This application claims priority to U.S. provisional application No. 62/909,318 filed on 2/10/2019, which is incorporated herein by reference in its entirety.
Detailed Description
Various aspects of the disclosure are described in more detail below. The terms and definitions used and set forth herein are intended to be indicative of the meanings of the present disclosure. To the extent that the terms and definitions incorporated by reference conflict, the terms and definitions provided herein control.
The singular forms "a", "an" and "the" include plural referents unless the context clearly dictates otherwise. The terms "about" and "about" mean almost the same as a reference number or value. As used herein, the terms "about" and "approximately" are generally understood to encompass ± 5% of a specified amount or value.
As used herein, the term "posterior" refers to the back of the patient, while the term "anterior" refers to the front of the patient. Thus, for example, the posterior side of a breast implant or tissue expander is the side of the implant facing the chest wall, while the anterior side is the opposite side closest to the skin. Similarly, the posterior side of the gluteus muscle or hip implant or tissue expander is the side closest to the skin and the anterior side is the opposite side facing the pelvis. "Upper" means the top of the patient, i.e., in the direction toward the patient's head. "lower" refers to the bottom of the patient, i.e., in the direction of the patient's foot. "medial" means near or near the midline or centerline of the implant. For example, the central portion of the implant may be the portion of the implant closest to the vertical plane that symmetrically bisects the implant. "lateral" may refer to one of the peripheral sides near the implant, such as the left or right side of the implant. The side of the implant may refer to the peripheral portion of the implant on either side of the aforementioned vertical plane (e.g., the left or right side portion).
Examples of the present disclosure may provide non-invasive systems and methods for obtaining information about an implant within a patient and/or about the patient, including but not limited to detecting condition information about the implant and/or tissue surrounding the implant. Some examples of the disclosure may allow for early detection and/or continuous monitoring of implant conditions, complications, and/or aberrations. In some cases, the temperature change may be related to a condition of the patient's tissue, such as inflammation, infection, or atypical cell growth in the tissue surrounding the implant. Early detection of such complications (e.g., by early detection of temperature changes in surrounding tissue) may allow for early diagnosis and/or treatment. Changes in temperature may indicate other conditions, such as reproductive ability.
The implants of the present disclosure may contain multiple sensors, where each sensor of the multiple sensors may be spaced apart from other sensors at a fixed location such that each sensor provides information about a different region of the implant and/or a different region of tissue proximate to a portion of the implant containing the sensor. Implants containing multiple sensors (e.g., implants including multi-sensor arrays) can help detect temperature changes in specific regions of tissue and/or specific regions of the implant, which can indicate abnormalities of the implant, potential adverse tissue reactions, or other potential complications. In some embodiments, detection of temperature changes and/or monitoring of temperature trends over time may allow for tracking of hormonal cycles related to fertility and/or pregnancy.
Although the methods and systems herein relate primarily to temperature measurement and sensors configured to measure temperature, it should be understood that the present disclosure encompasses implantable medical devices configured to monitor other physiological parameters. For example, the sensors described herein may be configured to monitor changes in pressure, motion, circumferential rotation, amplitude and/or frequency of mechanical waves (e.g., acoustic), electromagnetic frequency, electromagnetic intensity (e.g., light intensity), and/or other parameters or conditions that may indicate the health of the patient and/or the condition of the implant.
Exemplary systems and methods according to the present disclosure may include one or more sensors located on, incorporated into, or disposed adjacent to a shell of an implant, such as a tissue expander or breast implant. The one or more sensors may be disposed on, incorporated into, or disposed adjacent to any other portion of the implant (e.g., within the filler material or other interior portion of the breast implant). In some cases, the sensors may measure an average temperature of the vicinity of the respective sensor, including an average temperature of a portion of tissue surrounding the implant. For example, there may be several temperature sensors (e.g., two, three, four, five, or six or more) on or in an implant such as a tissue expander, allowing the temperature to be measured at different locations around the implant (e.g., measuring the temperature at multiple different localized regions of tissue adjacent to the sensors).
Each sensor may comprise an Application Specific Integrated Circuit (ASIC) (e.g., a temperature chip) configured to detect and/or measure a desired parameter such as temperature. The ASIC may contain or may communicate with an RFID circuit and/or a printed circuit board. According to some aspects, the one or more sensors may include a transponder including an electromagnetic coil coupled to the ASIC. In some embodiments, the one or more sensors include an ASIC with a built-in capacitor.
According to some aspects of the present disclosure, the sensor may include an antenna (e.g., an electromagnetic coil), and/or may communicate with the antenna, thereby providing wireless communication. For example, one or more sensors of the implant may contain and/or may be in communication with an RF coil, optionally a non-ferromagnetic RF coil, allowing transmission and/or reception of data. Thus, for example, the sensor may be configured as a transponder. The electromagnetic coil may comprise an electrically conductive material such as copper or other non-ferromagnetic metal. For example, the coil may comprise a wire wound on a non-conductive biocompatible polymer (e.g., polyether-ether-ketone (PEEK)), or a coil configured to surround air or other inert gas. A sensor according to the present disclosure may include an ASIC coupled to an electromagnetic coil (e.g., by a wire), optionally with the ASIC disposed within the center of the electromagnetic coil.
