US20090287120A1 - Circulatory monitoring systems and methods - Google Patents

Abstract

Systems and methods are described for obtaining and acting upon information indicative of circulatory health and related phenomena in human beings or other subjects.

Description

SUMMARY
• In one aspect, a method includes but is not limited to obtaining local circulatory information relating to a leg of a subject and signaling a decision whether to transmit a notification in response to one or more comparisons between filtering information specific to the subject and the local circulatory information relating to the leg of the subject. In addition to the foregoing, other method aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one or more various aspects, related systems include but are not limited to circuitry and/or programming for effecting the herein referenced method aspects; the circuitry and/or programming can be virtually any combination of hardware, software, and/or firmware configured to effect the herein referenced method aspects depending upon the design choices of the system designer.
• In one aspect, a system includes but is not limited to circuitry for obtaining local circulatory information relating to a leg of a subject and circuitry for signaling a decision whether to transmit a notification in response to one or more comparisons between filtering information specific to the subject and the local circulatory information relating to the leg of the subject. In addition to the foregoing, other system aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one aspect, a method includes but is not limited to obtaining local respiratory-status-indicative information about a first body part of a subject and causing one or more comparisons between the local respiratory-status-indicative information about the first body part of the subject and filtering information at least partly based on the subject. In addition to the foregoing, other method aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one or more various aspects, related systems include but are not limited to circuitry and/or programming for effecting the herein referenced method aspects; the circuitry and/or programming can be virtually any combination of hardware, software, and/or firmware configured to effect the herein referenced method aspects depending upon the design choices of the system designer.
• In one aspect, a system includes but is not limited to circuitry for obtaining local respiratory-status-indicative information about a first body part of a subject and circuitry for causing one or more comparisons between the local respiratory-status-indicative information about the first body part of the subject and filtering information at least partly based on the subject. In addition to the foregoing, other system aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one aspect, a method includes but is not limited to obtaining local thermal information about a peripheral part of a body of a subject and signaling a decision whether to transmit a notification in response to one or more comparisons between filtering information specific to an attribute of the subject and the local thermal information about the peripheral part of the body of the subject. In addition to the foregoing, other method aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one or more various aspects, related systems include but are not limited to circuitry and/or programming for effecting the herein referenced method aspects; the circuitry and/or programming can be virtually any combination of hardware, software, and/or firmware configured to effect the herein referenced method aspects depending upon the design choices of the system designer.
• In one aspect, a system includes but is not limited to circuitry for obtaining local thermal information about a peripheral part of a body of a subject and circuitry for signaling a decision whether to transmit a notification in response to one or more comparisons between filtering information specific to an attribute of the subject and the local thermal information about the peripheral part of the body of the subject. In addition to the foregoing, other system aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one aspect, a method includes but is not limited to obtaining information indicating a current thermal condition in a peripheral part of a subject's body and signaling a decision whether to transmit a notification at least partly in response to one or more comparisons between the information indicating the current thermal condition in the peripheral part of the subject's body and information indicating a prior thermal condition in the peripheral part of the subject's body. In addition to the foregoing, other method aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one or more various aspects, related systems include but are not limited to circuitry and/or programming for effecting the herein referenced method aspects; the circuitry and/or programming can be virtually any combination of hardware, software, and/or firmware configured to effect the herein referenced method aspects depending upon the design choices of the system designer.
• In one aspect, a system includes but is not limited to circuitry for obtaining information indicating a current thermal condition in a peripheral part of a subject's body and circuitry for signaling a decision whether to transmit a notification at least partly in response to one or more comparisons between the information indicating the current thermal condition in the peripheral part of the subject's body and information indicating a prior thermal condition in the peripheral part of the subject's body. In addition to the foregoing, other system aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one aspect, a method includes but is not limited to detecting a result of one or more comparisons between information indicating current local stress in a peripheral part of a subject's body and information indicating prior local stress in the peripheral part of the subject's body and signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body. In addition to the foregoing, other method aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one or more various aspects, related systems include but are not limited to circuitry and/or programming for effecting the herein referenced method aspects; the circuitry and/or programming can be virtually any combination of hardware, software, and/or firmware configured to effect the herein referenced method aspects depending upon the design choices of the system designer.
• In one aspect, a system includes but is not limited to circuitry for detecting a result of one or more comparisons between information indicating current local stress in a peripheral part of a subject's body and information indicating prior local stress in the peripheral part of the subject's body and circuitry for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body. In addition to the foregoing, other system aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one aspect, a method includes but is not limited to causing an artificial support to modify a force upon a first external portion of a subject's body as a programmatic response to locally-abnormal-stress-indicative information obtained from a second external portion of the subject's body. In addition to the foregoing, other method aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one or more various aspects, related systems include but are not limited to circuitry and/or programming for effecting the herein referenced method aspects; the circuitry and/or programming can be virtually any combination of hardware, software, and/or firmware configured to effect the herein referenced method aspects depending upon the design choices of the system designer.
• In one aspect, a system includes but is not limited to circuitry for causing an artificial support to modify a force upon a first external portion of a subject's body as a programmatic response to locally-abnormal-stress-indicative information obtained from a second external portion of the subject's body. In addition to the foregoing, other system aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one aspect, a method includes but is not limited to obtaining locally-abnormal thermal information about a first external portion of a subject's limb and causing an artificial support to exert an increasing force upon a second external portion of the subject's limb at least partly in response to locally-abnormal thermal information about the first external portion of the subject's limb. In addition to the foregoing, other method aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one or more various aspects, related systems include but are not limited to circuitry and/or programming for effecting the herein referenced method aspects; the circuitry and/or programming can be virtually any combination of hardware, software, and/or firmware configured to effect the herein referenced method aspects depending upon the design choices of the system designer.
• In one aspect, a system includes but is not limited to circuitry for obtaining locally-abnormal thermal information about a first external portion of a subject's limb and circuitry for causing an artificial support to exert an increasing force upon a second external portion of the subject's limb at least partly in response to locally-abnormal thermal information about the first external portion of the subject's limb. In addition to the foregoing, other system aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one aspect, a method includes but is not limited to obtaining a priori implant information and signaling a decision whether to initiate implant-site-targeting treatment partly based on the a priori implant information and partly based on one or more other clot-indicative determinants. In addition to the foregoing, other method aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one or more various aspects, related systems include but are not limited to circuitry and/or programming for effecting the herein referenced method aspects; the circuitry and/or programming can be virtually any combination of hardware, software, and/or firmware configured to effect the herein referenced method aspects depending upon the design choices of the system designer.
• In one aspect, a system includes but is not limited to circuitry for obtaining a priori implant information and circuitry for signaling a decision whether to initiate implant-site-targeting treatment partly based on the a priori implant information and partly based on one or more other clot-indicative determinants. In addition to the foregoing, other system aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one aspect, a method includes but is not limited to obtaining a flow-change-indicative measurement and signaling a decision whether to administer one or more clot-reducing agents at least partly based on the flow-change-indicative measurement. In addition to the foregoing, other method aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one or more various aspects, related systems include but are not limited to circuitry and/or programming for effecting the herein referenced method aspects; the circuitry and/or programming can be virtually any combination of hardware, software, and/or firmware configured to effect the herein referenced method aspects depending upon the design choices of the system designer.
• In one aspect, a system includes but is not limited to circuitry for obtaining a flow-change-indicative measurement and circuitry for signaling a decision whether to administer one or more clot-reducing agents at least partly based on the flow-change-indicative measurement. In addition to the foregoing, other system aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one aspect, a method includes but is not limited to obtaining one or more indications of a lytic material in a vicinity of one or more body lumens and accelerating a decrease in a local concentration of the lytic material in the vicinity of the one or more body lumens by causing one or more elements to extract at least a portion of the lytic material in the vicinity of the one or more body lumens in response to the one or more indications of the lytic material in the vicinity of the one or more body lumens. In addition to the foregoing, other method aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one or more various aspects, related systems include but are not limited to circuitry and/or programming for effecting the herein referenced method aspects; the circuitry and/or programming can be virtually any combination of hardware, software, and/or firmware configured to effect the herein referenced method aspects depending upon the design choices of the system designer.
• In one aspect, a system includes but is not limited to circuitry for obtaining one or more indications of a lytic material in a vicinity of one or more body lumens and circuitry for accelerating a decrease in a local concentration of the lytic material in the vicinity of the one or more body lumens by causing one or more elements to extract at least a portion of the lytic material in the vicinity of the one or more body lumens in response to the one or more indications of the lytic material in the vicinity of the one or more body lumens. In addition to the foregoing, other system aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one aspect, a method includes but is not limited to causing one or more evaluations of local respiratory-status-indicative information about a first body part of an occupant of a vehicle. In addition to the foregoing, other method aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In one or more various aspects, related systems include but are not limited to circuitry and/or programming for effecting the herein referenced method aspects; the circuitry and/or programming can be virtually any combination of hardware, software, and/or firmware configured to effect the herein referenced method aspects depending upon the design choices of the system designer.
• In one aspect, a vehicle includes but is not limited to circuitry for causing one or more evaluations of local respiratory-status-indicative information about a first body part of an occupant and a seat configured to bear the occupant. In addition to the foregoing, other system aspects are described in the claims, drawings, and text forming a part of the present disclosure.
• In addition to the foregoing, various other method and/or system and/or program product aspects are set forth and described in the teachings such as text (e.g., claims and/or detailed description) and/or drawings of the present disclosure.
• The foregoing is a summary and thus may contain simplifications, generalizations, inclusions, and/or omissions of detail; consequently, those skilled in the art will appreciate that the summary is illustrative only and is NOT intended to be in any way limiting. Other aspects, features, and advantages of the devices and/or processes and/or other subject matter described herein will become apparent in the teachings set forth herein.
• In one or more various aspects, related systems include but are not limited to circuitry and/or programming for effecting herein-referenced method aspects; the circuitry and/or programming can be virtually any combination of hardware, software, and/or firmware configured to effect the herein-referenced method aspects depending upon the design choices of the system designer. In addition to the foregoing, various other method and/or system aspects are set forth and described in the teachings such as text (e.g., claims and/or detailed description) and/or drawings of the present disclosure.
• The foregoing summary is illustrative only and is not intended to be in any way limiting. In addition to the illustrative aspects, embodiments, and features described above, further aspects, embodiments, and features will become apparent by reference to the drawings and the following detailed description.
BRIEF DESCRIPTION OF THE FIGURES
• FIGS. 1-81 depict exemplary environments in which one or more technologies may be implemented.
• FIG. 82 depicts a high-level logic flow of an operational process.
• FIGS. 83-84 depict variants of the flow ofFIG. 82.
• FIG. 85 depicts an exemplary environment in which one or more technologies may be implemented.
• FIG. 86 depicts a high-level logic flow of an operational process.
• FIGS. 87-88 depict variants of the flow ofFIG. 86.
• FIG. 89 depicts an exemplary environment in which one or more technologies may be implemented.
• FIG. 90 depicts a high-level logic flow of an operational process.
• FIGS. 91-92 depict variants of the flow ofFIG. 90.
• FIG. 93 depicts an exemplary environment in which one or more technologies may be implemented.
• FIG. 94 depicts a high-level logic flow of an operational process.
• FIGS. 95-96 depict variants of the flow ofFIG. 94.
• FIG. 97 depicts an exemplary environment in which one or more technologies may be implemented.
• FIGS. 98-99 depict high-level logic flows of operational processes.
• FIGS. 100-101 depict variants of the flow ofFIG. 98.
• FIGS. 102-103 depict variants of the flow ofFIG. 99.
• FIG. 104 depicts an exemplary environment in which one or more technologies may be implemented.
• FIG. 105 depicts a high-level logic flow of an operational process.
• FIGS. 106-107 depict variants of the flow ofFIG. 105.
• FIG. 108 depicts an exemplary environment in which one or more technologies may be implemented.
• FIG. 109 depicts a high-level logic flow of an operational process.
• FIGS. 110-111 depict variants of the flow ofFIG. 109.
• FIG. 112 depicts an exemplary environment in which one or more technologies may be implemented.
• FIG. 113 depicts a high-level logic flow of an operational process.
• FIGS. 114-115 depict variants of the flow ofFIG. 113.
• FIG. 116 depicts an exemplary environment in which one or more technologies may be implemented.
• FIG. 117 depicts a high-level logic flow of an operational process.
• FIGS. 118-119 depict variants of the flow ofFIG. 117.
DETAILED DESCRIPTION
• In the following detailed description, reference is made to the accompanying drawings, which form a part hereof. In the drawings, similar symbols typically identify similar components, unless context dictates otherwise. The illustrative embodiments described in the detailed description, drawings, and claims are not meant to be limiting. Other embodiments may be utilized, and other changes may be made, without departing from the spirit or scope of the subject matter presented here.
• Those having skill in the art will recognize that the state of the art has progressed to the point where there is little distinction left between hardware, software, and/or firmware implementations of aspects of systems; the use of hardware, software, and/or firmware is generally (but not always, in that in certain contexts the choice between hardware and software can become significant) a design choice representing cost vs. efficiency tradeoffs. Those having skill in the art will appreciate that there are various vehicles by which processes and/or systems and/or other technologies described herein can be effected (e.g., hardware, software, and/or firmware), and that the preferred vehicle will vary with the context in which the processes and/or systems and/or other technologies are deployed. For example, if an implementer determines that speed and accuracy are paramount, the implementer may opt for a mainly hardware and/or firmware vehicle; alternatively, if flexibility is paramount, the implementer may opt for a mainly software implementation; or, yet again alternatively, the implementer may opt for some combination of hardware, software, and/or firmware. Hence, there are several possible vehicles by which the processes and/or devices and/or other technologies described herein may be effected, none of which is inherently superior to the other in that any vehicle to be utilized is a choice dependent upon the context in which the vehicle will be deployed and the specific concerns (e.g., speed, flexibility, or predictability) of the implementer, any of which may vary. Those skilled in the art will recognize that optical aspects of implementations will typically employ optically-oriented hardware, software, and or firmware.
• In some implementations described herein, logic and similar implementations may include software or other control structures suitable to operation. Electronic circuitry, for example, may manifest one or more paths of electrical current constructed and arranged to implement various logic functions as described herein. In some implementations, one or more media are configured to bear a device-detectable implementation if such media hold or transmit a special-purpose device instruction set operable to perform as described herein. In some variants, for example, this may manifest as an update or other modification of existing software or firmware, or of gate arrays or other programmable hardware, such as by performing a reception of or a transmission of one or more instructions in relation to one or more operations described herein. Alternatively or additionally, in some variants, an implementation may include special-purpose hardware, software, firmware components, and/or general-purpose components executing or otherwise invoking special-purpose components. Specifications or other implementations may be transmitted by one or more instances of tangible transmission media as described herein, optionally by packet transmission or otherwise by passing through distributed media at various times.
• Alternatively or additionally, implementations may include executing a special-purpose instruction sequence or otherwise invoking circuitry for enabling, triggering, coordinating, requesting, or otherwise causing one or more occurrences of any functional operations described above. In some variants, operational or other logical descriptions herein may be expressed directly as source code and compiled or otherwise invoked as an executable instruction sequence. In some contexts, for example, C++ or other code sequences can be compiled directly or otherwise implemented in high-level descriptor languages (e.g., a logic-synthesizable language, a hardware description language, a hardware design simulation, and/or other such similar mode(s) of expression). Alternatively or additionally, some or all of the logical expression may be manifested as a Verilog-type hardware description or other circuitry model before physical implementation in hardware, especially for basic operations or timing-critical applications. Those skilled in the art will recognize how to obtain, configure, and optimize suitable transmission or computational elements, material supplies, actuators, or other common structures in light of these teachings.
• In a general sense, those skilled in the art will recognize that the various embodiments described herein can be implemented, individually and/or collectively, by various types of electromechanical systems having a wide range of electrical components such as hardware, software, firmware, and/or virtually any combination thereof; and a wide range of components that may impart mechanical force or motion such as rigid bodies, spring or torsional bodies, hydraulics, electro-magnetically actuated devices, and/or virtually any combination thereof. Consequently, as used herein “electro-mechanical system” includes, but is not limited to, electrical circuitry operably coupled with a transducer (e.g., an actuator, a motor, a piezoelectric crystal, a Micro Electro Mechanical System (MEMS), etc.), electrical circuitry having at least one discrete electrical circuit, electrical circuitry having at least one integrated circuit, electrical circuitry having at least one application specific integrated circuit, electrical circuitry forming a general purpose computing device configured by a computer program (e.g., a general purpose computer configured by a computer program which at least partially carries out processes and/or devices described herein, or a microprocessor configured by a computer program which at least partially carries out processes and/or devices described herein), electrical circuitry forming a memory device (e.g., forms of memory (e.g., random access, flash, read only, etc.)), electrical circuitry forming a communications device (e.g., a modem, communications switch, optical-electrical equipment, etc.), and/or any non-electrical analog thereto, such as optical or other analogs. Those skilled in the art will also appreciate that examples of electromechanical systems include but are not limited to a variety of consumer electronics systems, medical devices, as well as other systems such as motorized transport systems, factory automation systems, security systems, and/or communication/computing systems. Those skilled in the art will recognize that electromechanical as used herein is not necessarily limited to a system that has both electrical and mechanical actuation except as context may dictate otherwise.
• In a general sense, those skilled in the art will also recognize that the various aspects described herein which can be implemented, individually and/or collectively, by a wide range of hardware, software, firmware, and/or any combination thereof can be viewed as being composed of various types of “electrical circuitry.” Consequently, as used herein “electrical circuitry” includes, but is not limited to, electrical circuitry having at least one discrete electrical circuit, electrical circuitry having at least one integrated circuit, electrical circuitry having at least one application specific integrated circuit, electrical circuitry forming a general purpose computing device configured by a computer program (e.g., a general purpose computer configured by a computer program which at least partially carries out processes and/or devices described herein, or a microprocessor configured by a computer program which at least partially carries out processes and/or devices described herein), electrical circuitry forming a memory device (e.g., forms of memory (e.g., random access, flash, read only, etc.)), and/or electrical circuitry forming a communications device (e.g., a modem, communications switch, optical-electrical equipment, etc.). Those having skill in the art will recognize that the subject matter described herein may be implemented in an analog or digital fashion or some combination thereof.
• Those skilled in the art will further recognize that at least a portion of the devices and/or processes described herein can be integrated into an image processing system. A typical image processing system may generally include one or more of a system unit housing, a video display device, memory such as volatile or non-volatile memory, processors such as microprocessors or digital signal processors, computational entities such as operating systems, drivers, applications programs, one or more interaction devices (e.g., a touch pad, a touch screen, an antenna, etc.), control systems including feedback loops and control motors (e.g., feedback for sensing lens position and/or velocity; control motors for moving/distorting lenses to give desired focuses). An image processing system may be implemented utilizing suitable commercially available components, such as those typically found in digital still systems and/or digital motion systems.
• Those skilled in the art will likewise recognize that at least some of the devices and/or processes described herein can be integrated into a data processing system. Those having skill in the art will recognize that a data processing system generally includes one or more of a system unit housing, a video display device, memory such as volatile or non-volatile memory, processors such as microprocessors or digital signal processors, computational entities such as operating systems, drivers, graphical user interfaces, and applications programs, one or more interaction devices (e.g., a touch pad, a touch screen, an antenna, etc.), and/or control systems including feedback loops and control motors (e.g., feedback for sensing position and/or velocity; control motors for moving and/or adjusting components and/or quantities). A data processing system may be implemented utilizing suitable commercially available components, such as those typically found in data computing/communication and/or network computing/communication systems.
• With reference now toFIG. 1, shown is asystem100 configured to monitor at least onedetection site101 comprisesseveral zones111,112,113,114 of a subject's body, any of which may contain an infection or otherphysiological abnormality105. Such anomalies may manifest as physical phenomena detectable by acomparator130 applyingvarious filtering information131,132,137 to output from one ormore sensors126,127,128 in a proximity of the detection site(s)101 as exemplified below. (In some variants, for example, such features ofzone112 may be detected by a rangedsensor127 inother zones113 or by aportable sensor126 that enterszone112.)
• Othersuch detection sites102 may likewise includeseveral zones171,172,173,174 sometimes accessible tosystem100, any of which may be detectable at various times by one ormore sensors185,186. In some variants, also, a clinician orother service provider190 may be able inspect a patient's leg orother zone174 of interest,status information191 which may be acted upon according to a triage protocol or other suchfunctional information192 fromevaluation logic150. In some contexts,service provider190 may likewise applystatus information191 atsite102, such as by determining whether a symptom has changed.Functional information192 may likewise flow toevaluation logic150, such as byservice provider190 identifying what treatments or other events occurred.
• In some variants,module182 ofdetection logic180 may be configured to notifyevaluation logic150 only in the event of input from one ormore sensors185,186 atsite102. (A “module” may include special-purpose hardware, general-purpose hardware configured with special-purpose software, or other circuitry configured to perform one or more functions recited in this document.) In various embodiments as described below, one ormore modules141,142 of protocols may likewise be invoked in response to symptoms indicated bysuch detection logic180 and/orservice providers190. In some contexts, for example, one ormore service providers190 may orally or otherwise reportstatus information191 toevaluation logic150 based upon visual or other preliminary examination ofparticular zones173,174 of a patient's body. Alternatively or additional, the service provider(s) may perform a diagnostic procedure or other evaluation according to programmatic or otherfunctional information192 specified by evaluation logic150 (implementing, for example, an expert system).
• Module142 or other such components, for example, may be configured to apply one or more types of filtering information as exemplified below in deciding one or more of (a) whether to warn an individual or otherwise transmit a notification to an interface; (b) whom to notify; (c) when to transmit a notification; (d) what to include with a notification; (e) whether to adapt detection logic to reduce a frequency of detection events or other undesirable notifications, such by configuring inclusion criteria to be more selective; (f) whether to include one or more modules of detection logic in an update operation; (g) whether to retain or otherwise act upon one or more data samples; (h) which actuator drivers, relays, or other hardware control circuitry to activate; (i) whether to trigger one or more emitters or other active elements of sensors; (j) what conditions indicate an actionable health risk; and/or (k) when and which subjects warrant other such responsive actions. One or more instances ofresponsive protocols140,recorders148, or other components ofevaluation logic150 may be provided, in some variants, at a central processing facility that is remote from one or more ofsite102,detection logic180, and/orservice provider190.
• In some variants,evaluation logic150 may be configured to rank conditions or otherwise combine data effectively from two or more subjects, such as by using data from one subject (received viadetection logic180 orservice provider190, e.g.) to generate or updatefiltering information132,137 to be applied to data from another subject (atsite101, e.g.). Other such embodiments are described, for example, with reference toFIGS. 2,3,8,25, and74 below.
• In some variants, two ormore sensors126,127,128 may (optionally) implement a sensor array, an assay, or other such combinations of two or more sensor types and/or testing modes configured to detect a potential combination of aspects indicative and confirmatory of a circulatory problem or other pathology of particular concern. Other such embodiments are described, for example, with reference toFIGS. 3,6,8,9,10,12,19,22-28,32,52,74, and76 below.
• With reference now toFIG. 2, shown is asystem200 in which one or more technologies may be implemented, asedan comprising wheels201, anengine202, and one ormore modules210,215 configured to provide one or more types ofinformation221 from controls orinformation222,223,224 from within or around one ormore seats211 or other locations inside the vehicle.System200 may further include or otherwise interact with one ormore modules251,252 ofevaluation logic250, one ormore modules261,262 ofresponsive logic260, and/or one ormore modules272,273 ofdecision logic275 operable for transmitting or otherwise selectively acting uponsuch information271 as described below. In some variants, for example, one ormore clocks276 orantennas278 may facilitate selective notifications, aggregations, evaluations, or other programmatic responses as described herein. Alternatively or additionally, one or more stationary instances ofcircuitry280 may communicate withsystem200, for example, viaantenna278.
• An embodiment provides a vehicle having one ormore modules251,252 ofevaluation logic250 configured as circuitry for causing one or more evaluations of local respiratory-status-indicative information222,223,224 about a driver's or other occupant's weight-bearing body parts. Other such embodiments may, for example, include features described with reference to each ofFIGS. 3-16 and22-33. Such systems may include or otherwise interact with a steering wheel or other such utility device configured to be handled by an occupant. Alternatively or additionally, such embodiments may include one ormore engines202 operable for conveying one ormore seats211—such as by applying a torque (via one or more axles, e.g.) towheels201.
• In some embodiments, “respiratory” status may refer generally to oxygen saturation within a blood vessel segment, pH indications indicating a degree of regional exertion or elevation, a presence or absence of hypercapnea, or other such detectable conditions directly or indirectly reflecting discernable cellular respiration. In some embodiments, information “about a body part” may refer to a flow that enters or leaves the body part, a current position or other variable attribute of the body part, eye color or other such body part categories, injuries or other such historical data, tumors or their attributes, or other such information relating to vital organs or other such sub-structures within an individual or demographic grouping. In some embodiments, a conduit or other circuitry may be “invoked” by initiating a reboot or other such hardware function, by calling a procedure or other such identifiable objects, or otherwise by transmitting a pulse or other signal feature configured to trigger an execution of special-purpose functionality.
• With reference now toFIG. 3, shown is asystem300 in which one or more technologies may be implemented.System300 may be positioned centrally or local tosubjects310,320, for example, and/or configured to invoke one ormore interfaces330 orother response logic335 in response to one ormore indications311,312,313,314,321 fromsensors317,326,327 in, on, or nearextremities328 or other body parts of interest. This can occur, for example, in a context in whichhosiery318, clothing, or one ormore utility devices325 within a detection range ofsensors317,326,327 implements or otherwise interacts withsystem300. In some embodiments, such sensors may be implanted in a body tissue of interest or in a structure with which subjects310,320 may interact. Alternatively or additionally, some such sensors may be worn as clothing, a support, a patch, a bandage, a watch, or some other article in the subjects' vicinity. Such articles may (optionally) include one or more instances of storage ortransmission media340 configured to bear one ormore percentages343 orother indications341,342,344 such ascontent345;information346;decisions347; ornotifications348 containingcontent349, for example, in any of the flows described below in relation toFIGS. 82-119.
• With reference now toFIG. 4, shown is asystem400 in which one or more technologies may be implemented.System400 comprises asupport420 configured to contact or otherwise remain adjacent one or moreexternal portions403,404,405 ofbody410 in such a way as to permit a detection of surface roughness, discoloration, or otherdetectable anomalies409. As shown,support420 includes one ormore components413,414,415 that each include one ormore sensors423,424,425 respectively adjacent external portions of interest. In some variants, one ormore modules491,492 ofcontroller490 are configured to receive one ormore sensor inputs433,434,435, for example, and (optionally) to invoke a therapeutic dispensation as an optional feature of any of the flows described below in relation toFIGS. 82-119, such as by a drug dispenser or other suitable component(s)413,414,415.
• An embodiment provides a variant ofmodule491 configured as circuitry for deciding whether to transmit measurement content or other blood clot indications and one ormore components413,414,415 each coated with an ultrasound gel or other such medium to facilitate acoustic energy passing from asubject body410 torespective sensors423,424,425. (Other such embodiments are described, for example, with reference toFIGS. 23-27 below.)
• With reference now toFIG. 5, shown is asystem500 in which one or more technologies may be implemented comprising one ormore notification modules510 operably coupled with one ormore interfaces580 in anetwork590.Notification module510 may handle or otherwise include one ormore decisions531,532 ofvarious types533,destinations535,display elements536, orchannels550 operable for transmitting one ormore notifications541,542 such ascontent544, optionally via one or more radio-frequency orother antennas549. Such antennas may be used in an implanted or other portable article, for example, as described throughout this document.
• In some variants, such notification logic may be configured to provide timely information or advice to one or more individuals in a subject's vicinity. Other such embodiments are described, for example, with reference toFIGS. 2,3,6,8, and29. Alternatively or additionally, one or more such network components may include media configured for display: flat screen displays, image-projecting devices, touch screens, or other such display media. Other such embodiments are described, for example, with reference toFIGS. 8,11,14,22,29, and30.
• With reference now toFIG. 6, shown is awheelchair600, a system in which one or more technologies may be implemented.Wheelchair600 includes aseat610 having one ormore signal paths631,632,633,634 operably coupled with one ormore monitoring apparatuses660, such as for detecting weight or local phenomena.Monitoring apparatus660 may, for example, comprise one ormore modules641,642,643 ofdetection logic640,modules651,652 ofresponsive logic650,antennas654, or other circuitry for generating or usingdetection results655 as described herein.
• An embodiment provides a wheelchair or other vehicle comprising one ormodules642 ofdetection logic640 configured as circuitry for causing one or more evaluations of incoming signals (arriving along selectedpaths631,632,633,634, for example) indicating a status of an occupant's seat, back, feet, or other force-bearing body parts that may suffer local (cellular) respiratory problems for long periods. Such embodiments may be used, for example, in a context in which an occupant is cognitively or otherwise unable to respond to such problems. In some variants,seat610 may include or otherwise support elastic or other tensile elements configured to urge sensors617 toward a sitting subject. Other such vehicles configured to monitor a health status of one or more occupants are described, for example, with reference toFIGS. 2 and 8. In some embodiments, “health status” indicative data can reflect a physiological trend or other time-dependent phenomenon indicating some aspect of a subject's condition. Alternatively or additionally, a health status indicative data set can include portions that have no bearing upon a given subject's health. Although some types of distillations can require authority or substantial expertise (e.g. making a final decision upon a risky procedure or other course of treatment), many other types of distillations can readily be implemented without undue experimentation in light of teachings herein.
• With reference now toFIG. 7, shown issystem700 in which one or more technologies may be implemented, including one or moreactuator arrays705 operable for responding tocontroller775.Array705 comprisesseveral actuators701. Afirst actuator701 comprises at least twoactuator elements711,712 each operable to move cell710 (such as by motor715) relative to structure765 selectively in response tocontroller775. One or moreactuator elements722 are likewise operable to movecell720 relative to structure765 and/orcell740, also in response tocontroller775. One or moreactuator elements741,742,743 are likewise operable to movecell740 relative to structure765 in response tocontroller775. (In some contexts, for example, one or more pumps orvalves746,747 may be configured to permit a fluid to enter and/or leaveactuator element743 to control its expansion and contraction, for example.) One or moreactuator elements752,753 are likewise operable to movecell750 relative to structure765 in response tocontroller775.Controller775 may thus effectuate local position and/or tension control a selective invocation of such actuators.Controller775 may comprise one or more instances ofconfiguration modules777,support control logic780, or profile data790 comprisingoperating parameters791,792,793,794,795 or other aspects of one ormore profiles796. In some variants, implementing or using such control logic may include configuring a seat or other mechanical support. Other such embodiments are described, for example, with reference toFIGS. 2,3,6,12,89, and97-99. In some variants, moreover, one ormore modules781,782,783,784 may be configured to control one or moresuch cells730 comprising, for example, a selectable heating or liquid dispensation element. Any of the local modules described throughout this document may (optionally) include one or more of such anarray705,structure765, orcontroller775 for tissue manipulation, examples of which are described below in relation to the flows ofFIGS. 82-119.
• With reference now toFIG. 8, shown is asystem800 in which one or more technologies may be implemented, anairplane comprising wheels801,engines802, and acabin810 configured to include one ormore interfaces890 configured to receiveoutput845 from an instance ofmonitoring apparatus870. Eachmonitoring apparatus870 may be configured to receive one or more sensedindications821,822,823,824 fromrespective seats811,812,813,814 in which passengers may suffer circulatory or other actionable health risks. Eachmonitoring apparatus870 may likewise include one or more instances ofconduits844,recorders848,modules881 ofdetection logic880, ormodules841,842 of otherresponsive logic840 as described below. In some variants, for example, aninterface895 may be configured to display anoutput845 selectively in a vicinity of aseat814 that has generated one ormore indications824 of a circulatory obstruction or other such actionable health risk. Alternatively or additionally, prolonged or other more serious indications824 (an apparent stroke, for example, or a sleeping passenger with a large clot forming) may be configured to activate a beacon, alarm, orother interface890 more readily visible and/or audible from a front portion ofcabin810 or from other passengers'seats812,813 nearby. A variety of local sensors described in this document are suitable for use in a context like that ofsystem800, especially those described with reference toFIGS. 23-26.
• An embodiment provides an airplane or other vehicle comprising one orcomparators882 orother modules881 ofdetection logic880 configured as circuitry for causing one or more evaluations ofincoming indications821,822,823,824 from seats occupied by respective occupants. Such embodiments may likewise include acabin810 or other such enclosure configured to shelter the occupant(s). Alternatively or additionally, such embodiments may include one ormore engines802 operable for conveying one ormore seats811,812,813,814- such as by causing a force to be applied at least to a fuselage or other structure supporting the seat(s). In some variants, an embodiment may further include an auditory or other interface configured to handle user information; software or other modules configured as circuitry for comparing local respiratory-status-indicative information with filtering information selected in response to one or more attributes of occupant(s).
• In some variants, such one ormore modules841 ofresponsive logic840 may be configured to provide timely information or advice to others who may be near an at-risk vehicle occupant. Other such embodiments are described above, for example, with reference toFIGS. 3,5, and6.
• With reference now toFIG. 9, shown is atonometer925 orother instrument900 configured to facilitate one ormore sensors902 being positioned adjacent a subject'sskin910. One or more sensor elements905 may relay or otherwise facilitate a transmission ofimages931, signals932,933, orother data935 to aprimary module920. Then or later, one ormore modules943 ofevaluation logic950 may apply one ormore thresholds941 orother criteria942 to such data as described below.
• With reference now toFIG. 10, shown is asystem1000 in which one or more technologies may be implemented comprising two ormore actuators1021,1022 each configured to support correspondingsensors1001,1002 on or nearrespective portions1011,1012 of a subject'sskin1010. In various configurations,primary module1060 may include one ormore modules1051,1052 of configuration logic1050; one ormore profiles1071,1072 orother parameters1075,1076 ofcontrol data1079; and/orresponsive logic1095. As exemplified below, one ormore modules1091,1092,1093 ofresponsive logic1095 may trigger configuration logic1050 to update one ormore signals1031,1032 configured to control respective actuator sets in response to one ormore thresholds1086,1087 or other criteria being applied todata1081,1082,1083 and/orsignals1033,1034 received fromsensors1001,1002. In a variant in whichsuch signals1033,1034 signify a local force minimum inportion1012,configuration logic1032 may (optionally) be configured to energizeactuator1022, for example, to maintain a nominal contact force withskin1010.
• In some variants, one or more actuators or other circuitry may be configured to include or receive data indirectly from one or more sensor arrays and other combinations of sensor elements. Other such embodiments are described, for example, with reference toFIGS. 1-9,12,22-28,52,74, and76.
• With reference now toFIG. 11, shown is asystem1100 in which one or more technologies may be implemented. One ormore actuators1120 each comprise a plurality ofelements1121,1122 configured to respond to one ormore signals1131,1132 by exerting a controlled force uponrespective portions1111,1112 ofskin1110. An assembly of one ormore actuators1120 may likewise provide one ormore signals1125 toprimary module1190.Primary module1190 may include one or more instances of device-executable command sequences1157 orother modules1151,1152,1153,1154,1155,1156; sensor-deriveddata1161,1162,1163 and/orvector grids1165 orother profiles1167 ofdata1170 suitable for use bycontrol logic1160; one ormore modules1181,1182,1183 ofprocessing logic1180 configured to handle thedata1170 and other aspects ofincoming signals1125; and/or one ormore interfaces1185 configured to facilitate downloads, operational updates, or other such external interactions as described herein. In some variants, implementing or using such control logic may include configuring a seat or other mechanical support. Other such embodiments are described, for example, with reference toFIGS. 6,7,12, or89.
• With reference now toFIG. 12, shown is asystem1200 in which one or more technologies may be implemented for use with a custom cast, a fitted stocking, or other such special-purpose apparatus1205 configured to support a subject's limb as described herein. Anarray1221 of sensors, actuators, and/or other such devices may be configured to interact with aportion1201 of the subject's limb and/or to handle control and/or sensedinformation1211. At least oneother array1222 of devices may likewise be configured to interact with one or morerespective portions1202 of the subject's limb and/or to handlerespective information1212 passing to and/or fromsystem module1230.System module1230 may include one or more components supported byapparatus1205, on a nearby utility device, in other (optionally centralized) facilities, or distributed across a plurality of such locations.System module1230 may include one or more media bearing various types of sensedinformation1241,1242,1243 orother data1244,1245,1246,1247,1248,1250 as described herein. Other such data and/orthermal information1251 may be provided roughly contemporaneously as (current) status-indicative information1260, in some variants, or may indicate timing1252 associated therewith, such as in a series of periodic measurements reflecting a health status trend in the status-indicative information1260.System module1230 may likewise include one or more instances ofmodules1271,1272,1273 ofdetection logic1275,control logic1280,notification logic1290,recording devices1295, or other such components as described herein.
• In some variants, such detection logic may be implemented in hosiery, wristbands, bandages, or other such worn articles. Other such embodiments are described, for example, with reference toFIGS. 2,3,17,20,25, and29. In some variants, such embodiments may incorporate one or more existing technologies like those of the “BT2” wristwatch design, described at www.exmocare.com and in the Information Disclosure Statement filed herewith.
• With reference now toFIG. 13, shown is asystem1300 in which one or more technologies may be implemented, aserver1305 configured to communicate with one ormore sources1375,1385,1395 in a each of plurality ofnetworks1370,1380,1390. One or moresuch servers1305 may include instances ofdetection modules1310;modules1325 of (data)extraction logic1320; remote-resource invocation modules1330;devices1340; ormodules1351,1352 ofdecision logic1350. In some variants, an instrument orother device1340 as described herein may handlevarious data1343,1344;identifiers1345;indications1346; orother information1341,1342 as described herein for generating and/or responding to evaluation requests or other such remote invocations.
• With reference now toFIG. 14, shown is a system in which one or more technologies may be implemented, avehicle1470 or otherprimary module1400 configured to display or otherwise transmitoutput1485 and/or to interact with one ormore storage devices1492 innetwork1490.Primary module1400 may include or otherwise handle one or more instances ofdecision logic1460;notices1471,1472;transmitters1473;local devices1474; orinterfaces1475 as described herein.Decision logic1460 may include one or more instances ofdetection modules1411;invocation modules1412;comparators1431,1432,1433 orother processing modules1430; orother modules1441,1442 configured to perform or otherwise generate decisions upon images orother data1451,1452,1453 or othersuch information1455,1456,1457;measurements1458; or othersuch determinant data1459.Primary module1400 may archive such decisions or other data remotely upon one or moresuch storage devices1492, in some implementations as described herein, and/or may retrieve pathological models, thresholds, or other such programmatic information remotely from one or moresuch storage devices1492.
• With reference now toFIG. 15, shown is asystem1500 in which one or more technologies may be implemented for relaying or otherwise notifying one ormore destinations1591,1592 (in anetwork1590 of care providers, e.g.) of one ormore results1521,1522,1523,authorizations1538, or othersubstantive communications1539. In some variants, for example, one ormore modules1531,1532,1533,1534,1535 ofevaluation logic1530 may generate orselect content1581,1582 and/ordestinations1583,1584,1585 ofsuch communications1539 orother notifications1580 in response totemporal indications1541,1542 or othersuch data1551,1552,1553. In some variants, for example, such evaluation logic may generate or otherwise facilitate such communications orother notifications1580 by applying one ormore thresholds1561,1562;criteria1571,1572,1573; orother filtering data1570 as described herein to symptom-indicative or other subject status data as described herein.
• With reference now toFIG. 16, shown is a system in which one or more technologies may be implemented, for example, on an implantable chip or other apparatus suitable for long-term operation in a close vicinity of a subject. Aprimary module1600 may comprise one or more instances ofresponse modules1620;processing modules1650,1680;antennas1688, linkingmodules1690, or other components suitable for bearingsignals1693; orother media1695 configured to hold or otherwise bearimages1697 orother attributes1699 of potential relevance to a subject's status.Response module1620 may include one or more instances ofterm recognition modules1625 orother modules1621,1622 operable for handling one ormore parameters1624.Processing modules1650,1680 may be configured to apply one ormore thresholds1651,1652,1653,1654, for example, and/or to hold one ormore readings1681,1682 in aregistry1685.
• In some variants, one or more such media may be configured to contain images or otherwise handle shape-indicative data. Other such embodiments are described, for example, with reference toFIGS. 9,35,52,74,75,77, and79.
• With reference now toFIG. 17, shown is a context in which one or more technologies may be implemented, for example, for using asystem1700 to examine tissue1725 in one ormore limbs1721,1722 of a subject1720.System1700 comprises one ormore transducers1767 supported on a hand-heldinstrument1760 operably coupled to an external module as shown herein via a continuous signal-bearing conduit1765. In some variants, such examination may be facilitated by one ormore sensors1733 in or on such tissue, optionally comprising animplant1730 and/orresponse logic1735 configured to process or otherwise respond to sensed data therefrom even before becoming operable to forward any indication of the data totransducer1767.
• With reference now toFIG. 18, shown is asystem1800 in which one or more technologies may be implemented that include one ormore instruments1850 configured to position one ormore sensors1851 subcutaneously withintissue1875 ofbody part1871, for example. Variant configurations of commercially-available probes or other such instruments may be used to implant one ormore sensors1851, dispensers, or other such modules throughskin1876 of subject1870 via one ormore probes1855, for example, adjacent or extending intovessel1879. Such configurations may (optionally) be configured, for example, to detect one or more attributes of and/or administer one or more treatments viablood1873. Laparoscopic and thoracoscopic systems suitable for accessing a vasculature are in common use, for example, and readily adapted to implement various configurations described herein without undue experimentation.
• With reference now toFIG. 19, shown is asystem1900 in which one or more technologies may be implemented, such as for one ormore body parts1920 of subject1910 to interact withinterface logic1970 via one or more hand-heldinstruments1960. As shown,body part1920 contains one ormore vessels1929bearing blood1923 into or out oforgan1927. One or more chips orother implants1940 may be positioned under the subject'sskin1926 intissue1925adjacent vessel1929, and optionally extending into the vessel(s).Implant1940 may (optionally) include one ormore sensors1942 as described below and/or one ormore antennas1943 operable for receiving and/or transmitting data alongwireless data path1945 as shown.Interface logic1970 may include one or more instances ofdetectors1980 and/ortransducers1990 such asultrasound sensors1981 orinfrared sensors1982. Alternatively or additionally,detector1980 may include special-purpose software1974 or othersuch measurement logic1975 configured to handle configuration, control, measurement, orother data1978,1979 as described below.
• With reference now toFIG. 20, shown is asystem2000 in which one or more technologies may be implemented, such as for observing one or more attributes ofbody parts2071,2072 of subject2070 via one or more respectiveadhesive patches2031,2032 on the subject'sskin2006.Adhesive patch2032, for example, holds anarray2025 ofsensor elements2021,2022 in close contact withskin2006 so that attributes ofsubcutaneous tissues2005,vessels2009, orblood2003 or other such materials may be observed. In some contexts, for example, such anarray2025 may implement combinations of two or more types of sensors and/or related logic as exemplified in relation toFIGS. 23-26 below. In some variants, for example, one or moresuch elements2021,2022 may also include a configurable colorant, a light-emitting diode, or other such external feature detectable by aclinician2010 and/or by aninstrument2050 that contains acamera2056 or other optical sensor.
• An embodiment provides one ormore elements2022 configured as circuitry for deciding whether to transmit one or more blood clot indications (detected with reference, for example, to one or more components sensed withinblood2003 by element2021) and anadhesive patch2032 comprising one or more tensile elements configured to holdsuch elements2021,2022 ofarray2025 in tight contact withskin2006. (Other such embodiments are described, for example, with reference toFIG. 3 or27.) Such embodiments may be used, for example, in a context in which eachcontact element2021,2022 comprises a gel-filled capsule or otherwise includes a liquid-containing medium configured to facilitate acoustic energy passing to or from subject2070.
• In some variants, system components described herein may be configured to include adhesive, fluid, electrically conductive, and/or other special-purpose substances facilitating effective skin contact. Other such embodiments are described, for example, with reference toFIGS. 21 and 32. Alternatively or additionally, system components described herein may be configured to facilitate positioning one or more sensors in contact with or in close proximity to a subject's skin. Other such embodiments are described, for example, with reference toFIGS. 9-11.
• With reference now toFIG. 21, shown is a system2100 in which one or more technologies may be implemented, such as for detecting one or more attributes ofblood2103 invessels2109, for example, orskin2106 orother tissues2105 inbody part2171. A hand-held orother probe2140 may include one ormore sensors2141 or othersuch elements2142 operable for detecting such attributes through one or more liquid-containingcontact enhancement materials2149. Such materials may facilitate energy transfer throughskin2106, in some variants, or various modes of chemical detection as described herein.
• With reference now toFIG. 22, shown is anetwork2215 operable for facilitating communications among one or more interfaces2210 (of aclinician2205, e.g.), one ormore servers2220, or one or more local systems2240 (via one ormore media2225, e.g.). (In some embodiments described herein,sensors2268 or other such artificial structures are “local” if they are configured to extend into adetection proximity2277 of one ormore parts2271,2272 of a subject2270 of interest.) As shown,local system2240 may likewise include one or more instances ofdecision logic2250;results2251,2252;communication ports2255,2256; or interfaces2260.Decision logic2250 may include one or more instances ofnotifications2241,2242,instruction sequences2243 orother modules2244,2245, orother parameters2247,2248,2249 as described below.Interface2260 may relay auditory instructions or other such data for use by subject2270 via one ormore speakers2267 or other output devices. Alternatively or additionally,interface2260 may receive measurements orother indications2261,2262,2263,2264 as well asother determinant data2265 from and/or relating to subject2270. In some variants,local system2240 may be configured to facilitate such interchanges with subject2270 even when only aremote clinician2205 is available and/or without any contemporaneous involvement with such remote expertise. In some variants described herein, for example, another local system or other intermediary system withinnetwork2215 may decide whichnotifications2201,2202 are suitable in response to a programmatic interaction protocol (with a subject2270 and/or other individuals, for example, undergoing a triage or other intake) or othersuch determinant data2265.
