Evaluation of selected determinants of public procurement in the health sector

This article aims at anexaminationof the impact of the number of public procurement tenders in the healthcare sector on the final purchase price. We used the data from 1544 public contracts related to the acquisition of health technologies for the years 2014-2017. The highest number of public contracts was reached at level of 501 in 2014, and the lowest number was 238 in 2017. The highest average value of estimated and final prices was found in 2015. The proportion of tenders submitted with only one tenderer was over 39 %. For the analysis, we used a generalized linear model and quantile regression. The results showed that, as the number of bids increased by one unit, the ratio of final and projected price on average would change 0.975 times, which means an increase in savings by 2.45%. Using quantile regression, we modelled the influenceof the explanatory variables on the individual quantiles of the explained variable instead of the conditional mean. The aim was to determine the impact of the number of proposals at everyovercharge level. As the order value of the quantile increases, the effect of offers on generating savings in public procurement is gradually decreasing. For more than 40 % of the most overpriced orders, the number of offers does not have a statistically significant effect on the size of the savings. With 25 % of the most economical orders with an increasing number of bids by one unit, savings of 4.77 % were achieved. However, increasing the number of procurement contracts to create savings in public procurement may develop differently over time. By applying the generalized linear model, we found that in 2014 the increase in the number of offers by one unit had an impact on the average increase in public procurement savings of 7.15 %. In 2015, this impact fell to 1.59 %. In 2016, the growth in the number of proposals did not have a statistically significant impact on the average increase or decrease in savings. In 2017, this value increased slightly above 1.96 %. Public acquisition processes will continue to be a critical pointfor the efficient allocation of public resources. © 2020, Bucharest University of Economic Studies Publishing House. All rights reserved

Assessment Of COP Characteristics And Force-Time Changes During Walking In The Third Trimester Of Pregnancy

