Autonomic Management of Large Clusters and Their Integration into the Grid

We present a framework for the co-ordinated, autonomic management of multiple clusters in a compute center and their integration into a Grid environment. Site autonomy and the automation of administrative tasks are prime aspects in this framework. The system behavior is continuously monitored in a steering cycle and appropriate actions are taken to resolve any problems. All presented components have been implemented in the course of the EU project DataGrid: The Lemon monitoring components, the FT fault-tolerance mechanism, the quattor system for software installation and configuration, the RMS job and resource management system, and the Gridification scheme that integrates clusters into the Grid

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

CAP ReD : Cerisier Abricotier Pruniers - Réduction des intrants et durabilité des systèmes de production

Ce numéro est constitué d’articles de synthèse des projets DEPHY EXPE publiés à l’occasion du Colloque National DEPHY EXPE, qui s’est déroulé le 28 mai 2019 à l'Assemblée Permanente des Chambres d'Agriculture (ParisNational audienceCAP ReD aims to design and evaluate cherry, apricot, Ente plum, Japanese-American plum and mirabelle plum orchards, so that the use of phytosanitary products is halved, while maintaining the technico-economic performance. System experiments, conducted by 9 partners at 10 sites from 2013 to 2018, combined many levers of action (genetics, physics, biotechnology, biology ...), and choices were made from planting the trees to the annual management of orchards. For example, 17 low-pesticide-input control systems (LPIC) were compared each year to 11 reference systems (IFP). These LPIC systems, excluding biocontrol, achieved an average reduction of 58% of IFT (5.1 / 12.2 in IFP). The goal of “zero herbicide cultivation” was achieved in the majority of systems, of which two levers proved their worth: mechanical weeding and the woven weed control ground cover. Marketable yield was lower with the LPIC systems (-19%) except in high density orchards. CAP ReD's LPIC systems also required more work time to produce one tonne of fruit. This loss of production and efficiency is not offset by an increase in the sales price in the LPIC systems, so the economic performance is lower. Thus, the costs of production with LPIC systems is on average 20% higher, i.e. + 0.15 € / kg. 47% of LPIC systems (8/17) are classified as Economical and Efficient Systems. These are either i) high-density systems with insect nets, rain covers, dose reduction with innovative spraying techniques, but with high depreciation costs; or ii) systems of which the fruit are intended for the processing industry with lower production costs (no waste, mechanical harvesting), using decision-support tools, biocontrols and reduction of certain treatments. These results show the technical feasibility of a considerable reduction of phytosanitary product use, decreasing the risks of impacts on the environment and human health, but also the economic difficulty that these changes of practice generate for the grower, without revaluating prices.CAP ReD vise à concevoir et évaluer des vergers de cerisier, abricotier, prunier d’Ente, prunier américano-japonais et mirabellier, permettant de réduire l’usage des produits phytosanitaires par deux, tout en conservant les performances technico-économiques. Les expérimentations systèmes, conduites par 9 partenaires dans 10 sites de 2013 à 2018, combinent de nombreux leviers d’action (génétique, physique, biotechnique, biologique…), depuis le choix à la plantation, jusqu’à la gestion annuelle des vergers. Ainsi, 17 systèmes économes en produits phytosanitaires (ECO) sont comparés chaque année à 11 systèmes de référence (PFI). Ces systèmes ECO ont permis une réduction moyenne de 58% des IFT hors biocontrôle (5.1 vs 12.2 en PFI). L’objectif « zéro herbicide » a été atteint dans la majorité des systèmes, deux leviers ont fait leur preuve : le désherbage mécanique et la bâche tissée au sol. Le rendement commercialisable est plus faible dans ECO (-19 %), sauf dans les systèmes à haute densité ou biaxe d’arbres. Les systèmes ECO de CAP ReD nécessitent aussi plus de temps de travail pour produire une tonne de fruits. Cette perte de production et d’efficience n’est pas compensée par une augmentation du prix de vente des fruits dans les systèmes ECO, aussi les performances économiques sont moindres. Ainsi, le coût de production des systèmes ECO est en moyenne supérieur de 20%, soit +0.15€/kg. 47% des systèmes ECO (n=8) sont classés Systèmes Economes et Performants (SCEP). Ce sont soit, i) des systèmes avec filets anti-insectes, bâche anti-pluie, réduction de dose avec pulvérisation innovante, conduits en haute densité ou biaxe, mais ayant de fortes charges d’amortissement ; soit ii) des systèmes valorisant leurs fruits en industrie, avec des coûts de production moindres (moins de déchet, récolte mécanique), utilisant des Outils d’Aide à la Décision, biocontrôles et impasses. Ces résultats montrent la faisabilité technique d’une forte réduction des produits phytosanitaires, diminuant les risques d’impacts sur l’environnement et la santé humaine, mais aussi la difficulté économique qu’engendrent ces changements de pratiques pour le producteur, sans revalorisation des prix

