Abstract:
A coordinating interface for electrophysiological signals provides inputs for ECG and intra-cardiac electrodes and provides a computer controllable processing path outputting data using a shareable digital data output. Requests received over a digital control line allow the computer to control a multiway switch and analog filter set to arbitrate among different uses of the electrophysiological signals by different devices. A single coordinating interface helps reduce interference from competing uses. Pre-stored configuration data simplifies the connection of different devices having different uses of the physiological data.

Description:
STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
     Not Applicable 
     CROSS REFERENCE TO RELATED APPLICATION 
     Not Applicable 
     BACKGROUND OF THE INVENTION 
     The present invention relates to electronic equipment for electrophysiology studies and in particular to an interface for electrophysiology devices that reduces interference and conflict among the electrophysiology devices. 
     Electrophysiology studies provide complex measurements of the electrical activity and conduction pathways of the heart that may be used, for example, to analyze and treat heart arrhythmias. An example study may use multiple surface ECG electrodes applied to the patient&#39;s skin together with intra-cardiac electrodes inserted into the patient&#39;s heart and monitoring electrical activity directly on the muscle wall of the heart. Electrical stimulation may be applied to the heart muscle through an intra-cardiac pacing electrodes to promote heart action that may be monitored. An intra-cardiac ablation electrode may be used to burn tissue of the heart to alter heart conduction pathways in a manner that may reduce or stop arrhythmia. A mapping device may use signals from a catheter in the heart, for example, providing an insertion path for intra-cardiac electrodes or one of the intra-cardiac electrodes to locate the position of the intra-cardiac electrodes. 
     In an electrophysiology study, multiple devices must have access to electrical signals from the body. Those devices typically include an ECG monitor for monitoring patient heartbeat, a stimulator device for providing pacing signals to the heart through one or more intra-cardiac electrodes, an intra-cardiac signal-recording device recording signals from the intra-cardiac electrodes, a mapping device determining a location of the intra-cardiac electrodes, and an ablation circuit providing ablative power through one or more of the intra-cardiac electrodes. Other devices such as x-ray equipment may also require access to these electrical signals, for example, for the purpose of gating image data to particular physiological activity such as respiration or cardiac cycle. 
     As a practical matter, these multiple devices must share limited electrode resources either in the form of discrete electrodes or practical locations for electrodes. Electrically sharing individual electrodes can generate cross-coupled noise between devices, problems with ground stabilization, and direct interference from conflicting uses, for example, between ablation or pacing and the measurement of sensitive physiological signals. Competing and different filtration requirements can make shared electrodes impractical in many cases and substantially increase the amount of time setting up and troubleshooting circuit paths in the operating room. 
     SUMMARY OF THE INVENTION 
     The present invention provides a coordinating interface for multiple electrophysiology signals that permits limited electrode resources to be subject to a computer-mediated arbitration between competing devices. By creating a single, versatile interface that may receive and process signals to and from the patient for multiple devices, competing leads and incompatible uses may be intelligently reconciled. 
     Specifically, in one embodiment, the invention provides an interface for electrophysiological signals having a set of electrode electrical connectors adapted to connect to electrical leads communicating between a patient and the interface and an analog-to-digital converter system providing multiple independent analog-to-digital converters. A computer controllable multiway switch connects signals from different ones of the electrical connectors to different inputs of different analog-to-digital converters according to a computer signal for conversion of analog signals from the electrical connectors to digital signals. A data network receives the digital signals and provides connectors adapted to connect the digital signals to medical devices requiring electrical signals from given sets of electrode electrical connectors. In addition, a control network system receives requests from at least two given medical devices describing needed electrical signals from the set of electrode electrical connectors. An electronic computer communicates with the control network system and executes a program stored in non-transitory medium to receive the requests from the given medical devices and arbitrate among the requests to provide the computer signal to the computer controllable multiway switch to connect the given medical devices through the multiway switch to selected electrodes of the set of electrode electrical connectors. 
     It is thus a feature of at least one embodiment of the invention to provide intelligent arbitration between competing demands of different medical devices for limited electrode resources. By computerizing this arbitration, simplified connection to the patient may be made while maximizing the availability of the electrodes and minimizing interference and the need for manual reconfiguration. 
     The data network and/or the control network may provide a serial communication protocol such as but not limited to Ethernet or USB. It is thus a feature of at least one embodiment of the invention to provide a simple, scalable method of communicating with multiple medical devices needing electrode data amenable to computer arbitration. 
