The interconnection between Information Technologies and Operational Technologies is underway, with many impacts on the related cybersecurity of various application domains. For a long time, we have known that attacks or malfunctions in the cyber world can have critical impacts on the physical world, especially in critical infrastructures. Conversely, intentional perturbations of physical systems, through e.g. attacks on sensor measurements, can have disastrous consequences on digital control mechanisms, and thus on physical processes. In this interconnected cyber-physical world, the advent of Artificial Intelligence (AI) opens the door to various new kinds of attacks, and also offers numerous defence capabilities. In the KINAITICS project, we aim at exploring the new attack opportunities offered by the introduction of AI-based control and perceptive systems, as well as those offered by combination of behavioural understanding of physical systems and cyber-attacks. On the defence side, we aim at offering an innovative spectrum of tools and methodologies, to combine behavioural monitoring and classical cybersecurity tools to protects against these new threats. Importantly, we also target innovative methodologies, which incorporate human factors and their uncertainties in the tools. This last point raises crucial challenges on trustworthy approaches, explanations provided, and how to deal with uncertainties in response decisions. The project will also thoroughly assess the regulation of big data uses and provide guidelines for EU policy actions and cybersecurity experts’ responsible development, thanks to the implication of researchers specialised in legal and ethical aspects of ICT innovation. Our research will strive to counter AI attacks. The seven tools produced during the course of the project, as well as the cyber-defence platform, will significantly improve systems robustness, resilience and response, and will help Europe save 3-4 billion€ yearly by 2030.

xShare envisions everyone sharing their health data in EEHRxF with a click-of-a-button. The xShare button to be featured across health portals and patient apps and allow people to exercise their data portability rights under GDPR. Hence, the European EHRxF will be the driver for research and innovation in EHDS. xShare will establish the European EHRxF Standards and Policy Hub, the “Hub” partnership of six standards developing organizations (CEN/TC251, HL7 Europe, IHE Europe, SNOMED, CDISC, IEEE) market actors (DIGITAL Europe, MedTech-Europe and EUCROF), supported by competence centers, nationals and regional authorities and European SMEs. xShare will develop: 1) Harmonized common specifications, create and maintain xBundles i.e., collection of common data specifications including FHIR implementation guides, tools and data sets, and educational support for key EHRxF health information domains as noted in the EHDS draft regulation Annex 1. 2) A set of common elements across EHRxF health information domains applicable across EHDS-1 (JA-9), public/population health (EHDS-2), and clinical research. 3) Extended harmonized IPS specification to include care plans and making it fit for the purpose of clinical research use cases i.e. clinical trial eligibility, real world data, patient reported outcomes, and returning clinical research data to patients. 4) xShare feature the xShare Button in 8 adoption settings in Hospital network (Italy), National portal (Greece, Ireland, Cyprus), regional network with emphasis in medical tourism and the connection of the public to the private sector (Catalunya and Madeira), entry of digital health applications to the myHealthSpace ecosystem in France. Care plans will be demonstrated in Denmark. xShare investigate the feasibility and value of the EU xShare Industry label as a vehicle towards implementing the draft EHDS regulation. Lastly open calls at the last year of the project aim to onboard with EHRxF almost 100 settings across Europe.

