Turnaround Time Research Articles

AGV Scheduling for Optimizing Irregular Air Cargo Containers Handling at Airport Transshipment Centers

Airport transshipment centers play a pivotal role in global logistics networks, enabling the swift and efficient transfer of cargo, which is essential for maintaining supply-chain continuity and reducing delivery times. The handling of irregularly shaped air cargo containers presents new constraints for automated guided vehicles (AGVs), as these shapes can complicate loading and unloading processes, directly impacting overall operational efficiency, turnaround times, and the reliability of cargo handling. This study focuses on optimizing the scheduling of AGVs to enhance cargo-handling efficiency at these hubs, particularly for managing irregular air cargo containers. A mixed-integer linear programming (MILP) model is developed, validated for feasibility with the Gurobi solver, and designed to handle large-scale operations. It incorporates a novel approach by integrating a simulated annealing optimized genetic algorithm (GA). The experimental results demonstrate that the designed algorithm can solve models of considerable size within 8 s, offering superior time efficiency compared to the solver, and an average solution quality improvement of 12.62% over the genetic algorithm, significantly enhancing both the model’s efficiency and scalability. The enhanced AGV scheduling not only boosts operational efficiency but also ensures better integration within the global logistics framework. This research provides a robust foundation for future advancements in logistics technology, offering both theoretical and practical insights into optimizing complex transportation networks.

Development and validation of automated methods for COVID-19 PCR Master Mix preparation

Polymerase chain reaction (PCR)-based assays were widely deployed during the SARS-CoV-2 pandemic for population-scale testing. High-throughput molecular diagnostic laboratories required a high degree of process automation to cope with huge testing demands, fast turnaround times, and quality requirements. However, process developers and optimizers often neglected the critical step of preparing a PCR Master Mix. The construction of PCR Master Mix depends on operator skill during the manual pipetting of reagents. Manual procedures introduce variation, inconsistency, wastage, and potentially risks data integrity. To address this, we developed a liquid-handler-based solution for automated, traceable, and compliant PCR Master Mix preparation. Here, we show that a fully automated PCR Master Mix protocol can replace manual pipetting, even in a diagnostic environment, without affecting accuracy or precision. Ultimately, this method eliminated operator-induced wastage and improved the consistency of the quality of results.

Lean methodology in health care practice: an example of application for clinical laboratory urinalysis processing.

Improving quality and laboratory testing turnaround time (TAT) is a constant challenge for a clinical laboratory. The formulas that describe the best way to manage these goals are outlined in International Organization for Standardization standards. According to standards, improvement must be timely and continuous. Lean methodology is a tool to meet this requirement. One of the fundamental elements of Lean is a systematic approach to process improvement by removing waste to create value for the end-user (eg, patient) of the service. This methodology can be adapted in resource-limited settings. The aim of this study was to test the application of Lean methodology in urinalysis. Lean has various collections of tools and concepts. We applied the most useful for the clinical laboratory: Gemba walk, Takt time, cycle time, and value-stream mapping. Finally, we created and approved workplace standards to improve the performance of urinalysis. We compared the TATs of urinalysis tests before optimization, immediately after, and long after (~5 months). We found that TATs had significantly shortened. The TATs of emergency (STAT) urine tests immediately after optimization improved: automated microscopy to 16% (P =.194), fully automated test-strip to 23% (P = .0172), and standardized urine sediment examination to 20% (P =.0048). The TATs of routine urine tests also improved immediately after optimization: automated microscopy to 18% (P <.0001), fully automated test-strip to 11% (P =.0025), and standardized urine sediment examination to 18% (P =.0011). After 5 months of Lean application within the urinalysis laboratory, TATs of routine urine tests remained improved; however, the improvement of STAT urine test TATs dropped to approximately 4%. The application of the Lean methodology shows significant improvement in TATs of processes in our laboratory.

An Artificial Intelligence Algorithm Integrated into the Clinical Workflow Can Ensure High Quality Acute Intracranial Hemorrhage CT Diagnostic.

