Service evaluation of weight outcomes as a function of initial BMI in 34,271 adults referred to a primary care/commercial weight management partnership scheme

Peer reviewedPublisher PD

BookLeaf: An Unstructured Hydrodynamics Mini-application

With the age of Exascale computing causing a diversification away from traditional CPU-based homogeneous clusters, it is becoming increasingly difficult to ensure that computationally complex codes are able to run on these emerging architectures. This is especially important for large physics simulations that are themselves becoming increasingly complex and computationally expensive. One proposed solution to the problem of ensuring these applications can run on the desired architectures is to develop representative mini-applications that are simpler and so can be ported to new frameworks more easily, but which are also representative of the algorithmic and performance characteristics of the original applications. In this paper we present BookLeaf, an unstructured Arbitrary Lagrangian-Eulerian mini-application to add to the suite of representative applications developed and maintained by the UK Mini-App Consortium (UK-MAC). First, we outline the reference implementation of our application in Fortran. We then discuss a number of alternative implementations using a variety of parallel programming models and discuss the issues that arise when porting such an application to new architectures. To demonstrate our implementation, we present a study of the performance of BookLeaf on number of platforms using alternative designs, and we document a scaling study showing the behaviour of the application at scale

Pointers inside lambda closure objects in OpenMP target offload regions

With the diversification of HPC architectures beyond traditional CPU-based clusters, a number of new frameworks for performance portability across architectures have arisen. One way of implementing such frameworks is to use C++ templates and lambda expressions to design loop-like functions. However, lower level programming APIs that these implementations must use are often designed with C in mind and do not specify how they interact with C++ features such as lambda expressions. This paper discusses a change to the behavior of the OpenMP specification with respect to lambda expressions such that when functions generated by lambda expressions are called inside GPU regions, any pointers used in the lambda expression correctly refer to device pointers. This change has been implemented in a branch of the Clang C++ compiler and demonstrated with two representative codes. This change has also been accepted into the draft OpenMP specification for inclusion in OpenMP 5. Our results show that the implicit mapping of lambda expressions always exhibits identical performance to an explicit mapping but without breaking the abstraction provided by the high level frameworks

Classification and Identification of Pfiesteria and Pfiesteria-Like Species

Dinoflagellates can be classified both botanically and zoologically; however, they are typically put in the botanical division Pyrrhophyta. As a group they appear most related to the protistan ciliates and apicomplexans at the ultrastructure level. Within the Pyrrhophyta are both unarmored and armored forms of the dominant, motile flagellated stage. Unarmored dinoflagellates do not have thecal or wall plates arranged in specific series, whereas armored species have plates that vary in thickness but are specific in number and arrangement. In armored dinoflagellates, the plate pattern and tabulation is a diagnostic character at the family, subfamily, and even genus levels. In most cases, the molecular characterization of dinoflagellates confirms the taxonomy on the basis of external morphology; this has been demonstrated for several groups. Together, both genetic and morphological criteria are becoming increasingly important for the characterization, separation, and identification of dinoflagellates species. Pfiesteria and Pfiesteria-like species are thinly armored forms with motile dinospore stages characterized by their distinct plate formulae. Pfiesteria piscicida is the best-known member of the genus; however, there is at least one other species. Other genetically and morphologically related genera, now grouped under the common names of Lucy, Shepherd\u27s crook, and cryptoperidiniopsoid, are being studied and described in separate works. All these other heterotrophic dinoflagellate groups, many of which are thought to be benign, co-occur in estuarine waters where Pfiesteria has been found

Implicit mapping of pointers inside C++ Lambda closure objects in OpenMP target offload regions

With the diversification of HPC architectures beyond traditional CPU-based clusters, a number of new frameworks for performance portability across architectures have arisen. One way of implementing such frameworks is to use C++ templates and lambda expressions to design loop-like functions. However, lower level programming APIs that these implementations must use are often designed with C in mind and do not specify how they interact with C++ features such as lambda expressions. This paper proposes a change to the behavior of the OpenMP specification with respect to lambda expressions such that when functions generated by lambda expressions are called inside GPU regions, any pointers used in the lambda expression correctly refer to device pointers. This change has been implemented in a branch of the Clang C++ compiler and demonstrated with two representative codes. Our results show that the implicit mapping of lambda expressions always exhibits identical performance to an explicit mapping but without breaking the abstraction provided by the high level frameworks, and therefore also reduces the burden on the application developer

