POS0432 POST-IMMUNIZATION WITH COLLAGEN V CONFERS A DISADVANTAGEOUS IMMUNE MATRICES MICROENVIRONMENT FOR EARLY LUNG FIBROSIS IN A SSc MOUSE MODEL

Background:

The autoimmunity and inflammation phenomena observed in systemic sclerosis (SSc) lead to the dysregulation of type V collagen (Col V) and extracellular matrix (ECM) deposition of Col V, collagen I (Col I) and collagen III (Col III) fibers, characteristic of pulmonary fibroproliferative disease. T cells are the predominant inflammatory infiltrate in the lungs and are believed to produce cytokines that drive the synthesis of matrix proteins by fibroblasts, resulting in excessive fibrosis. Although most studies to date have focused on CD4+ T and CD20+ B immune cells in some SSc subsets, cytotoxic CD8+ T cells are also involved in the pathogenesis of SSc. We previously reported that reactivity to the ColV-self antigen predicts late SSc lung fibrosis in mice immunized with Col V after 120 days; however, the profile of underlying immune matrices in early SSc lung fibrosis remains unclear.

Objectives:

To quantify T and B-cells and collagen fibers in the days following immunization with Col V in a mouse model mimicking human lung involvement in SSc.

Methods:

Female C57BL/6 mice (n=18) were immunized subcutaneously with human Col V (150 μg) in complete Freund´s adjuvant, followed by two intramuscular boosters (IM-COLV). The control group (n=18) did not receive Col V. Three groups of animals (n=6 each) were euthanized on days 15, 30 and 45 after immunization. The lung sections were fixed in 10% buffered formalin, embedded in paraffin, and sectioned at 4 µm. Immunohistochemistry, immunofluorescence and histomorphometry were performed to phenotype and quantify CD4 and CD8 T-cells, CD20 B-cells, and Col I, III and V, respectively.

Results:

We found that T-cells (CD4+), cytotoxic T cells (CD8+), and B-cells (CD20+) were present in high densities in the lungs of IM-COLV mice, with variation in the absolute abundance of each of these immune cell lineages at 15, 30 and 45 days after immunization with Col V. In fact, a significantly higher density of CD4+, CD8+, and CD20+ was detected early along the connective matrix of alveolar septa at 15 days after Col V immunization. In addition, higher density of Col I, III and V fibers were also observed early (Table 1). Although early SSc-lung fibrosis is generally considered to be linked to inflammatory cytokines, we also infer that cytotoxic T-cells may induce alveolar cells apoptosis by triggering kinases on macrophages and then accelerate fibrotic scar.

Conclusion:

Our study quantitatively establishes that the densities of CD4+ CD8+ and CD20+, as well as Col I, Col III and Col V can be characterized as markers of early lung fibrosis in SSc. These findings suggest that cytotoxic T cells may induce apoptosis and secrete profibrotic cytokines to induce the deposition of collagen fibers in the lungs, inferring that early B cell depletion may improve early lung fibrosis in SSc.

Post-Col V Immunization (Days)153045ControlIM-COLVControlIM-COLVControlIM-COLVImmune CellsCD4+ cells/mm2 (%)13.85 ± 0.4634.14 ± 1.55*12.63 ± 0.5623.38 ± 0.8314.32 ± 0.5223.62 ± 0.40CD8+ cells/mm2 (%)13.84 ± 0.6039.40 ± 0.99**12.42 ± 0.5222.87 ± 0.8512.93 ± 0.5723.07±1.00CD20+ cells/mm2 (%)12.12 ± 1.0133.84±1.43#11.70 ± 1.1415.23 ± 6.7012.46 ± 0.5028.24 ± 0.67Collagen FibersCol V (area fraction)0.05 ± 0.0030.12±0.010.08 ± 0.0030.14±0.01††0.07 ± 0.0030.11±0,003Col I (area fraction)0.16 ± 0,010.38±0.05##0.14 ± 0.010.25±0.030.15 ± 0.020.24±0.01Col III (area fraction)0,16 ± 0,0030.28±0.01†0.14 ± 0.0040.25±0.050.13± 0,0070.16±0.02Total Col µg/mg2.7 ± 0.293.99 ± 0.583.15 ± 0.193.77 ± 0.272.87 ± 0.304.99 ± 0.60

