Initial Procurement Research Articles

Additional public procurements in health services: Lessons from Finnish physiotherapy markets

Private providers are often acquired through public procurements to provide publicly financed health services. The number of contracted providers and their capacity often turns out to be deficient during the contract period. Typically, the purchasers then organize additional procurements or negotiate directly with available uncontracted providers to acquire more capacity. In this study, we examine an unusual additional public procurement in Finnish physiotherapy markets, in which incumbent providers with an existing contract were also eligible to participate. In practice, these contracted providers did not bear any risk when they submitted their bids in the additional procurement. We compare contracted and uncontracted providers’ prices to free market prices using a difference-in-differences approach. The results show that contracted providers increased their prices on average by 9%, while the originally uncontracted providers decreased their prices by 8% compared to the development of free market prices. Although this inefficient procurement led to a waste of public funds, a simple back-of-the-envelope calculation indicates that additional procurement can still be a more efficient way to increase capacity than directly contracting providers that were not contracted in the initial procurement.

Intermittent demand forecasting for spare parts with little historical information

We propose a framework to address the demand forecast problem for spare parts with little or no historical demand information. This problem is relevant, e.g., in the context of forecasting the demand of parts in the initial procurement phase. We depart from the traditional forecasting approach by focusing on the distance between two demand profiles, rather than directly predicting the demand. That is, we build a model on the space induced by some distance metrics applied on attribute-wise comparisons of the spare parts, rather than directly working on the space induced by the original attributes. The three steps of the framework are: (i) data preparation, comparing parts along a set of attributes; (ii) model training, linking the attribute-wise distances and the distance between the demand profiles; (iii) neighborhood construction and forecasting, reconstructing the profile of the demand of the part with no historical demand. We tested the algorithm on a real-world instance with over 28 thousands spare parts from 131 Amazon sites, with the goal of reconstructing the demand of parts with no historical demand. Empirical evidence showcases the significant improvement brought about by the proposed approach, compared with a pool of alternative models.

NTK-3D chaotic map and a non-associative LA-field sequences for image encryption

The imperative protection of digital information and its secure transmission has evolved into a complex challenge. Within this context, non-linear dynamical systems assume a pivotal role in fortifying content security by their unpredictable behavior and susceptibility to initial conditions. This study introduces an innovative 3D-chaotic system. The proposed map is then examined through bifurcation diagrams and randomness tests, revealing an intricate chaotic behavior of the system. Moreover, an advanced method of securing information is introduced, incorporating a non-associative LA-field sequences-oriented affine transformation. The initial procurement of a non-associative LA field through computational approaches is succeeded by utilizing sequences of its components to establish an affine transformation. This transformative process serves as the central aspect of the suggested color image encryption method. In this strategy, the NTK-3D map and the innovative affine transformation collaborate to introduce both confusion and diffusion, thereby fortifying the overall security stance. The non-associative behavior of the involved algebraic structure, combined with a dynamical system, results in highly resilient encryption. The proposed scheme is not only time-efficient but also has an expanded key space. The results of some performance assessments demonstrate that the suggested encryption technique for the digital medium is capable of resisting well-known attacks.

