University of Southern Denmark

Grasping multiple object types (versatile object grasping) with a single gripper is always a challenging task in robotic manipulation. Different types of grippers, including rigid and soft, have been developed to try to achieve the task. However, each gripper type is still restricted to specific object types. In nature, many insects can be observed to use only one tarsus mechanism to cope with several tasks. They have a very high grasping capability with objects and can adhere to a variety of surface types. Inspired by insect tarsus, this paper proposes a novel underactuated, single cable-driven, compliant gripper design. The structure of the gripper is based on the hornet tarsus morphology with a proportional scale. An additional pulley-like structure is introduced to increase the generated grasping torque. To maintain the ability to automatically rebound back to the original position, a torsion spring is implemented at each joint. In order to stably grasp and hold objects, soft adhesive pads with an asymmetric sawtooth-like surface structure are attached at the tarsus segments. The performance of this insect tarsus-inspired gripper with the soft pads is evaluated by grasping 35 different objects of various sizes, shapes, and weights for comparison with industrial soft and rigid grippers. The proposed gripper shows a 100% success rate in grasping all objects, while the soft and rigid gripper success rates are 81.90% and 91.43% on average, respectively. We finally demonstrate the use of our gripper installed on a robot arm for pick-and-place and pouring tasks.

This systematic review updates a previous systematic review on work-related physical and psychosocial risk factors for elbow disorders. Medline, Embase, Web of Science, Cochrane Central and PsycINFO were searched for studies on associations between work-related physical or psychosocial risk factors and the occurrence of elbow disorders. Two independent reviewers selected eligible studies and assessed risk of bias (RoB). Results of studies were synthesized narratively. We identified 17 new studies and lateral epicondylitis was the most studied disorder (13 studies). Five studies had a prospective cohort design, eight were cross-sectional and four were case-control. Only one study had no items rated as high RoB. Combined physical exposure indicators (e.g. physical exertion combined with elbow movement) were associated with the occurrence of lateral epicondylitis. No other consistent associations were observed for other physical and psychosocial exposures. These results prevent strong conclusions regarding associations between work-related exposures, and the occurrence of elbow disorders.

Product configuration systems (PCSs) are peculiar IT applications used for efficient product customization. Unfortunately, PCS implementation involves many challenges. A well-defined business case (BC) could increase PCS project success. However, the literature does not provide specific guidance for building BCs for PCS projects. The proposed BC framework for PCS projects was developed based on literature and professional expertise, and tested in three PCS projects at two engineer-to-order (ETO) companies. Figures of benefits, costs, ROIs, scenario examples, sensitivity analyses, risk analyses, and key information about application experiences were reported. The framework test shows that it is viable and helps overcome PCS challenges.

Five ternary copper(II) complexes, [Cu2(phen)2(L1)(ClO4)2] (1), [Cu2(phen)2(L1)(DMSO)2](PF6)2 (2), [Cu2(bpy)2(L1)(ClO4)2(H2O)2] (3), [Cu2(dmp)2(L1)(ClO4)2(H2O)2] (4), and [Cu(phen)(L2)]2(ClO4)2 (5), in which phen = 1,10-phenanthroline, bpy = 2,2'-bipyridine, dmp = 2,9-dimethyl-1,10-phenanthroline, H2L1 = 1,4-dihydroxyanthracene-9,10-dione and HL2 = 1-hydroxyanthracene-9,10-dione, DMSO = dimethylsulfoxide, were synthesized and fully characterized. Complex 2 was obtained through the substitution of perchlorate for DMSO. When two hydroxyquinone groups are present, L1 makes a bridge between two Cu(II) ions, which also bind two nitrogens of the respective diimine ligand. The compounds bind to calf thymus DNA and oxidatively cleave pUC19 DNA according to the following order of activity 1 > 4-5 > 3. Furthermore, complexes 1, 3, 4 and 5 inhibit topoisomerase-I activity and the growth of myelogenous leukemia cells with the IC50 values of 1.13, 10.60, 0.078, and 1.84 μmol L-1, respectively. Complexes 1 and 4 are the most active in cancer cells and in DNA cleavage.

