Meeting the Demand for Results and Accountability: A Call for Action on Health Data from Eight Global Health Agencies

Margaret Chan, Director-General of the WHO, and the heads of seven other global health agencies, call for a concerted global effort to collect better health data

DBnorm as an R package for the comparison and selection of appropriate statistical methods for batch effect correction in metabolomic studies.

As a powerful phenotyping technology, metabolomics provides new opportunities in biomarker discovery through metabolome-wide association studies (MWAS) and the identification of metabolites having a regulatory effect in various biological processes. While mass spectrometry-based (MS) metabolomics assays are endowed with high throughput and sensitivity, MWAS are doomed to long-term data acquisition generating an overtime-analytical signal drift that can hinder the uncovering of real biologically relevant changes. We developed "dbnorm", a package in the R environment, which allows for an easy comparison of the model performance of advanced statistical tools commonly used in metabolomics to remove batch effects from large metabolomics datasets. "dbnorm" integrates advanced statistical tools to inspect the dataset structure not only at the macroscopic (sample batches) scale, but also at the microscopic (metabolic features) level. To compare the model performance on data correction, "dbnorm" assigns a score that help users identify the best fitting model for each dataset. In this study, we applied "dbnorm" to two large-scale metabolomics datasets as a proof of concept. We demonstrate that "dbnorm" allows for the accurate selection of the most appropriate statistical tool to efficiently remove the overtime signal drift and to focus on the relevant biological components of complex datasets

Post-Partum Pituitary Insufficiency and Livedo Reticularis Presenting a Diagnostic Challenge in a Resource Limited Setting in Tanzania: A Case Report, Clinical Discussion and Brief Review of Existing Literature.

Pituitary disorders following pregnancy are an important yet under reported clinical entity in the developing world. Conversely, post partum panhypopituitarism has a more devastating impact on women in such settings due to high fertility rates, poor obstetric care and scarcity of diagnostic and therapeutic resources available. A 37 year old African female presented ten years post partum with features of multiple endocrine deficiencies including hypothyroidism, hypoadrenalism, lactation failure and secondary amenorrhea. In addition she had clinical features of an underlying autoimmune condition. These included a history of post-partum thyroiditis, alopecia areata, livedo reticularis and deranged coagulation indices. A remarkable clinical response followed appropriate hormone replacement therapy including steroids. This constellation has never been reported before; we therefore present an interesting clinical discussion including a brief review of existing literature. Post partum pituitary insufficiency is an under-reported condition of immense clinical importance especially in the developing world. A high clinical index of suspicion is vital to ensure an early and correct diagnosis which will have a direct bearing on management and patient outcome

Is parasite clearance clinically important after malaria treatment in a high transmission area? A 3-month follow-up of home-based management with herbal medicine or ACT

Argemone mexicana (AM), a validated herbal medicine for uncomplicated malaria, seems to prevent severe malaria without completely clearing parasites in most patients. This study, in a high transmission area of South Mali, explores whether residual parasitaemia at day 28 was associated with subsequent malaria episodes and/or anaemia. Three hundred and one patients were randomly assigned to AM or artesunate/amodiaquine as first line treatment, of whom 294 were followed up beyond the standard 28 days, to 84 days. From day 29 to day 84, there were no significant differences between treatment groups in new clinical episodes of uncomplicated malaria (0.33 vs 0.31 episodes/patient), severe malaria (< 6% per month of patients aged ≤ 5 years) or moderate anaemia (hematocrit < 24%: 1.1% in both groups at day 84). Total parasite clearance at day 28 was not correlated with incidence of uncomplicated or severe malaria or of moderate anaemia over the subsequent two months. Total parasite clearance at day 28 was not clinically important in the context of high transmission. If this finding can be confirmed, some antimalarials which are clinically effective but do not completely clear parasites could nevertheless be appropriate in high transmission areas. Such a policy could be tested as a way to delay resistance to artemisinin combination therapies

Multi-scale governance in agriculture systems: Interplay between national and local institutions around the production dimension of food security in Mali

Enforcement of rules and laws designed at the national level is still one of the dominant institutional mechanisms for effective multiscale governance in most countries. At times, such blanket regulations are not only unable to meet practical needs at local levels, but they may conflict with local institutional logics, thereby creating new challenges. This study looks at three institutional arrangements in the agriculture and food security sector in the district of Koutiala, Mali to analyse the institutional variety across scale and the underlying institutional logics. On one side, the Cooperative Law as well as the Seed Law both designed at national level to enable famers’ access to agriculture services and improved seeds have yielded mixed results with regard to anticipated outcomes. The cooperative law is believed to degrade the social cohesion and the mutual support on which vulnerable farmers rely when facing climatic and non-climatic risks whereas the new seed system is found onerous and unaffordable for farmers. On the other side, the local convention for the management of natural resources established as part of ongoing decentralised governance policy seems to resonate with local culture but challenged by other stakeholders. Through exploring these cases, this paper tests bricolage as an analytical framework for doing an institutional diagnostic. It aims at contributing to methodological and theoretical insights on the way sustainable institutions can be generated in conflicting institutional logics in the context of multi-scale governance

Helping farmers adapt to climate and cropping system change through increased access to sorghum genetic resources adapted to prevalent sorghum cropping systems in Burkina Faso

Sorghum (Sorghum bicolor (L.) Moench) is a major staple crop of Burkina Faso where farmers continue to cultivate photoperiod-sensitive guinea landraces as part of the strategy to minimize risk and ensure yield stability. In the Boucle du Mouhoun region, however, sorghum farmers appear to have insufficient varietal choice due to cropping systems having shifted towards more intensive cultivation of cotton and maize, and rainfall patterns having decreased over the past decade. In search for new varietal options that can respond to this changing context, researchers decided to give farmers access to ex-situ national collections along with the opportunity to evaluate recent improved varieties. From 2002 to 2007, researchers and farmers worked closely together to implement on-farm testing, including varietal selection trials, crop management and multi-locational trials. Farmers’ choices tend to differ among groups, villages and years, with the exception of four particular landraces: two originating from a collection carried out in the Mouhoun region more than 30 years previous to this research, and two other landraces that came from the dissimilar agro-ecological zones of Burkina Faso. These four were the most commonly selected landraces out of 36 cultivars that covered both improved and landrace varieties. Farmers’ selection criteria were focused on adaptation to agro-climatic conditions as well as specific grain qualities for processing and consumption. The potential usefulness of each variety was verified via multi-locational trials. The paper also shows that wide dissemination of experimental seed, not just across the Mouhoun region but also at a national scale, was largely achieved through collaboration with a strong farmer organisation in conjunction with farmer training programs focused on the on-farm seed production and the commercialisation of this seed

Deciphering the genome structure and paleohistory of _Theobroma cacao_

We sequenced and assembled the genome of _Theobroma cacao_, an economically important tropical fruit tree crop that is the source of chocolate. The assembly corresponds to 76% of the estimated genome size and contains almost all previously described genes, with 82% of them anchored on the 10 _T. cacao_ chromosomes. Analysis of this sequence information highlighted specific expansion of some gene families during evolution, for example flavonoid-related genes. It also provides a major source of candidate genes for _T. cacao_ disease resistance and quality improvement. Based on the inferred paleohistory of the T. cacao genome, we propose an evolutionary scenario whereby the ten _T. cacao_ chromosomes were shaped from an ancestor through eleven chromosome fusions. The _T. cacao_ genome can be considered as a simple living relic of higher plant evolution