The present invention is to provide a process for the preparation of coil for an electric appliance by which a coil for electric appliances comprising an edgewise wound square coil having small intervals between coils and high quality can be easily prepared in good productivity and low-cost. The coil for electric appliance comprising edgewise wound square coil 11 is prepared by processing mechanically an electrically conductive flat plate to form plural strip-shaped coil fragments 1A to 1E, butting ends of the coil fragments 1A to 1E each other and welding the ends by beam to form plural one-turn square coils, each of the one-turn square coils having a ring-shape provided with a beginning end 2A and a terminal end 2B divided by a notch 3 whose location is different from one another in the one-turn square coils, and superposing the one-turn square coils on one another with shifting the locations of the notches 3 little by little in order so that the terminal and beginning ends of the one-turn square coils adjacent to each other are contact with each other to weld the terminal and beginning ends in the notch 3, whereby the one-turn square coils are spirally combined.

1. Field of the Invention
The present invention relates to a process for the preparation of a coil for an electric appliance useful in electric appliances such as rotating apparatuses (e.g., a motor or generator) or transformers and a coil for electric appliance.
2. Description of the Related Art
For example, there has been known an edgewise wound square coil as a coil for motor, the square coil being obtained by squarely winding an electric conductor having a rectangular cross section such that small sides of the cross section corresponds with the direction of the coil axis of the coil to helically superpose the wound conductor in the direction of the coil axis.
Such the edgewise wound square coil permits a proportion occupied by coil in a slot to enhance. Hence in the edgewise wound square coil, it is possible to increase the operation efficiency of a motor and also reduce the size and weight of the motor.
The edgewise wound square coil has been prepared, for example, as shown in FIG. 12 so far. In more detail, a pillar copper is cut to form strip-shaped coil fragments 51A to 51D for constituting a one-turn square coil, the edges of the coil fragments 51A to 51D are butted (i.e., brought into contact with) each other in order at three points and welded respectively in bonding portions 52 to form a one-turn square coil 51 in the form of circle (rectangle), and a terminal end 53 of the one-turn square coil 51 is brazed to a beginning end of another (next) one-turn square coil 51 prepared similarly, whereby a square coil having desired number of turns can be prepared. For example, the process is described in JP-A-2001-178052.
According to the above-mentioned process, the pillar copper is cut to form strip-shaped coil fragments 51A to 51D, and therefore it is expected that the coil fragments 51A to 51D is improved in processing properties and processing precision and further enhanced in material yield of the pillar copper resulting in good productivity and low-cost.

Process for the preparation of coil for electric appliance and coil for electric appliance


Provided is a multilayered transmission line plate including one pair of ground layers, a differential wiring layer disposed between one ground layer and the other ground layer of the one pair of ground layers, a first insulating portion disposed between the differential wiring layer and the one ground layer, and a second insulating portion disposed between the differential wiring layer and the other ground layer, wherein the first insulating portion has a resin layer, the first insulating portion or the second insulating portion has a fiber base material layer including a fiber base material, and a thickness of the first insulating portion is equal to or thinner than a thickness of the second insulating portion.

Following an increase in speed of signal, a differential transmission system is widely adopted. Although the differential transmission system is advantageous for noise reduction, as the signal becomes faster, signal degradation due to generation of a common-mode noise has become problematic.
Now, in an insulating layer of the multilayered transmission line plate, in order to secure handling properties of materials at the time of manufacturing the multilayered transmission line plate, mechanical properties of the multilayered transmission line plate itself, and the like, a composite material of a fiber base material such as a glass cloth, etc. and a resin is widely used.
As shown in FIG. 1, the glass cloth has a structure in which glass fibers are woven vertically and horizontally, and therefore, the glass fibers overlap in a weave texture portion. Accordingly, in the composite material of the glass cloth and the resin, an abundance ratio of glass becomes high in the weave texture portion of glass fibers. Conversely, the abundance ratio of glass becomes low in a portion where the glass fibers do not overlap. In general, since the resin and the glass are different from each other in a dielectric constant, when the abundance ratio between the resin and the glass within the composite material plane is heterogeneous, the dielectric constant within the composite material plane becomes heterogeneous, too.
As shown in FIG. 2, in a multilayered transmission line plate in which a differential wiring is formed, there is caused a case where a wiring is present in a portion where the abundance ratio of glass is high and a portion where the abundance ratio of glass is low. However, since the signal speed is different in the respective places, a deviation (skew) in the arrival time of signal is generated at a receiving side, thereby resulting in lowering of signal quality.
As a skew countermeasure, a measure by a design technology, such as oblique disposition of a wiring pattern against the weaving direction of glass, etc., is taken. However, according to this method, imposition of the wiring pattern becomes inefficient, resulting in a material loss. Thus, other solution means is required.
PTL 1 discloses a method of concentratedly adding fillers having a high dielectric constant in portions of a glass cloth that are not a weave texture, thereby making the dielectric constant within the composite material plane homogeneous.

This patent is subject to a terminal disclaimer.


Provided an electrophotographic image forming apparatus comprising an electrophotographic photosensitive member and a charging member. The electrophotographic photosensitive member includes a charge transport layer as a surface layer having a matrix-domain structure including specific resins. The charging member comprises an electro-conductive substrate, and an electro-conductive elastic layer. The electro-conductive elastic layer comprises a binder, and holding a bowl-shaped resin particle having an opening, so that at least a part of the bowl-shaped resin particle is exposed, and the charging member has a concavity derived from the opening of the bowl-shaped resin particle on the surface thereof, and a protrusion derived from an edge of the opening of the bowl-shaped resin particle on the surface thereof.

1. Field of the Invention
The present invention relates to an electrophotographic image forming apparatus.
2. Description of the Related Art
An electrophotographic image forming apparatus is repeatedly subjected to each of the processes such as charging, exposure, developing, transferring and cleaning. The surface of an electrophotographic photosensitive member is required to have high lubricity to a member in contact with the surface of the electrophotographic photosensitive member, such as a cleaning blade for removal of transfer residual toner.
In order to solve the problem of lubricity, a method for adding silicone oil such as polydimethyl siloxane to the surface layer of an electrophotographic photosensitive member is proposed in Japanese Patent Application Laid-Open No. H07-13368.
On the other hand, a charging member in contact with the electrophotographic photosensitive member at a predetermined contact pressure and driven to rotate on a steady basis in an electrophotographic image forming apparatus is required to be stably driven to rotate on a steady basis even when the lubricity of the electrophotographic photosensitive member is increased.
A method for reducing the area substantially in contact with an electrophotographic photosensitive member by increasing the surface roughness of a charging member is proposed in Japanese Patent Application Laid-Open No. 2012-42700 from the viewpoint of preventing the electrophotographic photosensitive member from being shaved off.
However, the present inventors examined the electrophotographic photosensitive member and the charging member described in Japanese Patent Application Laid-Open No. H07-13368 and Japanese Patent Application Laid-Open No. 2012-42700, and found the following problems. Namely, the combination of an electrophotographic photosensitive member having lubricity and a charging member containing large-size particles in a coating layer easily caused micro slips between the electrophotographic photosensitive member and the charging member when the electrophotographic photosensitive member and the charging member in contact with each other were rotated. Consequently, an image defect, i.e. horizontal micro striped image (hereinafter referred to as "banding image"), occurred in the output image in some cases.

Electrophotographic image forming apparatus having charge transport layer with matrix-domain structure and charging member having concavity and protrusion


A description is given of a communication set for connection to a communication line such as a telephone line, which communication set includes means for detecting set functions such as ringing signal detection, and a rectifier circuit which is connected to a common output which is coupled to a scanning device included in the set function detection means, which scanning device detects the line conditions. A large number of line conditions may be detected with a minimum of components required, among which an analog/digital converter for which only a single input pin on a chip is necessary.

1. Field of the Invention
The present invention relates to a communication set for connection to a communication line such as a telephone line, the communication set comprising line condition detection means and a rectifier circuit.
2. Description of the Related Art
A communication set of this type generally forming part of a telephone set is known from Philips Semiconductors User Manual ETT/AN93017. The known communication set is suitable for connection to a telephone line and comprises means for detecting so-called communication line conditions, among which the function of ringing signal detection by which the communication set detects whether a ringing signal is present on the telephone line by measuring a voltage on the telephone line. If a ringing signal is present, a sound source is activated which makes it clear to the subscriber that somebody tries to call him/her. Such a communication set also includes a rectifier circuit for providing in general that an internal supply voltage is derived from the voltage on the telephone line.
It is a drawback of the known communication set that the means for detecting the communication line conditions proportionally need a large number of hardware components and elements for detecting a number of line conditions that is often limited.

Communication set with detection of set function and line condition


An automated generative gear design process, which designs parallel axis gearsets to meet constraints and performance goals. The process uses state space searches, generate and test, and other knowledge based techniques to automatically generate gearset designs and recommend cutting and inspection tools. Specific knowledge applied includes standard gear and gearset equations and conditions for use, standard and specially developed gearset design methodologies, models of generic gears and gearsets, the specific limitations of geometry of various gears and gearsets, the ability to evaluate designs based on performance relative to goals, characteristics of available cutting and inspection tools, lubricants, and materials.

