Critical care specialists,the missing link in organ procurement for transplantation

The procurement process for organ donation begins with the identification of potential organ donors in emergency or critical care units(CCU),followed by their clinical evaluation,diagnostic procedures,and therapeutic interventions,mostly conducted in CCUs.It concludes with the request for organ donation and,if accepted,the retrieval of organs.Despite most interventions occurring in detection units,there has been a neglect of the strategic role played by critical care specialists(CCS)in managing and caring for brain-dead or near-brain-death patients.Questions arise:Are they willing to undertake this responsibility?Do they fully comprehend the nature of organ procurement?Are they aware of the specific interventions required to maintain possible organ donors in optimal physiological condition?Our objective is to examine the role of CCS in organ procurement and propose ways to enhance it,ultimately aiming to increase and enhance organ donation rates.

An Assessment of Procurement Risks Management Systems in the Public Sector

Risk management in public procurement is a critical aspect that needs to be addressed in the public sector.Several studies have been conducted to understand the challenges and factors influencing risk management in public procurement.These studies have explored the importance of risk management principles,the role of political influence,and the need for effective risk assessment and anticipation.The research has also highlighted the need for specific risk management mechanisms and tools to be implemented in public procurement processes.Risk management reforms in the public sector are essential but often circumvented due to assorted reasons,such as political influence and the emergence of new risks.The research investigation employs a quantitative research design.A total of 380 questionnaires were recovered from respondents.The study showed that the public sector has a procurement risk management system that is effective,but there may be some areas for improvement in the prequalification process,onboarding process,and support provided to newly onboarded suppliers.Additionally,the public sector used some strategies to mitigate and control contract risks during the procurement process,but there were some areas for improvement in the review and lessons learned process,risk mitigation measures,contract monitoring and performance evaluation mechanisms,and communication and documentation process.Finally,the results suggest that there were constraints placed on the risk management strategies currently utilized by professionals working in the public sector.These constraints include insufficient support and buy-in from senior management and stakeholders,bureaucratic or administrative hurdles,inadequate policies and regulations,insufficient training and skill development opportunities,and insufficient resources.The study highlights the significance of tackling risk management in the realm of public procurement and offers valuable perspectives on avenues for enhancement,obstacles encountered by practitioners,and the necessity of thorough evaluation and revisions.Through the adoption of the suggestions originating from this study,governmental entities can improve their procurement risk management frameworks and guarantee improved adherence to risk management principles.

Research on the Status Quo and Optimization of Centralized Procurement of Coronary Stents

Objective To study the impact of the first national centralized procurement of coronary stents on patients’psychology,the economy of medical institutions,and the survival and development of the coronary stents industry,and to provide suggestions on perfecting procedures to better carry out the centralized procurement of coronary stents.Methods Literature analysis was used to investigate the results of the procurement of coronary stent in a province and a hospital.Results and Conclusion The centralized procurement of coronary stents has alleviated the economic pressure of patients,but it has many problems.Therefore,this paper proposes some suggestions,such as promoting the orderly development of the coronary stent industry,improving the evaluation link of the centralized procurement of coronary stents,adopting the accurate reporting model to ensure the quality of coronary stents and improving the standardization of clinical services.

Research on Procurement Cost Control Based on Supply Chain Management

In modern enterprise management,strengthening the control and management of procurement processes can effectively reduce operational costs.However,with the continuous reform and improvement of China’s market economy system,competition among supply chain enterprises has intensified.The traditional procurement management model is no longer able to meet the needs of enterprise development in the current era.As a result,procurement management based on supply chain management has emerged,offering significant improvements in the scientific management of procurement processes.It has become an important means of promoting the long-term development of enterprises.This paper primarily analyzes and studies procurement cost control based on supply chain management,providing insights for reference.

Renal allograft procurement from living unrelated donors in Iran: What falls under the eclipse

Renal transplantation is the treatment of choice for end stage kidney disease.However,despite all the efforts to expand the donor pool,the shortage of donors is increasing and as a consequence,there has been a significant increase in the number of patients on transplant waiting lists globally.Societies worldwide have employed different methods to address this,each with specific ethical concerns surrounding them.Over three decades ago,a governmentally regulated program of kidney transplantation from living unrelated donors was introduced in Iran and since practiced which has been the subject of hot debate in the literature.Nevertheless,despite all these extensive discussions and publications,several key aspects of the program have still not been properly elucidated and addressed.In this article,the author aims to illuminate some dark corners related to this issue that have largely escaped the notice of ethicists.

