Patent Publication Number: US-2023148962-A1

Title: Communication devices, methods, and systems

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a § 1.53(b) continuation of U.S. patent application Ser. No. 17/213,117, filed Mar. 25, 2021, which is a continuation of U.S. patent application Ser. No. 16/757,482, now U.S. Pat. No. 10,959,674, which is a § 371 National Stage Entry of International Patent Application No. PCT/US18/56814, filed Oct. 22, 2018, claiming the benefit of priority of U.S. Provisional Patent Application No. 62/676,949, filed May 26, 2018, and U.S. Provisional Patent Application No. 62/575,951, filed Oct. 23, 2017, the entireties of which are incorporated by reference into this application. 
    
    
     TECHNICAL FIELD 
     Aspects of the present disclosure generally relate to communication devices, methods, and systems. 
     BACKGROUND 
     Computer screens have emerged as the most common means for person-to-computer communication. In 2015, for example, it was estimated that the average adult spends roughly 10 hours a day looking at a screen to consume information and/or communicate with others. The human eye was not designed for all this screen time, and numerous health problems have been associated therewith. For example, eyestrain from hours of screen time may cause instances of eye irritation, dryness, fatigue, and/or blurred vision that last for extended periods of time. These problems are increasingly common, and the near constant production of new screen-oriented devices (e.g., the next iPhone®) suggests further increases. 
     Alternate means for person-to-computer communications may reduce the negative effects of excessive screen time. For example, the human body includes many non-optical nerves that are capable of communicating data to the brain, such as the nerves associated with the skin. Further improvements are required to better leverage these and other communication capabilities of living tissue. Aspects of this disclosure may solve the above reference problems, solve other known problems, and/or overcome other deficiencies in the prior art. 
     SUMMARY 
     Numerous aspects are disclosed in this application. One exemplary aspect is a communication device comprising: a body comprising a distal surface compatible with skin; a tissue interface on the distal surface, the tissue interface comprising a plurality of energy generators, each energy generator being operable to output a plurality of energies in a signal direction toward the skin; an attachment element configured to maintain the tissue interface against the skin; and a processing unit configured to communicate with nerves associated with the skin by receiving input data from a data source and causing the plurality of energy generators to output an energy signal in the signal direction with one or more energies of the plurality of energies. 
     The body may be flexible. The body may comprise a plurality of communication bays, and each energy generator may be located in and configured to output the energy signal out of one of the communication bays. The body may comprise an insulating material configured to promote flows of the one or more energies out of each communication bay in the signal direction, and limit flows of the one or more energies between the plurality of communication bays. The attachment element may comprise a plurality of holes aligned with the plurality of communication bays, and each energy generator may be configured to output the plurality of energies through one of the holes. An interior surface of each communication bay or hole may be configured to direct the one or more energies in the signal direction. The interior surface of each communication bay or hole may be configured to focus at least one energy of the one or more energies in the signal direction. 
     The attachment element may comprise a biocompatible adhesive disposed on the distal surface of the body. The attachment element may comprise an elastic portion configured to maintain the tissue interface against the skin. The elastic portion may expand to receive a circular portion of the skin and contract to maintain the tissue interface against the circular portion of the skin. The body may be removably attached to the attachment element. The input data may comprise a measurement, and the processing unit may be configured to modify at the energy signal based on the measurement. The processing unit may be configured determine a change of the measurement and modify the energy signal based on the change of the measurement. 
     The plurality of energy generators may be spaced apart on the distal surface of the body in a pattern; each energy generator may be operable to output the one or more energies in the signal direction toward a different point on the pattern; and the energy signal may comprise a plurality of symbols based on the pattern. Each symbol may comprise a plurality of dots, and each dot may correspond with one of the different points on the pattern. The plurality of symbols may comprise at least one alphanumeric symbol. The processing unit may be operable with the plurality of energy generators to scroll the plurality of symbols across the skin at a scroll rate in a communication direction transverse with the signal direction. 
     The input data may comprise vital signs of a subject, and the plurality of symbols may comprise a symbol associated with each vital sign. The plurality of symbols may comprise a symbol associated with an identity or location of the subject. The processing unit may be configured to: determine a change of the vital signs; and modify the one or both of the plurality of symbols and the scroll rate based on the change of the vital signs. The processing unit may be configured to: output one or more of the plurality of symbols with a first combination of the one or more energies when the change is within a predetermined range; and output the one or more of the plurality of symbols with a second combination of the one or more energies when the change is outside the predetermined range. 
     The data source may comprise one or more data sources, and the processing unit may be configured to: receive the input data from the one or more data sources; generate a control signal based on the input data; and cause the plurality of energy generators to output the energy signal according to the control signal. The processing unit may be configured to: determine a change in the input data; and modify the control signal based on the change of the input data. The control signal may comprise a scroll rate for the energy signal the processing unit may be configured to: determine the scroll rate based on the input data; and cause the plurality of generators to scroll the energy signal across the skin at the scroll rate. 
     Each energy generator may comprise a plurality of generator elements and a controller operable with the plurality of generator elements to output the plurality of energies; the control signal may comprise output commands for each controller of each energy generator; and each controller may be configured to receive the control signal, select one of the output commands, and cause one or more of the plurality of generator elements to output the one or more energies based on the selected one of the output commands. 
     Each energy generator may comprise a plurality of generator elements, and each generator element may be operable to output one of the plurality of energies in the signal direction. The plurality of generator elements may comprise one or more of: an impact generator element; a heat generator element; a shock generator element; and a pressure generator element. Each generator element may be configured to output the one of the plurality of energies toward a similar point or area on the skin. The plurality of generator elements may be arranged coaxially with a communication axis parallel to the signal direction. 
     The data source may comprise a local sensor that is attached to the body and configured to output a portion of the input data. The data source may comprise at least one remote sensor that is remote from the body and configured to output a portion the input data. The processing unit may be configured to receive the input data from a server in communication with the at least one remote sensor. The at least one remote sensor may comprise a health monitoring device. The device may comprise a power generator attached to the body. The power generator may comprise a photovoltaic cell mounted to a proximal surface of the body. The one or more energies may comprise: a first energy configured to communicate the energy signal; and a second energy configured to modify a penetration depth of the first energy. The first energy may be communicable with a first portion of the nerves, and the second energy may be communicable with a second portion of the nerves. 
     The body may comprise an impact absorbing material; and the attachment element may comprise a garment configured to maintain a position of the impact absorbing material relative to a user body. The processing unit may be configured to determine a direction of movement for the user body and output the energy signal based on the direction of movement. The processing unit may be configured to determine a change in the direction of movement and modify the energy signal based on the change in the direction of movement. The attachment element may comprise a shoe, and the distal surface of the body may comprise an interior surface of the shoe. The input data may comprise GPS signals, the processing unit may be configured to determine a direction of movement for a user body based on the GPS signals. 
     The attachment element may comprise a grip, and the body may comprise an exterior surface of the grip. The grip may be integral with a weapon comprising a sight, the input data may comprise data associated with an orientation of the sight, and the energy signal may be configured to communicate a status of the weapon based on the orientation of the sight. The input data may comprise data associated with an alignment of the sight with a target, and the processing unit may be configured to output the energy signal with a first combination of the one or more energies when the target is not aligned with the sight and a second combination of the one or more energies when the target is aligned with the sight. 
     The device may be implantable. The attachment element may comprise a bone plate engageable with a bone to orient the tissue interface toward an underside of the skin. The attachment element may comprise a tissue in-growth structure interactable with living tissue to maintain an orientation of the tissue interface toward an underside of the skin. 
     The plurality of energy generators may be arranged in bands; the attachment element may be configured to maintain each band against the skin; the input data may comprise input data for each band; and the processing unit may be configured to communicate with nerves associated with the skin by causing the plurality of energy generators in each band to output a different energy signal based on the input data for each band. The body may extend along a longitudinal axis; and the bands may be spaced apart along the longitudinal axis. The body may be configured to wrap around a limb so that the longitudinal axis of body is aligned with a longitudinal axis of the limb, and the bands wrap around the limb about the longitudinal axis. The processing unit may be operable with the plurality of energy generators to scroll each different energy signal in each band in a communication direction transverse with the signal direction. The input data for each band may comprise different vital signs, and each different energy signal may be based on one of the different vital signs. 
     The signal direction may comprise a first signal direction and the device may comprise an optical interface on a proximal surface of the body; the optical interface may comprise at least one display element operable to output at least one color toward eyes in a second signal direction opposite of the first signal direction; and the processing unit may be operable with the tissue interface and the optical interface to communicate simultaneously with nerves associated the skin and the eyes by outputting the energy signal with the one or more energies of the plurality of energies in the first signal direction and outputting an optical signal with the at least one color in the second signal direction. 
     The body may extend along a longitudinal axis, and the first and second signal directions may be transverse with the longitudinal axis. The energy signal and the optical signal may be scrolled together along or about the longitudinal axis. The processing unit may be configured to: receive the input data from the data source; generate a control signal based on the input data; cause the plurality of energy generators to output the energy signal according to the control signal; and cause the at least one display element to simultaneously output the optical signal according to the control signal. The energy signal may correspond with the optical signal. 
     The input data may comprise vital signs of a subject, the energy signal may comprise a plurality of symbols associated with the vital signs, and the optical signal may comprise the plurality of symbols. The processing unit may be configured to: determine a change of the vital signs; and modify the plurality of symbols based on the change of the vital signs. The device may comprise a motion sensor attached to the body, and the processing unit may be configured to selectively output the optical signal in response to the motion sensor. 
     Another exemplary aspect may comprise a system. For example, the system may comprise: a plurality of any communication devices described herein; and at least one processor that is in communication with the plurality of communication devices and configured to: generate a corrective motion signal based on position data for the plurality of communication devices; and cause each communication device to output its energy signal based on the corrective motion signal. 
     The system may comprise at least one position sensor configured to determine the position data and output the position data to the at least one processor. The position data may comprise an actual location of each communication device; and the at least one processor may be configured to generate the corrective motion signal based on the actual location of each communication device and a target location of each communication device. The position data may comprise an actual spatial configuration of the plurality of communication devices; and the at least one processor may be configured to generate the corrective motion signal based on the actual spatial configuration and a target spatial arrangement for the plurality of communication devices. The at least one processor may be configured to: determine a movement direction for each communication device based on the actual and target spatial arrangements; and cause each communication device to scroll its energy signal across the skin in the movement direction. 
     Each communication device may be mounted to a different part of a user body; and the target spatial arrangement may comprise a physical position of the user body defined by relative positions of each different part of the user body. The physical position of the user body may comprise a pose or a stance. The at least one processor may be configured to guide the user body through a series of different positions by determining the movement direction at intervals and modifying the energy signal for each interval. 
     Another exemplary aspect may comprise another communication device. In keeping with above, the device may comprise: a body comprising a distal surface compatible with skin; a tissue interface on the distal surface, the tissue interface comprising a plurality of energy generators, each energy generator being operable to output a plurality of energies in a signal direction toward the skin; and a processing unit configured to communicate with nerves associated with the skin by receiving input data, and causing the plurality of energy generators to output one or more energies of the plurality of energies in the signal direction. 
     The body may be flexible. The device may further comprise an attachment element configured to maintain the tissue interface in a position on or adjacent the skin. The distal surface of the body may comprise a biocompatible adhesive that is adherable to the skin. The body may comprise a plurality of communication bays, and each energy generator may be located in one of the communication bays. The attachment element may comprise a plurality of holes aligned with the plurality of communication bays, and each energy generator may be configured to output the plurality of energies through one of the holes. An interior surface of each communication bay or hole may be configured to direct the one or more energies in the signal direction. The interior surface may be configured to focus the at least one energy of one or more energies. The attachment element may comprise an elastic band. The body may be removably attached to the attachment element. 
     Another exemplary aspect may comprise another communication device. The communication device may comprise: a body comprising a distal surface compatible with skin; a tissue interface on the distal surface, the tissue interface comprising a plurality of energy generators, each energy generator being operable to output a plurality of energies in a signal direction toward the skin; an attachment element configured to maintain the tissue interface against the skin; and a processing unit configured to communicate an energy signal to nerves associated with the skin by receiving input data, and causing the plurality of energy generators to output one or more energies of the plurality of energies in the signal direction. 
     The plurality of energy generators may be spaced apart in a grid pattern, and each energy actuator may be operable to output the plurality of energies towards a different point on the grid pattern. The energy signal may comprise a plurality of symbols, each symbol may comprise a plurality of dots, and each dot may correspond with one of the different points on the grid pattern. The plurality of dots in each symbol may be arranged in a dot pattern within the grid pattern. The processing unit may be operable with the plurality of energy generators to scroll the plurality of symbols across the skin in a communication direction transverse with the signal direction. For example, the processing unit may be operable with the plurality of energy generators to output and scroll each symbol using a different combination of the one or more energies of the plurality of energies. 
     The input data may comprise a measurement, and the processing unit may be configured to communicate the energy signal by selecting the one or more energies of the plurality of energies based on the measurement. For example, the processing unit may be configured to communicate the energy signal by determining a change of the measurement and modifying the one or more energies of the plurality of energies based on the change of the measurement. 
     Another exemplary aspect may comprise another communication device. For example, the communication device may comprise: a body comprising a distal surface compatible with skin; a tissue interface on the distal surface, the tissue interface comprising a plurality of energy generators, each energy generator being operable to output a plurality of energies in a signal direction toward the skin; an attachment element configured to maintain the tissue interface on or adjacent the skin; and a processing unit configured to communicate an energy signal to nerves associated with the skin by: (i) receiving input data; (ii) selecting one or more energies of the plurality of energies based on the input data; and (iii) causing the plurality of energy generators to output the one or more energies in the signal direction. 
     The processing unit may be further configured to communicate the energy signal by: (iii) determining a change in the input data; and (iv) modifying the one or more energies based on the change. The processing unit may be further configured to communicate the energy signal by: (v) selecting a scroll rate based on the input data; and (vi) causing the plurality of generators to scroll the one or more energies across the skin at the scroll rate. The energy signal may comprise a plurality of symbols scrolled across the skin in a communication direction transverse with the signal direction. At least one symbol of the plurality of symbols may be an alphanumeric symbol. 
     Another exemplary aspect may comprise a communication method. The method may comprise: receiving, with a processing unit, input data for a communication device comprising a tissue interface maintainable on or adjacent skin, the tissue interface comprising a plurality of energy generators, each energy generator being operable to output a plurality of energies in a signal direction toward the skin; and operating, with the processing unit, the plurality of energy generators to communicate with nerves associated with the skin by outputting one or more energies of the plurality of energies in the signal direction based on the input data. 