The traditional gear design process, used in the gear industry generally, requires heavy human involvement, can be time consuming, and is dependent on the expertise of the individual gear designers. Different designers use different approaches, resulting in a lack of standardization. Because of the user intensiveness of the current process and the breadth and depth of knowledge required, the resultant design is most often only acceptable rather than near-optimum. The current process is shown in FIG. 1.

Expert system for automically generating gear designs


A sensor that can be used for in-situ structural health monitoring with a triboluminescent material provided on a portion of an optical fiber that may be embedded in materials to be structurally monitored. Damage to the monitored material may result in a triboluminescent emission from the triboluminescent material that can be guided via the optical fiber. Analysis of the triboluminescent emission may provide information on the occurrence, severity and location of damage in a structure.

Structural health monitoring (SHM) of composite structures made from fiber reinforced polymer (FRP), concrete, and/or other materials can improve the safety of physical infrastructure. FRP composites, in particular, continue to find increasing use in structural applications in the aerospace and marine industries, as well as in wind turbine blades and civil infrastructural systems. This has largely been enabled by their relatively high strength to weight ratios, and excellent fatigue and corrosion resistance. They are however susceptible to low velocity impact resulting in barely visible impact damage (BVID). Similarly, key civil infrastructure systems (CIS) like bridges, dams, roads and buildings made of cementitious composites like concrete are continually exposed to natural degradation because of old age, over loading and seismic activities. They are also exposed to man-made damage from terrorist attacks and impact collisions.
There are currently a number of techniques being used for damage detection and monitoring of composite structures. These include imaging techniques such as ultrasonic cross sectional scan (C-scan), x-ray, and thermography. These techniques, however, do not provide for in-situ sensing of damage and/or fractures, and as a result, these techniques do not allow for reliable real-time monitoring of structures. Furthermore, the associated costs resulting from the downtime required for periodic non-destructive inspections can be very high for aerospace structures like aircrafts and civil structures like bridges. Acoustic emission techniques are promising, but suffer from low-signal-to-noise ratio. Surface-mounted resistive foil strain gages have potential for in-situ and continuous monitoring, however, they are less effective in monitoring internal delamination and/or damage and are vulnerable to electromagnetic and electrical interference, as well as physical damage.
Triboluminescence (TL) is the emission of light from materials when stressed, pulled apart, ripped, scratched, rubbed, or fractured. There have been a number of attempts to apply the TL phenomenon for damage sensing in composite structures. A challenge of applying TL-based sensor systems is the ability to effectively capture and transmit an optical signal generated within opaque composites like concrete and carbon fiber reinforced polymers. Other factors critical to the effective implementation of TL damage sensing include the effective dispersion of TL materials and the determination of optimized concentration levels in the host materials.
An approach being employed is to incorporate TL crystal into resin and infuse through the fiber layup in which optical fibers (for signal transmission) have been placed. The whole part is then cured. There are however many limitations with this approach. Firstly, the concentration level of the TL crystals in the host matrix required for good TL response is usually high. This introduces parasitic weight effect which is highly undesirable. The density differences between the TL crystals and resin matrix may also cause the settling of the crystals during curing. There will therefore be uneven dispersion of the crystals in the cured composite part or structure. Another problem associated with this approach is filtration during the infusion process.
An alternative approach requires the incorporation of TL crystals in a polymer to produce thin films. The films are then placed on the surface of composite laminates to monitor surface damage. In this case however, signal transmission may be an issue. Furthermore, placing the thin film within a laminate may promote delamination at the laminate interfaces.

Florida State University Research Foundation, Inc.


A portable telephone has a telephone body (1) with a first liquid crystal display (2) formed on the frontal face of the telephone body, a swingable plate (4) connected by a hinge (3) to one of lateral edges of said body (1), and a second liquid crystal display (5) formed in and disposed on the swingable plate (4). The second crystal display (5) will be at its exposed position to face backwards when the plate (4) is at its closed position folded back in a close contact with the rear face of the telephone body (1), and the swingable plate (4) can pivot forwards so that the second display (5) faces the same direction as the first display (2). The portable telephone of the invention can be used as it is to serve as an ordinary portable telephone, with its main liquid crystal display (2), but its swingable plate folded back on the back of its body may be put into a reversed position so that its supplementary display cooperates with the main display to form an enlarged area for displaying any information of a large volume such as obtained through INTERNET or the like.

1. Field of the Invention
The present invention relates to a portable telephone having a liquid crystal display device installed therein to display characters and/or images.
2. Background Art
Recently, portable telephones have been made smaller and smaller in size to be more convenient to carry. On the other hand, supplementary functions have been added to the normal ones of each portable telephone serving as a terminal output equipment for receiving information through INTERNET and/or from the like data source. Thus, larger liquid crystal devices are required to indicate thereon the information or data of such a larger volume. One of the proposals that has been made to meet this requirement is disclosed in the Japanese Patent Early Publication Gazette No. 11-249596. According to this proposal, a lid is attached to the first or ordinary liquid crystal display of a telephone body so as to be opened and closed relative thereto. In this case, a second liquid crystal display is formed in the inner face of such a lid such that when the lid is opened during use of this telephone the first and second display swill serve as portions of an integrated multi-display device.
It is however to be noted that such a prior proposal is not necessarily convenient to use. This is because the lid remains closed to hide the first display built in the telephone body, unless or until intentionally opened to allow an operator or user to look at the display in normal use of the portable telephone. It also is a problem that such an additional second liquid crystal display is not indispensable but rather useless to normal and ordinary operation of this telephone.
A primary object of the present invention made to resolve the drawbacks of the prior art is therefore to provide a portable telephone with a second liquid crystal display in addition to a first or ordinary liquid crystal display built in the telephone, such that the first display can play its normal role as it is and as usual. The second display that has been folded back to rear of the telephone body has to be reversed forwards so that the first and second displays form an extended display for indicating the information of a large capacity received through INTERNET or the like.


The embodiments disclosed herein provide a flash aware snapshot technique for two-way data recovery and back-in-time execution. The disclosed snapshot technique is designed to reduce the number of write operations to improve the performance on flash-based storage systems. The disclosed snapshot technique can guarantee data recovery no matter which of the production site or the backup site fails. The disclosed snapshot technique can also reduce the storage space requirement for snapshots by exploiting content locality. Furthermore, the disclosed snapshot technique can be implemented using hardware, software, firmware, or any combination of them. In case of hardware implementation, only minor hardware modifications are needed.

