STAMINA develops an intelligent decision support toolset for pandemic prediction and management and demonstrates its use by practitioners at national and regional levels within and across EU borders. The STAMINA toolset enables national planners and first responders to anticipate and respond to the the “known-unknowns” in their daily effort to enhance health security. Main functionality of the toolset includes: • Real-time web and social media analytics aiming at public trust monitoring and flagging possible disease outbreaks • POCT and smart wearable diagnostic devices for first line screening • Predictive modeling of pandemic outbreak and its impact, along with decision-making support in implementing mitigation strategies, • Early Warning System • Crisis management tool defining the roles and actions of key actors during crisis management • Scenario Generation tool for creation of training scenarios • Common Operational Picture as the main interface of the solution enabling timely and coordinated response The toolset is accompanied by a set of Guidelines on effective implementation of risk communication principles and best practices in cross-organisational preparedness and response plans. The use of the STAMINA toolset will be demonstrated through 12 national and regional small-scale demonstrators and one large-scale cross-border simulation exercise involving all consortium partners.

PREVENT improves upscaling of primary interventions for weight control management during childhood and adolescence to reduce cancer risks in adulthood. This relies on current evidence that relates excess body weight with increased cancer risk. Towards this end, PREVENT applies a series of implementation research actions in the following directions. First, it identifies barriers to current interventions and policies preventing them from upscaling to different geographical, socio-economic, and cultural settings. Then, it introduces new multi-actor and context-aware interventions along with new user engagement strategies to face the current upscaling bottlenecks; multi-actor in the sense that they target different types of users (e.g., students, family, educators, policymakers) and context-aware in the sense that PREVENT interventions are tailored to the specific implementation places (class, canteen, sports fields, labs, outside school). The PREVENT new policies are adapted, piloted, and scaled up within the schools’ communities of three European countries facing different epidemiological settings on childhood obesity, geographic, socio-economic and cultural attributes. The pilots are designed to be holistic end-to-end ecosystems, including users, medical professionals, policymakers, public authorities, and civil communities. They focus on the whole school communities of Greece, Sweden, and Spain-Catalonia, that is, PREVENT outreach to more than 3.3 million students, required for guideline provisioning, large-scale implementation, multi-parameter assessment, and scaling-up. Co-creation, active behavioral change, self-evaluation through user empowerment, motivational interviewing, social innovation, digital-assistive engagement, health apps, and multi-domain assessment are implementation research aspects of PREVENT to advance user acceptability and compatibility with existing policies, and thus improve sustainability and upscaling. This action is part of the Cancer Mission cluster of projects on "Prevention and Early Detection".

Mobile laboratories are becoming increasingly important for quick response to epidemic outbreaks in remote areas. Due to climate change and rising temperatures, emerging arboviruses (Crimean-Congo haemorrhagic fever virus, West Nile Virus, Rift Valley fever, Dengue fever) are finding their way into Europe through arthropod vectors (mosquitoes, ticks), and are becoming a major public health concern. Optimally monitoring zoonotic outbreaks requires a "One Health" approach, in which not only human, but also animal and environmental samples are analysed, as close as possible to the vectors' habitat. Also returning travellers might carry haemorrhagic Ebola/Marburg virus or respiratory pathogens such as SARS-CoV-2. A survey of existing European mobile laboratory capacity revealed several shortcomings: of 193 labs, 66% were civilian, 88% were exclusively for human diagnostics, with 11% having an accredited quality management system, and only 3% had the highest bio-safety level BSL-4 needed for (haemorrhagic) arbovirus handling. MOBILISE aims to close this diagnostic gap, by developing a novel, quality-assured, mobile One Health laboratory solution, to provide BSL-4 capacity to many European countries. It will receive human/animal/environmental samples for molecular diagnostics, serology, microbiology, and host a whole genome sequencing platform for pathogen discovery and epidemiological analysis. We will further develop novel rapid diagnostic tests for BSL-3/4 pathogens, and produce results in machine-readable form. A novel AI-based "Emergency Operating Centre and Decision Support System" software will assist end-users in coordinating MOBILISE fleets across Europe and manage outbreaks in real-time. Hosted on an electric/hybrid truck platform, and using solar and wind-energy, it will also reduce CO2 emissions in compliance with the European Green Deal. The lab will be field-tested to TRL-7 by National agencies and first-responders in Austria, Romania, Greece and Africa.

The UPRISE project aims to unravel the complex mechanisms by which air pollution, in particular ultrafine particles (UFPs) and micro-nanoplastics (MNPs), disrupt normal fetal development leading to an increased risk of adverse birth outcomes (ABOs), including preterm birth, increasing the risk of premature children to develop a range of non-communicable diseases (NCDs) in adulthood. UPRISE will develop exposure databases and assessment models for these emerging pollutants in different exposure scenarios to improve our understanding of their sources, concentrations and dispersion patterns. UPRISE will include a clinical study with pregnant participants exposed to different levels of UFPs and MNPs pollution to analyse possible modes of action leading to ABO based on transcriptomic, epigenetic or mitochondrial mutation analysis and subsequently identify possible key events, including molecular initiating events. As a result, causal models supported by weight-of-evidence analysis will be developed to demonstrate the link between contaminant uptake and events triggering the ABO of interest. To facilitate the dissemination of results and their application in policy-making, UPRISE will develop user-friendly tools for reporting and sharing data, with the aim of facilitating the integration of scientific evidence into the updating of European and national air quality standards. By advancing in the quantification of the public health impact of prenatal air pollution exposure and providing guidelines and decision support tools for policy makers, the project will contribute to reducing the burden of NCDs associated with preterm birth and other ABOs.

The aim of DxHub is to develop a strong ecosystem that mutually reinforces actors from two widening countries to consolidate individual efforts and allow for rapid and on the spot accurate diagnosis of infectious diseases within One-Health. The ecosystems in Crete, GR and the Oeiras region, PT, have already demonstrated a rich portfolio of activities to tackle the problem of efficient diagnosis outside a centralized lab. The DxHub will bring the two isolated regions together and, through a common R&I plan, accelerate innovations in diagnostics into impactful solutions by embracing the quadruple helix of main innovation players. Cutting-edge R&Is will be promoted based on joint research, innovation and investment plans. Pilot projects will be used to interlink academia with business providing solutions addressing the health, veterinary and agri/food sectors, all in line with both regions’ strategic priorities. In parallel, the efficient communication, dissemination and exploitation of the DxHub outcomes to the broad ecosystem will ensure high societal impact as a result of the co-development and acceptance of the new innovations by all actors of the quadruple helix. We expect that by building strong links between all payers of DxHub will foster knowledge transfer leading to the creation of new jobs and of attractive and sustainable place-based innovation ecosystems.