Time Of Procurement Research Articles

Estimated Median Waiting Time for Organ Procurement and Transplantation Network Human Immunodeficiency Virus Organ Policy Equity Act Variance Kidney Candidates: A Propensity Score Matched Analysis.

Prior to the 2013 HIV Organ Policy Equity (HOPE) Act, which enabled research on the transplantation of solid organs from donors with human immunodeficiency virus (HIV) to candidates living with HIV, it was prohibited for HIV+ individuals to donate organs in the United States. In 2015, alongside the release of HOPE Act research criteria, the Organ Procurement and Transplantation Network (OPTN) made organ allocation policy and system changes to allow HIV+ to HIV+ transplantation. The OPTN database was queried for all adult kidney registrations ever waiting from November 23, 2015, to December 31, 2022; the cohort was split into a HOPE cohort (ever willing to accept an HIV+ kidney) and a non-HOPE cohort (all remaining). Estimated median waiting times (eMWTs) were calculated using a period prevalent Kaplan-Meier approach; HOPE registrations were matched 1:5 without replacement to non-HOPE registrations using a logistic regression propensity score. Using all waiting time, the eMWT for the HOPE cohort was significantly lower than the matched non-HOPE cohort (3.04 years [95% confidence interval {CI}: 2.70, 3.41] versus 5.88 years [95% CI: 5.65, 6.18]). This trend persisted when estimating MWT using other active time and geographical definitions (ignoring geography and donor service area). These results suggest that transplantation through the OPTN HOPE variance yields decreases eMWT, perhaps reducing the medium and longer-term impacts of living with HIV.

Comparing Different Methods for the Diagnosis of Liver Steatosis: What Are the Best Diagnostic Tools?

Due to the ongoing organ shortage, marginal grafts with steatosis are more frequently used in liver transplantation, leading to higher occurrences of graft dysfunction. A histological analysis is the gold standard for the quantification of liver steatosis (LS), but has its drawbacks: it is an invasive method that varies from one pathologist to another and is not available in every hospital at the time of organ procurement. This study aimed to compare non-invasive diagnostic tools to a histological analysis for the quantification of liver steatosis. Male C57BL6J mice were fed with a methioninecholine-deficient (MCD) diet for 14 days or 28 days to induce LS, and were compared to a control group of animals fed with a normal diet. The following non-invasive techniques were performed and compared to the histological quantification of liver steatosis: magnetic resonance spectroscopy (MRS), CARS microscopy, 99mTc MIBI SPECT imaging, and a new near-infrared spectrometer (NIR-SG1). After 28 days on the MCD diet, an evaluation of LS showed ≥30% macrovesicular steatosis. High correlations were found between the NIR-SG1 and the blinded pathologist analysis (R2 = 0.945) (p = 0.001), and between the CARS microscopy (R2 = 0.801 (p < 0.001); MRS, R2 = 0.898 (p < 0.001)) and the blinded pathologist analysis. The ROC curve analysis showed that the area under the curve (AUC) was 1 for both the NIR-SG1 and MRS (p = 0.021 and p < 0.001, respectively), while the AUC = 0.910 for the Oil Red O stain (p < 0.001) and the AUC = 0.865 for the CARS microscopy (p < 0.001). The AUC for the 99mTc MIBI SPECT was 0.640 (p = 0.013), and this was a less discriminating technique for LS quantification. The best-performing non-invasive methods for LS quantification are MRS, CARS microscopy, and the NIR-SG1. The NIR-SG1 is particularly appropriate for clinical practice and needs to be validated by clinical studies on liver grafts.

