Turnaround Time Research Articles (Page 1)

Rapid identification (ID) and antibiotic susceptibility testing are vital for the treatment of bloodstream infections (BSIs). The aim of this study was to perform direct identification and rapid antimicrobial susceptibility testing (RAST), from positive blood cultures and to compare the performance of these rapid methods with standard reference methods. Blood cultures (BC) submitted to Marmara University Pendik Training and Research Hospital Clinical Microbiology Laboratory between September 2022 - April 2023, that yielded positive signal and were determined to be monomicrobial by gram staining were selected randomly. ID was performed using MALDI-TOF MS(bioMérieux, France). Based on these results, rapid antimicrobial susceptibility testing (RAST) was applied to 103 bottles that met RAST eligibility criteria. The results of rapid ID and RAST were evaluated by comparing them with the results obtained from colony-grown isolates. Rapid ID showed that out of 306 bottles, 281 (91.8%) were monomicrobial. High rates of correct identification were achieved for gram-negative bacilli (84.3%), gram-positive chain cocci (79.4%), and gram-positive cluster cocci (55.2%), while performance was lower for gram-positive bacilli (27.3%) and yeasts (37.5%). For RAST, the readability of inhibition zone diameters increased progressively with incubation time, reaching 85.2%, 94.5%, 100%, and 100% at 4, 6, 8, and 16-20h, respectively. The categorical agreement of the test remained consistently high across all time points, measuring 98.35% at 4h, 98.49% at 6h, 98.38% at 8h, and 98.84% at 16-20h. Rapid ID of microorganisms directly from positive BC bottles, combined with RAST based on EUCAST RAST criteria, demonstrates high accuracy and reliability compared to conventional methods. These rapid approaches significantly reduce the turnaround time for both identification and susceptibility results-by approximately 16-20h and 32-48h, respectively thereby enabling earlier targeted antimicrobial therapy and improving clinical management of BSIs.

Abstract. Aim: The aim of this study was to investigate the diagnostic performance of a novel rapid multiplex polymerase chain reaction (mPCR) in adults with suspected acute native joint infection. Methods: This retrospective single-centre study included 143 patients with suspected acute native joint infection from February 2023 to May 2024. A septic arthritis was classified based on institutional criteria. The agreement between mPCR and conventional culture of synovial fluid (SF) was assessed by calculating the Cohen's κ coefficient. The diagnostic performance of mPCR was calculated, and the area under the curve (AUC) was compared with conventional culture of synovial fluid by using the z test. Results: When considering only microorganisms targeted by mPCR, this method detected 13 novel microorganisms in 13 cases compared to conventional culture, resulting in an overall agreement of 91 %, a positive agreement of 100 %, a negative agreement of 88 %, and a Cohen's κ coefficient of 0.780. Of these 13 cases, 9 were classified as septic, with 6 (n=6/9, 67 %) on antibiotics prior to aspiration. When considering all microorganisms (including off-panel microorganisms), the overall percentage agreement between mPCR and conventional culture was 89 %, with a Cohen's κ coefficient of 0.735, indicating substantial agreement. Sensitivity, specificity, PPV, NPV, LR+, LR−, accuracy, and AUC of mPCR were 45 %, 89 %, 90 %, 44 %, 4.21, 0.62, 59 %, and 0.671, and those of conventional culture were 40 %, 100 %, 100 %, 45 %, 0.60, 59 %, and 0.698. No difference in performance was observed between both methods (p=0.183). The combination of both techniques showed a sensitivity, specificity, PPV, NPV, LR+, LR−, accuracy, and AUC of 48 %, 89 %, 90 %, 46 %, 4.5, 0.58, 62 %, and 0.686. Conclusion: Given its comparable diagnostic performance and faster turnaround time relative to conventional synovial fluid culture, this novel mPCR can be recommended as a valuable adjunct in the diagnosis of septic arthritis in adults, particularly in patients with prior antimicrobial treatment.

