Both short and long sleep duration have been associated with poor glycemic control and an increased risk of developing type 2 diabetes mellitus. Although sleep duration may differentially modify the effects of genetic risk factors for type 2 diabetes, this has not been systematically investigated. In the present study, we conducted genome-wide gene by sleep duration meta-analyses, separately assessing interactions of short and long sleep, for fasting glucose, fasting insulin, and hemoglobin A1c in up to 489,309 individuals without diabetes from seven different population groups. In total, 16 loci were identified to interact with sleep duration - six with short sleep and ten with long sleep. Of these, four loci were identified through cross-population meta-analysis. Mapped genes exhibit pathway connections to pericyte apoptosis, NMDA receptor activity, the GLUT1 receptor, neurological health, and sleep architecture. Eleven loci (VRK2, PCDH7, TFAP2A, CAP2, PAPPA, ZCCHC2, MYH9, SGIP1, JAKMIP3, RRAS2, MAPT) have not been reported in previous glycemic trait genome-wide association studies. Interaction loci identify divergent biological mechanisms for short and long sleep duration influencing glycemic control, suggesting specific pathways of intervention for precision medicine approaches to diabetes prevention and management.

Genetic predisposition is a risk factor for office hypertension. We sought to determine whether genetic predisposition identifies individuals with ambulatory daytime hypertension. 1444 participants from the GAPP study (ages 25-41) were analyzed. We evaluated two measures of predisposition to hypertension: family history and polygenic risk scores (PRS). We evaluated correlation of predisposition with blood pressure traits and compared incremental value of each predisposition measure to a validated ambulatory BP prediction model. 12% of participants had office hypertension, while 37% had out-of-office hypertension. The correlation between PRS and family history of hypertension was low (R2 = 4.96x10-3), but both were strongly associated with ambulatory blood pressure (2.2 mmHg per 1 SD increase [95% CI: 1.6, 2.7] & 2.4 mmHg increase with positive family history [95% CI: 1.3, 3.4], respectively). PRS provides incremental improvement predicting ambulatory systolic blood pressure beyond a validated blood pressure prediction score (ΔAIC = -33), whereas family history does not (ΔAIC = 1). The difference between a baseline prediction algorithm for identifying ambulatory systolic hypertension (positive likelihood ratio of 6.87 [95% CI: 5.56, 8.49]; negative likelihood ratio of 0.45 [95% CI: 0.39, 0.51]) and the same model with PRS integrated (positive likelihood ratio of 7.69 [95% CI: 6.18, 9.57]; negative likelihood ratio of 0.43 [95% CI: 0.37, 0.49]) was modest. In a white European sample from Liechtenstein, PRS provides incremental information in identification of individuals with ambulatory hypertension, unlike family history. However, these gains are modest and warrant further development to improve predictive utility at the point-of-care.

Background: Test descriptions from major diagnostic manufacturers do not include ferritin reference intervals (RIs) for individuals aged 60 and older. The absence of older adults-specific RIs contrasts with the widespread use of serum ferritin testing in older adults. We aimed to establish and verify RIs using two common analytical methods. Methods: For this study, 1467 older adults were prospectively enrolled and monitored for morbidity and mortality, and exclusion criteria were applied. Ferritin was measured using chemiluminescent microparticle immunoassay (CMIA) and transferred to an electrochemiluminescence immunoassay (ECLIA) using method comparison. RIs were evaluated using a direct method with a prospective observational study based on healthy individuals according to the Clinical and Laboratory Standards Institute (CLSI) 28-A3c guideline and compared with RIs obtained using an indirect approach based on data obtained in clinical routine outpatients, where normal and abnormal values are supposed to be statistically differentiated to determine RIs. When applied within a countrywide population-based setting in Liechtenstein, the impact of novel RIs on the frequency of abnormal values was analyzed. Results: A total of 386 men and 532 women were included in the direct RI determination. Women (W) had significantly lower ferritin levels than men (M), while age over the age of 60 years had no significant association with ferritin in men and women. RIs were 23-241 ng/mL (W) and 19-396 ng/mL (M) for CMIA and 27-293 ng/mL (W) and 23-480 ng/mL (M) for ECLIA. These RIs are higher than those mentioned in the test descriptions in both tests. In comparison, the indirect method for both assays showed comparably lower reference limits, whereas upper reference limits were only approximately similar. The prevalence of high abnormal ferritin levels was considerably lower with this study's RIs compared with manufacturer RIs. Conclusions: Employing older adults-specific RIs in clinical routine seems to be advisable. This reduces the frequency of abnormal high values in comparison with the widely applied practice of extrapolating RIs obtained from younger age groups to older adults and therefore leads to fewer follow-up investigations.

