AmelHap: Leveraging drone whole-genome sequence data to create a honey bee HapMap.

Honey bee, Apis mellifera, drones are typically haploid, developing from an unfertilized egg, inheriting only their queen's alleles and none from the many drones she mated with. Thus the ordered combination or 'phase' of alleles is known, making drones a valuable haplotype resource. We collated whole-genome sequence data for 1,407 drones, including 45 newly sequenced Scottish drones, collectively representing 19 countries, 8 subspecies and various hybrids. Following alignment to Amel_HAv3.1, variant calling and quality filtering, we retained 17.4 M high quality variants across 1,328 samples with a genotyping rate of 98.7%. We demonstrate the utility of this haplotype resource, AmelHap, for genotype imputation, returning >95% concordance when up to 61% of data is missing in haploids and up to 12% of data is missing in diploids. AmelHap will serve as a useful resource for the community for imputation from low-depth sequencing or SNP chip data, accurate phasing of diploids for association studies, and as a comprehensive reference panel for population genetic and evolutionary analyses.

[Incidence of alarm criteria and attitude towards patients with headache attended in emergency departments]. / Incidencia de criterios de alarma y actitud frente a los pacientes con cefalea atendidos en urgencias.

INTRODUCTION: Alarm criteria make it possible to identify persons who visit emergency services because of severe secondary headaches. AIMS: To determine the socio-demographic characteristics of the patients who visit emergency departments due to headache, the incidence of alarm criteria, treatment and the diagnosis after one year's follow-up. PATIENTS AND METHODS: We conducted a retrospective observational cross-sectional study of the persons attended in the emergency department of the Arnau de Vilanova Hospital between June 2014 and May 2015 due to headache. RESULTS: A total of 303 persons were identified, of whom 165 were finally included in the study. There was a predominance of women (66.7%). The mean age was 41.2 ± 15.9 years. Only 16.4% were referred from primary care and 52 (31.5%) presented alarm criteria. A computerised tomography head scan was performed in half of these cases, and lumbar puncture was carried out in four of them (7.7%). A serious cause of headache was found in four cases (2.4%). After one year of follow-up, three patients who did not initially visit because of alarm criteria were diagnosed with severe diseases of the central nervous system, and 23 (13.9%) returned to the emergency department for the same reason. CONCLUSIONS: Only one out of every two patients meets the alarm criteria. The proportion of severe secondary headache is really low. The multidisciplinary management of headache needs to be improved in our setting to prevent people visiting the emergency department due to primary headaches without any alarm criteria.

TITLE: Incidencia de criterios de alarma y actitud frente a los pacientes con cefalea atendidos en urgencias.Introduccion. Los criterios de alarma permiten identificar a las personas que consultan por cefaleas secundarias graves en los servicios de urgencias. Objetivo. Determinar las caracteristicas sociodemograficas de los pacientes que acuden a urgencias por cefalea, la incidencia de criterios de alarma, el tratamiento y el diagnostico tras un año de seguimiento. Pacientes y metodos. Estudio transversal retrospectivo y observacional de personas atendidas en el servicio de urgencias del Hospital Arnau de Vilanova entre junio de 2014 y mayo de 2015 por cefalea. Resultados. Se identifico a un total de 303 personas, de las cuales 165 se incluyeron finalmente en el estudio. Hubo un predomino de mujeres (66,7%). La edad media fue de 41,2 ± 15,9 años. Solo un 16,4% fue derivado desde atencion primaria y 52 (31,5%) presentaban criterios de alarma. En la mitad de estos casos se realizo una tomografia computarizada craneal, y en 4 (7,7%), una puncion lumbar. Se identifico una causa grave de la cefalea en 4 casos (2,4%). Tras un año de seguimiento, tres pacientes que inicialmente no consultaron por criterios de alarma fueron diagnosticados de enfermedades graves del sistema nervioso central, y 23 (13,9%) volvieron a urgencias por el mismo motivo. Conclusiones. Solo uno de cada dos pacientes cumple criterios de alarma. La proporcion de cefalea secundaria grave es realmente baja. Es necesario mejorar el abordaje multidisciplinar de la cefalea en nuestro ambito para evitar la consulta a urgencias por cefaleas primarias sin criterios de alarma.

Genome-wide scans between two honeybee populations reveal putative signatures of human-mediated selection.

