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The performance and scalability of modern data-intensive systems are limited by massive data movement of growing datasets across the whole memory hierarchy to the CPUs. Such traditional processor-centric DBMS architectures are bandwidth- and latency-bound. Processing-in-Memory (PIM) designs seek to overcome these limitations by integrating memory and processing functionality on the same chip. PIM targets near- or in-memory data processing, leveraging the greater in-situ parallelism and bandwidth.
In this paper, we introduce pimDB and provide an initial comparison of processor-centric and PIM-DBMS approaches under different aspects, such as scalability and parallelism, cache-awareness, or PIM-specific compute/bandwidth tradeoffs. The evaluation is performed end-to-end on a real PIM hardware system from UPMEM.
Even though near-data processing (NDP) can provably reduce data transfers and increase performance, current NDP is solely utilized in read-only settings. Slow or tedious to implement synchronization and invalidation mechanisms between host and smart storage make NDP support for data-intensive update operations difficult. In this paper, we introduce a low-latency cache-coherent shared lock table for update NDP settings in disaggregated memory environments. It utilizes the novel CCIX interconnect technology and is integrated in neoDBMS, a near-data processing DBMS for smart storage. Our evaluation indicates end-to-end lock latencies of ∼80-100ns and robust performance under contention.
Multi-versioning and MVCC are the foundations of many modern DBMSs. Under mixed workloads and large datasets, the creation of the transactional snapshot can become very expensive, as long-running analytical transactions may request old versions, residing on cold storage, for reasons of transactional consistency. Furthermore, analytical queries operate on cold data, stored on slow persistent storage. Due to the poor data locality, snapshot creation may cause massive data transfers and thus lower performance. Given the current trend towards computational storage and near-data processing, it has become viable to perform such operations in-storage to reduce data transfers and improve scalability. neoDBMS is a DBMS designed for near-data processing and computational storage. In this paper, we demonstrate how neoDBMS performs snapshot computation in-situ. We showcase different interactive scenarios, where neoDBMS outperforms PostgreSQL 12 by up to 5×.
This work is a report on practical experiences with the issue of interoperability in German practice management systems (PMSs) from an ongoing clinical trial on teledermatology, the TeleDerm project. A proprietary and established web-platform for store-and-forward telemedicine is integrated with the IT in the GPs’ offices for automatic exchange of basic patient data. Most of the 19 different PMSs included in the study sample lack support of modern health data exchange standards, therefore the relatively old but widely available German health data exchange interface “Gerätedatentransfer” (GDT) is used. Due to the lack of enforcement and regulation of the GDT standard, several obstacles to interoperability are encountered. As a partial, but reusable working solution to cope with these issues, we present a custom middleware which is used in conjunction with GDT. We describe the design, technical implementation and observed hindrances with the existing infrastructure. A discussion on health care interfacing standards and the current state of interoperability in German PMS software is given.
We introduce IPA-IDX – an approach to handle index modifications modern storage technologies (NVM, Flash) as physical in-place appends, using simplified physiological log records. IPA-IDX provides similar performance and longevity advantages for indexes as basic IPA [5] does for tables. The selective application of IPA-IDX and basic IPA to certain regions and objects, lowers the GC overhead by over 60%, while keeping the total space overhead to 2%. The combined effect of IPA and IPA-IDX increases performance by 28%.
Many modern DBMS architectures require transferring data from storage to process it afterwards. Given the continuously increasing amounts of data, data transfers quickly become a scalability limiting factor. Near-Data Processing and smart/computational storage emerge as promising trends allowing for decoupled in-situ operation execution, data transfer reduction and better bandwidth utilization. However, not every operation is suitable for an in-situ execution and a careful placement and optimization is needed.
In this paper we present an NDP-aware cost model. It has been implemented in MySQL and evaluated with nKV. We make several observations underscoring the need for optimization.
