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Effect of a Digital-Driven Physician-Pharmacist Collaborative Model for Diabetes in Primary Health Care: Cluster Randomized Trial

Background: Evidence-based physician-pharmacist collaborative clinics have demonstrated significant short-term benefits for patients with type 2 diabetes (T2D), but their long-term effectiveness remains unclear, especially in primary health care settings. Objective: This study aimed to explore the long-term effectiveness and cost-effectiveness of a novel, digital-driven, multifaceted physician-pharmacist collaborative model for managing patients with T2D in underresourced settings. Methods: We conducted a 12-month cluster randomized controlled trial from May 2021 to December 2022 across 6 primary health care settings in China. Guided by the theory of planned behavior, the intervention involved routine therapy from physicians along with pharmaceutical interventions from pharmacists. These were delivered through a combination of face-to-face visits and mobile health care. The intervention group received 4 face-to-face visits and biweekly remote education sessions over the 12 months. We conducted intention-to-treat analyses to estimate differences in clinical and behavior indicators between the intervention and control groups. Primary outcomes included glycosylated hemoglobin and 10-year atherosclerotic cardiovascular risk. Data were analyzed using adjusted generalized estimation equations. Results: This study included 574 patients (291 in the intervention group and 283 in the control group). Over 12 months, patients in the intervention group had significant reductions in hemoglobin A1c (–2.57 vs –1.96, respectively; P<.001; 95% CI –1.027 to –0.238) and 10-year atherosclerotic cardiovascular risk (–1.35 vs 0.01, respectively; P<.001; 95% CI –1.690 to –0.630) compared with the control group. Substantial improvements were also observed in several secondary outcomes, including fasting blood glucose, 2-hour postprandial blood glucose, waist circumference, waist-to-hip ratio, blood pressure, triglyceride, and total cholesterol. Total diabetes-related costs decreased, and patient satisfaction improved significantly in the intervention group. There were no significant differences in BMI, high-density lipoprotein, or low-density lipoprotein. Conclusions: These findings suggest that the physician-pharmacist collaborative model could improve the long-term quality and efficiency of T2D management and reduce medical costs in underresourced areas globally. Patients with T2D, especially those with central obesity or high cardiovascular risk, may benefit more from collaborative clinics. Trial Registration: Chinese Clinical Trial Registry ChiCTR2000031839; https://www.chictr.org.cn/showproj.html?proj=51910

S2S-FDD: Bridging Industrial Time Series and Natural Language for Explainable Zero-shot Fault Diagnosis

arXiv:2603.08048v1 Announce Type: new Abstract: Fault diagnosis is critical for the safe operation of industrial systems. Conventional diagnosis models typically produce abstract outputs such as anomaly scores or fault categories, failing to answer critical operational questions like "Why" or "How to repair". While large language models (LLMs) offer strong generalization and reasoning abilities, their training on discrete textual corpora creates a semantic gap when processing high-dimensional, temporal industrial signals. To address this challenge, we propose a Signals-to-Semantics fault diagnosis (S2S-FDD) framework that bridges high-dimensional sensor signals with natural language semantics through two key innovations: We first design a Signal-to-Semantic operator to convert abstract time-series signals into natural language summaries, capturing trends, periodicity, and deviations. Based on the descriptions, we design a multi-turn tree-structured diagnosis method to perform fault diagnosis by referencing historical maintenance documents and dynamically querying additional signals. The framework further supports human-in-the-loop feedback for continuous refinement. Experiments on the multiphase flow process show the feasibility and effectiveness of the proposed method for explainable zero-shot fault diagnosis.
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