Purpose: The primary aim of this study was to analyse the COP characteristics and force-time changes during walking between weeks 27 and 36 of pregnancy. The secondary objective was to verify the influence of the specific orthopaedic shoes that were given to the experimental group. This study represents the second part of a research project that processed the same group of pregnant women in order to acquire extended information about gait during pregnancy.Methods: Seventy-three pregnant women participated in this study. This group was random divided into the experimental group (35 pregnant women) wearing specific orthopaedic shoes and the control group (38 pregnant women). The motor task consisted of five gait trials where two foot prints for each leg were always recorded. The participants started barefoot walking 3 m ahead of the pressure platform and finished the trial 1 m after the end of the platform in order to preserve acceleration and deceleration in gait. Participants walked at their own preferred velocity. All pedobarometric parameters were registered by Emed walkway - trademark of novel gmbh in Munich, Germany.Results: The first script processed data to these variables (COP characteristics): Centre of pressure index (COPI), centre of pressure excursion index (COPEI), distance (D) of COP, maximum velocity (MaV) and mean velocity (MeV) of COP. The second script processed data for ten pre-defined areas of the foot: hindfoot, midfoot, MH1-5 – metatarsal heads, big toe, second toe, toes 3, 4 and 5 with these applied variables (force-time characteristics): Force-time integral (FTI) and contact time (CT). For the experimental group, in comparison between 27th week and the 36th week of gestation, we can find lower COPI for both feet, significantly only for the left foot (p=0.04). Also, significant difference in COPEI (p=0.03, p=0.03) for both feet was found. In comparison pre and post measurement we found higher values of parameters COPI and COPEI and that indicates more lateral weight shifting during the last trimester. We can distinctly register extension of D, especially for the left foot (p=0.04). Changes in velocity of COP indicate that MaV was increased for both feet (p=0.00, p=0.00) and MeV was significantly increased only for the right foot (p=0.00) in the 36 week of pregnancy. For the control group, we found no significant changes in COPI, COPEI or COP. MaV and MeV of COP were significantly increased for both feet in the 36 week of pregnancy (p=0.02, p=0.00, p=0.01, p=0.00). Higher values of MaV and MeV indicate that pregnant women accelerated their walking in the 36 week of pregnancy.Further, force-time characteristics in most cases did not reveal statistically significant changes in the last trimester.Conclusion: Over the last three months of pregnancy, significant observable changes can be found, especially through COP parameters of both groups. We found out that the specific orthopaedic shoes given to the experimental group influenced the trajectory of COP, which could have positive health aspects. Further, certain conflicting results of our study in comparison with other similar studies only confirm that individual biomechanic and physiological developments in pregnancy affect the kinematic and kinetic aspects of walking differently.Key Words: Center of pressure, pregnancy, gait, feetPurpose: The primary aim of this study was to analyse the COP characteristics and force-time changes during walking between weeks 27 and 36 of pregnancy. The secondary objective was to verify the influence of the specific orthopaedic shoes that were given to the experimental group. The experimental group wore patented J Hanák R biomechanical footwear and insoles, which are designed to help with redistribution of forces acting the feet, to support both longitudinal and transverse arches of the foot and to strengthen the foot muscles during movement.Methods: Seventy-three pregnant women participated in this study. This group was random divided into the experimental group (35 pregnant women) wearing specific orthopaedic shoes and the control group (38 pregnant women). The motor tasks consisted of five gait trials where two foot impacts for each leg were always recorded. The participants started barefoot walking 3m ahead of the pressure platform and finished the trial 1m after the end of the platform in order to preserve acceleration and deceleration in gait. Participants walked at their own preferred velocity. All pedobarometric parameters were registered by Emed walkway - trademark of novel gmbh in Munich, Germany. Data processing was divided to two scripts. The first script processed data of the variables (COP characteristics): Centre of pressure index (COPI), centre of pressure excursion index (COPEI), distance (D) of COP, maximum velocity (MaV) and mean velocity (MeV) of COP. The second script processed data for ten pre-defined areas of the foot: hindfoot, midfoot, MH1-5 – metatarsal heads, big toe, second toe, toes 3, 4 and 5 with these applied variables (force-time characteristics): Force-time integral (FTI) and contact time (CT).Results: For the experimental group, in comparison between 27th week and the 36th week of gestation, we found lower COPI for both feet, significantly only for the left foot (p=0.04). Also, significant difference in COPEI (p=0.03, p=0.03) for both feet was found. In comparison pre and post measurement we found higher values of parameters COPI and COPEI and that indicates more lateral weight shifting during the last trimester. We can distinctly register extension of D, especially for the left foot (p=0.04). Changes in velocity of COP indicated that MaV was increased for both feet (p=0.00, p=0.00) and MeV was significantly increased only for the right foot (p=0.00) in the 36 week of pregnancy. For the control group, we found no significant changes in COPI, COPEI or COP. MaV and MeV of COP were significantly increased for both feet in the 36th week of pregnancy (p=0.02, p=0.00, p=0.01, p=0.00). Higher values of MaV and MeV indicate that pregnant women accelerated their walking in the 36th week of pregnancy. Further, force-time characteristics in most cases did not reveal statistically significant changes in the last trimester.Conclusion: Over the last three months of pregnancy, significant observable changes can be found, especially through COP parameters of the experimental and the control group. We found out that the specific orthopaedic shoes given to the experimental group influenced the trajectory of COP, which could have positive health aspects. Further, certain conflicting results of our study in comparison with other similar studies only confirm that individual biomechanic and physiological developments in pregnancy affect the kinematic and kinetic aspects of walking differently

Multigrid Monte Carlo in the Sine Gordon model

We pose two questions about the dynamical critical behavior of multigrid Monte Carlo: Will a multigrid Monte Carlo simulation of the two dimensional Sine Gordon model exhibit critical slowing down, as expected by a theoretical analysis of Metropolis acceptance rates? Can we reduce critical slowing down caused by decreasing acceptance rates on large blocks by performing more updates on coarser lattices? To this end we simulate the model with a W-cycle (gamma = 2) and a higher cycle with gamma = 4 using piecewise constant interpolation. The answer to the first question is positive, the answer to the second one is negative.Comment: 3 pages in ps-format, to appear in the Proceedings of LATTICE 93, Dallas, USA, October 199

The development of the labor market of Czech small and medium-sized enterprises: Toward the digital economy

