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.

Analysis and Innovative Strategies of Tax Preferential Policies to Promote the Sustainable Development of Small-Scale Individual Businesses

This study conducted an in-depth analysis of the current tax preferential policies for small-scale individual businesses and compared them with similar policies both domestically and internationally,aiming to reveal the advantages and disadvantages of the current system.After examining the impact of these tax preferential policies on the economic status of individual business owners and the broader social economy,this article proposes a set of innovative tax preferential strategies based on theoretical foundations.By developing these innovative strategies and clarifying their implementation paths,the aim is to promote the sustainable and healthy development of small-scale individual businesses,thereby fostering comprehensive socio-economic progress.The conclusion of this study not only summarizes policy recommendations with practical significance but also provides theoretical support for the optimization and innovation of future related systems.

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.

An analytical model for estimating rock strength parameters from small-scale drilling data

The small-scale drilling technique can be a fast and reliable method to estimate rock strength parameters. It needs to link the operational drilling parameters and strength properties of rock. The parameters such as bit geometry, bit movement, contact frictions and crushed zone affect the estimated parameters.An analytical model considering operational drilling data and effective parameters can be used for these purposes. In this research, an analytical model was developed based on limit equilibrium of forces in a Tshaped drag bit considering the effective parameters such as bit geometry, crushed zone and contact frictions in drilling process. Based on the model, a method was used to estimate rock strength parameters such as cohesion, internal friction angle and uniaxial compressive strength of different rock types from operational drilling data. Some drilling tests were conducted by a portable and powerful drilling machine which was developed for this work. The obtained results for strength properties of different rock types from the drilling experiments based on the proposed model are in good agreement with the results of standard tests. Experimental results show that the contact friction between the cutting face and rock is close to that between bit end wearing face and rock due to the same bit material. In this case,the strength parameters, especially internal friction angle and cohesion, are estimated only by using a blunt bit drilling data and the bit bluntness does not affect the estimated results.

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.

Weak wide-band signal detection method based on small-scale periodic state of Duffing oscillator

The conventional Duffing oscillator weak signal detection method, which is based on a strong reference signal, has inherent deficiencies. To address these issues, the characteristics of the Duffing oscillator＇s phase trajectory in a small- scale periodic state are analyzed by introducing the theory of stopping oscillation system. Based on this approach, a novel Duffing oscillator weak wide-band signal detection method is proposed. In this novel method, the reference signal is discarded, and the to-be-detected signal is directly used as a driving force. By calculating the cosine function of a phase space angle, a single Duffing oscillator can be used for weak wide-band signal detection instead of an array of uncoupled Duffing oscillators. Simulation results indicate that, compared with the conventional Duffing oscillator detection method, this approach performs better in frequency detection intervals, and reduces the signal-to-noise ratio detection threshold, while improving the real-time performance of the system.

Shock-induced fracture of dolomite rock in small-scale blast tests

This paper attempts to study dolomite failure using small-scale blast tests.The experimental setup consisted of a cylindrical specimen with a central borehole fitted with a detonation cord inside a copper pipe.The specimen was confined using lead material.During the test,acceleration histories were recorded using sensors placed on the lead confinement.The results showed that heterogeneity and initial cracks significantly influenced the observed failure and cracking patterns.The tests were numerically represented using the previously validated Johnson-HolmquistⅡ(JH-2)constitutive model.The properties of the detonation cord were first determined and verified in a special test with a lead specimen to compare the deformation in the test with that of numerical simulation.Then,the small-scale blast test was simulated,and the failure of the dolomite was compared with the test observations.Comparisons of acceleration histories,scabbing failure,and number of radial cracks and crack density confirmed the overall repeatability of the actual testing data.It is likely that the proposed model can be further used for numerical studies of blasting of dolomite rock.

Study on the Roles of FWUA in Construction, Management and Maintenance of Small-Scale Irrigation and Water Conservancy

In recent years, China has been frequented by floods and droughts which has greatly evoked much concern from the Central Government about rural water conservancy construction. Irrigation is closely related to the "three rural" issues and concerns about the vital interests of farmers. To achieve a virtuous circle of agricultural water supply, it is necessary and urgent to establish Farmer Water User Association (FWUA) to participate in the construction, management and maintenance of small-scale irrigation system. Based on the survey on nationwide "Small-scale irrigation conditions", the roles of FWUA in the construction, management and maintenance of small-scale water conservancy have studied in this study.

