The effects of residual energy intake on nutrient use, methane emissions and microbial composition in dairy cows.

For sustainable food production selection and breeding of feed efficient animals is crucial. The objective of this study was to evaluate whether multiparous dairy cows, ranked during their first lactation based on residual energy intake (REI) as efficient (low; L-REI) or inefficient (high; H-REI), differ in terms of nutrient use efficiency, methane emissions, rumen fermentation, and gut microbiota composition. Six L-REI and 6 H-REI cows were offered two diets with either a low or high proportion of concentrates (30 vs. 50% of DM) on two consecutive periods of 21 d. Gas exchanges, milk yield, feces and urine excretions were measured in open-circuit respiratory chambers. The results indicated that L-REI cows had higher methane yields (22.6 vs. 20.4 g/kg DM intake) and derived more energy (energy balance - 36.6 vs. - 16.9 MJ/d) and protein (N balance - 6.6 vs. 18.8 g/d) from the tissues to support similar milk yields compared to H-REI cows. Nutrient intake and digestibility were not affected by REI, and there were no interactions between REI and diet. Milk yield, milk production efficiency, and milk composition were not affected by REI except for milk urea concentration that was higher for L-REI cows (14.1 vs. 10.8 mg/100 ml). The rumen and fecal microbiota community structure and function were associated with both the diet and REI, but the diet effect was more pronounced. The current study identified several physiological mechanisms underlying the differences between high and low REI cows, but further studies are needed to distinguish the quantitative role of each mechanism.

Ion Beam Assisted E-Beam Deposited TiN Microelectrodes-Applied to Neuronal Cell Culture Medium Evaluation.

Microelectrode material and cell culture medium have significant roles in the signal-to-noise ratio and cell well-being in in vitro electrophysiological studies. Here, we report an ion beam assisted e-beam deposition (IBAD) based process as an alternative titanium nitride (TiN) deposition method for sputtering in the fabrication of state-of-the-art TiN microelectrode arrays (MEAs). The effects of evaporation and nitrogen flow rates were evaluated while developing the IBAD TiN deposition process. Moreover, the produced IBAD TiN microelectrodes were characterized by impedance, charge transfer capacity (CTC) and noise measurements for electrical properties, AFM and SEM for topological imaging, and EDS for material composition. The impedance (at 1 kHz) of brand new 30 µm IBAD TiN microelectrodes was found to be double but still below 100 kΩ compared with commercial reference MEAs with sputtered TiN microelectrodes of the same size. On the contrary, the noise level of IBAD TiN MEAs was lower compared with that of commercial sputtered TiN MEAs in equal conditions. In CTC IBAD TiN electrodes (3.3 mC/cm2) also outperformed the sputtered counterparts (2.0 mC/cm2). To verify the suitability of IBAD TiN microelectrodes for cell measurements, human pluripotent stem cell (hPSC)-derived neuronal networks were cultured on IBAD TiN MEAs and commercial sputtered TiN MEAs in two different media: neural differentiation medium (NDM) and BrainPhys (BPH). The effect of cell culture media to hPSC derived neuronal networks was evaluated to gain more stable and more active networks. Higher spontaneous activity levels were measured from the neuronal networks cultured in BPH compared with those in NDM in both MEA types. However, BPH caused more problems in cell survival in long-term cultures by inducing neuronal network retraction and clump formation after 1-2 weeks. In addition, BPH was found to corrode the Si3N4 insulator layer more than NDM medium. The developed IBAD TiN process gives MEA manufacturers more choices to choose which method to use to deposit TiN electrodes and the medium evaluation results remind that not only electrode material but also insulator layer and cell culturing medium have crucial role in successful long term MEA measurements.

The contribution of eHealth in closing gaps in primary health care in selected countries of Latin America and the Caribbean

[ABSTRACT]. Objective. To use a newly developed framework to assess the contribution that eHealth makes to closing gaps in primary health care (PHC) and to providing person-centered, integrated PHC services in Latin America and the Caribbean. Methods. The new assessment model for eHealth-enabled primary health care (ePHC) is called the ePHC Assessment Framework. It is based on the National eHealth Strategy Toolkit developed by the World Health Organization and the International Telecommunications Union in 2012, and the Alberta Health Primary Health Care Evaluation Framework. To validate the ePHC Assessment Framework, a pilot study was conducted in 2017 in four locations: the city of Buenos Aires, Argentina, and the countries of Brazil, Costa Rica, and the Dominican Republic. Results. The ePHC Assessment Framework was successfully used to evaluate the building blocks of a primary health care–oriented approach to eHealth and the eHealth-enabled enhancements for management of chronic conditions needed to improve prevention and management at PHC centers in the studied locations. The study found that Brazil, Costa Rica, and Buenos Aires are clearly engaged in eHealth initiatives as part of the transformation of PHC to provide person-centered, high-quality services. As for the Dominican Republic, there was not enough evidence to verify the contribution of eHealth in improving PHC in the country. Conclusions. It is clear that eHealth helps improve the quality and effectiveness of the prevention and management of chronic conditions at the PHC level. To improve the foundations of ePHC, policymakers should ensure that their national eHealth strategies explicitly identify and establish the opportunities for eHealth to enable an effective PHC system to provide person-centered, integrated, high-quality services.