     The data network and/or the control network may employ an optical fiber link. 
     It is thus a feature of at least one embodiment of the invention to provide communication among multiple different medical devices that eliminated unwanted leakage currents. 
     The interface may further include a computer controllable filter array providing frequency filtering to signals received from the electrode electrical connectors and positioned between the electrode electrical connectors and the analog-to-digital converter system, the computer control filter array communicating with the electronic computer and providing multiple independent filters having frequency profiles selectable by the electronic computer. 
     It is thus a feature of at least one embodiment of the invention to permit each medical device to flexibly receive different types of filtration depending on the intended use and the other contemporaneous uses. 
     The multiple independent filters may operate in either the analog or digital domain. 
     It is thus a feature of at least one embodiment of the invention to pre-attenuate electrical noise to permit accurate analog-to-digital conversion. 
     The interface for electrophysiological signals includes a monitor output terminal connectable to an ECG monitor receiving output directly from the independent filters without analog-to-digital conversion. 
     It is thus a feature of at least one embodiment of the invention to permit direct connection of standardized ECG signals that do not need significant manipulation directly to an external medical device. 
     The interface may further include computer-controllable bypass switches having input terminals connectable to sources of electrical power and outputs connected to ones of the electrode electrical connectors, the bypass switches communicating with the electronic computer to be closed or opened by signals from the electronic computer. 
     It is thus a feature of at least one embodiment of the invention to permit the interface not only of received physiological signals but also of transmitted pacing and stimulation signals. 
     The bypass switches may be electromechanical relays or solid state devices 
     It is thus a feature of at least one embodiment of the invention to provide extremely low-impedance bypass connections for high-power conduction. 
     The interface may further include signal sensors positioned in series along an electrical path between the input terminals connectable to sources of electrical power and those sources of electrical power for providing monitoring signals to the analog-to-digital converter system. 
     It is thus a feature of at least one embodiment of the invention to permit accurate monitoring of stimulation and/or pacing signals for diagnostics or fault detection. 
     The interface may further include a right leg drive circuit for providing a drive current to one of the electrode electrical connectors connectable to a ground pad and receiving signals from the data network to determine the drive current. 
     It is thus a feature of at least one embodiment of the invention to provide a right leg drive circuit that may use the flexible structure of the interface for improved ground-level sensing. 
     The requests for electrode resources received by the electronic computer may be associated with priorities and the arbitration provides the computer signals according to the priority so that the multiway switch selects the electrodes of the set of electrode electrical connectors required for the request of highest priority. 
     It is thus a feature of at least one embodiment of the invention to permit automatic arbitration based on predetermined priorities. 
     The arbitration may allow simultaneous service of requests of different priority that do not require conflicting settings of the multiway switch. 
     It is thus a feature of at least one embodiment of the invention to intelligently maximize the use of limited electrode resources. 
     The priorities may be stored in non-transitory medium indexed to a particular medical device and the requests may identify the medical device. 
     It is thus a feature of at least one embodiment of the invention to provide a simple method of assigning priorities according to the medical device. 
     Alternatively or in addition, the non-transitory medium may be indexed to a particular process of a particular medical device and the requests may identify the medical device and the process of the medical device. 
     It is thus a feature of at least one embodiment of the invention to permit a process level of granularity in assigning priorities. 
     The requests may identify a particular process and the device data structure may link processes to process duration and the arbitration grants priority to a given process for the duration in the data structure. 
     It is thus a feature of at least one embodiment of the invention to prevent allocation “starvation” of low-priority devices by limiting process duration. 
     The requests may identify a particular process, and the non-transitory medium may hold a configuration data structure linking processes to configurations, and the electronic computer may execute the program to receive requests identifying a particular process and use the configurations from the configuration data structure to provide the computer signal to the computer controllable multiway switch. 
     It is thus a feature of at least one embodiment of the invention to accommodate a variety of different interface configurations by permitting automatic reconfiguration of the interface according to its current use. 
     The configuration data structure may provide configurations identifying a given sets of electrode electrical connectors according to functions of associated electrodes, and the non-transitory medium further includes a lead function table relating electrode electrical connectors to particular lead functions, and the electronic computer may execute the program to compare the configurations against the lead functions per the lead function table. For example, the functions may include the functions of: ECG electrode, intra-cardiac electrode, stimulating electrode, and pacing electrode. 
