Primary Reference Materials Research Articles

6651 A Traceable Clinical Free Thyroxine Assay Based on Equilibrium Dialysis ID-LC/MS/MS

Abstract Disclosure: D. Spector: None. L. Zhang: None. A. Ribera: None. A. Doty: None. C. Tse: None. O. Sugahara: None. N. Vazquez: None. U. Danilenko: None. H.W. Vesper: None. Accurate diagnosis and effective treatment of thyroid diseases rely on reliable thyroid function tests. Serum free thyroxine (FT4) immunoassays (IAs) are most commonly used for FT4 measurements in clinical practice. However, FT4 IAs have not been standardized with large variations between different assay platforms. A reference measurement procedure (RMP) for FT4 based on well-defined equilibrium dialysis (ED) of serum has been established for CDC standardization program to support the standardization of clinical assays for patient care. In the current study, we aim to develop a routine clinical FT4 assay based on ED-LC/MS/MS that is traceable to the RMP. ED-LC/MS/MS analysis was performed using a commercially available micro-ED plate. FT4 in dialysate was extracted with a 96-well C18 SPE plate. FT4 in the samples was quantitated by using LC/MS/MS in positive ion mode. The assay was calibrated with the certified primary reference material. By using RMP as a reference, we compared the analysis of 40 single donor sera between the ED-LC/MS/MS assay and FT4 IA on Roche e401platform. ED-LC/MS/MS assay could resolve T4, T3, reverse triiodothyronine (rT3), and other interferences in the samples with C18 chromatography in 4 min. The linear range of the routine FT4 assay was from 0.5-100 pg/mL covering clinically relevant FT4 concentrations including hypo-, hyperthyroid patient samples. The intra and inter-run CV% of the assay in 20 days was 3.72 and 5.25%, respectively. The effect of minor changes to the method conditions was studied. It was determined that serum/buffer ratios from 1:1 to 1:2 in the ED inserts, speeds of shaker for ED, and ED incubation time, did not influence the FT4 measurement. However, elevated ED temperature at 38°C could result in a more than 10% increase in FT4 values. A microplate format for the procedures of ED and SPE is amiable to the application of an automation system which significantly improves the throughput of the procedure. Method comparison showed good agreement between ED-LC/MS/MS assay and RMP in Deming regression analysis with a slope close to 1, while there was significant bias of IA from RMP. ED-LC/MS/MS assay was also applied for pregnancy serum samples with minimal difference on the FT4 measurement from RMP. We have developed a routine clinical FT4 assay that is traceable to RMP. The accuracy, precision, and sensitivity of the assay are suitable for high-throughput FT4 measurements in clinical laboratories and large epidemiologic studies. We demonstrate that the developed method can provide accurate FT4 measurements in patients including pregnant women. Presentation: 6/3/2024

8551 Comparability of Free Testosterone Measurements

Abstract Disclosure: H. Zhou: None. O. Sugahara: None. U. Danilenko: None. H.W. Vesper: None. Assessment of free testosterone (FT) has been recommended as a biomarker for diagnosis and management of hypogonadism and female hyperandrogenism. Reliable laboratory measurements are essential for properly diagnosing and treating these diseases. FT is currently measured using direct commercial immunoassays, assays using equilibrium dialysis (ED) or other separation techniques, or estimated by calculating free testosterone (cFT) using different formulas based on the levels of total testosterone and sex hormone binding globulin (SHBG). There are concerns about the accuracy and reliability of current methods that may negatively impact correct detection, treatment, and prevention in patient care. CDC’s Clinical Standardization Programs (CDC CSP) has developed an accurate, high throughput method using ED coupled with isotope dilution ultra-high-performance liquid chromatography tandem mass spectrometry (ED-UHPLC-MS/MS). The ED step uses an internationally recognized procedure and is performed in a custom designed dialyzer system that allows maintaining equal ratio of sample-to-buffer volume. The method uses certified pure primary reference material (National Measurement Institute-M914) as calibrator. The method has a limit of detection of 0.6 pg/mL, with an accuracy of ±5%, and precision less than 10% CV. The measurement range is 2 – 2000 pg/mL. The analytical performance of this method as well as other FT methods used in patient care was assessed using single-donor serum samples. The evaluated methods included two commercially available platforms utilizing Chemiluminescence Immunoassay or radioimmunoassay techniques, as well as six laboratory-developed assays using ED-LC-MS/MS. The results of the interlaboratory comparison study will help assessing the current level of agreement among FT assays, to identify potential factors causing differences among assays, and to assist with developing materials to improve the agreement among assays. Presentation: 6/1/2024

A-075 Comparability of Free Testosterone Measurements- Results of the Interlaboratory Study

