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PBSF partnerships

People come together for a purpose, and partnerships are based on the needs for cooperation to achieve them
Dr. Sudhin Thayyil e Setembro Verde Esperança

PREVENT Study

Epilepsy is one of the leading causes of disabilities in India, affecting more than 12 million people in the country. It often debilitates the lives of those affected and takes a massive toll on the socio-economic ecosystem. A significant number of epilepsy cases are caused by brain injuries in babies during childbirth.

Dr. Sudhin Thayyil, from Imperial College of London is the chief investigator of PREVENT (Prevention of Epilepsy by reducing Neonatal Encephalopathy) study. His team believes that we could help reduce epilepsy by preventing brain injuries sustained during childbirth. The study recruits infants in three different cities including Bangalore, Calicut and Hubli in India.

PBSF collaboration to PREVENT study includes Creation of an Advanced Telemedicine model and EEG cloud base system. The monitoring system was created by applying the most updated technologies, using Microsoft Azure infrastructure, security and software development.

Additionally, tele-education between healthcare professionals in India, UK and Brazil occur on weekly basis.

PREVENT study is sponsored by the National Institute of Health, UK.

Learn more at https://www.preventstudy.org/team

Dr. Sudhin Thayyil

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Setembro Verde Esperança

Dr. Sudhin Thayyil e Setembro Verde Esperança

U.S.-Brazil Newborn Brain Care Initiative

Newborn brain injury is a leading cause of neonatal mortality worldwide. Oxygen deprivation around the time of birth, bleeding in the brain, stroke, and infection may all contribute to death or long-term brain injury.  Medical advances including the use of neuromonitoring and brain imaging, treatment with whole-body cooling, and improved neurodevelopmental therapies have all contributed to improved outcomes for babies.  Despite these advances, significant disparities in health care related to resource allocation and variability in practice have impaired access to optimal brain care for newborns in Brazil.  Variations in practice may significantly impact the beneficial effects of therapy and potentially may cause harm.

We established U.S.-Brazil collaborative to leverage advances in educational telemedicine and neuromonitoring to address the significant public health problem of newborn brain injury.

This study will evaluate practice among 12 Brazilian hospitals with regards to major conditions affecting brain health in newborns.  We are using tele-education and neuromonitoring infrastructure to improve adherence to protocols and determine if these educational initiatives will reduce disparities in practice.

MirrorHR

MirrorHR

Epilepsy research is fragmented and hospitals and physicians are limited by the care often provided in silos and the lack of unified access needed for analysis and trending of large scale data. Each patient is unique and families are often forced to choose between conventional treatment pathways that are widely accepted but may not necessarily respond better to the patient’s needs, compared to taking high risks with untested studies and ideas that might work better. MirrorHR – Epilepsy Research Kit for Kids, is a project in which parents are using a new system with a mobile app connected to a wearable device that sends alerts when anomalous activity might indicate a seizure.  

MirrorHR is a robust project that aim to empower caregivers and physicians by collecting data and screening for seizures in infants with epilepsy. This project was the grand prize winner for Microsoft global hackathon

PBSF strongly support the work done by MirrorHR team, Fight The Stroke Foundation and we envision that connecting both PBSF and MirrorHR platforms may potentialize the good results in this population.

Microsoft Azure

Protecting Brains & Saving Futures, PBSF, has developed a system to monitor the brain activity in newborns who are at high risk of neurological injury, allowing rapid intervention, saving lives and preventing permanent damage. The technology relies on a central data hub populated with information from hospitals in Brazil, built on Microsoft Azure.

Having a robust cloud structure is essential for the PBSF operation, where a large repertoire of exams related to brain monitoring of babies needs to be stored safely and optimally.

In partnership with Microsoft professionals, the company has developed an architecture based on features such as Azure SQL Server, Event Hubs, IoT Central, Azure Data Lake Store, Azure Blob storage, among other solutions in the Azure environment.

Using Microsoft technology, PBSF created a structure called CSI (Central of Surveillance and Intelligence) so that specialized professionals can monitor patients anywhere across the Brazilian territories and also internationally. Upon discovering abnormalities, the CSI team notifies on-call physicians, who intervene quickly using advanced protocols that have been implemented by PBSF throughout its experience.