     It is thus a feature of at least one embodiment of the invention to simplify configuration of the interface by allowing identification of electrodes by function rather than, say, by connector number. 
     The interface may include at least one digital-to-analog converter communicating with the data network to provide an output signal derived from at least one of the signals received by the electrode electrical connectors. 
     It is thus a feature of at least one embodiment of the invention to provide an output for legacy devices that can not receive the digital network signal. 
     The interface may further include a multiplexer for multiplexing an output of the independent analog-to-digital converters to the data network. 
     It is thus a feature of at least one embodiment of the invention to provide a simple reduced media connection to multiple medical devices through the use of a multiplexed digital signal. 
     These particular objects and advantages may apply to only some embodiments falling within the claims and thus do not define the scope of the invention. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a simplified block diagram of the interface of the present invention positioned between the patient and multiple medical devices; 
         FIG. 2  is a detailed block diagram of the interface showing its principal functional circuits under the control of a programmable computer element; 
         FIG. 3  is a logical representation of several data structures used by the present invention; and 
         FIG. 4  is a flowchart showing the operation of the present invention in arbitrating requests for limited electrode resources among multiple medical devices. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
     Referring now to  FIG. 1 , the coordinating interface  10  of the present invention may provide a gateway between a patient  12  and multiple medical devices  14  including those related to electrophysiology. 
     In one example, the patient  12  may have multiple surface ECG electrodes  16  communicating via surface ECG leads  18  to input connectors  20  on the interface  10 . Intra-cardiac electrodes  22 , introduced within the heart  24  of the patient by a catheter  25 , may also communicate with connectors  20  communicating via intra-cardiac leads  26 . The intra-cardiac electrodes  22  may include sensing electrodes as well as stimulating and pacing electrodes. A ground pad electrode  28  may also communicate with connectors  20  via leads  30 . 
     The medical devices  14  may include, for example, a monitor  32  providing for visual display and automatic monitoring of the signals from the surface ECG electrodes  16  and intra-cardiac electrodes  22 . The medical devices  14  may also include a recorder unit  34  synchronously recording ECG signals from surface ECG electrodes  16  and intra-cardiac electrodes  22 , an ablation unit  36  providing ablative current flow to an intra-cardiac electrode  22  for burning or scarring muscle tissue, a stimulator  38  for providing an electrical pacing signal to an intra-cardiac electrode  22  for the purpose of generating particular heart activity or response, and a medical imaging device such as an x-ray machine  40  using electrophysiological signals to produce gated images of the heart  24  timed to particular physiological periods such as a heartbeat or respiration cycle. One medical device  14  may be a mapping unit  42  that may receive signals from the surface ECG electrodes  16  and/or the intra-cardiac electrodes  24  and apply signals to the intra-cardiac electrodes to track their position via localizing antennas  44 . An example mapping unit  42  suitable for use with the present invention is manufactured by Biosensor Webster under the trade name Carto3® and employs technology described in U.S. Pat. No. 5,813,991 hereby incorporated by reference. 
     Referring now to  FIG. 2 , ECG signals from surface ECG leads  18  and intra-cardiac signals from intra-cardiac leads  26  may be received by a switch/filter circuit  46  providing a set of independent electronically configurable filter blocks  48 . The filter blocks  48  may implement a variety of different filter configurations including, for example, high pass, low pass, band rejection and band pass filters with settable frequency points. These filters may be used to reduce interference, for example, from external noise sources or from other medical devices  14 , for example, from the pacing signals from stimulator  38  or from the ablation signal from ablation unit  36 . These filters may be implemented in the analog domain so as to be able to handle a wide dynamic range outside of that typically available in an analog-to-digital converter; however, suitable gain control and digital filter solutions may also be provided. The filter settings may be controlled by a central controller  50  communicating with the switch/filter circuit  46  by a control line  49 . 
     The ECG signals from surface ECG leads  18 , after passing through the filter blocks  48  controlled by the controller  50 , may be received by ECG processing circuit  54 . The ECG processing circuit  54  may apply, for example, additional signal processing to the signals, for example, removing respiration artifacts or the like, as is understood in the art, and may provide additional filtering unique to standard ECG recording. The ECG processing circuit  54  may provide standard 12-lead ECG signals. 