     The receiving step may comprise receiving the input data from one or more data sources. For example, the one or more data sources may comprise at least one of patient monitoring device, a remote server, and a sensor. The receiving step may comprise receiving the input data from the one or more data sources at regular intervals, and the operating step may comprise outputting the one or more energies based on the input data received during each regular interval. The input data may comprise a control signal, and the operating step may comprise outputting the one or more energies based on the control signal. 
     The method may further comprise generating, with the processing unit, a control signal based on the input data, wherein the operating step comprises outputting the one or more energies based on the control signal. Generating the control signal to may comprise associating the input data with a plurality of symbols, and the operating step may comprise communicating the plurality of symbols to the skin with the one or more energies. For example, the input data may comprise vital signs of a patient, and each symbol may be associated with one or more of the vital signs. The one or more energies may comprise a first combination of the plurality of energies followed by a second combination of the plurality of energies. The one or more energies also may comprise a first energy communicable with a first portion of the nerves, and a second energy communication with a second portion of the nerves. 
     Another exemplary aspect may comprise another communication method. The method may comprise: receiving, with a processing unit, input data for a communication device comprising a tissue interface maintainable on or adjacent skin, the tissue interface comprising a plurality of energy generators, each energy generator being operable to output a plurality of energies in a signal direction toward the skin; and operating, with the processing unit, the plurality of energy generators to communicate an energy signal to nerves associated with the skin by outputting one or more energies of the plurality of energies in the signal direction based on the input data. 
     The operating step may comprise outputting different combinations of the one or more energies, and each different combination may communicate a different portion of the energy signal. The energy signal may comprise one or more symbols, and the operating step may comprise outputting the one or more energies to communicate the one or more symbols. The operating step may comprise scrolling the one or more symbols across the skin in a communication direction transverse with the signal direction. The one or more symbols may comprise an alphanumeric symbol. 
     The operating step may comprise: outputting a first combination of the one or more energies to communicate a first symbol of the one or more symbols, and outputting a second combination of the one or more energies to communicate a second symbol of the one or more symbols. The operating step may comprise: outputting a first combination of the one or more energies to communicate the energy signal, and outputting a second combination of the one or more energies to communicate a characteristic of the energy signal. The input data may comprise a measurement, and the operating step may comprise outputting the one or more energies based on the measurement. For example, the operating step may comprise modifying the one or more energies based on a change of the measurement. 
     Another exemplary aspect may comprise another communication method. For example, the method may comprise: receiving, with a processing unit, input data for a communication device comprising a tissue interface maintainable on or adjacent skin, the tissue interface comprising a plurality of energy generators, each energy generator being operable to output a plurality of energies in a signal direction toward the skin; generating, with the processing unit, a control signal based on the input data; and operating, with the processing unit, the plurality of energy generators to communicate with to nerves associated with the skin by outputting one or more energies of the plurality of energies in the signal direction based on the control signal. 
     Another exemplary aspect may comprise another communication device. The device may comprise: a body comprising a distal surface compatible with skin; a tissue interface on the distal surface, the tissue interface comprising a plurality of energy generators arranged in bands, each energy generator being operable to output a plurality of energies in a signal direction toward the skin; and a processing unit configured to communicate with nerves associated with the skin by receiving input data, and causing the plurality of energy generators in each band to output one or more energies of the plurality of energies in the signal direction. 
     The body may be flexible. The device may further comprise an attachment element configured to maintain the tissue interface in a position on or adjacent the skin. For example, the attachment element may comprise a distal surface adherable to the skin. The attachment element may be proximal of the tissue interface and configured to maintain the bands against the skin. The attachment element may be configured to maintain the bands against the skin by applying a tensile force to the body. 
     Another exemplary aspect may comprise another communication device. The device may comprise: a body extending along a longitudinal axis, and comprising a distal surface compatible with skin; a tissue interface on the distal surface, the tissue interface comprising a plurality of energy generators arranged in bands spaced apart along the longitudinal axis, each energy generator being operable to output a plurality of energies in a signal direction toward the skin; an attachment element configured to maintain the bands of the tissue interface against the skin; and a processing unit configured to communicate energy signals to nerves associated with the skin by receiving input data, and causing the plurality of energy generators to output an energy signal in each band with one or more energies of the plurality of energies. 
     The body may be configured to wrap around a limb so that the longitudinal axis of body is aligned with a longitudinal axis of the limb, and the bands wrap around the limb about the longitudinal axis. The processing unit may be configured to move the energy signal in each band so as to scroll the energy signal around the limb. The one or more energies may comprise: a first energy configured to communicate one or more symbols; and a second energy configured to modify the one or more symbols. 
     Another exemplary aspect may comprise another communication method. The method may comprise: receiving, with a processing unit, input data for a communication device comprising a tissue interface maintainable on or adjacent skin, the tissue interface comprising a plurality of energy generators arranged in bands, each energy generator being operable to output a plurality of energies in a signal direction toward the skin; and causing, with the processing unit, the plurality of energy generators in each band to communicate with nerves associated with the skin by outputting one or more energies of the plurality of energies in response to the input data. 
     The receiving step may comprise receiving the input data from one or more data sources. For example, the receiving step may comprise: receiving input data comprise a plurality of measurements; and causing the plurality of energy generators in each band to output the one or more energies based on one measurement of the plurality of measurements. The method may further comprise outputting a first combination of the one or more energies when the one measurement is inside of an acceptable range; and outputting a second combination of the one or more energies when the one measurement is outside of the acceptable range. 
     The receiving step may comprise receiving input data comprising a plurality of vital signs; and the causing step may comprise causing the plurality of energy generators in each band to output the one or more energies based on one vital sign of the plurality of vital signs. The input data may comprise a control signal for each band, and the operating step may comprise outputting the one or more energies based on the control signal for each band. The method may further comprise generating, with the processing unit, a control signal for each band based on the input data, wherein the operating step may comprise outputting the one or more energies based on the control signal for each band. 
     Another exemplary aspect may comprise another communication method. The method may comprise: receiving, with a processing unit, input data for a communication device comprising a tissue interface maintainable on or adjacent skin, the tissue interface comprising a plurality of energy generators arranged in bands, each energy generator being operable to output a plurality of energies in a signal direction toward the skin; and causing, with the processing unit, the plurality of energy generators to communicate energy signals to nerves associated with the skin by outputting an energy signal in each band with one or more energies of the plurality of energies. The energy signal may comprise one or more symbols based on the input data, and the operating step may comprise outputting the one or more symbols to the skin with one or more energies. The operating step may comprise scrolling the one or more symbols across the skin in a communication direction transverse with the signal direction. 
     Another exemplary aspect may comprise a communication system. The system may comprise: (A) a plurality of communication devices, each communication device comprising: a body comprising a distal surface compatible with skin; and a tissue interface on the distal surface, the tissue interface comprising a plurality of energy generators, each energy generator being operable to output a plurality of energies in a signal direction toward the skin; and (B) a processing unit in communication with at least one of the plurality of communication devices and configured to: generate, with one or more processors, a corrective motion signal based on position data for the plurality of communication devices; and operate, with the one or more processors, the plurality of energy generators of each communication device to output one or more energies of the plurality of energies in the signal direction based on the corrective motion signal. 
     The system may further comprise at least one position sensor configured to determine the position data and output the position data to the processing unit. The position data may comprise an actual location of each device of the plurality of communication devices; and the processing unit may be configured to generate, with the one or more processors, the corrective motion signal based on the actual locations and a target location for each device of the plurality of communication devices. 
     The position data may comprise an actual spatial arrangement of the plurality of communication devices; and the processing unit may be configured to generate, with the one or more processors, the corrective motion signal based on the actual spatial arrangement and a target spatial arrangement for the plurality of communication devices. The processing unit may be configured to: determine, with the one or more processors, a movement direction for each communication device based on the actual and target spatial arrangements; and operate, with the one or more processors, the plurality of energy generators of each communication device to output the one or more energies toward the skin in the signal direction and move the one or more energies across the skin the movement direction. 
     Another exemplary aspect may comprise another communication method. The method may comprise: generating, with one or more processors, a corrective motion signal for a plurality of communication devices based on position data, each communication device comprising a tissue interface with a plurality of energy generators, each energy generator being operable to output a plurality of energies in a signal direction toward the skin; and operating, with the one or more processors, the plurality of energy generators of each communication device to output one or more energies of the plurality of energies in the signal direction based on the corrective motion signal. The method may comprise receiving the position data from the plurality of communication devices or a remote position sensor. 
     Another exemplary aspect may comprise another communication method. The method may comprise: receiving, with one or more processors, position data for a plurality of communication devices mountable on or adjacent skin, each device comprising a tissue interface with a plurality of energy generators, each energy generator being operable to output a plurality of energies in a signal direction toward the skin; receiving or generating, with the one or more processors, a corrective motion signal for the plurality of communication devices based on position data for each communication device; and operating, with the one or more processors, the plurality of energy generators of each communication device to output one or more energies of the plurality of energies in the signal direction based on the corrective motion signal. 
     At least one of the communication devices may comprise a position sensor, and the method may comprise receiving, with the one or more processors, the position data from the position sensor. The method may comprise: determining, with the one or more processors, an actual spatial arrangement of the plurality of communication devices based on the position data; and identifying, with the one or more processors, a target spatial arrangement for the plurality of communication devices, wherein the generating step comprises generating, with the one or more processors, the corrective motion signal based on the actual spatial arrangement and the target spatial arrangement. The method may comprise: determining, with the one or more processors, a movement direction for each communication device based on actual and target spatial arrangements; and operating, with the one or more processors, the plurality of energy generators of each communication device to output one or more energies toward the skin in a shape associated with the movement direction for each communication device. 
     The method may comprise operating, with the one or more processors, the plurality of energy generators of each communication device to move the shape across the skin in the movement direction. Each communication device may be mounted to a different portion of a body; and the target spatial arrangement may comprise a physical position of the body defined by the relative positions of each different portion of the body. The physical position of the body may comprise at least one of a stretching position, a lifting position, a pose, or a stance. 
     The target spatial arrangement may comprise a series of target spatial arrangements, and the method may comprise: selecting arrangements from the series of target spatial arrangements; and repeating the determining, generating, and operating steps for each selected arrangement. The selecting step may be performed at predetermined intervals so as to coordinate relative movements between each selected arrangement. The series of target spatial arrangements may comprise one or more stretches, yoga poses, or defensive postures. 
     Another exemplary aspect may comprise another communication device. The device may comprise: a body comprising a proximal surface compatible with eyes, and a distal surface compatible with skin; a tissue interface on the distal surface, the tissue interface comprising a plurality of energy generators, each energy generator comprising a tissue interface operable to output a plurality of energies in a first signal direction toward the skin; an optical interface on the proximal surface, the optical interface comprising at least one display element operable to output at least one color in a second signal direction toward the eyes; and a processing unit operable with the tissue interface and the optical interface to communicate simultaneously with nerves associated with skin and eyes by outputting one or more energies of the plurality of energies in the first signal direction and at least one color in the second signal direction. 
     The body may extend along a longitudinal axis, and the first signal direction may be transverse with the longitudinal axis. The second signal direction may be transverse with the longitudinal axis. The first and second signal directions may extend oppositely along a signal axis transverse with the longitudinal axis. The body may be conformable with a curved shape. The body comprises a flexible body configured to wrap around a limb so that the longitudinal axis has a circular shape. 
     The processing unit may receive input data from one or more sources, the one or more energies may be output as an energy signal based on the input data, and the one or more colors may be simultaneously output as an optical signal based on the input data. The energy signal may correspond with the optical signal. The outputs may be flashed or scrolled together. For example, the optical signal and the energy signal may be scrolled together along the longitudinal axis. The input data may comprise a vital sign of the patient, the energy signal may communicate the vital sign to the skin, and the optical signal may simultaneously communicate the vital sign to the eyes. The processing unit may be configured to determine a change of the vital sign over time and simultaneously modify one or both of the optical signal and the energy signal based on the change. The input data may comprise alphanumeric symbols, the optical signal may communicate the alphanumeric symbols to the eyes, and the energy signal may simultaneously communicate the symbols to skin. 
     Another exemplary aspect may comprise another communication device. The device may comprise: a body extending along a longitudinal axis, the body comprising a proximal surface compatible with eyes and a distal surface compatible with skin; a tissue interface on the distal surface of the body, the tissue interface comprising a plurality of energy generators, each energy generator being operable to output a plurality of energies in a first signal direction toward the skin; an optical interface on the proximal surface, the optical interface comprising at least one display element operable to output at least one color in a second signal direction toward the eyes; a sensor on the body; and a processing unit configured to communicate simultaneously with nerves associated with the eyes and the skin by: receiving input data from the sensor or a remote data source, causing the plurality of energy generators to output one or more energies of the plurality of energies in the first signal direction as an energy signal, and causing the display element to output the at least one color in the second signal direction as an optical signal. 
     The first and second communication signals may be scrolled together along the longitudinal axis. The energy signal may be output continuously. The optical signal may be output in response to a movement detected by the sensor. The movement may comprise aligning the optical interface with the eyes. 
     Another exemplary aspect may comprise another communication device. The device may comprise: a body comprising a proximal surface compatible with eyes and a distal surface compatible with skin; a tissue interface on the distal surface of the body, the tissue interface comprising a plurality of energy generators, each energy generator being operable to output a plurality of energies in a first signal direction toward the skin; at least one sensor; an optical interface on the proximal surface, the optical interface comprising at least one display element operable to output at least one color in a second signal direction toward the eyes; a processing unit configured to communicate simultaneously with nerves associated with the eyes and the skin by: receiving vital sign data from the at least one sensor, causing the plurality of energy generators to output one or more energies of the plurality of energies in the first signal direction as an energy signal, and causing the at least one display element to output the at least one color in the second signal direction as an optical signal. 
     The energy signal and the optical signal may be scrolled across the body in a communication direction transverse with the longitudinal axis. The at least one display element may comprise a touchscreen, and the energy signal may be moveable together with optical signal along or around the longitudinal axis by operation of the touchscreen. The first direction may be transverse with the second direction. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The accompanying drawings are incorporated in and constitute a part of this specification. These drawings illustrate exemplary aspects of the present disclosure that, together with the written descriptions provided herein, serve to explain the principles of this disclosure. 
