Reusable generic software robot

Abstract. The main purpose of this thesis was to create a generic reusable software robot which can be deployed into any IaaS type of a cloud service. In this thesis the first thing to be researched was how to implement a virtualised environment into a cloud service. The possibilities for virtualising the environment were a container and a virtual machine. The two possible implementations were researched since the resulting implementation must be compatible with a cloud service. Firstly, it was found that a container-based implementation would be the best option because it is lightweight to move around and secondly, a start-up time of a new instance in a cloud service is fast. Possible cloud providers were scanned after researching possible implementation methods. Two possible cloud providers, AWS and Azure, were studied more closely since they offer an infrastructure as a service and once they are commonly used. AWS was chosen to be the platform to be used because of a higher maturity level and also because of the possibility to add or remove container capabilities. Finally, it was discussed how a generic reusable software robot was implemented. Notable circumstances of suitable tasks for a software robot were considered.Kertakäyttöinen geneerinen ohjelmistorobotti. Tiivistelmä. Tässä työssä tutkittiin, kuinka geneerinen kertakäyttöinen ohjelmistorobotti voidaan toteuttaa pilvipalvelussa. Ensin tarkasteltiin erilaisia virtualisointimenetelmiä, joilla ohjelmistorobotti voitaisiin toteuttaa. Tutkitut menetelmät olivat virtuaalikone ja kontti. Näitä kahta toteutustapaa vertailtiin huomioiden valmiin toteutuksen sopivuus pilvipalveluun. Kontti todettiin sopivimmaksi toteutustavaksi, koska se vie vähän tilaa ja uuden instanssin käynnistäminen on nopeaa. Pilvipalvelutarjoajia tutkittiin, kun sopiva toteutusmenetelmä ohjelmistorobotille oli löydetty. Tutkimuksessa keskityttiin AWS:ään ja Azureen, jotka ovat tällä hetkellä suurimpia markkinoilla toimivia infrastructure as a service -tyyppisten pilvipalveuiden tarjoajia. AWS valittiin toteutusalustaksi, koska se on teknisesti edistyneempi kuin Azure ja AWS:ssä on mahdollista lisätä ja poistaa kontin oikeuksia. Lopuksi esiteltiin, kuinka geneerinen kertakäyttöinen ohjelmistorobotti toteutettiin ja mitä täytyy ottaa huomioon, kun päätetään sopivasta käyttökohteesta ohjelmistorobotille

Characteristics associated with initiation of hormone replacement therapy among Finnish women : A register-linkage study

Objective: To investigate which patient characteristics are associated with the initiation of hormone replacement therapy (HRT) in a cohort of Finnish women. Study design: Responses to postal questionnaires distributed to a nationwide, randomly selected cohort of women in 1998, 2000, 2003, 2005 and 2010 were analyzed. The cohort members were aged 40-44 years at the beginning of the study. Information on hormone replacement therapy was received from the national prescription register. Women who started taking HRT between January 1, 1999 and December 31, 2011 were included and previous users were excluded from the analysis. Main outcome measures: Initiation of HRT was the main outcome measure. The following explanatory factors for predicting the use of HRT were examined: sociodemographic factors, personality, health behavior, physiological and mental symptoms, chronic diseases and use of psychopharmaceuticals. The associations between starting HRT and the explanatory factors were analyzed with single-predictor and multi-predictor logistic regression models. Results: Factors predicting that a woman would start taking HRT were: living with a partner, weak sense of coherence, BMI less than 30 kg/m(2), heavy or moderate alcohol use, symptoms of hyperactivity of the sympathetic nervous system, climacteric symptoms and use of psychopharmaceuticals. Conclusions: Women with a good sense of coherence can cope with climacteric symptoms without resorting to HRT. Clinicians need to bear in mind the burden of menopausal symptoms on a woman's personal and working life when HRT is being considered. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Peer reviewe