Microsoft Customer Story

(Microsoft Azure)

Using Microsoft Azure, we are able to monitor the brain activity of babies at high risk for neurological injury, allowing quick intervention to save and protect them from permanent damage.

Watch the video:

PBSF combines Cloud technology and advanced medical protocols to improve quality of care for newborns at high risk for brain injury.

Microsoft Anomaly Detector

Microsoft Anomaly Detector

The use of technology has been growing rapidly in the intensive care unit where the use of telemedicine, machine learning and artificial intelligence in the NICU could enhance decision-making processes.

In the evolution of PBSF project, we must combine cost optimization with BIG DATA analysis and machine learning to improve the support provided to critical patients.

In the evolution of the Monitoring Center (CSI), we intend to make use of BIG DATA and advanced processes to identify non-explicit behavior patterns, trends and unique correlations and other useful information.

Finally, advanced predictive analyzes can be applied to neonates at high risk, and these results may contribute to the introduction of new treatments to prevent the incidence of neurological impairment.

Early diagnosis and predictive models, especially when talking about brain injury in newborns, can have the impact of changing the life of the patient and his entire family. It is the consolidation of telemedicine, through the use of technology to provide specialized knowledge support to professionals and high-risk patients.

PBSF is currently collaborating to Microsoft Anomaly Detector team in China, working into automated seizure detection algorithms and prediction of outcome tools by analyzing data collected by CSI.

Setembro Verde Esperança (National Awarenees Campaing about Perinatal Asphyxia)

Entities united to raise Society Awareness in Brazil on the Prevention and Treatment of Perinatal Asphyxia.

Neuroprotection strategies such as therapeutic hypothermia and brain monitoring have been implemented in Brazil with significant heterogeneity at several levels of management. It is estimated that less than 5% of infants with hypoxic-ischemic encephalopathy (HIE) in the country will receive the treatment accordingly to the validated international protocols (including adequate neurological exam, proper temperature control, brain monitoring, seizures diagnosis and treatment, access to brain imaging and adequate follow up).

In order to further enhance the attention to the prevention and treatment of perinatal asphyxia, national entities have joined together to launch the Setembro Verde Esperança – National Awareness Campaign on Birth Asphyxia – to endorse the importance awareness of risks, prevention and treatment of perinatal asphyxia and HIE.

The movement was initiated by the Protecting Brains Saving Futures Institute in partnership with the Brazilian Society of Pediatrics. This action received support from Ministry of Health in Brazil and also from over 70 different national and international entities ranging from medical societies, universities, hospitals and large companies including Microsoft. As a gesture of governmental support, the national congress and senate were illuminated in green in allusion to the campaign.

The movement’s goal is to launch a series of actions that bring this topic and discussion to the heart of the whole society and draw the attention of the public and private sectors to the need to reduce the impact of perinatal asphyxia and HIE in Brazil.

By joining forces we can implement strategies to reduce neurological impairment and achieve attainable results in the country’s socioeconomic condition.

Learn more at: https://setembroverdeesperanca.com.br/eng/ 

5)	Setembro Verde Esperança (National Awarenees Campaing about Perinatal Asphyxia)

Professor Topun Austin

&

Setembro Verde Esperança

Video

The 10th Neonatal Conference of McGill University

In the past decade, there have been many advances in the understanding of neurological disorders in preterm and term neonates, associated with the development of new diagnostic tools and treatment modalities. 

The 10th Neonatal Conference of McGill University will give the opportunity to participants to hear about the latest developments in the field, to acquire new knowledge about the pathophysiology of neurological disorders and learn about the best approaches to improve the outcome of neonates.

PBSF endorses and will host in our virtual platform, the 10th Neonatal Conference of McGill University, which will occur 100% online on May 26-27th 2021.