Abstract Background Assessment of free testosterone (FT) has been recommended as a biomarker for diagnosis and management of hypogonadism and female hyperandrogenism. Reliable laboratory measurements are essential for correctly diagnosing and treating these diseases. FT is currently measured using direct commercial immunoassays, assays employing equilibrium dialysis (ED) or other separation techniques, or it is estimated by calculating free testosterone (cFT). There are concerns about the accuracy and reliability of current methods that may impact patient care. To obtain more information about variability of FT measurements used in patient care, CDC’s Clinical Standardization Programs (CDC CSP) conducted an interlaboratory comparison study. Methods CDC CSP developed an accurate, automated method using ED coupled with isotope dilution ultra-high-performance liquid chromatography tandem mass spectrometry (ED-UHPLC-MS/MS). The ED step follows an internationally recognized procedure. The method is calibrated with primary reference material (National Measurement Institute-M914) and was used to assign target values to sera used in the study. The FT concentrations ranged from 3 to 339 pg/mL. In the interlaboratory comparison study single-donor serum samples were provided to participants operating FT methods used in patient care. The participating methods included commercially available platforms utilizing Chemiluminescence Immunoassay or radioimmunoassay techniques, as well as laboratory-developed assays using ED-LC-MS/MS. Results Preliminary findings of the CSP interlaboratory comparison study found large variability among participating assays. The agreement among IA and among ED-LC-MS/MS assays was close. However, FT concentrations obtained by IAs were in average 6 times lower compared to the ED-LC-MS/MS methods. Results estimated using the Vermeulen equation overestimated FT in average by 15% compared to the ED-LC-MS/MS methods and by over 6 times compared to IAs. Conclusions Large variability is observed between FT laboratory developed tests (LDTs) and IAs. As both LDTs and IAs are used in patient care, standardization of FT measurements to assure better patient care is needed. CDC CSP is addressing the need by developing highly accurate and precise FT method and conducting an interlaboratory comparison studies that can aid with improvement of the agreement among assays and identifying potential factors causing differences among assays.

B-021 Impact of Assay Conditions on FT4 Measurement Accuracy of Equilibrium Dialysis LC/MS/MS Clinical Assay

Abstract Background Reliable FT4 measurements are vital for accurate diagnosis and effective management of thyroid disorders. However, currently used FT4 immunoassays (IAs) lack standardization, leading to significant variations between platforms. Equilibrium dialysis (ED) coupled with LC-MS/MS analysis, considered the gold standard for FT4 measurement, has been adopted as a reference measurement procedure (RMP) for IA standardization. This study aimed to establish a high-throughput version of the routine clinical FT4 assay based on ED-LC/MS/MS technology and assess the impact of altered assay conditions on measurement accuracy. Methods A commercially available micro-ED plate was employed for ED-LC/MS/MS analysis. FT4 extraction from the dialysate was performed by utilizing a 96-well C18 SPE plate, followed by FT4 quantitation via LC-MS/MS in positive ion mode. Certified primary reference material was used to calibrate the assay. To evaluate assay robustness, the effects of minor method modifications were studied, including incubation time of ED, serum/buffer ratios in ED inserts, ED incubation temperature, shaker speed during ED, serum sample dilution ratio, and dialysate sample dilution ratio. Additionally, short-term and long-term stability of serum FT4 were assessed. Results The developed ED-LC/MS/MS assay successfully resolved T4, T3, reverse triiodothyronine (rT3), and other interferences within 4 minutes using C18 chromatography. The assay's linear range (0.5-100 pg/mL) encompassed clinically relevant FT4 concentrations across hypo- and hyperthyroid patient samples. Excellent agreement was observed between the routine assay based on ED-LC/MS/MS and CDC RMP with a Deming regression slope near 1 (95%CI: 0.87-1.06). Furthermore, serum/buffer ratios from 1:1 to 1:2.5 in ED inserts, shaker speeds from 75 to 150 rpm, and ED incubation times from 16 to 20 hours did not significantly affect FT4 measurement. However, elevated ED temperature (38°C) led to a more than 10% increase in FT4 values. Serum FT4 remained stable when exposed to room temperature for 12 hours, five freeze-thaw cycles, and -70°C storage for 1.5 years. Additionally, dilution of sera by up to 3-fold before ED did not alter FT4 measurement results. Diluting dialysate samples at least 3 times prior to SPE extraction proved accurate for samples exceeding the calibration curve range. Conclusions In conclusion, we successfully developed a routine clinical FT4 assay based on ED-LC/MS/MS that generates data comparable to the RMP. The assay exhibits robustness, with several altered conditions not significantly impacting measurement accuracy. This high-throughput and accurate assay demonstrates suitability for both clinical laboratories and large-scale epidemiological studies. Disclaimer: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention/the Agency for Toxic Substances and Disease Registry. Use of trade names is for identification only and does not imply endorsement by the Centers for Disease Control and Prevention, the Public Health Service, and the US Department of Health and Human Services.

