On the construction of decentralised service-oriented orchestration systems

Modern science relies on workflow technology to capture, process, and analyse data obtained from scientific instruments. Scientific workflows are precise descriptions of experiments in which multiple computational tasks are coordinated based on the dataflows between them. Orchestrating scientific workflows presents a significant research challenge: they are typically executed in a manner such that all data pass through a centralised computer server known as the engine, which causes unnecessary network traffic that leads to a performance bottleneck. These workflows are commonly composed of services that perform computation over geographically distributed resources, and involve the management of dataflows between them. Centralised orchestration is clearly not a scalable approach for coordinating services dispersed across distant geographical locations. This thesis presents a scalable decentralised service-oriented orchestration system that relies on a high-level data coordination language for the specification and execution of workflows. This system’s architecture consists of distributed engines, each of which is responsible for executing part of the overall workflow. It exploits parallelism in the workflow by decomposing it into smaller sub-workflows, and determines the most appropriate engines to execute them using computation placement analysis. This permits the workflow logic to be distributed closer to the services providing the data for execution, which reduces the overall data transfer in the workflow and improves its execution time. This thesis provides an evaluation of the presented system which concludes that decentralised orchestration provides scalability benefits over centralised orchestration, and improves the overall performance of executing a service-oriented workflow

A Dataflow Language for Decentralised Orchestration of Web Service Workflows

Orchestrating centralised service-oriented workflows presents significant scalability challenges that include: the consumption of network bandwidth, degradation of performance, and single points of failure. This paper presents a high-level dataflow specification language that attempts to address these scalability challenges. This language provides simple abstractions for orchestrating large-scale web service workflows, and separates between the workflow logic and its execution. It is based on a data-driven model that permits parallelism to improve the workflow performance. We provide a decentralised architecture that allows the computation logic to be moved "closer" to services involved in the workflow. This is achieved through partitioning the workflow specification into smaller fragments that may be sent to remote orchestration services for execution. The orchestration services rely on proxies that exploit connectivity to services in the workflow. These proxies perform service invocations and compositions on behalf of the orchestration services, and carry out data collection, retrieval, and mediation tasks. The evaluation of our architecture implementation concludes that our decentralised approach reduces the execution time of workflows, and scales accordingly with the increasing size of data sets.Comment: To appear in Proceedings of the IEEE 2013 7th International Workshop on Scientific Workflows, in conjunction with IEEE SERVICES 201

Workflow Partitioning and Deployment on the Cloud using Orchestra

Orchestrating service-oriented workflows is typically based on a design model that routes both data and control through a single point - the centralised workflow engine. This causes scalability problems that include the unnecessary consumption of the network bandwidth, high latency in transmitting data between the services, and performance bottlenecks. These problems are highly prominent when orchestrating workflows that are composed from services dispersed across distant geographical locations. This paper presents a novel workflow partitioning approach, which attempts to improve the scalability of orchestrating large-scale workflows. It permits the workflow computation to be moved towards the services providing the data in order to garner optimal performance results. This is achieved by decomposing the workflow into smaller sub workflows for parallel execution, and determining the most appropriate network locations to which these sub workflows are transmitted and subsequently executed. This paper demonstrates the efficiency of our approach using a set of experimental workflows that are orchestrated over Amazon EC2 and across several geographic network regions.Comment: To appear in Proceedings of the IEEE/ACM 7th International Conference on Utility and Cloud Computing (UCC 2014

Unikernel support for the deployment of light-weight, self-contained, and latency avoiding services

We have explored dataflow orchestration approaches that permit distributed systems to be constructed by interconnecting services. In such systems latency is often a problem. For example, large data volumes might have to be communicated across the network if computation cannot be co-located close to data sources. Similarly, high latency may be experienced if computation is geographically situated far from (mobile) users. A solution to this problem is the ability to deploy services in appropriate geolocations and wire them together in order to create distributed ecosystems. Such services should ideally be run within a separate protection domain. Hence, we seek to be able to rapidly deploy services in appropriate network locations and dynamically enact and orchestrate them. Whilst it is safe to deploy units of code dynamically in remote locations using existing technologies, this task is hindered by the size of the deployment units. Current monolithic-based virtual appliances are very large, thus are potentially slow to deploy as they may need to be transmitted across a network. In order to create a platform on which such services may be based, we are investigating Unikernel approaches. Employing Unikernels permits the services to be treated as first class computational components that can be composed easily and deployed dynamically. Unikernels are compact library operating systems that enable a single application to be linked against the kernel and to be executed in a single-address-space environment. Due to the absence of a large set of software modules that commonly exist in Unix-like operating systems, Unikernels are relatively smaller in size and are potentially more stable and cost-efficient. This research project presents Stardust – a new specialised Unikernel for the dynamic composition of services. Stardust is designed to run on the Xen hypervisor and has a small codebase that can be maintained easily. Its codebase consists of the kernel which manages the underlying virtual hardware resources presented by the hypervisor. Moreover, Stardust supports modularity and can be customised by integrating software libraries as necessary to extend its functionality. Its kernel and software libraries are linked statically against a particular application or service to provide an immutable and single-purpose virtual appliance that can be deployed onto virtualisation environments. Stardust is designed to support high-level abstractions based on the Java programming language. It supports pre-emptive threading and includes a minimal set of programming libraries, which are required to execute a light-weight open-source Java virtual machine. Our principles led us to take the route of re-engineering the standard software stack to create self- contained applications that are less-bloated and consequently much smaller. This research aims to engineer networks of distributed systems whose collective behaviour achieve some high-level objectives. Such networks are characterised by the functionality that resonates from nodal interactions instead of the individual nodes that run the computations. This project seeks to introduce strongly-typed communication channels in Stardust as a uniform mechanism to support communication and synchronisation of heterogeneous distributed system components.PreprintPeer reviewe

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

An Architecture for Decentralised Orchestration of Web Service Workflows

Service-oriented workflows are typically executed using a centralised orchestration approach that presents significant scalability challenges. These challenges include the consumption of network bandwidth, degradation of performance, and single-points of failure. We provide a decentralised orchestration architecture that attempts to address these challenges. Our architecture adopts a design model that permits the computation to be moved "closer" to services in a workflow. This is achieved by partitioning workflows specified using our simple dataflow language into smaller fragments, which may be sent to remote locations for execution.Comment: To appear in Proceedings of the IEEE 20th International Conference on Web Services (ICWS 2013