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Present study aimed for the design and development of a continuous ohmic heating system for heating of milk. The holding capacity of the designed heater was 8.24 litre and had a 'tube in tube' type arrangement. The heat transfer area of the ohmic heater was increased by employing two stages, consisting of SS-316 pipes. Process was controlled by using an electrical panel equipped with all the required electrical components. The designed ohmic heater for milk was optimized for heating of milk temperature up to 73癈. Efficient heating of milk was heated at optimized conditions of 137.7 V (stage-1) and 72.2V(stage-2) with 1.5 l/min flowrate. The average heating rate for milk 4.6?C/min. At optimized conditions, system performance co-efficient was found to be 86.95. The milk heated using ohmic heater showed no significant difference in the composition and sensory attributes when compared to the conventional heating method. Moreover, the alkaline phosphatase test was also parallel to the thermal heating system and milk was highly acceptable by the sensory panel and cost is considerably lower than the thermal system.

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Objective To establish a candidate reference measurement procedure for the detection of serum 25-hydroxy vitamin D3[25(OH)D3]based on isotope dilution liquid chromatography tandem mass spectrometry(LC-MS/MS).Methods Isotope standard solution was used as internal standard,liquid-liquid extraction was used for pre-treatment,and positive ion electrospray ionization mode was used for monitoring.The accuracy,precision,linear range,limit of quantitation,detection limit and relative matrix effect of method were verified based on documents of the America Clinical and Laboratory Standards Institute(CLSI)such as C62-A and EP15-A3.Candidate reference measurement procedure and mass spectrometry routine procedure were used to detect 40 clinical serum samples,and to evaluate the consistency of the two methods.Results The analysis time of the candidate method was 15 min.Isometric elution of chromatography was used to effectively separate the isomer 3-epi-25(OH)D3,with good specificity.RELA comparison sample was measured,with a bias of less than 1.5%.The intra-batch precision and inter-batch precision ranged from 0.75%to 2.31%and 1.28%to 2.01%,respectively.The limits of quantification and detection were 0.85 ng/ml and 1.84 ng/ml.It had good linearity in the concentration range of 2.5～220 ng/ml,and there was no relative matrix effect and carrier contamination.The correlation between the mass spectrometry routine procedure and candidate reference procedure was good(r=0.982),while the deviation at low concentration samples exceeded the allowable total error±25%in the external quality assessment of the National Center for Clinical Laboratories.Conclusion A candidate reference measurement procedure for serum 25(OH)D3 technology based on LC-MS/MS was successfully established,and the analytical performance met the requirements,which could be used for quantitative traceability by clinical conventional methods.

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Objective This study aimed to investigate the factors influencing the personal burden rate incerebral ische-mic patients,compare the difference in the burden rate among the patients with varying degrees of cerebral ischemia,provide a reference for establishing a personal burden rate evaluation,and propose suggestions for control its increase.Methods The medi-cal insurance data were collected from 8164 discharged patients in a tertiary hospital in Tianjin between January and December 2022.With the data,the Generalized Linear Model was utilized to analyze the factors affecting the personal burden rate across different Diagnosis Related Groups(DRGs).Results Statistically significant differences were observed in the cost structure a-mong different DRGs.Age,length of hospital stays,total hospitalization cost,hospital admission mode,number of hospitaliza-tions,and type of medical insurance significantly impacted the personal burden rate.The personal burden rate was inversely cor-related with age and length of hospital stays,but directly correlated with the total hospitalization cost.The patients admitted from emergency,first-time hospitalization,and those covered by the basic medical insurance program for urban employees had a lower personal burden rate.Conclusion Hospitals should establish diverse personal burden rate performance evaluation standards for patients with different types of medical insurance,incorporating factors such as average length of hospital stays and average hospi-talization cost.A more equitable hospital internal assessment plan should be developed by considering patients admitted to differ-ent departments and aligning with the characteristics of clinical pathways.Medical institutions should minimize self-funded pro-jects under declared medical insurance,increase the enrollment of cases in DRGs,and promote tiered diagnosis and treatment to reduce the personal burden rate for patients.

