Nonclassical Crystallization Causes Dendritic and Band-Like Microscale Patterns in Inorganic Precipitates.

The self-organization of complex solids can create patterns extending hierarchically from the atomic to the macroscopic scale. A frequently studied model is the chemical garden system which consists of life-like precipitate shapes. In this study, we examine the thin walls of chemical gardens using microfluidic devices that yield linear Ni(OH)2 precipitate membranes. We observe distinct light-scattering patterns within the compositionally pure membranes, including disorganized spots, dendrites, and parallel bands. The bands are tilted with respect to the membrane axis and their spacing (20-100 µm) increases with increasing flow rates. Scanning electron microscopy reveals that the bands consist of submicron particles embedded in a denser material and these particles are also found in the reactant stream. We propose that dendrites and bands arise from the attachment of solution-borne nanoparticles. The bands are generated by particle-aggregation zones moving upstream along the slowly advancing membrane surface. The speed of the aggregation zones is proportional to the band distance and defines the system's dispersion relation. This speed-wavelength dependence and the flow-opposing motion of the aggregation zones are likely caused by low particle concentrations in the wake of the zones that only slowly recover due to Brownian motion and particle nucleation.

Shape Evolution of Precipitate Membranes in Flow Systems.

Chemical gardens are macroscopic structures that form when a salt seed is submerged in an alkaline solution. Their thin precipitate membranes separate the reactant partners and slow down the approach toward equilibrium. During this stage, a gradual thickening occurs, which is driven by steep cross-membrane gradients and governed by selective ion transport. We study these growth dynamics in microfluidic channels for the case of Ni(OH)2 membranes. Fast flowing reactant solutions create thickening membranes of a nearly constant width along the channel, whereas slow flows produce wedge-shaped structures that fail to grow along their downstream end. The overall dynamics and shapes are caused by the competition of reactant consumption and transport replenishment. They are reproduced quantitatively by a two-variable reaction-diffusion-advection model which provides kinetic insights into the growth of precipitate membranes.

Nitisinone causes acquired tyrosinosis in alkaptonuria.

For over two decades, nitisinone (NTBC) has been successfully used to manipulate the tyrosine degradation pathway and save the lives of many children with hereditary tyrosinaemia type 1. More recently, NTBC has been used to halt homogentisic acid accumulation in alkaptonuria (AKU) with evidence suggesting its efficacy as a disease modifying agent. NTBC-induced hypertyrosinaemia has been associated with cognitive impairment and potentially sight-threatening keratopathy. In the context of a non-lethal condition (ie, AKU), these serious risks call for an evaluation of the wider impact of NTBC on the tyrosine pathway. We hypothesised that NTBC increases the tyrosine pool size and concentrations in tissues. In AKU mice tyrosine concentrations of tissue homogenates were measured before and after treatment with NTBC. In humans, pulse injection with l-[13 C9 ]tyrosine and l-[d8 ]phenylalanine was used along with compartmental modelling to estimate the size of tyrosine pools before and after treatment with NTBC. We found that NTBC increased tyrosine concentrations in murine tissues by five to nine folds. It also significantly increased the tyrosine pool size in humans (P < .001), suggesting that NTBC increases tyrosine not just in serum but also in tissues (ie, acquired tyrosinosis). This study provides, for the first time, the experimental proof for the magnitude of NTBC-related acquired tyrosinosis which should be overcome to ensure the safe use of NTBC in AKU.

Hydrophobin-Encapsulated Quantum Dots.

The phase transfer of quantum dots to water is an important aspect of preparing nanomaterials that are suitable for biological applications, and although numerous reports describe ligand exchange, very few describe efficient ligand encapsulation techniques. In this report, we not only report a new method of phase transferring quantum dots (QDs) using an amphiphilic protein (hydrophobin) but also describe the advantages of using a biological molecule with available functional groups and their use in imaging cancer cells in vivo and other imaging applications.

Tripodal tris(hydroxypyridinone) ligands for immunoconjugate PET imaging with (89)Zr(4+): comparison with desferrioxamine-B.