Data are shown as mean ± SD. Comparisons were done using ANOVA/Dunn´s Multiple comparison test

P<0.05). *15 vs 30 and 45 days; **15 vs 30 and 45 days; #15 vs 30 and 45 days; ## 15 vs 30 and 45 days; † 15 vs 45 days; †† 30 vs 45 days. Col I, collagen type I; Col III, collagen type III; Col V, collagen type V.

Disclosure of Interests:

Vitoria Elias: None declared, Zelita Queiroz: None declared, Sergio Catanozi: None declared, Antonio Santos Filho: None declared, Sandra Fernezlian: None declared, Ana Paula Velosa: None declared, Percival D. Sampaio-Barros Speakers bureau: Actelion, Boehringer Ingelheim, Abbvie, Lilly, Novartis, Consultant of: Abbvie, Bayer, Boehringer Ingelheim, Lilly, Novartis, Pfizer, Vera Capelozzi: None declared, Walcy Teodoro: None declared

Recommendations for antibiotic prescriptions for upper respiratory symptoms in children in Trinidad and Tobago: GRADE-ADOLOPMENT APPROACH

Background: In Trinidad and Tobago, 22,329 and 18,594 cases of acute respiratory infections (ARI) in children less than 5 years were recorded for 2016 and 2017 respectively. Often, antimicrobials are over prescribed without proof of bacterial infection. Recommendations for management of ARIs are needed. Methods: The GRADE-ADOLOPMENT approach was used to formulate recommendations. We established a guideline panel who met in person or by web conferences. We prioritised recommendation questions and searched for guidelines and systematic reviews from 2010 to July 2018 in several medical databases and guideline producer websites. We also searched for patients’ values and preferences, acceptability, resources, and feasibility studies specific to the Caribbean or Trinidad and Tobago. We summarised the evidence in evidence-to-decision frameworks and formulated recommendations by consensus. Results: The guideline panel developed recommendations including: 1. For children 5 years old or younger who present with fever and respiratory symptoms not suggestive of serious illness, we recommend to either not prescribe antibiotics or to provide a delayed prescription (48 hours later) of amoxicillin or clarithromycin (when children have a history of allergy to penicillin) rather than an immediate prescription; 2. For children with symptoms suggestive of serious illness, we recommend immediate prescription of amoxicillin or clarithromycin (when children have a history of allergy to penicillin); and, 3. We suggest 7-10 days of treatment, depending on the suspected illness and antibiotic used. Conclusion: Guidelines aid medical practitioners, patients and supply chain managers. This guideline will form the backbone of the 1st national standardisation of treatment using the GRADE-ADOLOPMENT approach.

Embedding implementation research to enhance health policy and systems: a multi-country analysis from ten settings in Latin America and the Caribbean

Background

Progress towards universal health coverage requires health policies and systems that are informed by contextualised and actionable research. Many challenges impede the uptake of evidence to enhance health policy implementation and the coverage, quality, efficiency and equity of health systems. To address this need, we developed an innovative model of implementation research embedded in real-world policy and programme cycles and led directly by policy-makers and health systems decision-makers. The approach was tested in ten settings in Latin America and the Caribbean, supported under a common funding and capacity strengthening initiative. The present study aims to analyse ten embedded implementation research projects in order to identify barriers and facilitators to embedding research into policy and practice as well as to assess the programme, policy and systems improvements and the cross-cutting lessons in conducting research embedded in real-world policy and systems decision-making.

