INTELLIGENT AUTONOMOUS PATIENT ROUTING FOR SCANS
20210391064 · 2021-12-16
Inventors
- Rajendra Singh SISODIA (Bangalore, IN)
- Sunil Kumar VUPPALA (Bangalore, IN)
- Sudipta CHAUDHURY (Bangalore, IN)
- Ravindra BHAT (Eindhoven, NL)
- Mark Thomas Johnson (Eindhoven, NL)
Cpc classification
G16H40/20
PHYSICS
G16H50/20
PHYSICS
A61G2203/22
HUMAN NECESSITIES
A61B5/1123
HUMAN NECESSITIES
G16H50/30
PHYSICS
International classification
G16H40/20
PHYSICS
A61B5/11
HUMAN NECESSITIES
Abstract
The present invention relates to patient routing. In order to provide a more efficient patient flow for autonomous image acquisition, a method is provided for controlling a patient transfer apparatus within a healthcare facility. The method comprises the following steps: providing a routing information for transferring the patient transfer apparatus to a required location; controlling the patient transfer apparatus to move on a first guided path according to the provided routing information; detecting at least one of a vital sign and an abnormal movement of the patient during a transit of the patient transfer apparatus; evaluating a patient condition based on at least one of the detected vital sign and the detected abnormal movement of the patient; updating the routing information in response to the evaluated patient condition, if the evaluated patient condition meets a predefined criterion; and controlling the patient transfer apparatus to move on a second guided path according to the updated routing information during the transit of the patient transfer apparatus.
Claims
1. A computer-implemented method for controlling a patient transfer apparatus within a healthcare facility, the method comprising the following steps: providing a routing information for transferring the patient transfer apparatus to a required location; controlling the patient transfer apparatus to move on a first guided path according to the provided routing information; detecting at least one of a vital sign and an abnormal movement of the patient during a transit of the patient transfer apparatus; evaluating a patient condition based on at least one of the detected vital sign and the detected abnormal movement of the patient; updating the routing information in response to the evaluated patient condition, if the evaluated patient condition meets a predefined criterion; and controlling the patient transfer apparatus to move on a second guided path according to the updated routing information during the transit of the patient transfer apparatus.
2. Method according to claim 1, further comprising the following steps: providing a priority information for triggering a control requirement for an access to a common facility within the healthcare facility such that when the patient transfer apparatus arrives at the common facility, the patient transfer apparatus is given a priority access to the common facility; and/or providing a priority information for determining a relative right of way for two or more patient transfer apparatuses; determining, according to the priority information, a first relative right of way of the patient transfer apparatus, when another patient transfer apparatus is encountered; controlling the patient transfer apparatus to move according to the first relative right of way; updating the priority information in response to the evaluated patient condition, if the evaluated patient condition meets the predefined criterion; determining, according to the updated priority information, a second relative right of way of the patient transfer apparatus, when another patient transfer apparatus is encountered; and controlling the patient transfer apparatus to move according to the second relative right of way.
3. Method according to claim 2, wherein the priority information is based on a decision from: a local distributed system; wherein in the local distributed system, each patient transfer apparatus is configured to negotiate and discuss with other patient transfer apparatuses according to a predefined protocol to determine each other's right or way; or a centrally coordinated system; wherein in the centrally coordinated system, the routing information of each patient transfer apparatus and the patient condition of the patient on each patient transfer apparatus are configured to be updated to determine the priority information.
4. Method according to claim 1, further comprising the following steps: providing a scan schedule to trigger a movement of the patient transfer apparatus; determining the routing information based on the provided scan schedule; controlling the patient transfer apparatus to move on a first guided path according to the determined routing information; updating the scan schedule in response to the evaluated patient condition, if the evaluated patient condition meets the predefined criterion; updating the routing information and/or the priority information in response to the updated scan schedule; and controlling the patient transfer apparatus to move on a second guided path according to the updated routing information and/or the updated priority information during the transit of the patient transfer apparatus.