Background Foehn winds—warm, dry downslope winds common in alpine regions—may impact human health, especially in weather-sensitive individuals, though evidence is lacking. Wearable devices now enable continuous health monitoring, offering new insights into physiological reactions to such weather conditions. This study investigates the association between Foehn winds and physiological parameters. Methods In a repeated-measures design, healthy adults in Liechtenstein wore medical sensory bracelets for 11 months, recording nightly heart rate (HR), heart rate variability (HRV), wrist skin temperature (WST), respiratory rate (RR), perfusion index (PI) and sleep duration. Foehn exposure was determined using local weather data. Linear mixed-effects models assessed associations, adjusting for confounders. Results A total of 714 participants (59.7% women; mean age 44.0 years) were included. Foehn was associated with changes in HR (+ 0.25 bpm; 95% CI: 0.17, 0.33), PI (+ 0.78%; 95% CI: 0.22, 1.33), and HRV (–0.29%; 95% CI: − 0.55, − 0.04), while RR, WST, and sleep duration remained unchanged. 40.8% disclosed being Foehn-sensitive via questionnaire. They showed a 9.92% lower PI irrespective of Foehn. Effects of Foehn differed by Foehn sensitivity: HR (+ 0.32 bpm vs. +0.15 bpm) and HRV (–0.53% vs. +0.04%) responses were more pronounced in non-sensitive individuals. Conclusions Our findings show that Foehn winds are linked to changes in physiological parameters, suggesting a weather-induced stress response. These effects were independent of sex. Interestingly, Foehn-sensitive individuals showed a lower baseline perfusion index (irrespective of Foehn), indicating a potential physiological predisposition. However, contrary to expectations, stronger physiological responses occurred in non-sensitive individuals.

Cigarette smoking influences blood pressure (BP) levels. Studying and accounting for potential gene-smoking interactions can help discover novel loci and provide insights into biological pathways for smoking-associated BP regulation. We conducted a genome-wide association meta-analysis involving 1,188,241 individuals from 66 studies in five ancestry groups, analyzing systolic BP, diastolic BP, and pulse pressure while considering interactions between genetic variants and three smoking exposures: smoking status, cigarettes per day, and pack years. These analyses identified twelve novel loci for BP at genome-wide significance ( P < 5 × 10 - 9 ), and highlighted biological processes including tight junction integrity, mitochondrial health, vascular relaxation, and endothelial function. In smoking status-stratified analyses, smoking modifies the genetic effect of six variants on BP. To prioritize likely causal, we developed and applied SuSiEgxe, a fine-mapping method based on a two-degree-of-freedom joint test using gene-environment interaction summary statistics. Fine-mapped loci uncovered immune-related pathway for smoking-associated BP regulation.

