VPH2018: VIRTUAL PHYSIOLOGICAL HUMAN 2018
PROGRAM FOR THURSDAY, SEPTEMBER 6TH
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09:00-10:00 Session 9: Plenary speaker II
09:00
Human In Silico Drug Trials with Multiscale Models of the Heart

ABSTRACT. 1. Introduction In silico trials in medicine refer to the evaluation of a medical therapy using computer models. Already established in engineering applications (such as aeronautics), in silico trials are now starting to be more widely adopted in medicine with broad potential impact in academy, industry and regulatory bodies.[1] The socio-economic potential in this area is thus huge. In my talk, I will describe progress made in computational modelling and simulation of the heart towards the realisation of in silico trials for cardiac pharmacology and medicine.

2. Materials and Methods I will describe the construction of populations of human atrial and ventricular multiscale models from ionic currents to whole-organ dynamics. Inter-subject and intra-subject differences are investigated through consideration of variability in ionic properties such as ion current densities and kinetics, and also stochastic ion channel properties. Anatomical cardiac variability is also considered by constructing anatomical models from clinical magnetic resonance images obtained in different patients’ cohorts. In addition, we further perturbed properties such as the orientation and pose within the torso. The functional and structural consequences of disease conditions such as myocardial ischemia and cardiomyopathy are implemented and validated based on experimental and clinical datasets. Drug effects are incorporated using experimental datasets, and the simulation results of the in silico trials are further evaluated using evidence from experiments and clinical trials.

3. Results I will present our latest results illustrating the power of computer modelling and simulation in human in silico trials for investigations of phenotypic electromechanical variability in disease and response to treatment. These build on our recent work demonstrating that human in silico drug trials using populations of single cell simulations can predict pro-arrhythmic risk with 90% accuracy, thus outperforming preclinical animal studies.[2] Results will focus on cardiac electrophysiological simulations from ionic mechanisms to the electrocardiogram, and will extend further towards simulations of electromechanical activity and contractility. I will also illustrate how we have developped this research programme into human in silico trials in partnership with collaborators in academia, industry and regulatory agencies.[3]

4. Discussion and Conclusions In summary, I will describe our recent work in multiscale computational modelling and simulation of human hearts, and its application to investigations of phenotypic variability through in silico drug trials. I will emphasize the importance of inter-disciplinary, inter-sectoral collaborations in this work.

5. References 1. Pappalardo F, et al. In silico clinical trials: concepts and early adoption. Briefings in Bioinformatics, bby043, https://doi.org/10.1093/bib/bby043 2. Passini E., Frontiers in Physiology, 8:668. doi: 10.3389/fphys.2017.006682017, 2017. 3. Rodriguez et al. Europace, Sep;18(9):1287-98, 2016.

Acknowledgements: The research presented in this talk is work conducted within the Computational Cardiovascular Science team (www.cs.ox.ac.uk/ccs), with financial support by Wellcome Trust Senior Research Fellowship in Basic Biomedical Sciences (100246/Z/12/Z), an Engineering and Physical Sciences Research Council Impact Acceleration Award (EP/K503769/1), the CompBioMed project (European Commission grant agreement No 675451) and the NC3Rs Infrastructure for Impact award (NC/P001076/1).