Investigation of Features Influencing on the Artworks of African American Female Artists Between 1960s and 2000s

The rich tapestry of cultural diversity is intricately woven by artists who have traversed various cultural landscapes, often producing distinctive artistic expressions. Among these artists, African American female painters stand out with their unmistakable styles and themes, a testament to their unique narrative. To explore the elements that shape the work of these artists in the United States, an extensive review of literature was conducted, distilling the essence of their creative output. The analysis encompasses personal and societal dimensions, unveiling a tapestry of influences including personal experiences, societal encounters, artistic styles, environmental nuances, technological advancements, sources of inspiration, and collaborative relationships. Through meticulous research and surveying, this investigation identified the paramount features that resonate most profoundly with the artistic vision of eight eminent painters. This study highlights the top three as being most influential in their creative journey. Future research endeavors should focus on conducting a more systematic case study of African American artists in order to provide a comprehensive analysis of their features. This will involve finding primary information and reference materials to make a deeper investigation into the influencing features on Africa American female artists between the 1960s and 2000s.

A fit-for-purpose nongaseous impurity assay procedure for potential inorganic primary reference materials by inductively coupled plasma mass spectrometry

A fit-for-purpose nongaseous impurity assay procedure for potential inorganic primary reference materials by inductively coupled plasma mass spectrometry

Assessment of Natural Reference Materials for U‐Pb Geochronology of Grossular‐Andradite Garnet

Garnet U‐Pb dating by laser ablation‐inductively coupled plasma‐mass spectrometry requires the development of matrix‐matched reference materials of variable chemistry and U mass fraction for accurate analysis. Additional calibration of existing primary reference materials is also justified based on the relatively poor calibration of some of the widely available primary reference materials that are currently utilised by the geoscience community. We present a micro sampling workflow combined with a refined ID‐TIMS methodology for the generation of high precision (~ 0.1%) U‐Pb dates from domains within garnet single crystals. Using this workflow, we calibrated two new natural andradite reference materials, the Jumbo andradite (And99; 110.34 ± 0.03 (0.04) [0.13] Ma, n = 7, MSWD = 1.21) and the Tiptop andradite (And87; 209.57 ± 0.11 (0.13) [0.26] Ma, n = 6, MSWD = 1.39). We also present additional calibration of the widely utilised Willsboro‐Lewis andradite primary reference material (And90; 1024.7 ± 9.5 (9.6) [9.6] Ma (2s; overdispersed), n = 6). Wafers of the Jumbo and Tiptop andradite reference materials are available from the authors upon request.

Pemerkasaan Strategi Institusi Wakaf dalam Mengurangkan Bebanan Ekonomi Masyarakat Akibat Covid-19

The transmission of the Covid-19 epidemic since late 2019 has caused widespread confusion due to its rapid infection rate and alarming death toll. This situation has led to significant changes in the lives of many, resulting in numerous individuals losing their sources of income due to layoffs and being unable to sustain their usual economic activities. The economic system has also been challenged, leading to a decline in various industrial sectors. Additionally, the rate of social problems has increased due to the emotional stress caused by financial difficulties. Given this complex situation, it is crucial to address these issues effectively and holistically through an Islamic economic system, particularly focusing on the waqf mechanism as a key tool to stabilize the economy during periods of financial uncertainty caused by pandemics. This study aims to examine the success of both historical and contemporary waqf institutions in addressing economic challenges. Furthermore, it investigates the strategies employed by waqf institutions to mitigate the economic burdens on society due to Covid-19 in Malaysia. The methodology of this study employs qualitative methods, with secondary data collection serving as the primary reference material. The data is then analyzed using content analysis. The results clearly indicate that the successes of past and present waqf institutions should serve as models to enhance the management of waqf in Malaysia. Additionally, the strategies of waqf institutions help alleviate the economic burdens imposed by Covid-19.

Criminological Study of Traffic Violations on Numbing Island

Traffic violations are no longer commonplace among society. This often happens in the community, sometimes even causing economic and physical losses due to traffic accidents. Positive law in Indonesia has explicitly regulated traffic safety rules which are regulated in Law Number 22 of 2009 concerning Road Traffic and Transportation. To study this, researchers took the research location Numbing Island, which is one of the islands in the Riau Islands Province. And from a criminological perspective, researchers want to examine in more depth what is the basis for the perpetrator to commit this offense. The research method used is empirical juridical research. As support in building the arguments for this research, researchers used primary and secondary reference materials. Data collection techniques used by researchers include observation methods, interviews and literature review. The research data analysis technique was carried out using a qualitative method, then in developing a line of thinking, the researcher used a deductive method. The results of this research show that the level of traffic violations on Numbing Island is sociologically caused by a lack of public awareness on the grounds that the application of traffic laws in the island area is not necessary, in terms of law enforcement factors, supervision by Bhabinkamtibmas is still not strictly implemented so that there is a form of negligence on the part of the authorities. law enforcers to enforce traffic regulations.

