The rapid development of Internet of Things(IoT)technology has led to a significant increase in the computational task load of Terminal Devices(TDs).TDs reduce response latency and energy consumption with the support ...The rapid development of Internet of Things(IoT)technology has led to a significant increase in the computational task load of Terminal Devices(TDs).TDs reduce response latency and energy consumption with the support of task-offloading in Multi-access Edge Computing(MEC).However,existing task-offloading optimization methods typically assume that MEC’s computing resources are unlimited,and there is a lack of research on the optimization of task-offloading when MEC resources are exhausted.In addition,existing solutions only decide whether to accept the offloaded task request based on the single decision result of the current time slot,but lack support for multiple retry in subsequent time slots.It is resulting in TD missing potential offloading opportunities in the future.To fill this gap,we propose a Two-Stage Offloading Decision-making Framework(TSODF)with request holding and dynamic eviction.Long Short-Term Memory(LSTM)-based task-offloading request prediction and MEC resource release estimation are integrated to infer the probability of a request being accepted in the subsequent time slot.The framework learns optimized decision-making experiences continuously to increase the success rate of task offloading based on deep learning technology.Simulation results show that TSODF reduces total TD’s energy consumption and delay for task execution and improves task offloading rate and system resource utilization compared to the benchmark method.展开更多
The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a pati...The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.展开更多
As an important complement to cloud computing, edge computing can effectively reduce the workload of the backbone network. To reduce latency and energy consumption of edge computing, deep learning is used to learn the...As an important complement to cloud computing, edge computing can effectively reduce the workload of the backbone network. To reduce latency and energy consumption of edge computing, deep learning is used to learn the task offloading strategies by interacting with the entities. In actual application scenarios, users of edge computing are always changing dynamically. However, the existing task offloading strategies cannot be applied to such dynamic scenarios. To solve this problem, we propose a novel dynamic task offloading framework for distributed edge computing, leveraging the potential of meta-reinforcement learning (MRL). Our approach formulates a multi-objective optimization problem aimed at minimizing both delay and energy consumption. We model the task offloading strategy using a directed acyclic graph (DAG). Furthermore, we propose a distributed edge computing adaptive task offloading algorithm rooted in MRL. This algorithm integrates multiple Markov decision processes (MDP) with a sequence-to-sequence (seq2seq) network, enabling it to learn and adapt task offloading strategies responsively across diverse network environments. To achieve joint optimization of delay and energy consumption, we incorporate the non-dominated sorting genetic algorithm II (NSGA-II) into our framework. Simulation results demonstrate the superiority of our proposed solution, achieving a 21% reduction in time delay and a 19% decrease in energy consumption compared to alternative task offloading schemes. Moreover, our scheme exhibits remarkable adaptability, responding swiftly to changes in various network environments.展开更多
To solve problems of poor security guarantee and insufficient training efficiency in the conventional reinforcement learning methods for decision-making,this study proposes a hybrid framework to combine deep reinforce...To solve problems of poor security guarantee and insufficient training efficiency in the conventional reinforcement learning methods for decision-making,this study proposes a hybrid framework to combine deep reinforcement learning with rule-based decision-making methods.A risk assessment model for lane-change maneuvers considering uncertain predictions of surrounding vehicles is established as a safety filter to improve learning efficiency while correcting dangerous actions for safety enhancement.On this basis,a Risk-fused DDQN is constructed utilizing the model-based risk assessment and supervision mechanism.The proposed reinforcement learning algorithm sets up a separate experience buffer for dangerous trials and punishes such actions,which is shown to improve the sampling efficiency and training outcomes.Compared with conventional DDQN methods,the proposed algorithm improves the convergence value of cumulated reward by 7.6%and 2.2%in the two constructed scenarios in the simulation study and reduces the number of training episodes by 52.2%and 66.8%respectively.The success rate of lane change is improved by 57.3%while the time headway is increased at least by 16.5%in real vehicle tests,which confirms the higher training efficiency,scenario adaptability,and security of the proposed Risk-fused DDQN.展开更多
Due to the numerous variables to take into account as well as the inherent ambiguity and uncertainty,evaluating educational institutions can be difficult.The concept of a possibility Pythagorean fuzzy hypersoft set(pP...Due to the numerous variables to take into account as well as the inherent ambiguity and uncertainty,evaluating educational institutions can be difficult.The concept of a possibility Pythagorean fuzzy hypersoft set(pPyFHSS)is more flexible in this regard than other theoretical fuzzy set-like models,even though some attempts have been made in the literature to address such uncertainties.This study investigates the elementary notions of pPyFHSS including its set-theoretic operations union,intersection,complement,OR-and AND-operations.Some results related to these operations are also modified for pPyFHSS.Additionally,the similarity measures between pPyFHSSs are formulated with the assistance of numerical examples and results.Lastly,an intelligent decision-assisted mechanism is developed with the proposal of a robust algorithm based on similarity measures for solving multi-attribute decision-making(MADM)problems.A case study that helps the decision-makers assess the best educational institution is discussed to validate the suggested system.The algorithmic results are compared with the most pertinent model to evaluate the adaptability of pPyFHSS,as it generalizes the classical possibility fuzzy set-like theoretical models.Similarly,while considering significant evaluating factors,the flexibility of pPyFHSS is observed through structural comparison.展开更多
Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective to...Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective tools to address these challenges.In this paper,new mathematical approaches for handling uncertainty in medical diagnosis are introduced using q-rung orthopair fuzzy sets(q-ROFS)and interval-valued q-rung orthopair fuzzy sets(IVq-ROFS).Three aggregation operators are proposed in our methodologies:the q-ROF weighted averaging(q-ROFWA),the q-ROF weighted geometric(q-ROFWG),and the q-ROF weighted neutrality averaging(qROFWNA),which enhance decision-making under uncertainty.These operators are paired with ranking methods such as the similarity measure,score function,and inverse score function to improve the accuracy of disease identification.Additionally,the impact of varying q-rung values is explored through a sensitivity analysis,extending the analysis beyond the typical maximum value of 3.The Basic Uncertain Information(BUI)method is employed to simulate expert opinions,and aggregation operators are used to combine these opinions in a group decisionmaking context.Our results provide a comprehensive comparison of methodologies,highlighting their strengths and limitations in diagnosing diseases based on uncertain patient data.展开更多
BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpfu...BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpful in uncertain situations is clinical judgment.Clinicians must deal with contradictory information,lack of time to make decisions,and long-term factors when emergencies occur.AIM To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019(COVID-19)pandemic and the factors affecting clinical decision-making.METHODS This pilot study,which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with COVID-19.The survey focused on topics related to their professional roles and personal relationships.We examined five core areas influencing critical care decision-making:Patients'personal factors,family-related factors,informed consent,communication and media,and hospital administrative policies on clinical decision-making.The collected data were analyzed using the χ^(2) test for categorical variables.RESULTS A total of 102 clinicians from 23 specialties and 17 countries responded to the survey.Age was a significant factor in treatment planning(n=88)and ventilator access(n=78).Sex had no bearing on how decisions were made.Most doctors reported maintaining patient confidentiality regarding privacy and informed consent.Approximately 50%of clinicians reported a moderate influence of clinical work,with many citing it as one of the most important factors affecting their health and relationships.Clinicians from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed countries.Regarding personal experiences,some respondents noted that treatment plans and preferences changed from wave to wave,and that there was a rapid turnover of studies and evidence.Hospital and government policies also played a role in critical decision-making.Rather than assessing the appropriateness of treatment,some doctors observed that hospital policies regarding medications were driven by patient demand.CONCLUSION Factors other than medical considerations frequently affect management choices.The disparity in treatment choices,became more apparent during the pandemic.We highlight the difficulties and contradictions between moral standards and the realities physicians encountered during this medical emergency.False information,large patient populations,and limited resources caused problems for clinicians.These factors impacted decision-making,which,in turn,affected patient care and healthcare staff well-being.展开更多
The advent of the internet-of-everything era has led to the increased use of mobile edge computing.The rise of artificial intelligence has provided many possibilities for the low-latency task-offloading demands of use...The advent of the internet-of-everything era has led to the increased use of mobile edge computing.The rise of artificial intelligence has provided many possibilities for the low-latency task-offloading demands of users,but existing technologies rigidly assume that there is only one task to be offloaded in each time slot at the terminal.In practical scenarios,there are often numerous computing tasks to be executed at the terminal,leading to a cumulative delay for subsequent task offloading.Therefore,the efficient processing of multiple computing tasks on the terminal has become highly challenging.To address the lowlatency offloading requirements for multiple computational tasks on terminal devices,we propose a terminal multitask parallel offloading algorithm based on deep reinforcement learning.Specifically,we first establish a mobile edge computing system model consisting of a single edge server and multiple terminal users.We then model the task offloading decision problem as a Markov decision process,and solve this problem using the Dueling Deep-Q Network algorithm to obtain the optimal offloading strategy.Experimental results demonstrate that,under the same constraints,our proposed algorithm reduces the average system latency.展开更多
Fog computing is a key enabling technology of 6G systems as it provides quick and reliable computing,and data storage services which are required for several 6G applications.Artificial Intelligence(AI)algorithms will ...Fog computing is a key enabling technology of 6G systems as it provides quick and reliable computing,and data storage services which are required for several 6G applications.Artificial Intelligence(AI)algorithms will be an integral part of 6G systems and efficient task offloading techniques using fog computing will improve their performance and reliability.In this paper,the focus is on the scenario of Partial Offloading of a Task to Multiple Helpers(POMH)in which larger tasks are divided into smaller subtasks and processed in parallel,hence expediting task completion.However,using POMH presents challenges such as breaking tasks into subtasks and scaling these subtasks based on many interdependent factors to ensure that all subtasks of a task finish simultaneously,preventing resource wastage.Additionally,applying matching theory to POMH scenarios results in dynamic preference profiles of helping devices due to changing subtask sizes,resulting in a difficult-to-solve,externalities problem.This paper introduces a novel many-to-one matching-based algorithm,designed to address the externalities problem and optimize resource allocation within POMH scenarios.Additionally,we propose a new time-efficient preference profiling technique that further enhances time optimization in POMH scenarios.The performance of the proposed technique is thoroughly evaluated in comparison to alternate baseline schemes,revealing many advantages of the proposed approach.The simulation findings indisputably show that the proposed matching-based offloading technique outperforms existing methodologies in the literature,yielding a remarkable 52 reduction in task latency,particularly under high workloads.展开更多
Blockchain technology,based on decentralized data storage and distributed consensus design,has become a promising solution to address data security risks and provide privacy protection in the Internet-of-Things(IoT)du...Blockchain technology,based on decentralized data storage and distributed consensus design,has become a promising solution to address data security risks and provide privacy protection in the Internet-of-Things(IoT)due to its tamper-proof and non-repudiation features.Although blockchain typically does not require the endorsement of third-party trust organizations,it mostly needs to perform necessary mathematical calculations to prevent malicious attacks,which results in stricter requirements for computation resources on the participating devices.By offloading the computation tasks required to support blockchain consensus to edge service nodes or the cloud,while providing data privacy protection for IoT applications,it can effectively address the limitations of computation and energy resources in IoT devices.However,how to make reasonable offloading decisions for IoT devices remains an open issue.Due to the excellent self-learning ability of Reinforcement Learning(RL),this paper proposes a RL enabled Swarm Intelligence Optimization Algorithm(RLSIOA)that aims to improve the quality of initial solutions and achieve efficient optimization of computation task offloading decisions.The algorithm considers various factors that may affect the revenue obtained by IoT devices executing consensus algorithms(e.g.,Proof-of-Work),it optimizes the proportion of sub-tasks to be offloaded and the scale of computing resources to be rented from the edge and cloud to maximize the revenue of devices.Experimental results show that RLSIOA can obtain higher-quality offloading decision-making schemes at lower latency costs compared to representative benchmark algorithms.展开更多
Low Earth orbit(LEO)satellite networks have the advantages of low transmission delay and low deployment cost,playing an important role in providing reliable services to ground users.This paper studies an efficient int...Low Earth orbit(LEO)satellite networks have the advantages of low transmission delay and low deployment cost,playing an important role in providing reliable services to ground users.This paper studies an efficient inter-satellite cooperative computation offloading(ICCO)algorithm for LEO satellite networks.Specifically,an ICCO system model is constructed,which considers using neighboring satellites in the LEO satellite networks to collaboratively process tasks generated by ground user terminals,effectively improving resource utilization efficiency.Additionally,the optimization objective of minimizing the system task computation offloading delay and energy consumption is established,which is decoupled into two sub-problems.In terms of computational resource allocation,the convexity of the problem is proved through theoretical derivation,and the Lagrange multiplier method is used to obtain the optimal solution of computational resources.To deal with the task offloading decision,a dynamic sticky binary particle swarm optimization algorithm is designed to obtain the offloading decision by iteration.Simulation results show that the ICCO algorithm can effectively reduce the delay and energy consumption.展开更多