Learn more at https://www.mcgillmchneonatalconference.com

The 10th Neonatal Conference of McGill University

Testimonials

The PREVENT study is a multi-centric study focused on reducing neonatal encephalopathy and is funded by the NIHR, UK, being conducted in 3 sites (Calicut, Bangalore and Hubli) in South India. As a part of this study, neonates with encephalopathy or seizures within 72 hours of birth are subjected to continuous video EEG monitoring. Two of the most challenging aspects of conducting trials involving neurodiagnostics in the Low- and middle-income countries(LMIC) include the lack of expertise locally in the interpretation and acquisition of neurodiagnostic techniques such as the EEG and robust data security and storage solutions. Protecting Brains and Saving Futures (PBSF), with its advanced telemedicine system helps provide prompt diagnosis and helps make clinical decisions thereby enhancing the quality of neurocritical care as well as high quality research data acquisition. In the PREVENT study, expert neurophysiologists from London(UK) can access the EEG real time and give feedback to the clinical team through the research fellows posted at each site. The local equipment is linked to a central server and the data sent is fully encrypted, protecting the privacy of transmitted information. With support of a highly committed team at PBSF, any technical challenges with regards to uploading or viewing EEGs are solved without any delay. Telemedicine implemented by organizations such as the PBSF is the future when it comes to research and neurodiagnostics in difficult regions.

Vaisakh Krishnan, MBBS, MD, DNB (Paediatrics) | PhD Student , Centre of Perinatal Neuroscience, Imperial College, London And Neonatal Neurology Clinical research fellow, Institute of Maternal and child health, Government medical college,  ozhikode.

Sudhin Thayyil MD, DCH, FRCPCH, PhD
Professor of Perinatal Neuroscience, Imperial College London Chief Investigator of the PREVENT Study.

I have had the opportunity to collaborate with Dr. Gabriel Variane after meeting him at the International Brain Monitoring Conference in Cork, Ireland in 2016.  In late 2016 we established a joint collaboration between the Division of Neonatal and Developmental Medicine at Stanford University School of Medicine and the Group Santa Joana’s Centers in Brazil. This collaboration included webinars and ongoing discussion and knowledge sharing regarding neonatal critical care. We had the pleasure of having Dr. Variane and his colleagues visit us and attend some conferences we hosted at Stanford University.  Dr. Variane has distinguished himself by creating an ambitious project of remote neuromonitoring in 30 hospitals in Brazil known as Protecting Brains Saving Futures (PBSF).  He and his colleagues have monitored over 4,500 babies and impacted the health and outcomes for these newborns throughout Brazil.  I have had the pleasure of visiting PBSF offices in Sao Paolo several times to see first-hand their work and accomplishments. I am amazed by what they have accomplished to-date and I look forward to their future endeavors and how they will impact the neurologic care and outcomes of babies.  I have also co-authored several manuscripts and am involved in several research endeavors with Dr. Variane and his PBSF colleagues. I strongly believe that Dr. Variane and PBSF will have broad impact on neonatal neurocritical care in the years to come.

Krisa van Meurs, MD
Rosemarie Hess Professor of Neonatal and Developmental Medicine
Associate Chief Clinical Research, Department of Pediatrics, Stanford University School of Medicine
Medical Director, NeuroNICU, Lucile Packard Children’s Hospital
Palo Alto, California 94304

As caregivers and founders of Fightthestroke Foundation, advocating for children with Cerebral Palsy, we’re honored to mention PBSF among our trusted partners: their commitment on the savvy usage of technology for building up a consistent knowledge base for researchers resonates a lot with our mission. We believe that together we can change the course of the life for many newborns and their families.

 

Roberto D’Angelo and Francesca Fedeli
Co-founders of Fightthestroke Foundation.

We have been excited to collaborate with PBSF on several research and educational projects in the past few years. The US-Brazil Newborn Brain Care Initiative is a project funded by the Stanford Office of International Affairs and is a collaboration between the Stanford NeuroNICU and PBSF. Through this initiative, a Brazilian brain registry has been developed to collect critical information on babies cooled for HIE to examine practice variations and help to improve patient outcomes. Implementation of educational modules through a shared learning platform will also be an important component of this initiative.

