Feasibility Of Implementation Research Articles

Suicide prevention inpatient group treatment-A treatment development and feasibility study.

One mainstay of psychiatric treatment for suicidal crises is inpatient psychiatric hospitalization. Despite the need to secure immediate safety and stabilization, inpatient treatment for acutely suicidal patients remains diagnosis-specific, which may fail to directly target and adequately manage suicidal behavior as a symptom and reason for admission or treatment. The post-discharge period is a high-risk period for repeat suicide attempts or death by suicide, but overburdened workforce and high patient turnover make it difficult to provide suicide-specific treatment. In response to this need, we developed the Suicide Prevention Inpatient Group Treatment (SPIGT), a four-module, group-based intervention, which provides evidence-supported concrete tools and psychoeducation to directly address suicidality. To assess feasibility and acceptability of implementation, the SPIGT was piloted on an inpatient psychiatric unit starting in 2016. Group participants were given optional, anonymous surveys after each module. Unit clinicians also completed optional, anonymous surveys to assess their attitudes towards the intervention. Results indicate that participants responded very favorably to each module, and that unit clinicians felt that the implementation of this intervention was feasible and acceptable. The SPIGT shows promise as a scalable suicide-specific, brief intervention, which addresses an unmet and critical need in suicide prevention.

Applied fault diagnosis with distributed monitoring systems: Bridging theory with practice

We address the feasibility of the pragmatic implementation of monitoring systems for real-time distributed fault diagnosis in complex processes. We delve into the integration of theoretical distributed estimation methods and practical distributed embedded systems. This study emphasizes the merger of distributed computing and signal processing to augment fault diagnosis in dynamic systems. We introduce a generic mathematical model for distributed fault diagnosis algorithms, laying the groundwork for a reference network computing architecture that details the essential components, organization, and operational characteristics necessary for distributed monitoring systems. Subsequently, we evaluate existing software and hardware solutions that facilitate the realization of these systems. The theoretical framework and system design are empirically validated through an experimental setup involving a liquid-level control system, demonstrating the efficacy and applicability of our approach.

Nonlinear Dynamic Analysis Using Harmonic Balance Method

There is a high demand for nonlinear structural dynamics in implicit Finite Element Analysis (FEA). Although such methods are available, there are several obstacles to use them daily. One is their extreme and unpredictable computation time, which makes it often impossible to get results in time. Another point is the restriction of the methods to the time domain, which is often in contrary to the usual design rules based on frequency domain results. The Harmonic Balance Method (HBM) is a solution for an important sub-class of analysis cases, which resolves the two mentioned obstacles. As a starting point, we define HBM as a frequency response analysis with local nonlinearities. This allows to solve contact problems or mounting problems with nonlinear force-deflection curves. The primary results of HBM are in frequency domain. For all calculated frequencies, a solution in time domain is also available for a periodic response. A simplified radiator is used as industrial example. To prove the validity of HBM, a comparison with a linear frequency response analysis is performed, which shows same results. Then, rubber bushes and contact are added to the model as nonlinearities. Key results of stress and fatigue are presented, and the computation times are analysed to demonstrate the feasibility of the HBM implementation for applications in research and industry. All simulations are performed with the FEA software PERMAS, which contains the HBM among many other analysis methods in structural dynamics.

The Impact of Dog-Assisted Therapy Among Children and Adolescents with Autism Spectrum Disorder: A Systematic Review

Background and Objectives: Animal-assisted therapies have been utilized in various profiles to improve people’s quality of life. This systematic review aims to assess the impact of dog-assisted therapies (DAT) on children and adolescents with Autism Spectrum Disorder (ASD). The benefits provided, the feasibility of implementation, and potential limitations are analysed. Methods: An exhaustive search was carried out in the following databases: Web of Science (WoS), Scopus, ERIC, PubMed, PubPsych, CINAHL, PsycInfo and Dialnet. The procedure was preregistered on PROSPERO. Results: This review included 19 scientific articles. Of these, 84% suggest that DAT has a positive impact on communication and social interaction during the development of children and adolescents diagnosed with ASD. The dog is often perceived as a communication facilitator that serves as a reinforcer, capturing the individual’s attention. Emotional benefits have also been reported, including reducing stereotyped and self-harming behaviours. Additionally, an increase in smiling frequency and self-esteem levels was observed. Conclusions: These findings highlight the potential of DAT as a component of socio-educational intervention for children and adolescents diagnosed with ASD. However, further research is necessary due to the limited sample sizes in the studies reviewed.