Intracranial hemorrhage (ICH) is alife-threatening condition requiring rapid diagnostic and therapeutic action. This study evaluates whether Artificial intelligence (AI) can provide high-quality ICH diagnostics and turnaround times suitable for routine radiological practice. Aconvolutional neural network (CNN) was trained and validated to detect ICHs on DICOM images of cranial CT (CCT) scans, utilizing about 674,000 individually labeled slices. The CNN was then incorporated into acommercial AI engine and seamlessly integrated into three pilot centers in Germany. Areal-world test-dataset was extracted and manually annotated by two experienced experts. The performance of the AI algorithm against the two raters was assessed and compared to the inter-rater agreement. The overall time ranging from data acquisition to the delivery of the AI results was analyzed. Out of 6284 CCT examinations acquired in three different centers, 947 (15%) had ICH. Breakdowns of hemorrhage types included 8% intraparenchymal, 3% intraventricular, 6% subarachnoidal, 7% subdural, < 1% epidural hematomas. Comparing the AI's performance on asubset of 255 patients with two expert raters, it achieved asensitivity of 0.90, aspecificity of 0.96, an accuracy of 0.96. The corresponding inter-rater agreement was 0.84, 0.98, and 0.96. The overall median processing times for the three centers were 9, 11, and 12 min, respectively. We showed that an AI algorithm for the automatic detection of ICHs can be seamlessly integrated into clinical workflows with minimal turnaround time. The accuracy was on par with radiology experts, making the system suitable for routine clinical use.

Monitoring of Pseudomonas aeruginosa mutational resistome dynamics using an enrichment panel for direct sequencing of clinical samples

Pseudomonas aeruginosa is a major cause of hospital-acquired and chronic infections, characterised by an extraordinary capacity to develop antimicrobial resistance through the selection of chromosomal mutations, leading to treatment failure. Here, we designed and tested a hybridisation-based capture system for the enrichment of genes of interest before sequencing to monitor resistant populations genomics directly from clinical samples. A panel for enrichment before sequencing of close to 200 genes related to P.aeruginosa antimicrobial resistance, multilocus sequence typing, mutability or virulence was designed, synthesised (KAPA HyperCap, Roche) and initially validated invitro using a multidrug-resistant ST175 isolate and representative isolates from major P.aeruginosa clades. Invivo testing included ventilator associated pneumonia by MDR P.aeruginosa in ICU (3-10 sequential samples from 3 patients) and chronic respiratory infection by hypermutable P.aeruginosa in cystic fibrosis (8 sequential samples from a single patient covering a 4-year period). Results from direct sequencing with the enrichment panel were compared with those of whole genome sequencing (WGS) and phenotypic profiling of 10 isolated colonies per sample. Invitro assays confirmed the selectivity of the enrichment panel and the correct identification of the vast mutational resistome of ST175, including specific mutations even when introduced in a 1:100 proportion. Invivo performance was at least equivalent to sequencing 10 colonies per sample, including the accurate identification of the sequence types and the basal and acquired mutational resistome. To note, specific resistance mutations, such as those in ampC leading to resistance to novel β-lactams, could be traced even at frequencies of 1%. Moreover, the coselection of mutator populations and antibiotic resistance mutations, predicted in theoretical and invitro studies, was evidenced invivo. This proof-of-concept study demonstrates that resistance genomics of P.aeruginosa can be analysed directly from clinical samples, determining not only a considerable reduction in turnaround time and cost from a diagnostics perspective, but also an unprecedented potency for accurate monitoring of invivo population dynamics in bacterial infections. Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea-NextGenerationEU.

Comparing Point-of-Care Technology to ELISA Testing for Infliximab and Adalimumab Levels in Adult Inflammatory Bowel Disease Patients: A Prospective Pilot Study.

