MiCADO – Towards a Microservice-based Cloud Application-level Dynamic Orchestrator

In order to satisfy end-user requirements, many scientific and commercial applications require access to dynamically adjustable infrastructure resources. Cloud computing has the potential to provide these dynamic capabilities. However, utilising these capabilities from application code is not trivial and requires application developers to understand low-level technical details of clouds. This paper investigates how a generic framework can be developed that supports the dynamic orchestration of cloud applications both at deployment and at run-time. The advantages and challenges of designing such framework based on microservices is analysed, and a generic framework, called MiCADO – (Microservices-based Cloud Application-level Dynamic Orchestrator) is proposed. A first prototype implementation of MiCADO to support data intensive commercial web applications is also presented

Effect of phenylephrine vs. ephedrine on frontal lobe oxygenation during caesarean section with spinal anesthesia:an open label randomized controlled trial

Background: During caesarean section spinal anesthesia may provoke maternal hypotension that we prevent by administration of phenylephrine and/or ephedrine. Phenylephrine is however reported to reduce the near infrared spectroscopy-determined frontal lobe oxygenation (ScO(2)) but whether that is the case for patients exposed to spinal anesthesia is not known. Objectives: To evaluate the impact of phenylephrine vs. ephedrine on ScO(2)during caesarean section with spinal anesthesia in a single center, open-label parallel-group study with balanced randomization of 24 women (1:1). Secondary aims were to compare the effect of the two drugs on maternal hemodynamics and fetal heart rate. Intervention: Ephedrine (0.8–3.3 mg/min) vs. phenylephrine infusion (0.02–0.07 mg/min). Results: For the duration of surgery, administration of ephedrine maintained ScO(2) (compared to baseline +2.1 ± 2.8%; mean ± SE, while phenylephrine reduced ScO(2) (−8.6 ± 2.8%; p = 0.005) with a 10.7% difference in ScO(2)between groups (p = 0.0106). Also maternal heart rate was maintained with ephedrine (+3 ± 3 bpm) but decreased with phenylephrine (−11 ± 3 bpm); difference 14 bpm (p = 0.0053), but no significant difference in mean arterial pressure (p = 0.1904) or CO (p = 0.0683) was observed between groups. The two drugs also elicited an equal increase in fetal heart rate (by 19 ± 3 vs. 18 ± 3 bpm; p = 0.744). Conclusion: In the choice between phenylephrine and ephedrine for maintenance of blood pressure during caesarean section with spinal anesthesia, ephedrine maintains frontal lobe oxygenation and maternal heart rate with a similar increase in fetal heart rate as elicited by phenylephrine. Trial registration: Clinical trials NCT 01509521 and EudraCT 2001 006103 35