Addressing Barriers Newcomer Families Face When Obtaining Routine Childhood Vaccines in Alberta, Canada

Background/Objectives: As the newcomer population in Canada continues to grow, we aimed to collaborate with newcomer families arriving in an urban center in Alberta, Canada to identify strategies to overcome identified barriers newcomers face in obtaining routine childhood vaccines (RCVs). Methods: We recruited newcomers living in Calgary, Alberta to participate in a workshop utilizing the Nominal Group Technique (NGT) to develop solutions addressing barriers to obtaining RCVs. Ranking exercises helped identify the top-proposed interventions based on perceived impact and feasibility for implementation. Based on the identified need for translated vaccine resources, infographics on school-based vaccines were developed. The infographics were pilot-tested in a first-language focus group before the final product was translated into 10 different languages. Results: Consensus from 15 NGT workshop participants identified five key solutions to facilitate obtaining routine childhood immunizations: (1) Increasing access to reliable vaccine information; (2) Ensuring vaccine information and healthcare services are available in different languages; (3) Increasing vaccine appointment availability and optimizing the booking system for ease of navigation; (4) Increasing the role of family doctors in vaccine counseling and administration; (5) Streamlining vaccine record tracking. We developed infographics on the vaccines children in Alberta can receive through school-based vaccine programs and these were pilot-tested with 16 participants in a first-language (Arabic) focus group. Conclusions: The collaborative and iterative process of solution development with newcomers provided a platform for knowledge translation through the development of educational resources on school-based vaccines, addressing the information barrier that newcomers identified when accessing RCVs.

Remotely Delivered Video Interaction Guidance for Families of Children With an Intellectual Disability Referred to Specialist Mental Health Services: Protocol for a Feasibility Randomized Controlled Trial.

Children with an intellectual disability (ID) are 3-4 times more likely to present with behaviors that challenge and mental health problems than typically developing children. Parenting and the quality of parent-child relationships are risk factors for these families. The COVID-19 pandemic further exacerbated difficulties, leading to an increase in child mental health problems and behaviors that challenge, a deterioration in parental mental health, and further strain on family relationships. Remote family interventions could be an effective solution for both families and specialist mental health services. Video interaction guidance (VIG) has shown promise for improving child mental health. However, it is unclear whether it is widely acceptable to families and feasible to implement across specialist child mental health services. This randomized controlled trial aims to evaluate the feasibility of delivering VIG as a remote intervention for parents of children aged 6-12 years with ID who have been referred to specialist mental health services. The study will be undertaken across 5-7 National Health Service specialist mental health services in England, involving 50 participants randomly allocated on a 1:1 basis to either the intervention group (receiving remote VIG) or the treatment-as-usual (TAU) group. The intervention group will engage in 3-5 cycles of VIG delivered remotely over 12 weeks. The primary feasibility outcomes include the recruitment rate, retention at 6-month follow-up, and VIG cycle completion rate. The secondary outcomes will assess the acceptability of VIG and the feasibility of remote implementation, including fidelity to the intervention protocol. Data will be gathered through online surveys and telephone interviews at baseline, 3 months, and 6 months. Feasibility outcomes will be summarized using descriptive statistics, while thematic analysis will be applied to qualitative data from semistructured interviews with participants, VIG practitioners, and service managers. An embedded process evaluation will explore barriers and facilitators to engagement with VIG, and a parallel health economics evaluation will assess the feasibility of capturing service use data and intervention costs. The trial was open to recruitment between December 2022 and March 2024. The first results should be available in 2025. The study is the first randomized evaluation of VIG as offered to parents of children with ID who have been referred to specialist mental health settings. The outcomes from this feasibility trial will inform the decision to proceed with a definitive trial, using a traffic light system to evaluate recruitment, retention, and VIG completion rates alongside qualitative insights and economic evaluations. ISRCTN Registry ISRCTN13171328; http://www.isrctn.com/ISRCTN13171328. DERR1-10.2196/54619.

