Neuromodulation News: February 2021

President's Message l INS 15th World Congress in 2022 l INS SCS Survey l INS Webinar Series l INS Virtual Journal Club l INS Journal Podcasts l Outreach Projects l e-INS in September 2021 l Member Visibility l Members' Website Access l INS Chapter Reports l Ways to Get Involved

A Message from the President

I would like to make a few comments about the current state in which we practice neuromodulation, addressing both major challenges and opportunities. As of today, there have been over 103 million cases of COVID-19 illness worldwide with over 2 million deaths attributed to COVID-19; in the United States there are now over 26 million cases with more than 441,000 deaths. This is an amazing and horrifying pandemic and it has significantly limited our ability not only to help our own patients but also for us to educate, collaborate and better the care for all patients. There have been a number of papers written over the past year describing the different approaches we must take in the practice of neuromodulation during the pandemic. I refer all practitioners to recent articles and white papers published by Professor Sam Eldabe and his collaborators in the United Kingdom (1, 2) and Dr. Tim Deer and coworkers in the United States (3). They recognize that (1, 2) our practice of neuromodulation, while critically important, suffers when the beds that we use in hospitals are filled with patients suffering from COVID-19 and (3) that COVID-19 is a much more emergent and life-threatening condition than chronic pain or movement disorders and as such must take precedence.

As responsible practitioners, we must thus assess locally the resources that are available and ensure that we are not detracting from the critical care of acutely ill COVID-19 patients. At this current moment in time, there are several areas in the U.S. and abroad where virtually all critical care beds are filled with COVID-19 patients and resources are stretched beyond their ability to serve those in critical need. Thus, this often means avoiding hospitals and performing our care in the office and our surgeries in ambulatory surgery units (ASU). In addition to removing our burden on local hospitals, ASUs have the additional ability to screen patients for COVID-19 so that the entire ambulatory surgery center environment is COVID-19 free and therefore safer for both the health care providers and the patient. As our bandwidth of care narrows, we must also look at patients awaiting neuromodulation procedures to evaluate their needs relative to others; establishing a hierarchy of needs may help to keep care in the office and ASU within our available ability to provide optimal care. For example, those who require refills of their pumps that deliver medications whose withdrawal could cause either severe discomfort or death, like the acute withdrawal of baclofen, need be placed at the front of the line. These patients cannot wait to have their pumps replaced or refilled. Similarly in patients with excellent pain relief whose batteries are at the end of life, we should replace those batteries as soon as possible so as not to make the patients again become dependent on opioids or disabled in terms of their activity. Patients needing new trials of therapy or patients who have been trialed and would like to have a permanent implant should appear later in our considerations, particularly if we have limitations to provide care using neuromodulation procedures. In order to treat patients we must also keep patients well informed of the increased risk of our procedures in the setting of COVID-19 and give those that can the opportunity to postpone their procedures until they are perceived to be safe.

It is our great fortune that a light is visible at the end of this long tunnel. In the past month, there have been introduced at least three apparently highly effective vaccines for the coronavirus causing COVID-19, including those developed by Pfizer, Moderna and Oxford/AstraZeneca. While the long term efficacy of these vaccines is as of yet unknown, in the short term they are reported to provide 95% protection against COVID-19. Last month, caregivers in the United States and the United Kingdom were first offered the vaccine and large scale vaccination programs are being rolled out worldwide, with the largest just introduced in India. While several important questions remain unanswered, it appears that we may see a significant abatement of the pandemic within the next six months.

Unfortunately, we have allowed this pandemic and the important public health response to it to become significantly politicized. In my humble opinion, politics should never be allowed to trump science. It appears that our disorganized and poorly executed response to the COVID-19 pandemic in the U.S. has resulted in the unnecessary loss of tens of thousands of lives. Rather than the U.S. population banding together around the rapidly evolving scientific knowledge surrounding coronavirus infection, the population became radically divided. Some believed the science and practiced appropriate infection control measures including wearing face masks, maintaining social distancing, using aggressive handwashing techniques, etc., while others interpreted these infection control measures as unfounded threats to their individual freedoms as was dictated by our political leaders. Daily confrontations ensued, some of which were violent. Several months ago, after politely asking the only other customer in a shop to observe the clearly marked request for social distancing, I was brutally assaulted; I am still suffering both the physical and psychological effects of this battery.

The INS membership, consisting of thoughtful health care providers, engineers and scientists, has a responsibility to continue to demand the supremacy of science over politics, proper medical and public health care over politics and most importantly, the value of educated discussion and debate over violent confrontation. The current political divisions may be an even more dangerous and long-lasting result of this pandemic than COVID-19 disease; I encourage the INS membership to further devote themselves to clear and comprehensible education of the science and nonsense surrounding the current pandemic.

Finally I would like to discuss how we as an international society have worked to maintain our educational and public-facing programs despite our inability to meet together physically as friends, colleagues and educators. Until this past year, we have had many regular meetings including our biennial meeting INS Congress, the meeting of the European Chapters of the INS, the biennial Interim Meeting of the INS to highlight areas of developing neuromodulation programs, as well as the annual meetings of our 23 regional chapters. This year, to our severe disappointment, all of these meetings have had to been postponed, canceled or held virtually.

As vaccine rollout programs are now being initiated throughout the world, the INS has now developed what we believe to be a reliable timeline for our upcoming meetings. The INS 15^th World Congress, Neuromodulation: From Scientific Theory to Revolutionary Therapy, will be held from May 21 to 26, 2022 in Barcelona, Spain. A remarkable program has been developed and will address the breadth and depth of this exciting field. Our 16^th World Congress will now be held in 2024 and we will soon announce the host country. E-INS 2021, the 2^nd Joint Congress of the INS European Chapters, will be held from Sept. 2 to 4, 2021 in Paris, France. With the tremendous work of Dr. Philippe Rigoard and the European chapter presidents, this promises to be an engaging and exciting meeting and our first opportunity to meet together as INS members since the COVID-19 pandemic began. The last of our major postponed meetings is the 3^rd Interim meeting of the INS. This meeting, made possible by the dedicated work of Prof. Paresh Doshi and held in collaboration with The Neuromodulation Society of India, will be held in Mumbai, India from Nov. 19 to 21, 2021. Details of these programs are available on the INS website.

