bluuebunny/crossref_metadata_2025 huggingface dataset:
Persistent Pulmonary Hypertension of Newborn: Analysis of 494 cases in a Tertiary Care Hospital
Authors: Fatema Nurun Nahar , Rahman Md Ferdousur , Khan Ashfaque Ahmmed
Published: September 2020

Introduction: Persistent pulmonary hypertension (PPHN) or persistent fetal circulation (PFC) is a commonly encountered problem in neonatal and pediatric cardiac intensive care units and cause significant mortality and morbidity.

Aim/Objective : To show the outcome of patient of PPHN treated by a cheap, locally available NNF protocol.

Methods: It was a retrospective study conducted in pediatric cardiology department of a tertiary care hospital in Dhaka, Bangladesh from February 2014 to March 2019. After diagnosis in noninvasive cardiac laboratory (NIC Lab), all cases were admitted in neonatal and pediatric cardiac intensive care units for specific management using NNF protocol. After 72 hours, echocardiography was repeated, and outcome was analyzed.

Results: Out of total 494 cases, 80.56% cases were diagnosed at first week and 4.45% cases were diagnosed at 3rd week of life. Male patients (60.32%) outnumbered female. Babies were delivered by caesarean section in 92.31% cases. PPHN was found alone in 24.69% cases and rest along with other less severe congenital heart diseases. Severe pulmonary hypertension was observed in 63.56% cases. Right ventricular volume was increased in 93.52% cases. Hundred percent neonates were treated with high flow oxygen therapy by optiflow/ nasal cannula/ head box. Antifailure treatment was offered in 73.27% cases, pulmonary vasodilators in 59.51% cases, inotropes in 15.18% cases. Outcome of treatment was analyzed after 72 hours by repeat echocardiography. Four hundred and seventy one (95.34%) cases were cured completely and only 1.01% expired.

Conclusion: PPHN is a life threatening condition in neonate only. Early diagnosis and proper management is must for survival. Management by low cost NNF protocol was found effective with 95.34% cure rate and only 1.01% mortality. This protocol may be used for treatment of PPHN in low cost set up.

J Bangladesh Coll Phys Surg 2020; 38(4): 176-184
Parahaemophilia: A Rare Case Report
Authors: Bhuiyan Mohammed Nuruzzaman , Giti Susane , Khan Arif Ahmed , Rahman Md Moshiur , Karim Md Anwarul
Published: September 2020

Parahaemophilia or Owren’s diseaseis a rare haemorrhagic disorder occurs due to congenital and frequently familial deficiency of Factor V.It is characterized by epistaxis, bruising, mucosal bleeding, soft tissue bleeding and haemarthrosis. We report a case of 6 year old female patient with overlapping features with other haemorrhagic disorder. With the complaints of recurrent episodic per rectal bleeding, patient was evaluated at different hospitals in Chattagram and was diagnosed as a case of Haemophilia B and treated accordingly. As her condition was not improved expectedly, she was referred to Armed Forces Institute of Pathology (AFIP) for further evaluation. The lab tests showed prolongation of prothrombin time (PT) and activated partial thromboplastin time (APTT), with normal bleeding time (BT) and thrombin time (TT). Coagulation factors assay revealed a significant decrease of factor V, 1% of normal range. Other coagulation factors are normal. She was treated with FFP and recovered four weeks after treatment.

J Bangladesh Coll Phys Surg 2020; 38(4): 205-208
Obituary, 2020 Vol 38(4)
Authors: In Chief Editor
Published: September 2020

Abstract not available

J Bangladesh Coll Phys Surg 2020; 38(4): 232-234
Vaccination Status and Socio-demographic Study of Laboratory Confirmed Measles Cases in Upazilla Hospitals of Bangladesh
Authors: Parvin Rukhsana , Nahar Zakia , Sultana Merina , Mowla Md Golam , Jabbar Tahira Salwa , Mridha Md Al Amin
Published: September 2020

Background: Though Bangladesh has done well to reduce the measles cases and measles related deaths through an effective vaccination programme, measles cases are still found in a good number in hospitals. The objectives of our study was to find out the vaccination status of laboratory confirmed measles patients and also to see the socio-demographic status of those patients.

Methodology: This is a descriptive cross-sectional study conducted in five Upazilla Health Complexes (UHC) of Gazipur district during a period of one year from 01/01/2017 to 31/12/ 2017. The Upazillas included were Gazipur Sadar, Kaliganj, Kaliakair, Sreepur and Tongi. The suspected measles patients were admitted after taking history and clinical examination and confirmed by doing specific laboratory investigation. Measles vaccination status and sociodemographic status of the these confirmed cases were analysed by using SPSS version 21.

Results: Blood samples were sent from 93 patients who were admitted during the study period after observing the diagnostic criteria of measles. Out of them 45 patients were confirmed as measles and they are included in the study. Among the laboratory confirmed measles, 28 cases (62.22%) were males and 17 (37.78%) cases were females, ratio of male and female was 1.6:1. The maximum number of patients (62.22%) were in the age group of 9 months to 4 years. Maximum patients came from low socioeconomic condition with a monthly income of 10,000- 15,000 taka. About maternal education, 26 mothers (57.78%) were uneducated, 12(26.67%) below primary and 7(15.55%) up or above primary level. Among the total patients, 27(60%) patients came with pneumonia, 16(35.56%) patients with both pneumonia and diarrhoea and 2(4.44%) patients only with diarrhoea. We found 32 patients (71.11%) received no MCV(Measles containing vaccine) , 11 patients (24.44%) with one MCV and 2 patients (4.44%) received two MCVs. There we found several causes of dropout of measles vaccine. Lack of awareness regarding one vaccine was the most common cause (42.22%) and then ignorance about two measles vaccine (28.89) followed by migration (17.78%) and parental occupation (11.11%). History of contact with measles patients were found in 24.44% cases , no history in 26.67% cases and in 48.89% cases the history of contact is unknown.

J Shaheed Suhrawardy Med Coll, December 2019, Vol.11(2); 86-90
Evaluation of Outcome of ORIF by DCP Vs LCP in Mid-Shaft Fractures of Radius – Ulna in A Secondary Level Hospital of Bangladesh
Authors: Rahman Md Asjadur , Kaiser Md Shahidullah , Alam SM Syeed Ul
Published: September 2020

Purpose: To compare the result of mid-shaft fracture radius and ulna treated by small DCP and LCP.

Methods: Prospective interventional study, done in the Department of Orthopaedic Surgery, 250 Bedded General Hospital, Tangail from January, 2017 to December, 2018. The study was carried out with sample size 30 patients of mid-shaft fracture of radius and ulna. Out of them 15 were treated by DCP and screws and 15 patients were treated by LCP and screws.

