Thematic Conference - ICBT2017

M.S. 01: Simulations for Cardiovascular Diagnosis and Treatment: From Computer through Devices to Bedside (Ferdinando Auricchio, Michele Conti, Sotirios Korossis, Michele Marino, Peter Wriggers)

Keywords:  In silico studies, Biomechanical modelling, Computational methods, Cardiovascular diseases, Diagnosis and treatments

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The aetiology of many cardiovascular diseases is still debated, leading to late diagnostic responses which are available only when the pathological condition is associated with relevant clinical signs. After diagnosis, therapeutic approaches usually follow population-based clinical records, neglecting the high patient-specific variability. Most of the times, open or endovascular surgical treatments is the elective choice for treatment. In this framework, two main issues can be recognised: the decision to electively intervene is mainly based on criteria that are highly unreliable; mortality and morbidity rates of surgical approaches remain high. Therefore, an in-depth understanding of the mechanisms involved in the initiation and progression of cardiovascular diseases could facilitate better criteria for diagnosis and selective surgical treatments, as well as to better drug-based therapies. Moreover, strategies for improving the clinical follow-up and the effectiveness of artificial organs could be conceived.

In this framework, in silico studies in medicine are thought to have the potential to speed the rate of discovery while reducing the need for expensive laboratory work and clinical trials. They allow indeed to reproduce different clinical scenarios and to conduct parametric analyses for the investigation of different hypotheses related to both pathological mechanisms and medical approaches. Moreover, if coupled with fast prototyping approaches, in silico studies open to develop proof-of-concepts for novel medical devices that optimize the clinical follow-up.

This mini-symposium aims at bringing together engineers, device manufactures, physicians, biochemists and biophysicists, with a view to facilitating an interdisciplinary debate on the present and the future of in silico approaches in medicine. The aim is to trace guidelines for reaching the ultimate goal of computational cardiovascular research, namely the bedside. The topics to be discussed in the mini-symposium include:

• experimental techniques for in vitro and in vivo measurements;
  
  

• modelling approaches in mechanics and biology;
  
  
• advanced computational techniques;
  
  
• in silico clinical trials;
  
  
• innovative diagnostic criteria;
  
  
• development and assessment of medical devices.

M.S. 02: Contact in Soft Tissues: Experimental, Theoretical & Computational Tools (Marco Paggi, Alessio Gizzi, Jose Reinoso)

Keywords: contact mechanics, biomechanics, multiphysics, soft tissues

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Contact theory is a well-established modelling tool in the context of hard and soft tissues mechanics. Recent advances have further introduced multiphysics couplings during the mechanical contact in which the development of complex interfaces has led to novel emerging behaviors. However, a comprehensive overview of the subject is still in its infancy when related to contact in soft biological tissues.

The aim of the present mini-symposium is to bring together different scientific communities under a novel inter- and trans-disciplinary subject. This session will allow sharing the last advances in the development of novel experimental techniques, generalized theoretical formulations and efficient computational tools addressing the study of the interaction between soft tissues as well as hard and soft tissues at different length scales. The additional identification of biomedical technological problems will further promote the exchange of ideas.The mini-symposium will promote a multidisciplinary discussion covering, but not restricted to, the following subjects:

• experimental techniques for quantifying contact interaction among biological media
  
  
• physiological and pathological contact mechanics characters at molecular, cellular, and tissue scale
  
  
• theoretical description of multiphysics contact interfaces
  
  
• numerical techniques of contact mechanics
  
  
• design, modeling and simulation of biomedical devices in contact with biological tissues
  
  
• adaptive modeling tools for soft tissue characterization towards contact problems in robotic         assisted biomedical procedures

M.S. 03: Behind Pathogenesis and Biocompatibility: Modeling and Experiments Linking Biomechanics to Biology (Antonella Camaioni, Alessio Gizzi, Michele Marino, Giuseppe Vairo)