With the development of vehicle networks and the construction of roadside units,Vehicular Ad Hoc Networks(VANETs)are increasingly promoting cooperative computing patterns among vehicles.Vehicular edge computing(VEC)of...With the development of vehicle networks and the construction of roadside units,Vehicular Ad Hoc Networks(VANETs)are increasingly promoting cooperative computing patterns among vehicles.Vehicular edge computing(VEC)offers an effective solution to mitigate resource constraints by enabling task offloading to edge cloud infrastructure,thereby reducing the computational burden on connected vehicles.However,this sharing-based and distributed computing paradigm necessitates ensuring the credibility and reliability of various computation nodes.Existing vehicular edge computing platforms have not adequately considered themisbehavior of vehicles.We propose a practical task offloading algorithm based on reputation assessment to address the task offloading problem in vehicular edge computing under an unreliable environment.This approach integrates deep reinforcement learning and reputation management to address task offloading challenges.Simulation experiments conducted using Veins demonstrate the feasibility and effectiveness of the proposed method.展开更多
Objectives This study aimed to clarify the relationship between the content of proxy decision-making made by families of patients with malignant brain tumors regarding treatment policies and daily care and the cues le...Objectives This study aimed to clarify the relationship between the content of proxy decision-making made by families of patients with malignant brain tumors regarding treatment policies and daily care and the cues leading to those decisions.Methods Semi-structured personal interviews were used to collect data.Seven family members of patients with malignant brain tumors were selected to participate in the study by purposive sampling method from June to August 2022 in the Patient Family Association of Japan.Responses were content analyzed to explore the relationship between the content of decisions regarding“treatment policies”and“daily care”and the cues influencing those decisions.Semi-structured interviews were analyzed by using thematic analysis.Results The contents of proxy decisions regarding“treatment policies”included implementation,interruption,and termination of initial treatments,free medical treatments,use of respirators,and end-of-life sedation and included six cues:treatment policies suggested by the primary physician,information and knowledge about the disease and treatment obtained by the family from limited resources,perceived life threat from symptom worsening,words and reactions from the patient regarding treatment,patient’s personality and way of life inferred from their treatment preferences,family’s thoughts and values hoping for better treatment for the patient.Decisions for“daily care”included meal content and methods,excretion,mobility,maintaining cleanliness,rehabilitation,continuation or resignation from work,treatment settings(outpatient or inpatient),and ways to spend time outside and included seven cues:words and thoughts from the patient about their way of life,patient’s reactions and life history inferred from their preferred way of living,things the patient can do to maintain daily life and roles,awareness of the increasing inability to do things in daily life,family’s underlying thoughts and values about how to spend the remaining time,approval from family members regarding the care setting,advice from medical professionals on living at home.Conclusions For“treatment policies,”guidelines from medical professionals were a key cue,while for“daily care,”the small signs from the patients in their daily lives served as cues for proxy decision-making.This may be due to the lack of information available to families and the limited time available for discussion with the patient.Families of patients with malignant brain tumors repeatedly use multiple cues to make proxy decision-making under high uncertainty.Therefore,nurses supporting proxy decision-making should assess the family’s situation and provide cues that facilitate informed and confident decisions.展开更多
This paper introduces a quantum-enhanced edge computing framework that synergizes quantuminspired algorithms with advanced machine learning techniques to optimize real-time task offloading in edge computing environmen...This paper introduces a quantum-enhanced edge computing framework that synergizes quantuminspired algorithms with advanced machine learning techniques to optimize real-time task offloading in edge computing environments.This innovative approach not only significantly improves the system’s real-time responsiveness and resource utilization efficiency but also addresses critical challenges in Internet of Things(IoT)ecosystems—such as high demand variability,resource allocation uncertainties,and data privacy concerns—through practical solutions.Initially,the framework employs an adaptive adjustment mechanism to dynamically manage task and resource states,complemented by online learning models for precise predictive analytics.Secondly,it accelerates the search for optimal solutions using Grover’s algorithm while efficiently evaluating complex constraints through multi-controlled Toffoli gates,thereby markedly enhancing the practicality and robustness of the proposed solution.Furthermore,to bolster the system’s adaptability and response speed in dynamic environments,an efficientmonitoring mechanism and event-driven architecture are incorporated,ensuring timely responses to environmental changes and maintaining synchronization between internal and external systems.Experimental evaluations confirm that the proposed algorithm demonstrates superior performance in complex application scenarios,characterized by faster convergence,enhanced stability,and superior data privacy protection,alongside notable reductions in latency and optimized resource utilization.This research paves the way for transformative advancements in edge computing and IoT technologies,driving smart edge computing towards unprecedented levels of intelligence and automation.展开更多
The rapid advance of Connected-Automated Vehicles(CAVs)has led to the emergence of diverse delaysensitive and energy-constrained vehicular applications.Given the high dynamics of vehicular networks,unmanned aerial veh...The rapid advance of Connected-Automated Vehicles(CAVs)has led to the emergence of diverse delaysensitive and energy-constrained vehicular applications.Given the high dynamics of vehicular networks,unmanned aerial vehicles-assisted mobile edge computing(UAV-MEC)has gained attention in providing computing resources to vehicles and optimizing system costs.We model the computing offloading problem as a multi-objective optimization challenge aimed at minimizing both task processing delay and energy consumption.We propose a three-stage hybrid offloading scheme called Dynamic Vehicle Clustering Game-based Multi-objective Whale Optimization Algorithm(DVCG-MWOA)to address this problem.A novel dynamic clustering algorithm is designed based on vehiclemobility and task offloading efficiency requirements,where each UAV independently serves as the cluster head for a vehicle cluster and adjusts its position at the end of each timeslot in response to vehiclemovement.Within eachUAV-led cluster,cooperative game theory is applied to allocate computing resourceswhile respecting delay constraints,ensuring efficient resource utilization.To enhance offloading efficiency,we improve the multi-objective whale optimization algorithm(MOWOA),resulting in the MWOA.This enhanced algorithm determines the optimal allocation of pending tasks to different edge computing devices and the resource utilization ratio of each device,ultimately achieving a Pareto-optimal solution set for delay and energy consumption.Experimental results demonstrate that the proposed joint offloading scheme significantly reduces both delay and energy consumption compared to existing approaches,offering superior performance for vehicular networks.展开更多