Results: In this study mean age in group I was 32.63±9.42 and in group II was 37.54+7.12. Male patients were 17 and female were 13 in number. Motor vehicle accident was the commonest cause of fracture found in 60% in group-I and 73.33% in group-II. In group-I, out of 15 cases all cases (100%) united with mean time of 15.87 ± 3.89 weeks. In group-II, out of 15 cases all (100%) cases united with the mean time of 14.0 ± 2.27 weeks. There was no major complication in both groups. Regarding the final outcome, excellent results in group-I were achieved with 11 (73.33%) cases while in group-II with 12 (80.00%) cases. Satisfactory results were seen in 04 (26.67%) cases in group-I and 03 (20.00%) cases in group-II.

Conclusion: On the statistical point of view there was no significant difference between dynamic compression plate group and locking compression plate group for the treatment of mid-shaft fracture radius and ulna.

J Shaheed Suhrawardy Med Coll, December 2019, Vol.11(2); 106-109
Psychological Features in Patients with Different Patterns of Irritable Bowel Syndrome
Authors: Chowdhury Sadia Rahman , Safwath Syed Alamgir , Ghosh Dilip Kumar , Akter Fahmida
Published: September 2020

Context: Irritable bowel syndrome (IBS) is one of the most common chronic gastrointestinal (GI) disorders. Recently, many studies have found the association between irritable bowel syndrome (IBS) & the psychological factors.

Aims: The study aimed to determine the relationship between psychological features and different subtypes and severity of irritable bowel syndrome.

Settings and Design: This cross-sectional study was performed among 208 outpatients diagnosed as irritable bowel syndrome in two government medical college hospitals of Dhaka city from January, 2015 to December, 2015. The subtypes and severity of irritable bowel syndrome were assessed by Rome-III and ‘Irritable bowel syndrome severity scoring scale’ respectively. Psychological features were assessed by Brief Symptom Inventory consisting 53 items of psychological problems.

Results: Global severity index of Brief Symptom Inventory, which is the best indicator of psychological distress, was found significantly higher in respondents with diarrhea predominant IBS (p< 0.001) and severe IBS patients (p< 0.001). Mean scores of other psychological problems among Brief Symptom Inventory -53 subscales (hostility, interpersonal sensitivity, paranoid ideation, psychoticism, depression, anxiety) were significantly higher in diarrhoea predominant IBS and severe IBS patients compared to the others (p<0.001). Severity score of irritable bowel syndrome was also moderately correlated with Global severity index (r= 0.417, p<0.001).

Conclusions: This study found relationship between psychological features and different pattern of irritable bowel syndrome. Hence, the appropriate psychological assessment and counseling in IBS patients is critically important.

J Shaheed Suhrawardy Med Coll, December 2019, Vol.11(2); 110-114
Cutaneous Rhinosporiodosis in Lower Limb Mimicking Squamous Cell Carcinoma : A Case Report
Authors: Rahman Md Mustafizur , Nahar Nazmun , Kiron Shah Alam , Uddin Md Nashir , Jahan Mst Nusrat , Oishi Sawantee Joarder , Bhakta Tapan , Ray Moon
Published: September 2020

Background: Rhinosporidiosis is a chronic granulomatous disease caused by Rhinosporidiumseeberi. Though cutaneous lesions in Rhinosporidiosis are rare, they may simulate many common dermatological conditions including malignancy thus posing a diagnostic dilemma. Surgical excision is treatment of choice but dapsone can also be used as an adjunct to surgery.

Case Presentation: Here, we are reporting a case where a 45 year old male presented with painless progressive polypoidal growth in the right lower limb for five months with central ulceration. Inguinal lymph nodes were also enlarged. Clinically the lesion appeared to be squamous cell carcinoma. FNAC from inguinal lymph node showed reactive changes and the patient underwent wide local excision of the mass. Histopathological report showed that it was a case of Rhinosporiodosis and the patient was referred to department of dermatology for better management.

J Shaheed Suhrawardy Med Coll, December 2019, Vol.11(2); 164-166
Kun kaikki pysyväinen haihtuu ilmaan
Authors: Suoranta Juha
Published: September 2020

Kommunistinen manifesti / Karl Marx & Friedrich Engels; suomentaneet Juha Koivisto & Markku Mäki & Timo Uusitupa. Tampere : Vastapaino, 1998.
Suomalaiset sivistysnousukkaat ja junttiuden häpeä
Authors: Rantanen Tuomas
Published: September 2020

Suomalaisen sivistyksen sokea piste kulminoituu käsitteeseen ”junttius”. Junttius viittaa myyttiseen maalaisuuden pelkoon. Halutessaan samaistua ”eurooppalaisena” pitämäänsä korkeakulttuurin symboliseen tasoon yhteisömme helposti torjuu oman kulttuurinsa lähtökohdat. – Puheenvuoro kuului osana Kansanvalistusseuran Mitä on sivistys? -seminaariin 3.2.1999.
Koulutuspolitiikkaa aaltoina – 2060-lukua odoteltaessa
Authors: Rinne Risto
Published: September 2020

Koulutus ja koulutuspolitiikka 2000-luvulle / Liekki Lehtisalo & Reijo Raivola. Porvoo : WSOY, 1999.
Vaikuttava oppiminen on sidoksissa oppijan oppimis- ja kehitysprosesseihin
Authors: Poikela Esa
Published: September 2020

Kontekstuaalinen oppiminen on raportin teoriavaiheen tulema, jonka tarkoituksena on osoittaa, että työssä oppiminen, työyhteisössä oppiminen ja koko organisaation oppiminen on luonteeltaan kontekstuaalista. Oppiminen ja kehittyminen on murtautumista kontekstista toiseen, aina syvempään ja laajempaan työn ja toiminnan kontekstiin. – Tiivistelmä Lectio praecursorianista. Esa Poikelan väitöskiriatutkimus 'Kontekstuaalinen oppiminen : oppimisen organisoituminen ia vaikuttava koulutus' tarkastettiin Tampereen yliopistossa 29.5.1999.
Sosiaalityön koulutusintressit ja elinikäisen oppimisen periaate
Authors: Vuorikoski Marjo
Published: September 2020