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Objective To investigate the causes and countermeasures of 159 cases of surgical complications and reduce the incidence of surgical complications.Methods According to the statistical caliber of surgical complications in"Operation Manual for Performance Appraisal of National Third-level Public Hospitals(2023 Edition)",the data of discharged surgical pa-tients from January 1,2021 to June 30,2023 were extracted from the medical record management system,and the data were sor-ted by EXCEL software and statistically processed by SPSS statistical software.The difference was statistically significant(P＜0.05).Results There was no gender difference.There were 57 cases of surgical complications at the age of 70-79.The most complications of thoracic surgery were 45 cases;The main surgical complications were grade Ⅲ and Ⅳ operations,accounting for 99.37％,and the titles of the chief surgeon were chief physician and deputy chief physician,accounting for 94.34％.Among 159 cases of surgical complications,pulmonary artery thrombosis ranked first,accounting for 15.72％.Conclusion The man-agement of surgical complications needs the support of information technology,strengthening preoperative risk assessment,impro-ving the grading management system of surgery,reducing the number of postoperative complications and reducing medical risks.

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Objective:To identify the strengths and weaknesses of hospital development through the application of individual scientific research performance assessment, thereby providing a basis for the formulation of science and technology policies.Methods:We established a research performance assessment system and conducted research performance assessments across the hospital for three consecutive years. The assessment results were analyzed in-depth, utilizing the Kruskal-Wallis test to determine if there were differences in the overall level of assessment scores between years and series; the Mann-Whitney test to analyze differences between the promoted and non-promoted groups; the χ2 test to analyze whether age, degree, gender, and maternity situations affected assessment grades. Results:From 2020 to 2022, the individual scientific research performance assessment scores showed an overall upward trend, with the average per capita assessment score increasing significantly from 35.26 points in 2020 to 74.04 points in 2022. There were statistical differences in the assessment scores of different professional titles, indicating that the senior professionals > the associate senior professionals > the intermediates. There was no significant difference between the promoted and non-promoted groups. Additionally, age, degree, gender, and maternity factors affected assessment grades.Conclusions:It has been preliminarily established that the assessment of individual scientific research performance can effectively steer the scientific innovation activities of researchers, and play a positive role in enhancing the overall scientific research strength. The findings from the data analysis indicate that the hospital is expected to continuously enhance its scientific research performance by focusing on newly recruited doctoral personnel, establishing a system of support and guidance, and providing preferential support to female researchers. The assessment results serve as a " benchmark" for management departments and provide data-driven insights for the development of science and technology policies.

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Objective:To explore the relationships among 4 primary indicators in the performance assessment and evaluation system of tertiary public hospitals.Methods:A questionnaire survey was employed to collect data on healthcare professionals'perceptions of the rationality of performance evaluation indicators.Structural equation modeling(SEM)and Amos 21.0 Statistical Software were utilized for data analysis,with the mediation effects tested using the Bootstrap method.Results:A total of 826 valid questionnaires were obtained.Medical quality,operational efficiency,and sustainable development had a positive impact on satisfaction.Operational efficiency and sustainable development played a chain-mediated role in the process of medical quality influencing satisfaction evaluation,namely"medical quality → operational efficiency → sustainable development → satisfaction".Conclusion:It helps to flexibly apply and deepen the integration of knowledge in the field of enterprise management into the field of hospital management,helps hospitals to scientifically formulate internal performance evaluation programs under the premise of limited resources,and provides new ideas for the country to optimize the performance appraisal index system of tertiary public hospitals.

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Objective:On the basis of post evaluation,the hospital pharmacy posts are scientifically classified and stratified,and the performance evaluation standard of pharmacy posts is constructed.Methods:The hospital pharmacy posts are classified and stratified by factor comparison method and the post value coefficient is determined.Delphi method and analytic hierarchy process are used to construct the performance evaluation index system of pharmaceutical posts and determine the performance evaluation standards.Results:Pharmacy posts in hospitals are divided into 5 categories,including clinical pharmacists,research pharmacists,static pharmacists,dispensing pharmacists and purchasing pharmacists.The indexes and weights of pharmaceutical post performance evaluation are determined from 4 dimensions:service,process,quality and cost,and the evaluation standard of pharmaceutical post performance oriented to rational drug use is established.Conclusion:The construction of pharmaceutical performance evaluation system meets the requirements of the reform of public hospitals for the transformation and development of pharmaceutical services,which is conducive to enhancing the enthusiasm of pharmaceutical personnel and improving the efficiency and benefit of pharmaceutical services.