Maintaining the integrity of blood samples during transport is essential for accurate laboratory diagnostics. Hemolytic, lipemic, and icteric (HIL) indices are critical preanalytical markers that detect hemolysis, lipemia, and icterus, which can interfere with diagnostic results. With the growing interest in drones as a method of medical transport, particularly for remote or underserved areas, it is crucial to evaluate their impact on the stability of HIL indices. This study investigates whether blood samples transported by drones maintain their integrity, focusing on four common sample types: serum, EDTA whole blood, lithium-heparin plasma, and citrate plasma. A total of 25 samples for each of the four blood types were collected and transported by a custom-built medical drone. The drone covered a 25 km route in 30 minutes at a cruising speed of 100 km/h and an altitude of 100 meters. Samples were placed in secure containers designed to minimize vibration and temperature fluctuations. Environmental conditions were monitored using data loggers and accelerometers. Hemolytic, lipemic, and icteric indices were measured spectrophotometrically before and after transport using standard absorbance techniques. Paired t-tests were performed to assess statistical significance, with a threshold of p < 0.05. The study found no significant changes in the HIL indices for any sample type after drone transport. Serum samples exhibited minimal variations, with the hemolytic index showing a mean change of -0.15 (p = 0.19) and the lipemic index a decrease of -0.20 (p = 0.38). EDTA whole blood demonstrated similarly stable results, with the hemolytic index showing a delta of -0.15 (p = 0.42) and the lipemic index increasing by +0.25 (p = 0.23). Lithium-heparin plasma displayed absolute stability in the hemolytic index (0.00, p = 1.00) and minor, non-significant changes in the icteric and lipemic indices (+0.05, p = 0.79). Citrate plasma results reflected comparable stability, with all p-values exceeding 0.19. Across all sample types, the variations in mean values were statistically and clinically insignificant, confirming the stability of preanalytical quality during drone transport. This study demonstrates that blood samples transported via drone maintain stable hemolytic, lipemic, and icteric indices, supporting the reliability of this method in medical logistics. Drones offer significant advantages, including bypassing traffic, reducing delays, and enabling transport in remote or underserved areas. Additionally, they present a sustainable alternative to traditional transportation methods. By ensuring the integrity of transported blood samples, this research supports the integration of drones into healthcare systems as an innovative, efficient, and environmentally friendly solution. Further exploration of drone scalability and its effects on additional diagnostic parameters is warranted to expand its application in modern laboratory medicine.

Background:Gene-environment interactions may enhance our understanding of hypertension. Our previous study highlighted the importance of considering psychosocial factors in gene discovery for blood pressure (BP) but was limited in statistical power and population diversity. To address these challenges, we conducted a multi-population genome-wide association study (GWAS) of BP accounting for gene-depressive symptomatology (DEPR) interactions in a larger and more diverse sample. Results:Our study included 564,680 adults aged 18 years or older from 67 cohorts and 4 population backgrounds (African (5%), Asian (7%), European (85%), and Hispanic (3%)). We discovered seven novel gene-DEPR interaction loci for BP traits. These loci mapped to genes implicated in neurogenesis (TGFA, CASP3), lipid metabolism (ACSL1), neuronal apoptosis (CASP3), and synaptic activity (CNTN6, DBI). We also identified evidence for gene-DEPR interaction at nine known BP loci, further suggesting links between mood disturbance and BP regulation. Of the 16 identified loci, 11 loci were derived from African, Asian, or Hispanic populations. Post-GWAS analyses prioritized 36 genes, including genes involved in synaptic functions (DOCK4, MAGI2) and neuronal signaling (CCK, UGDH, SLC01A2). Integrative druggability analyses identified 11 druggable candidate gene targets, including genes implicated in pathways linked to mood disorders as well as gene products targeted by known antihypertensive drugs. Conclusions:Our findings emphasize the importance of considering gene-DEPR interactions on BP, particularly in non-European populations. Our prioritized genes and druggable targets highlight biological pathways connecting mood disorders and hypertension and suggest opportunities for BP drug repurposing and risk factor prevention, especially in individuals with DEPR.