Due to its long half-life (78 h) and decay properties (77% electron capture, 23% ß(+), Emax = 897 keV, Eav = 397 keV, Eγ = 909 keV, Iγ = 100%) (89)Zr is an appealing radionuclide for immunoPET imaging with whole IgG antibodies. Derivatives of the siderophore desferrioxamine-B (H3DFO) are the most widely used bifunctional chelators for coordination of (89)Zr(4+) because the radiolabeling of the resulting immunoconjugates is rapid under mild conditions. (89)Zr-DFO complexes are reportedly stable in vitro but there is evidence that (89)Zr(4+) is released in vivo, and subsequently taken up by the skeleton. We have evaluated a novel tripodal tris(hydroxypyridinone) chelator, H3CP256 and its bifunctional maleimide derivative, H3YM103, for coordination of Zr(4+) and compared the NMR spectra, and the (89)Zr(4+) radiolabeling, antibody conjugation, serum stability and in vivo distribution of radiolabelled immunoconjugates with those of H3DFO and its analogues. H3CP256 coordinates (89)Zr(4+) at carrier-free concentrations forming [(89)Zr(CP256)](+). Both H3DFO and H3CP256 were efficiently radiolabelled using [(89)Zr(C2O4)4](4-) at ambient temperature in quantitative yield at pH 6-7 at millimolar concentrations of chelator. Competition experiments demonstrate that (89)Zr(4+) dissociates from [(89)Zr(DFO)](+) in the presence of one equivalent of H3CP256 (relative to H3DFO) at pH 6-7, resulting largely in [(89)Zr(CP256)](+). To assess the stability of H3DFO and H3YM103 immunoconjugates radiolabelled with (89)Zr, maleimide derivatives of the chelators were conjugated to the monoclonal antibody trastuzumab via reduced cysteine side chains. Both immunoconjugates were labelled with (89)Zr(4+) in >98% yield at high specific activities and the labeled immunoconjugates were stable in serum with respect to dissociation of the radiometal. In vivo studies in mice indicate that (89)Zr(4+) dissociates from YM103-trastuzumab with significant amounts of activity becoming associated with bones and joints (25.88 ± 0.58% ID g(-1) 7 days post-injection). In contrast, <8% ID g(-1) of (89)Zr activity becomes associated with bone in animals administered (89)Zr-DFO-trastuzumab over the course of 7 days. The tris(hydroxypyridinone) chelator, H3CP256, coordinates (89)Zr(4+) rapidly under mild conditions, but the (89)Zr-labelled immunoconjugate, (89)Zr-YM103-trastuzumab was observed to release appreciable amounts of (89)Zr(4+)in vivo, demonstrating inferior stability when compared with (89)Zr-DFO-trastuzumab. The significantly lower in vivo stability is likely to be a result of lower kinetic stability of the Zr(4+) tris(hydroxypyridinone complex) relative to that of DFO and its derivatives.

Comparison of (64)Cu-complexing bifunctional chelators for radioimmunoconjugation: labeling efficiency, specific activity, and in vitro/in vivo stability.

High radiolabeling efficiency, preferably to high specific activity, and good stability of the radioimmunoconjugate are essential features for a successful immunoconjugate for imaging or therapy. In this study, the radiolabeling efficiency, in vitro stability, and biodistribution of immunoconjugates with eight different bifunctional chelators labeled with (64)Cu were compared. The anti-CD20 antibody, rituximab, was conjugated to four macrocyclic bifunctional chelators (p-SCN-Bn-DOTA, p-SCN-Bn-Oxo-DO3A, p-SCN-NOTA, and p-SCN-PCTA), three DTPA derivatives (p-SCN-Bn-DTPA, p-SCN-CHX-A″-DTPA, and ITC-2B3M-DTPA), and a macrobicyclic hexamine (sarcophagine) chelator (sar-CO2H) = (1-NH2-8-NHCO(CH2)3CO2H)sar where sar = sarcophagine = 3,6,10,13,16,19-hexaazabicyclo[6.6.6]icosane). Radiolabeling efficiency under various conditions, in vitro stability in serum at 37 °C, and in vivo biodistribution and imaging in normal mice over 48 h were studied. All chelators except sar-CO2H were conjugated to rituximab by thiourea bond formation with an average of 4.9 ± 0.9 chelators per antibody molecule. Sar-CO2H was conjugated to rituximab by amide bond formation with 0.5 chelators per antibody molecule. Efficiencies of (64)Cu radiolabeling were dependent on the concentration of immunoconjugate. Notably, the (64)Cu-NOTA-rituximab conjugate demonstrated the highest radiochemical yield (95%) under very dilute conditions (31 nM NOTA-rituximab conjugate). Similarly, sar-CO-rituximab, containing 1/10th the number of chelators per antibody compared to that of other conjugates, retained high labeling efficiency (98%) at an antibody concentration of 250 nM. In contrast to the radioimmunoconjugates containing DTPA derivatives, which demonstrated poor serum stability, all macrocyclic radioimmunoconjugates were very stable in serum with <6% dissociation of (64)Cu over 48 h. In vivo biodistribution profiles in normal female Balb/C mice were similar for all the macrocyclic radioimmunoconjugates with most of the activity remaining in the blood pool up to 48 h. While all the macrocyclic bifunctional chelators are suitable for molecular imaging using (64)Cu-labeled antibody conjugates, NOTA and sar-CO2H show significant advantages over the others in that they can be radiolabeled rapidly at room temperature, under dilute conditions, resulting in high specific activity.

