Clinical laboratory最新文献

{"title":"Unveiling the Th17/Treg Imbalance: a New Lens on Macular Perfusion in Thyroid-Associated Ophthalmopathy.","authors":"XiaoQing Zhou, Qian Sha","doi":"10.7754/Clin.Lab.2025.250856","DOIUrl":"https://doi.org/10.7754/Clin.Lab.2025.250856","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate the association between Th17/Treg imbalance and macular blood flow abnormalities in patients with thyroid-associated ophthalmopathy (TAO).</p><p><strong>Methods: </strong>A prospective cohort study was designed to include 71 patients with TAO and 50 healthy controls. Macular blood flow measurements were quantified by optical coherence tomography angiography, including foveal vessel density (FVD) and foveal perfusion density (FPD) in 1 mm from the central fovea, macular vessel density (MVD) and macular perfusion density (MPD) in 6 mm from the central fovea, and macular foveal avascular zone (FAZ) was also measured. Peripheral blood Th17/Treg ratio was measured by flow cytometry and its association with blood flow measurements was assessed by multiple linear regression modeling, correcting for confounding factors such as age and gender.</p><p><strong>Results: </strong>MVD (16.38 ± 2.83 vs. 18.91 ± 2.20, p < 0.001) and MPD (44.5% vs. 48.1%, p < 0.001) in the TAO group were significantly lower than those of the control group. Th17/Treg ratio showed a significant positive correlation with MPD (multifactorial β = 0.01, p = 0.002) and negatively correlated with FAZ (multifactorial β = -0.36, p = 0.018). No significant correlations were found for other indicators (FVD, FPD, and MVD) and confounders (TAO activity, gender, and age).</p><p><strong>Conclusions: </strong>Th17/Treg imbalance is directly involved in microcirculatory disorders in TAO by decreasing MPD and enlarging macular FAZ, suggesting that immunomodulation may be a therapeutic target to improve macular blood flow abnormalities in TAO patients.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"72 8","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AST to ALT Ratio as a Potential Biomarker for Type 2 Diabetes: Findings from the NHANES Database.","authors":"Jing Xu, Yanhong Li","doi":"10.7754/Clin.Lab.2025.250806","DOIUrl":"https://doi.org/10.7754/Clin.Lab.2025.250806","url":null,"abstract":"<p><strong>Background: </strong>The aspartate transaminase to alanine aminotransferase ratio (AST/ALT) has been proposed as a potential biomarker for metabolic dysfunction, but its association with type 2 diabetes mellitus (T2DM) remains controversial. This study aimed to investigate the relationship between AST/ALT ratio and risk of T2DM using a nationally representative sample.</p><p><strong>Methods: </strong>We analyzed data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2004, collecting details on their T2DM status, AST/ALT ratio, and several other essential variables. There were 12,527 participants, with 13.9% (1,746/12,527) who experienced T2DM. Logistic regression, curve fitting, interaction effects were utilized to investigate the association between AST/ALT ratio and T2DM.</p><p><strong>Results: </strong>There was a substantial difference in AST/ALT ratios between the groups, with T2DM patients exhibiting significantly lower values (p < 0.001). Logistic regression analysis revealed a negative association between AST/ ALT ratio and T2DM, even after adjusting for the confounding variables (odds ratio: 0.28, 95% confidence interval: 0.25 - 0.32, p < 0.001). In addition, curve fitting after adjusting for all the confounding variables showed that there was a linear relationship between AST/ALT ratio and T2DM (p for non-linearity = 0.107). AST/ALT ratio was negatively correlated with T2DM.</p><p><strong>Conclusions: </strong>The AST/ALT ratio was associated with a lower risk of T2DM in a linear pattern, suggesting its potential role as a clinical indicator of metabolic risk. Further prospective studies are needed to clarify causality.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"72 8","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Room as a Window for Identifying Undiagnosed Anemia: a Clinical Evaluation.","authors":"Rana G Zaini","doi":"10.7754/Clin.Lab.2025.250915","DOIUrl":"https://doi.org/10.7754/Clin.Lab.2025.250915","url":null,"abstract":"<p><strong>Background: </strong>Anemia is a major global health concern with significant clinical consequences, particularly when undiagnosed. The emergency department (ED) provides an important opportunity for opportunistic screening; however, data on undiagnosed anemia in Saudi Arabia are limited. This study aimed to determine the prevalence and hematological characteristics of previously undiagnosed anemia among adult ED visitors in Makkah, Saudi Arabia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at the Security Forces Hospital, Makkah, from October through December 2024. Adult patients (≥ 18 years) without a prior diagnosis of anemia were included, while pregnant women and those with trauma or active bleeding were excluded. Demographic and clinical data were retrieved from medical records. Hemoglobin (Hb) levels were analyzed according to World Health Organization (WHO) criteria. Red blood cell indices, including mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH), were used to classify anemia types. Statistical analysis was performed using SPSS; chi-squared and t-tests were applied, with p < 0.05 considered significant. A total of 135 adults were enrolled.