text:
As "The Matrix" so pleasingly proved, sometimes all a science-fiction flick needs, in order to snare the intrigue of its audience, is a good hook; screw the giant robots and three-breasted women, give us a concept we can dig.
And like the Wachowski's high-concept '90s classic of our previous para, "Upside Down" uses the 'secret world' device to rob our attention. But unlike the former, the world in writer/director Juan Solanas's French-Canadian co-prod is visible – just ostensibly not reachable.
Doused in a super-sized tray of fantastical colour and effect (think the colour palette of "What Dreams May Come" but with the brighter shades used more sparingly), "Upside Down" is an artsy dazzler set in a world in which another, erm, world, slightly better off than our own, exists in the sky. Yes, that's right, instead of clouds, there's an upside-down world up there – with both worlds embodying gravities that pull in different directions. Even if we could jump up there, we, the poor folk, aren't allowed – that pretty flip-side is for the well-heeled and luckier of the human race. Geddit?
Adam (Jim Sturgess) and Eve (Kirsten Dunst) meet, inconveniently upside down, when they both cross paths at their world's highest peaks. Determined to come down below, she loses her grip and falls backwards – resulting in a motionless body and a pool of blood. He, haven taking to the pretty, pleasant girl (as the audience will, Dunst is her typically sweetie self), is understandably distraught but unable to do anything for her.
The End.
Or not.
Years later, when Adam glimpses Eve on television he makes it his mission to somehow reach her. Thanks to some scientific gifts that get him through the door (so to speak), a fake identity, and a whole lot of courage, the young man makes it into Eve's world. When he finally comes face-to-face with her, he's shocked to discover she doesn't remember him, nor anything of recent years – having knocked her head so badly, when she fell.
Bad luck. Roll Credits. The End.
Or not.
Nah, needless to say, things do start coming back to Eve, and with Adam's determination to not only remain 'upside down' with her, two do ultimately become one.
So it sounds as stupid as the snot-flicker that use to sit across from you in 9th grade, and scientifically, yes, it's a real joke, but "Upside Down"- even with its implausibility factory, story inconsistencies and plot holes – works because of its simple mesh of intriguing sci-fic and old Hollywood romance.
- Greg Mclean gunning for Belco Experiment - April 1, 2015
- Bloodline returning for season two - April 1, 2015
- What a Croc! - April 1, 2015
- The Lawnmower Man cuts From Dusk Till Dawn - April 1, 2015
- Trailer : Mad Max : Fury Road - April 1, 2015
- It Follows expanding any further this Friday! - April 1, 2015
- Trailer : Masterminds - March 31, 2015
- When will we see the next Star Wars trailer!? - March 31, 2015
- Shrek to appear in new Puss in Boots sequel? - March 31, 2015
- Disney developing live-action Mulan - March 31, 2015
Against the Current - the band, not adventures in dangerous swimming 101
Zedd - If our love is tragedy, why are you my remedy? (Well, answer my question!)
Arrow (Okay, Felicity from Arrow!)
Chrissy Costanza (cat eyes and buttery lyrics!)
Girls (TV) (Okay, Allison Williams!)
Movies - especially when they play in the dark.
Twin Peaks (TV)
Friends (TV) (It had me at "No way are you cool enough to pull Clint"; damn straight, Chandler!)
Traveling - preferably where water is, so I can splash someone!
Star Wars trilogy - no, the other one, fella!
Alex G - far more talented than her younger brother Alex H
Cameron Crowe movies - Say Anything..., Jerry Maguire, Almost Famous
The sign 'Free Wi-Fi'.
Reenacting dance/song scenes from "Grease" with my little girl (hey! Wait till you see my 'Summer Lovin'! - don't judge)
Die Hard - 40 stories of Sheer Adventure!
Alex Goot & Friends (his enemies aren't half as talented!)
Cooking up a nice dish and sitting in the entertainment area, on a cool night, basking in it's greatness.
Inflatable kids pools full of Vodka Lime Crush.
Acidic Email from angry, over passionate teenagers after I trash something "Twilight"-related on the site. Sparkle elsewhere.
My baby girl's big, caring heart.


text:
The present application relates to microfluidic devices and related technologies, and to chemical processes using such devices. More specifically, the application discloses a fully automated synthesis of radioactive compounds for imaging, such as by positron emission tomography (PET), in a fast, efficient and compact manner. In particular, this application describe an automated, stand-alone, microfluidic instrument for the multi-step chemical synthesis of radiopharmaceuticals, such as probes for PET and a method of using such instruments.
1. A microfluidic system for synthesis of a radiolabeled compound, the system configured to transfer and facilitate the reaction of microliters and/or nanoliters of reagent, the system comprising:
a microfluidic synthesis chip configured for conducting batch reactions, the chip comprising;
a reaction chamber;
an inlet flow channel in communication with the reaction chamber and configured to pass reagent into the reaction chamber, the inlet flow channel having a valve configured to regulate flow to the reaction chamber; and
a plurality of outlet channels in communication with the reaction chamber and configured to pass reagent out of the reaction chamber, each channel having a valve configured to close to trap reagent within the reaction chamber during a reaction and release reagent and products when the reaction is complete; and
a reagent source comprising at least one reagent, the reagent source in fluid communication with the reaction chamber via the at least one flow channel,
wherein the reaction chamber has an area substantially greater than a cross-sectional area of each of the inlet flow channel and the outlet channels.
2. The system of
a) the reagent source
b) microfluidic chip;
c) the purification system; and
d) the product receptacle.
3. The system of
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9. A portable microfluidic system for synthesis of a radiolabeled compound, the system configured to transfer and facilitate the reaction of microliters and/or nanoliters of reagent, the system comprising:
a microfluidic synthesis chip configured to conduct batch reactions comprising:
a reaction chamber;
a vent in communication with the reaction chamber;
at least one flow channel in communication with the reaction chamber;
at least one valve configured to regulate flow to or from the reaction chamber; and
a reagent source comprising at least one reagent in fluid communication with the reaction chamber via the flow channel; and
a filter in communication with the reaction chamber and an area outside of the system, the filter configured to filter exhaust from the reaction chamber wherein the valve is configured to close to trap reagent within the reaction chamber during a reaction during a reaction and release reagent and products when the reaction is complete.
10. The system of
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28. The system of
a temperature control system operatively coupled to the microfluidic chip, the temperature control system comprising a heat exchanger;
a pressure control system operatively coupled to the microfluidic chip, the pressure control system comprising a vacuum;
a controller operatively coupled to and controlling the function of at least one component selected from the group consisting of the gas delivery source, the vacuum system, the temperature control system and the valve on the synthesis chip; and
at least one external input device coupled to the controller.
29. The system of
30. The system of
31. A microfluidic system for synthesis of a radiolabeled compound, the system configured to transfer and facilitate the reaction of microliters and/or nanoliters of reagent, the system comprising:
a microfluidic synthesis chip configured to conduct batch reactions, the microfluidic synthesis chip comprising:
a substrate comprising:
a reaction chamber;
an inlet channel in communication with the reaction chamber and configured to pass reagent into the reaction chamber, the inlet channel comprising a valve configured to regulate flow to the reaction chamber;
an outlet channel in communication with the reaction chamber and configured to pass reagent out of the reaction chamber, the outlet channel having a valve configured to control reagent and product flow out of the reaction chamber;
a gas permeable membrane in communication with the reaction chamber;
a vent in communication with the reaction chamber;
a reagent source in fluid communication with the reaction chamber via the inlet channel; and
a gas source in communication with the at least one reagent such that gas conveys the reagent to the reaction chamber,
wherein the valve of the outlet channel is configured to close to trap reagent within the reaction chamber during a reaction and release reagent and products when the reaction is complete.
32. The system of
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This application claims priority to U.S. Provisional Application No. 60/897,002 filed Jan. 23, 2007, the contents of which is hereby incorporated in its entirety by reference.
The present application relates to microfluidic devices and related technologies, and to chemical processes using such devices. More specifically, the application discloses a fully automated synthesis of radioactive compounds for imaging, such as by positron emission tomography (PET), in a fast, efficient and compact manner. In particular, this application describes an automated, stand-alone, microfluidic instrument for the multi-step chemical synthesis of radiopharmaceuticals, such as probes for PET and methods of using such systems.
Positron Emission Tomography is a molecular imaging technology that is increasingly used for detection of disease. PET imaging systems create images based on the distribution of positron-emitting isotopes in the tissue of a patient. The isotopes are typically administered to a patient by injection of probe molecules that comprise a positron-emitting isotope, e.g. carbon-11, nitrogen-13, oxygen-15, or fluorine 18, covalently attached to a molecule that is readily metabolized or localized in the body or that chemically binds to receptor sites within the body. For PET probes the short half-lives of the positron emitters require that synthesis, analysis and purification of the probes are completed rapidly.
Large-volume synthesis modules have been developed and used for the preparation of a number of radiopharmaceutical compounds. Common pharmaceuticals radiolabeled with F-18 include 2-deoxy-2-[F-18]-fluoro-D-glucose (18F-FDG), 3′-deoxy-3′-[F-18]-fluorothymidine (18F-FLT), 9-[4-[F-18] fluoro-3-(hydroxymethyl)butyl]guanine (18F-FHBG), 9-[(3-[F-18] fluoro-1-hydroxy-2-propoxy)methyl]guanine (18F-FHPG), 3-(2′-[F-18] fluoroethyl)spiperone (18F-FESP), 4-[F-18] fluoro-N-[2-[1-(2-methoxyphenyl)-1-piperazinyl]ethyl]-N-2-pyridinyl-benzamide (18F-p-MPPF), 2-(1-{6-[(2-[F-18]fluoroethyl)-(methyl)amino]-2-naphthyl}ethylidine)malononitrile (18F-FDDNP), 2-[F-18] fluoro-α-methyltyrosine, [F-18] fluoromisonidazole (18F-FMISO), 5-[F-18] fluoro-2′-deoxyuridine (18F-FdUrd). Other common radiolabeled compounds include 11C-methionine and 11C-acetic acid. Large volume synthesis modules occupy a large amount of space and the chemical process requires longer reaction time cycles than desired for the preparation of the labeled compounds. Such modules are also difficult to modify for the research and development of new compounds and probes. Generally the reactions in such modules take place with reduced efficiency due to the tremendous dilution of reagents necessary for macroscopic liquid handling.
