Simulation Research in Gastrointestinal and Urologic Care-Challenges and Opportunities: Summary of a National Institute of Diabetes and Digestive and Kidney Diseases and National Institute of Biomedical Imaging and Bioengineering Workshop.

: A workshop on "Simulation Research in Gastrointestinal and Urologic Care: Challenges and Opportunities" was held at the National Institutes of Health in June 2016. The purpose of the workshop was to examine the extent to which simulation approaches have been used by skilled proceduralists (not trainees) caring for patients with gastrointestinal and urologic diseases. The current status of research findings in the use and effectiveness of simulation applications was reviewed, and numerous knowledge gaps and research needs were identified by the faculty and the attendees. The paradigm of "deliberate practice," rather than mere repetition, and the value of coaching by experts was stressed by those who have adopted simulation in music and sports. Models that are most useful for the adoption of simulation by expert clinicians have yet to be fully validated. Initial studies on the impact of simulation on safety and error reduction have demonstrated its value in the training domain, but the role of simulation as a strategy for increased procedural safety remains uncertain in the world of the expert practitioner. Although the basic requirements for experienced physicians to acquire new skills have been explored, the widespread availability of such resources is an unrealized goal, and there is a need for well-designed outcome studies to establish the role of simulation in improving the quality of health care.

The first NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy.

Chronic traumatic encephalopathy (CTE) is a neurodegeneration characterized by the abnormal accumulation of hyperphosphorylated tau protein within the brain. Like many other neurodegenerative conditions, at present, CTE can only be definitively diagnosed by post-mortem examination of brain tissue. As the first part of a series of consensus panels funded by the NINDS/NIBIB to define the neuropathological criteria for CTE, preliminary neuropathological criteria were used by 7 neuropathologists to blindly evaluate 25 cases of various tauopathies, including CTE, Alzheimer's disease, progressive supranuclear palsy, argyrophilic grain disease, corticobasal degeneration, primary age-related tauopathy, and parkinsonism dementia complex of Guam. The results demonstrated that there was good agreement among the neuropathologists who reviewed the cases (Cohen's kappa, 0.67) and even better agreement between reviewers and the diagnosis of CTE (Cohen's kappa, 0.78). Based on these results, the panel defined the pathognomonic lesion of CTE as an accumulation of abnormal hyperphosphorylated tau (p-tau) in neurons and astroglia distributed around small blood vessels at the depths of cortical sulci and in an irregular pattern. The group also defined supportive but non-specific p-tau-immunoreactive features of CTE as: pretangles and NFTs affecting superficial layers (layers II-III) of cerebral cortex; pretangles, NFTs or extracellular tangles in CA2 and pretangles and proximal dendritic swellings in CA4 of the hippocampus; neuronal and astrocytic aggregates in subcortical nuclei; thorn-shaped astrocytes at the glial limitans of the subpial and periventricular regions; and large grain-like and dot-like structures. Supportive non-p-tau pathologies include TDP-43 immunoreactive neuronal cytoplasmic inclusions and dot-like structures in the hippocampus, anteromedial temporal cortex and amygdala. The panel also recommended a minimum blocking and staining scheme for pathological evaluation and made recommendations for future study. This study provides the first step towards the development of validated neuropathological criteria for CTE and will pave the way towards future clinical and mechanistic studies.

NIH/NIBIB Introduces New Center for Biomedical Engineering Technology Acceleration.

In Late January 2023, the National Institute of Biomedical Imaging and Bioengineering (NIBIB) launched a new center designed to accelerate biomedical discovery and therapeutics, in part by pulling together expert, multidisciplinary teams from throughout the National Institutes of Health (NIH) to quickly respond when national or global health crises strike. The inaugural director of this Center for BME Technology Acceleration, or BETA Center, is biomedical engineer Manu Platt, Ph.D., (Figure 1) who is also taking on the role of NIBIB associate director for scientific diversity, equity, and inclusion. Platt previously held appointments as professor, Wallace H. Coulter distinguished faculty fellow, and diversity director of the Center on Emergent Behaviors of Integrated Cellular Systems and Cellular Manufacturing and Technologies at the Georgia Institute of Technology and Emory University.

The Second NINDS/NIBIB Consensus Meeting to Define Neuropathological Criteria for the Diagnosis of Chronic Traumatic Encephalopathy.

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder associated with exposure to head trauma. In 2015, a panel of neuropathologists funded by the NINDS/NIBIB defined preliminary consensus neuropathological criteria for CTE, including the pathognomonic lesion of CTE as "an accumulation of abnormal hyperphosphorylated tau (p-tau) in neurons and astroglia distributed around small blood vessels at the depths of cortical sulci and in an irregular pattern," based on review of 25 tauopathy cases. In 2016, the consensus panel met again to review and refine the preliminary criteria, with consideration around the minimum threshold for diagnosis and the reproducibility of a proposed pathological staging scheme. Eight neuropathologists evaluated 27 cases of tauopathies (17 CTE cases), blinded to clinical and demographic information. Generalized estimating equation analyses showed a statistically significant association between the raters and CTE diagnosis for both the blinded (OR = 72.11, 95% CI = 19.5-267.0) and unblinded rounds (OR = 256.91, 95% CI = 63.6-1558.6). Based on the challenges in assigning CTE stage, the panel proposed a working protocol including a minimum threshold for CTE diagnosis and an algorithm for the assessment of CTE severity as "Low CTE" or "High CTE" for use in future clinical, pathological, and molecular studies.