Methods

The multi-country analysis is based on the triangulation of data collected via three methods, namely (1) document review, (2) an electronic questionnaire and (3) in-depth interviews with decision-makers. Data from the document review was charted and narratively synthesised. Data from the questionnaire was used to assess three characteristics of the decision-maker’s participation in embedded research, namely (1) level of engagement in different stages of research; (2) extent to which their capacities to conduct and use research were developed; and (3) the level of confidence in undertaking implementation research activities. Interview data was analysed using a thematic approach.

Results

The main barriers to effective delivery or scale-up of health interventions identified in the research projects were inadequate financing, fragmentation of healthcare services and information systems, limited capacity of health system stakeholders, insufficient time, cultural factors, and a lack of information. Decision-makers’ experience in embedded research showed strong engagement in protocol development, moderate engagement in data collection and low engagement in data analysis. The in-depth interviews identified 17 facilitators and 8 barriers to embedding research into policy and systems. The principal facilitating factors were actionability of findings, relevance of research and engagement of decision-makers, whereas the main barriers were time and political processes. In Argentina, the research led to the development of new monitoring indicators to improve the implementation of the perinatal health policy, while in Chile, empirical findings supported the establishment of a training programme on reproductive rights, targeted to municipal health facilities.

Conclusions

This multi-country analysis contributes to the evidence base for the embedded research approach to support health policy and systems decisions-making. Embedding research into policy and practice stimulates the relevance and applicability of research, while promoting decision-makers’ engagement and likelihood to use research evidence in policy-making and health systems strengthening.

Understanding the relation between Zika virus infection during pregnancy and adverse fetal, infant and child outcomes: a protocol for a systematic review and individual participant data meta-analysis of longitudinal studies of pregnant women and their infants and children

INTRODUCTION

Zika virus (ZIKV) infection during pregnancy is a known cause of microcephaly and other congenital and developmental anomalies. In the absence of a ZIKV vaccine or prophylactics, principal investigators (PIs) and international leaders in ZIKV research have formed the ZIKV Individual Participant Data (IPD) Consortium to identify, collect and synthesise IPD from longitudinal studies of pregnant women that measure ZIKV infection during pregnancy and fetal, infant or child outcomes.

METHODS AND ANALYSIS

We will identify eligible studies through the ZIKV IPD Consortium membership and a systematic review and invite study PIs to participate in the IPD meta-analysis (IPD-MA). We will use the combined dataset to estimate the relative and absolute risk of congenital Zika syndrome (CZS), including microcephaly and late symptomatic congenital infections; identify and explore sources of heterogeneity in those estimates and develop and validate a risk prediction model to identify the pregnancies at the highest risk of CZS or adverse developmental outcomes. The variable accuracy of diagnostic assays and differences in exposure and outcome definitions means that included studies will have a higher level of systematic variability, a component of measurement error, than an IPD-MA of studies of an established pathogen. We will use expert testimony, existing internal and external diagnostic accuracy validation studies and laboratory external quality assessments to inform the distribution of measurement error in our models. We will apply both Bayesian and frequentist methods to directly account for these and other sources of uncertainty.

ETHICS AND DISSEMINATION

The IPD-MA was deemed exempt from ethical review. We will convene a group of patient advocates to evaluate the ethical implications and utility of the risk stratification tool. Findings from these analyses will be shared via national and international conferences and through publication in open access, peer-reviewed journals.

TRIAL REGISTRATION NUMBER

PROSPERO International prospective register of systematic reviews (CRD42017068915).

Conceptual framework of equity-focused implementation research for health programs (EquIR)

BACKGROUND

Implementation research is increasingly used to identify common implementation problems and key barriers and facilitators influencing efficient access to health interventions.

OBJECTIVE

To develop and propose an equity-based framework for Implementation Research (EquIR) of health programs, policies and systems.

