CAROL DAVILA UNIVERSITY OF MEDICINE AND PHARMACY

The overall aim of the project is to strengthen the strategic partnership of the University of Medicine and Pharmacy Carol Davila Bucharest (UMFCD), Romania, one of the Widening countries, with two internationally-leading counterparts at the EU level (Region H - Copenhagen University Hospital Herlev, Denmark and University College London, UK), to enhance networking activities among these institutions and to combine their skills and competences in the field of minimal invasive endoscopic interventions in pancreatico-biliary diseases. Translated expertise, in the form of training and educating early-stage researchers (ESR) in the field of minimally invasive endoscopic interventions is needed to increase the number and quality of innovative services at UMFCD and its clinical affiliated hospitals. The proposal is the result of a long-standing collaboration and joint multicentric research projects performed by the partners of the consortium. Thus, in the past 20 years, there was a sustained clinical research activity in the field of minimally invasive endoscopic procedures, supported by various national and international grants of the key persons involved in the TRIP proposal. One of the key WPs of the TRIP proposal is represented by a multicentre protocol for a research project on pancreatic organoid cultures derived from endoscopic ultrasound guided fine needle biopsy (EUS-FNB) specimens with consequent pharmacotyping, used for personalized therapy of pancreatic cancer patients. The project partners will thus transfer their expertise to UMFCD with an emphasis on PhD students and ESRs. This knowledge transfer and capacity building will be achieved through joint research activities and academic collaboration, enhanced staff mobility, education and training activities, workshops, summer schools, and dissemination events. Last, but not least, one of the concrete deliverables of the TRIP proposal is represented by the upgrading of the research management unit at UMFCD.

Five Noncommunicable Diseases (NCD) – diabetes, cardiovascular disease, cancer, chronic respiratory disease and Mental Health Disorders (MHD) – account for 86% deaths and 77% disease burden in the WHO Europe region. Of these five NCDs, MHD is unique as it has a complex bi-directional relationship with the other four major NCDs, meaning that, on one hand, it could be the initiator of the other NCDs, or other NCDs could lead to MHD which, in turn, can further aggravate the primary NCD leading to a vicious circle. Recent research identified MHD as the highest ranked NCD in adolescent population. A specific group in this population that is 3 - 6 times more vulnerable for developing MHD and subsequent NCD is the adolescents diagnosed with Autism Spectrum Disorders (ASD). There is no Evidence Based Intervention (EBI) for preventing MHD in an ASD adolescent since 1) the major risk factors are in-grained in their biological process and 2) they present with multiple MHD comorbidity. Personalisation is the key to prevent their already vulnerable mental states making transition to an MHD - "which" EBI is appropriate for "which" ASD adolescent and "how" to choose it - an unsolved question. Because of their neurobiological characteristics, personalisation must be done at biological level. Recent research showed how the environmental factors can alter gene expressions that leads to an MHD through Epigenetic-Genetic/metabolomic-Mental health (EGM) process. Using quantitative modelling of this process, ETHREAL will develop a personalised, flexible, single service delivery model that will empower an ASD adolescent to self-control their environmental factors while seamlessly accessing the community care services to prevent their mental health making transition to an MHD - a unique solution for sustainable prevention of MHD and subsequent NCDs in this population. Without loss of generality, the proposed solution could be adapted to prevent MHD in wider adolescent population.