• In some embodiments, instructions or other software “relating to” data can include executable code that belongs to a class relating to a class of the data (e.g. “video processing” code relating to “video” data, or “text” data relating to code in a messaging device or other text handling module). The code, data, or class can have a type with a common aspect (e.g. “video” in the type name) or can be related by a table entry (e.g. indicating the code or code type to be used for the data or data type). Code can also relate to data by virtue of a code module call or other invocation containing at least an indication of the data.
• In some variants, such local systems may be configured to notify or otherwise interact with care providers or other resources across a foreign or other communication network. Other such embodiments are described, for example, with reference toFIGS. 5,13,14,15,29,35,52,74,75, and78.
• With reference now toFIG. 23, shown is alocal module2320 in which one or more sensor technologies may be implemented, such as for monitoring a device or region, or other such tasks as described herein. In some embodiments as described herein, such modules may include one or moremicrowave frequency sensors2321, optionally configured to generate an indication of moisture or related symptoms in or on a subject's body. Alternatively or additionally,local module2320 may include one ormore fluorescence sensors2322, optionally configured to generate an indication of one or more artificial markers in or on specific tissue. (In many contexts, for example, such markers may be used for monitoring targeted physiological constituents and/or pathogens.) Such modules may likewise include one ormore impedance sensors2323, optionally configured to generate subject respiration rate indications, to detect fractures or other changes in electrode contact surfaces or other such artificial structures, or to detect other such circumstances relating to a subject of interest. Alternatively or additionally,local module2320 may include one ormore conductivity sensors2324, optionally configured to monitor sweat, apparent urinary incontinence, or other such external circumstances and/or (internally) to monitor blood flow, electrolyte levels, or other such internal conditions. Such modules may likewise include one or moreelectric field sensors2325 in some variants as described herein, optionally comprising (a) an implanted sensor configured to monitor nerve traffic, (b) an implanted or contact sensor configured to transmit electrocardiogram signals, brain activity indications, or other such status information about a subject. Alternatively or additionally,local module2320 may include one or morecarbon dioxide sensors2331 orother respiration sensors2332, optionally comprising a sensor implanted adjacent a target site and configured to monitor one or more indications of concentration, for example, to detect apparent occlusions of a blood vessel near the site. Such modules may likewise include one or more instances ofevent detection logic2333,pathogen detection logic2334, or othercondition detection logic2335 such as for comparing raw output from sensors as described herein with prior or other sensor output, with threshold values to determine an apparent occurrence of an event, or with other condition attributes as described herein for triggering notification or therapy. In some embodiments, several or all of such items may be included in a single instance oflocal module2320.
• In some variants, such local modules may be configured to illuminate, exert force upon, or otherwise pass energy into a subject skin. Other such embodiments are described, for example, with reference toFIGS. 11 & 24.
• With reference now toFIG. 24, shown is alocal module2450 in which one or more sensor technologies may be implemented, such as for monitoring a device or region, or other such tasks as described herein. In some embodiments as described herein, such modules may include one ormore accelerometers2461, supported in a fixed relation to a target area, optionally configured to generate an indication of the activity, motion, and/or orientation of the subject and/or region. Alternatively or additionally,local module2450 may include one ormore radioactivity sensors2462, optionally configured internally or externally to generate an indication of one or more artificial markers in or on specific tissue. (In many contexts, for example, such markers may be indicative of levels of administered therapeutic components, rates of adsorption or elimination of components, exposure levels to external radioactive materials, or other pathological or other biological processes.) Such modules may likewise include one or moreradio frequency sensors2463, optionally configured to facilitate communication to, from, or between implanted or external devices, and/or to detect lung- or other such organ-status-indicative information in circumstances in which coupling via a continuous conduit may be undesirable. In some variants,local module2450 may contain one or moremetabolic sensors2464, optionally configured as an implanted device or an external component configured to monitor the subject or region (ex situ or otherwise) and to generate an indication of uptake, breakdown, elimination, and/or other such metabolic processes relating, for example, to therapeutic materials as described herein. In some contexts, for example, such a metabolic sensor may be configured to indicate a generation and/or elimination of other components resulting from the breakdown of therapeutic components, the use or generation of physiological constituents resulting from glucose transforming into carbon dioxide or other such metabolic processes. Such modules may likewise contain one or more physiologicalconstituent sensors2465, optionally comprising an implanted or other sensor configured to generate an indication of physiological constituent levels observed in a subject or subject region. This may include items such as chemical components (e.g. calcium, sodium, cholesterol, pH), proteins and protein complexes (e.g. hemoglobin, insulin, binding proteins, antibodies) and/or structures (e.g. red and/or white blood cells, bacteria, viruses, platelets).
• Alternatively or additionally,local module2450 may likewise (optionally) include one ormore flow sensors2471, which may be configured to generate an indication of fluid flow in or across a region of interest. (In many contexts, for example, such phenomena as blood flow through a vein or artery, urine flow through a urethra, bile flow through a bile duct, or other fluid flow from one region to another may be monitored.) Alternatively or additionally,local module2450 may include one ormore motion sensors2472, optionally configured internally, externally, and/or remotely to give an indication of the motion and/or activity of a device or a portion of a subject. Such modules may likewise include one ormore emission sensors2473, optionally configured to internally or externally give an indication of subject or region status such as using emitted infrared wavelength and intensity levels as an indication of subject or region temperature. Other emission processes may be used to monitor artificial markers in or on tissue, for example, for monitoring specific tissue features, processes, constituents, and/or pathogens. Alternatively or additionally,local module2450 may include one or moregas pressure sensors2474 configured to monitor ambient pressure levels, applied pressure levels (in hyperbaric chambers, continuous positive airway pressure machines, respirators, or other such artificial devices) and/or pressure levels observed in a gas-filled support structure. (In some variants, pressure may likewise be indicated by a variety of indirect measures such as blood vessel thickness, pulse energy, position, noise, or other physical phenomena correlated therewith.)Local module2450 may likewise include one ormore position sensors2481 configured to monitor subject and/or region orientation. Alternatively or additionally,local module2450 may include one or morefluid pressure sensors2482, optionally configured to transmit or otherwise respond to physiological fluid pressure (aneurysm sac pressure or cranial pressure, e.g.) or external fluid pressure (as an indication of delivery amount and/or proper function in a therapeutic delivery system, for example, or in a fluid-filled support structure as described herein). Such modules may likewise contain one or morefluid volume sensors2483, optionally configured to give an indication of fluid volumes within a subject or region such as blood volume in a heart chamber, artery, or lung (as a measure of disease progression or risk, e.g.). Alternatively or additionally,local module2450 may include one ormore force sensors2484, optionally configured (a) to generate a pressure reading or other indication of force applied to a region (as a measure of tissue rigidity, e.g.) or (b) to indicate glaucoma, compartmental syndromes, abnormal structures, or other such potential pathologies. Such sensors may also be used as an indication of the force applied by a subject and/or region on a support structure to monitor subject activity levels and/or to give an indication of susceptibility to force/pressure related injuries such as pressure ulcers. Such modules may likewise contain one or moresonic sensors2495, optionally configured to enable communication to, from, and/or between implanted devices, for the recognition of sonic patterns such as heart rate, respiration rates, voice commands and other verbal input (via one or moresonic pattern sensors2491, e.g.) or of a subject's potential exposure to external stimuli (via one or moresonic volume sensors2492, e.g.). In some embodiments, several or all of such items may be included in a single instance oflocal module2450.
• With reference now toFIG. 25, shown is alocal module2510 in which one or more sensor technologies may be implemented, such as for monitoring a device or region. In some embodiments, such modules may (optionally) include one ormore temperature sensors2512, optionally configured to give an indication of ambient thermal conditions around a subject and/or systemic or local thermal conditions of the subject. (In some embodiments, “systemic” information may refer generally to current measurements, body temperature or other such status information, or other data reflecting one or more attributes of a subject as a whole. “Local” information, by contrast, may describe measurements, images, or other such data conventionally pertaining to an identifiable portion of a subject's body.)
• Such modules may be implemented using one ormore thermocouple sensors2531, for example, in implanted and/or direct contact devices. Thermal probes may likewise be implemented as optical sensors that are implanted, direct contact, and/or remotely operable. Alternatively or additionally,local module2510 may include one or moreblood pressure sensors2513, optionally configured to give an indication of peripheral and/or systemic blood pressure of a subject. Such modules may be configured to incorporate one or morefluid pressure sensors2482 orconductivity sensors2324 in some implanted contexts. Alternatively or additionally, one ormore force sensors2484 and/or ultrasound sensors2541 (ofultrasound scanner2540, e.g.) may be configured in a transdermal mode, for example, to generate information indicative of blood pressure.Local module2510 may likewise include one or more nearinfrared sensors2522 and/orinfrared sensors2523 sensors, optionally configured to determine local oxygenation levels or other such chemical and/or material properties of body tissues or fluids as described herein. Such sensors can likewise be configured astransmittance sensors2521, for example, receiving radiation that has passed through a subject fingertip or earlobe, or in other such short-path contexts such that the opacity of a tissue region allows for sufficient incident radiation to pass through it to form a usable image. Alternatively or additionally,local module2510 may comprise one ormore reflectance sensors2511 configured to emit energy into tissue and to capture a portion of the energy reflected.
• In some variants,local module2510 may contain one ormore activity sensors2532,weight sensors2533 and/ortissue pressure sensors2536, optionally configured to give an indication of subject activity, motion, or other information indicative of systemic or local physical status. Such modules may likewise include one or moremagnetic field sensors2547, optionally configured to allow for the control and/or inhibition of implanted devices transdermally. Alternatively or additionally,local module2510 may include mass-indicative or otherelectrochemical sensors2548, any of which may (optionally) be configured to give an indication of physiological constituent levels such as by incorporating ion-selective electrodes2551 (ofion sensor2550, e.g.) or other concentration-indicative sensors2560 for the monitoring of potassium, sodium, calcium, and/or other physiologically relevant components (atpH sensor2561 or other concentration-indicative sensors2560, e.g.). In some variants,electrochemical sensors2548 can be used in a faradaic mode to monitor levels of other relevant physiological components such as blood glucose levels, neurotransmitter release, blood oxygen levels, or other useful components either in an implanted setting and/or a contact setting (in which the sensor is inserted through the skin to the detection site, for example, or the target molecules can be isolated from the subject and detected externally. Such modules can also use one or moreelectrochemical sensors2548 and/or optical sensors2525 (includingfluorescence sensors2322,emission sensors2473, near-infrared sensors2522, or infrared sensors2523) individually or in combination to provide information for the monitoring of a drug substance administered to the subject (such asdrug sensor2562, e.g.).Local module2510 may also implement one ormore timestamps2544, location coordinates2545, or othersuch indices2546 relating to measurements or other aspects of subject status information. In some embodiments, several or all of such items may be included in a single instance oflocal module2510.
• With reference now toFIG. 26, shown is alocal module2690 in which one or more technologies may be implemented, optionally within a sensor, sensor-containing module, or other local instrumentation. Any oflocal modules2320,2450,2510 may (optionally) include one or more instances of differential orother comparators2670 configured to process one or more instances of real-time data2681,historical data2682, force-indicative data2683, pathology-indicative data2684,measurement data2685 using one ormore standards2671,thresholds2672, orother input2673. Those skilled in the art will recognize, for example, how to apply one ormore thresholds2672 configured to implement conditional retention, conditional transmission, or other such selective treatment to pressure-indicative, shear-indicative, strain-indicative, stress-indicative, deformation-indicative, acceleration-indicative, or other such force-indicative data2683 in light of teachings herein.
• With reference now toFIG. 27, shown is asystem2700 in which one or more technologies may be implemented for periodically or otherwise monitoringskin2774 orsubcutaneous tissue2775 of a subject2780 via one ormore sensor elements2760. One or more such modules may be remainadjacent tissue2775, for example, by hand, by gravity, by one ormore media2740, and/or by one or more straps or othertensile elements2750 as described herein. In some variants, for example, one or moresuch media2740 may contain agel2741, a bioadhesive, a liquid2742, a therapeutic material, apolymer2743, a carrier, or other such components as described herein. Alternatively or additionally,element2760 may include one or more instances ofdispensers2762 configured to inject such media so that they spread into direct contact with one ormore sensors2765. Alternatively or additionally, one or moresuch sensors2765 may transmit energy indicating one or more physical phenomena intissue2775 to one ormore elements2721,2722, software,indications2725, ormodules2726,2727,2728,2729 ofdecision logic2730 as described below.
• An embodiment provides a variant ofdecision logic2730 configured as circuitry for deciding whether to transmit one or moreblood clot indications2725, for example, and a liquid-containing medium2740 configured at least to facilitate acoustic energy passing between subject2780 and one ormore sensors2765 of thedecision logic2730. In some embodiments, data may be captured from a direct or indirect interaction between a device and a user that also involves other users or devices. Such devices may relay information passively between the user and the device, for example, or may constitute additional embodiments of teachings herein. In some embodiments, an intercommunication “between” a device and a user can include a session at a network terminal, retrieving messages, receiving tactile feedback from actuating an electromechanical device, having a telephone conversation, or other electrical, optical, auditory, or other information flowing from a source to a destination, with some information also flowing to the source. Alternatively or additionally, the intercommunication can include a “forward” and “reverse” flow that include common information, that are causally related, that flow along a common conduit, or that are at least partly simultaneous. In some embodiments, the “device” can include a memory, a display, a transducer, or some other data handling capability. Other such embodiments are described, for example, with reference toFIG. 4 or23-26 above.
• Some implementations include one ormore polymers2743 orother liquids2742 configured to adhese at least some of thedecision logic2730 in contact with or otherwise within a close proximity to subject2780. Such sensors may (optionally) include a conductivity sensor and/or other sensors, as well as (a variant of)condition detection logic2335 configured to infer a presence of the liquid-containing medium in response to a low-enough electrical resistance measurement. In some variants, each instance ofelement2760 may implement one or more instances oflocal modules2320,2450,2510,2690 as described herein. Such embodiments may further comprise one ormore dispensers2762 configured to dispense a supplemental amount of the liquid containing medium and/or a therapeutic material.
• A variant embodiment provides special-purpose software2723 orother decision logic2730 implementing circuitry for deciding whether to transmit one or more blood clot indications and one or more elastomeric or other tensile elements configured to exert force upon one ormore sensors2765 of thedecision logic2730 toward subject2780. (Other such embodiments are described, for example, with reference toFIG. 6 or20.) Such embodiments may be used, for example, in a vehicle or other context in which one or more lengths of a woven fiber or other seat material are under tension. In some variants, such tension may be measured, for example, by a force sensor of the tensile elements (optionally configured, for example, like sensor2770). In some variants,decision logic2730 may include an executable instruction sequence orother modules2728 configured to capture and/or evaluate one or more ultrasound images indicative of the one or more blood clot indications. Alternatively or additionally,decision logic2730 may include animplantable antenna1943, avehicle antenna278, or other such wireless communication conduits configured to transmit information from one ormore sensors2765. In some variants,decision logic2730 may also include or otherwise receive data from one ormore flow sensors2471, one ormore respiration sensors2332 or other concentration-indicative sensors2560, or other sensors or related logic described above with reference toFIGS. 23-26.
• In some variants, such decision logic may be implemented in worn articles. Other such embodiments are described, for example, with reference toFIGS. 12,17,25,29, and32. In some variants, local modules or other sensor-containing components may (optionally) be configured to include one ormedia2740 and/or other special-purpose substances facilitating effective skin contact. Other such embodiments are described above, for example, with reference toFIGS. 21-26.
• With reference now toFIG. 28, shown is an example of a system that may serve as a context for introducing one or more processes and/or devices described herein. As shownsystem2800 may affect or otherwise relate to one ormore sections2840 or other “upstream”portions2846 of a human or other living subject's vasculature2896 (receiving inflow2801) and also to one or more “downstream”portions2876 of such vasculatures2896 (bearing outflow2899). One ormore sections2840,2860 as shown may comprise one or more of capillary beds, tissues served byvasculature2896, or other blood vessels.
• In some variants, one or more intravascular orother modules2850 may (optionally) include one or more instances ofreceivers2825,transmitters2826, orother interface logic2820 such as for communicating (in one or both directions) with one ormore sensors2810 operable for monitoringupstream portion2846.Module2850 may likewise include one or more instances pumps2827 or other hardware controlled by dispensinglogic2830 for selectively releasing one or more (biological, radiotherapy, or other)agents2841 or othertherapeutic structures2842 intoupstream portion2846. Such module(s)2850 may also be configured, in some contexts, by including one or more software orother modules2833 of dispensinglogic2830 comprising one or more instances of port controls2831, (dispensing or other therapeutic)regimens2832, ormessages2834 as described below.
• As shown,system2800 may comprise one ormore modules2850 upstream operable for communicating (in one or both directions) with one or more intravascular orother modules2890 downstream, optionally in an integral and/or implanted structure as shown. Alternatively or additionally,module2890 may include one or more instances ofcapture agents2867,2868 or othertherapeutic agents2869;receivers2878;sensors2879; capturelogic2880 operable for controlling one ormore actuators2881, such as for optically or otherwise controlling the capture agent(s); pumps2887; ordisposals2888,2889. As shown, for example,disposal2889 may include one ormore ports2882 operable for accelerating a decrease in a local concentration of the agent(s)2841 or other therapeutic structure(s)2842 along portion2876 (downstream fromdispensation2897, as shown) by allowing the structure(s) to pass into one ormore conduits2886 traversing one ormore vessel walls2883,2884. One ormore vessels2885 configured to receive the structure(s) may include, in some embodiments, an esophagus or other natural vessels, implanted artificial vessels, or ex situ vessels.
• With reference now toFIG. 29, shown is an example of asystem2900 that may serve as a context for introducing one or more processes and/or devices described herein, optionally configured to interact withnetwork2995. As shown system includes one ormore modules2972,2973,2974,2977,2978 ofdecision logic2975,2976; one ormore transmitters2980; and/or one ormore parameters2984,2985 ofstimula2981 selected to facilitate one ormore sensors2982 obtaining sensedvalues2986,2987 or othersuch test data2989 about an individual or subpopulation to be monitored.System2900 may also include or otherwise interact with one or more instances ofinstruments2930 configured to obtain data from subject(s)2920, user interfaces2952 configured to interact with decision makers or expert resources, orhandheld devices2961 or othersuch interfaces2962 for relayinginput2965 to or from other such parties.
• One ormore instruments2930 in a vicinity of subject2920 may include, for example, one or more instances ofidentifiers2923 orother data2921,2922 about subject2920 obtained via one ormore interfaces2926 and/orsensors2927. User interface2952 may likewise present visual orother output2953 and/or receive keyed orother input2954.Response logic2970 as an entity may receive and/or transmit a variety ofcommunication2935 orother data2955 for or fromnetwork2995, in some contexts, as exemplified below. In various examples below, for example, one or more such subjects, caregivers, or others are potential message or other notification recipients. Some such entities have a priori information associating a subject identifier or other indicator withcurrent communications2935 or other data as described below.
• Some variants ofdecision logic2975,2976 may be configured to combine data effectively from two or more subjects, for example, to facilitate comparison at one or more user interfaces or servers. Other such embodiments are described, for example, with reference toFIGS. 2,3,13,22,25,26, and74.
• With reference now toFIG. 30, shown is an example of aninterface3000 that may serve as a context for introducing one or more processes and/or devices described herein.Interface3000 comprises one ormore media3040 configured to contain or otherwise handle one or more tables3010 or other such informational structures3020;notifications3051,3052;modules3061,3062,3063,3064,3065 orother processing logic3070;indications3081,3082 ormeasurements3085; and/or othersuch data3090. Table3010 may include one or more instances ofdecisions3004,indications3005, or other such information in each of one or morecommon records3011,3012,3013. In a context in which structure3020 includes one or more subjects' medical histories, study data, or other such content, a search agent or other such entity may use one ormore indicators3021,3022,3023,3024 orother criteria3025 to retrieve suitable information. One ormore identifiers3034 and/or othersuch criteria3035 may be used in asearch term3030, for example, in a variety of bots, web crawlers, search engines, or other such implementations.
• With reference now toFIG. 31, shown is an example of a network orother system3100 comprising one or moreprimary modules3180 operatively linked to one or moreremote modules3190.Remote module3190 may include or otherwise handle one ormore indications3181,3182,3183,3184,3185,data filters3189, orcomparators3198 ofevaluation logic3197.Primary module3180 may comprise a vehicle or othersuch item3150 configured to include or otherwise handleinvocation logic3140 comprising one ormore modules3141,3142,3143 responsive totiming3111,3121 orother indications3115,3125 ofrecords3110,3120;measurements3131,3132;results3136,3137; and/or hybrid orother indications3130.Primary module3180 may likewise apply one ormore values3155 as data filters3151,3152, or may apply one or moreother values3161,3165;thresholds3167; or othersuch filtering information3170 for determining whether one ormore parameters3168 warrant a response as described herein.
• With reference now toFIG. 32, shown is an example of asystem3200 including afiltering modules3210 configured to processdeterminant data3240 about one ormore body parts3271,3272 of subject3270. Such data may be received, for example, via one or more sensors3284 of one or more apparatuses3290 affixed, such as by one ormore adhesives3282, to body parts3272 of interest. In some variants, for example,detection logic3285 produces one ormore results3231,3232,3233,3234,3235,measurements3238, and/ortiming data3239 by generating an extraction ofdata3261,3262,3263 that complies with one or more retention and/ortransmission criteria3287. Alternatively or additionally, one ormore modules3221,3222,3223 orother decision logic3230 may be configured to applycriteria3225,3226,3227 for selectively generating one or more aspects ofnotifications3211,3212,3213 orother results3236.
• With reference now toFIG. 33, shown is an example of asystem3300 including an in-dwelling catheter orother instrument3355 suitable for transvascular placement. In some variants, for example,instrument3355 may couple with a bifurcated catheter orother conduit3354 suitable to administer one or moretherapeutic materials3340 locally to atreatment site3371 via one or more capillaries and/or othersmall vessels3378. As shown,site3371 may include some or all of an afflicted organ orother target mass3370 served by avasculature3365 of subject3360. In some variants, for example, intermediate-size vessels3372 may include arterioles through which material passes. Alternatively or additionally, a clamp or other suchcontrollable occlusion structure3356 occludes at least some flow between a vein or otherlarge vessel3379 and an injection site (segment3373, e.g.).
• An embodiment provides such a transvascular dispenser configured to administer atherapeutic material3340 containing anartificial component3330 locally, and in which the therapeutic material(s)3340 contain dioxygen3311 inoxyhemoglobin3323 ofblood3325, for example, or in acarrier3315. In some variants, oxygen-charged perfluoroheptane may be used, for example, in a context in which a majority of such material may be kept out of general circulation (supplying oxygen by injection and withdrawal oftherapeutic material3340, e.g.). Such therapeutic materials may, for example, include one ormore toxins3331,antineoplastic agents3334, heparin orother anticoagulants3335,nitric oxide sources3336,hormones3337, orother drugs3339 or therapeutic materials that may be delivered via a vasculature.
• Another embodiment provides an extravascular or otherartificial occlusion structure3356 operable to impede a flow exiting asegment3373 of a vasculature (intovessel3379, e.g.) and aninstrument3355 or other artificial structure operable to administer atherapeutic material3340 locally to thesegment3373. In some embodiments, such a structure may be used for limiting damage to kidneys or other systemic filtration organs.
• Another embodiment provides a bifurcated needle or othersuitable dispensation conduit3354 adapted to administer atherapeutic material3340 locally via (venules or other) intermediate-size vessels3372 to (capillaries or other small)vessels3378 and tosite3371. Such conduits may, in some contexts, comprise or otherwise access a reservoir operable for dispensingtoxins3331 or other dangerous dosages locally, some of which may then be absorbed intosite3371 and/or recaptured, for example, back intoconduit3354. In some variants, for example,therapeutic material3340 may include one or more of dioxygen3311 in one or moreartificial carriers3315 and/oroxyhemoglobin3323 borne inblood3325.Therapeutic material3340 may likewise include one ormore toxins3331 and/or sources ofantineoplastic agents3334 oranticoagulants3335 or (supplemental quantities of)nitric oxide3336,hormones3337, orother drugs3339. Such embodiments may also include imaging or other sensing components and/or control or communication components as described herein. Other such embodiments are described, for example, with reference toFIGS. 17-32 or34-43.
• With reference now toFIG. 34, shown is an example of a context in which one or more technologies may be implemented, a quasi-schematic representation of avasculature3465 of a mammal or other subject3400. Two or more systemic or otherarterial segments3410,3420 receive respective blood flows3401,3402, which then diverge into smaller vessels and then torespective capillary beds3450,3460,3470, one or more of which may include asite3471 of interest for a local treatment. After a nutrient/waste product exchange, blood may exit one or moresuch beds3470 via one ormore venules3495,3496 typically converging intolarger flows3488,3499 exiting respectivevenous segments3480,3490. In some variants, for example, one ormore sites3471 may receive a local treatment via backflow from one or moreartificial structures3455 that include one or more transvascular or intravasculardistal portions3456 extending within a venule and/orvenous segment3490 as shown. In some variants, injectors or other such structures may be configured to administer a therapeutic material into a vessel within a proximity of one or more occlusion structures operable for blocking most or all of such a flow.
• With reference now toFIG. 35, shown is an example of asystem3500 that may serve as a context for introducing one or more processes and/or devices described herein.Unit3510 ofsystem3500 may include one ormore conduits3504 configured to dispensetherapeutic material3520 from one ormore reservoirs3508. Suchtherapeutic material3520 may includeoxyhemoglobin3523 or other such sources of dioxygen in a pharmaceuticallyacceptable carrier3524, for example, that may also include one or more supplemental or other artificial components3525 susceptible to injection or other vascular administration.
• In some variants,unit3510 may be configured to include or otherwise interact with one ormore units3540 comprising one or more instances ofnotification logic3535,imaging apparatuses3536, and/or sensor-containingprobes3537 configured to detect physical phenomena on or in a subject's body. In a variant containing each, for example,imaging apparatus3536 may be configured capture one ormore images3534 viaprobe3537. Alternatively or additionally, for example,notification logic3535 may include one or more such images with one ormore notifications3533 to be transmitted tonetwork3545 as shown.
• Alternatively or additionally,unit3510 may likewise be configured to include or otherwise interact with one or moreother modules3551,3552,3553 ofdetection logic3550 configured to invoke one or more modules of responsive logic as exemplified herein. In some variants, for example,unit3560 may include such modules as described herein with reference toFIG. 2,6,8,15, or83-119.
• Alternatively or additionally,unit3510 may (optionally) be configured to interact with one or moreblood filtration devices3576,absorption ports3577,dispensation ports3578 configured to dispense active agent inhibitors, or other suchartificial units3580 effectively configured to extract someportion3511 oftherapeutic material3520 out of a vasculature. (Apart from such portions, for example, aremainder3512 of such material may be metabolized, captured locally in tissues, and/or otherwise handled by natural processes.)
• An embodiment provides one ormore units3510 as artificial structures configured to administer atherapeutic material3520 containing at least anartificial component3530 via one or more capillaries of a vasculature locally and one ormore units3580 as artificial structures configured to extract a portion of the therapeutic material out of the vasculature. One or moresuch units3510 may (optionally) include one ormore conduits3504 configured to administer thetherapeutic material3520 via one or more venules of the vasculature locally to one or more capillaries of the vasculature. See, e.g.,FIG. 34. In some variants, such aunit3510 may include one ormore reservoirs3508 containing at least a (systemically) lethal amount ofartificial component3530, which amount which may be dispensed locally and then extracted inportion3511. Alternatively or additionally, such a unit may comprise an antineoplastic agent dispenser. Alternatively or additionally, such anartificial component3530 may include a supplemental or other quantity of a hormone effective for a therapy uponsite3471, for example. In some variants, the embodiment may further include aprobe3537 or other structure configured to facilitate positioning at least a distal portion ofconduit3504 through an arterial segment of the vasculature. Alternatively or additionally, such an embodiment may include one ormore units3580 configured to extract someportion3511 oftherapeutic material3520 physically out of a vasculature or otherwise to filter a blood flow. Alternatively or additionally, the embodiment may includemodule3551 configured as circuitry for detecting a release oftherapeutic material3520 and/ormodule3552 configured as circuitry for detecting a presence oftherapeutic material3520. Other such embodiments are described, for example, with reference toFIGS. 10,11,19, and20.
• An embodiment provides an in-dwelling catheter or otherartificial structure3455 comprising atleast unit3510 configured to administer atherapeutic material3520 containing oxyhemoglobin3523 (or some other form of dioxygen acceptable for administration to aliving subject3400 via a vasculature) and anartificial component3530 locally to atreatment site3471 via one or morecapillary beds3470. (Other such embodiments are described, for example, with reference toFIGS. 24 and/or33.) In some contexts,unit3510 may further include one or more of aflow sensor2471, aforce sensor2484, asonic sensor2495, an in-dwelling catheter comprisingdistal portion3456, a pressure sensor, or other implantable components as described herein. Some variants may further include or otherwise interact withunit3540, which may comprise one or more instances ofnotification logic3535 configured to transmit anotification3533 relating to the first unit3510 (via a network as described herein, e.g.),imaging apparatuses3536 configured to facilitate positioning some or all of unit3510 (locally to and) upstream or downstream from atarget treatment site3471, or aprobe3537 for moving one ormore units3510,3540,3560,3580 into selected positions in or nearvasculature3465.
• A variant embodiment provides an artificial structure comprising one or more instances ofunit3510 configured to administer (an anticoagulant or otherartificial components3530 of)therapeutic materials3520 locally via capillaries. Another artificialstructure comprising unit3580 may include one ormore dispensation ports3578 configured to extract aportion3511 of the therapeutic material(s)3520 out of a vasculature, such as by “getter”-type removal. Alternatively or additionally,such units3580 may compriseabsorption ports3577 or otherblood filtration devices3576 configured to extractportion3511 of the therapeutic material(s)3520 physically out of thevasculature3465. Such configurations may permit such high dosages that areservoir3508 may contain a (systemically) lethal amount of theartificial component3530, in a context in which aremainder3512 will constitute a non-lethal dose. In contexts like that ofFIG. 34,unit3510 may further include one or moretransvascular conduits3504 configured to administertherapeutic material3520 via one ormore venules3495 of thevasculature3465 locally to the one or more capillaries.
• With reference now toFIG. 36 & 37, shown is an example of an endoscopic system that may serve as a context for introducing one or more processes and/or devices described herein. System3600 may include one or more elongate structures comprising one or more instances ofdispensers3635, thermal orother treatment elements3655, and/orballoons3654 guided at least partly along ablood flow3699 ofvasculature3665. Subsequently, atFIG. 37,therapeutic material3720 may be administered locally and/or one ormore balloons3654 or other occlusion structures may occludeflow3699 temporarily.
• An embodiment provides an occlusive structure operable to impede aflow3699 exiting one ormore segments3661,3662 of avasculature3665 and adispenser3635 and/orother treatment elements3655 operable to administer chilling or other therapies locally atsegment3662. (Other such embodiments are described, for example, with reference toFIG. 116.) The system may likewise include acontroller3620, optionally operable selectively to invoke one or more instances ofmodules3621 configured to trigger theballoon3654 or other occlusive structure to impedeflow3699;modules3622 configured to trigger thedispenser3635 or other therapeutic structure(s); and/ormodules3623 configured to trigger other such local intravascular therapies.
• With reference now toFIG. 38, shown is an example of a system that may serve as a context for introducing one or more processes and/or devices described herein. As shown,system3800 comprises a plurality ofdispensers3821,3831 operatively coupled with acontrol module3820 withinbody3830, positioned adjacent a forkedvessel3840 ofvasculature3805. As shown, adispenser3821 is configured to dispense a lytic agent through one ormore conduits3822 extending into an upstream portion ofvessel3840, the conduit(s) secured in place by a bioadhesive orother positioning feature3823.Dispenser3831 is likewise configured to dispense (at least) a lytic agent inhibitor through one ormore conduits3832 extending into a downstream portion ofvessel3840, the conduit(s) secured in place by asimilar positioning feature3833.
• With reference now toFIG. 39, shown is an example of a monitoring and/orcontrol instrument3900 configured to handle one or more instances of (one or more)indicators3971,3972,3973,3974 orother sensor data3970.Instrument3900 may, for example, comprise one or more instances of control logic3980 (such asmodules3981,3982), probes3987,imaging apparatuses3988, ornotification logic3991 operable for handling one ormore notifications3992 as described herein, optionally including one ormore images3993.
• In some variants, systems described herein may be configured to include transvascular or other implantable articles. Other such embodiments are described, for example, with reference to FIGS.33 and40-50.
• With reference now toFIG. 40, shown is an example of asystem4000 comprising one ormore dispensers4010,4020 configured to dispense materials (transvascularly) into respective branches of an artery or otherlarge blood vessel4005. Such dispensers may, in some variants, be secured in a vicinity of a vessel by one ormore sleeves4009 or other such positioning features. In response to one or more dispensation criteria as described below,control module4060 is configured to permit a fluid communication between apressurized reservoir4050 and one ormore plungers4041,4042 configured to actuate the respective dispensers.
• With reference now toFIGS. 41-44, shown is an operative example of an injector configuration suitable for use, for example, in dispensers like those ofFIG. 40. As shown inFIG. 41, aplunger4140 exerts force (leftward as shown) uponinjectable fluid4160 so thatneedle4132 slides along tapered body4130 (downward as shown). In response to pressure fromneedle4132 and/or fluid4245 (saline, e.g.), as shown inFIG. 42, acontainment film4287 breaks. As shown inFIG. 43,needle4132 piercesblood vessel wall4306. As shown inFIG. 44, a portion ofinjectable fluid4160 becomesdispensation4475 at a somewhat lower pressure than that initially present inpressure transfer fluid4446. In some variants,needle4132 comprises a blood-soluble portion coated with a film configured so that abrasion with taperedbody4130 exposes the blood-soluble portion. In others, a spring or other actuation mechanism may be used, optionally configured to withdraw a needle after the injection. Alternatively or additionally, an adhesive or other sealing mechanism may be applied at the point of injection.
• With reference now toFIG. 45, shown is an example of a system that may serve as a context for introducing one or more processes and/or devices described herein. As shownsystem4500 may affect or otherwise relate tovicinity4505,section4530,vicinity4535,section4570, andvicinity4575 of avascular lumen4595 through which one or more blood components may flow. One ormore inflows4501 of blood enter respective portions oflumen4595 as shown, pass throughsections4530,4570 and exit as one ormore outflows4599. In respective variants, arteries, veins, or smaller vessels oflumen4595 may traverserespective vicinities4505,4535,4575 as shown.Sections4530,4570 may likewise comprise one or more capillary beds as well as implants or other entities with which lumen4595 interacts.
• In some variants, one or moreupper modules4550 invicinity4535 may (optionally) send data to and/or receive data from one or more instances of intravascular orother sensors4510 invicinity4505.Upper module4550 may likewise comprise one or more instances ofmodules4513,4514 of dispensinglogic4515;dispensers4517,4518,4519;modules4521,4522 ofevaluation logic4520;transmitters4547,receivers4548, orother modules4541,4542,4543 ofinterface logic4540; ormodules4551,4552 ofresponse logic4555. Interface logic may handle data tooutput device4526 and/or frominput device4528 as well interacting with one or morelower modules4590.Lower module4590 may include one or more instances of microfluidic orother pumps4576,ports4577,dispensers4578,sensors4579, orsemi-permeable membranes4581 or othersuch modules4582 orvessels4583 ofextraction devices4580.
• With reference now toFIG. 46, shown is an example of a system that may serve as a context for introducing one or more processes and/or devices described herein. As shownsystem4600 may comprise alumen4695 comprising aheart valve4610 including anannular base4607 containing one ormore dispensers4616, aball4608, and one or moreupper modules4650 andlower modules4690 operatively coupled as shown.Upper module4650 may comprise one or more instances ofdispensation logic4615,evaluation logic4620, orwireless communication modules4644 orother interface logic4640 operable for communication with one or more user interfaces4625; for transmitting data to one ormore output devices4626 or receiving data from one ormore input devices4628 thereof as shown.Lower module4690 may comprise anoptical sensor4675, anauditory sensor4676, orother sensors4677; or pressure or force sensors or other a flow-force-responsive elements4678 orother elements4679 as described herein.
• An embodiment provides asystem4600 comprising dispensinglogic4615 orinterface logic4640 operable for signaling a decision whether to initiate implant-site-targeting treatment and one ormore dispensers4616 responsive to the decision. Eachdispenser4616 may (optionally) include a thrombolytic agent and/or other therapeutic materials as described herein, suitable for targeting a vicinity ofvalve4610. The above-described “signaling” circuitry may comprise one or more ofoptical sensors4675, auditory sensors, flow-force-responsive elements4678, or other components suitable for providing thrombus-indicative measurements or other data suitable for informing the decision in light of teachings herein.
• In some embodiments, “signaling” something can include identifying, contacting, requesting, selecting, or indicating the thing. In some cases a signaled thing is susceptible to fewer than all of these aspects, of course, such as a task definition that cannot be contacted.
• In some variants, systems described herein may be configured to include one or more controllable dispensers or other such control features. Other such embodiments are described, for example, with reference toFIGS. 4,10,50,68, and71.
• An embodiment provides asystem4600 comprisinginterface logic4640 operable for signaling a decision (a) whether to initiate implant-site-targeting treatment or (b) whether to administer one or more clot-reducing agents. Alternatively or additionally,system4600 comprising may similarly provide dispensing logic using such signaling, for example, for guiding one ormore dispensers4616 accordingly. Eachdispenser4616 may (optionally) contain a thrombolytic agent and/or other therapeutic materials as described herein, suitable for targeting a vicinity ofvalve4610. The above-described “signaling” circuitry may comprise one or more ofoptical sensors4675,auditory sensors4676, flow-force-responsive elements4678, or other components suitable for providing thrombus-indicative measurements or other data suitable for informing the decision in light of teachings herein.
• With reference now toFIG. 47, shown is an example of a system that may serve as a context for introducing one or more processes and/or devices described herein. As shownsystem4700 comprises (a top view of) avalve4710 having adispenser4716 in an upper portion thereof. Any of the embodiments described herein with reference toFIG. 45 may effectively implementvalve4710 as a combination ofupper module4550 andlower module4590 withinlumen4595. Any of the embodiments described herein with reference toFIG. 112 may effectively implementvalve4710 asmodule11250 withinlumen11295. Any of the embodiments described herein with reference toFIG. 116 may effectively implementvalve4710 asmodule11660 withinlumen11695. Any of the embodiments described herein with reference toFIG. 108 may effectively implementvalve4710 asmodule10890 withinlumen10895. Any of the embodiments described herein with reference toFIG. 28 or108 may likewise implementvalve4710 asmodule10890 orsystem2800 withinlumen10895 orvasculature2896.
• With reference now toFIG. 48, shown is (a bottom view of) a variant ofvalve4710 in which a dangerous, partiallyocclusive thrombus4716 has formed. An embodiment provides one ormore sensors4579 in alower module4590 suitable for detectingthrombus4716 and able to respond programmatically as described herein.
• With reference now toFIG. 49, shown is (a bottom view of) a variant ofvalve4710 in whichthrombus4716 has been prevented or removed as described herein.Valve4710 is accordingly operable for opening and closing effectively in this configuration, unlike that ofFIG. 48.
• With reference now toFIG. 50, shown is an implanted system5000 in which one or more technologies may be implemented, astructure5090 having a plurality of legs5020 (optionally a variant of a “Gunther Tulip” inferior vena cava filter, for example) engaging a wall of a lerge vein5010. In response to detecting a large-enough clot5080 (as a force increase, deformation, or other manifestation described herein, e.g.), one or more modules5035 ofcontrol logic5040 may cause adispenser5050 to inject a concentrated dose oflytic material5052 locally from anupstream portion5051 of system5000. Alternatively or additionally, one ormore modules5065 ofnotification logic5070 may cause or enable anotification5075 to be transmitted, for example, wirelessly to an external device as described herein signaling one or more such events.
• In some variants, systems described herein may be configured to include or interact with a pacemaker or other such implantable articles. Other such embodiments are described, for example, with reference toFIGS. 33 and 34.
• With reference now toFIG. 51, shown is an example of a system that may serve as a context for introducing one or more processes and/or devices described herein. As shownsystem module5100 may comprise one ormore thresholds5111,5112,criteria5115,filters5121,5122, orother conditions5125 detectable by one ormore modules5131,5132,5133 ofdetection logic5135. Such logic may be implemented in hardware or software, for example, optionally configured for analyzing values from one ormore event records5160, counters5173 orother timing logic5175, or other such data. In some variants, for example,event record5160 may associate one ormore timestamps5161 with measurements orother data5167,5168. Alternatively or additionally, such logic may analyze one or moreother values5181,indicators5182,statuses5183, or othersuch data5184,5190 of potential diagnostic utility.
• With reference now toFIG. 52, shown is an example of asystem5200 comprising asystem module5250 operable for communicating to and/or from one ormore sensors5201,5202,5203;other modules5210;aggregation modules5281;devices5291 orother resources5292; or other portions ofnetworks5280,5290. In some contexts, for example, such sensors may be (a) operatively coupled withsystem module5250 via aconduit5208 and/or (b) near aperipheral region5225 or core of subject5220 as shown. In some variants,system module5250 may include one ormore modules5231,5232,5233 of configuration logic5235 configured to handle one ormore images5241,data5242,other responses5245,other data5251,5252,5253,5255 as described herein, orother information5260 of potential utility in diagnosing a living subject. Alternatively or additionally,system module5250 may include one ormore ports5261,5262 or other features ofinterface5265;network linkages5285 for interacting to and/or from networks; orthresholds5271,5272, operatingparameters5275, or othercomparative information5276 potentially useful for diagnostic and/or monitoring purposes.
• With reference now toFIG. 53, shown is an example of a sensor-containingdevice5310 orother device5320 at least sometimes in communication with one or moreprimary systems5380. In some variants, for example, one ormore receivers5340,5350 may be configured to receive one ormore messages5341,5342 orother information5345 from such devices. Alternatively or additionally,primary system5380 may include one or more controller cards orother computer modules5360 implementingdecision logic275,1350,1460,2250,2730,3230 or other logic as described herein, for example, in hardware or software form.Primary system5380 may likewise include one or more hand-held orother user interfaces5370 for relaying notifications or other information to or from care providers orother users5390.
• With reference now toFIG. 54, shown is an example of arecording system5400 comprising one ormore receivers5430 for handling software orother modules5425, one ormore records5450 associatingdata5451,5452 in amemory5440 orstorage unit5445, ortiming information5470 as described herein. In some contexts, for example,recording system5400 may record or otherwise handle one ormore update times5464,implant times5465,dispensation times5466, or other such data in association with an event type, a quantity, or other such parameters of potential analytical utility.
• In some variants, other system components described herein may be configured to generate or act upon such timing information. Such embodiments are described, for example, with reference toFIGS. 11,55,56, and62-64.
• With reference now toFIG. 55, shown is asystem5500 in which one or more technologies may be implemented, a configuration module5570 wirelessly or otherwise operably coupled to one ormore networks5580, external devices5591, orimplants5597 in subject5595. In some variants, configuration module may include one ormore determinants5540 inmemory5541,storage5542, orother media5545. In various contexts as described below, for example, one ormore instruction sequences5551 orother modules5552 ofdecision logic5555 may behave in a manner that depends upon one or more of atype5511,date5512,status5513, orlocation5514 ofimplant5597, or othersuch implant data5510,comparison data5531,parameters5532, orprofile data5533 as described herein. Alternatively or additionally, one or more5521,location indices5522,sensor types5523,mode identifiers5524,5525 or othersuch monitoring information5520 and/orstatus information5535 may be received by one ormore modules5561,5562,5563 ofreceiver5565 for potential use by diagnosticians and/or decision logic as described herein.
• With reference now toFIG. 56, shown is asystem5600 in which one or more technologies may be implemented, configured to receive information fromimplant5690 and/or to convey information to a subject orother user5695 via one or more output devices5694 (a speaker, e.g.).Support device5610 may include one ormore ports5623,5624,antennae5628, or othersuch communication components5620 operable for handling one ormore profiles5621,5622, commands5625,5626 or other such information. Alternatively or additionally,support device5610 may include one ormore modules5634 ofdecision logic5635 ortiming modules5641 orother modules5644,5645 ofcontrol logic5640 suitable forhandling data5642,5643 as described herein. In some variants,detection logic5670 ofsupport device5610 may likewise include one ormore receivers5665 orother modules5661,5668 configured to handle one or moreblood pressure measurements5651, flowrate measurements5652, or othersuch determinants5655 that depend upon the implant(s)5690 or other characteristics of subject5695.
• With reference now toFIG. 57, shown is asystem5700 in which one or more technologies may be implemented, alocal module5730 configured to communicatesignals5725 to and/or from one ormore sensors5701 or othersuch elements5722 in aregion5710 adjacent ablood vessel5709. This can facilitate detection of anembolus5708 or other circulation-related features inblood5703,skin5706, ortissue5705. Such alocal module5730 may include one ormore modules5741,5742,5751,5752 ofdecision logic5750,5760 operable for generating one ormore decisions5745,5746. Such decisions may depend upon one ormore material indicators5743,5762,quantity indicators5744,model numbers5761, orother type indications5770. Alternatively or additionally, such decisions may depend upon one ormore measurements5771,ultrasonic signatures5772,impedance changes5773,symptom indicators5774,image sequences5785, or othersuch data5780,5790.
• With reference now toFIG. 58, shown is asystem5800 comprising two or more coupleddetection modules5860,5870 configured to handle sensor data manifesting measurements or other attributes of aregion5810adjacent blood vessel5809. In some variants, for example,detection module5860 includessensors5851,5852,5853 as described herein operable to transmit the sensor data. Accordingly,detection module5870 may be configured to handle one ormore images5861,5862,5863 or other shape-indicative data5865; one ormore complaints5871, subject-providedinput5872, secondary user input5873, or other such clot-indicative determinants; orother determinants5878 orother indications5879 comprisingischemia indicators5880.Detection module5870 may further include one ormore comparators5893 orother modules5891,5892 ofinvocation logic5895 for sending and/or receiving atreatment indication5890, status-indicative information5896, or other components ofmessages5897,5898,5899. In various contexts as described herein, one or moresuch treatment indications5841 orother messages5815,5825 may be transmitted to or received from one ormore stations5820, monitors5830,comparators5842, or other components ofnetworks5840 potentially remote fromregion5810.
• In some variants, such detection modules may be configured to capture and/or transmit images or otherwise handle shape-indicative data. Other such embodiments are described, for example, with reference toFIGS. 9,16,35,52,75,77, and79.
• With reference now toFIG. 59, shown is asystem5900 comprisingprimary module5920 configured to transmitoutput5983 to and/or receive input5984 frominterface5980.Primary module5920 may include one ormore comparators5921,circuitry5922,module5923, orother decision logic5930,5940 configured to generate one ormore decisions5925 or other data responsive to one ormore criteria5907,5908,5909,5910. Alternatively or additionally,primary module5920 may include one ormore modules5961,5962,5963,5964 ofevaluation logic5965 configured to generate metadata or other such information responsive to one or more such criteria. Such input or output data may, for example, comprise asuccession5951 orother indicatos5952,5953,5954,5955 transmitted to or fromprimary module5920.
• With reference now toFIG. 60, shown is anadministration unit6010 optionally comprising one or more primary modules described herein, and operatively coupled via acord6077 with a hand-heldunit6080 positionable adjacent a subject6090. In some variants, for example, hand-heldunit6080 may include one or more sensors or logic as described herein. Alternatively or additionally, hand-heldunit6080 may include one ormore dispensers6075 of avasodilator6071,lytic agent6072, or other such therapeutic components6073 (operatively controlled viacord6077, e.g.).Administration unit6010 may include one ormore microphones6021,speakers6022, orother modules6023 ofinterface6020 configured to conveyoutput6024 orother indications6025. Such information may be guided by one ormore interaction protocols6043 orother modules6041,6042 ofdecision logic6050. Alternatively or additionally, such information may be guided by one ormore results6031,6032,6033,6034 fromcomparator6030 and/or by one or morebody part identifiers6061,seat identifiers6062, global positioning system (GPS) coordinates6063, or othersuch location indicators6060.
• In some variants, hand-heldunit6080 may be implemented as a handle, a steering wheel, an arm rest, or other feature of a vehicle configured to monitor a health status of one or more occupants. Other such embodiments are described, for example, with reference toFIGS. 2,6, and8.
• With reference now toFIG. 61, shown is asystem6100 in which one or more technologies may be implemented comprising one ormore location sensors6101, flowattribute sensors6102,approvals6103, or other such input components to one ormore modules6104,6105,6121,6122,6123 ofdetection logic6110 orinvocation logic6120.System6100 may further include one or more instances ofdecisions6133 generated by one ormore modules6131,6132 responsive to a fulfillment of one ormore regimens6134. Alternatively or additionally,system6100 may further include one or more instances ofinitiations6151,updates6152,indications6171,6172,6173, orother notifications6160,6170 configured and/or triggerred by one ormore modules6181,6182,6183 ofnotification logic6180.
