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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
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Kaleido: Open-Sourced Multi-Subject Reference Video Generation Model

arXiv:2510.18573v2 Announce Type: replace-cross Abstract: We present Kaleido, a subject-to-video~(S2V) generation framework, which aims to synthesize subject-consistent videos conditioned on multiple reference images of target subjects. Despite recent progress in S2V generation models, existing approaches remain inadequate at maintaining multi-subject consistency and at handling background disentanglement, often resulting in lower reference fidelity and semantic drift under multi-image conditioning. These shortcomings can be attributed to several factors. Primarily, the training dataset suffers from a lack of diversity and high-quality samples, as well as cross-paired data, i.e., paired samples whose components originate from different instances. In addition, the current mechanism for integrating multiple reference images is suboptimal, potentially resulting in the confusion of multiple subjects. To overcome these limitations, we propose a dedicated data construction pipeline, incorporating low-quality sample filtering and diverse data synthesis, to produce consistency-preserving training data. Moreover, we introduce Reference Rotary Positional Encoding (R-RoPE) to process reference images, enabling stable and precise multi-image integration. Extensive experiments across numerous benchmarks demonstrate that Kaleido significantly outperforms previous methods in consistency, fidelity, and generalization, marking an advance in S2V generation.
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