An Investigation into the Improvement of Tendering Processes and the Level of Competition for PFI Construction Projects

The Private Finance Initiative (PFI) since its inception has grown in its use particularly by the UK government. Despite its popularity it has been considered controversial. The focus for this research is the practical issues associated with PFI at the pre-construction stage. The research derives its data from interviews with nine people from the construction industry with experience of PFI tendering. The research investigates issues relating to the PFI tendering process and the bidding strategies of main contractors within the PFI market. It evaluates the impact they have on the public sectors ability to generate greater competition for PFI projects. The results confirm that many of the issues highlighted in the literature still remain. These issues include the poor performance of the public sector team during tendering and the lack of political support for some projects. The research confirms that there are typically considerable economies of scale in relation to tender costs when compared to the capital value of PFI projects. The research also identifies that certain main contractors do not necessarily use all available opportunities to exhaust the funds available to bid on PFI projects. The research also discovers that construction companies often use market intelligence to avoid bidding for PFI projects with intense competition. The research concludes that the use of the competitive dialogue procedure for projects such as PFI can do little to increase the levels of competition due to the construction industry’s ability to regulate the competition levels. A return to the former negotiated procedure system is recommended if after the selection of the preferred bidder costs can be controlled more effectively

Efficacy and safety of fibrinogen administration in acute post-traumatic hypofibrinogenemia in isolated severe traumatic brain injury: A randomized clinical trial

Aim: This study was conducted to evaluate clinical outcomes after fibrinogen administration in hypofibrinogenemia following severe traumatic brain injury. Background: Post traumatic coagulopathy (PTC) is a common but devastating medical condition in patients with severe head injury. Hypofibrinogenemia is considered as an indicator for poor clinical outcomes in traumatic brain injury (TBI). Methods: In this randomized clinical trial (RCT), primarily 137 patients with severe traumatic brain injury (Glasgow coma scale score: GCS 200 mg/dL) could improve GOSE, GCS score progression within 3 days after primary head injury and hematoma expansion controllability

Low birth weight incidence in newborn' neonate in Qom, Iran: Risk factors and complications

Background: Low birth weight (LBW) is related with high morbidity of neonatal consequences and death. This study aimed to determine the incidence of LBW, its risk factors, and complications in born neonates in Qom, Iran 2017. Methods: This retrospective chart review was conducted with 602 newborns participants who were one of Qom hospitals in Iran. Data were extracted from the patients' medical records and entered into data collection sheet and were analyzed by t-test, Chi-square, Fisher exact, and independent t-tests in SPSS v. 18 software. Results: The overall incidence of LBW in born neonates was 9.6%, and the mean of maternal age was 28.8 years. Based on results, twin's birth (Odds ratio [OR] = 1.47), receiving corticosteroid (OR = 4.55), and premature rupture of membrane (PROM) (OR = 1.08) were the most important related factors of LBW and respiratory distress syndrome (RDS) (OR = 6.47.8), sepsis (OR = 5.36), and icterus (OR = 5.8) consequences of LBW. Nevertheless, poor feeding, hypoplasia, premature, tachypnea, meconium, intraventricular hemorrhage, hypotonic, and other neonatal complications do not show the significant relationship with LBW (P > 0.05). Conclusions: According to results, twin's births, receiving corticosteroid, and PROM are the important risk factors for LBW and RDS, sepsis and icterus were the most common complication of LBW. As a result, preventive programs for control of LBW and infant complications are essential

DMSA scintigraphy in febrile urinary tract infections could be omitted in children with low procalcitonin levels

PURPOSE: The objective was to assess procalcitonin (PCT) as a marker of renal involvement in children with urinary tract infections (UTI). METHODS: The study included 60 children with UTI, aged (median) 0.6 years (range, 0.1-9.5 years), admitted to a pediatric hospital. White blood cell count, C-reactive protein (CRP), and PCT levels were measured on admission and on the third treatment day, whereas renal involvement was assessed with dimercaptosuccinic acid (DMSA) scintigraphy within 7 days after admission and after 6 months. RESULTS: During febrile UTI, PCT, and CRP levels increased in parallel with the severity of renal lesions in acute DMSA. During repeat DMSA, PCT levels were increased in the group with partially versus totally reversible renal lesions (5.3 μg/L vs 3.0 μg/L; P = 0.005). Procalcitonin and CRP had increased sensitivity (94% and 100%, respectively) and negative predictive values (97% and 100%, respectively), whereas PCT had higher specificity than CRP (100% vs 55%). CONCLUSIONS: Procalcitonin is a sensitive marker of the development, severity, and persistence of renal lesions in childhood UTI. Because of the high negative predictive values of PCT, we suggest that, in case of low PCT levels, the possibility of renal involvement is low, and DMSA could be omitted. © 2007 Lippincott Williams & Wilkins, Inc

Targeted therapy in Coronavirus disease 2019 (COVID-19): Implication from cell and gene therapy to immunotherapy and vaccine

Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) is a highly pathogenic and transmissible virus. Infection caused by SARS-CoV-2 known as Coronavirus disease 2019 (COVID-19) can be severe, especially among high risk populations affected of underlying medical conditions. COVID-19 is characterized by the severe acute respiratory syndrome, a hyper inflammatory syndrome, vascular injury, microangiopathy and thrombosis. Antiviral drugs and immune modulating methods has been evaluated. So far, a particular therapeutic option has not been approved for COVID-19 and a variety of treatments have been studied for COVID-19 including, current treatment such as oxygen therapy, corticosteroids, antiviral agents until targeted therapy and vaccines which are diverse in each patient and have various outcomes. According to the findings of different in vitro and in vivo studies, some novel approach such as gene editing, cell based therapy, and immunotherapy may have significant potential in the treatment of COVID-19. Based on these findings, this paper aims to review the different strategies of treatment against COVID-19 and provide a summary from traditional and newer methods in curing COVID-19. © 2022 Elsevier B.V

Behavior of Asphaltene Adsorption onto the Metal Oxide Nanoparticle Surface and Its Effect on Heavy Oil Recovery

Preventing asphaltene-related damage in hydrocarbon reservoirs is an important concern. Many investigations have been performed on asphaltene and its effects and how to reduce these effects during oil production. In the present work, some experiments were conducted to investigate the effects of SiO₂, NiO, and Fe₃O₄ nanoparticles on oil recovery and to determine how they adsorb asphaltene and prevent its precipitation. Moreover, instead of crude oil, a synthetic solution with a given component concentration was used. The results of this study show that, in solutions without nanoparticles, an increase in the amount of <i>n</i>-heptane causes more asphaltene aggregation to take place; however, in the presence of nanoparticles, increasing the <i>n</i>-heptane content results in an increase in the asphaltene adsorption on the surface of nanoparticles. Furthermore, it is shown that the amount of oil recovery in the presence of different nanoparticles corresponds to the ordering SiO₂ > NiO > Fe₃O₄