METHODS

A systematic search of models and conceptual frameworks involving equity in the implementation of health programs, policies and systems was conducted in Medline (PubMed), Embase, LILACS, Scopus and grey literature. Key characteristics of models and conceptual frameworks were summarized. We identified key aspects of equity in the context of seven Latin American countries-focused health programs We gathered information related to the awareness of inequalities in health policy, systems and programs, the potential negative impact of increasing inequalities in disadvantaged populations, and the strategies used to reduce them.

RESULTS

A conceptual framework of EquIR was developed. It includes elements of equity-focused implementation research, but it also links the population health status before and after the implementation, including relevant aspects of health equity before, during and after the implementation. Additionally, health sectors were included, linked with social determinants of health through the "health in all policies" proposal affecting universal health and the potential impact of the public health and public policies.

CONCLUSION

EquIR is a conceptual framework that is proposed for use by decision makers and researchers during the implementation of programs, policies or health interventions, with a focus on equity, which aims to reduce or prevent the increase of existing inequalities during implementation.

Risk factors for chronic kidney disease of non-traditional causes: a systematic review

OBJECTIVES

To evaluate the potential associations between chronic kidney disease of uncertain or non-traditional etiology (CKDnT) and agrochemicals, heat stress, heavy metals, and other factors identified in the literature in any region of the world and at any time.

METHODS

This was a systematic review of the most frequent exposures suspected to be possible causes of CKDnT. A search was conducted of PubMed, LILACS, World Wide Science electronic databases, among other sources. Only medium- and high-quality studies were included. The synthesis of evidence included a narrative synthesis, meta-analysis, and meta-regression.

RESULTS

Four systematic reviews and 61 primary studies were included. Results of the meta-analysis suggest that exposure to agrochemicals and working in agriculture increase the risk of CKDnT, but this only reached significance for working in agriculture. When cross-sectional studies were excluded, agrochemical exposure became significant. However, there is substantial heterogeneity in the effect sizes.

CONCLUSIONS

Based on the existing evidence and the precautionary principle, it is important to implement preventive measures to mitigate the damage caused by CKDnT to both agricultural workers and their communities (i.e., improvement of working conditions, cautious management of agrochemicals, etc.). More high-quality research is needed to measure impact and to build the evidence base.

Prevalence of asymptomatic Zika virus infection: a systematic review

Objective

To conduct a systematic review to estimate the prevalence of asymptomatic Zika virus infection in the general population and in specific population groups.

Methods

We searched PubMed®, Embase® and LILACS online databases from inception to 26 January 2018. We included observational epidemiological studies where laboratory testing was used to confirm positive exposure of participants to Zika virus and in which Zika virus symptom status was also recorded. We excluded studies in which having symptoms of Zika virus was a criterion for inclusion. The main outcome assessed was percentage of all Zika virus-positive participants who were asymptomatic. We used a quality-effects approach and the double arcsine transformation for the meta-analysis.

Findings

We assessed 753 studies for inclusion, of which 23 were included in the meta-analysis, totalling 11 305 Zika virus-positive participants. The high degree of heterogeneity in the studies (I² = 99%) suggests that the pooled prevalence of asymptomatic Zika virus-positive participants was probably not a robust estimate. Analysis based on subgroups of the population (general population, returned travellers, blood donors, adults with Guillain–Barré syndrome, pregnant women and babies with microcephaly) was not able to explain the heterogeneity. Funnel and Doi plots showed major asymmetry, suggesting selection bias or true heterogeneity.

Conclusion

Better-quality research is needed, using standardized methods, to determine the true prevalence of asymptomatic Zika virus and whether it varies between populations or over time.

[Establishing research priorities for chronic kidney disease of non-traditional causes in Central AmericaDeterminação de prioridades em pesquisa da doença renal crônica associada a causas não tradicionais na América Central]

Introducción

En 2013, los Estados Miembros de la OPS reconocieron la epidemia de enfermedad renal crónica de causas no tradicionales (ERCnT) como un grave problema de salud pública. Este artículo describe el establecimiento de prioridades de investigación para abordar de manera integral la ERCnT en Centroamérica.

