Digital Services Landscape in Primary Care Setting in City of Zagreb; an EIP-AHA Reference Site Case Study

European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) brings together partners to create innovative solutions to the challenges of aging. Reference Sites (RS) of the Partnership act as hubs of innovation and assist the scale-up of identified solutions. "Blueprint on Digital Transformation of Health and Care for the Ageing Society" (The Blueprint) is guiding the shift towards ICT enabled patient-centered care. To further inform its development, a tool has been created and piloted across RS, to explore the digital services landscape and find services that address the needs of the personas developed for this tool, that represent the needs of the populations. The aim of this case study was to explore the digital services ecosystem in primary care in Zagreb from the services availability and accessibility perspective, using the personas needs tool. The total of 23 digital services was identified out of which 21 matched at least one persona need. Each service-need match was scored against usefulness and accessibility criteria and the resulting matrix was evaluated using original methods. The results point to several underperforming services and provide insight into possible improvement strategies. Several "workhorse" services were identified that are heavily dependent on the health workforce. The services adopted through EIP on AHA twinning schemes performed well against set criteria. The persona based tool, along with the original service assessment methodology based on the tool's framework provides a new perspective to the digital services landscape, useful for planning the areas for improvement and detecting underperforming services on a system level.

Pediatric reference Raman data for material characteristics of iliac trabecular bone

Bone material characteristics are important contributors in the determination of bone strength. Raman spectroscopic analysis provides information on mineral/matrix ratio, mineral maturity/crystallinity, relative pyridinoline (Pyd) collagen cross-link content, relative proteoglycan content and relative lipid content. However, published reference data are available only for adults. The purpose of the present study was to establish reference data of Raman outcomes pertaining to bone quality in trabecular bone for children and young adults. To this end, tissue age defined Raman microspectroscopic analysis was performed on bone samples from 54 individuals between 1.5 and 23 years with no metabolic bone disease, which have been previously used to establish histomorphometric and bone mineralization density distribution reference values. Four distinct tissue ages, three well defined by the fluorescent double labels representing early stages of bone formation and tissue maturation (days 3, 12, 20 of tissue mineralization) and a fourth representing old mature tissue at the geometrical center of the trabeculae, were analyzed. In general, significant dependencies of the measured parameters on tissue age were found, while at any given tissue age, sex and subject age were not confounders. Specifically, mineral/matrix ratio, mineral maturity/crystallinity index and relative pyridinoline collagen cross-link content index increased by 485%, 20% and 14%, respectively between days 3 and 20. The relative proteoglycan content index was unchanged between days 3 and 20 but was elevated in the old tissue compared to young tissue by 121%. The relative lipid content decreased within days 3 to 20 by -22%. Thus, the method allows not only the monitoring of material characteristics at a specific tissue age but also the kinetics of tissue maturation as well. The established reference Raman database will serve as sensitive tool to diagnose disturbances in material characteristics of pediatric bone biopsy samples.

Simultaneous Raman microspectroscopy and fluorescence imaging of bone mineralization in living zebrafish larvae

Confocal Raman microspectroscopy and fluorescence imaging are two well-established methods providing functional insight into the extracellular matrix and into living cells and tissues, respectively, down to single molecule detection. In living tissues, however, cells and extracellular matrix coexist and interact. To acquire information on this cell-matrix interaction, we developed a technique for colocalized, correlative multispectral tissue analysis by implementing high-sensitivity, wide-field fluorescence imaging on a confocal Raman microscope. As a proof of principle, we study early stages of bone formation in the zebrafish (Danio rerio) larvae because the zebrafish has emerged as a model organism to study vertebrate development. The newly formed bones were stained using a calcium fluorescent marker and the maturation process was imaged and chemically characterized in vivo. Results obtained from early stages of mineral deposition in the zebrafish fin bone unequivocally show the presence of hydrogen phosphate containing mineral phases in addition to the carbonated apatite mineral. The approach developed here opens significant opportunities in molecular imaging of metabolic activities, intracellular sensing, and trafficking as well as in vivo exploration of cell-tissue interfaces under (patho-)physiological conditions.

Chemical imaging of live fibroblasts by SERS effective nanofilm

Label-free Raman imaging of live single NIH3T3 fibroblast produced by SERS effective SiO₂@Ag–PAA nanoshells in real time.

Cortical bone composition and orientation as a function of animal and tissue age in mice by Raman spectroscopy

Important aspects of bone tissue quality include the physicochemical properties of its main constituents, the organic matrix and the mineral crystals. One of the most commonly reported measurements of Raman analysis of bone is the mineral to matrix ratio, obtained from the ratio of the integrated areas of any of the phosphate and amide peaks which depend on both tissue organization and composition. Cube-like samples of normal mouse cortical bone taken from the diaphysis and metaphysis of the femur were investigated within different age groups (2, 4, 8 and 12 weeks) by Raman microspectroscopy. Anatomically identical bone in both longitudinal and transverse directions was analyzed, enabling the discrimination between orientation and composition changes both as a function of animal age, and tissue age within the same animal. The results of the present study indicate that there is a parallel evolution of both orientation and chemical composition as a function of animal age, as well as tissue age within the same specimen. Our tissue age modified ratio of the carbonate to phosphate Raman peaks suggests that the bone mineral crystallite maturity remains relatively constant with animal age. Comparisons of polarized and depolarized experiments in the transversal plane of the diaphysis show a lack of orientation effects as a function of tissue age within the same animal, but exhibit differences as a function of animal age. In the metaphysis, the orientation effect is evident too, albeit less pronounced. This is most likely due to either the age difference between the two tissues within the same specimen in the long bone axis, as metaphyseal bone is generally younger than diaphyseal, or the more random orientation of the tissue collagen itself.