Patent Publication Number: US-2022218232-A1

Title: A device, system, and method for measuring physiological phenomena and physical activivies in a subject

Description:
FIELD OF THE DISCLOSURE 
     The present disclosure relates to a device, system, and method for measuring physiological phenomena and physical activities associated with a subject. Specifically, the present disclosure relates to determining a dominant activity observed from body-worn sensors and accurately characterizing that activity. 
     BACKGROUND OF THE DISCLOSURE 
     The health care industry is experiencing an emergence of wireless technologies that may replace conventional health monitoring devices with wearable devices. These wearable devices may monitor physiological data related to the health of a patient. As a result, these wearable devices may vastly improve disease prevention, clinical care, and quality of life. 
     However, obtaining clinically-accurate data from these wearable devices is proving quite difficult. For example, wearable medical devices may attempt to isolate useful physiological information from data gathered via a device worn on the body. In order to accomplish this goal, devices may employ a number of components including, for example, an accelerometer, gyrometer or gyroscope, magnetometer, and/or barometer. The physiological information may include, for example, pulse rate, blood pressure, respiratory rate, and/or temperature. Among this physiological information, respiratory rate is often not recorded or is inaccurate and therefore, unusable for adverse event detection. 
     For example, respiratory rate measurements may contain inaccuracies when based on periodic and aperiodic chest wall movements and vibrations. Mechanical motions as seen from periodic and aperiodic chest wall movements and vibrations may be defined as detection of dominant visible activity at any particular time. And, for a patient at rest, sensors may indicate a baseline respiration activity along with sensor noise that is aperiodic. When a patient rises to a standing or sitting position or otherwise changes posture, sudden aperiodic changes may manifest in sensor data. And, when a patient is mobile, such as when a patient is walking, a set of periodic oscillations may be seen. At any point in time, the ratio of the dominant activity versus the other activities may determine a signal quality index (SQI) measurement. And, in order to make use of measurements such as respiratory rate or other activity types, an assurance of quality via a quality index may be required to accept measurements that can be reliably used. Present models for respiratory rate do not provide high-quality SQI measurements, and thereby do not provide clinically accurate respiratory rate measurements. For example, when the dominant activity is not properly determined an accurate respiratory rate cannot be calculated. 
     But, activity levels are not often accurately determined. For example, medical quality algorithms may use measurements and/or context information that require an assurance or a quality index to obtain acceptable measurements that can be reliably used. Moreover, current models do not employ an accurate or near accurate signal quality index to use along with each measurement. 
     Further complications of existing methods include problems associated with overlapping activities related to, for example, respiration, slow walking cycles, posture changes, and/or other motion-related artifacts. These complications are evidenced by an inability to provide one-to-one relations that associate frequency domain information with a particular physiological phenomenon. 
     In addition to these problem is the fact that respiratory rate is often not recorded, even when the patient&#39;s primary problem is a respiratory condition. This is also in spite of the fact that an abnormal respiratory rate may be an important predictor of serious events such as cardiac arrest or admission to an intensive care unit (ICU). In fact, higher respiration rate in patients may been associated with increased mortality. These and other drawbacks exist. 
     Advantageously, the present invention seeks to solve these outstanding problems by measuring physiological phenomena and physical activities happening at any point in a subject&#39;s body. 
     SUMMARY OF THE DISCLOSURE 
     According to various embodiments, the present disclosure relates to a method to determine the dominant activity observed from body-worn sensors and accurately characterize the activity. Various embodiments may include using Periodicity Transform (PT) along with Partial Cycle Measurement (PCM) calculations to detect a dominant activity associated with a data interval from one or more data channels. 
     For example, in a body-worn sensor (e.g., chest-worn, limb-worn, etc.), there may be contradictory signals that overlap in time, frequency, amplitudes, and/or the like, and this overlapping data may convey the specific dominant information in a mixed way. Various embodiments described herein seek to determine the dominant source of information from any channel by using fractional cycles and periodicity transforms. For example periodicity transforms according to various embodiments may provide specific transformation methods that are implementable in real-time and identify the dominant cycle period when used along with heuristics to eliminate harmonic/sub-period information. Accordingly, the various embodiments described herein may determine a dominant activity happening inside or with the patient along with a reliability measure (e.g., signal-quality index) for the particular measurement interval. 
     By way of example, respiratory rate measurements such as a measurement of various mechanical motions as seen from periodic and aperiodic chest wall movements and vibrations, which can be defined as detection of dominant visible activity at any particular time. For a patient at rest, sensors may indicate a baseline respiration activity along with sensor noise, which is aperiodic. When a patient gets up, or changes posture, or turns around, sudden aperiodic changes manifest in sensor data. Again, a set of periodic oscillations may be seen, when a patient goes through a regular slow or quick walk. At any instant in time, the ratio of the dominant activity versus the rest of the activity can determine the signal quality index (SQI) measure. 
     Various embodiments of the disclosure may include a device having an accelerometer configured to receive accelerometer data; a gyroscope configured to receive gyroscope data; and a microprocessor configured to: perform partial cycle analysis to determine at least a top three cycles based on at least one of: the accelerometer data and gyroscope data; perform a periodicity transform (PT)-based selection of at least one top periodicity observed from the partial cycle analysis; and determine a most likely activity of the at least one top periodicity using heuristics. In various embodiments, the most likely activity may include at least one of: sudden motion, sustained motion, slow chest wall movement, deep chest wall movement, and vigorous vibration. 
     According to various embodiments, PT-based selection may be performed by: (a) assuming a threshold (T); (b) obtaining signal X of length N via at least one of: the accelerometer data and the gyroscope data; (c) locating a fractional cycle marker for each cycle of the at least top three cycles; (d) approximating a cycle length (CL i ) and an amplitude (A i ) for each cycle, wherein i is a cycle; (e) approximating the expected periodicities for each cycle; (f) relating the expected periodicities to the fractional cycle marker for each cycle; (g) letting an expected periodicity equal to one; (h) removing a linear DC component by removing the projection onto the first expected periodicity equal to one; (i) letting the expected periodicity equal CL 1 ; (j) determining whether A 1  contains at least T percentage of energy in X; (k) if A 1  contains at least T percentage of energy in X, accepting A 1  and CL 1  as a possible cycle; (l) repeating steps (i)-(k) for each CL i  and A i ; and (m) estimating a most likely cycle length based on each cycle length (CL i ) and an amplitude (A t ) for each cycle. 