During the pandemic, the INS has worked tirelessly to maintain our important educational and patient access commitments. We have encouraged all of our chapters to maintain their conference and course schedules using virtual formats. Chapter members can get together at least in spirit to learn about the latest developments and important aspects of neuromodulation. In addition, the INS has developed a monthly series of INS Webinars. In the first seven webinars, we reviewed and updated the findings of the Neuromodulation Appropriateness Consensus Conference (NACC) while the past four have reviewed and updated the findings of the Polyanalgesic Consensus Conference Guidelines. Monthly webinars on new topics will continue as a permanent feature for our members, CME will be awarded and suggestions for future topics are welcomed.

We have further initiated a Neuromodulation Journal Club series during which we will review salient articles from the peer-reviewed literature. Up to three articles will be presented, discussed and critiqued in each monthly journal club; authors will be invited to answer questions or provide further insight into these articles. These journal clubs have been planned for the next 18 months and will continue as a permanent feature for INS members and CME is available for participation. Between the journal clubs and the webinars, a virtual INS program will be available every two weeks; videos of previous programs are available on the INS members’ website and can be viewed at any time.

In offering these regular and frequent online meetings, webinars, and journal clubs to our INS members and others in the field of neuromodulation, we aim to maintain the warm sense of collegiality and friendship that we all share. While saying that, I recognize the severe challenges that we have faced in the practice of medicine and neuromodulation and I greatly admire those of you who have developed or participated in important virtual programs so that we can maintain our strong position as educators and champions for our patients. I look forward very much to the day soon when we can meet again together in person. Be well. Be kind. I thank you.

Robert M. Levy, MD, PhD
INS President

References

1. Recommendations For The Management Of Implanted Neurostimulation & Intrathecal Drug Delivery Devices During The COVID-19 Pandemic; 2020. https://www.neuromodulation.com/assets/NSUKI%20COVID-19%20recommendation.pdf. Accessed Jan. 22, 2021.

2. Guidance on Resumption of Neuromodulation Services during the COVID-19 Recovery Phase; 2020. https://www.neuromodulation.com/assets/NSUKI%20COVID%20Recovery%20Guidance.pdf. Accessed Jan. 22, 2021.

3. Deer T, Sayed D, Pope J et al. Emergence From the COVID-19 Pandemic and the Care of Chronic Pain: Guidance for the Interventionalist. Anesthesia & Analgesia. 2020;131(2):387-394. doi:10.1213/ane.0000000000005000

INS 15th World Congress - May 21 to 26, 2022

Due to the pandemic, the International Neuromodulation Society 15^th World Congress has been postponed from 2021 to May 21 to 26, 2022 in Barcelona, Spain. We very much hoped to meet you in person this coming year, but made the difficult decision to wait until 2022, when we believe it will be safe for us to meet in person again. The location will remain the Convenciones Internacional Barcelona (CCIB), in the heart of Barcelona.

We are deeply grateful to the scientific program committee members and our members who have contributed to the development of an exciting scientific program and we will update and refine the program for 2022.

With the theme Neuromodulation: From Scientific Theory to Revolutionary Therapy, the program emphasizes the field’s transformative force on disease treatment. The field has matured into proven therapies delivered with refined and personalized techniques. That transformation has benefitted from new insights into mechanisms of action of neuromodulation therapies. The scientific program will present evidence-based knowledge about basic, translational and clinical research; emerging technologies; and global health care trends to improve skills, outcomes, and access to patient care.

We remain committed to maintaining a sense of connection and community by offering free online education programs to our members until we can meet in person. We hope you and your loved ones remain well, and we look forward to seeing you at our online programs, and live in Barcelona in 2022!

INS SCS Survey: INS Member Responses Needed

The INS Centers of Excellence Committee is seeking to understand more fully the current state of neuromodulation practice worldwide by conducting surveys about neuromodulation practices, including peripheral nerve stimulation, sacral nerve stimulation, gastric electrical stimulation, and deep brain stimulation.

We invite you to help us achieve our goal of at least a 70% response rate. Every response is vital so that we can demonstrate the validity of this measure. Your answers will be collected anonymously and the results will serve as the basis for developing Neuromodulation Centers of Excellence, designed to enhance neuromodulation practice and improve its safety and efficacy.

Please stay tuned and plan to return the spinal cord stimulation practice survey when it arrives.

Join Us at Webinars During 2021

The International Neuromodulation Society instituted two series of webinars in 2020, one on the guidelines from the Neuromodulation Appropriateness Consensus Committee and a subsequent one on the Polyanalgesic Consensus Conference (PACC), which concludes Tuesday, Feb. 9, 2021 in the fourth and final PACC Webinar, Your Questions Answered (registration).

Members may log into the Members Only Area of the website to view the recorded webinars and/or fill out the CME evaluation form, which is available for up to one year after they have been presented.

Following the conclusion of the PACC series in February 2021, INS will continue with a monthly, CME-accredited webinar program. Please stay tuned for more details, and feel free to send your ideas for future webinar topics to ins [at] neuromodulation.com.

The INS Virtual Journal Club to Go Monthly in 2021

The INS is now offering a monthly Virtual Journal Club in 2021. CME credit is available to members who participate in the live event.

Several distinguished authors have been invited to participate in the discussion of their papers, many of them from Neuromodulation: Technology at the Neural Interface, the official journal of the INS, and other journals.

The activity is intended to offer an objective, non-commercial platform for discussing timely studies of neuromodulation techniques and clinical practice. Each club session will be recorded and made available with previous journal club videos on the INS members' website for later viewing.

Please send an email to ins [at] neuromodulation.com if you would like to get involved.