ABSTRACT Nipah virus (NiV) outbreak was declared in Kozhikode district, Kerala state, India, on 12 September 2023. The local, state, and national authorities worked in an integrated way to tackle and control the outbreak. Indian Council of Medical Research (ICMR) deployed a team from the ICMR-National Institute of Virology (NIV), Pune, India, along with an indigenously developed and validated Mobile BSL-3 (MBSL-3) laboratory for providing onsite NiV diagnosis. The Kozhikode district of Kerala state was the epicenter of three NiV outbreaks on May 2018, August 2021, and most recently in September 2023. The Ernakulam district of Kerala also reported a NiV outbreak in June 2019. In the 2023 outbreak, six confirmed NiV cases were detected, with two deaths. During previous outbreaks in 2019 and 2021, the team from ICMR-NIV, Pune, had successfully established a field laboratory utilizing the BSL-2 facility for NiV onsite diagnosis. BSL-3 personnel protective equipment and standard operative procedures were used to handle clinical specimens. Post COVID-19 pandemic, under the pioneering initiative of the Government of India, ICMR, and Klenzaids Contamination Control Pvt. Ltd, Mumbai developed a rapidly deployable, pragmatic, access control, and containment laboratory on bus chassis. The MBSL-3 laboratory was utilized for the NiV onsite diagnosis for early containment of outbreaks, reducing the turnaround time for diagnosis to just 4 hrs. The MBSL-3 laboratory plays a significant role in NiV outbreak response and could be utilized in the future also reaching the remotest areas of the country.

Aim Prosthetic joint infection (PJI) is a serious complication following total joint arthroplasty (TJA) and can have devastating consequences if not treated effectively. There is no clear ‘gold standard’ for the diagnosis of PJI, current techniques include blood biochemical markers and microbiological cultures to identify the species of bacteria. Challenges associated with microbiological cultures include inaccurate results and time delays before reporting of results. In the hospital of study, samples of joint fluid and tissue are collected during surgical intervention for PJI and are sent to a partner hospital for microbiological cultures. Results are typically reported back after 7-14 days. Nanopore sequencing is a third-generation genomic sequencing technology designed to facilitate fast, inexpensive, and simple genomic sequencing. This study aims to investigate nanopore sequencing, as a quick and cost-effective method to identify the species of bacteria causing PJI from joint aspirates. Method Joint fluid aspirates were collected during surgical interventions for PJI. DNA was extracted from these samples and sequenced using the MinION device. Sequencing data was classified using Basic Local Alignment Search Tool (BLAST) against the bacterial database. Sequencing data was filtered by quality parameters such as Phred score. 30 samples of fluid were used for nanopore sequencing (26 PJI-positive and 4 controls), based on clinical definitions of infection. Clinical assessments included blood biochemical markers (CRP, ESR), histology, physical signs (e.g., redness, swelling) and multi-disciplinary team (MDT) decision. The MDT decision was used as the clinical decision of infection. Results from nanopore sequencing and microbiological cultures were compared with clinical assessments. Results Contingency tables were made to compare nanopore sequencing with the clinical assessment of patients and to compare microbiological cultures with the clinical decision of patients. Combining the results from nanopore sequencing with microbiological cultures gave an accuracy of 0.89, positive predictive value (PPV) of 0.92, recall (sensitivity) of 0.96 and F1 score of 0.94. The accuracy for microbiological cultures alone was 0.62. Conclusions Nanopore sequencing shows promise as an additional test in diagnosing PJI, particularly when cultures are negative. The advantage for the use of nanopore sequencing in the diagnosis of PJI is the turn-around time of results compared to microbiological cultures. This could have implications with reducing hospital stays, length of treatment and time frames between the first and second stage of a two-stage prosthetic exchange. This may improve patient outcomes and reduced treatment costs. Further studies could solidify its role in routine PJI diagnosis.

