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Background： The emergency department （ED） has a pivotal influence on the management of acute heart failure （AHF）, but dataconcerning current ED management are scarce. This Beijing AHF Registry Study investigated the characteristics. ED management, and short- and long-term clinical outcomes of AHF. Methods： This prospective, multicenter, observational study consecutively enrolled 3335 AHF patients who visited 14 EDs in Beijing from January 1, 2011, to September 23, 2012. Baseline data on characteristics and management were collected in the EDs. Follow-up data on death and readmissions were collected until November 31, 2013, with a response rate of 92.80%. The data were reported as median （interquartile range） for the continuous variables, or as number （percentage） for the categorical variables. Results： The median age of the enrolled patients was 71 （58 79） years, and 46.84% wvere women. In patients with AHH coronary heart disease （43.27%） was the most common etiology, andmyocardium ischemia （30.22%） was the main precipitant. Most of the patients in the ED received intravenous treatments, including diuretics （79.28%） and vasodilators （74.90%）. Fewer patients in the ED received neurohormonal antagonists, and 25.94%, 31.12%, and 33.73% of patients received angiotensin converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers, and spironolactone, respectively. The proportions of patients who were admitted, discharged, left against medical advice, and died were 55.53%, 33.58%, 7.08%, and 3.81%, respectively. All-cause mortalities at 30 days and 1 year were 15.30% and 32.27%, respectively. Conclusions： Substantial details on characteristics and ED management of AHF were investigated. The clinical outcomes of AHF patients were dismal. Thus, further investigations of ED-based therapeutic approaches for AHF are needed.

Diabetic retinopathy (DR) is one of the leading causes of permanent central blindness worldwide. Despite the complexity and inadequate understanding of DR pathogenesis, many of the underlying pathways are currently partially understood and may offer potential targets for future treatments. Anti-VEGF medications are currently the main medication for this problem. This article provides an overview of the established pharmacological treatments and those that are being developed to cure DR. We firstly reviewed the widely utilized approaches including pan-retinal photocoagulation therapy, anti-VEGF therapy, corticosteroid therapy, and surgical management of DR. Next, we discussed the mechanisms of action and prospective benefits of novel candidate medications. Current management are far from being a perfect treatment for DR, despite mild-term favorable efficiency and safety profiles. Pharmacological research should work toward developing longer-lasting treatments or new drug delivery systems, as well as on identifying new molecular targets in the pathogenetical mechanism for DR. In order to find a treatment that is specifically designed for each patient, it is also necessary to properly characterize patients, taking into account elements like hereditary factors and intraretinal neovascularization stages for effective utilization of drugs. Graphical abstract The current and potential approaches for diabetic retinopathy. Image was constructed using Biorender.com

Human potential introduces an enormous range of knowledge, skills, predictable and unpredictable responses, ways of perception, experience, and behaviour. The human potential in the corporate environment, i.e. people and their complex positive and negative abilities are mostly constructive, but sometimes destructive creators of new values and new knowledge. The need to implement changes in management systems is a challenge and a condition for future competitiveness these days. In this paper, the authors focus on the cultural-historical development of human resource management from the time when people were only a secondary component of production to the present when they are a key element in maintaining competitiveness. A survey conducted between 2010 and 2019 analyses how human resource management in Slovak organizations has changed over the past decade. The survey revealed several findings. The most fundamental is the trend of increasing the size of human resource management units or personnel departments in organizations.

A sustainable urban water cycle is critical in terms of effective water network management, efficient use of water resources, protection of the environment and human health, and reuse of treated water. The objective of this study is to develop a novel assessment framework that evaluates the data quality of components and current implementation levels of wastewater management (WWM) practices, calculates performance indicators according to the data quality of the components, and proposes the most appropriate improvement methods according to the current status of the components. This assessment framework consists of five matrices, namely the current situation analysis and management system (CSAS), data matrix (DATA), performance assessment system (PAAS), target definition system (TARGET), and method matrix (TOOL). The current situation is analyzed with a total of 231 components under 11 main headings covering WWM practices. The assessment framework was tested in pilot utilities and the results were discussed. It is observed that the scores of utility I were generally better than those of utilities II and III. The novelty of this assessment framework is to evaluate the current situation of WWM practices with a unique scoring system, to define the weaknesses and strengths in WWM, and to present a roadmap for improvement according to the current situation.

Sarcomas are a heterogeneous group of neoplasms of mesenchymal origin. Approximately 80% arise from soft tissue and 20% originate from bone. To date more than 100 sarcoma subtypes have been identified and they vary in molecular characteristics, pathology, clinical presentation and response to treatment. While sarcomas represent <1% of adult cancers, they account for approximately 21% of paediatric malignancies and thus pose some of the greatest risks of mortality and morbidity in children and young adults. Metastases occur in one-third of all patients and approximately 10–20% of sarcomas recur locally. Surgery in combination with preoperative and postoperative therapies is the primary treatment for localized sarcoma tumours and is the most promising curative possibility. Metastasized sarcomas, on the other hand, are treated primarily with single-agent or combination chemotherapy, but this rarely leads to a complete and robust response and often becomes a palliative form of treatment. The heterogeneity of sarcomas results in variable responses to current generalized treatment strategies. In light of this and the lack of curative strategies for metastatic and unresectable sarcomas, there is a need for novel subtype-specific treatment strategies. With the more recent understanding of the molecular mechanisms underlying the pathogenesis of some of these tumours, the treatment of sarcoma subtypes with targeted therapies is a rapidly evolving field. This review discusses the current management of sarcomas as well as promising new therapies that are currently underway in clinical trials.