Vermilion monazite: A new Archean reference material for U-Pb and Sm-Nd microanalysis

Monazite (Vermilion) from the ∼2.7 Ga Vermilion Granitic Complex (Minnesota, USA) was investigated as a potential reference material for U-Pb geochronology, using electron microprobe, high-precision ID-TIMS and high-spatial resolution techniques (LA-(Q/SF/MC)-ICP-MS and SHRIMP). Vermilion monazite is relatively homogeneous in BSE images. It is characterised as a monazite-(Ce) with uniform, relatively LREE-enriched chondrite-normalised REE patterns (Eu/Eu* = 0.074–0.085). ID-TIMS U-Pb analyses yielded concordant to slightly (−0.6% to 1.8%) discordant isotope data with weighted mean 207Pb*/206Pb* dates of 2668.6 ± 1.8 Ma (2σ, MSWD = 1.3, n = 3) and 2666.8 ± 1.8 Ma (2σ, MSWD = 4.0, n = 4). High-spatial resolution data from SHRIMP and LA-(Q/SF/MC)-ICP-MS agree with the ID-TIMS age. Using Vermilion monazite as primary reference material, LA-SF-ICP-MS analyses reproduced the age of several other reference monazites within −1.13% to +1.64% accuracy. Nd isotopes obtained via ID-TIMS and solution MC-ICP-MS returned consistent 143Nd/144Nd ratios of 0.510694 ± 0.000040 (2σ) and 0.510726 ± 0.000014 (2σ), respectively. The LA-MC-ICP-MS 143Nd/144Nd ratios of 0.51071 ± 0.00001 (2σ) and 0.51065 ± 0.00001 (2σ) are also in agreement within uncertainties. Results of Sm-Nd isotope analyses by LA-MC-ICP-MS from two laboratories yielded mean 147Sm/144Nd ratios of 0.0869 ± 0.0002 (2.5% RSD, 2σ, n = 58) and 0.0835 ± 0.0001 (2.2% RSD, 2σ, n = 50), reflecting small variations in individual fragments. The initial epsilon Nd (εNdi) varies from −0.8 ± 0.5 to 0.6 ± 0.4 (2σ). The reproducibility of our results shows that Vermilion monazite can be used as a primary reference material for U-Pb geochronology and is suitable as a secondary reference material for Sm-Nd isotopic tracing. The Archean age of Vermilion monazite, the oldest available as a reference material, will facilitate the investigation of Archean crustal evolution processes and broaden the prospect of studying ancient metamorphic events by combining matrix-matched U-Pb geochronology and Sm-Nd isotopic tracing.

Molybdenite Reference Materials for In SituLA‐ICP‐MS/MS Re‐Os Geochronology

Re‐Os isotope‐dilution geochronology has been widely used to date the timing of molybdenite, pyrite and chalcopyrite formation across a variety of geological settings. However, in situ methods have been impeded by the isobaric interference of 187Re on 187Os. In situ Re‐Os geochronology using LA‐ICP‐MS/MS has been shown to be a useful technique to chemically separate Os from Re, as Os reacts with CH4 to create higher‐mass reaction products, which can then be measured with minimised interference of 187Re. However, application of the method requires matrix‐matched primary reference materials, e.g., age‐homogenous molybdenite amenable to laser ablation. Here, we characterise and present two new molybdenite mineral reference materials for in situ Re‐Os geochronology by LA‐ICP‐MS/MS, verified by ID‐TIMS Re‐Os measurements. We also present case studies from molybdenite samples with varying Re mass fractions and Re‐Os age mapping. The method provides accurate and precise age data, with excellent precision for high Re samples. The benefits of the LA‐ICP‐MS/MS approach include: (1) simple sample preparation, (2) rapid data acquisition, (3) targeting of specific textural domains including growth zones and (4) the ability to simultaneously collect trace elements used to link the timing and conditions of ore‐formation.