The increasing adoption of drones in medical logistics raises concerns about the potential cumulative effects of repeated transport on the quality of blood samples and the variability in laboratory results. This study investigates the stability of 35 analytes, including potassium, thrombocytes, international normalized ratio (INR), Quick value, and activated partial thromboplastin time (aPTT), over ten consecutive drone transport cycles, focusing on four blood types: serum, EDTA plasma, lithium-heparin plasma, and citrate plasma. Blood samples of four different materials (serum, citrate, EDTA, Li-Hep) were subjected to ten drone transport cycles over a standard route, with each cycle lasting approximately 30 minutes. A total of 35 analytes were measured pre- and post-transport using standard laboratory methods. Key transport parameters such as vibration and temperature fluctuations were monitored. Pre- and post-transport analyte concentrations were assessed using spectrophotometric and hematological techniques. Statistical analyses, including Passing-Bablok regression and Bland-Altman plots, were employed to evaluate variability, and paired t-tests determined significant changes in mean values. The majority of analytes exhibited stability across all blood types, with minimal variation in pre- and post-transport results. Potassium levels demonstrated a statistically significant increase in variability (Passing-Bablok slope: 1.07, r = 0.98) after repeated transport cycles, accompanied by a mean bias of +2.5%. Thrombocyte counts showed a similar trend, with Bland-Altman analysis revealing a proportional bias of +3.2% after the tenth cycle. The Quick value exhibited a significant increase from a mean pre-transport value of 91.05% to 107.12%, with a Passing-Bablok slope of 1.177 and a mean bias of +15.0%. In contrast, INR values decreased slightly from 0.94 to 0.90, with a Passing-Bablok slope of 1.000 and a mean bias of -0.04%. Additionally, the aPTT increased by 4.46 seconds on average, rising from 20.32 seconds pre-transport to 24.78 seconds post-transport, with a Passing-Bablok slope of 1.220 and a mean bias of +18.0%. Other analytes, such as bilirubin and alkaline phosphatase, remained within clinically acceptable limits across all cycles, confirming the robustness of drone transport for most laboratory parameters. Repeated drone transport does not compromise the integrity of the majority of blood analytes, supporting its viability for medical logistics. However, increased variability in potassium levels, thrombocyte counts, Quick values, and aPTT times, as well as the slight decrease in INR, highlight the need for cautious interpretation in clinical scenarios involving multiple transport cycles. This study underscores the importance of validating drone-based logistics for specific analytes to ensure reliable laboratory diagnostics.

Maintaining blood sample integrity is essential for accurate laboratory diagnostics. The hemolytic, lipemic, and icteric (HIL) indices are critical markers of sample quality, detecting common preanalytical interferences such as hemolysis, lipemia, and icterus. Drone technology offers a novel transport method for medical logistics, particularly in remote or underserved regions. This study assessed the stability of HIL indices in blood samples transported by drone. Twenty-five samples each of serum, EDTA whole blood, lithium-heparin plasma, and citrate plasma were collected from healthy volunteers using standard venipuncture techniques. Serum samples were collected in gel separator tubes. Samples were transported unprocessed using a rotor-type hybrid drone (Jedsy Glider) over a 25-kilometer route. Temperature and vibration were monitored during flight using data loggers and accelerometers. HIL indices were measured preflight and postflight using a Roche Cobas 6000 system. Paired t-tests assessed significant changes (P < 0.05). No statistically significant differences were observed in the HIL indices preflight and postflight for all blood sample types. For serum samples, the hemolytic index decreased slightly from 9.60 to 9.45 (P = 0.19), with negligible changes in lipemic and icteric indices. Similar stability was observed for EDTA whole blood, lithium-heparin plasma, and citrate plasma. Drone transport is a viable alternative for blood sample logistics, preserving HIL index stability across various sample types. These findings underscore the potential of drones to enhance healthcare logistics in remote or underserved environments. This study was conducted as a quality assurance project for the Institute of Clinical Chemistry at Dr. Risch, Buchs, Switzerland. The Ethics Committee Ostschweiz reviewed the study under BASEC-ID Req-2024-01510 and determined that it does not fall within the scope of the Swiss Human Research Act and therefore does not require formal ethics committee approval. This determination was based on the project's designation as a quality assurance initiative rather than a human research study. As per the committee's guidance, data protection and confidentiality were strictly maintained throughout the study, ensuring compliance with all relevant legal and institutional requirements.