In the 2000s, Czech small and medium-sized enterprises faced competition in the new technologies and innovations associated with the implementation of the digital economy. Competitive advantages of the Czech economy based on cheap labor and low-cost production are in decline, and finding a new economic paradigm seems to be problematic. Our study has traced a significant degree of interaction between the structure of employee education and the sectoral classification of the company, with medium–high-tech, medium–low-tech and low-tech firms behaving differently from each other from the labor market perspective. Companies implement different strategies in terms of employee education as well as R&D. Thus far, Czech companies have focused mainly on the market follower approach, i.e., with little effort toward innovation. This conservative strategy brings lower risks but also lacks the high profit potential necessary to reach competitive advantages. In particular, the digitization of the midtech sector is crucial for the future growth of the Czech economy. The midtech sector possesses high potential for the development of new business opportunities if it can overcome its significant gap in the use of R&D, knowledge, and technology. © Common Ground Research Networks, Martin Mikeska, Tomáš Urbánek

Relationships between road transport indicators and expenditure of visitors in the context of European countries’ tourism competitiveness

Research background: Transport represents a dynamic element in the tourism system. In recent decades, transport has been a subject of research mainly from the point of view of the sustainability of the economic systems and the environmental aspects. Purpose of the article: This study aimed to quantify the relationships between the selected indicators of road transport development and the expenditure of tourism visitors in the select-ed European countries in the context of the development of their competitiveness. Methods: The road transport indicators were applied in the research trajectories: density of road (DNST), hare of road infrastructure investment (SH INF), share of motorways (SH MANY), and indicators of visitor expenditure for business (BTS), leisure (LTS), domestic (DTS) and foreign (VEFS) tourism. In the first phase of the analyses, the countries of the European part of the OECD (N = 27; period of 2010-2018) were divided into two clusters based on the development index (HDI) and the innovation index (GII) through the cluster analysis. The two groups were created - more and less developed countries. The results of the analysis of differ-ences declare that there are differences between these groups in the DNST, SH INF, BTS, LTS, and DTS indicators. The correlation and regression analysis methods were applied to quantify the relationships between the variables. Findings & value added: The difference between the groups of the countries was also shown in the relationships between the road transport development indicators and visitor spending. In more developed countries, the relationship between the traffic indicators on BTS and DTS was significant. In less developed countries, significant relationships were identified with LST and VEFS. This finding underscores regional disparities and cautions against assuming that what policy guidelines from developed countries will be effective in less developed ones. Therefore, when designing improvement policies, it is vital to consider countries in terms of their level of development

The efficiency of public procurement in the health sector – the platform on sustainable public finances

At present, public procurement processes and their efficiency represent one of the key determinants of public finance system. Many countries of the European Union work intensively on reforming public procurement processes. The main aim of public procurement is to create an open competition in order to achieve the most efficient use of public funds. The Slovak hospitals, that have been inefficiently managed in the long run, are the weakest segment of the healthcare system. Also, the public hospitals continue to generate substantial losses even if many reforms had been implemented to increase cost efficiency. However, medical debt consolidation did not help the hospitals to set optimal functioning of the economic processes in order to improve their management permanently. The primary aim of the study is to examine an impact of selected determinants on an efficiency of public procurement processes in the healthcare system of the Slovak Republic during the 2014 – 2017. The data were obtained from the registers of the Public Procurement Office of the Slovak Republic. The multinomial logistic regression was used to determine the following findings: in case of zero, or positive savings, the number of offers, year of public procurement, type of public procurement procedure, NUTS level of procurement and participation of a subcontractor in procurement process are significant categorical variables. The study results enable a creation of multi-dimensional analyses and support models in order to make effective public procurement processes in the healthcare system. Similarly, these results enable to create comparative benchmarking analyses, and may lead to a creation of new agencies and institutions. © 2020, Bucharest University of Economic Studies Publishing House. All rights reserved

Multigrid Monte Carlo with higher cycles in the Sine Gordon model

We study the dynamical critical behavior of multigrid Monte Carlo for the two dimensional Sine Gordon model on lattices up to 128 x 128. Using piecewise constant interpolation, we perform a W-cycle (gamma=2). We examine whether one can reduce critical slowing down caused by decreasing acceptance rates on large blocks by doing more work on coarser lattices. To this end, we choose a higher cycle with gamma = 4. The results clearly demonstrate that critical slowing down is not reduced in either case.Comment: 7 pages, 1 figure, whole paper including figure contained in ps-file, DESY 93-00

Plantar Pressure Sore Formation During Advanced Phases Of Pregnancy And The Effect Of Special Footwear