The synthesis of the [F-18]-labeled molecular probe, 2-deoxy-2-[F-18]-fluoro-D-glucose (18F-FDG) is based on three major sequential synthetic processes: (i) Concentration of the dilute [F-18] fluoride solution (1-10 ppm) that is obtained from the bombardment of target water, [O-18]H2O, in a cyclotron; (ii) [F-18]fluoride substitution of the mannose triflate precursor; and (iii) acidic hydrolysis of the fluorinated intermediate. Presently, [F-18]FDG is produced on a routine basis in a processing time (or cycle time) of about 50 minutes using macroscopic commercial synthesizers. These synthesizers consist, in part, of an HPLC pump, mechanical valves, glass-based reaction chambers and ion-exchange columns. The physical size of these units is approximately 80 cm×40 cm×60 cm. Descriptions of macroscopic synthesizers can be found in WO 2007/066089, WO 2005/057589, US 2007/0031492, and US 2004/022696.
Because of the long processing times and low reagent concentrations of macroscopic synthesizers and the short half-life of [F-18]fluorine (t1/2=109.7 min), a considerable decrease in the radiochemical yields of the resulting probe are inevitably obtained. Moreover, because a number of commercialized automation system are constructed for macroscopic synthesis, the process requires the consumption of large amount of valuable reagents (e.g. mannose triflate or other such reagents), which is inefficient and wasteful for performing research at the smaller scale. For example, the required radioactivity for [F-18]FDG PET imaging of a single patient is about 20 mCi, which corresponds to about 240 ng of FDG. However, for small animal imaging applications, such as for a mouse, only about 200 μCi or less of [F-18]FDG is required.
Accordingly, there is a need to develop smaller or miniaturized systems and devices that are capable of processing such small quantities of molecular probes. In addition, there is a need for such systems that are capable of expediting chemical processing to reduce the overall processing or cycle times, simplifying the chemical processing procedures, and at the same time, provide the flexibility to produce a wide range of probes, biomarkers and labeled drugs or drug analogs, inexpensively.
Microfluidic devices can offer a variety of advantages over macroscopic reactors, such as reduced reagent consumption, high concentration of reagents, high surface-to-volume ratios, and improved control over mass and heat transfer. (See, K. Jahnisch, V. Hessel, H. Lowe, M. Baerns, Angew. Chem. 2004, 116: 410-451; Angew. Chem. Int. Ed. Engl. 2004, 43:406-446; P. Watts, S. J. Haswell, Chem. Soc. Rev. 2005, 34:235-246; and G. Jas, A. Kirschning, Chem. Eur. J. 2003, 9:5708-5723.)
The present application relates to microfluidic devices and related technologies, and to chemical processes using such devices. More specifically, the application discloses a fully automated synthesis of radioactive compounds for imaging, such as by positron emission tomography (PET), in a fast, efficient and compact manner. In particular, this application describes an automated, stand-alone, microfluidic instrument for the multi-step chemical synthesis of radiopharmaceuticals, such as probes for PET.
Generally, conventional automated synthesizers for synthesizing radiopharmaceutical are inefficient and efficient microfluidic reactors identified so far require manual operation. The present application allows automatic operation of microfluidic reactors. Previous microfluidic reactors have been operated inside stationary leaded hot cells by a variety of mechanical, pneumatic or very simple electronic controls, requiring operator attention at all times; these reactors demonstrate notable variability as a result. The automation enabled by one aspect of this invention makes the microfluidic device autonomous and portable. In one aspect, the microfluidic system of the present application can be used in either clinical or R&D setting by medical personnel and does not require the constant presence of an engineer or specially trained operator. In another aspect of the present invention, the microfluidic system allows various steps of the synthesis to take place in a controlled traceable manner. One aspect of the application relies on pneumatic delivery of fluids with metering provided by the fixed volume of the reaction chamber with a membrane, and uses timing for various steps as the indication of their completion. In an alternative aspect of the present application, syringe drivers can be used to deliver and meter reagents more precisely. Generally, sensors can be used to monitor step completion such as, for example, solvent evaporation. This arrangement can lead to a faster and more fail-safe instrument.
In particular, the present application discloses a microfluidic system for the fully-automated synthesis of biomarkers, or radiolabeled pharmaceuticals, for positron emission tomography. This application discloses improvements on current state-of-the-art automated systems for macroscopic scale synthesis of such radiolabeled compounds due to advantages of microfluidic components. These advantages include reduced reagent use (thus reduced cost of chemical product); increased concentration of the radiolabel, such as F-18, which drives up reaction efficiencies and yields; and the ability to synthesize compounds on demand and in a flexible manner.
The presently disclosed system can contain mechanisms to add additional reagent modules, waste modules, and synthesis modules to allow the system to be used for different biomarkers from one run to the next or even simultaneously. In cases when different biomarker syntheses involve the same number of steps, the instrument may even be reused without hardware modifications. It can also be envisioned with single-use cartridges pre-loaded with reagents and/or solvents for a single run. This ease of use enables tremendous flexibility in a research environment or in specialized clinical situations where on-demand synthesis of biomarkers is needed, such as when several patients in the same day require different scans performed with different biomarkers.
In one aspect, the present application provides an automated instrument that is easy to use and flexible. In this way, the system enables non-experts to synthesize a variety of PET biomarkers on demand for biomarker development, synthesis-optimization, and testing. In another aspect, the present application provides an instrument that can be deployed in hospitals further from cyclotrons than is currently possible. The presently disclosed devices enable synthesis of fresh product on demand as contrasted to the decayed product that would arrive after a long delivery time from a centralized synthesis facility. This type of on-site instrument would greatly expand the accessibility of PET scanning to additional clinics, patients, and research labs and provide them with flexibility in the biomarkers they use that goes beyond what is available from the local radio-pharmacy.
A number of components disclosed herein have been described previously: "Microfluidic method and structure with an elastomeric gas-permeable gasket" (U.S. Ser. No. 11/701,917); "Method and Apparatus for the Mechanical Actuation of Valves in Fluidic Devices" (U.S. Ser. No. 11/514,396), and "System and Method for Interfacing with a Microfluidic Chip" (U.S. Ser. No. 11/862,167). Each reference cited herein is incorporated herein in its entirety.
Unless specifically noted otherwise herein, the definitions of the terms used are standard definitions used in the art of organic synthesis, engineering and pharmaceutical sciences.
As used herein, a "microfluidic device" or "microfluidic chip" or "synthesis chip" or "chip" is a unit or device that permits the manipulation and transfer of microliters or nanoliters of liquid into a substrate comprising micro-channels. The device is configured to allow the manipulation of liquids, including reagents and solvents, to be transferred or conveyed within the micro channels and reaction chamber using mechanical or non-mechanical pumps. The device may be constructed using micro-electromechanical fabrication methods as known in the art. Examples of substrates for forming the device include glass, quartz or polymer. Such polymers may include PMMA (polymethylmethacrylate), PC (polycarbonate), PDMS (polydimethylsiloxane), DCPD (polydicyclopentadiene) and the like. Such device may comprise columns, pumps, mixers, valves and the like. Generally, the microfluidic channels or tubes (referred to as micro-channels or capillaries herein) have at least one cross-sectional dimension (e.g., height, width, depth, diameter) from about 1 to about 1,000 μm, alternately from about 1 to about 500 μm, or even from about 10 to about 500 μm. The micro-channels make it possible to manipulate extremely small volumes of liquid on the order of nL to μL. The micro reactors may also comprise one or more reservoirs in fluid communication with one or more of the micro-channels, each reservoir typically having a volume of about 5 to about 1,000 μL.
As used herein "reaction chamber" or "reactor" or "micro-reactor" refers to a cylindrical feature on the microfluidic chip (such as described here or for example in U.S. Ser. No. 11/514,396, U.S. Ser. No. 11/540,344, or U.S. Ser. No. 11/701,917, each of which is incorporated herein in its entirety by reference) where the reactions may take place. The reaction chamber has one or more micro-channels connected to it that deliver reagents and/or solvents or are designed for product removal (controlled by on-chip valves). Generally the reaction chamber has a height diameter to height with a ratio of greater than about 3, greater than about 5, greater than about 10 or more. The reactor height may be about 25 micrometer to about 1,000 micrometers. The reactor may have a diameter from about 1,000 to about 20,000 micrometers.
As used herein, "column" means a device that may be used to separate, purify or concentrate reactants or products. Such columns are well known in the art, and include ion exchange and affinity chromatography columns.
A "flow channel" or "channel" means a microfluidic channel through which a fluid or solution may flow. As is known in the art, such channels may have a cross section of less than about 1 mm, less than about 0.5 mm, less than about 0.3 mm, or less than about 0.1 mm. The flow channels of the present application may also have a cross section dimension in the range of about 0.05 microns to about 1,000 microns, or 0.5 microns to about 500 microns, or about 10 microns to about 300 microns. The particular shape and size of the flow channels will depend on the particular application required for the reaction process, including the desired throughput, and may be configured and sized according to the desired application.
