U.S. patent application number 13/162650 was filed with the patent office on 2011-12-22 for blood pressure irregularity sensing.
This patent application is currently assigned to WELCH ALLYN, INC.. Invention is credited to Matthew J. Kinsley, John A. Lane, David E. Quinn, John D. Seller, Tyson B. Whitaker.
Application Number | 20110313301 13/162650 |
Document ID | / |
Family ID | 45329266 |
Filed Date | 2011-12-22 |
United States Patent
Application |
20110313301 |
Kind Code |
A1 |
Lane; John A. ; et
al. |
December 22, 2011 |
BLOOD PRESSURE IRREGULARITY SENSING
Abstract
A medical device obtains a set of data associated with a
patient's non-invasive blood pressure cycle reading, provides a
representation of a pulse interval map on the display screen based
on the set of data, the pulse interval map including one or more
interval data points representing intervals between heat beats, and
alerts a caregiver if one or more of the interval data points fall
outside an interval bound. The medical device can also plot a pulse
volume map on the display screen based on the set of data, the
pulse volume map including one more volume data points representing
volumes associated with given heat beats, and alert a caregiver if
one or more of the volume data points fall outside a volume
bound.
Inventors: |
Lane; John A.; (Weedsport,
NY) ; Whitaker; Tyson B.; (Arden, NC) ; Quinn;
David E.; (Auburn, NY) ; Kinsley; Matthew J.;
(Liverpool, NY) ; Seller; John D.; (Syracuse,
NY) |
Assignee: |
WELCH ALLYN, INC.
Skaneateles Falls
NY
|
Family ID: |
45329266 |
Appl. No.: |
13/162650 |
Filed: |
June 17, 2011 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61355919 |
Jun 17, 2010 |
|
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|
61418186 |
Nov 30, 2010 |
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Current U.S.
Class: |
600/485 |
Current CPC
Class: |
A61B 5/02225
20130101 |
Class at
Publication: |
600/485 |
International
Class: |
A61B 5/021 20060101
A61B005/021 |
Claims
1. A medical device comprising: a central processing unit (CPU)
that is configured to control operation of the device; a display
screen; and a set of one or more computer readable data storage
media storing software instructions that, when executed by the CPU,
cause the device to: obtain a set of data associated with a
patient's non-invasive blood pressure cycle reading; provide a
representation of a pulse interval map on the display screen based
on the set of data, the pulse interval map including one or more
interval data points representing intervals between heat beats; and
alert a caregiver if one or more of the interval data points fall
outside an interval bound.
2. The device of claim 1, wherein the device calculates an
integrated pulse volume based on a pulse volume map.
3. The device of claim 2, wherein the pulse volume map includes an
upper bound and a lower bound represented by curves, a space
between the upper and lower bounds representing a normal variation
limits for pulse volumes.
4. The device of claim 3, wherein the device identifies beats
falling within the space between the upper and lower bounds as
representing beats with normal stroke volumes, and beats falling
outside the space as representing irregular stroke volumes.
5. The device of claim 1, wherein the device calculates a pulse
ramp up time.
6. The device of claim 1, wherein the device calculates a dichrotic
notch position in time.
7. The device of claim 1, wherein the device calculates a dichrotic
notch position in amplitude.
8. The device of claim 1, wherein the device calculates an area
under a curve of the pulse interval map pre-dichrotic notch versus
post dichrotic notch.
9. The device of claim 1, wherein the device calculates a dead
space between pulses.
10. The device of claim 1, wherein the device calculates a time
position of one or more reflected wave peaks.
11. The device of claim 1, wherein the device calculates a relative
amplitude of one or more reflected wave peaks.
12. The device of claim 1, wherein the device provides a visual or
audible representation of a recorded heart rate segment.
13. The device of claim 1, wherein the device provides an indicator
when pulse irregularity exceeds a predetermined level.
14. The device of claim 13, wherein the predetermined level is set
by a user.
15. A medical device comprising: a central processing unit (CPU)
that is configured to control operation of the device; a display
screen; and a set of one or more computer readable data storage
media storing software instructions that, when executed by the CPU,
cause the device to: obtain a set of data associated with a
patient's non-invasive blood pressure cycle reading; provide a
representation of a pulse volume map on the display screen based on
the set of data, the pulse volume map including one more volume
data points representing volumes associated with given heat beats;
and alert a caregiver if one or more of the volume data points fall
outside a volume bound.