Keywords: pathogenesis, biocompatibility, molecular mechanisms, biochemical and histological assessment, mechanobiology, growth and remodelling

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Pathogenesis is a multifactorial process in which the relationship between cellular imbalance and biomechanics plays a crucial role. As a matter of fact, tissue metabolism is governed by cell-cell and cell-matrix interactions based on signalling pathways whose imbalance is instrumental in the onset and progression of the disease. The biological activity of several molecular species (e.g., growth factors, cytokines, proteinases) alters indeed the microstructure, the biochemistry and the biophysics of a tissue. In turn, these mechanisms alter biomechanical properties such as stiffness, strength and anisotropy. Inflammatory conditions or non-physiological mechanical loads can impair cell and tissue balance and, for example, in the case of an implanted device, can lead to the reaction of the host against foreign body. In addition, the interaction of a device with adjacent cells not only can induce various degrees of inflammation but also impair local bacterial clearance. Therefore, biocompatibility highly affects the biomechanical performance of a prosthesis.

Accordingly, a closed feedback system between biomechanics and biology drives pathogenesis and biocompatibility, involving molecular mechanisms at the nanoscale level, cell metabolism at the microscale level, and organ response at the macroscale level. A better knowledge of these mechanisms and their interplay would improve clinical approaches and therapy effectiveness based on better criteria of choice for the elective treatment. To reach this goal, a multidisciplinary vision is needed, involving modeling approaches in biomechanics and mathematical biology, as well as data coming from molecular and cell biology experimental setups.

The aim of this mini-symposium is to promote a multidisciplinary discussion among engineers, mathematicians, biochemists, biophysicists and biologists by addressing the following issues:

•      assessment of biochemical properties and histological features of a tissue;
  
  

•       clarification of pathological pathways;
  
  

•       biocompatibility of medical devices;
  
  

•      multiphysics models in biomechanics and mechanobiology;
  
  

•      simulation techniques for molecular biology;
  
  

•      mathematical description of cell growth and tissue remodelling;
  
  

•      in silico biology.

M.S. 04: Bone Mechanics: From Experiments and Modelling to Clinic Applications (Michael Roland, Oliver Röhrle, Stefan Diebels)

Keywords: bone mechanics, clinical mechanics, patient-specific simulations, individualized osteosynthesis, bone fractures

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Personalized simulations based on patient-specific data become a more and more relevant task in orthopedic trauma surgery. One of the challenges hereby is to determine from experiments and from medical imaging techniques individual anatomical and functional data of the bone, e.g. geometries and material properties of bone. From a functional point of view, the fundamental understanding of the mechanical behavior of bone under realistic loading conditions are essential. For this, detailed experimental studies are indispensable. Besides modelling the mechanical behavior of the bone, successful simulation-based workflow concepts within clinical practice also rely on specialized computational techniques for segmentation, material assignment and volume meshing. Achieving such patient-specific workflows that combines material characterization, image analysis and simulation with realistic boundary conditions, one would have a powerful tool for providing individualized and on-demand customized osteosynthesis implants.

The main objectives of this mini-symposium are centered on bringing together engineers, mathematicians, physicist, biologists, computer scientists, experimentalists and (end)users in orthopedic trauma surgery to discuss concepts and strategies from experiment and simulation to clinical applications.

Topics of interest include, but are not restricted to, the following:

• novel concepts in computational biomechanics

• novel strategies in material modelling of bones

• simulation techniques based on medical imaging

• personalized simulations with a focus on clinical applications

• applications with potential relevance for orthopedic trauma surgery

M.S. 05: Multi-X Modelling of Organs and Tissue (Tim Ricken, Navina Waschinsky)

Keywords:
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Understanding the function and behaviour of organs and tissue means to understand the mutual interplay of coupled mechanisms on different time and length scales. Examples are such complex organs like e.g.

