Improving Medication Safety in the ICU: The Pharmacist’s Role

Purpose: The clinical impact of a critical care pharmacist in reducing medication errors in the intensive care unit (ICU) setting was evaluated. Methods: The study was divided into two 8-week phases: control phase without a critical care pharmacist and an ICU pharmacist phase with a critical care pharmacist. During both phases, pharmacy staff documented interventions using an electronic documentation system. Interventions that could be classified as medication errors were categorized by type of error and whether they were “averted” (intervention accepted) or “not averted” (intervention not accepted). The type and frequency of medication errors, number of medication errors “averted,” and clinical outcomes associated with the medication errors were compared between the control and ICU pharmacist phases. Results: There was no significant difference between the groups for gender and mean age. Of the 267 interventions included in the ICU pharmacist phase, 256 were classified as medication errors compared with 54 of 58 interventions for the control phase. The average number of medication errors per day was significantly higher during the ICU pharmacist phase (4.27 ± 5.2) compared with the control phase (0.92 ± 1.29, P \u3c 0.0001). The number of medication errors “averted” was higher in the ICU pharmacist phase compared with the control phase (212 vs 50). The “averted” medication errors during the ICU pharmacist phase were related to a higher percentage of improved or resolved clinical outcomes compared with the control phase (66/194 [34%] vs 7/46 [15.2%], P = 0.013). Conclusion: A critical care pharmacist improves medication safety by identifying and preventing medication errors and improving outcomes

Xpert HPV as a Screening Tool for Anal Histologic High-Grade Squamous Intraepithelial Lesions in Women Living With HIV

BackgroundWomen living with HIV (WLWH) experience high rates of anal cancer. Screening using anal cytology, high-resolution anoscopy (HRA) with biopsies, can histologically diagnose anal cancer precursors called high-grade squamous intraepithelial lesions (HSIL). The low specificity of screening using anal cytology results in HRA referral for many WLWH without HSIL. Screening using high-risk human papillomavirus (HR-HPV) may improve specificity.MethodsTwo hundred seven WLWH (63% non-Hispanic black) were screened for anal histologic HSIL (hHSIL) using cytology, HRA-guided biopsies, and Xpert HPV. Xpert performance for predicting anal hHSIL was compared with that of cytology. Usng Xpert 5 HPV genotypic results and accompanying cycle thresholds, receiver operator characteristic curve and recursive partitioning analyses were used to create predictive models for hHSIL.ResultsThe performance of Xpert to predict hHSIL was not different from that of cytology with a sensitivity (Sn) of 89% and specificity (Sp) of 49%. Interpretation of Xpert was modified using genotypic results and receiver operator characteristic curve analysis, which produced a screen with an Sn and Sp of 75% and 84% for hHSIL, respectively. Another reinterpretation of Xpert was created using recursive partitioning and cycle thresholds, which predicted hHSIL with an Sn and Sp of 75% and 86%, respectively. The detection of HPV-16 was highly predictive of hHSIL in all analyses. These modified screening tests would reduce HRA referral in this population by almost half compared with anal cytology.ConclusionsXpert HPV is an alternative to anal cytology to screen for anal HSIL and can be optimized to reduce the number of unnecessary HRAs performed in WLWH

Fly Cell Atlas: A single-nucleus transcriptomic atlas of the adult fruit fly

For more than 100 years, the fruit fly Drosophila melanogaster has been one of the most studied model organisms. Here, we present a single-cell atlas of the adult fly, Tabula Drosophilae , that includes 580,000 nuclei from 15 individually dissected sexed tissues as well as the entire head and body, annotated to >250 distinct cell types. We provide an in-depth analysis of cell type–related gene signatures and transcription factor markers, as well as sexual dimorphism, across the whole animal. Analysis of common cell types between tissues, such as blood and muscle cells, reveals rare cell types and tissue-specific subtypes. This atlas provides a valuable resource for the Drosophila community and serves as a reference to study genetic perturbations and disease models at single-cell resolution

Additional file 17 of Implicating genes, pleiotropy, and sexual dimorphism at blood lipid loci through multi-ancestry meta-analysis

Additional file 17: Table S9. PheWAS UKB-MVP meta-analysis results for each index lipid variant at Bonferroni threshold for multiple testing

Additional file 28 of Implicating genes, pleiotropy, and sexual dimorphism at blood lipid loci through multi-ancestry meta-analysis

Additional file 28: Table S18. Sex-participation association of the variants with significant sex-specific lipid results

Additional file 5 of Implicating genes, pleiotropy, and sexual dimorphism at blood lipid loci through multi-ancestry meta-analysis

Additional file 5: Table S4. Frequency of lipid-related publications for the PoPS+ prioritized genes