Suomen Akatemia käynnisti 1980-luvun lopulla elinikäisen oppimisen tutkimusohjelman, missä tuohon lupaavaan käsitteeseen haluttiin saada pitävämpi ote ja selvittää, mitä elinikäisen oppimisen periaate voisi merkitä koulutuksen oppimismahdollisuuksien kehittämisessä. Sen seurannaisena syntyi mm. väitöskirjatutkimus Sosiaalityön professionaalistuminen ja koulutus, missä tutkittiin sosiaalityöntekijöiden koulutuksen kehittymistä ja alan professionaalistumista kytkeytyneenä suomalaisen hyvinvointivaltion muotoutumiseen. Kiinnostuksen kohteiksi tutkimuksessa nousivat näin ollen sosiaalialan jatkokoulutus, täydennyskoulutus ja elinikäisen oppimisen periaate.
Ristiretki käytännön kentille
Authors: Juuti Pauli
Published: September 2020

Oppiminen ja asiantuntijuus : työelämän ja koulutuksen näkökulmia / toim. Anneli Eteläpelto ja Päivi Tynjälä. Porvoo : WSOY, 1999. 328 s.
Onko oppiminen elämänkokemusta?
Authors: Varila Juha
Published: September 2020

Persoonallisesti merkittävät oppimiskokemukset : tutkimus luokanopettajaksi opiskelevien oppimiskokemuksista / Raimo Silkelä. (Joensuun yliopiston kasvatustieteellisiä julkaisuja ; 52) Väitöskirja. Joensuu : Joensuun yliopisto, 1999.
Sukupuoli oppimisen voimavarana – feministinen pedagogiikka?
Authors: Hiltunen Aiska
Published: September 2020

Feministinen pedagogiikka lähtee oletuksesta, että naiset ja miehet sosiaalistuvat eri tavoin, ovat erilaisia ja hyötyvät näin ollen myös oppimisessaan erilaisista pedagogisista lähestymistavoista.
Meillä ainutlaatuinen oppikirja sosiokulttuurisesta innostamisesta
Authors: Nurmi Kari E.
Published: September 2020

Sosiokulttuurinen innostaminen : muutoksen pedagogiikka / Leena Kurki. Tampere : Vastapaino, 2000. 188 s.
Vapaan sivistystyön visiosta
Authors: Niemelä Seppo
Published: September 2020

Yksi mahdollisuus kuvata vapaan sivistystyön omaleimaisuus ja identiteettikin on Tanskan malli, missä vapaalla sivistystyöllä on muusta aikuiskasvatuksesta poikkeava ihmiskuva, yhteisökuva ja pedagogiikka. On tosin muistettava, että vapaalle sivistystyölle ominainen pedagogiikka on kohteena myös tavallisessa aikuiskasvatuksessa, esimerkiksi yhteistoiminnallisen oppimisen tai tiimioppimisen nimillä. Ehdotan silti, että sivistystyön erityistä pedagogiikkaa pidetään huolella silmällä uuden identiteetin rakennustyössä, kirjoittaa Seppo Niemelä.
Konstruktivistinen oppimisnäkemys ja esineellinen toiminta
Authors: Miettinen Reijo
Published: September 2020

Käsittelen tässä artikkelissa termin ’konstruktivistinen oppimiskäsitys’ merkitystä ja käyttötapoja eri teoriasuuntauksissa. Konstruoinnin eli rakentamisen metaforaa on käytetty kahden viime vuosikymmenen aikana lisääntyvässä määrin sosiologiassa, kulttuurin tutkimuksessa sekä kasvatustieteessä. Kuten itse sana antaa ymmärtää, sillä viitataan ihmisen aktiiviseen tekemiseen. Käsite on kuitenkin ylikäytetty ja sillä tarkoitetaan tavattoman monia eri asioista.
Suomalaisen naisyrittäjän historia – ruokaa, vaatteita ja hoivaa
Authors: Vainio-Korhonen Kirsi
Published: September 2020

Harva nainen on päätynyt yrittäjäksi koulutuksen kautta. Itsensä työllistäneiden naisten tärkein harjaantumisympäristö on ollut ja on edelleenkin koti taikka palvelus- tai työpaikka. Naisten yritysstrategiat vaikuttavat samantyyppisiltä 1700-, 1800- ja 1900-luvuilla. Naisyrittäjyys on aina ollut suuria taloudellisia riskejä karttavaa pienyrittäjyyttä.
Oppimisen haasteet sukupuolinäkökulmasta
Authors: Heiskanen Tuula
Published: September 2020

Sukupuolistuneiden käytäntöjen näkökulma soveltuu myös työssä oppimisen tarkasteluun. Ymmärrän työssä oppimisen, eli taitojen ja ongelmanratkaisuvalmiuksien kehittymisen ja työssä eteentulevien asioiden merkitysyhteyksien rakentamisen tapahtuvan valtaosaltaan niissä arkisissa käytännöissä, joihin työtätekevät osallistuvat. Organisaation käytännöt, mukaan lukien ne käytännöt, jotka rakentavat sukupuolta työpaikoilla, toimivat oppimisen ehtoina ja aikaansaajina.
Synnyttäminen ja raskaus oppimiskokemuksena
Authors: Judén-Tupakka Soila
Published: September 2020

Äitiyden alkumetrit: Naisten raskaudelle ja synnytykselle antamat merkitykset ja oppimiskokemukset, Tuula Piensoho, Helsinki (2001)
Web-foorum aidon yhteistyön välineeksi
Authors: Kuusinen Riitta
Published: September 2020

Sosiaalinen toimintaympäristö on osallisena yksilön kognitiivisessa tiedonkäsittelyssä. Ihminen ei opi vain asiatietoja ympäristönsä mukaisten käsitteiden varassa. Sen rinnalla ihminen oppii sosiaalisissa toimintaympäristöissä vaadittuja selviytymismalleja, toimintamalleja. Tämä toimintaoppiminen tapahtuu tiedostamatta, salakavalasti.
Voimme arvostaa teoreetikkojamme perehtymällä heidän näkemyksiinsä ja arvioimalla niitä
Authors: Toiviainen Timo
Published: September 2020

Urpo Harva pitäytyi jokseenkin Zachris Castrénin viitoittamalla aikuiskasvatuksen linjalla kansansivistystyön teorianmuodostuksessa, päättelee Timo Toiviainen puheenvuorossaan aikuiskasvatuksen klassikoistamme. Toiko Harva aikuiskasvatuspedagogiikkaan uutta ja omaa ja jos, niin mitä?
Gladiaattorit pedagogiikan colosseumilla
Authors: Kalli Pekka
Published: September 2020

Totuus, kieli ja käytäntö. Pragmaattisia näkökulmia toimintaan ja osaamiseen, Osmo Kivinen ja Pekka Ristelä, Helsinki (2001)
Luovuus yksilössä ja organisaatiossa
Authors: Kajanto Anneli
Published: September 2020

