Retrospective Analysis of External Quality Assessment Data of Humoral (Except Feces) Morphology in Guangxi from 2010 to 2022

[Objectives] The study aims to improve the ability of inspectors to recognize humoral morphology and provide data reference for the improvement of EQA work of humoral morphology by Guangxi Clinical Laboratory Center. [Methods] A retrospective analysis was made on the EQA of humoral morphology by Guangxi Clinical Laboratory Center from 2010 to 2022, and the number of participating laboratories, the rate of return, sample types and maps of EQA of humoral morphology such as urine sediment, vaginal secretions and so on(except feces), and the reasons for the high error rate of the results of the participating laboratories were analyzed. [Results] The number of laboratories participating in the assessment of humoral morphology increased from 98 in 2010 to 371 in 2022. Except for 2011(90.98%), the rate of return was more than 94%, and the highest rate of return was up to 100%. A total of 119 pictures of EQA of humoral morphology were studied, including 101 urine sediment smears, 13 vaginal secretions smears and 5 other smears. The types of specimens were relatively comprehensive. The distribution of the maps was basically reasonable. The urinary sediment was mainly composed of crystalline salts, followed by tubes, and cells and fungi ranked third. The coverage was relatively complete. The error rate of return results from high to low were bacteria(error rate was equal to 40%), tubes and crystalline salts(error rate was close to 29%), and cells and fungi(error rate was about 14%). The main cases with high error rate of return results are as follows: the difference between different tubes was not clear, and the diversity of crystal morphology was not understood enough;the phase division of cells in the same system was wrong. [Conclusions] The analysis and summary of the reasons for the high error rate of the data and results of Guangxi's EQA of humoral morphology is helpful for laboratory physicians to improve their awareness of morphological examination and identify clearly the error type and blurred concept, and lays a foundation for Guangxi Clinical Laboratory Center to carry out EQA of humoral morphology more specifically.

External quality assessment on detection of hepatitis C virus RNA in clinical laboratories of China

Background As with many studies carried out in European countries, a quality assurance program has been established by the National Center for Clinical Laboratories in China （NCCL）. The results showed that the external quality assessment significantly improves laboratory performance for quantitative evaluation of hepatitis C virus （HCV） RNA. Methods Serum panels were delivered twice annually to the clinical laboratories which performed HCV RNA detection in China. Each panel made up of 5 coded samples. All laboratories were requested to carry out the detection within the required time period and report on testing results which contained qualitative and/or quantitative test findings, reagents used and relevant information about apparatus. All the positive samples were calibrated against the first International Standard for HCV RNA in a collaborative study and the range of comparison target value （TG） designated as ±0.5 log. Results The numbers of laboratories reporting on qualitative testing results for the first and second time external quality assessment were 168 and 167 in the year of 2003 and increased to 209 and 233 in 2007; the numbers of laboratories reporting on quantitative testing results were 134 and 147 in 2003 and rose to 340 and 339 in 2007. Deviation between the mean value for quantitative results at home in 2003 and the target value was above 0.5 log, which was comparatively high. By 2007, the target value was close to the national average except for the low concentrated specimens （10^3 IU/ml）. The percentage of results within the range of GM±0.5 log10 varied from 8.2% to 93.5%. Some laboratories had some difficulties in the exact quantification of the lowest （3.00 log IU/ml） as well as of the highest viral levels （6.37 log IU/ml） values, very near to the limits of the dynamic range of the assays. Conclusions The comparison of these results with the previous study confirms that a regular participation in external quality assessment （EQA） assures the achievement of a high proficiency level in the diagnosis of HCV infection. During the 5-year external quality assessment, sensitivity and accuracy of detection in most of the clinical laboratories have been evidently improved and the quality of kits has also been substantially improved.

