We review the utility of centrifugal microfluidic technologies applied to point-of-care diagnosis in extremely under-resourced environments. The various challenges faced in these settings are showcased, using areas in India and Africa as examples. Measures for the ability of integrated devices to effectively address point-of-care challenges are highlighted, and centrifugal, often termed CD-based microfluidic technologies, technologies are presented as a promising platform to address these challenges. We describe the advantages of centrifugal liquid handling, as well as the ability of a standard CD player to perform a number of common laboratory tests, fulfilling the role of an integrated lab-on-a-CD. Innovative centrifugal approaches for point-of-care in extremely resource-poor settings are highlighted, including sensing and detection strategies, smart power sources and biomimetic inspiration for environmental control. The evolution of centrifugal microfluidics, along with examples of commercial and advanced prototype centrifugal microfluidic systems, is presented, illustrating the success of deployment at the point-of-care. A close fit of emerging centrifugal systems to address a critical panel of tests for under-resourced clinic settings, formulated by medical experts, is demonstrated. This emphasizes the potential of centrifugal microfluidic technologies to be applied effectively to extremely challenging point-of-care scenarios and in playing a role in improving primary care in resource-limited settings across the developing world.

The centrifugal “lab-on-a-disc” concept has proven to have great potential for process integration of bioanalytical assays, in particular where ease-of-use, ruggedness, portability, fast turn-around time and cost efficiency are of paramount importance. Yet, as all liquids residing on the disc are exposed to the same centrifugal field, an inherent challenge of these systems remains the automation of multi-step, multi-liquid sample processing and subsequent detection. In order to orchestrate the underlying bioanalytical protocols, an ample palette of rotationally and externally actuated valving schemes has been developed. While excelling with the level of flow control, externally actuated valves require interaction with peripheral instrumentation, thus compromising the conceptual simplicity of the centrifugal platform. In turn, for rotationally controlled schemes, such as common capillary burst valves, typical manufacturing tolerances tend to limit the number of consecutive laboratory unit operations (LUOs) that can be automated on a single disc. In this paper, a major advancement on recently established dissolvable film (DF) valving is presented; for the very first time, a liquid handling sequence can be controlled in response to completion of preceding liquid transfer event, i.e. completely independent of external stimulus or changes in speed of disc rotation. The basic, event-triggered valve configuration is further adapted to leverage conditional, large-scale process integration. First, we demonstrate a fluidic network on a disc encompassing 10 discrete valving steps including logical relationships such as an AND-conditional as well as serial and parallel flow control. Then we present a disc which is capable of implementing common laboratory unit operations such as metering and selective routing of flows. Finally, as a pilot study, these functions are integrated on a single disc to automate a common, multi-step lab protocol for the extraction of total RNA from mammalian cell homogenate.

Passive flow control techniques, and particularly vortex generators have been used successfully in a broad range of aero- and hydrodynamics applications to alter the characteristics of boundary layer separation. This study aims to review how such techniques can mitigate the extent and impact of cavitation in incompressible flows. This review focuses first on vortex generators to characterize key physical principles. It then considers the complete range of passive flow control technologies, including surface conditioning and roughness, geometry modification, grooves, discharge, injection, obstacles, vortex generators, and bubble generators. The passive flow control techniques reviewed typically delay and suppress boundary layer separation by decreasing the pressure gradient at the separation point. The literature also identifies streamwise vortices that result in the transfer of momentum from the free stream to near-wall low energy flow regions. The area of interest concerns hydraulic machinery, whose performance and life span are particularly susceptible to cavitation. The impact on performance includes a reduction in efficiency and fluctuations in discharge pressure and flow, while cavitation can greatly increase wear of bearings, wearing rings, seals, and impeller surfaces due to excessive vibration and surface erosion. In that context, few studies have also shown the positive effects that passive controls can have on the hydraulic performance of centrifugal pumps, such as total head and efficiency. It is conceivable that a new generation of design in hydraulic systems may be possible if simple design features can be conceived to maximize power transfer and minimize losses and cavitation. There are still, however, significant research gaps in understanding a range of impact factors such as manufacturing processes, lifetime, and durability, and essentially how a static design can be optimized to deliver improved performance over a realistic range of operating conditions.

Synthesis of nanoparticles (NPs) has garnered significant interest due to their wide-ranging applications. Microfluidics offers a superior alternative to traditional NPs synthesis by providing precise control over reaction parameters.

Modern advancements in pharmaceuticals have provided individuals who have been infected with the human immunodeficiency virus (HIV) with the possibility of significantly extending their survival rates. When administered sufficiently soon after infection, antiretroviral therapy (ART) allows medical practitioners to control onset of the symptoms of the associated acquired immune deficiency syndrome (AIDS). Active monitoring of the immune system in both HIV patients and individuals who are regarded as “at-risk” is critical in the decision making process for when to start a patient on ART. A reliable and common method for such monitoring is to observe any decline in the number of CD4 expressing T-helper cells in the blood of a patient. However, the technology, expertise, infrastructure and costs to carry out such a diagnostic cannot be handled by medical services in resource-poor regions where HIV is endemic. Addressing this shortfall, commercialized point-of-care (POC) CD4 cell count systems are now available in such regions. A number of newer devices will also soon be on the market, some the result of recent maturing of charity-funded initiatives. Many of the current and imminent devices are enabled by microfluidic solutions, and this review will critically survey and analyze these POC technologies for CD4 counting, both on-market and near-to-market deployment. Additionally, promising technologies under development that may usher in a new generation of devices will be presented.