Substantive behavioral aspects of consumer behavior in the conditions of sanctions pressure on the Russian economy

Relevance. Sanctions pressure on the economy of the Russian Federation is one of the most important factors influencing consumer behavior and their consumer preferences. Under sanctions, many social, economic and political aspects influence consumer behavior, from which new consumer trends and changes in consumer behavior emerge.The purpose is to explore the substantive behavioral aspects of consumer behavior under the conditions of sanctions pressure on the Russian economy.Objectives: study changes in consumer preferences in connection with global crises; analyze changes in consumer behavior depending on various factors and price dynamics as a factor in consumer behavior; explore the influence of cognitive distortions on the meaningful behavioral aspects of consumers; propose the concept of business company plans in accordance with new consumer expectations.Methodology. In the process of research, general scientific methods of logical and statistical analysis, field research, as well as qualitative and quantitative analysis were used. Results. The survey showed that consumers have become more frugal and choose domestic brands in order to save money, the study of the impact of cognitive distortions on consumers showed that society is prone to a pessimistic attitude in terms of adopting new domestic products and brands.Conclusions. A business plan under sanctions pressure, aimed at the novelty of the product and its effectiveness, will help companies promote their goods and services on the Russian market during the period of sanctions pressure. Focusing on changing the object of purchase, place of purchase (online trading if possible), timing and methods of procurement in accordance with new motives and customer expectations will give companies an advantage in conditions of market instability and changing behavioral aspects of consumers.

Evaluation of Implementation Procurement Policies Via E-Catalog for Construction Work (Case Study: National Road Implementation Agency For West Sumatera Region)

National Road Implementation Agency (BPJN) for West Sumatera Region has an important role in managing road infrastructure in the West Sumatra Province. In the context of procurement for construction implemented by BPJN for West Sumatra, the use of e-catalogs is a solution to simplify the procurement process. The aim of this research is to evaluate how it is implemented, analyze supporting factors, analyze weaknesses and evaluate the benefits of the policy of procurement via e-catalog in construction work. This research uses a qualitative approach with a semi-structured interview method and Data analysis used thematic analysis. The results of the research show that the implementation of the policy for procurement via e-catalog for construction work at the National Road Implementation Agency for West Sumatera Region has been successfully carried out without any significant problems. Implementation of the policy for procurement via e-catalog in construction work is influenced by various supporting factors, including ease of application, socialization and technical guidance, adequate infrastructure, staff competence and coordination, as well as clear regulations and guidelines. Weaknesses of e-catalogs such as no information on remaining package capabilities, main equipment having to be proprietary, provider selection opportunities, limited service locations, and complete product limitations, all have a significant impact on the effectiveness and efficiency of the procurement process. The E-catalog system provides various significant benefits for construction work. Procurement time efficiency, fair prices, transparent systems, price negotiation, work outcomes, bid documents, provider selection, as well as motivation and competitiveness are some of the key benefits identified.

CHALLENGES IN SUSTAINABLE RESIDENTIAL PROPERTY DEVELOPMENT IN SHAH ALAM: PATHWAYS TOWARDS IMPLEMENTING SUSTAINABLE DEVELOPMENT GOALS (SDGs)

There is an urgent need to align urban growth with environmental, social, and economic sustainability principles in rapidly developing cities like Shah Alam. The pressing issue is the current gap between the city's rapid development pace and its ability to implement sustainable practices that align with the SDGs. The study focuses on two main objectives: to identify potential pathways for implementing Sustainable Development Goals (SDGs) and challenges in residential property development in Shah Alam. By employing qualitative content analysis and purposive sampling, the research identifies critical challenges, including lack of awareness among buyers, high costs, inadequate government support, lack of expertise, strict regulations, longer procurement times, and a focus solely on achieving green certification. However, these obstacles also present opportunities for strategic pathways toward SDG implementation. The study emphasises that addressing these challenges and embracing these pathways can drive Shah Alam toward sustainable residential property development, contributing to the city's overall resilience and sustainability while aligning with crucial SDGs. This approach is crucial for alleviating poverty, enhancing urban sustainability, promoting resource efficiency, combating climate change, and protecting local ecosystems. By overcoming these challenges, Shah Alam can progress toward sustainable development that ensures long-term environmental, social, and economic benefits.