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Science and technology evaluation plays an important role in improving the hospital's science and technology innovation capabilities and academic discipline construction.The global Cardiovascular Academic Performance Evaluation(CAPE)system focuses on the development of cardiovascular specialties in hospitals,emphasizing the evaluation of international academic performance of cardiovascular specialties,and delving into the sub-specialty of cardiovascular diseases.CAPE system contributes to pioneering preliminary explorations in literature searching strategies,data standardization,disciplinary definitions and other aspects.

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Objectives:To establish a comprehensive system of Cardiovascular Academic Performance Evaluation(CAPE)and rank global TOP100 medical institutions in the fields of cardiovascular diseases(CVD). Methods:CVD-related terms were extracted from Medical Subject Headings(MeSH),Embase thesaurus(EMtrees)and International Classification of Diseases(ICD)by CVD-related professionals,as well as by librarians and information professionals.Terminology databases(named as Fuwai Subject Headings)were established,and nine sub-disciplines were proposed,including ischemic heart diseases,hypertension,vascular diseases,arrhythmia,pulmonary vascular diseases,heart failure,congenital heart diseases,cardiomyopathy,and valvular heart diseases.The mapping patterns of sub-discipline,cardiovascular terminology and entry terms were pre-defined.The CVD-related research literature published from January 1,2016 to December 31,2022 were retrieved from Web of Science,PubMed and Scopus.Based on this,metadata were fused and duplicates were excluded.Fuwai Subject Headings were searched and matched into four respects for each literature,including subject words,titles,keywords,and abstracts,which was used to generate an information table of"Position—CVD terminology—Frequency",and to calculate CVD correlation scores and sub-discipline scores.We standardized the names of medical institutions and scholars,and make a ranking system for CAPE based on original articles with strong cardiovascular correlation(correlation score≥4).When evaluating the science and technological performance for Chinese hospitals in cardiovascular diseases,National Natural Science Foundation Projects,authorized invention patents,prize achievements,research platforms,and registered data of drug clinical trials in Center for Drug Evaluation(CDE)were considered besides research papers. Results:During 2016 and 2022,1 545 103 CVD research literatures were found worldwide.After excluding meeting abstracts,books,biographies,news,videos,audio texts,retracted publications,and corrections,1 178 019 CVD research literatures were further evaluated.518 058 literatures were indexed as"strongly correlated to CVD"using Fuwai Subject Headings.Besides papers,other data sources were also collected,including 11 143 CVD-related Natural Science Foundation Projects,19 382 CVD-related effective authorized invention patents,103 CVD-related national prize achievements,24 CVD-related national research platforms,and 2 084 CDE registered data of CVD-related drug clinical trials.Research teams from nine sub-disciplines reviewed and validated research literature in respective fields,and classification rules of corresponding sub-disciplines were created and improved based on their opinions.Finally,eleven individual indexes were chosen to construct CAPE system for ranking global TOP100 medical institutions in overall CVD field and TOP30 in nine sub-disciplines.From 2016 to 2022,the number of cardiovascular disease research papers published by Chinese institutes has increased by 123.5%,with a total of approximately 76.8 thousands papers published(about 30 papers per day on average),ranked the second under the United States(approximately 114.1 thousands papers).However,the proportion of papers published by the Chinese Journal Citation Reports(JCR)and the Chinese Academy of Sciences only ranked eighth in the world.In the comprehensive academic performance of original cardiovascular research papers in global hospitals from 2020 to 2022,only two Chinese medical institutions ranked in the TOP20 as evaluated by CAPE system. Conclusions:Based on multi-source data from 2016 to 2022,CAPE initiated to establish a cardiovascular academic performance evaluation system.

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In this article, the relationship between the hospital departures indicator, the main indicator for evaluating the performance of hospital management contracts in Bahia, and the incidence of moral hazard in light of Agency Theory was evaluated. Using a qualitative approach based on management contracts and data from the Hospital Admission System (SIH/SUS) in 2019, the performance of three hospitals representing the prevailing management models in the state was compared: direct management, Social Organization (OS), and Public-Private Partnership (PPP). The lower productivity in direct management and the higher frequency of low-complexity hospitalizations in the OS suggest the incidence of moral hazard in service delivery. As a strategy to mitigate this risk, a quantitative indicator is proposed for management contracts, which considers different types of hospitalizations in a weighted manner, based on variables available in the SIH/SUS. Although the inconsistencies in this system limit the specificity and potential of the pro-posed indicator, it is believed that its use can contribute to improving the evaluation of hospital management contracts and enhancing the SIH/SUS database, enabling further study of hospital admission measurement in future research (AU)

