Direct Measurements of Colloidal Solvophoresis under Imposed Solvent and Solute Gradients

We describe a microfluidic system that enables direct visualization and measurement of diffusiophoretic migration of colloids in response to imposed solution gradients. Such measurements have proven difficult or impossible in macroscopic systems due to difficulties in establishing solution gradients that are sufficiently strong yet hydrodynamically stable. We validate the system with measurements of the concentration-dependent diffusiophoretic mobility of polystyrene colloids in NaCl gradients, confirming that diffusiophoretic migration velocities are proportional to gradients in the logarithm of electrolyte concentration. We then perform the first direct measurement of the concentration-dependent "solvophoretic" mobility of colloids in ethanol-water gradients, whose dependence on concentration and gradient strength was not known either theoretically or experimentally, but which our measurements reveal to be proportional to the gradient in the logarithm of ethanol mole fraction. Finally, we examine solvophoretic migration under a variety of qualitatively distinct chemical gradients, including solvents that are miscible or have finite solubility with water, an electrolyte for which diffusiophoresis proceeds down concentration gradients (unlike for most electrolytes), and a nonelectrolyte (sugar). Our technique enables the direct characterization of diffusiophoretic mobilities of various colloids under various solvent and solute gradients, analogous to the electrophoretic ζ-potential measurements that are routinely used to characterize suspensions. We anticipate that such measurements will provide the feedback required to test and develop theories for solvophoretic and diffusiophoretic migration and ultimately to the conceptual design and engineering of particles that respond in a desired way to their chemical environments

Long-term effect of endothelin receptor antagonism with bosentan on the morbidity and mortality of patients with severe chronic heart failure : primary results of the ENABLE Trials

Objectives: The objective of this clinical trial was to evaluate the long-term effect of endothelin receptor antagonism with bosentan on the morbidity and mortality of patients with severe chronic heart failure. Background: Endothelin may play a role in heart failure, but short-term clinical trials with endothelin receptor antagonists have reported disappointing results. Long-term trials are lacking. Methods: In 2 identical double-blind trials, we randomly assigned 1,613 patients with New York Heart Association functional class IIIb to IV heart failure and an ejection fraction <35% to receive placebo or bosentan (target dose 125 mg twice daily) for a median of 1.5 years. The primary outcome for each trial was clinical status at 9 months (assessed by the hierarchical clinical composite); the primary outcome across the 2 trials was death from any cause or hospitalization for heart failure. Results: Bosentan did not influence clinical status at 9 months in either trial (p = 0.928 and p = 0.263). In addition, 321 patients in the placebo group and 312 patients in the bosentan group died or were hospitalized for heart failure (hazard ratio [HR]: 1.01; 95% confidence interval [CI]: 0.86 to 1.18; p = 0.90). The bosentan group experienced fluid retention within the first 2 to 4 weeks, as evidenced by increased peripheral edema, weight gain, decreases in hemoglobin, and an increased risk of hospitalization for heart failure, despite intensification of background diuretics. During follow-up, 173 patients died in the placebo group and 160 patients died in the bosentan group (HR: 0.94; 95% CI: 0.75 to 1.16). About 10% of the bosentan group showed meaningful increases in hepatic transaminases, but none had acute or chronic liver failure. Conclusions: Bosentan did not improve the clinical course or natural history of patients with severe chronic heart failure and but caused early and important fluid retention