There is an imperative need to gain knowledge on the spread and evolution of antimicrobial resistance (AMR). Recent evidence from environmental, animal and human microbial studies shows that AMR is ancient and environments without contact with anthropogenic antibiotics possess abundant AMR genes. Bacteriophages are the most abundant entities in Earth and recent studies provide indirect evidence for the major role of transduction in the dissemination of AMR genes. Hence, phages might be of critical importance for evading one of the bottlenecks (ecological connectivity) that modulates the transmission of AMR genes from natural environments to animal and human biomes. In this proposal, a holistic and multidisciplinary approach that combines molecular genetics, genomics, metagenomics, in-vitro experimental analysis, computational biology, bioinformatics analysis, and modelling will be followed to measure the potential of naturally occurring phages to be vehicles for AMR transmission and spread in environmental systems with different antibiotic selective pressure. This comprehensive approach will allow us to better understand the phage-bacteria interactions that drive the AMR spread in different ecosystems. From this understanding we expect to be able to design and develop new tools for the control of antimicrobial resistance in clinical and veterinary practice as well as in agriculture. This project will contribute to the objectives of the Work Programme by: 1) allowing the researcher to gain new skills and additional training-through-research in phage and phage-bacteria interactions, computational and (meta)genomic analysis; and to become an EU leading specialist in a research field with emerging growth potential; 2) transferring the acquired knowledge to the EU; 3) establish a long-term collaboration between several centres of excellence that will enhance the quality of research of Europe and make it more competitive and attractive for high-profile researchers.

The BD-KNEE project is a “patient specific” system that provides innovative knee replacement devices, matching ICT with 3D printing new production technologies, which reduce patient pain, speeding up the recovery with a competitive price. This project is led by REJOINT, a company that work in the orthopaedic implant industry, that has joined forces with ORTHOKEY, the JV SensoriaHealth-ICT and Fundación Rioja Salud. Total Knee Arthroplasty, also known as Total Knee Replacement (TKR), is one of the most commonly performed orthopaedic procedures. The number of total knee replacements performed annually in the US is expected to grow +5 times to 4.34 million procedures by 2030. In Europe, this number has increased in recent years in most European countries as well (70%). Since many years, the biomedical “Total Knee Replacement” (TKR) industry is static and stationary in terms of material evolution, design and surgical procedures, although the orthopaedic market is a never stop growing market. The knee orthopaedic market value was $9bn in 2017 with a constant CAGR of 3% until 2020. BD-KNEE project is a medical e-platform that design and develop a family of medical devices and processes for the total knee replacement using the most advanced technologies (Electron Beam Melting or EBM 3D printing, Innovative software) at competitive cost and price (50% cheaper than the premium alternative ConforMis, our main competitor). Moreover, BD-KNEE e-medical platform reduces the rehabilitation of the patient, reducing the surgical time in OR thanks to customized pre-op software (design the implants and instrumentations for each patient) and intra-op software (a surgical technique to guide the surgeons). This project will have an important impact on the growth of BD-KNEE consortium, enabling to reach additional revenues of €30.36 million by 2025 and imply a growth in personnel, with the creation of 55 new jobs.