         FIG.  1 A  depicts an exemplary energy signal output onto a living tissue; 
         FIG.  1 B  depicts an exemplary communication device configured to output the energy signal of  FIG.  1 A ; 
         FIG.  2 A  depicts a top-down view of the  FIG.  1 B  device; 
         FIG.  2 B  depicts a bottom-up view of the  FIG.  1 B  device; 
         FIG.  2 C  depicts a cross-section view of the  FIG.  1 B  device taking along section line A-A of  FIG.  2 A ; 
         FIG.  3 A  depicts a cross-section of an exemplary energy generator; 
         FIG.  3 B  depicts a bottom-up view of the  FIG.  3 A  generator; 
         FIG.  4 A  depicts an impact energy output with the  FIG.  3 A  generator; 
         FIG.  4 B  depicts a heat energy output with the  FIG.  3 A  generator; 
         FIG.  4 C  depicts an electrical energy output with the  FIG.  3 A  generator; 
         FIG.  4 D  depicts a pressure energy output with the  FIG.  3 A  generator; 
         FIG.  5    depicts an exemplary processing unit; 
         FIG.  6 A  depicts another exemplary communication device; 
         FIG.  6 B  depicts another exemplary communication device; 
         FIG.  6 C  depicts another exemplary communication device; 
         FIG.  6 D  depicts another exemplary communication device; 
         FIG.  7 A  depicts another exemplary communication device; 
         FIG.  7 B  depicts another exemplary communication device; 
         FIG.  7 C  depicts another exemplary communication device; 
         FIG.  7 D  depicts another exemplary communication device; 
         FIG.  8 A  depicts another exemplary communication device; 
         FIG.  8 B  depicts a cross-section view of the  FIG.  8 A  device; 
         FIG.  9    depicts an exemplary method; 
         FIG.  10    depicts another exemplary method; 
         FIG.  11    depicts an exemplary communication system; 
         FIG.  12    depicts another exemplary method; 
         FIG.  13 A  depicts another exemplary communication device; 
         FIG.  13 B  depicts another view of the device of  FIG.  13 A ; 
         FIG.  14 A  depicts another view of the device of  FIG.  13 A ; and 
         FIG.  14 B  depicts another view of the device of  FIG.  13 A . 
     
    
    
     DETAILED DESCRIPTION 
     Aspects of the present disclosure are now described with reference to exemplary communication devices, methods, and systems. Particular aspects reference a healthcare setting, wherein the described devices, methods, and systems may allow a single caregiver to monitor vital signals for a plurality of patients without using a screen, or at least with a reduced amount of screen time. Any references to a particular setting, such as healthcare; a particular user, such as a caregiver; a particular data, such as vital signals; or particular amount of screen time, are provided for convenience and not intended to limit the present disclosure unless claimed. Accordingly, the aspects disclosed herein may be utilized for any analogous communication device, method, or system—healthcare-related or otherwise. 
     The terms “proximal” and “distal,” and their respective initials “P” and “D,” may be used to describe relative components and features. Proximal may refer to a position closer to a hand of user, whereas distal may refer to a position further away from said hand. With respect to a hand adjacent a living tissue, for example, proximal may refer to a position away from the tissue, whereas distal may refer to a position toward said tissue. As a further example, with respect to energy directed toward the living tissue, proximal may refer to energy directed away from the tissue and distal may refer to energy directed toward the tissue. Appending the initials P or D to a number may signify its proximal or distal location or direction. Unless claimed, these directional terms are provided for convenience and not intended to limit this disclosure. 
     Aspects of this disclosure may be described with reference to one or more axes. For example, an element may extend along an axis, be moved along said axis in first or second direction, and/or be rotated about said axis in a first or second direction. One axis may intersect another axis, resulting in a transverse and/or perpendicular relationship therebetween. For example, two or three perpendicular axes may intersect at an origin point to define a Cartesian coordinate system. The directional terms proximal and distal may be used with reference to any axis. One axis may be a longitudinal axis extending along a length of an element, such as a central longitudinal axis extending along the length and through a centroid of the element. 
     Terms such as “may,” “can,” and like variation, are intended to describe optional aspects of the present disclosure, any of which may be covered by the claims set forth below. Terms such as “comprises,” “comprising,” or like variation, are intended to describe a non-exclusive inclusion, such that a device, method, or system comprising a list of elements does not include only those elements, but may include other elements not expressly listed or inherent thereto. The term “and/or” indicates a potential combination, such that a first and/or second element may likewise be described as a first element, a second element, or a combination of the first and second elements. These potential combinations are provided as examples. Numerous other combinations are inherent to this disclosure. Unless stated otherwise, the term “exemplary” is used in the sense of “example” rather than “ideal.” 
     Aspects of this disclosure are directed to devices, methods, and systems for communicating with the brain through nerves associated with a living tissue. Some aspects are described with reference to an energy signal including one or more energies output to communicate symbols to the living tissue. The symbols may be used to communicate data, and the one or more energies may be used to communicate aspects of the data. The living tissue may be a portion of skin, as shown in  FIGS.  1 A- 8 D . In a healthcare setting, the energy signal may be output towards the skin of a caregiver to communicate symbols associated with a status of a patient. For example, an intensity of the one or more energies may escalate responsive to a measure of the status, providing a non-visual alert to the caregiver if the measure changes. 
     Exemplary energies and energy signals are now described with reference to  FIG.  1 A , which depicts an exemplary energy signal  90  including a plurality of symbols  92  output onto a communication area  4  of a skin  2  with one or more energies  32 . For illustrative purposes, the symbols  92  of  FIG.  1    are shown from a proximal-to-distal direction, as they would be output to skin  2  by an energy transceiver. Each energy  32  may be configured to communicate aspects of the data to the brain through nerves associated with skin  2 , such as nerves located distal of communication area  4 . For example, the one or more energies  32  shown in  FIG.  1 A  may be recognizable by touch receptors, such as the Meissner&#39;s corpuscle; temperature receptors, such the Ruffini corpuscle and Krause corpuscle; electrical receptors, such as the muscles and pain receptors located in the dermis layer; pressure receptors such as the Pacinian corpuscle; and/or other cutaneous or subcutaneous nerves that innervate the skin or other living tissue. 
     Each symbol  92  may be associated with different data. For example, in the healthcare setting, each symbol  92  may be associated with a vital sign of the patient, such as body temperature, pulse rate, respiration rate, and/or blood pressure. As shown in  FIG.  1 A , the plurality of symbols  92  may include a first symbol  92 A, a second symbol  92 B, and a third symbol  92 C. In keeping with the previous example, first symbol  92 A may be associated with temperature and pulse rate, second symbol  92 B may be associated with respiration rate, and third symbol  92 C may be associated with blood pressure. Any number of symbols  92  may be provided and/or associated with a measurable or non-measurable characteristic of the patient. 
     Symbols  92 A,  92 B, and  92 C are shown as pip patterns of dots in  FIG.  1 A , wherein each dot is a shaded area. Each dot may represent an output of the one or more energies  32 . Aspects of energies  32  and/or each symbol  92 A,  92 B, and  92 C may increase the complexity of energy signal  90 , and thus the amount of data transmitted therewith. As shown in  FIG.  1 A , symbols  92 A,  92 B, and  92 C may be scrolled across communication area  4  by outputting energies  32  toward the skin in the pip patterns; and moving the patterns across the skin in a communication direction CD. In  FIG.  1 A , first symbol  92 A is a pip five dot pattern; second symbol  92 B is a pip six dot pattern; and a third symbol  92 C is a pip three dot pattern that has been truncated by an end of communication area  4  due to the scrolling. Symbols  92  may be flashed and scrolled. For example, the five dots of first symbol  92 A in  FIG.  1 A  may be output to communicate a temperature range of the patient (e.g., a normal range), and flashed on-and-off to communicate the pulse rate of the patient. 
     An exemplary energy transceiver  10  is depicted in  FIG.  1 B  as being configured output energy signal  90  to communication area  4  of skin  2 . As shown, energy transceiver  10  may be attached to a portion of skin  2 , including any portion located on a limb, such as the underside of a human wrist shown in  FIG.  1 B  for example. Communication area  4  may be sized approximate to a perimeter of transceiver  10 . In this configuration, transceiver  10  may be configured to communicate energy signal  90  to skin  2  by outputting the one or more energies  32  toward communication area  4  in a signal direction oriented toward skin  2 . As shown in  FIG.  1 A , the energies  32  may be output individually and/or in combination to communicate aspects of any of symbols  92 A,  92 B, and  92 C to skin  2 . 
     Additional aspects of exemplary energy transceiver  10  are now described with reference to  FIGS.  2 A-C . As shown, transceiver  10  may comprise: a body  20 ; a tissue interface  30 ; a processing unit  60 ; and an attachment element  70 . With these elements, and the variations described herein, energy transceiver  10  may be configured to communicate energy signal  90  to nerves associated with skin  2  by outputting the one or more energies  32  towards skin  2  with tissue interface  30 . 
     As shown in  FIGS.  2 A-C , body  20  may contain the elements of energy transceiver  10 . For example, body  20  of  FIGS.  2 A-C  has a length extending along a longitudinal axis X-X, a width extending along a lateral axis Y-Y, and a thickness extending along a proximal-distal axis Z-Z. The length, width, and/or thickness of body  20  may be compatible with skin  2 . For example, body  20  may be composed of a flexible biocompatible base material, such as a polymeric material, so that the length and width of body  20  are conformable against a curvature of skin  2 . 
     Body  20  may include any shape and be conformable with any curvature. For example, body  20  may be conformable with a cylindrical shape of a human forearm (e.g.,  FIG.  1 B ), a semi-spherical shape a human forehead (e.g.,  FIG.  6 B ), or an irregular curved shape of a human foot (e.g.,  FIG.  7 A ). A plurality of bodies  20  may be joined together to accommodate some curvatures. For example, side surfaces of body  20  of  FIGS.  2 A-C  may be removable engageable with side surfaces of additional bodies  20  to create a joined layer conformable with the curvature. 
     The base material of body  20  may have insulating and/or energy-directing properties. For example, the base material may include compositions and/or coatings that promote energy flows along proximal-distal axis Z-Z, and limit energy flows along axes X-X and/or Y-Y. Body  20  may be manufactured from the base material using any known process. For example, body  20  may be molded or 3D printed from a base material that is biocompatible, dielectric, impact resistance, sound absorbing, and/or thermally resistant, such as polyether ether ketone (PEEK) and like polymeric materials. Additional materials and/or coatings may be included with the base material and/or applied to body  20  to further promote biocompatibility. 
     As shown in  FIGS.  2 A-C , body  20  may define a proximal surface  22  ( FIG.  2 A ) opposite of a distal surface  24  ( FIG.  2 B ) along proximal-distal axis Z-Z ( FIG.  2 C ). In  FIGS.  2 A and  2 C , for example, proximal surface  22  includes a processor compartment  23  configured to receive processing unit  60 . As shown, and described further below, processing unit  60  may be removable engageable (e.g., snap-fit into) with processor compartment  23 . Body  20  may include and/or be compatible with additional mechanisms for securing and/or releasing the snap-fit, such as a retaining screw and/or a lever. 
     Body  20  of  FIGS.  2 A-C  includes a plurality of communication bays  25 . As shown, each communication bay  25  may be spaced apart from the next on distal surface  24  in a grid pattern. The spacing may be uniform or non-uniform. In  FIGS.  2 B and  2 C , the bays  25  are spaced apart uniformly for communication with the skin  2  of  FIG.  1 B , which has a fairly planar surface area. Non-uniform spacing may be used to accommodate a curvature of skin  2 . As shown in  FIG.  2 C , each communication bay  25  may extend proximally into body  20  through distal surface  24  along a communication axis z-z that is parallel with the proximal-distal axis Z-Z of transceiver  10 . In  FIG.  2 C , a conduit  26  extends proximally from each bay  25 , through an interior portion of body  20 , and into processor compartment  23 , placing the plurality of bays  25  in communication with compartment  23 . 
     Aspects of tissue interface  30  are now described with reference to  FIGS.  2 B and  2 C . As shown, tissue interface  30  may include a plurality of energy generators  31 , and each generator  31  may be located in one of communication bays  25 . Each generator  31  may be operable with processing unit  60  to output energies  32  individually and/or in combination. In  FIGS.  2 B and  2 C , for example, the one or more energies  32  are being output from the shaded generators  31  to communicate energy signal  90  of  FIG.  1 A . As shown in  FIG.  2 C , one or more conductors  27  may extend through each conduit  26  to connect processing unit  60  to each energy generator  31 , allowing control signals to be transmitted between processing unit  60  and the plurality of energy generators  31  along one or more pathways. 
     As shown in  FIG.  2 C , the one or more conductors  27  may include any number of electrical wires and/or optical fibers configured to transmit the control signals. For example, the conductors  27  may comprise a plurality of electrical conductors interconnecting the plurality of generators  31  with processing unit  60 , and allowing electricity-based control signals, energies, and communications to be transmitted between unit  60  and generators  31 . In addition or alternatively, the conductors  27  may comprise a plurality of optical fibers interconnecting the plurality of generators with processing unit  60 , and allowing light-based control signals, energies, and communications to be transmitted between unit  60  and generators  31 . For example, each conductor  27  may comprise a twisted pair including at least one electrical conductor and at least one optical fiber. A flexible energy-insulating medium, such as an epoxy, may be used to seal conductors  27  in conduits  26 . 
     A cross-section of an exemplary energy generator  31  is depicted in  FIG.  3 A . As shown, each generator  31  may include: a housing  33 ; a controller  34 ; and a plurality of generator elements, such as: an impact generator element  36 ; a heat generator element  42 ; a shock generator element  48 ; and a pressure generator element  52 . Examples of each generator element are now described. 
     Similar to body  20 , housing  33  may include an insulating material that surrounds portions of each generator  31  and/or defines mounting surfaces for generator elements  36 ,  42 ,  48 , and/or  52 . For example, housing  33  may be made of the same base material as body  20  or a compatible material; and/or formed together with body  20  by a molding, printing, or like process. As described below, portions of each generator element  36 ,  42 ,  48 , and/or  52  may extend distally from housing  33  to contact skin  2 . Housing  33  of  FIG.  3 A  includes an attachment feature  33 A configured to secure each generator  31  in one of the communication bays  25 . For example, attachment feature  33 A may include a set of threads on housing  33  that are engageable with an interior surface of bays  25 . Other types of chemical or mechanical attachment may be used, including biocompatible adhesives, snap-fit connections, and the like. 
     Exemplary generator elements  36 ,  42 ,  48 , and  52  may be arranged to output their respective energies  32  in approximately the same direction. As shown in  FIGS.  3 A and  3 B , each generator element  36 ,  42 ,  48 , and  52  may be arranged coaxially with communication axis z-z so that each energy  32  may be output toward skin  2  in signal direction SD. Because of this coaxial configuration, each energy  32  may be output toward approximately the same point or area on skin  2 , making the energies  32  interchangeable. For example, any of the dots included in energy signal  90  of  FIG.  1 A  may be interchangeably communicated to approximately the same point on skin  2  with any of the energies  32 . 
