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705 patients (32%) had undergone surgical treatments, 1028 patients (46%) had undergone radiotherapy for metastatic vertebrae, and 855 patients (38%) had received systemic treatments. The age, primary tumor type, number of involved vertebrae, Frankel grade, and spinal instability neoplastic score would affect the surgical decision-making. Discussion This study provides insight into the epidemiological characteristics of spinal metastasis and health care service utilization in spinal metastasis patients in China. Abbreviations ICD-10 International Classification of Disease, Tenth Revision; VAS Visual Analogue Scale; KPS Karnofsky Performance Status; SINS Spinal Instability Neoplastic Score; SOSG Spine Oncology Study Group; MRI Magnetic Resonance Imaging; CT Computed Tomography; ECT Emission Computed Tomography.The increase in solid waste generation has been a major contributor to the amount of Greenhouse gases (GHGs) present in the atmosphere. To some extent a great chunk of these GHGs in the atmosphere is from landfill. This study assesses two theoretical models (LandGEM and Afvalzorg models) to estimate the amount of landfill gas (LFG) emitted from Thohoyandou landfill site. Also, the LFGcost Web model was used to estimate the cost and benefits of the implementation of a LFG utilisation technology. The Thohoyandou landfill started operations in the year 2005 and it is proposed to reach its peak at approximately, year 2026. The LandGEM calculates the mass of landfill gas emission using methane generation capacity, mass of deposited waste, methane generation constant and methane generation rate. Meanwhile, the Afvalzorg model determines the LFG emissions using the Methane correction factor, yearly waste mass disposal, waste composition, Degradation Organic Carbon, methane generation rate constant, LFG recovery effiH4 emission will peak in year 2026 (3336 Mg/year). The LandGEM model showed that total LFG, CH4 and CO2 emitted from the landfill between 2005 and 2040 (Mg/year) are 293,239, 78,325 and 214,908, respectively. The simulation from the Afvalzorg model found that CH4 emitted from years 2005 – 2040 is 74,302 Mg/year. Therefore, implementation of LFG utilisation is economically feasible from sales of electricity generated and Certified Emission Reductions.As of May 2020, nursing home residents account for a staggering one-third of the more than 80,000 deaths due to COVID-19 in the U.S. This pandemic has resulted in unprecedented threats to achieving and sustaining care quality even in the best nursing homes, requiring active engagement of nursing home leaders in developing solutions responsive to the unprecedented threats to quality standards of care delivery during the pandemic. This perspective offers a framework, designed with the input of nursing home leaders, to facilitate internal and external decision-making and collective action to address these threats. Policy options focus on assuring a shared understanding among nursing home leaders and government agencies of changes in the operational status of nursing homes throughout the crisis, improving access to additional essential resources needed to mitigate the crisis’ impact, and promoting shared accountability for consistently achieving accepted standards in core quality domains.Objective Some hyperacute stroke patients have unfavorable outcomes after endovascular thrombectomy (EVT) despite successful recanalization. We hypothesized that a cardiac parameter, moderate-to-severe mitral regurgitation (MR), might decrease the rate of favorable clinical outcome after EVT in patients with atrial fibrillation (AF). Method From our prospective EVT registry, AF patients who underwent transthoracic echocardiography (TTE) were retrospectively analyzed. Based on the presence of moderate-to-severe MR, patients were assigned to either significant MR or nonsignificant MR group. The severity of MR was determined by the ratio of the color Doppler jet area to the left atrial area in mid-systole. Moderate-to-severe MR was estimated to be at a ratio of >20%. Favorable outcome was defined as having a modified Rankin Scale score of 0-1 at 3 months. Result 127 patients with AF who underwent TTE were included in the study. TTE results found that 25 (20%) patients had significant MR. MK-8835 Patients with significant MR were older (p = 0.051) and had enlarged left (p = 0.015) and right (p = 0.002) atria. Tricuspid and aortic regurgitation (p = 0.007 and 0.043, respectively) were more severe in significant MR group. At 3 months, favorable outcomes were 11% in the significant MR group and 26% in the non-significant MR group (p = 0.031). Multivariate regression analysis reported that moderate-to-severe MR was a negative predictor of favorable outcome (odds ratio = 0.14; 95% confidence interval = 0.02, 0.84; p = 0.031). Conclusions Significant MR might prevent the clinical recovery of AF patients.Following a late fall wildfire in 2016 in the Great Smoky Mountains National Park, pyrophilous fungi in burn zones were documented over a 2-y period with respect to burn severity and phenology. Nuc rDNA internal transcribed spacer (ITS1-5.8S-ITS2 = ITS) barcodes were obtained to confirm morphological evaluations. Forty-one taxa of Ascomycota and Basidiomycota were identified from burn sites and categorized as fruiting only in response to fire or fruiting enhanced by fire. Twenty-two species of Pezizales (Ascomycota) were among the earliest to form ascomata in severe burn zones, only one of which had previously been documented in the Great Smoky Mountains National Park. Nineteen species of Basidiomycota, primarily Agaricales, were also documented. Among these, only five species (Coprinellus angulatus, Gymnopilus decipiens, Lyophyllum anthracophilum, Pholiota carbonicola, and Psathyrella pennata) were considered to be obligate pyrophilous taxa, but fruiting of two additional taxa (Hygrocybe conica and Mycena galericulata) was clearly enhanced by fire. Laccaria trichodermophora was an early colonizer of severe burn sites and persisted through the winter of 2017 and into spring and summer of 2018, often appearing in close association with Pinus pungens seedlings. Fruiting of pyrophilous fungi peaked 4-6 mo post fire then diminished, but some continued to fruit up to 2.5 y after the fire. In all, a total of 27 previously unrecorded taxa were added to the All Taxa Biodiversity Inventory (ATBI) database (~0.9%). Most pyrophilous fungi identified in this study are either cosmopolitan or have a Northern Hemisphere distribution, but cryptic endemic lineages were detected in Anthracobia and Sphaerosporella. One new combination, Hygrocybe spadicea var. spadicea f. odora, is proposed.