Métodos

Se estructuró una encuesta virtual utilizando la metodología Delphi mediante una búsqueda de estudios de investigación efectuados en Centroamérica y de agendas de investigación previas sobre la ERC. Los encuestados se identificaron en diversas fuentes. La primera ronda buscó refinar y añadir tópicos de investigación y priorizar los más relevantes. La segunda ronda priorizó los tópicos más relevantes. Se realizó un análisis por fuzzy sets para estimar umbrales de decisión y puntajes por tópico.

Resultados

La encuesta se envió a 83 personas de habla hispana y 38 de habla inglesa y respondió 46,2%. Para la segunda ronda, se envió la encuesta a 56 personas en español y 16 en inglés que habían contestado a la la primera. Se priorizaron 18 tópicos de investigación enmarcados en 10 áreas: políticas públicas, determinantes, etiología, diagnóstico y tratamiento de la ERC, prevención primaria, prestación de servicios, recursos humanos, sistemas de información y financiamiento. Se comprobó que la investigación en ERCnT es escasa y está restringida a ciertos tópicos.

Conclusiones

Además de los factores etiológicos, se dio gran relevancia a aspectos relacionados con la respuesta de los sistemas de salud, incluidos el abordaje de la prestación de servicios, los recursos humanos, el financiamiento y aspectos ocupacionales y ambientales.

Adherence to clinical trial registration in countries of Latin America and the Caribbean, 2015

Objective

To determine the prevalence of clinical trial registration in the International Clinical Trial Registry Platform (ICTRP) for studies from Latin America and the Caribbean (LAC) and to identify the key characteristics that lead to prospective and retrospective registration.

Methods

A cross-sectional study identified published, clinical trial studies through a search of PubMed, LILACS (Latin American and Caribbean Center on Health Sciences Information), and the Cochrane Central Register of Controlled Trials. Studies were included if published on 1 January – 31 December 2015, at least one author was affiliated with at least one LAC country, the clinical trial was conducted in at least one LAC site, and the full text of the article was available. A manual search of reference lists was also conducted. ICTRP registration information and key trial characteristics were compared.

Results

Of 1 502 CT references that met inclusion criteria, 297 were randomly-selected, 90.9% of which were published in English, 65% from Brazil, and 76.8% had a LAC author as the first author. The proportion of CT registered in the ICTRP was 59.9 %, of which 51.7% were registered prospectively. Clinicaltrials.gov was most frequently used registry (84.8%), followed by the Registro Brasileiro de Ensaios Clínicos and the Registro Público Cubano de Ensayos Clínicos. Key characteristics that favored registration were being in study phase 3 or 4 or being a multi-center study. Data was compared to a similar study from 2013 that reported a registration rate of only 19.8%.

Conclusions

Registration adherence and prospective registration have increased in LAC in recent years, but the proportion of unregistered CT remains high. While there are still many challenges to overcome, the adherence strategies implemented in recent years have proven effective.

[Incorporating health equity into implementation research: review of conceptual modelsIncorporação da igualdade em saúde na pesquisa de implementação: revisão de modelos conceituais]

OBJECTIVE

Search for conceptual frameworks or models that incorporate aspects of health equity into implementation research and prepare a systematic synthesis of them.

METHODS

A systematic search was done of MEDLINE-PubMed, Embase, and LILACS (1965-2016), and Scopus (1998-2016) databases, employing, in addition, a snowball strategy and gray literature search. Article type was assessed, along with elements that were included on implementation research, the science of implementation, and health equity.

RESULTS

A total of 701 articles were found, of which 100 were included for review of relevance. Of these, 19 articles related to conceptual frameworks: 12 were general, five were on ethnic or racial disparities, and two related to child health. The most frequent categories were financing, infrastructure, advocacy, quality, internal barriers, and coverage. The least frequent were other sectors, outpatient needs, health status, and equity impact assessment.