Upcoming schedule and topics:

Thursday, Feb. 18: Neuromodulation and COVID-19 (Registration)

Articles to be Reviewed
(1) Staats, P., Giannakopoulos, G., Blake, J., Liebler, E. and Levy, R.M. (2020), The Use of Non‐invasive Vagus Nerve Stimulation to Treat Respiratory Symptoms Associated With COVID‐19: A Theoretical Hypothesis and Early Clinical Experience. Neuromodulation: Technology at the Neural Interface, 23: 784-788. https://doi.org/10.1111/ner.13172

(2) Boezaart, A.P. and Botha, D.A. (2021), Treatment of Stage 3 COVID‐19 With Transcutaneous Auricular Vagus Nerve Stimulation Drastically Reduces Interleukin‐6 Blood Levels: A Report on Two Cases. Neuromodulation: Technology at the Neural Interface. https://doi.org/10.1111/ner.13293

(3) Rammo, R., Gostkowski, M., Rasmussen, P.A., Nagel, S. and Machado, A. (2021), The Need for Digital Health Solutions in Deep Brain Stimulation for Parkinson's Disease in the Time of COVID‐19 and Beyond. Neuromodulation: Technology at the Neural Interface. https://doi.org/10.1111/ner.13307

Thursday, March 18: Spinal Cord Stimulation – Outcomes Predictors and Assessment

Articles to be Reviewed
(1) Pilitsis, J.G., Fahey, M., Custozzo, A., Chakravarthy, K. and Capobianco, R. (2021), Composite Score Is a Better Reflection of Patient Response to Chronic Pain Therapy Compared With Pain Intensity Alone. Neuromodulation: Technology at the Neural Interface. https://doi.org/10.1111/ner.13212

(2) Witkam, R.L., Kurt, E., van Dongen, R., Arnts, I., Steegers, M.A., Vissers, K.C., Henssen, D.J. and Engels, Y. (2021), Experiences From the Patient Perspective on Spinal Cord Stimulation for Failed Back Surgery Syndrome: A Qualitatively Driven Mixed Method Analysis. Neuromodulation: Technology at the Neural Interface. https://doi.org/10.1111/ner.13277

(3) Duarte, R.V., Soliday, N., Leitner, A. and Taylor, R.S. (2021), Health‐Related Quality of Life Associated With Pain Health States in Spinal Cord Stimulation for Chronic Neuropathic Pain. Neuromodulation: Technology at the Neural Interface. https://doi.org/10.1111/ner.13267

Thursday, April 15: Dorsal Root Ganglion Stimulation – DRG for Back Pain

Articles to be Reviewed
(1) Chapman, K.B., Yousef, T.A., Foster, A., D. Stanton‐Hicks, M. and van Helmond, N. (2020), Mechanisms for the Clinical Utility of Low‐Frequency Stimulation in Neuromodulation of the Dorsal Root Ganglion. Neuromodulation: Technology at the Neural Interface. https://doi.org/10.1111/ner.13323

(2) Chapman, K.B., Groenen, P.S., Vissers, K.C., van Helmond, N. and Stanton‐Hicks, M.D. (2021), The Pathways and Processes Underlying Spinal Transmission of Low Back Pain: Observations From Dorsal Root Ganglion Stimulation Treatment. Neuromodulation: Technology at the Neural Interface. https://doi.org/10.1111/ner.13150

(3) Huygen, F., Liem, L., Cusack, W. and Kramer, J. (2018), Stimulation of the L2–L3 Dorsal Root Ganglia Induces Effective Pain Relief in the Low Back. Pain Pract, 18: 205-213. https://doi.org/10.1111/papr.12591

(4) Kallewaard, J.W., Nijhuis, H., Huygen, F., Wille, F., Zuidema, X., van de Minkelis, J. and Raza, A. (2019), Prospective Cohort Analysis of DRG Stimulation for Failed Back Surgery Syndrome Pain Following Lumbar Discectomy. Pain Pract, 19: 204-210. https://doi.org/10.1111/papr.12734

New Journal Social Media Consultants and Podcasts

We are pleased to announce podcast interviews have been posted to a “Highlights” section on the homepage of Neuromodulation: Technology at the Neural Interface.

The first podcast features Editor-in-Chief Dr. Robert M. Levy and Acting Editor-in-Chief Dr. Robert Foreman.

The second podcast features Neuromodulation editorial board member Dr. Richard North, whose seminal work has led to the tremendous development of spinal cord stimulation therapy.

The interviews were prepared by Dr. Alaa Abd-Elsayed, who is the recently appointed journal social media consultant. Dr. Heather Pinckard-Dover has joined the INS as associate social media consultant. We welcome Drs. Abd-Elsayed and Pinckard-Dover to their new roles, and are grateful to Dr. Georgios Matis, who was the first journal social media consultant from 2019 to 2020.

You may follow the social media accounts of the journal, @JNeuromod, on Twitter https://twitter.com/JNeuromod , Facebook https://www.facebook.com/JNeuromod , and Instagram https://www.instagram.com/JNeuromod/ .

Opportunities to Participate in INS Outreach Projects

The INS’s Public Education, Outreach, and Website Committee invites volunteers to get involved in several projects this year.

1) Share Educational Videos

Members who are active on social media are invited and encouraged to share brief overview videos that committee members have produced since 2018, available on the INS website:

2) Educational Video Development

Generate topic ideas to increase the INS video library and produce brief Adobe Spark videos to be published on the INS Facebook page and YouTube channel, as well as the INS website and its Instagram feed (in 60-second versions), under project lead Dr. Anthony Mazzola. The purpose of the videos is to raise awareness and educate those who are unfamiliar with neuromodulation therapies. Everyone can amplify attention to these videos through sharing and commenting upon them in social media.

Future topics for creation include:

1. Migraine
2. Cluster headache
3. Brain stimulation for psychiatric conditions, such as addiction (See: https://www.neuromodulation.com/for-patients#tables)

In addition, your suggestions for additional topics are welcome. Please see contact and signup information at the end of this article.

3) Video Translation

Translate text displayed in all these videos into other languages in collaboration with society members from different world regions, under project lead Dr. Jeffrey Ciccone.

4) INS Congress Social Media Ambassadors

We are once again recruiting Twitter/Social Media Ambassadors to build excitement for, and share developments about, the INS 15th World Congress via social media, with project lead Dr. Jay Shah.

5) Content Creation

In collaboration with volunteers in the INS mentorship program, create content or presentations on various neuromodulation indications to educate those who are unfamiliar with neuromodulation, under project lead Dr. Amit Gulati.

6) Virtual Journal Club Presentations

Volunteer to work with members of the Young Neuromodulators and International Women in Neuromodulation committees to present articles during INS virtual journal club meetings.

Please volunteer as soon as possible, by clicking your selected project(s) at this online form. You may write to INS Public Education and Website Manager Nancy Garcia, ngarcia (at) neuromodulation.com, with comments or questions.

2nd Joint Congress of the INS European Chapters in Paris, France, Sept. 2 to 4, 2021

The 2^nd Joint Congress of the INS European Chapters (e-INS 2021) will be held in Paris, France. With the new dates of the meeting now confirmed to be Sept. 2 to 4, 2021, it is time to start making your plans to join us in The City of Light. The Palais des Congrès de Paris is our meeting venue and we look forward to seeing all of you there in person later this year!