Introduction: Therapeutic drug monitoring (TDM) has proven to be a valuable strategy for optimizing biologic therapies, among which are anti-tumor necrosis factor (anti-TNF) treatments in inflammatory bowel disease (IBD). In particular, reactive TDM has been shown to manage treatment failures more cost-effectively than empirical dose adjustments for anti-TNF drugs. However, several challenges currently impede the widespread adoption of TDM in clinical practice, particularly addressing the delay between sample collection and result availability. To overcome this limitation, the use of point-of-care technology tests (POCTs) is a potential solution. Point-of-care technology tests are medical diagnostic tests performed at the site of patient care to provide immediate results, allowing for quicker decision-making and treatment. The current standard of care (SOC) for drug level measurement relies on the enzyme-linked immunosorbent assay (ELISA), a method that is time-consuming and requires specialized personnel. This study aims to evaluate a novel, user-friendly, and efficient POCT method (ProciseDx Inc.) and compare its performance with the SOC ELISA in assessing infliximab and adalimumab levels in blood samples from IBD patients. Methods: In this prospective, single-center study, we collected blood samples from IBD patients, both CD and UC, receiving infliximab (87 IBD patients; 50% UC and 50% CD) or adalimumab (60 patients; 14% UC and 48% CD) and we analyzed the blood's drugs levels using both the ProciseDx Analyzer POC and the SOC ELISA. We examined the correlation between the two methods using statistical analyses, including the Deming regression test. Additionally, we assessed the ease of use, turnaround time, and overall practicality of the POCT in a clinical setting. Results: The ProciseDx test demonstrated a strong correlation with the SOC ELISA for measuring both infliximab and adalimumab levels. In particular, the overall correlation between the ProciseDx POCT and the ELISA assessments showed an r coefficient of 0.83 with an R squared value of 0.691 (95% CI 0.717-0.902) for IFX measurements, and an r coefficient of 0.85 with an R squared value of 0.739 (95% CI 0.720-0.930). Conclusions: the ProciseDx POC test offers significantly faster turnaround times and is more straightforward to use, making it a viable alternative for routine clinical monitoring. Despite its promising potential, further refinement and validation of the ProciseDx test are necessary to ensure its effectiveness across diverse patient populations and clinical settings. Future research should focus on optimizing the POC tests' performance and evaluating its long-term impact on IBD management.

Comparison of commercial next-generation sequencing assays to conventional culture methods for bacterial identification and antimicrobial susceptibility of samples obtained from clinical cases of canine superficial bacterial folliculitis.

Bacterial identification and antimicrobial susceptibility testing is an important step in timely therapeutic decisions for canine superficial bacterial folliculitis (SBF), commonly caused by Staphylococcus pseudintermedius. Next-generation sequencing (NGS) offers the appeal of potentially expedited results with complete detection of bacterial organisms and associated resistance genes compared to culture. Limited studies exist comparing the two methodologies for clinical samples. To compare and contrast genotypic and phenotypic methods for bacterial identification and antimicrobial susceptibility from cases of canine SBF. Twenty-four client-owned dogs with lesions consistent with SBF were enrolled. A sterile culturette swab was used to sample dogs with SBF lesions. The swab was rinsed in 0.9 mL of sterile phosphate-buffered saline and vortexed to create a homogenous solution. Two swabs for NGS laboratories (Labs) and one swab for culture (Culture Lab) were randomly sampled from this solution and submitted for bacterial identification and antimicrobial susceptibility. No statistical difference regarding turnaround time for NGS Labs compared to Culture Lab was found. NGS Lab 1 identified more organisms than NGS Lab 2 and Culture Lab, which were both statistically significant. There was no statistical difference in detection frequency for Staphylococcus spp. among all laboratories. There was poor agreement for the presence of meticillin resistance and most antimicrobials among all laboratories. Utilisation of NGS as a replacement for traditional culture when sampling canine SBF lesions is not supported at this time.

