techniques that reduce link and router-level switching activity. We specifically focus on memory subsystem traffic, as it comprises the bulk of NoC load in a CMP. By transmitting only the flits that contain words predicted useful using a novel spatial locality predictor, our scheme seeks to reduce network activity. We aim to further lower NoC energy through microarchitectural mechanisms that inhibit datapath switching activity for unused words in individual flits. Using simulation-based performance studies and detailed energy models based on synthesized router designs and different link wire types, we show that 1) the prediction mechanism achieves very high accuracy, with an average rate of false-unused prediction of just 2.5 percent; 2) the combined NoC energy savings enabled by the predictor and microarchitectural support is 36 percent, on average, and up to 57 percent in the best case; and 3) there is no system performance penalty as a result of this technique

Machine learning algorithms performed no better than regression models for prognostication in traumatic brain injury

Objective: We aimed to explore the added value of common machine learning (ML) algorithms for prediction of outcome for moderate and severe traumatic brain injury. Study Design and Setting: We performed logistic regression (LR), lasso regression, and ridge regression with key baseline predictors in the IMPACT-II database (15 studies, n = 11,022). ML algorithms included support vector machines, random forests, gradient boosting machines, and artificial neural networks and were trained using the same predictors. To assess generalizability of predictions, we performed internal, internal-external, and external validation on the recent CENTER-TBI study (patients with Glasgow Coma Scale <13, n = 1,554). Both calibration (calibration slope/intercept) and discrimination (area under the curve) was quantified. Results: In the IMPACT-II database, 3,332/11,022 (30%) died and 5,233(48%) had unfavorable outcome (Glasgow Outcome Scale less than 4). In the CENTER-TBI study, 348/1,554(29%) died and 651(54%) had unfavorable outcome. Discrimination and calibration varied widely between the studies and less so between the studied algorithms. The mean area under the curve was 0.82 for mortality and 0.77 for unfavorable outcomes in the CENTER-TBI study. Conclusion: ML algorithms may not outperform traditional regression approaches in a low-dimensional setting for outcome prediction after moderate or severe traumatic brain injury. Similar to regression-based prediction models, ML algorithms should be rigorously validated to ensure applicability to new populations

Frequency of fatigue and its changes in the first 6 months after traumatic brain injury: results from the CENTER-TBI study

Background: Fatigue is one of the most commonly reported subjective symptoms following traumatic brain injury (TBI). The aims were to assess frequency of fatigue over the first 6 months after TBI, and examine whether fatigue changes could be predicted by demographic characteristics, injury severity and comorbidities. Methods: Patients with acute TBI admitted to 65 trauma centers were enrolled in the study Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI). Subj

Tracheal intubation in traumatic brain injury

Background: We aimed to study the associations between pre- and in-hospital tracheal intubation and outcomes in traumatic brain injury (TBI), and whether the association varied according to injury severity. Methods: Data from the international prospective pan-European cohort study, Collaborative European NeuroTrauma Effectiveness Research for TBI (CENTER-TBI), were used (n=4509). For prehospital intubation, we excluded self-presenters. For in-hospital intubation, patients whose tracheas were intubated on-scene were excluded. The association between intubation and outcome was analysed with ordinal regression with adjustment for the International Mission for Prognosis and Analysis of Clinical Trials in TBI variables and extracranial injury. We assessed whether the effect of intubation varied by injury severity by testing the added value of an interaction term with likelihood ratio tests. Results: In the prehospital analysis, 890/3736 (24%) patients had their tracheas intubated at scene. In the in-hospital analysis, 460/2930 (16%) patients had their tracheas intubated in the emergency department. There was no adjusted overall effect on functional outcome of prehospital intubation (odds ratio=1.01; 95% confidence interval, 0.79–1.28; P=0.96), and the adjusted overall effect of in-hospital intubation was not significant (odds ratio=0.86; 95% confidence interval, 0.65–1.13; P=0.28). However, prehospital intubation was associated with better functional outcome in patients with higher thorax and abdominal Abbreviated Injury Scale scores (P=0.009 and P=0.02, respectively), whereas in-hospital intubation was associated with better outcome in patients with lower Glasgow Coma Scale scores (P=0.01): in-hospital intubation was associated with better functional outcome in patients with Glasgow Coma Scale scores of 10 or lower. Conclusion: The benefits and harms of tracheal intubation should be carefully evaluated in patients with TBI to optimise benefit. This study suggests that extracranial injury should influence the decision in the prehospital setting, and level of consciousness in the in-hospital setting. Clinical trial registration: NCT02210221

Informed consent procedures in patients with an acute inability to provide informed consent

Purpose: Enrolling traumatic brain injury (TBI) patients with an inability to provide informed consent in research is challenging. Alternatives to patient consent are not sufficiently embedded in European and national legislation, which allows procedural variation and bias. We aimed to quantify variations in informed consent policy and practice. Methods: Variation was explored in the CENTER-TBI study. Policies were reported by using a questionnaire and national legislation. Data on used informed consent procedures were available for 4498 patients from 57 centres across 17 European countries. Results: Variation in the use of informed consent procedur