MeDiTATe aims to develop state-of-the-art image based medical Digital Twins of cardiovascular districts for a patient specific prevention and treatment of aneurysms. The Individual Research Projects of the 14 ESRs are defined across five research tracks: (1) High fidelity CAE multi-physics simulation with RBF mesh morphing (FEM, CFD, FSI, inverse FEM) (2) Real time interaction with the digital twin by Augmented Reality, Haptic Devices and Reduced Order Models (3) HPC tools, including GPUs, and cloud-based paradigms for fast and automated CAE processing of clinical database (4) Big Data management for population of patients imaging data and high fidelity CAE twins (5) Additive Manufacturing of physical mock-up for surgical planning and training to gain a comprehensive Industry 4.0 approach in a clinical scenario (Medicine 4.0) The work of ESRs, each one hired for two 18 months periods (industry + research) and enrolled in PhD programmes, will be driven by the multi disciplinary and multi-sectoral needs of the research consortium (clinical, academic and industrial) which will offer the expertise of Participants to provide scientific support, secondments and training. Recruited researchers will become active players of a strategic sector of the European medical and simulation industry and will face the industrial and research challenges daily faced by clinical experts, engineering analysts and simulation software technology developers. During their postgraduate studies they will be trained by the whole consortium receiving a flexible and competitive skill-set designed to address a career at the cutting edge of technological innovation in healthcare. The main objective of MeDiTATe is the production of high-level scientists with a strong experience of integration across academic, industrial and clinical areas, able to apply their skills to real life scenarios and capable to introduce advanced and innovative digital twin concepts in the clinic and healthcare sectors.

The 3-year EURAMED rocc-n-roll project aims to propose an integrated and coordinated European approach to research and innovation in medical applications of ionising radiation and related radiation protection based on stakeholder consensus and existing activities in the field (incl. existing SRAs of radiation protection platforms, EC health and digitisation programmes, EURATOM-funded projects, SAMIRA initiative). To achieve this, research and radiation protection needs in the clinical disciplines using ionising radiation will be analysed with the aim to generate the largest benefit for the European population in an equal, safe, high-quality way throughout Europe, by fostering clinical translation, while also strengthening economic growth and industrial competitiveness, supported by research and innovation in the field. Representation of relevant radiation protection disciplines like radiation biology, dosimetry for medical applications, ethics as well as clinical expertise in the fields of radiology, nuclear medicine, radiation therapy, oncology, cardiovascular diseases, neurology, paediatrics complemented by regulatory and health policy, AI and industry experts in the consortium will ensure a fully integrative approach and allow a broader framework of quality and safety in healthcare. Based on wide stakeholder input and consultation on above aspects, EURAMED rock-n-roll will produce an SRA for medical applications of ionising radiation and related radiation protection and a corresponding roadmap, as well as an interlink document, integrating the views and identifying synergies from the areas of radiation protection, health research and digitisation, with impactful guidance to the EC and stakeholders on future research including the potential needs for centres of excellence in this area. This will be accompanied by education and training schemes for health workforce and scientists to increase Europe’s research capacity in the field.

SMARTool aims at developing a platform based on cloud technology, for the management of patients with coronary artery disease (CAD) by standardizing and integrating heterogeneous health data, including those from key enabling technologies. The platform includes existing multiscale and multilevel ARTreat (FP7-224297) models of coronary plaque progression based on non-invasive coronary CT angiography (CCTA) and fractional flow reserve computation, refined by heterogeneous patient-specific non-imaging data (history, lifestyle, exposome, biohumoral data, genotyping) and cellular/molecular markers derivable from a microfluidic device for on-chip blood analysis. SMARTool models will be applied and validated by historical and newly acquired CCTA imaging plus non-imaging health data from the EVINCI project (FP7-222915) population. SMARTool cloud-based platform, through Human Computer Interaction techniques, 3D visual representation and artery models, will use heterogeneous data in a standardized format as input, providing as output a CDSS - assisted by a microfluidic device as a point of care testing of inflammatory markers – for: i) Patient specific CAD stratification - existing models, based on clinical risk factors, will be implemented by patient genotyping and phenotyping to stratify patients with non-obstructive CAD, obstructive CAD and those without CAD, ii) site specific plaque progression prediction - existing multiscale and multilevel ARTreat tools of CAD progression prediction will be refined by genotyping and phenotyping parameters and tested by baseline and follow CCTA and integrated by non-imaging patient-specific data, iii) patient-specific CAD diagnosis and treatment - life style changes, standard or high intensity medical therapy and a virtual angioplasty tool to provide the optimal stent type(s) and site(s) for appropriate deployment.