Engineering immunity for next generation HIV vaccines: The intersection of bioengineering and immunology.

Bioengineering approaches grounded in immunology have the potential for the discovery and development of a successful HIV vaccine. The overarching goal is to engineer immunity through a fusion of immunology with bioengineering to create novel strategies for the design, development and delivery of vaccines based on the controlled modulation of the immune system. To foster these collaborations, the National Institute of Allergy and Infectious Diseases (NIAID) and National Institute of Biomedical Imaging and Bioengineering (NIBIB) brought together a group of experts (see Table 1) from these diverse fields for a workshop in September 2018 to: (1) engage the engineering, immunology, and HIV vaccinology communities to dialogue on the topic of an HIV vaccine and; (2) generate a framework of new and innovative research avenues to explore in HIV vaccinology between knowledge stakeholders and problem solvers.

Grant Funding Needs Parallel the Start-Up Venture: An Analogy for Translational Research Success.

This editorial offers some ways to think about how best to position a research group for funding, by examining the parallels between what is needed for translational grants versus industry start-ups.

Advances in Biomedical Imaging, Bioengineering, and Related Technologies for the Development of Biomarkers of Pancreatic Disease: Summary of a National Institute of Diabetes and Digestive and Kidney Diseases and National Institute of Biomedical Imaging and Bioengineering Workshop.

A workshop sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute of Biomedical Imaging and Bioengineering focused on research gaps and opportunities in the development of new biomarkers of pancreatic disease. The session was held on July 22, 2015, and structured into 6 sessions: 1) Introduction and Overview; 2) Keynote Address; 3) New Approaches to the Diagnosis of Chronic Pancreatitis; 4) Biomarkers of Pain and Inflammation; 5) New Approaches to the Detection of Pancreatic Cancer; and 6) Shed Exosomes, Shed Cells, and Shed Proteins. Recent advances in the fields of pancreatic imaging, functional markers of pancreatic disease, proteomics, molecular and cellular imaging, and detection of circulating cancer cells and exosomes were reviewed. Knowledge gaps and research needs were highlighted. The development of new methods for the noninvasive determination of pancreatic pathology; the use of cellular markers of pancreatic function, inflammation, pain, and malignancy; and the refinement of methods to identify cells and cellular constituents of pancreatic cancer were discussed. The further refinement of sophisticated technical methods and the need for clinical studies to validate these new approaches in large-scale studies of patients at risk for the development of pancreatic disease were repeatedly emphasized.

Validation of 3d metric and superimposition tools in three software packages for the morphological comparison of laser scanned anterior dentition models / Validação de ferramentas tridimensionais de três softwares para mensuração e sobreposição tridimensional de modelos odontológicos visando à comparação morfológica

Introduction: Few studies succeeded on demonstrating that dentitions are unique. Methodological limitations may have influenced these outcomes. Objective: The present study aims to validate software packages for comparing human dentitions. Material and methods: A pool of 40 dental casts were laser scanned (XCAD 3D®, XCADCAM Technology®, São Paulo, Brazil) and implemented in Geomagic Studio® (GS) (3D Systems®, Rock Hill, USA), Cloud Compare® (CC) (Telecom Paris Tech® and EDF®, Paris, France), and Maestro 3D Ortho Studio® (MS) (AGE Solutions®, Pontedera, Italy) software packages to evaluate metric and superimposition tools. Results: Software performances did not significantly differ (p>0.05) considering cropping, landmarking and superimposition functions. GS was more precise for detecting identical models (p>0.05. Inter and intra examiner reproducibility reached optimal outcomes. Calibration was assured for software measuring tools and scanning process. Conclusion: Both GS and CC may be used for comparing 3D anterior dentitions. However, more practical and less operator-depending procedures are available in GS.