From the time levulinic acid was listed as one of the top-12 building blocks for the sugars-high value compounds conversion, the interest in this compound increased. As part of its possible production route, the definition of viable separation schemes appears of paramount importance in the overall development of levulinic acid exploitation. Hybrid sequences where liquid-liquid extraction is followed by distillation were considered proving how the direct and direct -indirect separation schemes appeared to be the best alternatives in terms of total annual cost and environmental impact. These alternatives were further analyzed to improve their design by complementing the process simulator database with thermophysical experimental values. After obtaining a reliable design for the hybrid direct and direct-indirect configurations used as benchmarks, two intensified alternatives were generated. The first intensified configuration is classified as thermodynamically equivalent sequence, while the second one includes a divided wall column. For both, it was achieved a reduction of the total annual cost of 11% without any penalty for the environmental impact compared to the reference case.

In the frame of the global phosphorus (P) crisis and ongoing eutrophication issues in the environmental sector, lake sediment can be considered as an alternative P source after its removal from eutrophic lakes. However, high water contents make sediment dewatering a crucial step towards the efficient reusability of remaining solids. The application of polymeric substances facilitates solid-liquid separation by flocculation of suspended particles. To lower the environmental risk of contamination with toxic, non-biodegradable monomeric residues during and after the application of synthetic polyacrylamide(PAM)-based polymers, switching to natural polymeric substances (biopolymers), e.g., starch- or chitosan-based, is increasingly emphasized. The dewatering performance of four conventional PAM-based polymers was compared to two starch- and one chitosan-based biopolymer. Laboratory experiments were conducted to determine the dewatering rate, floc size and strength, and reject water quality. Biopolymers generally caused the formation of smaller but less shear-sensitive flocs, and lower P levels in the reject water compared to synthetic polymers. Dewatering performance was correlated to the most important functioning influencing polymer-specific properties intrinsic viscosity (polymer extension) and surface charge density (CD). Due to the high CD and low intrinsic viscosity of the biopolymers, electrostatic patch flocculation seems to be the favored flocculation mechanism, while for synthetic polymers bridging seems to be dominating. Solid-liquid separation technologies should be adjusted to the resulting floc size and structure, while surface CD and intrinsic viscosity are important properties for the choice of biopolymer. Overall, biopolymers can function as a more environmentally friendly alternative to synthetic products for lake sediment dewatering accompanied by the potential for P recovery.

Background: School-based smoking preventive interventions are most effective if they consist of multiple components; one of them being strict anti-smoking rules, i.e., no smoking by anyone at any location during school hours. However, there is a lack of in-depth knowledge about how smoking practices and rules about smoking actually change over time. Therefore, the purpose of this study was to examine how smoking practices changed during a three-year period in which a smoking preventive intervention with strict anti-smoking rules was implemented at schools. Methods: We used data from 46 Danish schools that were enrolled in the evaluation of the X:IT II study - a smoking preventive intervention with three main components: one of them being strict anti-smoking rules. We collected questionnaire data among school employees at four timepoints from the autumn of 2017 until April 2020. The questionnaire covered topics regarding students' and employees' tobacco patterns at the school, control with smoking, and aspects of the intervention delivery. Results: Over time, student smoking rules got stricter; from three out of four at baseline to almost all schools having rules about no student smoking during school hours three years later. Employee smoking rules also changed, although not as much as student rules. Overall, smoking at school grounds seemed to decline - however, student smoking at other locations increased, hence, violating the rule about no smoking during school hours. Enforcement of smoking rules also increased over time. Conclusion: Although implementing and enforcing new rules in a school setting may be difficult, it seemed that most schools in the X:IT II study changed their rules and smoking practices for both students and employees over the three-year intervention period. It seemed, however, that students relocated their smoking to other places than the school or just outside school grounds. Implications of these findings are important to consider in future interventions, i.e., students leaving school during school hours to smoke and the physical separation between those who smoke and those who do not.