Investigating the Efficacy and Cost-Effectiveness of Technology-Delivered Personalized Feedback on Dietary Patterns in Young Australian Adults in the Advice, Ideas, and Motivation for My Eating (Aim4Me) Study: Protocol for a Randomized Controlled Trial

https://doi.org/10.2196/15999Background: Web-based health interventions may be easier to access and time efficient relative to face-to-face interventions and therefore may be the most appropriate mode to engage young adults. Objective: This study aims to investigate the impact of 3 different levels of personalized web-based dietary feedback and support on changes in diet quality. Methods: The Advice, Ideas, and Motivation for My Eating (Aim4Me) study is a 12-month assessor-blinded, parallel-group randomized controlled trial evaluating the impact of 3 levels of web-based feedback on diet quality, measured using the Australian Recommended Food Score (ARFS). Participants (N=2570) will primarily be recruited via web-based methods and randomized to 1 of 3 groups. Group 1 (control) will receive the Healthy Eating Quiz, a web-based dietary assessment tool that generates a brief feedback report on diet quality. Individuals randomized to this group can use the brief feedback report to make positive dietary changes. Group 2 will receive the Australian Eating Survey, a web-based dietary assessment tool that generates a comprehensive feedback report on diet quality as well as macro- and micronutrient intake. Group 2 will use the comprehensive feedback report to assist in making positive dietary changes. They will also have access to the Aim4Me website with resources on healthy eating and tools to set goals and self-monitor progress. Group 3 will receive the same intervention as Group 2 (ie, the comprehensive feedback report) in addition to a tailored 30-min video consultation with an accredited practicing dietitian who will use the comprehensive feedback report to assist individuals in making positive dietary changes. The self-determination theory was used as the framework for selecting appropriate website features, including goal setting and self-monitoring. The primary outcome measure is change in diet quality. The completion of questionnaires at baseline and 3, 6, and 12 months will be incentivized with a monetary prize draw. Results: As of December 2019, 1277 participants have been randomized. Conclusions: The web-based delivery of nutrition interventions has the potential to improve dietary intake of young adults. However, the level of support required to improve intake is unknown

The Giant Lavas of Kalkarindji: rubbly pāhoehoe lava in an ancient continental flood basalt province

The Kalkarindji continental flood basalt province of northern Australia erupted in the mid Cambrian (c. 511-505 Ma). It now consists of scattered basaltic lava fields, the most extensive being the Antrim Plateau Volcanics (APV) - a semi-continuous outcrop (c. 50,000 km2) reaching a maximum thickness of 1.1 km. Cropping out predominately in the SW of the APV, close to the top of the basalt succession, lies the Blackfella Rockhole Member (BRM). Originally described as ‘basaltic agglomerate’ the BRM has, in recent years, been assumed to be explosive tephra of phreatomagmatic origin, thus providing a potent vehicle for volatile release to the upper atmosphere. Our detailed field investigations reveal that this basaltic agglomerate is, in reality, giant rubble collections (15 - 20 m thick) forming the upper crusts of rubbly pāhoehoe lava units 25 - 40 m thick; covering 18,000 - 72,000 km2 and an estimated volume of 1,500 - 19,200 km3. These flows, rheologically but not chemically, distinct from the majority of Kalkarindji lavas, indicate a fundamental change in eruption dynamics. A low volatile content, induced high amounts of pre-eruptive degassing causing super-cooling and an increase in crystal nucleation and viscosity. A more viscous lava and a consistently faster rate of effusion (analogous to that of Laki, Iceland) created the flow dynamics necessary to disturb the lava crust to the extent seen in the BRM. Volatile release is estimated at 1.65 x 104 - 2.11 x 105 Tg total CO2 at a rate of 867 Tg a- 1 and 9.07 x 103 - 1.16 x 105 Tg SO2 at 476.50 Tg a- 1. These masses accounted for 0.5% of Cambrian atmospheric conditions whilst limiting factors reduced the effect of volatile delivery to the atmosphere, thus any potential global impact caused by these flows alone was minimal

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials