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The influence of perioperative red blood cell (RBC) transfusion on prognosis of glioblastoma patients continues to be inconclusive. The aim of the present study was to evaluate the association between perioperative blood transfusion (PBT) and overall survival (OS) in patients with newly diagnosed glioblastoma. Between 2013 and 2018, 240 patients with newly diagnosed glioblastoma underwent surgical resection of intracerebral mass lesion at the authors' institution. PBT was defined as the transfusion of RBC within 5 days from the day of surgery. The impact of PBT on overall survival was assessed using Kaplan-Meier analysis and multivariate regression analysis. Seventeen out of 240 patients (7%) with newly diagnosed glioblastoma received PBT. The overall median number of blood units transfused was 2 (95% CI 1-6). Patients who received PBT achieved a poorer median OS compared to patients without PBT (7 versus 18 months; p  65 years" (p  less then  0.0001, OR 6.4, 95% CI 3.3-12.3), "STR" (p = 0.001, OR 3.2, 95% CI 1.6-6.1), "unmethylated MGMT status" (p  less then  0.001, OR 3.3, 95% CI 1.7-6.4), and "perioperative RBC transfusion" (p = 0.01, OR 6.0, 95% CI 1.5-23.4) as significantly and independently associated with 1-year mortality. Perioperative RBC transfusion compromises survival in patients with glioblastoma indicating the need to minimize the use of transfusions at the time of surgery. Obeying evidence-based transfusion guidelines provides an opportunity to reduce transfusion rates in this population with a potentially positive effect on survival.

Research indicates that the implicit biases and racist attitudes of healthcare workers are fundamental contributing factors to race-based health inequities. However, few studies and reviews appear to have examined the provision and effects of anti-racist education and training on post-licensure healthcare workers. The purpose of this systematic literature review was to explore what research methods are being used to ascertain the training healthcare workers are receiving post-licensure and to identify the goals and outcomes of this training.

Using PubMed, CINAHL, and Google Scholar databases, peer-reviewed articles meeting inclusion criteria were identified and reviewed by the authors from March through October of 2020 in alignment with the renewed national focus on anti-racism and racial justice. Studies or initiatives involving students were excluded as were commentaries on studies and studies not specific to racism or anti-racism.

Eleven articles were identified as meeting stipulated inclusion criter and practice.In this study, the outcome serves to establish a measurement model to calculate the value of ecosystem services in Lhasa River Basin, China. Following on the principle of resource scarcity, a study paradigm is established according to the influence of natural and socio-economic location differences on the value of ecosystem services. Results show that the total value of ecosystem services in Lhasa River Basin is 104.503 billion yuan. The unit ecosystem service value of natural grassland in the lower reaches is 5.6 times and 1.07 times larger than that in the upper and middle reaches, respectively. The value of ecosystem services is clearly affected by the scarcity of ecosystem services and dependence of economic and social development on the ecosystem. The value of ecosystem services in the upper, middle, and lower reaches were 4.17%, 21.48%, and 74.35%, respectively. It is found that the value of ecosystem services in this particular region differs significantly in the upper, middle, and lower reaches of the basin. The scarcity of ecological resources has increased the value of ecosystem services, which is reflected in the highest value of ecosystem services in the middle of Lhasa River Valley and both sides of the river where population, economy, and ecological demand are relatively concentrated. According to the estimated results, this study proposes a variety of methods to improve the ecosystem service value and analysis of the ecological compensation mechanism, derived from the contribution made by ecological services.Promoting the development of electric vehicles (EVs) is regarded as an important measure to ensure energy security, mitigate climate change, and solve the transport sector's air pollution problems. Nowadays, compared to gasoline vehicles, whether the EVs are more competitive in terms of cost is still a question. There is no consensus achieved since the total cost depends on the development stage of the automobile industry and power generation structure as well as the cost accounting boundary. Many of existing studies did not include the costs occurred in all the stages. In response to this concern, this study estimates the lifecycle cost covering the whole process of production, use, disposal, and infrastructure construction as well as externalities for passenger battery electric vehicle (BEV), fuel cell vehicle (FCV), and gasoline vehicle (GV) by applying the comprehensive lifecycle cost model to China. The results indicate that in 2018, BEV and FCV were more expensive than GV (1.2-5.3 times), but that BEV will become cheaper after 2025, and its cost advantage will be enlarged to $419 (5%) compared to GV by 2030. The lifecycle cost of FCV will be $527 (or 5%) lower than that of GV by 2030. These results clarify that the costs of vehicle production account for the largest proportion in the total lifecycle cost.Detrimental effects of chemical pollution-primarily caused by human activities-on aquatic ecosystems have increasingly gained attention. Because of its hydrophobic qualities, mercury is prone to easily bioaccumulate and biomagnify through the food chain, decreasing biodiversity and eventually also affecting humans. In the present study, accumulated mercury concentrations were measured in muscle and liver tissue of perch (Perca fluviatilis) and European eel (Anguilla anguilla) collected at 26 sampling locations in Flemish (Belgian) waterbodies, allowing a comparison of these species within a variety of environmental situations. Furthermore, effects of size and weight have been assessed, expected to influence accumulation and storage of pollutants. Mercury concentrations in perch ranged up to 1.7 μg g-1 dw (median 0.29 μg g-1 dw) in muscle and from 0.02 to 0.77 μg g-1 dw (median 0.11 μg g-1 dw) in liver tissue. For eel, these concentrations were between 0.07 and 1.3 μg g-1 dw (median 0.39 μg g-1 dw) and between 0.08 and 1.4 μg g-1 dw (median 0.55 μg g-1 dw) respectively. We found a correlation of accumulated mercury with length in perch, independent of location. Furthermore, a significant difference in accumulated mercury concentrations between the targeted species was measured, with the highest mean concentrations per dry weight in eel liver and muscle tissue. MF-438 In perch, higher concentrations were found in muscle compared to liver tissue, while in eel, liver tissue showed the highest concentrations. These findings were further considered with concentrations corrected for lipid content, excluding the fat compartment, which is known to a hold negligible portion of the total and methyl mercury concentrations. This confirmed our previous conclusions, except for mercury concentrations in eel. Here there was no longer a significant difference between muscle and liver concentrations. Finally, health risk analyses revealed that only frequent consumption of local eel (> 71 g day-1) could pose risks to humans.With the rapid growth of global demand for water and energy, the two increasingly restrict economic and social development. The total energy consumption and water use are positively correlated. Identifying the key drivers influencing the energy-water development can realize national resource management and sustainable supplement. In this context, this study aims to capture the key driving forces that affect the sustainable energy-water development characteristics in Chinese change processes throughout 2000-2017. Five driving forces, the EW intensity effect, industrial structure effect, GDP value-added effect, income improvement effect, and population-scale effect, were further decomposed by the logarithmic mean Divisia index (LMDI) model to explore the energy consumption and water use. Our findings indicated that the largest and lowest energy consumers were the manufacturing and construction sectors, while agriculture accounted for the largest share in water use. During the three time intervals, the cumulative effects increased the EW use, but the contributions were declining. Further, these effects had a more prominent influence on water use than energy consumption; GDP value-added effect, income improvement effect, and population-scale effect increased the EW use, while intensity effect played a vital role in decreasing EW use during the study period. Notably, the industrial structure effect had a seesaw role during 2000-2006, which led to a tradeoff between various driving factors. In future sustainable issues, policymakers should pay more attention to energy-saving than water-saving to achieve the national energy and water conservation targets.Leather manufacturing is the process of transforming animal skin into high value-added commodity. As a crucial step in the leather producing process, conventional chrome tanning could lead to discharge of chromium contaminant due to the low efficiency of chromium uptake. In this paper, a series of polyethylene glycol triazine derivatives' tanning agent (PT) with different molecule weight was synthesized with one-step method and applied in the main tanning of hide. The chemical structure of the PT was detected by FT-IR and 1H-NMR. The application experimental results indicated that after 16% of PT tanning at pH of 6, the wet-white was endowed with shrinkage temperature over 80°C and thickening rate over 108%. The experimental results indicated that the PT tanning leather not only have a better physical and mechanical properties than commercial triazine derivatives tanning agent, but also the leather is endowed with the effects of outstanding thermal properties. Considering that the pickling process became unnecessary, a large number of neutral salts could be avoided, the chromium load in spent liquor decreased from 1288 mg/L to 0, and the total dissolved chlorine in spent liquor decreased from 15,360 to 9581 mg/L; no toxic and harmful substances such as chromium and aldehyde are introduced into the tanning process. Compared with the leather tanned with commercial triazine derivatives' tanning agent, the leather tanned with PT showed a similar overall tanning properties and better environmental friendliness, which makes PT matches the integral requirements of the modern sustainable leather industry.The sudden outbreak and prolonged impact of the global novel coronavirus disease (COVID-19) epidemic has caused an increase in demand for medical products, such as masks and protective clothing, leading to an exponential increase in the generation of medical waste. As medical waste under the epidemic is highly infectious, it poses a great danger to human health. Therefore, with the proliferation of medical waste, it has become crucial to construct a reverse logistics recycling network that can handle medical waste quickly and efficiently. In this study, we construct a multi-period medical waste emergency reverse logistics network siting model with the objectives of minimum cost, minimum safety risk, and minimum time for the safe and quick disposal of medical waste. The model considers disposal capacity bottlenecks of existing facilities. Based on an empirical analysis using the COVID-19 epidemic in New York City, USA, as a case study, we find that the use of a suitable number of synergistic facilities and the establishment of temporary medical waste disposal centers are viable options for handling the dramatic increase in medical waste during the peak of the COVID-19 epidemic.