Social entrepreneurship: problems and ways of their solution

For modern constantly developing societies, it is normal to create categories in the process of the activity of the participants of socio-economic processes themselves. Practice is theoretical, and theory is pragmatic, because it creates those concepts in which «practice» exists and develops. Such a category is "social entrepreneurship", which is "umbrella" for a number of socio-economic phenomena. The general term for social entrepreneurship includes those types of entrepreneurial activity that contradict the traditional notion of entrepreneurship as an activity of independent economic entities aimed at maximizing their profits. The development of social entrepreneurship is an indicator of the quality of the business climate in the region and requires a set of measures to ensure the mechanism and access of non-governmental organizations to the provision of services in the social sphere, the provision of state support to socially-oriented non-profit organizations, and the promotion of the development of PPP practices in the social sphere

がん抑制因子Reckは母体および胎児の血管リモデリングに関与する

京都大学0048新制・課程博士博士(医学)甲第15716号医博第3504号新制||医||984(附属図書館)28261京都大学大学院医学研究科分子医学系専攻(主査)教授 小西 郁生, 教授 武田 俊一, 教授 開 祐司学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDA

Urinary Biomarkers KIM-1 and NGAL for Detection of Chronic Kidney Disease of Uncertain Etiology (CKDu) among Agricultural Communities in Sri Lanka.

Chronic Kidney Disease of uncertain etiology (CKDu) is an emerging epidemic among farming communities in rural Sri Lanka. Victims do not exhibit common causative factors, however, histopathological studies revealed that CKDu is a tubulointerstitial disease. Urine albumin or albumin-creatinine ratio is still being used as a traditional diagnostic tool to identify CKDu, but accuracy and prevalence data generated are questionable. Urinary biomarkers have been used in similar nephropathy and are widely recognised for their sensitivity, specificity and accuracy in determining CKDu and early renal injury. However, these biomarkers have never been used in diagnosing CKDu in Sri Lanka. Male farmers (n = 1734) were recruited from 4 regions in Sri Lanka i.e. Matara and Nuwara Eliya (farming locations with no CKDu prevalence) and two CKDu emerging locations from Hambantota District in Southern Sri Lanka; Angunakolapelessa (EL1) and Bandagiriya (EL2). Albuminuria (ACR ≥ 30mg/g); serum creatinine based estimation of glomerular filtration rate (eGFR); creatinine normalized urinary kidney injury molecule (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) were measured. Fourteen new CKDu cases (18%) from EL1 and nine CKDu cases (9%) from EL2 were recognized for the first time from EL1, EL2 locations, which were previously considered as non-endemic of the disease and associated with persistent albuminuria (ACR ≥ 30mg/g Cr). No CKDu cases were identified in non-endemic study locations in Matara (CM) and Nuwara Eliya (CN). Analysis of urinary biomarkers showed urinary KIM-1 and NGAL were significantly higher in new CKDu cases in EL1 and EL2. However, we also reported significantly higher KIM-1 and NGAL in apparently healthy farmers in EL 1 and EL 2 with comparison to both control groups. These observations may indicate possible early renal damage in absence of persistent albuminuria and potential capabilities of urinary KIM-1 and NGAL in early detection of renal injury among farming communities in Southern Sri Lanka

Association of albumin to creatinine ratio (ACR, mg/g Cr) with urinary KIM-1 (5A), estimated glomerular filtration rate (eGFR) (ml/min/1.73 m²) with urinary KIM-1 (5B), albumin to creatinine ratio (ACR, mg/g Cr) with urinary neutrophil gelatinase-associated lipocalin (5C) and estimated glomerular filtration rate (eGFR) (ml/min/1.73 m²) with urinary NGAL (5D) in the CKDu emerging locations EL1 and EL2.

<p>Association of albumin to creatinine ratio (ACR, mg/g Cr) with urinary KIM-1 (5A), estimated glomerular filtration rate (eGFR) (ml/min/1.73 m²) with urinary KIM-1 (5B), albumin to creatinine ratio (ACR, mg/g Cr) with urinary neutrophil gelatinase-associated lipocalin (5C) and estimated glomerular filtration rate (eGFR) (ml/min/1.73 m²) with urinary NGAL (5D) in the CKDu emerging locations EL1 and EL2.</p

Study locations of the current study (Agunukolapalassa; EL1, Badagiriya; EL2, Matara; CM) in Southern Province and Nuwara Eliya (CN) in Central Province represented with different climatic zones in Sri Lanka.

