Proactive-Reactive Global Scaling, with Analytics

International audienceIn this work, we focus on by-design global scaling, a technique that, given a functional specification of a microservice architecture, or-chestrates the scaling of all its components, avoiding cascading slowdowns typical of uncoordinated, mainstream autoscaling. State-of-the-art by-design global scaling adopts a reactive approach to traffic fluctuations, undergoing inefficiencies due to the reaction overhead. Here, we tacklethis problem by proposing a proactive version of by-design global scaling able to anticipate future scaling actions. We provide four contributionsin this direction: i) a platform able to host both reactive and proactive global scaling; ii) a proactive implementation based on data analytics; iii)a hybrid solution that mixes reactive and proactive scaling; iv) use cases and empirical benchmarks, obtained through our platform, that comparereactive, proactive, and hybrid global scaling performance. From our comparison, proactive global scaling consistently outperforms reactive,while the hybrid solution is the best-performing one

Laparoscopic anterior gastropexy for chronic recurrent gastric volvulus: a case report

<p>Abstract</p> <p>Introduction</p> <p>Gastric volvulus is an uncommon clinical entity, first described by Berti in 1866. It is a rotation of all or part of the stomach through more than 180°. This rotation can occur on the longitudinal (organo-axial) or transverse (mesentero-axial) axis. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report the case of a patient with chronic intermittent gastric volvulus who underwent a successful laparoscopic treatment.</p> <p>Case presentation</p> <p>A 34-year-old woman presented with multiple episodes of recurrent upper abdominal pain associated with retching and vomiting, treated unsuccessfully with intramuscular metoclopramide. Endoscopic examination of the upper digestive tract showed a suspected rotation of the stomach, and a chronic recurrent gastric volvulus was revealed by barium meal. The patient was operated on successfully, with an anterior laparoscopic gastropexy performed as the first surgical approach.</p> <p>Conclusion</p> <p>Experience with laparoscopic anterior gastropexy is limited only to a few described cases. Our patient was clinically and radiologically followed-up for 2 years with no evidence of recurrence, either radiological or symptomatic. Based on this result, laparoscopic gastropexy can be seen and considered as an initial 'gold standard' for the treatment of gastric volvulus.</p

Upper gastrointestinal massive bleeding successfully treated intra-operatively with a collagen and thrombin-based high-viscosity gel for haemostasis. Case report

Un paziente di 57 anni è stato ricoverato nel nostro reparto per massiva emorragia digestiva superiore non da varici esofagee. In accordo con le linee guida, il paziente è stato sottoposto ad esame endoscopico precoce (entro 24 ore dall’ingresso), che ha mostrato la fonte del sanguinamento a livello della seconda porzione duodenale. Durante l’endoscopia è stata praticata un’iniezione emostatica con soluzione adrenalinica (epinefrina 1:10.000). A distanza di 8 ore una severa recidiva emorragica con riduzione dei livelli di emoglobina ci ha indotto al trattamento chirurgico d’urgenza. Intraoperativamente è stata portata a termine una gastroresezione seguita dall’applicazione di gel emostatico ad alta viscosità (Floseal®) nella sede dell’emorragia, all’interno del lume duodenale. Questa tecnica ha permesso di ottenere un’emostasi definitiva senza complicazioni a lungo termine. La nostra esperienza suggerisce che l’applicazione intraoperatoria di Floseal® può essere un’alternativa efficace alle tecniche emostatiche tradizionali nel trattamento chirurgico d’urgenza dell’emorragie digestive superiori. Ciò consente di ottenere una più rapida stabilizzazione emodinamica dando la possibilità di eseguire ulteriori tecniche emostatiche

Low-Latency Anomaly Detection on the Edge-Cloud Continuum for Industry 4.0 Applications: the SEAWALL Case Study

International audienc

SEAWALL: Seamless Low Latency Cloud Platforms for the Industry 4.0

International audienceThe paper presents the SEAWALL platform enabling heterogeneous data acquisition and low-latency processing for the Industry 4.0, developed within the homonymous project founded by the Italian BIREX industrial consortium. The architecture features cutting-edge technologies (such as Kubernetes, ISTIO, KubeEdge, W3C WoT), in order to support the seamless orchestration of workloads among the nodes of a cloud-edge continuum in QoS-aware scenarios where the latency requirement of the anomaly detection must be continuously assessed. The paper presents the industrial use-case from the SEAWALL project and the components of the cloud/edge architecture

Synchronous colorectal neoplasias: our experience about laparoscopic-TEM combined treatment

Abstract Synchronous colorectal neoplasias are defined as 2 or more primary tumors identified in the same patient and at the same time. The most voluminous synchronous cancer is called "first primitive" or "index" cancer. The aim of this work is to describe our experience of minimally invasive approach in patients with synchronous colorectal neoplasias. Since January 2001 till December 2009, 557 patients underwent colectomy for colorectal cancer at the Department of General and Emergency Surgery of the University of Perugia; 128 were right colon cancers, 195 were left colon cancers while 234 patients were affected by rectal cancers. We performed 224 laparoscopic colectomies (112 right, 67 left colectomies and 45 anterior resections of rectum), 91 Transanal Endoscopic Microsurgical Excisions (TEM) and 53 Trans Anal Excisions (TAE). In the same observation period 6 patients, 4 males and 2 females, were diagnosed with synchronous colorectal neoplasias. Minimal invasive treatment of colorectal cancer offers the opportunity to treat two different neoplastic lesions at the same time, with a shorter post-operative hospitalization and minor complications. According to our experience, laparoscopy and TEM may ease the treatment of synchronous diseases with a lower morbidity rate.</p