Solid state drives can include non-volatile solid-state memory, such as flash memory. Flash memory can include an improved form of Electrically-Erasable Programmable Read-Only Memory (EEPROM). Traditional EEPROM devices are only capable of erasing or writing one memory location (e.g., a memory cell) at a time. In contrast, flash memory allows multiple memory locations to be erased or written in one programming operation. Flash memory can thus operate at a higher speed compared to traditional EEPROM.
Solid-state memory has a number of advantages over other storage devices. For example, it generally offers faster read access times and better shock resistance than a hard disk drive (HDD). Unlike dynamic random access memory (DRAM), solid-state memory is generally non-volatile, meaning that data stored in flash memory is not lost when power to the memory is removed. These advantages, and others, may explain the increasing popularity of flash memory for storage applications in devices such as memory cards, USB flash drives, mobile phones, digital cameras, mass storage devices, MP3 players and the like. As with any storage systems, data stored in flash memory may be prone to various forms of undesired destruction. Traditional techniques for preventing data loss include file versioning or data backup to a remote server.
Data protection and recovery is an important feature of any storage systems. Data stored in storage systems can be inadvertently lost through a variety of unforeseen events, such as storage hardware failures and power outage. Also, data can be prone to hacks and virus attacks from third parties, and even unintended instructions from authorized users (e.g., unintended "delete" instruction.) Therefore, it is important to protect data from such unforeseen events and allow computing systems to go back to a healthy state after such events and perform back-in time execution (BITE) to rerun transactions for fault, failed, and/or incomplete transactions.
Storage systems can perform data protection and recovery using snapshots. A snapshot is a collection of data maintained by a storage system at a particular time instance. A storage system that uses snapshots for data recovery can maintain two storage volumes: a source volume and a snapshot volume. Depending on the snapshot technique, as discussed below, the source volume can maintain the actual current data in use and the snapshot volume can maintain the snapshot data for recovering data in case of data loss in the source volume. In some cases, the source volume can reside at a production site (which may include a server host and a production storage device), and the snapshot volume can reside at a production site or a backup site (which may include a backup server and a backup storage device) or both. The production site and the backup site are connected to one another by a communication system such as a network.
In some cases, a storage system can protect against data loss using a full-clone snapshot. A full-clone snapshot includes a copy of the entire data maintained by a storage system at a particular time instance. While a full-clone snapshot is effective in recovering data as maintained at the particular time instance, the full-clone snapshot is time-consuming to generate and space-consuming to store. Therefore, a storage system may generate the full-clone snap shot only periodically, for example, weekly, daily or hourly depending on reliability and performance requirement.
In some cases, a storage system can generate and maintain a copy-on-write (COW) snapshot. The COW snapshot of a particular time instance includes an image of memory blocks whose values have changed since the last COW snapshot was taken or declared. For example, when a memory controller receives a write request for a memory block for the first time after a snapshot is declared, the memory controller can cause a copy of prior data to be made in the snapshot volume. Therefore, when a memory block is overwritten for the first time after a snapshot is declared, the storage system performs two write operations and one read operation: one read operation for reading the prior data from the source volume, one write operation for writing the prior data in the snapshot volume, and one write operation for writing the new data in the source volume. The COW snapshot allows data to be recovered to snapshot time instances (e.g., time instances at which the snapshot is declared), and can save storage space and back-up time compared to full-clone snapshots.
In some cases, a storage system can generate and maintain a redirect-on-write (ROW) snapshot. The ROW snapshot is similar to a COW snapshot. However, when a memory controller receives write requests for a memory block after a snapshot is declared, the memory controller redirects them to a snapshot volume, leaving the memory block in the source volume intact. Therefore, the source volume keeps data as maintained at the snapshot time instance (e.g., the time instance at which the snapshot was declared); and the snapshot volume maintains changes to the memory blocks in the source volume since the snapshot time instance. Unlike the COW scheme, under the ROW scheme, the memory controller does not need to perform a separate copy operation to copy the prior data from the source volume to the snapshot volume, thereby reducing the number of write operations performed by the memory controller. However, under the ROW scheme, the memory controller does need to merge memory blocks upon receiving a read request. For example, when a memory controller receives a read request, the memory controller should determine whether the requested data is stored in the source volume or the snapshot volume.
Because COW snapshots and ROW snapshots can be generated easily, the COW and ROW snapshot operations can be performed more frequently compared to the full-clone snapshot operation. Furthermore the COW snapshots and ROW snapshots often require smaller storage space compared to the full-clone snapshot because the COW snapshots and ROW snapshots store only memory blocks that have changed value since the last snapshot time instance.
For data recovery, the snapshots can be located at either the backup site or the production site (or both). As long as the snapshots can be retrieved reliably, the actual location of the snapshots is of lesser importance because data recovery often does not require low latency. For this reason, full-clone snapshots are often stored at a backup site because full-clone snapshots tend to require a large storage space and such a large storage space may be too expensive to accommodate at the production site. Also, backup sites are often more reliable and secure than the production site. Therefore, full-clone snapshots can be stored more reliably at the backup site. Because the COW snapshots and ROW snapshots need smaller space to store, they can be stored at both the production site and the backup site for data recovery purposes.
For back-in-time execution (BITE) (e.g., execution of a transaction based on data that was present at the snapshot time instance), the location of the snapshot can become important because in general, BITE often requires low latency. Therefore, to accommodate BITE, it is desirable to store the snapshots at the production site. Unfortunately, because the full-clone snapshots often require a large storage space, it is difficult to store the full-clone snapshots at the production site. However, since the COW snapshots and ROW snapshots only require small storage space, maintaining COW snapshots and ROW snapshots at the production site is feasible. Therefore, storage systems can store COW snapshots and ROW snapshots at the production site to facilitate BITE.
In some cases, a storage system could use two or more full-clone snapshots, a COW snapshot, and/or a ROW snapshot to improve the data recovery performance and the BITE performance. However, a storage system is limited by the storage capacity dedicated to the snapshots. Therefore, a storage system is designed to improve the data recovery performance and the BITE performance with the constraint on the available storage capacity for snapshots.
Even with the use of multiple snapshots, traditional snapshot schemes do not readily guarantee data recovery when the backup site is down. This is problematic because the backup site is not fail-proof. For example, the backup site is usually located at a data center. When the data center is experiencing a power outage, then the snapshots stored in the data center may not be available for restoring lost data at the production site.
Also, snapshot techniques for flash-based storage systems is further constrained by the fact that write operations in flash devices are expensive. Flash-based storage systems often strive to reduce the number of write operations. Therefore, there is a need for snapshot techniques for flash-based storage systems designed to reduce the number of write operations for storing snapshots and recovering data based on the snapshots.

Apparatus, systems, and methods for data recovery


An area of a composite laminate structure is reworked by scarfing the area, generating a 3-D map of the scarfed area, and installing a rework patch that is built based on the 3-D map.

1. Field
The present disclosure generally relates to techniques for reworking areas of a structure, and deals more particularly with automated production and installation of patches used to rework areas.
2. Background
Composite structures sometimes include localized areas that may not conform to product and/or performance specifications, for any of a variety of reasons. For example, localized areas of the structure may be out-of-compliance because of non-conformities, including without limitation, dents, scratches, gouges, delamination or lightning strikes. These non-conformities may occur during the initial production of the structure, or later, after the structure has been placed in service.
Localized non-conformities may be reduced or eliminated by reworking (including repairing) the structure. The rework/repair process may involve removing one or more layers of material from the structure and then replacing the removed material with a composite patch that is bonded to the structure. In one technique, the edges of the rework area may be tapered or "scarfed" in order to form a scarf joint between the structure and the bonded patch. In another technique, the edges of the reworked/repaired area are stepped in order to form a series of lap joints between the patch and the structure.
The current method of fabricating a composite patch is time consuming, labor intensive and subject to human error. A workman measures the size and shape of each ply of the rework/rework area after material has been removed from the structure, and makes a pattern of the patch. The individual plies of the patch are cut by hand from bulk materials, and then oriented and stacked by hand. These manual steps may allow the introduction of inaccuracies which may make it difficult to achieve a desired fit between the rework patch and the rework/repair area. The consistency of the rework/repair process from one rework/repair to another may vary due to dependency on hand labor to fabricate the patch areas.
Accordingly, there is a need for a method and related rework/repair patch for reworking/repairing an area of a structure that reduces the need for hand labor, improves the quality of the rework/repair patch, and increases fitment and alignment accuracy between the rework/repair patch and the area requiring rework.

Automated production and installation of patches for reworking structures


An amplifier comprises a first amplifier circuit which amplifies a first signal to output an amplified first signal, a circuit which outputs a second signal corresponding to a difference between the first signal and the amplified first signal, a second amplifier circuit which amplifies the second signal to output an amplified second signal, a combine circuit which outputs an amplified signal by combining the amplified second signal with the amplified first signal, and a controller which controls a supply of a power to the first amplifier circuit and the second amplifier circuit and has a first mode to supply the power to the second amplifier circuit without supplying the power to the first amplifier circuit.

1. Field of the Invention
The present invention relates to a feedforward amplifier used to amplify the power of a radio signal in, for example, a base station for a mobile communication system, and also relates to a radio communication apparatus equipped with a feedforward amplifier.
2. Description of the Related Art
Recent mobile communication systems employ a multi-value modulation scheme in light of effective use of a frequency band. A signal obtained by modulation using a multi-value modulation scheme contains information in its amplitude and phase. Accordingly, radio communication apparatuses that employ the multi-value modulation scheme always require a power amplifier having excellent linearity. A feedforward amplifier is known as such a power amplifier. If a feedforward amplifier is used, the signal in an adjacent or nearby channel can be suppressed to a predetermined power level or less.
A feedforward amplifier comprises, for example, an error amplifier and feedforward circuit. The feedforward circuit detects a distortion component contained in a radio signal output from a main amplifier incorporated in the feedforward circuit, and generates, based on the distortion component, a cancel signal that has the same amplitude as the radio signal and a phase opposite to that of the radio signal. This cancel signal is amplified by the error amplifier and then combined with the radio signal, thereby canceling the distortion component contained in the radio signal (see, for example, Jpn. Pat. Appln. KOKAI Publication No. 11-55045).
This feedforward amplifier is generally used when the maximum power is output.
However, in recent cellular communication systems, cell sizes are often varied in accordance with, for example, geographical features or traffic density. In accordance with the cell size, the radio communication apparatus used in a base station is required to vary the transmission power level. Further, the transmission power level of the radio communication apparatus may also be varied in accordance with the distance between the base station and a mobile station, regardless of cell size.
However, if the transmission power level of the radio communication apparatus is low, the level of the distortion component falls within the allowable range of the main amplifier of the feedforward amplifier. In other words, it is not necessary to use the error amplifier. Therefore, in this case, power is wastefully used for operating the unnecessary error amplifier.
In light of the above, it has been proposed to stop the supply of power to the error amplifier when the feedforward amplifier is driven with low power, thereby reducing the power consumption. However, in the feedforward amplifier, the power consumption of the main amplifier occupies the greater part of the whole power consumption. This means that even if the supply of power to the error amplifier is stopped, the total power consumption is not greatly reduced, and the recent demand for saving power is not sufficiently satisfied.

Feedforward amplifier and radio communication apparatus with the amplifier


An electronic method and system for improving radiologists' efficiencies when viewing radiology procedures and rendering diagnosis in a manner that emulates current methods and apparatus. The method of the present invention includes reviewing electronic radiology images and reports contained in a patient's digital master folder (an information object invented to manage the patient's radiology information), comparing images from the current procedure to specific images from prior procedures in a specified order, and dictating the procedure's diagnosis into the digital master folder. The apparatus of the present invention includes a flat panel monitor for the viewing and manipulation of digital master folders, a dictation trackball device for manual and voice enabled operation and navigation of the system, and multiple high-resolution computer monitors functioning as a “light-box” for the viewing of radiology images.

