Control of the Neonatal Septisome and Hydrocephalus in sub-Saharan Africa

描述（由申请人提供）：我提出了一种新的方法来建立基于模型的反馈控制，以寻求一个合理的、最佳的框架来减少发展中国家的新生儿败血症（NS）。NS是全球儿童的主要杀手之一，除了减少NS的死亡外，这还将减少NS幸存者的后遗症，如感染后脑积水（PIH），这可能是全球儿童脑积水的主要原因。我目前是一名PI在三期美国国立卫生研究院资助的随机对照手术试验在非洲寻求优化治疗PIH（临床试验# NCT01936272）。然而，作为手术治疗无法修复脑损伤儿童的替代方案，我现在处于一个独特的位置，可以学习如何在这种情况下更有效地治疗NS，从而更好地预防世界上这个地区大量患有PIH的婴儿，否则我们就需要通过手术来缓解。虽然我是一名儿科神经外科医生，但我在控制工程和物理方面都获得了相当多的专业知识。我最近写了第一本关于神经控制工程的书，由麻省理工学院出版社于2012年出版。这个先锋奖旨在利用我在控制工程方面的知识，并将其应用于我的一个全新的研究途径——寻求以可持续的方式影响神经症的发病率和死亡率。我已经在乌干达建立了一个独特的基础设施来实现这个项目。我已获得乌干达医疗执照。我与两家重要机构组织了两个试点项目：位于姆巴莱的儿科神经外科专科医院（乌干达CURE儿童医院）和位于姆巴拉拉的一家大型转诊医院（位于姆巴拉拉科技大学）。在Mbale，乌干达的大多数脑积水现已得到治疗，其中大多数病例是NS后感染后病例。在Mbarara，他们的婴儿病房最常见的入院是NS，所有的脑积水都被转到Mbale。每一次

DESCRIPTION (provided by applicant): I propose a novel approach to institute model-based feedback control to seek a rational, and optimal, framework to reduce neonatal sepsis (NS) in developing countries. In addition to reducing deaths from NS, one of the leading global killers of children worldwide, this will reduce the sequelae in the survivors of NS such as postinfectious hydrocephalus (PIH) - likely the dominant cause of hydrocephalus in children worldwide. I presently am a PI on a Phase III NIH sponsored randomized controlled surgical trial in Africa seeking to optimize treatment of PIH (clinical trial # NCT01936272). However, as an alternative to surgical treatment of children with irreparable brain damage, I am now in a unique position to learn how to more effectively treat NS in this setting, and thereby better prevent the large numbers of infants with PIH in this part of the world that we would otherwise need to surgically palliate. Although a pediatric neurosurgeon, I have acquired considerable expertise in both control engineering and physics. I recently wrote the first book on Neural Control Engineering, published by the MIT press in 2012. This Pioneer Award seeks to leverage my knowledge of control engineering and apply this to an entirely new avenue of research for me - seeking to impact in a sustainable way both the morbidity and mortality of NS. I have put in place a unique infrastructure in Uganda to enable this project. I have secured Ugandan medical licensure. I have organized two pilot projects with two key institutions: a pediatric neurosurgery specialty hospital in Mbale (the CURE Children's Hospital of Uganda), and a major referral hospital in Mbarara (at the Mbarara University of Science and Technology). At Mbale, most of the hydrocephalus in Uganda is now treated, and the majority of these cases are postinfectious following NS. At Mbarara, the most common admission to their infant ward is NS, and all of their hydrocephalus is referred to Mbale. At each i