An Image-Recognition Dietary Assessment App for Adolescents With Obesity: Pilot Randomized Controlled Trial.

Adolescence is a period of increased susceptibility to developing obesity-related health issues due to poor eating patterns and increased sedentary behaviors. Recommendations for pediatric obesity management include dietary assessments. However, adolescents often avoid food logging through traditional methods. The use of image-recognition dietary assessment apps in adolescents with obesity is not well studied. Eating for Wellness (E4W) is a mobile app that determines the nutritional content of meals from photos and incorporates nutritional goal setting. Nutritional data can be displayed for health care providers (HCPs) via the Clinician Portal, while the data are presented to the user in a manner that minimizes the focus on calorie counting. This study aims to evaluate the usability and feasibility of E4W, a mobile health app designed to improve dietary intake in adolescents with obesity attending an obesity clinic, using a phased approach. The overall study was conducted in 2 phases to refine and evaluate E4W. In Phase 1, usability was tested through 3 iterative cycles of patient interviews. A total of 14 patient participants, aged 12-18 years with a BMI≥97th percentile, were included. Participants performed standardized scenario-based tasks in E4W and provided feedback on the app. Two iterative cycles were conducted for HCPs (n=4). Refinements were made during each cycle based on issues encountered and feedback provided. In Phase 2, a pilot randomized controlled trial of 32 adolescents (16 adolescents enrolled in the experimental group for 1 month, and 16 controls enrolled for 1 month) was completed. Both groups met with their dietitian at baseline, midstudy, and 1 month following their baseline visit to discuss goals and eating patterns. The control group was instructed to take photos of all intake using their default phone camera, without access to E4W, while those in the experimental group received full access to E4W. The primary outcome was the feasibility of implementation. Secondary outcomes examined overall change in dietary intake and achievement of nutritional goals. Usability testing demonstrated that E4W and the Clinician Portal were easy to use, efficient, and well-liked by patients and HCPs. Feasibility testing revealed high patient acceptability scores. However, significant technical challenges were encountered. Although the use of E4W did not significantly impact patient engagement (control: mean 0.9, SD 0.7; experimental: mean 1.7, SD 1.9; P=.14), there were outliers in the experimental group with very high engagement and improved self-reported efficacy. Overall, there was no improvement in dietary intake, although assessment was hindered by poor adherence to traditional methods of food logging. E4W and the Clinician Portal were well-received by patients and HCPs. Further research is warranted and planned to determine if E4W can improve dietary intake and achievement of nutritional goals in adolescents with obesity. ClinicalTrials.gov NCT05548868; https://clinicaltrials.gov/study/NCT05548868.

Um processo participativo de desenvolvimento de melhorias em áreas comuns de uso infantil

Abstract Research which evaluates Social Housing (SH) in Brazil often points out unfavorable conditions expressed by residents, in terms of the residential unit and common spaces, as well as surroundings. Participatory processes to improve projects are considered essential for political, social and economic reasons, and user values need to be prioritized. Processes to develop improvements for existing SH, that include residents as protagonists, with active participation, may guide more effective actions. However, participatory processes for home and public area renovations require procedures to effectively achieve their technical objectives and meet the needs and desires of their residents with feasibility of implementation. This research developed a case study with the participation of residents of a small SH project in Campinas - SP, with a specific focus on improvements for the children's leisure areas. The study involved the public targeted, children living in the analyzed SH complex, in defining their leisure space through dynamics and playful activities. Qualitative results are presented of this participatory process, involving children. Knowledge gained is methodological, with lessons learned for the planning and development of participatory co-design projects with children.

