Brazil was not absent during these developments. On the contrary, and almost simultaneously with renowned groups from abroad, from 1998 onwards, a vigorous program of Research and Development (R&D) in the field of predictive medicine through scientific computing was started at the LNCC/MCTI (www.lncc.br), led by researchers at the HeMoLab laboratory (http://hemolab.lncc.br/). This leadership at national, regional and international level led these researchers, together with researchers from laboratories LVCRV, ACiMA (http://acima.lncc.br/), ComCiDis (http://comcidis.lncc.br/) and MARTIN (http://martin.lncc.br/), all based at the Department of Scientific Computing (DSC) from the LNCC, to organize and coordinate the MACC-Rio in 2007. A statewide network was created, incorporating the most important institutions of R & D in engineering, computing and medicine in the State of Rio de Janeiro. In a similar manner, they organized a cooperative (and integrated) network of R&D and Human Resources Development (HRD) at a national level, formed by 25 Associate Laboratories based in 11 Brazilian states, with international coverage across 10 collaborating laboratories in Argentina, United States, Canada, England, Portugal, Spain, France, Italy and Switzerland. This coordinated action culminated in the establishment of the National Institute of Science and Technology in Medicine Assisted by Scientific Computing (, INCT-MACC in Portuguese, http://macc.lncc.br/) approved by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (National Council for Scientific and Technological Development) (CNPq) in November 2008 and starting operations in September, 2009.

For the period 2015-2021, the INCT-MACC shall consist of 31 Associate Laboratories, with headquarters in 11 states, and with 14 Collaborator Laboratories based abroad, distributed in seven countries. It is important to note here that, with the creation of INCT-MACC in November 2008, Brazil has consolidated scientific and technological competence in the frontiers of knowledge and achieved the level of developed countries like the United States in the area of scientific computing applied to medicine. The Institute for Medical Engineering Science (IMES) was founded only in July 2012, through integration between Harvard Medical School and the Massachusetts Institute of Technology (MIT), to fulfill a similar mission and with a role in similar areas to INCT-MACC. Likewise, through the integration between the Johns Hopkins University Whiting School of Engineering and the Johns Hopkins School of Medicine, the Institute for Computational Medicine (ICM) was created in order to act in areas similar to those proposed by the INCT-MACC. These examples show the importance that developed countries give to the use of computational modeling in medicine, a long-standing theme for the HeMoLab/LNCC and recognized/supported by MCTI with the creation of INCT-MACC in November 2008. Aiming to address several and diverse issues related to medicine and in general to health, over the last six years, the mission of INCT-MACC has been to perform and promote R&D and HRD activities of high scientific, technological and socio-economic impact by integrating and consolidating, in laboratories associated with the network, knowledge in many areas such as solid mechanics, fluid mechanics, transport phenomena, material behavior, medical image processing, virtual reality, databases and data mining for the generation of new knowledge, high performance computing (including cloud computing). These achievements were the basis for the multiphysics modeling of complex systems, capable of coupling multiple spatial scales (in the nanometer scale for the pore size of ion channels to the meter scale for the human body), temporal scales (from the microsecond scale, typical of Brownian motion, to 109 seconds of human life), biochemistry, biophysics, physiology and anatomy of cells, tissues and organs.

The results achieved can be readily accessed in the INCT-MACC website (http://macc.lncc.br/). In the Annual Activity Reports, the visitor can find a detailed description of this production and even download developed computational systems (with strong technological scientific content on the frontiers of knowledge) to meet the demands of professional/medical researchers participating with the INCT- MACC and other researchers belonging to the most important medical centers of the country such as the Heart Institute (InCor - Hospital das Clínicas, Medical Faculty, University of Sao Paulo); The Department of Neurosurgery, Transplant Hospital of São Paulo de Jesus Zerbini Euryclides – formerly known as the Brigadier Hospital of São Paulo; ICES, Univ Hospital. Clementino Fraga Filho, UFRJ; Faculties of Medicine and University Hospitals of UERJ and UFF in Rio de Janeiro, among other not less important institutions in states where the existing network INCT- MACC is active.

When the INCT-MACC was formed in 2008, the LNCC (National Laboratory for Scientific Computing MCTI) was selected as initial headquarters to indicate the need for developing the new area of knowledge “assisted medicine for scientific computing”. However, in the period 2015-2021, the major medical centers that participate in the institute will demand new knowledge and technologies, naturally leading to designate the Heart Institute (the largest Latin American center and one of the most important world centers in healthcare delivery and research in cardiology) as the new headquarters of the INCT-MACC This is a clear indicator of the importance of these prestigious medical institutions for the development and consolidation of the INCT-MACC. Fundamentally, this translates into the incorporation of scientific and technological innovations proposed in this project into healthcare services, diagnosis and treatment of various cardiovascular diseases, with the aim that such innovations turn into tools to be used in daily medical practice in Brazil. Finally, it must be noted that all planned activities are on the frontier of science, as it will be seen in the description of the program R&D and HRD of the INCT-MACC for the period 2015-2021, keeping Brazil at the forefront of leadership in this area of knowledge, which has a great impact on health and welfare of humanity. A proof of this is the extraordinary level of scientific researchers who make up the International Scientific Technical Council (see Section 7.2), which provides a clear indicator of scientific excellence and innovative features of the present proposal.