Analisis Perbandingan Biaya dan Waktu pada Penggunaan Duct Spacer dengan Prefabricated dan Hollow Baja Ringan Untuk Pekerjaan Underground Ducting

The Kediri Airport development project encountered challenges related to underground ducting work. The design of Kediri Airport adheres to international standards, which led to the use of materials not readily available in Indonesia, specifically pipes and duct spacers. Duct spacers are tools used to arrange ducting pipes according to their formation and prevent them from floating during concrete pouring due to buoyancy. The SKEP/114/VI/2002 serves as a reference for underground cable installation, involving direct burial of cables at a depth of 70 cm, covered with a 5 cm layer of sand above the cable surface. These two approaches significantly differ, necessitating problem-solving solutions. To address this issue, research was conducted to find suitable duct spacers in Indonesia. Two alternative materials were considered: PVC and lightweight hollow steel. The study compared costs and time associated with these materials. PVC duct spacers would be imported and be fabricated in Indonesia, while hollow steel duct spacers would be fabricated on-site. The research focused on three aspects: ducting work methods, duct spacer design, and cost-time analysis. Given tight installation spaces and busy schedules, duct spacers needed to be compact, simple, and adaptable to various pipe formations. The design for hollow steel duct spacers aimed for simplicity to reduce on-site construction work. However, care was taken to avoid potential injuries from exposed bolts on the hollow steel frame. The PVC duct spacer design utilized Polytam PF 1000 material, with a nominal shear strength of 399 kg and a nominal moment of 266 kg·cm—sufficient to withstand saturated soil loads up to 162 cm but not vehicular loads. Analyzing procurement time, PVC duct spacers from Indonesian manufacturers were the quickest, taking only 56 days due to no port clearance delays. The fastest completion time for the project was achieved using PVC duct spacers, taking 122 seconds—three times faster than hollow steel duct spacers. While lightweight steel was the most cost-effective option for on-site procurement, combining cost and time analysis favored PVC duct spacers. The minimal cost difference allowed for accelerated production, minimizing the risk of delays

Candida auris cluster in a center with no previous infections associated with a single organ donor

Background: Candida auris is an opportunistic pathogen reported in the US since 2016. C. auris infections (CAI) are frequently healthcare-associated, but only one case of donor-derived CAI in a lung transplant recipient has been reported (PMID 28520901). We describe a cluster of two CAIs at a single center in South Carolina occurring in 2 different recipients from the same solid organ transplant donor. Methods: We describe two cases of invasive CAIs occurring in an academic medical center without prior CAI in Charleston, SC in October 2023. C. auris was identified using Bruker MALDI-TOF and confirmed by the state health department. Results: Patient 1: 40-49 year-old male underwent heart transplantation on day 19 from admission complicated by growth of C. auris on post-op day #15 from a drain. He was readmitted post-op days 22-63 with positive blood cultures for C. auris and underwent re-operation with debridement and hardware removal. C. auris pericarditis required multiple returns to the OR (Figure). He was discharged on micafungin/posaconazole with plans for long-term antifungal therapy. Patient 2: 50-59 year-old male underwent liver and kidney transplantation on day 25 from admission from the same donor as Patient 1 in a separate hospital complex. His course was complicated by possible infected biloma not amendable to drainage and C. auris/C. glabrata fungemia, which was further complicated by abdominal wall collection cultures growing C. auris on post-operative day 35 on washout. He was managed with dual micafungin/posaconazole however, he died of unrelated causes at 93 days after transplant (Figure). Investigation: The donor for both recipients was a 10-19 year-old male who suffered brain death after trauma and was hospitalized for 56 days prior to procurement in Atlanta, GA without known CAI. Airway cultures at the time of organ procurement were positive for rare Pseudomonas and light unidentified yeast of multiple morphologies; urine cultures also grew 40,000 cfu/ml un-identified yeast. Screening of 35 and 4 inpatients in units exposed to patients 1 &amp; 2, respectively, with axilla/groin PCR was negative (Figure). A third organ recipient for this donor (kidney) at our center was identified and had negative urine fungus cultures. Conclusions: Despite no definitive link to a known donor infection, this cluster of CAI occurring simultaneously in 2 patients in separate hospitals/units at a single center with no known prior cases represents likely donor-derived CAI. Our experience suggests that organ procurement organizations should consider improved screening techniques for C. auris in donor cultures.Disclosure: Scott Curry: Consultant- Ferring; Abbott Diagnostics- Speaker honorarium