5. Method according to claim 4, further comprising: obtaining a local routing information of the patient transfer apparatus during transit; and updating the scan schedule of the patient based on the local routing information of the patient transfer apparatus.
6. Method according to claim 4, wherein the scan schedule comprises at least one of the following: availability of a scanner; a scan type; a scan duration; a modality type; and a scheduling of scan slot.
7. Method according to claim 1, further comprising: visualizing the routing information as a road map to assist a user with a manual decision.
8. Method according to claim 1, wherein the patient condition comprises at least one of the following: a current status of the patient based on an evaluation of at least one of the detected vital sign and the detected abnormal movement of the patient; and a patient's short-term prognosis based on an evaluation of at least one of the detected vital sign and the at least one detected abnormal movement of the patient, and historical data of the patient or similar patients.
9. Method according claim 8, wherein a predicted model is provided to evaluate the patient's short-term prognosis; wherein the predicted model comprises at least one of the following: a deep learning model; and a statistical model.
10. A system for controlling a patient transfer apparatus within a healthcare facility, comprising: i) a patient transport apparatus, comprising: a drive device; a control device; and a routing device; ii) an in-transit patient condition assessor; and iii) a clinical support decision subsystem, comprising a route-planning device; and a patient condition evaluation device; and wherein the route-planning device is configured to provide a routing information to the routing device of the patient transfer apparatus for transferring the patient transfer apparatus to a required location; wherein the drive device is configured to be controlled by the control device to move the patient transfer apparatus on a first guide path according to the routing information received by the routing device; wherein the in-transit patient condition assessor is configured to detect at least one of a vital sign and an abnormal movement of the patient during a transit of the patient transfer apparatus; wherein the patient condition evaluation device of the clinical decision support system is configured to evaluate a patient condition based on at least one of the detected vital sign and the detected abnormal movement of the patient; wherein the route-planning device is configured to update the routing information in response to the evaluated patient condition, if the evaluated patient condition meets a predefined criterion; and wherein the control device of the patient transfer apparatus is configured to control the drive device to move the patient transfer apparatus on a second guided path according to the updated routing information during the transit of the patient transfer apparatus.
11. System according to claim 10, wherein the in-transit patient condition assessor comprises at least one of the following: a camera configured to detect an abnormal movement of the patient; a touchless sensor arranged on the patient transfer apparatus and configured to detect a vital sign and/or an abnormal movement; and a patient support system arranged on the patient transfer apparatus and configured to detect a vital sign.
12. System according to claim 10, further comprising: a priority-planning device configured to provide a priority information for i) triggering a control requirement for an access to a common facility within the healthcare facility such that when the patient transfer apparatus arrives at the common facility, the patient transfer apparatus is given a priority access to the common facility; and/or (ii) determining a relative right of way for two or more patient transfer apparatuses; wherein the priority-planning device is configured to determine, according to the priority information, a first relative right of way of the patient transfer apparatus, when another patient transfer apparatus is encountered; wherein the control device of the patient transfer apparatus is configured to control the drive device to move the patient transfer apparatus according to the first relative right of way; wherein the priority-planning device is configured to update the priority information in response to the valuated patient condition, if the evaluated patient condition meets the predefined criterion; wherein the priority-planning device is configured to determine, according to the updated priority information, a second relative right of way of the patient transfer apparatus, when another patient transfer apparatus is encountered; and wherein the control device of the patient transfer apparatus is configured to control the drive device to move the patient transfer apparatus according to the second relative right of way.
