Bremansu OSA-ANDREWS, PhD.

The OSA Lab group is interested in understanding the clinical dynamics of pathological conditions, nutrition, quality metrics, assay validation and ameliorating interferences in clinical laboratory testing to improve the quality of life of patients through effective diagnosis and treatment. There are three active research projects currently ongoing in the OSA Lab:

1. The Effect of Lipemia on the Laboratory Assessment of Blood Gases: Unlike the electrolyte exclusion phenomenon, little is known about the effects of lipemia on the laboratory assessment of total carbon dioxide (tCO2) and bicarbonate (HCO3−). Depending on the method used, lipemia-induced turbidity of a specimen can impact the outcome of the results. The photometric-enzymatic, rather than the indirect ion selective method is more easily interfered with by a turbid sample. Consequently, HCO3− and tCO2 results from a severely lipemic sample may be falsely diminished. A recent case report suggests an association between high lipids and HCO3−. A larger study to investigate this trend is imperative to guide laboratory and medical practice, since preanalytical component accounts for approximately 68% of all clinical laboratory errors. This study aims to investigate the analytical relationship between lipemia and blood gases analyses.

2. Comparative studies on serum quantitative immunoglobulin assay and serum protein electrophoresis for the diagnosis of multiple myeloma: Various clinical laboratory tests are valuable in enhancing the diagnosis of monoclonal gammopathy. The nephelometric-based serum quantitative immunoglobulin test provides great utility to understand the magnitude of antibody-mediated responses and is useful in interpreting Serum protein electrophoresis (SPEs). In clinical practice, several (SPEs) are ordered without a preliminary order of serum quantitative immunoglobulins, but pathologists can and do order the test for comparison. However, there is seldom any data in the literature describing the correlative relationship between the two tests. It is therefore imperative to create an evidence-based system of test-ordering for the laboratory investigation of the presence of monoclonal protein. The goal of the project is to compare the results of quantitative serum immunoglobulin assay and SPE to determine their concordance.

3. Blood folate status and the risk of cancer, a blind spot: High incidence of folate deficiency in the ethnically and economically diverse Gainesville area is not unlikely. On the other hand, the association between elevated blood folate levels and the risk of developing cancer has been reported. This project aims to explore the utility of blood folate testing in the investigation of anemia. Specifically, this project aims to evaluate the prevalence of folate deficiency in the local patient population. Additionally, the prevalence of high folate status will be assessed concurrently with the prevalence of diagnosed cancers to further investigate this potential association. Findings from this study may be utilized to guide recommendations for the testing of blood folate levels by clinicians in the investigation of anemia.

4. Optimizing HbA1c Testing Workflows and Hemoglobin Variant Interpretation In collaboration with the Endocrinology Section of UF Health Pathology Laboratories, which I direct, I initiated a translational research program to optimize HbA1c testing workflows in individuals with suspected hemoglobin variants. Although the study utilizes specimens from endocrine clinical research participants, the findings are intended to improve routine clinical testing algorithms, laboratory efficiency, and cost-effectiveness. The first study evaluates the agreement between the Tosoh HPLC and Beckman AU chemistry analyzers when variant peaks occur before the A0 peak. The goal is to determine whether routine confirmatory testing on the AU analyzer can be safely reduced, thereby streamlining workflow while maintaining analytical accuracy. The second study evaluates the accuracy of expert interpretation of Tosoh chromatograms for predicting hemoglobin variants compared with confirmatory hemoglobin electrophoresis. As part of this project, I am training Dr. Wendel in the interpretation of complex HbA1c chromatographic patterns and their clinicopathologic significance. Together, these studies have the potential to reduce unnecessary confirmatory testing, lower laboratory costs, improve turnaround times, and strengthen evidence-based HbA1c testing practices.

5. Artificial Intelligence-Assisted Interpretation of ANA Pattern Recognition by Indirect Immunofluorescence: Validation, Pattern Distribution, and Clinicopathologic Correlation at UF Health Pathology Laboratories. Following the implementation of the ANA by indirect immunofluorescence (IFA) service, I initiated a translational research project evaluating the performance of the Thermo Fisher artificial intelligence (AI)-assisted ANA pattern recognition system. The primary objective is to validate AI-generated ANA pattern classifications against expert manual interpretation. The project will also characterize the spectrum of ANA fluorescence patterns encountered at UF Health Pathology Laboratories since implementation of the IFA service and correlate these patterns with the autoimmune diseases they help elucidate. Together, these findings will strengthen quality assurance, improve diagnostic interpretation, provide valuable institution-specific epidemiologic data, and support the responsible integration of artificial intelligence into autoimmune diagnostics.

6. Implementation of Z-Score with IGF-1 Reporting The project was inspired by the need to improve the consistency and clinical interpretation of IGF-1 results, as reliance on age-specific reference intervals alone can complicate assessment of patients with growth hormone disorders. As Director of the Endocrinology Section, I led the validation and clinical implementation of IGF-1 Z-score reporting at UF Health Pathology Laboratories, developing a practical framework for integrating standardized reporting into routine laboratory practice. The work provides a roadmap for other clinical laboratories to implement Z-score reporting, improving communication between laboratorians and clinicians while advancing endocrine diagnostics and patient care.

If you are interested in any of these projects, email the PI at b.osaandrews@ufl.edu

THE OSA LAB GROUP

Bremansu Osa-Andrews, PhD: Principal Investigator (PI)

Dr. Umar-Farouk Mamani, external research volunteer, mentee, Assistant professor, Larkin University- ANA by IFA project

Dr. Usman Susuni, external research volunteer, mentee, Assistant professor, LECOM University- Hb A1c project.

Dr. Makinsy Wendel, Pathology resident, Hb A1c project.

Nicholas Kobzar- medical student, Folate project.

Morgan Green- Undergraduate student, Lipemia 1 project.

Kelisha Andre- Undergraduate student, Lipemia 2 project.

Ella Daudbasic- Undergraduate nursing/pre-PA student, Folate project.

Ashley Espinoza Sanchez- Undergraduate student, Lab processor, Folate project.

Elvis Makaza: Medical technologist, Multiple myeloma project.

Ieva Sapiega- Undergraduate Pre-Med student, Multiple myeloma project.

Pinal Patel- Core lab supervisor, All projects.

Kathlene Magyar- Medical technologist, Multiple Myeloma project.

Aaron Ivey, James*- Biochemist, Lab processor, Lipemia project.

Mark Nelson*- Undergraduate student, Lab processor, Lipemia project.

Sunaina Shrestha, MD*- Medical resident, Multiple myeloma project.

Addison Moody, Undergraduate, University of Florida.