(161) Usage Patterns of Erectile Dysfunction Medications in Young Adult Men

Abstract Introduction There has been a significant increase in the accessibility of pharmacologic erectile dysfunction (ED) treatments through direct-to-consumer platforms. However, the impact of this broad accessibility on usage in young adult men has not been studied. Objective We sought to assess demographic, socioeconomic, and health factors associated with erectile dysfunction medication use among men aged 18-40 years. Methods We created a survey assessing prior phosphodiesterase-5 inhibitor (PDE-5) use, means of acquisition, and receipt of counseling prior to use. The survey was disseminated with the modified International Index of Erectile Function (IIEF-5) questionnaire to a convenience sample of men ages 18-40 via Research Match, an NIH-funded database of research participants. Demographic data including age, race, ethnicity, education level, insurance status, sexual orientation, and relationship status were collected. Descriptive statistics were performed using t-test, chi-squared test, and univariable and multivariable logistic regression with significance defined as p<0.05. Results Among 210 respondents, 82 (39.0%) indicated prior use of ED medication. Men identifying as Black or African American (OR = 3.54, 95% CI: 1.82-6.88, p<0.001) and Hispanic or Latino (3.32, 95% CI: 1.45-7.62, p=0.01) were more likely to have reported prior use. Higher rates of utilization were similarly observed among men insured by Medicare or Medicaid (OR = 6.07, 95% CI: 3.10-11.87, p<0.001). Income >$200,000 per year was associated with decreased utilization (OR 0.23, 95% CI: 0.06-0.92, p=0.04). Mild, mild to moderate, and severe erectile dysfunction per the modified IIEF scale were associated with increased utilization (OR = 3.09, 13.70, 20.25 and p-values = 0.01, <0.001, <0.001, respectively). There were no statistically significant differences among usage patterns with respect to age, education level, relationship status, or sexual orientation. Medicare or Medicaid coverage (p<0.001) and IIEF symptom severity were significant independent predictors on multivariable regression. Performance anxiety with a partner (56.6%), difficulty maintaining erections (46.9%), and providing confidence during intercourse (39.5%) were the most frequently cited reasons behind use. Primary care providers were the most frequent source of initial procurement (30.9%), followed by friends, family members, or partners (25.9%) and direct-to-consumer online platforms (18.5%). The most important factors considered in procuring medications were privacy (61.7%) and cost (54.3%). Despite 72.8% of men reporting counseling on proper use and risks, only 28.0% were able to correctly identify four key features surrounding proper use (including medication timing, dosage interval, prolonged erections, and sexual stimulation requirement). Conclusions We found high use of ED medication among young adult men, particularly among those identifying as Black or African American and Hispanic or Latino, as well as those insured by Medicare or Medicaid. The emphasis on privacy over cost and convenience in obtaining medications likely demonstrates continued stigma surrounding men’s health and sexual health issues. Despite most men reporting counseling on proper use, a stark knowledge gap exists as only a minority of men can correctly identify proper use. This underscores the need for healthcare professionals to provide thorough patient education and guidance to ensure safe and effective use of these medications in young men. Disclosure No.

COVID-19 PANDEMIC EVENTS AND PHILIPPINE STOCK MARKET PERFORMANCE: TESTING FOR MULTIPLE BREAKPOINTS

<p>This study examined several PSEi breakpoints to determine if COVID-19-related headlines or events cause significant stock market breaks. From December 2, 2019 to May 5, 2022 (T=632), time-series data revealed that the stock market performed the worst during the first four months of 2020. Regression with ordinary least squares on PSEi values revealed the Philippine stock market has random walk characteristics for the same time period. The Breusch-Godfrey serial correlation LM test at two lags demonstrated serial correlation in the mean equation residuals. During COVID-19 pandemic events, the Chow test was applied to daily stock market data to identify structural breaks and PSEi shifts. The Bai-Perron test identified four noteworthy multi-breakpoints. On April 17, 2020, Leyte reported the first confirmed case of COVID-19, and Johns Hopkins University reported that the global death toll exceeded 50,000. This event is likely related to the cutoff dates of November 5 and 6, 2020, when the Philippines will have an average of 1,000 COVID-19 cases per day and the government will have identified specific sectors to receive free vaccines under the initial procurement. On March 23, 2021, 17 mayors of Metro Manila and neighbouring cities voted unanimously to close recreational establishments for two weeks, indicating a possible parallel to the breakpoints on September 3, 2021, when the Philippine Food and Drug Administration approved Moderna vaccines for 12–17-year-olds. Another breakpoint found was on October 11, 2021924,300 COVAX vaccines donated by the United States arrived at Ninoy Aquino International Airport. Breakpoint events and their implications for the study of financial economics were discussed. </p><p><strong>JEL</strong>: E32; G11; G14; G17</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0048/a.php" alt="Hit counter" /></p>

Water Ambulance Service Provision to Improve Healthcare Access for Community in Nusa Penida Island, Bali: A Qualitative Feasibility Study