No artigo, avaliou-se a relação do indicador "saídas hospitalares", principal indicador de avalia-ção do desempenho de contratos de gestão hospitalar na Bahia, com a incidência do risco moral à luz da Teoria da Agência. Utilizando uma abordagem qualitativa a partir dos contratos de gestão e dos dados do Sistema de Internação Hospitalar (SIH/SUS) em 2019, comparou-se o desempenho de três hospitais que representam os modelos de gestão vigentes no estado: gestão direta, por Organização Social (OS) e por Parceria Público-Privada (PPP). A menor produtividade na gestão direta e a maior frequência de internações de baixa complexidade na OS são evidências que sugerem a incidência de risco moral na prestação do serviço. Como estratégia de mitigação deste risco, propõe-se um indicador quantitativo para os contratos de gestão, que considera de forma ponderada diferentes tipos de internação, a partir das variáveis disponíveis no SIH/SUS. Apesar das inconsistências deste sistema limitarem a especificidade e o potencial do indicador proposto, acredita-se que sua utilização pode contribuir para melhorar a avaliação dos contratos de gestão hospitalar e qualificar a base de dados do SIH/SUS, viabilizando o aprofundamento do estudo da medida da internação hospitalar em novas pesquisas (AU)

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O estudo buscou compreender a influência da estratégia do Pay for Performance (P4P), por meio do Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ-AB), na atuação do(a)s trabalhadore(a)s. Trata-se de um estudo de caso qualitativo realizado com o(a)s trabalhadore(a)s das Estratégias de Saúde da Família. A análise foi realizada mediante a técnica de construção de narrativas. Constatou-se que o P4P contribuiu para qualificação do processo de trabalho, ao mesmo tempo que estimulou competição e conflito entre as equipes, aflorando sentimentos de culpa e injustiça e, devido à precarização do trabalho, o estímulo financeiro se descaracteriza, tornando-se complemento salarial. Problemas macroestruturais afetam as condições de trabalho e a motivação do(a)s trabalhadore(a)s, de modo que modelos de incentivo financeiro, isoladamente, não são suficientes para reverter tal cenário.(AU)

This study sought to understand the influence of pay-for-performance (P4P) on worker performance using data from the National Program for Improving Primary Care Access and Quality (PMAQ-AB). We conducted a qualitative case study with professionals working in family health strategy teams. The data were analyzed using the narrative construction technique. The findings show that P4P contributed to the improvement of work processes, while at the same time stimulating competition and conflict between the teams, causing feelings of guilt and injustice. However, the original purpose of the financial incentive is defeated due to poor working terms and conditions, becoming akin to a salary supplement. Macrostructural problems affect working conditions and worker motivation, showing that financial incentive models alone are not sufficient to reverse this situation.(AU)

El estudio buscó comprender la influencia de la estrategia Pay for Performance (P4P), por medio del Programa de Mejora del Acceso y Calidad de la Atención Básica (Pmaq-AB), en la actuación de los trabajadores y las trabajadoras. Se trata de un estudio de caso, cualitativo, realizado con los trabajadores y las trabajadoras de las Estrategias de Salud de la Familia. El análisis se realizó mediante la construcción de narrativas. Se constató que el P4P contribuyó para la calificación del proceso de trabajo, al mismo tiempo que incentivó competencia y conflicto entre los equipos, haciendo aflorar los sentimientos de culpa e injusticia y, debido a la precarización del trabajo, el incentivo financiero se descaracteriza pasando a ser complemento salarial. Problemas macroestructurales afectan las condiciones de trabajo y la motivación de los trabajadores y de las trabajadoras, de modo que los modelos de incentivo económico, aisladamente, no son suficientes para revertir ese escenario.(AU)

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Abstract Risks are intrinsic to any human activity. Occupational Health and Safety Management Systems (OHSMSs) are mechanisms designed to mitigate risks, protect workers, and ensure productivity. This study aimed to support researchers' reflective analysis by examining scientific literature related to OHSMSs and identifying possibilities for future research with practical significance. Employing a qualitative approach, this systematic review was conducted using bibliographic procedures and action research. The intervention instrument ProKnow-C guided by a structured process from a constructivist perspective, was applied. A total of 3,130 studies were analyzed to select the bibliographic portfolio. The systemic analysis revealed that most articles neither demonstrate legitimacy nor consider companies' particularities. The paper advances theoretical knowledge of OHSMSs by assessing relevant studies in the field, identifying evolution patterns, and highlighting gaps. A research agenda is proposed to guide the development of future models. We conclude that the challenges of designing ad hoc OHSMSs and incorporating the decision-makers' knowledge throughout the process when addressed, have the potential to significantly contribute to the advancement of this field of knowledge.