Group living is widespread across diverse taxa,and the mechanisms underlying collective decision-making in contexts of variable role division are critical for understanding the dynamics of group stability.While studie...Group living is widespread across diverse taxa,and the mechanisms underlying collective decision-making in contexts of variable role division are critical for understanding the dynamics of group stability.While studies on collective behavior in small animals such as fish and insects are well-established,similar research on large wild animals remains challenging due to the limited availability of sufficient and systematic field data.Here,we aimed to explore the collective decision-making pattern and its sexual difference for the dimorphic Tibetan antelopes Pantholops hodgsonii(chiru)in Xizang Autonomous Region,China,by analyzing individual leadership distribution,as well as the joining process,considering factors such as calving stages and joining ranks.The distinct correlations of decision participants’ratio with group size and decision duration underscore the trade-off between accuracy and speed in decision-making.Male antelopes display a more democratic decision-making pattern,while females exhibit more prompt responses after calving at an early stage.This study uncovers a partially shared decision-making strategy among Tibetan antelopes,suggesting flexible self-organization in group decision processes aligned with animal life cycle progression.展开更多
Cybertwin-enabled 6th Generation(6G)network is envisioned to support artificial intelligence-native management to meet changing demands of 6G applications.Multi-Agent Deep Reinforcement Learning(MADRL)technologies dri...Cybertwin-enabled 6th Generation(6G)network is envisioned to support artificial intelligence-native management to meet changing demands of 6G applications.Multi-Agent Deep Reinforcement Learning(MADRL)technologies driven by Cybertwins have been proposed for adaptive task offloading strategies.However,the existence of random transmission delay between Cybertwin-driven agents and underlying networks is not considered in related works,which destroys the standard Markov property and increases the decision reaction time to reduce the task offloading strategy performance.In order to address this problem,we propose a pipelining task offloading method to lower the decision reaction time and model it as a delay-aware Markov Decision Process(MDP).Then,we design a delay-aware MADRL algorithm to minimize the weighted sum of task execution latency and energy consumption.Firstly,the state space is augmented using the lastly-received state and historical actions to rebuild the Markov property.Secondly,Gate Transformer-XL is introduced to capture historical actions'importance and maintain the consistent input dimension dynamically changed due to random transmission delays.Thirdly,a sampling method and a new loss function with the difference between the current and target state value and the difference between real state-action value and augmented state-action value are designed to obtain state transition trajectories close to the real ones.Numerical results demonstrate that the proposed methods are effective in reducing reaction time and improving the task offloading performance in the random-delay Cybertwin-enabled 6G networks.展开更多
BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encoura...BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encouraging collaborative patient-provider relationships may foster better adherence and patient outcomes.AIM To quantify the association between patient participation in treatment decisionmaking and adherence to oral mesalamine in UC.METHODS We conducted a 12-month,prospective,non-interventional cohort study at 113 gastroenterology practices in Germany.Eligible patients were aged≥18 years,had a confirmed UC diagnosis,had no prior mesalamine treatment,and provided informed consent.At the first visit,we collected data on demographics,clinical characteristics,patient preference for mesalamine formulation(tablets or granules),and disease knowledge.Self-reported adherence and disease activity were assessed at all visits.Correlation analyses and logistic regression were used to examine associations between adherence and various factors.RESULTS Of the 605 consecutively screened patients,520 were included in the study.The median age was 41 years(range:18-91),with a male-to-female ratio of 1.1:1.0.Approximately 75%of patients reported good adherence at each study visit.In correlation analyses,patient participation in treatment decision-making was significantly associated with better adherence across all visits(P=0.04).In the regression analysis at 12 months,this association was evident among patients who both preferred and received prolonged-release mesalamine granules(odds ratio=2.73,P=0.001).Patients reporting good adherence also experienced significant improvements in disease activity over 12 months(P<0.001).CONCLUSION Facilitating patient participation in treatment decisions and accommodating medication preferences may improve adherence to mesalamine.This may require additional effort but has the potential to improve long-term management of UC.展开更多
Information plays a crucial role in guiding behavioral decisions during public health emergencies. Individuals communicate to acquire relevant knowledge about an epidemic, which influences their decisions to adopt pro...Information plays a crucial role in guiding behavioral decisions during public health emergencies. Individuals communicate to acquire relevant knowledge about an epidemic, which influences their decisions to adopt protective measures.However, whether to disseminate specific information is also a behavioral decision. In light of this understanding, we develop a coupled information–vaccination–epidemic model to depict these co-evolutionary dynamics in a three-layer network. Negative information dissemination and vaccination are treated as separate decision-making processes. We then examine the combined effects of herd and risk motives on information dissemination and vaccination decisions through the lens of game theory. The microscopic Markov chain approach(MMCA) is used to describe the dynamic process and to derive the epidemic threshold. Simulation results indicate that increasing the cost of negative information dissemination and providing timely clarification can effectively control the epidemic. Furthermore, a phenomenon of diminishing marginal utility is observed as the cost of dissemination increases, suggesting that authorities do not need to overinvest in suppressing negative information. Conversely, reducing the cost of vaccination and increasing vaccine efficacy emerge as more effective strategies for outbreak control. In addition, we find that the scale of the epidemic is greater when the herd motive dominates behavioral decision-making. In conclusion, this study provides a new perspective for understanding the complexity of epidemic spreading by starting with the construction of different behavioral decisions.展开更多
文摘The rapid development of Internet of Things(IoT)technology has led to a significant increase in the computational task load of Terminal Devices(TDs).TDs reduce response latency and energy consumption with the support of task-offloading in Multi-access Edge Computing(MEC).However,existing task-offloading optimization methods typically assume that MEC’s computing resources are unlimited,and there is a lack of research on the optimization of task-offloading when MEC resources are exhausted.In addition,existing solutions only decide whether to accept the offloaded task request based on the single decision result of the current time slot,but lack support for multiple retry in subsequent time slots.It is resulting in TD missing potential offloading opportunities in the future.To fill this gap,we propose a Two-Stage Offloading Decision-making Framework(TSODF)with request holding and dynamic eviction.Long Short-Term Memory(LSTM)-based task-offloading request prediction and MEC resource release estimation are integrated to infer the probability of a request being accepted in the subsequent time slot.The framework learns optimized decision-making experiences continuously to increase the success rate of task offloading based on deep learning technology.Simulation results show that TSODF reduces total TD’s energy consumption and delay for task execution and improves task offloading rate and system resource utilization compared to the benchmark method.