Blindness is the most feared handicap leading to the greatest exclusion from society by reducing patient autonomy and mobility. There are still an estimated 39 million blind people worldwide. Clinical trials have demonstrated the possibility to regain some useful vision with retinal prostheses in patients having lost photoreceptors. New approaches are entering into clinical trials such as photovoltaic implants, optogenetic therapy and even cortical prostheses for patients having lost eye to brain connection. In the present ENTRAIN-Vision project, the Early Stage Researchers (ESRs) will work on these innovative technologies for restoring vision in blind patients. Their training in academic institutes or industry will be completed by several secondments, including one at an industry partner. In addition, several winter/summer schools will address scientific subjects on vision restoration and transferable skills in technology transfer, clinical trials, start-up creation, communication to media. Lectures will be followed by practice e.g. innovative technologies for assessing brain function. The project will thus create a unique European network of researchers, clinicians and industrials on visual restoration. This network will provide a comprehensive training across multiple disciplines including neuroscience, vision, psychophysics, genetic, electronic, bio-engineering and computational modelling. It will therefore prepare a new generation of leaders able to carry the new therapeutic strategies from bench to patients. ESRs will encounter founders of start-up and industrial partners enlarging thereby job opportunities to 1) remain in the career path of research & innovation, 2) contribute to clinical trials and/or develop the rehabilitation programs or 3) get involved in product manufacture, distribution and marketing throughout Europe. This project will generate great social and economic benefits in Europe by improving patient autonomy and daily life.

Emerging antibiotic resistance has become an endemic problem, slowly increasing under the radar and depriving future generations of effective therapies. The goal of REVERSE is to develop and implement cost-effective strategies and tools for the prevention and clinical management of healthcare-associated infections due to multidrug-resistant pathogens, and to reduce the burden of antimicrobial resistance in high prevalence healthcare settings. To achieve these goals, REVERSE will use a mixed-methods approach combining quantitative research with implementation science and economic analysis. The aim is to produce results that go beyond the evidence-base we have today. REVERSE will answer the question about real-life effectiveness of infection prevention and control programmes in combination with antibiotic stewardship on healthcare-associated infections due to multidrug-resistant microorganisms. It will offer implementation strategies to the participating hospitals but also study the effectiveness of external implementation support in a hybrid implementation-effectiveness trial. REVERSE will develop a novel health-economic framework that allows for incorporating of effect of changes in the use of a range of antibiotics on antibiotic resistant infections, and estimating long-term population effects, to integrate both into cost-effectiveness analyses. It will be able to conclude on effectiveness and applicability of prevention strategies in lower-resource settings by cross-checking its programmes with activities in low-and-middle income countries. Four European countries will have a platform of highly experienced hospitals to build on and expand a national network for combatting antibiotic resistance. REVERSE will produce tools and bundles on infection prevention and control, antibiotic stewardship and implementation support. Massive online open courses and other dissemination strategies will make the findings of REVERSE accessible to a wide range of stakeholders.

The gap in Research and Innovation (R&I) performance, which persists despite considerable investments from the European Structural and Investment Funds (ESIF) in the lower-performing regions of the EU, is an issue with major socio-economic and political consequences. In Health R&I the gap has a profound impact on distribution of funding from the EU Framework Programmes as well as on hindering the EU-wide impact of R&I on health and quality of life. With A4L_ACTIONS, we aim to address roots of this situation in the lower-performing Central and Eastern Europe (CEE) by improving culture, governance, recognition and innovation potential of the health research-performing institutions. Our goal is to increase their attractiveness for collaborations with advanced Europe and create spill-over effects in the whole region. As the Alliance4Life, we are an established network of progressive health research institutions in CEE and a source of successfully piloted good practice. By building upon our results and impact achieved so far, we will convert our recommendations and strategies into actions as follows: - Culture fostering excellence: piloting peer-evaluation and assessment of institutional practice as a strategic management tool, professionalizing research administration; - Recognition and trust towards CEE: attracting advanced partners to identified pockets of excellence, supporting scientific ideas originating in CEE, initiating new international projects and collaborations with industry; - Career policy nurturing talent: training and networking next generation of leaders, upgrading institutional career systems; - Impact on innovation: raising the competences of Technology Transfer specialists, creating industry relations platform linking academia and industry; - Spill-over effects: sharing, inspiring, communicating with stakeholders and policy makers; using the established networks to gain advice, new collaborations and EU-wide impact.