During the last decades, overweight & obesity rates have reached epidemic proportions across EU. Prevalence in childhood is particularly alarming, resulting in psychological impacts & increased risks for NCDs. However, although obesity-related research has provided interesting results, several issues arise due to the lack of meta-reviews & the nature of data collected. To address this, Bio-Streams aims on supporting the optimal use (and re-use) of health data (e.g. biological, demographic, epigenetic, etc.) to generate metadata/knowledge and provide new evidences, methodologies & tools for: a) creating and deploying the Bio-Streams Biobank that will act as a scientific platform for research in obesity and better diagnostic and therapeutic approaches;b) understanding the transition from metabolically healthy to unhealthy, preventing under age obesity; c) designing better strategies to educate & empower young citizens for weight self-management; d) coordinating authorities & policy makers to develop cross-sectoral solutions for health promotion & under age obesity prevention. Specifically, Bio-Streams delivers a dedicated under age obesity biobank providing real-world health data (including biospecimens, anthropometrics, behavioural and cost data) from retrospective and prospective sources, while taking into account efficient data harmonisation and standardisation principles, transforming data valorisation towards under age obesity prevention and future research. Moreover, the Bio-Streams framework for data handling, provides robust and transparent methodologies for operational procedures (data infrastructures), analysis and reporting (via meta-reviews and AI-based Apps/components, evaluated via 12 multi-site pilots (7 clinical and 5 schools)), citizen awareness and lifestyle alteration, delivering obesity prevention guidelines, knowledge generation while fostering considerable opportunities for regional and national health authorities/policymakers.

<< Background >>TO BE PART OF THE CREATION OF A COMMUNITY OF CITIZENS CONTRIBUTING TO A DIGITAL SOCIETY THAT IS SUSTAINABLE, INCLUSIVE, SUPPORTIVE AND RESPECTFUL OF THE ENVIRONMENT.With the check-ups that needed to be organised remotely, the pandemic has shown how important is that each patient takes charge of its own care, as this medical follow-up requires digital tools, leaving a large number of citizens in a difficult situation. In this context, our project, named Pragma-TIC, aims at bridging the digital divide for chronic patients suffering from digital illiteracy by giving the possibility to the frontline caregivers to become their e-health educators. To do this, Pragma-TIC will train the care staff and their patients in an innovative (blended learning) and inclusive way. The aim is to propose a solution, in order to reunite the strengths and resources that will allow each stakeholder to benefit from the work done by the group.This project will be carried out in collaboration with several European countries (Belgium, Latvia, Slovenia and Denmark). Hospitals in European countries need to implement digital support for their patients and frontline caregivers. Pragma-TIC proposes to implement a transnational educational project to address this need which will ultimately improve the health and quality of life of patients and relieve the workload of frontline carers in the long run. Through the support of Europe, Pragma-TIC will open doors that individual members of the Consortium would not have had access to on a national, regional or simply local level. It thus extends the scope and increases the visibility of the project.By responding to the KA220-ADU call, we wish to validate the competences acquired in digital literacy through non-formal certificates delivered by health institutions. Two levels of certifications will be targeted. At the level of the caregiver, the first level concerns the e-educator (involved caregivers) who will find themselves validated as educators and will use those new skills to train other patients. The second level concerns the e-educator + who will be able to train his peers. At the patient level, the first level concerns the e-patients who will find themselves assessed as capable of having a follow-up at home. The second level concerns the e-patients + who will use their new skills to train their fellow patients. The e-educator certificates will be integrated into the professional portfolio of the caregiver and those of the e-patient in patient's medical record.This project aims to meet the needs of the 3 actors of the health sector, which are the Hospital Institutions, the frontline caregivers (field staff) and the patient.HOSPITAL INSTITUTIONSare considerably short of beds, means and resources, while the number of patients is increasing exponentially. Therefore, the continuation of care in the patient's home is absolutely necessary and must be of high quality. FRONTLINE CAREGIVERS Lack the time and the means to educate their patients. Pragma-TIC will allow the patients to be trained in new learning modes, in order to evolve professionally and to be better prepared for any unforeseen circumstance, to feel involved and more valued as caregivers through a non-formal certificate.While they are looking for solutions with their project colleagues, they will be able to share through forums or exchange networks their difficulties and more. They will also create a community of carers on an international