Resumo Os riscos são intrínsecos a todas as atividades humanas. Os sistemas de avaliação de desempenho de saúde e segurança no trabalho (SADSSTs) são mecanismos projetados para lidar com riscos, proteger os trabalhadores e garantir produtividade. Este estudo objetivou apoiar a análise reflexiva dos pesquisadores com base na literatura científica relacionada aos SADSSTs, identificando possibilidades de pesquisas futuras de importância prática. Com abordagem qualitativa, esta revisão sistemática foi desenvolvida com a adoção de procedimentos bibliográficos e pesquisa-ação. Foi utilizado o instrumento de intervenção ProKnow-C, um processo estruturado orientado pela perspectiva construtivista. Um total de 3.130 estudos foi analisado para a seleção do portfólio bibliográfico. A análise sistêmica revelou que a maioria dos artigos não apresenta legitimidade, nem considera as particularidades das empresas. O artigo avança no conhecimento teórico dos SADSSTs avaliando os estudos relevantes na área e identificando padrões de evolução e lacunas. Propõe-se uma agenda de pesquisa para orientar o desenvolvimento de modelos futuros. Conclui-se que o desenvolvimento de um SADSST ad hoc, não genérico e concebido com o conhecimento do decisor em todo o processo, permanece sendo um desafio e tem potencial para contribuir para o avanço deste campo do conhecimento.

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Strawberry, an important berry fruit crop with high value and nutritional properties is picking up in the South Indian conditions, especially in Tamil Nadu under temperate region of Nilgiris district. Since the fruit is directly consumed by the children and all group of categories, the choice of varieties and its performance in terms of fruit yield and quality particularly sugar and acidity level will decide the marketability and preference. The field evaluation of strawberry varieties collected from different places and suitability will help the farmers to cultivate and get benefit and profitability out of the crop. A collection of nine strawberry varieties was done and assessed for the performance under greenhouse growing environment, in Nilgiris condition with randomized block design having three replications during the year 2018 to 2020 in Horticultural Research Station, TNAU, Ooty, Nilgiris.The variety Rania recorded better performance for plant height (33.81 cm), plant spread(E-W) [45.38 cm], (N-S) [43.96 cm] during 120 days after planting. Flavia recorded more number of leaves (24.80). Rania recorded a fruit length (4.05 cm), fruit width (11.29 cm), fruit weight (27.62 g). The variety Capri recorded more number of fruits per plant (68.86) which is on par with Flavia (68.80). The fruit quality parameters Total Soluble Solids (TSS) is high with 12.43o brix in Nabila and acidity (0.98 %) in Flaminia. The highest yield per plant (1190.20 g) was recorded in Flavia and with lowest yield in Capri (563.46 g). The variety Flavia recorded maximum in fruit parameters like fruit length, fruit width, fruit weight and highest yield whereas fruit quality parameters of TSS and acidity is highest in Nabila and Flaminia respectively.

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Objective To rapidly screen patients with novel coronavirus pneumonia (COVID-19) infection including asymptomatic ones. Method Established a rapid detection test kit, and evaluated analytical and clinical performance of it. Result The minimum limit of detection of the reagent was 9.75×102 TCID50/mL; there was no cross-reaction and interference in the high-concentration samples of 29 common respiratory pathogens tested. The diagnostic sensitivity of clinical samples was 98.56%, specificity was 99.00%, and the total coincidence rate was 98.85%; the consistency test Kappa value is 0.974 5. The stratified analysis of positive samples with different Ct values showed that the coincidence rate within each stratum was greater than 95%. Conclusion This COVID-19 antigen test kit with excellent detection performance, fast detection speed, and portable operation. It can be used as a supplementary method for existing nucleic acid detection methods for early screening of new coronavirus.