“If they take it without knowing, they will default…”: perceptions of targeted information transfer to promote adherence to intermittent preventive treatment with dihydroartemisinin-piperaquine for the prevention of malaria in pregnancy in western Kenya

BackgroundIncreasing resistance to sulfadoxine-pyrimethamine (SP) threatens the effectiveness of intermittent preventive treatment (IPTp) to prevent malaria in pregnancy. Dihydroartemisinin-piperaquine (DP) is the most promising candidate to emerge from clinical trials, but requires a multi-day regimen. Despite being a single-dose regimen, coverage of IPTp-SP remains low, fuelling concerns about adherence to multi-day drug options. An implementation feasibility trial in routine antenatal care settings in western Kenya demonstrated that adherence to the multi-day DP regimen was improved when IPTp-DP was delivered with a targeted information transfer intervention that comprised healthcare provider training and communication tools to support delivery and uptake. This study explored healthcare provider and pregnant women perspectives to understand (1) how the targeted information transfer improved adherence to IPTp-DP and (2) if improved adherence to IPTp-DP influenced provider perceptions towards implementation feasibility of multi-day drug regimens for IPTp.MethodsIn-depth interviews were conducted with 64 healthcare providers and 64 pregnant women, selected using a convenience sampling approach from across the three trial arms: IPTp-DP+ (with intervention), IPTp-DP, and current standard of care IPTp-SP. Transcripts from healthcare providers and pregnant women were coded in Nvivo-12 using separate a priori frameworks that included components of the consolidated framework for implementation research. Thematic analysis was used to understand how the targeted information transfer affected adherence to IPTp-DP and how concerns about adherence might influence provider perceptions towards multi-day drug regimens for IPTp.ResultsAdherence to IPTp-DP doses taken at home was compromised when women experienced unpleasant side effects. Pregnant women valued being given information about IPTp-DP, including potential side effects and how to manage them. Among providers in the IPTp-DP + arm, confidence in advising women on how to manage side effects increased, and they believed this guidance improved adherence. When concerns about adherence were reduced, providers in the IPTp-DP + arm were positive about implementation feasibility, whereas providers in the IPTp-SP arm remained focused on the dosing complexities and were less convinced of the feasibility of implementing IPTp-DP.ConclusionsHealthcare provider confidence in advising women on how to minimize side effects was boosted through targeted information transfer, which was perceived to improve adherence to IPTp-DP. Policy makers are encouraged to consider supportive interventions that enhance provider confidence around adherence should they shift to multi-day drug regimens for IPTp.

Digital twins as a tool for shaping the business environment of modern organizations

Subject. The article is devoted to the technology of digital twins as a tool for the formation of the business environment of modern organizations. Objectives. The aim is to show the need to improve the quality of business environment of modern organizations and improve the efficiency of business process management, to justify the importance of using modern digital technologies, to explore the technology of digital twins as a promising tool for shaping the business environment of modern organizations. Methods. The study rests on systems approach enabling to consider the technology of digital twins as a set of sequential modeling processes, which results in the creation of an adequate digital virtual reality. I also use the content analysis of available sources and statistical data. Results. The use of digital twins technology provides real opportunities for enterprises to operate in a dynamic market environment. However, their implementation faces a number of challenges that must be considered when deciding to implement the technology under study in the practical activities of Russian enterprises. Moreover, a fairly long investment and project cycle does not end with the creation of a digital twin, but requires constant work related to its improvement, saturation with information, technical and technological maintenance of this system. Conclusions. Currently, an urgent task is to develop pilot projects for the creation of digital twins implemented at experimental sites. These projects will provide the necessary information on the feasibility and specifics of this system implementation, and help gain necessary experience in its development, implementation, and operation.

Implementation and evaluation of a navigation program for people with cancer in old age and their family caregivers: study protocol for the EU NAVIGATE International Pragmatic Randomized Controlled Trial