     As shown in  FIG.  3 A , controller  34  may be configured receive a control signal  82  from processing unit  60 , and activate generator elements  36 ,  42 ,  48 , and  52  according to signal  82 . The one or more conductors  27  may transmit the control signal  82  to generator elements  36 ,  42 ,  48 , and  52  from processing unit  60  and/or direct electricity to generator elements  36 ,  42 ,  48 , and  52  from a power source  66  of processing unit  60  (e.g.,  FIG.  5   ). Energy transceiver  10  may be an all-electrical device, wherein control signal  82  is an electrical signal and first and the conductors  27  are electrical wires. For varied response times, and energy requirements, transceiver  10  also may be an electro-optical device, wherein control signal  82  includes an optical signal, and at least one of the conductors  27  includes an optical fiber. For example, controller  34  may receive control signal  82  from processing unit  60  with a first one of conductors  27  (e.g., a first electrical and/or optical conductor), and direct electricity to one or more of the generator elements  36 ,  42 ,  48 , and  52  with a second one of conductors  27  (e.g., a second electrical conductor) according to signal  82 . 
     Additional aspects of generator elements  36 ,  42 ,  48 , and  52  are now described with reference to  FIGS.  4 A-D . As shown in  FIG.  4 A , for example, impact generator element  36  may be configured to communicate an impact energy  32 A to the brain through nerves associated with skin  2 . For example, impact generator element  36  may be a mechanical actuator that converts electricity from power source  66  into a mechanical movement recognizable by touch receptors of skin  2 , such as Meissner&#39;s corpuscle. As shown, generator element  36  may include a drive mechanism  37 , a piston  38 , a tissue contact  39 , and a guide tube  40 . Drive mechanism  37  may include a motor assembly that is attached to controller  34  and conductively engaged therewith. In this configuration, controller  34  may direct electricity to drive mechanism  37 , causing the motor assembly to move piston  38  distally along communication axis z-z, outputting impact energy  32 A in signal direction SD. Different force transfer components also may be used to apply energy  32 A, including levers and like actuators. 
     As shown, drive mechanism  37  may be configured to move piston  38  between a retracted position, wherein tissue contact  39  is contained housing  33  (e.g.,  FIG.  3 A ); and an extended position, wherein at least a portion of contact  39  is distal of housing  33  (e.g.,  FIG.  4 A ). Accordingly, impact energy  32 A may be output in signal direction SD as a physical movement of skin  2  caused by moving tissue contact  39  distally. Aspects of impact energy  32 A may be modified. For example, outer tube  40  may be attached to housing  33  and include interior surfaces configured to modify the timing of energy  32 A by guiding the proximal-distal movements of tissue contact  39  (e.g., by rotating or stabilizing contact  39 ). A resilient element may be added between drive mechanism  37  and contact  39  to dampen such movements. 
     Heat generator element  42  may be configured to communicate a heat energy  32 B to the brain through nerves associated with skin  2 . As shown in  FIG.  4 B , generator element  42  may include an electrical resistor that converts electricity from power source  66  into an amount of heat recognizable by temperature receptors of skin  2 , such the Ruffini corpuscle. For example, heat generator element  42  may include an electrical resistor  43 , a heat reflecting groove  44 , a conductor  45 , and an insulating material  46 . Groove  44  may include a metal plate attached to an exterior surface of outer tube  40  of generator element  36 . Resistor  33  may include an electrical wire or coil attached to groove  44 . Conductor  45  may include an electrical wire extend between controller  34  and resistor  43 , and material  46  may including an epoxy surrounding conductor  45 . 
     As shown in  FIG.  3 B , electrical resistor  43  and heat-reflecting groove  44  may be circular elements arranged coaxially with communication axis z-z. Conductor  45  may be configured to transmit electricity to electric resistor  43  for conversion into heat energy  32 B. Groove  44  may include a concave shape extending proximally into housing  33  to contain resistor  43 , and the shape may include a distal surface configured to reflect heat energy  32 B toward skin  2 . In this configuration, heat signal  32 B may be output in signal direction SD as an amount of heat transferred to skin  2  by resistor  43 . Aspects of heat signal  32 B may be modified. For example, the size, shape, and/or exterior coating of resistor  43  or groove  44  may be configured to modify the intensity of heat energy  32 B. 
     Shock generator element  48  may be configured to communicate an electrical energy  32 C to the brain through nerves associated with skin  2 . As shown in  FIG.  4 C , shock generator element  48  may be an electroshock generator that converts electricity from power source  66  into an electrical shock recognizable by electricity-sensitive receptors, such as the muscles and pain receptors located in the dermis layer of skin  2 . For example, energy generator element  48  may include at least two electric contacts  49 , a conductor  50 , and an insulating material  51 . The conductors  50  may be metallic rods or wires extending distally from controller  34 . Insulating material  51  may be an epoxy surrounding each conductor  50 . Each contact  49  may include a discharge shape located on the distal-most end of one of conductors  50 . In this configuration, controller  34  may direct electricity through conductors  50 , and into the discharge shape of contact  49 , allowing electricity to flow through skin  2  between the contacts  49  to output electrical energy  32 C. 
     As shown in  FIG.  3 B , the electrical contacts  49  may be spaced apart in a radial pattern coaxial with communication axis z-z. Any number of contacts  49  may be used, in any geometrical and/or spatial configuration. Insulating material  51  may be used to define and maintain the spacing. As shown, insulating materials  51  and  46  may be the same material, such as an epoxy. Four contacts  49  are shown in  FIG.  3 B , for example, as being arranged in two pairs. Aspects of electrical energy  32 C may be modified. For example, the arrangement of contacts  49  may be changed; and/or the size of or spacing between each contact  49  changed to modify the intensity of energy  32 C. 
     Pressure generator element  52  may be configured to communicate a pressure energy  32 D to the brain through nerves associated with skin  2 . As shown in  FIG.  4 D , pressure generator element  52  may be an electroacoustic transducer that converts electricity from power source  66  into a sound wave recognizable by pressure receptors of skin  2 , such as the Pacinian corpuscle. For example, pressure generator element  52  may include a cone  53 , a voice coil  54 , and a magnet  55 . In this configuration, controller  34  may direct electricity into voice coil  54  for interaction with magnet  55 , causing movements of cone  53  that generate the pressure energy  32 D in signal direction SD. 
     As shown in  FIGS.  3 B and  4 D , cone  53  may have a frustoconical shape that is coaxial with communication axis z-z. An outer edge of cone  53  may be attached an interior surface of housing  33 , and an inner edge of cone  53  may be attached to voice coil  54 , which may be coupled to controller  34  and power source  66  by one or more conductors. As shown, coil  54  may have a circular shape, and generator elements  36 ,  42 , and  48  may be located in the interior of said shape. Aspects of pressure energy  32 D may be modified. For example, cone  53  and/or voice coil  54  may include a surround, a spider, a secondary frame, or any other structures configured to modify signal responsiveness; the strength of magnet  55  may be varied; and/or controller  34  may include an amplifier configured to modify an intensity of pressure energy  32 D. 
     Different generator element types also may be used to communicate signals to the skin with different energies  32 , and/or different combinations of energies  32 . For example, the plurality of generators  31  may be modified to vary individual or combined outputs of energies  32 A,  32 B,  32 C, and  32 D; and/or include additional generator elements configured to output additional signals to skin  2 , including optical signals, magnetic signals, and/or any physically recognizable signals. Any type of generator element may be used and likewise coaxially arranged according to  FIGS.  3 A through  4 D . 
     Additional aspects of an exemplary processing unit  60  are now described with reference to  FIG.  5   . As shown, processing unit  60  may be configured to receive input data  80  from a data source  81  and output control signal  82  and/or electricity to each controller  34  via conductors  27 , causing activation of one or more energy generators  31 . For example, processing unit  60  of  FIG.  5    includes a housing  61 , a data transceiver  62 , one or more processors  63 , a memory  64 , a communication bus  65 , and a power source  66 . 
     Data source  81  may include any combination of local and/or remote data sources. For example, source  81  may include a local sensor that is located in one of communication bays  25  and configured to send input data  80  to unit  60  using conductors  27  and/or bus  65 , This configuration may allow for closed loop communications in which energy signal  90  is based on data from the local sensors. For example, the local sensor may generate the input data  80  based on chemical and/or physical outputs related to skin  2 . 
     Data source  81  also may include a remote data source in constant communication with processing unit  60  via data transceiver  62 , such as a remote sensor configured to send input data  80  to processing unit  60  with data transceiver  62  over a wired or wireless connection. This configuration may allow for open loop communications in which energy signal  90  is based on data from the local sensor and/or the remote sensor. 
     Any number and type of local sensors may be used to generate input data  80 , and the sensor(s) may be located at any position on or relative to energy transceiver  10 . In the healthcare setting, for example, one local sensor may include a personal health tracker (e.g., a Fitbit® or an iWatch®) configured to generate input data  80  based on chemical and/or physical outputs of the wearer (e.g., heart rate, temperature), and communicate input data  80  to data transceiver  62  at regular intervals (e.g., once per second or once per minute). 
     Housing  61  may contain the elements of processing unit  60 , and/or provide a means for removing processing unit  60  from body  2 , allowing for easy repairs and upgrades. As shown in  FIGS.  1 B and  5   , for example, exterior surfaces of housing  61  may be snap-fit with interior surfaces of compartment  23  so that the distal surface of processing unit  60  is maintained against the proximal surface of compartment  23 . For example, the exterior surfaces of housing  61  of may include protrusions biased outwardly along the X-X and Y-Y axes, and the interior surfaces of compartment  23  may include grooves configured to receive said protrusions. 
     Transceiver  62  may include any wired or wireless communication technology configured to receive input data  80  form any data source(s)  81 , such as Bluetooth, Wi-Fi  33 , and the like. As shown in  FIG.  5   , input data  80  may be generated with or stored on data source  81  and received with transceiver  62 . In a healthcare setting, for example, data source  81  may include at least one patient monitoring device configured to send input data  80  to a remote server at regular intervals (e.g., once per minute). Data  80  may include various measures regarding the patient, such as body temperature, pulse rate, respiration rate, and/or blood pressure. For example, transceiver  62  may be configured to retrieve and/or receive data  80  from the remote server at regular intervals (e.g., once per second or once per minute). 
     Each control signal  82  may be received with input data  80 . Data transceiver  62  may be configured to relay the signals  82  to the one or more processors  63  and/or memory  64 . Alternatively, processing unit  60  may be configured to generate each control signal  82  based on input data  80 . For example, memory  64  may include a signal generating program, and the one more processors  63  may be configured to generate each control signal  82  with the program. In keeping with previous examples, the signal generating program may be configured to: analyze the input data  80  sent from data sources  81  including a patient monitoring device during an interval; generate symbol  92 A from the temperature and pulse rate, symbol  92 B from the respiration rate, and symbol  92 C from the blood pressure; and output a control signal  82  for communicating the symbols  92 A,  92 B, and  92 C to skin  2 . 
     As shown in  FIG.  5   , communication bus  65  may be configured to connect the one or more processors  63  and memory  64  to each generator  31 , such as to each controller  34 . Bus  65  may include electrical and/or optical connectors  67  located on and/or extending distally through housing  61 . For example, communication bus  65  may comprise a flexible circuit board including a proximal surface supporting elements of processing unit  60 , and a distal surface including an electrical and/or optical network extending from power source  66  to the connectors  67 . Any type of network may be used, such as a mesh network. Connectors  67  may be engageable with corresponding connectors of conductors  27  to provide at least one pathway for outputting control signal  82  from processing unit  60  to one or more generators  31 , and/or electricity from power source  66  to one or more generators  31 . Control signal  82  may include electrical and/or optical signals. For example, control signal  82  may be include a string of output commands for each generator  31 , and the entire string may be output to each generator  31  utilizing the electrical and/or optical signals, adding resiliency, in which the optical signals may be utilized for faster transmission. 
     As described above, the snap-fit connection between housing  61  and compartment  23  may place connectors  67  in communication with conductors  27 , and maintain that communication over time, allowing for continuous output of control signals  82  from processing unit  60  and/or electricity from power source  66 . A cover element may be attached to the proximal surface  24  of body  20  to seal processing unit  60  within compartment  23 , and/or reinforce or supplant the snap-fit connection between housing  61  and compartment  23 . For example, the cover may include a graphic design, a textual element, a writing surface, and/or like decorative feature. As a further example, the cover may provide a mounting surface for other technologies, such as an antenna, signal amplifier, and/or supplemental data transceiver. 
     Power source  66  may include any means for supplying electricity to processing unit  60  and/or the plurality of generators  31  (e.g., to each controller  34 ). As shown in  FIG.  5   , power source  66  may include a rechargeable battery, such as a lithium ion battery, chargeable by connection to an external power source, such as a wall outlet. Power source  66  may include power generation technologies. For example, a proximal surface of power source  66  may include a power generator, such as photovoltaic cells configured to charge the battery. As shown in  FIG.  5   , power source  66  also may include an optical energy source, such as a laser generator that is powered by power source  66  and configured to output optical energy to one or more generators  31  via optical pathways defined by communication bus  65  and conductors  27 . 
     Aspects of attachment element  70  are now described with reference to  FIG.  2 C . As shown, attachment element  70  may be configured to maintain a position of tissue interface  30  against or adjacent skin  2 . For example, element  70  may include an adhesive, elastic, and/or fastening element configured to apply a maintaining force in signal direction SD. In  FIG.  2 C , element  70  includes a proximal surface  72  adhered to the distal surface  24  of body  20 , and a distal surface  74  adherable with skin  2 . Distal surface  74  of element  70  may include a biocompatible adhesive configured to apply the maintaining force. 
     Attachment element  70  may be removably and/or semi-permanently attached to skin  2  by the biocompatible adhesive. For example, a first adhesive material may be used to attach the proximal surface  72  to distal surface  24 , and a second adhesive material may be used to attach distal surface  74  to skin  2 . As a further example, the first adhesive may be stronger so that energy transceiver  10  may be removed from skin  2  without separating surfaces  72  and  24 . Either the first or second adhesive material may be biocompatible, and may include anti-bacterial and/or moisture resistant coatings and/or compositions configured for prolonged contact with skin  2 . For example, at least the second adhesive material may be configured for contact with skin  2  during the entirety of a 4-hour, 8-hour, 12-hour, 24-hour shift, or longer shift. One or both adhesives also may be configured for semi-permanent contact with skin  2 , such as during the entirety of a multi-month or multi-year treatment period. For example, at least the second adhesive material may include medicinal coatings and/or compositions that promote prolonged or semi-permanent contact with skin  2  by time-releasing treatments configured to prevent or minimize contact-based injuries. 