"Target water" is [18O] H2O after bombardment with high-energy protons in a particle accelerator, such as a cyclotron; it contains [18F]fluoride. In one embodiment of the present application, preparation of target water is contemplated separately from the system disclosed herein. In one embodiment of the present application, target water is supplied to the system from a cartridge; in another embodiment, from a pre-filled individual vial.
A microfluidic "valve" (or "micro-valve") as used herein, means a device that may be controlled or actuated to control or regulate fluid or solution flow among various components of the microfluidic device, including flow between flow channels, solvent or reagent reservoirs, reaction chamber, columns, manifold, temperature controlling elements and devices, and the like. Such valves are known in the art and include, for example, mechanical (or micromechanical valves), (pressure activated) elastomeric valves, pneumatic valves, solid-state valves, etc. Examples of such valves and their method of fabrication may be found, for example, in "The New Generation of Microvalves" Analytical Chemistry, Felton, 429-432 (2003).
As used herein, the term "radioactive isotope" refers to isotopes exhibiting radioactive decay (i.e., emitting positrons). Such isotopes are also referred to in the art as radioisotopes or radionuclides. Radioactive isotopes are named herein using various commonly used combinations of the name or symbol of the element and its mass number (e.g., 18F, [F-18], fluorine-18). Exemplary radioactive isotopes include I-124, F-18, C-11, N-13, and O-15, which have half-lives of 4.2 days, 110 minutes, 20 minutes, 10 minutes, and 2 minutes, respectively.
The term "reactive precursor" or "precursor" refers to an organic or inorganic non-radioactive molecule that is reacted with a radioactive isotope, typically by nucleophilic substitution, electrophilic substitution, or ionic exchange, to form the radiopharmaceutical. The chemical nature of the reactive precursor depends upon the physiological process to be studied. Typically, the reactive precursor is used to produce a radiolabeled compound that selectively labels target sites in the body, including the brain, meaning the compound can be reactive with target sites in the subject and, where necessary, capable of transport across the blood-brain barrier. Exemplary organic reactive precursors include sugars, amino acids, proteins, nucleosides, nucleotides, small molecule pharmaceuticals, and derivatives thereof. One common precursor used in the preparation of 18F-FDG is 1,3,4,6-tetra-O-acetyl-2-O-trifluoromethanesulfonyl-β-D-mannopyranose.
As used herein, the phrase "reactor temperature" refers to a temperature observed and/or maintained in the reaction chamber.
As used herein, "reaction time" refers to the time allowed for a reaction to run before the next step takes place.
The phrase "reagent pressure" or "solvent pressure" refers to the pressure of a gas (usually an inert gas such as nitrogen or argon) applied to a reagent or solvent vial that drives a reagent or solvent into a flow channel, e.g. on the way to the reaction chamber.
The phrase "time of reagent filling" or "time of solvent filling" refers to the time allowed for a reagent or solvent to enter the microfluidic chip before the on-chip valve closes, thereby inhibiting passage of additional reagent or solvent onto the chip.
The term "evaporation" refers to the change in state of solvent from liquid to gas and removal of that gas from the reactor. Generally gas is removed by vacuum applied across the membrane. Various solvents are evaporated during the synthetic route disclosed herein, such as for example acetonitrile and water. As known to those of skill in the art, each solvent, such as acetonitrile and water, may have a different evaporation time and/or temperature.
The term "elution" generally refers to removal of a compound from a particular location. Elution of [F-18]fluoride from the ion exchange column refers to the conveyance of [F-18]fluoride by the eluting solution from the column to the reaction chamber. Elution of product from the reaction chamber refers to conveyance of the product from the reaction chamber to the off-chip product vial by flushing the reaction chamber with a volume of solvent, e.g. water.
The "off/on time" in reference to the vacuum applied at a point in the system refers to the point in time of the radiosynthesis operation when the vacuum is turned on or off.
"Inert gas pressure," including "nitrogen pressure" or "argon pressure" refers to pressure of inert gas, such as nitrogen or argon, allowed past a given regulator.
The phrase "internal filter" refers to a vial, a syringe or another container that is filled with absorbent material such as charcoal and comprises two ports. When the exhaust from the microfluidic chip is passed through such a filter, radioactive and non-radioactive contaminants are generally caught by and stay on the filter. After passage of the reaction exhaust through an internal filter purified gas is released into the atmosphere. Use of an appropriate internal filter reduces or even eliminates the need for an additional exhaust processing for safe operation of the portable system. In one embodiment, it is not necessary to operate the portable system disclosed herein in a fume hood.
The term "priming" when used in reference to a reagent flow channel refers to conveying a reagent through the flow channel connecting the reagent source and the reaction chamber, wherein the reagent flow passes a closed on-chip valve and flows via an open flow channel to a waste receptacle. In this fashion, when the reagent is to be added to the reaction chamber, the corresponding on-chip valve is opened and pneumatic actuation conveys the reagent from the primed flow channel into the reaction chamber with minimal delay. In the alternative when a flow channel is not primed, the reagent must travel the length of the flow channel from the reagent source to the reaction chamber, displacing the gas in that path through the gas-permeable membrane on the synthesis chip. Displacing a significant amount of gas through the gas permeable membrane on the synthesis chip can put a strain on the system, which is avoided by priming the flow channel. Analogously, when appropriate, the term 'priming' can be used in reference to a solvent flow channel.
The phase "pre-packaged disposable reagent cartridge" refers to an apparatus designed to fit removably and interchangeably into or onto an automated system described herein; where the apparatus contains one or more separate reagent sources. The reagent(s) held within the cartridge, after fitting the cartridge into the system described herein, can be conveyed to the reaction chamber as described herein via pneumatic delivery. When appropriate for the preparation of a radiolabeled compound, the reagent cartridge can contain solvents as well as reagents. Alternately, solvents can be provided separately from the reagents.
In one embodiment, automated systems disclosed herein include those which comprise a disposable reagent cartridge. In one embodiment, the present application discloses an automated system with the flexibility to make a variety of different radiopharmaceuticals with minimal risk of cross-contamination, by simply changing the cartridge. Using such a cartridge has a number of advantages including simplified set-up; rapid change between production runs; pre-run automated diagnostic checking of the cartridge and reagents; reagent traceability; single-use, tamper and abuse resistance. Substitution of a reagent cartridge eliminates the need to design an entirely new automated synthetic system each time a different radiopharmaceutical is to be prepared.
Suitable heat sources for use in the synthetic systems disclosed herein include but are not limited to resistive heating, localized and non-localized microwave heating and Peltier devices. Various sensors (e.g., flow sensors, radioactivity sensors, pressure sensors, temperature sensors, and the like) and other apparatus components (e.g., valves, switches, etc.) can be integrated into the system and connected to a computer for process control and monitoring purposes.
The synthetic systems disclosed herein comprise a microfluidic synthesis chip in which, for example, reagents are mixed and heated, solvents are exchanged, etc to carry out the desired chemical process.
Aspects, Embodiments, and Variations:
The present application provides the following embodiments, aspects and variations:
One aspect of the application is a portable system for the automated radiosynthesis of a radiolabeled compound comprising:
a microfluidic synthesis chip comprising a reaction chamber of fixed volume, a membrane, at least one flow channel and at least one valve;
a reagent source comprising at least one reagent in fluid communication via a flow channel with the synthesis chip, wherein the reagent is conveyed in a metered amount to the reaction chamber via pneumatic actuation; and
at least one external input device coupled to at least one controller which is coupled to and controls the function of at least one component selected from the group consisting of an inert gas delivery source, a vacuum system, a temperature control system and a valve on the synthesis chip.
In one embodiment, the system is further configured for priming the flow channel, wherein the priming comprises conveying the reagent from the reagent source to the valve on the synthesis chip, wherein the valve is closed and the reagent is conveyed to a waste receptacle in fluid communication thereto.
In another embodiment, the reagent is conveyed from a pre-filled individual vial or from a pre-packaged cartridge.
In yet another embodiment, the system further comprises radiation shielding. In one variation, the system does not require a separate hot cell. In another variation the radiation shielding shields one or more of:
a) a radiolabel source in fluid communication via a flow channel with the reaction chamber;
b) the flow channel of the radiolabel source;
c) the synthesis chip;
d) a purification system in fluid communication with the synthesis chip; and
e) a product receptacle in fluid communication with the purification system.
In another embodiment, the system further comprises a heat-exchanger. In one variation the heat-exchanger heats the reaction chamber via a resistive heater and cools the reaction chamber by air in a vortex cooler.
In one embodiment, the radiolabeled compound is radiolabeled with F-18, C-11, N-13, O-15 or I-124. In one embodiment, the radiolabeled compound is radiolabeled with C-11. In one variation, the radiolabeled compound is radiolabeled with F-18. In another variation, radiolabeled compound is selected from the group consisting of: 2 deoxy-2-[F-18]-fluoro-D-glucose (18F-FDG), 3′-deoxy-3′-[F-18]-fluorothymidine (18F-FLT), 9 [4-[F-18] fluoro-3-(hydroxymethyl)butyl]guanine (18F-FHBG), 9-[(3-[F-18] fluoro-1-hydroxy-2-propoxy)methyl]guanine (18F-FHPG), 3-(2′-[F-18] fluoroethyl)spiperone (18F-FESP), 4-[F-18] fluoro-N-[2-[1-(2-methoxyphenyl)-1-piperazinyl]ethyl]-N-2-pyridinyl-benzamide (18F-p-MPPF), 2(1{6[(2[F 18]fluoroethyl)-(methyl)amino]-2-naphthyl}ethylidine)-malononitrile (18F-FDDNP), 2-[F-18] fluoro-α-methyltyrosine, [F-18] fluoromisonidazole (18F-FMISO), and 5-[F-18] fluoro-2′-deoxyuridine (18F-FdUrd). Alternately, the radiolabeled compound is selected from the group consisting of: 2 deoxy-2-[F-18]-fluoro-D-glucose (18F-FDG), 3′-deoxy-3′-[F-18]-fluorothymidine (18F-FLT), and 2(1-{6-[(2-[F-18]fluoroethyl)-(methyl)amino]-2-naphthyl}ethylidine)malononitrile (18F-FDDNP).