10:00-10:30Coffee Break
10:30-12:30 Session 10A: Cardiovascular modeling: from simulation to clinical outcome organised by E-cardiology III
10:30
Cardiac dynamics and arrhythmic risk in aged and failing hearts: insights from experimental and computational research
SPEAKER: Esther Pueyo
11:00
Combining tissue heterogeneity and anisotropy in a fractional model of cardiac electrophysiology
11:15
A patient-specific fluid-structure interaction analysis of TAVI procedure
11:30
Effect of fibrosis on BSPM of patients with focal atrial tachycardia
11:45
Validation of a reduced order model for prediction of FFR, using in vivo data, 3D INS and UQ & SA
12:00
Mechanisms underlying interactions between low-frequency oscillations and beat-to-beat repolarization variability under sympathetic provocation
12:15
Computational pre-surgical planning of cardiovascular patch reconstruction – pre-operative structural and hemodynamic performance in selected clinical cases
SPEAKER: Kerem Pekkan
10:30-12:30 Session 10B: Orthopaedics and craneofacial II
Location: Room 0.01
10:30
Towards functional pre-planning in orthopaedic surgery
11:00
Stability of anterograde intramedullary nails in distal femoral fractures
11:15
Apex Vertebra Transpositions in the 3D Optical Diagnosis of 372 Patients with Adolescent Idiopathic Scoliosis
SPEAKER: Sasa Cukovic
11:30
A phantom-less calibration technique for use in femur strength prediction
SPEAKER: Carla Winsor
11:45
Design of an electro-stimulating system for a defective minipig mandible
12:00
Integration of Cortical Thickness data in a Statistical Shape Model of the Scapula
12:15
Development of a physiologically relevant structural model of the pelvic construct to simulate fracture
10:30-12:30 Session 10C: Other applications in organ physiology
Location: Room 0.02
10:30
FE modelling of alveolar mechanics based on the Weaire-Phelan unit cell
10:45
Modelling the cerebral diffusive spread of pathology in Parkinson’s disease
11:00
An Averaged Geometry of the Human Nasal Cavity
SPEAKER: Jan Bruening
11:15
o2S2PARC – The Simulation Core of the NIH SPARC Initiative
SPEAKER: Esra Neufeld
11:30
How Ionic Imbalances Alter Axonal Conduction. A Computational Study.
11:45
An in silico HBV model predicts viral response to the oral non-steroidal carboxylic acid FXR agonist EYP001a
SPEAKER: Evgueni Jacob
12:00
A preliminary in silico model of the thrombectomy procedure
12:15
Customized design of colonic stents based on a parametric model
10:30-12:30 Session 10D: Multiscale modeling III
Location: Room 0.03
10:30
A microstructurally-based material model for the description of skeletal muscle tissue
10:45
Simulating Electromyography (EMG) Signals by Using a Generalized Bidomain Approach
SPEAKER: Thomas Klotz
11:00
Semantics-based model discovery for renal transport
11:15
Whole Brain Simulations in Mouse Elucidate Mechanisms of Local Cerebral Blood Flow Control
11:30
Intracranial Aneurysms: A Patient-Specific Fluid-Solid-Growth (FSG) Framework with Modelling of Endothelial Response
SPEAKER: Yuqian Mei
11:45
BioGears: An In-Silico Whole-Body Framework to Simulate Kinetics and Dynamics of Pharmaceuticals and Associated Reversal Agents
SPEAKER: Austin Baird
12:00
Multiscale model of transport and uncoiling of ultralarge proteins in cellular blood flows
10:30-12:30 Session 10E: Model Reduction, Big Data and Dynamic Data-Driven Systems I
Location: Room 0.04
10:30
Organs Hybrid Twin: towards a new paradigm in computational surgery
SPEAKER: Elias Cueto
11:00
On the evaluation of hip fracture risk using advanced machine learning techniques
SPEAKER: Enrique Nadal
11:15
Deformable Augmented Reality via Model Order Reduction Methods
11:30
A Model Execution Environment for Valvular Heart Condition Simulations
11:45
Modelling and control of an adaptive biohybrid device for modulation of inflammation
SPEAKER: Judy Day
10:30-12:30 Session 10F: Industry Session: ANSYS

10:30 – 10:40: “Welcome and Introduction to ANSYS”; Thierry Marchal, Global Industry Director Healthcare, ANSYS

10:40 – 11:05: “Computational-based MRI Thermal Injury Risk Assessment for Patients implanted with Passive Spinal Devices”; Payman Afshari, Sr. Principal Engineer at DePuy Synthes Spine, Johnson and Johnson

11:05 – 11:30: “Getting to Know Your Digital Twin”; Marc Horner, Technical Lead Healthcare North America, ANSYS

