Bladder Volume Awareness for Individuals Living with Spinal Cord Injury

脊髓损伤患者的膀胱容量意识

基本信息

批准号：
1937158
负责人：
Soheil Ghiasi
金额：
$ 38.99万
依托单位：
University of California-Davis
依托单位国家：
美国
项目类别：
Standard Grant
财政年份：
2020
资助国家：
美国
起止时间：
2020-03-01 至 2024-02-29
项目状态：
已结题

来源：
https://www.nsf.gov/awardsearch/showAward?AWD_ID=1937158&HistoricalAwards=false
关键词：
Bladder Volume Awareness Individuals Living

项目摘要

Approximately 300,000 individuals in the US suffer from the consequences of spinal cord injury (SCI). Although many of these individuals have obvious limitations in mobility, unbeknownst to the general public is that nearly all lack control of their bladder and have to use catheters, typically 4 to 6 times per day, to empty their bladder. This high frequency of emptying adds "insult to injury." A common problem is making the difficult trip to the bathroom in a wheelchair or requesting help from a caregiver to only find a small amount of urine in the bladder, or not making it to the bathroom in time and leaking urine because the bladder was too full. Lack of the bladder fullness sensation is a major problem for individuals living with SCI, which significantly reduces their social activities and quality of life and increases their care complexity and cost. To address this problem, the project aims to build a non-invasive wearable device, which can be discreetly worn by SCI patients under their clothing, to receive (or to send to their caregivers) timely alerts for starting to look for a bathroom to perform self- or assisted-catheterization. The accuracy of the device will automatically and incrementally improve every time the SCI subject or his/her caregiver provides feedback on its performance. Furthermore, the project includes specific education and outreach activities that are driven by integration of research results into courses and recruitment and retention of students from underrepresented backgrounds into STEM education. Of particular note are efforts to reach out to local high school and middle school students, parents, and their teachers via the UC-Davis CSTEM center and the Sacramento Regional Science & Engineering Fair.Most individuals living with spinal cord injury (SCI) have neurogenic lower urinary tract dysfunction (NLUTD) and lack sensation and control of their bladder, which typically leads to scheduled catheterizations that are often not needed or are too late. Thus, the goal of this project is to develop a non-invasive, patch-like device that can be worn by SCI patients to receive timely alerts for starting to look for a bathroom to perform catheterization. The Research Plan is organized under three aims: The FIRST Aim is to leverage the principles of near infrared spectroscopy (NIRS)to build a device that utilizes an array of light-emitting diodes (LEDs) and photodetectors with fixed distances to infer information about spatial expansion of the bladder. The underlying physical principle exploited by the device is measurement of back scattered light at wavelengths for which water has an appropriate absorption coefficient, while other tissue chromophores are not highly absorptive (e.g., 975 nm). The device will be designed to be worn discreetly on the lower abdomen in the pelvic area, to run on the battery for at least a full waking day, to be very flexible, to have an area about twice that of a credit card, and to be only a few millimeters thick. The fundamental tradeoffs between system complexity and usefulness to patients will be investigated, e.g., the number of LEDs and photodetectors in the optical probe, the LED driving current and the battery size. Monte Carlo simulations of light propagation in bladder models will be used to estimate the quality of design candidates, and a cost function based on the number of LED/detectors and probe size will be developed. The SECOND Aim is to build and train machine learning models for bladder fill state prediction. Design tradeoffs among algorithm complexity, prediction accuracy, energy consumptions, and value proposition to SCI patients will be considered in determining what features and algorithms should be used. Algorithms will first be investigated for their ability to output discrete outcomes, e.g., alert (bladder volume is high enough) or no alert (bladder volume is too low). If relatively simple algorithms such as logistic regression and linear support vector machine (SVM) do not achieve the desired level of accuracy using a reasonable number of features, more sophisticated nonlinear SVMs using kernel trick with different choices of kernels will be used. Similarly, the possibility of regression methods that can predict the bladder volume from the collected features will be investigated. Algorithms will also be designed to automatically and adaptively determine the next time instance for measuring the diffuse optical signal and to incorporate the user's feedback to continuously improve the device's prediction accuracy. The THIRD Aim is to evaluate the feasibility of the approach in both short and day-long studies in 25 healthy and 25 SCI human subjects. The evaluation plan includes collecting real patient/caregiver feedback on practical issues that users will face as the device is used and to collect sufficient amount of data for development of predictive models.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