Aim Septic arthritis (SA) in adults can lead to serious complications if not diagnosed promptly. Conventional synovial fluid culture (CC) remains the gold standard for identifying the causing microorganism but is time-consuming and often insensitive, particularly in patients receiving antimicrobial therapy. This study aimed to evaluate the diagnostic performance of a novel automated multiplex PCR (mPCR) system and compared it to conventional culture (CC) in adults with suspected acute native joint infections. Method In this retrospective single-centre study, adult patients with suspected SA (February 2023-May 2024) were included. Diagnosis was based on institutional criteria incorporating clinical signs, synovial fluid cytological, microbiology, and histology. Agreement between mpCR and CC was assessed using overall percentage agreement and Cohen's Kappa coefficient. Diagnostic performance metrics were calculated for mPCR, CC, and their combined use. Results Of 143 included patients, 96 (67%) were diagnosed with SA. When considering mPCR-specific microorganisms, mPCR identified 13 additional microorganisms compared to CC. Nine of these (9/13) were diagnosed with SA and six of these (6/9, 67%) were on antibiotics prior to aspiration. Overall agreement between mPCR and CC was 91%, with a positive agreement of 100%, negative agreement of 88% and a Cohen's Kappa coefficient of 0.780. Considering all microorganisms (including off-panel organisms), the overall agreement was 89%, the positive agreement 92%, the negative agreement 88%, and the Cohen's Kappa 0.735. The mPCR demonstrated a sensitivity of 45% and specificity of 89%, while conventional culture showed a sensitivity of 40% and specificity of 100%. No significant difference in performance was observed between the two methods (p = 0.183). Moreover, the combined use (mPCR + CC) yielded a sensitivity of 48% and specificity of 89% (AUC = 0.686). Conclusions The novel automated mPCR system demonstrated a diagnostic performance similar to that of conventional synovial fluid culture, offering the added benefit of a quicker turnaround time, which can be crucial for patient care. Its use is especially evident in patients who have received prior antibiotic treatment, where conventional cultures may be less reliable.

Integrating two point-of-care (POC)-amenable technologies, namely, multiple cross displacement amplification (MCDA) and gold nanoparticle-based lateral flow biosensors (AuNPs-LFB), has demonstrated excellent detection of hepatitis B virus (HBV) and hepatitis C virus (HCV). In a recent study, Zhang et al. (H. Zang, Y. Shi, Z. Wu, Q. Zhao, et al., Microbiol Spectr 13:e01738-24, 2025, https://doi.org/10.1128/spectrum.01738-24) developed a novel, single-tube, multiplex MCDA-AuNPs-LFB assay that targets the HBV S gene and the HCV 5'-UTR region. The assay operates under isothermal conditions at 64°C for 35 min, and the AuNPs-LFB assay permits a visual interpretation of results. This platform achieves an analytical sensitivity comparable to lab-based quantitative PCR but with shorter turnaround time, reduced cost, operational simplicity, and undetectable cross-reactivity to anatomically relevant, non-target pathogens, making it highly suitable for decentralized POC diagnostic applications. The success of hybrid systems in simplifying nucleic acid testing while increasing portability indicates a potential transition in clinical diagnosis from centralized tech-centered labs to local clinics, field testing, and even home care.

Treating carbapenem-resistant Enterobacterales, mainly those producing metallo-β-lactamases (MBL) is a subject of major concern. The combination aztreonam-avibactam (AZA) was developed in an attempt to overcome this challenge, as avibactam inhibits KPC and other serine-β-lactamases, enabling aztreonam (ATM) to act against MBL. However, in scenarios where AZA is not licensed so far, the combination of ATM with ceftazidime-avibactam (CZA) is an alternative that has been proved in vivo efficacy and in vitro synergic activity. We propose the TurbiTest, an alternative method based on turbidity measurement of bacterial growth after a short incubation period (4h) in the presence and absence of antibiotics to easily determine susceptibility to this combination. A total of 134 Enterobacterales harboring a variety of resistance genes (52 blaKPC, 53 blaNDM, 26 blaKPC + blaNDM, 2 blaNDM + blaOXA-48-like, 1 blaOXA-48-like) as well as 11 Enterobacterales negative for carbapenemase genes by HRM-qPCR were evaluated for susceptibility to CZA, ATM, ATM-CZA and AZA. According to broth microdilution (BMD), 55.9% were resistant to CZA and 69.7% to ATM. All isolates were susceptible to ATM-CZA and AZA. Compared to BMD, TurbiTest from colonies (TTc) presented categorical agreement (CA) of 95.9% for CZA, 97.9% for ATM and ATM-CZA, and 99.3% for AZA. Fifty-eight spiked blood cultures were evaluated, with CA of 98.3% for CZA and ATM, and 100% for ATM-CZA and AZA. Besides, 41 clinical, consecutive Enterobacterales-positive blood cultures were tested (TTbc), with 100% of CA for CZA, 95.1% for ATM and 92.7% for ATM-CZA and AZA. TurbiTest is an inexpensive test that demonstrated a promising performance with considerably reduced turnaround time to results (less than 5h). Interlaboratory reproducibility, as well as the performance with other bacterial population remain to be explored.

