Patent ID: 12214114

DETAILED DESCRIPTION

Referring toFIG.1, a hemofiltration system100is shown in a treatment mode. Blood is pumped through an arterial blood line108at a selected flow rate by a blood pump124. A pump inlet pressure is indicated by a blood pump inlet pressure sensor134. A blood pump outlet pressure is indicated by a blood pump outlet pressure sensor122. A pre-hemofilter blood pressure immediately upstream of a hemofilter142is indicated by a pre-hemofilter blood pressure sensor. Replacement fluid is pumped by a replacement fluid pump128through a replacement fluid line104into the arterial blood line108at a selected rate by a replacement fluid pump128. Replacement fluid pump inlet and outlet pressure sensors130and112, respectively, indicate replacement fluid pump inlet and outlet pressures, respectively. The replacement fluid is combined with blood before it enters the hemofilter142. In alternative embodiments, the replacement fluid flows into a venous blood line102after passing through the hemofilter142. The pressure in the arterial blood line is indicated by a venous pressure sensor110. A bypass line117selectively conveys replacement fluid directly to an effluent line106. Waste from the hemofilter142is conveyed through the effluent line106by an effluent pump126. Effluent pump inlet pressure sensor114and effluent pump outlet pressure sensor132, respectively, indicate effluent pump inlet and outlet pressures. A pre-hemofilter pressure sensor138indicates pressure immediately upstream of the hemofilter142.

All line clamps are controlled by a controller101. All sensors apply corresponding signals to the controller101. A venous clamp103selectively allows and stops flow through the venous blood line102under control of the controller101. A replacement fluid clamp105selectively allows and stops flow through the replacement fluid line104under control of the controller101. A bypass clamp118selectively allows and stops flow through the bypass line117under control of the controller101. An effluent clamp140selectively allows and stops flow through the effluent line106under control of the controller101between the hemofilter142and the bypass line117while a waste clamp136selectively allows and stops flow downstream of the effluent pump126also under control of the controller101.

Background on the presented technology may be found in International Patent Application WO 2018017623, filed Jul. 18, 2017, incorporated herein by reference as if fully set forth in its entirety. The purpose of the presented technology for balancing fluid flow and synchronization of inflow and outflow pumps is to provide for fluid balance and the achievement of a target ultrafiltration over the course of a treatment. The basis for establishing volumetric balance is by synchronization (synch) of the hemofiltration pump to the hemofilter and the outlet effluent pump. The system is designed to balance two streams with this method to provide hemofiltration (HF).

For hemofiltration, synchronization occurs through the bypass fluid line117. A first sync target pressure is obtained by obtaining the effluent inlet pressure measured when the blood pump is at a desired flow rate and the hemofiltration pump and effluent pumps are off. Hemofiltration creates such a large difference at the effluent pump inlet when the pumps are on compared to the pressure when pumps are off, a second synch can be performed to meet accuracy specifications. The target pressure for the second sync is the effluent pump inlet pressure measured when the blood pump is at the desired flow rate with the pumps are set to the rates determined in the first sync.

The system may use peristaltic pumps for all pumping requirements. These pumps result in pulsatile flows and pressures at the inlet and outlets of the pumps. Depending on rates and compliance of the tubing at the pump inlets and outlets this pulsatile flow can produce noisy pressure signals. For use in the synchronization process, these signals may be electronically filtered by a low pass filter.

The peristaltic pump output for a fixed rotor revolution is impacted by the inlet pressure and tubing segment life and to a lesser extent the outlet pressure and fluid temperature. The system includes compensation algorithms to minimize the influence of these variables.

FIG.2shows the system ofFIG.1in a configuration for obtaining a target pressure for a first synchronization of inlet and outlet flow pumps, the effluent pump126and the replacement fluid pump128. In this configuration both the inlet and outlet flow pumps, the effluent pump126and the replacement fluid pump128are halted thereby occluding flow from and to the hemofilter142. The bypass clamp118is also closed so that no flow occurs into or out from the hemofilter142except for blood flow in the arterial and arterial blood lines108and102, respectively. The venous clamp103is opened and the waste clamp136is closed. The effluent clamp140is open so that pressure from the hemofilter142is detected by the effluent pump inlet pressure sensor114.