scale.The project will support the field staff in their role of therapeutic educators by implementing digital and pedagogical tools shared among peer carers. PATIENTS The chronic patients is isolated at home in the face of new technologies that they do not master.They lack the resources, the contacts, the self-confidence and the support.manage to teach the patients to be resilient by getting control back over their life project and their care (autonomy);- involve them in a learning process<< Objectives >>This project aims to meet the needs of the 3 main actors, i.e. the Hospital Institutions, the frontline caregivers and patients.The implementation of the project aims to overcome the digital divide in an inclusive way in order to access all the resources and benefits that telemonitoring offers in the health care environment. HOSPITAL INSTITUTIONSThis project will contribute to the digital and sustainable transformation of healthcare institutions while promoting savings in terms of human, material and financial resources. It should reduce the overcrowding of hospitals, which has a negative impact on the quality of care.At the same time, we want to collaborate and cooperate across the board and on all levels of competence and decision-making power, in order to facilitate the digital transition in the health sector.FRONTLINE CAREGIVERS In order to provide e-Health training in compliance with the RGPD, our values, and ethics, we want to help field staff to integrate e-Health into their daily work as educators. Therefore, it is imperative to provide them with the opportunity to develop skills through appropriate didactic and pedagogical materials. This will enable them to transfer to the patients in a sustainable way the knowledge and skill necessary to master telemonitoring so that, autonomously, the patients continue to follow their treatment in all circumstances in a secure manner and stay in contact with their care partner. PATIENTS To improve their quality of life through TELEMONITORING. It is imperative to strengthen the ability to LEARN TO TRANSMIT via the BLENDED LEARNING. Other objectives are to enable the patient to:- learn the basic techniques and knowledge (touch screen, keyboard, voice recognition, etc.) needed to use computer systems- search for and collect relevant and secure information- communicate with messaging software, chat, and on a forum with peers and carers- develop critical thinking skills in relation to digital technology (understanding the benefits of the Internet and its risks).OBJECTIVES1.Developing flexible and innovative education that promotes patients’ INCLUSION in digital literacy, so that they can acquire a minimal digital skill basis while evaluating them on a regular basis allowing them to use the Internet safely, health apps and medical devices. Developing or improving adult, and particularly elderly, patients’ Digital Health Literacy to empower them to manage their health.2. Using technology to engage in A DIGITAL PEDAGOGY adapted to their PTS, CGS could contribute to the design and development of toolkits, participate in a clinical study that aims to assess the usefulness of the toolkits for PTS, and exchange good, digitalized practices with peers and PTS.3. Building a PATIENT-ORIENTED digital learning platform in health (Pragma-TIC) as an intervention method to gain autonomy and eventually reintegrate in society after a pathology. It will help patients take responsibility (respecting their choices), understand their disease, change their behavior, apply their treatment (observance) and use tele-health tools. It will host a training catalog, digital support (in all partner languages + English) in digital health education co-created by the project partners and validated by the PT Committee of the partner hospitals.The other objectives we want to achieve are the following:- ensuring that the frontline caregivers are capable of accompanying the TELEMONITORING of chronic patients by facilitating their autonomy;- to make the patient feel secure by the support provided; - to acquire a sufficient base of techniques and knowledge to conduct educational activities and analyse the results;- to be part of an international community of caregivers; - to apply safety rules and good practice guidelines;- to provide clear, constructive and supportive feedback to patients and peers<< Implementation >>For 24 months, 20 frontline/field nurses from 4 hospitals will contribute to the development of digital health literacy skills for nearly 200 chronic patients (whose health condition requires daily care and are vulnerable) so that they can become more autonomous thanks to remote monitoring.IMPLEMENTATION: METHODOLOGY USED The implementation of the project consists in developing a simple, practical e-learning platform (in English and in the 4 languages of the Consortium), favouring through the blended-learning method the better understanding of the Web, medical devices tools, health Apps and other classic telecommunication tools.This platform will offer educational toolkits co-constructed and validated by the caregivers on the basis of their pedagogical tutorials. It will also provide access to places ideal for exchanges between patients, caregivers and their international peers, such as forums, messaging server, etc. The anonymization and RGPD will be guaranteed.PLANNING FOR THE CREATION OF THIS PLATFORMThe Co-CREATION of this platform will be organised