Protozoa such as Cryptosporidium spp, Giardia duodenalis and Toxoplasma gondii are identified as public health priorities because of possible waterborne transmission to humans. Protozoa are currently detected by immunofluorescence (IF), except T. gondii, on samples from filtered water. Limitations have been identified for both the IF detection method (requires antibodies, high-level expertise, etc.) and the matrix (water). The use of the water matrix to monitor the contamination level of water bodies gives variable results that depend on physico-chemical and meteorological parameters that are particularly important in the present context of global climate change. This could represent a limitation when applying a monitoring approach based on this matrix. Bioaccumulation measurements of these protozoa in invertebrate species, mainly bivalve molluscs, could represent an alternative tool to evaluate water contamination and avoid the limitations due to the water matrix. They would also break away from current approaches to protozoa research. Advantages would be the integrative (temporal) character of pathogen loads in invertebrates and the representativeness of pathogen measurements according to site (attached organisms). For us to have tools applicable on a large spatial scale (freshwater-seawater continuum), two bivalve mollusc species will be considered: a coastal one (the blue mussel, Mytilus edulis), and a continental one (the zebra mussel, Dreissena polymorpha). Using the capacity of our indicator species to accumulate parasites as a tool requires overcoming various scientific challenges by answering questions centred around three main issues: 1- It is necessary to develop and validate a sensitive procedure for simultaneous protozoa extraction and detection, and strict quantification of protozoa (oo)cysts in a complex matrix such as bivalve molluscs. The consortium proposes to develop innovative, rapid and sensitive molecular approaches, with special focus on the crucial step of (oo)cyst extraction/purification from molluscs. 2- It will be necessary to determine whether the parasite loads measured in zebra mussel and blue mussel tissues are correlated with the levels of contamination. To that end, the consortium proposes to define the kinetics of protozoa bioaccumulation by bivalves during single or combined exposures under laboratory conditions. 3- The physiology of mussels, in link with environmental and endogenous parameters, could modify their capacity to accumulate pathogens. The MOBIDIC project proposes to investigate the potential effect of environmental parameters (temperature, food availability, chemical stress) on pathogen bioaccumulation. In addition, in light of the lack of data in the literature, the project proposes to investigate the potential effects of (oo)cysts on mussel’s health, particularly on immune responses. This project proposes to provide new knowledge about interactions between protozoa (Cryptosporidium spp., Giardia duodenalis., and T. gondii) and mussels, with the aim to define a reliable indicator of the biological quality of water bodies to preserve the quality of water resources and protect human health. The MOBIDIC project will also provide interesting data in ecotoxicology in a multi-stress context, i.e. cumulative/interacting effects between biological and chemical contaminants, to better estimate the risk related to global climate change. To achieve the different objectives, a multidisciplinary consortium will associate environmental sciences (ecotoxicology and ecophysiology) and the fields of health (parasitology) on the one hand, and academic, institutional and private partners to combine basic and applied research and transfer skills to stakeholders, on the other hand. To facilitate skill transfer, the consortium applied for the HYDREOS cluster label. Members of this cluster will participate to the advisory board of the project.

Antimicrobial resistance (AMR) is of great public health concern, causing numerous losses of lives worldwide and threatening to reverse many of the considerable strides modern medicine has made over the last century. There is a need to stratify antibiotic and alternative treatments in terms of the actual benefit for the patient, improving patient outcome and limit the impact on AMR. High quality, effective and appropriate diagnostic tests to steer appropriate use of antibiotics are available. However, implementation of these tests into daily healthcare practice is hampered due to lack of insight in the medical, technological and health economical value and limited knowledge about psychosocial, ethical, regulatory and organisational barriers to their implementation into clinical practice. VALUE-Dx will define and understand these value indicators and barriers to adoption of diagnostics of Community-Acquired Acute Respiratory Tract Infections (CA-ARTI) in order to develop and improve health economic models to generate insight in the whole value of diagnostics and develop policy and regulatory recommendations. In addition, efficient clinical algorithms and user requirement specifications of tests will be developed fuelling the medical and technological value of CA-ARTI diagnostics. The value of diagnostics will be tested and demonstrated in a unique pan-European clinical and laboratory research infrastructure allowing for innovative adaptive trial designs to evaluate novel CA-ARTI diagnostics. Close and continuous interaction with the VALUE-Dx multi-stakeholder platform provides for optimal alignment of VALUE-Dx activities with stakeholder opinions, expert knowledge and interests. A variety of dissemination and advocacy measures will promote wide-spread adoption of clinical and cost-effective innovative diagnostics to achieve more personalized, evidence-based antibiotic prescription in order to transform clinical practice, improve patient outcomes and combat AMR.

The A-Patch Research & Innovation project will research, innovate, push technology barriers, and demonstrate innovative use of Flexible and Wearable Electronics in the medical and well-being sectors, validate its prototype devices in lab and hospital environments (TRL 4-5). Industrial exploitation of the A-Patch applications will be clearly identified. The project will develop non-invasive autonomous wearable diagnostic patches for real-time remote monitoring of infection status. The A-Patch will use a novel intelligent hybrid sensor array with multiplexed detection capabilities to detect disease-specific volatile organic compounds (VOCs) from the surface of the skin, enabling rapid and highly-accurate diagnosis using a small device. Product innovations for professionals and consumers will be incorporated, and benefits demonstrated. Integration of electronic devices in connected wearable, flexible and stretchable settings, low-power interconnection, compatibility with low-cost manufacturing, efficient energy scavenging and storage, functional performance, and durability will be successfully demonstrated. To ensure reliability and enable extended usage periods, the sensor array will be self-repairing and the device will be self-powered, by advancing cutting-edge research on chemical hybrid sensors and materials. A-Patch will incorporate secure transmission to enable privacy-ensured diagnosis monitoring by physicians, national health systems and worldwide health organisations. The project partners include a health-maintenance organisation, a diagnostic test implementer with in-depth understanding of end-user needs, technology developers, academic / research institutes and a system integrator. The project is planned for a 36-month duration and is estimated to require total funding of 4 M€.