X and Y chromosome analysis is a critical component of genetic testing, used both diagnostically and as a quality control (QC) metric. Discordances between expected and observed sex chromosome data can arise due to mislabeling, demographic data errors, transplant history, or biological variations. Such discordances pose challenges to laboratories and affect patient care, particularly in marginalized populations and unique clinical contexts. We reviewed cases of sex chromosome discordance identified at our laboratory from January 2021 through August 2023. Cases spanned various testing methods and were categorized by the root cause, including mislabeling, sample mix-ups, transgender individuals, stem cell transplants, and unexplained causes. Case outcomes were assessed, and potential resolutions were analyzed. Among 65 cases identified, the leading cause of discordance was mislabeling (n = 20, 31%), followed by other/not identified (n = 16, 25%), sample mix-ups (n = 13, 20%), transgender individuals (n = 9, 14%), and stem cell transplants (n = 7, 11%). Cases required additional QC processes such as reanalysis, clinician contact, and occasionally sample re-collection. The process extended turnaround times by up to 13 business days. Detailed case reviews highlighted the challenges and implications of managing these discordances, emphasizing the importance of accurate data transmission and inclusive practices. Using X and Y chromosome data as a QC metric can identify critical errors but also introduces limitations and bias. Improved standardization, inclusive practices, and alternative QC methods are necessary to ensure accuracy and equitable patient care. Collaborative efforts are required to address demographic complexities and reduce testing delays.

Candidemias caused by the yeasts formerly encompassed as Candida spp. require expedited identification to decide on the antifungal treatment and reduce mortality. Traditional methods rely on subcultures for diagnosis, with turnaround times of 72-96 h, or expensive equipment. Deep learning and convolutional neural networks (CNN) have shown high accuracy for image recognition in microbiology. We compared the accuracy of six CNNs (GoogLeNet, InceptionV3, AlexNet, ResNet18, ResNet50, and DenseNet161) to identify Candida spp. at the species level, with photographs obtained mainly from clinical blood cultures showing yeast structures in the Gram stain, which were identified as Candida spp. in the subculture. Images were obtained from January 2012 to May 2024 and stored in the image databank of two third-level teaching hospitals in Mexico City. We analyzed the five most frequent species from both centers' clinical samples and included simulated blood culture images from Candida auris (Candidozyma auris) and C. krusei (Pichia kudriavzevii) strains. After processing and segmentation, we loaded the CNNs with 531 whole photographs and 2804 patches. The CNN Densnet161, using a scan-based approach, showed higher accuracy identifying 87%, 99%, 94%, 100%, 89%, and 95% of the images containing C. albicans, C. auris, C. glabrata (Nakaseomyces glabrata), C. krusei (P. kudriavzevii), C. parapsilosis, and C. tropicalis, respectively. These results show that CNN image recognition can identify clinically relevant Candida spp. directly from positive Gram-stained smears, which may help make early decisions for antifungal treatment.