BackgroundCancer navigation programs aim to support, educate, and empower patients and families, addressing barriers to diagnostics, treatment, and care. Navigators engage with people to ensure timely access to services and resources. While promising for older people with cancer, these programs are scarce in Europe, and research on their effectiveness and implementation is limited. We describe the protocol of the EU NAVIGATE randomized controlled trial, aimed to evaluate (1) effectiveness and cost-effectiveness of NavCare-EU, an intervention that aims to support older people with cancer throughout their illness trajectory, spanning the continuum of supportive, palliative, and end-of-life care, and (2) the intervention’s implementation processes and feasibility of its integration into different health care systems in Europe, contextual barriers and facilitators for effective and sustainable implementation, and mechanisms involved in reaching the outcomes.MethodsWe will conduct a multisite pragmatic fast-track randomized controlled trial with embedded convergent mixed-method process evaluation in Belgium, Ireland, Italy, Netherlands, Poland, and Portugal. The study targets people with cancer and declining health, 70 years or older, and their close family caregivers. The trial compares the NavCare-EU intervention plus standard care with standard care alone. We will perform a baseline measurement prior to randomization and follow-up measurements at 12 weeks, 24 weeks, and 48 weeks in intervention and control group, and an additional measurement at 72 weeks in the control group. Primary outcomes, measured at 24 weeks are (1) the older person’s global health status/quality of life, a 2-item subscale from EORTC-QLQ-C30 (revised) measuring health-related quality of life, (2) level of social support measured with Medical Outcomes Study Social Support Survey (MOS-SSS scale). The study will include at least 246 older persons with completed global health status/quality of life at 24 weeks.DiscussionThe EU NAVIGATE trial will cross-nationally test the effectiveness and cost-effectiveness of a navigation intervention for older people with cancer and their family caregivers, and its implementation in different health care systems in Europe. As continuity and access to health, social, and community care is a priority for patients and caregivers, the trial is timely and critically needed.Trial registrationClinicaltrials.gov: identifier NCT06110312 (2023/10/31).

The Alberta Back Care Pathway: The feasibility of implementing a novel care pathway to improve low back pain management for family physicians in primary care.

Family physicians in Canada's universal healthcare system often manage low back pain patients using interventions not recommended in clinical guidelines, such as pharmaceuticals, imaging and spinal injections, while guideline-based treatments like education and exercise remain unfunded. The Alberta Back Care pathway was developed to address this gap, offering funded, evidence-based care for low back pain patients in 5 streams (acute, sub-acute, chronic, chronic non-responsive and stable radiculopathy). To evaluate the feasibility of implementing the pathway in two urban Primary Care Networks in Alberta, Canada. Each of the 5 pathway streams provided physicians with information scripts, no-cost interventions (pharmaceuticals and otherwise) and interventions to avoid. From April 2021 to November 2023, the RE-AIM framework was used to assess implementation feasibility of the pathway. For the RE-AIM dimension of reach, 25% (n = 41/162) of eligible family physicians in Primary Care Network "A" and 12% (n = 26/221) in Primary Care Network "B" enrolled in the study. Over half of enrolled physicians (n = 21/41 and 21/26) referred at least one patient with most referrals to the GLA:D Back program for chronic low back pain stream (93% in network "A" and 88% in network "B"). Implementation, evaluated as the proportion of referrals by physician compared to their total low back pain caseload, was low (> 0-10% referred) for 52% (n = 11/21) of physicians in network "A", and medium-low (10-25% referred) for 52% (n = 11/21) of physicians in network "B". The number of pathway-appropriate patients in each physician's caseload was unknown. Maintenance at 12 months was 56% (n = 10/18) in network "A" and 39% (n = 7/18) in network "B". The Alberta Back Care pathway was feasible to implement during the pandemic and primarily serving patients with chronic low back pain by providing access to a guideline-based education and exercise group program (GLA:D Back).

Cost of delivering childhood RSV prevention interventions to the health system in Kenya: a prospective analysis

ObjectivesTo evaluate the cost of delivering childhood respiratory syncytial virus (RSV) prevention interventions to the health system in Kenya.DesignA prospective (cost projection) activity-based costing study.SettingKenya, national introduction of interventions.ParticipantsNot applicable.InterventionsA...

Deepening and Practical Application of Sentiment Analysis: Through Exploration of Public Interest and Sentiment on “Biodiversity” From Twitter

With the evolution of information technology, dramatic innovations in computerized mining techniques and opinion mining from SNS, especially sentiment analysis, have been gaining attention in predicting the feasibility of global environmental policy implementation. However, discussions on how to more effectively apply analytical results to strategy building for global biodiversity governance have yet to progress. This paper proposes a strategy-building framework for promoting pro-environmental behaviors on biodiversity conservation and attempts to extract sentiment information (especially fear, sadness, and anticipation) from posts on Twitter (X) in 2021 and 2022 using natural language processing (NLP). The results showed that sentiments of fear, sadness, and anticipation were prominent in both years regarding topics related to species extinction and decline, as well as the 30by30 initiative. Furthermore, based on the information on the sentiment-inducing factors identified from the analysis results, we presented practical examples of strategy building for pro-environmental behavior promotion, according to the framework.