Human-mediated selection has left signatures in the genomes of many domesticated animals, including the European dark honeybee, Apis mellifera mellifera, which has been selected by apiculturists for centuries. Using whole-genome sequence information, we investigated selection signatures in spatially separated honeybee subpopulations (Switzerland, n = 39 and France, n = 17). Three different test statistics were calculated in windows of 2 kb (fixation index, cross-population extended haplotype homozygosity and cross-population composite likelihood ratio) and combined into a recently developed composite selection score. Applying a stringent false discovery rate of 0.01, we identified six significant selective sweeps distributed across five chromosomes covering eight genes. These genes are associated with multiple molecular and biological functions, including regulation of transcription, receptor binding and signal transduction. Of particular interest is a selection signature on chromosome 1, which corresponds to the WNT4 gene, the family of which is conserved across the animal kingdom with a variety of functions. In Drosophila melanogaster, WNT4 alleles have been associated with differential wing, cross vein and abdominal phenotypes. Defining phenotypic characteristics of different Apis mellifera ssp., which are typically used as selection criteria, include colour and wing venation pattern. This signal is therefore likely to be a good candidate for human mediated-selection arising from different applied breeding practices in the two managed populations.

Negative outcomes associated with medication in patients with chronic atrial fibrillation who present at the emergency department.

WHAT IS KNOWN AND OBJECTIVE: Medication is the main treatment option for patients with chronic atrial fibrillation. However, medication can have negative effects. We aimed to detect negative outcomes associated with medication that led to patients with chronic atrial fibrillation presenting themselves to hospital emergency departments. We assessed the severity of those outcomes and comment on whether they could have been avoided. METHODS: This descriptive, cross-sectional study included all patients with chronic atrial fibrillation who attended the emergency department of our tertiary hospital. We used the Dader method to identify and evaluate the negative outcomes associated with medication through interviews with patients and scrutiny of the clinical charts. RESULTS AND DISCUSSION: Of the 198 eligible patients who presented at the emergency department, 134 (67·7%) did so because of negative outcomes associated with medication (41% related to necessity, 32·1% to effectiveness and 26·9% to safety); 67·9% of those negative outcomes could have been avoided. In terms of severity, 6·7% were mild, 31·3% moderate, 51·5% severe and 10·4% fatal. The Anatomical Therapeutic Chemical Classification anatomical group most frequently associated with negative outcomes was the cardiovascular system, followed by blood/blood-forming organs. WHAT IS NEW AND CONCLUSION: A high percentage of patients with chronic atrial fibrillation presenting at hospital emergency departments had negative outcomes associated with medication. Some led to deaths. More than half of these were severe, and most could have been avoided.

Conciliación de los medicamentos en los servicios de urgencias / Medication reconciliation in emergency departments

Los errores de medicación (EM) son comunes en el ámbito hospitalario y conducen aun incremento de la morbilidad y mortalidad y de los costes económicos. Estos errores ocurren sobre todo durante la transición de pacientes entre los diferentes niveles asistenciales. La posibilidad de que se produzcan estos errores se ve aumentada en los servicios de urgencias (SU) por la naturaleza de éstos. Desde instituciones sanitarias a nivel mundial, se reconoce la conciliación de la medicación (CM) como la solución a esta problemática. Se define como el proceso que consiste en obtener un listado completo y exacto de la medicación previa del paciente y compararlo con la prescripción médica después de la transición asistencial. Si se encuentran discrepancias deben considerarse y, si es necesario, modificar la prescripción médica para finalmente comunicar al siguiente responsable en salud del paciente y al propio paciente, la nueva lista conciliada. Este documento de consenso ofrece una serie de recomendaciones generales para la conciliación de los medicamentos. Incluye para cada subgrupo una serie de recomendaciones específicas de tipo farmacológico, que permiten un abordaje personalizado del tratamiento del paciente que acude a urgencias en base a las características clínicas individuales. Existirán casos en los que se desestime las recomendaciones aquí descritas, ya que la relación riesgo/beneficio requerirá una valoración individualizada. Esta valoración individualizada para el paciente se llevará a cabo por el equipo multidisciplinar responsable de su asistencia sanitaria (AU)

Medication errors, which are common in hospitals, lead to higher morbidity, mortality, and expenditure. Errors are most common when patients are transferred from one level of care to another, and the likelihood of mistakes is higher in emergency departments because of the intrinsic nature of emergency care. The internationally recognized remedy for this situation is medication reconciliation, defined as the process of obtaining a complete, accurate list of the patient's prior medications and comparing it to the list of medicines prescribed after admission to a new level of care. Discrepancies should be considered and prescriptions changed if necessary. Both the person who will be responsible for the next phase of care and the patient should be informed of the new list of medications. This consensus statement offers a set of general recommendations for medication reconciliation. Specific recommendations for each subgroup of medications are also included to allow emergency department prescribing to be tailored to individual patient characteristics. The recommendations in this statement should be overridden in some cases if the risk-benefit ratio suggests that further individualization is required. Individualized assessment of medications should be carried out by a multidisciplinary team responsible for the patient’s care (AU)

[Health related problems as cause of visits to hospital emergency departments]. / Problemas de salud relacionados con los medicamentos en un servicio de urgencias hospitalario.

