Circulatory monitoring systems and methods

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

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 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 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 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 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 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 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 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 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 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 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 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.

DETAILED DESCRIPTION

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.

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.

With reference now toFIG. 1, shown is a system100configured to monitor at least one detection site101comprises several zones111,112,113,114of a subject's body, any of which may contain an infection or other physiological abnormality105. Such anomalies may manifest as physical phenomena detectable by a comparator130applying various filtering information131,132,137to output from one or more sensors126,127,128in a proximity of the detection site(s)101as exemplified below. (In some variants, for example, such features of zone112may be detected by a ranged sensor127in other zones113or by a portable sensor126that enters zone112.)

Other such detection sites102may likewise include several zones171,172,173,174sometimes accessible to system100, any of which may be detectable at various times by one or more sensors185,186. In some variants, also, a clinician or other service provider190may be able inspect a patient's leg or other zone174of interest, status information191which may be acted upon according to a triage protocol or other such functional information192from evaluation logic150. In some contexts, service provider190may likewise apply status information191at site102, such as by determining whether a symptom has changed. Functional information192may likewise flow to evaluation logic150, such as by service provider190identifying what treatments or other events occurred.

In some variants, module182of detection logic180may be configured to notify evaluation logic150only in the event of input from one or more sensors185,186at site102. (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 or more modules141,142of protocols may likewise be invoked in response to symptoms indicated by such detection logic180and/or service providers190. In some contexts, for example, one or more service providers190may orally or otherwise report status information191to evaluation logic150based upon visual or other preliminary examination of particular zones173,174of a patient's body. Alternatively or additional, the service provider(s) may perform a diagnostic procedure or other evaluation according to programmatic or other functional information192specified by evaluation logic150(implementing, for example, an expert system).

Module142or 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 of responsive protocols140, recorders148, or other components of evaluation logic150may be provided, in some variants, at a central processing facility that is remote from one or more of site102, detection logic180, and/or service provider190.

In some variants, evaluation logic150may be configured to rank conditions or otherwise combine data effectively from two or more subjects, such as by using data from one subject (received via detection logic180or service provider190, e.g.) to generate or update filtering information132,137to be applied to data from another subject (at site101, e.g.). Other such embodiments are described, for example, with reference toFIGS. 2,3,8,25, and74below.

In some variants, two or more sensors126,127,128may (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, and76below.

With reference now toFIG. 2, shown is a system200in which one or more technologies may be implemented, a sedan comprising wheels201, an engine202, and one or more modules210,215configured to provide one or more types of information221from controls or information222,223,224from within or around one or more seats211or other locations inside the vehicle. System200may further include or otherwise interact with one or more modules251,252of evaluation logic250, one or more modules261,262of responsive logic260, and/or one or more modules272,273of decision logic275operable for transmitting or otherwise selectively acting upon such information271as described below. In some variants, for example, one or more clocks276or antennas278may facilitate selective notifications, aggregations, evaluations, or other programmatic responses as described herein. Alternatively or additionally, one or more stationary instances of circuitry280may communicate with system200, for example, via antenna278.

An embodiment provides a vehicle having one or more modules251,252of evaluation logic250configured as circuitry for causing one or more evaluations of local respiratory-status-indicative information222,223,224about 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. 3-16and22-33. 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 or more engines202operable for conveying one or more seats211—such as by applying a torque (via one or more axles, e.g.) to wheels201.

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 a system300in which one or more technologies may be implemented. System300may be positioned centrally or local to subjects310,320, for example, and/or configured to invoke one or more interfaces330or other response logic335in response to one or more indications311,312,313,314,321from sensors317,326,327in, on, or near extremities328or other body parts of interest. This can occur, for example, in a context in which hosiery318, clothing, or one or more utility devices325within a detection range of sensors317,326,327implements or otherwise interacts with system300. In some embodiments, such sensors may be implanted in a body tissue of interest or in a structure with which subjects310,320may 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 or transmission media340configured to bear one or more percentages343or other indications341,342,344such as content345; information346; decisions347; or notifications348containing content349, for example, in any of the flows described below in relation toFIGS. 82-119.

With reference now toFIG. 4, shown is a system400in which one or more technologies may be implemented. System400comprises a support420configured to contact or otherwise remain adjacent one or more external portions403,404,405of body410in such a way as to permit a detection of surface roughness, discoloration, or other detectable anomalies409. As shown, support420includes one or more components413,414,415that each include one or more sensors423,424,425respectively adjacent external portions of interest. In some variants, one or more modules491,492of controller490are configured to receive one or more 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 of module491configured as circuitry for deciding whether to transmit measurement content or other blood clot indications and one or more components413,414,415each coated with an ultrasound gel or other such medium to facilitate acoustic energy passing from a subject body410to respective sensors423,424,425. (Other such embodiments are described, for example, with reference toFIGS. 23-27below.)

With reference now toFIG. 5, shown is a system500in which one or more technologies may be implemented comprising one or more notification modules510operably coupled with one or more interfaces580in a network590. Notification module510may handle or otherwise include one or more decisions531,532of various types533, destinations535, display elements536, or channels550operable for transmitting one or more notifications541,542such as content544, optionally via one or more radio-frequency or other 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 a wheelchair600, a system in which one or more technologies may be implemented. Wheelchair600includes a seat610having one or more signal paths631,632,633,634operably coupled with one or more monitoring apparatuses660, such as for detecting weight or local phenomena. Monitoring apparatus660may, for example, comprise one or more modules641,642,643of detection logic640, modules651,652of responsive logic650, antennas654, or other circuitry for generating or using detection results655as described herein.

An embodiment provides a wheelchair or other vehicle comprising one or modules642of detection logic640configured as circuitry for causing one or more evaluations of incoming signals (arriving along selected paths631,632,633,634, 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, seat610may include or otherwise support elastic or other tensile elements configured to urge sensors617toward 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 is system700in which one or more technologies may be implemented, including one or more actuator arrays705operable for responding to controller775. Array705comprises several actuators701. A first actuator701comprises at least two actuator elements711,712each operable to move cell710(such as by motor715) relative to structure765selectively in response to controller775. One or more actuator elements722are likewise operable to move cell720relative to structure765and/or cell740, also in response to controller775. One or more actuator elements741,742,743are likewise operable to move cell740relative to structure765in response to controller775. (In some contexts, for example, one or more pumps or valves746,747may be configured to permit a fluid to enter and/or leave actuator element743to control its expansion and contraction, for example.) One or more actuator elements752,753are likewise operable to move cell750relative to structure765in response to controller775. Controller775may thus effectuate local position and/or tension control a selective invocation of such actuators. Controller775may comprise one or more instances of configuration modules777, support control logic780, or profile data790comprising operating parameters791,792,793,794,795or other aspects of one or more 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 or more modules781,782,783,784may be configured to control one or more such cells730comprising, 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 an array705, structure765, or controller775for tissue manipulation, examples of which are described below in relation to the flows ofFIGS. 82-119.

With reference now toFIG. 8, shown is a system800in which one or more technologies may be implemented, an airplane comprising wheels801, engines802, and a cabin810configured to include one or more interfaces890configured to receive output845from an instance of monitoring apparatus870. Each monitoring apparatus870may be configured to receive one or more sensed indications821,822,823,824from respective seats811,812,813,814in which passengers may suffer circulatory or other actionable health risks. Each monitoring apparatus870may likewise include one or more instances of conduits844, recorders848, modules881of detection logic880, or modules841,842of other responsive logic840as described below. In some variants, for example, an interface895may be configured to display an output845selectively in a vicinity of a seat814that has generated one or more indications824of 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, or other interface890more readily visible and/or audible from a front portion of cabin810or from other passengers' seats812,813nearby. A variety of local sensors described in this document are suitable for use in a context like that of system800, especially those described with reference toFIGS. 23-26.

An embodiment provides an airplane or other vehicle comprising one or comparators882or other modules881of detection logic880configured as circuitry for causing one or more evaluations of incoming indications821,822,823,824from seats occupied by respective occupants. Such embodiments may likewise include a cabin810or other such enclosure configured to shelter the occupant(s). Alternatively or additionally, such embodiments may include one or more engines802operable for conveying one or more 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 or more modules841of responsive logic840may 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 a tonometer925or other instrument900configured to facilitate one or more sensors902being positioned adjacent a subject's skin910. One or more sensor elements905may relay or otherwise facilitate a transmission of images931, signals932,933, or other data935to a primary module920. Then or later, one or more modules943of evaluation logic950may apply one or more thresholds941or other criteria942to such data as described below.

With reference now toFIG. 10, shown is a system1000in which one or more technologies may be implemented comprising two or more actuators1021,1022each configured to support corresponding sensors1001,1002on or near respective portions1011,1012of a subject's skin1010. In various configurations, primary module1060may include one or more modules1051,1052of configuration logic1050; one or more profiles1071,1072or other parameters1075,1076of control data1079; and/or responsive logic1095. As exemplified below, one or more modules1091,1092,1093of responsive logic1095may trigger configuration logic1050to update one or more signals1031,1032configured to control respective actuator sets in response to one or more thresholds1086,1087or other criteria being applied to data1081,1082,1083and/or signals1033,1034received from sensors1001,1002. In a variant in which such signals1033,1034signify a local force minimum in portion1012, configuration logic1032may (optionally) be configured to energize actuator1022, for example, to maintain a nominal contact force with skin1010.

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 a system1100in which one or more technologies may be implemented. One or more actuators1120each comprise a plurality of elements1121,1122configured to respond to one or more signals1131,1132by exerting a controlled force upon respective portions1111,1112of skin1110. An assembly of one or more actuators1120may likewise provide one or more signals1125to primary module1190. Primary module1190may include one or more instances of device-executable command sequences1157or other modules1151,1152,1153,1154,1155,1156; sensor-derived data1161,1162,1163and/or vector grids1165or other profiles1167of data1170suitable for use by control logic1160; one or more modules1181,1182,1183of processing logic1180configured to handle the data1170and other aspects of incoming signals1125; and/or one or more interfaces1185configured 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 toFIG. 6,7,12, or89.

With reference now toFIG. 12, shown is a system1200in which one or more technologies may be implemented for use with a custom cast, a fitted stocking, or other such special-purpose apparatus1205configured to support a subject's limb as described herein. An array1221of sensors, actuators, and/or other such devices may be configured to interact with a portion1201of the subject's limb and/or to handle control and/or sensed information1211. At least one other array1222of devices may likewise be configured to interact with one or more respective portions1202of the subject's limb and/or to handle respective information1212passing to and/or from system module1230. System module1230may include one or more components supported by apparatus1205, on a nearby utility device, in other (optionally centralized) facilities, or distributed across a plurality of such locations. System module1230may include one or more media bearing various types of sensed information1241,1242,1243or other data1244,1245,1246,1247,1248,1250as described herein. Other such data and/or thermal information1251may be provided roughly contemporaneously as (current) status-indicative information1260, in some variants, or may indicate timing1252associated therewith, such as in a series of periodic measurements reflecting a health status trend in the status-indicative information1260. System module1230may likewise include one or more instances of modules1271,1272,1273of detection 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 a system1300in which one or more technologies may be implemented, a server1305configured to communicate with one or more sources1375,1385,1395in a each of plurality of networks1370,1380,1390. One or more such servers1305may include instances of detection modules1310; modules1325of (data) extraction logic1320; remote-resource invocation modules1330; devices1340; or modules1351,1352of decision logic1350. In some variants, an instrument or other device1340as described herein may handle various data1343,1344; identifiers1345; indications1346; or other information1341,1342as 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, a vehicle1470or other primary module1400configured to display or otherwise transmit output1485and/or to interact with one or more storage devices1492in network1490. Primary module1400may include or otherwise handle one or more instances of decision logic1460; notices1471,1472; transmitters1473; local devices1474; or interfaces1475as described herein. Decision logic1460may include one or more instances of detection modules1411; invocation modules1412; comparators1431,1432,1433or other processing modules1430; or other modules1441,1442configured to perform or otherwise generate decisions upon images or other data1451,1452,1453or other such information1455,1456,1457; measurements1458; or other such determinant data1459. Primary module1400may archive such decisions or other data remotely upon one or more such storage devices1492, in some implementations as described herein, and/or may retrieve pathological models, thresholds, or other such programmatic information remotely from one or more such storage devices1492.

With reference now toFIG. 15, shown is a system1500in which one or more technologies may be implemented for relaying or otherwise notifying one or more destinations1591,1592(in a network1590of care providers, e.g.) of one or more results1521,1522,1523, authorizations1538, or other substantive communications1539. In some variants, for example, one or more modules1531,1532,1533,1534,1535of evaluation logic1530may generate or select content1581,1582and/or destinations1583,1584,1585of such communications1539or other notifications1580in response to temporal indications1541,1542or other such data1551,1552,1553. In some variants, for example, such evaluation logic may generate or otherwise facilitate such communications or other notifications1580by applying one or more thresholds1561,1562; criteria1571,1572,1573; or other filtering data1570as 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. A primary module1600may comprise one or more instances of response modules1620; processing modules1650,1680; antennas1688, linking modules1690, or other components suitable for bearing signals1693; or other media1695configured to hold or otherwise bear images1697or other attributes1699of potential relevance to a subject's status. Response module1620may include one or more instances of term recognition modules1625or other modules1621,1622operable for handling one or more parameters1624. Processing modules1650,1680may be configured to apply one or more thresholds1651,1652,1653,1654, for example, and/or to hold one or more readings1681,1682in a registry1685.

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 a system1700to examine tissue1725in one or more limbs1721,1722of a subject1720. System1700comprises one or more transducers1767supported on a hand-held instrument1760operably coupled to an external module as shown herein via a continuous signal-bearing conduit1765. In some variants, such examination may be facilitated by one or more sensors1733in or on such tissue, optionally comprising an implant1730and/or response logic1735configured to process or otherwise respond to sensed data therefrom even before becoming operable to forward any indication of the data to transducer1767.

With reference now toFIG. 18, shown is a system1800in which one or more technologies may be implemented that include one or more instruments1850configured to position one or more sensors1851subcutaneously within tissue1875of body part1871, for example. Variant configurations of commercially-available probes or other such instruments may be used to implant one or more sensors1851, dispensers, or other such modules through skin1876of subject1870via one or more probes1855, for example, adjacent or extending into vessel1879. Such configurations may (optionally) be configured, for example, to detect one or more attributes of and/or administer one or more treatments via blood1873. 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 a system1900in which one or more technologies may be implemented, such as for one or more body parts1920of subject1910to interact with interface logic1970via one or more hand-held instruments1960. As shown, body part1920contains one or more vessels1929bearing blood1923into or out of organ1927. One or more chips or other implants1940may be positioned under the subject's skin1926in tissue1925adjacent vessel1929, and optionally extending into the vessel(s). Implant1940may (optionally) include one or more sensors1942as described below and/or one or more antennas1943operable for receiving and/or transmitting data along wireless data path1945as shown. Interface logic1970may include one or more instances of detectors1980and/or transducers1990such as ultrasound sensors1981or infrared sensors1982. Alternatively or additionally, detector1980may include special-purpose software1974or other such measurement logic1975configured to handle configuration, control, measurement, or other data1978,1979as described below.

With reference now toFIG. 20, shown is a system2000in which one or more technologies may be implemented, such as for observing one or more attributes of body parts2071,2072of subject2070via one or more respective adhesive patches2031,2032on the subject's skin2006. Adhesive patch2032, for example, holds an array2025of sensor elements2021,2022in close contact with skin2006so that attributes of subcutaneous tissues2005, vessels2009, or blood2003or other such materials may be observed. In some contexts, for example, such an array2025may implement combinations of two or more types of sensors and/or related logic as exemplified in relation toFIGS. 23-26below. In some variants, for example, one or more such elements2021,2022may also include a configurable colorant, a light-emitting diode, or other such external feature detectable by a clinician2010and/or by an instrument2050that contains a camera2056or other optical sensor.

An embodiment provides one or more elements2022configured as circuitry for deciding whether to transmit one or more blood clot indications (detected with reference, or example, to one or more components sensed within blood2003by element2021) and an adhesive patch2032comprising one or more tensile elements configured to hold such elements2021,2022of array2025in tight contact with skin2006. (Other such embodiments are described, for example, with reference toFIG. 3or27.) Such embodiments may be used, for example, in a context in which each contact element2021,2022comprises 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 system2100in which one or more technologies may be implemented, such as for detecting one or more attributes of blood2103in vessels2109, for example, or skin2106or other tissues2105in body part2171. A hand-held or other probe2140may include one or more sensors2141or other such elements2142operable for detecting such attributes through one or more liquid-containing contact enhancement materials2149. Such materials may facilitate energy transfer through skin2106, in some variants, or various modes of chemical detection as described herein.

With reference now toFIG. 22, shown is a network2215operable for facilitating communications among one or more interfaces2210(of a clinician2205, e.g.), one or more servers2220, or one or more local systems2240(via one or more media2225, e.g.). (In some embodiments described herein, sensors2268or other such artificial structures are “local” if they are configured to extend into a detection proximity2277of one or more parts2271,2272of a subject2270of interest.) As shown, local system2240may likewise include one or more instances of decision logic2250; results2251,2252; communication ports2255,2256; or interfaces2260. Decision logic2250may include one or more instances of notifications2241,2242, instruction sequences2243or other modules2244,2245, or other parameters2247,2248,2249as described below. Interface2260may relay auditory instructions or other such data for use by subject2270via one or more speakers2267or other output devices. Alternatively or additionally, interface2260may receive measurements or other indications2261,2262,2263,2264as well as other determinant data2265from and/or relating to subject2270. In some variants, local system2240may be configured to facilitate such interchanges with subject2270even when only a remote clinician2205is 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 within network2215may decide which notifications2201,2202are suitable in response to a programmatic interaction protocol (with a subject2270and/or other individuals, for example, undergoing a triage or other intake) or other such 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 a local module2320in 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 more microwave frequency sensors2321, optionally configured to generate an indication of moisture or related symptoms in or on a subject's body. Alternatively or additionally, local module2320may include one or more 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 or more 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 module2320may include one or more 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 more electric field sensors2325in 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 module2320may include one or more carbon dioxide sensors2331or other 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 of event detection logic2333, pathogen detection logic2334, or other condition detection logic2335such 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 of local module2320.

In some variants, such local modules may be configured to illuminate, exert force upon, or otherwise pass energy into a subject's skin. Other such embodiments are described, for example, with reference toFIGS. 11 & 24.

With reference now toFIG. 24, shown is a local module2450in 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 more 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 module2450may include one or more 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 more radio 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 module2450may contain one or more metabolic 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 physiological constituent 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 module2450may likewise (optionally) include one or more 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 module2450may include one or more 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 or more 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 module2450may include one or more gas pressure sensors2474configured 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 module2450may likewise include one or more position sensors2481configured to monitor subject and/or region orientation. Alternatively or additionally, local module2450may include one or more fluid 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 more fluid 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 module2450may include one or more 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 more sonic 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 more sonic pattern sensors2491, e.g.) or of a subject's potential exposure to external stimuli (via one or more sonic volume sensors2492, e.g.). In some embodiments, several or all of such items may be included in a single instance of local module2450.

With reference now toFIG. 25, shown is a local module2510in 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 or more 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 or more 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 module2510may include one or more blood 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 more fluid pressure sensors2482or conductivity sensors2324in some implanted contexts. Alternatively or additionally, one or more force sensors2484and/or ultrasound sensors2541(of ultrasound scanner2540, e.g.) may be configured in a transdermal mode, for example, to generate information indicative of blood pressure. Local module2510may likewise include one or more near infrared sensors2522and/or infrared sensors2523sensors, 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 as transmittance 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 module2510may comprise one or more reflectance sensors2511configured to emit energy into tissue and to capture a portion of the energy reflected.