A decade of geriatric traumatic brain injuries in Finland: population-based trends

acceptedVersionPeer reviewe

Mortality After Trauma Craniotomy Is Decreasing in Older Adults - A Nationwide Population-Based Study

OBJECTIVE: No evidence-based guidelines are available for operative neurosurgical treatment of older patients with traumatic brain injuries (TBIs), and no population-based results of current practice have been reported. The objective of the present study was to investigate the rates of trauma craniotomy operations and later mortality in older adults with TBI in Finland.METHODS: Nationwide databases were searched for all admissions with a TBI diagnosis and after trauma craniotomy, and later deaths for persons aged >= 60 years from 2004 to 2018.RESULTS: The study period included 2166 patients (64% men; mean age, 70.3 years) who had undergone TBI-related craniotomy. The incidence rate of operations decreased with a concomitant decrease in adjusted mortality (30-day mortality, P CONCLUSIONS: Among older adults in Finland, the rate of trauma craniotomy and later mortality has been decreasing although the mean age of operated patients has been increasing. This can be expected to be related to an improved understanding of geriatric TBIs and, consequently, improved selection of patients for targeted therapy.</p

Interferon-gamma and IL-5 associated cell-mediated immune responses to HPV16 E2 and E6 distinguish between persistent oral HPV16 infections and noninfected mucosa

Objectives: Natural history of human papillomavirus (HPV) infection in the head and neck region is poorly understood, and their impact on collective HPV-specific immunity is not known. Materials and methods: In this study, we have performed a systematic analysis of HPV16-specific cell-mediated immunity (CMI) in 21 women with known oral and genital HPV DNA status and HPV serology (Ab) based on 6-year follow-up data. These women being a subgroup from the Finnish Family HPV Study were recalled for blood sampling to be tested for their CMI-responses to HPV16 E2, E6, and E7 peptides. Results: The results showed that HPV16 E2-specific lymphocyte proliferation was more prevalent in women who tested HPV16 DNA negative in oral mucosa and were either HPV16 seropositive or negative than in HPV16 DNA+/Ab+ women (p = 0.046 and p = 0.035). In addition, the HPV16 DNA-/Ab- women most often displayed E6-specific proliferation (p = 0.020). Proportional cytokine profiles indicated that oral HPV16-negative women were characterized by prominent IFN-gamma and IL-5 secretion not found in women with persisting oral HPV16 (p = 0.014 and p = 0.040, respectively). Conclusions: Our results indicate that the naturally arising immune response induced by oral HPV infections displays a mixed Th1/Th2/Th17 cytokine profile while women with persisting oral HPV16 might have an impaired HPV16-specific CMI, shifted partly toward a Th2 profile, similarly as seen earlier among patients with high-grade genital HPV lesions. Thus, the lack of HPV 16 E2 and E6 specific T memory cells and Th2 cytokines might also predispose women for persistent oral HPV16 infection which might be related to the risk of cancer.Peer reviewe

Changing epidemiology of traumatic brain injury among the working-aged in Finland : Admissions and neurosurgical operations

Background: Recent studies from Finland have highlighted an increase in the incidence of traumatic brain injuries (TBI) in older age groups and high overall mortality. We performed a comprehensive study on the changing epidemiology of TBI focusing on the acute events in the Finnish working-age population. Methods: Nationwide databases were searched for all emergency ward admissions with a TBI diagnosis for persons of 16–69 years of age during 2004–2018. Results: In the Finnish working-age population, there were 52,487,099 person-years, 38,810 TBI-related hospital admissions, 4664 acute neurosurgical operations (ANO), and 2247 cases of in-hospital mortality (IHM). The TBI-related hospital admission incidence was 94/100,000 person-years in men, 44/100,000 in women, and 69/100,000 overall. The incidence rate of admissions increased in women, while in men and overall, the rate decreased. The incidence rate increased in the group of 60–69 years in both genders. Lowest incidence rates were observed in the age group of 30–39 years. Occurrence risk for TBI admission was higher in men in all age groups. Trends of ANOs decreased overall, while decompressive craniectomy was the only operation type in which a rise in incidence was found. Evacuation of acute subdural hematoma was the most common ANO. Mean length of stay and IHM rate halved during the study years. Conclusions: In Finland, the epidemiology of acute working-aged TBI has significantly changed. The rates of admission incidences, ANOs, and IHM nowadays represent the lower end of the range of these acute events reported in the western world.acceptedVersionPeer reviewe