Pump pressure compensation is a kind of pump control where the rate of the pump is controlled responsively to the inlet pressure of the pump according to an algorithm. The algorithm compensates the relationship between the commanded rate and the actual flow rate. In the process discussed with regard toFIG.2, pressure compensation is turned off so that the rate of flow is presumed to be governed strictly by the speed of the pump actuator.

The blood pump124is set to a desired flow rate Qb, that is, a flow rate that the system is intended to operate at after the synchronization process is completed. Then the effluent pump inlet pressure sensor114pressure indication is read. An average of the pressure signals from venous pressure sensor110and the pre-hemofilter pressure sensor138is used to obtain an average blood pressure in the hemofilter142(AvePb). The system waits a predefined number of seconds (Tstabilize) for AvePb to stabilize (cease varying within a predefined range) and then takes the average of the effluent pump inlet pressure sensor114indication over a period of Tstabilize seconds (EP1). The AvePb over Tstabilize seconds and the AvePb are used to measure oncotic pressure (Po) which is equal to the difference between AvePb and EP1, i.e., Po=AvePb−EP1. In the configuration ofFIG.2, called pre-dilution. Note, post-dilution is where replacement fluid is fed into the venous blood line102instead of the arterial blood line108. In alternative embodiments, replacement fluid is introduced in a fashion identified as post-dilution in which the replacement fluid line104may be connected to a junction109instead of the junction111. A hemofilter exit oncotic pressure of blood (Poe) is calculated as Po in the pre-dilution configuration. In the post-dilution configuration Poe is determined from
Poe=2.1*Ce+0.16*Ce2+0.009*Ce3[the Landis-Pappenheimer equation];where Ce=Ci*Qp/(Qp−Qhf);Ci is the solution to Po−(2.1*Ci+0.16*Ci2+0.009*Ci3)=0Qp is the plasma flow range given by:For the post-dilution configuration,
Qp=Qb*(1−Hct)where Hct is the hematocrit for the post-dilutionFor the pre-dilution configuration,
Qp=Qhf+Qb*(1−Hct)where Qhf=the replacement fluid flow rateQb is the blood flow rate

Note that Hct may be taken as 0.3 if not known. Note also that there is a known relationship of the Oncotic pressure as a function of plasma protein concentration may be employed in embodiments. The known relationship is called the Landis-Pappenheimer equation.

Referring now toFIG.3, the hemofiltration system100configuration is changed such that the blood pump124keeps running and replacement fluid pump128and effluent pump126are run according to a specific procedure now described. The bypass clamp118and the waste clamp136are opened and the replacement fluid clamp105and the effluent clamp140are closed. Thus, replacement fluid is pumped by replacement fluid pump128through the bypass line117into the effluent line106. This connects the replacement fluid pump128and effluent pump126in series. For effluent pump126pressure compensation is turned off. The effluent pump126is set to a desired flow rate and the replacement fluid pump128is adjusted until the pressure indicated by effluent pump inlet pressure sensor114reaches the value EP1. After Tdone seconds of control, the replacement fluid pump128commanded pumping rate is averaged for TavePer seconds and set equal to the synched rate for that pump with effluent pump126running at the selected commanded rate. The pressure indicated by effluent pump inlet pressure sensor114is averaged over TavePer and set equal to the EP1 reference pressure (EP1ref).

Under certain conditions, a second synchronization is done as indicated above. In certain circumstances instead of a second synchronization being done, the following procedure is performed. Referring toFIG.4, the replacement fluid clamp105and the effluent fluid clamp140are opened and the bypass clamp118is closed. The pressure compensation algorithm is used to control the effluent pump126according to the following equation:
FP3c=HFd*(1+(icompf)*(Poe−Po)−(icompf)*(EP−EP1ref)),where HFd is the desired replacement fluid flow rate and icomp (same as icompf for hemofiltration) is the inlet pressure compensation coefficient determined by a procedure at HFd in which a synchronization is performed at AvePb. Once replacement fluid pump128and effluent pump126are synchronized, the rate of replacement fluid pump128is perturbed first to a higher speed than the synchronized one and then to a lower speed than the synchronized one. At each point, the equilibrated pressure is recorded after a predefined interval to obtain three pressure vs commanded flow rate data points. These three data points are fitted to a straight line with pressure on the Y axis and flow rate on the X axis. The slope is divided by the effluent pump126commanded flow rate to obtain icomp.

