Locating the housing crisis in Kuwaiti state, land and society

Despite the oil wealth and hyper-welfare provision to its citizens, Kuwait has seen the rise of a ‘housing crisis’ discourse in recent years. This paper aims to provide an opportunity to understand the nature of Kuwait’s housing crisis and the reasons behind the state’s perceived inability to respond to it. Through the analysis of research findings from the field, we argue that the housing crisis in Kuwait is socially constructed, reflecting the multi- layered conditions of historic provision and consumption of housing in Kuwaiti society. The formulation of the housing crisis can be further disaggregated into (a) the crisis of the Kuwaiti welfare state, (b) the crisis of land development and (c) the society in crisis. Tackling the housing crisis, therefore, requires a holistic approach that involves multi-level stakeholder engagement, including a wide range of citizens. Our study on housing in Kuwait draws attention to the country’s contemporary state–society relations and the complexities of housing crises unfolding globally

Neuroprotective strategies for acute ischemic stroke: recent progress and future perspectives

Stroke is one of the leading causes of death and most common cause of disability in adult. Despite of recent advances in the recanalization therapy for acute ischemic stroke, the need for neuroprotectants is substantial, to extend the window for recanalization therapy and to prevent neuronal death by ischemic brain injury or by reperfusion injury after successful therapy. Herein, the possible reasons for the failure of neuroprotectants trials during the past two decades and current status of neuroprotective strategies for acute ischemic stroke are discussed. This review will also address the recent advances and future perspectives in preclinical and clinical trials of neuroprotective agents, including the efforts of high quality of transition of preclinical results to clinical trial, genetic studies to trigger neuroprotectants development, application of neuroprotectants at optimal time and duration after stroke, adjuvant approaches, and biomarker-based triage

Silent brain infarction: a quiet predictor of future stroke

A silent brain infarct (SBI) is defined as imaging or neuropathological evidence of brain infarction without a history of acute neurological dysfunction attributable to the lesion. The number of patients with SBIs is estimated as several-fold higher than the number with clinical stroke. In addition, SBIs have important clinical implications. The presence of SBIs more than doubles the risk of subsequent stroke and dementia. Although most SBIs are lacunes, for which hypertensive small vessel disease is thought to be the main cause, some of them could be embolic in origin. The pathological mechanisms of SBIs and most effective strategies for prevention of future stroke may differ depending on the cause of the SBI. The literature reviewed and cases presented herein underscore the need for application of appropriate workups and therapeutic strategies in patients with SBIs. In this review, the definition, causes, and clinical impact of SBIs are discussed, together with the questions that remain open and recent advances (e.g., machine learning techniques) in the study of SBIs

Stem cell therapy for stroke: lessons learned from recent successful randomized trials of interventional therapy for stroke

Cell-based therapy is a promising approach for treating acute stroke patients as well as those with fixed neurological deficits, and therefore, the number of stem cell trials conducted on stroke patients is increasing. However, more studies are needed to conclude the efficacy of stem cell therapy because while several studies showed a beneficial effect, there was significant bias in subsequent studies. Meanwhile, there have been recent advances in stroke treatment such as endovascular therapy for acute ischemic stroke and catheter-based closing of a patent foramen ovale in cryptogenic stroke. Clinical trials of the latter two interventional therapies have very similar histories of consistent success after repeated failures. In this review, the factors related to the success of these interventional therapies are discussed and applied to stem cell therapy for stroke patients. Through continued efforts, there is hope for success in stem cell therapy for stroke patients

Advances in biomarker for stroke patients: from marker to regulator

Biomarkers refer to indicators found in the blood, other body fluids or tissues that predict physiologic or disease states, increased disease risk, or pharmacologic responses to a therapeutic intervention. Stroke is a heterogeneous condition, and stroke biomarkers could be used as a guiding tool for more effective personalized therapy. In this review, the recent advances in the biomarkers in stroke field are discussed. First, various types of biomarkers including genetic, extracellular vesicle, and metabolomics-associated biomarkers as well as protein biomarkers were recently introduced. The studies reviewed herein suggest that comprehensive analysis of different types of stroke biomarkers will improve the understanding of individual pathophysiologies and further promote the development of screening tool of high-risk patients, predicting model of stroke outcome and rational stroke therapy tailored to the characteristics of each case. Second, several biomarkers can be bio-‘makers’ that regulate compensatory or pathological process in the development of stroke etiology and recovery after stroke. Several protein (e.g.,chemokines, caveoli), genetic (e.g., microRNA), and extracellular vesicles (e.g., cancer cell, stem cells-derived) may be directly involved in these processes. These bio-makers may be molecular target of treatment and can be used for new drug development

Mesenchymal Stem Cell-Derived Extracellular Vesicle Therapy for Stroke: Challenges and Progress

Stroke is the leading cause of physical disability among adults. Stem cells such as mesenchymal stem cells (MSCs) secrete a variety of bioactive substances, including trophic factors and extracellular vesicles (EVs), into the injured brain, which may be associated with enhanced neurogenesis, angiogenesis, and neuroprotection. EVs are circular membrane fragments (30 nm−1 μm) that are shed from the cell surface and harbor proteins, microRNAs, etc. Since 2013 when it was first reported that intravenous application of MSC-derived EVs in a stroke rat model improved neurological outcomes and increased angiogenesis and neurogenesis, many preclinical studies have shown that stem cell-derived EVs can be used in stroke therapy, as an alternative approach to stem cell infusion. Although scientific research regarding MSC-derived EV therapeutics is still at an early stage, research is rapidly increasing and is demonstrating a promising approach for patients with severe stroke. MSC therapies have already been tested in preclinical studies and clinical trials, and EV-mediated therapy has unique advantages over cell therapies in stroke patients, in terms of biodistribution (overcoming the first pass effect and crossing the blood-brain-barrier), cell-free paradigm (avoidance of cell-related problems such as tumor formation and infarcts caused by vascular occlusion), whilst offering an off-the-shelf approach for acute ischemic stroke. Recently, advances have been made in the understanding of the function and biogenesis of EVs and EVs therapeutics for various diseases. This review presents the most recent advances in MSC-derived EV therapy for stroke, focusing on the application of this strategy for stroke patients