1. Field of the Invention
The present invention relates to a method and apparatus for improving radiologists' efficiencies when viewing radiology procedures and rendering diagnosis.
2. General Background of the Invention
Typically, every radiology office uses a dictating machine for the preparation of reports, a stack of master folders that contain patient information, and a light box, roto viewer, or like device for viewing radiology images. These images can include for example x-rays, ultrasound, magnetic resonance imaging (MRI), computer tomography, nuclear medicine images and the like.
The manual file folder system employed by radiologists and radiology departments is inefficient and cumbersome.

Electronic method and system that improves efficiencies for rendering diagnosis of radiology procedures


An optical fiber according to an embodiment includes a core having a single-peaked and graded refractive index profile, an inner cladding surrounding the core, and an outer cladding surrounding the inner cladding. The inner and outer claddings have refractive indices lower than the maximum refractive index of the core. A photosensitive region constituted by the core and the inner cladding contains a photosensitive material. The inner cladding has an outer diameter one time or more and two times or less the MFD of an LP01 mode in a 1310-nm wavelength band.

When silica-based glass to which a photosensitive material is doped is irradiated with ultraviolet light, the refractive index of the irradiated region increases. Utilizing this phenomenon, an optical fiber grating (TFG: termination fiber grating) is manufactured. Specifically, an optical fiber comprised of silica-based glass is provided with a refractive index modulated region in which the refractive index periodically varies along the longitudinal direction of the optical fiber. An optical fiber grating is used as, for example, a filter for monitoring a passive optical network (PON).
As an example of enabling higher capacity transmission in a PON system, a PON monitoring filter selectively reflects light in a 1650-nm wavelength band ±5 nm for monitoring. On the other hand, the PON monitoring filter transmits not only signal light in a band (for example, C-band which is from 1530 nm to 1565 nm) different from the above wavelength band but also signal light in another band (for example, L-band which is from 1565 nm to 1625 nm), thereby enabling high capacity transmission in a wider wavelength band.
Note that the method for manufacturing an optical fiber grating is disclosed in Patent Documents 1 to 3, for example.

SUMITOMO ELECTRIC OPTIFRONTIER CO., LTD.


Various Huffman decoder architectures are presented. By these decoder architectures, more than one codeword in a stream of Huffman-coded data units may be decoded into more than one token in a single decoding operation on average. An efficient memory organization which is useful in many of these decoder architectures is also presented.

The present application is related to decoders for decompressing Huffman-coded data and, more particularly, to the architecture of high-speed decoders of Huffman-coded data.
In Huffman coding, units of original data are compressed into coded units consisting of codewords of varying lengths and optional non-Huffman coded words. The codewords are selected so that the most frequently occurring units of original data have the shortest length, i.e., the smallest number of bits, and the least frequently occurring units of original data have the largest codewords. In this manner, the original data is compressed into coded data. This is a general description of Huffman coding techniques and, of course, the selection and generation of Huffman codes for particular applications may be expressed with much greater precision.
The application of Huffman coding is typically used where there is a large amount of data which must be processed or transferred, such as digital image processing. For example, color images processed according to the JPEG (Joint Photographic Experts Group) standard, and the standard's Huffman coding, typically handle a large number of data units. Huffman coding is found in present and emerging digital video processing standards.
Included in these standards is the previously mentioned JPEG standard, which is a standard for still images. Existing and emerging standards for motion video systems, such as H.261, a CCITT video teleconferencing standard, and the Motion Picture Experts Group (MPEG) I, have coding systems which are very similar to the JPEG standard. In turn, the MPEG standards are related to the nascent High Definition Television (HDTV) technology. The commonality between HDTV, MPEG, H.261 and JPEG is expected to include Huffman coding.
Where Huffman coding is used, decoding of the Huffman-coded units must naturally be performed. In the decoding of each coded unit, a token is generated from each codeword. Each token, because it is unique, contains enough information about the coded unit (and original data unit) to be used as control information to assemble, or decompress, the coded unit into the original data unit.
A significant and fundamental problem is found in the decoding operation which generates each token from a codeword. The problem arises when high-speed decoding of the coded units is required. In decoding a stream of Huffman-coded units in a typical Huffman decoder, each unit contains a codeword and optional non-code words of varying length, which creates difficulty for high-speed decoding.
This difficulty in decoding Huffman-coded data at high speed poses a serious impediment to emerging technology. As explained above, it is likely that the emerging digital HDTV standards will incorporate Huffman coding. An estimate of HDTV requirements leads to the processing of pixel components at 100 million data units per second. To solve this problem, the present invention provides for novel Huffman decoding architectures in which coded units are decoded in parallel.
Various embodiments for Huffman decoder architectures are presented. These Huffman decoder architectures, all capable of high-speed operation, use differing amounts of memory and logic. The balance of memory and logic has different space/speed tradeoffs in the particular technology implemented by an integrated circuit designer. Thus the present invention offers high-speed alternatives for most, if not all, of the specific applications of Huffman decoders. The present invention permits the selection of the optimum decoder architecture.

Huffman decoder architecture for high speed operation and reduced memory


In addition to transfer units for transferring electric charges generated from photo receiving units for every cell, a high-speed transfer unit is provided which transfers electric charges generated from the photo receiving units collectively on a unit basis of plural cells, whereby a reading speed can be made higher without making the operation speed of a driving circuit higher. To be more concrete, the number of shift cycles necessary for transferring from the transfer unit electric charges generated from the photo receiving units during the open time period of a shutter or electric charges generated from the photo receiving units during a time period except for the open time period of the shutter can be reduced.

The present invention relates to an image pickup device and a method for driving the image pickup device.
Conventionally, image pickup devices such as CCD image sensors have been widely used for image scanners, facsimiles, digital cameras etc. JP-A-2001-157119 discloses an image pickup device in which a plurality of photo receiving units are arranged in parallel and each of the photo receiving units is configured in a manner that cells each for generating electric charges through photoelectric conversion are arranged in series.
An object of reading a document by lowering the resolution in the main scanning direction is to read the document at a high speed. Thus, it is required to make the frequency of shift pulses applied to a transfer unit higher as the resolution is made lower. However, there is a problem that the maximum frequency of the shift pulses is limited and, in general, a manufacturing cost increases when mounting a driving circuit for applying the shift pulses of a high frequency to the transfer unit. Further, in general, when the frequency of the shift pulses is determined, the frequency of output gate pulses is also determined in accordance with the determined frequency of the shift pulses. Thus, when the frequency of the shift pulses can not be made higher, the reading speed at a low resolution can not be made higher.

Image pickup device and driving method therefor


A portable electronic device is to be operated by a user with tinnitus. The portable electronic device is used to determine a primary phase cancellation tone that corresponds to the user's primary tinnitus, and a secondary phase cancellation tone that corresponds to the user's secondary. The portable electronic device outputs the primary and secondary phase cancellation tones at an output device based on input from the user.

Tinnitus is the sensation of a sound in the ear or head that is not being produced by an external source. Tinnitus often takes the form of a hissing, ringing, roaring, chirping or clicking sound which may be intermittent or constant.
Tinnitus affects about 10-15% of the adult population. More than two-million Americans are debilitated with tinnitus to the point where it affects their daily functions, including job performance, and personal relationships. Furthermore, the prevalence of tinnitus increases with age, and the demand for tinnitus treatment will significantly increase in the near future.
One approach for treating tinnitus is disclosed in U.S. Pat. No. 6,610,019 to Choy. Choy discloses an apparatus for treating tinnitus patients comprising a sound generator having adjustable frequency and amplitude controls for selecting an output tone having a predetermined frequency and amplitude, a pair of headphones to be worn by the patient for coupling the output of the sound generator to the patient to enable the patient to subjectively match the output tone of the generator to the patient's tinnitus tone, and a phase shift network for selectively shifting the phase of the output wave form of the sound generator through a plurality of discrete incremental phase shift steps. The phase shifted output wave is selectively connected to the tinnitus patient via the headphones to effect phase shift cancellation between the output of the generator and the patient's tinnitus tone. The apparatus resides in a doctors office. Consequently, there is a need for a portable apparatus for treating tinnitus that may be carried by a user suffering from tinnitus.
U.S. Pat. No. 5,167,236 to Junker discloses a portable tinnitus masker in the shape of a hearing aid carried behind the ear. The tinnitus masker includes a sine wave generator, a square wave generator and a potentiometer used as a frequency controller. Am adding device alternately feeds the sine wave signals or the square wave signals to a variable gain amplifier. The output signal from the amplifier is connected to an earphone that produces an audible signal that is led to the hearing channel.
U.S. Pat. No. 5,795,287 to Ball et al. discloses a portable tinnitus masker for use with direct drive hearing devices. A signal generator includes multiple user adjustable controls. The adjustable controls allow a user to select characteristics of the signals that the signal generator produces, with the signal corresponding to sounds the user will perceive to mask the tinnitus. In one embodiment, adjustable control allows a user to select the frequency of a primary tone. As the tinnitus sound is often a pure tone, the tinnitus sound may be masked by an audible signal that is 180 degrees out of phase with the tinnitus sound. In this manner, the tinnitus sound is effectively canceled out by the direct drive hearing device that receives the audible signal that is 180 degrees out of phase with the tinnitus sound.
Even in view of the advances made in providing portable devices for treating tinnitus, there is still a need to improve such devices.