Background: Internationally, teledermatology has proven to be a viable alternative to conventional physical referrals. Travel cost and referral times are reduced while patient safety is preserved. Especially patients from rural areas benefit from this healthcare innovation. Despite these established facts and positive experiences from EU neighboring countries like the Netherlands or the United Kingdom, Germany has not yet implemented store-and-forward teledermatology in routine care.
Methods: The TeleDerm study will implement and evaluate store-and-forward teledermatology in 50 general practitioner (GP) practices as an alternative to conventional referrals. TeleDerm aims to confirm that the possibility of store-and-forward teledermatology in GP practices is going to lead to a 15% (n = 260) reduction in referrals in the intervention arm. The study uses a cluster-randomized controlled trial design. Randomization is planned for the cluster “county”. The main observational unit is the GP practice. Poisson distribution of referrals is assumed. The evaluation of secondary outcomes like acceptance, enablers and barriers uses a mixed methods design with questionnaires and interviews.
Discussion: Due to the heterogeneity of GP practice organization, patient management software, information technology service providers, GP personal technical affinity and training, we expect several challenges in implementing teledermatology in German GP routine care. Therefore, we plan to recruit 30% more GPs than required by the power calculation. The implementation design and accompanying evaluation is expected to deliver vital insights into the specifics of implementing telemedicine in German routine care.
Background
Although teledermatology has been proven internationally to be an effective and safe addition to the care of patients in primary care, there are few pilot projects implementing teledermatology in routine outpatient care in Germany. The aim of this cluster randomized controlled trial was to evaluate whether referrals to dermatologists are reduced by implementing a store-and-forward teleconsultation system in general practitioner practices.
Methods
Eight counties were cluster randomized to the intervention and control conditions. During the 1-year intervention period between July 2018 and June 2019, 46 general practitioner practices in the 4 intervention counties implemented a store-and-forward teledermatology system with Patient Data Management System interoperability. It allowed practice teams to initiate teleconsultations for patients with dermatologic complaints. In the four control counties, treatment as usual was performed. As primary outcome, number of referrals was calculated from routine health care data. Poisson regression was used to compare referral rates between the intervention practices and 342 control practices.
Results
The primary analysis revealed no significant difference in referral rates (relative risk = 1.02; 95% confidence interval = 0.911–1.141; p = .74). Secondary analyses accounting for sociodemographic and practice characteristics but omitting county pairing resulted in significant differences of referral rates between intervention practices and control practices. Matched county pair, general practitioner age, patient age, and patient sex distribution in the practices were significantly related to referral rates.
Conclusions
While a store-and-forward teleconsultation system was successfully implemented in the German primary health care setting, the intervention's effect was superimposed by regional factors. Such regional factors should be considered in future teledermatology research.
In the present tutorial we perform a cross-cut analysis of database storage management from the perspective of modern storage technologies. We argue that neither the design of modern DBMS, nor the architecture of modern storage technologies are aligned with each other. Moreover, the majority of the systems rely on a complex multi-layer and compatibility oriented storage stack. The result is needlessly suboptimal DBMS performance, inefficient utilization, or significant write amplification due to outdated abstractions and interfaces. In the present tutorial we focus on the concept of native storage, which is storage operated without intermediate abstraction layers over an open native storage interface and is directly controlled by the DBMS.
A transaction is a demarcated sequence of application operations, for which the following properties are guaranteed by the underlying transaction processing system (TPS): atomicity, consistency, isolation, and durability (ACID). Transactions are therefore a general abstraction, provided by TPS that simplifies application development by relieving transactional applications from the burden of concurrency and failure handling. Apart from the ACID properties, a TPS must guarantee high and robust performance (high transactional throughput and low response times), high reliability (no data loss, ability to recover last consistent state, fault tolerance), and high availability (infrequent outages, short recovery times).
The architectures and workhorse algorithms of a high-performance TPS are built around the properties of the underlying hardware. The introduction of nonvolatile memories (NVM) as novel storage technology opens an entire new problem space, with the need to revise aspects such as the virtual memory hierarchy, storage management and data placement, access paths, and indexing. NVM are also referred to as storage-class memory (SCM).