关键词： Dual batteries   mixed-integer linear program (MILP)   multiarmed bandit (MAB)   routing   stochastic energy arrivals  

摘要： This article considers an energy-harvesting wireless sensor network (EH-WSN) where nodes have a dual alternative battery system. We aim to design a routing protocol that transmits a given amount of data to a sink using the minimum number of time slots. To this end, we first formulate the routing problem as a mixed-integer linear program (MILP) and model the charging and discharging process at each node. Moreover, we also propose a distributed multiarmed bandit-based routing algorithm (MABRA), where each node learns the best next hop(s) to forward its data based on the battery and data information of its neighbors. We study how the number of nodes that generate data or sources, solar panel area, and path exploration probability impacts the end-toend delays computed by MILP and MABRA. Numerical results show that the end-to-end delays computed by MILP increase with the number of sources. It, however, decreases if nodes use larger solar panels. Critically, nodes experience end-to-end delays that are 55% lower than the average end-to-end delay of a competing routing algorithm.

摘要： Amid the COVID-19 pandemic, women in medicine, including faculty, residents, medical students, and other health care workers (HCWs), are facing unparalleled challenges. The burdens of pandemic-associated increases in domestic and caregiving responsibilities, professional demands, health risks associated with contracting COVID-19, and the resulting psychosocial distress have exacerbated existing gender disparities at home, at work, and in academia. School and day care closures have created additional childcare needs, primarily for women, yet little support exists for parents and families. These increased childcare and domestic responsibilities have forced women HCWs, who make up the overwhelming majority of the workforce, to adapt their schedules and, in some cases, leave their jobs entirely. In this article, the authors detail how COVID-19 has exacerbated existing childcare accessibility and affordability issues as well as gender disparities. They argue that unless government and health care organization support for childcare increases, families, specifically women and children, will continue to suffer. Lack of access to affordable childcare can prevent HCWs from doing their jobs, including conducting and publishing academic scholarship. This poses incalculable risks to families, science, and society. COVID-19 should serve as a call to action to all sectors, including the government and health care organizations, to prioritize childcare provision and increase support for women HCWs, both now during the pandemic and going forward.

关键词： biopsy   logistic models   magnetic resonance imaging   prostate   prostatic neoplasms  

摘要： Purpose: NonHispanic Black (NHB) and Hispanic/Afro-Caribbean men have the highest risk of prostate cancer (PCa) compared to nonHispanic White (NHW) men. However, ethnicity-specific outcomes of targeted fusion biopsy (FB) for the detection of PCa are poorly characterized. We compared the outcomes of FB by Prostate Imaging Reporting and Data System (PI-RADS(R)) score and race/ethnicity among a diverse *** and Methods: We evaluated all men who underwent image-guided FB for suspicious lesions on prostate magnetic resonance imaging (>=PI-RADS 3) over a 2-year period. We examined associations of race/ethnicity and PI-RADS score with risk of PCa or clinically significant PCa (cs-PCa, Gleason Group >=2) on FB using mixed-effects logistic regression ***: A total of 410 men with 658 lesions were analyzed, with 201 (49.0%) identified as NHB and 125 (30.5%) identified as Hispanic. NHB men had a twofold increase in the odds of detecting cs-PCa (OR=2.7, p=0.045), while Hispanic men had similar odds of detecting cs-PCa compared to NHW men. With regard to all PCa, NHB men had a similar increase in the odds of detecting all PCa (OR=2.4, p=0.050), which was borderline statistically significant compared to NHW men on FB. When we excluded men on active surveillance, NHB men had even stronger associations with detection of cs-PCa (OR=3.10, p=0.047) or all PCa (OR=2.77, p=0.032) compared to NHW ***: NHB men have higher odds for overall PCa and cs-PCa on FB compared to NHW men. Further work may clarify differences per PI-RADS score. Clinicians should interpret prostate magnetic resonance imaging lesions with more caution in NHB men.(C) 2021 by the American Urological Association, Inc.

关键词： minimally invasive surgical procedures   prostate   prostatic hyperplasia   urologic surgical procedures, male  

摘要： Purpose: We present final 5-year outcomes of the multicenter randomized sham-controlled trial of a water vapor therapy (Rezum(TM)) for treatment of moderate to severe lower urinary tract symptoms due to benign prostatic *** and Methods: A total of 197 subjects >50 years of age with International Prostate Symptom Score >=13, maximum flow rate <=15 ml/second and prostate volume 30 to 80 cc were randomized and followed for 5 years. From the control arm of 61 subjects, a subset of 53 subjects requalified and after 3 months received treatment as part of the crossover group and were also followed for 5 years. The total number of vapor treatments to each lobe of the prostate was determined by length of prostatic urethra and included middle lobe treatment per physician ***: Significant improvement of lower urinary tract symptoms was observed at <3 months post-thermal therapy, remaining durable through 5 years in the treatment group (International Prostate Symptom Score reduced 48%, quality of life increased 45%, maximum flow rate improved 44%, Benign Prostatic Hyperplasia Impact Index decreased 48%). Surgical re-treatment rate was 4.4% with no reports of device or procedure related sexual dysfunction or sustained de novo erectile dysfunction. Results within the crossover group were similar through 5 ***: Minimally invasive treatment with water vapor thermal therapy provides significant and durable symptom relief as well as flow rate improvements through 5 years, with low surgical re-treatment rates and without impacting sexual function. It is a versatile therapy, providing successful treatment to obstructive lateral and middle lobes.(C) 2021 by the American Urological Association, Inc.

关键词： Single species growth models   Logistic growth   Beverton-Holt model   Delayed Beverton-Holt   Pielou model   Delay difference equation   Discretization   Global stability   Extinction threshold   Componentwise monotonicity  

摘要： We propose an alternative delayed population growth difference equation model based on a modification of the Beverton-Holt recurrence, assuming a delay only in the growth contribution that takes into account that those individuals that die during the delay, do not contribute to growth. The model introduced differs from a delayed logistic difference equation, known as the delayed Pielou or delayed Beverton-Holt model, that was formulated as a discretization of the Hutchinson model. The analysis of our delayed difference equation model identifies a critical delay threshold. If the time delay exceeds this threshold, the model predicts that the population will go extinct for all non-negative initial conditions. If the delay is below this threshold, the population survives and its size converges to a positive globally asymptotically stable equilibrium that is decreasing in size as the delay increases. We show global asymptotic stability of the positive equilibrium using two different techniques. For one set of parameter values, a contraction mapping result is applied, while the proof for the remaining set of parameter values, relies on showing that the map is eventually componentwise monotone.

关键词： alternative states   coastal wetlands   disturbances   n‐   dimensional hypervolumes   recovery   resilience   resistance   stress gradients  

摘要： Stress gradients influence many ecosystem processes and properties, including ecosystem recovery from and resistance to disturbance. While recent analytical approaches have advanced multivariate metrics of ecosystem resilience that allow quantification of conceptual resilience models and identification of thresholds of state change, these approaches are not often translated to landscape scales. Using natural and restored salt marshes in Louisiana, USA, we quantified plant community recovery and resistance metrics along flooding stress gradients. n-dimensional hypervolumes of plant community biomass and structure were simulated using field data collected from disturbance-recovery experiments. The relationships between multivariate resilience metrics and flooding stress gradients were then mapped at community- and landscape-relevant scales by scaling with airborne-derived data across the region. Greater pre-disturbance abiotic stress decreased live below-ground, but not above-ground, biomass, and ultimately led to lower post-disturbance total recovery, recovery rates and resistance of plant communities. Vegetated plots flooded >52% of the time transitioned to an alternative, unvegetated state after disturbance. Mapping revealed differences in spatial patterns of resilience-highlighting low, interior marsh edges as especially vulnerable to the combination of chronic flooding stress and acute disturbance. At the landscape scale, approximately half of the area (48%) is vulnerable to state change after pulse disturbances. Synthesis. Ultimately, we quantify the ball-and-cup conceptual model for a salt marsh ecosystem and its alternative state, mudflat. We find that increasing abiotic stress due to climate change diminishes ecosystem resilience, but the interaction with common episodic disturbances is necessary to reveal transitions to alternative states and quantify state change thresholds. Quantifying and mapping resilience and where alternative states may exist in this f