     According to various embodiments, partial cycle estimation may occur simultaneous to or separately from periodicity transformation estimations. 
     In various embodiments, if adjacent periodicities show dominant characteristics due to a variability inside the measurement interval, periodicity bands are formed, and a center periodicity inside a band is nominated as the most likely cycle length. And, in various embodiments heuristics may be based on at least one of: a particular amplitude range, a particular cycle length, data indicative of continuity, data indicative of a duration of continuity, data indicative of a periodic nature, data indicative of what channels of sensors a signal is dominant in, and a degree of correlation with measurements made in silent intervals. According to various embodiments heuristics may include at least one of: a maximum power cycle length associated with at the accelerometer data, a maximum power cycle length associated with the gyroscope data, a mean power cycle length associated with at the accelerometer data, a mean power cycle length associated with the gyroscope data, a maximum significant estimated cycle length associated with at the accelerometer data, a maximum significant estimated cycle length associated with the gyroscope data. 
     Also, according to various embodiments, a microprocessor may measure a signal quality index (SQI) for an incoming signal associated with at least one of the accelerometer data and gyroscope data using the presence or absence of periodicity information associated with the partial cycle analysis. Accordingly to various embodiments a sudden change in SQI for a duration less than a first SQI threshold may indicate a posture change. 
     In various embodiments, the accelerometer and gyroscope may be housed in a wearable device, which may be worn on a user&#39;s chest, either in the upper chest or lower chest regions. A user may include a patient. In various embodiments, accelerometer data and/or gyroscope data may be received on-demand and/or continuously. In various embodiments, sensor data may be pushed from a wearable device and/or pulled from a wearable device. 
     According to various embodiments a microprocessor may determine a signal quality index (SQI) associated with the most likely activity. 
     In various embodiments, a partial cycle analysis may be performed by mapping cycles onto regions of maximum amplitudes, minimum amplitudes, and zero crossing intervals and their periodicities. This mapping may be continuous. And, in various embodiments, a cycle may be selected as an at least top three cycles based on amplitude thresholds and repeatability of periodicity. Moreover, in various embodiments a baseline measurement noise amplitude may be computed and subtracted from amplitude measurements associated with at least one of accelerometer data and gyroscope data. 
     Various embodiments my include receiving accelerometer data via an accelerometer of a wearable device; receiving gyroscope data via a gyroscope of the wearable device; performing partial cycle analysis to determine at least a top three cycles based on at least one of: the accelerometer data and gyroscope data; performing a periodicity transform (PT)-based selection of at least one top periodicity observed from the partial cycle analysis; and determining a most likely activity of the at least one top periodicity using heuristics. Various embodiments may include a most likely activity of respiration and a top periodicity of a respiration rate. Moreover, various embodiments may conclude that a most likely activity includes at least one of: sudden motion, sustained motion, slow chest wall movement, deep chest wall movement, and vigorous vibration. 
     Various embodiments may include performing a PT-based selection is by: (a) assuming a threshold (T); (b) obtaining signal X of length N via at least one of: the accelerometer data and the gyroscope data; (c) locating a fractional cycle marker for each cycle of the at least top three cycles; (d) approximating a cycle length (CL i ) and an amplitude (A i ) for each cycle, wherein i is a cycle; (e) approximating the expected periodicities for each cycle; (f) relating the expected periodicities to the fractional cycle marker for each cycle; (g) letting an expected periodicity equal to one; (h) removing the linear DC component by removing the projection onto the first expected periodicity equal to one; (i) letting the expected periodicity equal CL 1 ; (j) determining whether A 1  contains at least T percentage of energy in X; (k) if A 1  contains at least T percentage of energy in X, accepting A 1  and CL 1  as a possible cycle; (l) repeating steps (i)-(k) for each CL i  and A i ; and (m) estimating a most likely cycle length based on each cycle length (CL i ) and an amplitude (A i ) for each cycle. 
     In various embodiments the implementation of any methods or device-based algorithms may be in the form of hardware and/or firmware. For example a low pass filter associated with a particular signal may filter or pass one or more signals with a frequency lower than a predefined threshold frequency. Advantageously, by placing filters in hardware, the filters may be sturdy. 
     Various embodiments of the present disclosure provide a device, system, and method for measuring physiological phenomena and physical activities associated with a subject. In various embodiments, 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Various embodiments of the present disclosure, together with further objects and advantages, may best be understood by reference to the following description taken in conjunction with the accompanying drawings, in the several Figures of which like reference numerals identify like elements, and in which: 
         FIG. 1  depicts an example embodiment of a system including device that measures physiological phenomena and physical activities associated with a subject; 
         FIG. 2  depicts an example embodiment of a system including device that measures physiological phenomena and physical activities associated with a subject; 
         FIG. 3  depicts an example embodiment of a system including device that measures physiological phenomena and physical activities associated with a subject; 
         FIG. 4  depicts a flow diagram that illustrates an example method that measures physiological phenomena and physical activities associated with a subject in accordance with an embodiment of the invention; 
         FIG. 5  depicts an example device housing technology that measures physiological phenomena and physical activities associated with a subject in accordance with an embodiment of the invention; and 
         FIG. 6  depicts an example device housing technology that measures physiological phenomena and physical activities associated with a subject in accordance with an embodiment of the invention. 
     
    
    
     DETAILED DESCRIPTION OF THE EMBODIMENTS 
     The following description is intended to convey a thorough understanding of the embodiments described by providing a number of specific exemplary embodiments and details involving a device, system, and method for measuring physiological phenomena and physical activities associated with a subject, such as measuring signal data, determining a signal quality index, and/or determining a most likely activity associated with sensor data. It should be appreciated, however, that the present disclosure is not limited to these specific embodiments and details, which are examples only. It is further understood that one possessing ordinary skill in the art, in light of known systems and methods, would appreciate the use of the invention for its intended purposes and benefits in any number of alternative embodiments, depending on specific design and other needs. 
       FIG. 1  depicts an exemplary system  100  for use with the device, system, and method for measuring physiological phenomena and physical activities associated with a subject, such as measuring signal data, determining a signal quality index, and/or determining a most likely activity associated with sensor data. As shown in  FIG. 1 , an example system  100  may include one or more wearable devices  120 , one or more monitoring systems  140 , and/or one or more mobile devices  150  connected over one or more networks  110 . 