文摘The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.
基金funded by the Fundamental Research Funds for the Central Universities(J2023-024,J2023-027).
文摘As an important complement to cloud computing, edge computing can effectively reduce the workload of the backbone network. To reduce latency and energy consumption of edge computing, deep learning is used to learn the task offloading strategies by interacting with the entities. In actual application scenarios, users of edge computing are always changing dynamically. However, the existing task offloading strategies cannot be applied to such dynamic scenarios. To solve this problem, we propose a novel dynamic task offloading framework for distributed edge computing, leveraging the potential of meta-reinforcement learning (MRL). Our approach formulates a multi-objective optimization problem aimed at minimizing both delay and energy consumption. We model the task offloading strategy using a directed acyclic graph (DAG). Furthermore, we propose a distributed edge computing adaptive task offloading algorithm rooted in MRL. This algorithm integrates multiple Markov decision processes (MDP) with a sequence-to-sequence (seq2seq) network, enabling it to learn and adapt task offloading strategies responsively across diverse network environments. To achieve joint optimization of delay and energy consumption, we incorporate the non-dominated sorting genetic algorithm II (NSGA-II) into our framework. Simulation results demonstrate the superiority of our proposed solution, achieving a 21% reduction in time delay and a 19% decrease in energy consumption compared to alternative task offloading schemes. Moreover, our scheme exhibits remarkable adaptability, responding swiftly to changes in various network environments.
基金Supported by National Key Research and Development Program of China(Grant No.2022YFE0117100)National Science Foundation of China(Grant No.52102468,52325212)Fundamental Research Funds for the Central Universities。
文摘To solve problems of poor security guarantee and insufficient training efficiency in the conventional reinforcement learning methods for decision-making,this study proposes a hybrid framework to combine deep reinforcement learning with rule-based decision-making methods.A risk assessment model for lane-change maneuvers considering uncertain predictions of surrounding vehicles is established as a safety filter to improve learning efficiency while correcting dangerous actions for safety enhancement.On this basis,a Risk-fused DDQN is constructed utilizing the model-based risk assessment and supervision mechanism.The proposed reinforcement learning algorithm sets up a separate experience buffer for dangerous trials and punishes such actions,which is shown to improve the sampling efficiency and training outcomes.Compared with conventional DDQN methods,the proposed algorithm improves the convergence value of cumulated reward by 7.6%and 2.2%in the two constructed scenarios in the simulation study and reduces the number of training episodes by 52.2%and 66.8%respectively.The success rate of lane change is improved by 57.3%while the time headway is increased at least by 16.5%in real vehicle tests,which confirms the higher training efficiency,scenario adaptability,and security of the proposed Risk-fused DDQN.
基金supported by the Deanship of Graduate Studies and Scientific Research at Qassim University(QU-APC-2024-9/1).
文摘Due to the numerous variables to take into account as well as the inherent ambiguity and uncertainty,evaluating educational institutions can be difficult.The concept of a possibility Pythagorean fuzzy hypersoft set(pPyFHSS)is more flexible in this regard than other theoretical fuzzy set-like models,even though some attempts have been made in the literature to address such uncertainties.This study investigates the elementary notions of pPyFHSS including its set-theoretic operations union,intersection,complement,OR-and AND-operations.Some results related to these operations are also modified for pPyFHSS.Additionally,the similarity measures between pPyFHSSs are formulated with the assistance of numerical examples and results.Lastly,an intelligent decision-assisted mechanism is developed with the proposal of a robust algorithm based on similarity measures for solving multi-attribute decision-making(MADM)problems.A case study that helps the decision-makers assess the best educational institution is discussed to validate the suggested system.The algorithmic results are compared with the most pertinent model to evaluate the adaptability of pPyFHSS,as it generalizes the classical possibility fuzzy set-like theoretical models.Similarly,while considering significant evaluating factors,the flexibility of pPyFHSS is observed through structural comparison.
文摘Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective tools to address these challenges.In this paper,new mathematical approaches for handling uncertainty in medical diagnosis are introduced using q-rung orthopair fuzzy sets(q-ROFS)and interval-valued q-rung orthopair fuzzy sets(IVq-ROFS).Three aggregation operators are proposed in our methodologies:the q-ROF weighted averaging(q-ROFWA),the q-ROF weighted geometric(q-ROFWG),and the q-ROF weighted neutrality averaging(qROFWNA),which enhance decision-making under uncertainty.These operators are paired with ranking methods such as the similarity measure,score function,and inverse score function to improve the accuracy of disease identification.Additionally,the impact of varying q-rung values is explored through a sensitivity analysis,extending the analysis beyond the typical maximum value of 3.The Basic Uncertain Information(BUI)method is employed to simulate expert opinions,and aggregation operators are used to combine these opinions in a group decisionmaking context.Our results provide a comprehensive comparison of methodologies,highlighting their strengths and limitations in diagnosing diseases based on uncertain patient data.