FIG.5summarizes the procedure described with reference toFIG.2. EP stands for effluent pressure and is given by the effluent pump inlet pressure sensor114. The procedure ofFIG.5includes steps S502and S504, and can be done at certain intervals or upon certain events, such as after the lapse of a predefined period of time, when a fluid circuit is changed or one of the pump speeds are changed, such as the blood pump or hemofiltration fluid pump.

FIG.8shows a procedure at S801like that ofFIG.5, namely a synchronization of pumps, however in this case, the replacement fluid pump128(FP2) speed is perturbed at S802, (i.e., increased and also decreased), and speed and effluent pump126inlet pressure given by effluent pump inlet pressure sensor114are recorded to obtain three data points of pressure versus pump speed. One data point is at the reduced speed. Another data point is at the increased speed. And the third data point is at the normal speed. This procedure yields a parameter icomp (icompf for hemofiltration) at S803which is used in the procedure ofFIG.7in the equation for FP3c. Note that FP3 refers to the effluent pump126. The calculation of icompf is described above.

The out of loop synchronization which is the same as that ofFIG.3,5, may be done on a different schedule or upon different events that the regular first synchronization with the additional steps of perturbing the flow rate of the replacement fluid pump128. Once each instance of the out of loop synch is performed, the icompf may be used to obtain the effluent pump126(FP3) compensation coefficient. The process is labeled as out of loop sync. For the first part of the formula first part of the algorithm, the next few steps are geared towards determining the effluent pump inlet pressure compensation coefficient in situ.

Note in the discussion ofFIG.8above, it should be understood that although the algorithm is identified as out of loop synchronization that this is true for the first part of the algorithm but not the next. Rather the next few steps are geared towards determining the effluent pump inlet pressure compensation coefficient in situ, as opposed to out of loop.

FIG.6summarizes the synchronization procedure described with reference to FIG.3, and includes steps S602and S604.

FIG.7summarizes the procedure described with reference toFIG.4which is an out of loop synchronization, and includes steps S701and S702, as shown in the figure.

FIG.9shows the configuration of the hemofiltration system100for establishing a second synchronization target. In this configuration, the flow of replacement fluid is through the hemofilter142and the pumping rates are the synchronized rates of effluent pump126and replacement fluid pump128found by the first synchronization procedure. The effluent pressure indicated by effluent pump inlet pressure sensor114is averaged and stored as a target EP2. Then the bypass configuration, identical toFIG.3, is assumed by the hemofiltration system100and a second synchronization is performed using EP2. This is now described in a complete procedure atFIG.10.

Referring now toFIG.10, at S2, the replacement fluid pump128and effluent pump126are halted and the blood pump124is run at a desired rate. The pressure given by effluent pump inlet pressure sensor114is averaged as described above and stored as a first target pressure EP1 S4. At S6, a synchronization procedure is performed using the target EP1 to obtain a synchronization coefficient for replacement fluid pump128that synchronizes it to effluent pump126. At S8, the bypass clamp118is closed and the replacement fluid pump128and at S10the effluent pump126are run at the rates obtained during S6. This causes the replacement fluid to flow through the hemofilter142. At S12, the pumps are run for a period of time and the effluent pressure from effluent pump inlet pressure sensor114averaged to obtain a new target EP2. At S14, flow is established through the bypass line117by opening the bypass clamp118and closing replacement fluid clamp105and a synchronization is performed at S16using the new target pressure EP2. That is, the rate of FP2 at which the flow balances with FP3 is determined and stored as a coefficient. The EP2 is also used as a reference point for pressure compensation.

Referring now toFIG.11, a relationship between out of loop synchronizations and conditional one and two synch procedures is shown. An out of loop procedure is shown at200and a synchronization procedure is shown at202. Data25is passed to the synchronization procedure for use in S56as will described. In the out of loop procedure200, at S40, the synchronization target is established just as EP1 is obtained as described above and at S42, a synchronization is done as described above based on EP1 as the target. At S44, before finishing the synchronization procedure, the replacement fluid pump128rate, which is now synchronized, is increased and decreased above and below the synchronized rate and the effluent pump inlet pressure sensor114pressure is recorded for each perturbed rate. This gives rise to three pressures, EP1 and the pressures corresponding to the two perturbed rates. The three points are fitted, at S46and the value of icompf computed (SeeFIG.8and associated text) and stored (represented as data25). At S48it is determined whether icompf should be recalculated or not and if so, control reverts to S40otherwise it loops to S48.