     Body  20  and/or attachment element  70  may be configured to boost the efficacy of energy signal  90  by minimizing and/or maintaining the distance between tissue interface  30  and skin  2 , allowing signal  90  to be communicated with less energy. For example, any of the one or more energies  32  may be output through body  20  and/or attachment element  70 . As shown in  FIGS.  2 B and  2 C , attachment element  70  may include a plurality of openings  76 . Each opening  76  may be sized approximate to one of communication bays  25 , allowing the energies  32  to be output towards skin  2  in signal direction SD through openings  76 . For example, each opening  76  may have an inner diameter approximate to an outer diameter of the communications bay  25  or housing  33  for each generator  31 . As shown in  FIG.  2 C , attachment element  70  may have a thickness that allows tissue contact  39 , electrical resistor  43 , and/or electrical contacts  49  to contact skin  2  through opening  76  or be adjacent to skin  2  within opening  76 . 
     Aspects of body  20  and/or attachment element  70  may direct and focus the energies  32 , making it easier for the brain to distinguish one output of energies  32  from another. In keeping with previous examples, body  20  and attachment element  70  of  FIGS.  2 B and  2 C  may be composed of base materials including an impact absorbing material configured to absorb any excessive vibrations of skin  2  caused by impact energy  32 A. One or both base materials may include an insulating material configured to direct heat energy  32 B, electrical energy  32 C, and pressure energy  32 D through openings  76  along axis Z-Z; and prevent transmission of energies  32 B,  32 C, and  32 D along axis X-X and Y-Y. For example, body  20  and element  70  of  FIG.  2 C  may be configured to absorb any portion of energies  32  output incidentally in directions transverse to signal direction SD to promote signal distinction by limiting unwanted communications. As a further example, each opening  76  of attachment element  70  in  FIG.  2 C  may have a reflective coating and/or a frustoconical interior shape centered about axis z-z to further focus the energies  32  towards skin  2 . 
     As described herein, energy transceiver  10  may be operable to communicate energy signal  90  to skin  2  by outputting any energy  32 , such as impact energy  32 A, heat energy  32 B, electrical energy  32 C, and/or pressure energy  32 D, individually or together. For example, any energies  32 A-D may be used interchangeably or in combination to communicate any of the dots shown in  FIG.  1 A  as symbols  92 A,  92 B, and  92 C. As now described, aspects of each energy  32  may be modified to increase the complexity of signal  90 , and thus the amount of data transmitted therewith. Modifiable aspects may include energy type, energy intensity, output duration, scroll rate, symbol shape, and the like. 
     Energy signal  90  may be communicated to skin  2  with energies  32 , individually or together. In  FIG.  1 A , for example, each dot within first symbol  92 A may be output with impact energy  32 A; each dot within second symbol  92 B may be output with heat energy  32 B; and each dot within third symbol  92 C may be output with electrical energy  32 C. The energies  32  may be combined for additional emphasis. For example, the first symbol  92 A may be output with impact energy  32 A in response to a baseline measure, and output with a combination of impact energy  32 A and heat energy  32 B if the measure changes. The energies  32  also may be combined to enhance the penetration depth of energy signal  90 . For example, first symbol  92 A may be formed by first outputting pressure energy  32 D to activate a portion of the nerves associated with skin  2 , and second outputting heat energy  32 B to the activated nerves. Any individual dot may be similarly modified relative to any other dot. 
     The intensity of energies  32  may be modified for emphasis. For example, processing unit  60  may be configured to output first symbol  92 A with impact energy  32 A at a first intensity level in response to a baseline measure, and a second intensity level to highlight signal  92 A if the measure changes. Output duration may be similarly modified. For example, the output duration of energies  32  may be instantaneous for normal measures, like a quick tap (e.g., about 100 ms); extended for abnormal measures, like a short hold (e.g., 500 ms to 1 s); or a combination thereof, as with Morse code. Scroll rate may be similarly modified. For example, symbols  92  may not be scrolled at all (i.e., a scroll rate of zero), and output duration may be used to communicate change over time by flashing symbols  92  off and or in a fixed position. As a further example, in the healthcare setting, the scroll rate may be based on an update schedule (e.g., one revolution per minute), and/or the output duration may be based on patient status (e.g., faster for more critical patients). 
     Symbol shape also may be modified. The plurality of symbols  92  are shown as pip pattern shapes in  FIG.  1 A , but any symbol shape may be used, particularly those amenable to dot-matrix representation. For example, the plurality of symbols  92  may include known Morse code, binary symbols, lines, and/or directional arrows that are scrolled across communication area  4  in communication direction CD. Alphanumeric symbols also may be communicated. For example, input data  80  may include a control signal  82  generated from a Twitter® feed, and the symbols  92  may include alphanumeric symbols for communicating the author, date, and content of each Tweet® contained in the feed. As a further example, input data  80  may include the subject and sender of an email, and the signal generating program included in memory  64  may be configured to: prioritize the email based on the sender; and generate a control signal  82  for outputting a set symbols  92  based on the subject, sender, and priority of the email. For example, first symbols  92  may be output with impact energy  32 A to communicate the subject and/or sender of prioritized emails in a shorthand notation, and at least one of heat energy  32 B, electrical energy  32 C, pressure energy  32 D to communicate the priority level of the shorthand notation. 
     The resolution of tissue interface  30  may match or exceed the distinguishing capabilities of the nerves associated with skin  2 . For example, in the grid formation shown in  FIG.  2 B , the resolution of tissue interface  30  may be measured as energy output per square inch, which may exceed the natural energy receptivity limits of the nerves associated with skin  2 . As shown, the resolution of interface  30  may be relative to the spacing between each bay  25 , the configuration of body  20  and/or attachment element  70 , and/or the intensity of energies  32 . The energy receptivity limits of skin  2  may vary by location. For example, energy transceiver  10  may be attached to a portion of skin  2  located in a highly innervated or sensitive area, such as the face, allowing even more complex symbol shapes to be communicated. 
     With sufficient resolution, tissue interface  30  may likewise be configured to output signal  90  to replicate image patterns and/or other sensory perceptions with energies  32 , including any of the symbols described herein and even more complex interactions. As described herein, the multi-energy capabilities of energy transceiver  10  may be configured to layer energies  32  so as to communicate far more complex image patterns and/or sensory perceptions that would otherwise be possible by communicating with a single energy because of the natural receptivity limits of the nerves, and their tendency to become less receptive during prolonged exposures. 
     Additional aspects of this disclosure are now described with reference to numerous additional examples of energy transceiver  10 , including: an exemplary energy transceiver  110  shown conceptually in  FIG.  6 A ; an exemplary energy transceiver  210  shown conceptually in  FIG.  6 B ; an exemplary energy transceiver  310  shown conceptually in  FIG.  6 C ; an exemplary energy transceiver  410  shown conceptually in  FIG.  6 D ; an exemplary energy transceiver  510  shown conceptually in  FIG.  7 A ; an exemplary energy transceiver  610  shown conceptually in  FIG.  7 B ; an exemplary energy transceiver  710  shown conceptually in  FIG.  7 C ; an exemplary energy transceiver  810  shown conceptually in  FIG.  7 D ; and an exemplary energy transceiver  910  shown conceptually in  FIGS.  9 A-B . 
     Each variation of transceiver  10 , such as transceivers  110 ,  210 ,  310 ,  410 ,  510 ,  610 ,  710 ,  810 ,  910 , may include elements similar to those of transceiver  10 , but within the respective  100 ,  200 ,  300 ,  400 ,  500 ,  600 ,  700 ,  800 , or  900  series of numbers, whether or not those elements are depicted in  FIGS.  6 A through  9 B . Any aspects described with references to transceivers  110 ,  210 ,  310 ,  410 ,  510 ,  610 ,  710 ,  810 , and  910  may be included within any variation of transceiver  10  described herein, each possible combination or iteration being part of this disclosure. For example, any variation of transceiver  10  may comprise any combination of the wearable aspects of transceivers  110 ,  210 ,  310 , and  410 ; the contact-based aspects of transceivers  510  and  610 ; and the implantable aspects of transceivers  710  and  810 ; and/or any multi-signal aspects of transceiver  910 . 
     Additional wearable aspects are now described with reference to  FIGS.  6 A-D . As shown in  FIG.  6 A , energy transceiver  110  may include: a body  120  and a tissue interface  130 , both shown conceptually with a dotted line; and an attachment element  170 , shown conceptually as a sweat band. Any type of band may be used, such as a head band, an arm band, or a bandana. Body  120  may wrap around a portion of skin  2 , such as circular portion of skin  2 , like around a human forearm or forehead. As shown in  FIG.  6 A , body  120  may be mounted on attachment element  170 ; and tissue interface  130  may be mounted on a distal surface of body  120 . For example, body  120  may be mounted on a distal surface of element  170 ; and tissue interface  130  may wrap around the circular portion of skin  2  with body  120 , providing a curved rectangular communication area  4  and a semi-circular (e.g., less than 360°) or circular (e.g., 360°) communication direction CD for energy signal  90 . 
     Attachment element  170  (e.g., a sweat band) may be configured to maintain tissue interface  130  against or adjacent a portion of skin  2 , such as against the arm or forehead, allowing energy signal  90  to be output in signal direction SD and/or scrolled around the head to communication are 4 in communication direction CD. For example, the band may include an elastic portion that pushes body  120  and tissue interface  130  distally toward skin  2  when placed around the circular portion of skin  2 , i.e., when the sweat band of  FIG.  6 A  is worn. As shown, the elastic portion may be proximal of energy transceiver  110 , attached to a proximal surface of body  120 , and configured to apply a circumferential maintaining force that maintains the position of interface  130  when element  170  is worn. 
     As shown in  FIG.  6 B , energy transceiver  210  may include: a body  220  and a tissue interface  230 , both shown conceptually with a dotted line; and an attachment element  270 , shown conceptually as a baseball cap. Any cap, hat, helmet, or like headwear may be used. Body  220  may wrap around a circular portion of skin  2  including the forehead and/or scalp. As shown in  FIG.  6 B , body  220  may be mounted on attachment element  270 ; and tissue interface  230  may be mounted on a distal surface of body  220 . For example, body  220  may be mounted on a distal surface of element  270 ; and tissue interface  230  may wrap around the circular portion of skin  2  with body  220 , providing a semi-circular (e.g., less than 360°) or circular (e.g., 360°) communication area  4  and communication direction CD for energy signal  90 . As a further example, body  220  and tissue interface  230  may have a semi-spherical shape covering interior surfaces of cap  270  for output of energy signal  90  to a semi-spherical communication area  4  of skin  2  in any communication direction(s) CD. 
     Similar to attachment element  170  of  FIG.  6 A , attachment element  270  (e.g., a cap) also may include an elastic or non-elastic portion configured to maintain tissue interface  230  against or adjacent a portion of skin  2 , such as against the forehead, allowing energy signal  90  to be output in signal direction SD and/or scrolled around the head in communication direction CD. For example, the elastic or non-elastic portion may push body  220  and tissue interface  230  distally toward skin  2  when placed around the circular portion of skin  2 , i.e., when the cap of  FIG.  6 B  is worn. As shown, the elastic or non-elastic portion may be proximal of energy transceiver  210 , attached to a proximal surface of body  220 , and configured to apply a circumferential maintaining force that maintains the position of interface  230  when attachment element  270  is worn. For example, the elastic or non-elastic portion may comprise a tension fastening mechanism, such any snaps, Velcro®, or other typically found on headwear. 
     As shown in  FIG.  6 C , energy transceiver  310  may include a body  320  and a tissue interface  330 , both shown conceptually a dotted line; and an attachment element  370 , shown conceptually as a sock. Any tube-like garment may be used, including gloves, shoes, stockings, and the like. Body  320  may wrap around a circular portion of skin  2 , such as around a leg. As shown in  FIG.  6 C , body  320  may be mounted on attachment element  370 ; and tissue interface  330  may be mounted on a distal surface of body  320 . For example, body  320  may be mounted on a distal surface of element  370 , and tissue interface  330  may wrap around the circular portion of skin  2  with body  320 , providing a semi-circular (e.g., less than 360°) or circular (e.g., 360°) communication area  4  and direction(s) CD. 
     Similar to above, attachment element  370  (e.g., a sock) may include an elastic layer configured to maintain tissue interface  330  against or adjacent a portion of skin  2 , such as against the leg, allowing energy signal  90  to be output in signal direction SD and/or scrolled around the head in communication direction CD. For example, the elastic layer may push body  320  and tissue interface  330  distally toward skin  2  when placed around the circular portion of skin  2 , i.e., when the sock of  FIG.  6 C  is worn. As before, the elastic layer may be proximal of energy transceiver  310 , attached to a proximal surface of body  320 , and configured to apply a circumferential maintaining force that maintains the position of interface  330  when attachment element  370  is worn. 
     As shown in  FIG.  6 C , transceiver  310  may be removably attached to attachment element  370 , and thus operable with a plurality of elements  370 , such as plurality of socks or other tube-like garments that typically become soiled during use. For example, element  370  may include a pouch configured to receive and secure body  320 , orient tissue interface  330  toward skin  2 , and/or maintain the position tissue interface  330  on or adjacent skin  2 . As a further example, the elastic layer and/or the pouch may include an opening, and portions of body  320  may be engageable with (e.g., snap fit into) the opening to further maintain interface  330 . 
     As shown in  FIG.  6 D , for example, energy transceiver  410  may include a body  420  and a tissue interface  430 , both shown conceptually with a dotted line; and an attachment element  470 , shown conceptually as a compression garment. Any type of compressive garment may be used, such as those made by Under Armour®. Body  420  of  FIG.  6 D  may wrap around a portion of skin  2 , and be composed of an impacting absorbing material (e.g., foam) configured to dissipate external impact forces directed toward the skin  2 . For example, body  420  may be a thigh pad used in hockey or American football, a shin guard used in soccer, or any other type of protective pad with a distal surface that is desirably maintained against skin  2 . Similar to above, body  420  may be mounted on attachment element  470 ; and tissue interface  430  may be mounted on a distal surface of body  420 . For example, body  420  may be mounted on a distal surface of element  470 ; and tissue interface  430  may wrap around the circular portion of skin  2  with body  420 , providing a curved communication area  4  and direction CD for signal  90 . 