Each sensor may have a communication range of about 1 inch to about 10 feet, such as about 1.5 inches to about 6 feet, about 2 inches to about 3 feet, or about 1 inch to about 5 feet. The sensors herein include circuitry that facilitates filtering noise from the raw data or otherwise improving the signal-to-noise ratio of the transmitted implant data. For example, the sensor may comprise a chip programmed with an algorithm that includes filtering, collating, organizing, and/or analyzing data. Such algorithms may be designed to incorporate specific relevant integrated data (such as information about the tissue surrounding the implant and/or characteristics of the implant) to provide appropriate signals indicative of patient physiological parameters.
According to some aspects of the disclosure, each sensor may transmit at a frequency of about 100kH to about 400kHz, such as about 100kHz to about 200kHz, about 120kHz to about 150kHz, or about 125kHz to about 134 kHz. For example, the frequency of each sensor (which may be the same or different from one or more other sensors of the implant) may be about 100kHz, about 110kHz, about 120kHz, about 125kHz, about 130kHz, about 135kHz, about 140kHz, about 150kHz, about 160kHz, about 170kHz, about 180kHz, about 190kHz, or about 200 kHz. One or more sensors may transmit at a different frequency than one or more other sensors of the implant. For example, each sensor may transmit at a different frequency than each other sensor, such that each sensor transmits at a unique frequency. Thus, in one example, the implant can comprise at least two sensors that transmit at a frequency that is at least 0.1kHz, at least 0.2kHz, at least 0.3kHz, at least 0.5kHz, at least 1kHz, at least 1.5kHz, or at least 2kHz different from each other sensor. The frequency difference between all sensors may vary in the range of about 0.1kHz to about 20kHz, such as about 0.2kHz to about 1kHz, about 0.5kHz to about 5kHz, about 0.5kHz to about 3kHz, or about 2kHz to about 10 kHz. In at least one example, the implant contains a plurality of sensors that transmit at different frequencies from about 100kHz to about 150kHz, where the frequency of each sensor differs from the frequency of one or more other sensors (e.g., each other sensor) by about 0.1kHz to about 20kHz, such as about 1kHz to about 10kHz, about 2kHz to about 5kHz, about 3kHz to about 8kHz, or about 5kHz to about 15 kHz.
In some examples of the disclosure, a sensor may transmit at the same frequency as one or more other sensors (including any of the frequencies listed above). Sensors transmitting at the same frequency may be configured to transmit at different rates and/or at different times, such as in an offset synchronized manner (e.g., exhibiting a time delay between the transmission of one sensor and the other) so that information transmitted by one sensor does not interfere with information transmitted by the other sensor.
In addition or as an alternative to transmitting at a different or unique frequency, the sensors herein may have different identifying information. For example, each sensor may have a unique device identifier for associating the sensor with data obtained by the sensor. The information provided by the unique device identifier may include, for example, one or more of a serial number, a manufacturer name, a manufacturing date, and/or a lot number.
The sensor may be configured to be undetectable on or through the exterior (e.g., housing) of the implant regardless of the position of the implant and the patient. The sensors herein may include a housing such as, for example, a vial, capsule, pouch, or other housing disposed around the electronic components of the sensor (e.g., ASIC, electromagnetic coil, etc.). The housing may be disposed within or otherwise coupled to the implant. The housing may help protect the electronic components, such as to provide thermal and/or shock resistance. Additionally or alternatively, the housing may be configured to limit separation or movement apart of components of the sensor. The housing may comprise materials such as, for example, polymers (such as PEEK or other plastics or silicone gel, etc.); ceramic, aluminum and alloys thereof, and/or glass. Alternatively, the housing may be coated with silicone or other biocompatible material.
The interior of the housing surrounding the electronic components may contain materials that do not interfere with the operation of the components contained within the housing. For example, a portion of the sensor within the housing may include air or other inert gas. The sensors herein may have any suitable shape, such as cylindrical, oval, rectangular, cubic, and other possible shapes. The sensor may have a size in the range of about 2mm to about 30mm (width, length and/or height). In at least one example, the length of the one or more sensors ranges from about 3mm to about 15mm, such as from about 9mm to about 12 mm; and has a width in the range of about 5mm to about 10mm, such as about 4mm to about 6 mm. In some examples, the length may be equal to the width, and the height may be in a range of about 1mm to about 6mm, such as about 2mm to about 5 mm.
The electronics of a given sensor may be in operative communication with the electronics of one or more other sensors or other transponders of the implant, and/or may be in operative communication with the implant and a reader external to the patient. For example, an exemplary implant may include a first sensor in wireless communication with a second sensor disposed at or coupled to a different location of the implant. As described below, one or more sensors may transmit data to a reader. In some aspects of the disclosure, the implant may include multiple sensors in communication with a single transponder of the implant (with or without the transponder including an ASIC configured to detect or measure a parameter), and the transponder may relay data from the sensors to the reader. Such a transponder may comprise any of the features of the transponder disclosed in WO 2017/137853, which is incorporated herein by reference in its entirety. Further, any tissue expander according to the present disclosure may incorporate an integrated port for receiving and expelling fluid during expansion and contraction of the tissue expander as disclosed in WO 2017/137853, which is incorporated herein by reference in its entirety.