13. System according to claim 10, wherein the system further comprises: at least one scanner; and a central scan schedule subsystem; wherein the at least one scanner is configured to perform medical imaging examinations on the patient; wherein the central scan schedule subsystem is configured to coordinate with the at least one scanner to provide a scan schedule of the patient for triggering a movement of the patient transfer apparatus towards the at least one scanner; wherein the priority-planning device of the clinical decision support subsystem is configured to determining the routing information based on the provided scan schedule; wherein the control device of the patient transfer apparatus is configured to control the drive device to move the patient transfer apparatus on a first guided path according to the determined routing information; wherein the central scan schedule subsystem is configured to update the scan schedule in response to the evaluated patient condition, if the evaluated patient condition meets the predefined criterion; wherein the route-planning device and/or the priority-planning device are configured to update the routing information and/or the priority information in response to the updated scan schedule; and wherein the control device of the patient transfer apparatus is configured to control the drive device to move the patient transfer apparatus on a second guided path according to the updated routing information and/or the updated priority information during the transit
14. Computer program element for controlling a system according to claim 10, which, when being executed by a processing unit, is adapted to perform method steps.
15. Computer readable medium having stored the program element of claim 14.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0067] Exemplary embodiments of the invention will be described in the following with reference to the following drawings:
[0068]
[0069]
[0070]
[0071]
[0072]
DETAILED DESCRIPTION OF EMBODIMENTS
[0073]
[0074] The route-planning device 24 is configured to provide a routing information to the routing device 22 of the patient transfer apparatus for transferring the patient transfer apparatus to a required location, such as a scan room. The route-planning device 24 may convey the routing information to the routing device 22 e.g. via a local area network connection (WLAN). The routing information may be a route map within the healthcare facility for moving the patient transfer apparatus from one location to another. The routing information may also comprise the estimation of the duration of the patient movement. In some implementations, the routing information may be based on patient, type of scan, time and modality type. For example, the routing information may comprise the estimation of the right route, time of movement and approach based on the type of scan and modality. The routing information may be displayed, visualized, e.g. on a display attached to the patient transfer apparatus, to provide required information.
[0075] The drive device 18 is configured to be controlled by the control device 20 to move the patient transfer apparatus on a first guide path according to the routing information received by the routing device 22. The control device 20 may send a control signal to drive device 18 according to the routing information received by the routing device 22. Upon receiving the control signal, the drive device 18 may cause the patient transfer apparatus 12 to move. The drive device 18 may include electric motors and wheels that are driven by the electric motors and can move in all the front, back, right, and left directions. A physical cable may be employed, e.g. a standard universal serial bus (USB) connection, to transmit the control signal and the routing information. Alternatively, the control signal and the routing information may be transmitted wirelessly.
[0076] The in-transit patient condition assessor 14 is configured to detect at least one of a vital sign and an abnormal movement of the patient during a transit of the patient transfer apparatus 12. The in-transit patient condition assessor 14 may comprise at least one of the following: a camera 28 configured to detect an abnormal movement of the patient, a touchless sensor 30 arranged on the patient transfer apparatus and configured to detect a vital sign and/or an abnormal movement, and a patient support system 32 arranged on the patient transfer apparatus and configured to detect a vital sign. In hospitals, cameras 28 are already provided in corridors and lifts for safety or surveillance purposes. These cameras 28 may also be used for vital sign monitoring and/or abnormal movements of patients. This may be used to alert the routing device or the concerned human observer for prioritized route or movements. The patient support system 32 may comprise connected monitors, sensors, residual devices strapped on the patient transport apparatus 12.
[0077] The patient condition evaluation device 26 of the clinical decision support subsystem 16 is configured to evaluate a patient condition based on at least one of the detected vital sign and the detected abnormal movement of the patient. The patient condition may include the patient's current state, such as being good or serious. The patient condition may also include the patient short-term prognosis, for example, the patient is improving, is getting worse, or no immediate change is expected, i.e. stable. The patient condition may be evaluated and categorized in the following terms: undetermined (patient awaiting physician and/or assessment), good (vital signs are stable and within normal limits), serious (serious vital signs may be unstable and not within normal limits), and critical (critical vital signs are unstable and not within normal limits). The patient condition evaluation device 26 is capable of receiving the detected vital sign and the detected abnormal movement, and/or historical data of the patient or similar patients, and evaluating the patient condition based thereon. A predicted model may be provided to evaluate the patient's short-term prognosis. The predicted model comprises at least one of the following: a deep learning model, and a statistical model. In an example, the statistical model is an ARIMA model. In an example, the deep learning model is a LSTM model.