Although both short and long sleep duration are associated with elevated hypertension risk, our understanding of their interplay with biological pathways governing blood pressure remains limited. To address this, we carried out genome-wide cross-population gene-by-short-sleep and long-sleep duration interaction analyses for three blood pressure traits (systolic, diastolic, and pulse pressure) in 811,405 individuals from diverse population groups. We discovered 22 novel gene-sleep duration interaction loci for blood pressure, mapped to 23 genes. Investigating these genes’ functional implications shed light on neurological, thyroidal, bone metabolism, and hematopoietic pathways that necessitate future investigation for blood pressure management that caters to sleep health lifestyle. Non-overlap between short sleep (12) and long sleep (10) interactions underscores the plausible nature of distinct influences of both sleep duration extremes in cardiovascular health. Several of our loci are specific towards a particular population background or sex, emphasizing the importance of addressing heterogeneity entangled in gene-environment interactions, when considering precision medicine design approaches for blood pressure management.

BACKGROUND:Rapid and early detection of SARS-CoV-2 infections, especially during the pre- or asymptomatic phase, could aid in reducing virus spread. Physiological parameters measured by wearable devices can be efficiently analysed to provide early detection of infections. The COVID-19 Remote Early Detection (COVID-RED) trial investigated the use of a wearable device (Ava bracelet) for improved early detection of SARS-CoV-2 infections in real-time. TRIAL DESIGN:Prospective, single-blinded, two-period, two-sequence, randomised controlled crossover trial. METHODS:Subjects wore a medical device and synced it with a mobile application in which they also reported symptoms. Subjects in the experimental condition received real-time infection indications based on an algorithm using both wearable device and self-reported symptom data, while subjects in the control arm received indications based on daily symptom-reporting only. Subjects were asked to get tested for SARS-CoV-2 when receiving an app-generated alert, and additionally underwent periodic SARS-CoV-2 serology testing. The overall and early detection performance of both algorithms was evaluated and compared using metrics such as sensitivity and specificity. RESULTS:A total of 17,825 subjects were randomised within the study. Subjects in the experimental condition received an alert significantly earlier than those in the control condition (median of 0 versus 7 days before a positive SARS-CoV-2 test). The experimental algorithm achieved high sensitivity (93.8-99.2%) but low specificity (0.8-4.2%) when detecting infections during a specified period, while the control algorithm achieved more moderate sensitivity (43.3-46.4%) and specificity (66.4-65.0%). When detecting infection on a given day, the experimental algorithm also achieved higher sensitivity compared to the control algorithm (45-52% versus 28-33%), but much lower specificity (38-50% versus 93-97%). CONCLUSIONS:Our findings highlight the potential role of wearable devices in early detection of SARS-CoV-2. The experimental algorithm overestimated infections, but future iterations could finetune the algorithm to improve specificity and enable it to differentiate between respiratory illnesses. TRIAL REGISTRATION:Netherlands Trial Register number NL9320.

Molecular methods to detect antimicrobial resistance in Neisseria gonorrhoeae (Ng) are increasingly needed worldwide to improve diagnostic tests and enable individualized patient treatments. The Allplex™ NG DR Assay (NG DR assay) was assessed for its ability to detect Ng and its antimicrobial resistance. The assay predicts ciprofloxacin resistance and susceptibility by targeting the molecular antimicrobial resistance (AMR) determinant gyrA S91F. The AMR determinants 23 S rRNA A2059G and C2611T were investigated to predict azithromycin wild-type and nonwild-type genotypes. After antimicrobial susceptibility testing, 153 Ng isolates were evaluated with the NG DR assay. Furthermore, 394 clinal specimens, including 76 with corresponding antimicrobial susceptibility results, were analyzed simultaneously by the NG DR assay and the in-house SYBR-Green assay. The NG DR assay predicted ciprofloxacin resistance and susceptibility with a sensitivity and specificity of 98.2