     For example, network  110  may be one or more of a wireless network, a wired network or any combination of wireless network and wired network. For example, network  110  may include one or more of a fiber optics network, a passive optical network, a cable network, an Internet network, a satellite network, a wireless LAN, a Global System for Mobile Communication (“GSM”), a Personal Communication Service (“PCS”), a Personal Area Network (“PAN”), Wireless Application Protocol (WAP), Multimedia Messaging Service (MMS), Enhanced Messaging Service (EMS), Short Message Service (SMS), Time Division Multiplexing (TDM) based systems, Code Division Multiple Access (CDMA) based systems, D-AMPS, Wi-Fi, Fixed Wireless Data, IEEE 802.11b, 802.15.1, 802.11n and 802.11g, a Bluetooth network, or any other wired or wireless network for transmitting and receiving a data signal. 
     In addition, network  110  may include, without limitation, telephone lines, fiber optics, IEEE Ethernet 902.3, a wide area network (“WAN”), a local area network (“LAN”), a wireless personal area network (“WPAN”), a wireless body area network (“WBAN”), or a global network such as the Internet. Also network  110  may support an Internet network, a wireless communication network, a cellular network, or the like, or any combination thereof. Network  110  may further include one network, or any number of the example types of networks mentioned above, operating as a stand-alone network or in cooperation with each other. Network  110  may utilize one or more protocols of one or more network elements to which they are communicatively coupled. Network  110  may translate to or from other protocols to one or more protocols of network devices. Although network  110  is depicted as a single network, it should be appreciated that according to one or more embodiments, network  110  may comprise a plurality of interconnected networks, such as, for example, the Internet, a service provider&#39;s network, a cable television network, corporate networks, and home networks. 
     Wearable device  120  may include, for example, one or more accelerometer  122 , one or more gyroscope  123 , on or more photoplethysmography (PPG) sensor  124 , one or more electrocardiogram (ECG) sensors  125 , one or more temperature sensor  126 , one or more humidity sensor  127 , location-detection technology  128 , and/or one or more microprocessor  129 . Wearable device may also include other sensors  130  such as any magnetometer or barometer. 
     A wearable device  120  may, for example, receive signals and/or data indicative of: a vital sign (e.g., heart rate, respiratory rate, temperature, blood pressure, blood glucose level, pulse oximetry, and/or the like), a pain measurement, a stress measurement (e.g., via vital signs, skin conductance data, and/or the like), an activity measurement (e.g., a number of steps taken, a number of floors climbed, a type of activity, a distance a user has moved, a gait characteristic, a gait speed, and/or the like). A wearable device  120  may be a limb-worn device (e.g., wrist, arm, ankle, leg, etc.), a chest-worn device, and/or a multi-location worn device. In various embodiments, an ECG device  110  and/or wearable device  120  may comprise a wireless patch, a wired patch, a limb-worn device, and/or an implantable device. By way of example, a wearable device may be a chest worn patch as illustrated in  FIGS. 5 and 6 . For example, a chest worn patch  502 ,  602  may be worn on a user/patient  500 / 600  as illustrated. A chest worn patch  502 ,  602  may have any shape and/or may be placed on the chest in any manner. 
     Monitoring system  140  may include an input/output interface  142 , a processor  144 , and/or data storage  146 . Although monitoring system  140  is depicted as a standalone system, monitoring system  140  may be incorporated into, for example a wearable device  120  and/or a mobile device  150 . 
     Monitoring system  140  and/or mobile device  150  may include, for example, one or more mobile devices, such as, for example, personal digital assistants (PDA), tablet computers and/or electronic readers (e.g., iPad®, Kindle Fire®, Playbook, Touchpad, etc.), wearable devices (e.g., Google® Glass, Apple Watch®, etc.), telephony devices, smartphones, cameras, music playing devices (e.g., iPod®, etc.), televisions, patient monitoring devices (e.g., Philips Intellivue®, Philips Avalon®, Philips IntelliSpace®, etc.), set-top-box devices, and the like. 
     Monitoring system  140  and/or mobile device  150  also may include a network-enabled computer system and/or device. As referred to herein, a network-enabled computer system and/or device may include, but is not limited to: e.g., any computer device, or communications device including, e.g., a server, a network appliance, a personal computer (PC), a workstation, a mobile device, a phone, a handheld PC, a personal digital assistant (PDA), a thin client, a fat client, an Internet browser, or other device. The network-enabled computer systems may execute one or more software applications to, for example, receive data as input from an entity accessing the network-enabled computer system, process received data, transmit data over a network, and receive data over a network. 
     Monitoring system  140  and/or mobile device  150  may include at least one central processing unit (CPU), which may be configured to execute computer program instructions to perform various processes and/or methods. Processes and/or methods as described herein may be understood to refer to computer executable software, firmware, hardware, and/or various combinations thereof. It is noted there where a process and/or method includes a software and/or firmware component, the software and/or firmware is configured to affect the hardware elements of an associated system. It is further noted that the processes and/or methods shown and described herein are intended as examples. The processes and/or methods may be combined, integrated, separated, or duplicated to support various applications. Also, a function described herein as being performed at a particular process and/or method may be performed during one or more other processes and/or methods and by one or more other devices instead of or in addition to the function performed as described. Further, the processes and/or methods may be implemented across multiple devices or other components local or remote to one another. Additionally, the processes and/or methods may be moved from one device and added to another device, or may be included in both devices. 
     Monitoring system  140  and/or mobile device  150  may include an input/output interface  142 ,  152 . Input/output interface  142 ,  152  also may include antennas, network interfaces that may provide or enable wireless and/or wire line digital and/or analog interface to one or more networks, such as network  110 , over one or more network connections, a power source that provides an appropriate alternating current (AC) or direct current (DC) to power one or more components of system  100 , and a bus that allows communication among the various components of system  100 . Input/output interface  142 ,  152  may include a display, which may include for example output devices, such as a printer, display screen (e.g., monitor, television, and the like), speakers, projector, and the like. Although not shown, input/output interface  142 ,  152  may include one or more encoders and/or decoders, one or more interleavers, one or more circular buffers, one or more multiplexers and/or de-multiplexers, one or more permuters and/or depermuters, one or more encryption and/or decryption units, one or more modulation and/or demodulation units, one or more arithmetic logic units and/or their constituent parts, and/or the like. 