[0078] The route-planning device 24 is configured to update the routing information in response to the evaluated patient condition, if the evaluated patient condition meets a predefined criterion. The routing information may be updated, i.e. changed, if the evaluated patient condition meets a predefined criterion. For example, the predefined criterion may be a downgrade of the patient condition, including the current status of the patient and short-term prognosis, such as a downgrade from “good” to “serious”. This usually indicates that a patient is likely to be in the intensive care unit or acute ward. If this predefined criterion is met, the patient transfer apparatus will be controlled to move the patient to the ICU for doctor's attention.
[0079] The control device 20 of the patient transfer apparatus is configured to control the drive device 18 to move the patient transfer apparatus on a second guided path according to the updated routing information during the transit of the patient transfer apparatus. The second guided path is different from the first guided path.
[0080] Accordingly, the patient transfer apparatus is aware of clinical conditions of the patient and uses the clinical conditions of the patient for routing decisions. Additionally, the system may also be adapted for non-human autonomous routing.
[0081] Optionally, the patient transfer apparatus 12 may further comprise a display 40 for visualizing the routing information as a road map to assist a user with a manual decision.
[0082] Optionally, the system 10 may further comprise a priority-planning device 34 configured to provide a priority information for triggering a control requirement for an access to a common facility within the healthcare facility such that when the patient transfer apparatus arrives at the common facility, the patient transfer apparatus is given a priority access to the common facility. For example, the priority-planning device 34, may also trigger specific control requirements, for the access to common facilities such as lift, access to corridors, so that when the patient transfer apparatus arrives, they may be at right location (floor) or reserved for them as well.
[0083] Alternatively or additionally, the priority-planning device 34 is configured to provide a priority information for determining a relative right of way for two or more patient transfer apparatuses. The priority-planning device 34 is configured to determine, according to the priority information, a first relative right of way of the patient transfer apparatus, when another patient transfer apparatus is encountered. The control device 20 of the patient transfer apparatus is configured to control the drive device 18 to move the patient transfer apparatus according to the first relative right of way. The right or way may include the right of the patient transfer apparatus to proceed with precedence over others in a particular situation or place within the healthcare facility. For example, the priority of routing may be required when a patient condition is or is becoming serious and thus the patient transfer apparatus carrying the patient has the right of way.
[0084] The priority-planning device 34 is configured to update the priority information in response to the valuated patient condition, if the evaluated patient condition meets the predefined criterion. The priority-planning device 34 is configured to determine, according to the updated priority information, a second relative right of way of the patient transfer apparatus, when another patient transfer apparatus is encountered. The control device 20 of the patient transfer apparatus is configured to control the drive device 18 to move the patient transfer apparatus according to the second relative right of way. The second relative right of way is different from the first relative right of way.
[0085] Accordingly, the patient transfer apparatus may determine the relative priority and right of way dynamically such that a patient with serious patient condition will be transferred with precedence over others and when the patient transfer apparatus arrives, they may be at right location (floor) or reserved for them as well.
[0086] The priority-planning device 34 may be provided as a device of the patient transfer apparatus for providing the priority information based on a decision from a local distributed system. In the local distributed system, the priority-planning device 34 of each patient transfer apparatus is configured to negotiate and discuss with that of other patient transfer apparatuses according to a predefined protocol to determine each other's right or way.
[0087] Alternatively and additionally, as shown in
[0088] The system 10 may optionally comprise at least one scanner 36, and a central scan schedule subsystem 38. The system 10 may comprise multiple scanners of different modalities, such as a magnetic resonance imaging (MRI) scanner, a computed tomography (CT) scanner, a positron-emission tomography (PET) scanner, etc. The scanners may be arranged in different scan rooms.
