Essential Medicines at the National Level : The Global Asthma Network's Essential Asthma Medicines Survey 2014

Patients with asthma need uninterrupted supplies of affordable, quality-assured essential medicines. However, access in many low- and middle-income countries (LMICs) is limited. The World Health Organization (WHO) Non-Communicable Disease (NCD) Global Action Plan 2013-2020 sets an 80% target for essential NCD medicines' availability. Poor access is partly due to medicines not being included on the national Essential Medicines Lists (EML) and/or National Reimbursement Lists (NRL) which guide the provision of free/subsidised medicines. We aimed to determine how many countries have essential asthma medicines on their EML and NRL, which essential asthma medicines, and whether surveys might monitor progress. A cross-sectional survey in 2013-2015 of Global Asthma Network principal investigators generated 111/120 (93%) responses41 high-income countries and territories (HICs); 70 LMICs. Patients in HICs with NRL are best served (91% HICs included ICS (inhaled corticosteroids) and salbutamol). Patients in the 24 (34%) LMICs with no NRL and the 14 (30%) LMICs with an NRL, however no ICS are likely to have very poor access to affordable, quality-assured ICS. Many LMICs do not have essential asthma medicines on their EML or NRL. Technical guidance and advocacy for policy change is required. Improving access to these medicines will improve the health system's capacity to address NCDs.Peer reviewe

Changes in nematode populations on sugarcane following fallow, fumigation and crop rotation, and implications for the role of nematodes in yield decline

A multi-disciplinary research program has been established in Australia to identify the causes of sugarcane yield decline (defined as “the loss in productive capacity of sugarcane-growing soils under long-term monoculture”). In one part of that program, five experiments were set up in which the monoculture was broken for 12–42 months by maintaining a bare fallow using herbicides, by growing a grass/legume pasture or by planting consecutive crops, most of which were legumes. Other plots were maintained in continuous sugarcane during the break period and were either fumigated with methyl bromide immediately before replanting to sugarcane, or left untreated. Nematode populations were monitored in the following sugarcane crop. These data showed that for the first 6 months after planting, fumigation, bare fallow and crop generally reduced populations of Pratylenchus zeae Graham in comparison to continuous sugarcane. Pasture had a similar effect but it was only apparent at, or soon after, planting. Fumigation and bare fallow initially decreased populations of most other plant-parasitic nematodes, but some ectoparasitic species [e.g. Tylenchorhynchus annulatus (Cassidy) Golden and Paratylenchus colbrani (Raski)] returned to relatively high population densities within 6-12 months following these treatments at some sites. Pasture generally increased populations of free-living nematodes in comparison to continuous sugarcane whereas a decrease was sometimes observed following fumigation and bare fallow. All treatments increased the yield of the plant plus first ratoon crop by 20-30% compared with continuous sugarcane, indicating that soil factors affected by fumigation and break crops were having widespread and significant effects on sugar production in Australia. A reduction in nematode populations may have contributed to the yield responses at some sites but it is impossible to be conclusive because treatments also affected many other soil physical, chemical and biological properties

Molecular signatures of fossil leaves provideunexpected new evidence for extinct plant relationships

Gene sequences form the primary basis for understanding the relationships among extant plant groups, but genetic data are unavailable from fossils to evaluate the affinities of extinct taxa. Here we show that geothermally resistant fossil cuticles of seed-bearing plants, analysed with Fourier transform infrared (FTIR) spectroscopy and hierarchical cluster analysis (HCA), retain biomolecular suites that consistently distinguish major taxa even after experiencing different diagenetic histories. Our results reveal that similarities between the cuticular biochemical signatures of major plant groups (extant and fossil) are mostly consistent with recent phylogenetic hypotheses based on molecular and morphological data. Our novel chemotaxonomic data also support the hypothesis that the extinct Nilssoniales and Bennettitales are closely allied, but only distantly related to Cycadales. The chemical signature of the cuticle of Czekanowskia (Leptostrobales) is strongly similar to that of Ginkgo leaves and supports a close evolutionary relationship between these groups. Finally, our results also reveal that the extinct putative araucariacean, Allocladus, when analysed through HCA, is grouped closer to Ginkgoales than to conifers. Thus, in the absence of modern relatives yielding molecular information, FTIR spectroscopy provides valuable proxy biochemical data complementing morphological characters to distinguish fossil taxa and to help elucidate extinct plant relationships.Additional funding from:Swedish Research Council (VR) under grant LUCCI (Lund University Carbon Cycle Centre); and the Utrecht Network Young researchers’ grant.</p

Capture of assay template by multiplex PCR of long amplicons for genotyping SNPs and InDels with MALDI-TOF mass spectrometry

Mis-priming associated with uncharacterised single nucleotide polymorphisms (SNPs) may lead to failure of PCR for genotyping. This is particularly troublesome in high-throughput SNP genotyping applications relying on multiplex PCR (2-40-plex) generating many short amplicons (80-120 bp) of similar size, an approach best suited for whole genome scans. However, if the target SNPs are clustered within a few target genes one option to ameliorate this is to increase the amplicon length, effectively reducing the potential for primer/template interactions and mis-priming. We tested this approach in a diverse population of 372 Eucalyptus pilularis individuals (pi = 8.11 x 10(-3), H (e) = 0.75) using a modified Sequenom iPLEX gold assay. Four candidate genes (MYB1, MYB2, CAD and CCR) were amplified in a single long range multiplex capture PCR generating 6 long amplicons ranging in size from 907 to 2,225 bp. This contrasts with the standard approach which would have required the amplification of 98 short amplicons in 4 multiplex reactions. These 6 long amplicons provided the assay template for 98 assays (87 SNP and 11 InDel) within the 4 candidate genes. Reaction results indicated that longer amplicons could provide a suitable template for genotyping assays, with 90.8% of assays functional and 84.3% of assays suitable for downstream analysis. Additional advantages of this approach were the capacity for troubleshooting using gel electrophoresis and savings of 94% in capture primer synthesis costs. This approach will have the greatest relevance for candidate gene approaches for association testing in uncharacterised populations of organisms with high sequence diversity