     Input/output interface  142 ,  152  may include a Bluetooth module or chipset with a Bluetooth transceiver, a chip, and an antenna. The transceiver may transmit and receive information via the antenna and an interface. The chip may include a microprocessor that stores and processes information specific to a piconet and provides device control functionality. Device control functionality may include connection creation, frequency-hopping sequence selection and timing, power control, security control, polling, packet processing, and the like. The device control functionality and other Bluetooth-related functionality may be supported using a Bluetooth API provided by the platform associated with the monitoring system  140  and/or mobile device  150 . Using a Bluetooth API, an application stored on monitoring system  140  and/or mobile device  150  may be able to scan for other Bluetooth devices, query the local Bluetooth adapter for paired Bluetooth devices, establish RFCOMM channels, connect to other devices through service discovery, transfer data to and from other devices, and manage multiple connections. A Bluetooth API used in the methods, systems, and devices described herein may include an API for Bluetooth Low Energy (BLE) to provide significantly lower power consumption and allow monitoring system  140  and/or mobile device  150  to communicate with BLE devices that have low power requirements (e.g., wearable device  120 ). 
     Input/output interface  142 ,  152  may also include an NFC antenna and secure element (SE). In one embodiment, the SE may be used for digitally and physically secure storage of sensitive data. The SE may include a computer processor or other computational hardware or software. 
     Input/output interface  142 ,  152  may enable Industry Standard NFC Transmission. For example, the input/output interface  142 ,  152  may enable two loop antennas to form an air-core transformer when placed near one another by using magnetic induction. Input/output interface  142 ,  152  may operate at 13.56 MHz or any other acceptable frequency. Also, input/output interface  142 ,  152  may provide for a passive communication mode, where the initiator device provides a carrier field, permitting answers by the target device via modulation of existing fields. Additionally, input/output interface  142 ,  152  also may provide for an active communication mode by allowing alternate field generation by the initiator and target devices. 
     Input/output interface  142 ,  152  may deactivate an electromagnetic field for wireless broadcasting and/or communication during particular (e.g., predefined and/or otherwise specified) intervals. For example, input/output interface  142 ,  152  may deactivate an RF field while awaiting data. This deactivation may use Miller-type coding with varying modulations, including 100% modulation. The deactivation may also use Manchester coding with varying modulations, including a modulation ratio of 10%. Additionally, input/output interface  142 ,  152  may be capable of receiving and transmitting data at the same time, as well as checking for potential collisions when the transmitted signal and received signal frequencies differ. 
     Input/output interface  142 ,  152  may be capable of utilizing standardized transmission protocols. Also, input/output module  142 ,  152  may be able to utilize transmission protocols and methods that are developed in the future using other frequencies or modes of transmission. Input/output module  142 ,  152  may also be backwards-compatible with existing techniques, for example RFID. 
     Monitoring system  140  and/or mobile device  150  may include data storage  146 ,  156 , including for example, random access memory (RAM) and read only memory (ROM), which may be configured to access and store data and information and computer program instructions. Data storage  146 ,  156  may also include storage media or other suitable type of memory (e.g., such as, for example, RAM, ROM, programmable read-only memory (PROM), erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM), magnetic disks, optical disks, floppy disks, hard disks, removable cartridges, flash drives, any type of tangible and non-transitory storage medium), where the files that comprise an operating system, application programs including, for example, web browser application, email application and/or other applications, and data files may be stored. Data storage  146 ,  156  may include electronic information, files, and documents stored in various ways, including, for example, a flat file, indexed file, hierarchical database, relational database, such as a database created and maintained with software from, for example, Oracle® Corporation, Microsoft® Excel file, Microsoft® Access file, or any other storage mechanism. 
     Monitoring system  140  and/or mobile device  150  may further include, for example, a processor  144 ,  154 , which may be several processors, a single processor, or a single device having multiple processors. Processor  144 ,  154  may include any range of processing, such as, for example a one-chip microprocessor or a multi-chip processing unit. In various embodiments, processor  144  and/or processor  154  may execute a number of instructions and/or modules. 
     Monitoring system  140  and/or mobile device  150  may include any mobile device running the Apple® iOS operating system (e.g., iPhone, iPad, Apple Watch, and/or the like) and/or any device running Google&#39;s Android® operating system, including, for example, smartphones running the Android® operating system and other wearable mobile devices, such as Google® Glass or Samsung Galaxy Gear® Smartwatch , any device running Microsoft&#39;s Windows® Mobile operating system, and/or any other smartphone or like device. 
     Although not shown, mobile device  150 , monitoring system  140 , ECG device  110  and/or wearable device  120  may connect to a system associated with a general practitioner and/or specialist over network  110  in order to transmit any received data and/or measurements associated with the monitoring described herein. 
       FIG. 2  depicts an example system that may be used for patient monitoring as described herein. The example system  200  in  FIG. 2  may enable a medical facility, for example, to provide networked services and solution to patients, such as vital signs monitoring and analysis as described herein. As shown in  FIG. 2 , system  200  may include a user device  202  (e.g., a wearable device, an implantable device, and/or the like as described herein), a network  204 , a front-end controlled domain  206 , a back-end controlled domain  212 , and a backend  218 . Front-end controlled domain  206  may include one or more load balancers  208  and one or more web servers  210 . Back-end controlled domain  212  may include one or more load balancers  214  and one or more application servers  216 . 
     User device  202  may include some form of a network-enabled computing device. As referred to herein, a network-enabled computing device may include, but is not limited to: e.g., any computer device, or communications device including, e.g., a wearable device, an implantable device, a thin client, a fat client, an Internet browser, or other device. The one or more network-enabled computing devices of the example system  200  may execute one or more software applications to enable, for example, network communications. 
     A computing device may include any computer device, or communications device including, e.g., a server, a network appliance, a personal computer (PC), a workstation, a mobile device, a phone, a handheld PC, a personal digital assistant (PDA), a thin client, a fat client, an Internet browser, or other device. These devices may include a monitoring device that receives data from a wearable and/or implantable device. The one or more network-enabled computers of the example system  200  may execute one or more software applications to enable, for example, network communications. 
     User device  202  also may be a mobile device. For example, a mobile device may include an iPhone, iPod, iPad from Apple® or any other mobile device running Apple&#39;s iOS operating system, any device running Google&#39;s Android® operating system, including for example, Google&#39;s wearable device, Google Glass, any device running Microsoft&#39;s Windows® Mobile operating system, and/or any other smartphone or like wearable mobile device. 
