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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Research on Public Participation in Public Procurement:In the Context of Digital Economy

Public participation in public procurement is an important guarantee for its sustainable and healthy operation.In the era of digital economy and big data,public participation in information disclosure,service quality,and service pricing in public procurement plays an important role.Public private partnerships are an innovative form of public procurement.This study sorts out the issues of public participation in PPP projects,and puts forward several suggestions based on data thinking.In terms of public procurement project information disclosure,big data technology is used to improve the timeliness and breadth of information disclosure,and enhance the professionalism of information disclosure.Performance-oriented public procurement focuses on service quality,and guarantees service security through information platforms and professional third parties.The stakeholders use big data to supervise social organizations,so that they actively represent the public to file lawsuits in public procurement and relieve the public’s damaged rights and interests.The protection of the public’s right to know,suggest and supervise is inseparable from the training of professional talents by universities.Colleges and universities attach great importance to the cultivation of big data-oriented public procurement professionals,which includes improving teachers’teaching ability,building a new knowledge system that combines big data and public procurement,and setting professional courses for students at different learning stages through connotative development.

Can adequate hemodynamic management of brain-dead donors improve donor organ procurement?

There is increasing evidence that adequate donor management with a goal of optimization of organ function is essential to maximize the number of organs that can be procured.Therefore,identification of the cause of hemodynamic instability is crucial in order to direct the right therapy.Several donor management goals for better hemodynamic management including serial echocardiography can guide hemodynamic management in potential donors to increase both number and quality of donor hearts.

Vodafone Signs Handset Procurement Agreement with China's ZTE

Vodafone Group and ZTE Corporation announced a handset procurement agreement which will see the Chinese company produce a range of Vodafone-only branded, ultra-low cost handsets for sale across Vodafone’s Markets.

Discussion on Drug Procurement with Target Quantity in China and Its Problem

Objective To provide reference for improving drug procurement with target quantity in China.Methods Documents on drug centralized procurement such as the “Guidance on Drug Procurement with Target Quantity for 4+7 Cities” issued by National Healthcare Security Administration in November 2018 and “Notice on the National Organization of the Pilot Program for Drug Centralized Procurement and Use of Bidding Drugs” issued by the State Council were studied to summarize the mode and result of drug procurement with target quantity.Results and Conclusion Drug procurement with target quantity led by National Healthcare Security Administration solved some problems in the previous centralized drug procurement.For instance,quantity could not determine drug price,and medical institutions didn’t pay to pharmaceutical companies on time.However,this new mode may also arouse new problems such as procurement monopoly,drug shortage,drug quality and inhibition of innovation.

Research of the Experience of Western Governments Procurement of Public Service

Government procurement of public services is developed from the market-oriented reform of public services in Western countries.Many Western countries have adopted the practice of reform and have gained success of this model.By analyzing the process of those in UK,the Netherlands,the United States and France,summing up experience,and I hope that’s useful for China’s reform.

A Modified, Rapid and Safe Technique of Kidney Only Procurement from Donors after Circulatory and Brain Death (DCD, DBD)

There is currently a lack of standard kidney-only procurement technique. Known techniques such as kidney-only procurement using the standard multi-organ procurement technique could potentially cause more iatrogenic injuries due to less adequate exposure. An alternative using the live open kidney donation technique could also be less than ideal due to prior unknown anatomical variation and potential the inability to adequately topically cool the kidneys. We describe here a novel easy kidney-only technique leading to an improved exposure, better cold perfusion and topical cooling. Herein we show how total bowel evisceration can be achieved by stapling the hepatic hilum, superior mesenteric artery and coeliac trunk. There is a need of a kidney only procurement in order to increase the quality of deceased kidney donation in our opinion. Results have to be compared in the future to determine the potential benefits.

Suggestions on Foreign Pharmaceutical Enterprises Dealing with China’s Drug Centralized Procurement - Taking the First Batch of Implementation Results as an Example

Objective To analyze the impact of the first batch of centralized drug procurement on foreign pharmaceutical enterprises since the national centralized drug procurement policy has brought great impact on pharmaceutical market,and put forward some suggestions on their marketing transformation in China.Methods Firstly,the documents of the drug centralized procurement were studied,and then the sales figures before and after the implementation of the policy were retrieved from MiNET.At the same time,the relevant business adjustment information of foreign pharmaceutical enterprises was collected for analysis.Results and Conclusion The sales of related products of foreign pharmaceutical enterprises have dropped sharply,so they have stripped off these products and reduced their staff.It is suggested that foreign pharmaceutical enterprises should adjust the structure of sales team,strengthen the layout of the market in the county,and accelerate the introduction of innovative drugs to cope with centralized drug procurement.