Continuing to refer toFIG.11, at S202the procedure for synchronization begins at S50with the establishment of a first effluent pressure target EP1 taken as an average of effluent pump inlet pressure sensor114as discussed above. At S52a first synchronization is performed as discussed. At S54it is determined if a second synchronization is required. Under certain conditions, for example when the replacement fluid flow rates are above a predefined threshold, a second synchronization may not need to be performed and sufficient accuracy can be obtained using the operation S56in which icompf is used to calculate the synch coefficient rather than going through the whole procedure of S58-S64. If a second synchronization is required, the control proceeds to S58and replacement fluid is run through the dialyzer with the pre-hemofilter pressure sensor138and effluent pump126run at the synchronized rates found in S52. The second synchronization target EP2 is stored at S60and used at S62to perform a synchronization through the bypass line117. At S64, the synch coefficient for replacement fluid pump128is then calculated and used with pressure compensation to perform treatments until updated again.

According to first embodiments, the disclosed subject matter includes a method of controlling pumps in a hemofiltration system. The method includes connecting inlet and outlet pumps in series and pumping while measuring a pressure within a connecting channel therebetween, sampling the pressure until it stabilizes within a predefined interval. The method includes varying the inlet pump speed until the pressure reaches a predefined target. The method includes changing the inlet pump speed incrementally above and below the speed at which the pressure reached the predefined target and recording inlet pump speed and pressure for the two speeds. The method includes fitting a line to the predefined target pressure and the inlet pump speeds at the above and below incrementally different speeds. The method includes deriving a parameter from the slope of the fitted line and using thereafter to control the inlet pump speed.

In variations thereof, the first embodiments include ones in which the inlet pump pumps replacement fluid into a blood line. In variations thereof, the first embodiments include ones in which the outlet pump withdraws waste fluid from a hemofilter. In variations thereof, the first embodiments include ones in which the predefined target pressure is obtained by measuring the pressure in the waste compartment when there is no flow across the membrane of the hemofilter and while blood is flowing such that a predefined average pressure exists on the blood side of the hemofilter. In variations thereof, the first embodiments include ones in which the predefined average pressure on the blood side is measured at a selected blood pumping speed.

According to second embodiments, the disclosed subject matter includes a method for controlling flow in a fluid circuit. The method includes, in a hemofiltration machine with a controller that controls a net ultrafiltration by independently regulating the speed of a waste pump that draws fluid from a hemofilter and the speed of a replacement fluid pump that pumps replacement fluid into a patient blood line, using the controller to control the pumps to implement synchronization and treatment modes. in the synchronization mode, the controller detecting a target pressure at an inlet of the waste pump while flowing blood through the hemofilter and while blocking flow through the replacement fluid and waste pumps. The method includes subsequently, in the synchronization mode, the controller connecting the replacement fluid pump and the waste pump directly in series and, while flowing replacement fluid between them and controlling the waste pump speed to establish a predetermined hemofiltration rate, controlling the replacement fluid pump speed to determine a synchronized replacement fluid pump speed that maintains the waste pump inlet pressure at said target pressure. The method includes subsequently, in a treatment mode, the controller connecting the replacement fluid pump to pump replacement fluid into a blood circuit at said synchronized replacement pump speed.

According to third embodiments, the disclosed subject matter includes a system for controlling flow in a fluid circuit. A hemofiltration machine as a fluid circuit having blood and non-blood portions, a controller waste, dialysate, and treatment fluid pumps connected to a hemodiafilter, a pressure sensor at an inlet of the waste pump, and flow controllers permitting selective interconnection of the blood and non-blood portions. The controller controls a net ultrafiltration, during a treatment mode, by independently regulating the speed of the waste pump that draws fluid from a hemodiafilter, the speed of a replacement fluid pump that pumps replacement fluid into the blood portion, and the speed of the dialysate pump that pumps dialysate into the hemodiafilter. The controller controls the pumps to implement first and second synchronization modes and a treatment mode. In the first synchronization mode, the controller detects a target pressure at an inlet of the waste pump while flowing blood through the hemodiafilter and while blocking flow through the replacement fluid and waste pumps. Subsequently, in the first synchronization mode, the controller pumps dialysate through the hemodiafilter using the dialysate and waste pumps and controlling the waste pump speed to establish a predetermined dialysate flow rate, controlling the dialysate pump speed to determine a synchronized dialysate pump speed that maintains the waste pump inlet pressure at said target pressure. Subsequently, in the second synchronization mode, the controller connects the replacement fluid pump and the waste pump directly in series and, while flowing replacement fluid between them and controlling the waste pump speed establish a predetermined hemofiltration rate, controlling the replacement fluid pump speed to determine a synchronized replacement fluid pump speed that maintains the waste pump inlet pressure at said target pressure. Subsequently, in a treatment mode, the controller connects the replacement fluid pump to pump replacement fluid into the blood portion at said synchronized replacement fluid pump speed, connect said dialysate pump to pump dialysate into said hemodiafilter at said synchronized dialysate pump speed, and to connect said waste pump to draw waste fluid from the hemodiafilter at a rate responsive to the predetermined dialysate flow rate and the predetermined hemofiltration rate.