Background and purpose: An important component of healthcare access is transportation. Lack of transportation has been cited as an important barrier to healthcare access in remote islands region. Here we conduct a feasibility study on the implementation of water ambulance service to improve healthcare access in the region of Nusa Penida and its surrounding islands in Bali Province, Indonesia. Methods: We employed a qualitative approach with interviews and focused group discussions with stakeholders. Data collection was conducted to assess the feasibility of operating water ambulance services, based on a framework that included technical, market, organizational, and financial feasibilities. Inductive coding was conducted and data was analyzed to evaluate the feasibility based on local capacity against pre-determined framework of assessment based in literature. Results: Qualitative interviews revealed perceived urgency and need for water ambulance service among stakeholders. They also perceive the need of water ambulance service was not mutually exclusive to other alternatives, such as expanding healthcare capacity on the islands. There was also readiness and adequate capacity from stakeholders which include a dedicated health emergency services under the health office that coordinate ambulance service in the region, readiness to create dedicated medical team and boat crew to operate water ambulance services, and readiness to cover the cost of initial procurement followed by operational costs which may include public-private partnerships. Conclusion: There was a strong perceived need for water ambulance service in Nusa Penida Islands. At the same time, local stakeholders revealed adequate basic capacity to feasibly operate water ambulance services according to benchmarks identified in literature review.

Two-stage inventory management with financing under demand updates

Considered is a retailer (she) facing non-stationary stochastic demand. Demand can be fully observed and backlogged, consequently the retailer can update the initial demand information using a Bayesian approach. To alleviate the demand risk, the retailer may use a secondary opportunity to replenish through an option contract. In addition, the retailer also has access to an immediate loan if she faces capital constraints and to a risk-free investment if she has surplus funds. The paper presents a recourse approach to solve the two-stage optimization problem and derive the optimal inventory/financing policies. The results show that the option procurement policy has a two-threshold base-stock structure depending on the first procurement, demand update and also the retailer’s financial state. The initial procurement can be computed subsequently. A sufficiently large initial demand will induce the retailer to seize the secondary procurement opportunity. Finally, a series of numerical examples demonstrate the resulting policy under various inventory/financial situations. This research incorporates the financial and operational decisions into demand updates, and brings new managerial results and insights.

Developing a craniomaxillofacial and cervical equipment module for surgeons in the austere environment: a systematic review.

The treatment of craniomaxillofacial and cervical wounds in a disaster relief setting is done by clinicians from local medical treatment facilities, non-governmental organisations (NGO), or the military. Although each group and individual surgeon will need specific equipment, this will be restricted by weight, portability and interoperability. We systematically reviewed scientific and commercial publications according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The papers we identified described the portable equipment that is required to treat patients who need damage-control surgery (decompressive craniectomy, temporary stabilisation, and internal and external fixation of the facial bones) for craniomaxillofacial and cervical injuries in austere or military settings. Austere settings are those in which there is an inherent lack of infrastructure, such as facilities, roads, and power. A total of 35 papers or scientific articles recommended the equipment that is needed to manage these injuries, but we could find no module that was specifically designed for use in these environments. Multiple modules are currently required to provide comprehensive surgical care and many of the items in the existing maxillofacial and neurosurgical kits are rarely used, which increases the cost of initial procurement and resupply. Duplications in equipment between modules also increase the size, weight, and financial cost. We suggest the equipment that is required to make up a rationalised, lightweight, and compact module that can be used for all craniomaxillofacial and cervical operations in austere settings.

Case Study: Innovation Procurement for a Cardiac Program.

This case describes a competitive dialogue strategy to procure a cardiac program solution to strengthen performance, outcomes and value in an Ontario hospital. All major contracts for the cardiac program were expiring, offering a unique opportunity for procurement of innovation. Procurement was completed in two phases, with an additional request for proposals issued for the unique specialty products not included in the initial procurement. The implementation of contracts was monitored to ensure that outcomes and deliverables were achieved. The procurement for the entire cardiac program was complex; however, it resulted in substantial cost savings and value-added services for the cardiac program.

