The readying of applications for heterogeneous computing

High performance computing is approaching a potentially significant change in architectural design. With pressures on the cost and sheer amount of power, additional architectural features are emerging which require a re-think to the programming models deployed over the last two decades. Today's emerging high performance computing (HPC) systems are maximising performance per unit of power consumed resulting in the constituent parts of the system to be made up of a range of different specialised building blocks, each with their own purpose. This heterogeneity is not just limited to the hardware components but also in the mechanisms that exploit the hardware components. These multiple levels of parallelism, instruction sets and memory hierarchies, result in truly heterogeneous computing in all aspects of the global system. These emerging architectural solutions will require the software to exploit tremendous amounts of on-node parallelism and indeed programming models to address this are emerging. In theory, the application developer can design new software using these models to exploit emerging low power architectures. However, in practice, real industrial scale applications last the lifetimes of many architectural generations and therefore require a migration path to these next generation supercomputing platforms. Identifying that migration path is non-trivial: With applications spanning many decades, consisting of many millions of lines of code and multiple scientific algorithms, any changes to the programming model will be extensive and invasive and may turn out to be the incorrect model for the application in question. This makes exploration of these emerging architectures and programming models using the applications themselves problematic. Additionally, the source code of many industrial applications is not available either due to commercial or security sensitivity constraints. This thesis highlights this problem by assessing current and emerging hard- ware with an industrial strength code, and demonstrating those issues described. In turn it looks at the methodology of using proxy applications in place of real industry applications, to assess their suitability on the next generation of low power HPC offerings. It shows there are significant benefits to be realised in using proxy applications, in that fundamental issues inhibiting exploration of a particular architecture are easier to identify and hence address. Evaluations of the maturity and performance portability are explored for a number of alternative programming methodologies, on a number of architectures and highlighting the broader adoption of these proxy applications, both within the authors own organisation, and across the industry as a whole

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

Replicating HPC I/O workloads with proxy applications

Large scale simulation performance is dependent on a number of components, however the task of investigation and optimization has long favored computational and communication elements above I/O. Manually extracting the pattern of I/O behavior from a parent application is a useful way of working to address performance issues on a per-application basis, but developing workflows with some degree of automation and flexibility provides a more powerful approach to tackling current and future I/O challenges. In this paper we describe a workload replication workflow that extracts the I/O pattern of an application and recreates its behavior with a flexible proxy application. We demonstrate how simple lightweight characterization can be translated to provide an effective representation of a physics application, and show how a proxy replication can be used as a tool for investigating I/O library paradigms

Rationale and design for SHAREHD: a quality improvement collaborative to scale up Shared Haemodialysis Care for patients on centre based haemodialysis.

BACKGROUND: The study objective is to assess the effectiveness and economic impact of a structured programme to support patient involvement in centre-based haemodialysis and to understand what works for whom in what circumstances and why. It implements a program of Shared Haemodialysis Care (SHC) that aims to improve experience and outcomes for those who are treated with centre-based haemodialysis, and give more patients the confidence to dialyse independently both at centres and at home. METHODS/DESIGN: The 24 month mixed methods cohort evaluation of 600 prevalent centre based HD patients is nested within a 30 month quality improvement program that aims to scale up SHC at 12 dialysis centres across England. SHC describes an intervention where patients who receive centre-based haemodialysis are given the opportunity to learn, engage with and undertake tasks associated with their treatment. Following a 6-month set up period, a phased implementation programme is initiated across 12 dialysis units using a randomised stepped wedge design with 6 centres participating in each of 2 steps, each lasting 6 months. The intervention utilises quality improvement methodologies involving rapid tests of change to determine the most appropriate mechanisms for implementation in the context of a learning collaborative. Running parallel with the stepped wedge intervention is a mixed methods cohort evaluation that employs patient questionnaires and interviews, and will link with routinely collected data at the end of the study period. The primary outcome measure is the number of patients performing at least 5 dialysis-related tasks collected using 3 monthly questionnaires. Secondary outcomes measures include: the number of people choosing to perform home haemodialysis or dialyse independently in-centre by the end of the study period; end-user recommendation; home dialysis establishment delay; staff impact and confidence; hospitalisation; infection and health economics. DISCUSSION: The results from this study will provide evidence of impact of SHC, barriers to patient and centre level adoption and inform development of future interventions to support its implementation. TRIAL REGISTRATION: ISRCTN Number: 93999549 , (retrospectively registered 1st May 2017); NIHR Research Portfolio: 31566