</p><p><strong>Results: </strong>The prevalence of previously undiagnosed anemia was 27.4% (n = 37). No significant differences were observed by gender (p = 0.96), age group (p = 0.28), or nationality (p = 1.00). Anemic patients had significantly lower Hb levels than non-anemic individuals (p < 0.001). Among anemic patients, 37.8% had microcytic anemia, 59.5% had normocytic anemia, and 2.7% had macrocytic anemia. A significant association between low MCV and anemia suggested iron deficiency anemia as the predominant cause. Over one-quarter of ED patients had undiagnosed anemia.</p><p><strong>Conclusions: </strong>Routine screening in EDs could facilitate early detection and timely intervention to reduce complications.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"72 8","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a Rapid Confirmatory Human Immunodeficiency Virus Test: Overall Performance and Band Analysis.","authors":"Yassmine Amor, Amal Zouaki, Jalila Zirar, Ghizlane El Amin, Nora Touyar, Myriam Seffar, Sessouma Abou, Sami Belkhettab, Wafae Ammouri, Hakima Kabbaj","doi":"10.7754/Clin.Lab.2025.250853","DOIUrl":"https://doi.org/10.7754/Clin.Lab.2025.250853","url":null,"abstract":"<p><strong>Background: </strong>Accurate human immunodeficiency virus diagnosis is required to treat and prevent transmission. HIV western blot (MP-WB) has major drawbacks such as prolonged turnaround times, and high percentages of indeterminate results. To address these issues, the CDC in 2014 recommended the use of an immunological test capable of differentiating anti-HIV-1 antibodies from anti-HIV-2 antibodies for HIV diagnosis. The Geenius™ HIV 1/2 Confirmatory Assay/Bio-Rad is a rapid, single-use immunochromatographic test designed to confirm and differentiate HIV antibodies.</p><p><strong>Methods: </strong>This study, conducted at the Central Virology Laboratory of the Rabat Specialty Hospital, Morocco, evaluated the performance of the Geenius test as an alternative to MP-WB for confirming HIV-1 diagnoses over 24 months. 116 samples were included, 113 patient samples with repeatedly reactive HIV screening test (HIV Combo Ag/Ab) and 3 external quality evaluation programs. Samples were tested by Geenius™ HIV-1/2 confirmatory assay and MP-WB. A nucleic acid amplification test (NAAT) was performed for discordant cases.</p><p><strong>Results: </strong>Geenius and MP-WB mostly agreed in 95% of the overall, with a Cohen's kappa coefficient at 0.728, indicating substantial agreement. Geenius also produced fewer indeterminate results compared with MP-WB (16.67% vs. 83.33%), mainly in low-reactive samples. At the band level, the highest performances were seen with Gp160 and Gp41, showing concordance rates of 97% and 99%, respectively, with Cohen's kappa coefficient of 0.866 and 0.955. In contrast, the p24 and p31 bands demonstrated lower performances. Among six discordant results, five had low HIV Combo index values and were NAAT confirmed negative. A single high screening ratio and positive NAAT discordant case was classified as acute HIV infection. Excluding indeterminate Geenius results, the Geenius assay displayed 99% sensitivity, 100% specificity, 100% PPV, and 90.9% NPV, which justifies its better diagnostic performance compared to MP-WB.</p><p><strong>Conclusions: </strong>The Bio-Rad Geenius HIV-1/2 confirmatory test represents a reliable, rapid, and less labor-intensive alternative to MP-WB, offering a simplified approach for confirming HIV diagnoses, with good sensitivity for gp41 and gp160 bands, and can be integrated into diagnostic algorithms.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"72 8","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Cutibacterium acnes and Bacteroides fragilis in Prostate Cancer: a Turkish Population-Based Case-Control Study.","authors":"Edip Tokuc, Iclal Gurses, Ugur Aferin, Birgi Ercili, Ahmet Gurbuz, Nur A Erozenci, Murat T Bakar, Ozge Aksu, Mehmet Demirci, Zeynep Kurt, Yesim Ozturk-Bakar, Ayse Ceylan-Kilincarslan, Muhuyedin A Ziyad, Sureyya Turk, Bekir S Kocazeybek, Hrisi Bahar-Tokman","doi":"10.7754/Clin.Lab.2025.250932","DOIUrl":"https://doi.org/10.7754/Clin.Lab.2025.250932","url":null,"abstract":"<p><strong>Background: </strong>Recent studies suggest that Cutibacterium acnes may be involved in prostate carcinogenesis. The po-tential association between Bacteroides fragilis and prostate cancer (PC) is still under investigation. This study aimed to determine the levels of C. acnes and B. fragilis in prostate biopsies from patients with PC and healthy controls (HCs) and to evaluate the possible roles of these bacteria in the etiopathogenesis of PC.