Luova hierre. Näkökulmia yksilöiden, ryhmien ja organisaatioiden luovuuteen, Jussi T. Koski (2001)
Kuusi laudaturia – kuusi uratyyppiä
Authors: Toimituskunta
Published: September 2020

Katsaus perustuu Markku Vanttajan tutkimukseen "Koulumenestyjät. Tutkimus laudaturylioppilaiden koulutus- ja työurasta" (Suomen Kasvatustieteellinen Seura. Kasvatusalan tutkimuksia 8/2002)
Syrjäytymispuhe vahvistaa omaa "normaaliuden" identiteettiämme
Authors: Karjalainen Jouko
Published: September 2020

Syrjäytymisen yhteiskunta, Tuula Helne, Helsinki (2002)
Aineeton pääoma puhuttelee
Authors: Onnismaa Jussi
Published: September 2020

Arvoa aineettomasta pääomasta, Taru Rastas ja Virpi Einola-Pekkinen, Helsinki (2001)
Työssäoppiminen ammatillisen koulutuksen merkittävin koskaan toteutettu uudistus?
Authors: Pasanen Heikki
Published: September 2020

Työssäoppiminen ja ohjaus ammatillisissa oppilaitoksissa, toim. Mari Räkköläinen ja Ilkka Uusitalo, Tampere (2001)
Henkilöstön kehittäjät aikuiskasvatuksen toimintakentillä
Authors: Hytönen Tuija
Published: September 2020

Jos työpaikkoja halutaan kehittää oppimista tukeviksi toimintaympäristöiksi, henkilöstön kehittäminen tulee ymmärtää oppimisnäkökulmasta eikä koulutuslähtöisesti. Tällöin henkilöstön kehittäjät voisivat ottaa organisaatioissa rohkeamman roolin oppimisen ja muutoksen asiantuntijoina. Heidän työnsä on samalla rajankäyntiä muutoksen ja pysyvyyden välillä.
Siirtovaikutus opetustyössä
Authors: Aalto Minna
Published: September 2020

Oppimisen siirtovaikutus eli transfer voidaan aina nähdä opettamisen tarkoituksena: opettaminen tähtää siirrettävän ja sovellettavan tiedon muodostumiseen. Artikkelissa analysoidaan yhden ammattikorkeakoulun opettajien kokeiluhanketta kehittävän siirtovaikutuksen kannalta. Muutoksen keskiössä on opettaja ja hänen roolinsa. Missä määrin opiskelijoiden aktiivisuuden vankentaminen voisi alkaa siitä, että opiskelijat voisivat olla mukana opetuksen kehittelytyössä ja sen suunnittelussa? kirjoittaja kysyy.
Sisällön asiantuntijoista verkkovirtuooseiksi
Authors: Norvanto Tuomo
Published: September 2020

Aikuisopettajan roolin muuttuessa opetuksen keskiöstä varjoon, oppimisympäristöjen mahdollisuuksien luojaksi, on opettajalle syntynyt tunne asemansa heikkenemisestä – henkisestä häviämisestä. Aiemman osaamisen perustana ollut sisällöllinen hallinta jää sivuraiteille ja pääosaan nousee uudenlainen osaaminen: oppijalähtöinen oppimisympäristöjen suunnittelu ja tietoverkkojen hyödyntäminen opetuksessa. Mitä opiksi?
Kuka raivaisi infoviidakkoa?
Authors: Rongas Anne
Published: September 2020

Valistajat ja viestijät infoviidakossa, Sakari Kiuru, Helsinki (2001)
Tekemällä oppimista loppuun asti
Authors: Pohjanheimo Esa
Published: September 2020

Tiimiakatemia. Tositarina tekemällä oppivasta yhteisöstä, Niina Leinonen, Timo Partanen ja Petri Palviainen, Jyväskylä (2002)
Vapaata sivistystyötä postmodernissa
Authors: Rantanen Pertti
Published: September 2020

Sivistyksellinen aikuiskasvatus, Petri Salo ja Juha Suoranta, Helsinki (2002)
Myöhäismodernissa ikänormit murtuvat – ikä on itsestä kiinni
Authors: Paloniemi Susanna
Published: September 2020

Kun tutkittiin työntekijäin käsityksiä siitä, mikä on iän merkitys ammatillisessa osaamisessa ja osaamisen kehittymisessä, nousi aiempaa selvemmin esiin ikääntyvien työntekijäin kokemuksellinen osaaminen sekä monet työelämän tarvitsemat osaamisen vahvuudet. Kronologista ikää tärkeämmäksi koettiin persoonalliset ominaisuudet. Kun ikää, osaamista ja sen kehittymistä tarkastellaan, tulisikin tarkasteltavaksi ottaa työtehtävien laatu, kokemuksen merkitys ja kokemuksen suhde ikään.
Mitä ryhmää ohjatessa on hyvä tietää
Authors: Pietikäinen Arto
Published: September 2020

Ryhmän salaisuudet : sosiometria muutoksen voimavarana, Antony Williams, Tampere (2002)
Hajautetun työskentelyn osaamisvaatimukset
Authors: Kokko Niina , Vartiainen Matti , Hakonen Marko
Published: September 2020

Kehittyvä tieto- ja viestintäteknologia mahdollistaa uusia ja aiempaa joustavampia työskentelytapoja yksilöille, työryhmille ja organisaatioverkostoille. Monet perinteiset organisaatiot] ja työryhmät ovat muuttuneet verkostomaisiksi ja hajautuneiksi vuorovaikutusrakenteiksi. Työntekijöiden välinen yhteistyö ja kommunikaatio tapahtuvat yhä useammin välittyneesti kuin kasvotusten. Tiimien työntekijät valitaan tarvittavan asiantuntemuksen ja erityisosaamisen mukaan riippumatta siitä, missä päin maailmaa he työskentelevät. Saumaton ja tuloksellinen yhteistyö hajautetussa organisaatiossa vaatii paljon osaamisen kehittämistä. Avainasemassa ovat avoin kommunikaatio, luottamus ja yhteiset toimintamallit. Tässä kirjoituksessa käsitellään hajautetussa työskentelyssä tarvittavaa osaamista.
Ammattiylpeys tutkimuksen kohteena
Authors: Salomaa Heikki
Published: September 2020

Ylpeys ja ammattiylpeys tutkimuksen kohteeksi : ylpeyden tunteen teoreetinen ja empiirinen tarkastelu, Juha Varila ja Merja Ikonen-Varila, Joensuu (2002)
Tutkimusten tuloksia esittelevä, pohdiskeleva teos tietotyöstä
Authors: Köppä Lassi
Published: September 2020