     The ECG signals from the surface ECG leads  18 , after passing through the filter blocks,  48  may be provided directly to the monitor  32  in analog form on signal wire  55  for monitors  32  that expect analog signals. Typically the monitors  32  will provide processing circuitry similar to that of ECG processing circuit  54 . Because the signals from the surface ECG leads  18  are relatively standardized they may be treated separately from the intra-cardiac leads  26 . 
     In addition, the output of the ECG processing circuit  52  may be received by multiple analog-to-digital converters  56  of a multiple analog-to-digital converter bank  58 . For example, each analog-to-digital converter  56  may receive and process one ECG lead. 
     Generally, analog-to-digital converter bank  58  provides a number of different analog-to-digital converters including single input analog-to-digital converters  56  and differential analog-to-digital converters  62 , the latter of which convert a difference signal at their inputs into a digital output. It will be appreciated that multiple analog-to-digital converter functions are required but these may be implemented by discrete independent circuits or by a single or limited number of high-speed analog-to-digital converters multiplexed among inputs and outputs which shall be considered herein as equivalent to multiple analog-to-digital converters. 
     The intra-cardiac signals from intra-cardiac leads  26 , after passing through filter blocks  48 , may be received by a crosspoint switch array  60 . The crosspoint switch array  60  may be implemented either as a solid-state switch or by a set of interconnected electromechanical relays and provides multiple electrically independent single-pole, multi-throw switches where pairs of poles are connected to differential inputs of differential analog-to-digital converters  62  and the individual throws are each connected to one of the intra-cardiac leads  26  after passing through the filter blocks  48 . In this way, the differential signal across arbitrary pairs of the intra-cardiac electrodes  22  may be measured. The control of the crosspoint switch array  60  (the state of each poll) may be also provided by control lines  49  from the controller  50 . 
     The central controller  50  may also control multiple electromechanical relays  52  which may connect upstream from the filter blocks  48  to designated connectors  20  associated with selected intra-cardiac leads  26  that may be used as stimulating electrodes and/or ablating electrodes, respectively. Relays  52  allow a direct connection to be made to these connectors  20  without passing through filter blocks  48 . Relays  52  may also be controlled by controller  50  by control lines  49 . 
     The output of the relays  52  may pass, respectively, to an ablation sensor  66  and a stimulation sensor  68  which in turn receive signals from the ablation unit  36  and stimulator  38 . The ablation sensor  66  may measure ablation current and voltage, for example, to provide information about the interface between an intra-cardiac electrode  22  used for ablation and the tissue. Such measurements may reveal, for example, the impedance of the connection which may reflect a degree of charring during the ablation process or the initial contact state of the electrode. The ablation sensor  66  may also provide for edge detection to provide an output signal indicating initiation of ablation that may be used for gating or noise suppression techniques. This information is received by one or more analog-to-digital converters  56  in the analog-to-digital converter bank  58 . 
     Likewise stimulation sensor  68  may provide measures of voltage, current, and edge detection, the latter for gating purposes as described above and the former for measuring impedance to ensure proper electrical connection to the heart tissue. Both the ablation sensor  66  and the stimulation sensor  68  may be controlled by controller  50  through control lines  49 . 
     The output of the analog-to-digital converter bank  58  may be provided to a multiplexer/network interface  70  which takes the data from each of the analog-to-digital converters  56  and  62 , encoded as to identity of the particular analog-to-digital converter  56  or  62 , for high-speed transmission on a data bus  72 . This data bus  72  is generally connected in star or daisy-chain fashion to all medical devices  14  (shown in  FIG. 1 ) that may receive digital data encoded in a standardized protocol. In this way digital data from multiple surface ECG leads  18  and multiple intra-cardiac leads  26  may be distributed to multiple devices  14  without problems of loading or the need for various distribution amplifiers or complex lead connections, all leading to risk of additional noise introduction or erroneous connections. Suitable protocols for the data bus  72  include, for example, data protocols such as Ethernet or the like. 
     As shown in  FIG. 1 , each of the medical devices  38 ,  36 ,  34  and  42  receiving data bus  72  may also connect to a control bus  74  received by the controller  50 . In this way the medical devices  14  may independently request different data sources from among the surface ECG electrodes  16  and intra-cardiac electrodes  22  and different combinations and filtering of this data, by means of action by the controller  50  through control lines  49 . The request process permits particular lead assets such as the intra-cardiac electrodes  22  to be allocated to individual medical devices  14  in cases where multiple uses might conflict (for example, uses that reflect variously data sensing versus ablation or stimulation). 