In response to escalating climate change concerns, this study evaluates the ecological impact and efficiency of medical sample transportation using drones, combustion cars, and electric cars across various terrains and weather conditions in Liechtenstein and Switzerland. Through a comparative analysis, we found that combustion cars emit the highest average CO2 at 159.5 g per kilometer (g/km), while electric cars significantly reduce emissions to an average of 3.43 g/km, representing just 2.15% of the emissions from combustion vehicles. Drones emerged as the most environmentally sustainable option, with an average CO2 emission of 0.09 g/km, which is only 0.07% of combustion car emissions and 2.6% of electric car emissions. Drones also demonstrated superior transport efficiency, covering routes that were, on average, 17% shorter in flat terrain and 24% shorter in mountainous regions compared to cars. Additionally, drones achieved substantial time savings, ranging from 13% to 80% faster delivery times depending on the terrain and traffic conditions. These findings highlight the potential of drone technology to revolutionize healthcare logistics by significantly reducing carbon footprints, optimizing transport routes, and improving delivery efficiency. Integrating drones into healthcare transportation networks offers a promising pathway toward a more sustainable and resilient healthcare system.

Abstract Background Laboratory medicine plays a fundamental role in patient care, especially in emergency departments where rapid diagnosis is critical to the efficient management of high patient volumes. With the aim of simplifying and standardizing laboratory requests, laboratory profiles have widely been established. This study uses the laboratory profile for “acute abdominal pain” as an example to illustrate the extent to which the laboratory profiles used in hospitals differ from each other and whether they are in line with current scientific recommendations. Methods Hospital data and laboratory profiles for “acute abdominal pain” from 18 hospitals, 9 from Germany and 9 from Switzerland, were analyzed and compared. The hospitals were distinguished by bed size, inpatient and outpatient case numbers, country affiliation and university level. In addition, an 'evidence-based laboratory profile' for acute abdominal pain was created based on current guidelines for the five most important causes of acute abdominal pain and compared with hospital laboratory profiles. Results German hospitals include significantly more laboratory parameters into acute abdominal pain profiles than Swiss hospitals (p = 0,0052). No significant differences in the number of laboratory parameters were found between university and non-university hospitals (p = 0,0507). There is a significant positive correlation between the hospital bed size and the number of laboratory parameters in the profiles (r = 0,5521). The number of inpatient cases in a hospital are also positively correlated with the number of laboratory parameters in the profiles (r = 0,4751). The number of outpatient cases ist not associated with the number of laboratory in the profiles parameters (r = 0,0599). The evidence-based laboratory profile for acute abdominal pain includes 21 laboratory parameters, but only two of them are collected by all investigated hospitals (bilirubin and ALAT).There were no significant differences in the fulfillment of the evidence-based laboratory profile between Germany and Switzerland, or between university or non-university status. Conclusions The study shows that there are quantitative and qualitative differences between the laboratory profiles for investigation of acute abdominal pain within the participating hospitals. In Germany and Switzerland there is no consensus on which analyses to include into a profile investigating acute abdominal pain. For increasing efficiency and accuracy of laboratory testing in in the diagnostic workup of acute abdominal pain it seems advisable to obtain consensus on what to reasonably include into a profile on a national or international level.