11:30 – 11:55: "Why In Silico Healthcare is important for Medtronic?"; Mark Palmer, Senior Principal Scientist, Science Technology & New Therapies, Medtronic

11:55 – 12:20: “An on-line platform to facilitate in silico clinical trials while complying to FDA guidances”; Luca Emil, CEO In Silico Trials Technologies

12:20 – 12:30: Wrap up & Discussion, Thierry Marchal

12:30-14:00Lunch Break
14:00-16:00 Session 12A: Cardiovascular modeling: from simulation to clinical outcome organised by E-cardiology IV
14:00
InSilc: In Silico Trials for drug-eluting bioabsorbable vascular scaffold (BVS) development and evaluation
SPEAKER: Ted Vaughan
14:15
A platform for patient-specific vascular medicine: a case study of a chronic type-B aortic dissection
14:30
In silico stent deployment in the coronary artery with plaque progression
14:45
Embedded Computational Fluid Dynamics to study cardiovascular pathologies: Aortic Dissection.
15:00
An anatomical surrogate of wall compliance in the child heart
15:15
A rule based method for assigning fiber information to heart complex structures
SPEAKER: Ruben Doste
15:30
A 4D Flow MRI-based modelling approach to assess left ventricular function during rest and stress conditions
SPEAKER: Belen Casas
15:45
Automatic segmentation of the atrial region using a competitive deformable model approach
14:00-16:00 Session 12B: Impact and Injury
Location: Room 0.01
14:00
Effect of high-impact exercise on trabecular bone adaptation in postmenopausal women
SPEAKER: Juan Du
14:15
Patient-Specific Principal Component Analysis Stratifies Multiple Organ Dysfunction Outcomes based on Type 17 Immune Responses in Blunt Trauma Patients in the First 24 Hours Following Injury
14:30
Thoracic Deformation in Nearside Oblique Sled Impacts
SPEAKER: Ana I Lorente
14:45
Development and Evaluation of a Subject-Specific Brain Injury Model
15:00
Effect of Bone Micromorphology on Multiple Crack Propagation: Finite-element Analysis
15:15
DXA-based 3D patient-specific femur model simulations for hip fracture prediction
15:30
Influence of the head size in the injury metrics for oblique impacts
SPEAKER: Ana Piqueras
15:45
Using digital image correlation to validate meniscus tear patterns predicted by continuum damage models
SPEAKER: Trevor Lujan
14:00-16:00 Session 12C: Image-based in-vitro analysis
Location: Room 0.02
14:00
Image-based in vitro analysis and computational modelling to characterise the mechanical environment of bone cells during osteoporosis
14:30
A model for endothelial cell migration under flow conditions
SPEAKER: Pavel Zun
14:45
Calibrating a stochastic model of cell migration using image-based in vitro analysis and Bayesian optimization.
15:00
Cerebral aneurysm tissue investigation: experiment and simulations
15:15
IMAGO: an online platform for microscopy image analysis in in-vitro experiments
SPEAKER: Carlos Borau
15:30
On the context of use of directly validated spinal functional units FE models
15:45
A novel 3D printed bioinspired cardiac pneumatic pump: from design to numerical and experimental study
14:00-16:00 Session 12D: Multiphysics modeling I
Location: Room 0.03
14:00
In silico characterisation of the spatiotemporal evolution of stem cell niches during neotissue growth in 3D scaffolds during perfusion bioreactor culture
SPEAKER: Liesbet Geris
14:30
Finite element analysis of individual cell migration under conditions of mechanical confinement
14:45
Influence of the mechanical properties of cell nucleus on overall deformation of the cell: a computational study
15:00
Cell resolved simulations of saccular aneurysms: effects of pulsatility and aspect ratio
15:15
A multiphysic simulation of mechanotransduction effect through stretch operated channels in the uterine muscle.
15:30
Modelling high shear-rate platelet aggregation on cellular level
15:45
NEUROMAN: Implementing Neuro-Functionalized Computational Human Body Models
SPEAKER: Bryn Lloyd
14:00-16:00 Session 12E: Model Reduction, Big Data and Dynamic Data-Driven Systems II
Location: Room 0.04
14:00
Development of Computational Patient Avatars by Manifold Learning
SPEAKER: Elías Cueto
14:15
The use of neuronal networks to help in pathologies diagnosis
14:30
Full-blown 3D blood flow simulation in approach of effective compressibility as a model of vessel elasticity
14:45
Reduced order modelling of electroporation in biological tissues for pulse delivery optimization
15:00
Instabilities in Time Series from Intensive Care Units: A Sepsis Case Study
14:00-16:00 Session 12F: Industry Session: Technology transfer and access: challenges and opportunities