In one embodiment, the radiolabeled compound can be 2 deoxy-2-[F-18]-fluoro-D-glucose ([F-18]FDG). In one variation, one reagent is target water, [O-18]H2O containing [F-18], and isolation of [F-18] from target water relies on electrochemical trapping. In another embodiment, isolation of [F-18] from the target water relies on an ion-exchange column. In one variation, the concentration of the [F-18]FDG is at least about 100 times that of the concentration of F-18 in target water. In yet another embodiment, the instrument can achieve 200-fold concentration of F-18 from target water, in contrast to conventional methods that rely on about 5-fold concentration. In another embodiment, the instrument achieves 300-fold concentration; and in a yet another embodiment, in the concentration of the F-18 radiolabeled compound is at least about 400 times that of the concentration of F-18 in the target water.
In one embodiment, the flow channel connecting the reagent source with the synthesis chip further comprises a check valve and/or a 3-way valve. In one variation, the system further comprises an inert gas inlet wherein the system is pressurized by inert gas from the inlet and the speed with which the reagents are conveyed from the source to the reaction chamber is controlled by pressure of an inert gas. In another variation, the inert gas is split into various pressures. In yet another variation, the speed with which the reagents are conveyed from the reagent source to the reaction chamber is controlled by the thickness and/or composition of the membrane.
In one embodiment, the system can be cleaned without requiring disassembly of the system, wherein the cleaning step comprises conveying a solvent from a solvent source via a flow channel through the reaction chamber to a waste receptacle and optionally conveying an inert gas from the inert gas delivery source through the reaction chamber.
In one embodiment, the radiolabeled compound is collected in a product vial, wherein the product vial is shielded from the microfluidic synthesis chip and/or the reagent source.
In another embodiment, the vacuum system comprises pump, a trap, a valve and an electronic pressure gauge readable by the external input device. In another embodiment, the system further comprises a pressure controller.
In yet a further embodiment, the system comprises at least one internal filter. In one variation, the system can safely operate outside a fume hood. In another variation, the purification system comprises a column.
In another embodiment, the radiolabeled compound is formed via a process occurring in the reaction chamber and is conveyed to a purification system via pneumatic actuation. In one variation, the process in the reaction chamber is monitored using a borescope inserted through an actuation plate positioned adjacent to the microfluidic device.
In one embodiment, the at least one controller controls the function of an inert gas delivery source, a vacuum system, a temperature control system and a valve on the synthesis chip.
Another aspect of the present application is a portable system for the automated radiosynthesis of a radiolabeled compound comprising:
a microfluidic synthesis chip comprising a reaction chamber of fixed volume, a membrane, at least one flow channel and at least one valve;
a reagent source comprising at least one reagent in fluid communication via a flow channel with the synthesis chip, wherein the reagent is conveyed in a metered amount to the reaction chamber via pneumatic actuation;
radiation shielding;
a heat-exchanger, wherein the heat-exchanger heats the reaction chamber via a resistive heater and cools the reaction chamber by air in a vortex cooler
at least one external input device coupled to at least one controller which is coupled to and controls the function of at least one component selected from the group consisting of an inert gas delivery source, a vacuum system, a temperature control system and the valve on the synthesis chip. In one embodiment, the system further comprises off-chip liquid and gas valves.
Another aspect of the present application is a method for the synthesis of purified [F-18]-FDG comprising the use of the system of claim 1 wherein one reagent is target water, [O-18]H2O containing F-18, one solvent is water and the [F-18]FDG is collected in a product receptacle. In one embodiment, an operator inputs into the external input device a value for one or more variables selected from the group consisting of: reactor temperature, reaction time, reagent pressure, times of reagent filling, evaporation, elution; vacuum on/off time, and inert gas pressure. In another embodiment, the operator inputs into the external input device the value before implementation of the system and does not input another value into the external input device at least until the radiolabeled compound is synthesized. In yet another embodiment, an operator inputs into the external input device a value for each of reactor temperature, reaction time, reagent pressure, times of reagent filling, evaporation, elution; vacuum on/off time, and inert gas pressure. In still another embodiment, the operator inputs into the external input device each of the values before implementation of the system and does not input another value into the external input device at least until the radiolabeled compound is synthesized. In one variation, the method further comprises removing [F-18]FDG from the system; cleaning the system with water and drying the system with an inert gas.
Another aspect of the present application is a machine-readable computer program code, the program code including instructions for causing a controller to implement a method for the synthesis system of claim 1, for method comprising:
introducing one or more reagents into for reaction chamber;
operating the synthesis system to process the reagent(s) responsive to a predetermined algorithm to generate a radiolabeled compound; and
collecting for radiolabeled compound.
In one embodiment, the algorithm includes parameters for one or more variables selected from the group of reactor temperature, reaction time, reagent pressure, times of reagent filling, evaporation, elution; vacuum on/off time, and inert gas pressure. In another embodiment, the algorithm includes parameters for each of the variables: reactor temperature, reaction time, reagent pressure, times of reagent filling, evaporation, elution; vacuum on/off time, and nitrogen pressure. In one variation, at least one parameter is input before implementation of the synthesis system. In another variation, the machine-readable computer program code is encoded onto a storage medium.
In one embodiment, each reagent and/or solvent is delivered to the synthesis chip from an individual reagent/solvent source. In such an example, each reagent/solvent source may have two ports into which tubing is inserted: an inlet and an outlet. The inlet tubing sits above the fluid surface and is in fluid communication with an electronically controlled 3-way valve connected to a pressurized inert gas supply (e.g. N2 or argon). In one embodiment, each reagent/solvent has its own individually-controllable pressure, to allow flexibility by allowing different flow rates. The outlet line (or outlet channel) of each reagent/solvent source can be a piece of tubing with one end at the bottom of the reagent vial and heading toward the microfluidic chip. The 3-way valve connected to the inlet can be opened such that the reagent/solvent vial is pressurized and the reagent/solvent is pushed into the outlet line, or it can be vented such that the reagent/solvent vial is open to atmosphere and depressurized.
Most lines (or channels) from reagent/solvent vials pass through an additional electronically-controlled 3-way valve on the way to the synthesis chip so that a "wash" solvent and/or inert gas (nitrogen or argon) can be directed toward the synthesis chip to clean and dry one or more lines at the end of a synthesis run. Drying the lines helps to avoid liquid leaks when removing and reinstalling the chip from the interface adapter. Drying also helps avoid contamination of subsequent runs with previously run components or dilution of reagents by cleaning solvents. In addition, check valves are placed in the inlet lines on the way to the synthesis chip to ensure no back flow into a reagent/solvent vial should there be any leaky microfluidic chip valves (or valves switched inadvertently at an incorrect time).
In one embodiment the reagents/solvents are loaded individually in pre-filled vials into the system. In another embodiment, these reagents/solvents can be packaged into a single reagent cartridge that can be installed in one step, or could be packaged in tiny quantities with each synthesis chip to easily allow the synthesis of different biomarkers. A different set of reagents/solvents and possibly different chip configuration could then be used for each desired radiosynthesis.
In one exemplary system, the radiolabel, such as F-18, is delivered from a cyclotron through a check valve and into a temporary storage vial inside the instrument. In a another exemplary system, the radiolabel is delivered each day in an easy-to-connect leaded-vial or possibly in the solid-phase (e.g. attached to an ion-exchange column to be eluted into a temporary storage vial inside the instrument). It is not anticipated that operators will have their own cyclotron and delivery as necessary, e.g. daily, of the radioactive label addresses this deficiency. In one example of [F-18]FDG synthesis, F-18 is provided in a solution of target water: the solution is first passed through an exchange resin to trap and concentrate F-18; the F-18 is then eluted into the microfluidic synthesis chip using a K2CO3 solution. To minimize the fluid volume transferred from the exchange column to the microfluidic synthesis chip, an ultra-low volume (0.5 μL) rotary valve is used in this part of the fluidic system.
Other methods of trapping fluoride ion (e.g. electrochemical trapping, such as is disclosed in U.S. Ser. No. 60/950,976 "Microfluidic Radiosynthesis device relying on electrochemical trapping and release of F-18 in its isotope concentration step") can alternatively be easily integrated into the system. With electrochemical trapping, the controller, and by extension the computer can additionally control the high voltage supply necessary in this setup.
The radiolabeled product made in the synthesis chip is eluted with solvent through a purification system, such as, for example, a column, and into the final collection vial (or product receptacle) and is diluted to the volume required for analysis and/or injection into the patient. In one embodiment, the product receptacle is located in a leaded vial or syringe affixed to the outside of the instrument for easy and quick removal and delivery to the patient or for further analysis.
In the pathway of a solvent, such as e.g. water, to the microfluidic synthesis chip can be found an additional electronically-controlled 3-way valve. In one position, this valves allows solvent to flow into the synthesis chip. In the other configuration, it allows liquid to come from the synthesis chip and flow to waste. This valve is used during the wash/clean phase. Wash solvents and gas (N2 or argon) are flowed through the synthesis chip to drain and clean it. In one embodiment, the system can be washed with solvent without disassembling the system.
