BackgroundAlthough Bangladesh has achieved tremendous success in health care over the last four decades, it still lagged behind in the areas of maternal and child malnutrition and primary health care (PHC). To increase access to PHC, the Bangladesh government established approximately 18,000 community clinics (CCs). The purpose of this study was to examine the associations of socioeconomic determinants of women aged 12–49 years with the CCs awareness and visitation.MethodsWe analyzed secondary data provided by Bangladesh Demographic and Health Survey-2011. A two-stage cluster sampling was used to collect the data. A total of 18,222 ever married women aged 12–49 years were identified from selected households and 17,842 were interviewed. The main outcome measures of our study were awareness and visitation of CCs. Bivariate logistic regression was used to calculate odds ratio (OR) and 95 % confidence interval (CI) to examine the associations between the awareness and visiting CCs with socioeconomic determinants.ResultsLow prevalence of awareness about CC (18 %) was observed among studied women and only 17 % of them visited CCs. Significant associations (P < 0.05) with CCs awareness and visitation were observed among aged 20–29 years (adjusted OR = 1.18; 95 % CI = 1.03–1.35 and adjusted OR = 1.49; 95 % CI = 1.05–2.11), primary education (adjusted OR = 1.20; 95 % CI = 1.08–1.34 and adjusted OR = 1.37; 95 % CI = 1.05–1.78), and poorest family (adjusted OR = 1.21; 95 % CI = 1.03–1.42 and adjusted OR = 2.36; 95 % CI = 1.56–3.55, respectively), after controlling potential confounders.ConclusionsAwareness and visitation of CCs were found to be positively associated with lower economic conditions, young age, and primary education. Awareness and access to CCs might be increased through community activities that involve health care workers. The government should also lower barriers to PHC access through CCs by providing adequate logistics, such as human resources and equipment.

Introduction: This study aimed to assess the knowledge and practice of health care workers (HCWs) towards universal precautions (UPs) and to look into any associations between knowledge and practice. Methodology: A cross-sectional study was undertaken between August and October 2012, involving 300 HCWs from four national public hospitals in Kabul, Afghanistan. A self-administered questionnaire assessing the knowledge and practice of UPs was used. Results: Among the 300 respondents, the mean knowledge score was 5.2 with a standard deviation (SD) of 1.5. On the practice score, the mean was 8.7 (SD = 2.2). A total of 90.6% and 70.8% of HCWs believed that UPs were necessary in contact with urine/feces and tears, respectively, although UPs are not necessary in these cases. On the other hand, 57.8% reported that they always recapped the needle after giving an injection, and 31.8% did not always change gloves in between patients. There were no associations between the knowledge and self-reported practice of UPs. Conclusions: The HCWs in Kabul had inadequate knowledge and poor practice of UPs. Training for HCWs is needed to encourage them to adhere to practice based on improved knowledge.

Neuroblastoma is the most common extracranial solid tumor in children that is refractory to intensive multimodal therapy. In particular, tumor-initiating cells (TICs) derived from neuroblastoma are believed responsible for tumor formation and resistance to the conventional therapy; an optimal strategy therefore should target this population. Technically, TICs can be enriched from neuroblastoma-derived spheres when the tumor cells are cultured in a serum-free medium supplemented with certain growth factors. Recently, a line of evidence has suggested antitumor potential of Vγ9Vδ2 T cells (γδ T cells), a T-cell population that recognizes and kills target cells independent of surface HLA expressions. Furthermore, a mevalonate pathway inhibitor, zoledronate, has been reported to enhance cytolytic activity of γδ T cells. On the basis of these findings, we hypothesized that zoledronate would sensitize neuroblastoma TICs to γδ T-cell-mediated cytolysis and promote therapeutic efficacy against neuroblastoma. In the current study, we show that zoledronate efficiently sensitizes both neuroblastoma-derived adherent cells and sphere-forming cells to γδ T-cell-mediated cytolysis. Subsequently, in vitro colony formation inhibition assay and in vivo animal studies reveal that the presence of γδ T cells decelerates outgrowth of neuroblastoma TICs. We finally show that addition of interleukin-15 and/or interleukin-18 in culture enhances the cytolytic activity of γδ T cells. On the basis of these data, we conclude that ex vivo expanded γδ T cells are a promising tool for antineuroblastoma immunotherapy with options for further improvement.

Glypican-3 (GPC3) is useful not only as a novel tumor marker, but also as an oncofetal antigen for immunotherapy. We recently established HLA-A2-restricted GPC3 [144][145][146][147][148][149][150][151][152] peptide-specific CTL clones from hepatocellular carcinoma patients after GPC3 [144][145][146][147][148][149][150][151][152] peptide vaccination. The present study was designed to evaluate the tumor reactivity of a HLA-A2-restricted GPC3 144-152 peptidespecific CTL clone against ovarian clear cell carcinoma (CCC) cell lines. The GPC3 144-152 peptide-specific CTL clone could recognize HLA-A2-positive and GPC3-positive ovarian CCC cell lines on interferon (IFN)-c enzyme-linked immunospot assay and showed cytotoxicity against KOC-7c cells. The CTL clone recognized naturally processed GPC3-derived peptide on ovarian CCC cells in a HLA class I-restricted manner. Moreover, we confirmed that the level of GPC3 expression was responsible for CTL recognition and that subtoxic-dose chemotherapy made tumor cells more susceptible to the cytotoxic effect of CTL. Thus, it might be possible to treat ovarian CCC patients by combining chemotherapy with immunotherapy. Our data suggest that GPC3 could be an effective target for immunotherapy against ovarian CCC. (Cancer Sci 2011; 102: 1622-1629) E pithelial ovarian carcinoma (EOC) is the leading cause of death from gynecological malignancy. Cytoreductive surgery and systemic combination chemotherapy with a platinum drug and a taxane represent the standard of care for EOC patients. Ovarian clear cell carcinoma (CCC) is the second most frequent subtype of EOC in Japan, although CCC represents 8-10% of all EOC in the United States.(1,2) Compared with other EOC subtypes, ovarian CCC is associated with a poorer prognosis and increased chemoresistance.(1,3) More efficient conventional therapies and novel strategies for effectively treating ovarian CCC are required.Glypican-3 (GPC3) is a member of the glypican family of heparan sulfate proteoglycans that are attached to the cell surface via the glycosylphosphatidylinositol (GPI) anchor.(4) It is known as an oncofetal antigen specifically overexpressed in hepatocellular carcinoma (HCC).(5) Previous studies have shown that GPC3 was also overexpressed in other malignant tumors, such as melanoma, Wilms' tumor, hepatoblastoma, yolk sac tumor, ovarian CCC and lung squamous cell carcinoma. (6)(7)(8)(9)(10) We previously identified the HLA-A24-restricted GPC3 [298][299][300][301][302][303][304][305][306] (EYILSLEEL) and HLA-A2-restricted GPC3 144-152 (FVGEFFTDV) peptides, both of which can induce GPC3-reactive cytotoxic T cells (CTL).(11) Recently, HLA-A2-restricted GPC3 144-152 peptide-specific CTL clones were established from HCC patients after GPC3 144-152 peptide vaccination in our laboratory.(12) Although CTL reactivity against HCC cell lines was analyzed using these CTL clones, other GPC3-positive tumor cell lines have not been studied. Therefore, we examined the reactivity of a HLA-A2-restricted GPC3 144-152 peptide-specific CTL clone ag...