The e-INS 2021 top-notch scientific programme will include a variety of sessions, i.e. plenary sessions, nurse’s session, e-Posters viewing, supported symposia and much more.

At our joint congress, you can showcase your latest research, make a difference, and get a new perspective about your work. You will have the chance to meet people from a wide range of backgrounds and build your professional network. What is more, you will be able to discover Paris’s mesmerizing boulevards, museums, and galleries.

Key dates to remember:

Abstract Submission Deadline: Wednesday, April 14, 2021
Early Registration Deadline: Wednesday, June 9, 2021

The 1st Joint Congress of the European INS chapters took place in Nijmegen, Netherlands and was focused on technologies that can help improve patients’ lives. The Congress in Nijmegen managed to gather close to 700 participants at the event and over 200 abstracts were submitted by participants. We are expecting the 2^nd Joint Congress of the European INS chapters to be an even greater success.

We are looking forward to seeing you in Paris, France on Sept. 2 to 4, 2021!

INS Resources for Members to Raise Professional Visibility

INS offers members several ways to enhance visibility, including:

Add clinic contact information on downloadable fact sheet PDFs https://inns.memberclicks.net/fact_sheets_for_members of explanatory content

Indicate on their member profile https://inns.memberclicks.net/my-profile that they want to opt to be listed in the INS public directory https://www.neuromodulation.com/find-a-clinic

Add social media contact information to the member profile https://inns.memberclicks.net/my-profile

Please see the following article regarding how to login https://www.neuromodulation.com/login and access these and other services.

“Keep Me Logged In” Provides Extended Access to INS Website Member Resources

International Neuromodulation Society members have an option, when logging https://www.neuromodulation.com/login in to the INS website, to select the check-box for “keep me logged in”.

On most browsers, this allows access resources in the Members Only area of the INS website for up to two weeks, as long as the user does not manually log out. If you have difficulty, clearing your cache in your browser may help.

Remaining logged in allows convenient members-only access to a number of resources, including:

Membership benefit links

Membership tools

Member resources

The INS Members Only home page also includes a reminder about finding the INS official journal, Neuromodulation: Technology at the Neural Interface, on Twitter, Facebook, and Instagram.

INS Chapter Reports

Activity summaries from:
Argentina l Australia and New Zealand l Benelux l Brazil l Canada l China l France l India l Nordic Region l North America l Russia l Spain l UK and Ireland

Argentina - Sociedad Argentina de Neuromodulación (SANE)

This is a brief summary of the activities carried out by the new Board, who took charge of SANE on Sept. 5, 2020.

Activities carried out in 2020:

Sept. 10: Signature of a cooperation agreement between SANe and the Argentine Society of Bioengineering (SABi).
New Social Media in Facebook, Instagram, and Tweeter.
Campaign to associate new professionals to SANE.
October: Sponsorship of the postgraduate course on Pain Medicine. National University of the Northeast.
October: Signature of a cooperation agreement between SANe and the Argentine Association of Neurosurgery (AANC).
October: SANE sent a proposal for a new nomenclator to the AANC so that new neuromodulation practices would be recognized.
Oct. 30 to 31: Sponsorship of the Argentine Scientific Congress of Medical Students. On this occasion, SANE awarded three medical students with a scholarship to join our Society.
Nov. 27: I Seminar SANe – SABi. The topic was, Neuromodulation for Parkinson's disease.
December: Signature of a cooperation agreement between SANe and Argentine Section of the Institute of Electrical and Electronic Engineers (IEEE Argentina).
December: Signature of a cooperation agreement between SANe and Argentine Chapter of the Engineering Society in Medicine and Biology (EMBS Argentina).
Dec. 2 to 4: Seminar SANe - AAP (Argentine Association of Psychiatrists). The main topic was Neuromodulation for psychiatric diseases, and Parkinson’s disease.

Planned activities for 2021:

New website.
February/March: II Seminar SANe - SABi (Argentine Society of Bioengineering.
Newsletter Spring 2021: Women in neuromodulation.
August: 1st SANe Virtual Congress.
Newsletter Fall 2021.

Australia and New Zealand - Neuromodulation Society of Australia and New Zealand (NSANZ)

COVID has shocked the globe in 2020. It appears there may be a pathway through this difficult time.

Despite the challenges faced with working our way through the global pandemic, The Neuromodulation Society of Australia and New Zealand (NSANZ) has had a successful year.

During our COVID ‘down time’, the NSANZ website has been designed, developed and born. Find it at https://www.nsanz.org.au/

We’ve refocused and crystalised our purpose and mission:

To raise awareness of neuromodulation.
To promote knowledge and understanding of neuromodulation.
To promote the safe and professional practice of neuromodulation.
To promote, assist and encourage research into the field of neuromodulation.
To support our members and keep them up to date.

We continue to build value for our members and now with our website, our members that are actively practicing neuromodulation, can now showcase their practice on our Find A Neuromodulation Service webpage.

After having a breather during 2020, we are now planning NSANZ 14^th Annual Scientific Meeting “Neuromodulation, Value Based Care” to be held Aug. 14 to 15, 2021 at the Sofitel Brisbane Central, Queensland. With the ever-popular Cadaver Workshop being held on the Aug. 13, 2021 at QUT Medical Engineering Research Facility, Brisbane.

We have much to teach and learn and many new therapies to showcase at our cadaver workshops, which includes the TGA approval of the closed-loop spinal cord stimulation device and the multifidus stimulator. These new therapies combined with the fact that our cadaver workshops have been very successful and oversubscribed, have led us to recently decide to host another cadaver workshop in Sydney in mid-April 2021. Watch this space.

NSANZ membership stands at 89 in 2020. Looking back to a membership base of 39 in 2016, this number has more than doubled. We have been working to enhance female representation in the neuromodulation sector and exploring the various opportunities. The Australasian Neuromodulation Nurses Special Interest Group (ANNSIG) continues to thrive.

Our Code of Conduct and Conflict of Interest documents have been ratified and published.

Lastly, sincere thanks to my friends and fellow board members Dr Marc Russo, Dr James Yu, Dr Murray Taverner, Dr Richard Sullivan, Dr Philip Finch, Dr Mo Awad, Ms. Christin Bird, Dr Matthew Keys and Ms. Megan Hannah for being so committed to the growth of Neuromodulation in Australia and New Zealand.