Preparedness of newly qualified midwives to deliver clinical care: an evaluation of pre-registration midwifery education through an analysis of key events.

OBJECTIVE: this study was part of a larger project commissioned to ascertain whether midwife teachers bring a unique contribution to the preparation of midwives for practice. The aim of this phase was to determine whether the student midwives' educational programme had equipped them to practise competently after entry to the professional register. DESIGN: this was a prospective, longitudinal qualitative study, using participant diaries to collect data. SETTING: data were collected from newly qualified midwives during the initial six months after they commenced their first post as a qualified midwife. PARTICIPANTS: the potential participants were all student midwives who were completing their education at one of six Universities (three in England, one in Scotland, one in Wales and one in Northern Ireland). Diary data were submitted by 35 newly qualified midwives; 28 were graduates of the three year programme and seven of the shortened programme. MEASUREMENTS AND FINDINGS: diary entries were analysed using thematic analysis (Braun and Clarke, 2006), with a focus on identification of key events in the working lives of the newly qualified midwives. A total of 263 key events were identified, under three main themes: (1) impact of the event on confidence, (2) gaps in knowledge or experience and (3) articulated frustration, conflict or distress. KEY CONCLUSIONS: essentially, pre-registration education, delivered largely by midwife teachers and supported by clinical mentors, has been shown to equip newly qualified midwives to work effectively as autonomous practitioners caring for mothers and babies. While newly qualified midwives are able to cope with a range of challenging clinical situations in a safe manner, they lack confidence in key areas. Positive reinforcement by supportive colleagues plays a significant role in enabling them to develop as practitioners. IMPLICATIONS FOR PRACTICE: whilst acknowledging the importance of normality in childbearing there is a need within the curriculum to enable midwives to recognise and respond to complex care situations by providing theory, simulations and practice experience.

Reasons for non-attendance at cervical screening.

Many women are anxious about cervical screening. The receipt of an abnormal result causes high levels of distress. Cervical screening uptake can be improved by the provision of information, sensitive communication and consideration of a woman's health beliefs. This article discusses the barriers that prevent some women from attending cervical screening. By informing nurses of the possible reasons why women do not have cervical smears it is hoped that they will be able to provide women with better health education in this area of practice.

The effect on radiochemical purity of modifications to the method of preparation and dilution of 99mTc-sestamibi.

BACKGROUND: 99mTc-sestamibi is a useful radiopharmaceutical for myocardial perfusion imaging, parathyroid imaging and breast tumour imaging. However, the preparation is time consuming and the limit of 3 ml on the volume of liquid that can be added to the Cardiolite kit vial means that it is often difficult to draw up small doses for patient studies. AIM: To modify the method of preparation of 99mTc-sestamibi in order to reduce the preparation time and to give a preparation which is more convenient for withdrawing patient doses. METHOD: A modified kit was prepared by reconstituting a Cardiolite kit vial with 3 ml Sodium Chloride Injection (0.9%) BP, sub-dividing it into two separate nitrogen-filled vials before adding sodium pertechnetate and boiling for radiolabelling. 99mTc-sestamibi was also prepared according to the manufacturer's recommended method and diluted with sodium chloride injection after preparation. Radiochemical purity was assessed by thin-layer chromatography and high-performance liquid chromatography. RESULTS: 99mTc-sestamibi prepared according to the manufacturer's recommended method had high radiochemical purity (96.9%+/-1.1%) and retained >90% radiochemical purity over 8 h following dilution. However, 99mTc-sestamibi prepared by the modified method gave variable and inconsistent results. CONCLUSION: The modified method of preparation was not robust enough to give reproducibly high radiochemical purity. However, dilution of 99mTc-sestamibi prepared according to the manufacturer's recommended method was satisfactory. This study highlights problems with the analysis of 99mTc-sestamibi and the limitations of modifying the method of preparation.

Conjugation of chelating agents to proteins and radiolabeling with trivalent metallic isotopes.

Peptides and proteins may be tagged with metallic elements in order to use them as imaging reporters or for other applications. The polypeptide of interest is first conjugated to a suitable chelating agent that forms stable complexes with the element of interest. This conjugation step is undertaken either in aqueous or in non-aqueous conditions depending on the solubility of the substrate. For polypeptides of greater than approximately 10 kDa in size, this is normally done in aqueous medium. Most commonly the chelators are reacted with lysine amino groups. The protein is first desalted into a suitable buffer at pH 8-9 and a molar excess of a bifunctional chelating agent is added. After a suitable period of incubation, excess, unreacted or hydrolyzed chelator is removed and the protein conjugate is desalted into an acidic buffer. The conjugate can then be tagged by addition of a suitable metal salt followed, if necessary, by removal of unchelated metal. As described in the protocol that follows, the entire conjugation, purification and labeling procedure takes about 2 d.