Small-Scale Tomato Cultivators’ Perception on Pesticides Usage and Practices in Buea Cameroon

It has been shown that farmers with limited knowledge of the use and safe handling of pesticides may suffer exposure which results in adverse health effects. In Buea, Cameroon, small-scale tomato farmers commonly use pesticides for pest control. Information was obtained from these tomato farmers to determine the extent and types of their pesticide use, their knowledge of pesticide use and effectiveness, and their perception of potential harm resulting from pesticide use. A standardized questionnaire, interviews, field observations and an analytical ranking game were used to describe the pesticide use of 93 tomato farmers. Many farmers (47.6%) used pyrethiod and organophosphorus insecticides and identified these chemicals as the most effective in pesticide control;these are WHO Class II pesticides which are the most hazardous to humans. Most farmers (83.8%) used knapsack sprayers to apply pesticides, with 76.3% using no or partial personal protective equipment (PPE). It was notable that 55.5% of farmers expressed no concern regarding the wind direction (pesticide drift) during spraying. The results showed a significant association between the method of pesticides application and farm size (P < 0.001). Most farmers (85.0%) reported at least one symptom of acute pesticide poisoning following spraying. This study revealed that the tomato farmers have a high exposure to pesticides secondary to inadequate knowledge of the safe and judicious use of pesticides. Strategies that provide training on the appropriate use of pesticides, how to reduce exposure to and health risks of pesticides and alternative options of pest management and control are required. The study also raised concerns that further control of the sale and distribution of pesticides may be indicated.

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.

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.

Processes of small-scale tidal flat accretion and salt marsh changes on the plain coast of Jiangsu Province,China

Large-scaled reclamation modifies the coastal environment dramatically while accelerating the disappearance of salt marshes,which causes the degradation of the coastal ecosystem and the biodiversity function.In this study,we explored the changes of tidal flat and salt marsh coverage in a small-scale tidal flat with an area of ~160 000 m^2 in the plain coast of Jiangsu Province,China.Human activities（e.g.,the construction of dikes） are a crucial contributor that benefits for the tidal flat accretions and the following changes of salt marsh coverage.Located in the front of the man-made ＂concave coastline＂,the study area is suitable for sediment accretion after the dike construction in the end of 2006.On the basis of the annual tidal surface elevation survey from 2007 to 2012,the sedimentation rates in the human influenced tidal flat varied from a few centimeters per year to 23 cm/a.The study area experienced a rapid accretion in the tidal flat and the expansion of the salt marsh,with the formation of a longshore bar,and a subsequent decline of the salt marsh.Breaking waves during the flooding tide brought much sediment from the adjacent tidal flat to the study area,which caused burial and degeneration of the salt marsh.The vertical grain size changes within a 66 cm long core in the study area also demonstrated the above changes in the tidal environment.This study indicates that the responses of small-scale tidal flat changes to reclamation are significant,and the rational reclamation would benefit for the new salt marsh formation in front of the dikes.Further research about the evolution of small scale tidal flat as well as the spatial planning of the polder dike should be strengthened for the purpose to maintain a healthier coastal environment.

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.

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.

The Human Dimension in the UNESCO Kogelberg Biosphere Reserve:Integrating Livelihood Issues of Small-Scale Fisheries with the Conservation of Natural Resources

Fisheries management worldwide struggles to strike a balance between protecting resources,ensuring fair access to resources and promoting economic effectiveness and stability.The transition to a participatory democracy in South Africa in 1994 resulted in the transformation of government institutions and an extensive process of legislative reform regarding

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.

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.

Small-Scale Duplications Play a Significant Role in Rice Genome Evolution

Genes are continually being created by the processes of genome duplication （ohnolog） and gene duplication （paralog）. Whole-genome duplications have been found to be widespread in plant species and play an important role in plant evolution. Clearly un-overlapping duplicated blocks of whole-genome duplications can be detected in the genome of sequenced rice （Oryza sativa）. Syntenic ohnolog pairs （ohnologues） of the whole-genome duplications in rice were identified based on their syntenic duplicate lines. The paralogs of ohnologues were further scanned using multi-round reciprocal BLAST best-hit searching （E〈e^-14）. The results indicated that an average of 0.55 sister paralogs could be found for every ohnologue in rice. These results suggest that small-scale duplications, as well as whole-genome duplications, play a significant role in the two duplicated rice genomes.

Effect of high-or low-speed fluctuations on the small-scale bursting events in an active control experiment

Active control of a fully developed turbulence boundary layer(TBL) over a flat plate has been investigated with a statistical view. The piezoelectric(PZT) oscillator is employed to produce periodic input into the inner region of the TBL.A wall probe is fixed upstream of the oscillator to identify the high-or low-speed fluctuations as the detecting signals.Then, the impact of the detecting signals on the small-scale bursting process is investigated based on the data acquired by the traversing probe downstream of the oscillator. The results indicate that the small-scale bursting intensity is restrained more apparently at high-speed detecting fluctuations but less impacted at low-speed detecting fluctuations. Furthermore, the perturbed-scale fluctuations arrange the small-scale bursting process in the near-wall region. The detecting signals have an obvious impact on this arrangement, especially the high-intensity regions of the small-scale bursting events: the vibration enhances the intensity at high-speed detecting signals but weakens it at low-speed detecting signals in these regions, which gives a direct evidence on how detecting signals interfering the small-scale bursting process.