<p>Study locations of the current study (Agunukolapalassa; EL1, Badagiriya; EL2, Matara; CM) in Southern Province and Nuwara Eliya (CN) in Central Province represented with different climatic zones in Sri Lanka.</p

Baseline characteristics of the study populations representing non-endemic control groups (CM & CN), CKDu emerging locations Angunakolapelessa (EL1) and Bandagiriya (EL2).

<p>All variables are presented as % and numbers indicates medical conditions.</p

Clinical characteristics of the study populations representing non-endemic locations in Matara (CM), Nuwara Eliya (CN) and CKDu emerging locations Angunakolapelessa (EL1) and Bandagiriya (EL2).

<p>Clinical characteristics of the study populations representing non-endemic locations in Matara (CM), Nuwara Eliya (CN) and CKDu emerging locations Angunakolapelessa (EL1) and Bandagiriya (EL2).</p

Flow chart representing study populations and study design in non-endemic control locations in Matara (CM), Nuwara Eliya (CN) and two farming locations (Agunukolapalassa—EL1 & Badagiriya—EL2).

<p>Flow chart representing study populations and study design in non-endemic control locations in Matara (CM), Nuwara Eliya (CN) and two farming locations (Agunukolapalassa—EL1 & Badagiriya—EL2).</p

Urinary Biomarkers KIM-1 and NGAL for Detection of Chronic Kidney Disease of Uncertain Etiology (CKDu) among Agricultural Communities in Sri Lanka

<div><p>Chronic Kidney Disease of uncertain etiology (CKDu) is an emerging epidemic among farming communities in rural Sri Lanka. Victims do not exhibit common causative factors, however, histopathological studies revealed that CKDu is a tubulointerstitial disease. Urine albumin or albumin-creatinine ratio is still being used as a traditional diagnostic tool to identify CKDu, but accuracy and prevalence data generated are questionable. Urinary biomarkers have been used in similar nephropathy and are widely recognised for their sensitivity, specificity and accuracy in determining CKDu and early renal injury. However, these biomarkers have never been used in diagnosing CKDu in Sri Lanka. Male farmers (n = 1734) were recruited from 4 regions in Sri Lanka i.e. Matara and Nuwara Eliya (farming locations with no CKDu prevalence) and two CKDu emerging locations from Hambantota District in Southern Sri Lanka; Angunakolapelessa (EL1) and Bandagiriya (EL2). Albuminuria (ACR ≥ 30mg/g); serum creatinine based estimation of glomerular filtration rate (eGFR); creatinine normalized urinary kidney injury molecule (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) were measured. Fourteen new CKDu cases (18%) from EL1 and nine CKDu cases (9%) from EL2 were recognized for the first time from EL1, EL2 locations, which were previously considered as non-endemic of the disease and associated with persistent albuminuria (ACR ≥ 30mg/g Cr). No CKDu cases were identified in non-endemic study locations in Matara (CM) and Nuwara Eliya (CN). Analysis of urinary biomarkers showed urinary KIM-1 and NGAL were significantly higher in new CKDu cases in EL1 and EL2. However, we also reported significantly higher KIM-1 and NGAL in apparently healthy farmers in EL 1 and EL 2 with comparison to both control groups. These observations may indicate possible early renal damage in absence of persistent albuminuria and potential capabilities of urinary KIM-1 and NGAL in early detection of renal injury among farming communities in Southern Sri Lanka.</p></div

Creatinine adjusted tubular markers (KIM-1 & NGAL) and clinical data in non-endemic controls (CM & CN) and two CKDu emerging locations (EL1 and EL2).

<p>EL1 and EL2 further divided as control subjects from the same locations (C-EL1 & C-EL2) and CKDu subjects (EL1-CKDu & EL2- CKDu). All variables are present as mean (SEM) and range.</p