• lung with the coupled air-blood interaction,

• liver with coupled oxygen-nutrient interaction, or

• heart with active/passive electro-mechanical coupling.

In particular, phenomena on smaller scales such as molecular or cell scales often contribute and significantly influence the overall behaviour on more macroscopic scales, such as the organ scale or the organ system scale. Hence, it is essential to develop new methodologies and modelling techniques that couple multiple phenomena within and/or across the scales, including e.g.

• non-linear tissue behaviour,

• blood perfusion,

• nutrient and substances transport,

• dynamic bio-chemical non-equilibrium state,

• cell metabolism and functionality, and

• growth and remodelling.

Once such computational models are established, they have great potential to become essential assistive tools within the field of predictive medicine.

The main aim of the mini symposia is to bring together researchers from different fields of mechanics that aim to build multi-scale and multi-physics continuum-mechanical models of organs. While different research groups might focus on modelling different biological tissues, it is important that these researchers meet and exchange their ideas on novel methodologies for coupling different physical phenomena, for implementing new homogenisation methodologies, or for developing biophysically-based bridging techniques.

Topics of interest include, but are not restricted to, the following:

• Multi-phasic continuum mechanical modelling of biological materials

• Multi-scale modelling of active biological materials

• Multi-field models describing the natural pathways of multi-field processes inside the tissue

• Computational models designed for enabling new pathways in predictive medicine

• Mass transport in soft biological tissues

• Growth and remodelling in soft and hard biological tissues

• Modelling of tissue functions

• Model reduction techniques

M.S. 06: Mechanics of Hearing (Hannes Maier)

Hearing is one of the most important senses, especially in humans as we rely on of speech and communication in daily life. Even today the underlying acoustical-mechanical properties of the middle and inner ear or sound transmission by the skull are only partially understood. Since the mid-eighties new hearing devices have been developed to treat common pathologies for which conventional therapies fail. Multiple implantable devices have been introduced for patients with conductive and mixed hearing loss, such as implantable bone conduction devices (BCD), active middle ear implants (AMEI) and direct acoustic cochlea stimulators (DACI) since then.

Experiments and computational model research helps to better understand the physiology and stimulation principles of hearing to optimize treatments, to extend applications and to develop new devices to compensate for hearing deficits more optimally than today. Applications extend along the entire peripheral sound transmission and processing chain and include:

• Sound transmission by bone conduction

• Tympanic membrane and acoustic input impedance

• Models of the middle ear sound transmission

• Mechanics of the inner ear and active amplification by outer hair cells

M.S. 07: Computational Modelling of Neuroprosthetics (Waldo Nogueira)

Recent advances in engineering, computing and neuroscience are contributing to novel approaches to recover human senses and to treat neurological and mental disorders as well as understanding various function of the brain. These new approaches are based on the ability to stimulate and record neural activity with increased accuracy.

New technologies including computational models permit the expansion and understanding of neural interfaces, devices that interact with the nervous system to restore or enable sensory and motor function. Examples of successful neural interfaces include cochlear implants for hearing impaired people, retinal implants for the blind, and devices for deep brain stimulation (DBS) for individuals with Parkinson’s disease, essential tremor and other motor symptoms.

Computational models are very useful to optimize and understand neural interfaces. This session will include review studies and novel contributions in the field of computational models of retinal, cochlear and deep brain stimulation devices. Bringing researchers together from different disciplines working in different applications of neuroprosthetics within the common topic of computational modelling will bring synergistic effects and offer the opportunity to learn from each other’s field.