Technology transfer and access: challenges and opportunities

In the last decades, universities and research centers have been applying modeling and simulation (M&S) to problems involving health and medicine, coining the new expression in silico clinical trials, but its use is still limited to a restricted pool of expert adopters.

Making M&S available to a broad spectrum of potential users (medical device and pharmaceutical companies, hospitals, healthcare institutions) would require an easy and controlled access to models and computational resources in a secure and compliant environment while protecting the intellectual property of the models’ creators.

Meanwhile, the European and USA regulatory agencies are starting to recognize the use of M&S in the research and technological development and to provide evidence in the approval process for new medical products. A joint effort from academia, industry and regulatory bodies is then required to reach a rapid adoption of a harmonized approach.

In this session, we will talk about potentials, limitations, challenges, and opportunities that the community has to deal with to leverage the significant value of M&S solutions which are being developed but are not fully exploited, in order to reach a broad adoption and democratization of simulations in healthcare.

Session topics:

  • 14:00 – 14:15 Is there a "Valley of Death" for in silico medicine technologies? - Marco Viceconti, Executive Director at Insigneo Institute for in silico Medicine
  • 14:15 – 14:30 In silico modelling: From lab to the end-users - Javier Saiz, Professor at Universidad Politécnica de Valencia
  • 14:30 – 14:45 Learning from other industries: exploiting world class research to accelerate industrial innovations - Thierry Marchal, ANSYS Global Industry director
  • 14:45 – 15:00 One model for all and all efforts as one! - Nico Verdonschot, Scientific Director of Technical Medical Center at University of Twente
  • 15:00 – 15:15 Commercializing Computational Models of Inflammation: Past, Present, and Future - Yoram Vodovotz, Director at Center for Inflammation and Regenerative Modeling, University of Pittsburgh
  • 15:15 – 15:30 Technology transfer and technology access. How InSilicoTrials is working with researchers and industry – Luca Emili, CEO at InSilicoTrials Technologies
  • 15:30 – 16:00 Round Table, moderator: Luca Emili, CEO at InSilicoTrials Technologies
16:00-16:30Coffee Break
16:30-19:00 Session 13: In silico clinical trials – a disruptive innovation for biomedical industry

Target: Industry specialists (product developers, regulatory affair, clinical trialists, etc.)

Tentative programme

16:30 – 16:45  The emerging regulatory landscape for in silico methods – Tina Morrison, FDA

16:45 – 17:30  Tools and services for in silico clinical trials: Moderator: Thierry Marchal, Avicenna Alliance.

                        Ansys – Representative.

                        Materialise – Sjoerd Kolk.

                        InsilicoTrials – Luca Emili.

                        Quibim – Angel Alberich-Bayarri.

17:30 – 17:45  In silico Clinical Trials: A vision of the future: Marco Viceconti, Insigneo Institute

17:45 – 18:00  Examples of early applications: Mark Palmer, Medtronic

18:00 – 18:10  Scalability of Computational Medicine applications: Peter Coveney, CompBioMed CoE

18:10 – 18:45  Round table. Moderator: Thierry Marchal, Avicenna Alliance

 

20:30-22:30Social Dinner