Hybridisovellukset SharePointissa : Suunnitelma laadunvarmistusprosesseista kohdeyrityksessä

SharePoint-alustojen päälle rakennettujen liiketoimintasovellusten kenttä on muuttumassa radikaalisti. Muutoksen katalyyttinä on trendi pilviteknologioihin siirtymisessä. Liiketoimintasovellukset ovat suurissa yrityksissä perinteisesti rakennettu yritysten itse hallinnoimien servereiden päälle. Pilviteknologiat mahdollistavat liiketoimintasovellusten rakentamisen palvelutarjoajan infrastruktuurin päälle pilveen, joko kokonaan tai osittain. Ongelmaksi muodostuu ohjelmistokehitykselliset ja laadunvarmistukselliset prosessit, jotka heijastavat edelleen perinteistä omiin servereihin perustuvaa liiketoimintasovellusmallia. Tutkimuksen tavoitteena oli luoda kohdeyritykselle uudistetut laadunvarmistusprosessit peilaamaan pilvipalveluteknologian mahdollistamia SharePoint-hybridisovelluksia. Tavoitteesta johdettiin tutkimukselle yleistettävämpi tavoite sovelluskehityksen implementointi- ja muutosprosessien suunnittelemiseksi laadunvarmistuksen näkökulmasta. Tutkimuskysymys muodostui seuraavaksi: Millaisin prosessein voimme viedä eteenpäin sovellusten implementointia ja muutoksia, niin että ne ovat linjassa yrityksen laadunvarmistuksen kanssa? Tutkimus toteutettiin iteratiivisena haastatteluihin perustuvana toimintatutkimuksena. Haastattelut olivat teemaperusteisia, ja ne käytiin kahdenkeskeisesti kirjoittajan ja kohdeyrityksestä tarkkaan valittujen sidosryhmien jäsenten välillä. Tutkimuksen lopputuotoksena syntyi hybridisovellusten laadunvarmistusprosessit, eli implementointi- ja muutosprosessit, jotka otetaan käyttöön kohdeyrityksessä osana SharePoint-sovellusten hallinnan päivittäistä työtä. Prosessien optimointi on merkittävässä roolissa kustannusten laskemiseksi laadunvarmistuksellisissa toimissa. Lisäksi tutkimuksessa tunnistetaan jatkokehityskohteet myös tulevaisuuden optimointeja ja prosessien elinkaarien pituuksia ajatellen. Tutkija on poistunut organisaatiosta ennen prosessien käyttöönottoa. Tutkimuksen tuotokset ovat vahvasti sidoksissa kohdeyritykseen, eikä niiden soveltuvuutta voida yleistää kaikkeen laadunvarmistukselliseen prosessikehitykseen

The effect of maternal alcohol and drug abuse on first trimester screening analytes: a retrospective cohort study

Background: The purpose of this study was to determine whether first trimester trisomy screening (FTS) parameters are affected by alcohol and drug use. Methods: A routine combined FTS including measurements of maternal serum levels of free beta-human chorionic gonadotropin subunit (free beta-hCG) and pregnancy-associated plasma protein A (PAPP-A) were measured at 9-11 weeks of gestation, and fetal nuchal translucency thickness (NTT) at 11-13 weeks of gestation. In total 544 women with singleton pregnancies [71 alcohol and drug abusers, 88 smokers, 168 non-smokers delivering a small for gestational age (SGA) child, and 217 unexposed control women] were assessed. Results: Free beta-hCG levels were higher in alcohol and drug abusing than in unexposed pregnant women [mean 1.5 vs. 1.2 multiples of medians (MoM); P=0.013]. However, stepwise multiple linear regression analyses suggested that smoking could explain increased free beta-hCG. Additionally, we observed lower PAPP-A levels in the smoking mothers (0.9 vs. 1.2 MoM; P=0.045) and in those giving birth to an SGA child compared to the controls (1.1 vs.. 1.2 MoM; P Conclusions: The present study shows increased free beta-hCG levels in alcohol and drug abusers, but maternal smoking may explain the result. Maternal serum PAPP-A levels were lower in smoking than non-smoking mothers, and in mothers delivering an SGA child. However, FTS parameters (PAPP-A, free beta-hCG and NTT) seem not to be applicable for the use as alcohol biomarkers because of their clear overlap between alcohol abusers and healthy controls.Peer reviewe

The prevalence of hemoglobin Tacoma in Finland detected by HbA1c capillary electrophoresis