Early-life formula feeding is associated with infant gut microbiota alterations and an increased antibiotic resistance load

Background Infants are at a high risk of acquiring fatal infections, and their treatment relies on functioning antibiotics. Antibiotic resistance genes (ARGs) are present in high numbers in antibiotic-naive infants' gut microbiomes, and infant mortality caused by resistant infections is high. The role of antibiotics in shaping the infant resistome has been studied, but there is limited knowledge on other factors that affect the antibiotic resistance burden of the infant gut. Objectives Our objectives were to determine the impact of early exposure to formula on the ARG load in neonates and infants born either preterm or full term. Our hypotheses were that diet causes a selective pressure that influences the microbial community of the infant gut, and formula exposure would increase the abundance of taxa that carry ARGs. Methods Cross-sectionally sampled gut metagenomes of 46 neonates were used to build a generalized linear model to determine the impact of diet on ARG loads in neonates. The model was cross-validated using neonate metagenomes gathered from public databases using our custom statistical pipeline for cross-validation. Results Formula-fed neonates had higher relative abundances of opportunistic pathogens such as Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumoniae, Klebsiella oxytoca, and Clostridioides difficile. The relative abundance of ARGs carried by gut bacteria was 69% higher in the formula-receiving group (fold change, 1.69; 95% CI: 1.12-2.55; P = 0.013; n = 180) compared to exclusively human milk-fed infants. The formula-fed infants also had significantly less typical infant bacteria, such as Bifidobacteria, that have potential health benefits. Conclusions The novel finding that formula exposure is correlated with a higher neonatal ARG burden lays the foundation that clinicians should consider feeding mode in addition to antibiotic use during the first months of life to minimize the proliferation of antibiotic-resistant gut bacteria in infants.Peer reviewe

High-Risk Periods for Adult Traumatic Brain Injuries : A Nationwide Population-Based Study

Introduction: There is minimal existing available information on nationwide seasonal peaks in traumatic brain injuries (TBIs). This lack of information is an impediment to the effective development of prevention programs, societal policies, and hinders the resourcing of medical emergency services. Our current aim is to study nationwide population-based high-risk periods TBI over a 15-year study period in Finland. Methods: Nationwide databases were searched for all admissions with a TBI diagnosis and later for deaths of persons ≥16 years of age during 2004-2018. The search included all hospitals that provide acute TBI care in Finland. Results: The study period included 69,231 TBI-related hospital admissions (men = 62%). We found that for men, the highest rate of TBIs occurred on Saturdays, whereas women experience the highest rate of TBIs on Mondays. The highest rate of TBIs in men occurred in July, while women experienced the highest rate of TBIs in January. TBI-related hospital admissions (incidence risk ratio [IRR] 1.090, 95% CI 1.07-1.11, p < 0.0001) and mortality within 30 days after TBI (hazard ratio [HR] 1.057, 95% CI 1.001-1.116, p = 0.0455) were more common on public holidays and weekends than on weekdays. There was an increasing trend in the proportion of TBI-related hospital admissions occurring on public holidays and weekends from 2004 (31.5%) to 2018 (33.4%) (p = 0.0007). In summer months, TBI-related hospital admissions (IRR 1.10, 95% CI 1.08-1.12, p < 0.0001) and 30-day mortality (HR 1.069, 95% CI 1.010-1.131, p = 0.0211) were more common than in other months. TBIs occurred more often in younger and healthier individuals on these index days and times. In terms of specific public holidays, the TBI risk was overall higher on New Year's Eves and Days (IRR 1.40, 95% CI 1.25-1.58, p < 0.0001) and Midsummer's Eves and Days (IRR 1.36, 95% CI 1.20-1.54, p < 0.0001), compared to nonworking days. This finding was significant in both genders. Conclusions: TBI-related hospital admissions and mortality were more common on public holidays, weekends, and in summer months in Finland. People who sustained TBIs on these days were on average younger and healthier. The occurrence of TBIs on public holidays and weekends is increasing at an alarming rate.acceptedVersionPeer reviewe

