13^th International Conference on Laboratory Medicine & Pathology June 25-26, 2018 Berlin, Germany

Omar Al Aufi has completed his Master’s Degree from the College of Medicine, King Abdulaziz University (KAU), Kingdom of Saudi Arabia in Clinical Biochemistry. He is the Head of the Department of Laboratory in Comprehensive Specialized Polyclinic for Security Forces in Medina, Kingdom of Saudi Arabia. He also works at King Fahad Research Center in KAU in Jeddah as a Researcher. He has many oral presentations in his field and has published a paper in Nature journal. His research interest includes clinical biochemistry, cancer research, and cell culture.

Habtamu Asrat is currently associated with Ethiopian Public Health Institute, Ethiopia. He has successfully produced his work on "Quality Control practices for quantitative tests in Ethiopian Public Health Facility Laboratories".

Background: Quality Control (QC) in the clinical laboratory is a system designed to increase the probability that each result reported by the laboratory is valid and can be used with confidence by the provider to make a diagnostic or therapeutic decision. It is a critical component of quality assurance in the laboratory and laboratory tests without quality control is not reliable. This study used as a baseline information for quality control usage in public health facility laboratories in Ethiopia. Methodology: A cross-sectional study was conducted from November 1, 2017- December 31, 2017. Systematic random

sampling technique was used to select hospital laboratories. A standardized questionnaire was developed to collect data from selected 71 public health facility laboratories nationwide.
Results: A total of 71 public health facility laboratories participated in the study, of which 5 specialized, 6 referral, 20 general and 29 primary hospital laboratories and 11 were regional reference laboratories. Among the study participants 51 (71.8%) directly used manufacturer’s set mean and standard deviation to monitor their quality control performance while 20 (28.2%) calculated their own mean and standard deviation. Out of 71 participants, only 16 (22.5%) laboratories drew Levey-Jennings chart, of which 14 (19.7%) laboratories used Westgard Rules (3 labs used single rule and 14 laboratories used multi rules). Only 4 (5.6%) laboratories calculated their monthly sigma or SEC as a quality indicator. Forty-two (59.5%) laboratories perform quality control lot verification during receiving new batch to their laboratory while 29 (39.5%) don’t do lot verification. But 48 (67.6%) laboratories faced inconsistent or shortage of quality control supplies.

Conclusions: Although the laboratory quality management system is being implemented in Ethiopia for the last 10 years, quality control practice showed a poor performance. Therefore, the national laboratory program should give attention to improve the quality control practice in the laboratory nationwide.

Christoph Hiemenz has completed his MSc from Ruprecht-Karls University Heidelberg. He work as a bioinformatician at PEPperPRINT GmbH and is the scientific instructor of the iGEM Team Heidelberg 2019. He has worked on diverse research projects: -DKFZ Heidelberg, Prof. Jörg Hoheisel- Kinase activity profiling with peptide arrays -BioQuant Heidelberg, Prof. Roland Eils/Prof. Barbara Di Ventura- Optogenetic nuclear protein shutteling and ODE modeling -KTH Stockholm, Prof. Stefan Ståhl – Surface functionalization of E.coli cells via sortases and inteins - EMBL Heidelberg, Dr. Carsten Schultz- Bioactivity of trifunctional Sphingolipids -IPMB Heidelberg, Prof. Andres Jäschke- Multivalent fluorescent turn-on probes for RNA imaging.

Binder drug conjugates such as antibody-drug conjugates have led to major improvements of personalized therapy of diseases such as cancer, autoimmunity and pathogenic virulence. The underlying methods which enable the position specific functionalization or semi-rational mutagenesis of bioactive proteins have been the key innovations. While academic research groups are already managing to computationally design small bioactive peptides, the majority of protein engineering projects are still relying on semi-rational directed evolution to identify the protein with desirable properties. Here a main leap forward has been the site-directed post-translational mutagenesis of proteins by means of state-of-the-art bioconjugation methods including enzymatic sortase A transpeptidation and chemical indium catalyzed the mild radical addition of diverse iodoalkanes to sp2-hybridized amino acids. Above all, a multitude of chemoenzymatic functionalization methods are continuously being improved and are fully compatible with directed evolution via cell surface display library screenings

Ghazi Zafar completed his MBBS from University of Health Sciences in 2013. He is currently pursuing his Postgraduation Residency in Histopathology from

Chughtai Lab, Pakistan.