We have also collaborated with PBSF to create the Multimodal Neuromonitoring Workshop at the 2021 Pediatric Academic Societies Meeting in which several neuromonitoring case studies from PBSF will be highlighted. We have published several neuromonitoring articles together and have ongoing research examining near-infrared spectroscopy sensors in the newborn.  Only with the infrastructure from PBSF in place were we able to accomplish these goals. PBSF has positively impacted the care of many babies with amazing potential for continued growth.

Valerie Chock

M.D., M.S. Epi, Arline and Pete Harman Endowed Faculty Scholar, Stanford Maternal & Child Health Research Institute Associate Professor of Neonatology Stanford University School of Medicine

PBSF - Protecting Brains and Saving Futures - is a leader and innovator in neonatal care and tele-health. Through their program they have been able to fulfill their mission on a daily basis. By using tele-health technology they provide life-saving consultations to other neonatal care providers in order to offer evidence-based neuro-protective care that truly has an impact on the short and long-term outcomes of newborns with brain injury. I continue to be impressed by the ongoing efforts by the entire PBSF to provide services and education to others around the globe. Personally, I am honored to be a part of their network, to collaborate on education efforts, and share their work and mission with our online community of more than 5,000 NICU professionals. I look forward to what the PBSF team and organization will do, and I know the whole world is watching too. PBSF inspires us all to do more, with less, to be innovative, to be persistent and to do whatever it takes to help protect baby brains and give them the greatest opportunity for a whole and healthy life. I wish the team the very best in their next ventures.

Kathi S. Randall

MSN, CNS, NNP-BC, Neonatal Intensive Care Nurse Practitioner President and CEO, Synapse Care Solutions, Inc.

Birth asphyxia remains a major challenge in resource-limited countries. Protecting Brains & Saving Futures is an important initiative using innovation and technology to overcome barriers and challenges. As the chair of the Newborn Brain Society education committee, I had the pleasure to collaborate with Dr. Gabriel Variane on several important activities endorsed by the newborn Brain Society such as the NeoBrain conference in 2019 which discussed the challenges in diagnosing, monitoring, and treating infants with birth asphyxia in Brazil with international speakers and more than 900 attendees from across the country. The mission of the organization is to decrease the incidence of birth asphyxia and improve management through education, empowerment of local healthcare providers and families, and utilizing local resources.  Another important initiative was a National Awareness Campaign on Birth Asphyxia – to endorse the importance of awareness of risks, prevention, and treatment of perinatal asphyxia. This Campaign was supported and endorsed by key organizations across Brazil such as the Association for Assistance to Disabled Children, Jô Clemente Institute, Brazilian Academy of Pediatrics, Brazilian Society of Child Neurology, Brazilian Federation of Gynecology and Obstetrics Associations, Brazilian Association of Physical Medicine, and Rehabilitation, Brazilian Society of Pediatric Neurosurgery, large communities of health professionals, in addition to several Brazilian hospitals. Furthermore, this project received support from the Ministry of Health in Brazil. Dr. Variane presented his vision and work at several international conferences including Newborn Brain society's weekly webinars. Dr. Variane and his team are closing the gap between high, middle, and low-income countries through networking, collaboration, and innovation.

Khorshid Mohamed

MD, MSc(pediatrics), FABP FRCP(Edin) FRCPC(Neonatology), The University of Calgary | HBI · Department of Paediatrics Co-Chair, Newborn Brain Society Education Committee

It’s been a great pleasure to know the work and collaborate with PBSF team in Brazil. With a focus on using technology to reduce the chances of neurological impairment in babies, the company has already assisted thousands of babies in Brazil and India.

Being able to use Artificial Intelligence is an important step to the PBSF project since it may allow faster and more assertive diagnoses of brain injury in babies. Our team at Microsoft collaborates with the creation of an automated seizure detection algorithm using Azure Cognitive Services - Anomaly Detector service, which will allow faster and simultaneous screening of multiple infants in this high-risk population. As a next step, Anomaly Detector’s multivariate feature can be applied to predict outcomes of patients by learning and creating an automated scores that correlate multiple parameters centralized on the online system.”

Tony Xing

Principal Product Manager at AI platform, Microsoft Cloud + AI, Microsoft, Beijing City, China.