AN ANALYSIS OF THE IMPACT OF PROCUREMENT AND COMMUNICATION MANAGEMENT ON THE PERFORMANCE OF CONSTRUCTION PROJECTS IN NIGERIA

The construction sector plays a vital role in driving economic growth and development in Nigeria. However, it faces significant challenges, particularly in project performance, which can be attributed, at least in part, to ineffective communication and procurement management. This research aims to evaluate how communication and procurement management impact the outcomes of construction projects in Nigeria. To conduct this study, a quantitative research design was employed, utilizing a survey questionnaire administered to 260 construction professionals. The data collected underwent analysis employing various techniques such as descriptive statistics, confirmatory factor analyses (CFA), exploratory factor analyses (EFA), and structural equation model (SEM) utilizing software including the Statistical Package for Social Sciences (SPSS), Microsoft Excel, and LISREL (Linear Structural Relations). The SEM analysis results revealed that 31 out of the 35 hypotheses used in the study were validated. Among these, the strongest relationships observed were those between procurement management and time performance, procurement management and cost performance, time performance and cost performance, time performance and quality performance, and communication management and time performance, in that specific order. This demonstrates the critical role of effective communication and procurement management in achieving successful construction projects in Nigeria. Additionally, the analysis of factors affecting the implementation of procurement and communication management in the Nigerian construction industry highlighted the need for stakeholders to be proactive in developing strategies that facilitate effective implementation of these practices to enhance project performance. The study also emphasizes the importance of establishing effective procurement policies and regulations, embracing technology, building capacity, managing stakeholders, and continuously improving project management practices to elevate project performance in the Nigerian construction industry.

Comparison of HTK-Custodiol and St-Thomas solution as cardiac preservation solutions on early and midterm outcomes following heart transplantation.

The choice of the cardiac preservation solution for myocardial protection at time of heart procurement remains controversial and uncertainties persist regarding its effect on the early and midterm heart transplantation (HTx) outcomes. We retrospectively compared our adult HTx performed with 2 different solutions, in terms of hospital mortality, mid-term survival, inotropic score, primary graft dysfunction and rejection score. From January 2009 to December 2020, 154 consecutive HTx of adult patients, followed up in pre- and post-transplantation by 2 different tertiary centres, were performed at the University Hospital of Lausanne, Switzerland. From 2009 to 2015, the cardiac preservation solution used was exclusively St-Thomas, whereafter an institutional decision was made to use HTK-Custodiol only. Patients were classified in 2 groups accordingly. There were 75 patients in the St-Thomas group and 79 patients in the HTK-Custodiol group. The 2 groups were comparable in terms of preoperative and intraoperative characteristics. Postoperatively, compared to the St-Thomas group, the Custodiol group patients showed significantly lower inotropic scores [median (interquartile range): 35.7 (17.5-60.2) vs 71.8 (31.8-127), P < 0.001], rejection scores [0.08 (0.0-0.25) vs 0.14 (0.05-0.5), P = 0.036] and 30-day mortality rate (2.5% vs 14.7%, P = 0.007) even after adjusting for potential confounders. Microscopic analysis of the endomyocardial biopsies also showed less specific histological features of subendothelial ischaemia (3.8% vs 17.3%, P = 0.006). There was no difference in primary graft dysfunction requiring postoperative extracorporeal membrane oxygenation. The use of HTK-Custodiol solution significantly improved midterm survival (Custodiol versus St-Thomas: hazard ratio = 0.20, 95% confidence interval: 0.069-0.60, P = 0.004). This retrospective study comparing St-Thomas solution and HTK-Custodiol as myocardial protection during heart procurement showed that Custodiol improves outcomes after HTx, including postoperative inotropic score, rejection score, 30-day mortality and midterm survival.