Genetic mechanisms of critical illness in COVID-19.

Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 ×  10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice

Assessment, endoscopy, and treatment in patients with acute severe ulcerative colitis during the COVID-19 pandemic (PROTECT-ASUC): a multicentre, observational, case-control study

BackgroundThere is a paucity of evidence to support safe and effective management of patients with acute severe ulcerative colitis during the COVID-19 pandemic. We sought to identify alterations to established conventional evidence-based management of acute severe ulcerative colitis during the early COVID-19 pandemic, the effect on outcomes, and any associations with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe COVID-19 outcomes. MethodsThe PROTECT-ASUC study was a multicentre, observational, case-control study in 60 acute secondary care hospitals throughout the UK. We included adults (≥18 years) with either ulcerative colitis or inflammatory bowel disease unclassified, who presented with acute severe ulcerative colitis and fulfilled the Truelove and Witts criteria. Cases and controls were identified as either admitted or managed in emergency ambulatory care settings between March 1, 2020, and June 30, 2020 (COVID-19 pandemic period cohort), or between Jan 1, 2019, and June 30, 2019 (historical control cohort), respectively. The primary outcome was the proportion of patients with acute severe ulcerative colitis receiving rescue therapy (including primary induction) or colectomy. The study is registered with ClinicalTrials.gov, NCT04411784. FindingsWe included 782 patients (398 in the pandemic period cohort and 384 in the historical control cohort) who met the Truelove and Witts criteria for acute severe ulcerative colitis. The proportion of patients receiving rescue therapy (including primary induction) or surgery was higher during the pandemic period than in the historical period (217 [55%] of 393 patients vs 159 [42%] of 380 patients; p=0·00024) and the time to rescue therapy was shorter in the pandemic cohort than in the historical cohort (p=0·0026). This difference was driven by a greater use of rescue and primary induction therapies with biologicals, ciclosporin, or tofacitinib in the COVID-19 pandemic period cohort than in the historical control period cohort (177 [46%] of 387 patients in the COVID-19 cohort vs 134 [36%] of 373 patients in the historical cohort; p=0·0064). During the pandemic, more patients received ambulatory (outpatient) intravenous steroids (51 [13%] of 385 patients vs 19 [5%] of 360 patients; p=0·00023). Fewer patients received thiopurines (29 [7%] of 398 patients vs 46 [12%] of 384; p=0·029) and 5-aminosalicylic acids (67 [17%] of 398 patients vs 98 [26%] of 384; p=0·0037) during the pandemic than in the historical control period. Colectomy rates were similar between the pandemic and historical control groups (64 [16%] of 389 vs 50 [13%] of 375; p=0·26); however, laparoscopic surgery was less frequently performed during the pandemic period (34 [53%] of 64] vs 38 [76%] of 50; p=0·018). Five (2%) of 253 patients tested positive for SARS-CoV-2 during hospital treatment. Two (2%) of 103 patients re-tested for SARS-CoV-2 during the 3-month follow-up were positive 5 days and 12 days, respectively, after discharge from index admission. Both recovered without serious outcomes. InterpretationThe COVID-19 pandemic altered practice patterns of gastroenterologists and colorectal surgeons in the management of acute severe ulcerative colitis but was associated with similar outcomes to a historical cohort. Despite continued use of high-dose corticosteroids and biologicals, the incidence of COVID-19 within 3 months was low and not associated with adverse COVID-19 outcomes