[RESUMEN]. Objetivo. Usar un marco formulado recientemente para evaluar la contribución de la eSalud al cierre de brechas en la atención primaria de salud (APS) y la prestación de servicios de APS integrados y centrados en la persona en América Latina y el Caribe. Métodos. El nuevo modelo de evaluación de la atención primaria de salud facilitada por la eSalud (APSe) se denomina Marco para la evaluación de la APSe. Se basa en el Conjunto de herramientas para una estrategia de eSalud nacional elaborado por la Organización Mundial de la Salud y la Unión Internacional de Telecomunicaciones en el 2012, y el Marco de evaluación de la atención primaria de salud de Alberta. En el 2017 se realizó un estudio piloto con el fin de validar el Marco para la evaluación de la APSe en cuatro lugares: una ciudad, Buenos Aires (Argentina), y tres países, Brasil, Costa Rica y República Dominicana). Resultados. El Marco para la evaluación de la APSe se usó con éxito para evaluar los elementos fundamentales que deben abordarse al aplicar la eSalud en la atención primaria de salud y las mejoras que se obtienen por medio de la eSalud para el tratamiento de trastornos crónicos, lo que resulta necesario para mejorar la prevención y el tratamiento de enfermedades en los centros de APS de los lugares estudiados. En el estudio se llegó a la conclusión de que Brasil, Costa Rica y Buenos Aires están ejecutando iniciativas de eSalud como parte de las actividades realizadas con el fin de transformar la APS para que se presten servicios de buena calidad centrados en la persona. En cuanto a República Dominicana, no hubo suficientes datos para comprobar la contribución de la eSalud en la mejora de la APS en el país. Conclusiones. Está claro que la eSalud ayuda a mejorar la calidad y la eficacia en la prevención y el tratamiento de trastornos crónicos a nivel de la APS. Para mejorar las bases de la APSe, los responsables de las políticas deben asegurarse de que en sus estrategias nacionales de eSalud se establezcan y se definan explícitamente las oportunidades para la eSalud facilite un sistema eficaz de APS con el fin de prestar servicios integrados, de alta calidad y centrados en la persona.

[RESUMO]. Objetivo. Utilizar uma estrutura recém-desenvolvida para avaliar a contribuição da saúde digital em diminuir a defasagem na atenção primária à saúde (APS) e na prestação de serviços de APS integrados centrados na pessoa na América Latina e no Caribe. Métodos. O novo modelo de avaliação da atenção primária à saúde capacitada com saúde digital (APS digital) é conhecido como estrutura de avaliação da APS digital. Ela está embasada no conjunto de instrumentos da estratégia nacional de saúde digital desenvolvido pela Organização Mundial da Saúde e União Internacional de Telecomunicações em 2012 e na Estrutura de Avaliação da Atenção Primária à Saúde de Alberta. Para validar a estrutura de avaliação da APS digital, um estudo piloto foi realizado em 2017 em quatro países: cidade de Buenos Aires, na Argentina, e no Brasil, Costa Rica e República Dominicana. Resultados. A estrutura de avaliação da APS digital foi usada com bons resultados para avaliar os componentes principais do enfoque de atenção primária à saúde orientado à saúde digital e os aperfeiçoamentos capacitados pela saúde digital na conduta de problemas crônicas necessários para melhorar a prevenção e o controle nas unidades de APS nos locais estudados. Verificou-se que o Brasil, a Costa Rica e a cidade de Buenos Aires estão claramente investindo em iniciativas de saúde digital como parte da transformação da APS para prestar serviços de alta qualidade centrados na pessoa. Em relação à República Dominicana, não havia evidências suficientes para comprovar a contribuição da saúde digital para melhorar a APS no país. Conclusões. É evidente que a saúde digital contribui para melhorar a qualidade e a efetividade da prevenção e controle das doenças crônicas ao nível da APS. A fim de melhorar as bases da APS digital, os responsáveis por políticas devem assegurar que sejam claramente identificadas e estabelecidas as oportunidades para a saúde digital nas estratégias nacionais de saúde digital a fim de capacitar um sistema de APS efetivo a prestar serviços integrados de alta qualidade centrados na pessoa.