Computational models may include:

• Electrical and mechanical models for neuroprosthetics
• Neural activity models
• Higher level perceptual models of hearing, vision and motor function
• Personalization of computational models
• Optimization of neural prosthetics based on computation models

M.S. 08: Innovative Neurointerfacing (Theodor Doll)

M.S. 09: Biomedical Imaging and Image Processing

Diagnoses and therapeutic decisions are frequently based on in vivo snapshots of biological structures. As a matter of fact, biomedical imaging can monitor the current condition of organs and tissues, providing instrumental information to clinicians. In this framework, advances on the technologies and on the post-processing in biomedical imaging can lead to improved models for a better understanding of health and disease. As a matter of fact, more reliable imaging and image processing techniques would help physicians for more effective diagnostic and treatment evaluations. Due to recent progresses in computer technology and to modern sensors, the scientific community is gaining significant advances in the field.

The improvement of imaging and image processing attracted the interest of a wide community of researchers, being intrinsically a multidisciplinary problem ranging from electrical through mechanical to software engineering, but also involving advanced mathematical techniques. Furthermore, the reliability of image reconstruction approaches in a user-friendly way can be assessed only within an interdisciplinary environment involving biologists, radiologists and physicians. This minisymposium addresses the latest research in all fields of biomedical image processing, image analysis and image reconstruction to create 3D models.

M.S. 10: Biomaterials and Biocompatibility

The development of biocompatible and functional biological replacements is essential for the improvement of existing therapeutic approaches. These replacements substitute indeed pathological tissue portions which confers non-functional behavior to organs or biological structures. In the last years, a significant progress has been made in developing new materials or refining existing material composition in order to obtain better performance of medical devices in clinical applications. In particular, biocompatibility ensures that employed materials can exist in a living environment.

In terms of the specific interaction of a material and biostructures, biomaterials should be either biotolerant, bioinert and bioactive. Moreover, bioresorbability properties allow developing non-permanent devices for less-invasive treatments. In this framework, a thorough understanding of the host response is therefore highly necessary and a number of open issues still arise. This minisymposium focuses on all aspects of biomaterials and biocompatibility as well as host response from a clinical, biological and engineering point of view which includes material science, computational and experimental aspects (in vivo and in vitro) as well as the fabrication of biomaterials.

M.S. 11: Computational Medicine

The outlook of biomedical research is the development and use of engineering tools to support the tailoring of clinical treatments to patient-specific features. Such a trend has been revealed to be particularly effective in orthopedic or cardiovascular problems, where in-silico approaches give nowadays important information for surgical planning. The core approach within in-silico models is to model the molecular biology, the physiology and the anatomy of diseases. As a matter of fact, in order to conduct reliable in-silico analyses in a patient-specific framework, three key ingredients have to be faced: i) the reconstruction of anatomical sites from a geometrical point of view; ii) the prediction of the mechanical response of biological tissues; iii) the definition of realistic boundary conditions for numerical simulations. In particular, for instance, tissue mechanics is related to the actual physiopathological remodeling state which is, in turn, associated with molecular biophysical mechanisms involved in cell-cell signaling pathways.

The development of accurate in-silico models offers the possibility of gaining a novel perspective in medicine, where computational methods might assist the clinical practice. To reach this aim, computational medicine requires interdisciplinary collaborations between mathematicians, computer scientists, engineers and medical doctors. Novel results in the field would have a tremendous impact on the effectiveness and the social impact of diseases’ treatments. This minisymposium addresses the most to-date approaches in the field of computational medicine, with the aim to present results on a better understanding of physiopathological mechanisms, as well as on improved computational approaches for the diagnosis and treatment of human diseases. Not only the latest research of computational models, but also the translation and application in the clinics, will be discussed within this minisymposium.

M.S. 12: Cell and Tissue Engineering

The improvement or the replacement of biological tissues can be performed by the use of scaffolds for the formation of new viable tissue, that is by means of cell and tissue engineering techniques. The latter are nowadays rapidly growing fields and employ a combination of cells, engineering and materials methods for conferring suitable biochemical, biomechanical and physicochemical properties for the repair or the replacement of whole tissues. In this framework, a great interest has been gained by stem cells which are a potentially powerful cell source to rebuild tissues. The understanding on the power of stem cells and novel techniques for the development of new biomaterials to guide cell behavior is at the cutting edge of biomedical research. Due to the tremendous progress in genetic medicine and stem cell technology, these disciplines offer indeed the potential to influence the cell and tissue performance. This outcome can drastically change regenerative medicine.