In some variants, local module2510may contain one or more activity sensors2532, weight sensors2533and/or tissue 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 more magnetic field sensors2547, optionally configured to allow for the control and/or inhibition of implanted devices transdermally. Alternatively or additionally, local module2510may include mass-indicative or other electrochemical sensors2548, any of which may (optionally) be configured to give an indication of physiological constituent levels such as by incorporating ion-selective electrodes2551(of ion sensor2550, e.g.) or other concentration-indicative sensors2560for the monitoring of potassium, sodium, calcium, and/or other physiologically relevant components (at pH sensor2561or other concentration-indicative sensors2560, e.g.). In some variants, electrochemical sensors2548can 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 more electrochemical sensors2548and/or optical sensors2525(including fluorescence 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 as drug sensor2562, e.g.). Local module2510may also implement one or more timestamps2544, location coordinates2545, or other such indices2546relating 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 of local module2510.

With reference now toFIG. 26, shown is a local module2690in which one or more technologies may be implemented, optionally within a sensor, sensor-containing module, or other local instrumentation. Any of local modules2320,2450,2510may (optionally) include one or more instances of differential or other comparators2670configured to process one or more instances of real-time data2681, historical data2682, force-indicative data2683, pathology-indicative data2684, measurement data2685using one or more standards2671, thresholds2672, or other input2673. Those skilled in the art will recognize, for example, how to apply one or more thresholds2672configured 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 data2683in light of teachings herein.

With reference now toFIG. 27, shown is a system2700in which one or more technologies may be implemented for periodically or otherwise monitoring skin2774or subcutaneous tissue2775of a subject2780via one or more sensor elements2760. One or more such modules may be remain adjacent tissue2775, for example, by hand, by gravity, by one or more media2740, and/or by one or more straps or other tensile elements2750as described herein. In some variants, for example, one or more such media2740may contain a gel2741, a bioadhesive, a liquid2742, a therapeutic material, a polymer2743, a carrier, or other such components as described herein. Alternatively or additionally, element2760may include one or more instances of dispensers2762configured to inject such media so that they spread into direct contact with one or more sensors2765. Alternatively or additionally, one or more such sensors2765may transmit energy indicating one or more physical phenomena in tissue2775to one or more elements2721,2722, software, indications2725, or modules2726,2727,2728,2729of decision logic2730as described below.

An embodiment provides a variant of decision logic2730configured as circuitry for deciding whether to transmit one or more blood clot indications2725, for example, and a liquid-containing medium2740configured at least to facilitate acoustic energy passing between subject2780and one or more sensors2765of the decision 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. 4or23-26above.

Some implementations include one or more polymers2743or other liquids2742configured to adhese at least some of the decision logic2730in 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 logic2335configured to infer a presence of the liquid-containing medium in response to a low-enough electrical resistance measurement. In some variants, each instance of element2760may implement one or more instances of local modules2320,2450,2510,2690as described herein. Such embodiments may further comprise one or more dispensers2762configured to dispense a supplemental amount of the liquid containing medium and/or a therapeutic material.

A variant embodiment provides special-purpose software2723or other decision logic2730implementing 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 or more sensors2765of the decision logic2730toward subject2780. (Other such embodiments are described, for example, with reference toFIG. 6or20.) 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 logic2730may include an executable instruction sequence or other modules2728configured to capture and/or evaluate one or more ultrasound images indicative of the one or more blood clot indications. Alternatively or additionally, decision logic2730may include an implantable antenna1943, a vehicle antenna278, or other such wireless communication conduits configured to transmit information from one or more sensors2765. In some variants, decision logic2730may also include or otherwise receive data from one or more flow sensors2471, one or more respiration sensors2332or 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 or media2740and/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 shown system2800may affect or otherwise relate to one or more sections2840or other “upstream” portions2846of a human or other living subject's vasculature2896(receiving inflow2801) and also to one or more “downstream” portions2876of such vasculatures2896(bearing outflow2899). One or more sections2840,2860as shown may comprise one or more of capillary beds, tissues served by vasculature2896, or other blood vessels.

In some variants, one or more intravascular or other modules2850may (optionally) include one or more instances of receivers2825, transmitters2826, or other interface logic2820such as for communicating (in one or both directions) with one or more sensors2810operable for monitoring upstream portion2846. Module2850may likewise include one or more instances pumps2827or other hardware controlled by dispensing logic2830for selectively releasing one or more (biological, radiotherapy, or other) agents2841or other therapeutic structures2842into upstream portion2846. Such module(s)2850may also be configured, in some contexts, by including one or more software or other modules2833of dispensing logic2830comprising one or more instances of port controls2831, (dispensing or other therapeutic) regimens2832, or messages2834as described below.

As shown, system2800may comprise one or more modules2850upstream operable for communicating (in one or both directions) with one or more intravascular or other modules2890downstream, optionally in an integral and/or implanted structure as shown. Alternatively or additionally, module2890may include one or more instances of capture agents2867,2868or other therapeutic agents2869; receivers2878; sensors2879; capture logic2880operable for controlling one or more actuators2881, such as for optically or otherwise controlling the capture agent(s); pumps2887; or disposals2888,2889. As shown, for example, disposal2889may include one or more ports2882operable for accelerating a decrease in a local concentration of the agent(s)2841or other therapeutic structure(s)2842along portion2876(downstream from dispensation2897, as shown) by allowing the structure(s) to pass into one or more conduits2886traversing one or more vessel walls2883,2884. One or more vessels2885configured 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 a system2900that may serve as a context for introducing one or more processes and/or devices described herein, optionally configured to interact with network2995. As shown system includes one or more modules2972,2973,2974,2977,2978of decision logic2975,2976; one or more transmitters2980; and/or one or more parameters2984,2985of stimula2981selected to facilitate one or more sensors2982obtaining sensed values2986,2987or other such test data2989about an individual or subpopulation to be monitored. System2900may also include or otherwise interact with one or more instances of instruments2930configured to obtain data from subject(s)2920, user interfaces2952configured to interact with decision makers or expert resources, or handheld devices2961or other such interfaces2962for relaying input2965to or from other such parties.

One or more instruments2930in a vicinity of subject2920may include, for example, one or more instances of identifiers2923or other data2921,2922about subject2920obtained via one or more interfaces2926and/or sensors2927. User interface2952may likewise present visual or other output2953and/or receive keyed or other input2954. Response logic2970as an entity may receive and/or transmit a variety of communication2935or other data2955for or from network2995, 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 with current communications2935or other data as described below.

Some variants of decision logic2975,2976may 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 an interface3000that may serve as a context for introducing one or more processes and/or devices described herein. Interface3000comprises one or more media3040configured to contain or otherwise handle one or more tables3010or other such informational structures3020; notifications3051,3052; modules3061,3062,3063,3064,3065or other processing logic3070; indications3081,3082or measurements3085; and/or other such data3090. Table3010may include one or more instances of decisions3004, indications3005, or other such information in each of one or more common records3011,3012,3013. In a context in which structure3020includes one or more subjects' medical histories, study data, or other such content, a search agent or other such entity may use one or more indicators3021,3022,3023,3024or other criteria3025to retrieve suitable information. One or more identifiers3034and/or other such criteria3035may be used in a search 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 or other system3100comprising one or more primary modules3180operatively linked to one or more remote modules3190. Remote module3190may include or otherwise handle one or more indications3181,3182,3183,3184,3185, data filters3189, or comparators3198of evaluation logic3197. Primary module3180may comprise a vehicle or other such item3150configured to include or otherwise handle invocation logic3140comprising one or more modules3141,3142,3143responsive to timing3111,3121or other indications3115,3125of records3110,3120; measurements3131,3132; results3136,3137; and/or hybrid or other indications3130. Primary module3180may likewise apply one or more values3155as data filters3151,3152, or may apply one or more other values3161,3165; thresholds3167; or other such filtering information3170for determining whether one or more parameters3168warrant a response as described herein.

With reference now toFIG. 32, shown is an example of a system3200including a filtering modules3210configured to process determinant data3240about one or more body parts3271,3272of subject3270. Such data may be received, for example, via one or more sensors3284of one or more apparatuses3290affixed, such as by one or more adhesives3282, to body parts3272of interest. In some variants, for example, detection logic3285produces one or more results3231,3232,3233,3234,3235, measurements3238, and/or timing data3239by generating an extraction of data3261,3262,3263that complies with one or more retention and/or transmission criteria3287. Alternatively or additionally, one or more modules3221,3222,3223or other decision logic3230may be configured to apply criteria3225,3226,3227for selectively generating one or more aspects of notifications3211,3212,3213or other results3236.

With reference now toFIG. 33, shown is an example of a system3300including an in-dwelling catheter or other instrument3355suitable for transvascular placement. In some variants, for example, instrument3355may couple with a bifurcated catheter or other conduit3354suitable to administer one or more therapeutic materials3340locally to a treatment site3371via one or more capillaries and/or other small vessels3378. As shown, site3371may include some or all of an afflicted organ or other target mass3370served by a vasculature3365of subject3360. In some variants, for example, intermediate-size vessels3372may include arterioles through which material passes. Alternatively or additionally, a clamp or other such controllable occlusion structure3356occludes at least some flow between a vein or other large vessel3379and an injection site (segment3373, e.g.).

An embodiment provides such a transvascular dispenser configured to administer a therapeutic material3340containing an artificial component3330locally, and in which the therapeutic material(s)3340contain dioxygen3311in oxyhemoglobin3323of blood3325, for example, or in a carrier3315. 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 of therapeutic material3340, e.g.). Such therapeutic materials may, for example, include one or more toxins3331, antineoplastic agents3334, heparin or other anticoagulants3335, nitric oxide sources3336, hormones3337, or other drugs3339or therapeutic materials that may be delivered via a vasculature.

Another embodiment provides an extravascular or other artificial occlusion structure3356operable to impede a flow exiting a segment3373of a vasculature (into vessel3379, e.g.) and an instrument3355or other artificial structure operable to administer a therapeutic material3340locally to the segment3373. 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 other suitable dispensation conduit3354adapted to administer a therapeutic material3340locally via (venules or other) intermediate-size vessels3372to (capillaries or other small) vessels3378and to site3371. Such conduits may, in some contexts, comprise or otherwise access a reservoir operable for dispensing toxins3331or other dangerous dosages locally, some of which may then be absorbed into site3371and/or recaptured, for example, back into conduit3354. In some variants, for example, therapeutic material3340may include one or more of dioxygen3311in one or more artificial carriers3315and/or oxyhemoglobin3323borne in blood3325. Therapeutic material3340may likewise include one or more toxins3331and/or sources of antineoplastic agents3334or anticoagulants3335or (supplemental quantities of) nitric oxide3336, hormones3337, or other 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 toFIG. 17-32or34-43.

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 a vasculature3465of a mammal or other subject3400. Two or more systemic or other arterial segments3410,3420receive respective blood flows3401,3402, which then diverge into smaller vessels and then to respective capillary beds3450,3460,3470, one or more of which may include a site3471of interest for a local treatment. After a nutrient/waste product exchange, blood may exit one or more such beds3470via one or more venules3495,3496typically converging into larger flows3488,3499exiting respective venous segments3480,3490. In some variants, for example, one or more sites3471may receive a local treatment via backflow from one or more artificial structures3455that include one or more transvascular or intravascular distal portions3456extending within a venule and/or venous segment3490as 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 a system3500that may serve as a context for introducing one or more processes and/or devices described herein. Unit3510of system3500may include one or more conduits3504configured to dispense therapeutic material3520from one or more reservoirs3508. Such therapeutic material3520may include oxyhemoglobin3523or other such sources of dioxygen in a pharmaceutically acceptable carrier3524, for example, that may also include one or more supplemental or other artificial components3525susceptible to injection or other vascular administration.

In some variants, unit3510may be configured to include or otherwise interact with one or more units3540comprising one or more instances of notification logic3535, imaging apparatuses3536, and/or sensor-containing probes3537configured to detect physical phenomena on or in a subject's body. In a variant containing each, for example, imaging apparatus3536may be configured capture one or more images3534via probe3537. Alternatively or additionally, for example, notification logic3535may include one or more such images with one or more notifications3533to be transmitted to network3545as shown.

Alternatively or additionally, unit3510may likewise be configured to include or otherwise interact with one or more other modules3551,3552,3553of detection logic3550configured to invoke one or more modules of responsive logic as exemplified herein. In some variants, for example, unit3560may include such modules as described herein with reference toFIG. 2,6,8,15, or83-119.

Alternatively or additionally, unit3510may (optionally) be configured to interact with one or more blood filtration devices3576, absorption ports3577, dispensation ports3578configured to dispense active agent inhibitors, or other such artificial units3580effectively configured to extract some portion3511of therapeutic material3520out of a vasculature. (Apart from such portions, for example, a remainder3512of such material may be metabolized, captured locally in tissues, and/or otherwise handled by natural processes.)

An embodiment provides one or more units3510as artificial structures configured to administer a therapeutic material3520containing at least an artificial component3530via one or more capillaries of a vasculature locally and one or more units3580as artificial structures configured to extract a portion of the therapeutic material out of the vasculature. One or more such units3510may (optionally) include one or more conduits3504configured to administer the therapeutic material3520via 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 a unit3510may include one or more reservoirs3508containing at least a (systemically) lethal amount of artificial component3530, which amount which may be dispensed locally and then extracted in portion3511. Alternatively or additionally, such a unit may comprise an antineoplastic agent dispenser. Alternatively or additionally, such an artificial component3530may include a supplemental or other quantity of a hormone effective for a therapy upon site3471, for example. In some variants, the embodiment may further include a probe3537or other structure configured to facilitate positioning at least a distal portion of conduit3504through an arterial segment of the vasculature. Alternatively or additionally, such an embodiment may include one or more units3580configured to extract some portion3511of therapeutic material3520physically out of a vasculature or otherwise to filter a blood flow. Alternatively or additionally, the embodiment may include module3551configured as circuitry for detecting a release of therapeutic material3520and/or module3552configured as circuitry for detecting a presence of therapeutic material3520. Other such embodiments are described, for example, with reference toFIGS. 10,11,19, and20.

An embodiment provides an in-dwelling catheter or other artificial structure3455comprising at least unit3510configured to administer a therapeutic material3520containing oxyhemoglobin3523(or some other form of dioxygen acceptable for administration to a living subject3400via a vasculature) and an artificial component3530locally to a treatment site3471via one or more capillary beds3470. (Other such embodiments are described, for example, with reference toFIGS. 24and/or33.) In some contexts, unit3510may further include one or more of a flow sensor2471, a force sensor2484, a sonic sensor2495, an in-dwelling catheter comprising distal portion3456, a pressure sensor, or other implantable components as described herein. Some variants may further include or otherwise interact with unit3540, which may comprise one or more instances of notification logic3535configured to transmit a notification3533relating to the first unit3510(via a network as described herein, e.g.), imaging apparatuses3536configured to facilitate positioning some or all of unit3510(locally to and) upstream or downstream from a target treatment site3471, or a probe3537for moving one or more units3510,3540,3560,3580into selected positions in or near vasculature3465.

A variant embodiment provides an artificial structure comprising one or more instances of unit3510configured to administer (an anticoagulant or other artificial components3530of) therapeutic materials3520locally via capillaries. Another artificial structure comprising unit3580may include one or more dispensation ports3578configured to extract a portion3511of the therapeutic material(s)3520out of a vasculature, such as by “getter”-type removal. Alternatively or additionally, such units3580may comprise absorption ports3577or other blood filtration devices3576configured to extract portion3511of the therapeutic material(s)3520physically out of the vasculature3465. Such configurations may permit such high dosages that a reservoir3508may contain a (systemically) lethal amount of the artificial component3530, in a context in which a remainder3512will constitute a non-lethal dose. In contexts like that ofFIG. 34, unit3510may further include one or more transvascular conduits3504configured to administer therapeutic material3520via one or more venules3495of the vasculature3465locally to the one or more capillaries.

With reference now toFIGS. 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. System3600may include one or more elongate structures comprising one or more instances of dispensers3635, thermal or other treatment elements3655, and/or balloons3654guided at least partly along a blood flow3699of vasculature3665. Subsequently, atFIG. 37, therapeutic material3720may be administered locally and/or one or more balloons3654or other occlusion structures may occlude flow3699temporarily.

An embodiment provides an occlusive structure operable to impede a flow3699exiting one or more segments3661,3662of a vasculature3665and a dispenser3635and/or other treatment elements3655operable to administer chilling or other therapies locally at segment3662. (Other such embodiments are described, for example, with reference toFIG. 116.) The system may likewise include a controller3620, optionally operable selectively to invoke one or more instances of modules3621configured to trigger the balloon3654or other occlusive structure to impede flow3699; modules3622configured to trigger the dispenser3635or other therapeutic structure(s); and/or modules3623configured 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, system3800comprises a plurality of dispensers3821,3831operatively coupled with a control module3820within body3830, positioned adjacent a forked vessel3840of vasculature3805. As shown, a dispenser3821is configured to dispense a lytic agent through one or more conduits3822extending into an upstream portion of vessel3840, the conduit(s) secured in place by a bioadhesive or other positioning feature3823. Dispenser3831is likewise configured to dispense (at least) a lytic agent inhibitor through one or more conduits3832extending into a downstream portion of vessel3840, the conduit(s) secured in place by a similar positioning feature3833.

With reference now toFIG. 39, shown is an example of a monitoring and/or control instrument3900configured to handle one or more instances of (one or more) indicators3971,3972,3973,3974or other sensor data3970. Instrument3900may, for example, comprise one or more instances of control logic3980(such as modules3981,3982), probes3987, imaging apparatuses3988, or notification logic3991operable for handling one or more notifications3992as described herein, optionally including one or more 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.33and40-50.

With reference now toFIG. 40, shown is an example of a system4000comprising one or more dispensers4010,4020configured to dispense materials (transvascularly) into respective branches of an artery or other large blood vessel4005. Such dispensers may, in some variants, be secured in a vicinity of a vessel by one or more sleeves4009or other such positioning features. In response to one or more dispensation criteria as described below, control module4060is configured to permit a fluid communication between a pressurized reservoir4050and one or more plungers4041,4042configured 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, a plunger4140exerts force (leftward as shown) upon injectable fluid4160so that needle4132slides along tapered body4130(downward as shown). In response to pressure from needle4132and/or fluid4245(saline, e.g.), as shown inFIG. 42, a containment film4287breaks. As shown inFIG. 43, needle4132pierces blood vessel wall4306. As shown inFIG. 44, a portion of injectable fluid4160becomes dispensation4475at a somewhat lower pressure than that initially present in pressure transfer fluid4446. In some variants, needle4132comprises a blood-soluble portion coated with a film configured so that abrasion with tapered body4130exposes 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 shown system4500may affect or otherwise relate to vicinity4505, section4530, vicinity4535, section4570, and vicinity4575of a vascular lumen4595through which one or more blood components may flow. One or more inflows4501of blood enter respective portions of lumen4595as shown, pass through sections4530,4570and exit as one or more outflows4599. In respective variants, arteries, veins, or smaller vessels of lumen4595may traverse respective vicinities4505,4535,4575as shown. Sections4530,4570may likewise comprise one or more capillary beds as well as implants or other entities with which lumen4595interacts.