Her-2 (ErbB-2) is an oncogene frequently overexpressed in breast and gastric adenocarcinomas and anti Her-2 targeted therapy can be given to such patients. Her-2 overexpression and role of anti Her-2 targeted therapy in cases of gallbladder adenocarcinomas (GBAC) is still debatable. Scoring protocols for Her-2 expression in breast and gastric carcinomas are standardized, however not for carcinomas arising in other body organs like gallbladder. This study is conducted to evaluate the expression of Her-2 in patients with GBAC which may benefit from targeted therapy. It is a cross-sectional study conducted on patients with GBAC (n=43; 34 women and 9 men). An automated immunohistochemical technique was used with an anti-ErbB2 antibody. Scoring was conducted according to the CAP (College of American Pathologists) criteria for breast cancer, as well as for gastric and gastroesophageal junction carcinomas. When the scoring protocol for breast carcinomas was used, positive Her-2 staining was observed in 11/43 (25.6%). Out of 11 positive cases, 5 cases (11.6%) were unequivocally positive (3+) and 6 (13.9%) showed equivocal staining. According to the gastric and gastroesophageal junction carcinomas protocol, positive Her-2 staining was observed in 16/43 (37.2%). Out of 16 positive cases, 11 (25.5%) were unequivocally positive (3+) and 5 (11.6%) showed equivocal staining. This study indicates that a significant number of GBAC cases show Her-2 overexpression when either of the two documented protocols is used. This subgroup may benefit from inhibitors of the Her-2 pathway. Standardization of scoring protocol for Her-2 expression in GBAC is needed to better evaluate predictive potential of Her-2 for treatment of these tumors.

Christoph Hiemenz has completed his MSc from Ruprecht-Karls University Heidelberg. He work as a bioinformatician at PEPperPRINT GmbH and is the scientific instructor of the iGEM Team Heidelberg 2019. He has worked on diverse research projects:

-DKFZ Heidelberg, Prof. Jörg Hoheisel- Kinase activity profiling with peptide arrays

-BioQuant Heidelberg, Prof. Roland Eils/Prof. Barbara Di Ventura- Optogenetic nuclear protein shutteling and ODE modeling

-KTH Stockholm, Prof. Stefan Ståhl – Surface functionalization of E.coli cells via sortases and inteins

- EMBL Heidelberg, Dr. Carsten Schultz- Bioactivity of trifunctional Sphingolipids

-IPMB Heidelberg, Prof. Andres Jäschke- Multivalent fluorescent turn-on probes for RNA imaging.

High-throughput technologies ranging from high-content microscopy screening to automated mass spectrometry pipelines and peptide microarray assays enable the generation of big medical data sets in a brief period of time with the requirement of very small analyte volumes. As a result, extremely large multiomics data sets can be generated which are ideally suited for statistical learning procedures using well established classifiers such as random forests or multivariate logistic regression models. To extract meaningful information from the data, a major challenge comprises the dimensionality reduction and

unsupervised pattern recognition via machine learning algorithms including Fisher discriminant analysis, shrunken centroid analysis or clustering. Another problem to be tackled is represented by multivariate feature collinearities and ways have to be identified to remove this ambiguity. Yet, the reward for this mathematical rigor is the generation of reliable classifiers which can quickly stratify individual patients into disease/treatment subpopulations with acceptable sensitivity and specificity from multiomics data sets. Above all, technology suppliers such as opentrons and Oxford Nanopore Technologies promise the automated generation of multiomics data sets for a reasonable price.

Prabhashankar Mishra, Working as an Assistant Professor,at utopia divine wanowrie Pune, India. He was successful achiever producing his work on "Association between expressions of a panel of immunohistochemistry (IHC) markers including Ki 67, Cyclin D1, p53, bcl2, C-KIT, and Her2/neu and metastatic disease in oral squamous cell

carcinoma (OSCC)".

Aim: This study aims to find out any association between expressions of a panel of immunohistochemistry (IHC) markers

including Ki 67, Cyclin D1, p53, bcl2, C-KIT, and Her2/neu and metastatic disease in oral squamous cell carcinoma (OSCC).

Materials and methods: A total of 236 cases of OSCC presenting to our centre between Jan 2013-Dec 2016 with available clinical details were included in the study. Forty cases each of non metastatic disease and metastatic disease at presentation were selected randomly for evaluation of IHC marker’s expression as enumerated above.IHC expression of the markers were interpreted as positive ,negative or indeterminate or non-contributory based on standard practice in clinical use. Other important clinical and pathological features were also noted for further evaluation and analysis.