Plantar pressure sore occurrence is an indicator of increased plantar pressures which may develop into subsequent foot problems and pain. Therefore, the aim of this study was to assess the effect of special footwear on plantar pressure sore distribution. 67 healthy pregnant women at 27, 32 and 37 gestational weeks participated in data collection sessions. At each data collection session, the plantar pressure sore distribution was assessed for both feet. During the first data collection session participants were randomly divided into a control and experimental group. Experimental group were given the special footwear. For the control group, the results show an increase in pressure sore occurrences in the medial edge of thumb and first metatarso-phalangeal joint. The special footwear introduction in the experimental group increased the pressure sore occurrence at the edge of the heel, probably due to an association with the plantar pressure redistribution more towards the heel area. The distribution of pressure sore areas of the control and experimental group is in accordance with our hypothesis that the special footwear redistributes plantar pressure. However, the trend of these changes is not clear as there are many factors influencing the foot condition during advanced stages of pregnancy

Enhancement of Antiferromagnetic Correlations Induced by Nonmagnetic Impurities: Origin and Predictions for NMR Experiments

Spin models that have been proposed to describe dimerized chains, ladders, two dimensional antiferromagnets, and other compounds are here studied when some spins are replaced by spinless vacancies, such as it occurs by $Zn$ doping. A small percentage of vacancies rapidly destroys the spin gap, and their presence induces enhanced antiferromagnetic correlations near those vacancies. The study is performed with computational techniques which includes Lanczos, world-line Monte Carlo, and the Density Matrix Renormalization Group methods. Since the phenomenon of enhanced antiferromagnetism is found to occur in several models and cluster geometries, a common simple explanation for its presence may exist. It is argued that the resonating-valence-bond character of the spin correlations at short distances of a large variety of models is responsible for the presence of robust staggered spin correlations near vacancies and lattice edges. The phenomenon takes place regardless of the long distance properties of the ground state, and it is caused by a ``pruning'' of the available spin singlets in the vicinity of the vacancies. The effect produces a broadening of the low temperature NMR signal for the compounds analyzed here. This broadening should be experimentally observable in the structurally dimerized chain systems $Cu(NO_3)_2\cdot2.5H_2O$, $CuWO_4$, $(VO)_2P_2O_7$, and $Sr_{14}Cu_{24}O_{41}$, in ladder materials such as $Sr Cu_2 O_3$, in the spin-Peierls systems $CuGeO_3$ and $NaV_2 O_5$, and in several others since it is a universal effect common to a wide variety of models and compounds.Comment: 18 pages revtex with 26 figures include

O6-Methylguanine-DNA methyltransferase protein expression by immunohistochemistry in brain and non-brain systemic tumours: systematic review and meta-analysis of correlation with methylation-specific polymerase chain reaction

Background: The DNA repair protein O6-Methylguanine-DNA methyltransferase (MGMT) confers resistance to alkylating agents. Several methods have been applied to its analysis, with methylation-specific polymerase chain reaction (MSP) the most commonly used for promoter methylation study, while immunohistochemistry (IHC) has become the most frequently used for the detection of MGMT protein expression. Agreement on the best and most reliable technique for evaluating MGMT status remains unsettled. The aim of this study was to perform a systematic review and meta-analysis of the correlation between IHC and MSP. Methods A computer-aided search of MEDLINE (1950-October 2009), EBSCO (1966-October 2009) and EMBASE (1974-October 2009) was performed for relevant publications. Studies meeting inclusion criteria were those comparing MGMT protein expression by IHC with MGMT promoter methylation by MSP in the same cohort of patients. Methodological quality was assessed by using the QUADAS and STARD instruments. Previously published guidelines were followed for meta-analysis performance. Results Of 254 studies identified as eligible for full-text review, 52 (20.5%) met the inclusion criteria. The review showed that results of MGMT protein expression by IHC are not in close agreement with those obtained with MSP. Moreover, type of tumour (primary brain tumour vs others) was an independent covariate of accuracy estimates in the meta-regression analysis beyond the cut-off value. Conclusions Protein expression assessed by IHC alone fails to reflect the promoter methylation status of MGMT. Thus, in attempts at clinical diagnosis the two methods seem to select different groups of patients and should not be used interchangeably