Electromechanical Modeling Approach in Assessing Female SUI

描述（由申请人提供）：作为重新提交，提出的五年计划将培养和促进我进入独立的跨学科研究生涯。我在生物医学工程、电气工程和机械工程领域的多学科背景，以及我在高级生物力学建模和电生理建模研究方面的杰出经验，培养了我对尿失禁（UI）跨学科生物医学研究的兴趣，并赋予了我独特的优势。近期目标是为独立科学家的职业生涯做准备，并开发一种基于尿道阴道支持和尿道功能评估（UUFA）技术的新型受试者专用机电盆腔模型，以微创和定量评估这两种病因，并研究导致女性SUI患病率增加的与年龄效应相关的具体变化。本研究的中心假设是，女性的尿道阴道支持和尿道功能以及年龄对女性SUI的影响可以通过受试者特定的骨盆建模方法进行微创和定量评估和表征。主要假设#1是，女性尿道功能可以使用特定受试者的电生理盆腔建模方法进行微创和定量评估。主要假设2是，女性的尿道阴道支持功能可以使用受试者特异性的生物力学骨盆建模方法进行非侵入性和定量评估。主要假设#3是衰老会导致尿道阴道支撑力差和/或尿道功能障碍，从而导致SUI。主要假设#4是，可以创建女性失禁概况，以预测女性在临床上的失禁状况，并为特定患者提供最佳治疗方式。我们提出了四个特定目标（SA）来验证这些假设：SA #1：开发一种基于受试者特定电生理骨盆模型的尿道周围肌肉疲劳评估（UMFA）技术，以微创和定量评估女性尿道功能。第一假设将被检验。目标2：开发一种基于受试者生物力学骨盆模型的尿道阴道支持功能评估（USFA）技术，以非侵入性和定量评估女性尿道阴道支持功能。第一假设#2将被检验。目的：研究年龄对有/无SUI的年轻/老年女性受试者尿道功能和尿道阴道支持的影响，使用ufa技术，该技术由UMFA和USFA技术组成。主要假设#3将被检验。SA #4：通过利用ufa技术定量表征女性尿道阴道支持和尿道功能中的SUI病因，建立女性SUI概况，作为女性SUI的临床标准。第一假设#4将被检验。在这个项目完成后，我们期望我们将建立和验证ufa技术及其在临床研究中应用的可行性，并更好地了解与衰老和更年期相关的特定变化对女性这些病因的贡献。

DESCRIPTION (provided by applicant): As a resubmission, the proposed five-year plan will train me and foster my launch into an independent interdisciplinary research career. My multidisciplinary background in Biomedical Engineering, Electrical Engineering and Mechanical Engineering fields and my outstanding experience in advanced biomechanical modeling and electrophysiological modeling research have fostered my interest and given me unique advantages in conducting interdisciplinary biomedical research in Urinary Incontinence (UI). The immediate goal is to prepare for a career as an independent scientist and to develop a novel subject-specific electromechanical pelvic model based urethrovaginal support and urethral function assessment (UUFA) technique to minimally invasively and quantitatively assess these two etiologic factors and to investigate the specific changes associated with aging effects that cause the increase in prevalence of SUI in women. The central hypothesis behind this research is that urethrovaginal support and urethral function in women and aging effects on female SUI can be minimally invasively and quantitatively assessed and characterized using a subject-specific pelvic modeling approach. Primary Hypothesis #1 is that urethral function in women can be minimally invasively and quantitatively assessed using a subject-specific electrophysiological pelvic modeling approach. Primary Hypothesis #2 is that urethrovaginal support function in women can be non-invasively and quantitatively assessed using a subject-specific biomechanical pelvic modeling approach. Primary Hypothesis #3 is that aging will cause poor urethrovaginal support and/or urethral dysfunction which will lead to SUI. Primary Hypothesis #4 is that a female continence profile can be created to predict the status of continence in women in women clinically and to suggest optimal therapeutic modalities for specific patients. We propose four Specific Aims (SA) to test these Hypotheses: SA #1: To develop a subject- specific electrophysiological pelvic model based periurethral muscle fatigue assessment (UMFA) technique to minimally invasively and quantitatively assess urethral function in women. Primary Hypothesis #1 will be tested. SA #2: To develop a subject-specific biomechanical pelvic model based urethrovaginal support function assessment (USFA) technique to non-invasively and quantitatively assess urethrovaginal support function in women. Primary Hypothesis #2 will be tested. SA #3: To investigate aging effects on urethral function and urethrovaginal support in young/elderly female subjects with/without SUI using the UUFA technique which consists of the UMFA and USFA techniques. Primary Hypothesis #3 will be tested. SA #4: To develop a female SUI profile as a clinical standard of female SUI by utilizing the UUFA technique to quantitatively characterize SUI etiologic factors in urethrovaginal support and urethral function in women. Primary Hypothesis #4 will be tested. At the completion of this project, it is our expectation that we will have established and validated the UUFA technique and the feasibility of its application in clinical studies, and have achieved a better understanding of the contributions of specific changes associated with aging and menopause to these etiologic factors in women. PUBLIC HEALTH RELEVANCE: In this research proposal an urethrovaginal support and urethral function assessment (UUFA) technique will be developed based on an advanced electromechanical pelvis modeling approach. The primary impact of this research would lead to a minimally invasive technique to quantitatively assess urethrovaginal support and urethra function in women which are common etiologic factors associated with stress urinary incontinence (SUI). The UUFA technique will further help us characterize the specific changes associated with aging that cause the increase in prevalence of SUI in women.