Results: MIB 1(Ki 67) index as a percentage value, and diffuse p53 expression were found to be independently associated with metastatic OSCC at presentation (p values <0.001, confidence interval 95%).Cyclin D1,bcl2, C-KIT, and Her2/neu expressions did not show any association with metastatic/ non-metastatic disease at presentation.

Conclusion: MIB 1 mitotic index and p53 positivity are significantly associated with metastatic OSCC. Further studies on this subject are needed to substantiate this important finding which may be used to analyze the role of these IHC markers in possible prediction of metastatic potential and therefore prognosis in the cases of OSCC.

Ana Lazaro Carrillo has completed her PhD from Autonomous University of Madrid (Spain) with mention of best thesis in 2017 granted by SEBC (Spanish Society of Cell Biology). She is a Teaching Assistant in the Department of Biology, a premier research organization. She has participated in more than 30 international congresses and more than 70 meetings, workshops and courses. She has published 7 papers in journals of high recognition and has been serving as Reviewer of repute journals. In addition, she has participated in research and dissemination activities related to Multifun project, funded by the European Union and has been a Research Member of two projects funded by Spanish Ministry for Economy and Competitiveness. Her research interest include: cell biology; photodynamic therapy and chemotherapy for cancer treatment; internalization, biocompatibility and efficient delivery of nanostructures in vitro (cell cultures); cell death mechanisms and cellular inactivation; activity of cancer stem cells (established cell lines and patient samples).

Nowadays different strategies are being introduced in order to enhance photodynamic therapy (PDT) effectiveness, such as combination of PDT with chemotherapy or improvement of photosensitizer (PS) features. A new combined PDTchemotherapy treatment comprising two drugs widespread in clinical research - the hydrophobic zinc(II)-phthalocyanine (ZnPc) as PS and the common chemotherapeutic agent doxorubicin (DOX) - were tested. Cytotoxicity assay showed that this combination remarkably increases the effectiveness of the treatment by inducing a synergistic cell death effect (lower than 10%) when compared to DOX or ZnPc monotherapy (cell surviving around 80%). In addition, annexin-V detection by flow cytometry, analysis of active caspase-3 and cytochrome c by immunofluorescence and time-lapse videomicroscopy corroborated a fine-tunable effect depending on light dose, leading to apoptotic or necrotic mechanism of cell death. Using DCFH-DA (dichlorodihydrofluorescein diacetate) probe, we demonstrate that a significant higher reactive oxygen species generation into cells was the main cause of the synergistic effect of this combined treatment. Further, mammosphere formation efficiency assay showed a reduced breast cancer stem cell activity in established cell line and primary cells obtained from patients, even using DOX at much lower concentration than clinical level. Finally, studies in human breast cancer xenografts indicated a high efficiency also in vivo. All these results provide novel and valuable information that contribute to consider chemophototherapy as a promising tool in current antitumoral treatments, potentially overcoming resistance to cancer chemotherapy and targeting cancer stem cells

Data analytics is evolving into a promising method to provide insight from large amounts of data into improving patient outcomes and reducing healthcare costs. Since most of the information used by healthcare providers for medical decisions is derived from laboratory testing, better use of the critical information within the laboratory’s data system can help to improve efficiency as well. One application for data analytics is to target the errors encountered in the preanalytical phase. These errors include patient/sample misidentification, hemolyzed/clotted specimens, insufficient specimen quantity, and improper test ordering, all of which may increase costs and negatively impact patient care. Reducing these errors can contribute to higher value-added patient outcomes (e.g., enhanced patient safety, fewer repeat blood draws). Additionally, incorporating data analytics can also assess laboratory competency and identify opportunities for overall quality improvement.

Aparna Jha Ahuja, MD, is currently the Worldwide Vice President, Medical Affairs, BD Life Sciences - Preanalytical Systems, Franklin Lakes, New Jersey, USA. She has more than two decades of laboratory experience, with hands-on experience in Biochemistry, Specialized Chemistry and Molecular Biology. She is a recognized speaker, having presented at many laboratory medicine conferences. Her current focus is on the improvement of quality laboratory testing and increasing awareness of the impact of the preanalytical phase on clinical diagnostic results.