     Network  204  may be one or more of a wireless network, a wired network, or any combination of a wireless network and a wired network. For example, network  204  may include one or more of a fiber optics network, a passive optical network, a cable network, an Internet network, a satellite network, a wireless LAN, a body area network (BAN), a wide area network (WAN), a Global System for Mobile Communication (GSM), a Personal Communication Service (PCS), a Personal Area Networks, (PAN), D-AMPS, Wi-Fi, Fixed Wireless Data, IEEE 802.11b, 802.15.1, 802.11n, and 802.11g or any other wired or wireless network for transmitting and receiving a data signal. 
     In addition, network  204  may include, without limitation, telephone lines, fiber optics, IEEE Ethernet 902.3, a wide area network (WAN), a local area network (LAN), a body area network (BAN) or a global network such as the Internet. Also, network  204  may support an Internet network, a wireless communication network, a cellular network, or the like, or any combination thereof. Network  204  may further include one network, or any number of example types of networks mentioned above, operating as a stand-alone network or in cooperation with each other. Network  204  may utilize one or more protocols of one or more network elements to which they are communicatively couples. Network  204  may translate to or from other protocols to one or more protocols of network devices. Although network  204  is depicted as a single network, it should be appreciated that according to one or more embodiments, network  204  may comprise a plurality of interconnected networks, such as, for example, the Internet, a service provider&#39;s network, a cable television network, corporate networks, and home networks. 
     Front-end controlled domain  206  may be implemented to provide security for backend  218 . Load balancer(s)  208  may distribute workloads across multiple computing resources, such as, for example computers, a computer cluster, network links, central processing units or disk drives. In various embodiments, load balancer(s)  210  may distribute workloads across, for example, web server(S)  216  and/or backend  218  systems. Load balancing aims to optimize resource use, maximize throughput, minimize response time, and avoid overload of any one of the resources. Using multiple components with load balancing instead of a single component may increase reliability through redundancy. Load balancing is usually provided by dedicated software or hardware, such as a multilayer switch or a Domain Name System (DNS) server process. 
     Load balancer(s)  208  may include software that monitoring the port where external clients, such as, for example, user device  202 , connect to access various services and/or devices of a medical facility, for example. Load balancer(s)  208  may forward requests to one of the application servers  216  and/or backend  218  servers, which may then reply to load balancer  208 . This may allow load balancer(s)  208  to reply to user device  202  without user device  202  ever knowing about the internal separation of functions. It also may prevent user devices from contacting backend servers directly, which may have security benefits by hiding the structure of the internal network and preventing attacks on backend  218  or unrelated services running on other ports, for example. 
     A variety of scheduling algorithms may be used by load balancer(s)  208  to determine which backend server to send a request to. Simple algorithms may include, for example, random choice or round robin. Load balancers  208  also may account for additional factors, such as a server&#39;s reported load, recent response times, up/down status (determined by a monitoring poll of some kind), number of active connections, geographic location, capabilities, or how much traffic it has recently been assigned. 
     Load balancers  208  may be implemented in hardware and/or software. Load balancer(s)  208  may implement numerous features, including, without limitation: asymmetric loading; Priority activation: SSL Offload and Acceleration; Distributed Denial of Service (DDoS) attack protection; HTTP/HTTPS compression; TCP offloading; TCP buffering; direct server return; health checking; HTTP/HTTPS caching; content filtering; HTTP/HTTPS security; priority queuing; rate shaping; content-aware switching; client authentication; programmatic traffic manipulation; firewall; intrusion prevention systems. 
     Web server(s)  210  may include hardware (e.g., one or more computers) and/or software (e.g., one or more applications) that deliver web content that can be accessed by, for example a client device (e.g., user device  202 ) through a network (e.g., network  204 ), such as the Internet. Web server(s)  210  may use, for example, a hypertext transfer protocol (HTTP/HTTPS or sHTTP) to communicate with user device  202 . The web pages delivered to client device may include, for example, HTML, documents, which may include images, style sheets and scripts in addition to text content. 
     A user agent, such as, for example, a web browser, web crawler, or native mobile application, may initiate communication by making a request for a specific resource using HTTP/HTTPS and web server  210  may respond with the content of that resource or an error message if unable to do so. The resource may be, for example a file on stored on backend  218 . Web server(s)  210  also may enable or facilitate receiving content from cardholder device  202  so cardholder device  202  may be able to, for example, submit web forms, including uploading of files. 
     Web server(s) also may support server-side scripting using, for example, Active Server Pages (ASP), PHP, or other scripting languages. Accordingly, the behavior of web server(s)  210  can be scripted in separate files, while the actual server software remains unchanged. 
     Load balancers  214  may be similar to load balancers  208  as described above. 
     Application server(s)  216  may include hardware and/or software that is dedicated to the efficient execution of procedures (e.g., programs, routines, scripts) for supporting its applied applications. Application server(s)  216  may comprise one or more application server frameworks, including, for example, Java application servers (e.g., Java platform, Enterprise Edition (Java EE), the .NET framework from Microsoft®, PHP application servers, and the like). The various application server frameworks may contain a comprehensive service layer model. Also, application server(s)  216  may act as a set of components accessible to, for example, an entity implementing system  200 , through an API defined by the platform itself. For Web applications, these components may be performed in, for example, the same running environment as web server(s)  210 , and application servers  216  may support the construction of dynamic pages. Application server(s)  216  also may implement services, such as, for example, clustering, fail-over, and load-balancing. In various embodiments, where application server(s)  216  are Java application servers, the web server(s)  216  may behaves like an extended virtual machine for running applications, transparently handling connections to databases associated with backend  218  on one side, and, connections to the Web client (e.g., client device  202 ) on the other. 
     Backend  218  may include hardware and/or software that enables the backend services of, for example, a medical facility and/or medical provider or other entity that maintains a distributed system similar to system  200 . Backend  218  may be associated with various databases, including databases that maintain, for example, medical information (e.g., patient data, vital signs data, classifier data, and/or the like). Backend  218  also may be associated with one or more servers that enable the various services provided by system  200 . Backend  218  may enable a medical facility and/or medical provider to implement various functions as shown and described herein. 