Indonesian contractors’ practices towards sustainable procurement principles for green building projects

Sustainable practices in Indonesia’s construction industry have been considered and implemented in green building projects, even though they are not yet enforced by specific regulations on the practices, especially for procurement processes by the contractors. It is believed that the contractors’ procurement for selecting subcontractors and suppliers could boost the implementation of sustainability in construction industry since most construction companies deliver majority of their works through their supply chains. This paper presents the comparison between the sustainable procurement principles to the Indonesian contractors’ practices in procuring subcontractors and suppliers of their supply chains to support their green building projects. By so doing, the study would measure the compliance of sustainable procurement principles and practices by the Indonesian contractors. For this purpose, the ISO 20400, which is a flexible framework for sustainable procurement were used. The study was conducted using an integrated approach of grounded theory and qualitative data analysis based on a semi-structured interview to 3 large state-owned contractors in Indonesia that have been involved in green building projects. The results show that all contractors have the same level of sustainable procurement practices where the sustainable elements in its procurement process are still in the initiation stage and there are some sustainable procurement resources already existed in the practices that could support further implementation. This study provides the first comprehensive insight into the comparison between the initial sustainable procurement practices by Indonesia’s contractors to the ISO 20400. The contribution of this study could be used by Indonesian contractors to improve their sustainable procurement practices for green building projects or other sustainable projects in the future.

Effects of DNA Methylation on Progression to Interstitial Fibrosis and Tubular Atrophy in Renal Allograft Biopsies: A Multi-Omics Approach.

Progressive fibrosis of the interstitium is the dominant final pathway in renal destruction in native and transplanted kidneys. Over time, the continuum of molecular events following immunological and nonimmunological insults lead to interstitial fibrosis and tubular atrophy and culminate in kidney failure. We hypothesize that these insults trigger changes in DNA methylation (DNAm) patterns, which in turn could exacerbate injury and slow down the regeneration processes, leading to fibrosis development and graft dysfunction. Herein, we analyzed biopsy samples from kidney allografts collected 24 months posttransplantation and used an integrative multi-omics approach to understand the underlying molecular mechanisms. The role of DNAm and microRNAs on the graft gene expression was evaluated. Enrichment analyses of differentially methylated CpG sites were performed using GenomeRunner. CpGs were strongly enriched in regions that were variably methylated among tissues, implying high tissue specificity in their regulatory impact. Corresponding to this methylation pattern, gene expression data were related to immune response (activated state) and nephrogenesis (inhibited state). Preimplantation biopsies showed similar DNAm patterns to normal allograft biopsies at 2 years posttransplantation. Our findings demonstrate for the first time a relationship among epigenetic modifications and development of interstitial fibrosis, graft function, and inter-individual variation on long-term outcomes.

PERAN PPAT DALAM PENYERAHAN FASILITAS UMUM DAN FASILITAS SOSIAL OLEH PENGEMBANG PERUMAHAN KEPADA PEMERINTAH KOTA SEMARANG

Submission of location permit is required in the provision of social facilities and public facilities. Licensing is a unified process in the housing that is from the beginning to the management stage. The research that the author did in the city of Semarang, Central Java province. The research method applied in this research is the sociological juridical approach.The results of this study are: The role of PPAT has not been directly due to the formation of regulations from the central government and in the city of Semarang has not involved PPAT in the formation of Regional Regulations Semarang City. Factors affecting PPAT in the delivery of public facilities (fasum) and social facilities (fasos) to the Government of Semarang City, the pre-transaction stage where the developer must already have all the relevant licensing in the pre-transaction process until after / after the transaction developer must providing all social facilities and social facilities as promised during the first bidding process. Legal consequences with future PPAT role is expected to provide infrastructure and facilities from initial procurement to delivery based on the principles of openness, accountability, legal certainty, written warning. Suggestion from this research is for PPAT should the process of procurement and management of public facility (fasum) and social facility (fasos) is arranged pursuant to agreement of sale and purchase agreement (PPJB), for Government of Fasum and Fasos which have finished development process should be submitted from the developer to Government so that the responsibility for the management of public facilities and fasos is in the government, and for the National Land Agency (BPN), there must be a harmonious relationship between PPAT and the Land Office as an equal partner.Keywords: Role of PPAT, Submission of Social Facility, Semarang City Government

Standardization and Phytochemical Investigation of Calendula Officinalis, Cassia Tora and Momordica Charantia Seed Extract