• In some variants, such notification logic may be configured to facilitate selective notifications according to one or more controllable parameters. Other such embodiments are described, for example, with reference toFIGS. 3,5,12,15,22,29,30,32,35, and77.
• With reference now toFIG. 62, shown is anadministration system6200 comprising one ormore modules6201,6202 ofevaluation logic6210 configured to generate one ormore results6260 in response to an evaluation of one ormore distributions6211,6212,6221,6222 with one ormore signals6231,6232, current flow-indicative data6233,historical data6234, or other such diagnostically relevant parameters as described herein. Alternatively or additionally, one ormore differences6251,6252,positional information6253, timinginformation6254,change rates6255,indicators6256,6257 orother results6260 may manifest or otherwise stem from aset6244 of one ormore regimens6241,6242,6243 (selected asinput6292 fromuser6290 at auser interface element6291, e.g.).Such results6260 can likewise manifest or otherwise stem from one ormore measurements6271,images6272,6273,values6274,6275,requests6276, or other such input data6280 (from one ormore users6290 and/orexpert system modules6294, e.g.). In some variants, for example, one ormore modules6245 ofdecision logic6240 may (a) define a default set of regimens in response to a pathological state indication6296 or other such data fromnetwork6295 and/or (b) permit the user(s) to configure theset6244 selectively as a mode of dispensation control.
• With reference now toFIG. 63, shown is asystem6300 comprising amediation module6310, such as may be configured to facilitate data aggregation or other such data-transformative interaction between one ormore networks6390 and a primary or other local system as described herein.Mediation module6310 may include one ormore recorders6311;ports6321,modules6322,6323 orother invocation logic6320; ormodules6332,6333 orother processing logic6330, such as for applying athreshold6331. Such components may, for example, trigger a recording or analysis in response to one or more instances oflimb pain indications6344, coolingindication6345, swellingindications6346,dispensation indications6347,discoloration indications6348, symptom indcations6349,decibel measurements6351,6352, timingdata6361,6362,6363, or a low-enough Reynolds number computation or other laminar-flow-indicative value6371,6372. In some variants, moreover, these or other data types may be used asconfirmatory measurements6353 or other data configured for a contingent confirmation of a follow-up evaluation, a diagnosis, a referral, a prognosis, or some other hypothesis of potential therapeutic relevance. In some variants, for example,invocation logic6320 may trigger one ormore decisions6391,6392 or other responses fromdecision logic6395, aremote evaluation module6396, or other such entities. Alternatively or additionally, some or allsuch data6340 may be transmitted tonetwork6390, for example, to permit such recording or other functions to be performed remotely.
• With reference now toFIG. 64, shown is anetwork6400 comprising a plurality ofaddressable destinations6401,6402 supported by one ormore server systems6490. In some variants,server system6490 may include one ormore modules6421,6422,6423,6454,6461 ofnotification logic6420,invocation logic6455, orevaluation logic6460. Such logic may generate one ormore risk indicators6431,6432 and/ordata samples6441,6442,6443 comprisingsignals6445, or other such components ofnotifications6440,6450 including or otherwise manifesting one or moremarginal probabilities6462,thresholds6463,composite indicators6491,measurements6492,availability data6493, timingdata6494, or othersuch data6495 useful for facilitating a diagnosis of a subject's medical or veterinary problem.
• In some variants, such notification logic may be configured to facilitate selective notifications according to one or more controllable parameters. Other such embodiments are described, for example, with reference toFIGS. 12,15,22,29,30,32,35, and74.
• With reference now toFIG. 65, shown is aninterface6500 in which one or more technologies may be implemented. To facilitate providing information to and/or from a user as described herein, such an interface may include one ormore comparators6521,6522 orother evaluation logic6520 configured to facilitate an application of one ormore criteria6523 for decisions or other evaluations as described below. Alternatively or additionally, such an interface may include one ormore modules6538 orother notification logic6540 configured to enable, trigger, configure, or otherwise facilitate one ormore notifications6544 as described herein.
• With reference now toFIG. 66, shown is adetection system6650 comprising one ormore modules6661,6662 ofprocessing logic6660 configured to interact with amodule6680 positioned onskin6690 of subject6670. Such modules may include one ormore sensors6681 configured to derive shape or other detectable attributes of aregion6691 at a first end of a segment of avessel6696 as shown, one ormore sensors6683 configured to derive shape or other detectable attributes of aregion6693 at a second end of the segment as shown, and/or one ormore sensors6682 configured to derive shape or other detectable attributes of aregion6692 at a middle portion of the segment of as shown. One or moresuch sensors6681,6682,6683 may provide signals from which such logic may derive one or more flow-indicative orother images6664 or other suchcirculatory indications6663, for example, via any of several existing technologies.
• With reference now toFIG. 67, shown is aconfiguration system6710 comprising one ormore modules6731,6732,6733 orother detection logic6720 configured to detect one ormore rates6721,indications6722,categorical attributes6725,quantitative attributes6726, or othersuch values6723 orother data6724 indicative of pathologies, therapies, or other such manifestations of conditions described herein. Alternatively or additionally,configuration system6710 may include one ormore interfaces6740,6750 configured to transmit data to and/or from a user, adispenser6780 orother device6790 for use in proximity to a subject, or other such resources. In some variants,configuration system6710 may likewise include one ormore sequences6761,6762,protocols6763,device settings6771, or other such parametric forms configured to guide one ormore modules6772,6773,6774 ofcontrol logic6770 as described herein.
• With reference now toFIG. 68, shown is afiltration system6800 configured to provide via one ormore returns6805 at least a portion of a bodily fluid received via one ormore inlets6895. In some variants,filtration system6800 may include one or more instances ofsensors6815,6865 in a vicinity of anair trap6820 and/orfluid pump6870. Alternatively or additionally,filtration system6800 may likewise include one ormore dispenser inlets6885,membranes6840 for use in ormore filter units6850, or other such mechanisms for adding or removing solid or other components of the fluid.
• With reference now toFIG. 69, shown is adialyser6910 in which one or more technologies may be implemented.Dialyser6910 may be configured to provide via one or more fluid returns6942 a portion of aflow6943 received via one ormore fluid inlets6941. Another portion offlow6943 merges into aflow6933 between the dialysate inlet(s)6931 and dialysate return(s)6932 through one ormore membranes6940.
• With reference now toFIG. 70, shown is another type oftransfer system7000 in which one or more technologies may be implemented. One ormore valves7050, pumps7060, orother actuators7045,7055 guide blood selectively frominlet7005 towardreturn7091,outlet7092, orextraction unit7080. One ormore modules7031,7032,7033 ofcontrol logic7030 control such actuation and/or an operation of one ormore dispensers7020 as described herein. Flow intosuch extraction units7080 may come into contact with one ormore foams7071,fibers7072, or othersuch materials7073 effective for removing a sample or potentially toxic portion, which can then be removed or guided towardoutlet7094. Alternatively or additionally a remaining portion may be guided back toward transfer unit7010 (via recovery conduit7093) as shown. In some variants,transfer unit7010 may be implanted or otherwise left in place even as cartridges or other such modular extraction units are occasionally replaced.
• In some variants, systems described herein may be configured to include one or more mechanical control features. Other such embodiments are described, for example, with reference toFIGS. 4,7,10,28,45,68, and71.
• With reference now toFIG. 71, shown is system in which one or more technologies may be implemented comprising at least oneprimary unit7110 operable for communication to and/or from one ormore delivery units7180.Delivery unit7180 may include one ormore reservoirs7181,actuators7182,iontophoretic modules7183, or pumps7184 in a delivery range of subject7190. In some variants, for example, one ormore modules7121,7122,7123 ofcontrol logic7120 may transmit one ormore activation signals7171 to cause a test or other therapeutic regimen relating to subject7190. Alternatively or additionally, one ormore modules7135 ofcommunication logic7140 may receivemeasurement data7133 orother data7131, optionally as a component of awireless signal7132 or other monitoring signal(s)7172 received bycommunication logic7140 in relation todelivery unit7180. Alternatively or additionally, such logic may selectively notify or otherwise interact with one ormore resources7161,7162 innetwork7160 as described herein.
• With reference now toFIG. 72, shown isdispensation system7200 in which one or more technologies may be implemented.Control logic7270 comprises one ormore regimens7263 orother modules7261,7262 configured to enable and/or trigger components of one ormore dispensers7290 in response to one ormore determinants7210 as described herein. In some contexts, for example, one or more instances ofregimen7263 may call fortissue plasminogen activator7283 or anotherlytic material7284 to be dispensed unless a givensystemic determinant7212 manifests (D-dimer concentration exceeding a given threshold, e.g.) in relation to a subject. Alternatively or additionally,regimen7263 may call for a dispensation from anotherreservoir7285 in response to a complementary determinant7211 (dispensing a vasodilator in response to apparent clotting in a vessel parallel to that of an intravenous dispenser, e.g.). Various other modes of controlling one ormore actuators7281, pumps7282, or other components ofdispensers7290 may be configured in response to these andother data7213,7214 without undue experimentation, in light of these teachings.
• With reference now toFIG. 73, shown is a subject7310 for whom one or more technologies may be implemented. A (right) common carotid artery7350 bifurcates into aflow7321 through internalcarotid artery7322 and aflow7331 through an externalcarotid artery7332. One ormore sensors7345 may be implanted or otherwise configured to detect such flows and/or arteries, optionally triggering one or more programmatic notifications, dispensations, or other such responses as described herein. In some variants, for example, apparent warning signs of a stroke may trigger a (confirmatory) diagnostic interaction with subject7310 and/or a warning or other advice to a caregiver or others in a vicinity of subject7310.
• With reference now toFIG. 74, shown is a distributedsystem7400 in which one or more technologies may be implemented comprising aserver7410 remote from an at-risk subject7495 innetwork7490. In some variants, for example, one ormore sensors7498 orother modules7492 may be configured to detect or otherwise interact with an afflictedregion7496 on a limb of a subject7495. Alternatively or additionally,external device7491 or othersuch modules7493 may be configured to facilitatecommunications7485 to and/or fromserver7410 and/or to detect systemic or complementary determinant conditions relating to subject7495.
• In some variants,external device7491 may comprise a vehicle ofnetwork7490 configured to monitor a health status of one or more occupants. Other such embodiments are described, for example, with reference toFIGS. 2,6, and8.
• In some variants,server7410 may include one or more special-purpose circuits orother modules7411,7412 ofdecision logic7415 configured to generate one ormore decisions7414 in response tovarious indications7480 as described herein. These may include one ormore images7471,inputs7472, or other such sensor data orother data7473,7474,7475,7476,7477. Alternatively or additionally,scheduling logic7455 orother notification logic7460 may generatenotifications7451,7452 and/or other suchconsequential data7454 derived from event counts7441,variable values7442 used for computations as described herein, or othersuch information7450. In some contexts, such information may (optionally) include at least onesuccession7420 of differences or othersuch indications7421,7422,7423 computed, for example, from one ormore successions7430 ofmeasurements7431,7432,7433 or other values as exemplified below.Such successions7420,7430 may signify an amount of moisture on a subject's skin, an indication of how long a body part has been stationary, an indicator of flow, a partial pressure or other manifestation of concentration, or other such information of diagnostic utility.
• With reference now toFIG. 75, shown is alocal system7570 configured to communicate withexpert system7585 or other parts ofnetwork7580 in relation to one ormore descriptors7581,scores7582, orinputs7583 as described herein. Alternatively or additionally,network7580 may contain one or moreadjunct services7590 configured to apply one ormore standards7588 tovarious indications7530 orinformation7531,7532,7533,7534;determinants7535; orother data7537,7538 transmitted acrosschannel7575. In some variants, for example, such indications may include one ormore images7510,7520 havingportions7511,7512,7521,7522 of potential diagnostic utility recognizable by a remote specialist, a pattern recognition module, or other such entity. In some variants,local system7570 may further include one ormore extraction modules7545 or other logic in alocal interface7540 configured to present abnormal indications selectively to a clinician, for example, holding an instrument7550 (supporting one ormore sensors7555 in a vicinity of a subject7505, e.g.). Alternatively or additionally,local system7570 may include one or morepattern recognition modules7564,interfaces7563, orother modules7561,7562 ofevaluation logic7565 as described herein.
• With reference now toFIG. 76, shown is asystem7600 in which one or more technologies may be implemented. Adetection module7610 as described herein may include one ormore pressure sensors7621, stress-indicative sensors7622, orother sample sensors7625 configured to generatevalues7631,7632,notification decisions7633 or other such manifestations of preference, coordinates7634, orother status indicators7645 relating to a subject. SeeFIGS. 23-26. Such information can, for example, be held in a circular buffer7651 (assuccessive samples7661,7662,7663, for example) orother buffer7652,7653,7654 configured to permit one ormore condition detectors7670,7680,7690 to applystandards7675,7685,7695 as exemplified herein.
• With reference now toFIG. 77, shown is asystem7700 comprising aprimary module7790 configured to acceptindications7711,7712,7713,7714 from one or more auditory orother sensors7717 in, on or about a subject7710 of observation. Such modules may be implemented, for example, to include or interact with one or more components or contexts ofFIGS. 1-76. In some variants,inputs7738,7739 orother information7745 as described herein may include one ormore categories7731,responses7732,verifications7733,distributions7734, or othersuch data7741 suitable for inclusion, for example, ascontent7771 of anotification7775. Alternatively or additionally, one ormore modules7751,7752 orother configuration logic7755 may maintain one ormore images7761, apply one ormore thresholds7762, or otherwise provide one ormore indications7780 ornotification destinations7785 in response to then-current contents ofmemory7765.
• In some variants,system7700 may be configured to include a vehicle configured to monitor a health status of one or more occupants. Other such embodiments are described, for example, with reference toFIGS. 2,6, and8.
• In some embodiments, data can be “acceptable” to a data analysis module if some or all of the data can be processed by the module with success. An indication of acceptable data can be appropriate in response to detecting an apparent presence or absence of a pattern in the data, for example, or to determining that the data has a file size or header format that is typical for data processed by the analysis module.
• With reference now toFIG. 78, shown is asystem7800 comprising one ormore modules7820,7825 in communication with ahub7830 having access to one ormore networks7890. In some variants, for example, amodule7820 positioned on or near a subject may include one ormore sensors7821,7822,7823,7824 operable for transmitting one ormore images7831,7832 (depictingzone7839, e.g.), counts7841,outputs7837 from sensors,indicators7843,thresholds7845 orother factors7842 to be applied, or othersuch determinants7850. Alternatively or additionally,hub7830 may receive (via one ormore interfaces7860, e.g.) one ormore categories7844 or othersuch input7834 from a user or other local entity. In response to such determinants, one ormore modules7871,7872,7873,7874 ofnotification logic7875 may configure one ormore notifications7868 for local delivery (viainterface7860, e.g.) and/or delivery to one or more interfaces7880 orlogging modules7885 ofnetwork7890. In some contexts,module7872 may configurenotification7864 to include a raw sample of slurredspeech7864 provided by a subject in response to programmatic queries, for example, or othersuch content7865 of an established diagnostic regimen. Such content may be omitted, in some contexts, in response to a determination that such content is normal (not slurred, e.g.) as described herein.
• With reference now toFIG. 79, shown is asystem7900 comprising one or morelocal modules7931,7932 each in a vicinity of one ormore body parts7921,7922 of subject7920. In some contexts, suchlocal modules7932 may include one or more sensors, support elements, dispensers, or othersuch elements7933 positioned in contact with or otherwise adjacent abody part7922 of interest. In various applications,detection logic7940 may include one or more instances ofconfiguration modules7942,control modules7951,invocation modules7967,notification modules7968, orvarious recognition modules7981,7982,7983 configured to processauditory information7941 or other input data as described herein.Detection logic7940 may (optionally) include one ormore evaluation modules7952 configured to implement one or morecomputed results7961,comparison results7962, user selections, or other such evaluation results7963. Such results may arise from a recognition of one ormore patterns7971,7972,7973,7974,7975 or profiles7970 (combinations of patterns, e.g.) evident indata7991,7992,7993,7994,7995,7996 residing inmemory7998. In some variants, for example,recognition module7981 may be configured to recognize one or more extended measurement trends or other suchpathological patterns7971 even indata7993 still in a normal range, in some contexts. Alternatively or additionally, one ormore recognition modules7982 may be configured to detect a shape, color, or otheroptical pattern7975 characteristic of a scar, birthmark, or other common and/or unchanging irregularity manifested indata7996 and not indicative of a circulatory pathology.
• In some variants, such notification logic may be configured to facilitate selective notifications according to one or more controllable parameters. Other such embodiments are described, for example, with reference toFIGS. 30,32,35,74,77,78,80,85-96, and104-107.
• With reference now toFIG. 80, shown is asystem8000 comprising one ormore modules8001,8002 ofextraction logic8010 configured to process one ormore samplings8014,distillations8015,measurements8016,8017,8018,identifiers8019, or othersuch output8011,8012 from sensors or other detection logic described herein. In some embodiments, such a “distillation” can comprise an average, estimate, range, or other computation at least partly distilling a set of data. It can likewise include an indexing, sorting, summarization, distributed sampling, or other process having a purpose or effect of showing some aspect of the data more concisely or effectively than a conventional display of the entire data. Selecting a last portion of a data set can constitute a distillation, for example, in a context in which the data's utility apparently increases. Those skilled in the art will recognize many useful modes of distilling data in light of the state of the art and of teachings herein.
• Such information8020,8030 may further include one or more instances ofprogrammatic advice8032,ratios8034,computations8036, or other such components ofnotifications8038. In some variants, for example, at least onedistribution module8050 may be configured to use such information to select one ormore destinations8041,8042 among a plurality ofdestinations8041,8042,8043 in response to these or other criteria8064 (defined in one ormore subscriber profiles8061, e.g.) or to aclient list8067. Alternatively or additionally,notification logic1290,3535,3991,6180,7460,7875 or other responsive logic described herein may use one or moresuch determinants8068 to select among one ormore databases8081 or othersecondary information sources8080 to draw upon for contextual information to be included in such notifications.
• In some variants, logic for applying one or more thresholds or other such criteria may be configured to preserve relevant data selectively, to generate a summary or evaluation, or otherwise to perform suitable data extractions. Other such embodiments are described, for example, with reference toFIGS. 1,8,12,31,32,59,65, and85. In some embodiments, such data extraction criteria can include maxima or other comparison values applied to durations, counts, lengths, widths, frequencies, signal magnitudes or phases, digital values or the like. Such criteria can be applied by determining when or how often a definable pattern can be found: a text string, a quantity, a cough-like sound, an arrhythmia, a visible dilation, a failure to respond, a non-change, an allergic response, a symptom relating to an apparent condition of the user, or the like.
• With reference now toFIG. 81, shown is asystem8100 in which one or more technologies may be implemented.Respective information8161,8162 may be obtained about two ormore body parts8108,8109 respectively containingblood vessels8118,8119 of avasculature8110 of amammal8103.Circuitry8170 configured to receivesuch information8161,8162 may include one or more instances ofmodules8151,8152,response logic8168, ormodules8172,8173,8174 ofdecision logic8171.
• With reference now toFIG. 82, shown is aflow8200 comprising operation8240-obtaining local respiratory-status-indicative information about a first body part of a subject (e.g. response logic8168 receiving one or more measurements orother information8161 indicative of a past or present respiratory status of organ tissues or other parts of a patient under observation). This can occur, for example, in a context in whichresponse logic8168 receives theinformation8161 via a sensor-containingmodule8151 or other direct mode of observation.
• In light of teachings herein, numerous existing techniques may be applied for detecting respiratory transitions or other phenomena from measurements or other raw data as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,308,292 (“Optical-based sensing devices”); U.S. Pat. No. 7,305,262 (“Apparatus and method for acquiring oximetry and electrocardiogram signals”); U.S. Pat. No. 7,200,431 (“Implantable blood flow monitoring system”); U.S. Pat. No. 7,136,704 (“Blood oxygen monitoring system and a lead therefor”); U.S. Pat. No. 7,025,778 (“Endovascular graft with pressure temperature flow and voltage sensors”); U.S. Pat. No. 7,011,633 (“Blood flow measuring apparatus”); U.S. Pat. No. 7,006,858 (“Implantable retrievable sensors and immunosensors”); U.S. Pat. No. 7,004,907 (“Blood-pressure monitoring device featuring a calibration-based analysis”); U.S. Pat. No. 6,895,265 (“Implantable sensor”); U.S. Pat. No. 6,731,976 (“Device and method to measure and communicate body parameters”); U.S. Pat. No. 6,682,490 (“Apparatus and method for monitoring a condition inside a body cavity”); U.S. Pat. No. 6,475,170 (“Acoustic biosensor for monitoring physiological conditions in a body implantation site”); U.S. Pat. No. 6,268,161 (“Biosensor”); U.S. Pat. No. 6,206,835 (“Remotely interrogated diagnostic implant device with electrically passive sensor”); U.S. Pat. No. 6,047,203 (“Physiologic signs feedback system”); U.S. Pat. No. 6,015,387 (“Implantation devices for monitoring and regulating blood flow”); U.S. Pat. No. 5,967,986 (“Endoluminal implant with fluid flow sensing capability”); U.S. Pat. No. 5,833,603 (“Implantable biosensing transponder”); U.S. Pat. No. 5,601,811 (“Substantive water-soluble cationic UV-absorbing compounds”); U.S. Pat. No. 5,593,431 (“Medical service employing multiple DC accelerometers for patient activity and posture sensing and method”); U.S. Pat. No. 5,188,106 (“Method and apparatus for chronically monitoring the hemodynamic state of a patient using doppler ultrasound”); U.S. Pat. No. 4,536,274 (“pH and CO.sub.2 sensing device and method of making the same”).
• Operation8270 describes invoking circuitry for causing one or more comparisons between the local respiratory-status-indicative information about the first body part of the subject and filtering information at least partly based on the subject (e.g. module8172 ofdecision logic8171 triggering one or moreother modules8174 to compareinformation8161 withinformation8162 received from anothermodule8152 configured for observing anotherbody part8109 in a vicinity of blood vessel8119). This can occur, for example, in a context in whichdecision logic8174 receives at least some of theinformation8161 aboutbody part8108 viaresponse logic8168 and in which one ormore modules8172,8174 ofdecision logic8171 perform such a comparison within a proximity ofmammal8103. In some variants, for example, some or all of the filtering information may be derived from similar measurements of nearby tissue and/or other information about the “first” body part. Alternatively or additionally, one or more of themodules8174 ofdecision logic8171 may retain and/or forward a sample of the information to a central facility for other such comparisons or for further evaluation.
• In some embodiments, “causing” events can include triggering, producing or otherwise directly or indirectly affecting the events. This can include causing the events remotely, concurrently, partially, or otherwise as a “cause in fact,” whether or not a more immediate cause also exists.
• In some embodiments, an action can be taken “at least partly based on” some data or event. This can include a context in which the event directly or indirectly triggers or directs the action, or otherwise in which the outcome of the action can depend upon some aspect of the data. Those skilled in the art will recognize many such relationships that are useful in light of the state of the art and of teachings herein.
• In light of teachings herein, numerous existing techniques may be applied for generating and applying quantitative or other comparative criteria as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,304,580 (“Intelligent medical vigilance system”); U.S. Pat. No. 7,286,872 (“Method and apparatus for managing data from multiple sensing channels”); U.S. Pat. No. 7,218,966 (“Multi-parameter arrhythmia discrimination”); U.S. Pat. No. 7,200,431 (“Implantable blood flow monitoring system”); U.S. Pat. No. 7,113,819 (“Method and apparatus for monitoring the condition of a fetus”); U.S. Pat. No. 7,065,465 (“Method and system for multi-sensor data fusion”); U.S. Pat. No. 6,983,178 (“Probe for use in non-invasive measurements of blood related parameters”); U.S. Pat. No. 6,942,616 (“System and method for collecting and transmitting medical data”); U.S. Pat. No. 6,908,431 (“System and method for providing feedback to an individual patient for automated remote patient care”); U.S. Pat. No. 6,809,653 (“Telemetered characteristic monitor system and method of using the same”); U.S. Pat. No. 6,802,811 (“Sensing, interrogating, storing, telemetering and responding medical implants”); U.S. Pat. No. 6,731,976 (“Device and method to measure and communicate body parameters”); U.S. Pat. No. 6,478,737 (“System and method for analyzing normalized patient voice feedback an automated collection and analysis patient care system”); U.S. Pat. No. 6,416,471 (“Portable remote patient telemonitoring system”); U.S. Pat. No. 6,387,048 (“Implantable sensor and integrity tests therefor”); U.S. Pat. No. 6,336,900 (“Home hub for reporting patient health parameters”); U.S. Pat. No. 6,312,378 (“System and method for automated collection and analysis of patient information retrieved from an implantable medical device for remote patient care”); U.S. Pat. No. 6,149,674 (“Patient thermal regulation system”); U.S. Pat. No. 6,047,203 (“Physiologic signs feedback system”); U.S. Pat. No. 5,833,603 (“Implantable biosensing transponder”); U.S. Pat. No. 5,558,638 (“Patient monitor and support system”).
• With reference now toFIG. 83, there are shown several variants of theflow8200 ofFIG. 82.Operation8240—obtaining local respiratory-status-indicative information about a first body part of a subject—may (optionally) include one or more of the following operations:8346 or8348. In some embodiments, variants ofoperation8240 may be performed by one or more instances ofprocessing modules1430,1650,1680;response modules1620; ordecision logic275,1350,1460,2250,2730,3230,5750,5930,6130,6395,7415.Flow8200 may likewise (optionally) include one or more of the following operations:8391,8394 or8397. Alternatively or additionally,flow8200 may be performed in a context as described above with reference to any ofFIGS. 1-80 and/or in conjunction with other flow variants as described below.
• Operation8346 describes receiving subject-provided data as the local respiratory-status-indicative information (e.g.term recognition module1625 or other components ofresponse module1620 receiving subject-provideddata2921,2922 directly or indirectly from one ormore interfaces2962 or other instruments2930). This can occur, for example, in a context in which an instance ofprimary module1600 ofFIG. 16 resides withinnetwork2995 and performsoperation8240 by interacting with one ormore instruments2930 in a proximity of subjects. In some variants, for example, a software or otherterm recognition module1625 identifies one or more diagnoses or other symptom-indicative parameters1624 within a subject's speech orother communication2935. Alternatively or additionally, one or moreother modules1621 may be configured to record, report, or otherwise respond tosuch communication2935 conditionally as described herein, such as by a timelyreciprocal communication2935 with subject2920. In some variants, moreover, one or morehandheld devices2961 orother interfaces2962 may performoperation8346 in relation to a subject within a proximity thereof, such as by receiving keyed orother input2965.
• In light of teachings herein, numerous existing techniques may be applied for requesting or otherwise receiving demographic parameters, event data, or other data via an interface with subjects as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,258,666 (“System and methods for monitoring a patient's heart condition”); U.S. Pat. No. 6,968,375 (“Networked system for interactive communication and remote monitoring of individuals”); U.S. Pat. No. 6,926,668 (“System and method for analyzing normalized patient voice feedback in an automated collection and analysis patient care system”); U.S. Pat. No. 6,893,396 (“Wireless internet bio-telemetry monitoring system and interface”); U.S. Pat. No. 6,755,783 (“Apparatus and method for two-way communication in a device for monitoring and communicating wellness parameters of ambulatory patients”); U.S. Pat. No. 6,478,737 (“System and method for analyzing normalized patient voice feedback an automated collection and analysis patient care system”); U.S. Pat. No. 6,168,563 (“Remote health monitoring and maintenance system”).
• Operation8348 describes activating one or more sensor-containing modules in a vicinity of the first body part of the subject (e.g. linking module1690 transmitting a sonic, optical, orother activation signal1693 to animplant1730 or other suitable device within a proximity of tissue1725 of subject1720). This can occur, for example, in embodiments in which such animplant1730 or hand-heldinstrument1760 implements one or moreprimary modules1600, in whichsuch signals1693 trigger or otherwise enable an effective image capture or other detection operation as described herein via one ormore transducers1767 orother sensors1733, and in which a clot or other circulatory obstruction may otherwise be difficult to locate and treat in time. Alternatively or additionally, such sensors may be configured to include or otherwise provide data tosoftware1974 or othersuch measurement logic1975 operable for performingoperation8348 by detecting a status or other attribute oflimb1722 orother body parts1920 within an effective detection range of one or more of the sensor(s).
• In light of teachings herein, numerous existing techniques may be applied for implementing and interacting with decision logic, data capture or transformation configurations, or other components within or for use with condition or event detection as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,304,580 (“Intelligent medical vigilance system”); U.S. Pat. No. 7,261,690 (“Apparatus for monitoring health, wellness and fitness”); U.S. Pat. No. 7,155,281 (“Complimentary activity sensor network for disease monitoring and therapy modulation in an implantable device”); U.S. Pat. No. 7,024,234 (“Method and apparatus for monitoring the autonomic nervous system”); U.S. Pat. No. 6,984,207 (“Passive physiological monitoring (P2M) system”); U.S. Pat. No. 6,980,851 (“Method and apparatus for determining changes in heart failure status”); U.S. Pat. No. 6,689,069 (“Apparatus and method for blood pressure pulse waveform contour analysis”); U.S. Pat. No. 6,600,949 (“Method for monitoring heart failure via respiratory patterns”); U.S. Pat. No. 6,358,201 (“Method and apparatus for facilitating physiological coherence and autonomic balance”); U.S. Pat. No. 6,312,378 (“System and method for automated collection and analysis of patient information retrieved from an implantable medical device for remote patient care”); U.S. Pat. No. 6,179,793 (“Cardiac assist method using an inflatable vest”); U.S. Pat. No. 5,978,693 (“Apparatus and method for reduction of motion artifact”); U.S. Pat. No. 4,860,751 (“Activity sensor for pacemaker control”).
• Operation8391 describes deciding whether to transmit a notice to a user interface in response to at least one of the one or more comparisons between the local respiratory-status-indicative information about the first body part of the subject and the filtering information at least partly based on the subject (e.g. module1441 ofdecision logic1460 deciding whether to send one ormore notices1472 viatransmitter1473 in response to one ormore comparators1431,1433). This can occur, for example, in a context in whichdecision logic1460 performsoperation8270, in which an interface or other component of remote module3190 (ofFIG. 31) is configured to receivenotice1471,1472 orother output1485, and in which the filtering information applied bysuch comparators1431,1433 may each apply an identifier, a type, an evaluation, or some other attribute of a specific subject for which such information is required or forbidden. In some variants, for example, the information transmitted for display may contain all local status indicators derived or otherwise measured for a medical patient. Alternatively or additionally,module1441 may be configured to causelocal interface1475 to display or otherwise reveal one or moresuch notice1471.
• In light of teachings herein, numerous existing techniques may be applied for the display of sensor data and/or derived information as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,321,862 (“System and method for patient-worn monitoring of patients in geographically dispersed health care locations”); U.S. Pat. No. 7,319,386 (“Configurable system for alerting caregivers”); U.S. Pat. No. 7,285,090 (“Apparatus for detecting, receiving, deriving and displaying human physiological and contextual information”); U.S. Pat. No. 6,731,976 (“Device and method to measure and communicate body parameters”); U.S. Pat. No. 6,246,992 (“Multiple patient monitoring system for proactive health management”); U.S. Pat. No. 5,576,952 (“Medical alert distribution system with selective filtering of medical information”); U.S. Publication No. 20040030578 (“Automated clinical system to facilitate secondary review and authentication of clinical laboratory result values”); U.S. Pat. No. 6,332,502 (“Pipe loading device for a directional drilling apparatus”); U.S. Pat. No. 6,893,396 (“Wireless internet bio-telemetry monitoring system and interface”); U.S. Pat. No. 7,304,580 (“Intelligent medical vigilance system”); U.S. Pat. No. 6,694,177 (“Control of data transmission between a remote monitoring unit and a central unit”); U.S. Pat. No. 6,035,230 (“Real-time biological signal monitoring system using radio communication network”).
• Operation8394 describes recording at least one difference between the local respiratory-status-indicative information about the first body part of the subject and the filtering information at least partly based on the subject (e.g. module8173 ofdecision logic8171 causing a recordation ofoutput1485 from one or more subtraction modules orother comparators1433 that receive such inputs). This can occur, for example, in a context in which one or more rotating storage media orother storage devices1492 are operatively coupled directly or indirectly toprimary module1400, in whichprimary module1400 includes or otherwise interacts withcircuitry8170, and in whichmodule8173 ofdecision logic8171 is configured to invokedevice1492 for recording such outputs. Such event information may include an identifier, a type, or some other attribute of a specific subject to which the information pertains. Alternatively or additionally,such recordable output1485 may likewise contain the respiratory-status-indicative information and the filtering information to which it was compared.
• In light of teachings herein, numerous existing techniques may be applied for recording of event information resulting from the comparison of measured and/or derived information to filtering information as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,226,422 (“Detection of congestion from monitoring patient response to a recumbent position”); U.S. Pat. No. 7,127,370 (“Attitude indicator and activity monitoring device”); U.S. Pat. No. 6,980,851 (“Method and apparatus for determining changes in heart failure status”); U.S. Pat. No. 6,978,182 (“Advanced patient management system including interrogator/transceiver unit”); U.S. Pat. No. 6,881,192 (“Measurement of sleep apnea duration and evaluation of response therapies using duration metrics”); U.S. Pat. No. 6,336,903 (“Automated collection and analysis patient care system and method for diagnosing and monitoring congestive heart failure and outcomes thereof); U.S. Pat. No. 6,035,230 (“Real-time biological signal monitoring system using radio communication network”).
• Operation8397 describes detecting an apparently-normal-respiration indicator from the one or more comparisons between the local respiratory-status-indicative information about the first body part of the subject and the filtering information at least partly based on the subject (e.g. module3221 ofdecision logic3230 determining that no cellular-respiration-abnormality-indicative criteria3227 are apparently satisfied byrecent measurements3238 of a subject). This can occur, for example, in a context where one or more respiratory-status-indicative information comparisons are used to assess the status of the “first” body part3272 of subject3270 and in which such specific detection may help avoid damage to a subject's heart or brain. In one variant, one ormore comparison results3233,3235 are correlated with one or moreprior comparison results3231,3232 or other historic filtering information to avoid a (false)positive notification3212 about a body part in a context in which the body part's respiratory status is apparently normal.
• In light of teachings herein, numerous existing techniques may be applied for assessing respiratory-status-indicative information including discrimination against false event recording and notification from the first body part of the subject as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,277,747 (“Arrhythmia memory for tachyarrhythmia discrimination”); U.S. Pat. No. 7,269,483 (“Multiple algorithm event discrimination method”); U.S. Pat. No. 7,248,921 (“Method and devices for performing cardiac waveform appraisal”); U.S. Pat. No. 7,189,204 (“Sleep detection using an adjustable threshold”); U.S. Pat. No. 6,990,980 (“Carbon dioxide-based Bi-level CPAP control”); U.S. Pat. No. 6,312,378 (“System and method for automated collection and analysis of patient information retrieved from an implantable medical device for remote patient care”).
• With reference now toFIG. 84, there are shown several variants of theflow8200 ofFIG. 82 or83.Operation8240—obtaining local respiratory-status-indicative10 information about a first body part of a subject—may (optionally) include one or more of the following operations:8443 or8447. In some embodiments, variants ofoperation8240 may be performed by one or more instances ofprocessing modules1430,1650,1680;transducers1990; orlocal modules2320,2450,2510,2690,7931,7932.Operation8270—invoking circuitry for causing one or more comparisons between the local respiratory-status-indicative information about the first body part of the subject and filtering information at least partly based on the subject—may include one or more of the following operations:8471,8474,8476 or8479. In some embodiments, variants ofoperation8270 may be performed byinvocation logic3140 and/or by one or more instances ofdecision logic275,1350,1460,2250,2730,3230,5750,5930,6130,6395,7415. Alternatively or additionally,flow8200 may be performed in a context as described above with reference to any ofFIGS. 1-80 and/or in conjunction with other flow variants as described below.
• Operation8443 describes obtaining at least some of the local respiratory-status-indicative information via one or more optical sensors (e.g. one or moreinfrared sensors1982 orother transducers1990 detecting calorimetric or otheroptical data1978 indicating an oxygenation ofblood1923 in one or more arteries orother vessels1929 upstream of a subject's brain or other organ1927). This can occur, for example, in embodiments in which one or more instances ofinterface logic1970perform operation8240 by sensing or otherwise obtaining indications of blood or other materials from30 withintissue1925, such as byimplant1940 and/or an instrument as described herein. Alternatively or additionally, one ormore component modules1621,1622 ofresponse module1620 ofFIG. 16 may performoperation8443 by triggeringprocessing module1680 to derive the local respiratory-status-indicative information from such indications. This can occur, for example, in embodiments in whichdecision logic1460 ofFIG. 14 performsoperation8270 with other respiratory-status-indicative information1456 as described herein, such as may be provided by linkingmodule1690 in a context in which primary module1600 (ofFIG. 16) comprises one or more instances of interface logic1970 (ofFIG. 19) innetwork1490. Alternatively or additionally,processing module1430 may receivefluid movement data1453, pressure-fluctuation data1452, or othersuch information1455 indicative of an apparently healthy flow ofblood1923 through avital organ1927 orother tissue1925.
• In light of teachings herein, numerous existing techniques may be applied for obtaining subject status information through the use of one or more optical measurement systems as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,308,292 (“Optical-based sensing devices”); U.S. Pat. No. 7,305,262 (“Apparatus and method for acquiring oximetry and electrocardiogram signals”); U.S. Pat. No. 7,280,858 (“Pulse oximetry sensor”); U.S. Pat. No. 7,004,907 (“Blood-pressure monitoring device featuring a calibration-based analysis”); U.S. Pat. No. 5,755,741 (“Body position and activity sensor”); U.S. Pat. No. 5,601,811 (“Substantive water-soluble cationic UV-absorbing compounds”); U.S. Publication No. 20030050542 (“Device for in-vivo measurement of the concentration of a substance contained in a body fluid”); U.S. Publication No. 20020016535 (“Subcutaneous glucose measurement device”) or U.S. Pat. No. 7,181,054 (“System for processing image representative data”).
• Operation8447 describes obtaining an indication of a respiratory status within a limb as the local respiratory-status-indicative information (e.g. registry1685 receiving one ormore readings1681,1682 from avessel1929routing blood1923 to or from limb tissue). This can occur, for example, in embodiments in which primary system1600 (ofFIG. 16) includes or otherwise interacts with aninstrument1960 configured to monitor a subject's limb, in which one or more such readings are obtained by atransducer1767 orother sensors1733 and/or animplant1730 orother instrument1760, and in which at least some ofprimary module1600 performsoperation8240 using one ormore readings1681,1682 and/or information derived from such readings byprocessing module1680. Alternatively or additionally, subject-provideddata2922 received via a handheld device, microphone, or other component ofinterface2926 may include an auditory orother identifier2923 of a limb experiencing a symptom, for example. Such information may enable or trigger monitoring or other measurements via sensors as described herein, for example, or may enable or trigger a notice to an interface as described below with reference tooperation8471.
• In light of teachings herein, numerous existing techniques may be applied for the monitoring of the respiratory-status-information and/or subject evaluation of the respiratory status of a body part or region including remote monitoring and evaluation of this information as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,077,809 (“System for measuring and analyzing vasodilatation index”); U.S. Pat. No. 6,983,178 (“Probe for use in non-invasive measurements of blood related parameters”); U.S. Pat. No. 6,939,304 (“Method and apparatus for non-invasively evaluating endothelial activity in a patient”); U.S. Pat. No. 6,926,668 (“System and method for analyzing normalized patient voice feedback in an automated collection and analysis patient care system”); U.S. Pat. No. 6,878,111 (“System for measuring subjective well being”); U.S. Pat. No. 6,740,045 (“Central blood pressure waveform estimation device and peripheral blood pressure waveform detection device”); U.S. Pat. No. 6,720,712 (“Piezoelectric identification device and applications thereof”); U.S. Pat. No. 6,540,668 (“Endoscope with a coupling device (video coupler) for connection of a video camera”); U.S. Pat. No. 6,445,945 (“Non-invasive detection of endothelial dysfunction by blood flow measurement in opposed limbs using tracer injection”); U.S. Pat. No. 6,282,441 (“Health monitoring system”); U.S. Pat. No. 6,152,881 (“Calibrated measurement of blood vessels and endothelium after reactive hyperemia and method therefor”); U.S. Pat. No. 5,941,829 (“Concurrent medical patient data and voice communication method and apparatus”); U.S. Pat. No. 5,671,750 (“Peripheral blood-flow condition monitor”); U.S. Pat. No. 5,497,787 (“Limb monitoring method and associated apparatus”).
• Operation8471 describes deriving the filtering information at least partly from respiratory-status-indicative information about a second body part of the subject (e.g. module3142 adjusting one ormore thresholds3167 offiltering information3170 to ahigher value3165 in response to ahigher pressure measurement3132 orother indication3130 of a measurable attribute increase in a subject's limb1722). This can occur, for example, in a context in whichinvocation logic3140 performsoperation8270 and in which one ormore data filters3152,3189 are configured to apply one or more suchnew values3165,3161 tomeasurements3131 or otherrespiratory status indicators3130 obtained from anotherlimb1721 of the subject. Alternatively or additionally, somesuch thresholds3167 orother values3155 may be derived by arithmetically combining quantities relating to matched body parts, other subject locations, and/or systemic values. In some variants, moreover, historical data ranges relating to a common sensor, subpopulation, or body part may likewise bear upon such values as described herein.
• In light of teachings herein, numerous existing techniques may be applied for the use of historic and/or concurrent status information derived from one or more additional body parts of the subject or from other similar subjects to evaluate status information derived from the first body part as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,312,619 (“Multiple local probe measuring device and method”); U.S. Pat. No. 7,098,678 (“Multiple local probe measuring device and method”); U.S. Pat. No. 7,098,673 (“Capacitive measuring system”); U.S. Pat. No. 7,052,474 (“Pharyngoesophageal monitoring systems”); U.S. Pat. No. 7,047,149 (“Optical measurement instrument and optical measurement method”); U.S. Pat. No. 6,943,574 (“Multiple local probe measuring device and method”); U.S. Pat. No. 6,822,564 (“Parallel measurement alarm processor”); U.S. Pat. No. 6,798,226 (“Multiple local probe measuring device and method”); U.S. Pat. No. 6,583,411 (“Multiple local probe measuring device and method”); U.S. Pat. No. 6,545,603 (“Measuring device using an indirect measurement of permittivity”); U.S. Pat. No. 6,238,349 (“Method and apparatus for noninvasive determination of cardiac performance parameters”).
• Operation8474 describes causing at least one of the one or more comparisons to occur while the subject sleeps (e.g. invocation module1412 directly or indirectly triggering one ormore comparators1432,3198 configured to determine whether a sleeping subject'scurrent sense data1451 apparently indicates an occluded blood vessel or other local respiratory abnormality in a weight-bearing or other peripheral body part). This can occur, for example, in a context in which one or moreprimary modules1400,3180 receivessense data1451 from sensors3284 as described herein, such as by implementingsystem3200 ofFIG. 32, and in which such timely detection may avoid a need for more intrusive measures. In some variants, for example, one or more sensor(s)3284 and/ordetection logic3285 of apparatus3290 may make basic or coarse determinations locally and frequently. In various embodiments as described herein, one ormore criteria3226,3287 may be used in deciding whether to signal a subject, whether to signal a care provider, whether to trigger further measurement and/or analysis, whether to forward data from apparatus3290 tofiltering module3210, or whether to invoke other modules or protocols as described herein.Invocation module1412 may (optionally) be configured for triggering one or more comparators remotely if and only if one or moreother comparators1432 signals a positive result, for example. Alternatively or additionally,invocation module1442 can be implemented in a system comprising one or more of an adhesive3282, a wearable or other manipulable apparatus3290, a bed orother item3150 of furniture, adetection module1411 operable for determining whether a subject is apparently asleep, avehicle1470 as described herein, or otherwise in configurations as described herein.
• In light of teachings herein, numerous existing techniques may be applied for obtaining a set of respiratory-status-indicative information based upon and/or independent of the sleep state of the subject as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,319,899 (“Sensing techniques for implantable medical devices”); U.S. Pat. No. 7,306,565 (“Ear temperature monitor and method of temperature measurement”); U.S. Pat. No.7189204 (“Sleep detection using an adjustable threshold”); U.S. Pat. No. 7,187,960 (“Apparatus and method for measuring biologic parameters”); U.S. Pat. No. 7,164,941 (“Method and system for contactless monitoring and evaluation of sleep states of a user”); U.S. Pat. No. 6,993,380 (“Quantitative sleep analysis method and system”); U.S. Pat. No. 6,835,351 (“Optical-chemical sensor”); U.S. Pat. No. 6,773,404 (“Discriminating between an awake phase and a sleep phase of a patient in an active implantable medical device”); U.S. Pat. No. 6,363,270 (“Monitoring the occurrence of apneic and hypopneic arousals”); U.S. Pat. No. 6,161,041 (“Pacemaker system with diurnal pattern controlled overdrive for prevention of tachycardia”); or U.S. Pat. No. 7,003,340 (“Electrochemical analyte sensor”).
• Operation8476 describes detecting an apparent vascular flow change as a result of the one or more comparisons between the local respiratory-status-indicative information about the first body part of the subject and filtering information at least partly based on the subject (e.g. one ormore modules3142,3143 triggering one ormore results3136,3137 of one or more comparisons betweenearlier indications3115,3183 andlater indications3125,3184 of flow in the subject). This can occur, for example, in a context in which one or more such indications3183-3185 are extracted from measurements or other event-indicative records3110,3120, in whichinvocation logic3140 performsoperation8270 by invoking evaluation logic3197 (remotely) orother data filters3151 that perform such comparisons.Such filtering information3170 may (optionally) be partly based upon contemporaneous local respiratory-status-indicative information obtained from other body parts of the subject, for example, to ascertain whether a detected change is apparently vascular, as described herein.
• In light of teachings herein, numerous existing techniques may be applied for monitoring apparent vascular flow, detecting apparent changes within parts of a subject, or evaluating such phenomena as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,331,928 (“Ultrasonic doppler bloodstream measurement device”); U.S. Pat. No. 7,297,280 (“Method and apparatus to measure blood flow in hemodialysis shunts”); U.S. Pat. No. 7,289,927 (“Method and apparatus for the monitoring of body temperature and/or blood flow”); U.S. Pat. No. 7,254,432 (“Method and device for non-invasive measurements of blood parameters”); U.S. Pat. No. 7,226,415 (“Microwave hemorrhagic stroke detector”); U.S. Pat. No. 7,200,431 (“Implantable blood flow monitoring system”); U.S. Pat. No. 7,195,598 (“Method for determining the effectiveness of a medical therapy by analysis of collateral vessels”); U.S. Pat. No. 7,171,251 (“Physiological stress detector device and system”); U.S. Pat. No. 7,128,713 (“Doppler ultrasound method and apparatus for monitoring blood flow and hemodynamics”); U.S. Pat. No. 6,740,042 (“Bilateral simultaneous doppler measurement of segmented sphygmomanometry”); U.S. Pat. No. 6,520,919 (“Inferior-and-superior-limb blood-pressure-index measuring apparatus”); U.S. Pat. No. 6,413,223 (“Cuffless continuous blood pressure monitor”); U.S. Pat. No. 6,117,087 (“Method and apparatus for noninvasive assessment of a subject's cardiovascular system”); U.S. Pat. No. 5,724,983 (“Continuous monitoring using a predictive instrument”).
• Operation8479 describes causing at least one of the one or more comparisons between the local respiratory-status-indicative information about the first body part of the subject and the filtering information at least partly based on the subject to be performed remotely (e.g. module3141 transmitting one ormore indications3181,3182 of an apparent respiratory status of a part of a subject's body to enableremote module3190 to compare such indications each against one or more comparative determinants as described herein). This can occur, for example, in a context in whichinvocation logic3140 performsoperation8270, in whichsystem300 ofFIG. 3 implementsprimary module3180, and in which one or more instances ofremote modules3190 receive indications of age, pathology, gender, risk profile, or other such categories ormeasurements1458 ofdeterminant data1459 relating to each of one ormore subjects310,320 to be used in the comparison(s). In some variants, for example,remote module3190 may implement a data aggregator, expert system, and/or other system described herein operable for analyzing one or more indications311-314 of a current status of the legs ofsubject310. This may facilitate a health care professional defining, applying, or adjusting the filtering information to update one or more heuristic models, such as by discounting anindication314 of a respiratory deficiency in a left thigh in response to acorresponding indication312 of a respiratory deficiency in the corresponding (left) calf. In a context in which one or more such indications suggest a dangerous clot or other urgent situation in a context like that of ofFIGS. 3-6, for example, a caregiver station or other entity nearby may receive a timely notification as described herein. In an embodiment in which the context ofFIG. 8 orFIG. 2 includesprimary module1400, for example, one or more indications as described herein may include global positioning system (GPS) coordinates, a seat identifier, or other such location-descriptive information1457 suitable for use by such caregivers.
• In light of teachings herein, numerous existing techniques may be applied for the transmission of current information and/or for the programmatic evaluation of subject-health-related information as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,319,386 (“Configurable system for alerting caregivers”); U.S. Pat. No. 7,311,665 (“Bio-information sensor monitoring system and method”); U.S. Pat. No. 7,304,580 (“Intelligent medical vigilance system”); U.S. Pat. No. 7,258,670 (“System and method for diagnosing and monitoring respiratory insufficiency for automated remote patient care”); U.S. Pat. No. 7,200,431 (“Implantable blood flow monitoring system”); U.S. Pat. No. 6,454,705 (“Medical wellness parameters management system, apparatus and method”); U.S. Pat. No. 6,416,471 (“Portable remote patient telemonitoring system”); U.S. Pat. No. 6,409,662 (“Patient interface system”); U.S. Pat. Pub. No. 2007/0010719 (“Remote access to healthcare device diagnostic information”).
• With reference now toFIG. 85, shown is asystem8500 in which one or more technologies may be implemented. An adhesive, rigid, orother mesh8531 is configured to hold one ormore sensors8561,8562,modules8563, or other such structures on or near a subject'sskin8502 as described herein. Alternatively or additionally, special-purpose orother circuitry8590 may include one or more instances ofinterface8575,memory8578,communication ports8579,decision logic8585,filtering criteria8588, or other such structures described herein, for example, configured to receiveinformation8521,8522 along respective conduits orother signal paths8538.Data8573,8574 may include one or more instances ofmeasurements8571 and/or shape-indicative images8572 in some variants, for example.Decision logic8585 may likewise handle one ormore notifications8581,modules8582, ordecisions8583 as described below.
• With reference now toFIG. 86, shown is aflow8600 comprisingoperation8610—obtaining local thermal information about a peripheral part of a body of a subject (e.g. interface8575 receiving one ormore measurements8571,infrared images8572, orother information8521,8522 indicating local thermal variations in respective portions of the subject's skin8502). This can occur, for example, in a context in which mesh8531 is configured to bear the subject's weight and/or hold one ormore sensors8561,8562 orother modules8563 adjacent the subject'sskin8502. In some variants, for example,interface8575 may apply one ormore filtering criteria8588 for extracting a selection or other indication ofsuch data8573,8574 for transmission tomemory8578,communication port8579, and/ordecision logic8585. Alternatively or additionally,such data8574 may (optionally) contain one or more indications of pressure, pathology, concentration, type, level change, timing, or other such parameters for use by other modules as described herein.
