uppsala university luleå university of...
TRANSCRIPT
![Page 1: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/1.jpg)
Data-driven modelling of pelvic floor muscles dynamics
Steffi Knorn Damiano Varagnolo & Ernesto Oliver-ChivaUppsala University Luleå University of Technology
Reinhilde Melles & Marieke DewitteMaastricht Universitair Medisch Centrum
June 19, 2018Reglermöte
1
![Page 2: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/2.jpg)
Motivations
can we help improving the treatments related to dyspareunia?
2
![Page 3: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/3.jpg)
Etiology
causes:
physiological
psychological
3
![Page 4: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/4.jpg)
Etiology
causes:
physiological
psychological
infections
3
![Page 5: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/5.jpg)
Etiology
causes:
physiological
psychological
infections
vaginal narrowing / shortening(side effects of cancer treatments, surgeries, genetic defects)
3
![Page 6: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/6.jpg)
Etiology
causes:
physiological
psychological
infections
vaginal narrowing / shortening(side effects of cancer treatments, surgeries, genetic defects)
injuries (childbirth, accidents)
3
![Page 7: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/7.jpg)
Etiology
causes:
physiological
psychological
infections
vaginal narrowing / shortening(side effects of cancer treatments, surgeries, genetic defects)
injuries (childbirth, accidents)
auto-immune conditions (Graph vs. host diseases)
3
![Page 8: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/8.jpg)
Etiology
causes:
physiological
psychological
infections
vaginal narrowing / shortening(side effects of cancer treatments, surgeries, genetic defects)
injuries (childbirth, accidents)
auto-immune conditions (Graph vs. host diseases)
male to female gender confirmation surgeries
3
![Page 9: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/9.jpg)
Etiology
causes:
physiological
psychological
infections
vaginal narrowing / shortening(side effects of cancer treatments, surgeries, genetic defects)
injuries (childbirth, accidents)
auto-immune conditions (Graph vs. host diseases)
male to female gender confirmation surgeries
unconscious tightening of the pelvic floor muscles(a.k.a. vaginismus, often caused by sexual traumas)
3
![Page 10: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/10.jpg)
Relevance of dyspareunia
approximately 15% of women1 in a variety of age groups
Indirect effects:self-shamingself-blamingisolationnegative effects on patients’ families and friends
1Hayes, Bennett, Dennerstein, Taffe & Fairley, “Are aspects of study design associated with thereported prevalence of female sexual difficulties?”, Fertility and Sterility, 2008.
4
![Page 11: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/11.jpg)
Relevance of dyspareunia
approximately 15% of women1 in a variety of age groups
Indirect effects:self-shamingself-blamingisolationnegative effects on patients’ families and friends
1Hayes, Bennett, Dennerstein, Taffe & Fairley, “Are aspects of study design associated with thereported prevalence of female sexual difficulties?”, Fertility and Sterility, 2008.
4
![Page 12: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/12.jpg)
How is it treated today?
infections
vaginal shortening / narrowing
injuries
auto-immune conditions
gender confirmation surgeries
vaginismus
5
![Page 13: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/13.jpg)
How is it treated today?
infections
vaginal shortening / narrowing
injuries
auto-immune conditions
gender confirmation surgeries
vaginismus
antibiotics & antifungals
5
![Page 14: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/14.jpg)
How is it treated today?
infections
vaginal shortening / narrowing
injuries
auto-immune conditions
gender confirmation surgeries
vaginismus
antibiotics & antifungals
5
![Page 15: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/15.jpg)
How is it treated today?