     Attachment element  470  (e.g., the compression garment) may include an elastic weave configured to maintain tissue interface  430  against or adjacent a portion of skin  2 , such as against the arm or forehead, allowing energy signal  90  to be output in signal direction SD and/or scrolled around the head to communication area  4  in communication direction CD. For example, the elastic weave may push body  420  and tissue interface  430  distally toward skin  2  when placed around the circular portion of skin  2 , i.e., when the compression garment of  FIG.  6 D  is worn. In this example, the elastic weave may be attached to body  420 , and configured to apply a circumferential maintaining force that maintains the position of interface  430  when attachment element  470  is worn. 
     Similar to above, energy transceiver  410  may be removably attached to attachment element  470 , and thus operable with a plurality of elements  470 , such as plurality of compressive garments. For example, impact absorbing body  420  may be mounted in a pocket of attachment element  470 , and tissue interface  430  may be mounted on a distal surface of impact absorbing body  420 , such as in a distal compartment of body  420 . Transceiver may be a game-time accessory. For example, as shown in  FIG.  6 D , signals  90  may comprise a plurality of arrows scrolled along communication direction CD to communicate movements to the user. In this example, the user may be trained to move in a particular direction (e.g., left or right) and intensity (e.g., slow or fast) based on the output of energy signal  90  and the particular combination of energies  32  associated therewith. 
     Although not shown in  FIGS.  6 A-D , attachment elements  170 ,  270 ,  370 , and  470  may include any adhesive and/or energy focusing elements, including those described above. For example, any aspects of attachment element  70  of  FIG.  2 C  may be combined with any aspects of attachment elements  170 ,  270 ,  370 , or  470  of  FIG.  6 A-D  to further maintain a position of tissue interface  430  relative to skin  2  and/or focus the energies  32  according to aspects of this disclosure. Aspects of any attachment elements may be combined and operable together. For example, attachment element  470  may be include an opening, body  420  may be snapped into the opening, and a second attachment element (e.g., a biocompatible low-tack adhesive) may be configured to further fix the position of interface  430  relative to skin  2  during rigorous physical activity, such as running. 
     As described above, aspects of energy transceivers  110 ,  210 ,  310 , and  410  may be included with any wearable item, giving aspects of this disclosure incredible breadth. For example, aspects of any of attachment elements  170 ,  270 ,  370 , and  470  may be integrated into any wearable item including any type of band, strap, or like item including any combination elastic and/or non-elastic layers or portions. Exemplary attachment elements may include: bandages, wherein the tissue interface may be located on a distal surface of a skin-attachment portion; belts, wherein the tissue interface may be located on a distal surface of the belt; bras, wherein the tissue interface may be located on a distal surface of a bra strap; earrings, wherein the tissue interface may be located on a distal surface of an earring front or back; pants, wherein the tissue interface may be located on a distal surface of a waste line or seam; rings, wherein the tissue interface may be located on an interior distal surface; shirts, wherein the tissue interface may be located on a distal surface of a neckline; underwear, wherein the tissue interface may be located on a distal surface of the legs or waistline; watches, wherein the tissue interface may be located on a distal surface of the watch strap; and any known or obvious variation of the same. 
     Aspects of transceivers  10 ,  110 ,  210 ,  310 , and  410  may be likewise included on any non-wearable object with a distal surface that is desirably maintained against skin  2  during use by application of an external force, such as a gravity force, a gripping force, or other externally applied maintaining force. Additional external force-based aspects are now described with reference energy transceiver  510  of  FIG.  7 A  and energy transceiver  610  of  FIG.  7 B . 
     As shown in  FIG.  7 A , energy transceiver  510  may include: a body  520  and a tissue interface  530 , both shown conceptually with a dotted line; and an attachment element  570 , shown conceptually as a shoe or a shoe insert. Any type of footwear and/or foot support with equivalent surfaces may be used. Body  520  may include a surface contoured for placement against skin  2 , such as an underside of a foot. As shown in  FIG.  7 A , body  520  may be mounted on attachment element  570 ; and tissue interface  530  may be mounted on or embedded in a distal portion of body  520 , allowing gravity to at least partially maintain interface  530  against or adjacent skin  2 , and providing a foot-shaped communication area  4  and communication direction CD for energy signal  90 . 
     Attachment element  470  may additionally comprise any tensioning elements configured apply a maintaining force that maintains the position of interface  530  when attachment element  570  is worn, such as shoe laces, Velcro, pumping mechanisms, elastic straps or structures, and the like. As a further example, attachment element  570  may be composed of an impact absorbing material, such as a polymeric material configured to distribute forces around body  520  when walking or running; and include bolster shapes contoured to further maintain tissue interface  530  by limiting lateral movements of the foot relative thereto. 
     Accordingly, energy signal  90  may be communicated to the communication area  4  of skin  2  by tissue interface  530  in any communication direction CD with any combination of energies  32 . As shown in  FIG.  7 A , energy signal  90  may include a plurality of directional shapes (e.g., the arrows of  FIG.  7 A ) flashed and/or scrolled in a linear direction to communication directional movements. The directional shapes may be responsive to directional data. For example, transceiver  510  may be configured to receive the directional data from one or more sources (e.g., GPS signals), determine communication direction CD based on the directional data, and scroll energy signal  90  across skin  2  as directional shapes scrolling along communication direction CD to compel movement of the user in a direction. 
     In keeping with above, transceiver  510  also may be configured to determine an importance measure based on the directional data, and communicate energy signal  90  with a particular combination of energies  32  and/or at a particular scroll rate based on the importance measure to direct a movement aspect, such as pace or direction. In the healthcare setting, for example, the directional data may include a vital sign of a patient and the GPS location of the patient; and transceiver  510  may determine the scroll rate based on the vital sign, allowing energy signal  90  to guide a healthcare provider toward the patient at walking pace appropriate for the condition of the patent. For example, energy signal  90  may be communicated a faster scroll rate with high intensity energies  32  to alert the provider to run if needed. 
     As shown in  FIG.  7 B , for example, energy transceiver  610  may include a body  620  and a tissue interface  630 , both shown conceptually with a dotted line; and an attachment element  670 , shown conceptually as a grip panel attached to the grip of a gun. Any type of gun may be used, including the handgun with a pistol grip and any other type of gun with similar surfaces that are gripped during use. In  FIG.  7 A , tissue interface  630  may be located on a distal surface of element  670  that is typically pushed toward a portion of skin  2  of a hand by a grip force applied by the hand during use, providing a regular or irregular shaped communication area  4 . Attachment element  630  may further maintain interface  630  by limiting movements the hand. For example, element  630  may be 3D printed based on a scan of the hand to include an outwardly curving surface shaped that maintains interface  630  against skin  2  by limiting movements of the hand relative to tissue interface  430  when gripped. 
     Accordingly, energy signal  90  may be communicated to the communication area  4  of skin  2  by tissue interface  630  in any communication direction CD with any combination of energies  32 . Aspects of energy signal  90  may be responsive to data, as with previous examples. For example, as shown in  FIG.  7 B , attachment element  670  (e.g., the gun) may include a sight, and energy signal  90  may include at least one decisional shape flashed and/or scrolled to communicate a status associated with gun based on a position of the sight. For example, energy transceiver  610  may include an elevation or motion sensor, and signal  90  may be output to skin  2  as a first shape (e.g., a circle) with a first energy (e.g., any combination of energies  32 A-D) whenever the sensor indicates that the sight of the gun has been raised with the safety off, alerting the user to a status of the gun. As a further example, energy transceiver  10  and/or the gun may be configured to determine whether the sight is aligned with a specific target, and output signal  90  as a second shape (e.g., an X shape) with a second energy (e.g., any combination of energies  32 A-D), alerting the user to a status of the target. 
     Any individual or combined aspects of energy transceivers  10 ,  110 ,  210 ,  310 ,  410 ,  510 , and  610  may likewise be included on any non-wearable object with a distal surface that is desirably maintained against skin  2  during use by application of an external force, such as a gravity, a gripping force, or other externally applied maintaining force. For example, aspects of tissue interfaces  510  and  610  may likewise be included on a distal surface of any load bearing surface of any type of attachment element. For example, aspects of attachment element  570  or  670  of  FIGS.  7 A-B  alternatively may include a bar, a chair, a handle, a floor, a rope, a wall, or any like object with a skin facing surface that is generally maintained against skin  2  during use; and aspects of issue interfaces  530  or  630  of  FIGS.  7 A-B  alternatively may be mounted therewith so that energy signal  90  may be output to skin  2  whenever the alternative attachment element  570  or  670  is used. 
     Additional implantable aspects are now described with reference to energy transceiver  710  of  FIG.  7 C  and energy transceiver  810  of  FIG.  7 D . As shown in  FIG.  7 C , for example, energy transceiver  710  may include a body  720  and a tissue interface  730 , both shown conceptually with a dotted line; and an attachment element  770 , shown conceptually as a portion of a bone plate. Any type of bone plate or other implantable object may be used. Attachment element  770  of  FIG.  7 C  includes a proximal bone-facing surface and a distal skin-facing surface. The bone-facing surface may be maintained against the bone by any combination of adhesives, screws, wires, and/or other bone fixation technologies. The skin-facing surface may maintain the position of tissue interface  730  relative to the bone, allowing for movement of skin  2  relative to interface  730 . For example, tissue interface  730  may be mounted in a compartment on the skin-facing surface. 
     As above, energy signal  90  may be communicated to the communication area  4  of skin  2  by tissue interface  730  in any communication direction CD with any combination of energies  32 . As shown in  FIG.  7 C , signal  90  may include any combination of shapes moving in any communication direction CD, including any combination of shapes and/or directions, any of which may be flashed and/or scrolled with any energies  32 . In contrast to above, energy signal  90  of  FIG.  7 C  may be output toward the underside of skin  2 , allowing for more direct communication with nerves associated with skin  2 . Aspects of transceiver  710  and energy signal  90  may be modified according to the implanted location of attachment element  770 . For example, tissue interface  730  may be embedded in an attachment element  770  sized for placement against a radius or finger bone wherein the distance between skin  2  and bone is minimal, allowing signal  90  to be communicated with less energy. As a further example, interface  730  may be mounted on an attachment element  770  sized for placement against a radius or ulna, wherein the distance between skin  2  and the bone is larger. 
     Similar to above, aspects of body  720  and/or attachment element  770  may direct and focus the energies  32 , making it easier to distinguish one output of energies  32  from another and/or prevent the energies  32  from being output to bone. Alternatively, all or portion of the energies  32  may be output toward the bone-facing surface of element  770  to communicate signals and/or apply treatments to the bone. For example, the energies  32  may be output through body  720  and/or attachment element  770  in a proximal and/or distal direction, such as through a plurality of openings extending through element  770 . As a further example, the distal surface of body  720  may include a first tissue interface  730  and/or the bone-facing surface of body  730  may include a second tissue interface  730 , allowing a corresponding set of first and/or second energy signals  90  to be toward in a first direction toward skin  2  and/or a second direction toward the bone. 
     As shown in  FIG.  7 D , for example, energy transceiver  810  may include a body  820  and a tissue interface  830 , both shown conceptually with a dotted line; and an attachment element  870 , shown as a biocompatible outer surface layer surrounding body  820 . Any type of biocompatible material or containing structure may be used. In this example, attachment element  870  may comprise a tissue in-growth promoting exterior layer that maintains the orientation and/or position of tissue interface  30  over time by interacting with living tissue. For example, element  870  may be composed of a polymeric material, such as a variant of polyether ether ketone (or “PEEK”); and/or include an outer surface textured to promote tissue ingrowth. 
     Energy signal  90  may be output from tissue interface  830  as above. As shown in  FIG.  7 D , tissue interface  830  may be oriented so that the signals  90  are output through attachment element  870  and toward a communication area  4  under skin  2  in a signal direction SD. For example, aspects of body  820  and/or attachment element  870  may direct and focus the energies  32  toward discrete areas  4  on the underside of skin  2 , making it easier for the brain to distinguish one output of energies  32  from another and/or preventing the energies  32  from being output other living portions, such as bone or muscle. Alternatively, all or portion of the energies  32  may be output simultaneously from proximal and distal sides of element  870  to communicate with nerves associated with skin  2  and the other living portions. For example, the energies  32  may be output through body  820  and/or attachment element  870  in either direction through a plurality of openings extending therethrough. Also similar to above, transceiver  810  may include a first interface  830  disposed opposite a second interface  830 , allowing for output of a corresponding set of first and second energy signals  90 . 
     Additional aspects are now described with reference to energy transceiver  910  of  FIGS.  8 A and  8 D , demonstrating that any variation of transceiver  10  described herein may be configured to output a plurality of signals  90 . For example, energy transceiver  910  may be configured to output a plurality of energy signals  90  in a signal direction SD toward skin  2 . As shown in in  FIGS.  8 A and  8 B , transceiver  910  may output a first signal  990   1  in a first divided area or band  924   1 , and a second signal  990   2  in a second divided area or band  924   2 . Each signal  990   1  and  990   2  may include a plurality of symbols. In  FIG.  8 A , for example, the symbols include dots made visible through an exemplary cut-out in transceiver  910  as they would be communicated to skin  2 , similar to  FIG.  1 A . Likewise, some of the generators  931  are shaded in  FIG.  8 A  indicate output of energies  32 , similar to  FIG.  2 B . 
     Transceiver  910  may comprise: a body  920 ; a tissue interface  930 ; a processing unit  960 ; and an attachment element  970 . Similar to above, body  920  may contain elements of transceiver  10  within a flexible biocompatible base material that is conformable against skin  2 , and maintainable against skin  2  for prolonged and/or semi-permanent durations. As shown in  FIGS.  8 A and  8 B , body  920  may have a length extending along a longitudinal axis X-X, a width extending along a lateral axis Y-Y, and a thickness extending along a proximal-distal axis Z-Z, similar to body  20  of  FIGS.  2 A-C . The length, width, and/or thickness of body  920  may be compatible with a curved portion of skin  2 , as in  FIG.  8 A , where body  920  is curved along axis X-X. For example, body  920  may be curved and/or wrapped around any body shape, such as a human forearm, a human shin, and/or portions of a human torso. 
     As also shown in  FIGS.  8 A and  8 B , body  920  may define a proximal surface  922 , a distal surface  924 , a distal compartment  926 , and an interior conduit  928 . The proximal surface  922  may include a cover  923  mounted thereto. Cover  923  may include a graphic design, a textual element, a writing surface, and/or like decorative feature. As shown in  FIG.  8 B , a distal surface of cover  923  may include a first attachment element (e.g., a first Velcro strip) engageable with a second attachment element (e.g., a second Velcro strip) on the proximal surface  922 , allowing cover  923  to be switched-out as needed. The second attachment element also may attach body  920  to another object such as the inside of a garment. 