Strengthening TINA: Using Pugh Matrix and Kano Analysis to Improve Its Design Threshold and Performance Criteria

Amidst the pandemic, the Teknoy-Inquiry Assistant (TINA) system was created to accommodate student institution–related questions while following the restrictions implemented by the government. Due to the rushed design, users experience untimely response problems when using the service. The research aims to investigate and propose improvements to the TINA system for the sustainability of the service. The researchers focused on the turn-around time for the replies to the questions in the TINA system. To further justify the importance of addressing the turn-around time of replies, the researchers also investigated the meaningful relationship between student satisfaction and response time. The researchers addressed and resolved the reply time using Kano Analysis. The research also used purposive sampling, using researcher-made survey questionnaires to find the relationship between student satisfaction and the timeliness of replies. With the help of the Pearson correlation coefficient, the researcher found a positive correlation between student satisfaction and reply time, with a positive correlation value of 0.4090. Since a positive correlation is found between student satisfaction and reply time, improving the turn-around time of reply certainly increases student satisfaction. Therefore, to improve TINA, the researchers advocate implementing its Artificial Intelligence Chatbot version to improve reply time. The research is the first to contribute to the Field of Technology and University Services within the local context since it may give practical suggestions on properly creating an Inquiry Assistant System among regional universities.

Real-Time Location Systems: Revolutionizing Porter Services for Improving Patient Care Efficiency.

Transport porters (TPTs) are essentially involved in supporting hospital operations and maintaining high-quality patient care. The traditional porter management lacks transmission of temporal and spatial information of the porters thus affecting porter operations. In this work, we investigate the barriers in traditional porter management and the impact of a real-time location system (RTLS) in improving time and cost efficiency for porter operations. A six-month study was conducted at Medanta - The Medicity, Gurugram investigating the limitations of traditional management and efficiency of indoor porter tracking system (IPTS) on TPTs operational activities by assessing the waiting time and total turnaround time (TAT). The cost-effectiveness of IPTS was determined based on capital expenditure and return on investment (ROI) post-technology implementation. This study highlights that improvements are required in porter management as 175 out of 285 (62%) calls were unanswered by TPTs. Post deployment of IPTS, the TAT for A-wing was reduced from 28 minutes to 20 minutes, and for B-wing, it was reduced from 26 minutes to 18 minutes. Staff optimization of three and four porters was done for A-wing and B-wing, respectively. The capital expenditure was recovered by reduced wait time and optimization of staff, thereby anticipating a monthly saving of ₹0.18 million (US$ 2150). The effective outcome of IPTS porter management envisaged its expansion to inpatient medicine delivery with a substantial cost reduction of ₹8.0 million (US$ 96,000) over three years. The implementation of IPTS improved the operational activities of porters and improved staff utilization. Cost savings from staff optimization lays the groundwork for new technology integrations for long-term operational advancements.

Role of teleradiology in the interpretation of ultrasound images acquired in the emergency setting

BACKGROUND: Teleradiology has become an important tool in emergency medicine, particularly in the interpretation of emergency ultrasonography. In emergency situations, where time is essential, rapid diagnosis and treatment can mean the difference between life and death. Teleradiology is an innovative alternative to augment the staffing and fill the gaps of onsite radiology personnel in emergency departments or during off-hours. AIM: To assess the effectiveness/impact of teleradiology in emergency ultrasound interpretation. MATERIALS AND METHODS: A retrospective study was performed in a cohort of 33,616 patients from 86 hospitals across the USA between January and December 2022. The study involved radiological interpretations of 37,253 ultrasound images acquired in the emergency setting by American Board Certified Radiologists empaneled by a teleradiology service provider, headquartered in Bangalore, India. RESULTS: The proposed telehealth model provided timely and quality reporting of 37,253 scans of patients with a mean turnaround time of 35.71 min (95% confidence interval 35.50–35.91). CONCLUSION: This study demonstrates that a structured telesonography program with defined protocols for image capture, transmission, and clinical communication can allow for successful immediate reporting of ultrasound data in the emergency care setting.