In some variants, one or more upper modules4550in vicinity4535may (optionally) send data to and/or receive data from one or more instances of intravascular or other sensors4510in vicinity4505. Upper module4550may likewise comprise one or more instances of modules4513,4514of dispensing logic4515; dispensers4517,4518,4519; modules4521,4522of evaluation logic4520; transmitters4547, receivers4548, or other modules4541,4542,4543of interface logic4540; or modules4551,4552of response logic4555. Interface logic may handle data to output device4526and/or from input device4528as well interacting with one or more lower modules4590. Lower module4590may include one or more instances of microfluidic or other pumps4576, ports4577, dispensers4578, sensors4579, or semi-permeable membranes4581or other such modules4582or vessels4583of extraction 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 shown system4600may comprise a lumen4695comprising a heart valve4610including an annular base4607containing one or more dispensers4616, a ball4608, and one or more upper modules4650and lower modules4690operatively coupled as shown. Upper module4650may comprise one or more instances of dispensation logic4615, evaluation logic4620, or wireless communication modules4644or other interface logic4640operable for communication with one or more user interfaces4625; for transmitting data to one or more output devices4626or receiving data from one or more input devices4628thereof as shown. Lower module4690may comprise an optical sensor4675, an auditory sensor4676, or other sensors4677; or pressure or force sensors or other a flow-force-responsive elements4678or other elements4679as described herein.

An embodiment provides a system4600comprising dispensing logic4615or interface logic4640operable for signaling a decision whether to initiate implant-site-targeting treatment and one or more dispensers4616responsive to the decision. Each dispenser4616may (optionally) include a thrombolytic agent and/or other therapeutic materials as described herein, suitable for targeting a vicinity of valve4610. The above-described “signaling” circuitry may comprise one or more of optical 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 a system4600comprising interface logic4640operable 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, system4600comprising may similarly provide dispensing logic using such signaling, for example, for guiding one or more dispensers4616accordingly. Each dispenser4616may (optionally) contain a thrombolytic agent and/or other therapeutic materials as described herein, suitable for targeting a vicinity of valve4610. The above-described “signaling” circuitry may comprise one or more of optical 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 shown system4700comprises (a top view of) a valve4710having a dispenser4716in an upper portion thereof. Any of the embodiments described herein with reference toFIG. 45may effectively implement valve4710as a combination of upper module4550and lower module4590within lumen4595. Any of the embodiments described herein with reference toFIG. 112may effectively implement valve4710as module11250within lumen11295. Any of the embodiments described herein with reference toFIG. 116may effectively implement valve4710as module11660within lumen11695. Any of the embodiments described herein with reference toFIG. 108may effectively implement valve4710as module10890within lumen10895. Any of the embodiments described herein with reference toFIG. 28or108may likewise implement valve4710as module10890or system2800within lumen10895or vasculature2896.

With reference now toFIG. 48, shown is (a bottom view of) a variant of valve4710in which a dangerous, partially occlusive thrombus4716has formed. An embodiment provides one or more sensors4579in a lower module4590suitable for detecting thrombus4716and able to respond programmatically as described herein.

With reference now toFIG. 49, shown is (a bottom view of) a variant of valve4710in which thrombus4716has been prevented or removed as described herein. Valve4710is accordingly operable for opening and closing effectively in this configuration, unlike that ofFIG. 48.

With reference now toFIG. 50, shown is an implanted system5000in which one or more technologies may be implemented, a structure5090having a plurality of legs5020(optionally a variant of a “Gunther Tulip” inferior vena cava filter, for example) engaging a wall of a large vein5010. In response to detecting a large-enough clot5080(as a force increase, deformation, or other manifestation described herein, e.g.), one or more modules5035of control logic5040may cause a dispenser5050to inject a concentrated dose of lytic material5052locally from an upstream portion5051of system5000. Alternatively or additionally, one or more modules5065of notification logic5070may cause or enable a notification5075to 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 shown system module5100may comprise one or more thresholds5111,5112, criteria5115, filters5121,5122, or other conditions5125detectable by one or more modules5131,5132,5133of detection logic5135. Such logic may be implemented in hardware or software, for example, optionally configured for analyzing values from one or more event records5160, counters5173or other timing logic5175, or other such data. In some variants, for example, event record5160may associate one or more timestamps5161with measurements or other data5167,5168. Alternatively or additionally, such logic may analyze one or more other values5181, indicators5182, statuses5183, or other such data5184,5190of potential diagnostic utility.

With reference now toFIG. 52, shown is an example of a system5200comprising a system module5250operable for communicating to and/or from one or more sensors5201,5202,5203; other modules5210; aggregation modules5281; devices5291or other resources5292; or other portions of networks5280,5290. In some contexts, for example, such sensors may be (a) operatively coupled with system module5250via a conduit5208and/or (b) near a peripheral region5225or core of subject5220as shown. In some variants, system module5250may include one or more modules5231,5232,5233of configuration logic5235configured to handle one or more images5241, data5242, other responses5245, other data5251,5252,5253,5255as described herein, or other information5260of potential utility in diagnosing a living subject. Alternatively or additionally, system module5250may include one or more ports5261,5262or other features of interface5265; network linkages5285for interacting to and/or from networks; or thresholds5271,5272, operating parameters5275, or other comparative information5276potentially useful for diagnostic and/or monitoring purposes.

With reference now toFIG. 53, shown is an example of a sensor-containing device5310or other device5320at least sometimes in communication with one or more primary systems5380. In some variants, for example, one or more receivers5340,5350may be configured to receive one or more messages5341,5342or other information5345from such devices. Alternatively or additionally, primary system5380may include one or more controller cards or other computer modules5360implementing decision logic275,1350,1460,2250,2730,3230or other logic as described herein, for example, in hardware or software form. Primary system5380may likewise include one or more hand-held or other user interfaces5370for relaying notifications or other information to or from care providers or other users5390.

With reference now toFIG. 54, shown is an example of a recording system5400comprising one or more receivers5430for handling software or other modules5425, one or more records5450associating data5451,5452in a memory5440or storage unit5445, or timing information5470as described herein. In some contexts, for example, recording system5400may record or otherwise handle one or more 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 a system5500in which one or more technologies may be implemented, a configuration module5570wirelessly or otherwise operably coupled to one or more networks5580, external devices5591, or implants5597in subject5595. In some variants, configuration module may include one or more determinants5540in memory5541, storage5542, or other media5545. In various contexts as described below, for example, one or more instruction sequences5551or other modules5552of decision logic5555may behave in a manner that depends upon one or more of a type5511, date5512, status5513, or location5514of implant5597, or other such implant data5510, comparison data5531, parameters5532, or profile data5533as described herein. Alternatively or additionally, one or more5521, location indices5522, sensor types5523, mode identifiers5524,5525or other such monitoring information5520and/or status information5535may be received by one or more modules5561,5562,5563of receiver5565for potential use by diagnosticians and/or decision logic as described herein.

With reference now toFIG. 56, shown is a system5600in which one or more technologies may be implemented, configured to receive information from implant5690and/or to convey information to a subject or other user5695via one or more output devices5694(a speaker, e.g.). Support device5610may include one or more ports5623,5624, antennae5628, or other such communication components5620operable for handling one or more profiles5621,5622, commands5625,5626or other such information. Alternatively or additionally, support device5610may include one or more modules5634of decision logic5635or timing modules5641or other modules5644,5645of control logic5640suitable for handling data5642,5643as described herein. In some variants, detection logic5670of support device5610may likewise include one or more receivers5665or other modules5661,5668configured to handle one or more blood pressure measurements5651, flow rate measurements5652, or other such determinants5655that depend upon the implant(s)5690or other characteristics of subject5695.

With reference now toFIG. 57, shown is a system5700in which one or more technologies may be implemented, a local module5730configured to communicate signals5725to and/or from one or more sensors5701or other such elements5722in a region5710adjacent a blood vessel5709. This can facilitate detection of an embolus5708or other circulation-related features in blood5703, skin5706, or tissue5705. Such a local module5730may include one or more modules5741,5742,5751,5752of decision logic5750,5760operable for generating one or more decisions5745,5746. Such decisions may depend upon one or more material indicators5743,5762, quantity indicators5744, model numbers5761, or other type indications5770. Alternatively or additionally, such decisions may depend upon one or more measurements5771, ultrasonic signatures5772, impedance changes5773, symptom indicators5774, image sequences5785, or other such data5780,5790.

With reference now toFIG. 58, shown is a system5800comprising two or more coupled detection modules5860,5870configured to handle sensor data manifesting measurements or other attributes of a region5810adjacent blood vessel5809. In some variants, for example, detection module5860includes sensors5851,5852,5853as described herein operable to transmit the sensor data. Accordingly, detection module5870may be configured to handle one or more images5861,5862,5863or other shape-indicative data5865; one or more complaints5871, subject-provided input5872, secondary user input5873, or other such clot-indicative determinants; or other determinants5878or other indications5879comprising ischemia indicators5880. Detection module5870may further include one or more comparators5893or other modules5891,5892of invocation logic5895for sending and/or receiving a treatment indication5890, status-indicative information5896, or other components of messages5897,5898,5899. In various contexts as described herein, one or more such treatment indications5841or other messages5815,5825may be transmitted to or received from one or more stations5820, monitors5830, comparators5842, or other components of networks5840potentially remote from region5810.

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 a system5900comprising primary module5920configured to transmit output5983to and/or receive input5984from interface5980. Primary module5920may include one or more comparators5921, circuitry5922, module5923, or other decision logic5930,5940configured to generate one or more decisions5925or other data responsive to one or more criteria5907,5908,5909,5910. Alternatively or additionally, primary module5920may include one or more modules5961,5962,5963,5964of evaluation logic5965configured to generate metadata or other such information responsive to one or more such criteria. Such input or output data may, for example, comprise a succession5951or other indicatos5952,5953,5954,5955transmitted to or from primary module5920.

With reference now toFIG. 60, shown is an administration unit6010optionally comprising one or more primary modules described herein, and operatively coupled via a cord6077with a hand-held unit6080positionable adjacent a subject6090. In some variants, for example, hand-held unit6080may include one or more sensors or logic as described herein. Alternatively or additionally, hand-held unit6080may include one or more dispensers6075of a vasodilator6071, lytic agent6072, or other such therapeutic components6073(operatively controlled via cord6077, e.g.). Administration unit6010may include one or more microphones6021, speakers6022, or other modules6023of interface6020configured to convey output6024or other indications6025. Such information may be guided by one or more interaction protocols6043or other modules6041,6042of decision logic6050. Alternatively or additionally, such information may be guided by one or more results6031,6032,6033,6034from comparator6030and/or by one or more body part identifiers6061, seat identifiers6062, global positioning system (GPS) coordinates6063, or other such location indicators6060.

In some variants, hand-held unit6080may 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 a system6100in which one or more technologies may be implemented comprising one or more location sensors6101, flow attribute sensors6102, approvals6103, or other such input components to one or more modules6104,6105,6121,6122,6123of detection logic6110or invocation logic6120. System6100may further include one or more instances of decisions6133generated by one or more modules6131,6132responsive to a fulfillment of one or more regimens6134. Alternatively or additionally, system6100may further include one or more instances of initiations6151, updates6152, indications6171,6172,6173, or other notifications6160,6170configured and/or triggered by one or more modules6181,6182,6183of notification 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 an administration system6200comprising one or more modules6201,6202of evaluation logic6210configured to generate one or more results6260in response to an evaluation of one or more distributions6211,6212,6221,6222with one or more signals6231,6232, current flow-indicative data6233, historical data6234, or other such diagnostically relevant parameters as described herein. Alternatively or additionally, one or more differences6251,6252, positional information6253, timing information6254, change rates6255, indicators6256,6257or other results6260may manifest or otherwise stem from a set6244of one or more regimens6241,6242,6243(selected as input6292from user6290at a user interface element6291, e.g.). Such results6260can likewise manifest or otherwise stem from one or more measurements6271, images6272,6273, values6274,6275, requests6276, or other such input data6280(from one or more users6290and/or expert system modules6294, e.g.). In some variants, for example, one or more modules6245of decision logic6240may (a) define a default set of regimens in response to a pathological state indication6296or other such data from network6295and/or (b) permit the user(s) to configure the set6244selectively as a mode of dispensation control.

With reference now toFIG. 63, shown is a system6300comprising a mediation module6310, such as may be configured to facilitate data aggregation or other such data-transformative interaction between one or more networks6390and a primary or other local system as described herein. Mediation module6310may include one or more recorders6311; ports6321, modules6322,6323or other invocation logic6320; or modules6332,6333or other processing logic6330, such as for applying a threshold6331. Such components may, for example, trigger a recording or analysis in response to one or more instances of limb pain indications6344, cooling indication6345, swelling indications6346, dispensation indications6347, discoloration indications6348, symptom indications6349, decibel measurements6351,6352, timing data6361,6362,6363, 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 as confirmatory measurements6353or 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 logic6320may trigger one or more decisions6391,6392or other responses from decision logic6395, a remote evaluation module6396, or other such entities. Alternatively or additionally, some or all such data6340may be transmitted to network6390, for example, to permit such recording or other functions to be performed remotely.

With reference now toFIG. 64, shown is a network6400comprising a plurality of addressable destinations6401,6402supported by one or more server systems6490. In some variants, server system6490may include one or more modules6421,6422,6423,6454,6461of notification logic6420, invocation logic6455, or evaluation logic6460. Such logic may generate one or more risk indicators6431,6432and/or data samples6441,6442,6443comprising signals6445, or other such components of notifications6440,6450including or otherwise manifesting one or more marginal probabilities6462, thresholds6463, composite indicators6491, measurements6492, availability data6493, timing data6494, or other such data6495useful 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 an interface6500in 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 or more comparators6521,6522or other evaluation logic6520configured to facilitate an application of one or more criteria6523for decisions or other evaluations as described below. Alternatively or additionally, such an interface may include one or more modules6538or other notification logic6540configured to enable, trigger, configure, or otherwise facilitate one or more notifications6544as described herein.

With reference now toFIG. 66, shown is a detection system6650comprising one or more modules6661,6662of processing logic6660configured to interact with a module6680positioned on skin6690of subject6670. Such modules may include one or more sensors6681configured to derive shape or other detectable attributes of a region6691at a first end of a segment of a vessel6696as shown, one or more sensors6683configured to derive shape or other detectable attributes of a region6693at a second end of the segment as shown, and/or one or more sensors6682configured to derive shape or other detectable attributes of a region6692at a middle portion of the segment of as shown. One or more such sensors6681,6682,6683may provide signals from which such logic may derive one or more flow-indicative or other images6664or other such circulatory indications6663, for example, via any of several existing technologies.

With reference now toFIG. 67, shown is a configuration system6710comprising one or more modules6731,6732,6733or other detection logic6720configured to detect one or more rates6721, indications6722, categorical attributes6725, quantitative attributes6726, or other such values6723or other data6724indicative of pathologies, therapies, or other such manifestations of conditions described herein. Alternatively or additionally, configuration system6710may include one or more interfaces6740,6750configured to transmit data to and/or from a user, a dispenser6780or other device6790for use in proximity to a subject, or other such resources. In some variants, configuration system6710may likewise include one or more sequences6761,6762, protocols6763, device settings6771, or other such parametric forms configured to guide one or more modules6772,6773,6774of control logic6770as described herein.

With reference now toFIG. 68, shown is a filtration system6800configured to provide via one or more returns6805at least a portion of a bodily fluid received via one or more inlets6895. In some variants, filtration system6800may include one or more instances of sensors6815,6865in a vicinity of an air trap6820and/or fluid pump6870. Alternatively or additionally, filtration system6800may likewise include one or more dispenser inlets6885, membranes6840for use in or more filter units6850, or other such mechanisms for adding or removing solid or other components of the fluid.

With reference now toFIG. 69, shown is a dialyser6910in which one or more technologies may be implemented. Dialyser6910may be configured to provide via one or more fluid returns6942a portion of a flow6943received via one or more fluid inlets6941. Another portion of flow6943merges into a flow6933between the dialysate inlet(s)6931and dialysate return(s)6932through one or more membranes6940.

With reference now toFIG. 70, shown is another type of transfer system7000in which one or more technologies may be implemented. One or more valves7050, pumps7060, or other actuators7045,7055guide blood selectively from inlet7005toward return7091, outlet7092, or extraction unit7080. One or more modules7031,7032,7033of control logic7030control such actuation and/or an operation of one or more dispensers7020as described herein. Flow into such extraction units7080may come into contact with one or more foams7071, fibers7072, or other such materials7073effective for removing a sample or potentially toxic portion, which can then be removed or guided toward outlet7094. Alternatively or additionally a remaining portion may be guided back toward transfer unit7010(via recovery conduit7093) as shown. In some variants, transfer unit7010may 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 one primary unit7110operable for communication to and/or from one or more delivery units7180. Delivery unit7180may include one or more reservoirs7181, actuators7182, iontophoretic modules7183, or pumps7184in a delivery range of subject7190. In some variants, for example, one or more modules7121,7122,7123of control logic7120may transmit one or more activation signals7171to cause a test or other therapeutic regimen relating to subject7190. Alternatively or additionally, one or more modules7135of communication logic7140may receive measurement data7133or other data7131, optionally as a component of a wireless signal7132or other monitoring signal(s)7172received by communication logic7140in relation to delivery unit7180. Alternatively or additionally, such logic may selectively notify or otherwise interact with one or more resources7161,7162in network7160as described herein.

With reference now toFIG. 72, shown is dispensation system7200in which one or more technologies may be implemented. Control logic7270comprises one or more regimens7263or other modules7261,7262configured to enable and/or trigger components of one or more dispensers7290in response to one or more determinants7210as described herein. In some contexts, for example, one or more instances of regimen7263may call for tissue plasminogen activator7283or another lytic material7284to be dispensed unless a given systemic determinant7212manifests (D-dimer concentration exceeding a given threshold, e.g.) in relation to a subject. Alternatively or additionally, regimen7263may call for a dispensation from another reservoir7285in 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 or more actuators7281, pumps7282, or other components of dispensers7290may be configured in response to these and other data7213,7214without undue experimentation, in light of these teachings.

With reference now toFIG. 73, shown is a subject7310for whom one or more technologies may be implemented. A (right) common carotid artery7350bifurcates into a flow7321through internal carotid artery7322and a flow7331through an external carotid artery7332. One or more sensors7345may 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 subject7310and/or a warning or other advice to a caregiver or others in a vicinity of subject7310.

With reference now toFIG. 74, shown is a distributed system7400in which one or more technologies may be implemented comprising a server7410remote from an at-risk subject7495in network7490. In some variants, for example, one or more sensors7498or other modules7492may be configured to detect or otherwise interact with an afflicted region7496on a limb of a subject7495. Alternatively or additionally, external device7491or other such modules7493may be configured to facilitate communications7485to and/or from server7410and/or to detect systemic or complementary determinant conditions relating to subject7495.