As noted above, in some aspects of the present disclosure, the sensor may be located on, incorporated into, or disposed adjacent to the housing of the implant. For example, the implant may comprise a polymeric housing, for example comprising an elastomeric material, such as a biocompatible silicone gel, for example polydimethylsiloxane or the like, wherein each sensor may be coupled to an inner surface, an outer surface or incorporated into a wall of the housing. In some examples, the sensor is incorporated into a wall thickness of the housing. In this case, the distance between each sensor and the outermost surface of the housing may be less than or equal to the thickness of the housing. The overall thickness of the housing may be in the range of about 0.1mm to about 1.5mm, such as about 0.2mm to about 0.8mm, about 0.3mm to about 1.1mm, or about 0.4mm to about 0.6 mm. In some examples, the thickness of the housing may be in a range of about 0.3mm to 1.0mm, such as about 0.4mm, about 0.5mm, about 0.6mm, about 0.7mm, about 0.8mm, about 0.9mm, or about 1.0 mm. The shell may have a substantially uniform thickness, or portions of the shell may vary in thickness. For example, in the case of a tissue expander for implanting breast tissue, the posterior side of the implant may have a relatively greater thickness than the anterior side to facilitate expansion in the anterior direction. In at least one example, the posterior side of the implant (also referred to herein as the base of the tissue expander) contains two or more sensors incorporated into the housing. A sensor disposed at or adjacent the anterior side of the implant may allow for measurement of temperature and/or other parameters of tissue proximate the patient's chest wall. The sensor may be coupled to other portions of the housing, including, for example, the front side. A sensor disposed at or adjacent the posterior side of the implant may allow for measurement of the temperature and/or other parameters of the tissue proximate the patient's skin. In some examples, one or more sensors may be disposed within a cavity of the implant, e.g., incorporated into a filler material such as saline solution or silicone gel, to provide information about the filler material and/or other conditions inside the implant.
Where the implant contains multiple sensors, each sensor may be spaced from the other sensors at a fixed location such that each sensor provides information about a different region of the implant or a different region of tissue proximate to the implant. In some embodiments, a sensor may measure a signal (e.g., an impedance signal) between two or more sensors and/or transponders. The impedance signal may be used to generate data indicative of a physiological condition of the patient. The sensor and/or transponder may be configured to assist in determining the position and/or orientation of the implant. For example, based on the relative position, relative signal strength, communication with a reference (e.g., a reference electrode or a reference transponder), and/or signals between the sensor and the transponder, the position and/or orientation of an implant containing the sensor and/or transponder may be determined.
An exemplary implant according to the present disclosure may include at least four sensors: a first sensor located in an upper portion of the implant; a second sensor located in a first lateral portion (e.g., left side portion) of the implant; a third sensor located in a second side (e.g., right side portion) of the implant, wherein the first side is opposite the second side; and a fourth sensor located in a lower portion of the implant. Other examples may include fewer or more sensors.
Providing sensors at fixed locations in different portions of the implant allows measurements (e.g., pressure and/or temperature measurements) to be taken at multiple locations around the implant. Several measurements may provide more localized and accurate information to assist a healthcare professional in assessing the health of a patient and the integrity of the implant. For example, an infection or abnormal tissue response to an implant may correspond to a change in temperature and/or other parameters detected or measured by a sensor proximate to the affected tissue. Thus, the abnormal or atypical pattern presented by one or more sensors may indicate which portions of the implant are near the abnormal or atypical source.
The implants herein can optionally include one or more features to further aid in imaging and/or securing the implant within the patient's tissue. For example, the implant may include one or more radiopaque markers that are visible by imaging, e.g., to help monitor the location, position, and/or orientation of the implant over time. The radiopaque markers may be in the form of a strip, cross, an "I" shaped structure, or other shape having a recognizable orientation. Additionally or alternatively, the implant may include one or more tabs integral to or coupled to an outermost surface of the implant. For example, the base of the breast implant or tissue expander may comprise one or more, such as two, three, four, five or six or more tabs. The tabs may be provided at different radial positions and allow for fixation of the suture to the chest wall tissue, for example, through the aperture of each tab.
Exemplary features of the present disclosure will be described with reference to the implant 100 shown in fig. 1-3. The implant 100 shown as a tissue expander is merely exemplary and does not limit the scope of the present disclosure. Tissue expanders are generally useful for stretching or facilitating expansion of tissue within a patient in preparation for permanent implants. Fig. 1 is a cross-sectional side view, fig. 2 is a front view, and fig. 3 is a rear view of an implant 100. It should be understood that the aspects described with respect to one or more of the figures are not limited to the devices shown in the discussed figures. Rather, all of the figures should be viewed in the context of the entire application and describe various aspects that may optionally be incorporated into the implants described herein. The components and aspects of the implants described herein may be used in any arrangement or combination that allows one or more parameters (e.g., temperature) to be measured at multiple locations of the implant.
Referring to fig. 1-3, the illustrated implant 100 includes a housing 122 containing a base 124 and a patch 126, wherein the housing 122 defines a cavity or interior 128 of the implant 100. The tabs 142 coupled to the base 124 can help secure the implant 100 to tissue. The implant 100 also includes a plurality of sensors 105a-105e (each sensor 105a-105e including, for example, one or more ASICs and electromagnetic coils 106a-106e) and a radiopaque marker 115.
Implant 100 includes an injection port 130 through which fluid may be introduced and removed from interior 128 of implant 100 to expand and contract its volume. The port contains a transponder 135 (e.g., with a unique device identifier) with an electromagnetic coil 107. The port 130 may be an integrated port such as disclosed in WO 2017/137853, which is incorporated by reference herein in its entirety. By having a transponder 135, a healthcare professional may be able to non-invasively identify the proper location of the port 130 for the introduction and removal of fluids. The implants herein need not include a port, such as, for example, a permanent implant (e.g., a breast implant, gluteal implant, etc.).