     With reference to  FIG. 3 , a monitoring system and/or mobile device  300 , which may be similar (in whole or in part) to monitoring system  140  and/or mobile device  150 , may be provided. For example,  FIG. 3  illustrates an example architecture (e.g., hardware and software) for an example mobile device and/or monitoring system  300 . It should be appreciated by one having ordinary skill in the art in the context of the present disclosure that the architecture of the mobile device and/or monitoring system  300  depicted in  FIG. 3  is but one example, and that in some embodiments, additional, fewer, and/or different components may be used to achieve similar and/or additional functionality. Mobile device and/or monitoring system  300  may be embodied as a smartphone, a tablet, a mobile computing device, a patient monitoring system, and/or the like. And, in some embodiments, other types of devices may be used, including a workstation, laptop, notebook, etc. The mobile device and/or monitoring system  300  may be used in some embodiments to receive data from a wearable device (e.g., wearable device  120 ), further process data received from wearable device (e.g., wearable device  120 ), generate alerts and/or reporting data based on received data from wearable device (e.g., wearable device  120 ), and/or transmit wearable device data and/or alerts/reports based on wearable device data. 
     Mobile device and/or monitoring system  300  may include at least two different processors, such as a baseband processor (BBP)  304  and an application processor (APP)  308 . A baseband processor  304  may primarily handle baseband communication-related tasks. An application processor  308  may handle inputs and outputs and/or all applications other than those directly related to baseband processing. The baseband processor  304  may include a dedicated processor for deploying functionality associated with a protocol stack, such as, but not limited to a GSM (Global System for Mobile communications) protocol stack, among other functions. The application processor  308  may include a multi-core processor for running applications, including all or a portion of application software. The baseband processor  304  and the application processor  308  may have respective associated memory including random access memory (RAM), Flash memory, etc., and peripherals, and a running clock. The memory may be each also referred to herein as a non-transitory computer readable medium. Note that, though depicted as residing in memory  310 , all or a portion of the application software may be stored in memory  310 , distributed among memory or reside in other memory. 
     The baseband processor  304  may deploy functionality of the protocol stack to enable the mobile device and/or monitoring system  300  to access one or a plurality of wireless network technologies, including WCDMA (Wideband Code Division Multiple Access), CDMA (Code Division Multiple Access), EDGE (Enhanced Data Rates for GSM Evolution), GPRS (General Packet Radio Service), Zigbee (e.g., based on IEEE 802.15.4), Bluetooth, Wi-Fi (Wireless Fidelity, such as based on IEEE 802.11), and/or LTE (Long Term Evolution), among variations thereof and/or other telecommunication protocols, standards, and/or specifications. The baseband processor  304  may manage radio communications and control functions, including signal modulation, radio frequency shifting, and encoding. The baseband processor  304  may include, or may be coupled to, a radio (e.g., RF front end)  302  and/or a GSM (or other communications standard) modem, and analog and digital baseband circuitry (ABB, DBB, receptively). The radio  302  may include one or more antennas, a transceiver, and a power amplifier to enable the receiving and transmitting of signals of a plurality of different frequencies, enabling access to a cellular (and/or wireless) network. The analog baseband circuitry may be coupled to the radio  302  and provide an interface between the analog and digital domains of the GSM modem. The analog baseband circuitry may include circuitry including an analog-to-digital converter (ADC) and digital-to-analog converter (DAC), as well as control and power management/distribution components and an audio codec to process analog and/or digital signals received indirectly via the application processor  308  or directly from a user interface (UI)  318  (e.g., microphone, earpiece, alert tone, vibrator circuits, touch-screen, etc.). The ADC may digitize any analog signals for processing by the digital baseband circuitry. 
     The digital baseband circuitry may deploy the functionality of one or more levels of the GSM protocol stack (e.g., Layer 1, Layer 2, etc.), and may include a microcontroller (e.g., microcontroller unit or MCU, also referred to herein as a processor) and a digital signal processor (DSP, also referred to herein as a processor) that communicate over a shared memory interface (the memory comprising data and control information and parameters that instruct the actions to be taken on the data processed by the application processor  308 ). The MCU may be embodied as a RISC (reduced instruction set computer) machine that runs a real-time operating system (RTIOS), with cores having a plurality of peripherals (e.g., circuitry packaged as integrated circuits) such as RTC (real-time clock), SPI (serial peripheral interface), I2C (inter-integrated circuit), UARTs (Universal Asynchronous Receiver/Transmitter), devices based on IrDA (Infrared Data Association), SD/MMC (Secure Digital/Multimedia Cards) card controller, keypad scan controller, and USB devices, GPRS crypto module, TDMA (Time Division Multiple Access), smart card reader interface (e.g., for the one or more SIM (Subscriber Identity Module) cards), timers, and among others. For receive-side functionality, the MCU may instruct the DSP to receive, for instance, in-phase/quadrature (I/Q) samples from the analog baseband circuitry and perform detection, demodulation, and decoding with reporting back to the MCU. For transmit-side functionality, the MCU presents transmittable data and auxiliary information to the DSP, which encodes the data and provides to the analog baseband circuitry (e.g., converted to analog signals by the DAC). 
     The application processor  308  may operate under control of an operating system (OS) that enables the implementation of a plurality of user applications, including, for example, the application software that supports vital sign calculations, alerting, and/or reporting. The application processor  308  may be embodied as a System on a Chip (SOC), and supports a plurality of multimedia related features including Internet/cloud-based access functionality to access one or more computing devices, of the cloud(s), that are coupled to the Internet. For instance, the application processor  308  may execute communications functionality of the application software (e.g., middleware which may include a browser with or operable in association with one or more application program interfaces (APIs)) to enable access to a cloud computing framework or other networks to provide remote data access/storage/processing, and through cooperation with an embedded operating system, access to calendars, location services, user data, public data, vital signs data, contact data, etc. 
     For instance, in some embodiments, vital signs calculations, alerting, and/or reporting may operate using cloud computing services, where the processing of raw and/or derived parameter data received, indirectly at mobile device and/or monitoring system  300  or directly from wearable device (e.g., wearable device  120 ) may be achieved by one or more devices of the cloud(s), and triggering signals (to trigger feedback) may be communicated from the cloud(s) (or other devices) to the mobile device and/or monitoring system  300 , which in turn may activate feedback internal to mobile device and/or monitoring system  300  or relay the triggering signals to other devices. 
     The application processor  308  may include a processor core (Advanced RISC Machine or ARM), and further comprises or may be coupled to multimedia modules (for decoding/encoding pictures, video, and/or audio), a graphics processing unit (GPU), communications interface  328 , and device interfaces. Communications interfaces  328  may include wireless interfaces, including a Bluetooth (BT) (and/or Zigbee in some embodiments, among others) module that enable wireless communication with any system component. 