文摘BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpful in uncertain situations is clinical judgment.Clinicians must deal with contradictory information,lack of time to make decisions,and long-term factors when emergencies occur.AIM To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019(COVID-19)pandemic and the factors affecting clinical decision-making.METHODS This pilot study,which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with COVID-19.The survey focused on topics related to their professional roles and personal relationships.We examined five core areas influencing critical care decision-making:Patients'personal factors,family-related factors,informed consent,communication and media,and hospital administrative policies on clinical decision-making.The collected data were analyzed using the χ^(2) test for categorical variables.RESULTS A total of 102 clinicians from 23 specialties and 17 countries responded to the survey.Age was a significant factor in treatment planning(n=88)and ventilator access(n=78).Sex had no bearing on how decisions were made.Most doctors reported maintaining patient confidentiality regarding privacy and informed consent.Approximately 50%of clinicians reported a moderate influence of clinical work,with many citing it as one of the most important factors affecting their health and relationships.Clinicians from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed countries.Regarding personal experiences,some respondents noted that treatment plans and preferences changed from wave to wave,and that there was a rapid turnover of studies and evidence.Hospital and government policies also played a role in critical decision-making.Rather than assessing the appropriateness of treatment,some doctors observed that hospital policies regarding medications were driven by patient demand.CONCLUSION Factors other than medical considerations frequently affect management choices.The disparity in treatment choices,became more apparent during the pandemic.We highlight the difficulties and contradictions between moral standards and the realities physicians encountered during this medical emergency.False information,large patient populations,and limited resources caused problems for clinicians.These factors impacted decision-making,which,in turn,affected patient care and healthcare staff well-being.
基金supported by the National Natural Science Foundation of China(62202215)Liaoning Province Applied Basic Research Program(Youth Special Project,2023JH2/101600038)+2 种基金Shenyang Youth Science and Technology Innovation Talent Support Program(RC220458)Guangxuan Program of Shenyang Ligong University(SYLUGXRC202216)the Basic Research Special Funds for Undergraduate Universities in Liaoning Province(LJ212410144067).
文摘The advent of the internet-of-everything era has led to the increased use of mobile edge computing.The rise of artificial intelligence has provided many possibilities for the low-latency task-offloading demands of users,but existing technologies rigidly assume that there is only one task to be offloaded in each time slot at the terminal.In practical scenarios,there are often numerous computing tasks to be executed at the terminal,leading to a cumulative delay for subsequent task offloading.Therefore,the efficient processing of multiple computing tasks on the terminal has become highly challenging.To address the lowlatency offloading requirements for multiple computational tasks on terminal devices,we propose a terminal multitask parallel offloading algorithm based on deep reinforcement learning.Specifically,we first establish a mobile edge computing system model consisting of a single edge server and multiple terminal users.We then model the task offloading decision problem as a Markov decision process,and solve this problem using the Dueling Deep-Q Network algorithm to obtain the optimal offloading strategy.Experimental results demonstrate that,under the same constraints,our proposed algorithm reduces the average system latency.
基金supported and funded by theDeanship of Scientific Research at Imam Mohammad Ibn Saud Islamic University(IMSIU)(grant number IMSIU-RP23082).
文摘Fog computing is a key enabling technology of 6G systems as it provides quick and reliable computing,and data storage services which are required for several 6G applications.Artificial Intelligence(AI)algorithms will be an integral part of 6G systems and efficient task offloading techniques using fog computing will improve their performance and reliability.In this paper,the focus is on the scenario of Partial Offloading of a Task to Multiple Helpers(POMH)in which larger tasks are divided into smaller subtasks and processed in parallel,hence expediting task completion.However,using POMH presents challenges such as breaking tasks into subtasks and scaling these subtasks based on many interdependent factors to ensure that all subtasks of a task finish simultaneously,preventing resource wastage.Additionally,applying matching theory to POMH scenarios results in dynamic preference profiles of helping devices due to changing subtask sizes,resulting in a difficult-to-solve,externalities problem.This paper introduces a novel many-to-one matching-based algorithm,designed to address the externalities problem and optimize resource allocation within POMH scenarios.Additionally,we propose a new time-efficient preference profiling technique that further enhances time optimization in POMH scenarios.The performance of the proposed technique is thoroughly evaluated in comparison to alternate baseline schemes,revealing many advantages of the proposed approach.The simulation findings indisputably show that the proposed matching-based offloading technique outperforms existing methodologies in the literature,yielding a remarkable 52 reduction in task latency,particularly under high workloads.
基金supported by the Project of Science and Technology Research Program of Chongqing Education Commission of China(No.KJZD-K202401105)High-Quality Development Action Plan for Graduate Education at Chongqing University of Technology(No.gzljg2023308,No.gzljd2024204)+1 种基金the Graduate Innovation Program of Chongqing University of Technology(No.gzlcx20233197)Yunnan Provincial Key R&D Program(202203AA080006).
文摘Blockchain technology,based on decentralized data storage and distributed consensus design,has become a promising solution to address data security risks and provide privacy protection in the Internet-of-Things(IoT)due to its tamper-proof and non-repudiation features.Although blockchain typically does not require the endorsement of third-party trust organizations,it mostly needs to perform necessary mathematical calculations to prevent malicious attacks,which results in stricter requirements for computation resources on the participating devices.By offloading the computation tasks required to support blockchain consensus to edge service nodes or the cloud,while providing data privacy protection for IoT applications,it can effectively address the limitations of computation and energy resources in IoT devices.However,how to make reasonable offloading decisions for IoT devices remains an open issue.Due to the excellent self-learning ability of Reinforcement Learning(RL),this paper proposes a RL enabled Swarm Intelligence Optimization Algorithm(RLSIOA)that aims to improve the quality of initial solutions and achieve efficient optimization of computation task offloading decisions.The algorithm considers various factors that may affect the revenue obtained by IoT devices executing consensus algorithms(e.g.,Proof-of-Work),it optimizes the proportion of sub-tasks to be offloaded and the scale of computing resources to be rented from the edge and cloud to maximize the revenue of devices.Experimental results show that RLSIOA can obtain higher-quality offloading decision-making schemes at lower latency costs compared to representative benchmark algorithms.
基金supported in part by Sub Project of National Key Research and Development plan in 2020 NO.2020YFC1511704Beijing Information Science and Technology University NO.2020KYNH212,NO.2021CGZH302+1 种基金Beijing Science and Technology Project(Grant No.Z211100004421009)in part by the National Natural Science Foundation of China(Grant No.62301058).