• In light of teachings herein, numerous existing techniques may be applied for receiving, extracting, or otherwise obtaining thermal indications via sensors or other structures in, on, or near body parts as described herein without undue experimentation. See, e.g., U.S. Pat. No. 6,983,178 (“Probe for use in non-invasive measurements of blood related parameters”); U.S. Pat. No. 6,975,232 (“Apparatus and method for “seeing” foot inside of shoe to determine the proper fit of the shoe”); U.S. Pat. No. 7,340,293 (“Methods and apparatus for a remote, noninvasive technique to detect core body temperature in a subject via thermal imaging”); U.S. Pat. No. 7,275,867 (“Probe assembly of infrared thermometer”); U.S. Pat. No. 7,087,903 (“Gamma camera and CT system”); U.S. Pat. No. 6,979,293 (“Blood flow reestablishment determination”); U.S. Pat. No. 6,542,767 (“Method and system for controlling heat delivery to a target”); U.S. Pat. No. 6,402,371 (“Axillary infrared thermometer and method of use”).
• Operation8660 describes signaling a decision whether to transmit a notification in response to one or more comparisons between filtering information specific to an attribute of the subject and the local thermal information about the peripheral part of the body of the subject (e.g. decision logic8585 queuing or otherwise causing a transmission of one ormore notifications8581 only ifmodule8582 generates an affirmative decision8583). This can occur, for example, in a context in whichcircuitry8590 is physically implemented withinmodule8563 or otherwise nearmesh8531, in which one ormore filtering criteria8588 are suitable for use with at least some thermal component ofdata8573,8574, and in whichmodule8582 will generate a negative decision if none of the one or more comparisons between the filtering information and the thermal information indicate a roughly simultaneous interpositional temperature difference greater than a given threshold. In some variants, an instance ofdecision logic8585 may be configured to detect temperature gradient that exceeds 1° C. for about ten minutes or more, for example, or otherwise to decide whether the subject'sskin8502 apparently indicates a localized area of persistent warmth or coolness. Alternatively or additionally, an instance ofdecision logic8585 may be configured to detect a locality of high pressure, discoloration, swelling, or other attributes of an objectively detectable trend that persists for more than a given threshold of time (e.g. on the order of an hour or a day, in some contexts). In some variants in whichcircuitry8590 is implemented in a distributed configuration, moreover, one or more modules ofdecision logic8585 may be implemented at an aggregation site, optionally remote from one or more subjects, such as to facilitate complex image processing, expert participation, or other such resource-intensive analysis.
• In light of teachings herein, numerous existing techniques may be applied for handling destinations, abstentions, conditions, configurations, or other notification decisions as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,340,687 (“Display control device and method”); U.S. Pat. No. 7,296,042 (“System and method for enabling communication among arbitrary components”); U.S. Pat. No. 7,284,061 (“Obtaining temporary exclusive control of a device”); U.S. Pat. No. 7,263,073 (“Systems and methods for enabling a mobile user to notify an automated monitoring system of an emergency situation”); U.S. Pat. No. 7,216,263 (“Performance monitoring and notification in a threshold sensitive storage management system”); U.S. Pat. No. 7,196,620 (“Sensor monitoring apparatus, monitoring system, sensor monitoring method and program”); U.S. Pat. No. 7,180,983 (“Guidance information notification apparatus in communication network system, communication network system and guidance information notification method”); U.S. Pat. No. 7,174,005 (“School-wide notification and response system”); U.S. Pat. No. 7,155,729 (“Method and system for displaying transient notifications”); U.S. Pat. No. 7,143,222 (“Adaptive message delivery system”); U.S. Pat. No. 7,136,357 (“Transmission path controlling apparatus and transmission path controlling method as well as medium having transmission path controlling program recorded thereon”); U.S. Pat. No. 7,088,993 (“Optimized message notification”); U.S. Pat. No. 7,039,698 (“Notification device interaction”); U.S. Pat. No. 6,886,002 (“Computational architecture for managing the transmittal and rendering of information, alerts, and notifications”); U.S. Pat. No. 6,871,214 (“Generating and providing alert messages in a communications network”); U.S. Pat. No. 6,690,267 (“Remotely controllable bicycle lock and alarm system”); U.S. Pat. No. 6,687,230 (“Routing system and method”); U.S. Pat. No. 6,591,182 (“Decision making process and manual for diagnostic trend analysis”); U.S. Pat. No. 6,513,026 (“Decision theoretic principles and policies for notification”); U.S. Pat. No. 6,438,216 (“Nonintrusive call notification method and system using content-specific information”); U.S. Pat. No. 6,195,571 (“Electronic apparatus capable of automatically switching notification devices”); U.S. Pat. No. 5,740,540 (“Method for telephone number notification and storage in a portable radio”).
• With reference now toFIG. 87, there are shown several variants of theflow8600 ofFIG. 86.Operation8610—obtaining local thermal information about a peripheral part of a body of a subject—may (optionally) include one or more of the following operations:8713 or8717. In some embodiments, variants ofoperation8610 may be performed by one or more instances oflocal modules2320,2450,2510,2690 configured to handle sensor data;event detection logic2333 orother detection logic180,640,880,1275,3285,3550,7940; or other devices configured for thermal imaging, statistical analysis, or other modes of facilitating data evaluations by various users.Operation8660—signaling a decision whether to transmit a notification in response to one or more comparisons between filtering information specific to an attribute of the subject and the local thermal information about the peripheral part of the body of the subject—may include one or more of the following operations:8762,8763,8765 or8769. In some embodiments, variants ofoperation8660 may be performed by one or more instances ofevaluation logic150,250,950,1530,7565;decision logic275,1350,1460,2250,2730,3230,5750,5930,6130,6395,7415, or other processing or communication devices as described herein. Alternatively or additionally,flow8600 may be performed in a context as described above with reference to any ofFIGS. 1-80 and/or in conjunction with other flow variants as described below.
• Operation8713 describes obtaining a first thermal indicator in association with a first location and a second thermal indicator in association with a second location (e.g.sensors126,127,128 taking temperature-indicative readings at their respective locations inzones111,112,113). This can occur, for example, in embodiments in whichmodule141 performsoperation8610 and in which comparator130 performsoperation8660 by applyingfiltering information131 to the thermal, temporal, and other data from the sensors. Alternatively or additionally,module141 may performoperation8713 by receiving a thermal image of a subject's limb or other such data associated with a range of locations.
• In light of teachings herein, numerous existing techniques may be applied for detecting, analyzing, or otherwise handling temperature-indicative data in various contexts as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,336,202 (“Temperature monitoring device”); U.S. Pat. No. 7,318,004 (“Temperature prediction system and method”); U.S. Pat. No. 7,264,591 (“System and method for monitoring air flow from a person”); U.S. Pat. No. 6,843,774 (“Technique for diagnosing attention deficit hyperactivity disorder”); U.S. Pat. No. 6,445,183 (“Magnetic resonance image diagnosing apparatus”); U.S. Pat. No. 6,299,347 (“Ambient and perfusion normalized temperature detector”).
• Operation8717 describes capturing one or more shape-indicative images in the local thermal information about the peripheral part of the body of the subject (e.g. recorder148 recording one ormore images1697 from a thermal sensor array into a memory or other media1695). This can occur, for example, in embodiments in which primary module1600 (ofFIG. 16) implements evaluation logic150 (ofFIG. 1) and in which one or more active sets ofinfrared sensors1982 or other optical sensors are configured to apply respective-set-specific intensity thresholds1651,1653 and/orfrequency thresholds1652,1654. Such an embodiment may be used, for example, to estimate an areal expansion or other gradient relating to a region of abnormal temperature. Alternatively or additionally, such data may be used to derive an aspect ratio, a shape type, or other such shape-indicative attributes1699 of developing infections, circulatory problems, or other such thermally detectablelocal abnormalities105.
• Operation8762 describes deciding not to transmit the notification responsive to none of the one or more comparisons between the filtering information and the local thermal information indicating a thermal abnormality (e.g. one ormore modules1531 ofevaluation logic1530 deciding whether to transmitnotification1580 in the negative responsive to one ormore results1523 of applying one ormore thresholds1561,1562 or other criteria1573). This can occur, for example, in a context in which the result(s)1523 indicate a normal thermal measurement relative to one ormore normality thresholds1561 such as those described herein and in which one or more users have indicated an availability to receive such notifications. Such decisions may likewise result from one or more auditory or other non-thermal indications of normalcy such as counter-indicia of pathologies identified herein. Alternatively or additionally, one or moresuch modules1531,1532 may be configured to generate such a negative decision in response to a prior notification recipient or other user's response directing or otherwise warranting thatnotification1580 not be sent.
• In light of teachings herein, numerous existing techniques may be applied for selective communications incorporating triage protocols or other programmatic responses as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,299,157 (“Event analysis system method and software”); U.S. Pat. No. 7,228,315 (“Computer-automated implementation of user-definable decision rules for medical diagnostic or screening interpretations”); U.S. Pat. No. 7,213,009 (“Systems and methods for manipulating medical data via a decision support system”); U.S. Pat. No. 7,209,671 (“Multiple detector decision receiver”); U.S. Pat. No. 7,116,825 (“Multilevel chain-and-tree model for image-based decisions”); U.S. Pat. No. 6,830,549 (“Method and apparatus for providing patient care”); U.S. Pat. No. 6,751,255 (“Decision feedback analyzer with filter compensation”); U.S. Pat. No. 6,636,621 (“Systems and methods with identity verification by comparison & interpretation of skin patterns such as fingerprints”); U.S. Pat. No. 6,629,937 (“System for processing audio, video and other data for medical diagnosis and other applications”).
• Operation8763 describes associating the subject with one or more of a duration indicator or a pathology indicator (e.g. module3061 providing access to table3010 or other structures3020 operable for containing or otherwise facilitating one or more duration orpathology indicators3023,3024 or other event orstatus indicators3022 responsive to one or moresubject identifiers3034 or other search terms3030). This can occur, for example, in a context in which at least some such indicators reside in acommon record3013 satisfying one ormore search terms3030. Alternatively or additionally, in some variants, a notification as described herein may refer to a recipient or be sent to a recipient interface or user having a priori knowledge of such an association.
• In light of teachings herein, numerous existing techniques may be applied for communicating event or status indications relating to a subject as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,248,916 (“Automated system and method for establishing a patient status reference baseline”); U.S. Pat. No. 7,232,158 (“Fitting for formation of a fluid-conducting connection”); U.S. Pat. No. 7,177,699 (“Lifestyle management system”); U.S. Pat. No. 7,122,005 (“Remote patient monitoring system with garment and automated medication dispenser”); U.S. Pat. No. 6,840,117 (“Patient monitoring system employing array of force sensors on a bedsheet or similar substrate”); U.S. Pat. No. 6,783,492 (“System and method for monitoring body functions”); U.S. Pat. No. 6,616,606 (“Patient monitoring system”); U.S. Pat. No. 6,584,931 (“System and method for controlling and monitoring the operation of an automatic milking system”).
• Operation8765 describes selecting at least one destination in response to at least one of the one or more comparisons between the filtering information and the local thermal information (e.g. one ormore modules1534 selecting one or more first-type destinations1583,1591 in response to acomparison result1522 and otherwise selecting one or more second-type destinations1584,1592). This can occur, for example, in a triage protocol in whichsuch results1522 respectively reflect greater and lesser degrees of urgency or in which the second-type destination1584 ofnotification1580 identifies a notification recipient list and in which a subject is unconscious, unable to communicate, or otherwise vulnerable to such thermally-manifested pathologies. Alternatively or additionally,module1534 may likewise select among risk-indicative data1553 or otheravailable content1581,1582 for inclusion in each such notification in response to one or moreother evaluation results1521 as described herein.
• In light of teachings herein, numerous existing techniques may be applied for notification routing or other modes of destination selection as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,286,648 (“Emergency locator system”); U.S. Pat. No. 7,260,064 (“Method and apparatus for performing network routing based on queue lengths”); U.S. Pat. No. 7,212,111 (“Method and system for use in emergency notification and determining location”); U.S. Pat. No. 7,203,294 (“System and method for dynamically routing communications”); U.S. Pat. No. 7,116,655 (“Telecommunication system for automatically locating by network connection and selectively delivering calls to mobile client devices”); U.S. Pat. No. 6,970,847 (“Business method for secure document folder distribution”); U.S. Pat. No. 6,638,218 (“System and method for delivering medical examination, diagnosis, and treatment over a network”); U.S. Pat. No. 6,539,302 (“Method, system, and article of manufacture for providing notification of traffic conditions”).
• Operation8769 describes generating the filtering information partly based on the attribute of the subject and partly based on an attribute of a caregiver (e.g. module2244 configuring one ormore parameters2247,2248 in response to one ormore indications2261,2263 of the subject's age or apparent pathology and in response to one ormore indications2262,2264 of a notification recipient's apparent availability). This can occur, for example, in contexts in whichdecision logic2250 performsoperation8660 and in which (a) anindication2261 of an elderly or otherwise at-risk patient and/or (b) anindication2262 of an “available” caregiver status warrant an incrementally narrower range of “normal” thermal information. Such a narrowing may be accomplished by an increased minimum and/or by a decreased maximum, for example, applied to a measurement or other quantitative determinant as described herein. Alternatively or additionally, one or more othersuch indications2263,2264 may likewise affect one or more parameters used in other filtering as described herein. In some variants, moreover, such filtering information may likewise depend on one or more expert inputs,operational parameters2248, or other programmatic updates as described herein.
• In light of teachings herein, numerous existing techniques may be applied for adaptive or other conditional data evaluation as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,123,950 (“Nuisance alarm reductions in a physiological monitor”); U.S. Pat. No. 7,079,035 (“Method and apparatus for controlling an alarm while monitoring”); U.S. Pat. No. 6,996,427 (“Pulse oximetry data confidence indicator”); U.S. Pat. No. 6,898,585 (“Fuzzy logic method for adaptively evaluating the validity of sensor data”); U.S. Pat. No. 6,569,095 (“Adaptive selection of a warning limit in patient monitoring”); U.S. Pat. No. 6,473,708 (“Device and method for self-verifying temperature measurement and control”); U.S. Pat. No. 6,241,661 (“Selecting limit values in particular for patient monitoring systems”); U.S. Pat. No. 6,047,201 (“Infant blood oxygen monitor and SIDS warning device”).
• With reference now toFIG. 88, there are shown several variants of theflow8600 ofFIG. 86 or87.Operation8610—obtaining local thermal information about a peripheral part of a body of a subject—may (optionally) include one or more of the following operations:8812 or8819. In some embodiments, variants ofoperation8610 may be performed by one or more instances ofinterface2260; apparatus3290; or other such sensor-containing, communication, or processing devices.Operation8660—signaling a decision whether to transmit a notification in response to one or more comparisons between filtering information specific to an attribute of the subject and the local thermal information about the peripheral part of the body of the subject—may include one or more of the following operations:8861,8864,8867 or8868. In some embodiments, variants ofoperation8660 may be performed by one ormore modules251 ofevaluation logic150,250,950,1530,7565;processing logic1180,3070; or other circuitry or software as described herein. Alternatively or additionally,flow8600 may be performed in a context as described above with reference to any ofFIGS. 1-80 and/or in conjunction with other flow variants as described below.
• Operation8812 describes receiving a result of a remote entity comparing the local thermal information about the peripheral part of the body of the subject with other thermal information about the body of the subject (e.g. port2255 receiving one ormore results2251,2252 from aserver2220,interface2210, or other resource that is remote from subject2270). This can occur, for example, in a context in whichsensors2268 and/orinterface2260 facilitates measurements or other indications2261-2264 being taken from a limb or otherperipheral body part2271 and from anothersuch body part2272 of subject2270. In various configurations as described herein, such measurements or other data may be derived from respective sensor-containing modules in, on, or otherwise within aproximity2277 ofsuch body parts2271,2272. Alternatively or additionally, in some variants, a skilled or other user may position one or more sensors successively to take such data at each ofsuch body parts2271,2272, optionally in response to audible directions transmitted via an output device such asspeaker2267. SeeFIGS. 18,21, &93.
• In light of teachings herein, numerous existing techniques may be applied for transmitting requests, receiving guidance, or otherwise interacting with a remote service as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,336,166 (“Remote monitoring system and method using the same”); U.S. Pat. No. 7,320,030 (“Remote health monitoring apparatus using scripted communications”); U.S. Pat. No. 7,308,492 (“Method and apparatus for use in remote diagnostics”); U.S. Pat. No. 7,283,153 (“Home-based remote medical assistance”); U.S. Pat. No. 7,202,844 (“Liquid crystal display controller and liquid crystal display”); U.S. Pat. No. 6,984,207 (“Passive physiological monitoring (P2M) system”); U.S. Pat. No. 6,908,431 (“System and method for providing feedback to an individual patient for automated remote patient care”); U.S. Pat. No. 6,847,913 (“Ambulatory surface skin temperature monitor”); U.S. Pat. No. 6,839,455 (“System and method for providing information for detected pathological findings”); U.S. Pat. No. 6,505,196 (“Method and apparatus for improving access to literature”).
• Operation8819 describes obtaining a current indication of a core temperature of the body of the subject (e.g. one or more thermometers or other sensors3284 taking one ormeasurements3238 indicative of a core temperature of subject3270 such as tympanic membrane and/or basal temperature data3261). This can occur, for example, in a context in whichdecision logic3230 and/or apparatus3290perform operation8610 and in which one ormore modules3222 ofdecision logic3230 are configured to determine whether a detected temperature change in a peripheral or other body part3272 apparently reflects a circadian or other systemic phenomenon. Alternatively or additionally, one or moreother modules3223 may applydecision criteria3226 or other such filtering information derived from other subjects of a common subpopulation (e.g. of the same age as subject3270), fromother data3262 from one or morecomparable body parts3271 of thesame subject3270, and/or from earlier-acquireddata3263 from the same peripheral part3272 as described herein.
• Operation8861 describes recording the decision whether to transmit the notification with a timestamp (e.g. module3063 recording an affirmative orother decision3004 contemporaneous with a date orother indication3005 of when such decisions were made or communicated). This can occur, for example, in a context in whichsystem200 ofFIG. 2 or other systems described herein implementmodule3063, with or without a common medium holding such modules or other elements. Alternatively or additionally,such records3011,3012,3013 may likewise include one or more supporting items indicative of a destination, a content component, a success, or other such attributes ofdecision3004. In some variants, for example,indication3005 may reflect one or more of (a) whenoperation8861 was performed, (b) whendecision3004 was obtained, (c) when such a notification arrived, or (d) when one or more of the comparisons were performed or obtained.
• In light of teachings herein, numerous existing techniques may be applied for indicating when a transmission decision was enabled or otherwise acted upon as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,225,013 (“Adaptive prediction of changes of physiological/pathological states using processing of biomedical signals”); U.S. Pat. No. 7,200,682 (“Time stamp generating system”); U.S. Pat. No. 7,117,037 (“Event marker alignment by inclusion of event marker transmission latency in the real-time data stream”); U.S. Pat. No. 7,062,528 (“Method and system for identifying a time specific event”); U.S. Pat. No. 6,961,327 (“TCP aware local retransmissioner scheme for unreliable transmission network”).
• Operation8864 describes triggering a retrieval of the filtering information with an invocation that recites at least the attribute of the subject (e.g. module3062 requesting or otherwise triggering a search for one ormore records3012 containing suitable quantitative information orother filtering data3090 by transmitting one ormore measurements3085 as described herein orother indications3081,3082 physically obtained from or otherwise specific to the subject). This can occur, for example, in a context in whichdecision logic275 ofFIG. 2 orresponse logic335 ofFIG. 3implements processing logic3070 configured to interact with any ofsubjects310,1720,1910,3270 or others described herein and in whichprocessing logic3070 performs atleast operation8660 with reference to any ofnotifications2241,2242,3051,3052 or others described herein. Alternatively or additionally, in some variants, one ormore component indications3081 of thefiltering data3090 may be derived from current or prior data from a subject as described herein without such retrieval and/or filtering.
• In light of teachings herein, numerous existing techniques may be applied for extracting comparative parameters or otherwise configuring suitable data filters as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,258,670 (“System and method for diagnosing and monitoring respiratory insufficiency for automated remote patient care”); U.S. Pat. No. 7,248,916 (“Automated system and method for establishing a patient status reference baseline”); U.S. Pat. No. 7,225,013 (“Adaptive prediction of changes of physiological/pathological states using processing of biomedical signals”); U.S. Pat. No. 7,147,600 (“System and method for determining a reference baseline of patient information”); U.S. Pat. No. 6,993,167 (“System and method for examining, recording and analyzing dermatological conditions”); U.S. Pat. No. 6,887,201 (“System and method for determining a reference baseline of regularly retrieved patient information for automated remote patient care”); U.S. Pat. No. 6,687,544 (“System and method for determining safety alert conditions for implantable medical devices”); U.S. Pat. No. 6,611,846 (“Method and system for medical patient data analysis”).
• Operation8867 describes selecting the notification in response to the one or more comparisons between the filtering information and the local thermal information (e.g. one ormore modules3064 selectingnotification3051 only if the thermal information passes one ormore criteria3035 andnotification3052 otherwise, or only if the thermal information passes one or more other criteria). This can occur in a context in whichcircuitry280 includes or otherwise interacts withinterface3000 ofFIG. 30, in whichinformation271 comprises the thermal information and reflects a circulatory obstruction or other pathology local to a limb or other peripheral body part, in whichprocessing logic3070 performsoperation8660, and in which a circulatory obstruction may be difficult to locate and treat in time. In some variants, for example, one ormore modules272,273 ofdecision logic275 may be configured to sound a local alarm (to notify a passenger, e.g.) for a local thermal deviation of at least X and to sound a remote alarm (to notify a caregiver, e.g.) for a local thermal deviation of at least X+Y. (In such a context, for example, X and Y may each be 0.3° C., 1° C., or 3° C. in respective combinations.) Alternatively or additionally, a subject-independent determinant may affect the filtering information, such as by modulating a systemic temperature estimate according to circadian rhythms based upon a time-of-day indication fromclock276.
• In light of teachings herein, numerous existing techniques may be applied for invoking various interfaces or other modes of notifying suitable parties as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,336,187 (“Patient activity monitor”); U.S. Pat. No. 7,319,386 (“Configurable system for alerting caregivers”); U.S. Pat. No. 7,138,902 (“Personal medical device communication system and method”); U.S. Pat. No. 7,130,396 (“Medical monitoring system having multiple communications channels”); U.S. Pat. No. 7,115,097 (“Positive airway pressure notification system for treatment of breathing disorders during sleep”); U.S. Pat. No. 6,978,169 (“Personal physiograph”); U.S. Pat. No. 6,340,928 (“Emergency assistance system using bluetooth technology”).
• Operation8868 describes selecting one or more pattern recognition criteria of the filtering information in response to at least one duration indicator associated with the subject (e.g. module1535 ofevaluation logic1530configuring module1533 to apply one or morelesion monitoring criteria1571,1572 in monitoringincoming data1551 responsive todata1552 indicating that a subject has been stationary for too many hours). This can occur, for example, in a context in which a user transmits a request,authorization1538, or othersuch communication1539 that one or more such systems locally or remotely monitor a subject as described herein directly at a veterinary clinic, a nursing home, or other such facility. Alternatively or additionally, one or moresuch determinant indications1542 may include a counter or other indication of how long a subject remains within a room or other vicinity, how old a subject is, how often a subject is fed or visited, or othersuch indications1541 of duration relating to healthcare as described herein.
• In light of teachings herein, numerous existing techniques may be applied for organizing, classifying, and recognizing thermal gradients or other patterns indicative of circulatory or other pathologies as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,276,031 (“System and method for classifying patient's breathing using artificial neural network”); U.S. Pat. No. 7,236,815 (“Method for probabilistically classifying tissue in vitro and in vivo using fluorescence spectroscopy”); U.S. Pat. No. 7,158,692 (“System and method for mining quantitive information from medical images”); U.S. Pat. No. 7,092,970 (“Medical image radiographing system, method for managing medical image and method for displaying medical image”); U.S. Pat. No. 7,058,450 (“Organizing data according to cardiac rhythm type”); U.S. Pat. No. 6,959,211 (“Device for capturing thermal spectra from tissue”); U.S. Pat. No. 6,856,831 (“Method for the early diagnosis of subacute, potentially catastrophic illness”); U.S. Pat. No. 6,611,846 (“Method and system for medical patient data analysis”); U.S. Pat. No. 6,430,430 (“Method and system for knowledge guided hyperintensity detection and volumetric measurement”); U.S. Pat. No. 6,377,834 (“Real time in vivo measurement of temperature changes with contrast enhanced NMR imaging”).
• With reference now toFIG. 89, shown is astructure8910 operable in conjunction withsystem8900, in which one or more technologies may be implemented.Structure8910 may include one or more items of transportation orother equipment8915,beds8916, and/or handheld or otherportable items8925. Such items may include hosiery, adhesive patches, or othersuch articles8926; bandages orother supports8927; or other such structures as described herein comprising one ormore elements8920 configured to provide information to and/or about such subjects.
• In some variants, for example,system8900 may comprisedecision logic8955 and/orinterfaces8970 operable for receiving or otherwise handlingsensor data8935 such asmeasurements8931, timingdata8934, orother data8932,8933 as described herein.System8900 may receivesuch information8921,8922,8923 or otherwise interact withsuch structures8910 via one or more intermittent orother data paths8917,8918,8919. As described herein,decision logic8955 may use some or all ofsuch temperatures8951 orother data8952 as described herein, such as for causingmodule8962 or other logic to configure orroute notification8961 orother data8965 to one ormore outputs8981,8982.
• With reference now toFIG. 90, shown is aflow9000 comprisingoperation9030—obtaining information indicating a current thermal condition in a peripheral part of a subject's body (e.g. decision logic8955 receiving one ormore temperatures8951 or othersuch information8921,8922,8923 via one or moreportable items8925 orother equipment8915 within a proximity of the subject). This can occur, for example, in a context in whichsystem8900 implements or otherwise interacts withsuch structures8910, such as by one or more conduits orother signal paths8917,8918,8919. In some variants, for example,decision logic8955 may reside within one or moreworn articles8926, abed8916, orother equipment8915 configured to support some or all of a subject. Alternatively or additionally, one or moresuch structures8910 may comprise or receive data from one or more implanted or other sensors and/or related circuitry as described above with reference toFIGS. 23-26. Such physical components may likewise incorporate or interact one or more instances ofinterface8970 operable for interacting with (some) such subjects or other parties, such as by performingoperation9090.
• Operation9090 describes signaling a decision whether to transmit a notification at least partly in response to one or more comparisons between the information indicating the current thermal condition in the peripheral part of the subject's body and information indicating a prior thermal condition in the peripheral part of the subject's body (e.g. interface8970 directing one ormore notifications8961 to one ormore outputs8981 corresponding to recipients who have requested or may otherwise benefit from such timely information). This can occur, for example, in a context in whichdecision logic8955 has addressed the notifications or otherwise selected the output(s)8981 according to one or more expert-defined thresholds or other criteria as described herein. In some variants, for example, a recipient or other managing entity associated withoutput8982 may choose a more extreme temperature or other threshold as a cutoff in response to receiving an excessive number of notifications that are not actionable. Alternatively or additionally, such an entity may likewise choose a mode of transmission, an inclusion ofdata8965, or some other aspect of configuringnotification8961 in response to a recipient's indication of availability as described herein.
• With reference now toFIG. 91, there are shown several variants of theflow9000 ofFIG. 90.Operation9030—obtaining information indicating a current thermal condition in a peripheral part of a subject's body—may (optionally) include one or more of the following operations:9135 or9137. In some embodiments, variants ofoperation9030 may be performed by one or more instances of extraction logic,detection logic640,7940; or other such data reception or distillation logic as described herein.Operation9090—signaling a decision whether to transmit a notification at least partly in response to one or more comparisons between the information indicating the current thermal condition in the peripheral part of the subject's body and information indicating a prior thermal condition in the peripheral part of the subject's body—may include one or more of the following operations:9191,9193,9196 or9199. In some embodiments, variants ofoperation9090 may be performed by one or more instances ofdetection logic180,640,880,1275,3285,3550,5135,5670,6110,6720,7940;notification logic1290,3535,3991,6180,7460,7875; or other such processing and/or communication components. Alternatively or additionally,flow9000 may be performed in a context as described above with reference to any ofFIGS. 1-80 and/or in conjunction with other flow variants as described below.
• Operation9135 describes determining that the information apparently manifests the current thermal condition in the peripheral part of the subject's body (e.g. evaluation module7952 identifying abnormal-temperature-indicative data7991 received from one or more components oflocal module7932 and normal-temperature-indicative data7992 received from local module7931). This can occur, for example, in a context in whichconfiguration module7942 andevaluation module7952 jointly performoperation9030; in which other components ofdetection logic7940perform operation9090; in whichevaluation module7952 implicitly treats such data7991-7996 as “current” and “spatially separated” for diagnostic purposes; in which at least two suchlocal modules7931,7932 each instantiatelocal module2510 ofFIG. 25 (local to subject7920, e.g.); and in whichlocal module7932 detects two or more physical phenomena as described herein fromperipheral body part7922. In some variants, for example, one ormore elements7933 of suchlocal modules7931,7932 may comprise respective instances oftemperature sensors2512 or other sensors as shown inFIG. 25. Alternatively or additionally, some or all such data7991-7996 may (optionally) include (a) color-indicative orother measurement data7994; (b) timestamps2544, coordinates2545, anatomical descriptions, shape data, or other such temporal orspatial indices2546; and/or (c)pathology profile data7995; or other such diagnostically useful information.
• In light of teachings herein, numerous existing techniques may be applied for determining a data object type, format, or other indication whether data may be evaluated as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,296,238 (“Method and apparatus for triggering automated processing of data”); U.S. Pat. No. 7,269,718 (“Method and apparatus for verifying data types to be used for instructions and casting data types if needed”); U.S. Pat. No. 7,263,688 (“Method and apparatus for dynamic data-type management”); U.S. Pat. No. 7,020,666 (“System and method for unknown type serialization”); U.S. Pat. No. 7,016,601 (“Method and apparatus for storing different types of data on the same storing medium”); U.S. Pat. No. 6,738,769 (“Sorting multiple-typed data”); U.S. Pat. No. 6,621,506 (“Applying operations to selected data of different types”); U.S. Pat. No. 6,170,997 (“Method for executing instructions that operate on different data types stored in the same single logical register file”); U.S. Pat. No. 5,718,247 (“Apparatus and process for interactive psychotherapy”).
• Operation9137 describes extracting a portion of detected information as the information indicating the current thermal condition in the peripheral part of the subject's body (e.g. module8002 ofextraction logic8010 selectively including one ormore measurements8017 orratios8034 or other measurement-basedcomputations8036 extracted fromoutput8012 of sensors or other detection circuitry as described herein). This can occur, for example, in a context in which asampling8014, adistillation8015, one ormore measurements8016,8017 of particular interest, or some other subset ofsuch output8012 is logged or otherwise retained for comparison and/or included in one or more notifications as described herein. In some variants, for example, such a notification may include ablood pressure measurement8018, a range orother type identifier8019, and/or other such extractedinformation8020. Alternatively or additionally, such a notification may includeadvice8032, a recipient-appropriate translation, or other suchcategorical information8030 extracted from adatabase8081 or other suchsecondary information source8080 using the extractedinformation8020, for example, as a search term.
• In light of teachings herein, numerous existing techniques may be applied for selectively retaining probative data portions or otherwise sampling or sifting detected information as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,343,305 (“Method and system for recording carious lesions”); U.S. Pat. No. 7,325,297 (“Automatic assembly machine for mounting bearings onto motors”); U.S. Pat. No. 7,280,992 (“Method for processing medically relevant data”); U.S. Pat. No. 7,254,425 (“Method for detecting artifacts in data”); U.S. Pat. No. 7,076,436 (“Medical records, documentation, tracking and order entry system”); U.S. Pat. No. 6,826,578 (“Method, system, and computer product for collecting and distributing clinical data for data mining”); U.S. Pat. No. 6,611,846 (“Method and system for medical patient data analysis”).
• Operation9191 describes deciding whether to transmit the notification responsive to whether any of the one or more comparisons indicate an abnormal temperature change in the peripheral part of the subject's body (e.g. module643 ofdetection logic640 sounding an alarm only if comparison result655 indicates that any part of a subject'sseat610 is excessively hot or cold). This can occur, for example, in a context in whichdetection logic640 is implemented in or otherwise coupled to respective portions ofseat610 via one ormore signal paths631,632,633,634; in whichmodule641 and/orresponsive logic650perform operation9030; in whichdetection logic640 performsoperation9090; in whichmonitoring apparatus660 resides in or aroundseat610, and in which a nearby person may be pre-trained and/or contemporaneously guided to provide adequate and timely aid. Such aid may include talking with or positioning a subject; helping a subject to administer medications; obtaining a defibrillator, ECG monitor, or other such therapeutic or diagnostic instruments; or contacting a physician or ambulance for more extreme situations. In some variants, for example, one ormore modules651 ofresponsive logic650 may enable such detection logic only when one or more such signal paths631-634 indicate an occupant's weight or other indication thatwheelchair600 is occupied. Alternatively or additionally,seat610 may include one or more instances oflocal module2510 ofFIG. 25 operable for transmitting comparison results, measurement data, or decisions as described herein along the signal path(s).
• Operation9193 describes signaling the decision by transmitting the notification to a portable interface (e.g. channel550 transmitting one ormore notifications541,542 as described herein via one ormore antennas549 to one or more wearable or otherportable interfaces7860,7880,580 or other destinations535). This can occur, for example, in a context in which such a transmission results from one or more hybrid-data decisions531 or other thermally-dependent decisions532 and in which one or more controllers as described herein include one or more implementations ofnotification module510. In some variants, for example, some or all of thecontent544 of such a notification may depend upon atype533 of one or more such interfaces orother destinations535. Alternatively or additionally, such a decision may be signaled to adisplay element536 or other configurable feature local tonotification module510.
• Operation9196 describes ranking a higher-priority destination and a lower-priority destination for the notification (e.g. module7871 ranking one or morenearby interfaces7860 with a higher-priority category7844 than that of one or more interfaces7880 of network7890). This can occur, for example, in a context in which anotification7868 is first routed to a subject or other higher-priority destination and in which a related notification is routed to another party a few minutes or hours later in the event thatmodule7872 does not receiveinput7834 from the higher-priority destination. In some variants, for example, such input may include an acknowledgment that someone has received the notification. Alternatively or additionally, any such decisions, notifications, or determinants may be logged to other destinations, such aslogging module7885.
• Operation9199 describes signaling the decision whether to transmit the notification partly in response to auditory information from the subject's body (e.g. notification module510 updating a party partly in response torecognition module7981 indicating one ormore comparison results7962 and partly in response torecognition module7983 indicating a recognition of one or more phrases orother patterns7973,7974 in speech or otherauditory information7941 from subject7920). This can occur, for example, in a context in which suchauditory information7941 indicates that subject7920 may currently be impaired and in which at least onesuch result7962 of comparing abnormal-temperature-indicative data7991 with historical or other filtering data indicates that a hot zone ofperipheral body part7922 has become measurably hotter and thatperipheral body part7921 has apparently remained in a normal condition. In some contexts, for example, such normality may be inferred from abnormal-temperature-indicative data7991 not referring topart7921 and/or not coming from one or morelocal modules7931 in a vicinity ofpart7921. Alternatively or additionally, the decision may depend upon one or more other determinants such as (a) whether acurrent notification542 differs from aprior notification541; (b) whetherinterface580 indicates that one or more recipients are apparently online; (c) whether any new comparison result reflects a new, unrecognized, and/or other urgent situation; or other criteria as described herein.
• In light of teachings herein, numerous existing techniques may be applied for recognizing words or other auditory patterns as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,257,531 (“Speech to text system using controlled vocabulary indices”); U.S. Pat. No. 6,990,455 (“Command and control using speech recognition for dental computer connected devices”); U.S. Pat. No. 6,934,579 (“Anaesthesia control system”); U.S. Pat. No. 6,804,654 (“System and method for providing prescription services using voice recognition”); U.S. Pat. No. 6,785,358 (“Voice activated diagnostic imaging control user interface”); U.S. Pat. No. 6,629,937 (“System for processing audio, video and other data for medical diagnosis and other applications”); U.S. Pat. No. 5,335,313 (“Voice-actuated, speaker-dependent control system for hospital bed”); U.S. Pat. No. 5,262,669 (“Semiconductor rectifier having high breakdown voltage and high speed operation”).
• With reference now toFIG. 92, there are shown several variants of theflow9000 ofFIG. 90 or91.Operation9030—obtaining information indicating a current thermal condition in a peripheral part of a subject's body—may (optionally) include one or more of the following operations:9231 or9239. In some embodiments, variants ofoperation9030 may be performed by one or more instances oflocal modules2320,2450,2510,2690,7931,7932 orother modules7820 configured to handle sensor data;decision logic275,1350,2730,2975,3230,5750,5930,6395,7415; or other components configured to handle such status information.Operation9090—signaling a decision whether to transmit a notification at least partly in response to one or more comparisons between the information indicating the current thermal condition in the peripheral part of the subject's body and information indicating a prior thermal condition in the peripheral part of the subject's body—may include one or more of the following operations:9292,9295,9297 or9298. In some embodiments, variants ofoperation9090 may be performed by one or more instances of distribution logic;notification logic1290,3991,6180,7460,7875; or other such control or communication components. Alternatively or additionally,flow9000 may be performed in a context as described above with reference to any ofFIGS. 1-80 and/or in conjunction with other flow variants as described below.
• Operation9231 describes obtaining an optical image of the peripheral part of the subject's body of the information indicating the current thermal condition in the peripheral part of the subject's body (e.g. module7820receiving image7831 frominfrared sensor7821 orimage7832 from anotheroptical sensor7822 from a position adjacent a subject's body part). This can occur, for example, in a context in which a subject or caregiver positions a charge-coupled device or similar image capture mechanism in a vicinity of the body part to monitor a growth or other optically detectable phenomenon, optionally in a manner that captures one or more isotherm-indicative shapes. In some variants, for example, a sensor array comprising infrared-sensitive elements may be used for implementing such data capture. Alternatively or additionally, other radiant-energy-sensitive and/or other elements as described below inFIGS. 23-27 may be used for sensing diagnostically useful information contemporaneously relating to the same part of the subject's body.
• Operation9239 describes detecting that the information indicates normalcy as the current thermal condition in the peripheral part of the subject's body (e.g. one ormore modules2977 ofdecision logic2976 indicating normalcy in response to receiving a high-enough and/or low-enoughnumerical value2987 directly or indirectly from one ormore sensors2927 operable for detecting a temperature at an extremity of subject2920). This can occur, for example, in a context in which subject2920 rests upon or otherwise interacts withinstrument2930, in whichdecision logic2976 is capable of detecting and indicating whethervalue2987 is too far from a normal temperature, and in whichtransmitter2980 is operable for performingoperation9090. In some variants, for example,module2977 may employ this information as a factor in deciding whether to transmit a notification to user interface2952 or to other destinations. Alternatively or additionally, in various implementations as described herein,instrument2930 may include one or more instances of response logic or other circuitry operable for responding conditionally to anidentifier2923 of a subject or other determinants in detecteddata2922.
• In light of teachings herein, numerous existing techniques may be applied for detecting statistical, anatomical, or other potentially useful thermal aberrations in light of other circumstances as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,340,293 (“Methods and apparatus for a remote noninvasive technique to detect core body temperature in a subject via thermal imaging”); U.S. Pat. No. 7,226,426 (“Apparatus and method for the detection and quantification of joint and tissue inflammation”); U.S. Pat. No. 6,963,772 (“User-retainable temperature and impedance monitoring methods and devices”); U.S. Pat. No. 6,757,412 (“System and method for helping to determine the condition of tissue”); U.S. Pat. No. 6,126,614 (“Apparatus and method for analysis of ear, pathologies by detecting fluid in the ear measuring body temperature and/or determining a characteristic of a fluid”); U.S. Pat. No. 6,023,637 (“Method and apparatus for thermal radiation imaging”); U.S. Pat. No. 5,999,842 (“Functional thermal imaging apparatus”); U.S. Pat. No. 5,997,472 (“Endodiagnostic method using differential thermal relaxation and IR imaging”).
• Operation9292 describes including auditory data with the notification (e.g. one or more modules7871-7874 ofnotification logic7875configuring notification7868 to includespeech7864 or other audible data withother content7865 ofnotification7868 delivered to one or more interfaces7869,7880). This can occur, for example, in a context in whichnotification logic7875 performs atleast operation9090 and in which one or more users or devices have indicated a telephone, computer speaker, or other interface facility for handling such data. In some variants, for example,output7837 from a microphone orother sensor7824 may first be detected as speech, a heartbeat or other audible metabolic indicator, or other device-detectable phenomena in a subject's vicinity. Alternatively or additionally,content7865 provided with anotification7868 may include one or more instances of translated or other programmatic notifications, for example, suitable for remote delivery at a speaker-containing interface7880.
• In light of teachings herein, numerous existing techniques may be applied for amplifying, recording, translating, selecting, or otherwise facilitating an inclusion of potentially useful auditory data as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,313,529 (“Portable extender for data transmission within a medical device communication system”); U.S. Pat. No. 7,291,111 (“Apparatus and method for non-invasive diagnosing of coronary artery disease”); U.S. Pat. No. 6,944,497 (“System and method of treating stuttering by neuromodulation”); U.S. Pat. No. 6,878,117 (“Handheld sensor for acoustic data acquisition”); U.S. Pat. No. 6,629,937 (“System for processing audio, video and other data for medical diagnosis and other applications”); U.S. Pat. No. 6,582,379 (“Apparatus and method of measuring the flow of a liquid, in particular urine, from a patient”); U.S. Pat. No. 6,126,614 (“Apparatus and method for analysis of ear pathologies by detecting fluid in the ear, measuring body temperature and/or determining a characteristic of a fluid”); U.S. Pat. No. 6,014,626 (“Patient monitoring system including speech recognition capability”).
• Operation9295 describes selecting one or more destinations for the notification (e.g. distribution module8050 selecting one ormore destinations8041,8042 usingclient list8067 or other determinants as described herein). This can occur, for example, in a context in which an aircraft orother system800 implements system8000 (ofFIG. 80) and in which one or more preferences of a client system, member, or other interested party are registered for notification viasubscriber profile8061 or other such indication. In some variants, for example, a passenger inseat814 ofcabin810 registers for notification of changes in physiological parameters signaled byindication823 and may receive anotification8038 vialocal interface895, in some variants, in response to a detection of one or more clot-indicative symptoms as described herein. Alternatively or additionally, a flight attendant may receive such anotification8038, for example viainterface890. In a variety of contexts as described herein, such implementations can facilitate a faster therapeutic response.
• In light of teachings herein, numerous existing techniques may be applied for the selection of one or more recipients for medical or other notifications as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,333,014 (“Notifying users of device events in a networked environment”); U.S. Pat. No. 7,310,615 (“Financial data reporting system with alert notification feature and free-form searching capability”); U.S. Pat. No. 7,308,246 (“Emergency notification system and emergency notification device”); U.S. Pat. No. 7,233,781 (“System and method for emergency notification content delivery”); U.S. Pat. No. 7,180,415 (“Safety/security alert system”); U.S. Pat. No. 7,003,525 (“System and method for defining, refining, and personalizing communications policies in a notification platform”); U.S. Pat. No. 6,834,306 (“Method and apparatus for notifying a user of changes to certain parts of web pages”); U.S. Pat. No. 6,442,241 (“Automated parallel and redundant subscriber contact and event notification system”); U.S. Pat. No. 6,177,873 (“Weather warning apparatus and method”); U.S. Pat. No. 6,014,346 (“Medical timer/monitor and method of monitoring patient status”).
• Operation9297 describes including thermal-decrease-size-indicative information with the notification (e.g. module8962 including a number of degrees orother data8965 received asinformation8922,8923 from one or moreportable items8925 indicating how much a subject's appendage has apparently cooled). This can occur in a context in which such cooling results from a wound dressing or other article significantly impairing a subject's circulation, for example, or in which such cooling signifies a return to normalcy from an overly-hot condition. In some contexts, for example, a notification recipient may respond with timely advice for treating the subject's leg in response to such quantified notification. Alternatively or additionally, in some contexts, such information may warrant a change in how the subject is monitored, such as by decreasing vigilance and/or by monitoring systemic, environmental, orother information8921 relating to a subject as described herein.
• Operation9298 describes including spatial-size-indicative information with the notification (e.g. module7874 ofnotification logic7875 including one or more of ascaling factor7842 or otherareal indicator7843, photographs orother images7831,7832, a volumetric or shape-descriptive category7844, and/or other such information included in or appended tocontent7865 of notification7868). This can occur, for example, in a context in which interface7860 performsoperation9030, in whichmodule7873 decides whether to transmit the notification, in whichnotification logic7875 performsoperation9090, and in which a subject cannot communicate such information and/or otherwise address a pathology. In some variants, for example,module7873 signals in the affirmative if ahot zone7839 of animage7832 is larger thanthreshold7845. Alternatively or additionally, the decision may likewise depend upon one or more of aniteration count7841 or other indicator of duration,user input7834, a concentration orother output7837 from achemical sensor7823, and/orother determinants7850 as described herein.
• In light of teachings herein, numerous existing techniques may be applied for shape recognition or other analyses of spatial attributes as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,346,205 (“System and method for rapidly identifying pathogens, bacteria and abnormal cells”); U.S. Pat. No. 7,340,077 (“Gesture recognition system using depth perceptive sensors”); U.S. Pat. No. 7,331,667 (“Iris pattern recognition and alignment”); U.S. Pat. No. 7,327,861 (“Organism authenticating apparatus”); U.S. Pat. No. 7,317,821 (“Automatic abnormal tissue detection in MRI images”); U.S. Pat. No. 7,242,807 (“Imaging of biometric information based on three-dimensional shapes”); U.S. Pat. No. 7,184,580 (“Fingerprint scar recognition method and apparatus”); U.S. Pat. No. 6,840,117 (“Patient monitoring system employing array of force sensors on a bedsheet or similar substrate”); U.S. Pat. No. 6,675,040 (“Optical object tracking system”); U.S. Pat. No. 6,529,759 (“Method for mapping internal body tissue”).
• With reference now toFIG. 93, shown is asystem9300 in which one or more technologies may be implemented, such as for interacting withexternal module9320 to receive information viasensors9321,9322,9323,9324 about one ormore body parts9310.System9300 may (optionally) include one ormore values9311,9312,9313,9331,9332 in anarray9315 orother indication9335; one ormore modules9381,9382,9383,9384 of comparelogic9380; and/or one ormore transmitters9390 operable to schedule, transmit, identify, or otherwise signal one ormore decisions9391,9392 ornotifications9393,9394 as described herein.
• With reference now toFIG. 94, shown is aflow9400 comprising operation9420-detecting a result of one or more comparisons between information indicating current local stress in a peripheral part of a subject's body and information indicating prior local stress in the peripheral part of the subject's body (e.g.external module9320 transmitting at least onevalue9331 manifesting an increasing or decreasing force level in or on body part9310). This can occur, for example, in a context in which one or moreexternal modules9320 include one or moremicrowave frequency sensors2321,event detection logic2333,fluid pressure sensors2482,force sensors2484,reflectance sensors2511,weight sensors2533,comparators2670, or other components of local modules described herein. In some contexts in whichexternal module2670 implementslocal module2690 ofFIG. 26, real-time data2681 or force-indicative data2683 may indicate the “current” local stress, for example, andhistorical data2682 orother measurement data2685 may indicate the “prior” local stress. Alternatively or additionally, some such images as described herein (showing swelling, e.g.) orother measurement data2685 may reside inarray9315 in raw form, optionally to be acted upon by comparelogic9380 or other modes of comparison as described herein.
• Operation9450 describes signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body (e.g. comparelogic9380 activatingtransmitter9390 if one ormore arrays9315 orother values9332 indicate a higher-than-nominal blood pressure or other manifestation of stress increasing repeatedly over a time interval, and otherwise not activating transmitter9390). This can occur, for example, in a context in which comparelogic9380 includes one ormore modules9381 for comparing pressure levels or other force-level indicators, one ormore modules9382 for comparing event counts, one ormore modules9383 for comparing time intervals, and/or one or moreother modules9384 as described herein. In some variants, a useful time interval (threshold) may be on the order of 2 hours or 2 weeks, for example, or the stress level thresholds may be specified by a notification recipient or other interested party. Alternatively or additionally, in some variants, such a decision may require an intermediary's authorization or may be affected by other determinants as described herein.
• With reference now toFIG. 95, there are shown several variants of theflow9400 ofFIG. 94.Operation9420—detecting a result of one or more comparisons between information indicating current local stress in a peripheral part of a subject's body and information indicating prior local stress in the peripheral part of the subject's body—may include one or more of the following operations:9524 or9528. In some embodiments, variants ofoperation9420 may (optionally) be performed by one ormore modules261 ofevaluation logic150,250,950,1530,7565 or other responsive logic as described herein.Operation9450—signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body—may include one or more of the following operations:9555,9557 or9558. In some embodiments, variants ofoperation9450 may be performed by one or more instances ofdetection modules5860,5870; or other such detection and/or evaluation logic as described herein. Alternatively or additionally,flow9400 may be performed in a context as described above with reference to any ofFIGS. 1-80 and/or in conjunction with other flow variants as described below.
• Operation9524 describes detecting the result at least one day after detecting the information indicating the prior local stress in the peripheral part of the subject's body (e.g. module7561 ofevaluation logic7565 configuring evaluations orother result data7537 arising from condition detectors,expert systems7585, or other comparative analysis based upon at least some pressure- or other stress-indicative data7538 measured one or more days earlier). This can occur, for example, in a context in whichevaluation logic7565 performsoperation9420, in whichlocal system7570 implements one or more instances ofdetection modules7610, in whichcircular buffer7651 captures hourly or othersuccessive samples7661,7662,7663 about subject7505 via one ormore sample sensors7625 over the course of a week or a month and in which one ormore condition detectors7670,7680 iteratively determine whether such digital or other samples indicate a large-enough and long-enough shift in local tissue stretching or blood pressure measurements, each relative to one or morerespective standards7675,7685. In some variants, for example, an at-risk patient may use or otherwise interact with one or more wheelchairs, articles of clothing, or other portable systems as described herein repeatedly over a course of weeks or months, so that such an instance oflocal system7570 may obtain multiple data points from one ormore pressure sensors7621, stress-indicative sensors7622, orother sample sensors7625 thereof. Alternatively or additionally,condition detectors7680,7690 may (optionally) accesspositional coordinates7634, timing-indicative values7632, or othersuch status indicators7645 as described herein for helpingevaluation logic7565 to identify and avoid transmitting notifications under ordinary circumstances of health indicia.