Previous studies have identified occasional cases of heterozygous Hb Tacoma in areas that have attracted Finnish immigrants, especially in Sweden and North America, but large studies of this slightly unstable beta variant in vitro have not been carried out. Here we determined the prevalence of hemoglobin variants across Finland. A total of 5059 samples from 11 different hospital districts were analyzed using HbA1c capillary electrophoresis and reviewed for atypical profiles (HbA1c, Capillarys 3 Tera, Sebia). 38 heterozygous Hb Tacoma cases were found (0.75%). The prevalence was highest in South Ostrobothnia (2.0%), located in western Finland, and second highest in the neighboring provinces (1.0-1.4%), but only two districts were devoid of variants. Heterozygous Hb Tacoma was confirmed by genetic testing (NM_000518.5(HBB):c.93G > T (p.Arg31Ser)). In addition, five other variants were found, suggestive of HbE, Hb Helsinki (two cases) and an alpha variant, as interpreted from the electropherograms. The fifth variant, belonging to the South Ostrobothnian cohort, remained unknown at the time of the initial analyses, but was later interpreted as homozygous Hb Tacoma and confirmed by hemoglobin fraction analysis (Hemoglobin(E), Capillarys 3 Tera). In a subsequent retrospective study of the electropherograms of routine HbA1c diagnostics, altogether nine homozygous Hb Tacoma cases were identified in South Ostrobothnia. While heterozygous Hb Tacoma is usually an incidental finding, it interferes with several HbA1c assays. The present study is the first demonstration of homozygous Hb Tacoma. The clinical presentations of homozygous Hb Tacoma are not known and need to be addressed in future studies.Peer reviewe

First trimester serum placental growth factor and hyperglycosylated human chorionic gonadotropin are associated with pre-eclampsia : a case control study

Background: To study whether maternal serum hyperglycosylated human chorionic gonadotropin (hCG-h) improves first trimester prediction of pre-eclampsia when combined with placental growth factor (PlGF), pregnancy-associated plasma protein-A (PAPP-A) and maternal risk factors. Methods: Gestational-age-adjusted concentrations of hCG, hCG-h, PlGF and PAPP-A were analysed in serum samples by time-resolved immunofluorometric assays at 8-13 weeks of gestation. The case-control study included 98 women who developed pre-eclampsia, 25 who developed gestational hypertension, 41 normotensive women with small-for-gestational-age (SGA) infants and 177 controls. Results: Of 98 women with pre-eclampsia, 24 women developed preterm pre-eclampsia (diagnosis <37 weeks of gestation) and 13 of them had early-onset pre-eclampsia (diagnosis <34 weeks of gestation). They had lower concentrations of PlGF, PAPP-A and proportion of hCG-h to hCG (% hCG-h) than controls. In receiver-operating characteristics (ROC) curve analysis, the area under the curve (AUC) for the combination of PlGF, PAPP-A, % hCG-h, nulliparity and mean arterial blood pressure was 0.805 (95% confidence interval, CI, 0.699-0.912) for preterm pre-eclampsia and 0.870 (95% CI 0.750-0.988) for early-onset pre-eclampsia. Without % hCG-h the AUC values were 0.756 (95% CI 0.651-0.861) and 0.810 (95% CI 0.682-0.938) respectively. For prediction of gestational hypertension, the AUC for % hCG-h was 0.708 (95% CI 0.608-0.808), but for other markers the AUC values were not significant. None of the AUC values were significant for the prediction of SGA infants in normotensive women. Conclusions: First trimester maternal serum % hCG-h tended to improve prediction of preterm and early-onset pre-eclampsia when combined with PlGF, PAPP-A and maternal risk factors.Peer reviewe

Usefulness of neuron specific enolase in prognostication after cardiac arrest : Impact of age and time to ROSC

Aim of the study: We evaluated the impact of patient age and time from collapse to return of spontaneous circulation (ROSC) on the prognostic accuracy of neuron specific enolase (NSE) after out-of-hospital cardiac arrest (OHCA). Methods: Using electrochemiluminescence immunoassay, we measured serum concentrations of NSE in 249 patients who were admitted to intensive care units after resuscitation from OHCA. In each quartile according to age and time to ROSC, we evaluated the ability of NSE at 48 h after OHCA to predict poor outcome (Cerebral Performance Category 3-5) at 12 months. Results: The outcome at 12 months was poor in 121 (49%) patients. The prognostic performance of NSE was excellent (area under the receiver operating characteristic curve, AUROC, 0.91 [95% confidence interval, 0.81-1.00]) in the youngest quartile (18-56 years), but worsened with increasing age, and was poor (AUROC 0.53 [0.37-0.70]) in the oldest quartile (72 years or more). The prognostic performance of NSE was worthless (AUROC 0.45 [0.30-0.61]) in the quartile with the shortest time to ROSC (1-13 min), but improved with increasing time to ROSC, and was good (AUROC 0.84 [0.74-0.95]) in the quartile with the longest time to ROSC (29 min or over). Conclusion: NSE at 48 h after OHCA is a useful predictor of 12-month-prognosis in young patients and in patients with a long time from collapse to ROSC, but not in old patients or patients with a short time to ROSC.Peer reviewe

Angiogenic Profile in the Finnish Genetics of Pre-Eclampsia Consortium (Finnpec) Cohort