Is Time Scheduling Important? An Analysis of Donor Heart Cross-clamp Times During Heart Transplantation.

Outcomes in heart transplantation are affected by a variety of variables and patient factors. However, the impact of circadian rhythms, gene expression, and transcription remain underexplored. We thus evaluated the potential role of donor heart cross-clamp times on short-term and long-term outcomes after heart transplantation. A total of 31 713 heart transplants were identified from the United Network for Organ Sharing Database. Patients were first stratified on the basis of time of donor procurement: 12 am to 12 pm or 12 pm to 12 am. To evaluate a possible effect of circadian rhythms, donor time was further divided into 5 groups based on preclinical data: 4 am to 8 am; 8 am to 11 am; 11 am to 5 pm; 5 pm to 10 pm; 10 pm to 4 am. Groups were assessed with comparative statistics. Long-term survival was evaluated using Kaplan-Meier methods and a multivariate Cox proportional hazard model. Patients who received hearts recovered between 12 am and 12 pm had significantly higher survival than those who received hearts recovered between 12 pm and 12 am. This survival difference was observed in both unadjusted (P = 0.002) and adjusted analyses (hazard ratio [HR]: 0.93; 95% confidence interval [CI], 0.89-0.97; P < 0.001). On unadjusted analysis, the survival difference among the 5 groups was insignificant (P = 0.07). Following adjustment, the periods of 11 am to 5 pm (HR: 1.09, 95% CI, 1.02-1.17; P = 0.012), 5 pm to 10 pm (HR: 1.11; 95% CI, 1.04-1.19; P = 0.002), and 10 pm to 4 am (HR: 1.07; 95% CI, 1.01-1.15; P = 0.034), were all independently associated with increased long-term mortality. Notably, the time of 8 am to 11 am was not associated with a change in survival (HR: 1.04; 95% CI, 0.96-1.14; P = 0.3). Given the independent association of donor timing and survival after adjustment in a large national cohort, further investigation into the role of donor circadian rhythm and donor procurement time is warranted in preclinical and clinical studies. Understanding the underlying mechanisms of this observation could potentially lead to the development of effective treatments and donor procurement processes that prepare the organs for transplantation in a better condition.

Framework for Strategic Selection of Maintenance Contractors

Selecting the right maintenance contractor is crucial for efficient operation and project success. Traditionally, this selection has been cost-driven, but the ever-growing complexity of projects has led to a shift towards best-value selection. The best value selection criteria evaluate the contractors based on factors like experience and past performance, along with the proposed cost. However, this approach lacks substantiated knowledge of these factors and often includes factors that cannot be validated at the time of procurement. This paper proposes a framework that applies the Analytical Hierarchy Process (AHP) to the maintenance contractor selection process. A detailed literature review was carried out to identify factors involved in maintenance selection. Data were collected from experts through a questionnaire developed based on the identified factors, facilitating AHP implementation. Substantiation strategies were identified using expert judgments. Our findings reveal that past performance criteria hold the maximum weight in the selection process. The proposed framework offers a more comprehensive approach for selecting maintenance contractors, ensuring both value and efficiency.