Objective Traditional newborn screening (tNBS) for inborn errors of metabolism (IEMs) and deafness has limitations, including the detection of few genetic disorders and variants, high false-positive rates, and long turnaround times. This study aimed to explore the clinical validity of newborn genetic screening (NBGS) in newborns screened for IEMs and deafness. Methods We retrospectively enrolled 223 cases screened for IEMs using tandem mass spectrometry-next-generation sequencing (MS/MS-NGS), including 55 study-defined positive, 68 study-defined suspected positive, and 100 negative cases. Additionally, 196 cases screened for deafness were enrolled, including 96 variant-positive and 100 negative cases. Dried blood spot samples (DBSs) from newborns were used for NBGS. Results For IEM, NBGS detected 34 positives in 55 study-defined positive cases with a sensitivity of 61.8% (34/55), no variants were detected in 21 cases. Four additional positive cases were identified, including one at risk of glucose-6-phosphate dehydrogenase deficiency and three at risk of deafness. The turnaround time was significantly different between the two methods: 13 days for NBGS versus 35 days for MS/MS-NGS. For deafness, the consistency of the positive results between the two methods was 96.9% (93/96). Unexpectedly, three mitochondrial gene (MT-RNR1) heteroplasmy variants (m.1555A > G and m.7445A > G) were not detected by NBGS. We also detected nine variants in the 100 negative cases, including seven variants in GJB2 (c.109G > A), one in GJB3 (c.547G > A), and one in MYO15A (c.10250_10252delCCT), for a 9% (9/100) detection rate by NBGS. Conclusion As an emerging screening method for newborns, NBGS offers the potential to detect a broader spectrum of pathogenic gene variants, reduce false-positive rates, and shorten the diagnostic cycle. However, current NBGS technology has limitations and cannot fully supplant traditional detection methods. Therefore, integrating both approaches can become a critical strategy for enhancing the accuracy and efficiency of newborn screening.

Background: Bloodstream infections (BSIs) leading to sepsis remain major causes of morbidity and mortality in hospitalized patients worldwide. Conventional blood culture methods, though regarded as the diagnostic gold standard, require prolonged incubation and manual monitoring, which delay the detection of microbial growth and the initiation of targeted therapy. The BACTEC Automated Blood Culture System (Becton Dickinson, USA) has been developed to address these limitations through continuous monitoring of carbon dioxide (CO₂) production using a fluorescent sensor, allowing rapid and reliable detection of microbial growth. This study aimed to evaluate the clinical impact of switching from the Conventional Blood Culture Method to the BACTEC System in a tertiary care hospital setting in Nepal. Methods: A total of 150 blood samples were analyzed—75 using the Conventional Method and 75 using the BACTEC System—to compare time to detection, positivity rate, contamination rate, turnaround time, and early clinical response. Results: The BACTEC system significantly reduced mean time to detection from 48.3 ± 8.7 hours to 18.6 ± 4.2 hours (p < 0.001), increased culture positivity from 34.7% to 50.7% (p = 0.03), and decreased contamination from 8.0% to 2.7% (p = 0.04). Antibiotic therapy was changed based on BACTEC results in 46.6% of patients, compared to 25.3% in the conventional group (p = 0.01). Conclusion: The findings indicate that the BACTEC Blood Culture System enhances diagnostic efficiency, accelerates clinical decision-making, reduces unnecessary empirical therapy, and supports antimicrobial stewardship. It represents a reliable, cost-effective solution for improving patient outcomes in resource-limited hospital settings. Novelty: Introducing automated blood culture testing strengthens diagnostic turnaround and supports earlier targeted therapy in a tertiary hospital with limited resources.

Rapid pathogen identification directly from positive blood cultures using AUTOF MS1000 MALDI-TOF MS compared to conventional methods: A prospective observational study.

CRISPR-based one-pot detection: A game-changer in nucleic acid analysis.

Transfusion-transmissible infections (TTIs) remain a serious and persistent concern in modern transfusion medicine. Despite remarkable advances in donor screening and testing technology, the goal of completely risk-free blood transfusion still feels distant. This study was conducted across multiple accredited blood centers in the Madinah region between 2020 and 2022 to evaluate both the prevalence of TTIs and the effectiveness of current screening practices. A total of 104,538 blood donations were reviewed. Initial serological reactivity was identified in 1.01% of samples, and confirmed positivity accounted for 0.39%. Hepatitis B virus (HBV) was the most common infection (66.3%), followed by hepatitis C virus (15.9%), syphilis (13.2%), human immunodeficiency virus (HIV) (3.1%), and HTLV (1.4%). All participating centers complied with AABB, CBAHI, and SFDA standards and were active in CAP external quality programs. In most cases, turnaround time did not exceed 24 hours. Overall, the unit rejection rate was 4%. These results demonstrate that integrated accreditation and quality systems can ensure consistent safety in donor screening and sustain low infection rates over time. Still, maintaining such achievements require continuous monitoring and professional commitment from laboratory teams.