infections
vaginal shortening / narrowing
injuries
auto-immune conditions
gender confirmation surgeries
vaginismus
antibiotics & antifungals
+ counterconditioning
5
![Page 16: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/16.jpg)
Side effects
“uncomfortable”, “shameful”
leads often to dropouts
needs better treatments
needs better understandings
6
![Page 17: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/17.jpg)
Side effects
“uncomfortable”, “shameful”
leads often to dropouts
needs better treatments
needs better understandings
6
![Page 18: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/18.jpg)
Side effects
“uncomfortable”, “shameful”
leads often to dropouts
needs better treatments
needs better understandings
6
![Page 19: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/19.jpg)
Side effects
“uncomfortable”, “shameful”
leads often to dropouts
needs better treatments
needs better understandings
6
![Page 20: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/20.jpg)
Our contributions, in this talk
help understanding the physiological responseto vaginal dilation stimuli
7
![Page 21: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/21.jpg)
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
![Page 22: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/22.jpg)
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
![Page 23: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/23.jpg)
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
![Page 24: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/24.jpg)
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
![Page 25: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/25.jpg)
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
![Page 26: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/26.jpg)
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
![Page 27: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/27.jpg)
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
![Page 28: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/28.jpg)
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
![Page 29: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/29.jpg)
Our aims, in an even broader perspectivehelp accounting for psychological effects in medical treatments
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
whatevercontrol
smartwhatever
.
9
![Page 30: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/30.jpg)
towards psycho-physiological systems
10
![Page 31: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/31.jpg)
This talk. . .
data-driven modelling of pelvic floor muscles dynamics
11
![Page 32: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/32.jpg)
Brief description of the medical trial
12
![Page 33: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/33.jpg)
Brief description of the medical trial
13
![Page 34: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/34.jpg)
A typical dataset
0 5 10 15 20 25 30 35 40 45 50 55 60 65 700
100
200
300
400
time [minutes]
movievolumepressurepleasure
14
![Page 35: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/35.jpg)
Our modelling approach
staticnon-linearity
dilationstimuli
q−kB (q−1)A (q−1)
rational model
+
disturbances
muscularforce
muscle
15
![Page 36: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/36.jpg)
The results of our sysid efforts, in a nutshell
HW-pwlin
ear-pw
linear
HW-pwlin
ear-sa
turati
on
HW-poly1
d-poly
1d
sigmoid
netlin
ear
HW-pwlin
ear-de
adzon
e
wavenet
treepa
rtition
0102030405060708090
100
64.69 64.49 63.3556.26
49.56 43.328.78
3.59
model type
aver
age
fitin
test
set
16
![Page 37: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/37.jpg)
Conclusions and future directions
1 control engineers can contribute to this area
2 it is definitely a non-trivial socio-psycho-physiological system
3 this is just a first step
right now:starting “PAIGE -Pelvic floor activation through gamified exercising”
17
![Page 38: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/38.jpg)
Conclusions and future directions
1 control engineers can contribute to this area
2 it is definitely a non-trivial socio-psycho-physiological system
3 this is just a first step
right now:starting “PAIGE -Pelvic floor activation through gamified exercising”
17
![Page 39: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/39.jpg)
Conclusions and future directions
1 control engineers can contribute to this area
2 it is definitely a non-trivial socio-psycho-physiological system
3 this is just a first step
right now:starting “PAIGE -Pelvic floor activation through gamified exercising”
17
![Page 40: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/40.jpg)
Conclusions and future directions
1 control engineers can contribute to this area
2 it is definitely a non-trivial socio-psycho-physiological system
3 this is just a first step
right now:starting “PAIGE -Pelvic floor activation through gamified exercising”
17
![Page 41: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/41.jpg)
Conclusions and future directions
1 control engineers can contribute to this area
2 it is definitely a non-trivial socio-psycho-physiological system
3 this is just a first step
right now:starting “PAIGE -Pelvic floor activation through gamified exercising”
17
![Page 42: Uppsala University Luleå University of Technologyfolk.ntnu.no/damianov/Speeches/Reglermote2018-SmartDilators.pdf · Relevance of dyspareunia approximately 15% of women1 in a variety](https://reader035.vdocuments.us/reader035/viewer/2022070922/5fba8de356afdb07f6623c06/html5/thumbnails/42.jpg)
Data-driven modelling of pelvic floor muscles dynamics
Steffi Knorn Damiano Varagnolo & Ernesto Oliver-ChivaUppsala University Luleå University of Technology
Reinhilde Melles & Marieke DewitteMaastricht Universitair Medisch Centrum
June 19, 2018Reglermöte
18