The clash of rural-urban migrants and real estate investors on Phnom Penh's housing market: Prospects for garment workers

Housing markets of large cities around the world, particularly in so-called developing and emerging countries, are currently experiencing a clash: On the one hand, large numbers of labour migrants arrive from rural areas and need cheap rental housing. On the other hand, international real estate investment, particularly in the upper market segment, is strong. The resulting mismatch of housing demand and supply increases segregation, marginalises the vulnerable and leads to massive urban development problems. Phnom Penh illustrates this particularly well: Along with Cambodia's rapid globalisation in the last decades, hundreds of thousands of migrants, particularly garment workers, have moved to the capital. Housing for them is insufficient both in terms of supply and quality, though, because Phnom Penh's entrepreneurial mode of governance also attracts many investors, who focus on more profitable and prestigious real estate projects, often linked to speculation. These push land values up and push cheap rental housing further and further outside the city. This study carries out an indepth analysis of the prospects for rural-urban migrant workers on Phnom Penh's investor-driven housing market by firstly outlining both migration and real estate investment trends and by secondly examining the case of garment workers' housing. To complement the scarce literature on the topic, field research and expert interviews have been conducted. From these, an assessment of the status quo, of stakeholders' approaches to it and finally, proposals for action are derived

Positionen zivilgesellschaftlicher Akteure und von Parteien zu Wettbewerb im Gesundheitswesen

Eine zentrale Rolle in der gesundheitspolitischen Auseinandersetzung spielen Ausmaß und Ausgestaltung des Wettbewerbs im Gesundheitssystem. Schwerpunkt dieses Artikels ist die Darstellung der unterschiedlichen Standpunkte von Parteien und zivilgesellschaftlichen Akteuren zum Systemwettbewerb zwischen Gesetzlicher (GKV) und Privater Krankenversicherung (PKV) im dualen Krankenversicherungssystem.A central issue in current health policy debates is the role of competition and its organisation in the German health care system. This article focuses on the different positions of political parties and civil society actors on competition between statutory health insurance (SHI) and private health insurance (PHI) in the dual health insurance system

Positionen zivilgesellschaftlicher Akteure und von Parteien zu Wettbewerb im Gesundheitswesen

Eine zentrale Rolle in der gesundheitspolitischen Auseinandersetzung spielen Ausmaß und Ausgestaltung des Wettbewerbs im Gesundheitssystem. Schwerpunkt dieses Artikels ist die Darstellung der unterschiedlichen Standpunkte von Parteien und zivilgesellschaftlichen Akteuren zum Systemwettbewerb zwischen Gesetzlicher (GKV) und Privater Krankenversicherung (PKV) im dualen Krankenversicherungssystem.A central issue in current health policy debates is the role of competition and its organisation in the German health care system. This article focuses on the different positions of political parties and civil society actors on competition between statutory health insurance (SHI) and private health insurance (PHI) in the dual health insurance system

Evaluation of soluble junctional adhesion molecule-A as a biomarker of human brain endothelial barrier breakdown

Background: An inducible release of soluble junctional adhesion molecule-A (sJAM-A) under pro-inflammatory conditions was described in cultured non-CNS endothelial cells (EC) and increased sJAM-A serum levels were found to indicate inflammation in non-CNS vascular beds. Here we studied the regulation of JAM-A expression in cultured brain EC and evaluated sJAM-A as a serum biomarker of blood-brain barrier (BBB) function. Methodology/Principal Findings: As previously reported in non-CNS EC types, pro-inflammatory stimulation of primary or immortalized (hCMEC/D3) human brain microvascular EC (HBMEC) induced a redistribution of cell-bound JAM-A on the cell surface away from tight junctions, along with a dissociation from the cytoskeleton. This was paralleled by reduced immunocytochemical staining of occludin and zonula occludens-1 as well as by increased paracellular permeability for dextran 3000. Both a self-developed ELISA test and Western blot analysis detected a constitutive sJAM-A release by HBMEC into culture supernatants, which importantly was unaffected by pro-inflammatory or hypoxia/reoxygenation challenge. Accordingly, serum levels of sJAM-A were unaltered in 14 patients with clinically active multiple sclerosis compared to 45 stable patients and remained unchanged in 13 patients with acute ischemic non-small vessel stroke over time. Conclusion: Soluble JAM-A was not suited as a biomarker of BBB breakdown in our hands. The unexpected non-inducibility of sJAM-A release at the human BBB might contribute to a particular resistance of brain EC to inflammatory stimuli, protecting the CNS compartment

Identification of the flotillin-1/2 heterocomplex as a target of autoantibodies in bona fide multiple sclerosis

