Abstract

The ABI is leading the [International Physiome Project](https://www.iups.org/activities/physiome/) for the International Union of Physiological Sciences (IUPS) and it is a founding member of the Virtual Physiological Human (VPH) Institute [VPH Institute](https://www.vph-institute.org), an international non-profit organisation, whose mission is to ensure that the Virtual Physiological Human is fully realised, universally adopted, and effectively used both in research and clinic. The Physiome Project aims to establish a standards-based framework for multiscale computational physiology and has established the Physiome journal and associated portal in support of this aim. A five year project has recently been funded by the NZ Government’s Ministry of Business, Innovation and Employment (MBIE) to extend the Physiome Project infrastructure and to develop clinical workflows based around three ‘exemplar projects’ using three underpinning technology platforms as described below. The overall goal for the 12 Labours project is to further develop the predictive modelling capability that ABI and its international partners have built in the Physiome Project, and to add personalised modelling and various forms of wearable or implantable device to assist in the clinical diagnosis and treatment of a range of medical conditions. All software and models are open source and freely available as our contribution to open science but we are also looking for opportunities to create spinout companies that facilitate the clinical uptake of our science. As described below, we will use three exemplar projects (EPs) to demonstrate healthcare applications of multiscale biophysically based modelling, by combining multiscale models of multiple organ systems to address complex physiological questions. These three exemplars are: - *EP1: Pulmonary hypertension*: this exemplar will couple our previously independent research on the cardiovascular and respiratory systems to treat pulmonary hypertension. - *EP2: Personalised rehabilitation of upper limb disorders*: based on our neuro-musculoskeletal system work that is closely linked with the ICON project co-funded by the German Government. - *EP3: Control of organ function by the autonomic nervous system*: based on coupling our previously independent work on maternal health and the digestive system with our NIH-funded work on mapping the autonomic nervous system. The three technology platforms being developed are: - *Platform 1: A framework for personalised Physiome modelling*. We will develop the tools and databases needed to combine models, to link models across spatial and temporal scales, and to personalise the models ready to be used by the EPs in platforms 2 and 3. - *Platform 2: A Physiome modelling platform for precision medicine*. We will develop the workflows and databases needed to implement personalised Physiome models in a clinical setting. - *Platform 3: Continuous monitoring using Physiome workflows*. We will develop an interface between personalised Physiome models and wearable, implanted and home-based devices that can provide a continuous flow of data to update an individual’s personalised model for diagnostic monitoring and predicting therapeutic outcomes. Under 12 Labours, the multiscale models developed in the Physiome Project will be personalised for an individual with the tools developed in Platform 1, incorporated into clinical workflows in Platform 2, and interfaced to home-based healthcare devices in Platform 3.

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