In some variants, external device7491may comprise a vehicle of network7490configured 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, server7410may include one or more special-purpose circuits or other modules7411,7412of decision logic7415configured to generate one or more decisions7414in response to various indications7480as described herein. These may include one or more images7471, inputs7472, or other such sensor data or other data7473,7474,7475,7476,7477. Alternatively or additionally, scheduling logic7455or other notification logic7460may generate notifications7451,7452and/or other such consequential data7454derived from event counts7441, variable values7442used for computations as described herein, or other such information7450. In some contexts, such information may (optionally) include at least one succession7420of differences or other such indications7421,7422,7423computed, for example, from one or more successions7430of measurements7431,7432,7433or other values as exemplified below. Such successions7420,7430may 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 a local system7570configured to communicate with expert system7585or other parts of network7580in relation to one or more descriptors7581, scores7582, or inputs7583as described herein. Alternatively or additionally, network7580may contain one or more adjunct services7590configured to apply one or more standards7588to various indications7530or information7531,7532,7533,7534; determinants7535; or other data7537,7538transmitted across channel7575. In some variants, for example, such indications may include one or more images7510,7520having portions7511,7512,7521,7522of potential diagnostic utility recognizable by a remote specialist, a pattern recognition module, or other such entity. In some variants, local system7570may further include one or more extraction modules7545or other logic in a local interface7540configured to present abnormal indications selectively to a clinician, for example, holding an instrument7550(supporting one or more sensors7555in a vicinity of a subject7505, e.g.). Alternatively or additionally, local system7570may include one or more pattern recognition modules7564, interfaces7563, or other modules7561,7562of evaluation logic7565as described herein.

With reference now toFIG. 76, shown is a system7600in which one or more technologies may be implemented. A detection module7610as described herein may include one or more pressure sensors7621, stress-indicative sensors7622, or other sample sensors7625configured to generate values7631,7632, notification decisions7633or other such manifestations of preference, coordinates7634, or other status indicators7645relating to a subject. SeeFIGS. 23-26. Such information can, for example, be held in a circular buffer7651(as successive samples7661,7662,7663, for example) or other buffer7652,7653,7654configured to permit one or more condition detectors7670,7680,7690to apply standards7675,7685,7695as exemplified herein.

With reference now toFIG. 77, shown is a system7700comprising a primary module7790configured to accept indications7711,7712,7713,7714from one or more auditory or other sensors7717in, on or about a subject7710of 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, inputs7738,7739or other information7745as described herein may include one or more categories7731, responses7732, verifications7733, distributions7734, or other such data7741suitable for inclusion, for example, as content7771of a notification7775. Alternatively or additionally, one or more modules7751,7752or other configuration logic7755may maintain one or more images7761, apply one or more thresholds7762, or otherwise provide one or more indications7780or notification destinations7785in response to then-current contents of memory7765.

In some variants, system7700may 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 a system7800comprising one or more modules7820,7825in communication with a hub7830having access to one or more networks7890. In some variants, for example, a module7820positioned on or near a subject may include one or more sensors7821,7822,7823,7824operable for transmitting one or more images7831,7832(depicting zone7839, e.g.), counts7841, outputs7837from sensors, indicators7843, thresholds7845or other factors7842to be applied, or other such determinants7850. Alternatively or additionally, hub7830may receive (via one or more interfaces7860, e.g.) one or more categories7844or other such input7834from a user or other local entity. In response to such determinants, one or more modules7871,7872,7873,7874of notification logic7875may configure one or more notifications7868for local delivery (via interface7860, e.g.) and/or delivery to one or more interfaces7880or logging modules7885of network7890. In some contexts, module7872may configure notification7864to include a raw sample of slurred speech7864provided by a subject in response to programmatic queries, for example, or other such content7865of 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 a system7900comprising one or more local modules7931,7932each in a vicinity of one or more body parts7921,7922of subject7920. In some contexts, such local modules7932may include one or more sensors, support elements, dispensers, or other such elements7933positioned in contact with or otherwise adjacent a body part7922of interest. In various applications, detection logic7940may include one or more instances of configuration modules7942, control modules7951, invocation modules7967, notification modules7968, or various recognition modules7981,7982,7983configured to process auditory information7941or other input data as described herein. Detection logic7940may (optionally) include one or more evaluation modules7952configured to implement one or more computed results7961, comparison results7962, user selections, or other such evaluation results7963. Such results may arise from a recognition of one or more patterns7971,7972,7973,7974,7975or profiles7970(combinations of patterns, e.g.) evident in data7991,7992,7993,7994,7995,7996residing in memory7998. In some variants, for example, recognition module7981may be configured to recognize one or more extended measurement trends or other such pathological patterns7971even in data7993still in a normal range, in some contexts. Alternatively or additionally, one or more recognition modules7982may be configured to detect a shape, color, or other optical pattern7975characteristic of a scar, birthmark, or other common and/or unchanging irregularity manifested in data7996and 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 a system8000comprising one or more modules8001,8002of extraction logic8010configured to process one or more samplings8014, distillations8015, measurements8016,8017,8018, identifiers8019, or other such output8011,8012from 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 information8020,8030may further include one or more instances of programmatic advice8032, ratios8034, computations8036, or other such components of notifications8038. In some variants, for example, at least one distribution module8050may be configured to use such information to select one or more destinations8041,8042among a plurality of destinations8041,8042,8043in response to these or other criteria8064(defined in one or more subscriber profiles8061, e.g.) or to a client list8067. Alternatively or additionally, notification logic1290,3535,3991,6180,7460,7875or other responsive logic described herein may use one or more such determinants8068to select among one or more databases8081or other secondary information sources8080to 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 a system8100in which one or more technologies may be implemented. Respective information8161,8162may be obtained about two or more body parts8108,8109respectively containing blood vessels8118,8119of a vasculature8110of a mammal8103. Circuitry8170configured to receive such information8161,8162may include one or more instances of modules8151,8152, response logic8168, or modules8172,8173,8174of decision logic8171.

With reference now toFIG. 82, shown is a flow8200comprising operation8240—obtaining local respiratory-status-indicative information about a first body part of a subject (e.g. response logic8168receiving one or more measurements or other information8161indicative 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 which response logic8168receives the information8161via a sensor-containing module8151or other direct mode of observation.

Operation8270describes 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. module8172of decision logic8171triggering one or more other modules8174to compare information8161with information8162received from another module8152configured for observing another body part8109in a vicinity of blood vessel8119). This can occur, for example, in a context in which decision logic8174receives at least some of the information8161about body part8108via response logic8168and in which one or more modules8172,8174of decision logic8171perform such a comparison within a proximity of mammal8103. 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 the modules8174of decision logic8171may 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.

With reference now toFIG. 83, there are shown several variants of the flow8200ofFIG. 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:8346or8348. In some embodiments, variants of operation8240may be performed by one or more instances of processing modules1430,1650,1680; response modules1620; or decision logic275,1350,1460,2250,2730,3230,5750,5930,6130,6395,7415. Flow8200may likewise (optionally) include one or more of the following operations:8391,8394or8397. Alternatively or additionally, flow8200may be performed in a context as described above with reference to any ofFIGS. 1-80and/or in conjunction with other flow variants as described below.

Operation8346describes receiving subject-provided data as the local respiratory-status-indicative information (e.g. term recognition module1625or other components of response module1620receiving subject-provided data2921,2922directly or indirectly from one or more interfaces2962or other instruments2930). This can occur, for example, in a context in which an instance of primary module1600ofFIG. 16resides within network2995and performs operation8240by interacting with one or more instruments2930in a proximity of subjects. In some variants, for example, a software or other term recognition module1625identifies one or more diagnoses or other symptom-indicative parameters1624within a subject's speech or other communication2935. Alternatively or additionally, one or more other modules1621may be configured to record, report, or otherwise respond to such communication2935conditionally as described herein, such as by a timely reciprocal communication2935with subject2920. In some variants, moreover, one or more handheld devices2961or other interfaces2962may perform operation8346in relation to a subject within a proximity thereof, such as by receiving keyed or other 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”).

Operation8348describes activating one or more sensor-containing modules in a vicinity of the first body part of the subject (e.g. linking module1690transmitting a sonic, optical, or other activation signal1693to an implant1730or other suitable device within a proximity of tissue1725of subject1720). This can occur, for example, in embodiments in which such an implant1730or hand-held instrument1760implements one or more primary modules1600, in which such signals1693trigger or otherwise enable an effective image capture or other detection operation as described herein via one or more transducers1767or other 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 to software1974or other such measurement logic1975operable for performing operation8348by detecting a status or other attribute of limb1722or other body parts1920within 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”).

Operation8391describes 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. module1441of decision logic1460deciding whether to send one or more notices1472via transmitter1473in response to one or more comparators1431,1433). This can occur, for example, in a context in which decision logic1460performs operation8270, in which an interface or other component of remote module3190(ofFIG. 31) is configured to receive notice1471,1472or other output1485, and in which the filtering information applied by such comparators1431,1433may 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, module1441may be configured to cause local interface1475to display or otherwise reveal one or more such 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”).

Operation8394describes 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. module8173of decision logic8171causing a recordation of output1485from one or more subtraction modules or other comparators1433that receive such inputs). This can occur, for example, in a context in which one or more rotating storage media or other storage devices1492are operatively coupled directly or indirectly to primary module1400, in which primary module1400includes or otherwise interacts with circuitry8170, and in which module8173of decision logic8171is configured to invoke device1492for 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 output1485may 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”).

Operation8397describes 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. module3221of decision logic3230determining that no cellular-respiration-abnormality-indicative criteria3227are apparently satisfied by recent measurements3238of 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 part3272of subject3270and in which such specific detection may help avoid damage to a subject's heart or brain. In one variant, one or more comparison results3233,3235are correlated with one or more prior comparison results3231,3232or other historic filtering information to avoid a (false) positive notification3212about 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 the flow8200ofFIG. 82or83. 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:8443or8447. In some embodiments, variants of operation8240may be performed by one or more instances of processing modules1430,1650,1680; transducers1990; or local 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:8471,8474,8476or8479. In some embodiments, variants of operation8270may be performed by invocation logic3140and/or by one or more instances of decision logic275,1350,1460,2250,2730,3230,5750,5930,6130,6395,7415. Alternatively or additionally, flow8200may be performed in a context as described above with reference to any ofFIGS. 1-80and/or in conjunction with other flow variants as described below.

Operation8443describes obtaining at least some of the local respiratory-status-indicative information via one or more optical sensors (e.g. one or more infrared sensors1982or other transducers1990detecting calorimetric or other optical data1978indicating an oxygenation of blood1923in one or more arteries or other vessels1929upstream of a subject's brain or other organ1927). This can occur, for example, in embodiments in which one or more instances of interface logic1970perform operation8240by sensing or otherwise obtaining indications of blood or other materials from within tissue1925, such as by implant1940and/or an instrument as described herein. Alternatively or additionally, one or more component modules1621,1622of response module1620ofFIG. 16may perform operation8443by triggering processing module1680to derive the local respiratory-status-indicative information from such indications. This can occur, for example, in embodiments in which decision logic1460ofFIG. 14performs operation8270with other respiratory-status-indicative information1456as described herein, such as may be provided by linking module1690in a context in which primary module1600(ofFIG. 16) comprises one or more instances of interface logic1970(ofFIG. 19) in network1490. Alternatively or additionally, processing module1430may receive fluid movement data1453, pressure-fluctuation data1452, or other such information1455indicative of an apparently healthy flow of blood1923through a vital organ1927or other tissue1925.

Operation8447describes obtaining an indication of a respiratory status within a limb as the local respiratory-status-indicative information (e.g. registry1685receiving one or more readings1681,1682from a vessel1929routing blood1923to or from limb tissue). This can occur, for example, in embodiments in which primary system1600(ofFIG. 16) includes or otherwise interacts with an instrument1960configured to monitor a subject's limb, in which one or more such readings are obtained by a transducer1767or other sensors1733and/or an implant1730or other instrument1760, and in which at least some of primary module1600performs operation8240using one or more readings1681,1682and/or information derived from such readings by processing module1680. Alternatively or additionally, subject-provided data2922received via a handheld device, microphone, or other component of interface2926may include an auditory or other identifier2923of 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 to operation8471.

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”).

Operation8471describes deriving the filtering information at least partly from respiratory-status-indicative information about a second body part of the subject (e.g. module3142adjusting one or more thresholds3167of filtering information3170to a higher value3165in response to a higher pressure measurement3132or other indication3130of a measurable attribute increase in a subject's limb1722). This can occur, for example, in a context in which invocation logic3140performs operation8270and in which one or more data filters3152,3189are configured to apply one or more such new values3165,3161to measurements3131or other respiratory status indicators3130obtained from another limb1721of the subject. Alternatively or additionally, some such thresholds3167or other values3155may 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”).

Operation8474describes causing at least one of the one or more comparisons to occur while the subject sleeps (e.g. invocation module1412directly or indirectly triggering one or more comparators1432,3198configured to determine whether a sleeping subject's current sense data1451apparently 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 more primary modules1400,3180receives sense data1451from sensors3284as described herein, such as by implementing system3200ofFIG. 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)3284and/or detection logic3285of apparatus3290may make basic or coarse determinations locally and frequently. In various embodiments as described herein, one or more criteria3226,3287may 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 apparatus3290to filtering module3210, or whether to invoke other modules or protocols as described herein. Invocation module1412may (optionally) be configured for triggering one or more comparators remotely if and only if one or more other comparators1432signals a positive result, for example. Alternatively or additionally, invocation module1442can be implemented in a system comprising one or more of an adhesive3282, a wearable or other manipulable apparatus3290, a bed or other item3150of furniture, a detection module1411operable for determining whether a subject is apparently asleep, a vehicle1470as 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. 7,189,204 (“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”).

Operation8476describes 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 or more modules3142,3143triggering one or more results3136,3137of one or more comparisons between earlier indications3115,3183and later indications3125,3184of flow in the subject). This can occur, for example, in a context in which one or more such indications3183-3185are extracted from measurements or other event-indicative records3110,3120, in which invocation logic3140performs operation8270by invoking evaluation logic3197(remotely) or other data filters3151that perform such comparisons. Such filtering information3170may (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.

Operation8479describes 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. module3141transmitting one or more indications3181,3182of an apparent respiratory status of a part of a subject's body to enable remote module3190to compare such indications each against one or more comparative determinants as described herein). This can occur, for example, in a context in which invocation logic3140performs operation8270, in which system300ofFIG. 3implements primary module3180, and in which one or more instances of remote modules3190receive indications of age, pathology, gender, risk profile, or other such categories or measurements1458of determinant data1459relating to each of one or more subjects310,320to be used in the comparison(s). In some variants, for example, remote module3190may implement a data aggregator, expert system, and/or other system described herein operable for analyzing one or more indications311-314of a current status of the legs of subject310. 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 an indication314of a respiratory deficiency in a left thigh in response to a corresponding indication312of 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. 8orFIG. 2includes primary 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 information1457suitable for use by such caregivers.

With reference now toFIG. 85, shown is a system8500in which one or more technologies may be implemented. An adhesive, rigid, or other mesh8531is configured to hold one or more sensors8561,8562, modules8563, or other such structures on or near a subject's skin8502as described herein. Alternatively or additionally, special-purpose or other circuitry8590may include one or more instances of interface8575, memory8578, communication ports8579, decision logic8585, filtering criteria8588, or other such structures described herein, for example, configured to receive information8521,8522along respective conduits or other signal paths8538. Data8573,8574may include one or more instances of measurements8571and/or shape-indicative images8572in some variants, for example. Decision logic8585may likewise handle one or more notifications8581, modules8582, or decisions8583as described below.

With reference now toFIG. 86, shown is a flow8600comprising operation8610—obtaining local thermal information about a peripheral part of a body of a subject (e.g. interface8575receiving one or more measurements8571, infrared images8572, or other information8521,8522indicating local thermal variations in respective portions of the subject's skin8502). This can occur, for example, in a context in which mesh8531is configured to bear the subject's weight and/or hold one or more sensors8561,8562or other modules8563adjacent the subject's skin8502. In some variants, for example, interface8575may apply one or more filtering criteria8588for extracting a selection or other indication of such data8573,8574for transmission to memory8578, communication port8579, and/or decision logic8585. Alternatively or additionally, such data8574may (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”).

Operation8660describes 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 logic8585queuing or otherwise causing a transmission of one or more notifications8581only if module8582generates an affirmative decision8583). This can occur, for example, in a context in which circuitry8590is physically implemented within module8563or otherwise near mesh8531, in which one or more filtering criteria8588are suitable for use with at least some thermal component of data8573,8574, and in which module8582will 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 of decision logic8585may 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's skin8502apparently indicates a localized area of persistent warmth or coolness. Alternatively or additionally, an instance of decision logic8585may 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 which circuitry8590is implemented in a distributed configuration, moreover, one or more modules of decision logic8585may 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.

With reference now toFIG. 87, there are shown several variants of the flow8600ofFIG. 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:8713or8717. In some embodiments, variants of operation8610may be performed by one or more instances of local modules2320,2450,2510,2690configured to handle sensor data; event detection logic2333or other 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:8762,8763,8765or8769. In some embodiments, variants of operation8660may be performed by one or more instances of evaluation 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, flow8600may be performed in a context as described above with reference to any ofFIGS. 1-80and/or in conjunction with other flow variants as described below.

Operation8713describes obtaining a first thermal indicator in association with a first location and a second thermal indicator in association with a second location (e.g. sensors126,127,128taking temperature-indicative readings at their respective locations in zones111,112,113). This can occur, for example, in embodiments in which module141performs operation8610and in which comparator130performs operation8660by applying filtering information131to the thermal, temporal, and other data from the sensors. Alternatively or additionally, module141may perform operation8713by receiving a thermal image of a subject's limb or other such data associated with a range of locations.

Operation8717describes capturing one or more shape-indicative images in the local thermal information about the peripheral part of the body of the subject (e.g. recorder148recording one or more images1697from 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 of infrared sensors1982or other optical sensors are configured to apply respective-set-specific intensity thresholds1651,1653and/or frequency 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 attributes1699of developing infections, circulatory problems, or other such thermally detectable local abnormalities105.

Operation8762describes 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 or more modules1531of evaluation logic1530deciding whether to transmit notification1580in the negative responsive to one or more results1523of applying one or more thresholds1561,1562or other criteria1573). This can occur, for example, in a context in which the result(s)1523indicate a normal thermal measurement relative to one or more normality thresholds1561such 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 more such modules1531,1532may be configured to generate such a negative decision in response to a prior notification recipient or other user's response directing or otherwise warranting that notification1580not 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”).

Operation8763describes associating the subject with one or more of a duration indicator or a pathology indicator (e.g. module3061providing access to table3010or other structures3020operable for containing or otherwise facilitating one or more duration or pathology indicators3023,3024or other event or status indicators3022responsive to one or more subject identifiers3034or other search terms3030). This can occur, for example, in a context in which at least some such indicators reside in a common record3013satisfying one or more 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”).

Operation8765describes 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 or more modules1534selecting one or more first-type destinations1583,1591in response to a comparison result1522and otherwise selecting one or more second-type destinations1584,1592). This can occur, for example, in a triage protocol in which such results1522respectively reflect greater and lesser degrees of urgency or in which the second-type destination1584of notification1580identifies 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, module1534may likewise select among risk-indicative data1553or other available content1581,1582for inclusion in each such notification in response to one or more other evaluation results1521as 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”).

Operation8769describes generating the filtering information partly based on the attribute of the subject and partly based on an attribute of a caregiver (e.g. module2244configuring one or more parameters2247,2248in response to one or more indications2261,2263of the subject's age or apparent pathology and in response to one or more indications2262,2264of a notification recipient's apparent availability). This can occur, for example, in contexts in which decision logic2250performs operation8660and in which (a) an indication2261of an elderly or otherwise at-risk patient and/or (b) an indication2262of 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 other such indications2263,2264may 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 the flow8600ofFIG. 86or87. 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:8812or8819. In some embodiments, variants of operation8610may be performed by one or more instances of interface2260; 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:8861,8864,8867or8868. In some embodiments, variants of operation8660may be performed by one or more modules251of evaluation logic150,250,950,1530,7565; processing logic1180,3070; or other circuitry or software as described herein. Alternatively or additionally, flow8600may be performed in a context as described above with reference to any ofFIGS. 1-80and/or in conjunction with other flow variants as described below.