Purpose of the study: Calreticulin is an endoplasmic reticulum chaperone protein, which is involved in protein folding and in peptide loading of major histocompatibility complex class I molecules together with its homolog calnexin. Mutated calreticulin is associated with a group of hemopoietic disorders, especially myeloproliferative neoplasms. Currently only the cellular immune response to mutated calreticulin has been described, although preliminary findings have indicated that antibodies to mutated calreticulin are not specific for myeloproliferative disorders. These findings have prompted us to characterize the humoral immune response to mutated calreticulin and its chaperone homologue calnexin. Patients and methods: We analyzed sera from myeloproliferative neoplasm patients, healthy donors and relapsing-remitting multiple sclerosis patients for the occurrence of autoantibodies to wild type and mutated calreticulin forms and to calnexin by enzyme-linked immunosorbent assay. Results: Antibodies to mutated calreticulin and calnexin were present at similar levels in serum samples of myeloproliferative neoplasm and multiple sclerosis patients as well as healthy donors. Moreover, a high correlation between antibodies to mutated calreticulin and calnexin was seen for all patient and control groups. Epitope binding studies indicated that cross-reactive antibodies bound to a three-dimensional epitope encompassing a short linear sequence in the C-terminal of mutated calreticulin and calnexin. Conclusion: Collectively, these findings indicate that calreticulin mutations may be common and not necessarily lead to onset of myeloproliferative neoplasm, possibly due to elimination of cells with mutations. This, in turn, may suggest that additional molecular changes may be required for development of myeloproliferative neoplasm.

Abstract Support interventions, such as nurse case managers, has been developed in response to the inequality in health and a growing population with multi-morbidity. The aim of the present study was to explore the everyday practices of nurse case managers at a Danish university hospital. An ethnographic approach with a constructionist perspective was applied. Data generation entailed participant observation and one group interviews with all nurse case managers in a Danish region (n = 4). The data were analysed using thematic analysis. The everyday practices of nurse case managers were characterised by providing something else than the usual hospital nursing care by continuously establishing and maintaining relationships with their patients. They emphasised the patient’s psychosocial needs in a biomedical context and accompanied patients across different healthcare settings. The nurse case managers’ everyday practices resonate with the key values of nursing. These values are under pressure in healthcare domi- nated by technical rationality and efficiency leading to increased inequality in health. Further exploration of the potential benefits for multi-morbidity and co-existing social issues is needed. There is a need for continued critical debate about the conditions for caring for patients’ psychosocial needs. The implications of continuing to neglect patients’ psychosocial needs are related to fur- ther increasing inequality in health and impeding equal access to services. Keywords: care coordination, field work, inequality in health, nurse case managers, nursing, qualitative research, thematic analysis

Mutations in the type III receptor tyrosine kinase FLT3 are frequent in patients with acute myeloid leukemia (AML) and are associated with a poor prognosis. AML is characterized by the overproduction of reactive oxygen species (ROS), which can induce cysteine oxidation in redox-sensitive signaling proteins. Here, we sought to characterize the specific pathways affected by ROS in AML by assessing oncogenic signaling in primary AML samples. The oxidation or phosphorylation of signaling proteins that mediate growth and proliferation was increased in samples from patient subtypes with FLT3 mutations. These samples also showed increases in the oxidation of proteins in the ROS-producing Rac/NADPH oxidase-2 (NOX2) complex. Inhibition of NOX2 increased the apoptosis of FLT3-mutant AML cells in response to FLT3 inhibitors. NOX2 inhibition also reduced the phosphorylation and cysteine oxidation of FLT3 in patient-derived xenograft mouse models, suggesting that decreased oxidative stress reduces the oncogenic signaling of FLT3. In mice grafted with FLT3 mutant AML cells, treatment with a NOX2 inhibitor reduced the number of circulating cancer cells, and combining FLT3 and NOX2 inhibitors increased survival to a greater extent than either treatment alone. Together, these data raise the possibility that combining NOX2 and FLT3 inhibitors could improve the treatment of FLT3 mutant AML.

Multidrug efflux pumps are among the main Pseudomonas aeruginosa antibiotic-resistance determinants. Besides, efflux pumps are also involved in other relevant activities of bacterial physiology, including the quorum sensing-mediated regulation of bacterial virulence. Nevertheless, despite the relevance of efflux pumps in bacterial physiology, their interconnection with bacterial metabolism remains obscure. The effect of several metabolites on the expression of P. aeruginosa efflux pumps, and on the virulence and antibiotic resistance of this bacterium, was studied. Phenylethylamine was found to be both inducer and substrate of MexCD-OprJ, an efflux pump involved in P. aeruginosa antibiotic resistance and in extrusion of precursors of quorum-sensing signals. Phenylethylamine did not increase antibiotic resistance; however, the production of the toxin pyocyanin, the tissue-damaging protease LasB and swarming motility were reduced in the presence of this metabolite. This decrease in virulence potential was mediated by a reduction of lasI and pqsABCDE expression, which encode the proteins that synthesise the signalling molecules of two quorum-sensing regulatory pathways. This work sheds light on the interconnection between virulence and antibiotic-resistance determinants, mediated by bacterial metabolism, and points to phenylethylamine as an anti-virulence metabolite to be considered in the study of therapies against P. aeruginosa infections.