Introduction: With currently available microbiological diagnostic tools, the Turnaround Time (TAT) of a positive Blood Culture (BC) report with conventional Antimicrobial Susceptibility Testing (AST) takes 5-9 days, delaying treatment. With Rapid Antimicrobial Susceptibility Test (RAST), a positive BC can be reported within 4-8 hours. Semiautomated ColorCult BC bottles have a chemical sensor at the bottom that continuously detects the increase in carbon dioxide produced by microbial growth. As of today, the RAST method has been validated only for automated systems, not for semiautomated culture systems. Aim: To evaluate the performance of RAST from semiautomated BC bottles with disk diffusion. Materials and Methods: This cross-sectional study was conducted at Hassan Institute of Medical Sciences, Hassan, Karnataka, India from February 2024 to August 2024 and included 144 positively flagged semiautomated BC bottles (Microxpress ColorCult vial, India) showing monomicrobial growth on Gram stain. These bottles were collected and processed for both RAST and standard AST. Results obtained in RAST at 4, 6 and 8 hours were correlated with the standard AST using Clinical and Laboratory Standards Institute (CLSI) M100 as the gold standard. Equivalence criteria, according to Food and Drug Administration (FDA), were: Categorical Agreement (CA) ≥90%, very major error (vmj) ≤1.5% and major error (maj) ≤3%. Results: Among 144 positively flagged semiautomated BC bottles, 53 (36.8%) showed monomicrobial growth. Escherichia coli (n=18, 34%), Klebsiella pneumoniae (n=16, 30.2%), Acinetobacter baumannii (n=9, 17%), Pseudomonas aeruginosa (n=5, 9.4%) and Staphylococcus aureus (n=5, 9.4%) were isolated. Among all antibiotic-organism combinations tested, CA for RAST at 4-, 6- and 8-hour readings were 80.5% (252/313), 87.4% (384/439) and 91.0% (491/540), respectively. Vmj rates were 5.2% (8/152), 2.95% (7/238) and 1.64% (5/306); maj rates were 6.08% (7/115), 4.8% (7/160) and 1.65% (3/193). Among all antibiotics tested, poor CA was noted for amikacin, tobramycin, piperacillin-tazobactam and ciprofloxacin at all reading times. Conclusion: RAST performed with semiautomated BC bottles at eight hours is equivalent to standard disk diffusion using CLSI guidelines, with a marginal VME rate.

The rise of illicitly manufactured fentanyl and fentanyl-related substances has overwhelmed seized-drug laboratories and resulted in an explosive surge of analysis requests, increasing backlogs and turn-around times. Direct analysis in real time (DART) ionization in combination with mass spectrometry has proven valuable as an identification tool for forensic laboratories by providing fast and reliable results. However, its application for quantitative analyses has been limited. In this work, the standardized DART-mass spectrometry (MS) qualitative method used throughout Drug Enforcement Administration laboratories was optimized and validated for rapid quantitation of fentanyl-containing samples. Sample solutions were prepared in methanol and ionized using a 3-s pulse of metastable helium atoms, while protonated molecular ions for fentanyl and fentanyl-d5 were monitored over a 12-s MS acquisition window using selected-ion monitoring. Measured peak area ratios resulted in great linear behavior (r > 0.999) over a fentanyl concentration range of 2-250 μg/mL and a calculated LOQ of 3.8 μg/mL. Validation of the method demonstrated excellent within-batch and between-day precision (relative standard deviations <6%) and high accuracy (mostly <10% error). Assessments involved numerous analyses (n = 57) of a quality control sample over the validation period and the testing of 9 laboratory-prepared and 15 real-life casework samples using an experimental protocol that allowed (a) contemporaneous establishment of a 3-point calibration curve; (b) analysis of negative and positive controls; and (c) analysis of two different samples (in duplicate), all within a single analysis batch of about 4.2 min. The validity and effectiveness of the DART-MS methodology for the quantitation of fentanyl in drug samples were hence demonstrated.