Operation8812describes 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. port2255receiving one or more results2251,2252from a server2220, interface2210, or other resource that is remote from subject2270). This can occur, for example, in a context in which sensors2268and/or interface2260facilitates measurements or other indications2261-2264being taken from a limb or other peripheral body part2271and from another such body part2272of 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 a proximity2277of such 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 of such body parts2271,2272, optionally in response to audible directions transmitted via an output device such as speaker2267. 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”).

Operation8819describes obtaining a current indication of a core temperature of the body of the subject (e.g. one or more thermometers or other sensors3284taking one or measurements3238indicative of a core temperature of subject3270such as tympanic membrane and/or basal temperature data3261). This can occur, for example, in a context in which decision logic3230and/or apparatus3290perform operation8610and in which one or more modules3222of decision logic3230are configured to determine whether a detected temperature change in a peripheral or other body part3272apparently reflects a circadian or other systemic phenomenon. Alternatively or additionally, one or more other modules3223may apply decision criteria3226or other such filtering information derived from other subjects of a common subpopulation (e.g. of the same age as subject3270), from other data3262from one or more comparable body parts3271of the same subject3270, and/or from earlier-acquired data3263from the same peripheral part3272as described herein.

Operation8861describes recording the decision whether to transmit the notification with a timestamp (e.g. module3063recording an affirmative or other decision3004contemporaneous with a date or other indication3005of when such decisions were made or communicated). This can occur, for example, in a context in which system200ofFIG. 2or other systems described herein implement module3063, with or without a common medium holding such modules or other elements. Alternatively or additionally, such records3011,3012,3013may likewise include one or more supporting items indicative of a destination, a content component, a success, or other such attributes of decision3004. In some variants, for example, indication3005may reflect one or more of (a) when operation8861was performed, (b) when decision3004was 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”).

Operation8864describes triggering a retrieval of the filtering information with an invocation that recites at least the attribute of the subject (e.g. module3062requesting or otherwise triggering a search for one or more records3012containing suitable quantitative information or other filtering data3090by transmitting one or more measurements3085as described herein or other indications3081,3082physically obtained from or otherwise specific to the subject). This can occur, for example, in a context in which decision logic275ofFIG. 2or response logic335ofFIG. 3implements processing logic3070configured to interact with any of subjects310,1720,1910,3270or others described herein and in which processing logic3070performs at least operation8660with reference to any of notifications2241,2242,3051,3052or others described herein. Alternatively or additionally, in some variants, one or more component indications3081of the filtering data3090may 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”).

Operation8867describes selecting the notification in response to the one or more comparisons between the filtering information and the local thermal information (e.g. one or more modules3064selecting notification3051only if the thermal information passes one or more criteria3035and notification3052otherwise, or only if the thermal information passes one or more other criteria). This can occur in a context in which circuitry280includes or otherwise interacts with interface3000ofFIG. 30, in which information271comprises the thermal information and reflects a circulatory obstruction or other pathology local to a limb or other peripheral body part, in which processing logic3070performs operation8660, and in which a circulatory obstruction may be difficult to locate and treat in time. In some variants, for example, one or more modules272,273of decision logic275may 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 from clock276.

Operation8868describes 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. module1535of evaluation logic1530configuring module1533to apply one or more lesion monitoring criteria1571,1572in monitoring incoming data1551responsive to data1552indicating 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 other such communication1539that 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 more such determinant indications1542may 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 other such indications1541of 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 a structure8910operable in conjunction with system8900, in which one or more technologies may be implemented. Structure8910may include one or more items of transportation or other equipment8915, beds8916, and/or handheld or other portable items8925. Such items may include hosiery, adhesive patches, or other such articles8926; bandages or other supports8927; or other such structures as described herein comprising one or more elements8920configured to provide information to and/or about such subjects.

In some variants, for example, system8900may comprise decision logic8955and/or interfaces8970operable for receiving or otherwise handling sensor data8935such as measurements8931, timing data8934, or other data8932,8933as described herein. System8900may receive such information8921,8922,8923or otherwise interact with such structures8910via one or more intermittent or other data paths8917,8918,8919. As described herein, decision logic8955may use some or all of such temperatures8951or other data8952as described herein, such as for causing module8962or other logic to configure or route notification8961or other data8965to one or more outputs8981,8982.

With reference now toFIG. 90, shown is a flow9000comprising operation9030—obtaining information indicating a current thermal condition in a peripheral part of a subject's body (e.g. decision logic8955receiving one or more temperatures8951or other such information8921,8922,8923via one or more portable items8925or other equipment8915within a proximity of the subject). This can occur, for example, in a context in which system8900implements or otherwise interacts with such structures8910, such as by one or more conduits or other signal paths8917,8918,8919. In some variants, for example, decision logic8955may reside within one or more worn articles8926, a bed8916, or other equipment8915configured to support some or all of a subject. Alternatively or additionally, one or more such structures8910may 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 of interface8970operable for interacting with (some) such subjects or other parties, such as by performing operation9090.

Operation9090describes 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. interface8970directing one or more notifications8961to one or more outputs8981corresponding to recipients who have requested or may otherwise benefit from such timely information). This can occur, for example, in a context in which decision logic8955has addressed the notifications or otherwise selected the output(s)8981according 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 with output8982may 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 of data8965, or some other aspect of configuring notification8961in response to a recipient's indication of availability as described herein.

With reference now toFIG. 91, there are shown several variants of the flow9000ofFIG. 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:9135or9137. In some embodiments, variants of operation9030may 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:9191,9193,9196or9199. In some embodiments, variants of operation9090may be performed by one or more instances of detection 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, flow9000may be performed in a context as described above with reference to any ofFIGS. 1-80and/or in conjunction with other flow variants as described below.

Operation9135describes determining that the information apparently manifests the current thermal condition in the peripheral part of the subject's body (e.g. evaluation module7952identifying abnormal-temperature-indicative data7991received from one or more components of local module7932and normal-temperature-indicative data7992received from local module7931). This can occur, for example, in a context in which configuration module7942and evaluation module7952jointly perform operation9030; in which other components of detection logic7940perform operation9090; in which evaluation module7952implicitly treats such data7991-7996as “current” and “spatially separated” for diagnostic purposes; in which at least two such local modules7931,7932each instantiate local module2510ofFIG. 25(local to subject7920, e.g.); and in which local module7932detects two or more physical phenomena as described herein from peripheral body part7922. In some variants, for example, one or more elements7933of such local modules7931,7932may comprise respective instances of temperature sensors2512or other sensors as shown inFIG. 25. Alternatively or additionally, some or all such data7991-7996may (optionally) include (a) color-indicative or other measurement data7994; (b) timestamps2544, coordinates2545, anatomical descriptions, shape data, or other such temporal or spatial 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”).

Operation9137describes 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. module8002of extraction logic8010selectively including one or more measurements8017or ratios8034or other measurement-based computations8036extracted from output8012of sensors or other detection circuitry as described herein). This can occur, for example, in a context in which a sampling8014, a distillation8015, one or more measurements8016,8017of particular interest, or some other subset of such output8012is 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 a blood pressure measurement8018, a range or other type identifier8019, and/or other such extracted information8020. Alternatively or additionally, such a notification may include advice8032, a recipient-appropriate translation, or other such categorical information8030extracted from a database8081or other such secondary information source8080using the extracted information8020, 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”).

Operation9191describes 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. module643of detection logic640sounding an alarm only if comparison result655indicates that any part of a subject's seat610is excessively hot or cold). This can occur, for example, in a context in which detection logic640is implemented in or otherwise coupled to respective portions of seat610via one or more signal paths631,632,633,634; in which module641and/or responsive logic650perform operation9030; in which detection logic640performs operation9090; in which monitoring apparatus660resides in or around seat610, 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 or more modules651of responsive logic650may enable such detection logic only when one or more such signal paths631-634indicate an occupant's weight or other indication that wheelchair600is occupied. Alternatively or additionally, seat610may include one or more instances of local module2510ofFIG. 25operable for transmitting comparison results, measurement data, or decisions as described herein along the signal path(s).

Operation9193describes signaling the decision by transmitting the notification to a portable interface (e.g. channel550transmitting one or more notifications541,542as described herein via one or more antennas549to one or more wearable or other portable interfaces7860,7880,580or other destinations535). This can occur, for example, in a context in which such a transmission results from one or more hybrid-data decisions531or other thermally-dependent decisions532and in which one or more controllers as described herein include one or more implementations of notification module510. In some variants, for example, some or all of the content544of such a notification may depend upon a type533of one or more such interfaces or other destinations535. Alternatively or additionally, such a decision may be signaled to a display element536or other configurable feature local to notification module510.

Operation9196describes ranking a higher-priority destination and a lower-priority destination for the notification (e.g. module7871ranking one or more nearby interfaces7860with a higher-priority category7844than that of one or more interfaces7880of network7890). This can occur, for example, in a context in which a notification7868is 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 that module7872does not receive input7834from 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 as logging module7885.

Operation9199describes signaling the decision whether to transmit the notification partly in response to auditory information from the subject's body (e.g. notification module510updating a party partly in response to recognition module7981indicating one or more comparison results7962and partly in response to recognition module7983indicating a recognition of one or more phrases or other patterns7973,7974in speech or other auditory information7941from subject7920). This can occur, for example, in a context in which such auditory information7941indicates that subject7920may currently be impaired and in which at least one such result7962of comparing abnormal-temperature-indicative data7991with historical or other filtering data indicates that a hot zone of peripheral body part7922has become measurably hotter and that peripheral body part7921has apparently remained in a normal condition. In some contexts, for example, such normality may be inferred from abnormal-temperature-indicative data7991not referring to part7921and/or not coming from one or more local modules7931in a vicinity of part7921. Alternatively or additionally, the decision may depend upon one or more other determinants such as (a) whether a current notification542differs from a prior notification541; (b) whether interface580indicates 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 the flow9000ofFIG. 90or91. 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:9231or9239. In some embodiments, variants of operation9030may be performed by one or more instances of local modules2320,2450,2510,2690,7931,7932or other modules7820configured 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:9292,9295,9297or9298. In some embodiments, variants of operation9090may 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, flow9000may be performed in a context as described above with reference to any ofFIGS. 1-80and/or in conjunction with other flow variants as described below.

Operation9231describes 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 image7831from infrared sensor7821or image7832from another optical sensor7822from 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. 23-27may be used for sensing diagnostically useful information contemporaneously relating to the same part of the subject's body.

Operation9239describes detecting that the information indicates normalcy as the current thermal condition in the peripheral part of the subject's body (e.g. one or more modules2977of decision logic2976indicating normalcy in response to receiving a high-enough and/or low-enough numerical value2987directly or indirectly from one or more sensors2927operable for detecting a temperature at an extremity of subject2920). This can occur, for example, in a context in which subject2920rests upon or otherwise interacts with instrument2930, in which decision logic2976is capable of detecting and indicating whether value2987is too far from a normal temperature, and in which transmitter2980is operable for performing operation9090. In some variants, for example, module2977may employ this information as a factor in deciding whether to transmit a notification to user interface2952or to other destinations. Alternatively or additionally, in various implementations as described herein, instrument2930may include one or more instances of response logic or other circuitry operable for responding conditionally to an identifier2923of a subject or other determinants in detected data2922.

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”).

Operation9292describes including auditory data with the notification (e.g. one or more modules7871-7874of notification logic7875configuring notification7868to include speech7864or other audible data with other content7865of notification7868delivered to one or more interfaces7860,7880). This can occur, for example, in a context in which notification logic7875performs at least operation9090and 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, output7837from a microphone or other sensor7824may 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, content7865provided with a notification7868may 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”).

Operation9295describes selecting one or more destinations for the notification (e.g. distribution module8050selecting one or more destinations8041,8042using client list8067or other determinants as described herein). This can occur, for example, in a context in which an aircraft or other system800implements system8000(ofFIG. 80) and in which one or more preferences of a client system, member, or other interested party are registered for notification via subscriber profile8061or other such indication. In some variants, for example, a passenger in seat814of cabin810registers for notification of changes in physiological parameters signaled by indication823and may receive a notification8038via local 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 a notification8038, for example via interface890. 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”).

Operation9297describes including thermal-decrease-size-indicative information with the notification (e.g. module8962including a number of degrees or other data8965received as information8922,8923from one or more portable items8925indicating 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, or other information8921relating to a subject as described herein.

Operation9298describes including spatial-size-indicative information with the notification (e.g. module7874of notification logic7875including one or more of a scaling factor7842or other areal indicator7843, photographs or other images7831,7832, a volumetric or shape-descriptive category7844, and/or other such information included in or appended to content7865of notification7868). This can occur, for example, in a context in which interface7860performs operation9030, in which module7873decides whether to transmit the notification, in which notification logic7875performs operation9090, and in which a subject cannot communicate such information and/or otherwise address a pathology. In some variants, for example, module7873signals in the affirmative if a hot zone7839of an image7832is larger than threshold7845. Alternatively or additionally, the decision may likewise depend upon one or more of an iteration count7841or other indicator of duration, user input7834, a concentration or other output7837from a chemical sensor7823, and/or other determinants7850as described herein.

With reference now toFIG. 93, shown is a system9300in which one or more technologies may be implemented, such as for interacting with external module9320to receive information via sensors9321,9322,9323,9324about one or more body parts9310. System9300may (optionally) include one or more values9311,9312,9313,9331,9332in an array9315or other indication9335; one or more modules9381,9382,9383,9384of compare logic9380; and/or one or more transmitters9390operable to schedule, transmit, identify, or otherwise signal one or more decisions9391,9392or notifications9393,9394as described herein.

With reference now toFIG. 94, shown is a flow9400comprising 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 module9320transmitting at least one value9331manifesting an increasing or decreasing force level in or on body part9310). This can occur, for example, in a context in which one or more external modules9320include one or more microwave 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 which external module2670implements local module2690ofFIG. 26, real-time data2681or force-indicative data2683may indicate the “current” local stress, for example, and historical data2682or other measurement data2685may indicate the “prior” local stress. Alternatively or additionally, some such images as described herein (showing swelling, e.g.) or other measurement data2685may reside in array9315in raw form, optionally to be acted upon by compare logic9380or other modes of comparison as described herein.

Operation9450describes 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. compare logic9380activating transmitter9390if one or more arrays9315or other values9332indicate 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 compare logic9380includes one or more modules9381for comparing pressure levels or other force-level indicators, one or more modules9382for comparing event counts, one or more modules9383for comparing time intervals, and/or one or more other modules9384as 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 the flow9400ofFIG. 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:9524or9528. In some embodiments, variants of operation9420may (optionally) be performed by one or more modules261of evaluation logic150,250,950,1530,7565or 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:9555,9557or9558. In some embodiments, variants of operation9450may be performed by one or more instances of detection modules5860,5870; or other such detection and/or evaluation logic as described herein. Alternatively or additionally, flow9400may be performed in a context as described above with reference to any ofFIGS. 1-80and/or in conjunction with other flow variants as described below.

Operation9524describes 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. module7561of evaluation logic7565configuring evaluations or other result data7537arising from condition detectors, expert systems7585, or other comparative analysis based upon at least some pressure- or other stress-indicative data7538measured one or more days earlier). This can occur, for example, in a context in which evaluation logic7565performs operation9420, in which local system7570implements one or more instances of detection modules7610, in which circular buffer7651captures hourly or other successive samples7661,7662,7663about subject7505via one or more sample sensors7625over the course of a week or a month and in which one or more condition detectors7670,7680iteratively 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 more respective 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 of local system7570may obtain multiple data points from one or more pressure sensors7621, stress-indicative sensors7622, or other sample sensors7625thereof. Alternatively or additionally, condition detectors7680,7690may (optionally) access positional coordinates7634, timing-indicative values7632, or other such status indicators7645as described herein for helping evaluation logic7565to 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”).

Operation9528describes receiving a structural change indication in the result of the one or more comparisons (e.g. pattern recognition module7564of evaluation logic7565detecting a swelling, discoloration, or other optically detectable tissue attribute change manifesting as a colorimetric shift between a portion7511of a weeks-old image7510and a corresponding portion7521of a newer image7520). This can occur, for example, in a context in which evaluation logic7565performs operation9420, in which another portion7512of the weeks-old image7510resembles a corresponding portion7522of the newer image7520, and in which such resemblance supports a heuristic change model that may likewise be applied to one or more portions7511,7521that have apparently changed. In some variants, for example, such reference portions7512,7522of 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 such primary portions7511,7521indicates a structural change. Alternatively or additionally, an expert system7585implementing some or all of such evaluation logic7565may query a caregiver or other expert for category descriptors7581(“site not recognized,” “swelling reduced,” “emergency,” etc.), scores7582, or other such input7583for 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”).

Operation9555describes enabling a performance of the one or more comparisons at a resource remote from the subject's body (e.g. interface7563transmitting force estimates or other stress-indicative information7533with corresponding locality information7531, timing information7532, patient-specific information7534, or other such comparative parameters). This can occur, for example, in a context in which evaluation logic7565performs operation9450and in which comparative information and/or other data as described herein is transmitted to or otherwise affects a configuration of one or more standards7588, logic modules7562, or other such comparison mode determinants7535configured to be applied remotely. In some variants, for example, one or more signal channels7575may be implemented in one or more aggregators or other such adjunct services7590operable remotely from an external module9320or 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.

Operation9557describes obtaining the result partly based on an indication of one or more nutrients in the subject's body (e.g. module181using one or more sensors185to monitor biological-process-indicative changes in zone171). This can occur, for example, in a context in which detection logic180and comparator130jointly perform operation9450and 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, sensor185may 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.

Operation9558describes extracting the decision whether to transmit the notification from the result of the one or more comparisons (e.g. condition detector7690generating one or more notification decisions7633by comparing a sample7661against a next sample7662or another subsequent sample7663). This can occur, for example, in a context in which one or more primary and/or local modules include an instance of detection module7610configured to perform operation9450, in which condition detector7690generates one or more result values7631signifying the necessity of such notifications by applying one or more instances of standard7695to successive samples7661,7662,7663from one or more 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 or other standards7695as 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 the flow9400ofFIG. 94or95. 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) include operation9629. In some embodiments, variants of operation9420may be performed by one or more instances of utility devices325or other devices in networks590,1380,1490,1590,2215,2995,3545,5280,5290,5580,5840,6295,6390,6400,7490,7580,7890containing 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:9651,9653or9656. In some embodiments, variants of operation9450may be performed by one or more instances of decision 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, flow9400may be performed in a context as described above with reference to any ofFIGS. 1-80and/or in conjunction with other flow variants as described below.

Operation9629describes 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 device7491and/or other sensor-containing modules7493configuring communication7485to include one or more thermal images7471, thermal input7472from subject7495or other users, or other such indications7480of recent physical phenomena relating to region7496). This can occur, for example, in a context in which one or more components of server7410and/or network7490each performs operation9420and in which communication7485also bears tension-indicative data7473, timing data7474, blood pressure data7475, historical data7476, or other data7477facilitating 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 calorimetric, 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”).