     Communication interface  328  may include a Wi-Fi module for interfacing with a local  802 . 11  network, according to corresponding communications software in the applications software. The application processor  308  may include or be coupled to, a global navigation satellite systems (GNSS) receiver  330  for enabling access to a satellite network to, for instance, provide position coordinates. In some embodiments, the GNSS receiver  330 , in association with GNSS functionality in the application software, may collect contextual data (time and location data, including location coordinates and altitude) to determine location data associated with the mobile device and/or monitoring system  300 . Note that, though described as a GNSS receiver  330 , other indoor/outdoor positioning systems may be used, including those based on triangulation of cellular network signals and/or Wi-Fi. 
     The device interfaces coupled to the application processor  308  may include the user interface  318 , such as a display screen. The display screen may be embodied in one of several available technologies, including LCD or Liquid Crystal Display (or variants thereof, such as Thin Film Transistor (TFT) LCD, In Plane Switching (IPS) LCD)), light-emitting diode (LED)-based technology, such as organic LED (OLED), Active-Matrix OLED (AMOLED), retina or haptic-based technology, or virtual/augmented reality technology. For instance, the user interface  318  may present visual feedback in the form of messaging (e.g., alphanumerical) and/or symbols/graphics (e.g., warning or alert icons, flashing screen, etc.), and/or flashing lights (LEDs). In some embodiments, the user interface  318  may be configured, in addition to or in lieu of a display screen, a keypad, microphone, speaker, ear piece connector, I/O interfaces (e.g., USB (Universal Serial Bus)), SD/MMC card, among other peripherals. For instance, the speaker may be used to audibly provide feedback, and/or the user interface  318  may comprise a vibratory motor that provides a vibrating feedback to the user. One or any combination of visual, audible, or tactile feedback may be used, and as described before, variations in the intensity of format of the feedback may be used. 
     Also coupled to the application processor  308  may be an image capture device (IMAGE CAPTURE)  326 . The image capture device  326  may include an optical sensor (e.g., a charged coupled device (CCD) or a complementary metal-oxide semiconductor (CMOS) optical sensor). The image capture device  326  may be configured to capture and/or receive medical imaging, such as ultrasounds and/or other scans. 
     A power management device  322  may control and manages operations of a battery  324  and/or other power supplies. The components described above and/or depicted in  FIG. 3  may share data over one or more busses, such as for example via data bus  332 . It should be appreciated by one having ordinary skill in the art, in the context of the present disclosure, that variations to the above may be deployed in some embodiments to achieve similar functionality. 
     An application processor  308  may run and/or execute application software  314 , and may include a vital signs application  315 , a language processing application  316 , and/or a feedback application  317 . 
     A method that utilizes the system components described herein is described with reference to  FIG. 4 . For example, a method may begin at block  402 . At block  404 , a wearable device, such as a wearable deice  120 , may receive raw sensor data via one or more sensors on the wearable device, such as accelerometer data, gyroscope data, magnetometer data, barometer data, PPG data, ECG data, and/or the like. 
     At block  406 , an initial processing may take place and a partial cycle analysis may determine at least the top three cycles at any point in time. By way of example, an initial processing may include smoothing and down-sample the raw sensor data (e.g., input signals or the time series of measurements). A partial cycle analysis may include locating the fractional cycle markers (e.g., waveform peaks—one to three scales, waveform valleys—one to three scales, and/or zero crossing sections). A partial cycle analysis may include approximating the cycle lengths and amplitudes for at least three cycles (e.g., A 1 , CL 1 , A 2 , CL 2 , A 3 , CL 3 ). A partial cycle analysis may assume three maximum periodicities in a body-worn sensor. A partial cycle analysis may approximate the expected periodicities (e.g., P 1 , P 2 , P 3 ) and relate them to an underlying mathematical model. 
     An underlying mathematical model for chest worn sensor may be presented as: 
       { y ( n )}={ x   r ( n )}+{ x   g ( n )}+{ x   a ( n )}+{ w ( n )}  (1)
 
     where 
     {y(n)}=Observed chest sensor signal 
     {X r (n)}=measured respiration signal 
     {x g (n)}=measured gait signal 
     {x a (n)}=measured artifact signal and 
     {w(n)}=white noise signal 
     At block  408 , a system component, e.g., a wearable device and/or an implantable device and/or a device in communication with a wearable and/or implantable device, may perform a periodicity transform-based selection of at least one top periodicity observed from the respiratory cycle analysis. Using a periodicity transform-based selection, digital signals and/or time series of physiological data may be detected. For example, a periodicity transform may decompose a sequence into a sum of periodic sequences by projecting onto a set of periodic subspaces, Pp, which may result in leaving residuals where periodicities have been removed. A resulting representation of the data may then be linear-in-period rather than linear-in-frequency or linear-in-scale. 
     By way of example, a periodicity-transform-based selection may include estimating the most likely cycle length based on amplitudes (e.g., A 1 , A 2 , A 3 ) and the available cycle lengths (e.g., CL 1 , CL 2 , CL 3 ). In this manner, a periodicity-transform-based selection may include determining whether adjacent periodicities show dominant characteristics due to the variability inside the measurement interval and, if so, determining that periodicity bands are formed and nominating a center periodicity inside the band as the most likely cycle length. 
     By way of example, where there are three expected periodicities, a periodicity may be set to  1  (e.g., P 1 =1). A linear DC component may then be removed by removing the projection onto the periodicity (e.g., P 1 =1). Next, a periodicity may be set to a cycle length (e.g., P 1 =CL 1 ) and a device may check to see if a projection (e.g., A 1 ) includes at least a threshold (e.g., T) percentage of the energy in a signal (e.g., X). If so, a device may accept the projection (e.g., Al) and cycle length (e.g., CL 1 ) as a possible cycle that may be present. This may be repeated for each identified cycle (e.g., CL 2 , CL 3 ). A most likely cycle length may then be estimated based on the available amplitudes and cycle lengths using the determine data, variability inside the measurement interval, and periodicity bands. 
     Additionally, a max power cycle length for a filtered time series of sensor data, a mean power cycle length for a filtered time serious of sensor data, and a maximum significant estimated cycle length for a filtered time series of data may be used to compute the most likely activity for a particular time. 