Abstract Brain tumors are the most common solid malignancy in children, accounting for one-third of all childhood cancers. Rapid and accurate diagnosis is critical for timely treatment. This study evaluated the diagnostic workflow and utility of immunohistochemistry (IHC) for diagnosing pediatric brain tumors at the Uganda Cancer Institute (UCI) Pathology Laboratory. We conducted a retrospective review of pathology reports for children (0-17 years) diagnosed with brain tumors at the UCI Pathology Laboratory between January and December 2024. Data collected included patient demographics (age and sex), specimen type, final diagnosis, IHC markers used, and turnaround time (TAT). Seventeen cases were analyzed, with a median age of 11 years (IQR: 5-16), and the majority (52.9%) were male. Most specimens (76.5%) were fresh tissue biopsies, while 23.5% were tissue blocks submitted for review. IHC was utilized in 92% of cases to confirm diagnosis but was not consistently applied across similar tumor types. Frequently used IHC markers included GFAP (19.6%), Ki67 (19.6%), Synaptophysin (19.6%), S100 (10.9%), Chromo (8.7%), NSE (6.5%), Vim (4.3%), CD99 (2.2%), EMA (2.2%), Oct-04 (2.2%), PR (2.2%), PR (2.2%), and P63 (2.2%). The most common tumors were Ependymoma (35.3%), Astrocytoma (17.6%), Medulloblastoma (17.6%), Meningioma (11.7%), and Pineoblastoma (5.9%). The mean TAT for Routine histology was 8.8 days (SD: 6.8 days), while IHC was 17.9 days (SD: 15.4 days), exceeding the pathology lab’s standard 6-day TAT for histology reported in 2024. Cases requiring extensive IHC experienced significant delays. Histology remains vital for pediatric brain tumor diagnosis, with Immunohistochemistry enhancing diagnostic accuracy, particularly in ambiguous cases. Optimizing workflows, integrating histology and IHC efficiently, and strengthening clinician-pathologist communication are essential for minimizing delays and improving diagnostic precision, ultimately leading to better patient outcomes.

Digoxin is a commonly prescribed drug for cardiovascular diseases, which is the leading cause of death globally, with those in resource-limited areas disproportionately affected. Unfortunately, digoxin has a narrow therapeutic window of 0.7-1.8ng/mL and therefore requires therapeutic drug monitoring (TDM) to ensure safe and effective doses are administered. While mobile clinics increase medical accessibility in point-of-care settings, they lack specialized equipment and electricity that TDM requires. To address this lack of TDM technology, we created a fully automated and battery-powered device that executes a newly developed workflow and requires only a push of a single button. Notably, this novel method integrates the simplicity and long-term stability of dried blood spot (DBS) sampling with a custom-made lateral-flow immunoassay (LFA) to measure digoxin concentrations in blood either immediately or for a comprehensive analysis over time. For managing multiple patient samples, we developed a smartphone app that aids clinicians in scanning patient data written on DBS collection cards. Additionally, the app is able to quantify therapeutic levels of digoxin by correlating LFA test line intensity in an image to the DBS's concentration. The automated device used in conjunction with the smartphone app delivers consistent LFA results in a rapid turnaround time of 40min for digoxin DBS concentrations between 0 and 10ng/mL. This work integrating an innovative automated system and mobile application advances medical diagnostics as this portable and cost-effective technology enables efficient monitoring of drug levels in patient blood and is especially suitable for mobile clinic settings.

Multienzyme isothermal rapid amplification (MIRA)-LFD assay for rapid detection of PEDV and PoRVA.

Rapid and practical microbial detection method for brewery hygiene management using the EZ-Fluo system.