Purpose : Standardization the process of developing and implementing technical standards and to maximize compatibility, safety, repeatability and quality of the drugs is one of the important measures in view of the various practical problems encountered from time to time especially in the field of herbal drugs and Ayurveda.Scientific data pertaining to the standardization of the herbal drugs could be of immense value to substantiate efficacy, safety or toxicity of an herb. Hence present study was intended to standardize Calendula officinalis flowers, Cassia tora and Momordicacharantia seed extracts, since these are widely used in large number of herbal, ayurvedic and homeopathic formulations. Methodology : Systematic investigations were carried out to assess various quality parameters as per WHO guidelines such as morphological, microscopical and proximate analysis including ash values, moisture contents and extractive values and TLC for Calendula officinalis flowers, Cassia tora and Momordicacharantia seed extracts. Results : Results indicated the authenticity of the herbal drugs used in the study. Organoleptic and proximate analyseswere well within the acceptable limits. TLC system was developed for identification of the extracts. Quantitative estimation of total saponins, phenols and flavonoid contents were determined. Herbs tested indicated absence of heavy metals and arsenic. Qualitative phyto chemical analysis of extracts obtained using different solvents revealed presence of glycosides, saponins, triterpenes, phenols, tannins and carbohydrates in different extracts. Conclusion : Study was successful in establishing quality standards for the flowers of Calendula officinalis, seed of Momordicacharantia and Cassia tora. These preliminary studies may offer great help in initial procurement and assessment of quality of the crude drugs when these are being used as raw materials for preparations of herbal formulations.

Development of a universal medical X-ray imaging phantom prototype.

Diagnostic X‐ray imaging depends on the maintenance of image quality that allows for proper diagnosis of medical conditions. Maintenance of image quality requires quality assurance programs on the various X‐ray modalities, which consist of projection radiography (including mobile X‐ray units), fluoroscopy, mammography, and computed tomography (CT) scanning. Currently a variety of modality‐specific phantoms are used to perform quality assurance (QA) tests. These phantoms are not only expensive, but suitably trained personnel are needed to successfully use them and interpret the results. The question arose as to whether a single universal phantom could be designed and applied to all of the X‐ray imaging modalities. A universal phantom would reduce initial procurement cost, possibly reduce the time spent on QA procedures and simplify training of staff on the single device. The aim of the study was to design and manufacture a prototype of a universal phantom, suitable for image quality assurance in general X‐rays, fluoroscopy, mammography, and CT scanning. The universal phantom should be easy to use and would enable automatic data analysis, pass/fail reporting, and corrective action recommendation. In addition, a universal phantom would especially be of value in low‐income countries where finances and human resources are limited. The design process included a thorough investigation of commercially available phantoms. Image quality parameters necessary for image quality assurance in the different X‐ray imaging modalities were determined. Based on information obtained from the above‐mentioned investigations, a prototype of a universal phantom was developed, keeping ease of use and reduced cost in mind. A variety of possible phantom housing and insert materials were investigated, considering physical properties, machinability, and cost. A three‐dimensional computer model of the first phantom prototype was used to manufacture the prototype housing and inserts. Some of the inserts were 3D‐printed, others were machined from different materials. The different components were assembled to form the first prototype of the universal X‐ray imaging phantom. The resulting prototype of the universal phantom conformed to the aims of a single phantom for multiple imaging modalities, which would be easy to use and manufacture at a reduced cost. A PCT International Patent Application No. PCT/IB2016/051165 has been filed for this technology.PACS number(s): 87.57.C, 87.59.‐e

A proactive approach to supply chain risk management: Shifting orders among suppliers to mitigate the supply side risks

Globalization, e-trade, advanced technologies and emerging production techniques have increased supply chains’ efficiency and added value. However, despite numerous advantages, these factors make supply chains more fragile and vulnerable to risks. For this reason, companies that perform supply chain risk management gain competitive advantage. In the past, supply chain managers mainly focused on reducing costs; but recently, they have begun to give importance to supply chain continuity and resiliency which have significant impacts on costs as well. Hence, conventional reactive planning has given way to proactive planning in supply chain risk management. In this study, the supply chain risk management process is investigated and a procedure is proposed in the risk mitigation phase. In the first stage of the proposed procedure, an initial procurement plan is obtained via a linear programming model, considering the cost criterion as the first priority. In the second stage, this plan is revised by including the risk criterion into the planning as the second priority. The aim of this procedure that enables proactive planning is to reduce the supply side risks. The model is tested with a hypothetical data set and the cost analysis is performed to evaluate the performance of the procedure. Finally, the whole supply chain risk management process including the proposed procedure is applied to an international automotive company.