     The control bus  74  may also be a communication protocol such as Ethernet. While typically separate from the data bus  72 , the control bus  74  and data bus  72  may be combined over a single medium by multiplexing techniques. In some embodiments, the control bus  74  and data bus  72  may be one or more optical fiber channels instead of direct copper connection. The optical fibers or similar optical isolation can eliminated the leakage currents associated with multiple medical host devices relative to the source. 
     One or more dedicated digital-to-analog converters  76  may attach to the data bus  72  through a demultiplexer  77  to provide an analog output representing the signal from any one of the surface ECG leads  18  or intra-cardiac leads  26  selected by the controller  50  for use with medical devices requiring analog signal output  78 , for example, gating applications on imaging devices such as an x-ray machine  40 . Alternatively, the digital-to-analog converter  76  may receive a composite signal generated by the controller  50  from data on the data bus  72  arbitrarily combining signals from multiple sources and applying edge detection algorithms to the signals. 
     The interface  10  may include a right leg drive circuit  90  that communicates with one connector  20  connecting with the Right Leg electrode  16  to provide a current drive to the Right Leg electrode  16  necessary to bring the analog ground reference level of interface  10  to the desired level of the patient  12 . In this regard, the right leg drive circuit  90  may receive control bus  49  to determine a RL drive circuit selection. For example, a measure of ground potential of the patient  12  may be made by a combined average of various signals from different electrodes  16  and various filter pole selections could be made in the RL drive circuit  90  with control from the control bus  49 . 
     The controller  50 , in one embodiment, may be a microprocessor or other similar device having at least one processor unit  92  executing a program  95  stored in non-transitory medium of electronic memory  94 . Referring also to  FIG. 3  the electronic memory  94  may also include various data structures including device files  96 , lead function table  98 , and process rules table  100 . One device file  96  may be associated with each of the medical devices  14  and may describe various processes  102  indicated by rows that may be executed by the associated medical device  14 . For example, a stimulator  38  may have different processes that apply different stimulations to different intra-cardiac electrodes  22  or different levels or patterns of stimulation. Each process  102  may provide for a different process type  104  and a different priority  106 , the latter which is used in the case of conflicts between medical devices  14  where the medical device  14  with higher priority is able to take access to the particular electrode asset of the surface ECG leads  18  or intra-cardiac leads  26  exclusive of a lower priority device. Each process  102  may also provide for a time duration  107  necessary to complete the process, such as prevents process starvation in other processes as will be described. 
     The process type  104  may be used to identify an entry in the process rules table  100  which maps process type  104  to a set of procedure rules  108  for that process. The procedure rules  108 , for example, may describe the settings of the filter blocks  48 , the relays  52 , and the crosspoint switch array  60  in implementing that process type  104  and may be prepared by the manufacturer or user of the medical device  14  before use of the coordinating interface  10  or may be prepared dynamically in response to the real-time needs of the medical procedure in process. The procedure rules  108  are used by the central controller  50  in executing the program  95  to generate signals on control lines  49 . The procedure rules  108  may further provide operating parameter data, for example, to the controller  50  indicating, for example, desired values from the ablation sensor  66  or stimulation sensor  68  during ablation or pacing, or this information may be passed directly to the medical devices  14  over the data bus  72 . Generally, the procedure rules  108  also describe the particular assets or lead types needed for the procedure by their functions. For example, the procedure rules  108  may describe the use of specific surface ECG signals or intra-cardiac signals. For this purpose, lead function table  98  provides a mapping between lead type or function  110  and the actual physical address  112  of the lead, being a location of the relevant connectors  20 , determined by the medical personnel connecting the interface  10  to the patient  12 . This allows flexibility in connecting particular leads to terminals  20 . 
     Referring now to  FIG. 4 , the program  95  may generally operate to receive and process requests from the medical devices  14  over control bus  74  to the controller  50  as indicated by process block  116 . Generally, each request will identify the particular medical device  14  making that request and having an associated device file  96  and one or more processes  102  also identified by the particular request. 