The contribution of eHealth in closing gaps in primary health care in selected countries of Latin America and the Caribbean.

OBJECTIVE: To use a newly developed framework to assess the contribution that eHealth makes to closing gaps in primary health care (PHC) and to providing person-centered, integrated PHC services in Latin America and the Caribbean. METHODS: The new assessment model for eHealth-enabled primary health care (ePHC) is called the ePHC Assessment Framework. It is based on the National eHealth Strategy Toolkit developed by the World Health Organization and the International Telecommunications Union in 2012, and the Alberta Health Primary Health Care Evaluation Framework. To validate the ePHC Assessment Framework, a pilot study was conducted in 2017 in four locations: the city of Buenos Aires, Argentina, and the countries of Brazil, Costa Rica, and the Dominican Republic. RESULTS: The ePHC Assessment Framework was successfully used to evaluate the building blocks of a primary health care-oriented approach to eHealth and the eHealth-enabled enhancements for management of chronic conditions needed to improve prevention and management at PHC centers in the studied locations. The study found that Brazil, Costa Rica, and Buenos Aires are clearly engaged in eHealth initiatives as part of the transformation of PHC to provide person-centered, high-quality services. As for the Dominican Republic, there was not enough evidence to verify the contribution of eHealth in improving PHC in the country. CONCLUSIONS: It is clear that eHealth helps improve the quality and effectiveness of the prevention and management of chronic conditions at the PHC level. To improve the foundations of ePHC, policymakers should ensure that their national eHealth strategies explicitly identify and establish the opportunities for eHealth to enable an effective PHC system to provide person-centered, integrated, high-quality services.

The contribution of eHealth in closing gaps in primary health care in selected countries of Latin America and the Caribbean / La contribución de la eSalud al cierre de brechas en la atención primaria de salud en algunos países de América Latina y el Caribe / Contribuição da saúde digital para diminuir a defasagem na atenção primária à saúde em países selecionados da América Latina e Caribe

ABSTRACT Objective To use a newly developed framework to assess the contribution that eHealth makes to closing gaps in primary health care (PHC) and to providing person-centered, integrated PHC services in Latin America and the Caribbean. Methods The new assessment model for eHealth-enabled primary health care (ePHC) is called the ePHC Assessment Framework. It is based on the National eHealth Strategy Toolkit developed by the World Health Organization and the International Telecommunications Union in 2012, and the Alberta Health Primary Health Care Evaluation Framework. To validate the ePHC Assessment Framework, a pilot study was conducted in 2017 in four locations: the city of Buenos Aires, Argentina, and the countries of Brazil, Costa Rica, and the Dominican Republic. Results The ePHC Assessment Framework was successfully used to evaluate the building blocks of a primary health care-oriented approach to eHealth and the eHealth-enabled enhancements for management of chronic conditions needed to improve prevention and management at PHC centers in the studied locations. The study found that Brazil, Costa Rica, and Buenos Aires are clearly engaged in eHealth initiatives as part of the transformation of PHC to provide person-centered, high-quality services. As for the Dominican Republic, there was not enough evidence to verify the contribution of eHealth in improving PHC in the country. Conclusions It is clear that eHealth helps improve the quality and effectiveness of the prevention and management of chronic conditions at the PHC level. To improve the foundations of ePHC, policymakers should ensure that their national eHealth strategies explicitly identify and establish the opportunities for eHealth to enable an effective PHC system to provide person-centered, integrated, high-quality services.

RESUMEN Objetivo Usar un marco formulado recientemente para evaluar la contribución de la eSalud al cierre de brechas en la atención primaria de salud (APS) y la prestación de servicios de APS integrados y centrados en la persona en América Latina y el Caribe. Métodos El nuevo modelo de evaluación de la atención primaria de salud facilitada por la eSalud (APSe) se denomina Marco para la evaluación de la APSe. Se basa en el Conjunto de herramientas para una estrategia de eSalud nacional elaborado por la Organización Mundial de la Salud y la Unión Internacional de Telecomunicaciones en el 2012, y el Marco de evaluación de la atención primaria de salud de Alberta. En el 2017 se realizó un estudio piloto con el fin de validar el Marco para la evaluación de la APSe en cuatro lugares: una ciudad, Buenos Aires (Argentina), y tres países, Brasil, Costa Rica y República Dominicana). Resultados El Marco para la evaluación de la APSe se usó con éxito para evaluar los elementos fundamentales que deben abordarse al aplicar la eSalud en la atención primaria de salud y las mejoras que se obtienen por medio de la eSalud para el tratamiento de trastornos crónicos, lo que resulta necesario para mejorar la prevención y el tratamiento de enfermedades en los centros de APS de los lugares estudiados. En el estudio se llegó a la conclusión de que Brasil, Costa Rica y Buenos Aires están ejecutando iniciativas de eSalud como parte de las actividades realizadas con el fin de transformar la APS para que se presten servicios de buena calidad centrados en la persona. En cuanto a República Dominicana, no hubo suficientes datos para comprobar la contribución de la eSalud en la mejora de la APS en el país. Conclusiones Está claro que la eSalud ayuda a mejorar la calidad y la eficacia en la prevención y el tratamiento de trastornos crónicos a nivel de la APS. Para mejorar las bases de la APSe, los responsables de las políticas deben asegurarse de que en sus estrategias nacionales de eSalud se establezcan y se definan explícitamente las oportunidades para la eSalud facilite un sistema eficaz de APS con el fin de prestar servicios integrados, de alta calidad y centrados en la persona.