CONCLUSIONS

In order to reduce health gaps and with them health inequities, it becomes necessary to have a consolidated implementation research framework that includes aspects of health equity. This framework would facilitate improving implementation processes for interventions, services, and health programs.

Correction: Risk of bias and confounding of observational studies of Zika virus infection: A scoping review of research protocols

[This corrects the article DOI: 10.1371/journal.pone.0180220.].

An overview of financial sources being utilized to support Zika Virus published research

Background

Since its initial detection in Brazil in 2015, Zika Virus (ZIKV) has spread rapidly throughout most of the Caribbean and South, Central and North America. An upsurge in congenital syndrome associated with ZIKV and Guillain-Barre Syndrome (GBS) has been associated with the increase in ZIKV. This amplification in numbers led to the need for funded research initiatives focusing on various countries globally and on specific experimental types.

Objectives

To determine the financial institutions involved in the production of primary research into the ZIKV epidemic. This research also intends to draw attention to the investigative areas that are dominating, experimental types being conducted and the geographical areas that are producing the bulk of the research utilizing available funds.

Methods

A cross sectional search of published primary research was conducted using Pan American Health Organization (PAHO) Zika platform and PubMed between January 2007 and October 2016. Titles, abstract and full articles were assed and one researcher extracted data. Information was crossed checked by a second researcher to ensure accuracy.

Findings

268 articles were included and investigations occurred across 48 countries with Brazil and USA dominating the research. Applied Research and Laboratory based studies were most frequently utilized. 38.1% of articles did not report financial sources. Public institutions were the major known contributors. Other financiers included private, non-profits and mixed funders exclusive of public sources. 156 individual financial bodies assisted with National Institute of Health being most frequently mentioned followed by The National Council for Scientific and Technological Development (CNPq) and the Institut Pasteur. Virus, vectors and reservoirs was most frequently used (99/268, 36.9%) followed by clinical management (70/268, 26.1%) and epidemiology (46/268, 17.2%).

Interpretation

The evidence suggests international efforts to fund ZIKV research and a need to foster collaborative and synchronized priority setting for resource allocation.

Knowledge of and attitudes toward heel prick screening for sickle cell disease in Saint Lucia

Objectives.

In the Caribbean country of Saint Lucia, umbilical-cord-blood screening for sickle cell disease (SCD) was the testing method that health care workers (HCWs) on the maternity wards of the hospitals preferred until the new heel prick (HP) testing method was introduced in the country in 2014. This SCD study sought to assess HCWs’ knowledge of and attitude toward HP screening and also determine new mothers’ favorability toward HP screening.

Methods.

A total of 70 HCWs and 132 new mothers answered survey questionnaires in three hospitals. In addition, four focus group discussions were held, two with HCWs and two with the mothers.

Results.

Among the HCWs interviewed, 85.7% of them had knowledge of the HP test. However, only 25.7% had attended training sessions on the procedure. Among the HCWs, 64.3% of them felt the HP test should be mandatory, 27.1% said it should not be mandatory, and 8.6% did not know if it should be mandatory. In their focus groups, the HCWs said they believed the mothers would accept the HP method. For their part, 22.0% of the mothers said they had heard about the HP test, and 63.6% reported knowing the reason why the baby would be tested. Further, 83.3% indicated that the test would be beneficial for the baby. In addition, 88.6% of the mothers said that more information on the HP test was needed. In their focus group discussions, the mothers said they were generally not concerned about the pain the heel prick method might cause the baby.

Conclusions.

The HCWs’ knowledge of the HP screening method was high. The mothers trust HCWs, and the mothers would accept the HP procedure irrespective of their knowledge of the test and any discomfort associated with this screening method.