over 2 years in 4 steps.Step 1Conceptualisation and requirements for the project, research, studies, analysis, reporting and co-creation of a learning tutorial repository validated by pedagogy specialists. Step 2Development and/or reinforcement of adult-friendly pedagogy and e-learning among frontline health workers who will participate in the study. They will get a better grasp of the e-Health tools with hybrid learning methods, either in self-taught or group settings. Their objective will be to build their own training plan for their patient. In order to experiment and readjust it, they will also train groups of digitally compromised patients by immersing them directly in digital learning via groups or individual sessions, via synchronous or asynchronous webinars. During this period, the carers will create their dashboard in which they will enter data that will be used to assess the benefits of this method.The caregivers will evaluate the results, readjust their training plan, model it and then MAKE IT SUBSTAINABLE AND SHARE IT WITH THEIR PAIRS. Patients from this first pool will also be very closely involved in the process and will complete satisfaction and self-assessment questionnaires. The caregivers will adjust their working methods based on the answers collected and update the contents of the platform.After step 2, all participants (caregivers and patients) will form a committee with the associated partners to establish the sustainability of the project.Step 3 A second pool of patients will be recruited. The group will be accompanied by the first pool of field staff in order to reinforce or readjust the process. Step 4 Preparation and presentation of the guidelines and recommendations on our platform which will be presented at the transnational closing meeting of the project and accessible to all interested parties.<< Results >>RESULTS and OTHER EXPECTED OUTCOMES 1.To relieve for overloaded hospital institutions and very expensive emergency departments.2.To lessen the risk of contracting nosocomial diseases. 3.To return or keep the patient at home with an economic and psychological impact on his health.4.To open new possibility of life goals with an impact on the patients’ acceptance of their treatment and on the positive evolution of their health condition. 5.To create a community of peer carers internally and internationally, as well as be part of it. 6. To harmonise the remote follow-up of the chronic patient and maintain the therapeutic link EVEN ABROAD or in remote rural areas.7.To strengthen the patient's ability to keep learning while developing a critical mind towards the digital world.8.To give access to the patient staff to training in an ATYPICAL environment reinforcing LIFELONG LEARNING.9.To reduce the carbon impact by cutting out any unnecessary travel to the hospital. 10.To reduce the carbon impact with fewer hospital visits. SUSTAINIBILITY through its TRANSFERABILITY to other institutions or sectors.

Rational. Mitral valve prolapse (MVP) is a common condition (2-3% in pop.) with frequent complications such as mitral regurgitation (MR), heart failure, ventricular arrhythmia (VA) and even sudden death. Recent data suggest MVP is a more complex pathology, with accumulating evidence of a frequent genuine MVP-Cardiomyopathy (MVP-CM) independent of volume overload, likely associated to the increased risk of sudden death. MVP-CM is thus changing the MVP paradigm. Objective. MUSSET proposes to decipher MVP-CM and to implement a high-level web-tool for diagnosis, prognostic stratification and management guidance of patients with MVP, including AI-imaging analysis. MUSSET aims to deeply and fully characterize MVP/MVP-CM and related complications for ensuring 100% proper diagnostic and offering all support elements for guiding MVP-CM management and its arrhythmia consequences to improve patient outcome. MUSSET's final goal is to offer an individualized, simplified management helping master the complexity implemented in a MVP vertical web-tool integrating personalized clinical, imaging data, biomarkers, comprehensive support and risk score. Methods. MUSSET is an entirely original project capitalizing on already constituted large clinical cohort of patients, with all MVP phenotypes and the availability of imaging, genetics, biologic, and bioinformatics capabilities within the consortium. MUSSET is built around 5 dimensions implemented in synergetic work packages: 1.The end goal is the development with industrial partners of a MVP/MVP-CM-personalized web tool. It will be set up in several phases of knowledge integration, as follows: i) Integration of clinical data of retrospective cohorts and diagnostic criteria identification, ii) Construction of the diagnostic algorithm, including imaging post processes with AI analysis, iii) Implementation of ECG and VA data, iv) Integration of prospective cohort data and patients follow-up data, v) Implementation of prognostic algorithm, vi) Tool validation with prospective cohort of replication, vii) Implementation of biomarkers/genetic data. The scientific knowledge incorporated will include WP 2 to 5 : 2.Comprehensive characterization of MVP/MVP-CM to determine the diagnostic criteria of MVP-CM, by algorithm or machine-learning in complex cases. MVP characteristics and management in cardiology practice, and its sex/gender expression, will be assessed. Personalized and predictive care based on real observed outcome in large cohorts will be captured under medical treatment and after surgery. 