Embedding Knowledge Management in Public Sector Procurement： Redesigning for the Knowledge Economy

There is a perception in the public, political, and trade discourse that private sector procurement performs ＂better＂ than does public sector procurement. This research considers whether this perception is justified. This paper proposes a conceptual framework for assessing issues that influence procurement performance. The framework takes into account the organization＇s business goals, its procurement principles, the design of its procurement capability, the intellectual capital or knowledge that is used to support procurement operations, and the use of knowledge management methods. To represent these factors, the framework adapts the conceptual framework proposed by McElroy （2002）, leverages Andriessen＇s （2005） characterization of intellectual capital, and adopts Bedford＇s （2012） description of the practice of knowledge management. The results, though preliminary and exploratory, suggest that factors which are more often practiced in the private sector than the public sector contribute to higher performance.

Research on choice of emergency procurement vendors

In order to make the supply chain select the best emergency procurement suppliers in case the procurement system encounters unexpected risks,six indices which can reflect the comprehensive abilities of alternative suppliers are selected,i.e.,the product yield,the toll standard,the on-time-delivery rate,the rate of turnover industry experience and customer satisfaction.Then standardized processing of evaluation is performed.For quantitative indices,vector normalization is adopted to perform standardized processing,and qualitative fuzziness indices are quantified through assignment.Finally,each index can be transformed into a standardized mark which has dimensionless 1 and the same magnitude.And an expert method is used to determine the index weights and then the linear weighted sum method is used to calculate the alternative supplier's comprehensive ability score and by comparing these scores,the optimal emergency procurement supplier is selected.

Aspects of International Public Procurement Regulation

The public procurement market is classified as one of the most important segments of the world economy with share of 7-18%in the world GDP.The importance of this segment leads to continuous liberalization.Despite the existing legislative framework,the share of cross-border public procurement remains limited due to several obstacles including discrimination in public procurement that was raised by governments as one of the non-tariff barriers to international trade.Surveys of the European Commission or the European Bank for Reconstruction and Development(EBRD)indicate that there are many other obstacles to entry to international public procurement markets.These obstacles are discussed in the first chapter of this article.The goal of this paper is to review aspects of international public procurement regulation and find ways of eliminating the obstacles through this regulation.Therefore,the second,third,and fourth chapters of the paper analyse the WTO Government Procurement Agreement(GPA),the United Nations Commission on International Trade Law(UNCITRAL)Model Law on Public Procurement,and the role of regional trade agreements.

Issues and Challenges in Implementing China’sGreen Public Procurement Program

Sustainable development and environmental protection are the themes of the day. One popular policy tool that government uses to promote sustainable development and to protect the environment is green public procurement. Chinese government established its public procurement system in the late 1990s. It has moved to implement green procurement since 2004. In this paper, the authors will first trace the development of Chinese green public procurement program. The authors will then examine the issues involved in its implementation and make suggestions as to how to make green public procurement program more effective. This is one of the first papers examining China’s green public procurement program.

Optimizing Bidders Selection of Multi-Round Procurement Problem in Software Project Management Using Parallel Max-Min Ant System Algorithm

This paper presents a Game-theoretic optimization via Parallel Min-Max Ant System(PMMAS)algorithm is used in practice to determine the Nash equilibrium value to resolve the confusion in choosing appropriate bidders of multi-round procurement problem in software project management.To this end,we introduce an approach that proposes:(i)A Game-theoretic model of multiround procurement problem(ii)A Nash equilibrium strategy corresponds to multi-round strategy bid(iii)An application of PSO for the determination of global Nash equilibrium.The balance point in Nash Equilibrium can help to maintain a sustainable structure not only in terms of project management but also in terms of future cooperation.As an alternative of procuring entities subjectively,a methodology to support decision making has been studied using Nash equilibrium to create a balance point on benefit in procurement where buyers and suppliers need multiple rounds of bidding.Our goal focus on the balance point in Nash Equilibrium to optimizing bidder selection in multi-round procurement which is the most beneficial for both investors and selected tenderers.Our PMMAS algorithm is implemented based on MPI(message passing interface)to find the approximate optimal solution for the question of how to choose bidders and ensure a path for a win-win relationship of all participants in the procurement process.We also evaluate the speedup ratio and parallel efficiency between our algorithm and other proposed algorithms.As the experiment results,the high feasibility and effectiveness of the PMMAS algorithm are verified.

Study on the Winning Probability for a Bid in Procurement Combinational Auction with Tree Structure

In this paper, the processes to determine winning probability for the corresponding bidder's deterministic bid are presented. The analysis of the winning probability is crucial for studying the bidding equilibria and designing the mechanism of procurement combinational auctions (CAs), and it also provides the decision making support for bidders who are in commercial synergies surrounding. Finally, an example is used to illustrate the feasibility and detailed processes of calculating winning probability.