     At process block  118 , the process rules table  100  is analyzed to determine the rules  108  applicable to that process  102  including, for example, the necessary surface ECG leads  18  and intra-cardiac leads  26  and the configurations of the filter blocks  48 , crosspoint switch array  60 , etc. As noted, the procedure rules  108  may describe the necessary surface ECG leads  18  and intra-cardiac leads  26  in terms of signal function. These particular signal functions may be compared against the lead function table  98  to determine the appropriate terminals  20  and make sure the necessary leads are available. For example, if certain ECG leads are required and are not present in the lead function table  98 , an error may be reported to the user. More generally, the lead function table  98  simply provides a mapping for the necessary data. 
     Assuming the necessary lead assets are available, the priority of the process  102  being requested is determined from the device file  96  and may be evaluated in light of any currently executing processes by other medical devices  14  or pending processes  102  in queue  132  as indicated by decision block  120 . Normally each process  102  will have an associated time duration  107 , noted above, and in the event that the new requested process  102  has a higher priority than a currently executing process  102 , the currently executing process  102  will be allowed to complete its time duration  107 . The time duration  107  value may further be set to indefinite to indicate that assets acquired will utilized until explicitly released through removal of the owning process  102  from the device file  96  or removal of the corresponding rule  108 . Then, at the conclusion of any executing process  102 , the highest priority process  102  in a queue  132  of pending processes  102  or new processes  102  received at process block  116  is allowed to execute next. Pending processes  102  that cannot be executed because of priority are placed in the queue  132  as indicated by the decision branch “lower” of decision block  120 . 
     In one embodiment, the decision block  120  may determine whether the requested process  102  has conflicting resource requirements with pending higher priority processes  102 . If not, those two processes  102  may be executed in parallel. For example, two processes  102  that only require the reading of signals from electrodes without inconsistent use of other electrodes may be able to execute concurrently. This determination is made by evaluating the process rules  108  determined at process block  118  against those rules for any ongoing processes  102 . In this regard, the process rules  108  for each process  102  may desirably provide a range of acceptable settings, for example, filtration settings, so as to promote the possibility of compatible simultaneous use with other processes  102 . 
     When the process  102  is ready to execute, at process block  122 , the necessary configuration is implemented by the central controller  50  and the data is collected and transmitted over the data bus  72 . At decision block  124  this process continues for the indicated duration  107  of the process  102  provided by duration  107 . 
     The steps are repeated for each pending process, allowing multiple medical device  14  to share the limited lead resources. 
     Certain terminology is used herein for purposes of reference only, and thus is not intended to be limiting. For example, terms such as “upper”, “lower”, “above”, and “below” refer to directions in the drawings to which reference is made. Terms such as “front”, “back”, “rear”, “bottom” and “side”, describe the orientation of portions of the component within a consistent but arbitrary frame of reference which is made clear by reference to the text and the associated drawings describing the component under discussion. Such terminology may include the words specifically mentioned above, derivatives thereof, and words of similar import. Similarly, the terms “first”. “second” and other such numerical terms referring to structures do not imply a sequence or order unless clearly indicated by the context. 
     When introducing elements or features of the present disclosure and the exemplary embodiments, the articles “a”, “an”, “the” and “said” are intended to mean that there are one or more of such elements or features. The terms “comprising”, “including” and “having” are intended to be inclusive and mean that there may be additional elements or features other than those specifically noted. It is further to be understood that the method steps, processes, and operations described herein are not to be construed as necessarily requiring their performance in the particular order discussed or illustrated, unless specifically identified as an order of performance. It is also to be understood that additional or alternative steps may be employed. 
     References to “a microprocessor” and “a processor” or “the microprocessor” and “the processor,” can be understood to include one or more microprocessors that can communicate in a stand-alone and/or a distributed environment(s), and can thus be configured to communicate via wired or wireless communications with other processors, where such one or more processor can be configured to operate on one or more processor-controlled devices that can be similar or different devices. Furthermore, references to memory, unless otherwise specified, can include one or more processor-readable and accessible memory elements and/or components that can be internal to the processor-controlled device, external to the processor-controlled device, and can be accessed via a wired or wireless network. 
     It is specifically intended that the present invention not be limited to the embodiments and illustrations contained herein and the claims should be understood to include modified forms of those embodiments including portions of the embodiments and combinations of elements of different embodiments as come within the scope of the following claims. All of the publications described herein, including patents and non-patent publications, are hereby incorporated herein by reference in their entireties.