Exploring the Legal and Contractual Impediments in BIM-based Application: A Systematic Literature Review

Building information modelling (BIM) has been theoretically proven to enhance the integration of design, construction, and operation processes, hence improving the holistic delivery of a construction project. Despite the many initiatives provided by the government across various countries to increase the uptake of BIM in project implementation, previous studies have discovered the many barriers to successfully applying BIM, among which are legal and contractual issues. Hence, the present study explores and reviews the current legal and contractual impediments that have restricted BIM-based applications in the construction industry. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were employed as a standard protocol for reviewing the current research in the existing literature. The overall search process resulted in a total of 44 articles, which were then thematically analysed to disclose the findings. The review derived eight key aspects, namely procurement method, contract documentation, time and cost, quality, coordination, liability, security and law and regulation and their respective subcomponents as the basis of legal and contractual impediments that could challenge the success of BIM application in construction projects. The study extends the existing knowledge of BIM application and the implications arising from its utilisation and offers some practical insights for design and construction practitioners to improve their roles, obligations, and compliance with BIM contractual requirements. Several recommendations are also made for future research on BIM functionalities for contract administration.

Recycling transplanted organs: An exceptional case and literature review.

Recycling transplant kidneys, in other words using an allograft which has previously been transplanted in one recipient for transplant in a second recipient, can be a source of opportunity for expanding the pool of available grafts in the United States and beyond. We describe a case of renal transplantation from a donor who had undergone a kidney transplant 3 years prior and had good graft function at the time of procurement. The recipient underwent transplantation uneventfully and to date has demonstrated excellent graft function. We also include a literature review of reported cases of recycled/retransplanted kidneys. -Recycling transplanted kidneys is a largely untapped resource which could help decrease the transplant waitlist. -Utilizing such kidneys does need special considerations in terms of procurement technique, backtable, crossmatch, recipient selection and follow-up.

IMPLEMENTASI LEAN SIX SIGMA UNTUK MENURUNKAN VARIASI DAN WAKTU PROSES PENGADAAN OBAT DI INSTALASI FARMASI RUMAH SAKIT ISLAM AMAL SEHAT SRAGEN

Background: Drug management needs to be done to prevent stock out, over stock, and drug purchases due to emergency conditions. Reports of drug management problems at Amal Sehat Sragen Hospital are stock outs resulting in immediate drug purchases and patients do not get the drug as they should. Lean Six Sigma combines two methodologies to help speed up certain processes so they can solve problems faster while creating more value for customers. When combined, these create a powerful methodology for managing a business and completing tasks on time, on budget, saving money, adding value and increasing productivity.&#x0D; Objectives: Assessing the implementation of Lean Six Sigma to reduce variation and processing time for drug procurement at the Pharmacy Installation of Amal Sehat Sragen Hospital.&#x0D; Methods: The method used in this study is a mixed methods with a Participatory Action Research (PAR) approach.&#x0D; Results: The results of the sample data that has variations and processing time are correlated with criticality, cost, and performance values to obtain Importance Index (II) values. Calculation of Importance Index (II), before implementation, 3 items with high Importance Index (II) values were obtained, namely "Gabapentin 300mg" (8.7), "Metformin 500mg (11.8), and "Lisinopril 5mg" (10.7) which decreased after implementation to “Gabapentin 300mg” (4.5), “Metformin 500mg (3.2), and “Lisinopril 5mg” (5.3). Assessment of the effectiveness and efficiency of drug procurement by measuring the lead time in cycle I was 9 days 23 hours 25 minutes, decreasing to 4 days 7 hours 50 minutes in cycle III. The efficiency measure based on the Value-added ratio (VAR) in cycle I was 14% and increased to 34% in cycle III.&#x0D; Conclusions: The implementation of Lean Six Sigma with DMAIC (Define, Measure, Analyze, Improve, Control) and Participatory Action Research approaches (three cycles) was able to reduce variations in the drug procurement process (critical criteria, performance, and cost) and overall lead time in the drug procurement process at Amal Sehat Sragen Hospital.

