A Comparison of Error Rates Between Intravenous Push Methods: A Prospective, Multisite, Observational Study

Objectives Current literature estimates the error rate associated with the preparation and administration of all intravenous (IV) medications to be 9.4% to 97.7% worldwide. This study aims to compare the number of observed medication preparation and administration errors between the only commercially available ready-to-administer product (Simplist) and IV push traditional practice, including a cartridge-based syringe system (Carpuject) and vials and syringes. Methods A prospective, multisite, observational study was conducted in 3 health systems in various states within the United States between December 2015 and March 2016 to observe IV push medication preparation and administration. Researchers observed a ready-to-administer product and IV push traditional practice using a validated observational method and a modified data collection sheet. All observations were reconciled to the original medication order to determine if any errors occurred. Results Researchers collected 329 observations (ready to administer = 102; traditional practice = 227) and observed 260 errors (ready to administer = 25; traditional practice = 235). The overall observed error rate for ready-to-administer products was 2.5%, and the observed error rate for IV push traditional practice was 10.4%. Conclusions The ready-to-administer group demonstrated a statistically significant lower observed error rate, suggesting that use of this product is associated with fewer observed preparation and administration errors in the clinical setting. Future studies should be completed to determine the potential for patient harm associated with these errors and improve clinical practice because it relates to the safe administration of IV push medications

Lidar technology measurements and technology: Report of panel

Lidar is ready to make an important contribution to tropospheric chemistry research with a variety of spaceborne measurements that complement the measurements from passive instruments. Lidar can now be considered for near-term and far-term space missions dealing with a number of scientifically important issues in tropospheric chemistry. The evolution in the lidar missions from space are addressed and details of these missions are given. The laser availability for space missions based upon the technical data is assessed

Developmental expression of COE across the Metazoa supports a conserved role in neuronal cell-type specification and mesodermal development

The transcription factor COE (collier/olfactory-1/early B cell factor) is an unusual basic helix–loop–helix transcription factor as it lacks a basic domain and is maintained as a single copy gene in the genomes of all currently analysed non-vertebrate Metazoan genomes. Given the unique features of the COE gene, its proposed ancestral role in the specification of chemosensory neurons and the wealth of functional data from vertebrates and Drosophila, the evolutionary history of the COE gene can be readily investigated. We have examined the ways in which COE expression has diversified among the Metazoa by analysing its expression from representatives of four disparate invertebrate phyla: Ctenophora (Mnemiopsis leidyi); Mollusca (Haliotis asinina); Annelida (Capitella teleta and Chaetopterus) and Echinodermata (Strongylocentrotus purpuratus). In addition, we have studied COE function with knockdown experiments in S. purpuratus, which indicate that COE is likely to be involved in repressing serotonergic cell fate in the apical ganglion of dipleurula larvae. These analyses suggest that COE has played an important role in the evolution of ectodermally derived tissues (likely primarily nervous tissues) and mesodermally derived tissues. Our results provide a broad evolutionary foundation from which further studies aimed at the functional characterisation and evolution of COE can be investigated

Early evolution of the LIM homeobox gene family

Background: LIM homeobox (Lhx) transcription factors are unique to the animal lineage and have patterning roles during embryonic development in flies, nematodes and vertebrates, with a conserved role in specifying neuronal identity. Though genes of this family have been reported in a sponge and a cnidarian, the expression patterns and functions of the Lhx family during development in non-bilaterian phyla are not known

Developing Safe Habits for Practice

Fatal and nonfatal medication errors continue to occur in American healthcare. These are reported in a variety of ways and formats, and can include sensationalistic case reports about a patient receiving the wrong medication or more rigorous science-based research reports. It is often difficult to truly quantify the number of medication errors that occur in the United States each year and the associated costs. Varied definitions used for the terms medication error, adverse drug event, and drug-related problems make for a toxic soup when trying to sort through the true impact and cost associated with medication mistakes. In most instances, it should be enough to know that U.S. patients are harmed by medications each day by well-intentioned caregivers

Chymotrypsin mRNA expression in digestive gland amoebocytes: cell specification occurs prior to metamorphosis and gut morphogenesis in the gastropod Haliotis rufescens

In the non-feeding larva of the marine gastropod, Haliotis rufescens, gut morphogenesis is initiated at metamorphosis. Intestine-specific chymotrypsin gene expression begins in amoebocytes located in the dorsoposterior region of the undifferentiated digestive gland prior to metamorphosis, 5 d post-fertilization. Transcript accumulates steadily in these cells over the next 6 d while the amoebocytes migrate slowly dorsally. Induction of metamorphosis dramatically accelerates the rates of chymotrypsin mRNA accumulation and amoebocyte migration, and is required for homing of the amoebocytes to the hindgut region. Induction of chymotrypsin gene expression occurs only in larvae that had developed competence to recognize an exogenous morphogenetic cue and initiate metamorphosis, with a more pronounced increase in chymotrypsin mRNA accumulation in occurring older larvae. Chymotrypsin mRNA accumulation patterns suggest that hindgut cell specification occurs prior to metamorphosis, but that completion of the morphogenetic program requires signaling events associated with metamorphosis

Comparison of Pharmacy-Based Measures of Adherence to Antiretroviral Therapy as Predictors of Virological Failure

We compared multiple pharmacy refill-based adherence indicators for antiretroviral therapy, as well as thresholds for defining non-adherent behavior, based on ability to predict virological failure. A total of 29,937 pharmacy visits with corresponding viral load assessments were contributed by 8,695 patients attending a large clinic in Johannesburg, South Africa. Indicators based on pill coverage and timing of refill pickup performed comparably using the strictest thresholds for adherence [100 % pill coverage: odds ratio (OR) (95 % confidence interval (CI)) : 1.26 (1.15, 1.39); prescription picked up on or before scheduled refill date: 1.27 (1.16,1.38)]. For both types of indicators, the association between non-adherence and virological failure increased as the threshold defining adherent behavior was lowered. All measures demonstrated high specificity (range 84–98 %), but low sensitivity (5–19 %). In this setting, patients identified as non-adherent using pharmacy-based indicators are likely correctly classified and in need of interventions to improve compliance. Pharmacy based measures alone, however, are inadequate for identifying most cases of nonadherence