BACKGROUND AND OBJECTIVE: Medication-related problems (MRPs) are health problems resulting from patient pharmacotherapy failure that interfere with the expected outcome in the patient's health status. The aim of this study was to discover the health problems associated with the appearance of MRPs. PATIENTS AND METHOD: Patient interviews, together with the assessment of medical records were the sources of information used in the assessment and identification of MRPs. A validated questionnaire was used for the interviews; in order to classify the health problems found, the ICD-9 was used. RESULTS: 2,556 patients were interviewed over a period of one year at a hospital emergency department. 2,261 of these cases were valid. Osteoarticular diseases, poorly defined signs and symptoms of illness, injuries and intoxications were the disorders most commonly associated with the appearance of MRPs. MRPs of necessity and effectiveness had a similar profile. MRPs of safety were more commonly associated with poorly defined signs and symptoms of illness, injuries and intoxications, as well as nervous, digestive and blood problems. CONCLUSIONS: Most frequent medication related health problems causing visits to hospital emergency departments were osteoarticular disorders, followed by poorly defined signs and symptoms of illness. Differences were observed in the diagnoses between the different dimensions and types of MRP.

Problemas de salud relacionados con los medicamentos en un servicio de urgencias hospitalario / Health related problems as cause of visits to hospital emergency departments

FUNDAMENTO Y OBJETIVO: Los problemas relacionados con los medicamentos (PRM) son problemas de salud que se producen como consecuencia de fallos de la farmacoterapia del paciente y que interfieren con los resultados esperados de salud. El objetivo de este trabajo es conocer los problemas de salud más frecuentes que constituyen PRM. PACIENTES Y MÉTODO: La entrevista con el paciente junto con la evaluación de la historia clínica son las principales fuentes de información para evaluar e identificar PRM. Se utilizó un cuestionario validado como instrumento para la entrevista y la CIE-9 para la clasificación de los problemas de salud encontrados. RESULTADOS: Se entrevistó a un total de 2.556 pacientes durante 1 año en el servicio de urgencias hospitalario, de los que se estudiaron 2.261 tras las exclusiones. Las enfermedades osteoarticulares, los signos y síntomas mal definidos y las lesiones y envenenamientos son los problemas más relacionados con la aparición de PRM. Los PRM de necesidad y efectividad mantienen un perfil similar. Los PRM de seguridad se asociaron más a signos y síntomas mal definidos y lesiones y envenenamientos así como a alteraciones nerviosas, digestivas y sanguíneas. CONCLUSIONES: Los PRM más frecuentes que son causa de consulta en un servicio de urgencias hospitalario son los osteoarticulares, seguidos de los signos y síntomas mal definidos. Se observan diferencias en los diagnósticos entre las distintas dimensiones de PRM y sus tipos

BACKGROUND AND OBJECTIVE: Medication-related problems (MRPs) are health problems resulting-from patient pharmacotherapy failure that interfere with the expected outcome in the patient’s health status. The aim of this study was to discover the health problems associated with the appearance of MRPs. PATIENTS AND METHOD: Patient interviews, together with the assessment of medical records were the sources of information used in the assessment and identification of MRPs. A validated questionnaire was used for the interviews; in order to classify the health problems found, the ICD-9 was used. RESULTS: 2,556 patients were interviewed over a period of one year at a hospital emergency department.2,261 of these cases were valid. Osteoarticular diseases, poorly defined signs and symptoms of illness, injuries and intoxications were the disorders most commonly associated with the appearance of MRPs. MRPs of necessity and effectiveness had a similar profile. MRP sof safety were more commonly associated with poorly defined signs and symptoms of illness, injuries and intoxications, as well as nervous, digestive and blood problems. CONCLUSIONS: Most frequent medication related health problems causing visits to hospital emergency departments were osteoarticular disorders, followed by poorly defined signs and symptoms of illness. Differences were observed in the diagnoses between the different dimensions and types of MRP