The automated system also controls the valves integrated in the microfluidic gasket chip. Pneumatic pistons that drive the mechanical actuating pins in these valves are driven by compressed air (or another gas) that is controlled by electronic valves on demand. Examples of placement and operation of pneumatic valves are disclosed in
A number of synthesizers known in the art employ gas pressure actuated elastomeric valves or pneumatic valves. In addition, there is significant literature disclosing the control of microfluidic valves by various methods of actuation. See for example, U.S. 2002/0127736 "Microfluidic devices and methods of use," incorporated herein in its entirety by reference. In one aspect, the microfluidic devices disclosed in the present application employ mechanical valves [such as presented in U.S. 2007/0051412, incorporated herein in its entirety by reference] that are capable of operating efficiently under high pressures. The design of the microfluidic device disclosed accomplishes these and other objectives as disclosed herein.
Details of a microfluidic chip, and reagent delivery via a dead-volume bypass mechanism which can be incorporated into the presently disclosed system are discussed in U.S. Ser. No. 11/862,167 "System and Method for Interfacing with a Microfluidic Chip," incorporated herein in its entirety by reference.
In one embodiment, the microfluidic synthesis chip contains a closed "coin-shaped" reactor surrounded by six channels and valves for flow of reagents and product. The reactor can be heated to facilitate reactions and solvents can be exchanged by evaporating across the gas-permeable membrane in the ceiling of the reactor then refilling with the next reagent in the new solvent.
In one aspect the presently disclosed system comprises a synthesis chip is fabricated from three layers—a flexible "gasket layer" between a rigid lower "fluid layer" and a rigid upper "vent layer" (see
The fluid layer (
In this embodiment, the gasket layer is a thin flat sheet of flexible material that serves three functions—it acts as a permeable gas-exchange membrane between the reactor in the fluid layer and the vacuum channel in the vent layer; it functions as the diaphragm in the on-chip microvalves, and it serves to seal the microchannels in the bottom and top layers (
The vent layer (
In this embodiment, integrated diaphragm microvalves are closed by metal rods (1 mm diameter), guided by holes in the vent layer, and driven by miniature pneumatic cylinders (FESTO EG2.5-10-PK-2). Six valves around the reactor control the flow of reagents and product, or can all be closed during heated reaction and evaporation steps.
The bypass portion of each inlet is connected to a check valve then to a single electronically-controlled dead-volume bypass valve.
In one embodiment, system components that can be under automatic control include an inert gas delivery source, a temperature control system, a pressure control system and one or more valves on the synthesis chip.
The temperature control system can operate somewhat autonomously. The desired temperature setpoint can be set by the computer software and can be changed during the synthesis run. The temperature control system automatically drives two relay output circuits to reach the target temperature: one for heating and one for cooling. The heater circuit can be an AC circuit (which can be switched on or off via computer) passing through a dimmer switch to control voltage and then to a heater cartridge that fits into the base of the microfluidic chip. The heater cartridge can be held in place by a small metal fixture. See
To enable more rapid evaporation of solvents, the top part of the microfluidic chip can contain channels to which vacuum can be applied in order to provide a larger pressure differential between the microreactor below the solvent-exchange membrane and the space above. See e.g. "Microfluidic method and structure with an elastomeric gas-permeable gasket" U.S. Ser. No. 11/701,917, which is incorporated by reference herein in its entirety. Generally a vacuum pump is controlled via a digital signal under computer control (on/off). The vacuum pump can be connected through a charcoal and fiber vacuum trap (to collect fluids arising from leaks or condensing), through an electronically controlled 2-way valve, through the microfluidic chip, and through an electronic pressure gauge that can be read by the computer. The other side of the pressure gauge can be connected via a 2-way electronic valve to an inert gas pressure supply (N2 or argon). This side is normally closed, but is present in one embodiment to allow the vacuum lines to be cleared out in case of leaks, and to allow the vent channels to be pressurized (if the vacuum valve is closed) to facilitate mixing in the micro-reactor, and to speed up filling of the reactor by pre-eliminating trapped air.
The hardware disclosed herein can be controlled for example by a PC-104 based system with 16 analog inputs, 10 analog outputs, 8 digital inputs, and 48 digital outputs. The controller can run embedded Windows-NT software that communicates via an Ethernet connection to a standard PC running the FIX32 automation software, an automation language that allows simple construction of graphical interfaces to visualize what is happening in the hardware and to control the various valves and other components. See
In one embodiment, the control software can access individual digital outputs (2-way and 3-way valves, on-chip valves, temperature control system, heater enable, cooler enable, vacuum system, rotary injector) and analog outputs (temperature setpoint). Analog inputs (reactor temperature, vent channel pressure, radiation levels) are scaled to engineering units for monitoring on the main screen.
In addition to the interactive graphical interface in
One embodiment of the system has successfully been constructed, tested, and optimized. Currently it is capable of repeatably producing purified human-scale amounts of FDG in a semi-automated (each step in the radio-synthesis is initiated with a button on the computer screen) fashion.
In a fully-automated system the needed reaction times are optimized and a simple script in FIX32 is written to execute all the operations in sequence. A working example involves automated unit operations, such as filling, which in turn involve multiple sub-steps. The semi-automated "unit operation" scripts are designed to be "parameterized". That is, in a single place, an operator sets the flow times, reaction times, and heating temperatures, and the automated script reads all these and adjusts the synthesis run accordingly.
In one aspect, the present application discloses a fully automated hands free operation of the entire radio-synthesis cycle on a microfluidic device yielding purified PET radiotracer. In one embodiment, the instrument is portable, has no external components and is self-shielded, that is it does not require a separate hot cell. In yet another embodiment, the instrument comprises internal filters which enable operation without any additional exhaust, i.e. a true tabletop operation that doesn't require a fumehood.
In one embodiment the radiopharmaceutical produced is [F-18]FDG, the reagent is target water, and the radiotracer comprises F-18. In one embodiment, an instrument disclosed herein can rely on either ion-exchange or electrochemical F-18 trapping to isolate F-18 from target water.
In one aspect of the present application, pneumatically actuated reagents are metered by filling the reactor of fixed volume with liquid while displacing gas across a membrane (gasket) In this way, the amounts of reagents used in the reaction chamber are controlled by the microfluidic synthesis chip, which is self-metering. In contrast, flow through reactors either require a syringe pump or have the reagents flush right through in an uncontrollable manner since they have an outlet. In another aspect, the entire system is pressurized from a single compressed inert gas inlet, which can optionally be split into various pressures, as required inside the instrument. In one embodiment, the inert gas is nitrogen; in another embodiment the inert gas is argon. In yet another aspect, gas flow restrictors control the speed of reagent introduction into the chip and allow facilitation of mixing of reagents at high rates. In one embodiment, the pneumatic valve actuation system is placed above the synthesis chip as shown in
In one embodiment, one or more reagents can be delivered from pre-filled individual vials or from a pre-packaged disposable cartridge. In one embodiment, the portable system can be cleaned without disassembly. Any of the reaction chamber, each of the reagent, product and waste channels can be cleaned, optionally in an automatic manner. The identity of the radiotracer produced can be easily changed without requiring hardware modifications. In one embodiment, the microfluidic synthesis chip can be exchanged. In one variation, the exchange of the synthesis chip can be performed by opening a single door in the lead shield, as opposed to disassembling the whole shield. In another embodiment, the final product vial is located in a separate shielded container so that the operator taking the product is not exposed to the rest of the radiation from the instrument.
In another embodiment, the instrument includes a heat-exchanger that allows rapid heating of the reaction chamber by a resistive heater and cooling of the reaction chamber by air in a vortex cooler.
According to one embodiment of the invention a computer system, or external input device, may be coupled to a program storage device and to a controller. The controller may be coupled to at least one valve on the synthesis chip, an inert gas delivery source, a temperature control system, a pressure monitor, and/or a vacuum system.
The general computer system includes a processing device, a system memory, a system bus coupling the system memory to the processing device, a storage device, such as a hard disk drive, a magnetic disk drive, e.g., to read from or write to a removable magnetic disk, and an optical disk drive, e.g., for reading a CD-ROM disk or to read from or write to other optical media. The storage device may be connected to the system bus by a storage device interface, such as a hard disk drive interface, a magnetic disk drive interface and an optical drive interface. Although this description of computer-readable media refers to a hard disk, a removable magnetic disk and a CD-ROM disk, it should be appreciated that other types of media that are readable by a computer system and that are suitable to the desired end purpose may be used, such as magnetic cassettes, flash memory cards, digital video disks, etc.
A user may enter commands and information into the general computer system or enter graphical information into the general computer system. A display device, such as a monitor, having a display screen, is connected to the system bus via an interface. In addition to the display screen, the general computer system can also include other peripheral output devices. The general computer system can operate in a networked environment using logical connections to one or more remote computer systems, such as a server, a router, a peer device or other common network node, and such a system can include any or all of the elements described relative to the general computer system.
When used in a local area network (LAN) environment, the general computer system is connected to the LAN through a network interface. When used in a WAN networking environment, the general computer system typically includes a modem or other means for establishing communications over a WAN, such as the Internet. The modem, which may be internal or external, may be connected to the system bus via the serial port interface. In a networked environment, program modules depicted relative to the general computer system, or portions thereof, may be stored in the remote memory storage device. It should be appreciated that the network connections shown are exemplary and other means of establishing a communications link between the computer systems may be used. It should also be appreciated that the application module could equivalently be implemented on host or server computer systems other than general computer systems, and could equivalently be transmitted to the host computer system by means other than a CD-ROM, for example, by way of the network connection interface. Program modules stored in the drivers of the computer system may control how the general computer system functions and interacts with the user, with I/O devices or with other computers. Program modules may include routines, operating systems, target application program modules, data structures, browsers, and other components.