16. The device of claim 15, wherein the pulse volume map includes
an upper bound and a lower bound represented by curves, a space
between the upper and lower bounds representing a normal variation
limits for pulse volumes.
17. The device of claim 16, wherein the device identifies beats
falling within the space between the upper and lower bounds as
representing beats with normal stroke volumes, and beats falling
outside the space as representing irregular stroke volumes.
18. A method for estimating pulse irregularity, the method
comprising: obtaining a set of data associated with a patient's
non-invasive blood pressure cycle reading; plotting a pulse
interval map on a display screen based on the set of data, the
pulse interval map including one or more interval data points
representing intervals between heat beats; alerting a caregiver if
one or more of the interval data points fall outside an interval
bound; plotting a pulse volume map on the display screen based on
the set of data, the pulse volume map including one more volume
data points representing volumes associated with given heat beats;
calculating an integrated pulse volume based on the pulse volume
map; and alerting the caregiver if one or more of the volume data
points fall outside a volume bound, wherein the pulse volume map
includes an upper bound and a lower bound represented by curves, a
space between the upper and lower bounds representing a normal
variation limits for pulse volumes, and wherein the device
identifies beats falling within the space between the upper and
lower bounds as representing beats with normal stroke volumes, and
beats falling outside the space as representing irregular stroke
volumes.
19. The method of claim 18, further comprising: calculating a pulse
ramp up time based on the pulse volume map; calculating a dichrotic
notch position in time based on the pulse volume map; calculating
the dichrotic notch position in amplitude based on the pulse volume
map; calculating an area under a curve of the pulse volume map
pre-dichrotic notch versus post dichrotic notch; calculating a dead
space between pulses based on the pulse volume map; calculating a
time position of one or more reflected wave peaks based on the
pulse volume map; calculating a relative amplitude of one or more
reflected wave peaks based on the pulse volume map.
20. The method of claim 18, further comprising: providing an
indicator when pulse irregularity exceeds a predetermined level;
and allowing the predetermined level to be set by a user.
Description
RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Patent
Application Ser. No. 61/355,919 filed on Jun. 17, 2010 and U.S.
Patent Application Ser. No. 61/418,186 filed on Nov. 30, 2010, the
entireties of which are hereby incorporated by reference.
BACKGROUND
[0002] A sphygmomanometer can be used to measure a patient's blood
pressure in a non-invasive manner. In a typical example, a cuff is
placed around the patient's arm and inflated. The cuff is deflated,
and the blood starts to flow within the arm again. By monitoring
the pressures at which the blood starts to flow (i.e., the maximum
output pressure or systolic reading) and the pressure upon
relaxation (i.e., the diastolic reading), an estimate of the
patient's blood pressure readings can be obtained. Throughout the
deflation of the cuff, arterial pressure changes cause pulsations
or oscillations in the cuff pressure which have a correlation to
the changing blood pressure in the underlying artery during a heart
cycle.
SUMMARY
[0003] Embodiments of the present disclosure are directed to
systems and methods for using data from a non-invasive blood
pressure cycle to assist in the identification of heart
irregularities. In example embodiments, such irregularities could
include, without limitation, pulse interval, heart contraction, and
heart output volume irregularities.
[0004] In one aspect, a medical device includes: a central
processing unit (CPU) that is configured to control operation of
the device; a display screen; and a set of one or more computer
readable data storage media storing software instructions that,
when executed by the CPU, cause the device to: obtain a set of data
associated with a patient's non-invasive blood pressure cycle
reading; provide a representation of a pulse interval map on the
display screen based on the set of data, the pulse interval map
including one or more interval data points representing intervals
between heat beats; and alert a caregiver if one or more of the
interval data points fall outside an interval bound.
[0005] In another aspect, a medical device includes: a central
processing unit (CPU) that is configured to control operation of
the device; a display screen; and a set of one or more computer
readable data storage media storing software instructions that,
when executed by the CPU, cause the device to: obtain a set of data
associated with a patient's non-invasive blood pressure cycle
reading; provide a representation of a pulse volume map on the
display screen based on the set of data, the pulse volume map
including one more volume data points representing volumes
associated with given heat beats; and alert a caregiver if one or
more of the volume data points fall outside a volume bound.