The housing 122 can define a cavity therein, which in the case of the tissue expander implant 100 is an expandable cavity. This cavity is referred to as an interior space 128 in fig. 1. The implant 100 also includes a seat 124 that forms the anterior side of the shell 122. For example, the base 124 may be generally circular, oval, or teardrop shaped. The base may be an integral part of the housing 122 or may be coupled to the remainder of the housing 122 by vulcanization or with an adhesive.
As described above, positioning the plurality of sensors 105a-105e within the base 124 may allow the sensors 105a-105e to measure temperature and/or determine a condition of patient tissue proximate to the chest wall. Further, placing the sensors 105a-105e at different locations, e.g., different quadrants, of the base 124 may allow measurements (e.g., temperatures) representative of several tissue regions to be taken. For example, referring to fig. 3, a first sensor 105a may transmit data corresponding to tissue adjacent an upper portion of the implant 100, a second sensor 105b may transmit data corresponding to tissue adjacent a first side (e.g., left side portion) of the implant 100, a third sensor 105c may transmit data corresponding to tissue adjacent a lower portion of the implant 100, a fourth sensor 105d may transmit data corresponding to tissue adjacent a second side (e.g., right side portion) of the implant 100, and a fifth sensor 105e may transmit data corresponding to tissue adjacent a middle (e.g., center) portion of the implant 100. The fifth sensor 105e may be integrated into the patch 126 and optionally may provide information regarding the condition (e.g., integrity of the seal) of the implant near the patch 126 and/or the tissue near the patch 126.
The figures illustrate some exemplary distributions and positioning of sensors 105a-105 e. However, any distribution of sensors that allows data (e.g., temperature measurements) to be collected at various points along the exterior of the implant 100 is contemplated. For example, one or more sensors may be incorporated into the portion of the base 124 adjacent to the tab 142, thereby enabling assessment of the condition (e.g., temperature) of the tissue in the vicinity of the tab 142.
In some embodiments, each sensor 105a-105e has a unique transmission frequency and/or a unique device identifier, thereby indicating to the healthcare professional through the reader which sensor 105a-105e (and which portion of the implant 100) is associated with which measurement. For example, each sensor 105a-105e may transmit data containing a parameter (e.g., temperature) at a unique frequency and/or with a unique device identifier (e.g., serial number, etc.). The unique frequencies and/or device identifiers associated with the respective sensors, in combination with their known locations in different portions of the implant 100, may allow a healthcare professional or other user to better assess the condition of the patient and the implant.
The sensors 105a-105e and/or transponders 135 in communication with the sensors 105a-105e are shown incorporated into the base 124 and patch 126 of the housing 122. In other examples, the sensors may be coupled to an innermost or outermost surface of the housing 122 and/or incorporated into the interior or other structure of the implant. For example, one or more sensors may be attached or encapsulated in a suitable material, such as a silicone rubber that is dielectrically sealed or bonded to the housing.
The sensors 105a-105e and transponder 135 may be positioned to avoid interfering with each other and/or to avoid interfering with the introduction and removal of fluids from the port 130. Each of the sensors 105a-105e and the port 130 can include a non-ferromagnetic material such that the implant 100 does not include a ferromagnetic material. By being non-ferromagnetic, the implant 100 may avoid interfering with imaging techniques used for screening (e.g., MRI, fluoroscopy imaging, and/or ultrasound imaging).
The implants disclosed herein can be produced using any suitable manufacturing process. For example, a shell of an implant according to some aspects of the present disclosure, such as, for example, shell 122, may be produced by dip molding. For example, the mandrel may be used as a mold and immersed, e.g., at least partially or fully immersed, in a thermoplastic or thermoset material such as a silicone dispersion, such that the silicone material at least partially or fully covers the surface of the mandrel. The mandrel may be repeatedly impregnated to form a multi-layer shell. The mandrel may have an imprint to provide biocompatible surface features and characteristics to the shell and outermost surface of the implant. The implants herein may comprise any of the surface features and characteristics thereof disclosed in WO 2017/196973 and/or WO 2015/121686, both of which are incorporated by reference in their entirety.
After or during formation of the implant housing, one or more sensors may be secured to or integrated into the housing, such as by adhesive, vulcanization, dielectric bonding, or other types of thermoplastic integration.
Each layer of the housing 122 may have the same or different composition relative to the other layers. For example, in forming the housing 122, the mandrel may be dipped into a different material, such as a silicone dispersion having a different viscosity and/or different types of additives. In some examples, the housing 122 may include one or more barriers to inhibit or prevent the passage of liquid or gel material through the housing 122. One or more layers of shell 122 may include, for example, diphenyl silicone elastomer, dimethyl silicone elastomer, diphenyl-dimethyl silicone elastomer, methylphenyl silicone elastomer, fluorinated silicone elastomer (such as trifluoropropyl silicone elastomer), and combinations thereof. One or more layers of the housing 122 may be colored, for example, by adding one or more pigments to the thermoplastic or thermoset material into which the mandrel is being dipped. For example, pigments may be included in the barrier layer to facilitate inspection of the continuity and/or integrity of the barrier layer.