Tietotyö ja ammattitaito = Knowledge work and occupational competence, toimittanut / edited by Juhani Kirjonen, Jyväskylä (2003)
Uskonnon vetäytymistie kosmoksesta
Authors: Mannila Simo
Published: September 2020

Kosmoksen hahmo, Kari Enqvist, Helsinki (2003)
Alussa oli piste
Authors: Rautakilpi Sirkku
Published: September 2020

Megaevoluutio, Eero Paloheimo, Helsinki (2002)
Tunteiden kognitiivisuus ja oppiminen
Authors: Puolimatka Tapio
Published: September 2020

Tunteet eivät ole järjen vastakohta vaan järjellisen ajattelun perusta. Tunteet tarjoavat informaatiota, jota ilman järki ei pysty muodostamaan kokonaisvaltaista käsitystä todellisuudesta. Tunteet vaikuttavat siihen, mitä havaitsemme, minkälaisia päätelmiä teemme ja millaisiin luoviin ajatuksiin saamme herätteitä. Toisaalta järkeä tarvitaan tunteiden tarjoaman informaation pätevyyden arvioimiseen. Tunteilla on tärkeä merkitys oppimisprosessia motivoivina tekijöinä. Niinpä tunteet ja järki ovat oppimisessa molemminpuolisessa vuorovaikutuksessa.
Koulutus on kannattava investointi niin yksilöille kuin aluetaloudellekin
Authors: Saarivirta Toni
Published: September 2020

”Koulutuksen ja talouden välisiä suhteita käsittelevä aihepiiri ei ole uusi tutkimusalue. Uutta on sen sijaan painotus”, kirjoittaa Toni Saarivirta lektiossaan. Hän väitteli toukokuun lopussa Tampereella tutkimuksellaan koulutuksen ja tutkimuksen taloudellisesta merkityksestä. Siinä hän tutki yliopistollisen koulutuksen ja tutkimuksen merkitystä seitsemällä alueella. – Artikkeli perustuu kirjoittajan väitöstutkimukseen Koulutuksen ja tutkimuksen taloudellinen merkitys : vertaileva tutkimus yliopistollisen koulutuksen ja tutkimuksen taloudellisesta merkityksestä seitsemälle alueelle (Tampereen yliopisto 2004)
Kappale suomalaisen aikuiskasvatuksen vaiettua historiaa
Authors: Salo Petri , Suoranta Juha
Published: September 2020

Itsekasvatusta ja kapinaa : tutkimus Karkkilan työläisnuorten kirjoittavasta keskusteluyhteisöstä 1910- ja 1920-luvuilla, Kirsti Salmi-Niklander, Helsinki (2004)
The Relationship of Perioperative Blood Transfusion With Bladder Cancer Mortality In Radical Cystectomy Patients
Authors: Nur Qohari Aria Utama , Hendri Ahmad Zulfan
Published: September 2020

Background: Perioperative blood transfusion is correlated to adverse effects which lead to mortality on a few cases of patients with malignancy, especially kidney tumors. The objective of this study is to evaluate the relationship between blood transfusion timings and survival of patients with bladder cancer who undergo radical cystectomy and measure the differences in the outcomes between patients undergoing intraoperative blood transfusion and patients undergoing blood transfusion after surgery.Methods: This research is a retrospective analytic study with a cohort design. Thirty patients with bladder tumors who performed radical cystectomy and did not undergo perioperativechemotherapy were included in the study data. Recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were analyzed by the Kaplan-Meier method and compared between groups with log-rank tests. Chi-square test was used for comparative evaluation of each group. Univariate and multivariate analyzes were performed to evaluate the relationship between clinical and pathological variables with risks such as RFS, CSS, and OS. P<.005 were considered statistically significant, and SPSS software was used for the entire analysis process.Results: From a total of 29 patients who had a radical cystectomy, 22 patients received perioperative blood transfusion. The 17 patients had the transfusion intraoperatively while the rest had the transfusion after the operation. The mean of blood loss was 1491 cc and the mean of survival was 13.2 months. Intraoperative blood transfusion was associated with a significantly increased risk of disease recurrence (HR: 1.32; P=.034), bladder cancer mortality (HR: 1.65; P=.015), and all-cause mortality (HR: 12.38; P=.013).Conclusions: Intraoperative blood transfusion is significantly associated with an increased risk of cancer mortality. Further investigation is needed to determine the biological mechanismsunderlying patient outcomes.
Parotid Gland Metastasis From Breast Cancer: A Case Report
Authors: Andinata Bob , Iriani Dewi , Karisyah Adlina
Published: September 2020

Introduction: Breast cancer metastasis at the parotid gland is uncommon. There were only 21 cases reported until the recent year, and none of them came from Indonesia. The reports showed that breast cancer metastasis is more often found at the liver, lung, bone, and brain. Therefore, any masses found on the parotid are usually considered as a double primer.Case Presentation: We report a case of a woman, firstly diagnosed with luminal A stage IIA breast cancer at 39 years old. The patient had undergone breast-conserving therapy (BCT), followed by adjuvant hormonal therapy before being diagnosed with bone metastasis four years later. She also complained about a painful mass on her left upper neck. Ultrasonography and CT-scan resulted in insignificant abnormality. After a year with increasing painful mass, we performed FNAB. The result showed metastatic adenocarcinoma with a suspicious breast cancer origin. We did total parotidectomy with facial nerve preservation to alleviate the pain. Pathology results showed a confirmed diagnosis of breast cancer metastasis. The patient was given radiotherapy as local control and was scheduled to receive chemotherapy as systemic therapy.Conclusions: Parotid mass with a clinical symptom in the patient with the history of breast cancer should be evaluated firstly by imaging and may be followed by cytology or pathology evaluation to confirm whether it is primary or secondary malignancy. If the parotid metastasis from breast cancer is confirmed, we should consider adding systemic therapy after completing the local control.
Apresentação | Foreword
Authors: Choukr Fauzi Hassan , Pontes José Antonio Siqueira
Published: September 2020

Apresentação | Foreword

Vol. 3, n. 1
Erratum in: Budget Impact Analysis of anakinra in the treatment of patients with Still’s Disease
Authors: Ravasio Roberto , Giacomelli Roberto , Bianchi Stefano
Published: September 2020

In the article, “Budget Impact Analysis of anakinra in the treatment of patients with Still’s Disease”,[1] which appeared in Volume 7, Issue 1 of  Global & Regional Health Technology Assessment, the number of patients undergoing treatment with tocilizumab and anakinra displayed in Table V (column Current Scenario) was inadvertently inverted. Affected data have been corrected in the article now appearing online. The authors apologize for any inconvenience caused to the readers by these changes, which do not affect the final results of the study. 