It should be appreciated that no particular programming language is described for carrying out the various procedures described in the detailed description because it is considered that the operations, steps, and procedures described herein are sufficiently disclosed to permit one of ordinary skill in the art to practice an exemplary embodiment of the present application. Moreover, there are many computers and operating systems which may be used in practicing an exemplary embodiment, and therefore no detailed computer program could be provided which would be applicable to all of these many different systems. Each user of a particular computer should be aware of the language and tools which are most useful for that user's needs and purposes.
Moreover, the method may be embodied in the form of computer-implemented processes and apparatuses for practicing those processes. The above may also be embodied in the form of computer program code containing instructions embodied in tangible media, such as floppy diskettes, CD-ROMs, hard drives, or any other computer-readable storage medium, wherein, when the computer program code is loaded into and executed by a computer, the computer becomes an apparatus for practicing the invention. Existing systems having reprogrammable storage (e.g., flash memory) can be updated to implement the invention. The above can also be embodied in the form of computer program code, for example, whether stored in a storage medium, loaded into and/or executed by a computer, or transmitted over some transmission medium, such as over electrical wiring or cabling, through fiber optics, or via electromagnetic radiation, wherein, when the computer program code is loaded into and executed by a computer, the computer becomes an apparatus for practicing the invention. When implemented on a general-purpose microprocessor, the computer program code segments may configure the microprocessor to create specific logic circuits in whole or in part.
Both the fluid and vent layers and adapter interface were fabricated from pDCPD, a rigid, transparent polymer developed by Materia Incorporated. This polymer has good machining properties, allowing rapid prototyping of intricate chip designs by CNC, including minute chamfers to remove sharp burrs from channels and valve seats.
The gasket layer must be both strong (for reliable valve operation) and gas-permeable (for rapid evaporation of H2O and CH3CN). Numerous materials were evaluated and good results were obtained with a layered composite of 25-30 μm of polydimethylsiloxane (PDMS, Dow-Corning Sylgard® 184) on top of 15-20 μm of an optimized perfluoropolyether (Liquidia Technologies FluoroCur™), each cured separately after spin-coating. The PDMS is very permeable and provides strength; the FluoroCur™ is less permeable but protects PDMS against attack by F-18.
Extensive experiments confirmed resistance to solvents, stability above 140° C. (peak temperature of reactions and evaporations), and compatibility with reactions. Less than 3% adsorption of F-18 (ion, intermediates, or product) onto pDCPD and less than 1% onto FluoroCur™ was measured.
To connect to the external (macroscopic) fluid handling system, the chip is installed on a plastic fluidic adapter manifold (
The gap between macrofluidic and microfluidic volumes is bridged by a novel mechanism utilizing the on-chip valves and portions of the microfluidic inlet channels to allow rapid automatic priming of reagent lines up to the reactor (
Temperature Control: An insulated metal heat transfer rod is inserted into the bottom of the microfluidic chip, the tip of the rod sitting only about 0.5 mm below the reactor, to provide localized heating (
Vacuum system: The two ends of the channel in the upper layer of the microfluidic chip are connected to a single-stage vacuum pump (KNF MPU953) and a pressure supply, each controlled by a 2-way valve. A charcoal trap in the vacuum line collects liquid and can be mounted in a dose calibrator to monitor F-18 losses due to formation of volatile compounds during synthesis. An approximate reading of the pressure inside the vent channel is provided by an electronic gauge, allowing occlusions to be detected and evaporation progress to be monitored.
Fluid System The complete fluidic system is shown in
Radiation shielding Integrated shielding is one feature that makes the instruments disclosed herein independent from traditional hot cells and radiopharmacies. In one embodiment, shielding consisted of a box built from 18 interlocking 0.565″-thick lead panels (2000 lb total). In another embodiment, the production instrument can have lead components minimized, shielding only critical components and detectors, thus yielding a lighter and more portable instrument.
For the particular example of 18F-FDG synthesis, the reagents include: (i) MT, mannose triflate in acetonitrile (precursor), (ii) HCl, hydrochloric acid (hydrolysis agent used in deprotection reaction), (iii) K2CO3 solution (elutes F-18 from ion exchange column), (iv) K222, Kryptofix2.2.2 in acetonitrile (to solvate the F-18 in preparation for fluorination reaction), (v) water (used for elution of FDG out of the microfluidic synthesis chip, and dilution of product), (vi) [F-18]fluoride ion in [O-18]H2O (radioactive label).
Synthesis of FDG was carried out according to the following process steps. The many parameters for each step (temperatures, heating times, flow times, etc.) can easily be adjusted to optimize the process.
1) F-18 concentration. Dilute F-18 is delivered from the cyclotron in 1.8 mL of [O-18]H2O to the F-18 vial, then is flowed through an AG 1-X8 resin exchange column to trap F-18. Concentration by a factor of about 350× is achieved by eluting with 5 μL of 0.5M K2CO3 directly into the microreactor through the F-18 inlet. By eluting with several plugs of 1-2 μL volume separated by nitrogen, 79% of F-18 could be transferred. To achieve a low-volume fluid pathway between the K2CO3 vial and the chip, small diameter tubing and a rotary injection valve with minimized internal volume (Rheodyne 9910-000) were used.
2) Phase transfer. Water is evaporated by closing all on-chip valves and heating the reactor to 105° C. with the vacuum on. Next, the reactor is filled with Kryptofix 222 (K222, 50 mg/mL in CH3CN) to solvate F-18 in the organic phase. Next, the reactor is closed and heated to about 105° C. to evaporate solvent. Note that all filling steps involve priming of the reagent line and opening of the on-chip valve while the reagent vial is pressurized. Typically, >10% of the reactor is left empty because the remaining gas bubble is a convenient monitor of evaporation progress.
3) Fluorination reaction. The precursor mannose triflate (25 mg/mL in CH3CN) is then introduced into the reactor where it mixes with F-18/K222 and is reacted at 105° C. to form the intermediate fluoro-1,3,4,6-tetra-O-acetyl-D-glucose (FTAG). Heating continues until about 65% of the solvent has evaporated.
4) Deprotection reaction. 1 M HCl is then added to the reactor to deprotect the FTAG and yield FDG. After filling the reactor, the contents are heated to 105° C. for 10 min. As in other steps, HCl is introduced while there is still CH3CN from the previous step left in the reactor in order to facilitate improved dissolution and mixing.
5) Elute product from reactor. The FDG inside the reactor is eluted with 10-15 mL water into a collection vial, optionally passing through a purification column.
After synthesis, all lines can be washed and dried to avoid cross-contamination on subsequent runs or to avoid dripping on the O-ring interface when chips are exchanged.
Using similar microfluidic technology we have also demonstrated the synthesis of 2-(1,1-dicyanopropen-2-yl)-6-(2-[18F]fluoroethyl)-methylamino)-naphthalene ([F-18]FDDNP) and 3′-[18F]fluoro-3′-deoxy-L-thymidine ([F-18]FLT).
As exemplified in
For a process utilizing a carbon-11-labeling agent (e.g., methyl iodide, methyl triflate, carbon monoxide, hydrogen cyanide), any of the following steps can be performed within a microfluidic device:
a) Receive [11C]-labeling agent from the cyclotron target or post-irradiation processor
b) Generate a solution of reactive [11C]-labeling agent in an organic and/or polar aprotic solvent (acetonitrile, DMF, DMSO, etc.)
c) Provide a solution of a reactive precursor in an organic and/or polar aprotic solvent (acetonitrile, DMF, DMSO, etc.)
d) React the [11C]-labeling agent with the precursor using a SN2 nucleophilic substitution reaction or other suitable reaction to create a new carbon-nitrogen, carbon-oxygen, carbon-sulfur or carbon-carbon bond, using heat or microwave energy if necessary
e) Purify the initial [11C]-labeled product by, for example, solid phase extraction or chromatography
f) React the purified initial [11C]-labeled product with a second reagent to generate the final [11C]-labeled product (e.g., hydrolysis of protecting group(s), if necessary)
g) Purify the final [11C]-labeled product by solid phase extraction or chromatography
h) Remove solvents from the [11C]-labeled product
i) Deliver the final [11C]-labeled product to a final product vial.
All references cited herein are incorporated by reference as if each had been individually incorporated by reference in its entirety. In describing embodiments of the present application, specific terminology is employed for the sake of clarity. However, the invention is not intended to be limited to the specific terminology so selected. Nothing in this specification should be considered as limiting the scope of the present invention. All examples presented are representative and non-limiting. The above-described embodiments may be modified or varied, without departing from the invention, as appreciated by those skilled in the art in light of the above teachings. It is therefore to be understood that, within the scope of the claims and their equivalents, the invention may be practiced otherwise than as specifically described.
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Heat butter in large frying pan.
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Stir in tomato paste and cook 1 minute over medium heat.
Pour mixture into large ovenproof dish.
Top with parsley and cheese.
Broil in oven until golden brown.