[0006] In yet another aspect, a method for estimating pulse
irregularity includes: obtaining a set of data associated with a
patient's non-invasive blood pressure cycle reading; plotting a
pulse interval map on a display screen based on the set of data,
the pulse interval map including one or more interval data points
representing intervals between heat beats; alerting a caregiver if
one or more of the interval data points fall outside an interval
bound; plotting a pulse volume map on the display screen based on
the set of data, the pulse volume map including one more volume
data points representing volumes associated with given heat beats;
calculating an integrated pulse volume based on the pulse volume
map; and alerting the caregiver if one or more of the volume data
points fall outside a volume bound, wherein the pulse volume map
includes an upper bound and a lower bound represented by curves, a
space between the upper and lower bounds representing a normal
variation limits for pulse volumes, and wherein the device
identifies beats falling within the space between the upper and
lower bounds as representing beats with normal stroke volumes, and
beats falling outside the space as representing irregular stroke
volumes.
DESCRIPTION OF THE DRAWINGS
[0007] The present disclosure can be better understood with
reference to the description below. Within the drawings, like
reference numbers are used to indicate like parts throughout the
various views. Differences between like parts may cause those like
parts to be each indicated by different reference numbers. Unlike
parts are indicated by different reference numbers.
[0008] FIG. 1 shows an example blood pressure cycle as measured by
a non-invasive blood pressure device.
[0009] FIG. 2 an example physiological monitor device.
[0010] FIG. 3 shows example physical components of the
physiological monitor device of FIG. 2.
[0011] FIG. 4 shows an example pulse interval map based on data
collected from a blood pressure cycle.
[0012] FIG. 5 shows another example pulse interval map based on
data collected from a blood pressure cycle.
[0013] FIG. 6 shows another example pulse interval map based on
data collected from a blood pressure cycle.
[0014] FIG. 7 shows an example pulse volume map based on data
collected from a blood pressure cycle.
[0015] FIG. 8 shows another example pulse volume map based on data
collected from a blood pressure cycle.
[0016] FIG. 9 illustrates aspects of a portion of an example blood
pressure cycle.
[0017] FIG. 10 illustrates additional aspects of a portion of an
example blood pressure cycle.
[0018] FIG. 11 illustrates additional aspects of a portion of an
example blood pressure cycle.
[0019] FIG. 12 illustrates additional aspects of a portion of an
example blood pressure cycle.
DETAILED DESCRIPTION
[0020] Embodiments of the present disclosure are directed to
systems and methods for using data from a non-invasive blood
pressure cycle to assist in the identification of heart
irregularities. In example embodiments, such irregularities could
include, without limitation, pulse interval and volume
irregularities.
[0021] FIG. 1 illustrates an example blood pressure cycle 100 as
measured by a blood pressure device. The blood pressure cycle 100
shows the measured pressures associated with the movement of blood
through the patient's body, typically an arm. Specifically, the
pulses shown are the variations in cuff pressure caused by changes
in pressure within the underlying artery.
[0022] The timing of each heart beat 110 is shown on the X-axis in
samples, and an amplitude of each heart beat 110 is shown on the
Y-axis in mmHg.times.100. The spacing between adjacent heart beats
110 is referred to as the pulse interval.
[0023] FIG. 2 illustrates an example physiological monitor device
200. The device 200 generally assists the caregiver in gathering
data associated with the patient, such as vital signs, etc. For
example, in embodiments described herein, the physiological monitor
device 200 is configured to take a patient's non-invasive blood
pressure. The physiological monitor device 200 is also configured
to interpret the patient's blood pressure reading and to identify
potential heart irregularities.
[0024] In the example shown, the physiological monitor device 200
includes multiple health care equipment (HCE) modules. Each of the
HCE modules is configured to measure one or more physiological
parameters of a health-care recipient, also referred to herein as a
patient. Example modules include a temperature measurement module,
an SpO2 module, and a non-invasive blood pressure (NIBP)
module.
[0025] The NIBP module connects to one or more peripheral NIBP
components, such as an inflatable cuff that attaches to an
appendage of a patient, such as an upper arm of the patient. The
inflatable cuff is designed to measure the systolic and diastolic
blood pressure of the patient, the mean arterial pressure (MAP) of
the patient, and the pulse rate of blood flowing within the
patient.
[0026] A front side of the physiological monitor device 200
includes a display screen 218. The display screen 218 is used to
display physiological measure data obtained from the patient. For
example, the patient's blood pressure and pulse rate can be
displayed on the display screen 218. In another example, the blood
pressure cycle 100 can be displayed. In addition, as described
further below, data associated the irregularities detected using
the NIBP data can be displayed on the display screen 218.