Retrospective evaluation of rapid genotypic ID and phenotypic AST systems on positive blood culture turnaround time and simulated potential impacts on bloodstream infection management

Abstract Background Bloodstream infections are linked to heightened morbidity and mortality rates. The consequences of delayed antibiotic treatment can be detrimental. Effective management of bacteraemia hinges on rapid antimicrobial susceptibility testing. Objectives This retrospective study examined the influence of the VITEK® REVEAL™ Rapid AST system on positive blood culture (PBC) management in a French tertiary hospital. Materials and methods Between November 2021 and March 2022, 79 Gram-negative monomicrobial PBC cases underwent testing with both VITEK®REVEAL™ and VITEK®2 systems. Results The study found that VITEK®REVEAL™ yielded better results than the standard of care, significantly shortening the time to result (7.0 h compared to 9.6 h) as well as the turnaround time (15 h compared to 31.1 h) when applied for all isolates. Conclusions This study implies that the use of VITEK®REVEAL™ enables swift adaptations of antibiotic treatment strategies. By considerably minimizing the turnaround time, healthcare professionals can promptly make necessary adjustments to therapeutic regimens. Notably, these findings underscore the potential of VITEK®REVEAL™ in expediting appropriate antibiotic interventions, even in less ideal conditions. Further studies in varied laboratory contexts are required to validate these encouraging outcomes.

Validation of short culture method for rapid bacterial identification of blood cultures via matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.

Development of rapid bacterial identification from blood cultures has been an area of intense study in diagnostic microbiology. Shortened turnaround time coupled with antimicrobial stewardship interventions have been shown to improve patient outcomes and decrease healthcare-associated costs. We report the validation of a short incubation method for Gram-positive and Gram-negative bacterial identification utilizing MALDI-TOF MS without additional instrumentation, processing or cost compared with current practice. Prospective, observational, single-centre study in a quaternary care academic hospital encompassing 376 blood cultures subjected to bacterial identification after short incubation periods of 3-4 and 6-8 h. There was 97.5% species-level identification agreement with tests undertaken after 3-4 h incubation with 83.6% isolates identified, and 99.7% species-level identification agreement after 6-8 h incubation with 96.7% isolates identified. The short incubation method provides a rapid MALDI-TOF MS bacterial identification method, reducing turnaround time by 10-18 h compared with standard practice without additional cost, processing or instrumentation.

Evaluating the impact of rapid antimicrobial susceptibility testing for bloodstream infections: a review of actionability, antibiotic use and patient outcome metrics.

Antimicrobial susceptibility testing (AST) is a core function of the clinical microbiology laboratory and is critical to the management of patients with bloodstream infections (BSIs) to facilitate optimal antibiotic therapy selection. Recent technological advances have resulted in several rapid methods for determining susceptibility direct from positive blood culture that can provide turnaround times in under 8 h, which is considerably shorter than conventional culture-based methods. As diagnostic results do not directly produce a medical intervention, actionability is a primary determinant of the effect these technologies have on antibiotic use and ultimately patient outcomes. Randomized controlled trials and observational studies consistently show that rapid AST significantly reduces time to results and improves antimicrobial therapy for patients with BSI across various methods, patient populations and organisms. To date, the clinical impact of rapid AST has been demonstrated in some observational studies, but randomized controlled trials have not been sufficiently powered to validate many of these findings. This article reviews various metrics that have been described in the literature to measure the impact of rapid AST on actionability, antibiotic exposure and patient outcomes, as well as highlighting how implementation and workflow processes can affect these metrics.

Preanalytical Errors in Hematology: Insights From a Tertiary Care Hospital.