The final version of this article is available online and includes a reference to this correction.
ФУНКЦІЇ QR-КОДІВ У СТРУКТУРІ ПІДРУЧНИКА УКРАЇНСЬКОЇ МОВИ
Authors: Горошкіна Олена Миколаївна , Греб Марія Михайлівна , Горошкін Ігор Олександрович , Караман Станіслав Олександрович
Published: September 2020

У статті розглянуто проблему використання QR-кодів як складника сучасного підручника. Обґрунтовано актуальність уведення QR-кодів до змісту підручників української мови. Уточнено визначення QR-коду, під яким визначено компактний носій навчальної інформації обсягом близько трьох тисяч байт, закодованої за допомогою спеціальних програм або сервісів і графічно представленої як чорно-білий або кольоровий квадрат. Установлено, що QR-код уможливлює розширення й поглиблення теоретичних відомостей із навчального предмета. У підручниках української мови матеріали, вміщені на QR-кодах, розширюють і поглиблюють теоретичні відомості й дидактичний матеріал, сприяють удосконаленню орфоепічних, граматичних, правописних умінь і навичок учнів, виконують функцію контролю, пропонуючи тестовий та інший матеріал для встановлення рівня сформованості знань, умінь і навичок учнів. Визначено й обґрунтовано функції QR-кодів у структурі підручників української мови – мотиваційну, інформаційну, розвивальну, виховну, рефлексійну, контрольну. Здійснено аналіз змісту підручників української мови для 10 класу та рукопису підручника для 11 класу, що містять QR-коди. Наведено відомості про експериментальну перевірку ефективності застосування QR-кодів, у процесі якої учні експериментальних класів систематично залучалися до роботи з QR-кодами, уміщеними в підручнику української мови, що передбачали опрацювання теоретичних відомостей, які розширювали й поглиблювали зміст підручника, виконання творчих, дослідницьких завдань, що спонукали учнів до спостережень над мовою, виконання вправ на редагування, тестових завдань. Визначено принципи відбору теоретичного матеріалу для QR-кодів, до яких віднесено доступність матеріалу, його комунікативну значущість, новизну, емоційність, роль у формуванні предметної компетентності учнів.

Наведено конкретні приклади кодування інформації в підручниках української мови: теоретичних відомостей, матеріалів засобів масової інформації (інтерв’ю, телепередач, виступів) для аналізу їх учнями, тестових завдань, прикладів правильних відповідників девіантних текстів, запропонованих учням для редагування тощо.
RUHSAL RAHATSIZLIKLARA YÖNELİK BİLGİ DÜZEYİ VE DİNDARLIĞIN RUHSAL RAHATSIZLIKLARA İLİŞKİN DAMGALAMA İLE İLİŞKİSİ: ÜNİVERSİTE ÖĞRENCİLERİ ÜZERİNE NİCEL BİR ARAŞTIRMA
Authors: AYTEN Ali , HARDAL Fatma
Published: September 2020

Makale, ruhsal rahatsızlıkların damgalanması, ruhsal rahatsızlıklara ilişkin bilgi düzeyi ve dindarlık arasındaki ilişki ve etkileşimi konu edinmektedir. Bu çerçevede araştırmada, ruhsal rahatsızlıklara ilişkin bilgi düzeyinin ve dindarlığın ruhsal rahatsızlıkların damgalanması üzerindeki rolü ve dindarlık damgalama arasındaki ilişkide bilgi düzeyinin aracı rolünü tespit etmek amaçlanmıştır. Araştırmanın çalışma grubu, Marmara ve Uludağ üniversitelerinde İlahiyat, Psikoloji ve Psikolojik Danışma ve Rehberlik bölümlerinde okuyan yaşları 17 ile 40 arasında değişen 370 öğrenciden oluşmaktadır. Bilgi düzeyi ve damgalama ilişkisinin anlaşılması için İlahiyat Fakültesi öğrencilerinden psikoloji ile ilgili dersleri alanlar ve almayanlar ayrıca gruplandırılmıştır. Araştırma hipotezlerinin testi için, Kişisel Bilgi Formu, Ruhsal Rahatsızlıklarla İlgi Bilgi Düzeyi Ölçeği, Kısa Dindarlık Ölçeği ve Damgalama Ölçeği’nden müteşekkil bir anket uygulanarak veriler toplanmıştır. Bulgulara göre, psikolojiye ilişkin dersleri alma damgalamayı anlamlı düzeyde düşürmüştür. Ayrıca bulgular, ruhsal rahatsızlıklara ilişkin damgalama ile ruhsal rahatsızlıklara dair bilgi düzeyi arasında negatif dindarlık arasında ise pozitif ilişki olduğunu göstermiştir. Bilgi düzeyinin, damgalama ve dindarlık ilişkisindeki kısmî aracılık rolü de ayrıca bulgulanmıştır.
الألفاظ العربية في المعجم التركي: دراسة لغوية
Authors: RAMADAN Hany
Published: September 2020

إن العلاقة بين اللغة العربية واللغة التركية علاقة تاريخية تمتد إلى قرون منذ أن دخل الأتراك إلى الإسلام، وبدأ الاحتكاك المباشر بينهم وبين العرب، الذي أثر بدوره على اللغتين، فأخذت كل لغة من أختها، بيد أن اللغة التركية أدخلت العديد من الألفاظ العربية إليها، وذلك بسبب تقديس الأتراك للغة العربية باعتبارها لغة شعائرهم الدينية، وقد بلغ عدد الألفاظ المشتركة بين العربية والتركية أكثر من ستة آلاف لفظة، أي ما يقارب 10% من ألفاظ المعجم التركي.

لذلك تسعى الدراسة إلى البحث في المعجم التركي عن الألفاظ العربية، وتتناولها بالدراسة كما وكيفا، وذلك بغرض الكشف عما لحق بهذه الألفاظ من تطور دلالي وتغيُّر صوتي بعد دخولها إلى المعجم التركي، وقد اعتمدت الدراسة في ذلك على المنهج الوصفي، مع الاستعانة في بعض المباحث بالمنهج التاريخي.