Personal experience with the procurement of 32 liver allografts

AIM: To introduce the American Pittsburgh's method of rapid liver procurement under the condition of brain death and factors influencing the quality of donor liver.METHODS: To analyze 32 cases of allograft liver procurement retrospectively and observe the clinical outcome of orthotopic liver transplantation.RESULTS: Average age of donors was 38.24±12.78 years,with a male:female ratio of 23:9. The causes of brain death included 21 cases of trauma (65.63%) and nine cases of cerebrovascular accident (28.13%). Fourteen grafts (43.75%) had hepatic arterial anomalies, seven cases only right hepatic arterial anomalies (21.88%), five cases only left hepatic arterial anomalies (15.63%) and two cases of both right and left hepatic arterial anomalies (6.25%) among them. Eight cases (57.14%) of hepatic arterial anomalies required arterial reconstruction prior to transplantation. Of the 32 grafts evaluated for early function, 27 (84.38%) functioned well, whereas three (9.38%) functioned poorly and two (6.25%) failed to function at all. Only one recipient died after transplantation and thirty-one recipients recovered. Four recipients needed retransplantation. The variables associated with less than optimal function of the graft consisted of donor age (35.6±12.9 years vs 54.1±4.3 years, P＜0.05), duration of donor's stay in the intensive care unit (ICU) (3.5±2.4 d vs 7.4±2.1 d, P＜0.005), abnormal graft appearance (19.0% vs 100%, P＜0.05), and such recipient problems as vascular thromboses during or immediately following transplantation (89.3% vs 50.0%, P＜0.005).CONCLUSION: During liver procurement, complete heparization, perfusion in situ with localized low temperature and standard technique procedures are the basis ensuring the quality of the graft. The hepatic arterial anomalies should be taken care of to avoid injury. The donor age,duration of donor's staying in ICU, abnormal graft appearance and recipient problem are important factors influencing the quality of the liver graft.

Beyond the Audit: Making Efficiency Easy and Enticing by Addressing Project Procurement

Many states have implemented an Energy Efficiency Resource Standard (EERS) or target to curtail greenhouse gas (GHG) emissions. California alone has set a target of doubling energy efficiency savings in existing buildings by 2030. As more states rely on energy efficiency to reduce GHG emissions, programs designed to support the planning and implementation of energy efficiency projects will become more important. Identifying energy efficiency projects has traditionally been the focus of these programs, however delivering savings remains a key challenge. Strategies to address procurement are often overlooked as program resources focus more on technical resources, such as audits and monetary incentives. Then once identified, specialized energy efficiency projects are often folded in with standard maintenance or capital improvement projects, putting them at risk of compromising the expected performance. This paper focuses on procurement as a key component of program implementation and success and outlines key issues and challenges specifically faced by the public sector. Furthermore, the paper shares a procurement strategy implemented through the Southern California Regional Energy Network (SoCalREN) Public Agency Program that addresses these problems in order to assure intended project performance. The strategy includes engaging procurement stakeholders early in the project process, exploring the different types of procurement pathways and following an implementation checklist to enhance project success. With this systematic approach to procurement, there will be fewer barriers and energy efficiency will be easy and enticing, which will further enable states to achieve their GHG emission reduction targets.

Deceased donor organ procurement injuries in the United States

AIM: To determine the incidence of surgical injury during deceased donor organ procurements. METHODS: Organ damage was classified into three tiers, from 1-3, with the latter rendering the organ nontransplantable. For 12 consecutive months starting in January of 2014, 36 of 58 organ procurement organization's(OPO)'s prospectively submitted quality data regarding organ damage(as reported by the transplanting surgeon and confirmed by the OPO medical director) seen on the procured organ.RESULTS: These 36 OPOs recovered 5401 of the nations' s 8504 deceased donors for calendar year 2014.A total of 19043 organs procured were prospectively analyzed. Of this total, 59 organs sustained damage making them non-transplantable(0 intestines; 4 pancreata; 5 lungs; 6 livers; 43 kidneys). The class 3 damage was spread over 22(of 36) reporting OPO's.CONCLUSION: While damage to the procured organ is rare with organ loss being approximately 0.3% of procured organs, loss of potential transplantable organs does occur during procurement.