Background: Autoantibodies, in particular those against aquaporin-4 and myelin-oligodendrocyte glycoprotein (MOG), aid as biomarkers in the differential diagnosis of demyelination. Here, we report on discovery of autoantibodies against flotillin in patients with multiple sclerosis (MS). Methods: The target antigen was identified by histo-immunoprecipitation using the patients’ sera and cryosections of rat or pig cerebellum combined with mass spectrometrical analysis. Correct identification was ascertained by indirect immunofluorescence and neutralization tests using the target antigens recombinantly expressed in HEK293 cells. Results: Serum and CSF of the index patient produced a fine-granular IgG indirect immunofluorescence staining of the hippocampal and cerebellar molecular layers. Flotillin-1 and flotillin-2 were identified as target autoantigens. They also reacted with recombinant human flotillin-1/2 co-expressed in HEK293 cells, but not with the individual flotillins in fixed- and live-cell assays. Moreover, neutralization using flotillin-1/2, but not the single flotillins, abolished the tissue reactivity of patient serum. Screening of 521 patients, for whom anti-aquaporin-4 testing was requested and negative, revealed 8 additional patients with anti-flotillin-1/2 autoantibodies. All eight were negative for anti-MOG. Six patients ex post fulfilled the revised McDonald criteria for MS. Vice versa, screening of 538 MS sera revealed anti-flotillin-1/2 autoantibodies in eight patients. The autoantibodies were not found in a cohort of 67 patients with other neural autoantibody-associated syndromes and in 444 healthy blood donors. Conclusions: Autoantibodies against the flotillin-1/2 heterocomplex, a peripheral membrane protein that is involved in axon outgrowth and regeneration of the optic nerve, are present in 1–2% of patients with bona fide MS

Investigation of sex-specific effects of apolipoprotein E on severity of EAE and MS

Background Despite pleiotropic immunomodulatory effects of apolipoprotein E (apoE) in vitro, its effects on the clinical course of experimental autoimmune encephalomyelitis (EAE) and multiple sclerosis (MS) are still controversial. As sex hormones modify immunomodulatory apoE functions, they may explain contentious findings. This study aimed to investigate sex-specific effects of apoE on disease course of EAE and MS. Methods MOG35-55 induced EAE in female and male apoE-deficient mice was assessed clinically and histopathologically. apoE expression was investigated by qPCR. The association of the MS severity score (MSSS) and APOE rs429358 and rs7412 was assessed across 3237 MS patients using linear regression analyses. Results EAE disease course was slightly attenuated in male apoE-deficient (apoE −/− ) mice compared to wildtype mice (cumulative median score: apoE −/−  = 2 [IQR 0.0–4.5]; wildtype = 4 [IQR 1.0–5.0]; n = 10 each group, p = 0.0002). In contrast, EAE was more severe in female apoE −/− mice compared to wildtype mice (cumulative median score: apoE −/−  = 3 [IQR 2.0–4.5]; wildtype = 3 [IQR 0.0–4.0]; n = 10, p = 0.003). In wildtype animals, apoE expression during the chronic EAE phase was increased in both females and males (in comparison to naïve animals; p < 0.001). However, in MS, we did not observe a significant association between MSSS and rs429358 or rs7412, neither in the overall analyses nor upon stratification for sex. Conclusions apoE exerts moderate sex-specific effects on EAE severity. However, the results in the apoE knock-out model are not comparable to effects of polymorphic variants in the human APOE gene, thus pinpointing the challenge of translating findings from the EAE model to the human disease

Peripheral blood biomarkers in multiple sclerosis.

Multiple sclerosis is the most common autoimmune disorder affecting the central nervous system. The heteroge-neity of pathophysiological processes in MS contributes to the highly variable course of the disease and unpre-dictable response to therapies. The major focus of the research on MS is the identification of biomarkers inbiologicalfluids, such as cerebrospinalfluid or blood, to guide patient management reliably. Because of the diffi-culties in obtaining spinalfluid samples and the necessity for lumbar puncture to make a diagnosis has reduced,the research of blood-based biomarkers may provide increasingly important tools for clinical practice. However,currently there are no clearly established MS blood-based biomarkers. The availability of reliable biomarkerscould radically alter the management of MS at critical phases of the disease spectrum, allowing for interventionstrategies that may prevent evolution to long-term neurological disability. This article provides an overview ofthis researchfield and focuses on recent advances in blood-based biomarker researc

ASO Author Reflections: How Many Centers Do We Need for High-Quality Penile Cancer Surgery in Germany? An Analysis of Total Population Data from 2006 to 2016

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