ولا شك أن دراسة الألفاظ العربية في المعجم التركي لها أهمية بالغة لدى دارسي العربية من الطلاب الأتراك في تحقيق كفايتهم المعجمية، وذلك من خلال تنمية مفرداتهم، وإثراء ذخيرتهم اللغوية، فالمفردات عنصر أساسي من عناصر تعلم اللغة، لا سيما أن الدراسة انتهت إلى أن اللغة العربية راسخة في الوجدان التركي، وأكدت الدور الحضاري الذي قاموا به نحوها
18. VE 19. YÜZYILLARDA HİNT ALTKITASINDA MÜSLÜMANLARIN EĞİTİM ÖĞRETİM MESELESİ: ORYANTALİZM – EVANJELİZM MÜCADELESİ VE MEDRESELERDE EKOLLEŞME
Authors: YÜRÜK Emre
Published: September 2020

Bu çalışmada, Babür İmparatorluğu zamanında altın çağını yaşayan ve belli bir kurumsallığa ulaşan medrese ve medrese öğretiminin İngilizlerin Hint yarımadasına gelişiyle birlikte 18. yüzyılın ortalarından itibaren girdiği sıkıntılı süreç izah edilmeye çalışılmıştır. Bu bağlamda İngilizlerin oryantalizm ve evanjelizm ekseninde eğitim ve öğretimde yaptığı veya yapmaya çalıştığı reformların sebepleri ve sonuçları ortaya konmuştur. Reformların medreselerdeki öğretimi değersizleştirmeye çalıştığını düşünen Hint Müslümanları “İslâm dinini ve kültürünü koruma” refleksi geliştirip medreselerde ekolleşme yoluna gittiği sonucuna ulaşılmıştır. Farklı ekollerin ortaya çıkması medreselerdeki müfredat birliğini yok etmiş ve medrese mezunu Müslüman öğrenciler arasında fikir ayrılıkları kadar bilgi uçurumu da meydana getirmiştir.
ŞEHÎD-İ SÂNÎ’NİN BİDÂYE’SİNİN SÜNNÎ HADİS USÛLÜ KAYNAĞI NEYDİ?: TÎBÎ’NİN HULÂSA’SI MI, CÜRCÂNÎ’NİN MUHTASAR’I MI?
Authors: KUZUDİŞLİ Bekir
Published: September 2020

Bu makalenin amacı, Şîa’da müstakil ve kapsamlı ilk hadis usulü eserinin müellifi olan Şehîd-i Sânî’nin, Bidâye adlı kitabının kaynağını tam olarak tespit etmektir. Şehîd-i Sânî’nin Sünnî âlimlerce yazılan hadis usulü çalışmalarından etkilendiği yaygın bir şekilde zikredilse de kaynağının tam olarak belirlenip ilgili kitapların birebir karşılaştırılması, hem etkilenmenin boyutlarını hem de Şehîd-i Sânî’nin Sünnî usulü Şiî geleneğe uyarlarken yaptığı tasarrufları değerlendirmeye yardımcı olacaktır. Zira Şehîd-i Sânî’nin ziyade, hazif veya düzenleme şeklinde yaptığı bu tasarruflar aynı zamanda Şiî hadis tenkidinin yapısını anlamaya kapı aralayan durumlardır. Böylece Şîa’da Sünnî hadis usulünün esas alınması ve bunların Şiî hadis rivayetine uyarlayabilmek için bazı meselelerde çeşitli düzenlemelerin yapılması gibi hususlar, tarihte ve günümüzde Şiî hadis usulü yazımının arka planının anlaşılması açısından önemlidir.
Performance “Ellen with Will Smith Full Interview” Talk Show: Emotive Language Functions
Authors: Yusuf Faidah
Published: September 2020

This study is focused to analyze the emotive language functions in the Ellen DeGeneres talk show. The objective of this study is to describe the emotive language functions work in the conversation performance by the actors “Ellen with Will Smith Full Interview” talk show. This study uses qualitative method. The data are analyzed based on Jacobson’s theory. The result of this study shows that only 5 of 17 emotive language functions are applied. The emotive language functions applied are pleasure, like, dislike, surprise, gratitude. While the emotive language functions that not applied are hope, satisfaction, dissatisfaction, worry, preference, sympathy, intentions, want, desire, dear and disappointment. This study finds that the most emotive function that frequently used in the Ellen DeGeneres Talk Show is “like expression”. The emotive function in the Ellen DeGeneres talk show works to express the actor’s feelings to other people based on the context and situation of the conversation
GUIDING QUESTIONS TECHNIQUE TO IMPROVE STUDENTS’ WRITING SKILLS: RECOUNT TEXT
Authors: Muhtar Siti Nuraeni , Rustina Lina Rustina , Dalimunthe R Nadia R P
Published: September 2020

This research aimed to find out whether there was an improvement of the students’ skills in writing recount text after using guiding questions as a technique of writing. The method applied in this research was a quantitative method which use one group pre-test and post-test design. Random group sampling is used as the technique in taking a sample. Afterthat, the researcher took one class consist of 31 of second grade students as research participants. This research was held in 6 meetings involved pre-test, four meetings for treatment, and post-test. The instrument of data collecting was a written test. In analyzing the data, the researcher used SPSS v.16 and t-test.
PENGARUH MODEL PEMBELAJARAN PROBING PROMPTING LEARNING TERHADAP HASIL BELAJAR SISWA SMA NURUL AMAL
Authors: Theriana Ana
Published: September 2020

The problem in this research was whether there is the effect of the Probing Prompting Learning model on student learning outcomes in the10thgradersof SMANurulAmal Palembang. The purpose of this study was to determine the influence of the Probing Prompting Learning model on student learning outcomes at SMA NurulAmal Palembang. The method used in this study was the experimental method using two classes, namely the experimental class, and the control class. Meanwhile, the data collection technique was done by tests, and documentation techniques, then the data were analyzed by the data analysis technique using t-test analysis. The results showed that the average value of the experimental class was more than 80.24 compared to the control class of 63.6 and the calculations resulted tcountedtableie, 7.02 ≥ 1.667 then Ho was rejected and Ha was accepted. In other words, there was the influence of the Probing Prompting Learning model on learning outcomes.
Konteks dalam Studi Linguistik Pragmatik
Authors: Saifudin Akhmad
Published: September 2020

This paper tries to provide an understanding of the context in pragmatic linguistic studies. Pragmatic linguistic studies are known as branches of linguistics which discuss the meaning of speech based on context. In this paper the context is understood as a conceptual framework about everything that is used as a reference in speaking or understanding speech. Context is classified into two types, namely linguistic and nonlinguistic. Linguistic contexts are contexts whose references are contained in previous speeches and nonlinguistic contexts are not found in speech or outside of language. The nonlinguistic context can be divided into four types, namely physical, psychological, social, and shared knowledge contexts.Keywords: Pragmatics, Context, Text, Meaning,Â Shared knowledge
Teori Tindak Tutur dalam Studi Linguistik Pragmatik
Authors: Saifudin Akhmad
Published: September 2020