Calibration methods for laser ablation Rb–Sr geochronology: comparisons and recommendation based on NIST glass and natural reference materials

Abstract. In situ rubidium–strontium (Rb–Sr) geochronology, using laser ablation–inductively coupled plasma–tandem mass spectrometry (LA-ICP-MS/MS) technology, allows rapid dating of K-rich minerals such as micas (e.g. biotite, muscovite, and phlogopite) and K-feldspar (potassium-containing feldspar). While many studies have demonstrated the ability of the method, analytical protocols vary significantly, and to date, no studies have provided an in-depth comparison and synthesis in terms of precision and accuracy. Here we compare four calibration protocols based on commonly used reference materials (RMs) for Rb–Sr dating. We demonstrate that downhole fractionation trends (DHFs) for natural biotite, K-feldspar, and phlogopite contrast with that for the commonly used Mica-Mg nano powder reference material. Consequently, Rb–Sr dates calibrated to Mica-Mg can be up to 5 % inaccurate, and the degree of inaccuracy appears to be unsystematic between analytical sessions. Calibrating to Mica-Mg also introduces excess uncertainty that can be avoided with a more consistent primary calibration material. We propose a calibration approach involving (1) NIST-610 glass as the primary reference material (PRM) for normalisation and drift correction and (2) a natural mineral with similar DHF characteristics to the analysed samples as matrix correction RM (MCRM) to correct the Rb/Sr ratio for matrix-induced offsets. In this work, MDC phlogopite (the source mineral for Mica-Mg nano powder) was used as the MCRM, consistently producing accurate Rb–Sr dates for a series of natural biotites and K-feldspars with well-characterised expected ages. Biotite from the Banalasta Adamellite, Taratap Granodiorite, and Entire Creek pegmatite are also suitable RMs for Rb/Sr ratio calibration purposes, with consistently <1.5 % fully propagated uncertainties in our methodological approach. Until calibration using isochronous natural standards as the primary RM becomes possible in data reduction software, the two-step calibration approach described here is recommended.

Pemikiran Al-Fudholi dalam Kitab Kifayatul Awam Mengenai Sifat Allah

The book "Kifayatul Awam" by Al-Fudholi is one of the important works of Islamic literature in the context of religious and legal thought. This book has become a primary reference material in Islamic law in various societies. This article aims to analyze twenty characteristics of Al-Fudholi's thought found in the book "Kifayatul Awam." This research employs a text analysis method to identify and explain the characteristics of Al-Fudholi's thought in his book. The results of the analysis indicate that these twenty characteristics of thought encompass various aspects of Islamic law, ethics, and beliefs. Some of these characteristics include concepts related to justice, worship, transactions, and social responsibility. This study provides a deeper understanding of Al-Fudholi's thought in the context of Islamic religion and law. It can also serve as an important reference for those studying and examining classical Islamic literary works, contributing to a better understanding of Islamic teachings in general.

SAT451 High-throughput Measurement Procedure Of Free Thyroid Hormones In Serum Based On Equilibrium Dialysis ID-LC/MS/MS

Abstract Disclosure: L. Zhang: None. A. Ribera: None. Z. D'Zio: None. A. Doty: None. O. Sugahara: None. C. Tse: None. U. Danilenko: None. H.W. Vesper: None. A Reliable and accurate measurement of serum free thyroxine (FT4) is critical for diagnosis and treatment of thyroid disorders. Immunoassays (IAs) are most popularly used for FT4 measurements in-patient care. However, there are concerns about the accuracy of FT4 IAs. A reference measurement procedure (RMP) for FT4 based on well-defined equilibrium dialysis (ED) of serum has been established for standardization of routine FT4 IAs. FT4 RMP is highly accurate and precise, while it is labor-intensive and time-consuming which is not intended for routine clinical application. In the current study, we aim to develop a high-throughput FT4 method based on ED ID-LC/MS/MS that can be traceable to the RMP. FT4 in dialysate was isolated from protein-bound T4 in serum by using a commercially available micro-ED plate after 18-hours ED. The 13C6 labeled T4 was spiked into collected dialysate as an internal standard. FT4 in dialysate was extracted by using 96-well C18 SPE plate. FT4 in the samples was quantitated by using LC/MS/MS. The certified primary reference material was used to for assay calibration. T4, T3, reverse triiodothyronine (rT3), and other interferences in the dialysate were resolved on a C18 UPLC column within 4 min. The linear range of the routine FT4 assay covered 1-100 pg/mL. The assay sensitivity allowed detection of 0.3 pg/mL FT4 in serum, which is sufficient for FT4 measurement covering clinically relevant ranges including hypothyroid patient samples. Method comparison showed good agreement between our high-throughput method and RMP in Deming regression analysis with slope close to 1, while there was significant bias of IA from RMP. The intra and inter-day CV% of the assay was 6.96 and 3.38 %, respectively. The use of a micro-ED plate together with automation system could improve the throughput of the procedure. The accuracy, precision, and sensitivity of our method are suitable for the high-throughput FT4 measurements in clinical laboratories and large epidemiologic studies. The traceability of the described FT4 method to RMP can support the standardized FT4 measurements in patient care. Presentation: Saturday, June 17, 2023