Once the appropriate number of layers are formed around the mandrel, the thermoplastic and/or thermoset material may be allowed to cure. The shell 122 may be cured at a temperature in the range of about 100 ℃ to about 200 ℃, such as, for example, about 125 ℃ to about 150 ℃. In some examples, the curing temperature may be in the range of about 125 ℃ to about 127 ℃, e.g., about 125 ℃, about 126 ℃, or about 127 ℃. In a further example, the curing temperature may be about 150 ℃. The cured shell 122 may be removed from the mandrel and inverted or turned inside out. Thus, the surface of the housing 122 that was previously in contact with the mandrel forms the outer surface of the housing 122. Alternatively, the cured shell may be removed from the mandrel and not turned inside out.
The base 124 may be formed by a molding technique, such as, for example, injection molding or cast molding. The base 124 may contain indentations or depressions that correspond to the desired locations or positions of the sensors 105a-105e, thereby allowing the sensors 105a-105e to be incorporated into the walls of the base 124 and have a uniform thickness even when the sensors 105a-105e are incorporated therein. This may also help the sensors 105a-105e collect data about the tissue surrounding the implant 100, as less material may be disposed between the sensors 105a-105e and the surrounding tissue. Thus, in some examples, the mold used to form the base 124 may contain protrusions that provide corresponding indentations or recesses for receiving the sensors 105a-105 e. After or during curing of the base 124, the sensors 105a-105e may be secured to the base 124 at desired locations or positions (e.g., within indentations or recesses).
After the base 124 is formed and the sensors 105a-105e are disposed in the desired locations and positions, the base 124 may be bonded or otherwise sealed to the remainder of the housing 122. For example, the base 124 may be vulcanized to the housing 122 such that the entire edge surface of the base 124 (e.g., the surface between the inner surface of the base 124 and the outer surface of the base 124) is bonded to the remainder of the housing 122.
The base 124 may contain a patch 126 comprising the same or similar material as the rest of the housing 122, wherein the patch 126 covers the opening left by the mandrel (e.g., the handle of the mandrel). The patch 126 may be vulcanized or otherwise coupled or bonded to the base 124 and/or the remainder of the housing 122. Optionally, the patch 126 may include one or more sensors incorporated therein, and/or one or more sensors may be coupled to an inner and/or outer surface of the patch 126.
Referring to fig. 4, a system for monitoring, recording, tracking, or analyzing implant data is illustrated using an implant 100 as an example. The implant sensors 105a-105e and/or transponder 135 may communicate with an external reader 600 (e.g., an RF reader). The sensors 105a-105e and/or the transponder 135 may transmit data to the reader 600 at a desired frequency. Alternatively, the reader 600 may transmit one or more signals to the sensors 105a-105e and/or the transponder 135, such as, for example, signals configured to cause the sensors 105a-105e and/or the transponder 135 to transmit data. The reader 600 in turn may communicate the data to the cloud-based server 300. The cloud-based server 300 may be accessed through one or more electronic devices 700a-700c (e.g., a laptop 700a, a smartphone 700b, and/or other mobile device such as a tablet 700 c). For example, the cloud-based server 300 may be in bi-directional communication with one or more devices 700a-700 c. In some examples, reader 600 may communicate directly with one or more devices 700a-700 c.
The data communicated from the implant 100 (e.g., from one or more sensors 105a-105e and/or transponder 135) to the reader 600 may include, for example, measurements or detections of various parameters (e.g., temperature), serial or other identification or reference numbers of the sensors, and/or lot or other manufacturing information of the implant 100, such as, for example, manufacturer name, implant size and/or shape, etc. When the data contains an identification number or other information for each sensor, such data can be used to determine the location of the respective sensor.
As described above, the sensors 105a-105e and/or the transponder 135 may include circuitry that facilitates filtering noise from the raw data or otherwise improving the signal-to-noise ratio of the transmitted data. The data collected and/or filtered by the transponder may be transmitted, communicated, or otherwise communicated to an external reader 600 (e.g., an RF reader). The reader 600 may include a graphical display (e.g., an LED display). In some examples, the reader 600 may include and/or communicate with firmware or software that includes instructions for analyzing data, filtering data, sorting data, ordering data, organizing data, presenting data on a display, and/or providing notification signals. For example, one or more sensors 105a-105e and/or transponder 135 may communicate raw data to reader 600, which may be analyzed, optionally by a remote server, by an algorithm that facilitates filtering noise from the raw data or otherwise increasing the signal-to-noise ratio of the implant data. In some embodiments, reader 600 may communicate a notification or event to a user. For example, the notification signal may be a suggestion that the patient displayed on the reader 600 contact his/her caregiver or clinician to follow up with a particular action item.
The reader 600 may be incorporated into a handheld device or a miniature device adapted to be held in relatively close proximity to the implant 100 on the patient's body. The reader 600 may optionally be handheld and/or incorporated into an article of clothing or accessory to be carried by the patient throughout the day. For example, the reader 600 may be integrated into a bracelet, necklace, brooch, bra, shirt, scarf, vest, or other item that may be worn or carried. The reader 600 may be integrated into a handheld device that may be held by a user (e.g., a patient or a healthcare professional) in proximity to the implant 100 to receive data from the implant 100. The reader 600 may be used to read data (e.g., implant data including one or more temperature measurements) from the implant 100 continuously (e.g., when the reader 600 is integrated into an article of clothing), semi-continuously (e.g., every certain time, such as once every hour, once every 15 minutes, etc.), and/or on-demand at periodic intervals (e.g., when activated by a patient or other user).