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Dangers of Rodent Bait
Anticoagulant rodenticides can come in many forms from liquid, to pellets, to blocks. They are made to be palatable, thus the increase in risk to pets. Unfortunately, signs of sickness begin days ...View Article
Puppy Plan
Congratulations on the recent adoption of a new member to your family. Just as human babies need frequent exams, vaccinations and care, so does your puppy. Our puppy plan has been created to give your puppy the best in medical care during his/her time of growing and developing. We will be able to point out changes in development, both normal and abnormal, properly administer the needed vaccinations, offer tips on house training and other puppy behavior issues, nutrition recommendations and advice on many other areas that may be of concern or interest to you. Good medical care and pertinent information during the formative months of your pet's life will help ensure a better quality life for your pet.


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Why are the bamboo posts always on top of page
At least that's how it shows up on mine. In the other forums, the most recently posted/responded posts are on the first page, Just curious.
Hey I was wondering this very same question Bill. Maybe they have invisible posts that we can't see? it makes no sense to me either.
ps I thought you'd be interested in this: I have been giving away my home grown tomatoes to my neighbors for Christmas!! I still have many, many more...so I'm busy making salsa and slicing some to eat,etc...and the rest I will freeze for cooking.
Hello Bill and Beca,
Thinking you might be as tired of those bamboo posts on top also I have tried a theory of how to get them down and on their way into oblivion. I think that the reason they stay on top is because they have never been responded to. Imagine posting a thread on a busy day (not likely on our forum) and then having it disappear off the front page before anyone gets around to replying. In order to keep this from happening they stick around on top until they are responded too. At least this is what I think. Usually you bump a post to bring it to the top but I just bumped these to get them off the top. If that is really how it works than this post should be on top because it is posted minutes after the others were bumped.
Beca stop talking about your tomatoes:) I'm afraid to go into my greenhouse and see all the damage on my plants after all my water storage and heating pad ideas just weren't enough. Well I have two spindly things in the house, maybe I'll try potting them up in something bigger and bringing them out in the morning and in at night. Some of us will do anything for a decent tomato in the winter, and we don't have fifty pounds sitting around in boxes, baskets and every other container we can find waiting to ripen.
You're a genius. Well compared to me, that is - for what it's worth LOL. I just looked at this forum, and noticed the bamboo posts dropped back down a notch. Yay! Now we need more posts to prove to whoever that this forum is a keeper.
Well Galllie (trying to sound like Gomer Pyle here)Maria.......
I will "try" to not talk about my tomatoes (much anyway)....LOL.
Let's hope this post moves on down...I didn't think this would do it either. The things we still learn how to do. Love it.


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Pro Cycling
Giro d'Italia (Tour of Italy): 10 Riders to Watch
Roman Kreuziger (Czech Republic, Astana)
2 / 10
The 24-year-old Kreuziger is one of cycling's big up-and-coming young riders. After replacing Alberto Contador as leader of the Astana team in 2011, Kreuziger hopes to get his first podium finish in a Grand Tour at this year's Giro. He has the legs to do it too.


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June 8, 2010 Communication & Media Department 1 Hawk Drive Coykendall Science Building, Room 51 New Paltz, NY 12561 845-658-8069 firstname.lastname@example.com A Blogger in the Midst Teaching Note Purpose This teaching note is designed to accompany the Halley Suitt's case study "A Blogger in the Midst" published in the Harvard Business Review. This case was designed to discuss how executives should respond to social media. Specifically, this case follows Will Somerset, the CEO of Lancaster-Webb Medical Supply, a manufacturer of disposable gloves and other medical products, as he finds out that one his employees is a widely known blogger known as GloveGirl. Teaching Objectives 1) Students will understand the reality of social media and its effect on current business practices. 2) Students will be able to identify possible directions a CEO can take when confronted with employee use of social media that influences the organization. 3) Students will analyze how uncontrolled external communication can positively and negatively impact an organization. 4) Students will explore the importance of monitoring social media related to one's organization. Summary Will Somerset, the CEO of Lancaster-Webb Medical Supply, a manufacturer of disposable gloves and other medical products, is about to launch a new line of medical gloves. As he prepares to deliver his big unveiling no one is showing up to his presentation. He quickly finds out that he is being upstaged by GloveGirl, an internet sensation blogger in the medical glove community. Furthermore, GloveGirl is actually one of his employees. The case follows Will as he attempts to wrap his head around blogging and how GloveGirl has actually increased his organization's sales. However, GloveGirl doesn't Jason S. Wrench, Assistant Professor, SUNY New Paltz, firstname.lastname@example.com. A Blotter in the Midst – Teaching Note 6/08/10 always get information correct on her blog. Admittedly, GloveGirl has no problem updating and correcting information, but how does one manage or handle someone within an organization that has gone rogue? Will is ultimately left trying to make a decision for how to proceed with GloveGirl. Case Analysis Within this case there are two basic issues that can be dealt with within a classroom context: social media and external communication. Social Media. This case involves a CEO coming to terms with how social media is impacting his organization. Unbeknownst to Will Somerset social media has had a strong impact on his organization's profitability. However, Will's organization has not authorized or had overseeing ability of the blogger in question. While Will has been unaware of how social media is impacting his organization, organizations need to seriously address the use of social media both by its employees and by the organization itself. At a basic level, organizations need to adopt social media policies to prevent proprietary information from being leaked to the public. As people have started to communicate their every move and life situation, creating policies that limit how people communicate what happens in their workplace has become a necessity. As such, one of the first things that Lancaster-Webb Medical Supply must do is determine what its policy on social media will be. Only after the organization has created a specific policy related to social media can it really make a decision on how to handle GloveGirl. Second, Lancaster-Webb Medical Supply needs to determine how it wants to use social media to promote its organization. In a study conducted by Cone, they found that 93% of Americans expect companies to have a presence in social media (Cone Consumer New Media Study, 2009). Furthermore, 85% of Americans say companies should interact with consumers via social media. Lastly, two-thirds of households making $75K or more feel a stronger connection to brands they interact with online. Because the general public is utilizing social media and desires to interact with its favorite organizations through social media, all organizations need to develop a crystal plan for utilizing and implementing social media. Ultimately, this case is about what the CEO of Lancaster-Webb Medical should do about GloveGirl. Unfortunately, there really is no easy solution to handling Glove Girl. On one hand, one of the reasons people trust and respect GloveGirl is that she is an independent voice blogging online. While some people see her as a corporate mouth piece of Lancaster-Webb Medical, many others do not see the immediate connection. If Lancaster-Webb Medical brought GloveGirl into the corporate structure, she could end up losing the credibility she has an independent voice. External Communication. Traditional perspectives on the lines between organization and the external environment held that the two constructs were easily differentiated. As technology has advanced, the lines between internal and external have disappeared in some contexts because the flow information has become less 2 A Blotter in the Midst – Teaching Note 6/08/10 filtered by gatekeepers. Now, one employee can have a social media posting read by more people than an organization's latest advertising campaign. In many respects, the rise of social media has actually enabled a more democratic approach to external communication because a variety of voices can now be heard. However, organizations must control their external image. In essence, Grunig and Hunt's (1984) Typology of Public Relations (e.g., Press Agentry/Publicity, Public Information, Two-Way Asymmetric, and Two-Way Symmetric) because historically external communication has been viewed as an activity of the organization and not by numerous members within the organization itself. Theoretical Extension One possible theoretical extension for this case study is social presence theory. Short, Williams, and Christie's (1976) social presence theory classifies different communication media along a continuum of social presence, where the degree of social presence is equated to the degree of awareness of the other person in the mediated interaction. According to social presence theory, communication is effective if the communication medium has the appropriate social presence required for the level of interpersonal involvement required for a task. One can argue that the effectiveness of a blog is directly related to not only the content contained within the blog but to the extent the blog writer interjects his or herself into the blog itself. In the case of GloveGirl, she not only writes about the products she's promoting and analyzing, but she also throws in tidbits about her own life. Whether GloveGirl realizes it or not, the personal information is what ultimately keeps her readers coming back to her blog because people become aware of her as a real person in the mediated environment. Teaching Plan (60 minute Class) 5-10 minutes Go over the basic parts of the "A Blogger in the Midst". 10 minutes Discuss the nature of the case and how organizational communication content and theory can be applied to the case. 10 minutes Propose possible decision alternatives for the CEO. 10 minutes Discuss what criteria should be utilized when selecting the best alternative presented. 10 minutes Apply the criteria selected to the possible decision alternatives. 5-10 minutes Select the best decision. 5-10 minutes Come up with a clear plan of action. 5 minutes Case wrap-up. 3 A Blotter in the Midst – Teaching Note 6/08/10 NOTE: Depending on the nature of your class, you may not get through the entire case in one sitting, which is perfectly normal. References Cone New Media Consumer Study. (2009). Retrieved from http://www.coneinc.com/consumer-new-media-study Gruning, J. E., & Hunt, T. (1984). Managing public relations. New York, NY: Holt, Rinehart, & Winston. Short, J., Williams, E., & Christie, B. (1976). The social psychology of telecommunications. London, England: John Wiley. Suitt, H. (2003). A blogger in their midst. Harvard Business Review, 81(9), 30-40. Recommended Readings Ellet, W. (2007). The case study handbook: How to read, discuss, and write persuasively about cases. Cambridge, MA: Harvard Business School Press. McAfee, A. (2009). Enterprise 2.0: New collaborative tools for your organization's toughest challenges. Cambridge, MA: Harvard Business School Press. Safko, L., & Brake, D. K. (2009). The social media bible: Tactics, tools, and strategies for business success. Hoboken, NJ: John Wiley and Sons. 4
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Been in San Francisco 9 years working in Finance. Grew up in Southern California and went to college down there. Live in the city and love the bay area... Have had a great time in San Francisco over the past 9 years.