• In light of teachings herein, numerous existing techniques may be applied for recognizing pathologies presenting with a detectable mechanical stress and/or other symptoms as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,232,415 (“System and method for noninvasively evaluating a limb suspected of compartment syndrome”); U.S. Pat. No. 7,183,057 (“Tape stripping methods for analysis of skin disease and pathological skin state”); U.S. Pat. No. 7,112,318 (“Non-invasive diagnostic imaging technology for mitochondria dysfunction using radiolabeled lipophilic salts”); U.S. Pat. No. 7,110,806 (“Method for imaging an artery using a magnetic resonance contrast agent”); U.S. Pat. No. 7,001,338 (“System and method for diagnosing pathologic heart conditions”); U.S. Pat. No. 6,929,922 (“Methods for the detection of demyelinating diseases”); U.S. Pat. No. 6,847,841 (“Detector of living tissue strength and electrical resistance and activity”); U.S. Pat. No. 6,813,009 (“Detection of metabolic dysfunctions using fluorescence emission from serum”); U.S. Pat. No. 6,735,331 (“Method and apparatus for early detection and classification of retinal pathologies”); U.S. Pat. No. 6,671,540 (“Methods and systems for detecting abnormal tissue using spectroscopic techniques”); U.S. Pat. No. 6,636,755 (“Method and apparatus for obtaining an optical tomographic image of a sentinel lymph node”); U.S. Pat. No. 6,629,937 (“System for processing audio, video and other data for medical diagnosis and other applications”); U.S. Pat. No. 6,620,115 (“Apparatus and method for mechanical imaging of breast”); U.S. Pat. No. 6,507,754 (“Device for the medical monitoring in real time of a patient from the analysis of electroencephalograms”).
• Operation9528 describes receiving a structural change indication in the result of the one or more comparisons (e.g.pattern recognition module7564 ofevaluation logic7565 detecting a swelling, discoloration, or other optically detectable tissue attribute change manifesting as a calorimetric shift between aportion7511 of a weeks-old image7510 and acorresponding portion7521 of a newer image7520). This can occur, for example, in a context in whichevaluation logic7565 performsoperation9420, in which anotherportion7512 of the weeks-old image7510 resembles acorresponding portion7522 of thenewer image7520, and in which such resemblance supports a heuristic change model that may likewise be applied to one ormore portions7511,7521 that have apparently changed. In some variants, for example,such reference portions7512,7522 of respective images may be used to establish a position shift or other baseline transfer function for determining whether an area, shape, shade, or other substantial, quantifiable difference between suchprimary portions7511,7521 indicates a structural change. Alternatively or additionally, anexpert system7585 implementing some or all ofsuch evaluation logic7565 may query a caregiver or other expert for category descriptors7581 (“site not recognized,” “swelling reduced,” “emergency,” etc.), scores7582, or othersuch input7583 for facilitating subsequent evaluations of such potential structural change indications.
• In light of teachings herein, numerous existing techniques may be applied for aggregating symptomatic or other structural data or implementing predictive or other expert systems as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,315,825 (“Rules-based patient care system for use in healthcare locations”); U.S. Pat. No. 7,272,435 (“System and method for sudden cardiac death prediction”); U.S. Pat. No. 7,225,013 (“Adaptive prediction of changes of physiological/pathological states using processing of biomedical signals”); U.S. Pat. No. 7,027,871 (“Aggregation of data from external data sources within an implantable medical device”); U.S. Pat. No. 6,988,088 (“Systems and methods for adaptive medical decision support”); U.S. Pat. No. 6,643,646 (“Analysis of massive data accumulations using patient rule induction method and on-line analytical processing”); U.S. Pat. No. 6,533,724 (“Decision analysis system and method for evaluating patient candidacy for a therapeutic procedure”); U.S. Pat. No. 6,442,421 (“Method for the medical monitoring in real time of a patient from the analysis of electroencephalograms to characterize and differentiate between physiological or pathological conditions, and a method for anticipating epileptic seizures”); U.S. Pat. No. 6,317,731 (“Method for predicting the therapeutic outcome of a treatment”); U.S. Pat. No. 6,025,128 (“Prediction of prostate cancer progression by analysis of selected predictive parameters”).
• Operation9555 describes enabling a performance of the one or more comparisons at a resource remote from the subject's body (e.g. interface7563 transmitting force estimates or other stress-indicative information7533 withcorresponding locality information7531, timinginformation7532, patient-specific information7534, or other such comparative parameters). This can occur, for example, in a context in whichevaluation logic7565 performsoperation9450 and in which comparative information and/or other data as described herein is transmitted to or otherwise affects a configuration of one ormore standards7588,logic modules7562, or other suchcomparison mode determinants7535 configured to be applied remotely. In some variants, for example, one ormore signal channels7575 may be implemented in one or more aggregators or other suchadjunct services7590 operable remotely from anexternal module9320 or other structures described herein for interacting with subjects. Alternatively or additionally, one or more comparisons or other evaluations as described herein may initially be performed locally to the subject's body.
• Operation9557 describes obtaining the result partly based on an indication of one or more nutrients in the subject's body (e.g. module181 using one ormore sensors185 to monitor biological-process-indicative changes in zone171). This can occur, for example, in a context in whichdetection logic180 andcomparator130 jointly performoperation9450 and in which calcium or other nutrients are monitored to give an indication of a deficiency, an excess, or other attributes of subject status. In some variants, for example,sensor185 may be configured within or adjacent a blood vessel for monitoring and/or controlling blood glucose level. Alternatively or additionally, monitoring of physiological constituents may be used to determine subject compliance with and/or responsiveness to dietary or other therapeutic treatments.
• In light of teachings herein, numerous existing techniques may be applied for monitoring nutritional or other physiologically indicative components as an indication of patient status as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,087,395 (“Vitamin D assay”); U.S. Pat. No. 6,990,365 (“Apparatus for measurement of blood analytes”); U.S. Pat. No. 6,953,666 (“Biomarkers for oxidative stress”); U.S. Pat. No. 6,885,882 (“Method and apparatus for non-invasive glucose sensing through the eye”); U.S. Pat. No. 6,878,518 (“Methods for determining steroid responsiveness”); U.S. Pat. No. 6,671,540 (“Methods and systems for detecting abnormal tissue using spectroscopic techniques”); U.S. Pat. No. 6,573,063 (“Methods and systems for assessing biological materials using optical and spectroscopic detection techniques”); U.S. Pat. No. 6,455,243 (“Nutritional assessment by measuring mitochondrial complex activity”); U.S. Pat. No. 6,300,085 (“Diagnostic method for Alzheimer's disease”).
• Operation9558 describes extracting the decision whether to transmit the notification from the result of the one or more comparisons (e.g. condition detector7690 generating one ormore notification decisions7633 by comparing asample7661 against anext sample7662 or another subsequent sample7663). This can occur, for example, in a context in which one or more primary and/or local modules include an instance ofdetection module7610 configured to performoperation9450, in whichcondition detector7690 generates one ormore result values7631 signifying the necessity of such notifications by applying one or more instances of standard7695 tosuccessive samples7661,7662,7663 from one ormore sample sensors7625, and in which one or more users or devices might otherwise receive an excessive quantity of such notifications. Alternatively or additionally, such decisions may depend upon each successive ratio or other combination of samples, or upon event counts or other logical combinations of comparison results, or upon other applications of scalar orother standards7695 as described herein. In some variants, for example, subject measurements exceeding a specified threshold may trigger local and or remote user interface alarms and/or other visual or auditory notifications. Additionally or alternately, notification messages may be sent to a local or remote data processing center for automated analysis and/or recording.
• In light of teachings herein, numerous existing techniques may be applied for the transmission of notifications to local and/or remote sites based on one or more evaluation criteria as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,304,580 (“Intelligent medical vigilance system”); U.S. Pat. No. 7,224,281 (“Patient monitoring and alarm processing system and user interface”); U.S. Pat. No. 7,115,097 (“Positive airway pressure notification system for treatment of breathing disorders during sleep”); U.S. Pat. No. 7,047,083 (“Method and apparatus for identifying lead-related conditions using lead impedance measurements”); U.S. Pat. No. 6,835,553 (“Photometric glucose measurement system using glucose-sensitive hydrogel”); U.S. Pat. No. 6,732,884 (“Bulk medication dispenser and monitoring device”); U.S. Pat. No. 6,687,544 (“System and method for determining safety alert conditions for implantable medical devices”); U.S. Pat. No. 6,646,556 (“Apparatus and method for reducing the risk of decubitus ulcers”); U.S. Pat. No. 6,454,705 (“Medical wellness parameters management system, apparatus and method”); U.S. Pat. No. 6,383,137 (“Labor alerting device”); U.S. Pat. No. 6,305,377 (“System and method for improving compliance of a medical regimen”).
• With reference now toFIG. 96, there are shown several variants of theflow9400 ofFIG. 94 or95.Operation9420—detecting a result of one or more comparisons between information indicating current local stress in a peripheral part of a subject's body and information indicating prior local stress in the peripheral part of the subject's body—may (optionally) includeoperation9629. In some embodiments, variants ofoperation9420 may be performed by one or more instances ofutility devices325 or other devices innetworks590,1380,1490,1590,2215,2995,3545,5280,5290,5580,5840,6295,6390,6400,7490,7580,7890 containing sensors or otherwise configured to handle sensory data.Operation9450—signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body—may include one or more of the following operations:9651,9653 or9656. In some embodiments, variants ofoperation9450 may be performed by one or more instances ofdecision logic275,1460,2250,2975,3230,5750,6130,6395,7415; subtraction logic; pattern recognition logic; or other circuitry or software implementing comparators or otherwise configured to handle data derived from comparison. Alternatively or additionally,flow9400 may be performed in a context as described above with reference to any ofFIGS. 1-80 and/or in conjunction with other flow variants as described below.
• Operation9629 describes including a current thermal indication of the peripheral part of the subject's body in the information indicating the current local stress in the peripheral part of the subject's body (e.g.external device7491 and/or other sensor-containingmodules7493configuring communication7485 to include one or morethermal images7471,thermal input7472 from subject7495 or other users, or othersuch indications7480 of recent physical phenomena relating to region7496). This can occur, for example, in a context in which one or more components ofserver7410 and/ornetwork7490 each performsoperation9420 and in whichcommunication7485 also bears tension-indicative data7473, timingdata7474,blood pressure data7475,historical data7476, orother data7477 facilitating current comparisons or other analysis. In some contexts in which an expert or expert system may monitor a large number of subjects' weight-bearing sites programmatically ranked, for example, according to which have recent images exhibiting the largest colorimetric, areal, thermal, or other detectable trends. Statistics like these rankings may be used at a given subject's site or at an expert's site for triage, for triggering treatment or other testing, or for other resource allocation functions. Alternatively or additionally, a current thermal indication may warrant a higher or lower priority for a subject exhibiting a measurable abnormality in local stress.
• In light of teachings herein, numerous existing techniques may be applied for obtaining and expressing temporal or spatial topographies of stress, temperature, or other physical properties as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,339,587 (“Method for medical imaging and image processing, computed tomography machine, workstation and computer program product”); U.S. Pat. No. 7,303,555 (“Imaging and therapeutic procedure for carpal tunnel syndrome”); U.S. Pat. No. 7,162,068 (“Medical image displaying device, image obtaining and displaying device, method for displaying image in displaying device, and program for selecting display format”); U.S. Pat. No. 6,975,898 (“Medical imaging, diagnosis, and therapy using a scanning single optical fiber system”); U.S. Pat. No. 6,793,625 (“Method and apparatus for concurrently displaying respective images representing real-time data and non real-time data”); U.S. Pat. No. 6,776,756 (“Applanation tonometer”); U.S. Pat. No. 6,757,412 (“System and method for helping to determine the condition of tissue”); U.S. Pat. No. 6,631,287 (“Infrared thermometer”); U.S. Pat. No. 6,551,306 (“Refractive laser ablation through topography”); U.S. Pat. No. 5,987,345 (“Method and system for displaying medical images”).
• Operation9651 describes deciding to transmit the notification in response to the result indicating a monotonic measurement change over at least N sampling intervals, where N>1 (e.g. module7412 ofdecision logic7415 generating one or morenotification transmission decisions7414 responsive to asuccession7420 of N or moremeasurement change indications7421,7422,7423 each signifying a respective increase). This can occur, for example, in a context in whichnotification logic7460 performs at least one instance ofoperation9450 and in which anabnormal succession7430 ofmeasurements7431,7432,7433 manifest a constantly increasing or other monotonic deviation from abaseline value7442, and in which a therapeutic treatment is more likely to be effective at an early stage of a subject's pathology. Such a trend may, in many therapeutic contexts, signify a progression toward a worsening patient state over a period of several minutes, hours, days, months, or other sampling periods. Under these circumstances, one or moresuch notifications7451,7452 can occur in response to exceeding a definedevent count7441 or other time-indicative threshold. In some variants, for example, anotification7452 may be sent for a subject7495 being monitored remotely via one or moreexternal devices7491 or other sensor-containingmodules7492,7493 when a blood pressure increase or other apparent trend persists for more than 1-10 hours.
• In light of teachings herein, numerous existing techniques may be applied for using condition duration or other trend-related indicators as determinants in notification decisions as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,319,400 (“Method and apparatus for monitoring a restraint device”); U.S. Pat. No. 7,117,036 (“Using activity-based rest disturbance as a metric of sleep apnea”); U.S. Pat. No. 7,030,764 (“Apparatus and method for reducing the risk of decubitus ulcers”); U.S. Pat. No. 6,671,529 (“System and method for closed loop controlled inspired oxygen concentration”); U.S. Pat. No. 6,305,377 (“System and method for improving compliance of a medical regimen”); U.S. Pat. No. 6,014,346 (“Medical timer/monitor and method of monitoring patient status”).
• Operation9653 describes accepting a caregiver's input as a determinant of the decision whether to transmit the notification (e.g. module2245 using instructions orother parameters2249 received via medium2225 to specify one or more conditions under which each type ofnotification2241,2242 will be sent to interface2210). This can occur, for example, in a context in whichdecision logic2250 performsoperation9450 and in which aclinician2205 indicates viainterface2210 that one or moreprior notifications2201,2202 warranted no therapeutic response. In some variants, for example, notifications of subject interactions such as administration of medicine and/or other therapeutic actions are logged locally and/or anotification2242 is transmitted to aremote server2220. Alternatively or additionally, other such log entries and/or notifications may be generated from caregiver observations of a subject's status.
• In light of teachings herein, numerous existing techniques may be applied for the generation of one or more notifications based upon input received from one or more external interfaces as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,340,240 (“Monitoring device”); U.S. Pat. No. 7,269,484 (“Vehicular touch switches with adaptive tactile and audible feedback”); U.S. Pat. No. 7,133,661 (“Emergency information notifying system, and apparatus, method and moving object utilizing the emergency information notifying system”); U.S. Pat. No. 7,047,083 (“Method and apparatus for identifying lead-related conditions using lead impedance measurements”); U.S. Pat. No. 7,035,684 (“Method and apparatus for monitoring heart function in a subcutaneously implanted device”); U.S. Pat. No. 6,559,769 (“Early warning real-time security system”); U.S. Pat. No. 6,525,712 (“Method and device for manual recording of various events or states”); U.S. Pat. No. 6,014,346 (“Medical timer/monitor and method of monitoring patient status”).
• Operation9656 describes transmitting a common graphical image containing the information indicating the current local stress in the peripheral part of the subject's body with the information indicating the prior local stress in the peripheral part of the subject's body (e.g. module2972 ofdecision logic2975 invokingtransmitter2980 to cause one or more composite images or other suchsuccessive indications7530 relating to a subject's limb or back to output2953). This can occur, for example, in a context in whichlocal system7570 uploads such images or other measurement data to an implementation ofresponse logic2970 innetwork7580, for example, responsive to a request that remote users may generate after notifications as described herein. Alternatively or additionally, one or more such users may respond by modifying one ormore standards7675,7685,7695 or configurations of buffers7652-7654, in some variants, so that subsequent sense data may result in other patterns of data capture and/or notification as described herein.
• In light of teachings herein, numerous existing techniques may be applied for the transmission of graphical images of subject body parts for display and storage as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,310,564 (“Arrangement and method for producing therapeutic insoles”); U.S. Pat. No. 7,289,883 (“Apparatus and method for patient rounding with a remote controlled robot”); U.S. Pat. No. 7,286,877 (“Device programmer with enclosed imaging capability”); U.S. Pat. No. 7,158,861 (“Tele-robotic system used to provide remote consultation services”); U.S. Pat. No. 7,016,467 (“Mobile digital radiography x-ray apparatus and system”); U.S. Pat. No. 6,625,252 (“Emergency vehicle with medical image scanner and teleradiology system”); U.S. Pat. No. 6,621,918 (“Teleradiology systems for rendering and visualizing remotely-located volume data sets”); U.S. Pat. No. 6,612,982 (“Fully-swallowable endoscopic system”); U.S. Pat. No. 6,529,757 (“Picture archiving and communication system and method for multi-level image data processing”); U.S. Pat. No. 6,490,490 (“Remote operation support system and method”); U.S. Pat. No. 6,137,527 (“System and method for prompt-radiology image screening service via satellite”).
• With reference now toFIG. 97, shown is asystem9700 in which one or more technologies may be implemented in relation torespective portions9703,9704,9705 of a subject'sbody9710, one or more of which may exhibit an inflammation orother abnormality9709. Anadaptable support9750 comprises severaloblong actuators9752,9753,9754,9755 supported on a common frame or othersuitable substrate9760.Support9750 further includes or otherwise supports one ormore sensor modules9713,9714,9715 (including or in proximity to a respective one ormore actuators9753,9754,9755) operable for transmitting or otherwise detecting quantitative orother values9723,9724,9725 ofmeasurement data9729 forcircuitry9790.Circuitry9790 may further include one ormore processors9744 and/ormodules9781,9782,9783 ofsupport control logic9780, such as may be configured to provide one ormore control signals9785,9786 selectively to one ormore actuators9752,9753,9754,9755 as shown.
• With reference now toFIG. 98, shown is aflow9800 comprisingoperation9840—causing an artificial support to modify a force upon a first external portion of a subject's body as a programmatic response to locally-abnormal-stress-indicative information obtained from a second external portion of the subject's body (e.g. at leastsupport control logic9780 causing one ormore actuators9753 to increase a force at least uponexternal portion9703 in response tomeasurement data9729 containing an indication fromsensor module9715 of an unusual swelling or other local manifestation of pressure withinexternal portion9705 of body9710). This can occur, for example, in a context in which one or moreother sensor modules9714 indicate a lower pressure nearby and/or in which the locally-abnormal-stress-indicative information has persisted for about a minute or more.
• With reference now toFIG. 99, shown is aflow9900 comprisingoperation9950—obtaining locally-abnormal thermal information about a first external portion of a subject's limb (e.g. one ormore modules9781,9782,9783 ofsupport control logic9780 and/orprocessor9744 receiving and/orcomputing measurement data9729 indicating alocal abnormality9709 relating to the temperatures of one ormore portions9703,9704,9705 in a subject's arm or other limb). This can occur, for example, in a context in whichsubstrate9760 comprises a bed, a seat, a cast or other fitted article, or other such support structures as described herein.
• Operation9970 describes causing an artificial support to exert an increasing force upon a second external portion of the subject's limb at least partly in response to locally-abnormal thermal information about the first external portion of the subject's limb (e.g.support control logic9780 causing atleast actuator9753 to exert an increasing force uponportion9703 in response toabnormality9709 comprising a locally warm or cool part of a limb of body9710). This can occur, for example, in an embodiment in which such actuators form part of a feedback system responsive to thermal, force-indicative, circulation-indicative, or other such values as described herein.
• With reference now toFIG. 100, there are shown several variants of theflow9800 ofFIG. 98.Operation9840—causing an artificial support to modify a force upon a first external portion of a subject's body as a programmatic response to locally-abnormal-stress-indicative information obtained from a second external portion of the subject's body—may include one or more of the following operations:10043,10044, or10049. In some embodiments, variants ofoperation9840 may (optionally) be performed by one or more instances of configuration logic1050,5235;7755 or other configuration or control logic as described herein.Flow9800 may likewise include one or more ofoperations10085 or10088, for example. In some contexts, for example,flow9800 may be performed in a context as described above with reference to any ofFIGS. 1-80 and/or in conjunction with other flow variants as described below.
• Operation10043 describes configuring a valve of the artificial support to modify the force upon the first external portion of the subject's body (e.g. one ormore modules783 urgingcell740 laterally toward or away fromadjacent cell710 by causing one ormore elements743 to expand or contract). SeeFIG. 7. This can occur, for example, in a context in which supportcontrol logic780 performsoperation9840 and in whichmodule783 selectively opens one ormore valves746,747 in fluid communication with higher- or lower-pressure reservoirs (not shown) so thatelement743 controllably expands or contracts. In some variants, for example, one or moreother elements741 may (optionally) undergo an offsetting transition so that the net motion ofcell740 is primarily lateral. Alternatively or additionally, such other elements may undergo a transition like that ofelement743 so that the net motion ofcell740 is primarily orthogonal to structure765.
• Operation10044 describes configuring a motor of the artificial support to modify the force upon the first external portion of the subject's body (e.g. module1152 causing one or more piezomotors or other motor-containingactuators1120 to retract, reducing or removing forces exerted at one or moreexternal portions1111,1112). This can occur, for example, in a context in which controllogic1160 ofFIG. 11 performsoperation9840 such as by selectively engaging one or more motors to extend and/or contract one ormore elements1121,1122 of actuators in adjustment to a programmatic operating mode, such as for massage, and/or in response to one or more indications of local phenomena as described herein. In some variants, for example,control module9780 adjusts actuator elements to maintain a consistent pressure or a programmatically cycled pressure at external portions9703-9705 to treat poor circulation, cramps, or other pathologies aggravated by immobility. Alternatively or additionally, such motors may be configured as shown inFIG. 7 in which the engagement of one ormore motors715 may selectively constrict or expand selected ones of cells710-750, effectuating a local profile increasing or decreasing the pressure selectively applied to portions of subjects as described herein.
• In light of teachings herein, numerous existing techniques may be applied for the use of motors to adjust the pressure and/or force applied to a structure as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,273,053 (“Monitoring and control for a laryngeal mask airway device”); U.S. Pat. No. 7,270,374 (“Structure for anatomical support with frame and convex cushioned plate for back, headrest and seat, for seating in general, especially seats in motor vehicles, with manual and motor-driven adaption of cushioned plate covexity and position”); U.S. Pat. No. 7,134,157 (“Motor-adjustable head rest”); U.S. Pat. No. 6,961,971 (“Motor adjustable support device for the upholstery of a seat and/or reclining furniture”); U.S. Pat. No. 6,810,876 (“Assisted ventilation to match patient respiratory need”); U.S. Pat. No. 6,689,974 (“Pressure switch for motorized chairs”); U.S. Pat. No. 6,547,749 (“Body pulsating method and apparatus”).
• Operation10049 describes configuring the programmatic response partly based on thermal data obtained from the second external portion of the subject's body (e.g. module1052 ofFIG. 10 selecting one ormore control profiles1071,1072 orother operating parameters1075,1076 configured to update at least a force exerted uponportion1011 in response tomodule1091 indicating thatportion1012 has apparently remained beyondthermal threshold1086 for longer than time threshold1087). This can occur, for example, in a context in which configuration logic1050 performsoperation9840, in whichthermal threshold1086 is within an order of magnitude of 0.5° C. or 5° C. of a nominally normal temperature, in whichtime threshold1087 is within an order of magnitude of 1 hour or 1 day, in whichpattern recognition module1092 is configured to determine whetherthermal data1081 from one ormore sensors1002adjacent portion1012 indicates such an abnormality, and in which the programmatic response comprises updating one ormore control signals1031,1032 to respective ones ofactuators1021,1022 supporting respective zones of the subject'sskin1010. In some contexts, for example, an external portion of a subject's limb remaining at 1° C. or more lower than a standard value for a period of hours may trigger an automatic therapy (such as massage), a timely-scheduled examination by a caregiver, and/or other such programmatic responses. Alternatively or additionally, the programmatic response(s) may be tailored according to locally-abnormal-stress-indicative information, such as by including an urgency indicator, notifying additional parties, or otherwise responding to such information in one or more notifications as described herein. One or more such response may be adapted in some contexts, moreover, in response to whetherother data1082 from anysuch sensors1001,1002 indicates a systemic or local abnormality as described herein.
• In light of teachings herein, numerous existing techniques may be applied for recognizing patterns in thermal, pressure, and/or other measurement data as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,331,667 (“Iris pattern recognition and alignment”); U.S. Pat. No. 7,324,661 (“Computer-implemented system and method for automated and highly accurate plaque analysis, reporting, and visualization”); U.S. Pat. No. 7,252,640 (“Detection of disordered breathing”); U.S. Pat. No. 7,248,733 (“Color-image processing apparatus and method, and storage medium”); U.S. Pat. No. 7,190,996 (“Monitor for early detection of ischemic heart disease”); U.S. Pat. No. 7,162,061 (“Abnormal pattern detection processing method and system”); U.S. Pat. No. 6,675,040 (“Optical object tracking system”); U.S. Pat. No. 6,647,093 (“Method and device for the processing of X-ray images”); U.S. Pat. No. 6,606,579 (“Method of combining spectral data with non-spectral data in a produce recognition system”); U.S. Pat. No. 6,196,973 (“Flow estimation using an ultrasonically modulated contrast agent”); U.S. Pat. No. 6,069,696 (“Object recognition system and method”).
• Operation10085 describes comparing the locally-abnormal-stress-indicative information with other locally-abnormal-stress-indicative information from the second external portion of the subject's body (e.g. one ormore modules1181,1182 ofprocessing logic1180 triggering or otherwise performing comparisons between swelling-indicative data1162 received insignal1125 andprior data1161 from the same or similar site. This can occur, for example, in a context in whichmodule1183 is configured either (a) to process one or more changes inmeasurement data1163 fromportion1111 in relation to at least some measurement information fromportion1111 to determine whether differences are apparently localized or systemic or (b) to aggregate such data or otherwise permit at least some such processing at a common facility as described herein. In some variants, for example, changes in such information localized to one observation region (e.g. from portion1112) may be used as an indication of healing or deterioration progress for a pressure wound or other abnormality thereof.
• In light of teachings herein, numerous existing techniques may be applied for using comparisons of information acquired from two or more observation sites as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,340,951 (“Distributed impedance sensor”); U.S. Pat. No. 7,340,337 (“Vehicle control system for detecting a short-circuit condition between redundant position sensors”); U.S. Pat. No. 7,337,677 (“Differential pressure flowmeter, flow controller, and apparatus for processing substrate”); U.S. Pat. No. 7,225,013 (“Adaptive prediction of changes of physiological/pathological states using processing of biomedical signals”); U.S. Pat. No. 6,898,457 (“Method for determining temperature, radiation thermometer with several infrared sensor elements”); U.S. Pat. No. 6,584,345 (“Apparatus and method for measuring a plurality of electrical signals from the body of a patient”); U.S. Pat. No. 6,413,233 (“Perfusion hyperthermia treatment system and method”); U.S. Pat. No. 6,304,775 (“Seizure warning and prediction”); U.S. Pat. No. 5,755,571 (“Differential measurement periodontal structures mapping system”).
• Operation10088 describes causing a data recordation responsive to the locally-abnormal-stress-indicative information (e.g. module1351 ofdecision logic1350 requesting one ormore storage devices1340 to record locally-abnormal-stress-indicative information1341 from a vehicle or other remote source1385). This can occur, for example, in a context in whichremote source1385 comprises a system configured to receive such information in some form via one or more sensors in a vicinity of the subject's body—such as byresponsive logic260 ordecision logic275 receiving information221-224 via sensor(s)215 in real time—and in which a conventional structure may aggravate a seat occupant's pressure ulcer or other such pathology. In some contexts,module1351 may then (or later) receive and store at least a sample of such information as the locally-abnormal-stress-indicative information1341, optionally in a form that is selected or otherwise distilled from information221-224 as described herein. Alternatively or additionally,module1351 may likewise cause a recordation of subject orsite identifiers1345, time orplace indications1346,other measurement data1343 from one or more sensors in the subject's vicinity, and/or other related, diagnosticallyuseful information1342 as described herein that may potentially relate to one or more pathologies as indicated ininformation1341.
• In light of teachings herein, numerous existing techniques may be applied for the recording of subject information resulting from sensor measurements as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,338,443 (“Secure patient data recorder for recording monitored vital sign data”); U.S. Pat. No. 7,294,108 (“Cardiac event microrecorder and method for implanting same”); U.S. Pat. No. 7,277,903 (“Method and apparatus for distributed data archiving”); U.S. Pat. No. 7,142,632 (“Radiation image recording device”); U.S. Pat. No. 7,104,955 (“System and method for collection and analysis of regularly retrieved patient information for automated remote patient care”); U.S. Pat. No. 6,966,650 (“Method and apparatus for an automated procedure to detect and monitor early-stage glaucoma”); U.S. Pat. No. 6,668,188 (“Determination of long-term condition of cardiac patients”); U.S. Pat. No. 6,468,242 (“Medical apparatus with patient data recording”); U.S. Pat. No. 5,879,292 (“Bandage including data acquisition components”).
• With reference now toFIG. 101, there are shown several variants of theflow9800 ofFIG. 98 or100.Operation9840—causing an artificial support to modify a force upon a first external portion of a subject's body as a programmatic response to locally-abnormal-stress-indicative information obtained from a second external portion of the subject's body—may include one or more of the following operations:10141,10142,10146 or10147. Variants ofoperation9840 may be performed by one or more instances ofcontroller775,support control logic9780, or other configuration or control logic, for example, implemented in a bed, vehicle, or other primary and/or local module described herein. Alternatively or additionally,flow9800 may be performed in a context as described above with reference to any ofFIGS. 1-80 and/or in conjunction with other flow variants as described below.
• Operation10141 describes obtaining the locally-abnormal-stress-indicative information as a response of the second external portion of the subject's body to a pressure pulse (e.g. a special-purpose tonometer925 or other components of sensor-containinginstrument900 deriving one ormore images931, signals932,933, orother data935 indicative of a locally abnormal tension or pressure in a subject's skin or other body surface). This can occur, for example, in a context in which a pulse element905 exerts the pressure pulse uponskin910, in which one ormore sensors902 convert a physical response to the pulse into a digital orother signal932, and in whichmodule943 ofevaluation logic950 applies one ormore thresholds941 orother criteria942 configured to evaluate whethersuch signals932 orother data935 are abnormal. In some variants, for example, such athreshold941 may be derived from nearby tissue, from a prior signal of the “second” external portion, and/or from one or more other subjects. Alternatively or additionally,such data935 may likewise include colorimetric or other abnormality-indicative signals933 signifying a status of the external body portion.
• In light of teachings herein, numerous existing techniques may be applied for using tissue response to external perturbations as a probe for detecting abnormalities, features, and/or other physiological information as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,260,440 (“Method and apparatus for measurement of pressure at a device/body interface”); U.S. Pat. No. 7,232,415 (“System and method for noninvasively evaluating a limb suspected of compartment syndrome”); U.S. Pat. No. 7,211,063 (“Pressure sensor for therapeutic delivery device and method”); U.S. Pat. No. 6,845,146 (“Mammography apparatus and method”); U.S. Pat. No. 6,733,461 (“Methods and apparatus for measuring arterial compliance, improving pressure calibration, and computing flow from pressure data”); U.S. Pat. No. 6,706,001 (“Dual tonometer pressure measurement device”); U.S. Pat. No. 6,547,746 (“Method and apparatus for determining response thresholds”); U.S. Pat. No. 6,507,663 (“Method and apparatus for detecting very small breast anomalies”); U.S. Pat. No. 6,425,875 (“Method and device for detection of a tooth root apex”); U.S. Pat. No. 6,361,495 (“Hand-held non-contact tonometer”); U.S. Pat. No. 6,186,962 (“Method and device for detecting edema”); U.S. Pat. No. 6,139,499 (“Ultrasonic medical system and associated method”); U.S. Pat. No. 6,063,044 (“Apparatus for measuring muscle tone”).
• Operation10142 describes transmitting a first control signal to a first actuator operable for modifying the force upon the first external portion of the subject's body and a second control signal to a second actuator operable for modifying a force upon the second external portion of the subject's body (e.g. module9782 ofsupport control logic9780transmitting signals9785,9786 or other control data selectively to two ormore actuators9752,9753,9754,9755 in an array configured to reduce one or more shear stress measurements or otherwise to respond to information from one ormore sensor modules9713,9714,9715 near an inflammation or other externally detected abnormality9709). This can occur, for example, in a context in which supportcontrol logic9780 performsoperation9840 and in which respective states of the actuators change simultaneously or in respective cycles, for example, with or without closed-loop control (via sensors of modules9713-9715, e.g.) configured to respond to tissue stress indications in a vicinity of the actuator(s). In some variants, for example,module1156 ofcontrol logic1160 implements avector grid1165,profile1167, transfer function, or othersuch control data1170 to respective instances ofactuators1122 each configured to alleviate at least one worst-case shear inskin1110 by exerting forces upon respective portions ofskin1110 within a vicinity of which a stress-indicative signal1125 is obtained. Alternatively or additionally,module784 ofsupport control logic780 may be configured with one ormore parameters793,794 defining a model that increases a normal incident force at one or more actuator cells (e.g. at cell730) in a vicinity of a detected anomaly (e.g. at cell740). Such a model may be implemented for coarse positioning, for example, in response to one ormore motion sensors2472 or other elements oflocal modules2320,2450,2510, or2690 detecting the subject's limb being repositioned.
• In light of teachings herein, numerous existing techniques may be applied for configuring a system for implementing a programmatic response to local sensor observations as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,164,948 (“Cardiac output measurement using dual oxygen sensors in right and left ventricles”); U.S. Pat. No. 6,947,780 (“Auditory alarms for physiological data monitoring”); U.S. Pat. No. 6,892,405 (“Therapeutic bed and related apparatus and methods”); U.S. Pat. No. 6,671,547 (“Adaptive analysis method for an electrotherapy device and apparatus”); U.S. Pat. No. 6,658,292 (“Detection of patient's position and activity status using 3D accelerometer-based position sensor”); U.S. Pat. No. 6,604,650 (“Bottle-cap medication reminder and overdose safeguard”); U.S. Pat. No. 6,440,090 (“Spinal cord simulation systems with patient activity monitoring and therapy adjustments”); U.S. Pat. No. 6,413,233 (“Perfusion hyperthermia treatment system and method”); U.S. Pat. No. 5,963,997 (“Low air loss patient support system providing active feedback pressure sensing and correction capabilities for use as a bed mattress and a wheelchair seating system”).
• Operation10146 describes causing an actuator of the artificial support to modify a lateral component of the force upon the first external portion of the subject's body (e.g. module1155 ofcontrol logic1160 executing acommand sequence1157 causing a transmission of one ormore control signals1131,1132 torespective elements1121,1122 each configured to exert a primarily-tangential force across the subject's skin1110). This can occur, for example, in a context in whichcommand sequence1157 is configured to control one or moreactuator elements741,742,743 configured to push and/or pull one ormore cells740 supporting the “first” external body portion. In some variants, for example, one or more such actuator cells may include (a) aseat211,814, bed, or other support element operable for engaging or otherwise supporting a subject's leg and (b) two or more respectively selectable non-coaxialactuator elements741,742 operable to guide at least one cell of the support element each according to a respective state thereof. Alternatively or additionally, one or more such actuators may be configured to exert a primarily-lateral force at least uponcell740, such as for measurably reducing a shear force betweencell740 and the body portion.
• In light of teachings herein, numerous existing techniques may be applied for electronically or otherwise controlling or otherwise configuring microelectromechanical, fluidic, or other actuator systems as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,339,299 (“Electric actuator and motor used therein”); U.S. Pat. No. 7,336,018 (“Circuit configuration for charging and discharging a plurality of capacitive actuators”); U.S. Pat. No. 7,327,637 (“Acoustic pulse actuator”); U.S. Pat. No. 7,301,256 (“Method and circuit configuration for operating a piezoelectric actuator”); U.S. Pat. No. 7,199,494 (“Electric linear actuator”); U.S. Pat. No. 7,172,493 (“Fine force actuator assembly for chemical mechanical polishing apparatuses”); U.S. Pat. No. 7,144,099 (“Liquid drop emitter with split thermo-mechanical actuator”); U.S. Pat. No. 7,124,837 (“Pneumatic motor trigger actuator”); U.S. Pat. No. 7,100,491 (“Fluid-powered mechanical actuator and method for controlling”); U.S. Pat. No. 7,052,427 (“Electric screw actuator system”); U.S. Pat. No. 6,955,113 (“Electro-hydraulic actuator with mechanical servo position feedback”); U.S. Pat. No. 6,748,929 (“Electronic circuit configuration and corresponding method for controlling actuators such as valves or injectors”); U.S. Pat. No. 6,717,337 (“Piezoelectric acoustic actuator”); U.S. Pat. No. 6,715,402 (“Hydraulic control circuit for operating a split actuator mechanical mechanism”); U.S. Pat. No. 6,685,303 (“Thermal actuator with reduced temperature extreme and method of operating same”); U.S. Pat. No. 6,497,222 (“Actuator configuration and method in particular for actuating an injection valve of an internal combustion engine”); U.S. Pat. No. 6,271,618 (“Method and configuration for driving a capacitive actuator”).
• Operation10147 describes configuring the programmatic response partly based on colorimetric data obtained from the second external portion of the subject's body (e.g. configuration module777 selecting one ormore control profiles796 and/orother parameters795 configured to reduce a force upon the second external portion by a greater degree in response to one or more indications of bruising or inflammation thereof). This can occur, for example, in a context in whichcontroller775 includes one or more local modules as described herein, in whichoptical sensor2525 detects one or more indications of discoloration within or overlapping the “second” external portion, in which the “first” or other external portions extend within a few millimeters thereof, and in whichreflectance sensor2511 or other optical sensors described herein are sensitive to visible frequency phenomena or other such symptoms. In some variants, for example, shape recognition, thermal, pathological, or other analysis as described herein may likewise be used for selectingprofile796 orother parameters795 of the programmatic response. Alternatively or additionally, some such responses may include other notifications, evaluations, therapies, aggregations, or other protocols as described herein.
• In light of teachings herein, numerous existing techniques may be applied for analyzing, treating, or otherwise responding in contexts in which optically detectable symptoms can occur as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,297,154 (“Optical apparatus for detecting and treating vulnerable plaque”); U.S. Pat. No. 7,275,829 (“Ophthalmic laser irradiation apparatus”); U.S. Pat. No. 7,244,122 (“Methods for determining optical characteristics of dental objects”); U.S. Pat. No. 7,155,273 (“Blanching response pressure sore detector apparatus, and method”); U.S. Pat. No. 6,950,692 (“Optical coherence tomography apparatus optical fiber lateral scanner and a method for studying biological tissues in vivo”); U.S. Pat. No. 6,663,242 (“Simultaneous, wavelength multiplexed vision screener”); U.S. Pat. No. 6,507,747 (“Method and apparatus for concomitant structural and biochemical characterization of tissue”); U.S. Pat. No. 5,892,570 (“Method and apparatus for measuring and correcting metamorphopsia”).
• With reference now toFIG. 102, there are shown several variants of theflow9900 ofFIG. 99.Operation9950—obtaining locally-abnormal thermal information about a first external portion of a subject's limb—may (optionally) include one or more of the following operations:10252,10256 or10257. In some embodiments, variants ofoperation9950 may be performed by one or more instances ofdetection logic180,640,1275,3285,3550,5135,5670,6110,6720,7940 and/orlocal modules2320,2450,2510,2690,5730 (in a vicinity of one ormore subjects310,320,1720,1910,2270,2920,3270,3360,5220,6090, e.g.) configured to handle infrared images, temperature readings, or other such sensor data of potential diagnostic utility.Operation9970—causing an artificial support to exert an increasing force upon a second external portion of the subject's limb at least partly in response to locally-abnormal thermal information about the first external portion of the subject's limb—may include operation10274. In some embodiments, variants ofoperation9970 may be performed by one or more instances ofdecision logic275,2250,2730,3230,5750,5930,6130,6395,7415;support control logic780,9780; or other configuration or control logic described herein. Alternatively or additionally,flow9900 may be performed in a context as described above with reference to any ofFIGS. 1-80 or in conjunction with other flow variants as described below.
• Operation10252 describes receiving thermal information from one or more sensors adjacent the subject's limb (e.g. interface5265 receiving temperature-indicative data5252 from one ormore sensors5203 relating to a subject's arm or leg). This can occur, for example, in a context in which one or more instances ofinterface5265 and/or configuration logic5235 each performoperation9950 and in which one or more such sensors are implanted into, affixed to, or arranged around a subject site and configured to send thermal and/or other status indicative information tosystem module5250. In some variants, for example, communication between the sensor(s) and the system module will be accomplished through acontinuous conduit5208. Alternatively or additionally, other such linkages among sensors or other modules as described herein may incorporate one or more wireless linkages such as Bluetooth, wireless USB, RF telemetry, cellular, 802.11 (B, G, N), far field telemetry, or other such existing technologies.
• Operation10256 describes detecting additional information about the first external portion of the subject's limb (e.g. module1272 ofdetection logic1275 receivingauditory data1244,optical data1247, subject-provideddata1246, pressure-indicative data1245, or otheradditional data1248 relating to anupper portion1201 of a subject's limb). This can occur, for example, in a context in whichdetection logic1275 performsoperation9950 and in whichmodule1273 is configured to receive the locally-abnormalthermal information1251 from one or more other sensors ofarray1221 before or aftermodule1272 receives such “additional” data. In some variants, for example,optical sensors2525 implanted into, affixed onto or arranged nearupper portion1201 may be configured to provide otherthermal information1241,chemical composition information1242, and/or otherphysiological information1243. Other such sensors or related logic described above with reference toFIGS. 23-26 may likewise be included in the monitoring, evaluation, or other detection modules of this document, for example, many of which may be configured to record or otherwise respond to status-indicative information1260 selectively as described herein.
• In light of teachings herein, numerous existing techniques may be applied for using one or more sensor types to detect and/or derive suitable types of status information as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,292,719 (“System and method for imaging”); U.S. Pat. No. 7,254,430 (“Measuring apparatus for measuring a metabolic characteristic in a human body”); U.S. Pat. No. 7,226,426 (“Apparatus and method for the detection and quantification of joint and tissue inflammation”); U.S. Pat. No. 7,205,991 (“Graphical user interface widgets viewable and readable from multiple viewpoints in a volumetric display”); U.S. Pat. No. 7,187,960 (“Apparatus and method for measuring biologic parameters”); U.S. Pat. No. 6,733,447 (“Method and system for remotely monitoring multiple medical parameters”); U.S. Pat. No. 6,679,830 (“Infant incubator with non-contact sensing and monitoring”); U.S. Pat. No. 6,454,718 (“Intra aural integrated vital signs monitor”).
• Operation10257 describes causing a thermal abnormality in the first external portion of the subject's limb (e.g. module5210 applying thermal energy to a target region5225). This can occur, for example, in a context in which the region is heated or cooled to produce a thermal perturbation, such as by dispensing a suitable reactive material or actuating a heating element. In some variants, for example, the duration and/or shape of such perturbations may be used as an indication of circulation and/or other thermal transfer properties of local tissues in thetarget region5225. Alternatively or additionally, one ormore modules5232 of configuration logic5235 may selectively or otherwise record one or morethermal images5241, timingdata5242, or other attributes ofresponse5245 of the region to such thermal deviations may be used to characterize local tissue for diagnostic purposes.
• In light of teachings herein, numerous existing techniques may be applied for the use of thermal manipulation and/or detection to probe subject status information and/or pathological indicators as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,300,453 (“System and method for inducing hypothermia with control and determination of catheter pressure”); U.S. Pat. No. 7,254,430 (“Measuring apparatus for measuring a metabolic characteristic in a human body”); U.S. Pat. No. 7,226,426 (“Apparatus and method for the detection and quantification of joint and tissue inflammation”); U.S. Pat. No. 7,214,094 (“Twist mount wiring receiver”); U.S. Pat. No. 7,167,734 (“Method for optical measurements of tissue to determine disease state or concentration of an analyte”); U.S. Pat. No. 6,974,463 (“System and method for patient temperature control employing temperature projection algorithm”); U.S. Pat. No. 6,950,693 (“Device recording a thermo-optical image of the female breast”); U.S. Pat. No. 6,660,028 (“Method for determining the effective thermal mass of a body or organ using a cooling catheter”); U.S. Pat. No. 6,464,646 (“Instrument and method for locating and marking a hot spot in a person's body tissue”); U.S. Pat. No. 6,458,150 (“Method and apparatus for patient temperature control”); U.S. Pat. No. 6,086,247 (“Differential temperature sensor device for use in the detection of breast cancer and breast disease”).
• Operation10274 describes signaling a selective expansion of one or more actuation elements configured to affect the second external portion of the subject's limb (e.g. one ormore modules9781 ofsupport control logic9780 triggering one ormore actuators9752,9753,9754,9755 to either advance or retract thereby increasing or reducing a force applied to subject body part9710). This can occur, for example, in a context in which one or more instances ofcircuitry9790 locally performoperation9840, in which alocal tissue abnormality9709 is detected, and in which one or moreadjacent actuators9752,9753,9754 are advanced andlocal actuator9755 is retracted to reduce the pressure and/or force exerted uponportion9705. In some variants, for example,support9750 is incorporated into a bed in which one ormore actuators9752,9753,9754,9755 are selectively advanced or retracted automatically based upon detectedtissue abnormalities9709. Alternatively or additionally,actuators9752,9753,9754,9755 may be cycled in one or more selected patterns or randomly bysupport control logic9780 to avoid the formation of pressure wounds or other adverse effects.
• In light of teachings herein, numerous existing techniques may be applied for the adjustment of support pressure on one or more body parts to treat and/or prevent pressure wounds, circulatory disruptions, or other adverse physiological phenomena as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,330,127 (“Force optimization surface apparatus and method”); U.S. Pat. No. 7,278,179 (“Inflatable decubitis mat with vent structures controlled by heat sensors”); U.S. Pat. No. 7,146,664 (“Pneumatic surgical prone head support and system”); U.S. Pat. No. 6,721,980 (“Force optimization surface apparatus and method”); U.S. Pat. No. 6,584,628 (“Hospital bed having a rotational therapy device”); U.S. Pat. No. 6,560,804 (“System and methods for mattress control in relation to patient distance”); U.S. Pat. No. 6,034,526 (“Apparatus for controlling the inflation pressure of a mattress in response to deformation of the mattress using impedance measurement”); U.S. Pat. No. 5,983,429 (“Method and apparatus for supporting and for supplying therapy to a patient”).
• Operation10290 describes determining whether a decreased force is exerted upon the first external portion of the subject's limb (e.g. one ormore sensor modules9713,9714,9715 placed in one or more subject contact regions detecting localized pressure and/or force-change-indicative values9723,9724,9725 in some or all of these regions). This can occur, for example, in a context in which a portion of thesubject body9710 rests onsupport9750 as shown and in which a symptom is effectively detectable only by monitoring such force-indicative, shape-indicative, size-indicative, or other stress-indicative data in relation that portion over a period of several seconds or more. (Motion from the subject may affect the pressure and/or force observed exerted on thesubject body9710 by thesupport9750 for shorter periods.) In some variants, for example, brief subject movements may be tracked by monitoring one or more pressure values recorded bysensor modules9713,9714,9715. Alternatively or additionally, pressure changes inrespective portions9703,9704,9705 may be used to adjust actuator positions to maintain the force exerted on thesubject body part9710 within a desired range.
• In light of teachings herein, numerous existing techniques may be applied for monitoring the pressure exerted on a body part by a support as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,337,680 (“System and method for measuring plantar foot pressure”); U.S. Pat. No. 7,234,359 (“Semiconductor force sensor”); U.S. Pat. No. 6,822,571 (“Patient movement detection system for a bed including a load cell mounting assembly”); U.S. Pat. No. 6,791,460 (“Patient position detection apparatus for a bed”); U.S. Pat. No. 6,770,045 (“Orthosis knee joint”); U.S. Pat. No. 6,721,980 (“Force optimization surface apparatus and method”); U.S. Pat. No. 6,585,328 (“Customized mattress evaluation system”); U.S. Pat. No. 6,133,837 (“Patient position system and method for a support surface”); U.S. Pat. No. 5,993,400 (“Apparatus and method for monitoring contact pressure between body parts and contact surfaces”).
• With reference now toFIG. 103, there are shown several variants of theflow9900 ofFIG. 99 or102.Operation9950—obtaining locally-abnormal thermal information about a first external portion of a subject's limb—may (optionally) include one or more of the following operations:10351,10353,10355 or10359. In some embodiments, variants ofoperation9950 may be performed by one or more instances of sensors and/or interfaces configured to handle thermal information of potential diagnostic utility.Operation9970—causing an artificial support to exert an increasing force upon a second external portion of the subject's limb at least partly in response to locally-abnormal thermal information about the first external portion of the subject's limb—may include one or more of the followingoperations10376 or10378. In some embodiments, variants ofoperation9970 may be performed by one or more instances of actuators, control circuitry, and/or other responsive elements as described herein. Alternatively or additionally,flow9900 may be performed in a context as described with reference to any ofFIGS. 1-80 or in conjunction with other flow variants as described below.
• Operation10351 describes obtaining information from a remote source including at least the locally-abnormal thermal information about the first external portion of the subject's limb (e.g. aggregation module5281 remotely receivinginformation5260 including at least some local-abnormality-indicative data5253 about region5225). This can occur, for example, in a context in whichport5261 andnetwork5290 each performsoperation9950 by receiving such data from one ormore sensors5203 local toregion5225, with or withoutcomparative information5276. Alternatively or additionally,system module5250 may implement one ormore controllers775,notification logic7875, and/or other such structures in this document suitable for acting uponcomparative information5276 or othersuch information5260 after retrieving it or otherwise receiving distributions ofupdate data5255 fromaggregation module5281 or other resources.