美国大约有30万人遭受脊髓损伤（SCI）的后果。尽管这些人中的许多人在流动性上有明显的局限性，但对公众的限制是，几乎所有人都缺乏对膀胱的控制，并且必须使用导管，通常每天4至6次才能清空膀胱。排空的高频增加了“侮辱伤害”。一个普遍的问题是，坐在轮椅上遇到艰难的去浴室，或者要求护理人员的帮助，以便在膀胱中发现少量尿液，或者由于膀胱太饱而及时渗入浴室并泄漏尿液。对于患有SCI的人来说，缺乏膀胱饱满感是一个主要问题，这大大降低了他们的社交活动和生活质量，并提高了他们的护理复杂性和成本。为了解决这个问题，该项目旨在建造一种非侵入性可穿戴设备，SCI患者在衣服下可以谨慎佩戴，以接收（或发送给护理人员）及时警报，以便开始寻找浴室以进行自我辅助或辅助的塞耐具作用。每当SCI主题或他/她的护理人员提供其性能的反馈时，设备的准确性将自动和逐步提高。此外，该项目还包括由研究结果整合到课程，招聘和保留来自代表性不足的STEM教育中的学生的特定教育和外展活动。特别值得注意的是，通过UC-DAVIS CSTEM中心和萨克拉曼多区域科学与工程博览会与当地高中和中学生，父母及其老师接触。大多数患有脊髓损伤的人（SCI）具有神经源性下尿路功能障碍（NLUTD）（NLUTD）（NLUTD）的神经源性下，并且缺乏较晚的脑电图，而典型的是无需计划的人，或者是典型的导致序列。因此，该项目的目的是开发一种非侵入性的，类似贴片的装置，SCI患者可以佩戴，以及时提醒，以开始寻找浴室进行导管插入术。该研究计划是在三个目的下组织的：第一个目的是利用近红外光谱法（NIR）的原理来构建一种使用一系列光发射二极管（LED）（LED）和具有固定距离的光电探测器，以推断有关Bladder的空间扩展的信息。该设备利用的基本物理原理是在水长的波长下测量后散射光，而水具有适当的吸收系数，而其他组织发色团并不高度吸收性（例如975 nm）。该设备将设计为谨慎地在骨盆区域的下腹部磨损，以至少在电池上奔跑，至少要整整一个醒来的一天，非常灵活，可以拥有大约两倍的信用卡，只有几毫米厚。将研究系统复杂性和对患者有用性之间的基本权衡，例如，光学探测器中的LED和光电探测器数量，LED驱动电流和电池大小。蒙特卡洛模拟膀胱模型中的光传播模拟将用于估计设计候选质量的质量，并且将根据LED/探测器的数量和探针大小的成本功能。第二个目的是建立和训练机器学习模型，以填充状态预测。在确定应使用哪些特征和算法时，将考虑算法复杂性，预测准确性，能源消耗和价值主张之间的设计权衡。将首先研究算法的输出离散结果的能力，例如，警报（膀胱量足够高）或没有警报（膀胱体积太低）。如果相对简单的算法（例如逻辑回归和线性支持向量机（SVM））无法使用合理数量的功能实现所需的准确性，则将使用具有不同选择内核选择的内核技巧更复杂的非线性SVM。同样，将研究可以预测收集特征的膀胱体积的回归方法的可能性。算法还将设计为自动和自适应确定下一个时间实例，用于测量弥散光学信号并结合用户的反馈，以不断提高设备的预测准确性。第三个目的是评估25名健康和25个SCI人类受试者的短期和一天研究中该方法的可行性。评估计划包括收集对用户在使用设备时将面临的实际患者/护理人员的反馈，并收集足够数量的数据以开发预测模型。该奖项反映了NSF的法定任务，并被认为是通过基金会的知识分子优点和更广泛的审查标准来通过评估来获得支持的。