In variations thereof, the third embodiments include ones in which in the treatment mode, the waste pump is controlled to draw waste fluid from the hemodiafilter at a rate equal to the sum of the predetermined dialysate flow rate and the predetermined hemofiltration rate.

According to fourth embodiments, the disclosed subject matter includes a method for controlling flow in a fluid circuit. The method includes, in a treatment machine that controls the total volume of fluid flowing into or from a patient against the total volume of fluid drawn from the patient by regulating the relative speeds of peristaltic pumps that flow fluid in a fluid circuit connected to the patient, implementing a priming mode in which priming fluid is pumped through the fluid circuit the priming mode including pumping fluid through the fluid pumps for a break-in interval of at least five minutes, before establishing a treatment mode in which the peristaltic pumps are used to control a net flow of fluid into or from the patient.

In variations thereof, the fourth embodiments include ones in which the treatment machine is a hemodialysis machine and the pumps regulate the flow of dialysate into and out of a dialyzer. In variations thereof, the fourth embodiments include ones that include after said break-in interval, performing a flow calibration procedure in which the flow of one of said peristaltic pumps is calibrated against a standard or another of said peristaltic pumps. In variations thereof, the fourth embodiments include ones in which the calibration procedure generates a control parameter that is used by the controller to regulate said peristaltic pumps during the treatment mode.

FIG.12shows a block diagram of an example computer system according to embodiments of the disclosed subject matter. In various embodiments, all or parts of system1000may be included in a medical treatment device/system such as a renal replacement therapy system. In these embodiments, all or parts of system1000may provide the functionality of a controller of the medical treatment device/systems. In some embodiments, all or parts of system1000may be implemented as a distributed system, for example, as a cloud-based system.

System1000includes a computer1002such as a personal computer or workstation or other such computing system that includes a processor1006. However, alternative embodiments may implement more than one processor and/or one or more microprocessors, microcontroller devices, or control logic including integrated circuits such as ASIC.

Computer1002further includes a bus1004that provides communication functionality among various modules of computer1002. For example, bus1004may allow for communicating information/data between processor1006and a memory1008of computer1002so that processor1006may retrieve stored data from memory1008and/or execute instructions stored on memory1008. In one embodiment, such instructions may be compiled from source code/objects provided in accordance with a programming language such as Java, C++, C #, .net, Visual Basic™ language, LabVIEW, or another structured or object-oriented programming language. In one embodiment, the instructions include software modules that, when executed by processor1006, provide renal replacement therapy functionality according to any of the embodiments disclosed herein.

Memory1008may include any volatile or non-volatile computer-readable memory that can be read by computer1002. For example, memory1008may include a non-transitory computer-readable medium such as ROM, PROM, EEPROM, RAM, flash memory, disk drive, etc. Memory1008may be a removable or non-removable medium.

Bus1004may further allow for communication between computer1002and a display1018, a keyboard1020, a mouse1022, and a speaker1024, each providing respective functionality in accordance with various embodiments disclosed herein, for example, for configuring a treatment for a patient and monitoring a patient during a treatment.

Computer1002may also implement a communication interface1010to communicate with a network1012to provide any functionality disclosed herein, for example, for alerting a healthcare professional and/or receiving instructions from a healthcare professional, reporting patient/device conditions in a distributed system for training a machine learning algorithm, logging data to a remote repository, etc. Communication interface1010may be any such interface known in the art to provide wireless and/or wired communication, such as a network card or a modem.