Portable electronic device with a tinnitus relief application


An anesthetic dispensing device (100) particularly adapted to apply anesthetic agent to the oral cavity and upper tracheal area of a medical patient prior to intubation of such patient. An exemplary dispenser (100) includes a handle (110) operably connected to a retractor (112) that carries an anesthetic dispensing device (104). A currently preferred dispensing device (104) includes a fluid-dispersing nozzle (118) in fluid communication with a syringe (116). Sometimes, an optical device (164) is coupled to the dispenser (100) to permit direct visualization of the application of anesthetic agent.

Endotracheal intubation procedures are performed on certain medical patients. For example, a tube providing an airway may be introduced to assist the breathing of a patient having undergone certain kinds of trauma. The arcuate shape of a conventionally formed oral cavity and upper throat area of a human is known. Various devices are also known, having a cooperating arcuate shape, effective to assist in introducing a tube, or other medical device, through the mouth and into the throat of a patient.
One device effective to assist in introducing an endotracheal tube includes an arcuate-shaped laryngoscope blade. Such a blade typically is formed from metal, or a very stiff plastic-like material, and has a spatulate, axially curved shape formed to cooperate with the conventional shape of oral cavity structure. The curved spatula portion of the blade is used for retracting soft tissue and opening the patient's jaw and mouth to form a clear, open path through which a tube or instrument may be inserted. In general, a laryngoscope blade is transversely very stiff to permit its use as a retractor for soft and hard tissue, while resisting significant bending deflection of the curved portion of the blade. Significant bending deflection of the curved portion under a working load would undesirably place the proximal handle associated with the blade into a blocking position and thereby interfere with creating the desired clear passage through which installation of a tube may be visualized.
In those cases where the patient is unconscious, there is no patient gag reflex over which the medical practitioner must surmount to install a tube, or to insert some other medical device. Consequently, difficulty of an intubation procedure is greatly reduced, although not eliminated. However, there exist instances where the patient is awake, at least partially alert, desirably remains in such condition for a further period of time, and prompt intubation must be effected in spite of such facts. In such cases, the patient's own gag reflex can constitute a significant obstacle to intubation.
Awake endotracheal intubations are typically accomplished using a fiber optic guide, and require anesthetizing the oral cavity, oropharynx, tonsillar pillars, base of the tongue, supragottic region and vocal cords, and other deep pharyngeal structure, such as the deep posterior pharyngeal wall, pyriform fossa on either side of the larynx, vallecula, and on to the proximal trachea. Anesthetization typically starts with topical application of anesthetic fluid at the front of the oral cavity, and then progresses inward toward the tracheal-esophageal bifurcation area. Typically, an area will be numbed prior to moving on to the next deeper area. Unfortunately for the patient, each new area receiving anesthetic initially presents a new stimulated area to promote a gag reflex.
It is generally desirable to apply anesthetic agent in a substantially uniform coating to reduce waste and avoid over-, or under-, medication. Application of anesthetic topically by way of a transfer medium, such as a sponge, often produces a substantially non-uniform coating of agent on the patient's tissue, as well as physically imposing on non-anesthetized areas. Squirting anesthetic agent from the nozzle of a syringe, e.g., as a jet, is equally unsatisfactory, and also wasteful. Known misting nozzle arrangements are not satisfactory to apply anesthetic agent in all desired areas for an endotracheal intubation procedure.


A semiconductor assembly comprises a semiconductor die which is attached by a carrier material to a lead frame. The carrier material is coated on the die side with one type of adhesive and on the lead frame side with a different adhesive. The lead frame has a small surface area to connect to the carrier material, while the semiconductor die has a large surface area to connect to the carrier material. As used with one inventive embodiment, the adhesive between the die and the carrier softens at a low temperature preventing the die from cracking at elevated temperatures. The adhesive on the lead frame side of the carrier material softens at a higher temperature than the adhesive of the die side of the adhesive, thereby firmly connecting the lead frame having a small surface area to the carrier.

Various types of semiconductor devices are manufactured in much the same way. A starting substrate, usually a thin wafer of silicon or gallium arsenide, is masked, etched, and doped through several process steps, the steps depending on the type of devices being manufactured. This process yields a number of die on each wafer produced. The die are separated with a die saw, and then packaged into individual components.
During the plastic packaging process, several semiconductor die are attached to a lead frame, often with a material such as metal, an epoxy, a thermoset, a thermoplastic, or other viscous adhesives. Bond wires couple each of several terminals (bond pads) on each die to conductive leads on the lead frame. The die, the wires, and a portion of the leads are encapsulated in plastic. These leads couple the die with the device into which the component is installed, thereby forming a means of input/output (I/O) between the die and the device.
Bond pads historically have been located around the periphery of the semiconductor die. This allows the lead fingers of the lead frame to be placed very near the edge of the die, and therefore very short bond wires are required to attach the bond pads to the lead fingers. This configuration requires a lead frame paddle, however, to which is attached the semiconductor die, and the use of a die paddle is known to have several problems For example, the metal of the paddle and the material from which the die is manufactured have different coefficients of expansion. If an adhesive is not carefully chosen, the die can be damaged during temperature cycling from stress placed upon it by the expanding and contracting paddle. Also, the lead fingers are typically plated with gold or silver to facilitate bonding with the bond wires, and the paddle is also unnecessarily plated, thereby increasing the cost of production.
One way to solve these as well as other problems associated with the lead frame paddle is described in U.S. Pat. No. 4,862,245 by Pashby, et al. which is incorporated herein by reference. Pashby, et al. describe a die which allows for a "leads over die" configuration, in which the lead fingers of the lead frame are attached to the top of the die, then the bond pads are coupled with the lead fingers by bond wires. A leads over die configuration has the advantage of not requiring a die paddle. It also allows for a smaller package, as well as other advantages described therein.
One step of semiconductor manufacture using the die of Pashby that is not without problems is the die-lead frame attachment. Die-lead frame attachment, as suggested by Pashby, includes an alpha barrier of polymeric film coated on both sides with an adhesive material selected from the group of epoxies, acrylics, silicones and polyimides For the die-alpha barrier attachment, the silicone adhesive is recommended since the silicones minimize corrosion. For the die-lead frame attachment, an epoxy Or acrylic is recommended since these materials assure that the conductors are fully bonded to the alpha barrier, thereby enhancing the thermal conductivity between the semiconductor chip and the conductors, and mechanically locking the lead frame conductors to the semiconductor chip.
A problem which can occur by using any of the referenced materials results from their hard-cure properties. The epoxies and acrylics both harden immediately upon curing to form a somewhat "brittle" attachment. The silicones and polyimides also tend to cure with the repeated application of heat such as that typically found during the formation of a semiconductor device, for example at wire bond, encapsulation, and wave solder, although their attachment is somewhat more pliable than that of the acrylics and epoxies Using any of the materials, once any of the adhesive materials set up it is no longer possible to return them to their precured viscous state.
Once the materials set up, a stress can result between the die and the adhesive material and between the lead frame and the adhesive material resulting from temperature variations and differences in the thermal expansion coefficients between the adhesives and the materials to which they are attached. For example, the metal material of the lead frame expands and contracts at a greater rate than the acrylics and epoxies, and the lead fingers extending over the surface of the die can separate from the adhesive material due to these stresses. Contributing to the separation of the lead fingers from the adhesive is the small size of the lead fingers which results in a small contact area with the adhesive. For this reason, the adhesive which connects the lead fingers to the alpha barrier must be stronger than the adhesive which connects the die to the alpha barrier, as the die to alpha barrier connection has a greater surface area. Damage of the circuitry on the surface of the die can result as the metal circuitry expands and contracts at a greater rate than the adhesive material
Thermoset materials have also been used to connect the die to the lead frame. As is known in the art the thermoset materials are viscous at low temperatures and cure with the application of heat. Once the materials cure they are no longer capable of softening. The materials can cure at various temperatures, depending on the material. In any case, with the application of additional heat, the materials further harden. This material can create problems similar to the acrylics and epoxies in that differences in thermal expansion coefficients with the die and lead frame can cause stress on the surface of the die.
Thermoplastics have also been used to couple the die and the lead frame. As is known in the art, these materials are hard at low temperatures, but soften and flow at elevated temperatures. As they cool, they again harden, and again soften with the application of heat. These materials can solve the stress problems associated with the materials described above, as they soften with the application of heat, and therefore the stress is relieved as the die circuitry and lead frame materials expand and the material softens. An identical thermoplastic is conventionally used on both sides of the polyimide carrier material. A problem that can occur when using a thermoplastic to couple the die and the lead frame results from the die contact area being greater than the contact area of the lead frame to the thermoplastic. A thermoplastic which softens at a temperature optimized for the die-alpha barrier attachment can result in separation of the lead frame from the alpha barrier as the softening point is reached, for example during wire bond or at elevated temperatures. Alternately, a thermoplastic optimized for the lead frame-alpha barrier attachment can result in stress on the surface of the die.
An assembly which has reduced susceptibility to separation of the lead frame from the alpha barrier and reduced stress to the surface of the die would be a desirable structure.