• In light of teachings herein, numerous existing techniques may be applied for connecting to and retrieving subject status information from a remote data source and/or processing system as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,269,476 (“Smart medicine container”); U.S. Pat. No. 7,250,855 (“False alarm mitigation using a sensor network”); U.S. Pat. No. 7,248,917 (“Self treatment device”); U.S. Pat. No. 7,226,426 (“Apparatus and method for the detection and quantification of joint and tissue inflammation”); U.S. Pat. No. 7,147,600 (“System and method for determining a reference baseline of patient information”); U.S. Pat. No. 7,027,871 (“Aggregation of data from external data sources within an implantable medical device”); U.S. Pat. No. 6,922,592 (“Implantable medical device controlled by a non-invasive physiological data measurement device”); U.S. Pat. No. 6,824,512 (“Communications system for an implantable device and a drug dispenser”); U.S. Pat. No. 6,801,137 (“Bidirectional communication between a sensor unit and a monitor unit in patient monitoring”); U.S. Pat. No. 6,463,310 (“Method and circuit for storing and providing historical physiological data”); U.S. Pat. No. 6,440,067 (“System and method for remotely monitoring functional activities”).
• Operation10353 describes indicating one or more of a thigh location, a calf location, or a foot location as the first external portion of the subject's limb (e.g. module2973 ofdecision logic2975receiving communication2935 orother data2955 activating one or more sensors identified with or otherwise identifying a subject body portion). This can occur, for example, in a context in whichdecision logic2975 performsoperation9950 and in which one ormore sensors2927 are placed on or near the subject limb, optionally in one ormore arrays1221,1222 as shown inFIG. 12. In some contexts, for example, one or moresuch portions1201,1202 may be selected as a primary sensor location for limb monitoring. Alternatively or additionally, one or more other sensors as described with reference toFIG. 23-26 may be positioned to monitor suchsubject portions1201 and/or other contemporaneous attributes of the subject as described herein.
• In light of teachings herein, numerous existing techniques may be applied for the selective inclusion and/or activation of one or more sensors from a sensor set as a primary sensor location without undue experimentation. See, e.g., U.S. Pat. No. 7,332,743 (“Thin film transistor array panel and liquid crystal display”); U.S. Pat. No. 7,208,983 (“Image-sensor signal processing circuit”); U.S. Pat. No. 7,190,987 (“Neonatal bootie wrap”); U.S. Pat. No. 7,155,281 (“Complimentary activity sensor network for disease monitoring and therapy modulation in an implantable device”); U.S. Pat. No. 7,149,645 (“Method and apparatus for accurate on-die temperature measurement”); U.S. Pat. No. 6,275,733 (“Dual sensor rate response pacemaker”); U.S. Pat. No. 6,271,766 (“Distributed selectable latent fiber optic sensors”).
• Operation10355 describes updating a normality threshold configured to evaluate other thermal information about the subject's limb (e.g. module5233 of configuration logic5235 changing or otherwise updating one or more thermal thresholds5271). This can occur, for example, in a context in which a symptom is effectively detectable only by monitoring such thermal indicia in relation to the limb and in whichnew operating parameters5275 or othercomparative information5276 are received from a sensor as described above, for example, in relation toFIGS. 23-26. In some variants, for example, information from anambient sensor5201 and/or acore body sensor5202 may be used to generate and/or adjust thresholds applied tosensor data5251 from one or more other sensors extending into, in contact with, or otherwise arranged around the subject. Alternatively or additionally, historic and/or processed information from a remote storage and/orprocessing device5291 or fromother resources5292 may be used to provide and/or adjust thresholds or other filtering information applied to thesensor data5251 or other portions ofinformation5260 obtained from the subject limb.
• In light of teachings herein, numerous existing techniques may be applied for requesting, receiving, or otherwise interacting with numerical thresholds as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,250,855 (“False alarm mitigation using a sensor network”); U.S. Pat. No. 7,079,035 (“Method and apparatus for controlling an alarm while monitoring”); U.S. Pat. No. 7,037,273 (“Core body temperature monitoring in heart failure patients”); U.S. Pat. No. 6,942,626 (“Apparatus and method for identifying sleep disordered breathing”); U.S. Pat. No. 6,569,095 (“Adaptive selection of a warning limit in patient monitoring”); U.S. Pat. No. 6,552,531 (“Method and circuit for processing signals for a motion sensor”); U.S. Pat. No. 6,263,243 (“Rate adaptive pacemaker”).
• Operation10359 describes detecting how long a thermal abnormality apparently remains in the first external portion of the subject's limb (e.g. counter5173 orother timing logic5175 generating one ormore values5181 indicating how long a limb portion remains below a temperature-change-rate or other thermal threshold5112). This can occur, for example, in a context in whichdetection logic5135 performsoperation9950, in whichmodule5133 signals counter5173 to stop responsive to one ormore values5181 satisfying a normality-indicative condition5125, in whichmodule5131 ofdetection logic5135 is configured to reset and/or enable one ormore counters5173 in response tomodule5132 detecting thatsensor data5184 violatesdata filter5121, and in which one ormodules5131,5132,5133 ofdetection logic5135 are configured to halt and/or read counter5173 in response to a reset offilter violation status5183. Alternatively or additionally, one or more such modules ofdetection logic5135 may trigger a recording device to store one ormore event records5160 containing, for example, one or more of atimestamp5161,filter configuration data5167,sensor data5168, or other information relating to a condition in which a filter status is engaged or removed.
• In light of teachings herein, numerous existing techniques may be applied for using experimental data for measuring or otherwise estimating intervals as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,319,400 (“Method and apparatus for monitoring a restraint device”); U.S. Pat. No. 7,151,957 (“Method and device for analyzing a periodic or semi-periodic signal”); U.S. Pat. No. 7,029,447 (“Measuring blood pressure”); U.S. Pat. No. 6,720,875 (“Self-adjusting alarm device with low energy consumption”); U.S. Pat. No. 6,691,979 (“Adaptive object-sensing system for automatic flusher”); U.S. Pat. No. 6,600,425 (“Method and apparatus for detecting and recording episodic overloads in a circuit”); U.S. Pat. No. 6,580,994 (“Driving force controlling apparatus and method for four-wheel drive vehicle”); U.S. Pat. No. 6,200,270 (“Sensor for non-invasive and continuous determination of the duration of arterial pulse waves”); U.S. Pat. No. 6,047,201 (“Infant blood oxygen monitor and SIDS warning device”); U.S. Pat. No. 6,014,346 (“Medical timer/monitor and method of monitoring patient status”).
• Operation10376 describes selecting an element configured to interact with apparently healthy tissue as the second external portion of the subject's limb (e.g. one ormore modules782 ofsupport control logic780 selecting one ormore cells740 or one or more of theiractuation elements741,742,743 in response to a determination that no anomalies have been detected in tissue adjacent cell740). This can occur, for example, in a context in which supportcontrol logic780 performsoperation9970, in which support420 ofFIG. 4implements array705 ofFIG. 7, in whichcomponent414 containscell740, in which one ormore sensors424 as described herein are positioned in or nearcell740 for detecting one or more tissue attributes ofexternal portion404 ofbody410, in which one or moresuch cells740,750 are positioned so that a movement ofcell740 may directly result in an increasing lateral and/or normal force uponexternal portion404, and in which a selection ofcell740 may thereby effectively result in a determination of the “second” external portion. In some variants, for example, an expansion of one ormore elements742,743 may cause such an increasing force, a direction of which may be modified by one or moreother elements741. Alternatively or additionally,module782 may may control such movement ofcomponent414 with closed-loop control so thatcomponent414 is positioned to minimize a shear force or otherwise favorably influence an attribute ofabnormality409 detected, for example, viasensor425.
• In light of teachings herein, numerous existing techniques may be applied for detecting or characterizing injuries or other localized structures and/or phenomena as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,303,555 (“Imaging and therapeutic procedure for carpal tunnel syndrome”); U.S. Pat. No. 7,226,426 (“Apparatus and method for the detection and quantification of joint and tissue inflammation”); U.S. Pat. No. 7,155,273 (“Blanching response pressure sore detector apparatus and method”); U.S. Pat. No. 7,006,676 (“Method and apparatus for detecting an abnormality within a host medium utilizing frequency-swept modulation diffusion tomography”); U.S. Pat. No. 6,993,167 (“System and method for examining, recording and analyzing dermatological conditions”); U.S. Pat. No. 6,880,387 (“Acoustic micro imaging method providing improved information derivation and visualization”); U.S. Pat. No. 6,544,186 (“System and method for diagnostic imaging”); U.S. Pat. No. 6,464,646 (“Instrument and method for locating and marking a hot spot in a person's body tissue”); U.S. Pat. No. 6,258,046 (“Method and device for assessing perfusion failure in a patient by measurement of blood flow”); U.S. Pat. No. 6,233,479 (“Microwave hematoma detector”); U.S. Pat. No. 6,192,143 (“Apparatus for detecting very small breast anomalies”); U.S. Pat. No. 6,056,692 (“Apparatus and method for locating and marking blood vessels”); U.S. Pat. No. 5,999,836 (“Enhanced high resolution breast imaging device and method utilizing non-ionizing radiation of narrow spectral bandwidth”); U.S. Pat. No. 5,989,194 (“Method and apparatus for detecting ocular disease and abnormalities”).
• Operation10378 describes causing one or more actuation elements to reduce a force exerted upon the first external portion of the subject's limb (e.g. module781 ofsupport control logic780 causing a contraction of one ormore elements753 so thatcell750 exerts a decreasing shear or other force upon a subject's leg wound). This can occur, for example, in a context in which one or more arrangements of actuation and/or sensor elements are distributed over a region of concern in a subject limb, in whichsystem module1230 configures a suitable actuation controller as described herein, and in which conventional modes of observation may fail to reveal an abnormality in time. In some variants, for example,array705 may expand or contract to maintain a pressure within a detection range as the body part expands or contracts due to increased or decreased tissue swelling. Alternatively or additionally, one ormore modules783,784 ofsupport control logic780 may be configured to actuate one ormore arrays1221,1222 or other configurations of actuators cyclically or otherwise in patterns selected by specifying one or more parameters793-795, such as to prevent circulatory disruptions or other adverse effects.
• In light of teachings herein, numerous existing techniques may be applied for the adjustment of pressure and/or force applied to one or more body parts by a surface contact element to treat and/or prevent circulatory disruptions or other adverse physiological phenomena as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,338,482 (“External catheter access to vacuum bandage”); U.S. Pat. No. 7,314,478 (“High efficiency external counterpulsation apparatus and method for controlling same”); U.S. Pat. No. 7,214,202 (“Therapeutic apparatus for treating ulcers”); U.S. Pat. No. 7,135,032 (“Femoral compression device with support”); U.S. Pat. No. 7,135,007 (“Compression garments and related methods”); U.S. Pat. No. 7,037,256 (“Method, system and kit for treatment of Peyronie's disease”); U.S. Pat. No. 6,988,499 (“Mechanical resuscitator”); U.S. Pat. No. 6,945,944 (“Therapeutic limb covering using hydrostatic pressure”); U.S. Pat. No. 6,786,879 (“Gradient sequential compression system for preventing deep vein thrombosis”); U.S. Pat. No. 6,752,771 (“Cardiac assist method using an inflatable vest”); U.S. Pat. No. 6,645,165 (“Lymphedema treatment system”); U.S. Pat. No. 6,620,146 (“Adult incontinence article with body-shaping elastics”).
• With reference now toFIG. 104, shown is asystem10400 in which one or more technologies may be implemented in relation to aninstrument10440 configured to interact with one ormore legs10421,10422 ofsubject10420. As shown,instrument10440 may (optionally) include one ormore sensors10441 configured at least to providedata10448 tomodule10450 viachannel10445.Module10450 may include one or more instances ofresponsive logic10460 and/ormodules10475 ofdecision logic10470 configured to act upondata10448.Responsive logic10460, for example, may include one or more instances ofcontrol modules10461 and/orevaluation modules10462 as described herein.
• With reference now toFIG. 105, shown is aflow10500 comprisingoperation10520—obtaining local circulatory information relating to a leg of a subject (e.g.responsive logic10460 receiving local flow rate orother data10448 describing circulation within one ormore legs10421 of subject10420). This can occur, for example, in a context in whichinstrument10440 detects physical conditions withinleg10421 directly or via sensors in clothing or otherwise supported nearleg10421 as described herein. Alternatively or additionally, the local circulatory information may include a history of such measurements ofleg10421 over a period of hours, days, or months.
• Operation10580 describes signaling a decision whether to transmit a notification in response to one or more comparisons between filtering information specific to the subject and the local circulatory information relating to the leg of the subject (e.g. decision logic10470 sounding an alarm or otherwise transmitting a notification ifmodule10475 detects unusually slow flow or other evidence of poor circulation locally within leg10421). This can occur, for example, in a context in whichmodule10475 is configured to perform a normalcy comparison operation and in whichmodule10450 is implemented in or otherwise operable for interacting with aportable instrument10440, a utility device, or some other suitable hardware at least sometimes accessible to subjects as described herein.
• With reference now toFIG. 106, there are shown several variants of theflow10500 ofFIG. 105.Operation10520—obtaining local circulatory information relating to a leg of a subject—may (optionally) include one or more of the following operations:10622 or10624. In some embodiments, variants ofoperation10520 may be performed by one or more instances ofsupport control logic780, invocation-logic3140, or other such sensor-containing or other responsive elements as described herein.Operation10580—signaling a decision whether to transmit a notification in response to one or more comparisons between filtering information specific to the subject and the local circulatory information relating to the leg of the subject—may include one or more of the followingoperations10681,10683,10685 or10689. In some embodiments, variants ofoperation10580 may be performed by one or more instances ofnotification logic1290,3535,3991,6180,7460,7875;evaluation logic150,250,950,1530,7565; remote resources, or other components responsive to a measurement, user input, and/or other indication of circulatory status. Alternatively or additionally,flow10500 may be performed in a context as described above with reference to any ofFIGS. 1-80 and/or in conjunction with other flow variants as described below.
• Operation10622 describes obtaining a comparison result as the local circulatory information relating to the leg of the subject (e.g. module3143 obtaining one ormore results3136 of one or more comparisons betweenearlier indications3115,3183 andlater indications3125,3184 of flow in the subject). This can occur, for example, in a context in which one or more such indications3183-3185 are extracted from measurements or other event-indicative records3110,3120, in whichinvocation logic3140 performsoperation10520 by invoking evaluation logic3197 (remotely) orother data filters3151 that perform such comparisons.Such filtering information3170 may (optionally) be partly based upon contemporaneous local circulatory information obtained from other body parts of the subject, for example, to ascertain whether a detected change is apparently vascular, as described herein. See, e.g., the description ofoperation10788 below.
• Operation10624 describes configuring an artificial support to modify a force upon the leg of the subject (e.g. one ormore modules783 ofsupport control logic780 urgingcell740 laterally toward or away fromadjacent cell710 by causing one ormore elements741,742,743 to expand or contract). This can occur, for example, in a context in which a support layer or othersuitable structure765 adhesively or otherwise holdsarray705 in a vicinity ofleg10421, in whichcontrol module10461implements controller775, in which supportcontrol logic780 performsoperation10520, and in whichmodule783 selectively opens one ormore valves746,747 in fluid communication with higher- or lower-pressure reservoirs (not shown) so thatelement743 controllably expands or contracts. In some variants, for example, one or moreother elements741,742 may undergo an offsetting transition so that the net motion ofcell740 is primarily across the subject's skin. Alternatively or additionally, such other elements may undergo a like transition as that ofelement743 so that the net motion ofcell740 is primarily orthogonal to structure765, toward or away from the subject's skin.
• In light of teachings herein, numerous existing techniques may be applied for configuring expanding, contracting, and/or other actuator elements as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,328,472 (“Configurable inflatable support devices”); U.S. Pat. No. 6,893,089 (“Method and apparatus for lumbar support with integrated actuator housing”); U.S. Pat. No. 6,886,200 (“Hydraulic actuator apparatus for a surgical table”); U.S. Pat. No. 6,837,351 (“Electromagnetic clutch assembly having enhanced torque throughput”); U.S. Pat. No. 6,240,582 (“Apparatus for positioning a patient-support deck”); U.S. Pat. No. 6,098,908 (“Configuration of an actuation mechanism which controls operation of a sub-drag mechanism in a fishing reel”).
• Operation10681 describes including at least user-provided input with the notification (e.g. module7752 ofconfiguration logic7755 including acategory7731,response7732,verification7733,distribution7734, orother user input7738 within or otherwise with notification content7771). This can occur, for example, in a context in whichvarious subjects7710, caregivers, or other parties provide such input as described herein and in which these orother inputs7738,7739 may affect what the notification includes and/or whether or where the notification is transmitted. In some variants, for example,module7752 may respond to anindication7780 of a resource availability change, such as by rerouting, rescheduling, or otherwise reconfiguring a potential or partial notification's content or delivery parameters. Alternatively or additionally, an indication of a lack of timely input (from a first user, e.g.) may be included in a notification to another user, in some variants.
• In light of teachings herein, numerous existing techniques may be applied for configuring a notification to include or otherwise indicate user preferences, status, or other such input as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,325,054 (“System for notifying destination user when status of consumable products of printing devices meets user selected notification condition”); U.S. Pat. No. 7,209,955 (“Notification system and method for a mobile data communication device”); U.S. Pat. No. 6,968,294 (“Automatic system for monitoring person requiring care and his/her caretaker”); U.S. Pat. No. 6,907,375 (“Method and apparatus for dynamic checking and reporting system health”); U.S. Pat. No. 6,878,111 (“System for measuring subjective well being”); U.S. Pat. No. 6,277,071 (“Chronic disease monitor”); U.S. Pat. No. 6,190,313 (“Interactive health care system and method”).
• Operation10683 describes receiving information from one or more sensors adjacent the leg of the subject (e.g. module10475 ofdecision logic10470 receiving images orother data10448 via one ormore sensors10441 adjacent leg10421). This can occur, for example, in a context in whichdecision module10470 performsoperation10580, in which a symptom is effectively detectable only by monitoring a subject's leg(s) over a period of a few hours or more, and in which the sensor(s) are configured to send circulatory and/or other status indicative information tomodule10450. In some variants, for example, one ormore channels10445 between the sensor(s) and the system module may be accomplished through a continuous conduit. Alternatively or additionally, other such linkages among sensors or other circuitry as described herein may incorporate one or more wireless linkages such as Bluetooth, wireless USB, RF telemetry, cellular, 802.11 (B, G, N), far field telemetry, or other such existing technologies.
• In light of teachings herein, numerous existing techniques may be applied for using wired and/or wireless technology for the communication between one or more sensor modules and the acquisition system as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,299,085 (“Remote monitoring of implanted medical device and surface ECG signals”); U.S. Pat. No. 7,289,253 (“System and methods for shearless hologram acquisition”); U.S. Pat. No. 7,198,603 (“Apparatus and methods using acoustic telemetry for intrabody communications”); U.S. Pat. No. 7,069,086 (“Method and system for improved spectral efficiency of far field telemetry in a medical device”); U.S. Pat. No. 6,970,737 (“Portable ECO device with wireless communication interface to remotely monitor patients and method of use”); U.S. Pat. No. 6,816,744 (“Device and system for remote for in-clinic trans-abdominal/vaginal/cervical acquisition, and detection, analysis, and communication of maternal uterine and maternal and fetal cardiac and fetal brain activity from electrical signals”); U.S. Pat. No. 6,597,948 (“Defibrillator with wireless communications”); U.S. Pat. No. 6,577,901 (“Network compatible RF wireless link for medical device data management”); U.S. Pat. No. 6,485,416 (“Remote monitoring apparatus for medical conditions”).
• Operation10685 describes detecting additional information about the leg of the subject (e.g. module1272 ofdetection logic1275 receivingauditory data1244,optical data1247, subject-provideddata1246, pressure-indicative data1245, or otheradditional data1248 relating to one or more portions of the leg). This can occur, for example, in a context in whichdetection logic1275 performsoperation10580, in which a subject is at home or at some other site at which maintaining adequate vigilance may be difficult, and in whichmodule1273 is configured to receive (locally-abnormal)thermal information1251 or other information from one or more other sensors ofarray1221 before or aftermodule1272 receives such “additional” data. In some variants, for example,optical sensors2525 implanted into, affixed onto or arranged near the leg may be configured to provide otherthermal information1241,chemical composition information1242, and/or otherphysiological information1243. Other such sensors or related logic described above with reference toFIGS. 23-26 may likewise be included in the monitoring, evaluation, or other detection modules of this document, for example, many of which may be configured to record or otherwise respond to status-indicative information1260 selectively as described herein.
• Operation10689 describes enabling a performance of at least one of the one or more comparisons at a resource remote from the subject (e.g. interface7563 transmitting force estimates or other stress-indicative information7533 withcorresponding locality information7531, timinginformation7532, patient-specific information7534, or other such comparative parameters). This can occur, for example, in a context in whichevaluation logic7565 performsoperation10580 and in which comparative information and/or other data as described herein is transmitted to or otherwise affects a configuration of one ormore standards7588,logic modules7562, or other suchcomparison mode determinants7535 configured to be applied remotely. In some variants, for example, one ormore signal channels7575 may be implemented in one or more aggregators or other suchadjunct services7590 operable remotely from anexternal module9320 or other structures described herein for interacting with subjects. Alternatively or additionally, one or more comparisons or other evaluations as described herein may initially be performed locally to the subject's body.
• In light of teachings herein, numerous existing techniques may be applied for comparing measurements, images, pathologies, profiles, or other such patterns as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,258,670 (“System and method for diagnosing and monitoring respiratory insufficiency for automated remote patient care”); U.S. Pat. No. 7,252,637 (“Method for continuous monitoring of patients to detect the potential onset of sepsis”); U.S. Pat. No. 6,926,668 (“System and method for analyzing normalized patient voice feedback in an automated collection and analysis patient care system”); U.S. Pat. No. 6,921,365 (“Remote non-invasive biofeedback diagnostic system based on patient image”); U.S. Pat. No. 6,908,437 (“System and method for diagnosing and monitoring congestive heart failure for automated remote patient care”); U.S. Pat. No. 6,616,613 (“Physiological signal monitoring system”); U.S. Pat. No. 6,501,849 (“System and method for performing image-based diagnosis over a network”); U.S. Pat. No. 6,454,705 (“Medical wellness parameters management system, apparatus and method”); U.S. Pat. No. 6,416,471 (“Portable remote patient telemonitoring system”); U.S. Pat. No. 5,793,969 (“Network review and analysis of computer encoded slides”); U.S. Pat. No. 6,210,301 (“Patient monitoring system”).
• With reference now toFIG. 107, there are shown several variants of theflow10500 ofFIG. 105 or106.Operation10520—obtaining local circulatory information relating to a leg of a subject—may (optionally) include one or more of the following operations:10721 or10725. In some embodiments, variants ofoperation10520 may be performed by one or more instances ofdecision logic2975 or other response logic as described herein.Operation10580—signaling a decision whether to transmit a notification in response to one or more comparisons between filtering information specific to the subject and the local circulatory information relating to the leg of the subject—may include one or more of the followingoperations10782,10786 or10788. In some embodiments, variants ofoperation10580 may be performed by one or more instances of control logic,configuration logic5235,7755,notification logic1290,3535,3991,6180,7460,7875;evaluation logic150,250,950,1530,7565; or other components suitable for generating content for use in such a decision or notification. Alternatively or additionally,flow10500 may be performed in a context as described above with reference to any ofFIGS. 1-80 and/or in conjunction with other flow variants as described herein.
• Operation10721 describes relating the local circulatory information to one or more of a thigh location, a calf location, or a foot location of the leg of the subject (e.g. module2973 ofdecision logic2975receiving communication2935 or other data causing an activation of one or more sensors identified with or otherwise identifying such a body portion within subject2920). This can occur, for example, in a context in whichdecision logic2975 performsoperation10520 and in which one ormore sensors2927 are placed on or near the subject portion, optionally in one ormore arrays1221,1222 as shown inFIG. 12). In some contexts, for example, one or moresuch portions1201,1202 may be selected as a primary sensor location for limb monitoring. Alternatively or additionally, one or more other sensors as described with reference toFIG. 23-26 may be positioned to monitor suchsubject portions1201 and/or other contemporaneous attributes of the subject as described herein.
• In light of teachings herein, numerous existing techniques may be applied for the selective inclusion and/or activation of one or more sensors from a sensor set as a primary sensor location without undue experimentation. See, e.g., U.S. Pat. No. 7,332,743 (“Thin film transistor array panel and liquid crystal display”); U.S. Pat. No. 7,208,983 (“Image-sensor signal processing circuit”); U.S. Pat. No. 7,190,987 (“Neonatal bootie wrap”); U.S. Pat. No. 7,155,281 (“Complimentary activity sensor network for disease monitoring and therapy modulation in an implantable device”); U.S. Pat. No. 7,149,645 (“Method and apparatus for accurate on-die temperature measurement”); U.S. Pat. No. 6,275,733 (“Dual sensor rate response pacemaker”); U.S. Pat. No. 6,271,766 (“Distributed selectable latent fiber optic sensors”).
• Operation10725 describes capturing one or more shape-indicative images in the local circulatory information relating to the leg of the subject (e.g. module1621 causing a recordation of one ormore images1697 from an array or other configuration ofsensors7717 intomemory7765 or other media1695). This can occur, for example, in embodiments in which response module performsoperation10520 and in whichprimary module7790 may communicate in one or both directions with one or more active sets ofultrasound sensors1981 or other shape-indicative sensors configured to apply one or more respective-set-specific intensity thresholds1653 and/orfrequency thresholds1654. Such an embodiment may be used, for example, to estimate an areal expansion or other gradient relating to a region of abnormal circulation. Alternatively or additionally, such data may be used to derive an aspect ratio, a shape type, or other such shape-indicative attributes1699 of such detectable abnormalities.
• In light of teachings herein, numerous existing techniques may be applied for pattern recognition or other such techniques suitable for use in monitoring pathologies as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,336,804 (“Method and apparatus for detection of drowsiness and quantitative control of biological processes”); U.S. Pat. No. 7,317,821 (“Automatic abnormal tissue detection in MRI images”); U.S. Pat. No. 7,214,195 (“Method of and apparatus for detecting diseased tissue by sensing two bands of infrared radiation”); U.S. Pat. No. 7,214,194 (“Method for thermal diagnosis of pathology of a bioobject and device for carrying out said method”); U.S. Pat. No. 7,171,680 (“Method and apparatus for electro-biometric identity recognition”); U.S. Pat. No. 7,162,061 (“Abnormal pattern detection processing method and system”); U.S. Pat. No. 6,963,772 (“User-retainable temperature and impedance monitoring methods and devices”); U.S. Pat. No. 6,440,084 (“Thermal scanning system and method”).
• Operation10782 describes including at least a magnitude indication with the notification (e.g. module781 ofsupport control logic780 causing a contraction of one ormore elements753 so thatcell750 exerts a decreasing shear or other force upon a subject's leg wound). This can occur, for example, in a context in which one ormore arrays1221,1222 ofFIG. 12 implementarray705 ofFIG. 7, in which atleast control logic1280 performsoperation10580, in which one or more arrangements of actuation and/or sensor elements are distributed over a region of concern in a subject limb and in whichsystem module1230 configures a suitable actuation controller as described herein. In some variants, for example,array705 may expand or contract to maintain a pressure within a detection range as the body part expands or contracts due to increased or decreased tissue swelling. Alternatively or additionally, one ormore modules783,784 ofsupport control logic780 may be configured to actuate one or more arrays or other configurations of actuators cyclically or otherwise in patterns selected by specifying one or more parameters793-795, such as to prevent circulatory disruptions or other adverse effects.
• Operation10786 describes performing at least one of the one or more comparisons using an updated normalcy threshold (e.g. module7751 ofconfiguration logic7755 changing or otherwise updating one or more optical or other normalcy thresholds7762). This can occur, for example, in a context in whichconfiguration logic7755 performsoperation10580, in which such comparative information is derived from sensor data described herein, and in which one or more users or devices have indicated an availability to receive such notifications with one or more such parametric updates. In some variants, for example, information from one ormore sensors7717 on or near a subject7710 may be used to generate and/or adjust thresholds applied tosensor data7741 from one or more other sensors extending into, in contact with, or otherwise arranged around the subject. Alternatively or additionally, historic and/or processed information from a remote storage and/or processing device may be used to provide and/or adjust thresholds or other filtering information applied to thesensor data7741 or other types ofinformation7745 obtained about the subject limb.
• In light of teachings herein, numerous existing techniques may be applied for requesting, receiving, or otherwise interacting with numerical thresholds as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,250,855 (“False alarm mitigation using a sensor network”); U.S. Pat. No. 7,079,035 (“Method and apparatus for controlling an alarm while monitoring”); U.S. Pat. No. 7,037,273 (“Core body temperature monitoring in heart failure patients”); U.S. Pat. No. 6,942,626 (“Apparatus and method for identifying sleep disordered breathing”); U.S. Pat. No. 6,569,095 (“Adaptive selection of a warning limit in patient monitoring”); U.S. Pat. No. 6,552,531 (“Method and circuit for processing signals for a motion sensor”); U.S. Pat. No. 6,263,243 (“Rate adaptive pacemaker”).
• Operation10788 describes obtaining at least some of the filtering information from another limb of the subject (e.g. one ormore modules782 ofsupport control logic780 selecting one ormore cells740 or one or more of theiractuation elements741,742,743 in response to a determination that no anomalies have been detected in tissue adjacent cell740). This can occur, for example, in a context in which supportcontrol logic780 performsoperation10580, in whichcomponent414 containscell740, in which one ormore sensors424 as described herein are positioned in or nearcell740 for detecting one or more tissue attributes ofexternal portion404 ofbody410, in which one or moresuch cells740,750 are positioned so that a movement ofcell740 may directly result in an increasing lateral and/or normal force uponexternal portion404, and in which a selection ofcell740 may thereby effectively implement a determination of the “second” external portion. In some variants, for example, an expansion of one ormore elements742,743 may cause such an increasing force, a direction of which may be modified by one or moreother elements741. Alternatively or additionally,module782 may may control such movement ofcomponent414 with closed-loop control so thatcomponent414 is positioned to minimize a shear force or otherwise favorably influence an attribute ofabnormality409 detected, for example, viasensor425.
• In light of teachings herein, numerous existing techniques may be applied for detecting or characterizing injuries or other localized structures and/or phenomena as described herein without undue experimentation. See, e.g., U.S. Pat. No. 7,303,555 (“Imaging and therapeutic procedure for carpal tunnel syndrome”); U.S. Pat. No. 7,226,426 (“Apparatus and method for the detection and quantification of joint and tissue inflammation”); U.S. Pat. No. 7,155,273 (“Blanching response pressure sore detector apparatus and method”); U.S. Pat. No. 7,006,676 (“Method and apparatus for detecting an abnormality within a host medium utilizing frequency-swept modulation diffusion tomography”); U.S. Pat. No. 6,993,167 (“System and method for examining, recording and analyzing dermatological conditions”); U.S. Pat. No. 6,880,387 (“Acoustic micro imaging method providing improved information derivation and visualization”); U.S. Pat. No. 6,544,186 (“System and method for diagnostic imaging”); U.S. Pat. No. 6,464,646 (“Instrument and method for locating and marking a hot spot in a person's body tissue”); U.S. Pat. No. 6,258,046 (“Method and device for assessing perfusion failure in a patient by measurement of blood flow”); U.S. Pat. No. 6,233,479 (“Microwave hematoma detector”); U.S. Pat. No. 6,192,143 (“Apparatus for detecting very small breast anomalies”); U.S. Pat. No. 6,056,692 (“Apparatus and method for locating and marking blood vessels”); U.S. Pat. No. 5,999,836 (“Enhanced high resolution breast imaging device and method utilizing non-ionizing radiation of narrow spectral bandwidth”); U.S. Pat. No. 5,989,194 (“Method and apparatus for detecting ocular disease and abnormalities”).
• With reference now toFIG. 108, shown is an example of asystem10800 that may serve as a context for introducing one or more processes and/or devices described herein, comprising one or more instances ofmodule10830 operable for interacting withmodule10890. As shown,module10830 may include one ormore modules10811 of dispensinglogic10810 operable for controllingstatin dispenser10818 or (other)therapeutic dispenser10819;memory10821 operable for handling software-implemented or other regimens; or one ormore sensors10822 as described herein. Also shown is a kidney orother organ10860 having one or more (therapeutic-agent-) suffusedportions10861 and one or moreother portions10862, at least one of the suffusedportions10861 comprising avicinity10865 of (convergingvenules10864 of)lumen10895.
• Next downstream as shown,module10890 comprises one ormore modules10831,10832 ofresponse logic10835; (transvascular or other)extraction modules10845;sensors10881;dispensers10882; or clamps10855. As shown,extraction module10845 comprises one or more ports10841 to be formed throughvessel wall10846, operable for extracting aportion10844 of lytic-material-infusedblood10842, for example, into one or moreabsorbent elements10847, dialysis extractors, and/or to other such disposal vessels. As shown, one ormore clamps10855 are configured to limitoutflow10899 frommodule10890 by expanding one ormore actuators10857, thereby leveringlumen10895 to occlude it temporarily as shown. Alternatively or additionally,vicinity10885 oflumen10895 may include one ormore conduits10867 operable for selectively removing a portion ofoutflow10899 by redirecting it to one or moreartificial disposal vessels10870 as shown.
• Concerning the opening of port10841 or other timing of capture logic2880 (ofFIG. 28) or similar responsive circuitry described herein, a delay time between a capture site and an upstream site can be readily estimated. A human blood cell typically travels about ⅓ of a millimeter per second in capillaries, for example. In some contexts, an accurate model may best be developed by measuring a specific interpositional delay empirically using, for example, a fluorescent material or other detectable measurement technique. Such a delay can readily be implemented in a digital or other timing feature of modules as described herein, for example, initiating a later operation at a programmed interval following a triggering event as described herein. In situations where a more reliable model is needed, a pulse-dependent, local-pressure-dependent, or other adaptive model may be appropriate, and well within the capabilities of skilled practitioners without undue experimentation in light of teachings herein.
• An embodiment provides amodule10890 comprising aclamp10855 and/or other artificial structure(s) operable to impede most ofoutflow10899 fromvascular lumen10895 and adispenser10819 or other structure operable to administer a lytic or other therapeutic material locally to thelumen10895. (Other such embodiments are described, for example, with reference toFIG. 36.) Such dispensers can be positioned upstream from some or all oforgan10860, for example, in an artery or arteriole. Such artificial structures can likewise include one ormore disposals2889, pumps2887,extraction modules10845, sensors, a housing or other support structure (as indicated in system2800), communication conduits, or other components described herein.
• With reference now toFIG. 109, shown is aflow10900 comprisingoperation10910—obtaining one or more indications of a lytic material in a vicinity of one or more body lumens (e.g. module10831 ofresponse logic10835 responding to a signal from one ormore sensors10822,10881 or some other indication that an anticoagulant or other lytic material will apparently be present in avicinity10865 of lumen10895). This can occur, for example, in a context in whichresponse logic10835 receives a notification that one or more lytic-material-containingdispensers10819 have been activated. Alternatively or additionally, such indications can result from one ormore sensors10881 detecting one or more natural chemical markers resulting from injury, for example. Alternatively or additionally, such indications can result fromdispenser10882 administering a lytic compound by backflow intoorgan portion10861—injecting the compound at a somewhat higher pressure than that of blood invenules10864.
• Flow10900 further comprisesoperation10970—accelerating a decrease in a local concentration of the lytic material in the vicinity of the one or more body lumens by causing one or more elements to extract at least a portion of the lytic material in the vicinity of the one or more body lumens in response to the one or more indications of the lytic material in the vicinity of the one or more body lumens (e.g. port10841 orconduit10867 opening shortly after a dispensation of fibrinolytic material in upstream vicinity). This can occur, for example, in embodiments in which such ports or conduits are configured to allow higher-than-nominal concentrations of the lytic material to drain out of the vascular system, optionally by a timely exposure to anabsorbent element10847 orother disposal vessel10870. Alternatively or additionally, such extraction may be performed actively, such as by microfluidic or other pumps as described herein.
• With reference now toFIG. 110, there are shown several variants of theflow10900 ofFIG. 109.Operation10910—obtaining one or more indications of a lytic material in a vicinity of one or more body lumens—may (optionally) include one or more of the following operations:11012,11013, or11017. In some embodiments, variants ofoperation10910 may be performed by one or more instances ofsensors4510,10822,response logic4555,10835, or the like as exemplified herein.Operation10970—accelerating a decrease in a local concentration of the lytic material in the vicinity of the one or more body lumens by causing one or more elements to extract at least a portion of the lytic material in the vicinity of the one or more body lumens in response to the one or more indications of the lytic material in the vicinity of the one or more body lumens—may include one or more of the following operations:11071 or11078. In some embodiments, variants ofoperation10970 may be performed by one or more instances ofextraction device4580 or the like as described herein.
• Operation11012 describes causing at least a statin to be dispensed as the lytic material (e.g. dispensing logic10810 invokingmodule10811 or other circuitry for actuatingstatin dispenser10818 or other lytic-material-containingdispenser10819 according to one or more dosage profiles in memory10821). This can occur, for example, in embodiments in which one or more instances ofmodules10830 are positioned (locally) upstream from a lung orother organ10860 and in which at least aportion10861 oforgan10860 has been perfused with an abnormally high concentration of lytic material (relative to a time-averaged systemic normal range, for example). Alternatively or additionally, in some variants,module10890 may be configured in a context in which one or more hemorrhage-risk determinants have been established in relation to one or more other organs in adownstream vicinity10885 oflumen10895 relative tooutflow10899.
• Operation11013 describes obtaining a concentration-indicative scalar of the one or more indications of the lytic material (e.g. one ormore modules6732 ofdetection logic6720 receiving ascalar value6723 indicative of a concentration gradient or other concentration-indicative data6724 from anoptical sensor2525 or other concentration-indicative sensor2560 nearby or downstream from a dispensation). This can occur, for example, in a context in whichdetection logic6720 is configured to performoperation10910, and in whichconfiguration system6710 overlaps or otherwise interacts with one or more local systems having sensors in a vicinity of the dispensation, in which the lytic material dispensed includes an optically or other detectable marker material that does not interfere significantly with the desired action of the lytic material. In some variants, for example, a quantitative expression of lytic material concentration can be generated directly, such as by measuring a concentration of a marker material covalently bonded or otherwise linked to the lytic material. Alternatively or additionally, some such expressions can by generated by inference, such as by detecting a marker material commingled with the lytic material or by interpolating a concentration between two measurement locations.
• Operation11017 describes signaling a dispensation of the lytic material into an upstream portion of the one or more body lumens (e.g. module7261 ofcontrol logic7270 triggeringactuator7281 to inject or releasetissue plasminogen activator7283 or otherlytic materials7284 locally into a common carotid artery7350 responsive todata7213 signifying a sudden volumetric decrease in one ormore flows7321,7331 exiting a segment downstream). This can occur, for example, in a context in which a clot has lodged itself downstream (in the anterior or middle cerebral arteries, for example) and/or in which one or moresystemic determinants7212 indicate an absence of detectable hemorrhaging in subject7310, and in which a care provider has defined aprogrammatic regimen7263 by which such material(s) are to be administered immediately in these contingencies. In some variants,regimen7263 may further depend upon one or morecomplementary determinants7211 or other data7214: whether one or more complementary arteries exhibit a substantially increased local blood pressure or flow. Alternatively or additionally,regimen7263 may define a (therapeutic contraindication or other) response to othersystemic determinants7212 such as a substantial increase in (resting) heart rate or substantial decreases in blood pressure over a course of minutes or hours. (In some embodiments, such “substantial” changes as described herein may include changes of about 10% or more, except as noted.)
• Operation11071 describes causing the portion of the lytic material to be drawn into an artificial vessel (e.g. actuator2881 allowing one ormore ports2882 to draw out at least some ofoutflow2899 through one ormore vessel walls2883,2884 into vessel2885). This can occur, for example, in a context in whichdispenser2841 has been dispensing a therapeutic material containing one or more carcinogens or other ingredients having potentially undesirable side effects inoutflow2899. Alternatively or additionally, aconduit2886 and/or pump2887 may be used for accelerating a decrease of the local concentration of such materials (nearport2882, e.g.).
• Operation11078 describes reversing a flow direction of at least some of the lytic material (e.g. pump7282 withdrawing some of a dispensed lytic-agent-containing material from one or more arteries responsive to one ormore sensors7345 indicating a local diastolic blood pressure decrease). This can occur, for example, in a context in which a flow is apparently restored or in a context of hemorrhage, either of which may warrant a such a prompt withdrawal pursuant toregimen7263. Alternatively or additionally, in some contexts, a reverse flow direction may be used for perfusing an organ with a lytic-agent-containing material via one or more venules. See, e.g., descriptions above relating toFIGS. 33 & 34.
• With reference now toFIG. 111, there are shown several variants of theflow10900 ofFIG. 109 or110.Operation10910—obtaining one or more indications of a lytic material in a vicinity of one or more body lumens—may include one or more of the10 following operations:11111,11114,11116,11118, or11119. In some embodiments, variants ofoperation10910 may be performed by one or more instances ofresponse logic4555,10835 or the like as exemplified herein.Operation10970—accelerating a decrease in a local concentration of the lytic material in the vicinity of the one or more body lumens by causing one or more elements to extract at least a portion of the lytic material in the vicinity of the one or more body lumens in response to the one or more indications of the lytic material in the vicinity of the one or more body lumens—may include one or more of the following operations:11175 or11177. In some embodiments, variants ofoperation10970 may be performed by one or more instances ofextraction device4580 or the like as described herein.
• Operation11111 describes permitting the lytic material to perfuse one or more organs in the vicinity of the one or more body lumens (e.g. dispensinglogic10810 invoking one ormore dispensers10819 to inject a lytic compound or other lytic material into a renal artery or otherwise to perfuse organ10860). This can occur, for example, in an embodiment in which dispensinglogic10810 can invoke other logic modules and in whichsystem10800 implements one or more devices like those disclosed in U.S. Pat. No. 6,592,567 (“Kidney perfusion catheter”) or U.S. Pat. No. 6,514,226 (“Method and apparatus for treatment of congestive heart failure by improving perfusion of the kidney”). Alternatively or additionally, such a perfusion may reasonably be inferred at some time after a sufficiently large systemic administration of the lytic material. In some contexts this may be desirable, for example, even for a cancer patient for whom a lytic treatment inoutflow10899 presents a danger. In a case in which a majority of blood flowing throughmodule10890 is removed from a patient's vasculature into one ormore conduits10867, for example, a transfusion or other blood replacement atmodule10890 may be provided to supplement outflow10899 (optionally with a concomitant decrease in the local concentration of the lytic material).
• Operation11114 describes signaling at least one of the one or more indications of the lytic material via a wireless signal (e.g. module7122 ofcontrol logic7120 activating one or more modules ofcommunication logic7140 resulting in the transmission ofmeasurement data7133 and/or lytic-material-indicative data7131 to one or more remote modules through telemetry or other wireless signals7132). This can occur, for example, in a context in which sensor data indicating the presence and/or concentration of lytic material at one or more target regions in a subject are sent to a display module to facilitate monitoring by a subject and/or caregiver. Alternatively or additionally,module7121 can performoperation11114 by transmiting such output toremote resources7161,7162 innetwork7160 for storage, correlation analysis, and/or monitoring of a subject by remote personnel.
• Operation11116 describes detecting a marker material indicative of the lytic material in the vicinity of the one or more body lumens (e.g. module6731 ofdetection logic6720 detecting one or more attributes of a marker material using one ormore fluorescence sensors2322,radioactivity sensors2462,electrochemical sensors2548, or other suitable sensors implemented in device6790). This can occur, for example, in a context in whichdetection logic6720 performsoperation10910; in whichdevice6790 is positioned on, in, or near a target vessel; and in which such a device is configured to indicate one or morecategorical attributes6725 and/orquantitative attributes6726 of an artificial marker material viawireless communication linkage6752. In some embodiments,device6790 may be configured to perform or facilitate such modes of detection continuously, intermittently, upon request, conditionally, or otherwise. Alternatively or additionally, one or more suchlocal modules2320,2450,2510 can be implemented on a subject's skin or in a hand-held instrument as described herein, especially in a context in which a subject has varicose veins or other large-enough body lumens of interest near the subject's skin.
• Operation11118 describes causing the lytic material to be urged into the one or more body lumens (e.g. module7123 ofcontrol logic7120 transmitting anactivation signal7171 to apump7184,iontophoretic module7183, orother delivery unit7180 causing one or more lytic components to flow into one or more target vessel sites). This can occur, for example, in a context in which activation of one or more delivery modules triggers anactuator7182 in such units to exert an increasing pressure upon one or more lytic-material-containingreservoirs7181. The increase in pressure forces a lytic-component-containing material through a needle or other conduit into a target region. Alternatively or additionally, electrical, acoustic, or other energy systems can be used to drive the delivery of the lytic material into a target tissue.
• Operation11119 describes accelerating a dispensation of the lytic material transluminally into the one or more body lumens as a programmed response to one or more pathology-indicative signals (e.g. a command sequence orother module6774 ofcontrol logic6770 signaling an injection of a bolus of an antiplatelet drug or other antiaggregant transluminally responsive to one or more imaging and/or pressure sensors indicating an apparent blockage). This can occur, for example, in a context in which controllogic6770 performsoperation10910, in which one or moreimplantable devices6790 indicate a vessel blockage or other pathology treatable with an available lytic compound, and in which such a dispensation can be signaled (a) directly todispenser6780 or (b) via aninterface6740 to a person with a syringe. In some variants, for example, one or more sensors anddispensers6780 of alocal module2320,2450,2510 may be implanted or otherwise positioned near a common vascular blockage site and configured to respond to an apparent blockage with a targeted release of lytic material locally to alleviate the blockage. Alternatively or additionally,decision logic2250 can be configures so that detection of a local blockage or dispensation will cause anotification2241 of such local conditions and/or anotification2242 of a systemic dispensation of a lytic material. In some crises, for example, an informed subject might elect to self-administer a treatment promptly in light of such information, even before reaching a hospital and completing a diagnostic protocol sufficient to avoid hospital liability. Alternatively or additionally, one or more interfaces may ask or otherwise monitor a (conscious) subject for an indication of whether such action is being taken and providesuch parameters2249 to emergency caregivers who later encounter the subject. In some variants, moreover, one ormore modules2245 ofdecision logic2250 may inquire of an authorized caregiver, a central medical history database, or some othersuch resource7161 whether a recent surgery or other contraindications of an immediate lytic therapy may exist.
• Operation11175 describes causing the lytic material to be exposed to a lytic-material-absorbent element (e.g. module7033 ofcontrol logic7092 signaling one ormore actuators7055 to guide flow frominlet7005 towardextraction unit7080 so that lytic-material-containing fluid comes into contact with one ormore foams7071,fibers7072, or othersuch materials7073 suitable for binding to or otherwise absorbing at least some of the lytic material). This can occur, for example, in a context in whichsuch actuators7045,7055 comprise one ormore valves7050 and/orpumps7060 selectively operable to divert at least some lytic-material-containing fluid from a normal flow (towardextraction unit7080 or into analternate outlet7092, for example, rather than to a primary return7091). Once the fluid has been in contact with the lytic-material-absorbent element(s) for a suitable interval (one the order of seconds or minutes, e.g.) it may then be returned totransfer unit7010. In some variants, for example, one ormore pumps7060 orother actuators7055 may be configured to regulate a fraction of an inflow (viainlet7005, e.g.) that is routed to contact absorbent materials. Alternatively or additionally, one ormore modules7032 may performoperation11175 by routing a primary flow (containing an artificial lytic material, for example, and flowing frominlet7005 to return7091, e.g.) along one or more preferentially absorbent structures. In some variants, moreover, such structures (a) may include one or more such units in an implant and/or (b) may include one ormore dispensers7020 as described herein.
• Operation11177 describes causing a lytic activity inhibitor dispensation into the one or more body lumens (e.g. module3981 ofcontrol logic3980 causing one ormore dispensers3831 to release an amount of protease nexin or other such plasminogen activator inhibitors sufficient to inhibit a lytic activity of at least about 0.1% to 1% of an amount of a plasminogen activator currently dispensed in vasculature3805). This can occur, for example, in a context in which one or moreother dispensers3831 has released the plasminogen activator(s) earlier and/or upstream, in which two or moresuch dispensers3821,3831 for different materials are configured in acommon body3830, in whichcontrol module3820 implementscontrol logic3980 configured to performoperation10970, and in which such inhibitors directly or indirectly cause at least one lytic activity of the lytic material to be inhibited invasculature3805. In some variants, the inhibitor(s) may be release in sufficient quantities to inhibit a lytic activity of up to about 5% to 50% of the dispensed plasminogen activator(s). Alternatively or additionally,module3982 may performoperation11177 in response to one or more of ahemorrhage indication3973 orblockage removal indication3974 indicating avessel3840 near or downstream fromdispenser3821. Alternatively or additionally,module3982 may likewise performoperation11177 in response to one or more of a continuing lyticmaterial dispensation indication3971 or anindication3972 thatvessel3840 is an appropriate (low risk, e.g.) location in which to dispense the inhibitor(s) for a systemic effect upon the subject.
• With reference now toFIG. 112, shown is an example of a system that may serve as a context for introducing one or more processes and/or devices described herein. As shownsystem11200 may affect or otherwise relate tovicinity11225,section11270, andvicinity11275 of avascular lumen11295 through which one or more blood components may flow. One ormore inflows11201 of blood enter respective portions oflumen11295 as shown, pass throughsection11270, and exit as one ormore outflows11299. In respective variants, arteries, veins, or smaller vessels oflumen11295 may traversevicinities11225,11275 as shown.Section11270 may likewise comprise one or more capillary beds as well as vital organs and other tissues served bylumen11295.
• In some variants, one or more intravascular orother modules11250 invicinity11225 may (optionally) include one or more instances ofsensors11210;modules11223 orother dispensing logic11220;dispensers11228,11229; ortransmitters11247,receivers11248, orother interface logic11240. (Somesuch modules11250 may be operable for penetrating a vascular structure with ultrasonic or other energy, for example, or may comprise an implanted cannula or other transvascular structure.)Module11223 may, as shown, comprise one or more instances of port controls11221,regimens11222 or other programmatic dispensing information (optionally embodied in software or other instruction sequences, for example), or requests orother messages11224.
• Alternatively or additionally,system11200 may comprise one or more intravascular orother sensors11290 that may be configured to communicate (in one or both directions) withmodule11250, such as by a signal-bearing conduit or radio-frequency signal. (Somesuch sensors11290 may be operable for monitoring one or more physical phenomena within vascular structures, for example, from within or in a vicinity of the structures.)Systems11200 may likewise be configured to include or otherwise interact with one or more instances ofexternal modules11280 operable, for example, for obtaining and providingdata11285 as described herein. In some variants, for example, the one ormore sensors11290 are only operable for communicating sensed analog or digital values tomodule11250. In others, one or more of the sensor(s)11290 are able to receive updates or other information from one or moreexternal modules11280 orother transmitters11247 as described herein.
