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Overexpression of soluble urokinase receptor (suPAR) causes pathology in animal models similar to primary FSGS, and one recent study demonstrated elevated levels of serum suPAR in patients with the disease. Here, we analyzed circulating suPAR levels in two cohorts of children and adults with biopsyproven primary FSGS: 70 patients from the North America-based FSGS clinical trial (CT) and 94 patients from PodoNet, the Europe-based consortium studying steroid-resistant nephrotic syndrome. Circulating suPAR levels were elevated in 84.3% and 55.3% of patients with FSGS patients in the CT and PodoNet cohorts, respectively, compared with 6% of controls (P,0.0001); inflammation did not account for this difference. Multiple regression analysis suggested that lower suPAR levels associated with higher estimated GFR, male sex, and treatment with mycophenolate mofetil. In the CT cohort, there was a positive association between the relative reduction of suPAR after 26 weeks of treatment and reduction of proteinuria, with higher odds for complete remission (P=0.04). In the PodoNet cohort, patients with an NPHS2 mutation had higher suPAR levels than those without a mutation. In conclusion, suPAR levels are elevated in geographically and ethnically diverse patients with FSGS and do not reflect a nonspecific proinflammatory milieu. The associations between a change in circulating suPAR with different therapeutic regimens and with remission support the role of suPAR in the pathogenesis of FSGS.

Our results indicate a strong association between LVH and enhanced expression levels of FGF23, FGFR4 and calcineurin, activation of NFAT and reduced levels of soluble Klotho in the myocardium of patients with CKD. These alterations are not observed in kidney transplant patients.

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Purpose The purpose of this paper is to examine the role of regulatory focus in sustainable entrepreneurship processes to answer questions on how sustainable entrepreneurs pursue their goals and what motivates them. Knowledge about an entrepreneur’s motivational attribute is essential when trying to understand new venture creation processes. To determine an entrepreneur’s affiliation with one of the two self-regulatory systems, promotion focus and prevention focus, it is helpful to establish whether he or she is motivated by growth and development goals (promotion) or rather by responsibility and security goals (prevention). Design/methodology/approach In a qualitative study of seven sustainable ventures, two semi-structured interview rounds with 14 founders were conducted. Archival data from internal and external sources were gathered, resulting in more than 80 text documents. Findings Findings reveal that the self-regulatory focus of sustainable entrepreneurs changes during the entrepreneurial process with regard to the temporal dynamics of motivation. While conceiving ideas, sustainable entrepreneurs engage in a prevention-focused self-regulatory process because social or ecological problems induce them to direct their attention toward sustainable development goals. During rollout, in contrast, they increasingly engage in a promotion-focused self-regulatory process and concentrate more on venture growth goals. Practical implications The results highlight the important role of a regulatory fit between key self-regulatory entrepreneurial behaviors and entrepreneurs’ regulatory orientation toward increased motivation and enjoyment when pursuing goals. Originality/value This study’s contributions extend and combine the theories of regulatory focus, entrepreneurial motivation, and entrepreneurial processes in the field of sustainable entrepreneurship. They are valuable for understanding the determinants of sustainable entrepreneurial action.

AimsThe objective of this study was to examine cognitive and psychological processes systematically in patients with decompensated chronic heart failure (CHF) and to document changes in cognitive function after compensation. Executive functions, episodic memory, and attention are impaired in patients with stable CHF, influencing health behaviour and disease management. Cognitive function and psychological co-morbidities are associated with hospitalization, disability, and mortality. Methods and resultsCognitive performance, self-perceived quality of life, and depression were compared in 20 patients with decompensated CHF [ejection fraction (EF) 27 + 8%, N-terminal pro brain natriuretic peptide (NT-proBNP) 10 880 pg/mL, interquartile range (4495-13 683)] before and after compensation, 20 age-and gender-matched stable CHF patients [New York Heart Assocation (NYHA) III -IV, EF 32 + 10%, NT-proBNP 1881 pg/mL (323 -1502)], and 20 healthy controls (EF 70 + 5%). Patients with decompensated CHF showed significantly poorer performance in terms of short-term memory, working memory, executive control, and processing speed (P , 0.05) compared with stable CHF patients. Compensation improved the cognitive performance of decompensated CHF patients up to the level of patients with stable CHF. Compared with healthy controls, both patient groups were affected with respect to episodic memory (P , 0.0001) and fluid intelligence (P , 0.01). ConclusionDecompensated heart failure patients are highly impaired in cognitive functioning, which improves but does not normalize after compensation. Neuropsychological diagnostics delivers important details for daily life activities and might identify individuals deserving special care.--