Bus1004may further allow for communication with a sensor1014and/or an actuator1016, each providing respective functionality in accordance with various embodiments disclosed herein, for example, for measuring signals indicative of a patient/device condition and for controlling the operation of the device accordingly. For example, sensor1014may provide a signal indicative of a viscosity of a fluid in a fluid circuit in a renal replacement therapy device, and actuator1016may operate a pump that controls the flow of the fluid responsively to the signals of sensor1014.

It will be appreciated that the modules, processes, systems, and sections described above can be implemented in hardware, hardware programmed by software, software instruction stored on a non-transitory computer readable medium or a combination of the above. For example, a method for controlling balancing in renal replacement therapy, for synchronizing balanced pumps, etc. can be implemented, for example, using a processor configured to execute a sequence of programmed instructions stored on a non-transitory computer readable medium. For example, the processor can include, but not be limited to, a personal computer or workstation or other such computing system that includes a processor, microprocessor, microcontroller device, or is comprised of control logic including integrated circuits such as, for example, an Application Specific Integrated Circuit (ASIC). The instructions can be compiled from source code instructions provided in accordance with a programming language such as Java, C++, C #.net or the like. The instructions can also comprise code and data objects provided in accordance with, for example, the Visual Basic™ language, LabVIEW, or another structured or object-oriented programming language. The sequence of programmed instructions and data associated therewith can be stored in a non-transitory computer-readable medium such as a computer memory or storage device which may be any suitable memory apparatus, such as, but not limited to read-only memory (ROM), programmable read-only memory (PROM), electrically erasable programmable read-only memory (EEPROM), random-access memory (RAM), flash memory, disk drive and the like.

Furthermore, the modules, processes, systems, and sections can be implemented as a single processor or as a distributed processor. Further, it should be appreciated that the steps mentioned above may be performed on a single or distributed processor (single and/or multi-core). Also, the processes, modules, and sub-modules described in the various figures of and for embodiments above may be distributed across multiple computers or systems or may be co-located in a single processor or system. Exemplary structural embodiment alternatives suitable for implementing the modules, sections, systems, means, or processes described herein are provided below.

The modules, processors or systems described above can be implemented as a programmed general purpose computer, an electronic device programmed with microcode, a hard-wired analog logic circuit, software stored on a computer-readable medium or signal, an optical computing device, a networked system of electronic and/or optical devices, a special purpose computing device, an integrated circuit device, a semiconductor chip, and a software module or object stored on a computer-readable medium or signal, for example.

Embodiments of the method and system (or their sub-components or modules), may be implemented on a general-purpose computer, a special-purpose computer, a programmed microprocessor or microcontroller and peripheral integrated circuit element, an ASIC or other integrated circuit, a digital signal processor, a hardwired electronic or logic circuit such as a discrete element circuit, a programmed logic circuit such as a programmable logic device (PLD), programmable logic array (PLA), field-programmable gate array (FPGA), programmable array logic (PAL) device, or the like. In general, any process capable of implementing the functions or steps described herein can be used to implement embodiments of the method, system, or a computer program product (software program stored on a non-transitory computer readable medium).

Furthermore, embodiments of the disclosed method, system, and computer program product may be readily implemented, fully or partially, in software using, for example, object or object-oriented software development environments that provide portable source code that can be used on a variety of computer platforms. Alternatively, embodiments of the disclosed method, system, and computer program product can be implemented partially or fully in hardware using, for example, standard logic circuits or a very-large-scale integration (VLSI) design. Other hardware or software can be used to implement embodiments depending on the speed and/or efficiency requirements of the systems, the particular function, and/or particular software or hardware system, microprocessor, or microcomputer being utilized. Embodiments of the method, system, and computer program product can be implemented in hardware and/or software using any known or later developed systems or structures, devices and/or software by those of ordinary skill in the applicable art from the function description provided herein and with a general basic knowledge of control engineering, medical systems, and/or computer programming arts.

Moreover, embodiments of the disclosed method, system, and computer program product can be implemented in software executed on a programmed general purpose computer, a special purpose computer, a microprocessor, or the like.

It is, thus, apparent that there is provided, in accordance with the present disclosure, synchronization devices, methods, and systems. Many alternatives, modifications, and variations are enabled by the present disclosure. Features of the disclosed embodiments can be combined, rearranged, omitted, etc., within the scope of the invention to produce additional embodiments. Furthermore, certain features may sometimes be used to advantage without a corresponding use of other features. Accordingly, Applicants intend to embrace all such alternatives, modifications, equivalents, and variations that are within the spirit and scope of the present invention.