[0027] FIG. 3 illustrates example physical components of the
physiological monitor device 200. As illustrated, the physiological
monitor device 200 include at least one central processing unit
("CPU") 308, a system memory 312, and a system bus 310 that couples
the system memory 312 to the CPU 308. The system memory 312
includes a random access memory ("RAM") 318 and a read-only memory
("ROM") 320. A basic input/output system containing the basic
routines that help to transfer information between elements within
the physiological monitor device 200, such as during startup, is
stored in the ROM 320. The physiological monitor device 200 further
includes a mass storage device 314. The mass storage device 314
stores software instructions and data.
[0028] The mass storage device 314 is connected to the CPU 308
through a mass storage controller (not shown) connected to the bus
310. The mass storage device 314 and its associated
computer-readable data storage media provide non-volatile,
non-transitory storage for the physiological monitor device 200.
Although the description of computer-readable data storage media
contained herein refers to a mass storage device, such as a hard
disk or CD-ROM drive, it should be appreciated by those skilled in
the art that computer-readable data storage media can be any
available non-transitory, physical device or article of manufacture
from which the physiological monitor device 200 can read data
and/or instructions.
[0029] Computer-readable data storage media include volatile and
non-volatile, removable and non-removable media implemented in any
method or technology for storage of information such as
computer-readable software instructions, data structures, program
modules or other data. Example types of computer-readable data
storage media include, but are not limited to, RAM, ROM, EPROM,
EEPROM, flash memory or other solid state memory technology,
CD-ROMs, digital versatile discs ("DVDs"), other optical storage
media, magnetic cassettes, magnetic tape, magnetic disk storage or
other magnetic storage devices, or any other medium which can be
used to store the desired information and which can be accessed by
the physiological monitor device 200.
[0030] The physiological monitor device 200 also includes an
input/output controller 322 for receiving and processing input from
a number of other devices, including a keyboard, a mouse, a touch
user interface display screen, or another type of input device.
Similarly, the input/output controller 322 may provide output to a
touch user interface display screen, a printer, or other type of
output device.
[0031] As mentioned above, the mass storage device 314 and the RAM
318 of the physiological monitor device 200 can store software
instructions and data. The software instructions include an
operating system 332 suitable for controlling the operation of the
physiological monitor device 200. The mass storage device 314
and/or the RAM 318 also store software instructions, that when
executed by the CPU 308, cause the physiological monitor device 200
to provide the functionality of the physiological monitor device
200 discussed in this document. For example, the mass storage
device 314 and/or the RAM 318 can store software instructions that,
when executed by the CPU 308, cause the physiological monitor
device to display various user interface screens.
[0032] Referring again to FIG. 1, the physiological monitor device
200 can obtain an NIBP cycle reading from the patient and, in some
examples, display the blood pressure cycle 100 on the display 218
of the physiological monitor device 200.
[0033] In example embodiments, the physiological monitor device 200
can obtain an NIBP measurement using a traditional process during
which a cuff is inflated to a pressure well above a patient's
systolic blood pressure. The cuff is thereupon deflated, and the
patient's systolic and diastolic pressures are calculated based on
signals provide during the deflation. Other techniques can be
used.
[0034] For example, the physiological monitor device 200 can obtain
an NIBP measurement using fast blood pressure reflected wave
technology as described in U.S. patent application Ser. No.
12/650,984 filed on Dec. 31, 2009, the entirety of which is hereby
incorporated by reference. This application describes a method for
determining the reflective wave attributes during a period when the
pressure is held constant after the end of an inflation blood
pressure cycle. During this measurement period the variations in
those pulse attributes could also be measured and used to determine
the variability of a patient's pulses.
[0035] In addition, the physiological monitor device 200 is
programmed to analyze the data obtained from the NIBP cycle reading
to assist in the identification of heart irregularities. Such
irregularities can include, without limitation, pulse interval and
volume irregularities.
[0036] For example, the data obtained during recording of the NIBP
includes the pulse rate of the patient. This pulse rate information
can be used to detect irregularities associated with pulse
intervals.
[0037] Referring now to FIG. 4, a pulse interval map 400 is shown.
The pulse interval map 400 is derived from the data obtained during
the NIPB measurements. The pulse interval map 400 plots successive
heart beats (X-axis) versus heart rate (Y-axis).