OPTIMASI PERSEDIAAN BAHAN BAKU DAN PRODUKSI USAHA GANEPO PUTRI YOSE DENGAN MENGGUNAKAN ALGORITMA GREY WOLF OPTIMIZER

Putri Yose's Ganepo business, located in Padang Kandi seven koto talago, is one of the Rubik Ganepo producers that has grown to be one of the main suppliers in the Bukittingi and Riau areas. Interviews with the business owner revealed problems in inventory management that affect the profitability of this business. This study aims to assess and improve inventory management with a focus on raw material procurement and production cycle time. The model used in this study is Integrated Procurement Production (IPP) with the Grey Wolf Optimizer (GWO) optimization algorithm to determine the decision variables, namely the frequency of raw material procurement and production cycle time. GWO algorithm is chosen because it is a metaheuristic optimization method that is able to overcome real-world problems, avoid stagnation in solutions of local, and has a wide search space. The results showed that the IPP model with GWO was able to provide a new inventory policy, including the optimal procurement quantities of salt, cooking oil, garlic, turmeric, and production cycle time. The implementation of the policy increased revenue by 0.309203%.

ПОВЫШЕНИЕ ЭФФЕКТИВНОСТИ ТОРГОВО-ЗАКУПОЧНЫХ ПРОЦЕДУР В СТРОИТЕЛЬНОЙ СФЕРЕ С ИСПОЛЬЗОВАНИЕМ АВТОМАТИЗИРОВАННЫХ СИСТЕМ

The article considers the actual problem of increasing the efficiency of trade and procurement procedures in the construction sector using automated systems. The authors analyze the current situation in the construction industry and identify the main problems faced by participants in trade and procurement processes. The article proposes methods and strategies for the implementation of automated systems aimed at optimizing procurement and bidding processes in construction. The methodological basis of the study is the basic categories of project management and management of investment and construction activities. The work uses methods of analyzing empirical data on trade and procurement procedures, methods of logical, system analysis, and the method of expert assessments. The research includes the following stages: analysis of the practice of using automated systems in the field of procurement; identification of needs for automation of trade and procurement procedures; development of the concept of an automated system designed to optimize procurement processes; evaluation of the results. The conducted research made it possible to systematize and analyze information about existing approaches to automation of trade and procurement procedures, as well as identify the needs and problems faced by companies in this area. Based on this analysis, the concept of an automated system designed to optimize procurement processes has been developed, taking into account the basic needs and requirements of the market. Testing and modeling of the new system made it possible to evaluate its effectiveness and functionality in the real working conditions of construction companies. The test results showed that automation of trade and procurement procedures helps to reduce the time and cost of procurement, increase transparency of processes and improve management. The authors of the article conclude that the introduction of automated systems for conducting trade and procurement procedures in the construction sector has significant potential to improve the efficiency of procurement management, reduce risks and improve the competitiveness of companies in the construction market.

Non-anastomotic biliary strictures after liver transplantation influenced by ischemic factors including liver graft procurement time: the forgotten luke-warm periods

Non-anastomotic biliary strictures after liver transplantation influenced by ischemic factors including liver graft procurement time: the forgotten luke-warm periods

A potential framework for cross-zonal reserve procurement on European power exchanges based on robust optimization

In order to prepare for unexpected events in the power system, regulation reserves are routinely procured in advance. Economic considerations dictate that it is advantageous to perform reserve procurement and energy allocation on a joint market platform using a single clearing algorithm. Furthermore, it is also beneficial if the option exists to allocate resources between different bidding zones to alleviate local shortages and corresponding price pressures. The present paper proposes a solution algorithm for this task in a European market environment without unit commitment and uplift payments to non-convex bidders. The main challenge of cross-zonal reserve allocation arises from the fact that deployment decisions are not yet known, therefore the actual deployment flows are uncertain at the time of procurement. The proposed algorithm handles this issue with robust optimization techniques and provides a guarantee of feasible transmission limits for deployment i.e. reserve deliverability. The clearing model is formalized as a computationally efficient Mixed Integer Linear Problem; its exact equations are presented along with case studies for the purpose of demonstration. The research is part of the FARCROSS H2020 project of the European Union.