     Tissue interface  930  may be similar to any variation of tissue interface  30  described herein. As shown in  FIG.  8 B , tissue interface surface  930  may be mounted in the distal compartment  926  of body  920 , and include plurality of energy generators  931  directed toward skin  2 . Each generator  931  may be similar to generators  31  described above. For example, each generator  931  may be operable with processing unit  960  to output energies  32  individually and/or in combination in a signal direction SD; and contained with base material  933  (e.g., epoxy) that directs and/or focusses energies  32  in the signal direction SD. Each generator  931  may likewise include a plurality of generator elements arranged (e.g., coaxially) to output their respective energies  32  in approximately the same direction along an axis z-z, making the outputs interchangeable. As before, the energies  32  may include impact energy  32 A (e.g.,  FIG.  4 A ), heat energy  32 B (e.g.,  FIG.  4 B ), shock energy  32 C (e.g.,  FIG.  4 C ), pressure energy  32 D (e.g.,  FIG.  4 D ); and/or any like energies. 
     In contrast to above, the plurality of generators  931  may be arranged into a plurality of divided areas or bands. As shown in  FIG.  8 B , the width of body  920  along lateral axis Y-Y may include the first band  924   1  of generators  931 , which may extend around the length of body  920  along a first longitudinal axis X 1 -X 1  of transceiver  910 ; and the second band  924   2  of generators  931 , which may extend around the length of body  20  along a second longitudinal axis X 2 -X 2 . The generators  931  located in first band  924   1  may be configured to output first signal  990   1 , and the generators  931  located in second band  924   2  may be configured to output second signal  990   2 . To enhance distinguishability, an interior portion of compartment  926  and/or base material  933  may physically separate first band  924   1  from second band  924   2 , as in  FIG.  8 B . 
     As shown in  FIG.  8 A , processing unit  960  may be configured to: receive first input data  980 A from a first data source  981 A; receive second input data  980 B from a second data source  981 B; and output a control signal  982  and/or to electricity to generators  931 , causing various combinations of said generators  931  to output first signal  990   1  and second signal  990   2 . For example, processing unit  960  of  FIGS.  8 A and  8 B  may include any elements of processor  60  of  FIG.  5   , such as transceiver  62 , one or more processors  63 , memory  64 , communication bus  65 , and power source  66 . Each of these elements may perform a similar function within processing unit  960 . Similar to above, one or more wired and/or wireless connections (e.g., such as conductors  27 ) may extend between processing unit  960  and each generator  931 . 
     Attachment element  970  may maintain a position of tissue interface  930  against or adjacent skin  2 . As shown in  FIG.  8 B , attachment element  970  may be proximal of tissue interface  930 , and configured to maintain the position of interface  930  by applying a distally-directed force to body  920 . The distally-directed force may press tissue interface  930  against skin  2 , and/or cause portions of interface  930  to conform against a curvature of skin  2 . As also shown in  FIG.  8 B , attachment element  970  may include a strap  972  extending through an interior conduct  928  of body  920 . Strap  972  may apply the distally-directed force. For example, strap  972  may be composed of a resilient material (e.g., metal) having a cross-sectional shape (e.g., a semi-circular shape) that maintains body  920  in either an elongated configuration (e.g.,  FIGS.  2 A-C ) or a curved configuration (e.g.,  FIG.  8 A ), like a slap bracelet. 
     Attachment element  970  also may apply the distally-directed force by applying a tensile force to strap  972 . As shown in  FIG.  8 A , a first end  973  of strap  972  may extend from one end of conduit  928 , a second end  977  of strap  972  may extend from another end of conduit  928 , and the tensile force may be imparted by removably attaching ends  973  and  974 . For example, a proximal surface of the first end  973  may include a first attachment element (e.g., a first Velcro strip), a distal surface of second end  974  may include a second attachment element (e.g., a second Velcro strip), and the first and second attachment elements may be overlapped to impart the tensile force. Any type of attachment element may be used to attached ends  973  and  974 , including buckles, ratchets, and the like. In some aspects, band  972  may be an elastic band, and ends  973  and  974  may be permanently attached together. 
     Processing unit  960  may be removably attached to transceiver  910 , allowing for easy repairs and upgrades. As shown in  FIG.  8 A , processing unit  960  may be attached to a distal surface of the first end  973  of strap  972 , and connected to tissue interface  930  by one or more conductors. For example, similar to conductors  27  described above, the conductors may include a network that is located in distal compartment  926  with tissue interface  930 , and configured to transmit power and/or control signals between processing unit  960  and generators  931 . As shown in  FIG.  8 A , a distal surface of processing unit  960  may include one or more sensors  968 , and attachment element  970  may be configured to maintain a position of the one or more sensors  968  one or adjacent to skin  2 , allowing characteristics of the user to be monitored and/or output with processing unit  960 . 
     Signals  990   1  and  990   2  may be similar to signal  90  of  FIG.  1 A . For example, first signal  990   1  may include a plurality of first symbols output in first band  924   1 , and second signal  990   2  may include a plurality of second symbols output in second band  924   2 . As shown in  FIGS.  8 A and  8 B , each of first and second symbols and/or dot may be associated with different data. For example, in the healthcare setting, first signal  990   1  may include first symbols associated with a first patient, and each first symbol may be associated with a vital sign for the first patient; whereas second signal  990   2  may include second symbols associated with a second patient, and each second symbol may be associated with a vital sign for the second patient, allowing the user to simultaneously monitor the first and second patients with transceiver  910 . 
     As shown in  FIG.  8 A , first signal  990   1  may be scrolled around first band  924   1  by outputting energies  32  toward skin  2  in signal direction SD, and moving the output across skin  2  in a first communication direction CD 1 ; and second signal  990   2  may be scrolled around second band  924   2  by outputting energies  32  toward skin  2  in signal direction SD, and moving the output across skin  2  in a second communication direction CD 2 . Each signal  990   1  and  990   2 , and/or each first or second symbol included therein, may be configured for increased complexity, allowing more data to be transmitted therewith. In keeping with the previous healthcare example, each signal  990   1  and  990   2  may be scrolled in one of communication directions CD 1  or CD 2  at a scroll rate associated with a vital sign of the respective first and second patients (e.g., pulse rate); each first and second symbol may be associated with another vital sign for said first and second patients (e.g., body temperature, pulse rate, respiration rate, and/or blood pressure); and the first and second symbols may be output with different combinations of energies  32  to communicate different aspects the vital signals (e.g., an increase or decrease in body temperature, pulse rate, respiration rate, and/or blood pressure). 
     Although shown as having two divided areas (e.g., first band  924   1  and second band  924   2 ) configured to output two different energy signals (e.g., first signal  990   1  and second signal  990   2 ), transceiver  910  may include any number of divided areas having any shape. For example, the width of body  920  may accommodate a plurality of divided areas, at least one tissue interface  930  may be located in each divide area, and attachment element  970  may be configured to maintain each tissue interface  930  against a different portion of skin  2 . For example, body  920  of  FIG.  8 A  may accommodate a plurality of bands spaced apart along a length of a limb (e.g., a forearm), and each band (e.g., similar to bands  924   1  and  924   2 ) may output a different energy signal (e.g., similar to signals  990   1  and  990   2 ) based on input data from a different data source (e.g., similar to sources  981   1  and  981   2 ). In a healthcare setting, each data source may include a patient monitoring device, allowing the user to simultaneously monitor a plurality of different patients with transceiver  910 . 
     Various methods associated with transceiver  10  are now described, including methods of operating transceiver  10 . Aspects of each method may be used with any variation of transceiver  10  described herein, such as transceivers  110 ,  210 ,  310 ,  410 ,  510 ,  610 ,  710 ,  810 , and  910  described above. For ease of description, aspects these methods are now described with various references to these exemplary transceivers, including numerous references to energy transceiver  10 . Unless claimed, these references are exemplary and non-limiting. 
     As shown in  FIG.  9   , an exemplary method  1000  may comprise: receiving, with processing unit  60 , input data  80  for a communication device  10  including a tissue interface  30  maintainable on or adjacent skin  2 , the interface  30  including a plurality of energy generators  31 , each generator  31  being operable to output a plurality of energies  32  in a signal direction SD toward skin  2  (a receiving step  1020 ); and operating, with processing unit  60 , the plurality of energy generators  31  to communicate with nerves associated with the skin  2  by outputting one or more energies (e.g., any of energies  32 A,  32 B,  32 C, and  32 D) of the plurality of energies  32  in the signal direction SD based on input data  80  (an operating step  1040 ). 
     Receiving step  1020  may comprise receiving input data  80  from one or more data sources  81 . For example, the one or more data sources  81  may include at least one of patient monitoring device, a remote server, and a sensor. In this example, receiving step  1020  may comprise receiving input data  80  from the one or more data sources  81  at regular intervals, and operating step  1040  may comprise outputting the one or more energies based on the input data  80  received during each regular interval. 
     Input data  80  may include a control signal  80 , and operating step  1040  may comprise outputting the one or more energies based on the control signal  82 . Alternatively, method  1000  may comprise: generating, with processing unit  60 , control signal  82  based on input data  80 , wherein operating step  1040  may comprise outputting the one or more energies based on control signal  82 . For example, the generating step  1030  may include associating the input data  80  with a plurality of symbols  92 , and operating step  1040  may comprise communicating the symbols  92  with the one or more energies. In this example, the input data  80  may include measurements (e.g., vital signs of a patient), and each symbol may be associated with one or more of the measurements (e.g., one or more of the vital signs). 
     In any of these examples, the one or more energies may include a first combination of the plurality of energies  32  (e.g., impact energy  32 A and pressure energy  32 D); and a second combination of the plurality of energies  32  (e.g., heat energy  32 B and pressure energy  32 D). The first combination may be followed by any second combination(s). For example, the one or more energies may include a first energy (e.g., impact energy  32 A) communicable with a first portion of the nerves (e.g., Meissner&#39;s corpuscle); and a second energy (e.g., heat energy  32 D) communication with a second portion of the nerves (e.g., the Ruffini corpuscle). 
     Operating step  1040  may alternatively comprise: operating, with processing unit  60 , the plurality of energy generators  31  to communicate energy signal  90  to nerves associated with the skin  2  by outputting one or more energies of the plurality of energies  32  in signal direction SD based on input data  80 . For example, step  1040  may comprise outputting different combinations of the one or more energies, and each different combination may communicate a different portion of the energy signal  90 . Similar to above, energy signal  90  may include one or more symbols  92 , and operating step  1040  may comprise outputting the one or more energies to communicate the one or more symbols  92 . Step  1040  may comprise scrolling the one or more symbols  92  across skin  2  in a communication direction CD transverse with the signal direction SD; and/or flashing any of symbols  92  on-and-off. The plurality symbols  92  may include any type of signal, including pip patters, alphanumeric symbols, and the like. 
     Various energy types may be used. For example, operating step  1040  may comprise outputting a first combination of the one or more energies to communicate a first symbol of the one or more symbols (e.g., symbol  92 A), and outputting a second combination of the one or more energies to communicate a second symbol of the one or more symbols (e.g., symbol  92 B). In some aspects, operating step  1040  may comprise: outputting a first combination of the one or more energies to communicate energy signal  90  and outputting a second combination of the one or more energies to communicate a characteristic of energy signal  90 , so as to highlight energy signal  90  or a portion thereof. Input data  80  may include a measurement, and step  1040  may comprise outputting a first combination of the one or more energies based on the measurement. In this example, step  1040  may comprise modifying the first combination based on a change of the measurement, and/or outputting a second combination of the one or more energies based on the change of the measurement. 
     The larger size of transceiver  910  relative to transceivers  10  may allow for different methods of operation. As shown in  FIG.  10   , for example, an exemplary method  1100  may comprise: receiving, with processing unit  960 , input data  980  for a communication device  910  including a tissue interface  930  maintainable on or adjacent skin  2 , the interface  930  including a plurality of energy generators  931  arranged in bands  924   1  and  924   2 , each generator  931  being operable to output a plurality of energies  32  in a signal direction SD toward the skin  2  (a receiving step  1120 ); and operating, with processing unit  60 , the plurality of energy generators  931  in each band  924   1  and  924   2  to communicate with nerves associated with the skin  2  by outputting one or more energies of the plurality of energies  32  in response to the input data  80  (an operating step  1140 ). 
     Receiving step  1020  may comprise receiving input data  980  from one or more data sources  981 . As shown in  FIG.  10   , for example, step  1020  may comprise receiving a first input data  980 A from a first data source  981 A, and a second input data  980 B from a second data source  981 B. Input data  980  may include a plurality of measurements. Accordingly, receiving step  1020  may comprise receiving input data include a plurality of measurements; and operating step  1040  may comprise operating the plurality of energy generators  931  in each band  924   1  and/or  924   2  to output the one or more energies based on one measurement of the plurality of measurements. 
     In the healthcare setting, first data source  981 A may include a patient monitoring device or sensor configured to output measurements associated with a first patient, and second data source  981 AB may include a patient monitoring device or sensor configured to output measurements associated with a second patient. The measurements may include vital signs for the respective first and second patients. In this example, receiving step  1120  may comprise receiving input data  980  including a plurality of vital signs; and operating step  1140  may comprise operating the plurality of energy generators  931  in each band  924   1  and  924   2  to output the one or more energies based on one vital sign of the plurality of vital signs. For example, step  1140  may comprise operating the generators  931  in band  924   1  to output energies  32  based on the vital signs for the first patient, and/or operating the generators  931  in band  924   2  to output energies  32  based on the vital signs for the second patient. 
     Aspects of energies  32  may be modified based on the measurements. For example, operating step  1040  may comprise: outputting a first combination of energies  32  when the at least one of the measurements is inside of an acceptable range; and outputting a second combination of energies  32  when at least one of the measurements is outside of the acceptable range. In the healthcare setting, one of the vital signs of the patient (e.g., pulse rate) may serve as the baseline measure. 
     Similar to above, input data  980  may include a control signal for each band  924   1  and  924   2 , and operating step  1140  may comprise outputting the energies  32  based on the control signal for each band  924   1  or  924   2 . Alternatively, method  1100  may further comprise: generating, with the processing unit  960 , a control signal for each band  924   1  and  924   2  based on input data  980 , wherein the operating step  1140  comprises outputting the energies  32  based on the control signal for each band. 