[0038] The pulse interval map 400 also includes an upper bound 412
and a lower bound 414 represented by lines. The space between the
bounds 412, 414 represents the normal variation limits for a pulse
interval. The placement of the bounds 412, 414 can be modified
based one or more parameters, such as patient age, sex, height,
weight, activity level, etc. The bounds 412, 414 can be calculated
empirically using data from representative groups or can be
measured through trials. For example, a study such as the
Farmingham Heart Study or references like the American Heart
Association or other sources can be used to set the bounds.
[0039] Alternatively, the bounds can be entered by the care giver
as a percent variation from the mean. In the example shown, the
caregiver provides information to the physiological monitor device
200 or the physiological monitor device 200 obtains information
from, for example, an electronic medical record associated with the
patient, to allow the physiological monitor device 200 to
automatically set the bounds 412, 414 based on the obtained patient
information.
[0040] A portion or all of the heart beats 420 measured by the
physiological monitor device 200 during a NIBP cycle are plotted on
the pulse interval map 400. For the example pulse interval map 400,
all of the heart beats 420 falls within the bounds 412, 414 and
therefore can be considered to be normal.
[0041] Referring now to FIG. 5, another example pulse interval map
500 is shown. In the pulse interval map 500, a plurality of the
heart beats 510 fall outside the bounds 412, 414. In such a
situation, the pulse interval map 500 may indicate that the pulse
interval for the patient is irregular. In other words, the patient
may have an arrhythmia or other irregularity associated with the
patient's heart based on the irregular intervals between adjacent
heart beats.
[0042] In one example, the pulse interval maps 400, 500 are
displayed on the display screen 218 of the physiological monitor
device 200 so that the caregiver can review the pulse interval maps
when providing care to the patient. If one or more beats fall
outside the bounds 412, 414, an alarm can also be provided to alert
the caregiver of a possible irregularity. The pulse intervals that
fall outside of the bounds may be highlighted using further indicia
such as, for example, a different color or flashing the points.
[0043] In another example, the physiological monitor device 200
calculates the pulse interval maps 400, 500 and simply provides an
indicator to the caregiver regarding whether or not an irregularity
is found. For example, if all the beats are within the bounds, the
physiological monitor device 200 can do nothing or provide the
caregiver with an indicator such as a green icon or text like
"Pulse Interval Normal." Conversely, if one or more fall outside
the bounds, an indicator such as a red icon or text like "Irregular
Pulse Interval Detected" or "Additional Testing Recommended" can be
displayed. In some examples, the caregiver can then click on the
indicator to receive more information, if desired, such as the
pulse interval maps themselves. Other methods of presentation and
alert can also be used. These other methods include, but are not
limited to, an audio playback in sounds of the heart beating, a
video showing an audio and/or visual replay of the pulse
information, and an animated representation of the data including a
representation of a heart beating.
[0044] Referring now to FIG. 6, another pulse map 600 is shown. In
the pulse map 600, the patient has exhibited a skipped beat 610
during the blood pressure cycle. When the physiological monitor
device 200 detects such an irregularity, the physiological monitor
device 200 can alert the caregiver of the same in one or more of
the manners described above.
[0045] Referring now to FIG. 7, an example relative pulse volume
map 700 is shown. The pulse volume map 700 is also derived from the
data obtained during the NIPB cycle measurements. The pulse volume
map 700 plots successive heart beats (X-axis) versus an estimate of
the stroke volume associated with each of the heart beats (Y-axis).
In example embodiments, the relative stroke volume for each beat
can be estimated as the area under the curve associated with each
beat 110. See FIG. 1.
[0046] The relative pulse volume map 700 also includes an upper
bound 712 and a lower bound 714 represented by curves. The space
between the bounds 712, 714 represents the normal variation limits
for pulse volumes. Beats falling within the space between the
bounds 712, 714 represent beats with normal stroke volumes, while
beats falling outside the space represent irregular stroke
volumes.
[0047] As before, the placement of the bounds 712, 714 can be
modified based one or more parameters, such as patient age, sex,
height, weight, activity level, blood pressure, etc.
[0048] A portion or all of the heart beats 720 measured by the
physiological monitor device 200 during a NIBP cycle are plotted on
the pulse volume map 700. For the example pulse volume map 700, all
of the heart beats 720 falls within the bounds 712, 714 and
therefore can be considered to be normal.