Dissimilar adhesive die attach for semiconductor devices


Systems and methods are described that facilitate performing model-based planning techniques for allocations of multi-capacity resources in a machine. The machine may be, for instance, a printing platform, such as a xerographic machine. According to various features, the multi-capacity resource may be a sheet buffer, and temporal constraints may be utilized to determine whether an insertion point for a new allocation of the sheet buffer is feasible. Multiple insertion points may be evaluated (e.g., serially or in parallel) to facilitate determining an optimal solution for a print job or the like.

As processing power and memory capacity increase, a need arises for control mechanisms that permit a machine to fully exploit system capabilities. In the case of printers, photocopiers, and the like, conventional control mechanisms are limited in the manner in which they process information, allocate resources, perform jobs or tasks, etc. When designing a control system for a machine, it is desirable to optimize resource allocation and utilization in order to reduce cost and increase throughput. For instance, a resource that is capable of multiple concurrent allocations may be employed to provide improved performance in a machine, such as a printer or photocopier. Traditionally, a single resource could be allocated to a single component or for a single task at a given time. However, in the case of multi-capacity resources (e.g., resources capable of multiple allocations at a given time), control mechanisms to date have failed to provide planning and scheduling mechanisms that optimize resource capacity.
For instance, some attempts at control optimization for multi-function, multi-resource parallel-operation systems have employed manually encoded rules, which to date have not been concluded to be optimal or complete. Other approaches, such as adding component descriptions to responsibilities associated with a planning engine may be functional but may lead to combinatorial challenges in planner performance. However, there exists an unmet need in the art for systems and/or methodologies that facilitate optimizing multi-capacity resource utilization while minimizing computational overhead to improve throughput and reduce costs associated with machine control.

Model-based planning with multi-capacity resources


A plurality of co-operative and complementary software programs are implemented in a web-enabled high speed computer system to remotely monitor, manage and modify the operational and functional parameters of a plurality of implanted medical devices (IMDs). The system utilizes virtual electrophysiologist module (VEM), chronic monitoring module (CMM) and prescription program module (PPM) programs to effect specific therapeutic and diagnostic methods for managing the IMDs, remotely on a conditions and real-time basis. The modules enable remote and continuous monitoring, management and maintenance of the IMDs by identifying critical medical events, determining optimal clinical settings and upgrading performance parameters based on prescriptive data. The modules are implemented in a data center having high-speed computers operating in a web-enabled environment. The modules and the IMDs communicate through wireless communications system via a programmer or an interface medical unit (IMD).