Operation9651describes 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. module7412of decision logic7415generating one or more notification transmission decisions7414responsive to a succession7420of N or more measurement change indications7421,7422,7423each signifying a respective increase). This can occur, for example, in a context in which notification logic7460performs at least one instance of operation9450and in which an abnormal succession7430of measurements7431,7432,7433manifest a constantly increasing or other monotonic deviation from a baseline 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 more such notifications7451,7452can occur in response to exceeding a defined event count7441or other time-indicative threshold. In some variants, for example, a notification7452may be sent for a subject7495being monitored remotely via one or more external devices7491or other sensor-containing modules7492,7493when 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”).

Operation9653describes accepting a caregiver's input as a determinant of the decision whether to transmit the notification (e.g. module2245using instructions or other parameters2249received via medium2225to specify one or more conditions under which each type of notification2241,2242will be sent to interface2210). This can occur, for example, in a context in which decision logic2250performs operation9450and in which a clinician2205indicates via interface2210that one or more prior notifications2201,2202warranted 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 a notification2242is transmitted to a remote 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”).

Operation9656describes 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. module2972of decision logic2975invoking transmitter2980to cause one or more composite images or other such successive indications7530relating to a subject's limb or back to output2953). This can occur, for example, in a context in which local system7570uploads such images or other measurement data to an implementation of response logic2970in network7580, 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 or more standards7675,7685,7695or 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 a system9700in which one or more technologies may be implemented in relation to respective portions9703,9704,9705of a subject's body9710, one or more of which may exhibit an inflammation or other abnormality9709. An adaptable support9750comprises several oblong actuators9752,9753,9754,9755supported on a common frame or other suitable substrate9760. Support9750further includes or otherwise supports one or more sensor modules9713,9714,9715(including or in proximity to a respective one or more actuators9753,9754,9755) operable for transmitting or otherwise detecting quantitative or other values9723,9724,9725of measurement data9729for circuitry9790. Circuitry9790may further include one or more processors9744and/or modules9781,9782,9783of support control logic9780, such as may be configured to provide one or more control signals9785,9786selectively to one or more actuators9752,9753,9754,9755as shown.

With reference now toFIG. 98, shown is a flow9800comprising 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 (e.g. at least support control logic9780causing one or more actuators9753to increase a force at least upon external portion9703in response to measurement data9729containing an indication from sensor module9715of an unusual swelling or other local manifestation of pressure within external portion9705of body9710). This can occur, for example, in a context in which one or more other sensor modules9714indicate 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 a flow9900comprising operation9950—obtaining locally-abnormal thermal information about a first external portion of a subject's limb (e.g. one or more modules9781,9782,9783of support control logic9780and/or processor9744receiving and/or computing measurement data9729indicating a local abnormality9709relating to the temperatures of one or more portions9703,9704,9705in a subject's arm or other limb). This can occur, for example, in a context in which substrate9760comprises a bed, a seat, a cast or other fitted article, or other such support structures as described herein.

Operation9970describes 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 logic9780causing at least actuator9753to exert an increasing force upon portion9703in response to abnormality9709comprising 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 the flow9800ofFIG. 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 of operation9840may (optionally) be performed by one or more instances of configuration logic1050,5235;7755or other configuration or control logic as described herein. Flow9800may likewise include one or more of operations10085or10088, for example. In some contexts, for example, flow9800may be performed in a context as described above with reference to any ofFIGS. 1-80and/or in conjunction with other flow variants as described below.

Operation10043describes configuring a valve of the artificial support to modify the force upon the first external portion of the subject's body (e.g. one or more modules783urging cell740laterally toward or away from adjacent cell710by causing one or more elements743to expand or contract). SeeFIG. 7. This can occur, for example, in a context in which support control logic780performs operation9840and in which module783selectively opens one or more valves746,747in fluid communication with higher- or lower-pressure reservoirs (not shown) so that element743controllably expands or contracts. In some variants, for example, one or more other elements741may (optionally) undergo an offsetting transition so that the net motion of cell740is primarily lateral. Alternatively or additionally, such other elements may undergo a transition like that of element743so that the net motion of cell740is primarily orthogonal to structure765.

Operation10044describes configuring a motor of the artificial support to modify the force upon the first external portion of the subject's body (e.g. module1152causing one or more piezomotors or other motor-containing actuators1120to retract, reducing or removing forces exerted at one or more external portions1111,1112). This can occur, for example, in a context in which control logic1160ofFIG. 11performs operation9840such as by selectively engaging one or more motors to extend and/or contract one or more elements1121,1122of 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 module9780adjusts actuator elements to maintain a consistent pressure or a programmatically cycled pressure at external portions9703-9705to treat poor circulation, cramps, or other pathologies aggravated by immobility. Alternatively or additionally, such motors may be configured as shown inFIG. 7in which the engagement of one or more motors715may 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”).

Operation10049describes configuring the programmatic response partly based on thermal data obtained from the second external portion of the subject's body (e.g. module1052ofFIG. 10selecting one or more control profiles1071,1072or other operating parameters1075,1076configured to update at least a force exerted upon portion1011in response to module1091indicating that portion1012has apparently remained beyond thermal threshold1086for longer than time threshold1087). This can occur, for example, in a context in which configuration logic1050performs operation9840, in which thermal threshold1086is within an order of magnitude of 0.5° C. or 5° C. of a nominally normal temperature, in which time threshold1087is within an order of magnitude of 1 hour or 1 day, in which pattern recognition module1092is configured to determine whether thermal data1081from one or more sensors1002adjacent portion1012indicates such an abnormality, and in which the programmatic response comprises updating one or more control signals1031,1032to respective ones of actuators1021,1022supporting respective zones of the subject's skin1010. 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 whether other data1082from any such sensors1001,1002indicates a systemic or local abnormality as described herein.

Operation10085describes 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 or more modules1181,1182of processing logic1180triggering or otherwise performing comparisons between swelling-indicative data1162received in signal1125and prior data1161from the same or similar site. This can occur, for example, in a context in which module1183is configured either (a) to process one or more changes in measurement data1163from portion1111in relation to at least some measurement information from portion1111to 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”).

Operation10088describes causing a data recordation responsive to the locally-abnormal-stress-indicative information (e.g. module1351of decision logic1350requesting one or more storage devices1340to record locally-abnormal-stress-indicative information1341from a vehicle or other remote source1385). This can occur, for example, in a context in which remote source1385comprises 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 by responsive logic260or decision logic275receiving information221-224via sensor(s)215in real time—and in which a conventional structure may aggravate a seat occupant's pressure ulcer or other such pathology. In some contexts, module1351may 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 information221-224as described herein. Alternatively or additionally, module1351may likewise cause a recordation of subject or site identifiers1345, time or place indications1346, other measurement data1343from one or more sensors in the subject's vicinity, and/or other related, diagnostically useful information1342as described herein that may potentially relate to one or more pathologies as indicated in information1341.

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 the flow9800ofFIG. 98or100. 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:10141,10142,10146or10147. Variants of operation9840may be performed by one or more instances of controller775, 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, flow9800may be performed in a context as described above with reference to any ofFIGS. 1-80and/or in conjunction with other flow variants as described below.

Operation10141describes 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 tonometer925or other components of sensor-containing instrument900deriving one or more images931, signals932,933, or other data935indicative 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 element905exerts the pressure pulse upon skin910, in which one or more sensors902convert a physical response to the pulse into a digital or other signal932, and in which module943of evaluation logic950applies one or more thresholds941or other criteria942configured to evaluate whether such signals932or other data935are abnormal. In some variants, for example, such a threshold941may 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 data935may likewise include colorimetric or other abnormality-indicative signals933signifying a status of the external body portion.

Operation10142describes 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. module9782of support control logic9780transmitting signals9785,9786or other control data selectively to two or more actuators9752,9753,9754,9755in an array configured to reduce one or more shear stress measurements or otherwise to respond to information from one or more sensor modules9713,9714,9715near an inflammation or other externally detected abnormality9709). This can occur, for example, in a context in which support control logic9780performs operation9840and 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, module1156of control logic1160implements a vector grid1165, profile1167, transfer function, or other such control data1170to respective instances of actuators1122each configured to alleviate at least one worst-case shear in skin1110by exerting forces upon respective portions of skin1110within a vicinity of which a stress-indicative signal1125is obtained. Alternatively or additionally, module784of support control logic780may be configured with one or more parameters793,794defining 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 or more motion sensors2472or other elements of local modules2320,2450,2510, or2690detecting 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”).

Operation10146describes 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. module1155of control logic1160executing a command sequence1157causing a transmission of one or more control signals1131,1132to respective elements1121,1122each configured to exert a primarily-tangential force across the subject's skin1110). This can occur, for example, in a context in which command sequence1157is configured to control one or more actuator elements741,742,743configured to push and/or pull one or more cells740supporting the “first” external body portion. In some variants, for example, one or more such actuator cells may include (a) a seat211,814, bed, or other support element operable for engaging or otherwise supporting a subject's leg and (b) two or more respectively selectable non-coaxial actuator elements741,742operable 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 upon cell740, such as for measurably reducing a shear force between cell740and the body portion.

Operation10147describes configuring the programmatic response partly based on colorimetric data obtained from the second external portion of the subject's body (e.g. configuration module777selecting one or more control profiles796and/or other parameters795configured 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 which controller775includes one or more local modules as described herein, in which optical sensor2525detects 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 which reflectance sensor2511or 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 selecting profile796or other parameters795of 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 the flow9900ofFIG. 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:10252,10256or10257. In some embodiments, variants of operation9950may be performed by one or more instances of detection logic180,640,1275,3285,3550,5135,5670,6110,6720,7940and/or local modules2320,2450,2510,2690,5730(in a vicinity of one or more 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 of operation9970may be performed by one or more instances of decision logic275,2250,2730,3230,5750,5930,6130,6395,7415; support control logic780,9780; or other configuration or control logic described herein. Alternatively or additionally, flow9900may be performed in a context as described above with reference to any ofFIGS. 1-80or in conjunction with other flow variants as described below.

Operation10252describes receiving thermal information from one or more sensors adjacent the subject's limb (e.g. interface5265receiving temperature-indicative data5252from one or more sensors5203relating to a subject's arm or leg). This can occur, for example, in a context in which one or more instances of interface5265and/or configuration logic5235each perform operation9950and 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 to system module5250. In some variants, for example, communication between the sensor(s) and the system module will be accomplished through a continuous 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.

Operation10256describes detecting additional information about the first external portion of the subject's limb (e.g. module1272of detection logic1275receiving auditory data1244, optical data1247, subject-provided data1246, pressure-indicative data1245, or other additional data1248relating to an upper portion1201of a subject's limb). This can occur, for example, in a context in which detection logic1275performs operation9950and in which module1273is configured to receive the locally-abnormal thermal information1251from one or more other sensors of array1221before or after module1272receives such “additional” data. In some variants, for example, optical sensors2525implanted into, affixed onto or arranged near upper portion1201may be configured to provide other thermal information1241, chemical composition information1242, and/or other physiological information1243. Other such sensors or related logic described above with reference toFIGS. 23-26may 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 information1260selectively 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”).

Operation10257describes causing a thermal abnormality in the first external portion of the subject's limb (e.g. module5210applying 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 the target region5225. Alternatively or additionally, one or more modules5232of configuration logic5235may selectively or otherwise record one or more thermal images5241, timing data5242, or other attributes of response5245of 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”).

Operation10274describes 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 or more modules9781of support control logic9780triggering one or more actuators9752,9753,9754,9755to 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 of circuitry9790locally perform operation9840, in which a local tissue abnormality9709is detected, and in which one or more adjacent actuators9752,9753,9754are advanced and local actuator9755is retracted to reduce the pressure and/or force exerted upon portion9705. In some variants, for example, support9750is incorporated into a bed in which one or more actuators9752,9753,9754,9755are selectively advanced or retracted automatically based upon detected tissue abnormalities9709. Alternatively or additionally, actuators9752,9753,9754,9755may be cycled in one or more selected patterns or randomly by support control logic9780to 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”).

Operation10290describes determining whether a decreased force is exerted upon the first external portion of the subject's limb (e.g. one or more sensor modules9713,9714,9715placed in one or more subject contact regions detecting localized pressure and/or force-change-indicative values9723,9724,9725in some or all of these regions). This can occur, for example, in a context in which a portion of the subject body9710rests on support9750as 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 the subject body9710by the support9750for shorter periods.) In some variants, for example, brief subject movements may be tracked by monitoring one or more pressure values recorded by sensor modules9713,9714,9715. Alternatively or additionally, pressure changes in respective portions9703,9704,9705may be used to adjust actuator positions to maintain the force exerted on the subject body part9710within 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 the flow9900ofFIG. 99or102. 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:10351,10353,10355or10359. In some embodiments, variants of operation9950may 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 following operations10376or10378. In some embodiments, variants of operation9970may be performed by one or more instances of actuators, control circuitry, and/or other responsive elements as described herein. Alternatively or additionally, flow9900may be performed in a context as described with reference to any ofFIGS. 1-80or in conjunction with other flow variants as described below.

Operation10351describes 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 module5281remotely receiving information5260including at least some local-abnormality-indicative data5253about region5225). This can occur, for example, in a context in which port5261and network5290each performs operation9950by receiving such data from one or more sensors5203local to region5225, with or without comparative information5276. Alternatively or additionally, system module5250may implement one or more controllers775, notification logic7875, and/or other such structures in this document suitable for acting upon comparative information5276or other such information5260after retrieving it or otherwise receiving distributions of update data5255from aggregation module5281or 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”).

Operation10353describes 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. module2973of decision logic2975receiving communication2935or other data2955activating one or more sensors identified with or otherwise identifying a subject body portion). This can occur, for example, in a context in which decision logic2975performs operation9950and in which one or more sensors2927are placed on or near the subject limb, optionally in one or more arrays1221,1222as shown inFIG. 12. In some contexts, for example, one or more such portions1201,1202may be selected as a primary sensor location for limb monitoring. Alternatively or additionally, one or more other sensors as described with reference toFIG. 23-26may be positioned to monitor such subject portions1201and/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”).

Operation10355describes updating a normality threshold configured to evaluate other thermal information about the subject's limb (e.g. module5233of configuration logic5235changing 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 which new operating parameters5275or other comparative information5276are received from a sensor as described above, for example, in relation toFIGS. 23-26. In some variants, for example, information from an ambient sensor5201and/or a core body sensor5202may be used to generate and/or adjust thresholds applied to sensor data5251from 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 device5291or from other resources5292may be used to provide and/or adjust thresholds or other filtering information applied to the sensor data5251or other portions of information5260obtained 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”).

Operation10359describes detecting how long a thermal abnormality apparently remains in the first external portion of the subject's limb (e.g. counter5173or other timing logic5175generating one or more values5181indicating how long a limb portion remains below a temperature-change-rate or other thermal threshold5112). This can occur, for example, in a context in which detection logic5135performs operation9950, in which module5133signals counter5173to stop responsive to one or more values5181satisfying a normality-indicative condition5125, in which module5131of detection logic5135is configured to reset and/or enable one or more counters5173in response to module5132detecting that sensor data5184violates data filter5121, and in which one or modules5131,5132,5133of detection logic5135are configured to halt and/or read counter5173in response to a reset of filter violation status5183. Alternatively or additionally, one or more such modules of detection logic5135may trigger a recording device to store one or more event records5160containing, for example, one or more of a timestamp5161, 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”).

Operation10376describes selecting an element configured to interact with apparently healthy tissue as the second external portion of the subject's limb (e.g. one or more modules782of support control logic780selecting one or more cells740or one or more of their actuation elements741,742,743in response to a determination that no anomalies have been detected in tissue adjacent cell740). This can occur, for example, in a context in which support control logic780performs operation9970, in which support420ofFIG. 4implements array705ofFIG. 7, in which component414contains cell740, in which one or more sensors424as described herein are positioned in or near cell740for detecting one or more tissue attributes of external portion404of body410, in which one or more such cells740,750are positioned so that a movement of cell740may directly result in an increasing lateral and/or normal force upon external portion404, and in which a selection of cell740may thereby effectively result in a determination of the “second” external portion. In some variants, for example, an expansion of one or more elements742,743may cause such an increasing force, a direction of which may be modified by one or more other elements741. Alternatively or additionally, module782may control such movement of component414with closed-loop control so that component414is positioned to minimize a shear force or otherwise favorably influence an attribute of abnormality409detected, for example, via sensor425.

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”).

Operation10378describes causing one or more actuation elements to reduce a force exerted upon the first external portion of the subject's limb (e.g. module781of support control logic780causing a contraction of one or more elements753so that cell750exerts 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 which system module1230configures 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, array705may 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 or more modules783,784of support control logic780may be configured to actuate one or more arrays1221,1222or 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.

With reference now toFIG. 104, shown is a system10400in which one or more technologies may be implemented in relation to an instrument10440configured to interact with one or more legs10421,10422of subject10420. As shown, instrument10440may (optionally) include one or more sensors10441configured at least to provide data10448to module10450via channel10445. Module10450may include one or more instances of responsive logic10460and/or modules10475of decision logic10470configured to act upon data10448. Responsive logic10460, for example, may include one or more instances of control modules10461and/or evaluation modules10462as described herein.

With reference now toFIG. 105, shown is a flow10500comprising operation10520—obtaining local circulatory information relating to a leg of a subject (e.g. responsive logic10460receiving local flow rate or other data10448describing circulation within one or more legs10421of subject10420). This can occur, for example, in a context in which instrument10440detects physical conditions within leg10421directly or via sensors in clothing or otherwise supported near leg10421as described herein. Alternatively or additionally, the local circulatory information may include a history of such measurements of leg10421over a period of hours, days, or months.

Operation10580describes 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 logic10470sounding an alarm or otherwise transmitting a notification if module10475detects unusually slow flow or other evidence of poor circulation locally within leg10421). This can occur, for example, in a context in which module10475is configured to perform a normalcy comparison operation and in which module10450is implemented in or otherwise operable for interacting with a portable 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 the flow10500ofFIG. 105. Operation10520—obtaining local circulatory information relating to a leg of a subject—may (optionally) include one or more of the following operations:10622or10624. In some embodiments, variants of operation10520may be performed by one or more instances of support 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 following operations10681,10683,10685or10689. In some embodiments, variants of operation10580may be performed by one or more instances of notification 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, flow10500may be performed in a context as described above with reference to any ofFIGS. 1-80and/or in conjunction with other flow variants as described below.

Operation10622describes obtaining a comparison result as the local circulatory information relating to the leg of the subject (e.g. module3143obtaining one or more results3136of one or more comparisons between earlier indications3115,3183and later indications3125,3184of flow in the subject). This can occur, for example, in a context in which one or more such indications3183-3185are extracted from measurements or other event-indicative records3110,3120, in which invocation logic3140performs operation10520by invoking evaluation logic3197(remotely) or other data filters3151that perform such comparisons. Such filtering information3170may (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 of operation10788below.

Operation10624describes configuring an artificial support to modify a force upon the leg of the subject (e.g. one or more modules783of support control logic780urging cell740laterally toward or away from adjacent cell710by causing one or more elements741,742,743to expand or contract). This can occur, for example, in a context in which a support layer or other suitable structure765adhesively or otherwise holds array705in a vicinity of leg10421, in which control module10461implements controller775, in which support control logic780performs operation10520, and in which module783selectively opens one or more valves746,747in fluid communication with higher- or lower-pressure reservoirs (not shown) so that element743controllably expands or contracts. In some variants, for example, one or more other elements741,742may undergo an offsetting transition so that the net motion of cell740is primarily across the subject's skin. Alternatively or additionally, such other elements may undergo a like transition as that of element743so that the net motion of cell740is primarily orthogonal to structure765, toward or away from the subject's skin.