The widespread use of government contracting opens up learning opportunities in public organizations’ engagements with private contractors. However, whether public organizations utilize these opportunities to improve their practices has scant coverage in the government contracting literature. We adapt insights from the organizational learning literature, develop an argument on the learning logic in government contracting, and examine manager perceptions of learning outcomes and whether intra- and inter-organizational and contextual conditions shape the learning outcomes. The argument is assessed against survey data reporting on the municipal park and road managers’ contracting experiences in Scandinavia. The findings show that government contracting in the context of the study is associated with positive learning outcomes and indicates possible tradeoffs between conventional cost-driven and learning strategies. The implications contribute to discussions about the role and benefits of government contracting beyond cost savings in the post-NPM reform era.

Performance in short-duration sports is highly dependent on muscle glycogen, but the total degradation is only moderate and considering the water-binding property of glycogen, unnecessary storing of glycogen may cause an unfavorable increase in body mass. To investigate this, we determined the effect of manipulating dietary carbohydrates (CHO) on muscle glycogen content, body mass and short-term exercise performance. In a cross-over design twenty-two men completed two maximal cycle tests of either 1-min (n = 10) or 15-min (n = 12) duration with different pre-exercise muscle glycogen levels. Glycogen manipulation was initiated three days prior to the tests by exercise-induced glycogen-depletion followed by ingestion of a moderate (M-CHO) or high (H-CHO) CHO-diet. Subjects were weighed before each test, and muscle glycogen content was determined in biopsies from m. vastus lateralis before and after each test. Pre-exercise muscle glycogen content was lower following M-CHO than H-CHO (367 mmol · kg-1 DW vs. 525 mmol · kg-1 DW, P < 0.00001), accompanied by a 0.7 kg lower body mass (P < 0.00001). No differences were observed in performance between diets in neither the 1-min (P = 0.33) nor the 15-min (P = 0.99) test. In conclusion, pre-exercise muscle glycogen content and body mass was lower after ingesting moderate compared with high amounts of CHO, while short-term exercise performance was unaffected. This demonstrates that adjusting pre-exercise glycogen levels to the requirements of competition may provide an attractive weight management strategy in weight-bearing sports, particularly in athletes with high resting glycogen levels.

Multiple myeloma (MM) is an incurable bone marrow cancer characterized by the development of osteolytic lesions due to the myeloma-induced increase in osteoclastogenesis and decrease in osteoblastic activity. The standard treatment of MM often involves proteasome inhibitors (PIs), which can also have a beneficial off-target bone anabolic effect. However, long-term treatment with PIs is unadvised due to their high side-effect burden and inconvenient route of administration. Ixazomib is a new generation, oral PI that is generally well tolerated; however, its bone effect remains unknown. Here, we describe the three-month results of a single center phase II clinical trial investigating the effect of ixazomib treatment on bone formation and bone microstructure. Thirty patients with MM in stable disease not receiving anti-myeloma treatment for ≥3 months and presenting ≥2 osteolytic lesions received monthly ixazomib treatment cycles. Serum and plasma samples were collected at baseline and monthly thereafter; Sodium 18Fluoride-Positron Tomography (NaF-PET) whole-body scans and trephine iliac crest bone biopsies were collected before and after three treatment cycles. The serum levels of bone remodeling biomarkers suggested an early ixazomib-induced decrease in bone resorption. NaF-PET scans indicated unchanged bone formation ratios; however, histological analyses of bone biopsies revealed a significant increase in bone volume per total volume after treatment. Further analyses of bone biopsies showed unchanged osteoclast number and COLL1A1High -expressing osteoblasts on bone surfaces. Next, we analyzed the superficial bone structural units (BSUs), which represent each recent microscopic bone remodeling event. Osteopontin staining revealed that following treatment, significantly more BSUs were enlarged (>200,000 μm2 ), and the distribution frequency of their shape was significantly different from baseline. Overall, our data suggest that ixazomib induces overflow remodeling-based bone formation through decreasing the level of bone resorption and promoting longer bone formation events, making it a potentially valuable candidate for future maintenance treatment.