Procurement Method Selection for Building Maintenance Projects: The Case of Malaysian Public Universities

The purpose of this paper is to implement and validate a decision making framework for building maintenance projects. The growing importance of maintenance sector not only in Malaysia but al- so increasingly globalized, the difficulty in selecting an appropriate procurement method and lack of research in this area provide an impetus for this research. There were 19 procurement selection criteria identified. In addition, there were 4 types of procurements methods which include outsourcing by specialist term contract, outsourcing by tendered schedule term contract, out- sourcing by repair and maintenance contract and outsourcing by measured term contract identified to be the most popular procurement methods adapted by public universities currently and at the same time were considered most important. The decision making framework was developed based on AHP technique and principles. Expert Choice Software was employed as development tool where the criteria and alternatives were integrated into the framework. Finally, structured interview was conducted to validate the framework developed. The validation process was carried out through structured interview with selected public university.

Quality Assurance of Bread and Bakery Pastries in Public Institutions According to the Law on Public Procurement

Public institutions, such as kindergartens, are committed to ordering food according to the Slovenian Law on public procurement （ZJN-3）, which is compliant with EU legislation. There are many bread manufacturers in the market, therefore contracting authority has the challenging task to provide a diverse and high-quality bread and bakery pastries through the process of public procurement. Each buyer has the option of ordering food through the so-called ＂short chain＂, which allows the ordering of locally produced cereals, bread from the organic and integrated production. The Ministry of Health of the Republic of Slovenia issued a ＂Guide to Quality Standards of Food in Public Ordering for Educational Institutions＂ which supports the ordering process. In addition to quality requirements, the buyer divides the tender documentation into several groups and subgroups （e.g. Bread, Bakery pastries and Bread of organic production）. The bakery industry is aware that in kindergartens high-quality bread and bakery pastries are required, therefore they already offer products with reduced salt, sugars, fats, products without trans-fatty acids and gluten. Taking into account the appropriate purchasing specifications and good knowledge of legislation, with respect to public procurement law-related orders, children in kindergartens can be provided with high-quality bread and bakery pastries.

The analysis of government procurement in the frame of principal agent theory

In government procurement activities, asymmetric information, incomplete contracts and opportunism, led to the dysfunction of principal-agent. Through the reference of the principal-agent theory, this paper uses the model of the principal-agent to analyze government procurement activity, and proposes some countermeasures to improve principal-agent in government procurement.

Optimal Link Tolls for Multi-node and Multi-link Transportation Networks Taking into Account the Welfare Cost of Fund Procurement

This study discusses the optimal link toll,which maximizes social surplus under a user equilibrium condition,with imperfect substitution assumption for route choice in a transportation network with many nodes and links,as well as taking into account the welfare cost of funds procurement.In contrast to previous studies,this study formulates optimal link tolls,taking into account the marginal cost of public funds(MCF),which is the marginal welfare loss of taxpayers due to a marginal tax raise.The formula for optimal tolls on links is derived from the following conditions.One is MCF classified into two,not taking into account funding(MCF equal to-1)and pricing for funding(MCF does not equal-1).Another is tolls classified into two,pricing on all links(full link pricing),and pricing on a specific link(partial link pricing).Following the above conditions,this study succeeds in deriving the formula for optimal tolls on a full network with many links and nodes.Furthermore,this study indicates two calculation methods:one is to solve analytically or numerically for when the functional form of link flow demand is known.When the functional form is unknown,such as a perfect substitution case,it is necessary to carry out iteration until convergence:with the traffic assignment given the price level and with a change in price level based on the traffic assignment.

Barriers and Challenges to the Sustainability Requirements Implementation in Public Procurement of Engineering Works and Services

The environmental damage arising from the construction and engineering services was responsible for the appearance of several norms and resolutions regulating and directing the sector’s performance. In this article, we research how professionals with experience in public bids assess the difficulty degree of the implementation of those requirements and how they assess the environmental legislation regarding the protection and conservation of the environment, impact on costs, deadlines and the solution to environmental problems. The results show that industry professionals consider as “high” the level of difficulty to implement the addressed sustainability requirements, and that the Brazilian environmental legislation does not comply with its environmental protection role, increases the possibility of delays and costs of projects and services and hampers the emergence of solutions that could solve environmental problems.

Application Research on Big Data in Material Bidding and Procurement Management

The 21st century is an era of rapid development of informatization.Under the background of the development of this era,people are increasingly researching the application of information technology.The application of big data technology is the development and application trend of an information technology formed after the rapid development of modem information technology.Big data technology has been applied to the development of many industries,including the material bidding and procurement management as well.With the aid of scientific analysis of big data,it is possible to help material procurement management to analyze the corresponding bidding procurement information,which is an important guarantee for improving its bidding procurement management capabilities.In view of this,this article has conducted special research on the application of big data in material bidding and procurement management,hoping to provide references for the application of big data technology in material bidding and procurement management with the help of the research in this article.