The present invention relates to medical device systems. Specifically, the invention pertains to a remote bi-directional communications with one or more programmers and medical units, or related controls that are associated with implantable medical devices (IMDs). More specifically, the invention relates to an integrated system and method of bi-directional telecommunications between a web-based expert data center and a medical device, utilizing various types of network platforms and architecture, to implement in the medical device and the IMDs, a virtual electro-physiological monitoring/consultation system, alert activation to initiate a remote monitoring session and prescriptive device programming regimens in real time.
A technology-based health care system that fully integrates the technical and social aspects of patient care and therapy should be able to flawlessly connect the client with care providers irrespective of separation distance or location of the participants. While clinicians will continue to treat patients in accordance with accepted modern medical practice, developments in communications technology are making it ever more possible to provide a seamless system of remote patient diagnostics, care and medical services in a time and place independent manner.
Prior art methods of clinical services are generally limited to in-hospital operations. For example, if a physician needs to review the performance parameters of an implantable device in a patient, it is likely that the patient has to go to the clinic. Further, if the medical conditions of a patient with an implantable device warrant a continuous monitoring or adjustment of the device, the patient would have to stay in a hospital indefinitely. Such a continued treatment plan poses both economic and social problems. Under the exemplary scenario, as the segment of the population with implanted medical devices increases many more hospitals/clinics including service personnel will be needed to provide in-hospital service for the patients, thus escalating the cost of healthcare. Additionally the patients will be unduly restricted and inconvenienced by the need to either stay in the hospital or make very frequent visits to a clinic.
Yet another condition of the prior art practice requires that a patient visit a clinic center for occasional retrieval of data from the implanted device to assess the operations of the device and gather patient history for both clinical and research purposes. Such data is acquired by having the patient in a hospital/clinic to down load the stored data from the implantable medical device. Depending on the frequency of data collection this procedure may pose serious difficulty and inconvenience for patients who live in rural areas or have limited mobility. Similarly, in the event a need arises to upgrade the software of an implantable medical device, the patient will be required to come into the clinic or hospital to have the upgrade installed. Further, in medical practice it is an industry-wide standard to keep an accurate record of past and temporaneous procedures relating to an IMD uplink with, for example, a programmer. It is required that the report contain the identification of all the medical devices involved in any interactive procedure. Specifically, all peripheral and major devices that are used in down linking to the IMD need to be reported. Currently, such procedures are manually reported and require an operator or a medical person to diligently enter data during each procedure. One of the limitations of the problems with the reporting procedures is the fact that it is error prone and requires rechecking of the data to verify accuracy.
Yet a further condition of the prior art relates to the operator-programmer interface. Generally a medical device manager/technician, should be trained on the clinical and operational aspects of the programmer. Current practice requires that an operator attend a class/session sponsored by a clinic, hospital or the manufacturer to successfully manage a programmer-IMD procedure. Further, the manager should be able to keep abreast of new developments and new procedures in the management, maintenance and upgrade of the IMD. Accordingly, under current practice it is imperative that operators of programmers, IMDs and related medical devices be trained on a regular basis.
A further limitation of the prior art relates to the management of multiple medical devices in a single patient. Advances in modern patient therapy and treatment have made it possible to implant a number of devices in a patient. For example, IMDs such as a defibrillator or a pacer, a neural implant, a drug pump, a separate physiologic monitor and various other IMDs may be implanted in a single patient. To successfully manage the operations and assess the performance of each device in a patient with multi-implants requires a continuous update and monitoring of the devices. Further, it may be preferred to have an operable communication between the various implants to provide a coordinated clinical therapy to the patient. Thus, there is a need to monitor the IMDs including the programmer on a regular, if not a continuous, basis to ensure optimal patient care. In the absence of other alternatives, this imposes a great burden on the patient if a hospital or clinic is the only center where the necessary upgrade, follow up, evaluation and adjustment of the IMDs could be made. Further, even if feasible, the situation would require the establishment of multiple service areas or clinic centers to support the burgeoning number of multi-implant patients world-wide.
The proliferation of patients with multi-implant medical devices worldwide has made it imperative to provide remote services to the IMDs and timely clinical care to the patient. Frequent use of programmers to communicate with the IMDs and provide various remote services, consistent with co-pending applications titled xe2x80x9cSystem and Method for Transferring Information Relating to an Implantable Medical Device to a Remote Location,xe2x80x9d filed on Jul. 21, 1999, Ser. No. 09/358,081; xe2x80x9cApparatus and Method for Remote Troubleshooting, Maintenance and Upgrade of Implantable Device Systems,xe2x80x9d filed on Oct. 26, 1999, Ser. No. 09/426,741; xe2x80x9cTactile Feedback for Indicating Validity of Communication Link with an Implantable Medical Device,xe2x80x9d filed Oct. 29, 1999, Ser. No. 09/430,708; xe2x80x9cApparatus and Method for Automated Invoicing of Medical Device Systems,xe2x80x9d filed Oct. 29, 1999, Ser. No. 09/430,208; xe2x80x9cApparatus and Method for Remote Self-Identification of Components in Medical Device Systems,xe2x80x9d filed Oct. 29, 1999, Ser. No. 09/429,956; xe2x80x9cApparatus and Method to Automate Remote Software Updates of Medical Device Systems,xe2x80x9d filed Oct. 29, 1999, Ser. No. 09/429,960; xe2x80x9cMethod and Apparatus to Secure Data Transfer From Medical Device Systems,xe2x80x9d filed Nov. 2, 1999, Ser. No. 431,881; xe2x80x9cImplantable Medical Device Programming Apparatus Having An Auxiliary Component Storage Compartment,xe2x80x9d filed Nov. 4, 1999, Ser. No. 09/433,477; xe2x80x9cRemote Delivery Of Software-Based Training For Implantable Medical Device Systems,xe2x80x9d filed Nov. 10, 1999, Ser. No. 09/437,615; xe2x80x9cApparatus and Method for Remote Therapy and Diagnosis in Medical Devices Via Interface Systems,xe2x80x9d filed Dec. 14, 1999, Ser. No. 09/460,580; which are all incorporated by reference herein in their entirety which are all incorporated by reference herein in their entirety, has become an important aspect of patient care. Thus, in light of the referenced disclosures, remote training of the technicians/operators of the programmers and other peripheral equipment, that are associated with the IMDs, is a vital step in providing efficient therapy and clinical care to the patient.
The prior art provides various types of remote sensing and communications with an implanted medical device. One such system is, for example, disclosed in Funke, U.S. Pat. No. 4,987,897 issued Jan. 29, 1991. This patent discloses a system that is at least partially implanted into a living body with a minimum of two implanted devices interconnected by a communication transmission channel. The invention further discloses wireless communications between an external medical device/programmer and the implanted devices.
One of the limitations of the system disclosed in the Funke patent includes the lack of communication between the implanted devices, including the programmer, with a remote clinical station. If, for example, any assessment, monitoring or maintenance is required to be performed on the IMD the patient will have to go to the remote clinic station or the programmer device needs to be brought to the patient""s location. More significantly, the operational worthiness and integrity of the programmer cannot be evaluated remotely thus making it unreliable over time as it interacts with the IMD.
Yet another example of sensing and communications system with a plurality of interactive implantable devices is disclosed by Stranberg in U.S. Pat. No. 4,886,064, issued Dec. 12, 1989. In this disclosure, body activity sensors, such as temperature, motion, respiration and /or blood oxygen sensors, are positioned in a patient""s body outside a pacer capsule. The sensors wirelessly transmit body activity signals, which are processed by circuitry in the heart pacer. The heart pacing functions are influenced by the processed signals. The signal transmission is a two-way network and allows the sensors to receive control signals for altering the sensor characteristics.
One of the many limitations of Stranberg is the fact that although there is corporeal two-way communications between the implantable medical devices, and the functional response of the heart pacer is processed in the pacer after collecting input from the other sensors, the processor is not remotely programmable. Specifically, the system does not lend itself to web-based communications to enable remote troubleshooting, maintenance and upgrade from outside the patient""s body because the processor/programmer is internally located in the patient forming an integral part of the heart pacer.
Yet another prior art reference provides a multi-module medication delivery system as disclosed by Fischell in U.S Pat. No. 4,494,950 issued Jan. 22, 1985. The disclosure relates to a system consisting a multiplicity of separate modules that collectively perform a useful biomedical purpose.
The modules communicate with each other without the use of interconnecting wires. All the modules may be installed intracorporeal or mounted extracorporeal to the patient. In the alternate, some modules may be intracorporeal with others being extracorporeal. Signals are sent from one module to the other by electromagnetic waves. Physiologic sensor measurements sent from a first module cause a second module to perform some function in a closed loop manner. One extracorporeal module can provide electrical power to an intracorporeal module to operate a data transfer unit for transferring data to the external module.
The Fischell disclosure provides modular communication and cooperation between various medication delivery systems. However, the disclosure does not provide an external programmer with remote sensing, remote data management and maintenance of the modules. Further, the system does neither teach nor disclose an external programmer for telemetrically programming the modules.
Yet another example of remote monitoring of implanted cardioverter defibrillators is disclosed by Gessman in U.S. Pat. No. 5,321,618 issued. In this disclosure a remote apparatus is adapted to receive commands from and transmit data to a central monitoring facility over telephone communication channels. The remote apparatus includes equipment for acquiring a patient""s ECG waveform and transmitting that waveform to the central facility over the telephone communications channels. The remote apparatus also includes a segment, responsive to a command received from the central monitoring facility, for enabling the emission of audio tone signals from the cardioverter defibrillator. The audio tones are detected and sent to the central monitoring facility via the telephone communication channel. The remote apparatus also includes patient alert devices, which are activated by commands received from the central monitoring facility over the telephone communication channel.
One of the many limitations of the apparatus and method disclosed in the Gessman patent is the fact that the segment, which may be construed to be equivalent to a programmer, is not remotely adjustable from the central monitoring device. The segment merely acts as a switching station between the remote apparatus and the central monitoring station.
An additional example of prior art practice includes a packet-based telemedicine system for communicating information between central monitoring stations and a remote patient monitoring station disclosed in Peifer, WO 99/14882 published Mar. 25, 1999. The disclosure relates to a packet-based telemedicine system for communicating video, voice and medical data between a central monitoring station and a patient that is remotely located with respect to the central monitoring station. The patient monitoring station obtains digital video, voice and medical measurement data from a patient and encapsulates the data in packets and sends the packets over a network to the central monitoring station. Since the information is encapsulated in packets, the information can be sent over multiple types or combination of network architectures, including a community access television (CATV) network, the public switched telephone network (PSTN), the integrated services digital network (ISDN), the Internet, a local area network (LAN), a wide area network (WAN), over a wireless communications network, or over asynchronous transfer mode (ATM) network. A separate transmission code is not required for each different type of transmission media.
One of the advantages of the Pfeifer invention is that it enables data of various forms to be formatted in a single packet irrespective of the origin or medium of transmission. However, the data transfer system lacks the capability to remotely debug the performance parameters of the medical interface device or the programmer. Further, Pfeifer does not disclose a method or structure by which the devices at the patient monitoring station may be remotely updated, maintained and tuned to enhance performance or correct errors and defects.
Another example of a telemetry system for implantable medical devices is disclosed in Duffin et al, U.S. Pat. No. 5,752,976, issued May 19, 1998, incorporated by reference herein in its entirety. Generally, the Duffin et al disclosure relates to a system and method for communicating with a medical device implanted in an ambulatory patient and for locating the patient in order to selectively monitor device function from a remote medical support network. The communications link between the medical support network and the patient communications control device may comprise a world wide satellite network, a cellular telephone network or other personal communications system.
Although the Duffin et al disclosure provides significant advances over the prior art, it does not teach a communications scheme in which a programmer is remotely debugged, maintained, upgraded or modified to ultimately enhance the support it provides to the implantable device with which it is associated. Specifically, the Duffin et al disclosure is limited to notifying remote medical support personnel or an operator about impending problems with an IMD and also enables constant monitoring of the patient""s position worldwide using the GPS system. However, Duffin et al does not teach the remote programming scheme contemplated by the present invention.
In a related art, Thompson discloses a patient tracking system in a co-pending application entitled xe2x80x9cWorld-wide Patient Location and Data Telemetry System For Implantable Medical Devicesxe2x80x9d, Ser. No. 09/045,272, filed on Mar. 20, 1998 which is incorporated by reference herein in its entirety. The disclosure provides additional features for patient tracking in a mobile environment worldwide via the GPS system. However, the remote programming concepts advanced by the present invention are not within the purview of the Thompson disclosure because there is no teaching of a web-based environment in which an implantable medical device is remotely evaluated and monitored to effect functional and parametric tune up, upgrade and maintenance as needed.