Background: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed and treated psychiatric disorders in childhood. Typically, children and adolescents with ADHD find it difficult to pay attention and they are hyperactive and impulsive. Methylphenidate is the psychostimulant most often prescribed, but the evidence on benefits and harms is uncertain. This is an update of our comprehensive systematic review on benefits and harms published in 2015. Objectives: To assess the beneficial and harmful effects of methylphenidate for children and adolescents with ADHD. Search methods: We searched CENTRAL, MEDLINE, Embase, three other databases and two trials registers up to March 2022. In addition, we checked reference lists and requested published and unpublished data from manufacturers of methylphenidate. Selection criteria: We included all randomised clinical trials (RCTs) comparing methylphenidate versus placebo or no intervention in children and adolescents aged 18 years and younger with a diagnosis of ADHD. The search was not limited by publication year or language, but trial inclusion required that 75% or more of participants had a normal intellectual quotient (IQ > 70). We assessed two primary outcomes, ADHD symptoms and serious adverse events, and three secondary outcomes, adverse events considered non-serious, general behaviour, and quality of life. Data collection and analysis: Two review authors independently conducted data extraction and risk of bias assessment for each trial. Six review authors including two review authors from the original publication participated in the update in 2022. We used standard Cochrane methodological procedures. Data from parallel-group trials and first-period data from cross-over trials formed the basis of our primary analyses. We undertook separate analyses using end-of-last period data from cross-over trials. We used Trial Sequential Analyses (TSA) to control for type I (5%) and type II (20%) errors, and we assessed and downgraded evidence according to the GRADE approach. Main results: We included 212 trials (16,302 participants randomised); 55 parallel-group trials (8104 participants randomised), and 156 cross-over trials (8033 participants randomised) as well as one trial with a parallel phase (114 participants randomised) and a cross-over phase (165 participants randomised). The mean age of participants was 9.8 years ranging from 3 to 18 years (two trials from 3 to 21 years). The male-female ratio was 3:1. Most trials were carried out in high-income countries, and 86/212 included trials (41%) were funded or partly funded by the pharmaceutical industry. Methylphenidate treatment duration ranged from 1 to 425 days, with a mean duration of 28.8 days. Trials compared methylphenidate with placebo (200 trials) and with no intervention (12 trials). Only 165/212 trials included usable data on one or more outcomes from 14,271 participants. Of the 212 trials, we assessed 191 at high risk of bias and 21 at low risk of bias. If, however, deblinding of methylphenidate due to typical adverse events is considered, then all 212 trials were at high risk of bias. Primary outcomes: methylphenidate versus placebo or no intervention may improve teacher-rated ADHD symptoms (standardised mean difference (SMD) -0.74, 95% confidence interval (CI) -0.88 to -0.61; I² = 38%; 21 trials; 1728 participants; very low-certainty evidence). This corresponds to a mean difference (MD) of -10.58 (95% CI -12.58 to -8.72) on the ADHD Rating Scale (ADHD-RS; range 0 to 72 points). The minimal clinically relevant difference is considered to be a change of 6.6 points on the ADHD-RS. Methylphenidate may not affect serious adverse events (risk ratio (RR) 0.80, 95% CI 0.39 to 1.67; I² = 0%; 26 trials, 3673 participants; very low-certainty evidence). The TSA-adjusted intervention effect was RR 0.91 (CI 0.31 to 2.68). Secondary outcomes: methylphenidate may cause more adverse events considered non-serious versus placebo or no intervention (RR 1.23, 95% CI 1.11 to 1.37; I² = 72%; 35 trials 5342 participants; very low-certainty evidence). The TSA-adjusted intervention effect was RR 1.22 (CI 1.08 to 1.43). Methylphenidate may improve teacher-rated general behaviour versus placebo (SMD -0.62, 95% CI -0.91 to -0.33; I² = 68%; 7 trials 792 participants; very low-certainty evidence), but may not affect quality of life (SMD 0.40, 95% CI -0.03 to 0.83; I² = 81%; 4 trials, 608 participants; very low-certainty evidence). Authors' conclusions: The majority of our conclusions from the 2015 version of this review still apply. Our updated meta-analyses suggest that methylphenidate versus placebo or no-intervention may improve teacher-rated ADHD symptoms and general behaviour in children and adolescents with ADHD. There may be no effects on serious adverse events and quality of life. Methylphenidate may be associated with an increased risk of adverse events considered non-serious, such as sleep problems and decreased appetite. However, the certainty of the evidence for all outcomes is very low and therefore the true magnitude of effects remain unclear. Due to the frequency of non-serious adverse events associated with methylphenidate, the blinding of participants and outcome assessors is particularly challenging. To accommodate this challenge, an active placebo should be sought and utilised. It may be difficult to find such a drug, but identifying a substance that could mimic the easily recognised adverse effects of methylphenidate would avert the unblinding that detrimentally affects current randomised trials. Future systematic reviews should investigate the subgroups of patients with ADHD that may benefit most and least from methylphenidate. This could be done with individual participant data to investigate predictors and modifiers like age, comorbidity, and ADHD subtypes.