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In recent years, the biopharmaceutical industry has developed rapidly, creating urgent demand for high-quality, innovative, and application-oriented talents. In the context of "first-class undergraduate education", it is of great significance to reform and explore biopharmaceutics blended learning to foster professional talents who can adapt to the industrial development. The blended teaching of biopharmaceutics course in Hubei University was based on small private online course (SPOC) and ChaoXing platform, aiming to meet the first-class "AIC (advanced, innovation, challenge)". The course strengthened the three phases of teaching: before, during, and after class, and innovated teaching methods actively to achieve curriculum goals, and integrated typical cases organically. In addition, the course improved the discriminative power of assessment by strengthening the formative performance evaluation. Moreover, the course provided guidance for students to improve the learning efficiency through investigating the students' learning behavior and employing the marginal utility curve to analyze the characteristics of group activities. Furthermore, the course also offered students personalized learning guidance based on their career planning. The reform of biopharmaceutics blended teaching has achieved significant outcomes, such as improving students' satisfaction, students' innovation and entrepreneurship ability, and curriculum construction level, thus may serve as a reference for the teaching reform and research of the related courses.

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Objective To establish a method to quantify serum fat-soluble vitamins by liquid chromatography-tandem mass spectrome-try and evaluate their performance in preliminary clinical application.Methods The contents of fat-soluble vitamin in serum were quantified by liquid chromatography-tandem mass spectrometry.The samples were collected from 1 113 pregnant women from November 2022 to November 2023 at the Obstetrics Clinic of the First Affiliated Hospital of Soochow University.The method of liquid chromatog-raphy-tandem mass spectrometry for determination of fat-soluble vitamins in serum was validated referring to"Consensus of method de-velopment and validation of liquid chromatography-tandem mass spectrometry in clinical laboratories".Results The linear ranges of vitamin A,E,D2,D3 and K1 in serum were from 40 to 4 000 ng/mL,0.5 to 50 μg/mL,2 to 200 ng/mL,5 to 250 ng/mL and 0.1 to 10 ng/mL,respectively.The detectable limit was 2.50 ng/mL,0.10 ng/mL,0.40 ng/mL,1.00 ng/mL and 0.02 ng/mL,respec-tively.The limit of quantitation was 10.00 ng/mL,0.50 ng/mL,1.00 ng/mL,5.00 ng/mL and 0.10 ng/mL,respectively.The intra-batch coefficient of variation(CV)and inter-batch CV were all less than 15％.The rate of recovery was 91.25％to 107.18％,90.00％to 105.51％,92.88％to 107.87％,93.36％to 107.40％and 90.20％to 104.40％,respectively.The various fat-soluble vitamins in ser-um remained stable within 7 days under-20 ℃.The levels of fat-soluble vitamins in serum of pregnant women were detected by liquid chromatography-tandem mass spectrometry.There were significant differences of the levels and distributions for various fat-soluble vita-mins in the pregnant women in different age groups(P＜0.05),and the levels of fat-soluble vitamins gradually increased with the age.Conclusion The basic performance of the liquid chromatography-tandem mass spectrometry verified in this experiment was in line with the evaluation criteria,thus it should be highly sensitive and accurate for analyzing the contents of various fat-soluble vitamins in serum.

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Objective:We conducted a real-world multi-center clinical study with a large sample size to comprehensively evaluate the performance of three commercial hepatitis C virus (HCV) core antigen assays. The study aimed to evaluate the performance for their use in HCV infection screening, and to provide clues for further improving the sensitivity and specificity of the assays.Methods:Key performance indicators including the lower limit of detection (LOD), diagnostic sensitivity, and specificity of three HCV antigen assays (the Architect, Laibo, and ChemClin HCV core antigen assays) were evaluated using commercial seroconversion panels reflecting early HCV infection and clinical routine serum samples of outpatients and inpatients from 3 tertiary hospitals from January 2018 to April 2022. Factors that affect the performance indicators were further investigated.Results:The window period for detecting HCV infection with the three antigen assays was equal to or slightly longer than that of the RNA assay, but all are shorter than that of the anti-HCV assay. There was a good linear positive correlation between HCV core antigen and HCV RNA levels in treatment naive patients with hepatitis C ( r=0.90, P<0.01). For the most common genotype 1b strain in China, the LOD of the three HCV assays were equivalent to 531 IU/ml (Architect), 3,698 IU/mL (Laibo), and 4,624 IU/mL (ChemClin) HCV RNA, respectively. Due to the skewed distribution of HCV RNA levels in treatment-naive hepatitis C patients, more than 95% of the patients had viral loads higher than 6 166 IU/ml. Therefore, the three HCV antigens assays still maintained a satisfactory diagnostic sensitivity (94.33%-99.40%). Among 54 immunodeficient patients (leukemia patients) with HCV infection, 9% (5/54) had negative anti-HCV results, while the HCV antigen assays found all these infectors. Through further experiments, we revealed the amino acid polymorphism in the core region of genotype 3 strain impaired the sensitivity of all three HCV antigen assays. In addition, the sensitivity of the two domestic assays was impaired by anti-HCV antibodies in the serum. The specificity of HCV antigen assays for diagnosing hepatitis C is 99.94% to 99.98%. The rheumatoid factors, autoantibodies, and other unknown interference substances can lead to a small number of low level, "false positive" antigen results. Conclusions:HCV core antigen assay may be used as a satisfactory approach of infection screening, especially for the immunodeficient patents. However, the sensitivity and specificity of the assays are influenced by multiple factors, which should be further improved.