文摘Low Earth orbit(LEO)satellite networks have the advantages of low transmission delay and low deployment cost,playing an important role in providing reliable services to ground users.This paper studies an efficient inter-satellite cooperative computation offloading(ICCO)algorithm for LEO satellite networks.Specifically,an ICCO system model is constructed,which considers using neighboring satellites in the LEO satellite networks to collaboratively process tasks generated by ground user terminals,effectively improving resource utilization efficiency.Additionally,the optimization objective of minimizing the system task computation offloading delay and energy consumption is established,which is decoupled into two sub-problems.In terms of computational resource allocation,the convexity of the problem is proved through theoretical derivation,and the Lagrange multiplier method is used to obtain the optimal solution of computational resources.To deal with the task offloading decision,a dynamic sticky binary particle swarm optimization algorithm is designed to obtain the offloading decision by iteration.Simulation results show that the ICCO algorithm can effectively reduce the delay and energy consumption.
基金supported by the Open Foundation of Henan Key Laboratory of Cyberspace Situation Awareness(No.HNTS2022020)the Science and Technology Research Program of Henan Province of China(232102210134,182102210130)Key Research Projects of Henan Provincial Universities(25B520005).
文摘With the development of vehicle networks and the construction of roadside units,Vehicular Ad Hoc Networks(VANETs)are increasingly promoting cooperative computing patterns among vehicles.Vehicular edge computing(VEC)offers an effective solution to mitigate resource constraints by enabling task offloading to edge cloud infrastructure,thereby reducing the computational burden on connected vehicles.However,this sharing-based and distributed computing paradigm necessitates ensuring the credibility and reliability of various computation nodes.Existing vehicular edge computing platforms have not adequately considered themisbehavior of vehicles.We propose a practical task offloading algorithm based on reputation assessment to address the task offloading problem in vehicular edge computing under an unreliable environment.This approach integrates deep reinforcement learning and reputation management to address task offloading challenges.Simulation experiments conducted using Veins demonstrate the feasibility and effectiveness of the proposed method.
文摘Objectives This study aimed to clarify the relationship between the content of proxy decision-making made by families of patients with malignant brain tumors regarding treatment policies and daily care and the cues leading to those decisions.Methods Semi-structured personal interviews were used to collect data.Seven family members of patients with malignant brain tumors were selected to participate in the study by purposive sampling method from June to August 2022 in the Patient Family Association of Japan.Responses were content analyzed to explore the relationship between the content of decisions regarding“treatment policies”and“daily care”and the cues influencing those decisions.Semi-structured interviews were analyzed by using thematic analysis.Results The contents of proxy decisions regarding“treatment policies”included implementation,interruption,and termination of initial treatments,free medical treatments,use of respirators,and end-of-life sedation and included six cues:treatment policies suggested by the primary physician,information and knowledge about the disease and treatment obtained by the family from limited resources,perceived life threat from symptom worsening,words and reactions from the patient regarding treatment,patient’s personality and way of life inferred from their treatment preferences,family’s thoughts and values hoping for better treatment for the patient.Decisions for“daily care”included meal content and methods,excretion,mobility,maintaining cleanliness,rehabilitation,continuation or resignation from work,treatment settings(outpatient or inpatient),and ways to spend time outside and included seven cues:words and thoughts from the patient about their way of life,patient’s reactions and life history inferred from their preferred way of living,things the patient can do to maintain daily life and roles,awareness of the increasing inability to do things in daily life,family’s underlying thoughts and values about how to spend the remaining time,approval from family members regarding the care setting,advice from medical professionals on living at home.Conclusions For“treatment policies,”guidelines from medical professionals were a key cue,while for“daily care,”the small signs from the patients in their daily lives served as cues for proxy decision-making.This may be due to the lack of information available to families and the limited time available for discussion with the patient.Families of patients with malignant brain tumors repeatedly use multiple cues to make proxy decision-making under high uncertainty.Therefore,nurses supporting proxy decision-making should assess the family’s situation and provide cues that facilitate informed and confident decisions.
基金supported by National Natural Science Foundation of China(Nos.62071481 and 61501471).
文摘This paper introduces a quantum-enhanced edge computing framework that synergizes quantuminspired algorithms with advanced machine learning techniques to optimize real-time task offloading in edge computing environments.This innovative approach not only significantly improves the system’s real-time responsiveness and resource utilization efficiency but also addresses critical challenges in Internet of Things(IoT)ecosystems—such as high demand variability,resource allocation uncertainties,and data privacy concerns—through practical solutions.Initially,the framework employs an adaptive adjustment mechanism to dynamically manage task and resource states,complemented by online learning models for precise predictive analytics.Secondly,it accelerates the search for optimal solutions using Grover’s algorithm while efficiently evaluating complex constraints through multi-controlled Toffoli gates,thereby markedly enhancing the practicality and robustness of the proposed solution.Furthermore,to bolster the system’s adaptability and response speed in dynamic environments,an efficientmonitoring mechanism and event-driven architecture are incorporated,ensuring timely responses to environmental changes and maintaining synchronization between internal and external systems.Experimental evaluations confirm that the proposed algorithm demonstrates superior performance in complex application scenarios,characterized by faster convergence,enhanced stability,and superior data privacy protection,alongside notable reductions in latency and optimized resource utilization.This research paves the way for transformative advancements in edge computing and IoT technologies,driving smart edge computing towards unprecedented levels of intelligence and automation.
基金funded by Shandong University of Technology Doctoral Program in Science and Technology,grant number 4041422007.
文摘The rapid advance of Connected-Automated Vehicles(CAVs)has led to the emergence of diverse delaysensitive and energy-constrained vehicular applications.Given the high dynamics of vehicular networks,unmanned aerial vehicles-assisted mobile edge computing(UAV-MEC)has gained attention in providing computing resources to vehicles and optimizing system costs.We model the computing offloading problem as a multi-objective optimization challenge aimed at minimizing both task processing delay and energy consumption.We propose a three-stage hybrid offloading scheme called Dynamic Vehicle Clustering Game-based Multi-objective Whale Optimization Algorithm(DVCG-MWOA)to address this problem.A novel dynamic clustering algorithm is designed based on vehiclemobility and task offloading efficiency requirements,where each UAV independently serves as the cluster head for a vehicle cluster and adjusts its position at the end of each timeslot in response to vehiclemovement.Within eachUAV-led cluster,cooperative game theory is applied to allocate computing resourceswhile respecting delay constraints,ensuring efficient resource utilization.To enhance offloading efficiency,we improve the multi-objective whale optimization algorithm(MOWOA),resulting in the MWOA.This enhanced algorithm determines the optimal allocation of pending tasks to different edge computing devices and the resource utilization ratio of each device,ultimately achieving a Pareto-optimal solution set for delay and energy consumption.Experimental results demonstrate that the proposed joint offloading scheme significantly reduces both delay and energy consumption compared to existing approaches,offering superior performance for vehicular networks.