This article explains the theory of speech acts proposed by John L. Austin and his student John R. Searle. Speech act theory is a sub-field of pragmatics. This field of study deals with the ways in which words can be used not only to present information but also to carry out actions. This theory considers three levels or components of speech: locutionary acts (the making of a meaningful statement, saying something that a hearer understands), illocutionary acts (saying something with a purpose, such as to inform), and perlocutionary acts (saying something that causes someone to act). Many view speech acts as the central units of communication, with phonological, morphological, syntactic, and semantic properties of an utterance serving as ways of identifying the meaning of speakerâ€™s utterance or illocutionary force. There are fiveÂ types of IllocutionaryÂ point according to Searle: declarations, assertives, expressives, directives, and commissives (1979:viii). A speech act, in order to be successful, needs to be performed along certain types of conditions. These conditions were categorized by the linguist John Searle, who introduced the term felicity conditions: propositional content condition, preparatory condition, sincerity condition, and essential condition.
An Exploratory Study of Omni-Channel Retailing Strategies in the Drugstore Industry: The Case of B Company in Taiwan
Authors: Huang Wei-Jen
Published: September 2020

In recent years, O2O was becoming an important channel strategy actively explored by major companies. This new O2O model was an important marketing development trend, especially within the retail industry. The drugstore industry in Taiwan should also consider using this strategy. However, Philip Kotler emphasized in Marketing 4.0 that the mobile and community era was at hand, represented by the concept of “Mobile Community Marketing,” which could be interpreted as bringing businesses and consumers together to connect virtual and physical networks.
The current study utilized a case method and selected B company as the research object. Several in-depth interviews with multiple senior management directors were conducted. The study findings indicated that omni-channel retailing strategies were becoming more popular and the case company will continue to implement this kind of retailing strategy. The results of this paper could generalize some practical marketing suggestions for the drugstore industry.
The Formation of Thinking
Authors: Hjertström Lappalainen Jonna
Published: September 2020

In recent years, we have seen examples of how political leaders, such as Bolsonaro in Brazil or Orbán in Hungary, have controlled and restricted the freedom of the university in a way that frightens us and reminds us of the inherent fragility of our own societies. However horrible these political acts are, I would like to claim that there is a danger in letting oneself be hypnotized by those who hold political power and who, through dramatic gestures and authoritarian rule, suffocate free thought. Equally important is to pay attention to the slow and barely noticed political processes in which, through government directives and reforms based on economically motivated ideas about efficiency and employability, officials and authorities limit the freedom of higher education. An example of such a process I would like to scrutinize is how thinking came to be regarded as a generic skill in the Western education system.
Metabolic Profiling of a CB2 Agonist, AM9338, Using LC-MS and Microcoil-NMR: Identification of a Novel Dihydroxy Adamantyl Metabolite
Authors: Honrao Chandrashekhar , Ma Xiaoyu , Kulkarni Shashank , Joshi Vinit , Malamas Michael , Zvonok Alexander , Wood JodiAnne , Kautz Roger A. , Strand David , Guo Jason J. , Makriyannis Alexandros
Published: September 2020

Adamantyl groups are key structural subunit commonly used in many marketed drugs targeting diseases ranging from viral infections to neurological disorders. The metabolic disposition of adamantyl compounds has been mostly studied using LC-MS based approaches. However, metabolite quantities isolated from biological preparations are often insufficient for unambiguous structural characterization by NMR. In this work, we utilized microcoil NMR in conjunction with LC-MS to characterize liver microsomal metabolites of an adamantyl based CB2 agonist AM9338, 1-(3-(1H-1,2,3-triazol-1-yl) propyl)-N-(adamantan-1-yl)-1H-indazole-3-carboxamide, a candidate compound for potential multiple sclerosis treatment. We have identified a total of 9 oxidative metabolites of AM9338 whereas mono- or di-hydroxylation of the adamantyl moiety is the primary metabolic pathway. While it is generally believed that the tertiary adamantyl carbons are the preferred sites of CYP450 oxidation, both the mono- and di-hydroxyl metabolites of AM9338 show that the primary oxidative sites are located on the secondary adamantyl carbons. To our knowledge this di-hydroxylated metabolite is a novel adamantyl metabolite that has not been reported before. Further, the stereochemistry of both mono- and di-hydroxyl adamantyl metabolites has been determined using NOE correlations. Furthermore, docking of AM9338 into the CYP3A4 metabolic enzyme corroborates with our experimental findings, and the modelling results also provide a possible mechanism for the unusual susceptibility of adamantyl secondary carbons to metabolic oxidations. The novel dihydroxylated AM9338 metabolite identified in this study, along with the previously known adamantyl metabolites, gives a more complete picture of the metabolic disposition for adamantyl compounds.
Angiotensin Converting Enzyme 2 (ACE2) in Pregnancy: Preeclampsia and Small for Gestational Age
Authors: Tamanna Sonia , Clifton Vicki L. , Rae Kym , van Helden Dirk F. , Lumbers Eugenie R. , Pringle Kirsty G.
Published: September 2020

Introduction

An imbalance in angiotensin (Ang) peptides could contribute to the pathophysiology of preeclampsia (PE) and poor fetal growth.

Methods

We measured maternal plasma levels of Ang peptides and converting enzymes in non-pregnant women (n = 10), in normal pregnant women (n = 59), women delivering small for gestational age babies (SGA, n = 25) across gestation (13–36 weeks) and in women with PE (n = 14) in their third trimester.

Results

Plasma ACE, ACE2, and Ang-(1-7) levels, and ACE2 activity were significantly higher in normal pregnant women compared with non-pregnant women; neprilysin (NEP) levels were not changed. In SGA pregnancies, ACE and ACE2 levels were higher in early-mid pregnancy compared with normal pregnant women. In women with PE, plasma ACE, ACE2, NEP, and Ang-(1-7) levels and ACE2 activity were lower than levels in normal pregnant women.

Conclusion

The higher plasma ACE2 levels and activity in pregnancy could be driving the higher Ang-(1-7) levels. The early gestation increases in ACE and ACE2 levels in SGA pregnancies highlights the possibility that these enzymes could be used as potential early biomarkers of poor fetal growth. In women with PE, the reduced ACE2 and NEP levels at term, could be contributing to the reduction in Ang-(1-7) levels. These findings suggest that dysfunctional relationships between two key enzymes in the circulating RAS are involved in the pathogenesis of PE and SGA. Since soluble ACE2 can prevent binding of the novel coronavirus, SARS-CoV-2, to membrane bound ACE2, the interplay between ACE2 and the coronavirus and its impact in pregnancy requires further investigation.