Simultaneous Lung-abdominal Organ Procurement From Donation After Circulatory Death Donors Reduces Donor Hepatectomy Time.

Prolonged organ procurement time impairs the outcome of donation after circulatory death (DCD) and liver transplantation (LiT). Our transplant team developed a simultaneous, rather than sequential, lung-abdominal organ explantation strategy for DCD donation to prioritize liver procurement. We evaluated whether this change in strategy effectively reduced donor hepatectomy time (dHT), without affecting donor pneumonectomy time (dPT), and influenced LiT and lung transplantation outcome. All lung-abdominal and abdominal-only transplant procedures between 2010 and 2020 were analyzed in this retrospective cohort study. Relationships were assessed between the year of transplant and dHT and dPT (univariate linear regression), 1-y patient and graft survival, primary graft dysfunction, and nonanastomotic biliary strictures (univariate logistic regression). Fifty-two lung-abdominal and 110 abdominal-only DCD procedures were analyzed. A significant decrease in dHT was noted in lung-abdominal (slope -1.14 [-2.14; -0.15], P = 0.026) but not in abdominal-only procedures; dPT did not increase. There were no significant associations between the year of transplant and nonanastomotic biliary strictures frequency, primary graft dysfunction incidence, 1-y patient, and graft survival. Simultaneous organ procurement in multiorgan lung-abdominal DCD procedures is feasible, and effectively shortened dHT without affecting lung transplantation outcome. No impact on LiT outcome was observed; however, larger multicenter studies are needed.

The value of point-of-care tests for the detection of SARS-CoV-2 RNA or antigen in bronchoalveolar lavage fluid

BackgroundTransmission of SARS-CoV-2 from donor to recipient is a clinically relevant risk for developing severe COVID-19 after lung transplantation (LTx). This risk of iatrogenic transmission can be reduced by timely detection of viral RNA or antigen in samples of bronchoalveolar lavage (BAL) fluid obtained at the time of lung procurement. We aimed to retrospectively evaluate the detection of SARS-CoV-2 RNA or antigen in BAL fluid samples using three point-of-care tests (POCTs). MethodsBAL fluid samples came from patients hospitalized in an intensive care unit during the COVID-19 pandemic. These pandemic samples were scored as positive or negative for SARS-CoV-2 by a RT-qPCR comparator assay for orf1ab. Three commercially available POCTs were then evaluated: cobas SARS-CoV-2 & Influenza A/B assay with the cobas Liat RT-qPCR system (Roche Diagnostics), ID NOW COVID-19 and COVID-19 2.0 (Abbott), and SARS-CoV-2 Rapid Antigen Test (RAT) (Roche Diagnostics). Samples from the pre-pandemic era served as negative controls. ResultsWe analyzed a total of 98 BAL fluid samples, each from a different patient: 58 positive pandemic samples (orf1ab Ct<38), 20 putatively negative pandemic samples (orf1ab Ct≥38), and 20 pre-pandemic samples. Univariate logistic regression shows that the probability of detection was highest for cobas Liat, followed by ID NOW, and then RAT. Of clinical relevance, cobas Liat detected SARS-CoV-2 RNA in 30 of the 31 positive pandemic samples that were collected within 10 days after RT-qPCR diagnosis of SARS-CoV-2 infection. None of the 20 pre-pandemic samples had a false-positive result for any POCT. ConclusionsPOCTs enable the detection of SARS-CoV-2 RNA or antigen in BAL fluid samples and may provide additional information to decide if donor lungs are suitable for transplantation. Detection of respiratory pathogens with POCTs at the time of donor lung procurement is a potential strategy to increase safety in LTx by preventing iatrogenic transmission and severe postoperative infections.