A-080 Overcoming Challenges of Equilibrium Dialysis-Based Free Thyroxine Measurements

Abstract Background Thyroid function tests are widely used to detect diseases of the thyroid. Concerns about the accuracy and reliability of free thyroxine (FT4) measurements have been stated by the clinical laboratory community. To address these concerns, CDC established a reference measurement procedure (RMP) for FT4 based on equilibrium dialysis (ED). ED-based methods have advantages over traditional direct immunoassays. As with all analytical methods, factors affecting accuracy and reliability of ED-based methods need identification and understanding. To investigate potential sources of error, the CDC FT4 RMP was used to evaluate T4 stability at different of storage conditions, adsorption of FT4 to common labware surfaces, and the effect of dialysis membrane materials on the measured FT4 in serum. Methods FT4 was measured in serum using the IFCC RMP (1). FT4 was separated from the protein-bound form during the equilibrium dialysis step of the RMP. Dialysates were spiked with internal standard (13C6-T4) and the analyte was further isolated by C18 solid phase extraction (SPE) and liquid-liquid extraction (LLE) in ethyl acetate prior to injection on an UHPLC system coupled with a triple quadrupole mass spectrometer. Bracketed calibration and primary reference materials were used to determine FT4 concentration in serum. This procedure was used to evaluate stability of serum FT4 during storage at −70 to 5 °C. Short- and long-term T4 stability of calibrator solutions at −70 °C to ambient temperature and the extent of adsorption of T4 calibrator solutions to the commonly used labware surfaces were evaluated. Furthermore, the suitability of 4 different dialysis membranes was assessed. In addition, three alternatives to the currently used SPE and LLE extraction steps were tested: LLE using cyclohexane and ethyl acetate, LLE with ethyl acetate, and supported liquid extraction with cyclohexane and ethyl acetate. Results T4 calibrator solution was stable in 1.7% ammonium hydroxide in ethanol for at least 2.9 years at −70 °C and up to 7 days at ambient temperature. Exposure of various calibrator solutions such as T4 in ethanol, ethanol with 1.7% ammonium hydroxide, 10% acetonitrile with 0.1% formic acid to common labware resulted in up to 10.1% loss of the analyte. FT4 in serum and T4 in dialysates and extracts were stable at −70 to 5 °C. Use of alternative dialysis membranes resulted in up to −8.8% mean bias to the reference membranes. Recoveries of the analyte using four extraction methods were 85.4%–95.0%. None of the tested extraction conditions significantly changed the results obtained with the original FT4 RMPs. Conclusion Although FT4 RMP must strictly adhere to the ED conditions described for the RMP, other parts of the sample preparation procedures can deviate from the originally published procedure. Careful selection of procedure for calibrator solvents, dialysis membranes, labware, and storage conditions is required to ensure accurate and reproducible FT4 measurements.

B-129 Uncertainty Calculations for Reference Measurement Procedures

Abstract Background Quantitative results based on reference measurement procedures (RMP) require the calculation of the uncertainty of the result. In order to take the uncertainty of the full traceability chain into account a modularisation of the different execution steps is needed, starting from the primary reference material until the final concentration value. Different strategies have to be applied and combined to obtain the final uncertainty.We combine different ways for calculating the uncertainty of an isotope dilution -liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS) based reference measurement procedure for Cortisol, and explain the differences between Type A and Type B uncertainties and best strategies to choose from them. In addition, combinations of results from subsequent steps to a final overall uncertainty are presented. Methods An ID-LC-MS/MS based reference measurement procedure requires as a starting point a primary reference material with known purity of the analyte under consideration. Nowadays this purity assessment is often done with quantitative nuclear magnetic resonance (qNMR) spectroscopy. The qNMR uncertainty calculation is a Type A approach, based on replicate sample preparations and measurements. With this primary material a first set of primary calibrators is produced, often through multiple steps of weighings, preparation of stock solutions and dilutions. For these steps balances, volumetric flasks, or pipettes are used, all of them coming with an error budget which has to enter the uncertainty budget of the primary calibrator preparation. We will show how this can be done through Type B uncertainty calculation. Based on the primary calibrators the LC/MS instrument is calibrated and measurements of individual samples are carried out. We will introduce a hierarchical variability experiment, which takes into account the most important error sources and results in a Type A uncertainty for the LC/MS measurements.Finally, the errors of the LC/MS measurements have to be combined with those of the primary calibrator preparation to obtain the overall uncertainty of an LC/MS reference measurement procedure. Results We show the approaches and calculation strategies based on the Cortisol candidate reference measurement procedure, developed within the Roche LC/MS Reference Measurement Procedure project. The purity assessment by qNMR carries an uncertainty of 0.18%. This is incorporated into the uncertainty calculations of the primary calibrators, where in addition uncertainties from weighing and dilutions are incorporated resulting in uncertainties of the primary calibrator values between 0.6% and 1.1%. Combining these uncertainties with the variabilities of the LC/MS measurement procedure results in final uncertainties between 1.6% and 2.8%. Conclusion We have developed a sound framework for uncertainty calculation of reference measurement procedures, taking into account the different procedure steps, and included this into a process for the management of the different input variables up to comprehensive reports of the calculations.

