Electromechanical Modeling Approach in Assessing Female SUI

描述(由申请人提供)：作为重新提交，拟议的五年计划将培训我，并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在高级生物力学建模和电生理建模研究方面的出色经验培养了我的兴趣，并使我在进行尿失禁(UI)的跨学科生物医学研究方面具有独特的优势。目前的目标是为独立科学家的职业生涯做准备，并开发一种新的基于特定对象的电子机械盆腔模型的尿路阴道支持和尿路功能评估(UUFA)技术，以最小限度地侵入性和定量地评估这两个病因，并调查导致女性SUI患病率增加的与年龄效应相关的具体变化。这项研究背后的中心假设是，可以使用特定于受试者的盆腔建模方法，对女性的尿路阴道支持和尿路功能以及年龄对女性SUI的影响进行微创和定量的评估和表征。基本假设#1是女性的尿路功能可以使用特定于受试者的电生理盆腔建模方法进行微创和定量的评估。基本假设2是女性的尿路阴道支持功能可以使用受试者特定的生物力学骨盆模型方法进行非侵入性和定量的评估。基本假设#3是年龄增长会导致不佳的尿路阴道支持和/或会导致SUI的尿路功能障碍。基本假设#4是，可以创建女性可控轮廓，以在临床上预测女性在女性中的可控状态，并为特定患者建议最佳治疗方式。我们提出了四个特定的目标(SA)来检验这些假说：SA#1：开发一种基于受试者特定的盆腔电生理模型的尿道肌疲劳评估(UMFA)技术，以微创、定量地评估女性的尿路功能。第一个主要假设将会得到检验。SA#2：开发一种基于特定对象的生物力学骨盆模型的尿路阴道支持功能评估(USFA)技术，以非侵入性和定量的方式评估女性的尿路阴道支持功能。将检验主要假设#2。SA#3：应用UUFA技术(包括UMFA技术和USFA技术)，研究年龄对有无SUI的青年女性和老年女性的尿路功能和阴道支持的影响。主要假设#3将会得到检验。SA#4：通过利用UUFA技术建立女性SUI简表作为女性SUI的临床标准，以定量表征女性SUI的致病因素对女性的尿路阴道支持和尿路功能的影响。将检验主要假设#4。在这个项目完成后，我们期望建立并验证UUFA技术及其在临床研究中应用的可行性，并更好地了解与年龄和更年期相关的特定变化对女性这些病因的贡献。 公共卫生相关性：在这项研究提案中，将基于先进的电动骨盆建模方法开发一种尿路阴道支持和尿路功能评估(UUFA)技术。这项研究的主要影响将导致一种微创技术，以定量评估女性的尿路阴道支持和尿路功能，这是与压力性尿失禁(SUI)相关的常见病因。UUFA技术将进一步帮助我们确定与衰老相关的具体变化，这些变化导致女性SUI患病率增加。

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.