     At block  410 , a system component, e.g., a wearable device and/or an implantable device and/or a device in communication with a wearable and/or implantable device, may determine a most likely activity of the at least one top periodicity observed from the partial cycle analysis using heuristics. Heuristics may include data and/or data features regarding characteristics of a respiratory signal, characteristics of a gait signal, characteristics of a motion artifact signal, and/or characteristics of baseline electronic noise. By way of example, data and/or data features that may represent characteristics of a respiratory signal may include, continuity, a particular amplitude range, one or more particular cycle lengths (periodicities), a pseudo-periodic nature, a dominance in a few channels of sensors (if not in all), and a correlation with measurements made in silent intervals. By way of example, data and/or data features that may represent characteristics of a gait signal may include, a continuity for a short duration of time, a particular amplitude range, one or more particular cycle length(s) (periodicities), a pseudo-periodic nature, and a difference from measurements made in silent intervals. By way of example, data and/or data features that may represent characteristics of a motion artifact signal may include, a lack of continuity, a particular amplitude range, one or more particular cycle lengths (periodicities) (aperiodic), a dominance in a few channels of sensors (if not all), and a non-correlation with measurements made in silent intervals. By way of example, data and/or data features that may represent characteristics of baseline electronic noise may include: a lack of periodicity of any time, a non-correlation between segments, and bounded amplitudes. 
     At block  412 , a system component, e.g., a wearable device and/or an implantable device and/or a device in communication with a wearable and/or implantable device, may measure a signal quality index for an incoming signal using the presence or absence of periodicity information associated with the partial cycle analysis. By way of example, the data features present in the heuristics may be used to determine a signal quality index. Or rather, the data features in each activity band may be defined by information continuity, band-limitedness, and/or the absence of presence of noise. A signal quality index may identify non-significance as defined by sampling content outside a region of interest in time and/or frequency domains. By way of example, activities such as ambulation and/or climbing stairs may induce higher frequency content and may be outside the band of respiratory activity (e.g., episode 1). Similarly, complete inactivity due to lack of sensor adhesion and/or contact may result in DC content (e.g., episode 2). Both of these types of episodes may lie outside the region of interest. 
     At block  414 , a system component, e.g., a wearable device and/or an implantable device and/or a device in communication with a wearable and/or implantable device, may use the signal quality index to determine user characteristics and/or device status information. For example, a sudden change in a signal quality index may indicate a possible posture change. As another example, a sudden increase in DC may push the signal quality index down and will indicate device removal and/or sensor error(s). 
     The method may end at block  416 . 
     These examples are merely illustrative and transaction cards may be reprogrammed according to any data described herein. 
     It is further noted that the systems and methods described herein may be tangibly embodied in one of more physical media, such as, but not limited to, a compact disc (CD), a digital versatile disc (DVD), a floppy disk, a hard drive, read only memory (ROM), random access memory (RAM), as well as other physical media capable of storing software, or combinations thereof. Moreover, the figures illustrate various components (e.g., servers, computers, processors, etc.) separately. The functions described as being performed at various components may be performed at other components, and the various components bay be combined or separated. Other modifications also may be made. 
     The present disclosure is not to be limited in terms of the particular embodiments described in this application, which are intended as illustrations of various aspects. Many modifications and variations can be made without departing from its spirit and scope, as may be apparent. Functionally equivalent methods and apparatuses within the scope of the disclosure, in addition to those enumerated herein, may be apparent from the foregoing representative descriptions. Such modifications and variations are intended to fall within the scope of the appended representative claims. The present disclosure is to be limited only by the terms of the appended representative claims, along with the full scope of equivalents to which such representative claims are entitled. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting. 
     With respect to the use of substantially any plural and/or singular terms herein, those having skill in the art can translate from the plural to the singular and/or from the singular to the plural as is appropriate to the context and/or application. The various singular/plural permutations may be expressly set forth herein for sake of clarity. 
     It may be understood by those within the art that, in general, terms used herein, and especially in the appended claims (e.g., bodies of the appended claims) are generally intended as “open” terms (e.g., the term “including” should be interpreted as “including but not limited to,” the term “having” should be interpreted as “having at least,” the term “includes” should be interpreted as “includes but is not limited to,” etc.). It may be further understood by those within the art that if a specific number of an introduced claim recitation is intended, such an intent may be explicitly recited in the claim, and in the absence of such recitation no such intent is present. For example, as an aid to understanding, the following appended claims may contain usage of the introductory phrases “at least one” and “one or more” to introduce claim recitations. However, the use of such phrases should not be construed to imply that the introduction of a claim recitation by the indefinite articles “a” or “an” limits any particular claim containing such introduced claim recitation to embodiments containing only one such recitation, even when the same claim includes the introductory phrases “one or more” or “at least one” and indefinite articles such as “a” or “an” (e.g., “a” and/or “an” should be interpreted to mean “at least one” or “one or more”); the same holds true for the use of definite articles used to introduce claim recitations. In addition, even if a specific number of an introduced claim recitation is explicitly recited, such recitation should be interpreted to mean at least the recited number (e.g., the bare recitation of “two recitations,” without other modifiers, means at least two recitations, or two or more recitations). Furthermore, in those instances where a convention analogous to “at least one of A, B, and C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, and C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). In those instances where a convention analogous to “at least one of A, B, or C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, or C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). It may be further understood by those within the art that virtually any disjunctive word and/or phrase presenting two or more alternative terms, whether in the description, claims, or drawings, should be understood to contemplate the possibilities of including one of the terms, either of the terms, or both terms. For example, the phrase “A or B” may be understood to include the possibilities of “A” or “B” or “A and B.” 
     The foregoing description, along with its associated embodiments, has been presented for purposes of illustration only. It is not exhaustive and does not limit the invention to the precise form disclosed. Those skilled in the art may appreciate from the foregoing description that modifications and variations are possible in light of the above teachings or may be acquired from practicing the disclosed embodiments. For example, the steps described need not be performed in the same sequence discussed or with the same degree of separation. Likewise various steps may be omitted, repeated, or combined, as necessary, to achieve the same or similar objectives. Accordingly, the invention is not limited to the above-described embodiments, but instead is defined by the appended claims in light of their full scope of equivalents. 
     In the preceding specification, various preferred embodiments have been described with references to the accompanying drawings. It may, however, be evident that various modifications and changes may be made thereto, and additional embodiments may be implemented, without departing from the broader scope of the invention as set forth in the claims that follow. The specification and drawings are accordingly to be regarded as an illustrative rather than restrictive sense.