Thus, the sensors 105a-105e of the implant 100 may be activated when the reader 600 is in close proximity. Thus, the sensors 105a-105e may be configured to transmit data (e.g., temperature data) when proximate to the respective reader 600 and/or after receiving a signal from the reader 600. Additionally or alternatively, the sensors 105a-105e may be configured to continuously transmit data upon detecting that the reader 600 is within communication range. The method of additional transmission of data disclosed in WO 2017/137853, incorporated herein by reference, may be used.
After the reader 600 receives data (e.g., implant data including one or more temperature measurements) from the implant 100 (e.g., tissue expander), the reader 600 may transmit the implant data to the device 700 (e.g., smartphone 700b, tablet 700c, laptop 700a, etc.). For example, the reader 600 may transmit the implant data to the cloud-based server 300 or other remote storage via 4G, 5G, other wireless network, or wired connection. The device 700 (e.g., smartphone 700b, tablet 700c, laptop 700a, etc.) may then access the implant data on the cloud-based server 300 or remote storage.
One or more devices 700 may contain software (e.g., an application containing an algorithm) that allows a user to interact with implant data stored on a cloud-based server or remote storage. In some embodiments, device 700 may access a web-based application that allows a user to interact with implant data. A healthcare professional or other user may be able to track implant data through device 700. Software accessed by the device may help the user track implant data (e.g., temperature data) measured at each reading, may identify trends, create reports, and/or generate alerts when significant changes are detected. The software may include pattern recognition algorithms to identify changes, trends, patterns, periods, and clinical indicators. For example, after surgery (e.g., implantation of the implant 100), the temperature of the tissue surrounding the implant 100 may be monitored continuously or periodically. A sustained increase in the average temperature may indicate an infection or adverse reaction to the implant 100. The patterns detected in the monitored temperature data may also be indicative of the patient's reproductive status, such as, for example, pregnancy, ovulation, or affecting hormonal activity of the reproductive system. The software accessed by the device 700 may assist a healthcare professional in managing the care of several patients, for example, by developing a profile (e.g., a patient profile) for each patient.
Referring to fig. 5A-5C and 6A-6C, various aspects of applications, software, or other programs or instructions executable by the device 700 relating to implant data are described. It should be appreciated that aspects described with respect to one or more of the figures are not limited to the embodiments shown in the discussed figures. Rather, all of the figures should be viewed in the context of the entire specification and describe various aspects that may optionally be taken together with the devices and systems described herein. The various aspects of the components and interfaces described herein may be used in any arrangement or combination that allows one or more users to interact with implant data stored on the cloud-based server 300 or other remote storage.
Some aspects described herein may be limited by the type or category of user profile. For example, the software described herein may allow for the creation of user profiles. The user profile may include a patient profile and a profile of a doctor or other healthcare professional. Depending on the type of configuration file and/or configuration file, different aspects of the software described herein may be available or accessible. For example, the patient profile may also allow a user (e.g., a patient) to view data related to their own implant (e.g., the nature of the implant, such as serial number, size, shape, etc.). A healthcare professional profile may allow a user (e.g., a doctor) to access data related to implants of several patients. In some embodiments, the health care professional profile may access implant data, including measurements (e.g., temperature) recorded by the sensor 105. The healthcare professional profile may have more rights to access, view, sort, track, sort, edit, or modify data, such as, for example, implant data stored on the cloud-based server 300, than the patient profile.
Referring to fig. 5A, the implant data may include data relating to the structure, size, condition, or other properties of the implant 100 and/or the sensors 105 within the implant. For example, each implant 100 and each sensor 105 within each implant 100 may have one or more unique identifiers or codes. The status screen may allow a user (e.g., a patient or a healthcare professional) to view data related to one or more implanted implants 100 or sensors 105 of the implants 100. The status screen may display one or more characteristics or conditions of the implanted device, such as, for example, a reference number, a serial number, a type of print, a shape, a size, a base size, a projection size, a volume, one or more other sizes of the implant 100, a model type, an identifier, and/or whether a signal is received from one or more sensors 105 or transponders 135. The status screen may also provide information to the user about the doctor or patient. For example, information about the patient (e.g., name, gender, age, weight, date of surgery, etc.) may be accessed in a healthcare professional profile, and information about the responsible physician (e.g., the transplant surgeon, oncologist, or other healthcare provider), such as their name or contact information, may be accessed in a patient profile.
Referring to fig. 5B, in some embodiments, the apparatus 700 or software of the apparatus 700 may assist a user (e.g., a healthcare professional or patient) in obtaining measurements from the implant 100. For example, the software may provide a step-by-step tutorial process for the patient to obtain measurements from each sensor 105 of each implanted implant 100 using the reader 600. The software and/or device 700 may prompt the user to take each measurement, display an image graphic indicating where the reader 600 should be placed to obtain the measurement, display text or graphics indicating the patient's progress in obtaining a prescribed measurement, and/or display implant data received by the reader 600. The software may also allow the user to browse between measurements, for example, skipping or repeating a specified measurement.