Optimal Control of Hydrocarbons’ Hydrogenation with Catalysts

In this paper, the optimal control problem of hydrocarbons’ hydrogenation was investigated in the presence of two catalysts—Nickel–Kieselguhr and Raney Nickel. This multistage chemical reaction holds significant practical importance, particularly in the production of high-density fuels. The optimal control problem was reformulated as a nonlinear global optimization problem and addressed using a modified Mind Evolutionary Computation algorithm. The proposed modifications include methods designed to ensure solution feasibility and ease of practical implementation. Using the proposed method, the performance of the two catalysts was compared under constant temperature conditions and with optimal control strategies. The results demonstrate that selecting an effective catalyst has a greater impact on the reaction’s efficiency than temperature control alone, with the Raney Nickel catalyst consistently outperforming the Nickel–Kieselguhr catalyst by at least 17%. Additionally, the optimization approach was applied to identify a new set of catalyst parameters. The newly obtained catalyst parameters allowed for the improvement of the results of the Raney Nickel catalyst by 18%. The results of all numerical experiments and implementation details are described in the paper.

Design and synchronization control application of a new five-dimensional memristor CNN conservative hyperchaotic system

Abstract Incorporating memristors into a cellular neural network (CNN) and introducing chaotic characteristics can generate highly complex and unpredictable dynamic behaviors. To advance this research area, this paper proposes a new five-dimensional memristor CNN conservative hyperchaotic system and systematically analyzes its dynamic properties. The analysis content includes equilibrium point analysis, Poincaré sections, Lyapunov exponent spectra, bifurcation diagrams, two-parameter Lyapunov exponent spectra, complexity assessment, homogeneous and heterogeneous extreme multistability, etc In addition, the simulation circuit for the new system is designed and constructed. The digital circuit of the new system is implemented using a microcontroller (MCU). After running simulations, the experimental results from the analog circuit, digital circuit, and numerical simulation are consistent with each other, demonstrating the feasibility of the circuit implementation. Finally, two different synchronization control strategies are employed to achieve synchronization control within a finite time.

Qualitative study of the feasibility and acceptability of implementation, and potential mechanisms of Learning Together for Mental Health, a whole-school intervention aiming to promote mental health and wellbeing in secondary schools

BackgroundDespite high rates of adolescent mental-health problems, there are few effective whole-school interventions to address this. Whole-school interventions offer a feasible and sustainable means of promoting mental health. We previously evaluated the Learning Together (LT) intervention which was effective in preventing bullying (primary outcome), promoting mental well-being, psychological functioning, and reducing substance use (secondary outcomes). We adapted LT to develop Learning Together for Mental Health (LTMH) with a new menu of evidence-based actions to address mental health and an enhanced SEL curriculum.MethodsWe undertook a feasibility study of LTMH, a whole-school intervention featuring needs assessment, student and staff participation in decision-making via action groups selecting actions from an evidence-based menu, restorative practice, and a SEL and resilience skills curriculum between 2022 and 2023. This article examines the feasibility, acceptability, and potential mechanisms of LTMH, qualitatively, drawing on interviews and focus groups with 49 students in years 8 and 10, and 20 staff across four state secondary schools in southern England.ResultsThe intervention was feasible and acceptable to implement. In terms of feasibility, the SEL curriculum was the most challenging to implement and was not prioritised by schools that had existing social and emotional learning lessons. Training and external facilitation were well-rated. Some schools struggled with the resourcing and workload implications of implementing actions from the evidence-based menu. Some aspects were not clear. Some staff were not aware that the various components worked together. Needs reports were not easy to understand for all. Students were generally supportive of restorative practice and SEL lessons. Data supported a potential mechanism involving increased school belonging and developing practical knowledge and skills to manage emotions and relationships. The intervention has little potential for harm.ConclusionsThe intervention is ready for phase III trial with minor adaptations. A phase III trial of effectiveness is justified.Trial registrationISRCTN15301591 https://doi.org/10.1186/ISRCTN15301591