• With reference now toFIG. 113, shown is aflow11300 comprisingoperation11340—obtaining a priori implant information (e.g. receiver11248 receiving user-provided orother data11285 describing one ormore sensors11290 or other implants downstream from one ormore modules11250 in avicinity11275 of lumen11295). This can occur, for example, in a context in whichmodule11250 comprises a cannula or other implantable structure positioned upstream from anoutflow11299 local to the implant(s) to which the a priori information pertains. Alternatively or additionally,receiver11248 may obtain sensor data or other determinants relating to such implants, as described herein.
• Flow11300 further comprisesoperation11380—signaling a decision whether to initiate implant-site-targeting treatment partly based on the a priori implant information and partly based on one or more other clot-indicative determinants (e.g. interface logic11240 invoking one ormore modules11223 of dispensinglogic11220 operable for activating one ormore dispensers11228 containing one or more thrombolytic agents or other locally-administered therapeutic materials selectively when apparently needed in avicinity11275 of lumen11295). This can occur, for example, in a context in which the a priori implant information indicates a drug-eluting stent or other potentially thrombogenic implant atoutflow11299.
• With reference now toFIG. 114, there are shown several variants of theflow11300 ofFIG. 113.Operation11340—obtaining a priori implant information—may include one or more of the following operations:11444,11446, or11447. In some embodiments, variants ofoperation11340 may be performed by one or more instances of dispensinglogic4515,11220,receivers4548,11248, or the like as exemplified herein.Operation11380—signaling a decision whether to initiate implant-site-targeting treatment partly based on the a priori implant information and partly based on one or more other clot-indicative determinants—may include one or more of the following operations:11482,11483,11485, or11488. In some embodiments, variants ofoperation11380 may be performed by one or more instances ofdispensers4519,11229,transmitters4547,11247, or the like as described herein.
• Operation11444 describes obtaining the a priori implant information from one or more implantable devices (e.g.external module11280 receiving specifications orother data11285 aboutmodule11250 from a wireless orother transmitter11247 thereof). This can occur, for example, in a context in whichexternal module11280 notifies locally-available caregivers of the existence ofmodule11250 and/or of dispensations or dosages from it. Such information may be used to expedite care or avoid redundant dispensations, for example.
• Operation11446 describes obtaining the a priori implant information from one or more objects borne by a subject (e.g. one ormore modules5561 ofreceiver5565 accepting atype5511, adate5512, astatus5513, alocation5514, or othersuch implant data5510 from at least one of the implant(s)5597, from a wristwatch or other information-bearing article worn by a subject, or from a cell phone or other such carried article). This can occur, for example, in a context in which such items are configured to provide such information as a component of a subject's medical history. Alternatively or additionally, configuration module5570 or an external device may be configured to poll such objects for such information during a crisis, for example, in a context in whichsystem5500 is implemented in a mobile or emergency-room unit.
• Operation11447 describes obtaining the a priori implant information ex situ (e.g. receiver5340 externally accepting one ormore messages5341,5342 containingcontextual information5345 pertaining to patient and/or device status from device5310). This can occur, for example, in a context in whichexternal device7491 ofFIG. 74 implementsprimary system5380, and in which identification, history, location, monitoring type, and/or othersuch configuration information5345,5355 is available via one ormore devices5310,5320 implanted, attached or otherwise associated with a subject area to be monitored. In some variants, for example, areceiver5350 is configured to deliver subject orimplant information5355 suitable to guide follow-up care, for example, via a hand-held projection device orother user interface5370. Alternatively or additionally,primary system5380 or other such logic can be implemented in acomputer module5360 configured for use, for example, in a rescue unit.
• In some embodiments, a “device state” may comprise “available” or some other such state-descriptive labels, an event count or other such memory values, a partial depletion or other such physical property of a supply device, a voltage, or any other such conditions or attributes that may change between two or more possible values irrespective of device location. Such device states may be received directly as a measurement or other detection, in some variants, and/or may be inferred from a module's behavior over time. A distributed or other composite system may comprise vector-valued device states, moreover, which may affect dispensations or departures in various ways as exemplified herein.
• Concerning variants ofoperation11380 presented inFIG. 114, these or other operations may (optionally) be performed in a preparatory sub-operation—before or during one or more instances or variants ofoperation11340 as described above, for example—or may be performed at other times or omitted.Operation11482, for example, describes obtaining one or more of a blood pressure indicator or a flow rate indicator of the one or more other clot-indicative determinants (e.g. one ormore modules5661 ofreceiver5665 acceptingblood pressure measurement5651, flowrate measurement5652, and/or other such clot-indicative determinants5655). This can occur, for example, in a context in whichdecision logic5635 anddetection logic5670 jointly performoperation11380 and in which the determinants indicate a large clot at or downstream from an implanted dispenser or other suitable injection site of a subject. See, e.g., dispenser configurations ofFIGS. 35 through 46. In some variants, for example, a speaker or other local output device5694 may announce an apparent need for a lytic material (a fibrinolytic-enzyme-containing syringe carried by a patient, e.g.) to be injected into a left femoral or popliteal vein responsive to a large pressure drop just downstream. Alternatively or additionally, in some variants,operation11380 may include signaling implanted dispensers as described herein.
• Operation11483 describes generating the decision whether to initiate the implant-site-targeting treatment partly in response to an implant type (e.g. module5741 ofdecision logic5750,5760 signaling a selection of a suitablelytic material indicator5743 and/orquantity indicator5744 partly based on a thrombosis symptom or othersuch symptom indicator5774 and partly based upon amodel number5761,material indicator5762, orother type indication5770 of a stent or other implant just downstream from a dispensation site). This can occur, for example, in a context in which such indications signal a venerable patient, a recent surgery, a side effect from a current dispensation regimen, a controllable material removal or other partial containment structure, ameasurement5771 indicative of local blockage, or other such contraindications of indiscriminate (non-targeted) dispensations as described herein. In some variants, for example,module5741 may indicate anaffirmative decision5745 for any evaluation context exceeding a threshold of 3 to 5 points, with each such factor counting 1 to 2 points. Such local blockage may be indicated by an unusual pressure drop, a change in D-dimer score or other such chemical marker indications, a flow rate change, or others as described herein. Alternatively or additionally, a recent lytic material dispensation, an apparent loss of cognitive function, presence at a hospital, or other such factors may each count −1 or −2 points on a similar scale. Alternatively or additionally, a blockage size indicator may count one or more points on a similar scale, for example, so that larger and/or more recent occlusions generally bear toward larger targeted dispensations. In some variants, for example, a targeted dispensation may comprise 20% or more of a recommended systemic dosage of an identified material, and may optionally exceed such a dosage. Alternatively or additionally, antibiotics or other appropriate medicinal components may be dispensed in a manner that similarly targets regions of detected local infection or related pathologies.
• Operation11485 describes invoking circuitry for deciding whether to transmit one or more other treatment indications partly based on one or more hemorrhagic-stroke-indicative determinants (e.g. module5892 ofinvocation logic5895 activating one ormore comparators5842,5893 configured for comparing current data fromsensors5851,5852,5853 with historic, concurrent, threshold, and/or other pertinent information in deciding whether to transmit one ormore treatment indications5841,5890). This can occur, for example, in a context in whichsensors5852,5853 configured to observe a vicinity of amajor blood vessel5809 are monitored for changes in blood pressure, flow, and/or other status-indicative information5896 to determine if one or moretreatment indication messages5825,5898 are to be transmitted. In some variants, for example, an implanted orother detection module5860 configured to monitor aregion5810 nearvessel5809 will trigger one ormore messages5815,5825 to abedside monitor5830 and/ornurse station5820 warning of an apparent (actual or imminent) vessel rupture. Alternatively or additionally, transdermal sensors employed in external monitors can be employed for such detection and notification.
• Operation11488 describes generating the decision whether to initiate the implant-site-targeting treatment partly in response to detecting one or more emboli in a blood flow (e.g. module5742 ofdecision logic5750 transmitting an activation signal to a transvascular or other dispenser directly in response to one ormore signals5725 fromsensors5701,5702 or other such elements directly or indirectly indicating the presence ofemboli5708 in detection region5710). This can occur, for example, in a context in which one ormore sensors11210,11290 outside a blood vessel indicate one or more (apparent) emboli manifestingultrasonic signatures5772,impedance changes5773, and/or othersuch data5780,5790 are configured to triggerdecision logic5760 to enable a dispensing module. Alternatively or additionally, transdermal detection and/or delivery systems can be employed in subjects where surgical intervention is dangerous or is otherwise undesirable. In some variants, for example, an extravascular or other implantedsensor5701,5702 can be inserted relative to a surgical site to detect emboli released as a result of the surgical trauma triggering the release of medicinal components to aid in the elimination of the emboli.
• With reference now toFIG. 115, there are shown several variants of theflow11300 ofFIG. 113 or114.Operation11340—obtaining a priori implant information—may include one or more of the following operations:11542,11546, or11548. In some embodiments, variants ofoperation11340 may be performed by one or more instances of dispensinglogic4515,11220,receivers4548,11248, or the like as exemplified herein.Operation11380—signaling a decision whether to initiate implant-site-targeting treatment partly based on the a priori implant information and partly based on one or more other clot-indicative determinants—may include one or more of the following operations:11581,11584,11585,11587, or11589. In some embodiments, variants ofoperation11380 may be performed by one or more instances ofdispensers4519,11229,transmitters4547,11247, or the like as described herein.
• Operation11542 describes obtaining an update for the a priori implant information (e.g. module5562 ofreceiver5565 accepting one or more modifications ofimplant data5510 instorage5542 as a result of status or other changes in an implant, an implanted subject, a pathology, or other such internal or external information about implant5597). This can occur, for example, in a context in whichcomparison data5531 and/ortherapeutic delivery parameters5532 are modified based upon one or more status indications5534 of a progression in a subject's pathology or health. In some variants, for example, progression through post surgical healing can lead to adjustments of therapeuticcomponent delivery parameters5521,subject location indices5522,sensor types5523, or othersuch mode identifiers5524,5525 operable for describing and/or implementing modes of monitoring. Alternatively or additionally,module5552 may be configured to respond to one or more indicators of a disease state progression by conditionally implementing (a) an appropriate change in dosage orother delivery parameters5521, (b) an invocation ofinstruction sequence5551 or other such modules responsive in scenarios previously excluded, or (c) other such operational adjustments as described herein.
• Operation11546 describes obtaining timing information in the a priori implant information (e.g. module5425 ofreceiver5430 accepting one ormore records5450 associating a measurement or otherparametric data5451 withdata5452 indicative of one or moredevice update times5464,implant times5465,dispensation times5466, measurement times, or othersuch timing information5470 of potential diagnostic relevance). This can occur, for example, in a context in which implant, therapeutic delivery, decision logic trigger, and/or notification message date and time is stored inmemory5440 orother storage units5445 for later retrieval. In some variants, for example, one or more records indicating at least one recent delivery of a therapeutic component is made available for retrieval by a remote or other external module, configured to indicate a potential current need, or lack of need, for additional delivery. Alternatively or additionally,record5450 may contain data indicative of one or more results of subject and/or device diagnostics.
• Operation11548 describes obtaining an implant type of the a priori implant information (e.g. module5563 ofreceiver5565 receiving animplant type5511 or other such distinguishing data usable to retrieve or otherwise determine one or more capacities of an implant). This can occur, for example, in a context in which implant5597 is configurable to monitor and conditionally record, to monitor and conditionally notify, to monitor and conditionally deliver therapy, or otherwise to invoke appropriate responsive circuitry as described herein. In some variants, for example, configuration module5570 may request and/or receivedeterminants5540 indicating a current category, protocol, or state relating to an implant and/or subject from anetwork5580. In some contexts, for example, one ormore modules5561,5563 ofreceiver5565 may obtain one ormore mode identifiers5525 indicating thatimplant5597 is in “notification mode” and/or that one or more notification events have occurred. Alternatively or additionally, configuration module5570 can likewise obtain amode identifier5524 indicating an apparent type of dispensation, monitoring, or other responsive protocol—“arterial rupture,” “emboli detection,” “swelling,” or other such modes as described herein. Any of these variants ofoperation11340 may be omitted or performed before, after, or interleaved with one or more instances or variants ofoperation11380 as described herein, in some embodiments.
• Operation11581 describes generating the decision whether to initiate the implant-site-targeting treatment partly in response to an apparent change in a chemical composition (e.g. module11223 of dispensinglogic11220 causingtransmitter11247 to transmit amessage11224 indicating one or more diagnostic ortherapeutic material dispensers11228,11229 and/or a dispensation site local tosection11270 as a programmatic response to an apparently severe hypoxic condition or other circumstance detected via one ormore sensors11210,11290 operable for detecting chemical concentrations). This can occur, for example, in a context in which a caregiver can validate and/or administer the dispensation of such a treatment material via an intravenous catheter. Alternatively or additionally, the decision to administer an already-implanted material may be performed according to a programmatic crisis-response regimen11222 specified in advance by a caregiver in response to an abnormally high platelet concentration detected locally, for example, bysensor11210.
• Operation11584 describes signaling a decision whether to dispense one or more therapeutic materials from an implant (e.g. module5644 ofcontrol logic5640 transmitting one ormore commands5625,5626 configured to cause a dispensation atimplant5690 wirelessly via antenna5628). This can occur, for example, in a context in which anexternal support device5610 implements a dosage and timing by triggering one ormore communication components5620 or other such logic to transmit timing, dispensation, detection, evaluation, notification, or other such commands toimplant5690. In some variants, for example, sensor information and/or a subject request can serve as a trigger for such communications and dispensations. Alternatively or additionally, such a transmission can implement a periodic orresponsive treatment profile5622 specified by a physician.
• Operation11585 describes signaling a decision whether to dispense one or more of a thrombolytic agent or an anticoagulant (e.g. module5645 ofcontrol logic5640 signaling such a dispensation fromimplant5690 only ifmodule5634 detects an apparent need for one or more such materials). This can occur, for example, in a context in which implant5690 includes one ormore dispensers11228,11229 and/orsensors11290 in close proximity, in whichsupport device5610 comprisesexternal module11280, and in whichmodule5668 signals an apparent blockage inlumen11295 warranting an activation of one ormore dispensers11228. In many treatment contexts for healthy human adults, for example, a 50% reduction in blood flow through an artery provides a sufficient indication of blockage to call for dispensing a 100,000 I.U. of streptokinase over a 10 to 30 minute period starting within a few minutes or hours of such detection.
• Operation11587 describes generating the decision whether to initiate the implant-site-targeting treatment partly in response to an apparent change in vascular flow (e.g. module5923 ofdecision logic5930 generating anaffirmative decision5925 only ifindicators5954,5955 of change in flow through a vessel violates one or more givencriteria5908,5909). This can occur, for example, in a context in whichcriterion5909 includes a requirement that the flow change be local, whichmodule5923 may determine by invokingcomparator5921 or other other such modules for comparing measurements orother sensor transmissions5950 of the the subject region each with correspondingindicators5952,5953 of one or more other sites of the same subject. Alternatively or additionally,module5923 may likewise invoke circuitry orother modules5923 for comparing asuccession5951 of transmissions from a common sensor, such as for determining whether a shape of a specific vessel of of interest is changing too fast. In some variants, for example,module5923 can effectively detect a rupture in a vessel wall as either of a rapid increase of flow into the vessel or a large-enough, rapid-enough, non-reversing change in the vessel's shape. Alternatively or additionally,module5923 may likewise invokecircuitry5922 for detecting an apparent obstruction of the vessel manifesting as a large-enough, rapid-enough local decrease in vascular flow (ascriterion5907, e.g.).
• In some embodiments,decision logic5940 may contraindicate dispensing (a) a lytic agent into a target region within which a vessel has apparently ruptured or (b) a coagulant into a target region within which a vessel has apparently not ruptured. Such contraindications may manifest as a negative recommendation, a requirement for a confirmation by a user, or other suchappropriate output5983. In a more aggressive variant, one or more modules ofdecision logic5940 may be configured to perform a dispensation of (a) a lytic agent into a target region within which a vessel has apparently not ruptured or (b) a coagulant into a target region within which a vessel has apparently ruptured.
• Operation11589 obtaining one or more ischemia indicators of the one or more other clot-indicative determinants (e.g. module5891 ofinvocation logic5895 receiving a significant D-dimerscore increase indication5879 from one ormore detection modules5860,5870). This can occur, for example, in a context in which a “significant” score increase is ascertained by a fractional score increase (with an existing point-of-care assay, e.g.) on the order of 5% or 50% within a time span on the order of an hour or a day. In some contexts, for example, such a recent transition can be indicative of ischemia. Alternatively or additionally, such clot-indicative determinants5875 may include a complaint of sudden and severe local leg pain or other such subject-providedinput5872; symptom interpretations or other such secondary user input5873 (vianetwork5840, e.g.); anultrasound image5861, computedtomography image5862, or other such shape-indicative data5865; contraindications of hemorrhage orother indications5879 relating to alternative hypotheses, or othersuch ischemia indicators5880.
• With reference now toFIG. 116, shown is an example of a system that may serve as a context for introducing one or more processes and/or devices described herein. As shownsystem11600 may affect or otherwise relate tovicinity11605,section11630, andvicinity11635 of a subject'slumen11695 through which one or more blood components may flow. One ormore inflows11601 of blood enter respective portions oflumen11695 as shown, pass throughsection11630, and exit as one ormore outflows11699. In respective variants, arteries, veins, or smaller vessels oflumen11695 may traversevicinities11605,11635 as shown.Section11630 may likewise comprise one or more capillary beds as well as vital organs and other tissues served bylumen11695.
• In some variants,module11660 may (optionally) include one or more instances ofmodules11613,11614 of dispensinglogic11615;dispensers11617,11618,11619;modules11621,11622 ofevaluation logic11620;interface logic11640;modules11651 orother response logic11655; or intravascular orother sensors11650. (Somesuch sensors11650 may be operable for monitoring radiant or other physical phenomena within alumen11695, for example, from within or in adetection vicinity11605 oflumen11695.)Interface logic11640 may, as shown, comprise one or more instances oftransmitters11647,receivers11648, orother modules11642 operable for communicating (in one or both directions) with one ormore sensors11610 in (upstream)vicinity11605 oflumen11695.
• In some variants, system components described herein may be configured to trigger or otherwise facilitate dispensation of therapeutic materials. Other such embodiments are described above, for example, with reference to FIGS.28 and35-45. In some embodiments, a material is “therapeutic” if it contains one or more medications or other components having a primary effect or purpose of relieving symptoms, reducing health risks, or otherwise promoting the subject's health. Some treatment regimens may comprise one or more conditional or other “therapeutic material dispensations” and/or other aspects of treatment. In some contexts, such a therapy may be administered “locally” by positioning a significant portion of a material or other physical component thereof at a treatment site, even if some of the component is then extracted or permitted to metabolize systemically.
• With reference now toFIG. 117, shown is aflow11700 comprisingoperation11730—obtaining a flow-change-indicative measurement (e.g. one ormore modules11621 ofevaluation logic11620 detecting abnormally frequent blood pressure fluctuations for days consecutively). This can occur, for example, in a context in which a blood pressure fluctuation distribution for a specific pressure sensor is empirically determined and in whichmodule11621 implements a threshold or other baseline derived by a reasonable statistical model. In some variants, for example, an appropriate normality threshold may be selected so that a frequency of occurrence or other measurable variable will be expected only to exceed the threshold once per decade (or similar duration within 1-2 orders of magnitude. Alternatively or additionally, a triggering condition may be selected in relation to one or more of optical, force, auditory, or other measurable criteria or to a combination of such criteria. Numerous reasonable triggering conditions will readily be apparent to those skilled in the art without undue experimentation, many of which are a mere matter of design choice in light of teachings herein.
• Flow11700 further comprisesoperation11790—signaling a decision whether to administer one or more clot-reducing agents at least partly based on the flow-change-indicative measurement (e.g. one ormore modules11613,11614 of dispensinglogic11615 causing one ormore dispensers11617,11618 to administer an antiplatelet-drug-containing or other therapeutic agent in response to the one ormore modules11621,11622 of evaluation logic11620). This can occur, for example, in a context in whichmodule11614 specifically selects such a therapeutic material by selecting thedispenser11618 containing the material in lieu of another dispenser. Alternatively or additionally, one ormore modules11642 may be configured to signal the decision in some other way, such as by a speaker orother transmitter11647 conveying medication instructions to the (implanted) subject, or otherwise by sending such a message to a party who is able to implement the decision.
• With reference now toFIG. 118, there are shown several variants of theflow11700 ofFIG. 117.Operation11730—obtaining a flow-change-indicative measurement—may (optionally) include one or more of the following operations:11831,11835,11838, or11839. In some embodiments, variants ofoperation11730 may be performed by one or more instances ofsensors4579,11650,evaluation logic4520,11620, or the like as exemplified herein.Operation11790—signaling a decision whether to administer one or more clot-reducing agents at least partly based on the flow-change-indicative measurement—may include one or more of the following operations:11892,11893, or11897. In some embodiments, variants ofoperation11790 may be performed by one or more instances ofoutput devices4526, dispensinglogic4515,11615, or the like as described herein.
• AsFIG. 118 indicates, (optional)operation11831 describes programming an implantable device (e.g. module6772 ofcontrol logic6770 transferring one ormore device settings6771 orcommand sequences6761,6762 into anintravascular dispenser6780 or other implantable device). This can occur, for example, in a context in whichdispenser6780 is operably coupled via awireless communication linkage6752 and/ordocking port6751, in which such controls affect one or more operating modes of the implanted or other device, and in which controllogic6770 performsoperation11730. In some variants, for example,wireless communication linkage6751 may implement an 802.11b/g/n, Bluetooth, far field telemetry, near field telemetry, wireless USB, or other such protocol for communicating with one or more implantable devices automatically or in response to requests by a subject and/or caregiver. In various configurations and contexts, such devices can be enabled, disabled, and/or adjusted by one ormore modules6773 performingoperation11730. Alternatively or additionally, an initial set ofdevice settings6771 or other such parameters can be programmed into such devices prior to implantation to establish a baseline of device operation in the subject.
• Operation11835 describes obtaining a turbulence-indicative auditory value as the flow-change-indicative measurement (e.g. module6332 ofprocessing logic6330 accepting one ormore decibel measurements6351,6352 high enough to indicate past or present turbulence in a blood vessel). This can occur, for example, in a context in whichmodule6333 associates an earlier laminar-flow-indicative value6371 or a later laminar-flow-indicative value6372 (a Reynolds number or other such measurement below a turbulence-indicative threshold6331, e.g.) withtiming data6361 signifying an appearance or disappearance of detectable turbulence in the blood vessel. In some variants, for example, such transition-indicative timing data may signify a growing thrombosis, a thrombosis breakage, a therapeutic success, or other such flow-change-indicative phenomena. Alternatively or additionally,invocation logic6320 may trigger one or moreremote evaluation modules6396 to evaluate whether such timing data sufficiently coincides with timingdata6362 of a dispensation, timingdata6363 of a pressure-indicative or otherconfirmatory measurement6353, or other such therapeutically relevant and detectable events.
• Operation11838 describes detecting one or more conditions optically (e.g module6662 ofprocessing logic6660 detecting an apparent blockage manifested in animage6664 of one ormore regions6691,6692 of a subject vessel6696). This can occur, for example, in a context in whichnetwork6295 includesdetection system6650 and in which there are one ormore differences6251,6252 between spectral and/ortemporal absorbance distributions6211,6212 and the corresponding baseline distribution(s)6221,6222 indicative of a blockage. In some variants, for example, the heterogeneous nature of blood can cause an absorbance distribution that fluctuates rapidly over time (at a primary or mean frequency F, e.g.) so that a reduced flow can manifest as a measurably more stable signal (at a primary or mean frequency lower than F, e.g., by at least a threshold of 5% to 50% in some contexts). Alternatively or additionally, achange rate6255 or othersuch indicator6256 of color or intensity change in asignal6232 from anoptical sensor2525 can likewise triggermodule6201 to generate a Boolean alarm indicator6257 (signifying an apparent blockage, e.g.) and optionally providepositional information6253 and/ortiming information6254 relating to objects in a subject region.
• Operation11839 describes detecting one or more force-change-indicative values (e.g module6661 ofprocessing logic6660 detecting a fractionalforce change indication6663 from a subject region indicative of an apparent blockage, aneurism, or other such flow-modifying phenomenon). This can occur, for example, in a context in which one or more distortion sensors or other force-change-indicative sensors6682 detect a sudden, substantial change in one or more mechanical properties internal tissue in abody part6690 of subject6670. In some contexts, for example, a complete or partial blockage of a subject vessel6696 (inregion6692, e.g.) can measurably increase such rigidity in a vicinity of such blockages. Alternatively or additionally, such blockages in blood vessels can manifest as a measurably increased rigidity and/or pressure in tissue adjacent to the blockage (atregion6692, e.g.) and/or as a contemporaneous change several millimeters away from the blockage. Such changes can manifest as changes in vascular pressure in anupstream region6691 and/or adownstream region6693, for example, detectable by one or moreother sensors6681,6683 ofmodule6680.
• Operation11892 describes deciding upon at least one of the one or more clot-reducing agents in response to obtaining an anomalous value as the flow-change-indicative measurement (e.g. module6041 ofdecision logic6050 selecting one or more injectable therapeutic components from a set of locally availabletherapeutic components6073 for use in response to one ormore comparator results6031,6033 corresponding thereto, of which at least one indicates abnormally poor circulation in a subject6090 under observation). This can occur, for example, in a context in which a blood thinner or other such therapeutic component is selected programmatically based upon the comparator result(s)6033. Alternatively or additionally, one or more such results may depend upon a body part identifier6061 (identifying a measurement or dispensation site of subject6090, e.g.), an elevation, or other such location indicators6060 (such as by deciding against an automatic administration to a prone and unresponsive subject, as determined via a programmatic triage or other such interaction protocol6043). In some variants, moreover, a complete blockage of a subject vessel or a partial blockage in a primary location may warrant a selection of a faster-acting therapeutic agent than a partial blockage or a blockage in a secondary location. Alternatively or additionally,module6042 may display an ingestible clot-reducing agent indication6025 (viaoutput6024, e.g.) or may indicate other medically appropriate responses (being seated or calling an ambulance, e.g.).
• Operation11893 describes signaling at least an anticoagulant of the one or more clot-reducing agents in response to an apparent flow degradation (e.g. module6322 ofinvocation logic6320 receiving and relaying thedecision6391 to administer one or more therapeutic components to a nurse or other party cable of administering such agents via port6321). This can occur, for example, in a context in whichinvocation logic6320 anddecision logic6395 jointly or iteratively performoperation11730, in whichmediation module6310 interacts with a local module as described herein viaport6321, and in which such flow degradation manifests as one or more of a complaint or other severelimb pain indication6344, aswelling indication6346, alocal discoloration indication6348, other such detectable phenomena local to a portion of subject's body, or as a confirmatory measurement6353 (in combination with such indications, e.g.). In some variants, moreover, anothermodule6323 may signal a caregiver to check one or more potential effects of the clot-reducing or other therapeutic agents or to provide other appropriate follow-up. Alternatively or additionally,module6322 may invokerecorder6311 to capture a distillation of one ormore dispensation indications6347,symptom indications6349, and/orrelated timing data6363 selectively for future evaluation.
• Operation11897 describes causing one or more dispensations in response to an apparent problem in the flow-change-indicative measurement (e.g. module6122 ofinvocation logic6120 enabling or otherwise facilitating an activation of one ormore dispensers6075 containing one or more local dispensations of avasodilator6071, alytic agent6072, or other suchtherapeutic components6073 effective for modifying circulatory flow). This can occur, for example, in a context in whichsystem6100 includes or otherwise interacts withadministration unit6010, in which one ormore location sensors6101 or flowattribute sensors6102 are implemented in or can otherwise detect vessel properties in relation to hand-heldunit6080, and in whichmodule6104 ofdetection logic6110 detects a sharply decreased volume, speed, or other flow attribute (of 5% to 50% or more, e.g., such as may manifest an apparent obstruction) in a vessel segment near or downstream from an injection or implant site. In some variants including an injection dispenser, for example, a physician or veterinarian may configure one ormore modules6122,6123 to trigger such a dispenser to inject an anticoagulant or other such component locally and promptly upstream from a clot-prone site. Alternatively or additionally,module6182 can be configured to respond similarly by transmitting a (human) subject or other such care provider anotification6170 including one or more of adispensation indication6172 or anindication6173 of detected conditions that warrant the dispensation.
• Operation11932 describes receiving the flow-change-indicative measurement from a user (e.g. record3110 accepting one ormore parameters3168 indicative of flow change from a user via remote module3190). This can occur, for example, in a context in whichremote module3190 includes one or moreuser interface elements6291 accessible to a subject or other user, in whichinvocation logic3140 prompts a user for such information, and in which the measurement(s) are accepted asinput6292. Such measurements can include one or more local measurements of blood pressure, pulse, or other such flow change indicators, some of which may be programmatically measured or confirmed using devices not configured to communicate directly withadministration system6200. Alternatively or additionally, some such parameters can be used for guiding an intake protocol, even without recordation.
• Operation11934 describes detecting one or more impedance-change-indicative values (e.g module6733 ofdetection logic6720 detecting a sustained, small-enough change rate6721 to indicate an apparent blood vessel obstruction or some otherimpedance change indication6722 reflecting a circulatory phenomenon of interest). This can occur, for example, in a context in whichconfiguration system6710 includes or otherwise interacts with one or morelocal modules2320,2450 and in whichimpedance sensor2323 or other sensors are positioned to detect a change in a conductivity or other electrical property of fluid and/or tissue in a subject region. In some variants, for example, such modes of detection can confirm or otherwise facilitate an identification of plaque or other such affixed structures in a vessel as described herein.
• Operation11937 describes comparing an earlier-flow-indicative value with a later-flow-indicative value (e.g. module6202 ofevaluation logic6210 comparing current flow-indicative data6233 withhistoric data6234 provided to or measured by a sensor-containing device). This can occur, for example, in a context in which one ormore ankle images6272,size measurements6271, or othersuch indications822 are held locally in a data-handling medium885 and later used by one ormore comparators882 or other entities as a baseline value or other historic indication for comparison with one or more similar (subsequent or current)images6272,6263 orother values6274,6275. In some variants, for example, such values may include one or more representative values, averages, and/or other appropriate arithmetic combinations thereof. Alternatively or additionally, such historic flow indicative information can be loaded into an implanted device for use in future data filtering as described herein.
• Operation11939 describes confirming a flow-change indication with a confirmatory evaluation (e.g. module6132 ofdecision logic6130 performing, guiding, or otherwise causing one or more measurements, comparisons, or other such operations configured to confirm or refute a pathological hypothesis, a course of action, a normalcy determination, or other such apparent circumstance). This can occur, for example, in a context in whichmediation module6310 is operably coupled withsystem6100 ofFIG. 61 and in which discrimination against false indications is important enough to warrant two or more modes of evaluation. In some variants, for example, suchconfirmatory measurements6353 may compriseadditional data6340 of the same and/or orthogonal types in the subject region can be employed as additional information in the evaluation. In some variants in which an in situ or other convenient sensor initially generates one ormore cooling indications6345 or swellingindications6346 relating to a subject region, such indications may be corroborated or otherwise selectively confirmed by more accurate instrumentation. Alternatively or additionally,similar data6340 obtained from one or more alternate subject sites (using a sensor array or manipulable sensor instrument, e.g.) can effectively differentiate between localized and systemic variations.
• Operation11991 describes indicating one or more options by which a user can override the decision whether to administer the one or more clot-reducing agents (e.g. module6245 ofdecision logic6240 causing auser interface element6291 to present a subject and/or caregiver an option to initiate, select, approve, and/or refuse one or more of aset6244 of two ormore therapy regimens6241,6242,6243). This can occur, for example, in a context in which one ormore implants1730,1940,5690 detect an apparent pathological state indication6296 (vianetwork6295, e.g.) triggering arequest6276 toadministration system6200 to queryuser6290 for approval and/or selection of one ormore therapy regimens6242,6243. In some variants, for example, one or moreexpert system modules6294 ofadministration system6200 will present such a set of regimens pursuant to one or more identifiers ofvalues6274,6275 or othercurrent input6292 fromuser6290. Alternatively or additionally, a subject orother user6290 may obtain other regimens, options, prognoses, or other information or advice fromexpert system module6294 or other resources onnetwork6295.
• Operation11994 describes communicating a notification partly based on a risk indicator and partly based on the flow-change-indicative measurement to a user interface (e.g. module6423 ofnotification logic6420 transmitting one ormore notifications6440,6450 configured bymodule6422 to include one ormore risk indicators6431,6432 and two or moresequential samples6441,6442,6443 of signal6445). This can occur, for example, in a context in whichmodule6454 invokes one or more such modules ofnotification logic6420 in response to a sustained trend or other symptom-indicative event sequence in signal6446. In some variants, for example, one ormore modules6461 ofevaluation logic6460 compute amarginal probability6462 or othersuch risk indicator6431 periodically (each 5 to 50 sample periods, e.g.). Alternatively or additionally, one or more such notifications may be deferred or otherwise made dependent upon a low-enough-risk (belowthreshold6463, e.g.). Alternatively or additionally, one or moresuch notifications6440,6450 may include computed differences or othercomposite indicators6491 derived fromsignal6445, pictographic data, measurements,timing data6494, current personnel availability or otherresource availability data6493, or other such information.
• Operation11995 describes signaling a response protocol reflecting the decision via a user interface (e.g. module6181 ofnotification logic6180transmitting notification6160 to a telephonic or other interface articulating aninitiation6151 orupdate6152 of one or more clot-reducing protocols). This can occur, for example, in a context in whichnotification logic6180 and one or more interfaces described herein iteratively performoperation11790. Alternatively or additionally, one or more attributes of the decision(s)6133 and/or regimen(s)6134 may, in some variants, be implemented after receiving anapproval6103 or similar decision indicator via the user interface (from a subject and/or caregiver, e.g.).
• Operation11998 describes communicating the flow-change-indicative measurement to a remote user (e.g. module6538 ofnotification logic6540 transmitting one ormore notifications6544 to one or more remote client systems as a result of one ormore comparators6521 signaling the violation of one or more evaluation criteria6523). This can occur, for example, in a context in whichserver system6490 implementsinterface6500. In some variants, for example, a nurses' station orother aggregation destination6402 is configured to receive remote notifications of patient blood flow changes such as those described below with reference toFIG. 66. Alternatively or additionally, notifications can be sent to off-site caregivers and/or emergency health professionals to trigger appropriate telephonic or other follow-up.
• Those skilled in the art will appreciate that the foregoing specific exemplary processes and/or devices and/or technologies are representative of more general processes and/or devices and/or technologies taught elsewhere herein, such as in the claims filed herewith and/or elsewhere in the present application.
• In light of teachings herein, and referring again toFIG. 45, those skilled in the art will recognize that any of these systems may include a variant in which receiver4546 obtains a priori implant information by receiving configuration information to describe or otherwise accommodate alower module4590 that has been or will be implanted. This can occur, for example, in a context in which one or more instances ofupper module4550 is (or will be) well situated to administer one or more lytic materials or other therapies that may be needed at one or more instances oflower module4590. Alternatively or additionally, the a priori implant information may include implant status, material reservoir status, or other such indications of modules as described herein.
• Any of the above-described embodiments can likewise comprise a variant in whichinterface logic4540 invokes circuitry for performing operation11380 (ofFIG. 113) such as one ormore modules4513 of dispensinglogic4515 operable for activating one ormore dispensers4518,4519 when an apparent clot is detected. This can occur, for example, in a context in which the a priori implant information is embedded in circuitry or other structure ofsuch dispensing logic4515.
• Any of the above-described embodiments can likewise comprise a variant in whichtiming module4552 or anothermodule4551 ofresponse logic4555 performsoperation10910 by responding to a signal fromsensor4510 or some other indication that a lytic material will apparently be present in ornear section4530 oflumen4595. This can occur, for example, in a context in whichresponse logic4555 receives a notification that dispenser4519 has been activated. Alternatively or additionally, such indications may be received from one ormore sensors4510 operable for detecting the lytic material directly or by detecting other such conditions as described herein. Alternatively or additionally, any of these modules or other components may likewise include a delay orother timing module4552 responsive to at least one of the one or more dispensation components. Alternatively or additionally, any of these modules or other components may likewise include one or moresemi-permeable membranes4581.
• Referring again toFIGS. 108-116, those skilled in the art will recognize that any of the herein-described modules or other components may likewise include one or more thrombolytic-agent-containingdispensers11228 and/or may include one or more (artificial)disposal vessels10870 and/or other features described herein. Referring again toFIG. 28, for example, those skilled in the art will recognize that any such components may likewise include one ormore disposals2888, optionally transluminal ones likedisposal2889 in which one ormore conduits2886 are configured to bear a blood-containing material into a body lumen. Any may likewise include one or more radiotherapy treatment modules or other suchtherapeutic structures2842.
• Referring again toFIG. 46, alternatively or additionally, any of these modules or systems herein may likewise include an implantable, dispenser-containingvalve4610. Any may likewise include one or more instances ofwireless communication modules4644 for sending data to or receiving data from an outside network or other entity. Any may likewise include one or moreoptical sensors4675,auditory sensors4676, pressure sensors, pressure-limiting valves, strain gauges, or other such flow-force-responsive elements4678. Alternatively or additionally, any of these extraction modules or other material movement components may likewise comprise a lower-than-ambient pressure, at least initially. Alternatively or additionally, any of the above-described modules or other components may (optionally) include one or more implant-site-targeting dispensers, positioned for dispensing (a) above an implant of interest or (b) from an upstream or intermediate portion of the implant of interest.
• Some or all of the embodiments described herein may generally comprise technologies for handling one or more bioactive agents and/or carriers in releasable module form, via a liquid-bearing conduit, in a mist or other spray form, in a pumped or other pressurized form, or otherwise according to technologies described herein. In a general sense, those skilled in the art will recognize that the various aspects described herein which can be implemented, individually and/or collectively, by a wide range of hardware, software, firmware, or any combination thereof can be viewed as being composed of various types of “electrical circuitry.” Consequently, as used herein “electrical circuitry” includes, but is not limited to, electrical circuitry having at least one discrete electrical circuit, electrical circuitry having at least one integrated circuit, electrical circuitry having at least one application specific integrated circuit, electrical circuitry forming a general purpose computing device configured by a computer program (e.g., a general purpose computer configured by a computer program which at least partially carries out processes and/or devices described herein, or a microprocessor configured by a computer program which at least partially carries out processes and/or devices described herein), electrical circuitry forming a memory device (e.g., forms of random access memory), and/or electrical circuitry forming a communications device (e.g., a modem, communications switch, or optical-electrical equipment). Those having skill in the art will recognize that the subject matter described herein may be implemented in an analog or digital fashion or some combination thereof.
• The foregoing detailed description has set forth various embodiments of the devices and/or processes via the use of block diagrams, flowcharts, and/or examples. Insofar as such block diagrams, flowcharts, and/or examples contain one or more functions and/or operations, it will be understood by those within the art that each function and/or operation within such block diagrams, flowcharts, or examples can be implemented, individually and/or collectively, by a wide range of hardware, software, firmware, or virtually any combination thereof. In one embodiment, several portions of the subject matter described herein may be implemented via Application Specific Integrated Circuits (ASICs), Field Programmable Gate Arrays (FPGAs), digital signal processors (DSPs), or other integrated formats. However, those skilled in the art will recognize that some aspects of the embodiments disclosed herein, in whole or in part, can be equivalently implemented in integrated circuits, as one or more computer programs running on one or more computers (e.g., as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., as one or more programs running on one or more microprocessors), as firmware, or as virtually any combination thereof, and that designing the circuitry and/or writing the code for the software and or firmware would be well within the skill of one of skill in the art in light of this disclosure. In addition, those skilled in the art will appreciate that the mechanisms of the subject matter described herein are capable of being distributed as a program product in a variety of forms, and that an illustrative embodiment of the subject matter described herein applies regardless of the particular type of signal bearing medium used to actually carry out the distribution. Examples of a signal bearing medium include, but are not limited to, the following: a recordable type medium such as a floppy disk, a hard disk drive, a Compact Disc (CD), a Digital Video Disk (DVD), a digital tape, a computer memory, etc.; and a transmission type medium such as a digital and/or an analog communication medium (e.g., a fiber optic cable, a waveguide, a wired communications link, a wireless communication link (e.g., transmitter, receiver, transmission logic, reception logic, etc.), etc.).
• All of the above-mentioned U.S. patents, U.S. patent application publications, U.S. patent applications, foreign patents, foreign patent applications and non-patent publications referred to in this specification and/or listed in any Application Data Sheet, are incorporated herein by reference, to the extent not inconsistent herewith.
• One skilled in the art will recognize that the herein described components (e.g., operations), devices, objects, and the discussion accompanying them are used as examples for the sake of conceptual clarity and that various configuration modifications are contemplated. Consequently, as used herein, the specific exemplars set forth and the accompanying discussion are intended to be representative of their more general classes. In general, use of any specific exemplar is intended to be representative of its class, and the non-inclusion of specific components (e.g., operations), devices, and objects should not be taken limiting.
• With respect to the use of substantially any plural and/or singular terms herein, those having skill in the art can translate from the plural to the singular and/or from the singular to the plural as is appropriate to the context and/or application. The various singular/plural permutations are not expressly set forth herein for sake of clarity.
• The herein described subject matter sometimes illustrates different components contained within, or connected with, different other components. It is to be understood that such depicted architectures are merely exemplary, and that in fact many other architectures may be implemented which achieve the same functionality. In a conceptual sense, any arrangement of components to achieve the same functionality is effectively “associated” such that the desired functionality is achieved. Hence, any two components herein combined to achieve a particular functionality can be seen as “associated with” each other such that the desired functionality is achieved, irrespective of architectures or intermedial components. Likewise, any two components so associated can also be viewed as being “operably connected”, or “operably coupled,” to each other to achieve the desired functionality, and any two components capable of being so associated can also be viewed as being “operably couplable,” to each other to achieve the desired functionality. Specific examples of operably couplable include but are not limited to physically mateable and/or physically interacting components, and/or wirelessly interactable, and/or wirelessly interacting components, and/or logically interacting, and/or logically interactable components.
• In some instances, one or more components may be referred to herein as “configured to,” “configurable to,” “operable/operative to,” “adapted/adaptable,” “able to,” “conformable/conformed to,” etc. Those skilled in the art will recognize that “configured to” can generally encompass active-state components and/or inactive-state components and/or standby-state components, unless context requires otherwise.
• While particular aspects of the present subject matter described herein have been shown and described, it will be apparent to those skilled in the art that, based upon the teachings herein, changes and modifications may be made without departing from the subject matter described herein and its broader aspects and, therefore, the appended claims are to encompass within their scope all such changes and modifications as are within the true spirit and scope of the subject matter described herein. It will be understood by those within the art that, in general, terms used herein, and especially in the appended claims (e.g., bodies of the appended claims) are generally intended as “open” terms (e.g., the term “including” should be interpreted as “including but not limited to,” the term “having” should be interpreted as “having at least,” the term “includes” should be interpreted as “includes but is not limited to,” etc.). It will be further understood by those within the art that if a specific number of an introduced claim recitation is intended, such an intent will be explicitly recited in the claim, and in the absence of such recitation no such intent is present. For example, as an aid to understanding, the following appended claims may contain usage of the introductory phrases “at least one” and “one or more” to introduce claim recitations. However, the use of such phrases should not be construed to imply that the introduction of a claim recitation by the indefinite articles “a” or “an” limits any particular claim containing such introduced claim recitation to claims containing only one such recitation, even when the same claim includes the introductory phrases “one or more” or “at least one” and indefinite articles such as “a” or “an” (e.g., “a” and/or “an” should typically be interpreted to mean “at least one” or “one or more”); the same holds true for the use of definite articles used to introduce claim recitations. In addition, even if a specific number of an introduced claim recitation is explicitly recited, those skilled in the art will recognize that such recitation should typically be interpreted to mean at least the recited number (e.g., the bare recitation of “two recitations,” without other modifiers, typically means at least two recitations, or two or more recitations). Furthermore, in those instances where a convention analogous to “at least one of A, B, and C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, and C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). In those instances where a convention analogous to “at least one of A, B, or C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., ” a system having at least one of A, B, or C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). It will be further understood by those within the art that typically a disjunctive word and/or phrase presenting two or more alternative terms, whether in the description, claims, or drawings, should be understood to contemplate the possibilities of including one of the terms, either of the terms, or both terms unless context dictates otherwise. For example, the phrase “A or B” will be typically understood to include the possibilities of “A” or “B” or “A and B.”
• With respect to the appended claims, those skilled in the art will appreciate that recited operations therein may generally be performed in any order. Also, although various operational flows are presented in a sequence(s), it should be understood that the various operations may be performed in other orders than those which are illustrated, or may be performed concurrently. Examples of such alternate orderings may include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplemental, simultaneous, reverse, or other variant orderings, unless context dictates otherwise. Furthermore, terms like “responsive to,” “related to,” or other past-tense adjectives are generally not intended to exclude such variants, unless context dictates otherwise.
• Those skilled in the art will recognize that it is common within the art to implement devices and/or processes and/or systems, and thereafter use engineering and/or other practices to integrate such implemented devices and/or processes and/or systems into more comprehensive devices and/or processes and/or systems. That is, at least a portion of the devices and/or processes and/or systems described herein can be integrated into other devices and/or processes and/or systems via a reasonable amount of experimentation. Those having skill in the art will recognize that examples of such other devices and/or processes and/or systems might include—as appropriate to context and application—all or part of devices and/or processes and/or systems of (a) an air conveyance (e.g., an airplane, rocket, helicopter, etc.) , (b) a ground conveyance (e.g., a car, truck, locomotive, tank, armored personnel carrier, etc.), (c) a building (e.g., a home, warehouse, office, etc.), (d) an appliance (e.g., a refrigerator, a washing machine, a dryer, etc.), (e) a communications system (e.g., a networked system, a telephone system, a Voice over IP system, etc.), (f) a business entity (e.g., an Internet Service Provider (ISP) entity such as Comcast Cable, Qwest, Southwestern Bell, etc.), or (g) a wired/wireless services entity (e.g., Sprint, Cingular, Nextel, etc.), etc.
• In certain cases, use of a system or method may occur in a territory even if components are located outside the territory. For example, in a distributed computing context, use of a distributed computing system may occur in a territory even though parts of the system may be located outside of the territory (e.g., relay, server, processor, signal-bearing medium, transmitting computer, receiving computer, etc. located outside the territory).
• A sale of a system or method may likewise occur in a territory even if components of the system or method are located and/or used outside the territory. Further, implementation of at least part of a system for performing a method in one territory does not preclude use of the system in another territory.
• While various aspects and embodiments have been disclosed herein, other aspects and embodiments will be apparent to those skilled in the art. The various aspects and embodiments disclosed herein are for purposes of illustration and are not intended to be limiting, with the true scope and spirit being indicated by the following claims.