Referring to fig. 5C, the device 700 may allow a user (e.g., a patient) to track or record their symptoms and/or conditions. For example, the software may allow a user to record one or more metrics relating to their condition or health and associate these recorded metrics with a date and/or time. The software may identify, track, determine or highlight any patterns in the provided indicators and conditions. The software may allow a healthcare professional profile associated with the patient profile to access, view, and/or edit the patient's input symptoms and conditions.
Referring to fig. 6A, device 700 may allow a user to track, record, view, review and/or analyze implant data collected over time. For example, the device 700 may plot or otherwise graph a series of data, such as, for example, measurements (e.g., temperature measurements) collected by the sensors 105a-105e over time. The software may provide statistical analysis of the collected data and/or may highlight or mark data points that are outside of a threshold, range, or desired condition. In some examples, measurements may be grouped by time of recording and/or by location of the sensors 105a-105e providing the measurements. In this manner, a user (e.g., a healthcare professional) can monitor trends in implant data from different regions or portions of the implant 100 (e.g., monitor temperature changes in tissue adjacent one portion of the implant 100 as compared to tissue adjacent another portion of the implant 100). In some embodiments, measurements (e.g., temperature measurements) recorded and transmitted by the sensors 105 may only be accessible to a healthcare professional profile.
Referring to FIG. 6B, the software may allow a user to navigate between different aspects of the device interface. For example, the menu screen may allow the user to access one or more patient profiles, access one or more types of data (e.g., data about the implant 100 or data recorded by the sensor 105), track physician/patient appointments, record and review symptoms and conditions, or contact another user. For example, the software may allow a patient user to contact their physician to schedule an appointment, or may allow a healthcare professional user to review collected data and prompt the patient to collect more measurements if necessary.
Referring to fig. 6C, one or more profiles associated with the patient (e.g., a patient profile or a profile of a healthcare professional attending the patient) may access historical data collected regarding the measurements. This portion of the device interface may encourage, assist or otherwise assist the user in collecting data from the sensors 105a-105 e. The device may also prompt the user to take more measurements when it is detected that no measurements have been recorded within a predetermined period of time.
Fig. 7 shows a block diagram of components of the reader 600 and the device 700, both in bidirectional communication with the cloud-based server 300. Accordingly, the reader 600 and the device 700 may communicate with each other through the cloud-based server 300. Additionally or alternatively, the reader 600 and the device 700 may communicate directly (e.g., with or without data being transmitted to and from the cloud-based server 300). For example, reader 600 may communicate with device 700 through RF communication, a wired connection (e.g., a USB cable), or through a local network. For example, device 700 may communicate with reader 600 via RF communication, a wired connection (e.g., a USB cable), or via a local or global network.
Still referring to fig. 7, reader 600 may include one or more of the following components: a microcontroller 602, a USB connection 604, a display 606, a power supply 608, a clock generator 610, a driver/amplifier 612, an antenna 614, a converter 616, an analog front end 618, one or more analog-to-digital converters (ADCs) 620, 626, a receive antenna 622, or a logarithmic amplifier 624.
The microcontroller 602 may be coupled to one or more USB connections 604 and a display 606. The reader 600 may also include one or more power supplies 608 connected to the microcontroller 602. The microcontroller 602 may control a clock generator 610, which in turn may control a driver/amplifier 612. Driver/amplifier 612 may be connected to antenna 614. The antenna 614 may be connected to a transducer 616, which in turn may be connected to an analog front end 618. An analog-to-digital converter (ADC)620 may be connected to the analog front end 618 and the microcontroller 602. Antenna 614 and/or receive antenna 622 may be connected to a logarithmic amplifier 624.
For example, microcontroller 602 may be a small computer on an integrated circuit capable of receiving data from various components and also capable of directing the various components to perform their functions. For example, microcontroller 602 may include one or more Computer Processing Units (CPUs), as well as memory and programmable input/output peripherals. Microcontroller 602 may receive inputs and instructions, for example, through a digital connection, which may be, for example, USB connection 604. In alternative embodiments, the USB connection 604 may be another type of connection, such as an eSATA connection, a firewire connection, an ethernet connection, or a wireless connection. The connection 604 may connect the microcontroller 602 to, for example, an input/output device, such as a computer, capable of programming the microcontroller 602.
The microcontroller 602 may also have a display 606, which may be, for example, an LED display. Display 606 may be configured to display calculations, inputs, outputs, and instructions sent and received by microcontroller 602. In some embodiments, the display 806 may be configured to display instructions or inputs received over, for example, the connection 604. In an alternative embodiment, the display 606 may simply be a series of display lights. In further alternative embodiments, display 606 may be a non-LED display, such as an LCD display or other display.
The power supply 608 may comprise any type of power supply compatible with the elements of the platform reader 600, including, for example, an ac power supply, a dc power supply, a battery power supply, and the like. In fig. 8, a power supply 608 is shown connected to the microcontroller 602. However, in further embodiments, the power source may additionally or alternatively be one or more other components of the reader 600.
The microcontroller 602 may be connected to a clock generator 610, which in turn may be connected to a driver/amplifier 612. Clock generator 610 may be a circuit that may provide a timing signal having a precise frequency and/or wavelength through which microcontroller 602 may instruct driver/amplifier 612 to output a series of broadcast signals at a desired speed or interval. Driver/amplifier 612 may include, for example, a driver that generates an RF signal and an electronic amplifier that may generate a low power RF signal and amplify the signal to a higher power signal. Driver/amplifier 612 may comprise, for example, any type of RF driver/amplifier known in the art, such as a solid state amplifier or a vacuum tube amplifier.