External quality control and training of semen analysis in the Netherlands:starting point for further reduction of outcome variability

Semen analysis is characterized by high levels of intra-and inter-laboratory variability,due to a low level of standardization,high subjectivity of the assessments,and problems with automated procedures.To improve consistency of laboratory results,quality control and training of technicians are important requisites.The goals of this study are to evaluate the results of an external quality control(EQC)program and standardized training by ESHRE Basic Semen Analysis Courses(BSAC)on the variability in manual assessments of semen parameters.We performed retrospective analyses of(1)the interlaboratory variability in the Dutch EQC program and(2)the interobserver variability in BSACs for concentration,motility,and morphology assessments.EQC data showed that the interlaboratory coefficient of variation(CV)for concentration assessment decreased(range from 24.0%–97.5%to 12.7%–20.9%)but not for morphology and motility assessments.Concentration variability was lower if improved Neubauer hemocytometers were used.Morphology assessment showed highest CVs(up to 375.0%),with many outliers in the period of 2007–2014.During BSAC,a significant reduction of interobserver variability could be established for all parameters(P<0.05).The absence of an effect in the EQC program for motility and morphology might be explained by respectively the facts that motility assessment was introduced relatively late in the EQC program(since 2013)and that criteria for morphology assessment changed in time.BSAC results might have been influenced by the pretraining level of participants and the influence of external factors.Both EQC and training show positive effects on reducing variability.Increased willingness by laboratories to change their methods toward standards may lead to further improvements.

Calculation of the external quality factor of the high power input coupler for the BEPCⅡ superconducting cavity

It is very important to predict the coupling between the cavity and the high power input source in the coupler design. In this paper, a time domain method is used to calculate the external quality factor Qext for the BEPC Ⅱ superconducting cavity. A comparison between simulation results and experimental results is presented. The results of simulation and measurement of Qext have a good agreement within an error of 10%. The geometry parameters related with Qext are also studied.

Urgent needs in fostering neglected tropical diseases(NTDs)laboratory capacity in WHO Western Pacific Region:results from the external quality assessment on NTDs diagnosis in 2012-2015

Background:Neglected tropical diseases(NTDs)are a heterogeneous group of mainly chronic,debilitating and often stigmatizing diseases that largely affects low-income and politically marginalized populations,causing a large burden of public health,social and economies in the NTDs endemic countries.NTDs are caused by infections with a range of pathogen,including bacteria,parasites,protozoa and viruses.The accurate diagnosis of NTDs is important for reducing morbidity,preventing mortality and for monitoring of control programs.External Quality Assessment(EQA),a component of laboratory quality assurance,aims to assess the performance of participating laboratories in detecting parasitic infections.The aim of this paper is to report the findings and put forward the recommendations on capacity build from the EQA results of participating NTDs laboratories in selected countries in the WHO Western Pacific Region from 2012 to 2015.Methods:Reference or public health laboratories at national level working on NTDs in 6 countries participated in EQAs organized by the National Institute of Parasitic Diseases(NIPD)of Chinese Center for Disease Control and Prevention(CDC)based in Shanghai,China.Two representatives of each participating laboratory were invited to NIPD to detect NTDs’parasitic infections using the same prepared samples for serological tests(IHA and ELISA)and helminth eggs’morphological tests(Direct smear and Kato-Katz).All of the results were scored and analyzed by using SPSS statistics 19.0 software.Results:The percentage of participants who had EQA score≥60 during 2012-2015 for direct smear test were 80.00%(2012),71.43%(2013),100%(2014)and 75.00%(2015),whereas for Kato-Katz test were 80.00%(2012),57.14%(2013),100%(2014)and 37.50%(2015),respectively.The detection rate of helminth eggs varied in different species,with Ascaris lumbricoides being the highest at 94.07%in average.All laboratories did very well with ELISA tests as shown by the high scores in all four years except Lab A in the first and last EQA.For the positive or negative judgments of serum samples,the total coincidence rates of ELISA between 2012 and 2015 were 90.00%,99.29%,94.29%and 98.75%,respectively.While the total coincidence rates of IHA were respectively 100%,95.00%,90.00%and 97.50%.However,detecting low levels of serum antibody remained problematic for IHA when the titres of samples were taken into consideration.Conclusion:This study demonstrate that EQA scheme have been beneficial to the participating laboratories.The EQA programme identifies certain deficiencies which were needed to overcome and improved the laboratories’performance in helminthiasis diagnosis.However,further optimization of accuracy and uniformity in NTDs diagnosis remains a big challenge.