     Also similar to above, operating step  1140  also may comprise operating the plurality of energy generators  931  to simultaneously communicate a plurality of energy signals to nerves associated with the skin  2  by outputting an energy signal in each band with energies  32 , and/or scrolling the energy signal in its respective band. As shown in  FIG.  10   , step  1140  may comprise outputting first energy signal  990   1  in first band  924   1  with a first combination of energies  32 , and outputting second energy signal  990   2  in second band  924   2  with a second combination of energies  32 . Each signal  990   1  and  990   2  may include a plurality of symbols (e.g., symbols  92 ), and operating step  1140  may comprise scrolling the symbols across one of bands  924   1  and  924   2 . In keeping with above, first signal  990   1  (and any symbols contained therein) may be scrolled along a first communication direction CD 1  transverse with signal direction SD, and second signal  990   2  (and any symbols contained therein) may be scrolled along a second communication direction CD 2  transverse with signal direction SD. 
     Although described with reference to two divided areas (e.g., first band  924   1  and second band  924   2 ) configured to output two energy signals (e.g., first signal  990   1  and second signal  990   2 ), it is contemplated that method  1100  may be configured for any number of divided areas. Accordingly, variations of method  1100  may allow the user to simultaneously monitor a plurality of sources of input data, from one or more data sources, with aspects of transceiver  910  described herein. 
     Additional aspects described above with reference to transceivers  10 ,  110 ,  210 ,  310 ,  410 ,  510 ,  610 ,  710 ,  810  and  910 , and methods  1000  and  1100 , are now described with reference to a communication system  2000 . Aspects of an exemplary system  2000  are depicted in  FIGS.  11  and  12   . As shown in  FIG.  11   , communication system  2000  may comprise a plurality of energy transceivers configured to receive input data and output one or more of a plurality of energies  32  to different locations of skin  2  according to the input data. Each transceiver may include any element and perform any function described above with reference to transceivers  10 ,  110 ,  210 ,  310 ,  410 ,  510 ,  610 ,  710 ,  810  and  910 , and methods  1000  and  1100 . Different aspects may be combined in system  2000 . For example, as shown in  FIG.  11   , system  2000  may comprise: a first energy transceiver  2012  on a head of a user  1 , similar to transceiver  110  of  FIG.  6 A ; a second energy transceiver  2014  on one arm of user  1 , similar to transceiver  900  of  FIGS.  9 A-B ; a plurality of energy transceivers  2016  attached to a torso of user  1 , similar to transceiver  10  of  FIGS.  2 A-C ; an energy transceiver  2018  on each leg of user  1 , similar to transceiver  410  of  FIG.  6 D ; and an energy transceiver  2020  in each shoe of user  1 , similar to transceiver  510  of  FIG.  7 A . 
     Each transceiver  2012 ,  2014 ,  2016 ,  2018 , and  2020  may be interconnected in system  2000  so that coordinated control signals may be output to each transceiver for output of a corresponding signal  90  with a corresponding one or more of energies  32 . The coordinated control signals may be used to coordinate activities or movements of user  1  in response to the input data. As shown in  FIG.  11   , each of said transceivers may output data associated with a first form or position of user  1 , receive input data regarding a second form or position, and output signals  90  in the same or communication directions CD to direct the user  1  to move according to the desired form or position. In one aspect, the first form or position may be a first pose or stance, and the second form or position may be a second pose; in other aspects, the first form or position may be a first (e.g., GPS) position on a field, and the second form or position may be a second (e.g., GPS) position on the field. 
     As shown in  FIG.  11   , for example, transceiver  2012  may scroll a first signal  90  in a first communication direction CD 1  around the head; transceiver  2014  may scroll a second signal  90  around the arm in a second communication direction CD 2 ; transceivers  2016  may output third signals  90  without scrolling; transceivers  2018  may scroll fourth signals  90  in communication directions CD 3R  and CD 3L  around the legs; transceivers  2020  may scroll fourth signals  90  in communication directions CD 4R  and CD 4L  across the feet. Accordingly, each of the respective signals and communication directions may be coordinated in system  2000  to direct the user to move in a particular direction and/or move one or more of their limbs into a particular form or position. 
     Aspects of methods  1000  and  1100  may be modified for use within system  2000 . As shown in  FIG.  12   , for example, an exemplary method  2100  may comprise: receiving, with one or more processors, position data for a plurality of communication devices (e.g., transceivers  2012 ,  2014 ,  2016 ,  2018 ,  2020 ) mountable on or adjacent skin, each device including a tissue interface with a plurality of energy generators  31 , each generator  31  being operable to output a plurality of energies  32  in a signal direction SD toward skin  2  (a “receiving step  2120 ”); receiving or generating, with the one or more processors, a corrective motion signal for the plurality of communication devices based on position data for each communication device (a “receiving or generating step  2140 ”); and operating, with the one or more processors, the plurality of energy generators  31  of each communication device to output one or more energies of the plurality of energies  32  in signal direction SD based on the corrective motion signal. Although described with reference to elements of transceiver  10 , method  2100  may be performed with any transceiver described herein. 
     Additional aspects described above with reference to transceivers  10 ,  110 ,  210 ,  310 ,  410 ,  510 ,  610 ,  710 ,  810  and  910 , methods  1000  and  1100 , system  2000 , and method  2100  are now described with reference to aspects of an energy transceiver  3010  shown in  FIGS.  13 A,  13 B,  14 A , and  14 B. As before, any aspect of energy transceiver  3010  may be combined with any aspect described above. 
     As shown in  FIG.  13 A , energy transceiver  3010  may include: a body  3020  and a tissue interface  2030 ; and an attachment element  3070 , shown conceptually as a band in this example. As above, body  3020  may wrap around a circular portion of skin  2 , such as around the human forearm shown in  FIG.  13 B . For example, as before, body  3020  may be mounted on attachment element  3070 ; and tissue interface  3030  may be mounted on a distal surface of body  3020 , providing a curved rectangular communication area  4  and a semi-circular (e.g., less than 360°) or circular (e.g., 360°) communication direction CD for energy signal  90 . In keeping with above, attachment element  3070  (e.g., the band) may be configured to maintain tissue interface  3030  against or the forearm when element  3070  is worn, allowing energy signal  90  to be output communication area  4  in signal direction SD and/or scrolled across area  4  in communication direction CD. 
     As described above, aspects of each energy  32  may be modified to increase the complexity of energy signal  90 , and thus the amount of data transmitted therewith; and the modifiable aspects may include energy type, energy intensity, output duration, scroll rate, symbol shape, and the like, providing an incredibly broad range of obtainable complexity. Training may be required to leverage the full communicative capabilities of tissue interface  3030  and signal  90 . For example, within a repetition program, the user may be trained to more easily and/or quickly to distinguish between: any number of known shapes output by one of energies  32 , such as between a pip two dot pattern output with impact energy  32 A and a pip four dot pattern output with energy  32 A; or the same shape output with different energies  32 , such as a pip five dot pattern with impact energy  32 A or heat energy  32 B. 
     Communicating more complex variations, unknown signals, and/or unknown shapes may require additional training. For example, interface  3030  may output energy signal  90  to include pip patterns in which each dot is output with a different combination of energies  32 , allowing the pattern to be associated with a target, and each dot to be associated with a characteristic thereof. In the healthcare setting, for example, the pattern may be associated with a patient, and each dot may be associated with a different vital sign of the patient, providing immediate insight into patient health that may be updated continuously. Further training may be required to quickly distinguish between the characteristics communicated by each dot in these examples, particularly if energy signal  90  includes a plurality of pip patterns, as shown in  FIG.  2 C ; or a dynamic shape, such as the echocardiogram depicted in  FIGS.  13 A and  13 B ; the plurality of echocardiograms depicted in  FIG.  14 A ; or the alphanumeric symbol stream depicted in  FIG.  14 B . 
     Aspects of energy transceiver  3010  may be configured to provide additional communicative capabilities to, for example, assist with training. As shown in  FIG.  13 A , transceiver  3010  may further comprise an optical interface  3030 ′ compatible with eyes of the user. For example, optical interface  3030 ′ may comprise at least one display element operable to output an optical energy signal  90 ′ to the eyes, such as a flexible LED configured to output a plurality of colors. Any display technology may be used. As shown in  FIG.  13 A , interface  3030 ′ may provide a curved optical communication area that wraps around apparatus  3010  along an axis X-X and/or substantially corresponds with the communication area  4 . For example, tissue interface  330  may be configured to output non-optical energy signal  90  toward skin  2  with one or more energies  32  in a first or distal direction toward skin  2 ; and optical interface  330 ′ may be configured to output optical signal  90 ′ with one or more colors in a second or proximal direction toward the eyes. 
     Energy transceiver  3010  may comprise a processing unit similar to any variation of processing unit  60  described herein. For example, the processing unit may be operable with tissue interface  3030  and optical interface  3030 ′ to simultaneously communicate with nerves associated with skin  2  and the eyes by outputting signal  90  distally and signal  90 ′ proximally at the same time. Additional training capabilities may be realized by the simultaneous outputs. For example, the user may already be trained to react to optical signal  90 ′, whether or not signal  90  is communicated, such as when transceiver  3010  excludes interface  3030 . Accordingly, by consistently outputting energy signal  90  with optical signal  90 ′, the user may be trained to react to recognize and react to energy signal  90  with or without optical signal  90 ′. 
     In a healthcare setting, for example, optical signal  90 ′ may communicate a vital sign of a patient to the eyes of a provider, such as the echocardiogram of  FIG.  13 A ; and energy signal  90 ′ may communicate the same vital sign to skin  2  of the provider at the same time. For example, signals  90 ′ and  90  may be scrolled together in communication direction CD along axis X-X to simultaneously communicate aspects of the vital sign over time. As a further example, signal  90 ′ may comprise a plurality of colors, and the output of energies  32  in signal  90  may be modified according to a color matching algorithm to communicate similar aspects to skin  2  at the same time. Reactions to different vital signs may be trained in this manner. As shown in  FIG.  13 B , for example, a first portion of optical interface  3030 ′ may output a first optical signal  90 A′, a second portion of interface  3030 ′ may output a second optical signal  90 B′, corresponding portions of tissue interface  3030  may output corresponding energy signals  90 , much like interface  930  described above. As also shown in  FIG.  13 B , the signals  90 A′ and  90 B′ may be different, in which one may be a vital sign and other may include symbols communicating related patient data as above. 
     Accordingly, by simultaneously outputting optical signal  90 ′ together with energy signal  90 , transceiver  3010  may train reactions to any stimulus, such as the exemplary vital signs and signals depicted in  FIGS.  13  and  13 B . As shown in  FIGS.  14 A and  14 B , the complexity of the stimulus may be increased. For example, as shown in  FIG.  14 A , optical interface  3030 ′ and tissue interface  3030  may output their respective signals in a plurality of rows arranged around axis X-X, wherein each row includes a different set of corresponding signals movable along a communication direction CD that is transverse with axis X-X. In this example, four rows are shown as outputting four different optical signals, including a first optical signal  90 A′, a second optical signal  90 B′, a third optical signal  90 C′, and a fourth optical signal  90 D′. A corresponding set of rows and outputs may be realized by tissue interface  90 . 
     In the healthcare setting, for example, each output of optical signals  90 A′,  90 B′,  90 C′ and  90 D′ together with its corresponding energy signal  90  may communicate a different vital sign of a different patient to a provider, training them to simultaneously monitor all of the different patients at once. As described above, aspects of each energy signal  90 , such as energies  32 , may be modified to communicate changes in the associated vital sign. For training purposes, the color of optical signals  90 A,  90 B,  90 C, and  90 D may be varied based on these changes so that the provider may be trained to first recognize the changes based one of the optical signals; and second recognize the same changes based on one of the energy signals based on the color matching algorithm. For example, the color matching algorithm may comprise a correspondence between visual colors and energy intensity, in which warmer colors (e.g., red) are associated with higher intensities and cooler colors (e.g., blue) are associated with lower intensities. 
     Another example is provided in  FIG.  14 B , in which each output of signals  90 A′,  90 B′,  90 C′ and  90 D′ together with its corresponding signal  90  may communicate aspects of an alphanumeric stream. As shown in  FIG.  14 B , for example, each alphanumeric stream may comprise a stock ticker so that the user may be trained to simultaneously monitor a plurality of tickers. As before, aspects of the different optical signals  90 A′,  90 B′,  90 C′, and  90 ′D may be modified simultaneously with aspects of their corresponding energy signals  90  to communicate changes over time. 
     In keeping with above, optical interface  3030 ′ and tissue interface  3030  may be configured to individually and/or simultaneously output signals  90 ′ and  90  to include any symbols and shapes, as well as more complex depictions, such as graphics. For example, for more complex depictions, the color matching algorithm may be used to output different combinations of energies  32  based on color. 
     Optical interface  3030 ′ may comprise touchscreen capabilities allowing manipulation of signals  90  and/or  90 ′ by interaction therewith. For example, the position of each row depicted in  FIGS.  14 A and  14 B  may be movable via a tactile interaction with interface  3030 ′. As shown in  FIG.  13 B , for example, attachment element  3070  may maintain the position of tissue interface  3030  on or adjacent skin  2  of a forearm, meaning that at least some portion of optical interface  3030 ′ may not be aligned with the eyes of the user at all times. Accordingly, because of the dynamic capabilities of interfaces  3030  and  3030 ′, the touchscreen capabilities of apparatus  3010  may allow the user to move a particular row into alignment with the eyes by scrolling the rows together around axis X-X, in which the outputs of signals  90 A′,  90 B′,  90 C′, and  90 ′D and corresponding energy signal  90  move with each row. Any type of touchscreen-enabled two-way communication means may be used, including buttons, sliders, textual inputs, graphic inputs, and the like. 
     Aspects of methods  1000 ,  1100 , and  2100  and/or system  200  may be modified according to aspects of energy transceiver  3010 . For example, any method steps described herein may be modified to comprise training and/or communication steps according to the above-described aspects of transceiver  3010 . As a further example, the second energy transceiver  2014  shown in  FIG.  11    may comprise transceiver  3010 , which may be further operable with each of transceivers  2012 ,  2016 ,  2018 , and  2020  to train the user. To provide another example, aspects of each transceiver within system  2000  also may be configured to placement at a particular sensory zone of skin  2 , and transceiver  3010  may be used to both tune the respective energy signals  90  for output to each zone and train the user to react accordingly based on one or more of the signals  90 . In this example, the receptive capabilities of the nerves associated with skin  2  in each zone may vary, and transceiver  3010  may be configured to operate the transceivers in system  2000  so that the most complex signals are communicated to the most receptive zones. 
     While principles of the present disclosure are disclosed herein with reference to illustrative aspects for particular applications, the disclosure is not limited thereto. Those having ordinary skill in the art and access to the teachings provided herein will recognize additional modifications, applications, aspects, and substitution of equivalents all fall in the scope of the aspects disclosed herein. Accordingly, the present disclosure is not to be considered as limited by the foregoing description.