Purpose Single doses of gentamicin have demonstrated clinical efficacy in the treatment of urogenital gonorrhea, but lower cure rates for oropharyngeal and anorectal gonorrhea. Formulations selectively enriched in specific gentamicin C congeners have been proposed as a less toxic alternative to gentamicin, potentially permitting higher dosing to result in increased plasma exposures at the extragenital sites of infection. The purpose of the present study was to compare the antibacterial activity of individual gentamicin C congeners against Neisseria gonorrhoeae to that of other aminoglycoside antibiotics. Methods Antimicrobial susceptibility of three N. gonorrhoeae reference strains and 152 clinical isolates was assessed using standard disk diffusion, agar dilution, and epsilometer tests. Results Gentamicin C1, C2, C1a, and C2a demonstrated similar activity against N. gonorrhoeae . Interestingly, susceptibility to the 1- N -ethylated aminoglycosides etimicin and netilmicin was significantly higher than the susceptibility to their parent compounds gentamicin C1a and sisomicin, and to any other of the 25 aminoglycosides assessed in this study. Propylamycin, a 4’-propylated paromomycin analogue, was significantly more active against N. gonorrhoeae than its parent compound, too. Conclusion Selectively enriched gentamicin formulations hold promise for a less toxic but equally efficacious alternative to gentamicin. Our study warrants additional consideration of the clinically established netilmicin and etimicin for treatment of genital and perhaps extragenital gonorrhea. Additional studies are required to elucidate the mechanism behind the advantage of alkylated aminoglycosides.

The integration of unmanned aerial vehicles or uncrewed aerial vehicles (UAVs)—commonly known as drones—into medical logistics offers transformative potential for the transportation of sensitive medical materials, such as blood samples. Traditional car transportation is often hindered by traffic delays, road conditions, and geographic barriers, which can compromise timely delivery. This study provides a comprehensive analysis comparing high-speed drone transportation with traditional car transportation. Blood samples, including EDTA whole blood, serum, lithium-heparin plasma, and citrate plasma tubes, were transported via both methods across temperatures ranging from 4 to 20 degrees Celsius. The integrity of the samples was assessed using a wide array of analytes and statistical analyses, including Passing–Bablok regression and Bland–Altman plots. The results demonstrated that drone transportation maintains blood sample integrity comparable to traditional car transportation. For serum samples, the correlation coefficients (r) ranged from 0.830 to 1.000, and the slopes varied from 0.913 to 1.111, with minor discrepancies in five analytes (total bilirubin, calcium, ferritin, potassium, and sodium). Similar patterns were observed for EDTA, lithium-heparin, and citrate samples, indicating no significant differences between transportation methods. Conclusions: These findings highlight the potential of drones to enhance the efficiency and reliability of medical sample transport, particularly in scenarios requiring rapid and reliable delivery. Drones could significantly improve logistical operations in healthcare by overcoming traditional transportation challenges.

Background Few methicillin-resistant Staphylococcus aureus (MRSA) from the early years of its global emergence have been sequenced. Knowledge about evolutionary factors promoting the success of specific MRSA multi-locus sequence types (MLSTs) remains scarce. We aimed to characterize a legacy MRSA collection isolated from 1965 to 1987 and compare it against publicly available international and local genomes. Methods We accessed 451 historic (1965–1987) MRSA isolates stored in the Culture Collection of Switzerland, mostly collected from the Zurich region. We determined phenotypic antimicrobial resistance (AMR) and performed whole genome sequencing (WGS) using Illumina short-read sequencing on all isolates and long-read sequencing on a selection with Oxford Nanopore Technology. For context, we included 103 publicly available international assemblies from 1960 to 1992 and sequenced 1207 modern Swiss MRSA isolates from 2007 to 2022. We analyzed the core genome (cg)MLST and predicted SCC mec cassette types, AMR, and virulence genes. Results Among the 451 historic Swiss MRSA isolates, we found 17 sequence types (STs) of which 11 have been previously described. Two STs were novel combinations of known loci and six isolates carried previously unsubmitted MLST alleles, representing five new STs (ST7843, ST7844, ST7837, ST7839, and ST7842). Most isolates (83% 376/451) represented ST247-MRSA-I isolated in the 1960s, followed by ST7844 (6% 25/451), a novel single locus variant (SLV) of ST239. Analysis by cgMLST indicated that isolates belonging to ST7844-MRSA-III cluster within the diversity of ST239-MRSA-III. Early MRSA were predominantly from clonal complex (CC)8. From 1980 to the end of the twentieth century, we observed that CC22 and CC5 as well as CC8 were present, both locally and internationally. Conclusions The combined analysis of 1761 historic and contemporary MRSA isolates across more than 50 years uncovered novel STs and allowed us a glimpse into the lineage flux between Swiss-German and international MRSA across time.