A-032 Comparative Serum Free Thyroxine Measurements between Immunoassays and ID-LC/MS/MS Procedure Based on Equilibrium Dialysis

Abstract Background Serum free thyroxine (FT4) measurement is one of the most important clinical laboratory tests for diagnosis and classification of thyroid disorders. Currently serum FT4 is commonly measured with Immunoassays (IAs) in patient care. However, there are concerns about the accuracy of FT4 IAs. A reference measurement procedure (RMP) for FT4 based on well-defined equilibrium dialysis (ED) of serum has been established for standardization of routine FT4 IAs. As FT4 RMP is not intended for routine clinical application, in the current study, we aim to develop a high-throughput routine FT4 method based on ED-isotope dilution liquid chromatography tandem mass spectrometry (ED-ID-LC/MS/MS). FT4 RMP was used as a reference to evaluate the measurement accuracy of our ED-ID-LC/MS/MS method and an IA method, respectively. Methods FT4 in dialysate was isolated from protein-bound T4 in serum by using a commercially available micro-ED plate after 18-h ED. The 13C6 labeled T4 was added into dialysate as an internal standard. FT4 in dialysate was purified with 96-well C18 SPE plate. FT4 in the dialysate samples was analyzed by using LC/MS/MS. The T4 certified primary reference material (IRMM-468) was used for assay calibration. FT4 IA measurement was conducted in clinical analyzers (Roche e411). A set of 40 single donor sera, covering a FT4 concentration range of 11.2–32.1 pmol/L were measured by IA and our ED-ID-LC/MS/MS, respectively. Deming regression analysis was performed to compare the results obtained by these two methods with the reference values assigned by FT4 RMP. Results The described high-throughput method based on ED-ID-LC/MS/MS could simultaneously quantified T4, T3, reverse triiodothyronine (rT3) in the dialysate within 4.5 min. The linear range of the routine FT4 assay covered 1–100 pg/mL. The assay sensitivity allowed detection of 0.3 pg/mL FT4 in serum, which is sufficient for FT4 measurement in clinically relevant ranges including hypothyroid patient samples. The throughput of the ED-ID-LC/MS/MS method could be further improved by application of automated liquid handling system. Deming regression analysis showed good agreement between RMP and the routine ED-ID-LC/MS/MS method with a slope close to 1 (P > 0.05) and an intercept close to 0 (P > 0.05), indicating that the results generated from the platform of high-throughput ED-ID-LC/MS/MS could be tracible to FT4 RMP. However, proportional bias (P < 0.05) with slope of 0.74 and constant bias (P < 0.05) with intercept of 2.6 was observed between RMP and IA tested, indicating calibration bias should be addressed to standardize IA. Conclusion In summary, the accuracy, sensitivity, and throughput of ED-ID-LC/MS/MS method are appropriate for FT4 measurements in clinical laboratories and in large epidemiologic studies to establish accurate reference intervals for FT4. Population data generated by FT4 ED-ID-LC/MS/MS method will support the use of standardized FT4 measurements.

A-048 Accurate Measurement of Free Testosterone in Serum using Equilibrium Dialysis Coupled with ID-UHPLC-MS/MS

Abstract Background Assessment of free testosterone (FT) has been recommended in recent clinical practice guidelines as a biomarker for diagnosis and management of testosterone related disorders such as male testosterone deficiency due to hypogonadism and female androgen excess due to polycystic ovary syndrome (PCOS). FT is currently measured using direct commercial immunoassays, assays using equilibrium dialysis (ED) or other separation techniques. Though the ED approach is recognized as the recommended approach, it is laborious and technically challenging for routine clinical use. The CDC Clinical Standardization Program is developing a high throughput automated method using the ED procedure coupled with isotope dilution ultra-high-performance liquid chromatography tandem mass spectrometry (ID-UHPLC-MS/MS) that is suitable for routine patient care and large-scale epidemiologic studies. Methods Serum samples are dialyzed in a custom-designed multi-well plate against a protein-free HEPES buffer (pH 7.4) at 37 °C until equilibrium. After isolating endogenous FT from protein-bound testosterone by ED, isotope-labeled internal standard (13C3-testosterone) was added to the dialysate for quantification. Certified pure primary reference material (National Measurement Institute-M914) was used to prepare calibrators, enabling traceability and ensuring measurement trueness. FT was further isolated from the dialysate matrix using supported liquid extraction and a chromatographic separation from interfering compounds and quantitation by tandem MS. Results The measurement ranges covered 0.2–1000 ng/dL for testosterone, with the bias within ±5% and precision less than 10% CV. A total of 45 samples with a wide range of total testosterone (TT, 21–912 ng/dL) and SHBG (11–129 nmol/L) were analyzed and showed the suitability of this assay to measure the serum free testosterone levels in normal, hypogonadal males as well as in the majority of normal females and females with androgen excess. The application of 48-well format plate and automated liquid handler system significantly improves the throughput of sample preparation. In addition, comparison of the TT results measured with the presented TT method with calculated TT concentrations, suggest that on average calculation overestimates TT concentration by 34%. Conclusion The described high throughput method for FT allows for sufficiently accurate and precise measurement for routine applications including large epidemiologic studies to help with establishing reference intervals.