In 2020, we say goodbye to Dr. Richard Sullivan, who will focus on his role as Regional Director-at-Large for the INS and several roles within the Faculty of Pain Medicine of the Australian and New Zealand College of Anesthetists, and we will be welcoming new board members.

2021 will bring a raising awareness in neuromodulation campaign as well as further policy documents and increased membership benefits.

Nick Christelis
President
November 2020

Benelux - Benelux Neuromodulation Society (BNS)

Starting in the year 2018 with the 1st joint congress of the INS European Chapters, hosted by the BNS at the venue in Nijmegen, Sept. 20 to 22 with a preconference on Sept. 19 (cadaver workshop and a specific training for nurses) and was a huge success.

The European chapters were that enthusiastic and decided to organize this European congress biennially, with a focus on both innovative new science regarding neuromodulation, starting in Paris.

And then ... corona came and the world was busy with the corona pandemic and unfortunately the conference in Paris had to be postponed two times.

The mission of the Benelux chapter is changing in a more scientific community with a scientific committee of young researchers in neuromodulation. The goal is to do research to improve the quality of life of patients with neuromodulation.

Benelux is stimulating nurse practitioners to become a member of the Benelux chapter.

In 2018 Mike DeJongste resigned from his position as president of the BNS and Monique Steegers has accepted to be the president for three years. Maarten Moens will prolong his position as secretary and Harold Nijhuis as treasurer.

A new member of the board is Lisa Goudman, a young researcher who did her PhD on neuromodulation (objective measurements in patients with chronic low back and leg pain). She will chair the scientific committee.

All minutes of the BNS meetings are available for the INS. Please contact the secretary Prof dr Maarten Moens for further information.

Monique Steegers and Maarten Moens on behalf of the BNS board

Brazil - Sociedade Brasileira Neuromodulação (SBNM)

Despite the Covid-19 pandemics, the Brazilian Chapter of INS worked hard to carry out all needed measures to grow as a Society.

- Renewal of societal By-law, in order to make it more modern, with clearer objectives, including organizational protection.

- Creation of a brand-new home page (www.sbnm.com.br), including historical data from our Chapter, list of members, scientific news and information for members, as well as FAQ for patients and for those interested in more information.

Assistance and Participation on the Congreso Iberroamericano de Neuromodulacion, from July 7 to 8 organized by the Spanish Society of Neuromodulation.

Elaboration and execution of Webinars, including a Neuromodulation Week, in conjunction with Brazilian Society of Neurosurgery, from Aug. 3 to 7, when important topics have been discussed with speakers such as: Drs. Robert Levy, MD, PhD; Sebastian Gillner, MD; Dirk de Ridder, MD, PhD; Timothy Deer, MD; and Fabian Piedimonte, MD, PhD.

Development of a network with regional societies, especially with neighbor and related countries such as Argentina, Colombia and Spain.

In 2021, a series of further scientific program is prepared.

Daniel Benzecry Almeida
Neurocirurgia Funcional, Dor e Gamma Knife
Instituto de Neurologia de Curitiba
Department of Functional Neurosurgery, Pain and Gamma Knife
Instituto de Neurologia de Curitiba
Curitiba-Brazil

Canada - Canadian Neuromodulation Society (CNS)

As usual we spent much of our time up until March planning the annual meeting which was to take place in Kelowna, BC in September. We had several international speakers lined up and confirmed but had to cancel due to the pandemic.

Fortunately, many of the board members had great enthusiasm to throw a virtual meeting. On Nov 14, 2020 we put together a comprehensive program using all Canadian speakers. We presented 5 separate sessions on topics covering DBS for Epilepsy, DRG stimulation, new waveforms, Sacral nerve stimulation, SCS for Angina, and Intrathecal therapy for Cancer pain. Additionally, we had 11 abstracts presented and the submitted work was outstanding and on par with any international neuromodulation meeting. We had 64 attendees which was similar to the previous year’s physical meeting in the arctic in 2019! Overall the quality and the delivery of the program was outstanding and we are all very proud of what we accomplished.

We had to forgo our annual cadaver lab normally delivered in September held in conjunction with the Canadian Pain Society’s fellows course but look forward to doing it again next year and hopefully in 2024.

We published our first edition of the CNS newsletter this year and will continue to do so several times per year going to keep our members better connected and apprised of developments within Canada in the field of neuromodulation. In addition, we are starting a bimonthly journal club in January 2021 to disseminate new knowledge within our field.

Our new Treasurer, Dr. Anuj Bhatia, has kept us in good stead and our finances are in order. He has done an outstanding job and is a superlative organizer.

Our next planned national meeting is planned for Sept. 24 to 26, 2021 in Kelowna, British Columbia. I hope you and some of the INS board members will consider joining us for what will be a top-rate scientific event in a spectacular setting.

Sincerely,

Keith MacDougall, BSc (hon), MD, FRCSC
President, Canadian Neuromodulation Society
Associate Professor,
Program Director
Division of Neurosurgery
Schulich School of Medicine and Dentistry

Canadian Neuromodulation Society board members:
Keith MacDougall, MD FRCSC - President
Anuj Bhatia, MD, MBBS, FRCPC, FRCA - Treasurer
Magdy Hassouna, MD, PhD, FRCSC, FACS - Secretary
Members at Large:
Yasmine Hoydonckx, MD – Scientific Program Coordinator
Antonios El Helou, MD
Jill Osborn, MD, PhD, FRCPC
Lutz Weise, MD, PhD
Vishal Varshney, MD, FRCPC
Joseph Buwembo, MB-ChB, CRCSC
Susan Schellinck, OT
Christopher Honey, MD, DPhil, FRCSC, FACS - Past-President

China - Chinese Neuromodulation Society (CNMS)

The China branch of the International Neuromodulation Society was established in 2009 and currently has 30 employees.

The Chinese Neuromodulation Society (CNMS) was founded in 2010, with Professor Luan Guoming as the chair, and has become one of the most influential medical societies in China.

In the new term of CNMS members, Professor Luan Guoming was re-elected as the chair. Meanwhile, 10 vice-chairs, 41 standing committee members and 118 members were elected.

The number of new members has increased to 667, covering 22 provinces, municipalities and autonomous regions across the country, and these members are experts in neurosurgery, neurology, psychiatry, anesthesiology, orthopedics and other areas.