Operation10681describes including at least user-provided input with the notification (e.g. module7752of configuration logic7755including a category7731, response7732, verification7733, distribution7734, or other user input7738within or otherwise with notification content7771). This can occur, for example, in a context in which various subjects7710, caregivers, or other parties provide such input as described herein and in which these or other inputs7738,7739may affect what the notification includes and/or whether or where the notification is transmitted. In some variants, for example, module7752may respond to an indication7780of 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”).

Operation10683describes receiving information from one or more sensors adjacent the leg of the subject (e.g. module10475of decision logic10470receiving images or other data10448via one or more sensors10441adjacent leg10421). This can occur, for example, in a context in which decision module10470performs operation10580, 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 to module10450. In some variants, for example, one or more channels10445between 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 ECG 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”).

Operation10685describes detecting additional information about the leg of the subject (e.g. module1272of detection logic1275receiving auditory data1244, optical data1247, subject-provided data1246, pressure-indicative data1245, or other additional data1248relating to one or more portions of the leg). This can occur, for example, in a context in which detection logic1275performs operation10580, in which a subject is at home or at some other site at which maintaining adequate vigilance may be difficult, and in which module1273is configured to receive (locally-abnormal) thermal information1251or other information from one or more other sensors of array1221before or after module1272receives such “additional” data. In some variants, for example, optical sensors2525implanted into, affixed onto or arranged near the leg may be configured to provide other thermal information1241, chemical composition information1242, and/or other physiological information1243. Other such sensors or related logic described above with reference toFIGS. 23-26may 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 information1260selectively as described herein.

Operation10689describes enabling a performance of at least one of the one or more comparisons at a resource remote from the subject (e.g. interface7563transmitting force estimates or other stress-indicative information7533with corresponding locality information7531, timing information7532, patient-specific information7534, or other such comparative parameters). This can occur, for example, in a context in which evaluation logic7565performs operation10580and in which comparative information and/or other data as described herein is transmitted to or otherwise affects a configuration of one or more standards7588, logic modules7562, or other such comparison mode determinants7535configured to be applied remotely. In some variants, for example, one or more signal channels7575may be implemented in one or more aggregators or other such adjunct services7590operable remotely from an external module9320or 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 the flow10500ofFIG. 105or106. Operation10520—obtaining local circulatory information relating to a leg of a subject—may (optionally) include one or more of the following operations:10721or10725. In some embodiments, variants of operation10520may be performed by one or more instances of decision logic2975or 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 following operations10782,10786or10788. In some embodiments, variants of operation10580may 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, flow10500may be performed in a context as described above with reference to any ofFIGS. 1-80and/or in conjunction with other flow variants as described herein.

Operation10721describes 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. module2973of decision logic2975receiving communication2935or 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 which decision logic2975performs operation10520and in which one or more sensors2927are placed on or near the subject portion, optionally in one or more arrays1221,1222as shown inFIG. 12). In some contexts, for example, one or more such portions1201,1202may be selected as a primary sensor location for limb monitoring. Alternatively or additionally, one or more other sensors as described with reference toFIG. 23-26may be positioned to monitor such subject portions1201and/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”).

Operation10725describes capturing one or more shape-indicative images in the local circulatory information relating to the leg of the subject (e.g. module1621causing a recordation of one or more images1697from an array or other configuration of sensors7717into memory7765or other media1695). This can occur, for example, in embodiments in which response module performs operation10520and in which primary module7790may communicate in one or both directions with one or more active sets of ultrasound sensors1981or other shape-indicative sensors configured to apply one or more respective-set-specific intensity thresholds1653and/or frequency 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 attributes1699of 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”).

Operation10782describes including at least a magnitude indication with the notification (e.g. module781of support control logic780causing a contraction of one or more elements753so that cell750exerts 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 arrays1221,1222ofFIG. 12implement array705ofFIG. 7, in which at least control logic1280performs operation10580, 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 which system module1230configures a suitable actuation controller as described herein. In some variants, for example, array705may 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 or more modules783,784of support control logic780may 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.

Operation10786describes performing at least one of the one or more comparisons using an updated normalcy threshold (e.g. module7751of configuration logic7755changing or otherwise updating one or more optical or other normalcy thresholds7762). This can occur, for example, in a context in which configuration logic7755performs operation10580, 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 or more sensors7717on or near a subject7710may be used to generate and/or adjust thresholds applied to sensor data7741from 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 the sensor data7741or other types of information7745obtained 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”).

Operation10788describes obtaining at least some of the filtering information from another limb of the subject (e.g. one or more modules782of support control logic780selecting one or more cells740or one or more of their actuation elements741,742,743in response to a determination that no anomalies have been detected in tissue adjacent cell740). This can occur, for example, in a context in which support control logic780performs operation10580, in which component414contains cell740, in which one or more sensors424as described herein are positioned in or near cell740for detecting one or more tissue attributes of external portion404of body410, in which one or more such cells740,750are positioned so that a movement of cell740may directly result in an increasing lateral and/or normal force upon external portion404, and in which a selection of cell740may thereby effectively implement a determination of the “second” external portion. In some variants, for example, an expansion of one or more elements742,743may cause such an increasing force, a direction of which may be modified by one or more other elements741. Alternatively or additionally, module782may control such movement of component414with closed-loop control so that component414is positioned to minimize a shear force or otherwise favorably influence an attribute of abnormality409detected, for example, via sensor425.

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 a system10800that may serve as a context for introducing one or more processes and/or devices described herein, comprising one or more instances of module10830operable for interacting with module10890. As shown, module10830may include one or more modules10811of dispensing logic10810operable for controlling statin dispenser10818or (other) therapeutic dispenser10819; memory10821operable for handling software-implemented or other regimens; or one or more sensors10822as described herein. Also shown is a kidney or other organ10860having one or more (therapeutic-agent-) suffused portions10861and one or more other portions10862, at least one of the suffused portions10861comprising a vicinity10865of (converging venules10864of) lumen10895

Next downstream as shown, module10890comprises one or more modules10831,10832of response logic10835; (transvascular or other) extraction modules10845; sensors10881; dispensers10882; or clamps10855. As shown, extraction module10845comprises one or more ports10841to be formed through vessel wall10846, operable for extracting a portion10844of lytic-material-infused blood10842, for example, into one or more absorbent elements10847, dialysis extractors, and/or to other such disposal vessels. As shown, one or more clamps10855are configured to limit outflow10899from module10890by expanding one or more actuators10857, thereby levering lumen10895to occlude it temporarily as shown. Alternatively or additionally, vicinity10885of lumen10895may include one or more conduits10867operable for selectively removing a portion of outflow10899by redirecting it to one or more artificial disposal vessels10870as shown.

Concerning the opening of port10841or 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 a module10890comprising a clamp10855and/or other artificial structure(s) operable to impede most of outflow10899from vascular lumen10895and a dispenser10819or other structure operable to administer a lytic or other therapeutic material locally to the lumen10895. (Other such embodiments are described, for example, with reference toFIG. 36.) Such dispensers can be positioned upstream from some or all of organ10860, for example, in an artery or arteriole. Such artificial structures can likewise include one or more 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 a flow10900comprising operation10910—obtaining one or more indications of a lytic material in a vicinity of one or more body lumens (e.g. module10831of response logic10835responding to a signal from one or more sensors10822,10881or some other indication that an anticoagulant or other lytic material will apparently be present in a vicinity10865of lumen10895). This can occur, for example, in a context in which response logic10835receives a notification that one or more lytic-material-containing dispensers10819have been activated. Alternatively or additionally, such indications can result from one or more sensors10881detecting one or more natural chemical markers resulting from injury, for example. Alternatively or additionally, such indications can result from dispenser10882administering a lytic compound by backflow into organ portion10861—injecting the compound at a somewhat higher pressure than that of blood in venules10864.

Flow10900further comprises 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 (e.g. port10841or conduit10867opening 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 an absorbent element10847or other 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 the flow10900ofFIG. 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 of operation10910may be performed by one or more instances of sensors4510,10822, 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:11071or11078. In some embodiments, variants of operation10970may be performed by one or more instances of extraction device4580or the like as described herein.

Operation11012describes causing at least a statin to be dispensed as the lytic material (e.g. dispensing logic10810invoking module10811or other circuitry for actuating statin dispenser10818or other lytic-material-containing dispenser10819according to one or more dosage profiles in memory10821). This can occur, for example, in embodiments in which one or more instances of modules10830are positioned (locally) upstream from a lung or other organ10860and in which at least a portion10861of organ10860has 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, module10890may 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 a downstream vicinity10885of lumen10895relative to outflow10899.

Operation11013describes obtaining a concentration-indicative scalar of the one or more indications of the lytic material (e.g. one or more modules6732of detection logic6720receiving a scalar value6723indicative of a concentration gradient or other concentration-indicative data6724from an optical sensor2525or other concentration-indicative sensor2560nearby or downstream from a dispensation). This can occur, for example, in a context in which detection logic6720is configured to perform operation10910, and in which configuration system6710overlaps 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.

Operation11017describes signaling a dispensation of the lytic material into an upstream portion of the one or more body lumens (e.g. module7261of control logic7270triggering actuator7281to inject or release tissue plasminogen activator7283or other lytic materials7284locally into a common carotid artery7350responsive to data7213signifying a sudden volumetric decrease in one or more flows7321,7331exiting 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 more systemic determinants7212indicate an absence of detectable hemorrhaging in subject7310, and in which a care provider has defined a programmatic regimen7263by which such material(s) are to be administered immediately in these contingencies. In some variants, regimen7263may further depend upon one or more complementary determinants7211or other data7214: whether one or more complementary arteries exhibit a substantially increased local blood pressure or flow. Alternatively or additionally, regimen7263may define a (therapeutic contraindication or other) response to other systemic determinants7212such 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.)

Operation11071describes causing the portion of the lytic material to be drawn into an artificial vessel (e.g. actuator2881allowing one or more ports2882to draw out at least some of outflow2899through one or more vessel walls2883,2884into vessel2885). This can occur, for example, in a context in which dispenser2841has been dispensing a therapeutic material containing one or more carcinogens or other ingredients having potentially undesirable side effects in outflow2899. Alternatively or additionally, a conduit2886and/or pump2887may be used for accelerating a decrease of the local concentration of such materials (near port2882, e.g.).

Operation11078describes reversing a flow direction of at least some of the lytic material (e.g. pump7282withdrawing some of a dispensed lytic-agent-containing material from one or more arteries responsive to one or more sensors7345indicating 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 to regimen7263. 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 the flow10900ofFIG. 109or110. 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 the following operations:11111,11114,11116,11118, or11119. In some embodiments, variants of operation10910may be performed by one or more instances of response logic4555,10835or 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:11175or11177. In some embodiments, variants of operation10970may be performed by one or more instances of extraction device4580or the like as described herein.

Operation11111describes permitting the lytic material to perfuse one or more organs in the vicinity of the one or more body lumens (e.g. dispensing logic10810invoking one or more dispensers10819to 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 dispensing logic10810can invoke other logic modules and in which system10800implements 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 in outflow10899presents a danger. In a case in which a majority of blood flowing through module10890is removed from a patient's vasculature into one or more conduits10867, for example, a transfusion or other blood replacement at module10890may be provided to supplement outflow10899(optionally with a concomitant decrease in the local concentration of the lytic material).

Operation11114describes signaling at least one of the one or more indications of the lytic material via a wireless signal (e.g. module7122of control logic7120activating one or more modules of communication logic7140resulting in the transmission of measurement data7133and/or lytic-material-indicative data7131to 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, module7121can perform operation11114by transmitting such output to remote resources7161,7162in network7160for storage, correlation analysis, and/or monitoring of a subject by remote personnel.

Operation11116describes detecting a marker material indicative of the lytic material in the vicinity of the one or more body lumens (e.g. module6731of detection logic6720detecting one or more attributes of a marker material using one or more fluorescence sensors2322, radioactivity sensors2462, electrochemical sensors2548, or other suitable sensors implemented in device6790). This can occur, for example, in a context in which detection logic6720performs operation10910; in which device6790is positioned on, in, or near a target vessel; and in which such a device is configured to indicate one or more categorical attributes6725and/or quantitative attributes6726of an artificial marker material via wireless communication linkage6752. In some embodiments, device6790may be configured to perform or facilitate such modes of detection continuously, intermittently, upon request, conditionally, or otherwise. Alternatively or additionally, one or more such local modules2320,2450,2510can 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.

Operation11118describes causing the lytic material to be urged into the one or more body lumens (e.g. module7123of control logic7120transmitting an activation signal7171to a pump7184, iontophoretic module7183, or other delivery unit7180causing 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 an actuator7182in such units to exert an increasing pressure upon one or more lytic-material-containing reservoirs7181. 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.

Operation11119describes 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 or other module6774of control logic6770signaling 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 control logic6770performs operation10910, in which one or more implantable devices6790indicate a vessel blockage or other pathology treatable with an available lytic compound, and in which such a dispensation can be signaled (a) directly to dispenser6780or (b) via an interface6740to a person with a syringe. In some variants, for example, one or more sensors and dispensers6780of a local module2320,2450,2510may 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 logic2250can be configures so that detection of a local blockage or dispensation will cause a notification2241of such local conditions and/or a notification2242of 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 provide such parameters2249to emergency caregivers who later encounter the subject. In some variants, moreover, one or more modules2245of decision logic2250may inquire of an authorized caregiver, a central medical history database, or some other such resource7161whether a recent surgery or other contraindications of an immediate lytic therapy may exist.

Operation11175describes causing the lytic material to be exposed to a lytic-material-absorbent element (e.g. module7033of control logic7092signaling one or more actuators7055to guide flow from inlet7005toward extraction unit7080so that lytic-material-containing fluid comes into contact with one or more foams7071, fibers7072, or other such materials7073suitable for binding to or otherwise absorbing at least some of the lytic material). This can occur, for example, in a context in which such actuators7045,7055comprise one or more valves7050and/or pumps7060selectively operable to divert at least some lytic-material-containing fluid from a normal flow (toward extraction unit7080or into an alternate 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 to transfer unit7010. In some variants, for example, one or more pumps7060or other actuators7055may be configured to regulate a fraction of an inflow (via inlet7005, e.g.) that is routed to contact absorbent materials. Alternatively or additionally, one or more modules7032may perform operation11175by routing a primary flow (containing an artificial lytic material, for example, and flowing from inlet7005to 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 or more dispensers7020as described herein.

Operation11177describes causing a lytic activity inhibitor dispensation into the one or more body lumens (e.g. module3981of control logic3980causing one or more dispensers3831to 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 more other dispensers3831has released the plasminogen activator(s) earlier and/or upstream, in which two or more such dispensers3821,3831for different materials are configured in a common body3830, in which control module3820implements control logic3980configured to perform operation10970, and in which such inhibitors directly or indirectly cause at least one lytic activity of the lytic material to be inhibited in vasculature3805. 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, module3982may perform operation11177in response to one or more of a hemorrhage indication3973or blockage removal indication3974indicating a vessel3840near or downstream from dispenser3821. Alternatively or additionally, module3982may likewise perform operation11177in response to one or more of a continuing lytic material dispensation indication3971or an indication3972that vessel3840is 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 shown system11200may affect or otherwise relate to vicinity11225, section11270, and vicinity11275of a vascular lumen11295through which one or more blood components may flow. One or more inflows11201of blood enter respective portions of lumen11295as shown, pass through section11270, and exit as one or more outflows11299. In respective variants, arteries, veins, or smaller vessels of lumen11295may traverse vicinities11225,11275as shown. Section11270may likewise comprise one or more capillary beds as well as vital organs and other tissues served by lumen11295.

In some variants, one or more intravascular or other modules11250in vicinity11225may (optionally) include one or more instances of sensors11210; modules11223or other dispensing logic11220; dispensers11228,11229; or transmitters11247, receivers11248, or other interface logic11240. (Some such modules11250may be operable for penetrating a vascular structure with ultrasonic or other energy, for example, or may comprise an implanted cannula or other transvascular structure.) Module11223may, as shown, comprise one or more instances of port controls11221, regimens11222or other programmatic dispensing information (optionally embodied in software or other instruction sequences, for example), or requests or other messages11224.

Alternatively or additionally, system11200may comprise one or more intravascular or other sensors11290that may be configured to communicate (in one or both directions) with module11250, such as by a signal-bearing conduit or radio-frequency signal. (Some such sensors11290may be operable for monitoring one or more physical phenomena within vascular structures, for example, from within or in a vicinity of the structures.) Systems11200may likewise be configured to include or otherwise interact with one or more instances of external modules11280operable, for example, for obtaining and providing data11285as described herein. In some variants, for example, the one or more sensors11290are only operable for communicating sensed analog or digital values to module11250. In others, one or more of the sensor(s)11290are able to receive updates or other information from one or more external modules11280or other transmitters11247as described herein.

With reference now toFIG. 113, shown is a flow11300comprising operation11340—obtaining a priori implant information (e.g. receiver11248receiving user-provided or other data11285describing one or more sensors11290or other implants downstream from one or more modules11250in a vicinity11275of lumen11295). This can occur, for example, in a context in which module11250comprises a cannula or other implantable structure positioned upstream from an outflow11299local to the implant(s) to which the a priori information pertains. Alternatively or additionally, receiver11248may obtain sensor data or other determinants relating to such implants, as described herein.

Flow11300further comprises 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 (e.g. interface logic11240invoking one or more modules11223of dispensing logic11220operable for activating one or more dispensers11228containing one or more thrombolytic agents or other locally-administered therapeutic materials selectively when apparently needed in a vicinity11275of 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 at outflow11299.

With reference now toFIG. 114, there are shown several variants of the flow11300ofFIG. 113. Operation11340—obtaining a priori implant information—may include one or more of the following operations:11444,11446, or11447. In some embodiments, variants of operation11340may be performed by one or more instances of dispensing logic4515,11220, 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 of operation11380may be performed by one or more instances of dispensers4519,11229, transmitters4547,11247, or the like as described herein.

Operation11444describes obtaining the a priori implant information from one or more implantable devices (e.g. external module11280receiving specifications or other data11285about module11250from a wireless or other transmitter11247thereof). This can occur, for example, in a context in which external module11280notifies locally-available caregivers of the existence of module11250and/or of dispensations or dosages from it. Such information may be used to expedite care or avoid redundant dispensations, for example.

Operation11446describes obtaining the a priori implant information from one or more objects borne by a subject (e.g. one or more modules5561of receiver5565accepting a type5511, a date5512, a status5513, a location5514, or other such implant data5510from 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 module5570or an external device may be configured to poll such objects for such information during a crisis, for example, in a context in which system5500is implemented in a mobile or emergency-room unit.

Operation11447describes obtaining the a priori implant information ex situ (e.g. receiver5340externally accepting one or more messages5341,5342containing contextual information5345pertaining to patient and/or device status from device5310). This can occur, for example, in a context in which external device7491ofFIG. 74implements primary system5380, and in which identification, history, location, monitoring type, and/or other such configuration information5345,5355is available via one or more devices5310,5320implanted, attached or otherwise associated with a subject area to be monitored. In some variants, for example, a receiver5350is configured to deliver subject or implant information5355suitable to guide follow-up care, for example, via a hand-held projection device or other user interface5370. Alternatively or additionally, primary system5380or other such logic can be implemented in a computer module5360configured 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 of operation11380presented inFIG. 114, these or other operations may (optionally) be performed in a preparatory sub-operation—before or during one or more instances or variants of operation11340as 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 or more modules5661of receiver5665accepting blood pressure measurement5651, flow rate measurement5652, and/or other such clot-indicative determinants5655). This can occur, for example, in a context in which decision logic5635and detection logic5670jointly perform operation11380and 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 device5694may 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, operation11380may include signaling implanted dispensers as described herein.