Introduction Errors occur in the laboratory at any level of the testing process. Recognizing these errors may cause patient distress by delaying diagnosis and management until results are released. This study aims to assess preanalytical errors in the laboratory and suggests methods to prevent them to improve accuracy and efficiency in the hematology department of a tertiary care hospital. The background emphasizes the critical role of preanalytical procedures in ensuring accurate hematological diagnoses and highlights the frequent mistakes that occur during specimen collection, handling, and transportation. Staff training, process standardization, using suitable collecting and transport equipment, putting quality control measures in place, and using automation technologies are some strategies for reducing errors and speeding up turnaround times. To increase diagnostic accuracy, patient care outcomes, and laboratory efficiency, hematology laboratories should address preanalytical mistakes and employ fostering methods. Aims and objectives The objective of this research is to evaluate the frequency and characteristics of preanalytical errors within the hematology laboratory of a tertiary care hospital. The study seeks to gauge the scope of the problem, identify key factors contributing to these errors, such as issues in specimen collection, handling, and transportation, and highlight areas where improvements can be made. Also, it intends to assess how preanalytical errors affect hematological accuracy and turnaround times, with a focus on patient care outcomes, and recommend techniques to reduce preanalytical errors and improve the accuracy of hematological results. Materials and methods This study was conducted at the hematology laboratory of our hospital from January 2023 to June 2024 after getting proper approval from the Institutional Review Board (IRB approval number 294/08/2024/PG/SRB/SMCH). It is a retrospective analytical study, and the study population comprised samples of patients from the emergency, inpatient, and outpatient departments, which included 51,155 complete blood count (CBC) and 5,449 peripheral smear(PS) samples. The study included only test samples sent specifically for hematological analysis, while those sent for cytological, biochemical, or microbiological testing were excluded. The distribution frequency of the samples and the number of rejected samples were analyzed, and the results were then compared and correlated. Results During the study period, a total of 56,604 samples were processed in the hematology laboratory. Of these, 886 samples (1.3%) were rejected due to preanalytical errors. The most frequent error was submitting an insufficient sample (54.17%), while the least frequent was the use of an empty or defective tube (0.4%). In the emergency department, the primary issues were insufficient and clotted samples, while in pediatric cases, errors were mainly due to inadequate or diluted samples. Conclusion Preanalytical errors in hematology laboratories, though often overlooked, can significantly impact diagnostic accuracy and patient care. Our study highlights that a substantial portion of errors arise from inadequate sample collection and handling, particularly in emergency and pediatric cases. Adherence to standard laboratory techniques can dramatically reduce preanalytical errors.

A comparative study of a rapid phenotypic antimicrobial susceptibility testing system directly from positive blood cultures to the disk diffusion and VITEK 2 methods

BackgroundSepsis is a life-threatening condition that impacts 49 million people annually and causes 11 million deaths worldwide. Surviving bloodstream infections (BSIs) depends on the rapid administration of effective antimicrobial treatment, underscoring a need for rapid antimicrobial susceptibility testing (AST). AimTo evaluate the performance of Quantamatrix's dRAST v2.5 system (Seoul, South Korea) for AST directly from positive blood cultures as compared to the Disk-Diffusion (DD) and VITEK 2 methods. MethodsThe study included 191 positive blood cultures from clinical samples and spiked blood culture bottles. Following Gram staining and species-level identification, AST was performed by VITEK 2 and standard DD methods using CLSI (2021) interpretation. ResultsdRAST demonstrated very good AST performance for a Gram-negative isolate, and good performance for Gram-positive isolates, meeting CLSI criteria for the acceptance of a new method. Antimicrobials that were not considered verified compared to VITEK 2 and DD were cefazolin, ceftazidime, meropenem, and trimethoprim/sulfamethoxazole for Gram-negatives and clindamycin, erythromycin, penicillin, and oxacillin for Gram-positives. dRAST ESBL detection results were strongly correlated with the ESBL phenotypes obtained with other methods. Additional resistance mechanisms were in concordance with traditional tests. ConclusionsdRAST demonstrated good AST performance, meeting CLSI criteria for most relevant antibiotics. dRAST was associated with a significant reduction in time-to-results, labor, and the subjectivity of result analyses, making it a valuable addition to efforts supporting the treatment of patients with bacteremia.AST (antimicrobial susceptibility test), blood culture, dRAST, rapid methods, sepsis, turnaround time (TAT).