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Objective:To establish a performance evaluation system for medical equipment and conduct empirical research, providing a reference for the performance assessment and refined management of medical equipment.Methods:Based on literature research and expert consultation, a multi-dimensional medical equipment performance evaluation index system was constructed. Based on this indicator system, the fuzzy comprehensive evaluation method was used to objectively evaluate the performance level of CT, MRI, digital subtraction angiography (DSA), and ultrasound equipment of 6 hospitals in Hubei Province from 2019 to 2021.Results:The evaluation system included 4 first-level indicators including equipment service benefits, social benefits, economic benefits, and sustainable development benefits, including 9 second-level indicators and 21 three-level indicators. In the comprehensive evaluation of hospitals and equipments, there were obvious differences in the performance evaluation results of different types of equipment among hospitals. The comprehensive performance level of DSA was relatively lower compared to other devices. A longitudinal comparison was conducted on DSA equipment, and it was found that its economic benefits had declined and its social benefits had not been fully utilized.Conclusions:The establishment of a scientific performance evaluation system for medical equipment can effectively serve the decision-making and efficient operation of hospital equipment management. It can help hospitals continuously improve the level of refined management of medical equipment from the aspects of establishing management mechanisms and strengthening personnel management, and fully leverage the comprehensive benefits of equipment.

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Performance evaluation of administrative personnel is challenging for performance reform of public hospitals. Constructing a reasonable performance evaluation plan for such personnel is conducive to promoting the high-quality and efficient development of hospitals. Hospital H has been exploring the implementation of performance evaluation reform for administrative personnel since 2019. Firstly, it clarified the responsibilities of various administrative management positions throughout the hospital and adopted the Hay position evaluation method for job value evaluation. Secondly, based on this, a performance evaluation index system covering common indexes, personality indexes, and implicit ability indexes was constructed, and the calculation and distribution methods of performance bonuses were clarified. The development of common indexes was based on the hospital′s " 14th Five Year Plan" , while individual indexes were used as key performance evaluation points of each department formulated according to the hospital′s annual key work breakdowns and the " 14th Five Year Plan" . The implicit ability index was constructed based on the competency model to guide and promote the personal development of employees. Finally, the hospital established a feedback and monitoring mechanism to ensure the steady operation of the performance evaluation plan. Thanks to the performance reform of administrative personnel based on job value evaluation, Hospital H has eliminated the phenomenon of " egalitarianism" in the distribution of administrative personnel performance, played a guiding and motivating role in performance evaluation for employees, and achieved better implementation of the hospital′s strategic goals. This can provide reference for the performance reform of administrative personnel in other medical institutions.

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In order to ensure the smooth implementation of the capitation reform of outpatient clinics in China, it is urgent to establish a set of appropriate performance evaluation framework and index system. This study sorted out and described the capitation performance evaluation framework, index system content and payment rules of the United Kingdom, the United States, the Netherlands and Portugal, and conducted international comparison and analysis from the dimensions of service delivery mode, evaluation system, evaluation object, evaluation purpose, evaluation dimension, indicator setting, and incentive mechanism. Combined with the implementation status of the outpatient capitation payment reform in China, the following suggestions were put forward for the establishment of the outpatient capitation payment performance evaluation index system: introduce medical quality evaluation indicators based on value results, and link the evaluation results with the incentive mechanism; Select appropriate evaluation content based on the characteristics of the implementation institution and guarantee scope of the capitation reform and so on; The setting of evaluation indicators should be adjusted dynamically according to local conditions, and the combination of fixed indicators and personalized indicators should be explored; Adopt diversified index assessment forms and quality evaluation dimensions to ensure the statisticity and malleability of performance evaluation.