The study challenges the dominant narrative that Romanian consumer and residential credit laws are a product of the country’s return to capitalism and the market economy, proposing an alternative interpretation. It demonstrates that the origins of Romanian consumer and residential credit laws lay in the pre-World War II and communist legislation that survived the 1989 Revolution. This shows that the communist legacy in consumer and residential credit is real and more enduring than expected and that communism did not differ from capitalism in this respect, other than how consumer and residential credit was organised. Using legal history and doctrinal analysis in a functional approach coupled with statistical and empirical data, the study proves the existence of a normative continuity between pre-and post-1989 Romanian consumer and residential credit laws that ended with the EU accession efforts. Finally, this continuity between communist and capitalist consumer and residential credit laws indicates functional similarities between the monarchic (capitalist) and communist legal systems, further undermining the relevance of political and economic ideology and the idea that communism was inimical to consumers and consumer or residential credit.

Drug metabolism might be altered in patients with type 2 diabetes. We aimed to evaluate if initiation of glucose-lowering drugs impacts warfarin efficacy and drug metabolism. First, we conducted a register-based self-controlled cohort study on Danish and Scottish warfarin users. Warfarin efficacy (International Normalized Ratio (INR)) was compared before and after initiation of glucose-lowering drugs. Second, we conducted a clinical pharmacokinetic trial comprising treatment-naïve type 2 diabetes patients. Patients ingested probe drugs for drug-metabolizing enzymes (the Basel Cocktail) before initiating glucose-lowering treatment, and after three and 12 weeks of treatment. Drug metabolism, glycemic control, and inflammation were assessed on each visit. In the Danish and Scottish cohorts (n=982 and n=44, respectively), initiating glucose-lowering drugs reduced warfarin efficacy. INR decreased from 2.47 to 2.21 in the Danish cohort (mean difference -0.26; 95% CI -0.35;-0.17) and from 2.33 to 2.13 in the Scottish cohort (-0.21; 95% CI -0.52;0.11) after initiation of glucose-lowering treatment. This impact on INR was more pronounced among individuals with stronger effects of glucose-lowering treatment. In the clinical pharmacokinetic trial (n=10), initiating metformin did not affect drug metabolism after three weeks (geometric mean ratio of CYP3A metabolic ratio: 1.12 (95% CI: 0.95;1.32)) or 12 weeks of metformin treatment. Glycemic control improved during treatment, while inflammation remained low and unchanged during treatment. In conclusion, initiation of glucose-lowering drugs among chronic warfarin users seems associated with a reduction in INR, particularly among individuals with a large decrease in HbA1c . This effect seems unrelated to CYP enzyme activity and warfarin drug metabolism.

Background: GA2 LEN-ADCARE is a branch of the largest multidisciplinary network of research centres and clinical care in allergy and asthma, GA2 LEN, focussing on the field of atopic dermatitis (AD). AD is a chronic inflammatory skin disease with high burden and many comorbidities requiring different levels of treatment. The need for aligned information from all involved healthcare providers led to the discussion of an integrated care pathway (ICP) plan for AD patient care involving all stakeholders and considering the complexity and variability of the disease, with a particular focus placed on the large number of patients with milder forms of AD. Methods: The GA2 LEN ADCARE network and all stakeholders, abbreviated the AD-ICPs working group, were involved in the discussion and preparation of the AD-ICPs during a series of subgroup workshops and meetings in years 2020 and 2021. Results: Here we discuss the unmet needs in AD, the methodology for devising an AD-ICP and the ICP action plan. Conclusion: The GA2 LEN ADCARE network has outlined the unmet needs in AD and provided an action plan for devising AD-ICPs, considering the complexity and variability of the disease.