Quality oriented value and performance drivers

The quality endeavors of an organization, like other enterprise activities, must be oriented towards the economic principles. This approach gives a way to many organizations to question the extent to which the quality management contributes for the overall business success and to pin point the areas where particularly a high value or performance can be created in order to attain the maximum possible economic benefits out of quality management systems. Without including the answer of this question in the decision making process, the resources can not be allocated optimally for the quality purpose. Quality management activities create variety of effects that indirectly contributes towards the economic success and thus increase the company and stakeholder value. A closer look at the quality management philosophy reveals eight major principles namely： customer focus, leadership, involvement of people, process approach, system approach to management, continual improvement, factual approach to decision making, mutually beneficial supplier relationships. These eight principles lead the efforts in the domain of quality management to project a positive impact on the company. For an understanding of response relationships, it is necessary to consider in detail the indicators along the response relationships. They provide helpful clues and give an insight into the complex mechanisms of action of the quality approaches on the path to the company＇s success. The following illustration depicts how the quality based activities generate the value to enhance the performance and a variety of indicators reflects how they indirectly add value to an organization and hence contribute to its economic success.

Quality Assurance Mechanisms and Strategies for the Internationalization of Chinese Higher Education

This study comprehensively analyzes the current state,challenges,and strategies for the internationalization of Chinese higher education.It underscores the significance of internationalization in enhancing the soft power of the nation and cultivating globally-minded talents.The research concludes that robust internal quality assurance mechanisms and external quality assurance frameworks are fundamental to ensuring the quality of education and propelling its internationalization.By comparing different countries’higher education quality assurance mechanisms,valuable experiences and insights have been drawn.The study proposes strategic recommendations aimed at reforming and innovating to comprehensively improve the international quality of Chinese higher education.However,the research has limitations,including data constraints and a focus primarily on undergraduate education,with less exploration of other educational levels.Future research should employ empirical investigations and quantitative analyses to further verify the conclusions and recommendations of this study.

The Impact of the External Audit Quality on the Financial Performance of Conventional and Islamic Banks

The continuing emergence of sudden financial crises and the bankruptcy of Big banks audited by the‘Big Four’auditors confirms that the external audit quality(EAQ)always remains insufficient compared to the desired quality.The quality weakness is due either to the bad audit company choice,although their sizes,or to the disrespect of the good audit rules.Because there is a lack of comparative studies in the framework of conventional and Islamic banks,this paper aims to compare the impact of EAQ on the financial performance(FP)of 180 conventional banks and 180 Islamic banks.FP and EAQ variables are collected from 56 countries over the period(2010-2020).To overcome the mystery of the best EAQ selection based on its impact on FP,this paper relied on the GLS estimator.Consequently,this paper concluded that the EAQ affected the conventional banks’FP,but it improved that of Islamic banks with a moderate impact.

Annual report readability and corporate agency costs

Annual reports are the main sources of information for outside investors' investment decisions and enable shareholders to supervise the management.Difficulties with the readability of these reports may therefore have serious consequences. Using 19,221 firm-year observations of Chinese A-share listed firms from 2001 to 2015, we investigate the association between annual report readability and corporate agency costs, where readability is proxied by report file length and/or file size. We find that firms with better annual report readability experience lower agency costs, and the negative association between readability and agency costs is more pronounced in firms with higher external audit quality, internal control quality or analyst coverage. These results hold after several robustness checks. The positive effect of annual report readability is stronger in private firms than in state-owned enterprises, and becomes stronger after the implementation of new accounting standards in 2007. Readable annual reports can help in monitoring corporate insiders' opportunistic behavior and thus reduce agency costs.