However, a lot of research is still necessary for moving towards the clinical application of tissue engineering therapies. In this framework, the open challenges attracted the interest of a wide community of researchers. Few examples are: fundamental studies to determine a cell’s response to its environment; the development of applied technologies (e.g., microfabrication, polymer and biomaterial synthesis); drug and gene delivery approaches. This minisymposium addresses all aspects related to cell and tissue engineering. It ranges from computer-aided cell and tissue engineering, experimental testing, design and fabrication techniques to the clinical translation, clinical tests and applications.

M.S. 13: Prostheses and Implants

Prostheses and implants are designed to help the patient to partially or completely recover the normal function, esthetics and comfort like before the replacement. Although a lot of progress has been made, many challenges, like individuality and persistence, has still to be resolved. The analysis of the performance of prostheses and implants involves the coupling of complex mechanical behavior, complex loading and boundary conditions, as well as complex design requirements. In the design of prostheses and implants, the need of conducting highly-individualized simulations is essential for the understanding of their behavior under in-vivo loading conditions. Therefore, advances on the techniques for acquiring patient-specific data (e.g., image processing techniques or external measurement procedures) would have a significant impact on design improvements. In this framework, additive manufacturing technologies can significantly contribute to improve the personalization of prostheses and implants, as well as their optimization in terms of functional behavior for the correct physiological response. Furthermore, novel bioactive and smart materials open the door to groundbreaking developments where the behavior of prostheses and implants tune in agreement with the surrounding conditions.

The development of novel individualized implants and prostheses can be reached by a collaborative research environment based on interdisciplinary interaction between engineers, material scientists, biologists and medical users. Both experimental and computational approaches are required for combining the several challenges endowed by the design of customized implants and prostheses. This minisymposium focuses on challenges and on available solutions: for the application of implants and prostheses in the clinical practice; for patient specific fabrication (e.g., 3D printing); for new design concepts; for computational modeling and experimental testing of implants and prostheses. The ultimate goal is to present a general overview of the ingredients which make up the workflows that allow to predict the behavior of implants and prostheses on a subject-specific basis, as well as to propose non-conventional design paradigms, by means also of specific clinical case-studies.

M.S. 14: Simulations in Dentistry: From Modelling and Simulation to the Virtual Dental Patient (Meike Stiesch, Peter Behrens)

Keywords:  In silico studies, Biomechanical modelling, Computational methods, Dentistry

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Many patients suffer from tooth decay or even tooth loss which requires dental treatment. While small tooth cavities can often be treated with fillings, more severe damage or tooth loss frequently requires treatment with dental implants and/ or dental prosthesis.

The long term success of these dental restorations depends upon several factors including, but not limited to: bone quantity and quality, biofilm formation, bite forces, type of implant system and its osseo-integration, prosthetic supraconstruction and its processing, occlusal design and anchorage. For sustainable restorations, one should keep these factors in mind, which can have a significant impact on biomechanical properties and long term prognosis of dental implants.

In this context in silico studies can speed up research and development for dental implant and/or restorative solutions, and can also address topics which are too complex to be studied solely by means of physical experiments. This mini-symposium aims to bring together scientists from various communities in order to develop new interdisciplinary strategies for the improvement in the long term success of dental implants/restorations. The topics to be discussed in the mini-symposium include:

• biomechanical modelling approaches
  
  
• experimental techniques for in vitro and in vivo measurements
  
  
• innovative treatment planning using patient specific data and simulation results
  
  
• numerical investigations of biofilm formation or tissue/bone formation
  
  
• simulations focusing on the implant bone interaction
  
  
• simulations focusing on implant, supra constructions, jawbone or occlusal design aspects