Objectives: To study first and second/third trimester levels of soluble fms-like tyrosine kinase 1 (sFlt1), placental growth factor (PlGF) and soluble endoglin (sEng) in FINNPEC case-control cohort. The participants were further divided into subgroups based on parity and onset of the disease. Recommended cut-off values in aid of pre-eclampsia (PE) prediction and diagnosis were also tested. Methods: First trimester serum samples were available from 221 women who later developed PE and 239 women who did not develop PE. Second/third trimester serum samples were available from 175 PE and 55 non-PE women. sFl1-1 and PlGF were measured electro-chemiluminescence immunoassays and sEng by ELISA. Results: In all timepoints PlGF, endoglin and the sFlt-1/PlGF ratio were increased in the PE group compared to the non-PE group. The serum concentrations of sFlt-1 were increased only a second/third trimester in PE women. Higher concentrations of s-Flt1, endoglin and higher sFlt/PlGF ratio were found a the third trimester in primiparous women compared to multiparous women. Primiparous PE women also had lower concentrations of PlGF a the third trimester. The proportion of women exceeding all cut-offs of the sFlt-1/PlGF ratio (>= 33, >= 38, >= 85 and >= 110) was greater in the PE group, but there were also pre-eclamptic women who met rule-out cut-off or did no meet rule-in cut-off. Conclusions: Primiparous pregnancies have more anti-angiogenic profile during second/third trimester compared with multiparous pregnancies. Our findings also suggest that certain maternal characteristics, e.g. BMI, smoking and pre-existing diseases, should be taken into account when different sFlt-1/PlGF ratio cut-offs are utilized.Peer reviewe

A history of diabetes but not hyperglycaemia during exacerbation of obstructive lung disease has impact on long-term mortality: a prospective, observational cohort study

OBJECTIVE: Hyperglycaemia is very common during exacerbations of asthma and chronic obstructive pulmonary disease (COPD). However, its clinical significance is not clear. The objective of the present study was to assess whether exacerbation-associated hyperglycaemia affects long-term mortality in these patients. DESIGN: A prospective, observational cohort study. SETTING: A single hospital in eastern Finland. PARTICIPANTS: 153 consecutive patients who were hospitalised due to mild to moderate obstructive lung disease exacerbation (110 with asthma and 43 with COPD) and who survived at least 30 days. INTERVENTIONS: Plasma glucose levels were recorded seven times during the first day on the ward. Several possible confounders were also recorded. The median follow-up time was 6 years and 2 months. RESULTS: During the follow-up, 57 (37%) of the patients died. Previously diagnosed diabetes was strongly associated with elevated mortality (adjusted HR (aHR) 3.03 (1.28 to 7.18). The highest fasting glucose value (aHR 1.10 (1.01 to 1.20) per 1 mmol/L) and the highest postprandial glucose value ((aHR 1.07 (1.00 to 1.16)) were also associated with late mortality. However, the associations between highest glucose values and mortality vanished when the diagnosis of diabetes was included in the same model. Within the patients without diabetes, neither fasting (aHR 0.92 (0.42 to 2.02)) nor postprandial ((aHR 1.04 (0.50 to 2.12)) hyperglycaemia was associated with late mortality. There were no statistically significant differences in the underlying causes of death between the patients with and without diabetes. CONCLUSION: A history of diabetes but not hyperglycaemia during exacerbation of obstructive lung disease has impact on long-term mortality

Endothelial function and concentrations of high-sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor-alpha during a long agonist IVF protocol

Publisher Copyright: © 2021 The Author(s)We examined possible changes in endothelial function during a long agonist in vitro fertilization (IVF) protocol. We measured flow-mediated dilatation (FMD) and FMD percent (FMD%) from the brachial artery and plasma levels of high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-〈). We studied longitudinally three time points in 27 women undergoing a long agonist IVF treatment at Kuopio University Hospital. The first visit was at the beginning of their period (low estradiol). The other two visits were during gonadotrophin-releasing hormone (GnRH) analog downregulation (low estradiol) and at the end of follicle-stimulating hormone (FSH) stimulation (high estradiol). The first visit was used as the reference, and the women served as their own controls. During the stimulation protocol, FMD and FMD% remained. Toward the end of stimulation, hsCRP (P = 0.003), IL-6 (P = 0.04), and TNF-〈 (P = 0.008) concentrations all decreased, while estradiol levels increased (P < 0.001). Correlations between estradiol and proinflammatory factors or FMD were, however, non-significant. The only significant correlation appeared between FMD% and hsCRP at Visit 2 (r = 0.485, P = 0.01). In conclusion, IVF stimulation promoted no change in endothelial function, whereas hsCRP, IL-6, and TNF-〈 decreased. These findings indicate that estrogen may improve the cytokine profile among healthy women undergoing IVF, but this is not reflected in endothelial function.Peer reviewe