Development of matrix-based reference materials for 17 beta-estradiol by the recommended reference method of ID-LC-MS/MS.

We developed and evaluated two-level, namely 2017011 and 2017012, serum-based reference materials (RMs) for 17 beta-estradiol (17 β-E2) by the reference method of isotope dilution liquid chromatography tandem mass spectrometry (ID-LC-MS/MS) from the remaining serum samples after routine clinical tests, to help improve clinical routine testing and provide the traceability of results. This paper describes the development process of these RMs. The National Metrology Institute of Japan (NMIJ) certified reference material (CRM) 6004-a was used as the primary RM for the measurement of 17 β-E2. These serum-based RMs showed satisfactory homogeneity and stability. They also assessed the commutability between the reference method and the three routine clinical immunoassay systems. Besides, a collaborative study was carried out in five reference laboratories, all of which had been accredited by the China National Accreditation Service for Conformity Assessment (CNAS) in accordance with ISO/WD 15725-1. Statistical analysis of raw results and uncertainty assessment obtained certified values: 2017011 was 445.2 ± 39.0pmol/L, and 2017012 was 761.9 ± 35.5pmol/L.

A systematic evaluation of titanite reference materials for optimizing trace element and U[sbnd]Pb analysis by LA-ICP-MS

Titanite (CaTiSiO5) is a commonly occurring and versatile accessory mineral with broad applications in petrochronology. In situ U-Pb and trace element analyses via SIMS and LA-ICPMS are routinely performed using a matrix-matched reference material for U-Pb and standard glasses (non-matrix matched reference material) for elemental abundance determination. We report U-Pb isotopic ratios and major and trace element concentrations for three titanite samples (Ecstall, McClure and FCT) which are commonly used as reference materials in petrochronology studies. In addition, we characterize two new samples which can potentially serve as matrix-matched reference materials for titanite trace element geochemistry (BLR-2 and BRA-1). Based on electron microprobe analysis, samples BLR-1 and BLR-2 are homogeneous and suitable for use as a primary reference material for trace element concentrations. Whereas Ecstall, McClure, and FCT titanite reference materials show high intra-grain heterogeneity, yielding relative standard deviations for most trace elements between 5% and 40%, with higher standard deviations for U of 70% for Ecstall (n = 26), 265% for McClure (n = 22), and 202% for FCT (n = 26). Therefore, we suggest that these grains are unsuited to serve as reference materials for trace element quantification. The BRA-1 titanite has low trace element concentrations and is chemically heterogeneous (total REE abundances of 40 ppm for the rim and 95 ppm for the core of the grain), thus is not suitable for standardization of chemical composition using LA-ICPMS. It is commonly asserted that a matrix-matched standardization provides a more robust downhole fractionation correction compared to a non-matrix matched standardization. However, it remains unclear which standardization approach (matrix-matched vs non-matrix matched/glass) is more accurate for titanite trace element quantification. To resolve this, we tested several standardization approaches for trace element quantification, comparing matrix-matched (BLR-1) and non-matrix-matched (NIST612) standardizations with different internal elemental standards (IES; Ca, Si and Ti) and without internal standardization (semi-quantitative). To provide an independent constraint on the accuracy of the various trace element standardization techniques we compared results to trace element concentrations obtained via solution Q-ICPMS on crushed BLR-2 and BRA-1 aliquots. The matrix-matched standardization using Si as the IES yields the best reproducibility of trace element concentrations followed by the matrix-matched reduction using Ti as the IES. Moreover, the matrix-matched semi-quantitative correction yielded the lowest weighted percentage of difference compared to reference trace composition quantified by solution ICPMS. Finally, in this contribution we also benchmark sampling-size for precise U-Pb dating of common-Pb rich phases like titanite.