Operation11483describes generating the decision whether to initiate the implant-site-targeting treatment partly in response to an implant type (e.g. module5741of decision logic5750,5760signaling a selection of a suitable lytic material indicator5743and/or quantity indicator5744partly based on a thrombosis symptom or other such symptom indicator5774and partly based upon a model number5761, material indicator5762, or other type indication5770of 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, a measurement5771indicative of local blockage, or other such contraindications of indiscriminate (non-targeted) dispensations as described herein. In some variants, for example, module5741may indicate an affirmative decision5745for 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.

Operation11485describes 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. module5892of invocation logic5895activating one or more comparators5842,5893configured for comparing current data from sensors5851,5852,5853with historic, concurrent, threshold, and/or other pertinent information in deciding whether to transmit one or more treatment indications5841,5890). This can occur, for example, in a context in which sensors5852,5853configured to observe a vicinity of a major blood vessel5809are monitored for changes in blood pressure, flow, and/or other status-indicative information5896to determine if one or more treatment indication messages5825,5898are to be transmitted. In some variants, for example, an implanted or other detection module5860configured to monitor a region5810near vessel5809will trigger one or more messages5815,5825to a bedside monitor5830and/or nurse station5820warning 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.

Operation11488describes 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. module5742of decision logic5750transmitting an activation signal to a transvascular or other dispenser directly in response to one or more signals5725from sensors5701,5702or other such elements directly or indirectly indicating the presence of emboli5708in detection region5710). This can occur, for example, in a context in which one or more sensors11210,11290outside a blood vessel indicate one or more (apparent) emboli manifesting ultrasonic signatures5772, impedance changes5773, and/or other such data5780,5790are configured to trigger decision logic5760to 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 implanted sensor5701,5702can 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 the flow11300ofFIG. 113or114. Operation11340—obtaining a priori implant information—may include one or more of the following operations:11542,11546, or11548. In some embodiments, variants of operation11340may be performed by one or more instances of dispensing logic4515,11220, 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 of operation11380may be performed by one or more instances of dispensers4519,11229, transmitters4547,11247, or the like as described herein.

Operation11542describes obtaining an update for the a priori implant information (e.g. module5562of receiver5565accepting one or more modifications of implant data5510in storage5542as 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 which comparison data5531and/or therapeutic delivery parameters5532are modified based upon one or more status indications5534of a progression in a subject's pathology or health. In some variants, for example, progression through post surgical healing can lead to adjustments of therapeutic component delivery parameters5521, subject location indices5522, sensor types5523, or other such mode identifiers5524,5525operable for describing and/or implementing modes of monitoring. Alternatively or additionally, module5552may be configured to respond to one or more indicators of a disease state progression by conditionally implementing (a) an appropriate change in dosage or other delivery parameters5521, (b) an invocation of instruction sequence5551or other such modules responsive in scenarios previously excluded, or (c) other such operational adjustments as described herein.

Operation11546describes obtaining timing information in the a priori implant information (e.g. module5425of receiver5430accepting one or more records5450associating a measurement or other parametric data5451with data5452indicative of one or more device update times5464, implant times5465, dispensation times5466, measurement times, or other such timing information5470of 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 in memory5440or other storage units5445for 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, record5450may contain data indicative of one or more results of subject and/or device diagnostics.

Operation11548describes obtaining an implant type of the a priori implant information (e.g. module5563of receiver5565receiving an implant type5511or 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 implant5597is 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 module5570may request and/or receive determinants5540indicating a current category, protocol, or state relating to an implant and/or subject from a network5580. In some contexts, for example, one or more modules5561,5563of receiver5565may obtain one or more mode identifiers5525indicating that implant5597is in “notification mode” and/or that one or more notification events have occurred. Alternatively or additionally, configuration module5570can likewise obtain a mode identifier5524indicating 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 of operation11340may be omitted or performed before, after, or interleaved with one or more instances or variants of operation11380as described herein, in some embodiments.

Operation11581describes generating the decision whether to initiate the implant-site-targeting treatment partly in response to an apparent change in a chemical composition (e.g. module11223of dispensing logic11220causing transmitter11247to transmit a message11224indicating one or more diagnostic or therapeutic material dispensers11228,11229and/or a dispensation site local to section11270as a programmatic response to an apparently severe hypoxic condition or other circumstance detected via one or more sensors11210,11290operable 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 regimen11222specified in advance by a caregiver in response to an abnormally high platelet concentration detected locally, for example, by sensor11210.

Operation11584describes signaling a decision whether to dispense one or more therapeutic materials from an implant (e.g. module5644of control logic5640transmitting one or more commands5625,5626configured to cause a dispensation at implant5690wirelessly via antenna5628). This can occur, for example, in a context in which an external support device5610implements a dosage and timing by triggering one or more communication components5620or other such logic to transmit timing, dispensation, detection, evaluation, notification, or other such commands to implant5690. 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 or responsive treatment profile5622specified by a physician.

Operation11585describes signaling a decision whether to dispense one or more of a thrombolytic agent or an anticoagulant (e.g. module5645of control logic5640signaling such a dispensation from implant5690only if module5634detects an apparent need for one or more such materials). This can occur, for example, in a context in which implant5690includes one or more dispensers11228,11229and/or sensors11290in close proximity, in which support device5610comprises external module11280, and in which module5668signals an apparent blockage in lumen11295warranting an activation of one or more 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.

Operation11587describes generating the decision whether to initiate the implant-site-targeting treatment partly in response to an apparent change in vascular flow (e.g. module5923of decision logic5930generating an affirmative decision5925only if indicators5954,5955of change in flow through a vessel violates one or more given criteria5908,5909). This can occur, for example, in a context in which criterion5909includes a requirement that the flow change be local, which module5923may determine by invoking comparator5921or other such modules for comparing measurements or other sensor transmissions5950of the subject region each with corresponding indicators5952,5953of one or more other sites of the same subject. Alternatively or additionally, module5923may likewise invoke circuitry or other modules5923for comparing a succession5951of transmissions from a common sensor, such as for determining whether a shape of a specific vessel of interest is changing too fast. In some variants, for example, module5923can 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, module5923may likewise invoke circuitry5922for detecting an apparent obstruction of the vessel manifesting as a large-enough, rapid-enough local decrease in vascular flow (as criterion5907, e.g.).

In some embodiments, decision logic5940may 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 such appropriate output5983. In a more aggressive variant, one or more modules of decision logic5940may 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.

Operation11589obtaining one or more ischemia indicators of the one or more other clot-indicative determinants (e.g. module5891of invocation logic5895receiving a significant D-dimer score increase indication5879from one or more 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 determinants5875may include a complaint of sudden and severe local leg pain or other such subject-provided input5872; symptom interpretations or other such secondary user input5873(via network5840, e.g.); an ultrasound image5861, computed tomography image5862, or other such shape-indicative data5865; contraindications of hemorrhage or other indications5879relating to alternative hypotheses, or other such 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 shown system11600may affect or otherwise relate to vicinity11605, section11630, and vicinity11635of a subject's lumen11695through which one or more blood components may flow. One or more inflows11601of blood enter respective portions of lumen11695as shown, pass through section11630, and exit as one or more outflows11699. In respective variants, arteries, veins, or smaller vessels of lumen11695may traverse vicinities11605,11635as shown. Section11630may likewise comprise one or more capillary beds as well as vital organs and other tissues served by lumen11695.

In some variants, module11660may (optionally) include one or more instances of modules11613,11614of dispensing logic11615; dispensers11617,11618,11619; modules11621,11622of evaluation logic11620; interface logic11640; modules11651or other response logic11655; or intravascular or other sensors11650. (Some such sensors11650may be operable for monitoring radiant or other physical phenomena within a lumen11695, for example, from within or in a detection vicinity11605of lumen11695.) Interface logic11640may, as shown, comprise one or more instances of transmitters11647, receivers11648, or other modules11642operable for communicating (in one or both directions) with one or more sensors11610in (upstream) vicinity11605of lumen11695.

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.28and35-45. 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 a flow11700comprising operation11730—obtaining a flow-change-indicative measurement (e.g. one or more modules11621of evaluation logic11620detecting 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 which module11621implements 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.

Flow11700further comprises operation11790—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 or more modules11613,11614of dispensing logic11615causing one or more dispensers11617,11618to administer an antiplatelet-drug-containing or other therapeutic agent in response to the one or more modules11621,11622of evaluation logic11620). This can occur, for example, in a context in which module11614specifically selects such a therapeutic material by selecting the dispenser11618containing the material in lieu of another dispenser. Alternatively or additionally, one or more modules11642may be configured to signal the decision in some other way, such as by a speaker or other transmitter11647conveying 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 the flow11700ofFIG. 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 of operation11730may be performed by one or more instances of sensors4579,11650, 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 of operation11790may be performed by one or more instances of output devices4526, dispensing logic4515,11615, or the like as described herein.

AsFIG. 118indicates, (optional) operation11831describes programming an implantable device (e.g. module6772of control logic6770transferring one or more device settings6771or command sequences6761,6762into an intravascular dispenser6780or other implantable device). This can occur, for example, in a context in which dispenser6780is operably coupled via a wireless communication linkage6752and/or docking port6751, in which such controls affect one or more operating modes of the implanted or other device, and in which control logic6770performs operation11730. In some variants, for example, wireless communication linkage6751may 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 or more modules6773performing operation11730. Alternatively or additionally, an initial set of device settings6771or other such parameters can be programmed into such devices prior to implantation to establish a baseline of device operation in the subject.

Operation11835describes obtaining a turbulence-indicative auditory value as the flow-change-indicative measurement (e.g. module6332of processing logic6330accepting one or more decibel measurements6351,6352high enough to indicate past or present turbulence in a blood vessel). This can occur, for example, in a context in which module6333associates an earlier laminar-flow-indicative value6371or a later laminar-flow-indicative value6372(a Reynolds number or other such measurement below a turbulence-indicative threshold6331, e.g.) with timing data6361signifying 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 logic6320may trigger one or more remote evaluation modules6396to evaluate whether such timing data sufficiently coincides with timing data6362of a dispensation, timing data6363of a pressure-indicative or other confirmatory measurement6353, or other such therapeutically relevant and detectable events.

Operation11838describes detecting one or more conditions optically (e.g. module6662of processing logic6660detecting an apparent blockage manifested in an image6664of one or more regions6691,6692of a subject vessel6696). This can occur, for example, in a context in which network6295includes detection system6650and in which there are one or more differences6251,6252between spectral and/or temporal absorbance distributions6211,6212and the corresponding baseline distribution(s)6221,6222indicative 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, a change rate6255or other such indicator6256of color or intensity change in a signal6232from an optical sensor2525can likewise trigger module6201to generate a Boolean alarm indicator6257(signifying an apparent blockage, e.g.) and optionally provide positional information6253and/or timing information6254relating to objects in a subject region.

Operation11839describes detecting one or more force-change-indicative values (e.g. module6661of processing logic6660detecting a fractional force change indication6663from 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 sensors6682detect a sudden, substantial change in one or more mechanical properties internal tissue in a body part6690of subject6670. In some contexts, for example, a complete or partial blockage of a subject vessel6696(in region6692, 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 (at region6692, e.g.) and/or as a contemporaneous change several millimeters away from the blockage. Such changes can manifest as changes in vascular pressure in an upstream region6691and/or a downstream region6693, for example, detectable by one or more other sensors6681,6683of module6680.

Operation11892describes 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. module6041of decision logic6050selecting one or more injectable therapeutic components from a set of locally available therapeutic components6073for use in response to one or more comparator results6031,6033corresponding thereto, of which at least one indicates abnormally poor circulation in a subject6090under 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, module6042may display an ingestible clot-reducing agent indication6025(via output6024, e.g.) or may indicate other medically appropriate responses (being seated or calling an ambulance, e.g.).

Operation11893describes signaling at least an anticoagulant of the one or more clot-reducing agents in response to an apparent flow degradation (e.g. module6322of invocation logic6320receiving and relaying the decision6391to 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 which invocation logic6320and decision logic6395jointly or iteratively perform operation11730, in which mediation module6310interacts with a local module as described herein via port6321, and in which such flow degradation manifests as one or more of a complaint or other severe limb pain indication6344, a swelling indication6346, a local 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, another module6323may 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, module6322may invoke recorder6311to capture a distillation of one or more dispensation indications6347, symptom indications6349, and/or related timing data6363selectively for future evaluation.

Operation11897describes causing one or more dispensations in response to an apparent problem in the flow-change-indicative measurement (e.g. module6122of invocation logic6120enabling or otherwise facilitating an activation of one or more dispensers6075containing one or more local dispensations of a vasodilator6071, a lytic agent6072, or other such therapeutic components6073effective for modifying circulatory flow). This can occur, for example, in a context in which system6100includes or otherwise interacts with administration unit6010, in which one or more location sensors6101or flow attribute sensors6102are implemented in or can otherwise detect vessel properties in relation to hand-held unit6080, and in which module6104of detection logic6110detects 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 or more modules6122,6123to trigger such a dispenser to inject an anticoagulant or other such component locally and promptly upstream from a clot-prone site. Alternatively or additionally, module6182can be configured to respond similarly by transmitting a (human) subject or other such care provider a notification6170including one or more of a dispensation indication6172or an indication6173of detected conditions that warrant the dispensation.

Operation11932describes receiving the flow-change-indicative measurement from a user (e.g. record3110accepting one or more parameters3168indicative of flow change from a user via remote module3190). This can occur, for example, in a context in which remote module3190includes one or more user interface elements6291accessible to a subject or other user, in which invocation logic3140prompts a user for such information, and in which the measurement(s) are accepted as input6292. 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 with administration system6200. Alternatively or additionally, some such parameters can be used for guiding an intake protocol, even without recordation.

Operation11934describes detecting one or more impedance-change-indicative values (e.g. module6733of detection logic6720detecting a sustained, small-enough change rate6721to indicate an apparent blood vessel obstruction or some other impedance change indication6722reflecting a circulatory phenomenon of interest). This can occur, for example, in a context in which configuration system6710includes or otherwise interacts with one or more local modules2320,2450and in which impedance sensor2323or 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.

Operation11937describes comparing an earlier-flow-indicative value with a later-flow-indicative value (e.g. module6202of evaluation logic6210comparing current flow-indicative data6233with historic data6234provided to or measured by a sensor-containing device). This can occur, for example, in a context in which one or more ankle images6272, size measurements6271, or other such indications822are held locally in a data-handling medium885and later used by one or more comparators882or other entities as a baseline value or other historic indication for comparison with one or more similar (subsequent or current) images6272,6263or other 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.

Operation11939describes confirming a flow-change indication with a confirmatory evaluation (e.g. module6132of decision logic6130performing, 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 which mediation module6310is operably coupled with system6100ofFIG. 61and in which discrimination against false indications is important enough to warrant two or more modes of evaluation. In some variants, for example, such confirmatory measurements6353may comprise additional data6340of 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 or more cooling indications6345or swelling indications6346relating to a subject region, such indications may be corroborated or otherwise selectively confirmed by more accurate instrumentation. Alternatively or additionally, similar data6340obtained 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.

Operation11991describes 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. module6245of decision logic6240causing a user interface element6291to present a subject and/or caregiver an option to initiate, select, approve, and/or refuse one or more of a set6244of two or more therapy regimens6241,6242,6243). This can occur, for example, in a context in which one or more implants1730,1940,5690detect an apparent pathological state indication6296(via network6295, e.g.) triggering a request6276to administration system6200to query user6290for approval and/or selection of one or more therapy regimens6242,6243. In some variants, for example, one or more expert system modules6294of administration system6200will present such a set of regimens pursuant to one or more identifiers of values6274,6275or other current input6292from user6290. Alternatively or additionally, a subject or other user6290may obtain other regimens, options, prognoses, or other information or advice from expert system module6294or other resources on network6295.

Operation11994describes communicating a notification partly based on a risk indicator and partly based on the flow-change-indicative measurement to a user interface (e.g. module6423of notification logic6420transmitting one or more notifications6440,6450configured by module6422to include one or more risk indicators6431,6432and two or more sequential samples6441,6442,6443of signal6445). This can occur, for example, in a context in which module6454invokes one or more such modules of notification logic6420in response to a sustained trend or other symptom-indicative event sequence in signal6446. In some variants, for example, one or more modules6461of evaluation logic6460compute a marginal probability6462or other such risk indicator6431periodically (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 (below threshold6463, e.g.). Alternatively or additionally, one or more such notifications6440,6450may include computed differences or other composite indicators6491derived from signal6445, pictographic data, measurements, timing data6494, current personnel availability or other resource availability data6493, or other such information.

Operation11995describes signaling a response protocol reflecting the decision via a user interface (e.g. module6181of notification logic6180transmitting notification6160to a telephonic or other interface articulating an initiation6151or update6152of one or more clot-reducing protocols). This can occur, for example, in a context in which notification logic6180and one or more interfaces described herein iteratively perform operation11790. Alternatively or additionally, one or more attributes of the decision(s)6133and/or regimen(s)6134may, in some variants, be implemented after receiving an approval6103or similar decision indicator via the user interface (from a subject and/or caregiver, e.g.).

Operation11998describes communicating the flow-change-indicative measurement to a remote user (e.g. module6538of notification logic6540transmitting one or more notifications6544to one or more remote client systems as a result of one or more comparators6521signaling the violation of one or more evaluation criteria6523). This can occur, for example, in a context in which server system6490implements interface6500. In some variants, for example, a nurses' station or other aggregation destination6402is 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.

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 receiver4546obtains a priori implant information by receiving configuration information to describe or otherwise accommodate a lower module4590that has been or will be implanted. This can occur, for example, in a context in which one or more instances of upper module4550is (or will be) well situated to administer one or more lytic materials or other therapies that may be needed at one or more instances of lower 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 which interface logic4540invokes circuitry for performing operation11380(ofFIG. 113) such as one or more modules4513of dispensing logic4515operable for activating one or more dispensers4518,4519when 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 of such dispensing logic4515.

Any of the above-described embodiments can likewise comprise a variant in which timing module4552or another module4551of response logic4555performs operation10910by responding to a signal from sensor4510or some other indication that a lytic material will apparently be present in or near section4530of lumen4595. This can occur, for example, in a context in which response logic4555receives a notification that dispenser4519has been activated. Alternatively or additionally, such indications may be received from one or more sensors4510operable 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 or other timing module4552responsive 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 more semi-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-containing dispensers11228and/or may include one or more (artificial) disposal vessels10870and/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 or more disposals2888, optionally transluminal ones like disposal2889in which one or more conduits2886are configured to bear a blood-containing material into a body lumen. Any may likewise include one or more radiotherapy treatment modules or other such therapeutic structures2842.

Referring again toFIG. 46, alternatively or additionally, any of these modules or systems herein may likewise include an implantable, dispenser-containing valve4610. Any may likewise include one or more instances of wireless communication modules4644for sending data to or receiving data from an outside network or other entity. Any may likewise include one or more optical 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.

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.