</p><p><strong>Methods: </strong>This age-matched case-control study was conducted between 2020 and 2022. Prostate biopsies were collected from 60 patients with PC and 60 HCs divided in two age groups of 55 - 65 years and 66 - 75 years, respectively. C. acnes and B. fragilis levels were determined using real-time quantitative polymerase chain reaction (qPCR).</p><p><strong>Results: </strong>C. acnes was detected in 58 (96.6%) biopsies from PC patients and in 39 (65%) from HCs (p < 0.001), B. fragilis was detected in 9 (15%) biopsies from PC patients and in 4 (6.7%) from HCs (p = 0.142). Compared with HCs, C. acnes abundance was significantly higher in PC patients aged 55 - 65 years (p = 0.002). No significant difference in B. fragilis abundance was found between the two groups in either age category (p = 0.211).</p><p><strong>Conclusions: </strong>Our findings suggest that C. acnes may contribute to the etiopathogenesis of PC, particularly in patients aged 55 - 65 years. In contrast, our data do not support a clear association between B. fragilis and PC. Larger, prospective, molecular-based studies are needed to clarify the potential role of these bacteria in prostate carcinogenesis.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"72 8","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposed Solutions for a Multiple Myeloma Case with Unobtainable Serum.","authors":"Zeliha Kocaismail, Ceylan Bal, Gülsüm Özet, Özcan Erel","doi":"10.7754/Clin.Lab.2025.250834","DOIUrl":"https://doi.org/10.7754/Clin.Lab.2025.250834","url":null,"abstract":"<p><strong>Background: </strong>Multiple myeloma (MM) is a plasma cell malignancy characterized by monoclonal protein secretion. Excessive immunoglobulin production increases blood viscosity, impairing serum separation and complicating laboratory analyses. We present a case of a 54-year-old male MM patient with hyperviscous samples, describing the laboratory solutions applied.</p><p><strong>Methods: </strong>To extract a sufficient liquid compartment from the initial sample, several approaches were planned: repeated or extended centrifugation using serum separator tubes (SST), collection in heparinized tubes, use of plain tubes with dilution at 1/2 and 1/4 ratios, and mechanical separator tube (MST) usage.</p><p><strong>Results: </strong>Repeated or prolonged centrifugation in SSTs did not produce sufficient serum. Blood collected in a hep-arinized tube also failed to yield adequate plasma. Sampling into a plain tube with dilution enabled sufficient serum collection, and MST provided the required plasma volume. MST test results were consistent with the patient's clinical status, whereas increasing the dilution ratio in plain tubes led to greater percentage differences compared with MST results.</p><p><strong>Conclusions: </strong>MST provided optimal and clinically reliable results. If MST is unavailable, we recommend diluting hyperviscous samples in plain tubes, beginning with a 1/2 ratio.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"72 8","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the Workflow of Hematology and Coagulation Workstations Using a Total Laboratory Automation System.","authors":"Chen-Yu Lee, Jiunn-Min Wang, Ming-Tze Yang","doi":"10.7754/Clin.Lab.2025.250851","DOIUrl":"https://doi.org/10.7754/Clin.Lab.2025.250851","url":null,"abstract":"<p><strong>Background: </strong>Total Laboratory Automation (TLA) integrates pre-analytical, analytical and post-analytical processes into a seamless workflow, improving efficiency, reducing errors, and enhancing diagnostic accuracy. Despite its advantages, comprehensive TLA integration in hematology and coagulation laboratories remains challenging due to complex sample handling and instrument-specific requirements. This study evaluates the impact of TLA implementation on workflow efficiency and turnaround time (TAT) in a high-volume clinical laboratory.</p><p><strong>Methods: </strong>This study was conducted at Taichung Veterans General Hospital (VGHTC). Since October 2023, the laboratory has integrated hematology and coagulation analyzers with an Abbott GLP SYSTEMS TRACK.</p><p><strong>Results: </strong>The integration of TLA significantly improved workflow efficiency and reduced operational costs. TAT compliance rates for hematology and coagulation testing improved from 82.0% and 76.9% to 95.2% and 93.0%, respectively, one year after implementation. Monthly blood collection tube consumption decreased by 2,915 units, resulting in cost savings of $437 USD and reducing carbon emissions by 32 kg CO2e. The automation system eliminated manual specimen transport requirements, saving one full-time equivalent staff position.</p><p><strong>Conclusions: </strong>Implementing TLA in hematology and coagulation testing enhances operational efficiency, reduces environmental impact, and improves diagnostic turnaround time. Future studies should focus on long-term sustainability and clinical outcomes associated with laboratory automation.