Prognosis of patients with operated chronic subdural hematoma

Chronic subdural hematoma (cSDH), previously considered fairly benign and easy to treat, is now viewed a possible sign of incipient clinical decline. We investigated case-fatality, excess fatality and need for reoperations following operated cSDH in a nationwide setting focusing on patient-related characteristics. Finnish nationwide databases were searched for all admissions with operated cSDH as well as later deaths in adults (≥ 16 years) during 2004–2017. There were 8539 patients with an evacuated cSDH (68% men) with a mean age of 73.0 (± 12.8) years. During the follow-up, 3805 (45%) patients died. In-hospital case-fatality was 0.7% (n = 60) and 30-day case-fatality 4.2% (n = 358). The 1-year case-fatality was 14.3% (95% CI = 13.4–15.2%) among men and 15.3% (95% CI = 14.0–16.7%) among women. Comorbidity burden, older age, and alcoholism were significantly associated with fatality. One-year excess fatality rate compared to general Finnish population was 9.1% (95% CI = 8.4–9.9) among men and 10.3% (95% CI = 9.1–11.4) among women. Highest excess fatality was observed in the oldest age group in both genders. Reoperation was needed in 19.4% (n = 1588) of patients. Older age but not comorbidity burden or other patient-related characteristics were associated with increased risk for reoperation. The overall case-fatality and need for reoperations declined during the study era. Comorbidities should be considered when care and follow-up are planned in patients with cSDH. Our findings underpin the perception that the disease is more dangerous than previously thought and causes mortality in all exposed age groups: even a minor burden of comorbidities can be fatal in the post-operative period.publishedVersionPeer reviewe

Prognosis of patients with operated chronic subdural hematoma

Chronic subdural hematoma (cSDH), previously considered fairly benign and easy to treat, is now viewed a possible sign of incipient clinical decline. We investigated case-fatality, excess fatality and need for reoperations following operated cSDH in a nationwide setting focusing on patient-related characteristics. Finnish nationwide databases were searched for all admissions with operated cSDH as well as later deaths in adults (>= 16 years) during 2004-2017. There were 8539 patients with an evacuated cSDH (68% men) with a mean age of 73.0 (+/- 12.8) years. During the follow-up, 3805 (45%) patients died. In-hospital case-fatality was 0.7% (n = 60) and 30-day case-fatality 4.2% (n = 358). The 1-year case-fatality was 14.3% (95% CI = 13.4-15.2%) among men and 15.3% (95% CI = 14.0-16.7%) among women. Comorbidity burden, older age, and alcoholism were significantly associated with fatality. One-year excess fatality rate compared to general Finnish population was 9.1% (95% CI = 8.4-9.9) among men and 10.3% (95% CI = 9.1-11.4) among women. Highest excess fatality was observed in the oldest age group in both genders. Reoperation was needed in 19.4% (n = 1588) of patients. Older age but not comorbidity burden or other patient-related characteristics were associated with increased risk for reoperation. The overall case-fatality and need for reoperations declined during the study era. Comorbidities should be considered when care and follow-up are planned in patients with cSDH. Our findings underpin the perception that the disease is more dangerous than previously thought and causes mortality in all exposed age groups: even a minor burden of comorbidities can be fatal in the post-operative period