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Metastatic renal cell carcinoma (RCC) has a poor prognosis. Recent advances have shown beneficial responses to immune checkpoint inhibitors, such as anti-PD-1/PD-L1 antibodies. As only a subset of RCC patients respond, alternative strategies should be explored. Patients refractory to anti-PD-1 therapy may benefit from autologous tumor-infiltrating lymphocyte (TIL) therapy. Even though efficient TIL expansion was reported from RCC lesions, it is not well established how many RCC TIL products are tumor-reactive, how well they produce pro-inflammatory cytokines in response to autologous tumors, and whether their response correlates with the presence of specific immune cells in the tumor lesions. We here compared the immune infiltrate composition of RCC lesions with that of autologous kidney tissue of 18 RCC patients. Tcell infiltrates were increased in the tumor lesions, and CD8+ Tcell infiltrates were primarily of effector memory phenotype. https://www.selleckchem.com/products/cid755673.html Nine out of 16 (56%) tested TIL products we generated were tumor-reactive, as defined by CD137 upregulation after exposure to autologous tumor digest. Tumor reactivity was found in particular in TIL products originating from tumors with ahigh percentage of infiltrated Tcells compared to autologous kidney, and increased CD25 expression on CD8+ Tcells. Importantly, although TIL products had the capacity to produce the key effector cytokines IFN-γ, TNF-α or IL-2, they failed to produce significant amounts in response to autologous tumor digests. In conclusion, TIL products from RCC lesions contain tumor-reactive Tcells. Their restricted tumor-specific cytokine production requires further investigation of immunosuppressive factors in RCC and subsequent optimization of RCC-derived TIL culture conditions.[This corrects the article DOI 10.1080/2162402X.2018.1461303.].

To study the trends in and risk factors for patient delay (the time from the onset of symptoms to the initial doctor visit) in pulmonary tuberculosis (PTB) using three temporal categories - short (2 weeks to <2months), medium (2months to <6months) and long (≥6months) - and discuss implications for social protection measures.

A descriptive cross-sectional study was conducted by analysing Japanese TB surveillance data from patients with symptomatic PTB registered between 2007 and 2017 (

=88351).

While the proportion of patients with short delay has decreased significantly (

<0.001), the proportions of those with medium or long delays have decreased slightly (

=0.0015 and

<0.001, respectively). Not having health insurance, receiving public assistance, being a temporary worker, and having a history of homelessness were some of the risks identified for patient delay. Being male and working full-time were two risks specifically associated with long delay (for males, the adjusted odds ratio=1.17,

<0.05; for being a full-time worker, the adjusted odds ratio=1.72,

<0.05).

Despite the implementation of universal health coverage decades ago, patient delay remains a challenge in Japan. Our study identified various risk factors, many of which could have been resolved if appropriate social protection measures were in place, indicating shortcomings in universal health coverage in Japan and the need for continued effort to ensure that no one is left behind.

Despite the implementation of universal health coverage decades ago, patient delay remains a challenge in Japan. Our study identified various risk factors, many of which could have been resolved if appropriate social protection measures were in place, indicating shortcomings in universal health coverage in Japan and the need for continued effort to ensure that no one is left behind.

The burden of influenza on primary health-care services is not well established in tropical countries, where there are no clearly defined influenza seasons. We aimed to estimate the association between influenza infection activity and polyclinic attendance rates for upper respiratory tract infections (URTIs) in the Singapore population.

We used generalized additive time series models to estimate the association between the proportion of respiratory tests positive for influenza infection in Singapore reported to the World Health Organization every week, and the population rate of polyclinic attendances in Singapore for physician-diagnosed URTI, which includes influenza-like illness (ILI), for sixyears from 2012 through 2017. Where data were available, we controlled for other infections that can cause fever or respiratory symptoms.

Influenza, dengue fever and chickenpox (varicella) were positively associated with acute URTI polyclinic attendances. The estimated URTI polyclinic attendance rates attributable to influenza, dengue fever and chickenpox were 618.9 (95% confidence interval [CI] 501.6-736.3), 153.3 (95% CI 16.5-290.2) and 1751.5 (95% CI 1246.3-2256.8) per 100000 population per year, respectively.

Influenza poses a considerable burden on primary health-care services in Singapore. However, a substantial number of polyclinic attendances due to febrile infections such as dengue fever and chickenpox appear to be recorded as URTI in the polyclinic database. These associations require further investigation.

Influenza poses a considerable burden on primary health-care services in Singapore. However, a substantial number of polyclinic attendances due to febrile infections such as dengue fever and chickenpox appear to be recorded as URTI in the polyclinic database. These associations require further investigation.

The study aimed to determine the factors that influence vaccine hesitancy among parents and caregivers of children 2years old and younger in selected urban communities in Manila, Philippines.

The study used a cross-sectional study design with a modified questionnaire adapted from the SAGE Working Group on Vaccine Hesitancy. Self-administered surveys were conducted in two highly urbanized barangays (smallest administrative divisions) in Manila, Philippines.

The survey was completed by 110 respondents, comprised mostly of 20-39-year-old mothers. Most respondents (95.5%) believed that vaccines are protective however vaccine hesitancy rates among the respondents reached 36.4%. Respondents who believed in the protective nature of vaccines were less likely to report vaccine hesitancy and were nine times less likely to refuse vaccination for their children because of negative media exposure. The main reasons identified for vaccine hesitancy were exposure to negative media information and concerns about vaccine safety.