Achondroplasia (ACH) is the most common skeletal dysplasia and characterized by a disproportionate short stature, macrocephaly with frontal bossing, exaggerated lumbar lordosis, and trident hands. It is induced by activated mutations in the fibroblast growth factor receptor 3 (FGFR3) gene. In addition to short stature, patients with ACH have a high prevalence of medical complications, including upper airway obstructive apnea, increased mortality, foramen magnum stenosis, hydrocephalus, developmental delay, recurrent ear infections, genu varum, obesity, and spinal canal stenosis, throughout their whole life. Several investigational drugs that modulate abnormal FGFR3 signaling have recently emerged, vosoritide being the most developed. This review presents the different disease-specific complications of ACH occurring in neonates, infants, childhood, adolescent, and adults and reports the current multidisciplinary interventions for these various complications. Moreover, we propose treatment strategies for children with ACH from the perspective of quality of life in adulthood.

Early efforts in wildlife management focused on reducing population variability and maximizing yields of selected species. Later, Aldo Leopold proposed the concept of habitat management as superior to population management, and more recently, ecosystem management, whereby ecological processes are conserved or mimicked, has come into favour. Managing for resilience builds upon these roots, and focuses on maintaining key processes and relationships in social-ecological systems so that they are robust to a great variety of external or internal perturbations at a range of ecological and social scales. Managing for resilience focuses on system-level characteristics and processes, and the endurance of system properties in the face of social or ecological surprise. Managing for resilience consists of actively maintaining a diversity of functions and homeostatic feedbacks, steering systems away from thresholds of potential concern, increasing the ability of the system to maintain structuring processes and feedbacks under a wide range of conditions, and increasing the capacity of a system to cope with change through learning and adaptation. The critical aspect of managing for resilience, and therefore ecosystem management, is undertaking adaptive management to reduce uncertainty and actively managing to avoid thresholds in situations where maintaining resilience is desired. Managing adaptively for resilience is the approach best suited for coping with external shocks and surprises given the non-linear complex dynamics arising from linked social-ecological systems.

Background. Cystic echinococcosis (CE) is a significant public health problem worldwide. However, there remains a dearth of evidence guiding treatment in various stages of CE. The 2010 World Health Organization (WHO) Informal Working Group on Echinococcosis (WHO IWGE) guidance is thus based on expert consensus rather than a good evidence base. This study aims to describe the way clinicians worldwide manage CE and to establish whether clinicians follow WHO IWGE guidance. Methods. Using the online surveying tool SurveyMonkey, a questionnaire was produced detailing 5 clinical cases. Clinicians treating CE were identified and asked how to manage each case through tick-box and short-answer questions. Results. The results showed great variation in practice worldwide. There are practices in common use that are known to be ineffectual, including puncture, aspiration, injection, reaspiration procedures on WHO type 2 cysts, or outdated, including interrupted, rather than continuous, courses of albendazole. A number of unsafe practices were identified such as using scolicidal agents in cysts communicating with the biliary tree and short-course medical therapy for disseminated disease. Most clinicians do not follow the WHO IWGE guidance, but the reasons for this are unclear. Conclusions. Management of CE varies greatly worldwide. There are key areas of CE for which there is no evidence on which to base guidelines, and randomized controlled trials are needed together with a well-designed international registry to collect data. Further work is required to establish why clinicians do not follow the IWGE guidance, together with better dissemination of future guidance.

Craniopharyngiomas (CP) are rare noncancerous brain tumors located in the skull base. To date, CP remain challenging-to-resect tumors, owing to their difficult location and invasive potential, with profound adverse effects for the patient if left to grow. Indeed, gross total resection may also be accompanied by unwelcome sequalae, underscoring the need for continued investigation. In the present work, we provide a scoping review of current CP management, with emphasis on our knowledge of their genesis, available treatment options, post-intervention clinical outcomes. Leading theories of CP development are (1) the embryonic theory, explaining the development of adamantinomatous CP from epithelial remnants of Rathke’s pouch and (2) the metaplastic theory, which describes papillary CP development as a result of adenohypophyseal cell metaplasia. Treatment may include surgery, intracystic therapy, or irradiation depending on tumor size, history and location. However, whether a single ideal approach and timing for CP intervention exists remains debated. We appraise and critique these areas with priority for emerging basic results and innovation.

Lack of reliable data is one of the most important constraints of solid waste management. We investigated generation rates of solid waste in Tehran and the factors affecting generation rates. Data were collected from the statistical center of Tehran Waste Management Organization (TWMO). The data analysis showed that the municipal solid waste (MSW) generation was increased from 2006 to 2012; however, because of a decline in gross domestic production (GDP) per capita, a decline of the MSW generation was observed between 2012 and 2014. The correlation coefficient between the total MSW and GDP was 0.91. Thus, the MSW generation rate in Tehran was highly correlated with the GDP per capita and the rate was predictable with a high confidence. The MSW per capita per day in Tehran was 0.96 kg and 76% of the MSW was landfilled. Construction and demolition (C&D) wastes per capita per day was 5.2 kg and 81% of them were landfilled. A low recycling rate indicated that the education programs and/or public participation for waste reduction and recycling in recent years have not been efficient and a revision should be made to the current program.