CNMS has several branches, including youth council, urological and functional viscera group, electroconvulsive and neurostimulation group, pain group and psychiatric group. Furthermore, new branches have recently been established:

cranial nerve regulation and control group
neural regulation of program-controlled group
robot assisted treatment group
posture and gait disorder neural control group

The CNMS2020 annual conference and the 11th neuromodulation conference have been successfully held in Nanjing, China on Sept. 13, 2020 on Sept. 12, solstice. Due to the COVID-19 pandemic, the conference was held in the form of a combination of on-site and virtual meeting.

More than 150 scholars gave oral presentations and keynote talks. They summarized recent academic research achievements of neuromodulation in China, and discussed the cutting-edge technological development in the field of neuromodulation.

Participants came from basic, clinical and translative research and other fields, including experts, scholars, clinicians and scientific research and technical personnel. More than 30,000 people watched online. The special committee of neuromodulation will persistently be dedicated to providing an academic exchange platform for domestic and international practitioners, and to advancing the Chinese neuromodulation career, which is an important part of the word-wide neuromodulation development and potentially has great impact on the health and well-being of all humankind.

France - Societe Française de Neuromodulation (SFNM)

The SFNM board dedicated this year to organize the next European INS congress. Sanitary conditions imposed us to postpone the congress due to the COVID-19 but all efforts which have been made will be the substrate of this event later.

French Events calendar:
- Intrathecal Drug Delivery Symposium, D. DUPOIRON hosted by SFNM, Jan. 27 to 28, 2020, Angers
- SNFM Board Meeting (Feb. 14, 2020, Strasbourg):
Executive Board election & Neurizon Neuromodulation Database initiation decision with the initial support of Poitiers University Hospital for the implementation of the database. Resources to be confirmed on the long term. Under prospection.
- 2nd Joint Congress of the INS European Chapters, Paris. Oct. 14 to 15. Postponed to Sept. 1 to 4, 2021.

India - The Neuromodulation Society of India (TNS)

This has been a challenging year for all of us. We started on a very upbeat note with the preparations of INS-IM 2020 in full swing in January 2020. There was a great amount of interest for participating in this meeting. Unfortunately, the Covid pandemic struck and by March all our plans started looking shaky. As early as June 2020, with the consent and support of the INS leadership, we were able to reschedule our meeting to November 2021. We are now pleased to announce that the meeting dates have been finalized for Nov. 19 to 21, 2021. November is a very pleasant part of the year in India and all the attendees will enjoy a good weather. We look forward to the same enthusiasm and support for this meeting. We are fortunate to have the confirmation of all the faculty that were planning to join this year to join us in November 2021.

In order to continue the momentum of academics for our newly formed society we decided to organize a course on neuromodulation in pain and DBS endorsed by the International Neuromodulation Society. Once again, we had the full support of the leadership of INS and we are thankful to them for the same. The webinar series comprising of seven 90-minute sessions of neuromodulation for pain had been greatly successful with 579 registrations from 60 different countries. The participants were offered a course certificate signed jointly by the INS and neuromodulation society leaders. The webinar series on DBS is underway and we have completed 5 webinars on the same. We have 745 registrations from 79 countries for the DBS webinars. CME credit hours are offered for both of the above series.

Earlier this month, we launched our website.

We would like to thank the INS leadership for their continued support and encouragement and Tia and her team for all the help she provides us.

Dr. Paresh Doshi
President, TNS

Nordic - Nordic Neuromodulation Society (NNS)

On behalf of the board of the Nordic Neuromodulation Society (NNS) I would like to supply the INS with a brief summary of Chapter activities in 2020.

The NNS board in 2020 has been consisting of:

Kliment Gatzinsky, Sweden (president)
Mikael Fraunberg, Finland (treasurer)
Ala Ouraiby, Sweden
Audun Stubhaug, Norway
Kaare Meier, Denmark (past president, co-opted member)

The NNS had 70 registered members in November 2020.

The ongoing Covid-19 pandemic has heavily hampered the activities of the NNS with no face to face meetings or educational events being held during the year. Several web-based, educational events, mainly dealing with new neuromodulation techniques and innovations, have been taking place during the pandemic. The annual meeting of the Chapter with the general assembly was supposed to be held during the 2nd eINS Congress in Paris in June which was initially moved to October, and finally postponed.

Due to these circumstances the NNS board has had two web-based meetings in February and November in order to keep up the activities of the Chapter. During these meetings the main topics discussed were:

i) Overview of the present bylaws of the chapter. It was decided to suggest to the members of the NNS during the Annual meeting that starting 2020 the past president should be added on a term of two years as an additional member of the Board, thus increasing the number of Board members from 4 to 5.

ii) Establishment of a bank account in the name of NNS as a non-profit organisation for keeping the assets of the Chapter.

iii) To elect a scientific officer who will have an overview of ongoing research activities in the Nordic region, and also be responsible for coordination of new collaborative studies and trials within the region.

Since the INS and Chapter Bylaws template require that each Chapter hold an annual meeting, including a General assembly of members, it was decided by the NNS Board to hold an independent, virtual meeting of the NNS on Dec. 16 at 5-6 pm with invitation to all active NNS members to discuss society business, such as elections and bylaws, and provide an update of ongoing and upcoming activities of the Chapter.

The NNS Board is hoping that 2021 will be a year when the activities of the NNS and INS will return to more normal standards, with the resuming of face to face meetings in order to allow educational and social activities, as well as offering the members of NNS to attend national and international conferences.

Kliment Gatzinsky MD, PhD
President of the Nordic Neuromodulation Society

North America - The North American Neuromodulation Society (NANS)

The following is a brief synopsis of NANS accomplishments during 2020.

In January 2020, NANS once again partnered with several of our major supporters and industry partners to showcase neuromodulation as a growing therapeutic field among other rapidly growing medical technologies at the Consumer Electronics Show (CES). We conducted a panel discussion for an audience of over 700 attendees and had an exhibit booth in the exhibit hall. We look forward to continuing this collaboration on into the future.

NANS continued our strong start to 2020 by hosting a successful 23rd Annual Meeting, Driving Science Through Science & Evidence. From Jan. 23 to 26, 2020, once again exceeded all previous years with an attendance of 3131, a 12% growth from the previous year. The two-and-one-half days of content and networking offered attendees the opportunity to learn about the latest developments in our field. Our Scientific Program Oversight Committee, led by Julie Pilitsis, MD, PhD; David Provenzano, MD; Lawrence Poree, MD, PhD and Nebojsa (Nick) Knezevic, MD, PhD produced the final scientific program for the Annual Meeting. The group’s efforts to produce an event full of current content and many opportunities for engagement resulted in an event that surpassed all expectations.

