Hajautetun reaktiivisen ohjelmoinnin haasteet

Tiivistelmä. Hajautetun arkkitehtuurin ja reaktiiviseen ohjelmointiin yhdistäminen luo monenlaisia haasteita sovelluksen toiminnan tason takaamiselle. Eri komponenttien pitää pystyä esittämään jaettua tilaa yhtäpitävästi ja tiedon kulkua niiden välillä pitää pystyä koordinoimaan. Reaktiivisen arvojen topologisen päivitysjärjestyksen skaalautuminen hajautettuihin ympäristöihin on rajallista. Virheiden todennäköisyys kasvaa, kun komponenttien pitää kommunikoida verkon yli. Verkkohäiriöt voivat katkaista tai hidastaa kommunikaatiokanavia. Yksittäisten komponenttien joutuessa vikatilaan, pitäisi muiden osata reagoida siihen. Tämä tutkielma selvitti minkälaisia haasteita liittyy hajautettuun reaktiiviseen ohjelmointiin. Se tehtiin kirjallisuuskatsauksena, jonka tulosten pohjalta nämä keskeiset haasteet luokiteltiin kuuteen aihealueeseen. Nämä ovat tiedon toisintaminen, tapahtumaohjautuvuus, topologinen päivitysjärjestys, virheet, verkkohäiriöt ja osittaiset häiriöt

Is the unemployment inflation trade-off still alive in the Euro Area and its member countries? It seems so

The unemployment inflation trade-off can be interpreted as a proposition concerning the response of these two variables to aggregate demand shocks. In this paper we study the possible presence of the trade-off in the Euro Area and in a wide group of Euroarea countries in the last 20 years, i.e. since the start of EMU. We use the structural VAR methodology that allows the separation between supply and demand shocks. Our main finding is that the existence of a trade-off is largely confirmed both at the Euro Area and at the national level. Nevertheless, the size of the trade-off, measured at different horizons, shows some heterogeneity among countries. No less important, when we augment the VAR model by introducing monetary policy in the context of an open economy, we find that monetary policy shocks push inflation and unemployment in opposite directions in the Currency Area. Another interesting result concerns the evidence of a relatively flat relation between unemployment and inflation, conditionally to monetary policy shocks

Low incidence of severe bacterial infections in hospitalised patients with COVID-19 : A population-based registry study

Background Bacterial infections complicating COVID-19 are rare but present a challenging clinical entity. The aim of this study was to evaluate the incidence, aetiology and outcome of severe laboratory-verified bacterial infections in hospitalised patients with COVID-19. Methods All laboratory-confirmed patients with COVID-19 admitted to specialised healthcare hospitals in the Capital Province of Finland during the first wave of COVID-19 between 27 February and 21 June 2020 were retrospectively studied. We gathered the blood and respiratory tract culture reports of these patients and analysed their association with 90-day case-fatality using multivariable regression analysis. Results A severe bacterial infection was diagnosed in 40/585 (6.8%) patients with COVID-19. The range of bacteria was diverse, and the most common bacterial findings in respiratory samples were gram-negative, and in blood cultures gram-positive bacteria. Patients with severe bacterial infection had longer hospital stay (mean 31; SD 20 days) compared to patients without (mean 9; SD 9 days; p < 0.001). Case-fatality was higher with bacterial infection (15% vs 11%), but the difference was not statistically significant (OR 1.38 CI95% 0.56-3.41). Conclusions Severe bacterial infection complicating COVID-19 was a rare occurrence in our cohort. Our results are in line with the current understanding that antibiotic treatment for hospitalised COVID-19 patients should only be reserved for situations where a bacterial infection is strongly suspected. The ever-evolving landscape of the pandemic and recent advances in immunomodulatory treatment of COVID-19 patients underline the need for continuous vigilance concerning the possibility and frequency of nosocomial bacterial infections.Peer reviewe

Real-life clinical sensitivity of SARS-CoV-2 RT-PCR test in symptomatic patients

Background Understanding the false negative rates of SARS-CoV-2 RT-PCR testing is pivotal for the management of the COVID-19 pandemic and it has implications for patient management. Our aim was to determine the real-life clinical sensitivity of SARS-CoV-2 RT-PCR. Methods This population-based retrospective study was conducted in March-April 2020 in the Helsinki Capital Region, Finland. Adults who were clinically suspected of SARS-CoV-2 infection and underwent SARS-CoV-2 RT-PCR testing, with sufficient data in their medical records for grading of clinical suspicion were eligible. In addition to examining the first RT-PCR test of repeat-tested individuals, we also used high clinical suspicion for COVID-19 as the reference standard for calculating the sensitivity of SARS-CoV-2 RT-PCR. Results All 1,194 inpatients (mean [SD] age, 63.2 [18.3] years; 45.2% women) admitted to COVID-19 cohort wards during the study period were included. The outpatient cohort of 1,814 individuals (mean [SD] age, 45.4 [17.2] years; 69.1% women) was sampled from epidemiological line lists by systematic quasi-random sampling. The sensitivity (95% CI) for laboratory confirmed cases (repeat-tested patients) was 85.7% (81.5-89.1%) inpatients; 95.5% (92.2-97.5%) outpatients, 89.9% (88.2-92.1%) all. When also patients that were graded as high suspicion but never tested positive were included in the denominator, the sensitivity (95% CI) was: 67.5% (62.9-71.9%) inpatients; 34.9% (31.4-38.5%) outpatients; 47.3% (44.4-50.3%) all. Conclusions The clinical sensitivity of SARS-CoV-2 RT-PCR testing was only moderate at best. The relatively high false negative rates of SARS-CoV-2 RT-PCR testing need to be accounted for in clinical decision making, epidemiological interpretations, and when using RT-PCR as a reference for other tests.Peer reviewe