Blade production and the consumption of obsidian in Stentinello period Neolithic Sicily

This study explores obsidian consumption during the Early/Middle Neolithic Stentinello period (ca. 5600–4000cal B.C.) on the Italian island of Sicily through the analysis of 622 obsidian artifacts from eight sites in eastern Sicily and the Aeolian Islands. By combining obsidian sourcing by means of portable X-ray fluorescence (pXRF) spectrometry with techno-typological characterization, it is shown that distinctively wide Lipari blades were the primary artifact type used during this period. Our data suggest that the primary reduction of these materials occurred at the source area by local populations, with obsidian being transported from Lipari to eastern Sicily and Calabria in the form of preformed cores. Despite similarities between Sicily and southern Italy in the initial procurement of Lipari obsidian, there are distinct differences in how these materials were subsequently reduced.

306 離散凸最適化による予備品在庫管理アプリケーションの開発(OS3-2 生産システムの最適化手法)

We consider the initial procurement problem for a reparable inventory system. For this problem, we develop an application which minimizes an inventory cost. The inventory cost consists of the backorder penalty, which is computed by the product of the backorder-cost by the steady state expected number of backorders of the random item with the most backorders, and the cost of spares purchases. Our application is based on the fact that the inventory cost function has L^#-convexity, which is an inportant concept of discrete convexity in the theory of optimization.

Life cycle cost based procurement decisions: A case study of Norwegian Defence Procurement projects

A Norwegian Ministry of Defence publication states that when procurement decisions are made, systems that yield the lowest possible life cycle cost (LCC) for the Norwegian Defence must be procured, even if this means that initial procurement cost becomes higher. However, several projects within the community are still carried out and reviewed based on initial procurement cost alone. This study investigates four hypotheses, based on agency theory and earlier LCC work, in order to help explain why this is happening. A questionnaire was administered to all projects currently running in the defence community. Findings regarding project uncertainty, information symmetry, the project leader’s attitude and knowledge about LCC, as well as control variables are discussed both towards theory and in terms of managerial implications.

Optimal inventory policy for specialty chemical products in multiple packages

Many products are inventoried and sold in multiple outer packages, which causes the manufacturer or distributor to maintain a segmented inventory. Oftentimes, this scenario leads to shortages in some packages and over-stock in other package types. The shortages are usually linked to specific shortage costs, and the over-stock is always associated with some sort of unnecessary holding cost that either erodes profit margins or results in increased costs for the consumer. In this paper, the inventory policy for a specialty chemical manufacturer's cleaner, which is inventoried in four unique packages, is studied. A mathematical model is developed to account for the costs associated with initial procurement, holding and repackaging (shortage), which are the primary costs associated with the inventory system. Based upon this model, an optimal inventory policy is generated that reduces the need for repackaging, without requiring a prohibitive amount of safety stock. A specific historical case is summarized, and the results of this example are compared with the results that the new inventory policy would have produced, given the same circumstances.

STRATEGIC INTERACTIONS IN A SUPPLY CHAIN GAME

The TAC 2003 supply-chain game presented automated trading agents with a challenging strategic problem. Embedded within a high-dimensional stochastic environment was a pivotal strategic decision about initial procurement of components. Early evidence suggested that the entrant field was headed toward a self-destructive, mutually unprofitable equilibrium. Our agent, Deep Maize, introduced a preemptive strategy designed to neutralize aggressive procurement, perturbing the field to a more profitable equilibrium; it worked. Not only did preemption improve Deep Maize's profitability, it improved profitability for the whole field. Whereas it is perhaps counterintuitive that action designed to prevent others from achieving their goals actually helps them, strategic analysis employing an empirical game-theoretic methodology verifies and provides insight about this outcome.