RESUMO Objetivo Utilizar uma estrutura recém-desenvolvida para avaliar a contribuição da saúde digital em diminuir a defasagem na atenção primária à saúde (APS) e na prestação de serviços de APS integrados centrados na pessoa na América Latina e no Caribe. Métodos O novo modelo de avaliação da atenção primária à saúde capacitada com saúde digital (APS digital) é conhecido como estrutura de avaliação da APS digital. Ela está embasada no conjunto de instrumentos da estratégia nacional de saúde digital desenvolvido pela Organização Mundial da Saúde e União Internacional de Telecomunicações em 2012 e na Estrutura de Avaliação da Atenção Primária à Saúde de Alberta. Para validar a estrutura de avaliação da APS digital, um estudo piloto foi realizado em 2017 em quatro países: cidade de Buenos Aires, na Argentina, e no Brasil, Costa Rica e República Dominicana. Resultados A estrutura de avaliação da APS digital foi usada com bons resultados para avaliar os componentes principais do enfoque de atenção primária à saúde orientado à saúde digital e os aperfeiçoamentos capacitados pela saúde digital na conduta de problemas crônicas necessários para melhorar a prevenção e o controle nas unidades de APS nos locais estudados. Verificou-se que o Brasil, a Costa Rica e a cidade de Buenos Aires estão claramente investindo em iniciativas de saúde digital como parte da transformação da APS para prestar serviços de alta qualidade centrados na pessoa. Em relação à República Dominicana, não havia evidências suficientes para comprovar a contribuição da saúde digital para melhorar a APS no país. Conclusões É evidente que a saúde digital contribui para melhorar a qualidade e a efetividade da prevenção e controle das doenças crônicas ao nível da APS. A fim de melhorar as bases da APS digital, os responsáveis por políticas devem assegurar que sejam claramente identificadas e estabelecidas as oportunidades para a saúde digital nas estratégias nacionais de saúde digital a fim de capacitar um sistema de APS efetivo a prestar serviços integrados de alta qualidade centrados na pessoa.

Optimised PDMS Tunnel Devices on MEAs Increase the Probability of Detecting Electrical Activity from Human Stem Cell-Derived Neuronal Networks.

Measurement of the activity of human pluripotent stem cell (hPSC)-derived neuronal networks with microelectrode arrays (MEAs) plays an important role in functional in vitro brain modelling and in neurotoxicological screening. The previously reported hPSC-derived neuronal networks do not, however, exhibit repeatable, stable functional network characteristics similar to rodent cortical cultures, making the interpretation of results difficult. In earlier studies, microtunnels have been used both to control and guide cell growth and amplify the axonal signals of rodent neurons. The aim of the current study was to develop tunnel devices that would facilitate signalling and/or signal detection in entire hPSC-derived neuronal networks containing not only axons, but also somata and dendrites. Therefore, MEA-compatible polydimethylsiloxane (PDMS) tunnel devices with 8 different dimensions were created. The hPSC-derived neurons were cultured in the tunnel devices on MEAs, and the spontaneous electrical activity of the networks was measured for 5 weeks. Although the tunnel devices improved the signal-to-noise ratio only by 1.3-fold at best, they significantly increased the percentage of electrodes detecting neuronal activity (52-100%) compared with the controls (27%). Significantly higher spike and burst counts were also obtained using the tunnel devices. Neuronal networks inside the tunnels were amenable to pharmacological manipulation. The results suggest that tunnel devices encompassing the entire neuronal network can increase the measured spontaneous activity in hPSC-derived neuronal networks on MEAs. Therefore, they can increase the efficiency of functional studies of hPSC-derived networks on MEAs.