Embedding research to improve program implementation in Latin America and the Caribbean

In the last 10 years, implementation research has come to play a critical role in improving the implementation of already-proven health interventions by promoting the systematic uptake of research findings and other evidence-based strategies into routine practice. The Alliance for Health Policy and Systems Research and the Pan American Health Organization implemented a program of embedded implementation research to support health programs in Latin America and the Caribbean (LAC) in 2014–2015. A total of 234 applications were received from 28 countries in the Americas. The Improving Program Implementation through Embedded Research (iPIER) scheme supported 12 implementation research projects led by health program implementers from nine LAC countries: Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, Panama, Peru, and Saint Lucia. Through this experience, we learned that the “insider” perspective, which implementers bring to the research proposal, is particularly important in identifying research questions that focus on the systems failures that often manifest in barriers to implementation. This paper documents the experience of and highlights key conclusions about the conduct of embedded implementation research. The iPIER experience has shown great promise for embedded research models that place implementers at the helm of implementation research initiatives.

[Composite Index of health Inequity for a Middle Income Country]

OBJECTIVE

To develop and validate a composite index of health inequity based on mortality by grouped causes.

METHODS

An ecological study in a middle-income Latin American country, with aggregate indicators available from municipalities and departments, which were selected from health observatories, research groups and health authorities. They were divided into intolerable and "not completely avoidable" according to current scientific progress, and were added in categories: traffic accident, aggression, kidney disease, HIV infection, intestinal parasitic diseases, syphilis, fecal / oral transmission disease, tuberculosis, disease Vector-borne diseases, respiratory disease, cerebral hemorrhagic / ischemic events, maternal mortality, lower mortality 5 years, meningitis. After analysis of main components, a composite index of health inequity (IIS) is obtained for men and women. Internal consistency was evaluated using Cronbach's Alpha coefficient. Concurrent validation was done with proportion of people in Unsatisfied Basic Needs (UBN), Human Development Index (HDI), Life Expectancy at Birth (LEB), among others.

RESULTS

IIS is built showing higher values for women in most municipalities and departments; And for sites with high HDI, high LEB and low UBN. Cronbach's alpha was 0.6688, IIS-men and 0.725, IIS-women.

CONCLUSIONS

An IIS was obtained, is valid and reproducible. The role of big cities in inequities in health is highlighted, probably due to the effect of intolerable health.

Relationships between diet-related changes in the gut microbiome and cognitive flexibility

Western diets are high in fat and sucrose and can influence behavior and gut microbiota. There is growing evidence that altering the microbiome can influence the brain and behavior. This study was designed to determine whether diet-induced changes in the gut microbiota could contribute to alterations in anxiety, memory or cognitive flexibility. Two-month-old, male C57BL/6 mice were randomly assigned high-fat (42% fat, 43% carbohydrate (CHO), high-sucrose (12% fat, 70% CHO (primarily sucrose) or normal chow (13% kcal fat, 62% CHO) diets. Fecal microbiome analysis, step-down latency, novel object and novel location tasks were performed prior to and 2weeks after diet change. Water maze testing for long- and short-term memory and cognitive flexibility was conducted during weeks 5-6 post-diet change. Some similarities in alterations in the microbiome were seen in both the high-fat and high-sucrose diets (e.g., increased Clostridiales), as compared to the normal diet, but the percentage decreases in Bacteroidales were greater in the high-sucrose diet mice. Lactobacillales was only significantly increased in the high-sucrose diet group and Erysipelotrichales was only significantly affected by the high-fat diet. The high-sucrose diet group was significantly impaired in early development of a spatial bias for long-term memory, short-term memory and reversal training, compared to mice on normal diet. An increased focus on the former platform position was seen in both high-sucrose and high-fat groups during the reversal probe trials. There was no significant effect of diet on step-down, exploration or novel recognitions. Higher percentages of Clostridiales and lower expression of Bacteroidales in high-energy diets were related to the poorer cognitive flexibility in the reversal trials. These results suggest that changes in the microbiome may contribute to cognitive changes associated with eating a Western diet.