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When President Obama stated that he couldn't guarantee that Social Security checks would go out if Republicans force the government into default, those Republicans said they would and accused him of scaring seniors. Neither side has explained why payments would or would not go out. Here's the scoop.
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I find it helps immensely to think of your goal in three parts. There is the ideal goal — if everything went right and there were no snafus, this is what you would want done by a certain date. Then there is your plan B, where you pare down your list to the essentials. To make a plan C, pick just one thing that if you got done would still make you feel somewhat accomplished.
They did it: Sherry and John started their blog Young House Love while they were fixing up their first home, and it became a wildly popular and award-winning site that attracts many visitors each day. Realistically, most of us won't become the next Young House Love, but starting a blog can still be a worthwhile project and documentation of your home progress.
Try keeping a list of simple tasks that you can do anytime. Then, when you start feeling antsy, pull out your list and get to work. Cleaning, organizing, decluttering and doing small repairs are all good places to start.
See how to survive a kitchen remodel
... and know when to get out of town. Of course there are times when it's best to admit it's time for a break. When the entire house in in utter disarray, taking a spontaneous weekend getaway can be just what the doctor ordered.
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Lonely Planet, 2004 - Travel - 328 pages
Features comprehensive coverage of the island's attractions, from the nightclubs and bars of Rejkyavik to the rugged wilderness of the interior. Includes extensive information on the many activities on offer, from snowboarding across glaciers to whale watching in the Atlantic.
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The Lonely Planet books are essential for me when travelling. I just which that they'd cross reference maps and text better (giving a page on the map, and the map reference on the page) Read full review
Review: Iceland (Lonely Planet Country Guide)User Review - Scoats - Goodreads
A good guide to this small country. Read full review


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CeBIT Open Source 2010 in PicturesMar 08, 2010
From March 2-6 CeBIT Open Source 2010 called open source projects, enterprises, and organizations to Hannover, Germany. Here's our photo gallery from the talks in the Open Source forum, the project lounge, and the Linux New Media awards.more »
NetSecL 2.6 with QEMUMar 01, 2010
NetSecL, a Slackware-based Linux distro with a special eye to security, is now available in version 2.6.more »
SEP Open Sources Its Server CodeFeb 25, 2010
Backup specialist SEP is providing additional parts of its data security software under GPL, including disclosing the SEP file backup format.more »
Chuck Norris Botnet Affects Linux RoutersFeb 23, 2010
Researchers at the University of Masaryk in Brno, Czech Republic, have detected a botnet that can hit Linux routers and DSL modems.more »
PC-BSD 8.0 with KDE 4.3.5Feb 23, 2010
PC-BSD, the FreeBSD-based free desktop platform, is available in version 8.0.more »
Twitter and Co. to Protect Ubuntu Users with Update AlertsFeb 19, 2010
A new alert system should warn Ubuntu users via micro-blogging about potentially harmful updates.more »
NagAconda: Python Instead of Perl for Nagios PluginsFeb 18, 2010
The NagAconda Python tool helps when writing plugins for the Nagios monitoring tool and is available in its first open release.more »
Video: Andrew Tanenbaum on Bugs and Minix' Reincarnation ServerFeb 16, 2010
Linux Pro Magazine met the author of numerous standard works in informatics and the most famous Linux critic at the Fosdem in Brussels.more »
Issue 174/2015
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Microsoft Frees Code for .NET Build Engine
MSBuild is now just another GitHub project as Redmond continues its path to the light.
Researchers Demonstrate Hack by Heat
Malware could pass data and commands between disconnected computers without leaving a trace on the network.
Kernel Developers Adopt Code of Conflict
New rules emphasize collegiality in coding.
Ubuntu Switches to systemd
Upstart lands in the dust bin as a new era begins for Linux.
Old Vulnerabilities Are Kept Alive Through Bad Configuration
HP's annual Cyber Risk report offers a bleak look at the state of IT.
Linus Torvalds Announces Linux 4.0
But what do the big numbers really mean?
Microsoft Frees CoreCLR
.NET Core execution engine is the basis for cross-platform .NET implementations.
New Trojan Attacks Linux Servers
The Xnote trojan hides itself on the target system and will launch a variety of attacks on command.
Cisco Releases Annual Security Report
Spammers go low-volume, and 90% of IE browsers are unpatched.
Zero Day Exploits Target Flash
Adobe scrambles to release patches for vulnerable Flash Player.


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A former town of Kinnickinnic man pleaded guilty to felony possession of child pornography and child sexual assault charges last Friday.
Craig F. Ahlman, 42, currently living in Minnetonka, Minn., entered a deferred judgment agreement Dec. 11 on first-degree child sex assault charge. Judge Eric J. Lundell ordered a pre-sentence investigation on the possession of child pornography charge and will set a sentencing hearing when the results are complete.


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Everything tagged
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Cyberattack hits Rockwood
Aug. 19, 2014 in City on Page A1 Hospital operator Community Health Systems said a cyberattack took information on 4.5 million patients from its computer network earlier this year. The theft includes information from CHS' Rockwood Health System … 47
Former Deaconess CEO Jeff Nelson found dead
Oct. 25, 2013 in Business, City, Health Jeff A. Nelson, an executive brought in to attempt a financial turnaround of Deaconess Medical Center nine years ago, was found dead Tuesday of a gunshot wound at his home … 11
Former Rockwood CFO suing clinic
March 7, 2012 in City on Page A5 Rockwood Clinic's former chief financial officer has filed a whistleblower complaint accusing the large medical practice of attempting to force him into filing misleading financial reports. When Gregg Becker refused, … 4
Sacred Heart growth OK'd
May 18, 2010 in City on Page A5 Washington state hospital regulators have approved a $54 million expansion plan for Providence Sacred Heart Medical Center. The decision allows the addition of 75 patient beds. When the expansion is …
Sacred Heart expansion OK'd
May 17, 2010 in City Washington state hospital regulators have approved a $54 million expansion plan for Providence Sacred Heart Medical Center. The decision allows the addition of 75 patient beds. 1
Deaconess, INHS temper latest clash
Jan. 16, 2010 in City on Page B1 Deaconess Medical Center and Inland Northwest Health Services have stepped back from a dispute over unpaid bills and financial records that threatened to disrupt the hospital's use of electronic medical …
Local economy didn't escape the downturn
Dec. 27, 2009 in Business on Page E1 The economy cast a long shadow over everything in 2009. The recession and efforts at recovery set the scene for top business news in the Inland Northwest, from the shaky …


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Lance Franklin was knocked out after colliding with teammate Gary Rohan in the first term of their pre-season win over Greater Western ...
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Fremantle enjoyed a three-goal win over the Demons in ideal footy conditions at Fremantle Oval.
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NAB Challenge: Sydney Swans v GWS Giants
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This weekend has been very sad as more details of the elementary school shooting have been released. I feel so terrible for the parents of all of the victims. But reading through the news this evening, I encountered further disturbing stories of someone calling a church in Newtown, CT and threatening to come in the building and shoot everyone. In Indiana some man threatened to burn his wife alive and then go to the local elementary school and shoot everyone. On FB I read a posting from someone who said that her son was playing Xbox, and some man told him that he was going to go come to his classroom and kill everyone tomorrow. What is this world coming to? Empty threats or not, I find all of this very disturbing. WTH is wrong with people?
WTH is wrong with people? *trigger*
Posted 12/17/2012
Have you noticed Facebook making more memorials for the victims instead of showing the bad guy and giving him/her attention? I think people do the horrible things they do these days for exactly that... the attention. Its not in a good way like 99% of people want to be recognized but its attention. Their 15 minutes of fame. Instead of seeking help from friends or family or doctors they go off the deep end and resort to killing. 60 minutes last night did a whole show on the shooter. The news needs to stop putting the bad guys in the spotlight and recognize the teachers and students instead. Also gun control laws won't do jack crap. Criminals are not law abiding citizens. They are criminals! If they played by the rules they wouldn't exist. I'm thinking about getting a license to carry. Not to go shoot up the local schools and neighborhoods but to protect my family. I happen to not live in a very safe neighborhood. They started excepting hud housing and well. We live in a rich town... so now that we except hud housing the gang members are moving in. Not all of them are horrible though. My neighbors gets free/reduced housing and they are very nice family oriented people. But the townhomes next to my building have 2 sets of drug dealers and gang members.... guess which two are the biggest rivals of the neighborhood. You guessed it! They pull guns on each other and their girlfriend whatever you want to call them in the parking lot. Its not safe to be out after dark. I hate walking from the lot to my building. One day I was outside with my neighbor and a dealer comes out the house stops a random old guy in his car and tells him if he doesn't give him all of his money he will blow up the car! I looked at Alex grabbed his phone and we ran.
But no matter what bad guys seek attention. The teachers. Or all teachers now should be thought to use guns and have one in the class room just I case something like this happens again. Many children could have been saved. I think Switzerland has the every 1 in 2 people carry a gun. They have the lowest crime rate.
But no matter what bad guys seek attention. The teachers. Or all teachers now should be thought to use guns and have one in the class room just I case something like this happens again. Many children could have been saved. I think Switzerland has the every 1 in 2 people carry a gun. They have the lowest crime rate.
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Your growing child
Your 23-month-old: Week 1
By 23 months, your child can probably hum and sing and make three-word sentences like "Bird fly high." Read More
Your 23-month-old: Week 2
If it seems like your little one's growth has slowed down dramatically compared with her first year, you're right. Read More
Your 23-month-old: Week 3
The approaching second birthday is a good time to rethink your child's safety. Read More
Your 23-month-old: Week 4
Nothing says "she's not so little anymore" like watching your child pedal around on a tricycle or a bicycle. Read More


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