The SQUEEZE project aims to improve the treatment and quality of life for patients with rheumatoid arthritis (RA) by maximizing the effectiveness of existing drugs through the use of biomarkers and tailored care. The SQUEEZE project consists of a multidisciplinary team from 9 European countries, including clinicians, healthcare professionals, patient research partners, and scientists. The project's initial findings highlighted the significant differences in the use of disease modifying anti-rheumatic drugs (DMARDs) across European countries, including variations in administration routes, dosages, and accessibility. Such differences often reflect the influence of socio-economic factors, leading to inequalities in treatment standards. We therefore present here SQUEEZE-UP, a proposal that will widen SQUEEZE’s scope by including the expertise of the University of Medicine in Bucharest, Romania. This collaboration will provide insights into the socio-economic context and country-specific strategies for the treatment of RA, and access to patients and clinical cohorts from a distinct socio-economic background. SQUEEZE-UP’s further objectives are to advance the careers of young researchers, enhance the competences and infrastructure of UMFCD, and provide better personalized care tailored to patient needs across Europe. The project will combine large-scale data analysis and prospective studies, and its impact will be seen at the system, organization, and beneficiary levels: increased visibility, economic impact on healthcare systems, access to novel technologies, and positive changes in care models. SQUEEZE-UP will also cover the dissemination, exploitation, and communication of results through various channels, including collaboration with national patient organizations and scientific publications. Overall, SQUEEZE-UP will have a significant impact on the lives of RA patients across Europe and will significantly advance research and innovation in Romania.

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.

Context: Due to population ageing, dementia is a top health and social challenge across Europe. For an appropriate management of dementia knowledge, skills and collaboration of several professions are needed. This requirement is not met in many countries, and students of relevant occupational disciplines care are not being prepared to perform these tasks. The gaps regarding interprofessional shared learning, mutual understanding and networking can be closed by modern learning methods such as e-learning or online courses, particularly in times of social distancing such as the current COVID-10 pandemic. However, such digital learning methods have not yet been applied to dementia education in southeastern Europe and are not available in local languages.Objectives: On this background, a group of researchers and educators from four universities who have been successfully working together on previous transnational projects in dementia education (Technical University of Munich, Germany; University of Ljubljana, Slovenia; Carol Davila University of Medicine and Pharmacy of Bucharest, Romania) and one centre for dementia-related vocational training (Centrum Memory, Bratislava, Slovakia) will join forces to strengthen the digital competence of educators and students in the field of dementia and, by enhancing education, improve dementia care. The aims of STUDICODE are to create, evaluate and implement in regular curricula a digital online course on dementia that simultaneously addresses students of various disciplines which have a key role in dementia care (medicine, psychology, nursing, social work, occupational therapy and speech and language therapy). Activities and methodology: The project is structured in four workpackages (WP). In WP1 (Content production,) educators (professors, assistants) at the partner sites will select from the previously created multi-language pool of materials (texts, videos, charts, images, graphics, quizzes) the contents that are most relevant for the education of students, adapt and complement it as needed. The educators will be supported by specialists in e-learning, medical education, and multimedia design who will act as external advisors. In WP2 (Course building), the selected contents will be assembled into the learning management system used by the institution, thus creating a dementia online course in the local language. Progress of work will be monitored by regular reports to the lead partner and regular consortium meetings. Quality of work will be evaluated by local review sessions involving independent experts and student delegates at the partner sites. Before and after the production of the online course, a self-assessment of digital competence will be carried-out by the educators. In WP3 (Course evaluation), the dementia online course will be completed and evaluated by approximately 50 students from different of fields of study at each partner institution (200 in total). Evaluation will include pre-post self-assessments of digital competence and knowledge tests, standardised questionnaires of usability and acceptance, and back-end monitoring of user behaviour. In WP4 (Dissemination), the dementia online course and the results of the evaluation will be presented to persons responsible for the education and training of professions involved in dementia care (e.g. Deans of Study), representatives of Ministries of Health and Ministries of Education, and other relevant stakeholders including national and international patient organisations with the aim of implementing the course in regular curricula of higher and vocational education.Results, impact and potential long-term benefits: At project termination an online course on dementia will be available in several languages. The course will nicely complement traditional educational formats such as lectures or face-to-face workshops at the partner sites as well as at similar institutions nationwide. It may serve as a template for digital-based education in other fields of healthcare. By participating in the production and evaluation process, educators at each partner institution will increase their competence for creating and using digital media. By contributing to quality monitoring during the production phase and to testing the final product students will improve their skills in assessing digital learning formats and incorporating them into their individual learning practice. The impact of the project will go beyond increasing digital readiness at institutions of higher education and vocational training. It will improve the competence and potential for collaboration of key professions involved in dementia care by providing shared person-centred and holistic concepts and skills already at the pre-graduate stage. In this way the project ultimately aims to contribute to improving the quality of life of people with dementia and their carers in southeastern Europe and to support national dementia plans and strategies.

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.