Comparison of national health research priority-setting methods and characteristics in Latin America and the Caribbean, 2002-2012

OBJECTIVE

To compare health research priority-setting methods and characteristics among countries in Latin America and the Caribbean during 2002 - 2012.

METHODS

This was a systematic review that identified national health research policies and priority agendas through a search of ministry and government databases related to health care institutions. PubMed, LILACS, the Health Research Web, and others were searched for the period from January 2002 - February 2012. The study excluded research organized by governmental institutions and specific national strategies on particular disease areas. Priority-setting methods were compared to the "nine common themes for good practice in health research priorities." National health research priorities were compared to those of the World Health Organization's Millennium Development Goals (MDG).

RESULTS

Of the 18 Latin American countries assessed, 13 had documents that established national health research priorities; plus the Caribbean Health Research Council had a research agenda for its 19 constituents. These 14 total reports varied widely in terms of objectives, content, dissemination, and implementation; most provided a list of strategic areas, suggestions, and/or sub-priorities for each country; however, few proposed specific research topics and questions.

CONCLUSIONS

Future reports could be improved by including more details on the comprehensive approach employed to identify priorities, on the information gathering process, and on practices to be undertaken after priorities are set. There is a need for improving the quality of the methodologies utilized and coordinating Regional efforts as countries strive to meet the MDG.

Radiative electroweak symmetry breaking revisited

In the absence of a tree-level scalar-field mass, renormalization-group methods permit the explicit summation of leading-logarithm contributions to all orders of the perturbative series within the effective potential for SU(2)xU(1) electroweak symmetry. This improvement of the effective potential function is seen to reduce residual dependence on the renormalization mass scale. The all-orders summation of leading-logarithm terms involving the dominant three couplings contributing to radiative corrections is suggestive of a potential characterized by a plausible Higgs boson mass of 216 GeV. However, the tree potential's local minimum at phi=0 is restored if QCD is sufficiently strong.

Immunocytochemical localization of aromatase in the ovary of superovulated cattle, pigs and sheep

The localization of aromatase, an enzyme converting androgens to estrogen, in the ovaries of superovulated cattle, pigs and sheep was studied immunocytochemically in the preovulatory and postovulatory period using anti-human placental aromatase cytochrome P-450 antiserum. Immunostaining for aromatase was detected in the granulosa cells of preovulatory follicles of all species studied. Theca interna cells were stained in preovulatory follicles in the pig but not in cattle and sheep. Interstitial gland cells, cumulus cells and oocytes were unstained in all species. In cattle and pig the corpora lutea were unstained whereas they displayed staining in the sheep. Preantral and small antral follicles were unstained during both the preovulatory and postovulatory period in all species. It is concluded that granulosa cells of preovulatory follicles are the main residence for aromatase activity in superovulated cattle, pig and sheep, whereas the activity of theca interna and corpora lutea is species specific.

Immunocytochemical localization of aromatase in the ovary of superovulated cattle, pigs and sheep

The localization of aromatase, an enzyme converting androgens to estrogen, in the ovaries of superovulated cattle, pigs and sheep was studied immunocytochemically in the preovulatory and postovulatory period using anti-human placental aromatase cytochrome P-450 antiserum. Immunostaining for aromatase was detected in the granulosa cells of preovulatory follicles of all species studied. Theca interna cells were stained in preovulatory follicles in the pig but not in cattle and sheep. Interstitial gland cells, cumulus cells and oocytes were unstained in all species. In cattle and pig the corpora lutea were unstained whereas they displayed staining in the sheep. Preantral and small antral follicles were unstained during both the preovulatory and postovulatory period in all species. It is concluded that granulosa cells of preovulatory follicles are the main residence for aromatase activity in superovulated cattle, pig and sheep, whereas the activity of theca interna and corpora lutea is species specific.