Introdução: Poucos estudos obtiveram êxito em demonstrar a unicidade da dentição humana. Falhas metodológicas podem ter influenciado os resultados destes estudos. Objetivo: O presente estudo objetivou validar ferramentas contidas em pacotes de software existentes para comparar dentições humanas. Material e método: Uma amostra de 40 modelos odontológicos digitalizados (XCAD 3D®, XCADCAM Technology®, São Paulo, Brazil) foi selecionada e analisada utilizando os seguintes softwares: Geomagic Studio® (GS) (3D Systems®, Rock Hill, USA), Cloud Compare® (CC) (Telecom Paris Tech® and EDF®, Paris, France), and Maestro 3D Ortho Studio® (MS) (AGE Solutions®, Pontedera, Italy). Resultados: Os softwares não apresentaram performances com diferença estatisticamente significante (p>0.05) considerando os procedimentos de recorte, colocação de pontos de referência (landmarks) e sobreposição de modelos. O software GS apresentou maior precisão para detectar modelos idênticos ((p>0.05). Testes intra e interexaminador resultaram em ótima concordância. Os softwares apresentaram ótima calibração de ferramentas métricas. Conclusão: Ambos os softwares GS e CC podem ser utilizados para comparar modelos odontológicos digitalizados. Contudo, performances mais práticas e independentes do operador podem ser alcançadas por meio do software GS.

Clasificación internacional del funcionamiento, de la discapacidad y de la salud en Rehabilitación: de la teoría a la práctica / The international classification of functioning, disability and health in rehabilitation: from the theory to the practice

Objetivo: La Clasificación internacional del funcionamiento, de la discapacidad y de la salud fue creada en el 2001 con el fin de proporcionar un marco conceptualmente universal para clasificar y describir el funcionamiento, la discapacidad y la salud desde una perspectiva biopsicosocial. El uso de esta clasificación es enormemente útil en el campo de la Rehabilitación, ya que permite describir el estado de salud de un paciente de forma global, universal y, además, etiológicamente neutral. Resultados: No obstante, la gran cantidad de categorías de la Clasificación internacional del funcionamiento, de la discapacidad y de la salud la hacen poco práctica en la realidad diaria, por lo que el objetivo de este artículo es el de presentar las diferentes iniciativas que existen sobre el desarrollo de nuevas herramientas de trabajo basadas en ella que posibilitan su uso en las diferentes prácticas profesionales (AU)

Objetive: The International Classification of Functioning, Disability and Health was created in 2001 with the aim of promoting a universally accepted conceptual framework to classify and describe functioning, disability and health from a biopsycosocial perspective. This classification is very useful in the rehabilitation field because it provides a way of describing the health status of a patient based on an universally globally agreed perspective and moreover neutral. Results: Nevertheless, the great number of categories from the ICF, makes it unpractical for the daily reality, therefore the objetive of this article is to present the diferent initiatives that exist in the developing of different new tools to posibilitate the use of the ICF in different sectors (AU)

Aplicação do ultrassom para avaliação de cavidades intraósseas em mandíbulas de porco / Application of ultrasound for evaluation of intraosseous cavites in pig jaws

O ultrassom é rotineiramente utilizado para avaliação de tecidos moles, contudo é um método que possui características importantes para avaliação não somente destes tecidos, mas dos ósseos também, além de possuir recursos diferenciais que auxiliariam muito no planejamento do tratamento e do prognóstico; embasados nessa premissa analisamos a possibilidade de avaliação de alterações intra-ósseas por meio do ultrassom. A amostra foi constituída por cinco mandíbulas de porco, maceradas, e avaliadas nas regiões dos terceiros molares (tanto do lado direito quanto do esquerdototalizando 10 avaliações), por possuírem nessa região uma crítica óssea expressiva, o que simularia uma lesão infra-óssea. Para as avaliações ultrassonográficas dois grupos de três observadores foram formados, sendo um de Cirurgiões-Dentístas (Radiologistas) e outro de Médicos (Ultrassonografistas), os quais avaliaram, individualmente, a facilidade de visualização da imagem obtida por meio da ultrassonografia, bem como também o grau de translucidez do osso. Sendo que 46,6% das avaliações feitas pelos Cirurgiões-Dentistas foram ponteadas como de fácil visualização 13,3% foram considerados de média dificuldade para avaliação, contra 23,3% que foram classificadas como de difícil localização, contudo 16,6% não foram possíveis de serem observadas...

Ultrasoud (US) is routinely used for evaluation of soft tissues; however it is a method tha has important features to evaluate not only these tissues, but also hard tissues that could help in the treatment planning and prognosis. This study analyzed the possibility of evaluation of infra-osseous changes, by means of US; grounded in this premise. The sample consiste of five macerated pig jaws, and the third molars areas (both the right and the left, totling 10 ratings), were evaluated as these regions have a significant bone crypt, which simulate an infra-osseous lesion. For ultrasound images assessments two groups of three observers were traine, one of dentists (Radiology specialists) and other of physicians (US specialists), which evaluated individually, the visualization of the image obtained by US, and also the translucency degree of the bone. Dentists have been considered 46,6% of the assessments of easy viewing; 13,3% were considered of medium difficulty; 23,3% were classified as very difficult, although 16,6% were not found. Physicians considere 43,3% of images of easy viewing 23,3% were considered of medium difficulty; 20% were classified as very difficult, although 13,3% were not found. Based on this results and the literature findings, it is possible to conclude that US is a useful tool for assessment of ontraosseus cavities, but cortical bone should be thin so the sound waves can penetrate...