[0049] Referring now to FIG. 8, another example pulse volume map
800 is shown. In the pulse volume map 800, a plurality of the heart
beats 810 fall outside the bounds 712, 714. In such a situation,
the pulse volume map 800 may indicate that the pulse volume for the
patient is irregular. In other words, the patient may have an
arrhythmia or other irregularity associated with the patient's
stroke volume. This irregularity can be expressed to the caregiver
by displaying the pulse volume map 800 and/or providing one or more
alerts.
[0050] In some examples, the data provided to the caregiver can be
the raw data or represented as a percentage of the average. In some
embodiments, the bounds (e.g., 412, 414 and 712, 714) can be
tailored to the individual by dynamically calculating the bounds
based on a signal to noise calculation. For example, the standard
device could be divided by the mean to determine the outer bounds.
Other configurations are possible.
[0051] One or both of the both timing and volume information can be
combined or examined with additional information to provide
enhanced information to the caregiver. For example, the interval
and volume information can be combined to provide a better
understanding of possible irregularities associated with a
patient's NIPB data. In such a scenario, the interval and stroke
volume data could be provided on a single map. The combination or
relative severity of timing and volume variation can serve as a
separate indication of abnormal heart function. For example, normal
interval variation combined with abnormally varying volume data can
indicate proper electrical function in the heart but improper
filling or flow.
[0052] For example, in one embodiment, an expected envelop shape is
plotted, and then the actual dots illustrating the patient's
deviation, to the extend it exists, are plotted on top of the
envelop. Other methods of presenting the data, including both
numeric and graphical, can also be used.
[0053] Another example of data presentation includes the
"normalization" of pulse volumes over different cuff pressures.
During a blood pressure cycle the applied pressure in the cuff is
varied systematically and there is an expected effect on the volume
of the pulses that are induced in the cuff by the underlying artery
in response to these different cuff pressures. For example, the
pulsations that occur when the cuff pressure near mean arterial
pressure are expected to be large verses the pulsations in the cuff
when the cuff pressure is below diastolic or above systolic. Based
on the measured systolic and diastolic blood pressures, the volume
changes can be normalized using expected changes across different
cuff pressures and only the deviation or residual from that
expected curve can be plotted to be evaluated by the clinician for
evidence of abnormal beat to beat volume variation.
[0054] Other attributes of the oscillometeric pulse can be measured
and evaluated for beat to beat regularity. These attributes
include: [0055] integrated pulse volume (area under the curve for
each pulse)--see FIG. 9; [0056] pulse ramp up time--see FIG. 9;
[0057] dichrotic notch position in time--see FIG. 10; [0058]
dichrotic notch position in amplitude--see FIG. 10; [0059] area
under the curve pre-dichrotic notch vs. post dichrotic notch--see
FIG. 11; [0060] over all pulse time--see FIG. 11; [0061] "dead
space" between pulses--see FIG. 12; [0062] Time position of
reflected wave peak--see FIG. 12; and [0063] Relative amplitude of
reflected wave peak--see FIG. 12.
[0064] In some examples, the information regarding pulse interval,
heart contraction, and/or heart output volume irregularities can be
processed and presented to the caregiver directly on the
physiological monitor device 200. In other examples, the data can
be processed and/or displayed remotely, such as at a central
monitoring station in a hospital or on a portable device such as
personal data assistant (for example, an mp3 or other video-type
could be rendered and played on the device). For example, the data
can be sent to a central monitoring station in a hospital, and a
nurse can review maps and alerts at a computing device located at
the central monitoring station. Other configurations are
possible.
[0065] Various embodiments disclosed herein can be implemented (1)
as a sequence of computer implemented acts or program modules
running on a computing system and/or (2) as interconnected machine
logic circuits or circuit modules within the computing system. The
implementation is a matter of choice dependent on the performance
requirements of the computing system. Accordingly, logical
operations including related algorithms can be referred to
variously as operations, structural devices, acts or modules. It
will be recognized by one skilled in the art that these operations,
structural devices, acts and modules may be implemented in
software, firmware, special purpose digital logic, and any
combination thereof without deviating from the spirit and scope of
the present disclosure.
[0066] Although the disclosure has been described in connection
with various embodiments, those of ordinary skill in the art will
understand that many modifications may be made thereto.
Accordingly, it is not intended that the scope of the disclosure in
any way be limited by the above description.
* * * * *