Objectives This study systematically compared the performance and comparability of two medical laboratory analytical instruments, the conventional wet chemistry analyzer (cobas) and the dry slide technology (Vitros), across various clinical chemistry assays. Methods The evaluation focused on assessing imprecision, inaccuracy, recovery, and method comparison using leftover patient serum samples. Results The results indicated good to very good agreement for most clinical chemistry analytes, with larger differences observed for comparison of serum patient samples on albumin and protein. Conclusions Understanding and acknowledging method-specific variations, are crucial for accurate result interpretation in clinical laboratories. This study contributes valuable insights to ongoing discussions on method standardization.

Background: The integration of unmanned aerial vehicles (UAVs), commonly known as drones, into medical logistics offers transformative potential for the transpor-tation of sensitive medical materials, such as blood samples. Traditional car transportation is often hindered by traffic delays, road conditions, and geographic barriers, which can compromise timely delivery. Methods: This study provides a comprehensive analysis comparing high-speed drone transportation with traditional car transportation under various weather conditions. Blood samples, including EDTA whole blood, Serum, Li-Heparin Plasma, and citrate plasma tubes, were transported via both methods across temperatures ranging from 4 to 20 degrees Celsius. The integrity of the samples was assessed using a wide array of analytes and statistical analyses, including Passing-Bablok regression and Bland-Altman plots. Results: The results demonstrated that drone transportation maintains blood sample integrity comparably to traditional car transpor-tation. For serum samples, the correlation coefficients (r) ranged from 0.830 to 1.000, and the slopes varied from 0.913 to 1.111, with minor discrepancies in five analytes (total bilirubin, calcium, ferritin, potassium, and sodium). Similar patterns were observed for EDTA, Lithium-Heparin, and Citrate samples, indicating no significant differences between transportation methods. Conclusions: These findings highlight the potential of drones to enhance the efficiency and reliability of medical sample transport, particularly in scenarios requiring rapid and reliable delivery. Drones could significantly improve logistical operations in healthcare by overcoming traditional transportation challenges.

Abstract Background This research explores the ecological implications associated with different methods of transporting medical samples, specifically focusing on drones, combustion cars, and electric cars within two laboratories in central European countries. With the primary goal of assessing and comparing CO2 consumption, delivery time, and overall environmental impact, the study aims to provide a basis for adopting sustainable practices in healthcare logistics. Methods The transportation of medical samples occurred between two laboratories in the Principality of Liechtenstein and Switzerland, utilizing authorized aerial and road routes. Various weather conditions and distances were considered for sample transports using different vehicles (8 combustion cars, two electric cars, and one drone model). Energy consumption was documented, and the CO2 footprint was calculated based on data from the Swiss Federal Office for the Environment (FOEN) for both imported and renewable electricity. Comparative analyses were conducted to quantify the environmental impact of each transportation method. Results In terms of CO2 footprint, combustion cars exhibited a CO2 release of 159.5 g/km, while electric cars showed 3.43g (2.15 to 4.08% of combustion cars). Drones demonstrated a minimal 0.09g CO2 emission per kilometer (0.066% of combustion car CO2 emission; 2.6% of electric car CO2 emission). The distance traveled by drones was significantly shorter (16.7% to 50%). Additionally, the efficiency of drone transport was emphasized by its ability to avoid traffic jams and associated detours, resulting in time savings ranging from 31.25 to 50% per delivery when comparing transport times during rush hour and regular hours in the selected setting. Conclusions The integration of drone technology emerges as a crucial strategy for establishing a “green laboratory.” The substantial reduction in CO2 emissions and enhanced delivery efficiency position drone transport as a sustainable and operationally effective solution for medical sample logistics, offering shorter delivery times. These findings highlight the potential for transformative change in healthcare logistics, aligning with the global shift towards sustainability and green practices.