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Purpose: The objective of this study is to determine the impact of a 48-hour time-out on the utilization of targeted empiric intravenous (IV) antibiotics through a systematic approach. Methods: This is a single-center, prospective, interventional study approved by the Institutional Review Board. Study groups were stratified into a control and intervention arm. Inclusion criteria consisted of patients 18 years of age or greater, on targeted broad-spectrum IV antibiotics for more than 24 hours: daptomycin, ertapenem, meropenem, piperacillin-tazobactam, vancomycin. Exclusion criteria included febrile neutropenic, pregnant, critically ill, and surgical prophylactic patients. Targeted interventions made by pharmacists included: IV to oral conversions, dose optimizations/adjustments, and de-escalations. Primary endpoints were days of therapy per 1000 patient days (DOT/1000), days of therapy at risk per 1000 patient days (DOT/1000 DAR), and de-escalation rates. Results: Table 1 depicts a total 88.69% mean reduction of DOT/1000 of the intervention arm for vancomycin, piperacillin/tazobactam, and meropenem ( P -value <.0001) when compared to the control arm. Table 2 depicts a total 88.86% mean reduction of DOT/1000 DAR of the intervention arm for vancomycin, piperacillin/tazobactam, and meropenem ( P -value <.0001) when compared to control. Table 3 shows a 77.11% increase in total de-escalation rates ( P -value = .0107) in the intervention group when compared to control group (63.52%). Conclusion: This study displays the essential role that pharmacists play in antibiotic stewardship. This study further reveals that the stewarding tool utilized contributed to significant reductions in the usage of targeted empiric intravenous antibiotics., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Background: The impact of pharmacist-led transition of care services with collaborative drug therapy management has shown to improve patients' outcomes and decrease health costs. Compelling statistics show higher readmission rates for under-insured patients compared with insured patients at primary health care clinics. Methods: This is a single center, prospective, cohort study designed to examine team-based collaborative drug therapy management and its effect on therapeutic outcomes of under-insured patients with target chronic diseases managed in a primary health center. Targeted chronic diseases included dyslipidemia, diabetes, hypertension, anticoagulation disorders, chronic obstructive pulmonary disease, and heart failure. The primary outcome measures included percentage of time in therapeutic international normalized ratio (INR) and percentage of patients at targeted goals of blood pressure, lipids, and hemoglobin A1c (HbA1c). Secondary outcomes included reduced emergency department visits, number of patient encounters, hospital readmissions within 30 days of discharge, and disease exacerbation rates. Results: Patients were at INR goal 58% of the time compared with 52% at baseline ( P = .66). There was a 9% improvement in mean HbA1c in the intervention group when compared with baseline (9.6% vs 10.9%, P = .03). With pharmacist intervention, 73.8% of the patients had their blood pressure at goal compared with 50% at baseline ( P = .14). A limited number of patients were readmitted for different reasons, including uncontrolled disease states. Conclusions: The pharmacist-physician collaborative drug therapy management led to improved blood pressure control, average HbA1c, and time in therapeutic INR range. A decrease in health care utilization was also identified., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2019.)

An outstanding idea originally introduced by Greenberg is to investigate whether there is equivalence between intermediate statistics, which may be different from anyonic statistics, and q-deformed particle algebra. Also, a model to be studied for addressing such an idea could possibly provide us some new consequences about the interactions of particles as well as their internal structures. Motivated mainly by this idea, in this work, we consider a q-deformed Fermi gas model whose statistical properties enable us to effectively study interpolating statistics. Starting with a generalized Fermi-Dirac distribution function, we derive several thermostatistical functions of a gas of these deformed fermions in the thermodynamical limit. We study the high-temperature behavior of the system by analyzing the effects of q deformation on the most important thermostatistical characteristics of the system such as the entropy, specific heat, and equation of state. It is shown that such a deformed fermion model in two and three spatial dimensions exhibits the interpolating statistics in a specific interval of the model deformation parameter 0 < q < 1. In particular, for two and three spatial dimensions, it is found from the behavior of the third virial coefficient of the model that the deformation parameter q interpolates completely between attractive and repulsive systems, including the free boson and fermion cases. From the results obtained in this work, we conclude that such a model could provide much physical insight into some interacting theories of fermions, and could be useful to further study the particle systems with intermediate statistics.

The discovery of hydrogen isocyanide (HNC) in comet Hyakutake with an abundance (relative to hydrogen cyanide, HCN) similar to that seen in dense interstellar clouds raised the possibility that these molecules might be surviving interstellar material. The preservation of material from the Sun's parent molecular cloud would provide important constraints on the processes that took place in the protostellar nebula. But another possibility is that HNC is produced by photochemical processes in the coma, which means that its abundance could not be used as a direct constraint on conditions in the early Solar System. Here we show that the HNC/HCN ratio determined for comet Hale-Bopp varied with heliocentric distance in a way that matches the predictions of models of gas-phase chemical production of HNC in the coma, but cannot be explained if the HNC molecules were coming from the comet's nucleus. We conclude that HNC forms mainly by chemical reactions in the coma, and that such reactions need to be considered when attempting to deduce the composition of the nucleus from observations of the coma.

The recently discovered comet Hale-Bopp (C/1995 01) sports a bright dust coma even though it is still far from the sun (presently 6 astronomical units). This feature has attracted considerable interest in the public and scientific arenas. The comet is headed toward perihelion at 0.92 astronomical unit in April 1997 and is widely expected to then become a spectacular naked-eye comet. With millimeter-wave observations, carbon monoxide (CO) has been identified as the driver for the early activity observed in Hale-Bopp.