Prospective Evaluation of Artificial Intelligence Triage of Incidental Pulmonary Emboli on Contrast-Enhanced CT Examinations of the Chest or Abdomen.

BACKGROUND. Artificial intelligence (AI) algorithms improved detection of incidental pulmonary embolism (IPE) on contrast-enhanced CT (CECT) examinations in retrospective studies; however, prospective validation studies are lacking. OBJECTIVE. The purpose of this study was to assess the effect on radiologists' real-world diagnostic performance and report turnaround times of a radiology department's clinical implementation of an AI triage system for detecting IPE on CECT examinations of the chest or abdomen. METHODS. This prospective single-center study included consecutive adult patients who underwent CECT of the chest or abdomen for reasons other than pulmonary embolism (PE) detection from May 12, 2021, to June 30, 2021 (phase 1), or from September 30, 2021, to December 4, 2021 (phase 2). Before phase 1, the radiology department installed a commercially available AI triage algorithm for IPE detection that automatically processed CT examinations and notified radiologists of positive results through an interactive floating widget. In phase 1, the widget was inactive, and radiologists interpreted examinations without AI assistance. In phase 2, the widget was activated, and radiologists interpreted examinations with AI assistance. A review process involving a panel of radiologists was implemented to establish the reference standard for the presence of IPE. Diagnostic performance and report turnaround times were compared using the Pearson chi-square test and Wilcoxon rank sum test, respectively. RESULTS. Phase 1 included 1467 examinations in 1434 patients (mean age, 53.8 ± 18.5 [SD] years; 753 men, 681 women); phase 2 included 3182 examinations in 2886 patients (mean age, 55.4 ± 18.2 years; 1520 men, 1366 women). The frequency of IPE was 1.4% (20/1467) in phase 1 and 1.6% (52/3182) in phase 2. Radiologists without AI, in comparison to radiologists with AI, showed significantly lower sensitivity (80.0% vs 96.2%, respectively; p = .03), without a significant difference in specificity (99.9% vs 99.9%, p = .58), for the detection of IPE. The mean report turnaround time for IPE-positive examinations was not significantly different between radiologists without AI and radiologists with AI (78.3 vs 74.6 minutes, p = .26). CONCLUSION. An AI triage system improved radiologists' sensitivity for IPE detection on CECT examinations of the chest or abdomen without significant change in report turnaround times. CLINICAL IMPACT. This prospective real-world study supports the use of AI assistance for maximizing IPE detection.

Optical biosensor based on the dual-functional gold nanoparticles for rapid and accurate multiplex detection of influenza A and B viruses

Due to the global pandemic of influenza and related respiratory diseases, rapid and accurate detection is in high demand to control virus spread and facilitate early treatment. However, most current molecular detection methods either require long turnaround times, suffer from low sensitivity and/or can only detect single pathogens. To overcome these challenges, we constructed a novel colorimetric gold nanoparticle (AuNPs) biosensor containing functionalized probes to detect multiple targets simultaneously. Utilizing the salt aging method, AuNPs were functionalized by the designed oligonucleotides to fabricate biosensors. This biosensor can show visible color change within 20 min, and could minimally detect the target influenza viruses at 10 nM. This detection technique presents high sensitivity in a short time, meanwhile identifying two different influenza viruses simultaneously. It opens a window to a multiplex-in-one strategy for a clinical viral diagnostic.

Impact of Type and Screen Method on Turnaround Time and Man-Hour Utilization Compared to Conventional Coomb's Crossmatch: A Cross-Sectional Analytical Study.