Análisis de la información sobre las condiciones de conservación fuera del envase original de los medicamentos más prescritos / Analisys on information about preservation conditions of the most prescribed medicines when removed from their original package

La práctica de reenvasado de medicamentos, tanto por los pacientes en diferentes dispositivos, como por los farmacéuticos en los sistemas de ayuda al cumplimiento, requiere un estudio previo de requisitos de condiciones de conservación de las especialidades a reenvasar. Objetivo: Conocer la información disponible para pacientes (prospectos) y farmacéuticos (fichas técnicas e información de la industria) sobre las condiciones de conservación y la posible alteración de los medicamentos fuera de su envase original. Métodos: Se seleccionaron los medicamentos cuya venta en la provincia de Granada en Septiembre de 2000 superaba la mediana (sólo las formas farmacéuticas orales sólidas). En diciembre de 2000 se solicitó a los laboratorios fabricantes la información sobre las condiciones de conservación una vez desprovisto de su envase original, la ficha técnica, y el prospecto para cada especialidad incluida en el estudio. Resultados: De las 162 especialidades, se recibió respuesta de 148. Sólo 124 enviaron prospectos y 85 fichas técnicas. En 107 (72,3%) de las contestaciones recibidas fueron calificadas como con «ausencia de información»; igual que ocurría en 70 (56,4%) de los prospectos y 35 (41,0%) de las fichas técnicas. Para 79 especialidades, la respuesta era que no existían estudios sobre la estabilidad fuera del envase original. Conclusiones: La información disponible en prospectos y fichas técnicas no permite conocer ni a los ciudadanos ni a los profesionales farmacéuticos las condiciones de conservación propias de cada especialidad farmacéutica a la hora de poder re-envasarlas (AU)

The practice of re-packaging of medicines, by patients in different appliances and by the pharmacists in the adherence help systems, requires a preliminary study on the requisites of conservation conditions in the specialties to be re-packaged. Objective: The objective was to know the available information for patients (insert) and pharmacists (summary of product characteristics -SPC- and industry information) about conditions of preservation and eventual alteration of medicines once the original package was removed. Methods: The medicines whose sale in Granada province in September 2000 was superior to the average (only the oral solid forms of pharmaceuticals) were chosen. In December 2000 information from the manufacturing laboratories as to condition of preservation once the original package was removed, the Summary of Product Characteristics and the insert for each specialty included in the study was requested. Results: Of the [62 specialties, [48 replies were received. Only 124 sent inserts and 85 SPC. In 107 (72.3%) ofthe replies received were qualified as «lack of information»; the some as occurred in 70 (56.4%) of the inserts and 35 (41.O%) of the SPC. The reply for 79 specialties was that studies on stability outside the original package did not exist. Conclusions: The available information on insert and SPC does not allow either citizens or pharmaceutical professionals knowledge on individual conditions of preservation for each pharmaceutical specialty when they can be re-packaged (AU)

[Opinion of the primary care veterinarians of Andalusia concerning the management of their professional practice]. / Opinión de los veterinarios de atención primaria de Andalucía sobre la gestión de su ejercicio profesional.

BACKGROUND: This study describes the opinion of the veterinarians in Andalusia regarding the organization and management of their professional practice and pinpoints solutions to the problems found for the purpose of providing planning and management aspects in view of the reforms undertaken in the Andalusian Health Service Strategy Plan. METHOD: Descriptive opinion poll employing a questionnaire filled out by each individual among all of the Primary Care (PC) veterinarians in Andalusia (including those who have been currently employed who possess at least one year's experience, except substitutes). A description was provided of their personal traits, their opinion of the management-related factors involved in their professional practice. A description was also provided of the suggestions for improving the problems found to exist. RESULTS: Over 70% said they were aware of the objectives, although only the coordinators found them to be clearly motivating the practice. Their opinion was that the indicators of activity neither include any quality-related criteria nor afford the possibility of evaluating the activity they are carrying out. They believed that the contributions from other members of the multidisciplinary team improve their work and are in favor of continuing their involvement therein. They were satisfied with doing their work (the coordinators to a greater degree). They found the productivity pay to be too low and not useful as regards providing them with any incentive. They were not satisfied with the training with which they are provided and thought that what they are offered is far less than their other colleagues in the health care field. Most were of the opinion that they should remain under the authority of the Andalusian Health Service. CONCLUSIONS: This group prefers to continue working for the same organization, but improving the following management aspects: training offer, practice incentives and activity indicators.