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"72 8","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-Specific Lipid Parameters Predict Excessive Daytime Sleepiness in Parkinson's Disease.","authors":"Yu-Lian Dong, Yishi Wang, Qi Fan, Hong Jin, Yulan Cao, Jing Chen","doi":"10.7754/Clin.Lab.2025.250820","DOIUrl":"https://doi.org/10.7754/Clin.Lab.2025.250820","url":null,"abstract":"<p><strong>Background: </strong>Lipid metabolism plays an important role in neurodegenerative diseases, including Parkinson's disease (PD). However, the relationship between lipid profiles and excessive daytime sleepiness (EDS) remains unclear. This study aimed to explore the relationship between lipid parameters and EDS in PD patients, especially focusing on gender differences.</p><p><strong>Methods: </strong>A total of 176 PD patients were included in this study, and clinical data was collected. The Epworth Sleepiness Scale (ESS) was used to classify patients into PD EDS (ESS ≥ 8) and PD non-EDS (ESS < 8) groups. Univariate and multivariate analyses, along with receiver operating characteristic (ROC) analyses, were performed to detect potential biomarkers for EDS in PD.</p><p><strong>Results: </strong>In male PD patients, univariate analysis indicated an association between disease duration, Hoehn-Yahr (H-Y) stage, and lipid parameters (total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)) and EDS. Multivariate analysis identified TC and HDL-C as significant predictors, especially HDL-C. The TC/HDL-C ratio (AUC = 0.745) and non-HDL-C (defined as TC - HDL-C, AUC = 0.691) exhibited high predictive ability for EDS. Female PD patients, in contrast, showed no significant link between lipid parameters and EDS. Instead, motor dysfunction (UPDRS score) and psychological factors (HAMD/HAMA scores) were the main predictors of EDS in females.</p><p><strong>Conclusions: </strong>Research findings indicate a significant gender difference in the factors influencing EDS in PD patients. In male PD patients, lipid metabolism disorders (elevated TC, reduced HDL-C) predict EDS, with TC/ HDL-C and non-HDL-C as potential biomarkers. In female PD patients, motor and psychological factors primarily contribute to the risk of EDS.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"72 8","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between Immune Cell Traits and Tonsil and Adenoid Hypertrophy in Children: a Bidirectional Two-Sample Mendelian Randomization Study.","authors":"Xiaoyu Wen, Jiarou Zhong, Yunyun Luo, Chaojie Yang","doi":"10.7754/Clin.Lab.2025.250747","DOIUrl":"10.7754/Clin.Lab.2025.250747","url":null,"abstract":"<p><strong>Background: </strong>Mounting evidence indicates associations between immune cells and chronic diseases of the tonsils and adenoids (CDTA). Whether these observational links reflect underlying causality has yet to be determined. To elucidate causal links between immune cell traits and CDTA we used two-sample Mendelian randomization (MR).</p><p><strong>Methods: </strong>Summary data of 731 immune cell traits were acquired from the OPEN GWAS repository, encompassing absolute cell counts (n = 118), morphological parameters (MP; n = 32), relative cell counts (n = 192), and median fluorescence intensity of surface antigens (n = 389). Causality was investigated using forward MR analyses (immune cell traits as exposures, CDTA as outcomes) and reverse MR analyses (CDTA as exposures, immune cell traits as outcomes) and the inverse-variance weighting (IVW) method, complemented by sensitivity analyses to assess robustness.</p><p><strong>Results: </strong>Forward MR by IVW identified 14 immune cell traits that were positively associated with CDTA (p < 0.05, odds ratio [OR] > 1) and 12 immune cell traits that were negatively associated with CDTA (p < 0.05, OR < 1). Five of the immune cell traits exhibited heterogeneity (p < 0.05), but no horizontal pleiotropy (p > 0.05). Reverse MR revealed 3 immune cell traits that were positively associated with CDTA (p < 0.05, OR > 1), demonstrating bidirectional causality, with no heterogeneity or horizontal pleiotropy (p > 0.05).</p><p><strong>Conclusions: </strong>This study used bidirectional two-sample MR to identify intricate causal links between multiple immune cell traits and CDTA, underscoring complex interactions between immunology and pathology in CDTA.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"72 7","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming Outreach Clinical Laboratory Services - An ADKAR based Change Management Approach.","authors":"Sibtain Ahmed, Shan Lakhani, Ayra Siddiqui, Imran Siddiqui","doi":"10.7754/Clin.Lab.2025.250814","DOIUrl":"10.7754/Clin.Lab.2025.250814","url":null,"abstract":"","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"72 7","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}