Driver/amplifier 612 may be connected to antenna 614. Antenna 614 may be, for example, an RF antenna. In one aspect, the antenna 614 may be connected to a converter 616, which in turn is connected to an analog front end 618 and an ADC 620. Together, the converter 616, analog front end 618, and ADC 620 may be configured to receive and process signals, such as carrier signals and modulation signals, from the antenna 614 and convert them to digital values for return to the microcontroller 602. In particular, the converter 616 may be configured to convert the high voltage signal received from the antenna 618 and into a voltage that may be processed by other components of the reader 600 (e.g., the analog front end 818, the ADC820, and/or the microcontroller 602) without damaging the other components. The analog front end 618 may be configured to filter out portions of the received and transformed signal from the transformer 616. For example, analog front end 618 may be configured to process the received signal such that a carrier signal having the same wavelength and/or frequency as the signal broadcast by antenna 614 is removed, leaving only a modulated signal (e.g., a signal modulated by a transponder that receives and returns a signal from antenna 614). The ADC 620 may be configured to convert the filtered modulated signal to a digital value.
Receive antenna 622 may be used as an additional antenna configured to aid in receiving weaker signals. The weak signal received by antenna 614 or receive antenna 622 may be amplified by logarithmic amplifier 624 and passed to ADC 26. The logarithmic amplifiers 8624 may be amplifiers configured to receive weak signals and amplify them on a logarithmic scale so that they may be processed by the ADC 626 and the microcontroller 602. The ADC 626 may be configured to convert signals received from the logarithmic amplifier 624 and provide them to the microcontroller 602, which may be configured to evaluate the strength of the signals received from the ADC 626. In this manner, reader 600 may be able to evaluate and process signals across the width of the signal strength.
In some embodiments, microcontroller 602 may be connected directly to driver/amplifier 612, for example. In such embodiments, microcontroller 602 may be configured to provide the signal frequency and wavelength directly to driver/amplifier 602 without clock generator 610 generating the signal.
The elements of the reader 600 may be permanently or removably connected to each other. For example, the components of the reader 600 may be rearranged such that units, components, or modules of the system may be connected to alternative or additional units, components, or modules than those shown in fig. 8.
The reader 600 (e.g., RF reader) as described above may communicate implant data to a device (e.g., smartphone, tablet, laptop, desktop, etc.) directly or through a remote database (e.g., cloud-based memory 300). As shown in fig. 7, such a device 700 may contain a Central Processing Unit (CPU) 720. CPU720 may be any type of processor device including, for example, any type of special purpose or general purpose microprocessor device. CPU720 may also be a single processor in a multi-core/multi-processor system, such a system operating alone, or in a cluster of computing devices operating in a cluster farm or server farm. CPU720 may be connected to a data communication infrastructure 710 such as a bus, message queue, network, or multi-core messaging scheme.
Device 700 may also include a main memory 740, such as Random Access Memory (RAM), and may also include a secondary memory 730. The secondary memory 730, such as Read Only Memory (ROM), may be, for example, a hard disk drive or a removable storage drive. Such removable storage drives may include, for example, magnetic tape drives, optical disk drives, flash memory, and the like. The removable storage drive in this example reads from and/or writes to a removable storage unit in a well-known manner. A removable storage unit may include a magnetic tape, optical disk, or other memory component that is read by and written to by a removable storage drive. The removable storage unit typically comprises a computer usable storage medium having stored therein computer software and/or data.
In alternative embodiments, the secondary memory 730 may contain other similar means for allowing computer programs or other instructions to be loaded into the device 700. Examples of such means may include a program cartridge and cartridge, a removable memory chip (such as an EPROM, or PROM) and associated socket, and other removable storage units and interfaces that allow software and data to be transferred from the removable storage unit to the device 700.
The device 700 may also contain a communication interface ("COM") 760. The communication interface 760 allows software and data to be transferred between the device 700 and external devices, such as, for example, a reader or a cloud-based storage system. Communications interface 760 may include a modem, a network interface (such as an ethernet card), a communications port, a PCMCIA slot and card, or the like. Software and data transferred via communications interface 760 may be in the form of signals which may be electronic, electromagnetic, optical or other signals capable of being received by communications interface 760. These signals may be provided to communications interface 760 via a communications path of device 700, which may be implemented using, for example, wire or cable, fiber optics, a phone line, a cellular phone link, an RF link, or other communications channels.
Device 700 may also contain input and output ports 750 to connect input and output devices, such as a keyboard, mouse, touch screen, monitor, display, and the like. In some embodiments, the cloud-based server 300 may be similar in structure to the device 700. For example, cloud-based server 300 may include a bus 710, a CPU720, secondary storage 730, main memory 740, input and output ports 750, and/or a communication interface 760. The cloud-based server 300 may perform any of the functions of the device 700 described herein.
The principles and representative examples of the present disclosure have been described in the foregoing description and drawings. However, the various aspects of the disclosure should not be construed as limited to the particular examples and embodiments disclosed. Further, the examples described herein should be considered as illustrative and not restrictive. It is to be understood that changes and variations may be made, and equivalents may be employed, without departing from the spirit of the disclosure. Accordingly, it is expressly intended that all such variations, changes and equivalents fall within the spirit and scope of the present disclosure, as claimed.