基金supported by the National Natural Science Foundation of China(Grant no.32101237)the China Postdoctoral Science Foundation(Grant no.2021M691522)+1 种基金the National Key Research and Development Program(Grant no.2022YFC3202104)the Tibet Major Science and Technology Project(Grant no.XZ201901-GA-06).
文摘Group living is widespread across diverse taxa,and the mechanisms underlying collective decision-making in contexts of variable role division are critical for understanding the dynamics of group stability.While studies on collective behavior in small animals such as fish and insects are well-established,similar research on large wild animals remains challenging due to the limited availability of sufficient and systematic field data.Here,we aimed to explore the collective decision-making pattern and its sexual difference for the dimorphic Tibetan antelopes Pantholops hodgsonii(chiru)in Xizang Autonomous Region,China,by analyzing individual leadership distribution,as well as the joining process,considering factors such as calving stages and joining ranks.The distinct correlations of decision participants’ratio with group size and decision duration underscore the trade-off between accuracy and speed in decision-making.Male antelopes display a more democratic decision-making pattern,while females exhibit more prompt responses after calving at an early stage.This study uncovers a partially shared decision-making strategy among Tibetan antelopes,suggesting flexible self-organization in group decision processes aligned with animal life cycle progression.
基金funded by the National Key Research and Development Program of China under Grant 2019YFB1803301Beijing Natural Science Foundation (L202002)。
文摘Cybertwin-enabled 6th Generation(6G)network is envisioned to support artificial intelligence-native management to meet changing demands of 6G applications.Multi-Agent Deep Reinforcement Learning(MADRL)technologies driven by Cybertwins have been proposed for adaptive task offloading strategies.However,the existence of random transmission delay between Cybertwin-driven agents and underlying networks is not considered in related works,which destroys the standard Markov property and increases the decision reaction time to reduce the task offloading strategy performance.In order to address this problem,we propose a pipelining task offloading method to lower the decision reaction time and model it as a delay-aware Markov Decision Process(MDP).Then,we design a delay-aware MADRL algorithm to minimize the weighted sum of task execution latency and energy consumption.Firstly,the state space is augmented using the lastly-received state and historical actions to rebuild the Markov property.Secondly,Gate Transformer-XL is introduced to capture historical actions'importance and maintain the consistent input dimension dynamically changed due to random transmission delays.Thirdly,a sampling method and a new loss function with the difference between the current and target state value and the difference between real state-action value and augmented state-action value are designed to obtain state transition trajectories close to the real ones.Numerical results demonstrate that the proposed methods are effective in reducing reaction time and improving the task offloading performance in the random-delay Cybertwin-enabled 6G networks.
文摘BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encouraging collaborative patient-provider relationships may foster better adherence and patient outcomes.AIM To quantify the association between patient participation in treatment decisionmaking and adherence to oral mesalamine in UC.METHODS We conducted a 12-month,prospective,non-interventional cohort study at 113 gastroenterology practices in Germany.Eligible patients were aged≥18 years,had a confirmed UC diagnosis,had no prior mesalamine treatment,and provided informed consent.At the first visit,we collected data on demographics,clinical characteristics,patient preference for mesalamine formulation(tablets or granules),and disease knowledge.Self-reported adherence and disease activity were assessed at all visits.Correlation analyses and logistic regression were used to examine associations between adherence and various factors.RESULTS Of the 605 consecutively screened patients,520 were included in the study.The median age was 41 years(range:18-91),with a male-to-female ratio of 1.1:1.0.Approximately 75%of patients reported good adherence at each study visit.In correlation analyses,patient participation in treatment decision-making was significantly associated with better adherence across all visits(P=0.04).In the regression analysis at 12 months,this association was evident among patients who both preferred and received prolonged-release mesalamine granules(odds ratio=2.73,P=0.001).Patients reporting good adherence also experienced significant improvements in disease activity over 12 months(P<0.001).CONCLUSION Facilitating patient participation in treatment decisions and accommodating medication preferences may improve adherence to mesalamine.This may require additional effort but has the potential to improve long-term management of UC.
基金Project supported by the National Natural Science Foundation of China (Grant No. 72174121)the Program for Professor of Special Appointment (Eastern Scholar) at Shanghai Institutions of Higher Learning, and the Soft Science Research Project of Shanghai (Grant No. 22692112600)。
文摘Information plays a crucial role in guiding behavioral decisions during public health emergencies. Individuals communicate to acquire relevant knowledge about an epidemic, which influences their decisions to adopt protective measures.However, whether to disseminate specific information is also a behavioral decision. In light of this understanding, we develop a coupled information–vaccination–epidemic model to depict these co-evolutionary dynamics in a three-layer network. Negative information dissemination and vaccination are treated as separate decision-making processes. We then examine the combined effects of herd and risk motives on information dissemination and vaccination decisions through the lens of game theory. The microscopic Markov chain approach(MMCA) is used to describe the dynamic process and to derive the epidemic threshold. Simulation results indicate that increasing the cost of negative information dissemination and providing timely clarification can effectively control the epidemic. Furthermore, a phenomenon of diminishing marginal utility is observed as the cost of dissemination increases, suggesting that authorities do not need to overinvest in suppressing negative information. Conversely, reducing the cost of vaccination and increasing vaccine efficacy emerge as more effective strategies for outbreak control. In addition, we find that the scale of the epidemic is greater when the herd motive dominates behavioral decision-making. In conclusion, this study provides a new perspective for understanding the complexity of epidemic spreading by starting with the construction of different behavioral decisions.