2020 also marked another remarkable success for the NANS preconference neuromodulation workshops. Michael Fishman, MD; Michael Hanes, MD; and Bryan Hoelzer, MD continued as course directors. Other specialty specific course directors included Al Mashal, PhD (Engineering); Ashwin Viswanathan, MD (Neurosurgery); Ahmed Raslan, MD (Neurosurgery); Scott Pello, MD (Neurology); and Chris Skidmore, MD (Neurology); Einar Ottestad, MD (Peripheral Nerve Stimulation), and Michael Fishman, MD (Peripheral Nerve Stimulation).

As in previous years, the overall attendance of the course grew this year with a total attendance of 215 participants. This included 97 Pain Medicine fellows, 16 Certificate of Attendance (Pain Medicine physicians currently in practice), 27 Peripheral Nerve Stimulation attendees, 21 Neurosurgery residents, 28 Neurology residents, 26 Engineers, making it the largest attendance in the course’s history. This reinforces that the NANS workshop is one of the largest international cadaver labs and perhaps the only multidisciplinary workshop of its kind in the world.

As mentioned, there was a wealth of cutting edge, innovative research presented during the general and concurrent sessions. Four hundred and eighty-three abstracts in total were submitted for the Annual Meeting Program. The Annual Kumar New Investigator Best Manuscript Award was presented to Alik Widge MD, PhD for his submission entitled “Deep Brain Stimulation of the Internal Capsule Enhances Human Cognitive Control and Prefrontal Cortex Function.”

Steven Falowski, MD and Jason Pope, MD, Annual Meeting Co-Chairs, worked to ensure that the overall atmosphere, meeting venue and related meeting events were well planned and met the expectations of our constituents. Dr. Pope also chaired an Emerging Technology Forum that was well received and provided a platform for emerging researchers and companies to present their innovations. At the conclusion of the 2020 Annual Meeting, NANS also announced that we will be changing meeting venues for the next 2 years; relocating to the Walt Disney World Swan and Dolphin Resort for 2021 and 2022. We look forward to welcoming our colleagues to this exciting new venue.

Throughout the course of 2020, despite the global pandemic, NANS has once again been very engaged in various advocacy and policy issues. Under the guidance of David Provenzano, MD; Joshua Rosenow, MD and Senior Advisor David Kloth, MD, the NANS Advocacy and Policy Committee has been working tirelessly to advocate for our therapy and constituents. NANS’s membership and involvement in the AMA Specialty Section Council and, more specifically, the RUC/CPT process. Engagement with several partner societies has also allowed NANS to contribute to various comment letters and other initiatives that have resulted in positive changes to several reimbursement and practice parameters. We look forward to continuing our engagement here to better serve our patients and the field of neuromodulation.

Our educational priorities continue to focus on being advocates for Neuromodulation therapies. Through efforts of our Education Committee, NANS has focused on creating more on-line education content for the neuromodulation community. NANS has been offering regularly scheduled webinars and plans to expand this in the coming year. We have also been collaborating with the INS on a joint curriculum task force. We look forward to continuing this collaboration and the eventual release of the final product. The Education Committee is also currently working on several guideline projects and publications and hopes to make these available in the near future.

In late August, the NANS Board met virtually for our annual board retreat. Several members did gather in-person in Asheville, NC USA. While together, we reviewed the progress of our yearly initiatives and discussed several of our strategic planning initiatives. NANS will shortly begin enacting on several governance projects intended to improve the overall operations and functioning of the Board and Committees.

This winter, the NANS Nominating Committee will conduct an election to fill several vacant director-at-large positions on the NANS Board.

Lastly, the NANS Board decided to offer our 2021 Annual Meeting in a virtual format. In the interests of serving our members and constituents in a safe and engaging manner, it was determined that this would be the best course to pursue at this time. The NANS 2021 Virtual Annual Meeting took place Jan. 15 to 16, 2021, with an opening exhibit hall event on Jan. 14, 2021. For more information, please visit: https://conference.neuromodulation.org/

We look forward to continuing our progress on these and many other fronts throughout the remainder of the year and on into 2021.

Peter Konrad, MD PhD
President, North American Neuromodulation Society

Russia - The National Neuromodulation Society in Russia (NNSR)

Annual activities for the 2020:

Development our social network:

Creation of YouTube channel
https://www.youtube.com/channel/UCc3s2O00p_8djYMW9IeZJTA/featured
Promote of Facebook page
https://web.facebook.com/nnsr.com.ru
Promote of Instagram
https://www.instagram.com/emil_isagulyan/

Webinars

Minimally invasive and neurosurgical pain therapy - to whom and when? (RASP ONLINE)
New Frontier - Energy-Saving Neuromodulation
Neurological aspects of proctological diseases. Pain syndrome. (ProctoWeb)
Interdisciplinary Council “What to do with a difficult headache? Dialogue between a neurologist and a neurosurgeon " (NNSR and AIM; Webinar.ru)
Neuromodulation of pain (1st webinar of NNSR, Webinar.ru)
Radiculopathy in the 21 centuries (NNSR and AIM; Webinar.ru)

Publishing a monograph
- Neuromodulation of pain
Isagulyan Emil
Konovalov Nikolay
www.neuromodulationofpain.com
The III International Congress of the Association Interventional Treatment of Pain and the II Congress of the Society of Neuromodulation in Russia, Dec. 9 to 11, 2020, online.
Radio airplay (Govorit Moskva)
- Chronic Pain
Isagulyan E.
Society meeting (5)

Future activities for the 2021:

Development our social network: proliferation of publications, increased members
Webinars
Society meeting (5)

The National Neuromodulation Society in Russia (NNSR) 2020 newsletter.

Spain - the Spanish Chapter of the INS

The current situation of the COVID pandemic has forced us to hold our annual Congress virtually. On this occasion we were able to hold the Congress together with our colleagues from Iberoamerica and in this way we were able to hold the "I Ibero-American Congress of Neuromodulation" on July 7 to 8, 2020.

The congress obtained the recognition and endorsement of different scientific societies: Sociedad Brasileira de Neuromodulaciao, SANE (Argentine Society of Neuromodulation), SENFE (Spanish Society of Functional and Steroatáxic Neurosurgery), VALDOLOR (Valencian Society of Pain) and Working Group of the SED (Spanish Society of Pain).