Claims (32)

1. A system comprising:

means for detecting a result of one or more comparisons between information indicating current local stress in a peripheral part of a subject's body and information indicating prior local stress in the peripheral part of the subject's body; and

means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body.

2. The system ofclaim 1 in which the means for detecting a result of one or more comparisons between information indicating current local stress in a peripheral part of a subject's body and information indicating prior local stress in the peripheral part of the subject's body comprises:

means for detecting the result at least one day after detecting the information indicating the prior local stress in the peripheral part of the subject's body.

3. The system ofclaim 1 in which the means for detecting a result of one or more comparisons between information indicating current local stress in a peripheral part of a subject's body and information indicating prior local stress in the peripheral part of the subject's body comprises:

means for receiving a structural change indication in the result of the one or more comparisons.

4. The system ofclaim 1 in which the means for detecting a result of one or more comparisons between information indicating current local stress in a peripheral part of a subject's body and information indicating prior local stress in the peripheral part of the subject's body comprises:

means for including a current thermal indication of the peripheral part of the subject's body in the information indicating the current local stress in the peripheral part of the subject's body.

5. The system ofclaim 1 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for enabling a performance of the one or more comparisons at a resource remote from the subject's body.

6. The system ofclaim 1 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for obtaining the result partly based on an indication of one or more nutrients in the subject's body.

7. The system ofclaim 1 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for extracting the decision whether to transmit the notification from the result of the one or more comparisons.

8. The system ofclaim 1 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for deciding to transmit the notification in response to the result indicating a monotonic measurement change over at least N sampling intervals, where N>1.

9. The system ofclaim 1 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for accepting a caregiver's input as a determinant of the decision whether to transmit the notification.

10. The system ofclaim 1 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for transmitting a conmmon graphical image containing the information indicating the current local stress in the peripheral part of the subject's body with the information indicating the prior local stress in the peripheral part of the subject's body.

11. The system ofclaim 1 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

a buffer; and

a condition detector configured to apply one or more standards.

12. The system ofclaim 1 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for transmitting one or more images of an abnormality in the peripheral part of the subject's body with the notification.

13. The system ofclaim 1 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for transmitting one or more measurements of the peripheral part of the subject's body with the notification.

14. The system ofclaim 1 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

a concentration-indicative sensor.

15. The system ofclaim 1 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

a force-indicative sensor.

16. The system ofclaim 1, further comprising:

a user interface; and

means for recognizing whether a signal from the user interface apparently contains any of the information indicating the current local stress in the peripheral part of the subject's body.

17. The system ofclaim 1, further comprising:

one or more sensor-containing modules external to the subject's body.

18. The system ofclaim 1, further comprising:

one or more items implanted into the subject's body and configured to provide at least some of the information indicating the current local stress in the peripheral part of the subject's body.

19-68. (canceled)

69. The system ofclaim 2 in which the means for detecting a result of one or more comparisons between information indicating current local stress in a peripheral part of a subject's body and information indicating prior local stress in the peripheral part of the subject's body comprises:

means for receiving a structural change indication in the result of the one or more comparisons.

70. The system ofclaim 2 in which the means for detecting a result of one or more comparisons between information indicating current local stress in a peripheral part of a subject's body and information indicating prior local stress in the peripheral part of the subject's body comprises:

means for including a current thermal indication of the peripheral part of the subject's body in the information indicating the current local stress in the peripheral part of the subject's body.

71. The system ofclaim 2 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for enabling a performance of the one or more comparisons at a resource remote from the subject's body.

72. The system ofclaim 2 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for obtaining the result partly based on an indication of one or more nutrients in the subject's body.

73. The system ofclaim 2 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for extracting the decision whether to transmit the notification from the result of the one or more comparisons.

74. The system ofclaim 2 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for deciding to transmit the notification in response to the result indicating a monotonic measurement change over at least N sampling intervals, where N>1.

75. The system ofclaim 2 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for transmitting a common graphical image containing the information indicating the current local stress in the peripheral part of the subject's body with the information indicating the prior local stress in the peripheral part of the subject's body.

76. The system ofclaim 2 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

a buffer; and

a condition detector configured to apply one or more standards.

77. The system ofclaim 2 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for transmitting one or more images of an abnormality in the peripheral part of the subject's body with the notification.

78. The system ofclaim 2 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

means for transmitting one or more measurements of the peripheral part of the subject's body with the notification.

79. The system ofclaim 2 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

a concentration-indicative sensor.

80. The system ofclaim 2 in which the means for signaling a decision whether to transmit a notification in response to the result of the one or more comparisons between the information indicating the current local stress in the peripheral part of the subject's body and the information indicating the prior local stress in the peripheral part of the subject's body comprises:

a force-indicative sensor.

81. The system ofclaim 2, further comprising:

one or more items implanted into the subject's body and configured to provide at least some of the information indicating the current local stress in the peripheral part of the subject's body.

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