A prospective observational study of clinical pharmacist interventions was conducted over a 2-year period from November 2012 to October 2014 to evaluate the clinical activity of pharmacists in the care they provide to patients and to promote safe and effective medication therapy by quantifying medicine-related interventions on a Chinese neurology ward. All pharmacist interventions made in the department of neurology were recorded, categorized, and assessed for potential patient harm if the intervention had not taken place. The quantity, outcomes, and potential severity of clinical pharmacists' interventions were recorded. 619 interventions were made in 385 patients over the 2-year observational period. The mean severity of potential harm assessment was 3.7 (1.12), range 0.8 - 7.0. 87 of the 619 interventions (14.0%) were classified as medication errors. The results of the clinical pharmacist intervention study demonstrated that pharmacists play an important role in the care of neurological patients by improving patient care and reducing clinical risk.
Mutations of DNA organisms are introduced by replication errors. However, SARS-CoV-2, as an RNA virus, is additionally subjected to rampant RNA editing by hosts. Both resources contributed to SARS-CoV-2 mutation and evolution, but the relative prevalence of the two origins is unknown. We performed comparative genomic analyses at intra-species (world-wide SARS-CoV-2 strains) and inter-species (SARS-CoV-2 and RaTG13 divergence) levels. We made prior predictions of the proportion of each mutation type (nucleotide substitution) under different scenarios and compared the observed versus the expected. C-to-T alteration, representing C-to-U editing, is far more abundant that all other mutation types. Derived allele frequency (DAF) as well as novel mutation rate of C-to-T are the highest in SARS-CoV-2 population, and C-T substitution dominates the divergence sites between SARS-CoV-2 and RaTG13. This is compelling evidence suggesting that C-to-U RNA editing is the major source of SARS-CoV-2 mutation. While replication errors serve as a baseline of novel mutation rate, the C-to-U editing has elevated the mutation rate for orders of magnitudes and accelerates the evolution of the virus.
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