3.VA, a frequent and worrying manifestation of MVP-CM, will be fully characterized. The consortium will rely on classical rest and exercise ECG characteristics in MVP-CM, and on mid-term recording and multiple electrodes tool to decipher VA for patients at higher risk. Identification of patients at risk of life-threatening VA and VA management in these patients is an essential goal of the proposal. 4.Myocardial mechanics and remodeling including replacement fibrosis, a key marker of MVP-CM and VA risk, will be explored by advanced imaging analyses. Left ventricular (LV) and myocardial remodeling of MVP-CM will be assessed based on 2 successive CMR examinations performed 3-years apart (450 CMR performed yet). Development of new CMR sequences and dedicated software will help reach this target. Development of semi-automatized CMR and echocardiography images analyses with AI-based tools will enable a simplified evaluation of mitral valve apparatus and cardiac chambers alteration. 5.Frequent and rare genetic variants involved in isolated or familial forms of MVP-CM, and their relation to VA, will be unraveled. Myocardial tissue and mitral leaflet tissue will be analyzed for transcriptome expression. Zebrafish model will screen the effect of the best candidate genes that would affect both mitral valve and myocardium structure and function. A rodent model of MVP-CM will allow to decipher myocardial alteration.

The overall concept of INTERCEPT-T2D is to establish whether an inflammatory-mediated profile contributes to the onset of Type 2 Diabetes (T2D) complications, thus enabling the identification of patients most at risk of complications and the design of personalized prevention measures. T2D is a heterogeneous disease, which is an obstacle to the delivery of an optimal tailored treatment. Consequently, patients’ individual trajectories of progressive hyperglycemia and risk of chronic complications are so far difficult to predict. In this context, onset of diabetic complications represents the most important transitional phase of T2D development toward premature disability and mortality. Chronic systemic inflammation has been suggested to be a major contributor to the onset and progression of T2D complications. INTERCEPT-T2D will bring a new and clinically relevant dimension in T2D care considering at diagnosis inflammatory parameters that are of importance for the transition to T2D-related complications. The combination of state-of-the-art genomics and cell-biology technologies with targeted clinical interventions should lead to potent patients’ stratification. It should allow the identification and prognosis of a novel class or subclass of patients characterized by an “Inflammatory-mediated T2D” endotype. The project has access to the best-documented longitudinal human European cohorts of patients with T2D, with reliable clinical and biological data allowing to trace the transition and evolution towards organ complications. This, added to the exploitation of an extensive health data warehouse, will enable us to establish the inflammatory trajectory of citizens with T2D from diagnosis to the development of complications. To explore the ability to prevent the transition phase of T2D towards organ complications, INTERCEPT-T2D will conduct a phase II clinical trial with an anti-inflammatory therapy targeting NLRP3 Inflammasome activity in patients with T2D.

PERSIST aims at developing an open and interoperable ecosystem to improve the care of cancer survivors. The key results to be achieved by partners are: increased self-efficacy and satisfaction with care as well as reduced psychological stress for a better management of the consequences of the cancer treatment and the disease, resulting in an improvement in health and wellbeing and a faster integration into the labour market, where applicable, compared to usual care (KR1); increased effectiveness in cancer treatment and follow-up by providing prediction models from Big Data that will support decision-making and contribute to optimal treatment decisions with positive consequences in the QoL and the health status of survivors (KR2); and improved information and evidence to advance the efficacy of management, intervention and prevention policies/strategies in order to timely treat side effects and, if possible, avoid secondary diseases and fatal events. The long-term result will be to reduce the socio-economic burden related to cancer survivors’ care (KR3). The ecosystem proposed consists of a Big Data platform to be built on top of an open infrastructure from one of the partners and a mHealth application for patients. The main building blocks to be developed are a multimodal sensing network running on a smart phone that will collect relevant data regarding the wellbeing of the patient; predictive models from anonymised health data from thousands of breast and colorectal patients; and modules essential for the development of a decision support system, which will employ the predictive models mentioned. Furthermore, PERSIST will contribute to establish evidence on the use of liquid biopsy techniques to the follow-up of cancer patients treated with curative purposes. A pilot study involving 160 patients and 32 health care professionals will be decisive to establish a co-creation methodology ranging from the earlies phases of the project throughout its conclusion.