Background Blood component transfusion is vital for various medical conditions, requiring thorough pretransfusion testing to ensure safety and compatibility. The Type and Screen (T and S) method allows for efficient detection of clinically significant antibodies while reducing unnecessary crossmatching. This study evaluates T and S's impact on turnaround time and man-hour utilization compared to conventional crossmatching. Methodology The study included 835 elective crossmatch requests. Blood grouping, antibody screening, and antihuman globulin (AHG) crossmatching were performed using column agglutination technology, while immediate saline crossmatching was done by tube technique. Turnaround time (TAT), man-hour utilization, and saved rates were calculated for both the T and S protocol and routine AHG crossmatch. Results In this study, 835 elective blood samples underwent antibody screening and immediate saline phase crossmatching, with validation by AHG phase crossmatch. The T and S protocol significantly reduced TAT for both first (51.24 vs. 71.56 minutes) and subsequent transfusions (17.47 vs. 39.67 minutes) compared to AHG crossmatching, with reductions being statistically significant (p < 0.0001). T and S also saved 279.28 man-hours (11.6 man-days), equating to 0.33 man-hours saved per sample. Conclusion Our study shows that the T and S protocol significantly enhances blood bank efficiency by reducing TAT and man-hour utilization compared to conventional AHG crossmatching. This improvement not only optimizes manpower but also makes the process more cost-effective.

Culture and amplification-free nanopore sequencing for rapid detection of pathogens and antimicrobial resistance genes from urine.

Urinary Tract Infections (UTIs) are among the most prevalent infections globally. Every year, approximately 150million people are diagnosed with UTIs worldwide. The current state-of-the-art diagnostic methods are culture-based and have a turnaround time of 2-4 days for pathogen identification and susceptibility testing. This study first establishes an optical density culture-based method for spiking healthy urine samples with the six most prevalent uropathogens. Urine samples were spiked at clinically significant concentrations of 103-105 CFU/ml. Three DNA extraction kits (BioStic, PowerFood, and Blood and Tissue) were investigated based on the DNA yield, average processing time, elution volume, and the average cost incurred per extraction. After DNA extraction, the samples were sequenced using MinION and Flongle flow cells. The Blood and Tissue kit outperformed the other kits based on the investigated parameters. Using nanopore sequencing, all the pathogens and corresponding genes were only identified at a spike concentration of 105 CFU/ml, achieved after 10min and 3 hours of sequencing, respectively. However, some pathogens and antibiotic-resistance genes (ARG) could be identified from spikes at 103 colony formation units (CFU/mL). The overall turnaround time was five hours, from sample preparation to sequencing-based identification of pathogen ID and antimicrobial resistance genes. This study demonstrates excellent promise in reducing the time required for informed antibiotic administration from 48 to 72h to five hours, thereby reducing the number of empirical doses and increasing the chance of saving lives.

Enterprise supply chain network optimization algorithm based on blockchain-distributed technology under the background of digital economy

Demand forecasting is essential for streamlining supply chain operations in the digital economy and exceeding customer expectations. On the other hand, traditional forecasting techniques cannot frequently present real-time data and respond to dynamic changes in the supply chain network, leading to less-than-ideal decision-making and higher costs. This research aims to create a technique for optimizing the supply chain network based on blockchain-distributed technology (SCN-BT) to overcome these drawbacks and fully utilize the potential of the digital economy. The suggested framework uses the hybridized LSTM network and Grey Wolf Optimization (GWO) algorithm to examine demand forecasting in the supply chain network for inventory planning. The SCN-BT framework develops a safe and productive, enabling precise and flexible demand by combining blockchain with optimization techniques. A thorough case study utilized information collected from an enterprise supply chain that operates in the digital economy to show the efficiency of the suggested framework. Compared to conventional approaches, the results show considerable gains in demand forecasting precision, responsiveness of the supply chain, and cost-effectiveness. In the context of the digital economy, demand sensing and prediction enable firms to react to changes swiftly, shorten turnaround times, optimize inventory levels, and improve overall supply chain performance. The results highlight how blockchain technology has the potential to enhance collaboration, trust, and transparency inside intricate supply chain networks working in the digital economy. The experimental results show the proposed to achieve prediction rate of demand prediction rate of 128.93, demand forecasting accuracy ratio of 92.18%, optimum efficiency of 94.25%, RMSE rate of 1841.25, MAE rate of 260.74, and sMAPE rate of 0.1002 compared to other methods.