Rapid prototyping Lab-on-Chip devices for the future: A numerical optimisation of bulk optical parameters in microfluidic systems

Nuclear reactor process control is typically monitored for pure β-emitting radionuclides via manual sampling followed by laboratory analysis, leading to delays in data availability and response times. The development of an in situ microfluidic Lab on Chip (LoC) system with integrated detection capable of measuring pure β-emitting radionuclides presents a promising solution, enabling a reduction in occupational exposure and cost of monitoring whilst providing improved temporal resolution through near real-time data acquisition. However, testing prototypes with radioactive sources is time-consuming, requires specialist facilities/equipment, generates contaminated waste, and cannot rapidly evaluate a wide range of designs or configurations. Despite this, modelling multiple design parameters and testing their impact on detection with non-radioactive substitutes has yet to be adopted as best practice. The measurement of pure β emitters in aqueous media relies on the efficient transport of photons generated by the Cherenkov effect or liquid scintillators to the detector. Here we explore the role of numerical modelling to assess the impact of optical cell geometry and design on photon transmission and detection through the microfluidic system, facilitating improved designs to realise better efficiency of integrated detectors and overall platform design. Our results demonstrate that theoretical modelling and an experimental evaluation using non-radiogenic chemiluminescence are viable for system testing design parameters and their impact on photon transport. These approaches enable reduced material consumption and requirement for specialist facilities for handling radioactive materials during the prototyping process. This method establishes proof of concept and the first step towards numerical modelling approaches for the design optimisation of microfluidic LoC systems with integrated detectors for the measurement of pure β emitting radionuclides via scintillation-based detection

Lab-on-chip for in situ analysis of nutrients in the deep sea

Microfluidic reagent-based nutrient sensors offer a promising technology to address the global undersampling of ocean chemistry but have so far not been shown to operate in the deep sea (>200 m). We report a new family of miniaturized lab-on-chip (LOC) colorimetric analyzers making in situ nitrate and phosphate measurements from the surface ocean to the deep sea (>4800 m). This new technology gives users a new low-cost, high-performance tool for measuring chemistry in hyperbaric environments. Using a combination of laboratory verification and field-based tests, we demonstrate that the analyzers are capable of in situ measurements during profiling that are comparable to laboratory-based analyses. The sensors feature a novel and efficient inertial-flow mixer that increases the mixing efficiency and reduces the back pressure and flushing time compared to a previously used serpentine mixing channel. Four separate replicate units of the nitrate and phosphate sensor were calibrated in the laboratory and showed an average limit of detection of 0.03 μM for nitrate and 0.016 μM for phosphate. Three on-chip optical absorption cell lengths provide a large linear range (to >750 μM (10.5 mg/L-N) for nitrate and >15 μM (0.47 mg/L-P) for phosphate), making the instruments suitable for typical concentrations in both ocean and freshwater aquatic environments. The LOC systems automatically collected a series of deep-sea nitrate and phosphate profiles in the northeast Atlantic while attached to a conductivity temperature depth (CTD) rosette, and the LOC nitrate sensor was attached to a PROVOR profiling float to conduct automated nitrate profiles in the Mediterranean Sea

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

A Lab-on-Chip analyzer for in situ measurement of soluble reactive phosphate: improved phosphate blue assay and application to fluvial monitoring

Here, we present a new in situ microfluidic phosphate sensor that features an improved “phosphate blue” assay which includes polyvinylpyrrolidone in place of traditional surfactants—improving sensitivity and reducing temperature effects. The sensor features greater power economy and analytical performance relative to commercially available alternatives, with a mean power consumption of 1.8 W, a detection limit of 40 nM, a dynamic range of 0.14–10 μM, and an infield accuracy of 4 ± 4.5%. During field testing, the sensor was continuously deployed for 9 weeks in a chalk stream, revealing complex relations between flow rates and phosphate concentration that suggest changing dominance in phosphate sources. A distinct diel phosphorus signal was observed under low flow conditions, highlighting the ability of the sensor to decouple geochemical and biotic effects on phosphate dynamics in fluvial environments. This paper highlights the importance of high resolution in situ sensors in addressing the current gross under-sampling of aquatic environments

A Lab-On-Chip Phosphate Analyzer for Long-term In Situ Monitoring at Fixed Observatories: Optimization and Performance Evaluation in Estuarine and Oligotrophic Coastal Waters

The development of phosphate sensors suitable for long-term in situdeployments in natural waters, is essential to improve our understanding of the distribution, fluxes, and biogeochemical role of this key nutrient in a changing ocean. Here, we describe the optimization of the molybdenum blue method for in situ work using a lab-on-chip (LOC) analyzer and evaluate its performance in the laboratory and at two contrasting field sites. The in situ performance of the LOC sensor is evaluated using hourly time-series data from a 56-day trial in Southampton Water (UK), as well as a month-long deployment in the subtropical oligotrophic waters of Kaneohe Bay (Hawaii, USA). In Kaneohe Bay, where phosphate concentrations were characteristic of the dry season (0.13 ± 0.03 μM, n = 704), the in situ sensor accuracy was 16 ± 12% and a potential diurnal cycle in phosphate concentrations was observed. In Southampton Water, the sensor data (1.02 ± 0.40 μM, n = 1,267) were accurate to ±0.10 μM relative to discrete reference samples. Hourly in situ monitoring revealed striking tidal and storm derived fluctuations in phosphate concentrations in Southampton Water that would not have been captured via discrete sampling. We show the impact of storms on phosphate concentrations in Southampton Water is modulated by the spring-neap tidal cycle and that the 10-fold decline in phosphate concentrations observed during the later stages of the deployment was consistent with the timing of a spring phytoplankton bloom in the English Channel. Under controlled laboratory conditions in a 250 L tank, the sensor demonstrated an accuracy and precision better than 10% irrespective of the salinity (0–30), turbidity (0–100 NTU), colored dissolved organic matter (CDOM) concentration (0–10 mg/L), and temperature (5–20°C) of the water (0.3–13 μM phosphate) being analyzed. This work demonstrates that the LOC technology is mature enough to quantify the influence of stochastic events on nutrient budgets and to elucidate the role of phosphate in regulating phytoplankton productivity and community composition in estuarine and coastal regimes

A Lab-on-Chip Analyzer for <i>in Situ</i> Measurement of Soluble Reactive Phosphate: Improved Phosphate Blue Assay and Application to Fluvial Monitoring

Here, we present a new <i>in situ</i> microfluidic phosphate sensor that features an improved “phosphate blue” assay which includes polyvinylpyrrolidone in place of traditional surfactantsimproving sensitivity and reducing temperature effects. The sensor features greater power economy and analytical performance relative to commercially available alternatives, with a mean power consumption of 1.8 W, a detection limit of 40 nM, a dynamic range of 0.14–10 μM, and an infield accuracy of 4 ± 4.5%. During field testing, the sensor was continuously deployed for 9 weeks in a chalk stream, revealing complex relations between flow rates and phosphate concentration that suggest changing dominance in phosphate sources. A distinct diel phosphorus signal was observed under low flow conditions, highlighting the ability of the sensor to decouple geochemical and biotic effects on phosphate dynamics in fluvial environments. This paper highlights the importance of high resolution <i>in situ</i> sensors in addressing the current gross under-sampling of aquatic environments