The local organizing committee had the invaluable help of an international organizing committee made up of Doctors Contreras from Colombia, Bezecry from Brazil and Piedimonte from Argentina.

The congress was divided into two days with a total of 4 tables and 2 keynotes.

The inaugural lecture was conducted by Dr. Robert Levy, president of INS, and he gave us a global vision of neuromodulation and the current situation we were experiencing.

The first table revolved around an update on spinal and peripheral neurostimulation, was moderated by Dr José Lopez and featured presentations by Doctors Vallejo, Abejón and Rosado. During the table, a review was made of the novelties in neuromodulation with new waves, new systems and new therapeutic targets.

The second table focused on neurosurgical techniques and we were able to assess different neurosurgical indications for neuromodulation. With special attention to movement disorders, psychiatric disorders that can be treated with deep brain stimulation and also disorders that present with pain and that have neurosurgical techniques as a treatment option.

The third table focused on intrathecal infusion with an interesting review of the latest PACC recommendations and an assessment of new indications.

The fourth table had an interesting debate on the lines of research in Neuromodulation. A field little exploited in most of the congresses and that this time had special attention. We also had the opportunity to see the conference we have to do to be able to publish on neuromodulation.

The closing lecture was delivered by Dr Peter Staats, president-elect of WIP (Word Institute of Pain), and he gave us a tour of the new horizons that lie ahead in neuromodulation.

And we ended the congress with the virtual Assembly of Members of INS Spain.

Registered to the congress exceeded 500 people, a really important figure since it is a congress in a special situation but which aroused the interest of Spanish-speaking health professionals around the world interested in neuromodulation.

From INS Spain, we are very satisfied to have been able to carry out this congress together with our sister scientific societies in America, whose union is the Spanish language as a meeting place. This has been the first Ibero-American Neuromodulation congress, with a very good reception by the different health professionals and we hope that in the coming years we can continue to hold them to continue with the dissemination and dissemination of neuromodulation.

J Carlos Tornero Tornero MD, PhD
Jefe de Servicio de Anestesiología, Reanimación y Terapéutica del Dolor
Hospital Clínico Universitario de Valencia
Profesor Asociado. Departamento de Cirugía. Universitat de Valencia
Director Cátedra Dolor. Fundación VITHAS - CEU
Presidente Sociedad Española de Neuromodulación. INS España

UK and Ireland - Neuromodulation Society of the UK and Ireland (NSUKI)

I am honoured and privileged to assume the role of President of the Neuromodulation Society of the UK & Ireland for a term of two years from November 2020 to November 2022. Serving as a Honorary Treasurer for 6 years and then as a President Elect for one year, NSUKI has been an important part of my professional life. In response to the restrictions of study leave budgets in NHS organisations, I introduced the NSUKI Bursary scheme for members to fully cover all expenses involved in attending key educational events in Neuromodulation. NSUKI was the first organisation to introduce this in the field of Neuromodulation.

I appreciate and would like to thank Dr Ganesan Baranidharan for all the hard work he has put in to take NSUKI further in its mission. Please join me in applauding his contribution to the Society. I look forward to his guidance as a Past President.

2020 has been marred with the COVID-19 pandemic and there are no signs of this easing as we approach 2021. As Covid-19 inpatient numbers accelerated during the first wave, all non-urgent elective surgery was stopped from the 15th of April to help services deal with the pandemic. In many places, NSUKI members were redeployed to cover Covid patients. As new implant activity came to a standstill it had a huge impact on patients suffering from severe neuropathic pain. We produced guidelines on managing neuromodulation services during Covid-19 pandemic and also on resuming services during the Covid-19 recovery phase. Whilst recovering and restarting neuromodulation services after the first wave, we now face a second wave. We need to work collectively along with the NHS bodies to provide the best possible care and treatments to our patients, who suffer from severe, intractable neuropathic pain.

NSUKI ASM & Educational Events:
Since the inception of the European INS-Chapters Meeting in 2018 at Nijmegen, NSUKI annual scientific meetings were planned every alternate year. With cancellation of the 2020 European INS-Chapters Meeting in Paris, we have lost networking opportunities and also an educational platform. We introduced a series of Webinars to replace this. I understand the value of face to face meetings and networking, and how virtual congresses can never replace it. We will be planning NSUKI ASM along with the rescheduled Paris European INS-Chapters Meeting in 2021. We are monitoring the pandemic and will announce our meeting dates and venue when we have more clarity on how the pandemic will evolve.

National Neuromodulation Registry (NNR)
NNR was launched in 2018. We had a great uptake with many of Neuromodulation Centres signing up to it. Under the leadership of Dr Baranidharan, the registry has developed really well. We are always striving to improve and develop it further. We are looking towards launching phase 2 of the registry and investigating the feasibility of a smartphone App for patients. You would have seen the excellent hospital reports that the registry can produce. On demand it can also produce individual clinician reports for your appraisal and revalidation. Getting It Right First Time (GIRFT) and Specialised Commissioning have given high priority to NNR as a performance indicator for NHS trusts undertaking Neuromodulation.

There have been a substantial number of entries in the registry, however, we have noticed that we do not have 100% data entry and sign up for the registry. I request all of you to sign up for the registry and aim for 100% data entry for new implants as well as revisions and explants.

SPIN & SNNAP
Specialist Practitioners in Neuromodulation (SPIN) have created an effective network of Neuromodulation nurses over the years. Within this network, they could exchange protocols, pathways & work practices etc. With the initiative of some professionals, a new organization named Specialist Neuromodulation Nurses and Associated Professionals (SNNAP), was formed. Some of the SNNAP members have become NSUKI members. SNNAP has developed a MSc module in Neuromodulation in conjunction with Leeds Beckett University. The module is aimed at all individuals involved in Neuromodulation.

I would encourage all the Nurses and Associated Professionals to join NSUKI and make it a multidisciplinary society.

During my presidential term my goals are:
• To increase patients' awareness of Neuromodulation and improve their access to it.
• To increase awareness of Neuromodulation amongst other health care professionals.
• To develop teaching programs for young implanters.
• To increase the uptake of the National Neuromodulation Registry.
• To instigate independent NSUKI initiated research projects.

I have very enthusiastic and devoted council members and very supportive Industry Partners. Together we will strive to deliver on these goals.

Yours Truly,

Dr Ashish Gulve
President NSUKI