A dynamic semi-quantum private comparison protocol for size relations

Abstract Semi-quantum private comparison allows multiple ``classical'' users who have restricted quantum capabilities to compare their private data with the assistance of a quantum third party. In this work, we propose a novel dynamic semi-quantum private comparison protocol using a circular transmission mode along with $d$-dimensional single-particle states. The protocol enables the comparison of data size relations among several ``classical'' users, while the third party can only determine the relative sizes without accessing the users' secret information. Security evaluations demonstrate that the designed protocol withstands typical external and internal attacks. Compared to previous works, this protocol offers several improvements: first, it supports dynamic addition or removal of users, enhancing applicability in practical scenarios; second, it eliminates the need for pre-shared keys, reducing quantum resource consumption; third, it avoids the use of high-dimensional multi-particle entangled states, thereby enhancing the feasibility of implementation. Therefore, the proposed protocol may have more practical potential compared to previous protocols.

Screening and referral programs for diabetes and cardiovascular disease: Can community pharmacists bridge the care gap?

Background and ObjectivesHeart disease and diabetes are leading causes of death in the U.S., with timely screening, referrals, and education being critical for effective treatment. The Community-based Valued-driven Care Initiative (CVCI) aimed to develop, implement, and evaluate the feasibility of delivering patient-centered care interventions for high priority disease states in community pharmacies. This article focuses specifically on two of the selected interventions, both of which were screening and referral (S&R) programs for the prevention and treatment of cardiovascular disease (CVD) and diabetes (DM) respectively. This exploratory evaluation was designed as an effectiveness-implementation hybrid Type II study. Its objectives were to assess both implementation and preliminary program effectiveness using mixed data. MethodsFifteen community pharmacies opted to implement one of the two programs over a 12-month period. Implementation feasibility involved examining program adoption rates by sites and patients; acceptability, appropriateness, feasibility, and intent to sustain use survey scores; and pharmacists' interviews. Program effectiveness was based on patient referral rates, physician follow-up communication rates, and perceived outcomes, collected via patient logs, surveys, and interviews. ResultsTwo of the 15 sites discontinued participation, yielding an 87 % adoption rate. Patient adoption varied based on contact and screening rates, due to differences in patient recruitment, staffing, and workflow. Pharmacist acceptability, compatibility, and feasibility remained high throughout implementation; however, only three pharmacy sites planned on continuing offering the programs. All at-risk patients were appropriately referred based on screening results, with 65 % having their screening results communicated to their primary healthcare providers. The programs were perceived as beneficial, increasing pharmacists' knowledge and motivation, enhancing relationships with patients, and producing an impact on patients'' health. DiscussionResults highlight the implementation feasibility and preliminary outcomes of delivering DM and CVD S&R programs in community pharmacies. However, despite these positive results, most pharmacies did not intend to continue the programs, underscoring the continued need for sustainable clinical services models in non-traditional settings. Success with broader implementation will require a paradigm shift in support of community pharmacists as clinical care extenders.

Design and development of bridge erecting machine with small curve radius and bottom feeding beam

As a key equipment in highway and railway construction, bridge erecting machines directly affect the feasibility, progress, and quality of project implementation. In order to solve the problem that traditional bridge building machines are only suitable for application scenarios with large turning radii and large lifting sites, and have low lifting efficiency, which cannot meet the requirements of urban elevated bridge construction, a small radius bottom feeding beam bridge building machine suitable for urban highway and railway construction is proposed. The feasibility and reliability were verified through force analysis and finite element analysis; Design a secondary turning structure and bridge construction process for the front leg, adjusting the turning angle to around 7°, significantly reducing the turning radius of the bridge building machine; Propose a technology for feeding and lifting beams at the bottom of dual-use bridge decks for highways and railways. By vertically lifting beams and slabs, the lifting space is significantly reduced and the lifting efficiency is improved. Finally, a small radius bottom feeding beam bridge erecting machine was developed and tested and applied. The results show that the small radius bottom feeding beam bridge erecting machine designed in this article reduces the turning radius of traditional bridge erecting machines from over 300 m to about 80 m, making it possible to carry out projects that were originally impossible, and solving the problem of elevated bridge construction in limited urban spaces.