CAP ReD : Cerisier Abricotier Pruniers - Réduction des intrants et durabilité des systèmes de production

CAP ReD vise à concevoir et évaluer des vergers de cerisier, abricotier, prunier d’Ente, prunier américano-japonais et mirabellier, permettant de réduire l’usage des produits phytosanitaires par deux, tout en conservant les performances technico-économiques. Les expérimentations systèmes, conduites par 9 partenaires dans 10 sites de 2013 à 2018, combinent de nombreux leviers d’action (génétique, physique, biotechnique, biologique…), depuis le choix à la plantation, jusqu’à la gestion annuelle des vergers. Ainsi, 17 systèmes économes en produits phytosanitaires (ECO) sont comparés chaque année à 11 systèmes de référence (PFI). Ces systèmes ECO ont permis une réduction moyenne de 58% des IFT hors biocontrôle (5.1 vs 12.2 en PFI). L’objectif « zéro herbicide » a été atteint dans la majorité des systèmes, deux leviers ont fait leur preuve : le désherbage mécanique et la bâche tissée au sol. Le rendement commercialisable est plus faible dans ECO (-19 %), sauf dans les systèmes à haute densité ou biaxe d’arbres. Les systèmes ECO de CAP ReD nécessitent aussi plus de temps de travail pour produire une tonne de fruits. Cette perte de production et d’efficience n’est pas compensée par une augmentation du prix de vente des fruits dans les systèmes ECO, aussi les performances économiques sont moindres. Ainsi, le coût de production des systèmes ECO est en moyenne supérieur de 20%, soit +0.15€/kg. 47% des systèmes ECO (n=8) sont classés Systèmes Economes et Performants (SCEP). Ce sont soit, i) des systèmes avec filets anti-insectes, bâche anti-pluie, réduction de dose avec pulvérisation innovante, conduits en haute densité ou biaxe, mais ayant de fortes charges d’amortissement ; soit ii) des systèmes valorisant leurs fruits en industrie, avec des coûts de production moindres (moins de déchet, récolte mécanique), utilisant des Outils d’Aide à la Décision, biocontrôles et impasses. Ces résultats montrent la faisabilité technique d’une forte réduction des produits phytosanitaires, diminuant les risques d’impacts sur l’environnement et la santé humaine, mais aussi la difficulté économique qu’engendrent ces changements de pratiques pour le producteur, sans revalorisation des prix.CAP ReD aims to design and evaluate cherry, apricot, Ente plum, Japanese-American plum and mirabelle plum orchards, so that the use of phytosanitary products is halved, while maintaining the technico-economic performance. System experiments, conducted by 9 partners at 10 sites from 2013 to 2018, combined many levers of action (genetics, physics, biotechnology, biology ...), and choices were made from planting the trees to the annual management of orchards. For example, 17 low-pesticide-input control systems (LPIC) were compared each year to 11 reference systems (IFP). These LPIC systems, excluding biocontrol, achieved an average reduction of 58% of IFT (5.1 / 12.2 in IFP). The goal of “zero herbicide cultivation” was achieved in the majority of systems, of which two levers proved their worth: mechanical weeding and the woven weed control ground cover. Marketable yield was lower with the LPIC systems (-19%) except in high density orchards. CAP ReD's LPIC systems also required more work time to produce one tonne of fruit. This loss of production and efficiency is not offset by an increase in the sales price in the LPIC systems, so the economic performance is lower. Thus, the costs of production with LPIC systems is on average 20% higher, i.e. + 0.15 € / kg. 47% of LPIC systems (8/17) are classified as Economical and Efficient Systems. These are either i) high-density systems with insect nets, rain covers, dose reduction with innovative spraying techniques, but with high depreciation costs; or ii) systems of which the fruit are intended for the processing industry with lower production costs (no waste, mechanical harvesting), using decision-support tools, biocontrols and reduction of certain treatments. These results show the technical feasibility of a considerable reduction of phytosanitary product use, decreasing the risks of impacts on the environment and human health, but also the economic difficulty that these changes of practice generate for the grower, without revaluating prices