Yet in another related art, Ferek-Petric discloses a system for communication with a medical device in a co-pending application, Ser. No. 09/348,506 which is incorporated by reference herein in its entirety. The disclosure relates to a system that enables remote communications with a medical device, such as a programmer. Particularly, the system enables remote communications to inform device experts about programmer status and problems, The experts will then provide guidance and support to the remotely to service personnel or operators located at the programmer. The system may include a medical device adapted to be implanted into a patient; a server PC communicating with the medical device; the server PC having means for receiving data transmitted across a dispersed data communication pathway, such as the Internet; and a client PC having means for receiving data transmitted across a dispersed communications pathway from the SPC. In certain configurations the server PC may have means for transmitting data across a dispersed data communication pathway (Internet) along a first channel and a second channel; and the client PC may have means for receiving data across a dispersed communication pathway from the server PC along a first channel and a second channel.
One of the significant teachings of Ferek-Petric""s disclosure, in the context of the present invention, includes the implementation of communication systems, associated with IMDs that are compatible with the Internet. Specifically the disclosure advances the art of remote communications between a medical device, such as a programmer, and experts located at a remote location using the Internet. As indicated hereinabove, the communications scheme is structured to primarily alert remote experts to existing or impending problems with the programming device so that prudent action, such as early maintenance or other remedial steps, may be timely exercised. Further, because of the early warning or advance knowledge of the problem, the remote expert would be well informed to provide remote advice or guidance to service personnel or operators at the programmer.
While Ferek""s invention advances the art in communications systems relating to interacting with a programmer via a communication medium such as the Internet, the system does neither propose nor suggest remote programming, debugging and maintenance of a programmer without the intervention of a service person.
Another disclosure relating to ambulatory patient health monitoring techniques utilizing interactive visual communications is disclosed by Daniel et al in U.S. Pat. No. 5,441,047, issued Aug. 15, 1995. The invention relates to a system in which the patient is monitored by a health care worker at a certain station, while the patient is at a remote location. The patient""s condition is monitored in the home using various monitoring devices. The health care worker is placed into interactive visual communication with the patient.
Yet another prior art provides a monitoring method and a monitoring equipment in U.S. Pat. No. 5,840,020 by Pekka et al issued on Nov. 24, 1998. The patent relates to a monitoring equipment including means for receiving a measurement result indicating the patients blood glucose level, and for storing it in memory. In order to improve and facilitate the treatment of the patient, the monitoring equipment further includes means for receiving data concerning the patient""s diet, medication and physical strain and for storing it in the memory. A series of calculations are refined to provide predictive values
Further, another prior art provides a method for monitoring the health of a patient as disclosed in U.S. Pat. No. 5,772,586 issued to Pekka et al on Jun. 30, 1998. The disclosure relates to a method for monitoring the health of a patient by utilizing measurements. In order to improve the contact between the patient and the person treating him, the results of the measurements are supplied via a communications device utilizing a wireless data transmission link to a data processing system available to the person monitoring the patient""s health. The patient""s health is monitored by means of the data stored in the data processing system.
Yet a further example of a prior art is provided in U.S. Pat. No. 5,701,904 by Simmons et al issued on Dec. 30, 1997 relating to telemedicine instrumentation pack. The invention includes a portable medical diagnostic apparatus for data gathering. A video camera generates signals based on images taken from the visual instruments. Other electronics circuitry generates signals based on output of the audio instrument and data-gathering instruments. The signals are transmitted to a remote site for analysis by medical personnel.
A related prior art is disclosed in U.S. Pat. No. 5,434,611 issued to Tamura on Jul. 18, 1995. The disclosure relates to a health care system which employs a two-way communications antenna television network to permit communication between a doctor and patients at different locations. The system utilizes a community antenna television (CATV) so that the doctor can directly interrogate patients at home, and the patients can be automatically monitored at home using images and voice by the doctor in the medical office, without hindrance to normal CATV broadcasting.
Yet another related prior art is disclosed in U.S. Pat. No. 5,791,907 by Ramshaw issued on Aug. 11, 1998. The disclosure relates to an interactive medical training device including a computer system with a display. The computer is programmed to provide education and training in medical procedures.
Another related prior art is disclosed in U.S. Pat. No. 5,810,747 by Brudny et al. issued on Sep. 22, 1998. The invention relates to an interactive intervention training system used for monitoring a patient. An expert system and a neural network determine a goal to be achieved during training.
One of the limitations of Brudny""s teachings is the fact that the interactive training does not provide for a programmer type interface between the expert system (remote station) and a plurality of IMDs. Further, there is no software structure or scheme to provide the various remote programming functions contemplated by the present invention.
Some of the limitations of Ramshaw""s disclosure, in light of the present invention, include the fact that there is no teaching of a program that is used for managing implantable devices to effect various clinical procedures and therapy based on a remotely transmitted interactive software from a web-based data center.
Further U.S. Pat. No. 5,590,057 by Ruuska et al., issued on Dec. 31, 1996 provides a training and certification system for a user to perform a task. The invention includes an input device, output device and a controller. The controller receives input data from the input device and controls the output displayed on the output device. The system presents a user with a pretest, a module containing instructions, information about a certain portion of the task to be performed, as well as mini-simulations and a variety of questions. The system present a post-test result and determines if the user is certifiable.
Ruuska et al""s disclosure relates to training on a task and provides an advance in computer implemented system for training and certifying a trainee to perform a task. However, in light of the present invention, Ruuska et al. has several limitations. Specifically, Ruuska does not disclose a programmer for managing the operations of IMDs. Further, Ruuska does not relate to a highly globally distributed number of programmers on which technicians need to be trained to operate both the programmers and the IMDs. In the present invention, each programmer may manage a plurality of IMDs via, preferably, a telemetric data transmission system. IMD data download, new software installation, patient history, including significant clinical/therapy information are routinely exchanged between the programmer and the IMDs using the program modules implemented by the present invention. The globally distributed programmers that manage the IMDs locally are connected, via a bi-directional communications link, to a remote data center to exchange data, voice and video. The remote data center is a universal command/control point in which expert system""s reside.
Accordingly, it would be advantageous to provide a system in which a programmer could uplink to a remote expert data center to import enabling software for self-diagnosis, maintenance and upgrade of the programmer. Yet another desirable advantage would be to provide a system to implement the use of remote expert systems to manage a programmer on a real-time basis. A further desirable advantage would be to provide a communications scheme that is compatible with various communications media, to promote a fast uplink of a programmer to remote expert systems and specialized data resources. Yet another desirable advantage would be to provide a high speed communications scheme to enable the transmission of high fidelity sound, video and data to advance and implement efficient remote data management of a clinical/therapy system via a programmer or an interface medical device thereby enhancing patient clinical care. Preferably, a remote web-based expert data center would direct, command and control the clinical, therapeutic and operational functions of a multiple set of implantable medical devices, on a continuous and real time basis, utilizing a high speed communication scheme. As discussed herein below, the present invention provides these and other desirable advantages.
The present invention generally relates to a communications scheme in which a remote web-based expert data center interacts with a patient having one or more implantable medical devices (IMDs) via an associated external medical device, preferably a programmer, located in close proximity to the IMDs. Some of the most significant advantages of the invention include the use of various communications media between the remote web-based expert data center, the programmer and an interface medical unit to remotely exchange clinically significant information and ultimately effect real-time parametric and operational changes in the IMDs as needed.
In the context of the present invention, one of the many aspects of the invention includes a real-time access of a programmer to a remote web-based expert data center, via a communication network, which includes the Internet. The operative structure of the invention includes the remote web-based expert data center, in which an expert system is maintained, having a bi-directional real-time data, sound and video communications with the programmer via a broad range of communication link systems. The programmer is in turn in telemetric communications with the IMDs such that the IMDs may uplink to the programmer or the programmer may down link to the IMDs, as needed.
In yet another context of the invention, the critical components and embedded systems of the programmer are remotely maintained, debugged and/or evaluated to ensure proper functionality and performance by down linking expert systems and compatible software from the web-based expert data center.
In a further context of the invention, a programmer or an interface medical unit is remotely monitored, assessed and upgraded as needed by importing software from a remote expert data center via a wireless or equivalent communications system. The operational and functional software of the embedded systems in the programmer or the interface medical unit may be remotely adjusted, upgraded or changed as apparent. The software changes installed in the programmer/interface medical unit may ultimately be implemented in the IMDs as needed by down linking to the IMDs.
Yet another context of the invention includes a communications scheme that provides a highly integrated and efficient method and structure of clinical information management in which various networks such as Community access Television, Local area Network (LAN), a wide area network (WAN) Integrated Services Digital Network (ISDN), the Public Switched telephone Network (PSTN), the Internet, a wireless network, an asynchronous transfer mode (ATM) network, a laser wave network, satellite, mobile and other similar networks are implemented to transfer voice, data and video between the remote data center and a programmer. In the preferred embodiment, wireless communications systems, a modem and laser wave systems are illustrated as examples only and should be viewed without limiting the invention to these types of communications alone. Further, in the interest of simplicity, the applicants refer to the various communications system, in relevant parts, as a communications system. However, it should be noted that the communication systems, in the context of this invention, are interchangeable and may relate to various schemes of cable, fiber optics, microwave, radio, laser and similar communications or any practical combinations thereof.
Some of the distinguishing features of the present invention include the use of a robust web-based expert data center to manage and tune the operational and functional parameters of a plurality of IMDs in real-time. Specifically, the invention enables remote diagnosis, maintenance, upgrade, performance tracking, tuning and adjustment of the IMDs via a programmer. One additional benefit of the present invention is an enhancement of the IMDs using a prescriptive program data set to be implemented, on a proactive basis, in the IMDs by down linking from the programmer thereby upgrading the IMDs to promote the patient""s well being.
Yet one of the other distinguishing features of the invention includes the use a highly flexible and adaptable communications scheme to promote continuous and real-time communications between a remote expert data center and a programmer associated with a plurality of IMDs. The IMDs are structured to share information intracorporeally and may interact with the programmer, as a unit. Specifically, the IMDs either jointly or severally can be interrogated to implement or extract clinical information as required. In other words, all of the IMDs may be accessed via one IMD or, in the alternate, each one of the IMDs may be accessed individually. The information collected in this manner may be transferred to the programmer by up linking the IMDs as needed.
Further, the present invention provides significant advantages over the prior art by enabling remote troubleshooting, maintenance and software upgrade to the IMDs. The communications scheme enables remote debugging and analysis of the IMDs via the programmer. In the event a component or software defect is noted, the system is able to check whether a xe2x80x98remote-fixxe2x80x99 is possible. If not, the system broadcasts an alert to an operator thus attending to the problem on a real-time basis. In the execution of this function the communications scheme of the present invention performs, inter alia, a review of usage logs, error logs, power and battery status, data base integrity and the mean time between failures status of all the significant and relevant components. Further, patient history, performance parameter integrity and software status are mined from the IMDs via programmer""s database and analyzed by an analyzer at the remote expert data center.
The invention provides significant compatibility and scalability to other web-based applications such as telemedicine and emerging web-based technologies such as tele-immersion. For example, the system may be adapted to interface with medical applications in which an interface medical unit may be used to uplink the patient to a remote data center for information exchange between the IMDs and the remote expert data center. More significantly, the invention provides a system and method to remotely install various operational and functional software in the IMDs via a surrogate device which is tailored to provide the required functional capabilities to manage the IMDs.
Specifically, the invention implements a virtual electrophysiologist module (VEM), a chronic monitor module (CMM) and prescriptive program module (PPM) to remotely program IMDs via a programmer or an interface medical unit. The remote communication is facilitated by a web-enabled system utilizing various types of high speed communication media to effect real-time clinical care and therapy to patients with IMDs.

Virtual remote monitor, alert, diagnostics and programming for implantable medical device systems