[0089] The at least one scanner 36 is configured to perform medical imaging examinations on the patient. The central scan schedule subsystem 38 is configured to coordinate with the at least one scanner to provide a scan schedule of the patient for triggering a movement of the patient transfer apparatus towards the at least one scanner. The priority-planning device 34 of the clinical decision support subsystem is configured to determining the routing information based on the provided scan schedule. The control device 20 of the patient transfer apparatus 12 is configured to control the drive device 18 to move the patient transfer apparatus 12 on a first guided path according to the determined routing information.
[0090] The scan schedule may comprise the schedule of the patient for the scans with one or more patient scan systems. The scan schedule may determine when the next patient is due. The scan schedule may comprise at least one of the following: availability of a scanner, a scan type, a scan duration, a modality type, and a scheduling of scan slot. Based on the scan schedule, the right route, time of movement, and approach may be estimated for determining the routing information and/or priority information. Route specified preference might be based on whether the current bed is compatible to specific modality, attachment to the patients etc.
[0091] The central scan schedule subsystem 38 is configured to update the scan schedule in response to the evaluated patient condition, if the evaluated patient condition meets the predefined criterion. The route-planning device 24 and/or the priority-planning device 34 are configured to update the routing information and/or the priority information in response to the updated scan schedule. The control device 20 of the patient transfer apparatus is configured to control the drive device 18 to move the patient transfer apparatus on a second guided path according to the updated routing information and/or the updated priority information during the transit of the patient transfer apparatus. For example, the change in patients' condition results in change in priority and the route to follow. These changes are coordinated with the central scan schedule subsystem as it effects the overall scheduling of patients for the scan. For example, if the patient is not ready for the scan due to change in his clinical parameters during the transit to the scan room, immediately the system 10 routes the patient to ICU for doctor's attention and updates the same to the central scan schedule subsystem such that the reschedule of scan is performed in real time. This may improve the overall efficiency of the system in scheduling the patients for the scans and routing them autonomously.
[0092] Optionally, the central scan schedule system 10 may be configured to coordinate with the routing device 22 of individual patient transfer apparatus 12, which may allow a dynamic change in the scan schedule based on the patients' condition and a change in clinical pathways. For example, the central scan schedule subsystem 16 may obtain a local routing information of the patient transfer apparatus 12 during transit and update the scan schedule of the patient based on the local routing information of the patient transfer apparatus. The local routing information relates to the information of the surroundings of the patient transfer apparatus 12. The local routing information may comprise the position information of the patient transfer apparatus. The local routing information may also comprise traffic conditions of the surroundings of the patient transfer apparatus 12.
[0093]
[0094] In step 104, the patient transfer apparatus is controlled to move on a first guided path according to the provided routing information. A drive device may be provided to cause the patient transfer apparatus to move in all the front, back, right, and left directions following the routing information. The drive device may comprise electric motors and wheels that are driven by the electric motors.
[0095] In step 106, at least one of a vital sign and an abnormal movement of the patient is detected during a transit of the patient transfer apparatus. The detection may be achieved by using an in-transit patient condition assessor. The in-transit patient condition assessor may comprise at least one of the following: a camera configured to detect an abnormal movement of the patient, a touchless sensor arranged on the patient transfer apparatus and configured to detect a vital sign and/or an abnormal movement, and a patient support system arranged on the patient transfer apparatus and configured to detect a vital sign.
[0096] In step 108, a patient condition is evaluated based on at least one of the detected vital sign and the detected abnormal movement of the patient. The patient condition may comprise the patient's current state and the patient short-term prognosis. A predicted model may be provided to evaluate the patient's short-term prognosis. The predicted model comprises at least one of the following: a deep learning model, and a statistical model. In step 110, the routing information is updated in response to the evaluated patient condition, if the evaluated patient condition meets a predefined criterion, e.g. a downgrade of the patient condition.
[0097] In step 112, the patient transfer apparatus is controlled to move on a second guided path according to the updated routing information during the transit of the patient transfer apparatus. The second guided path is different from the first path. For example, if the patient condition is downgraded from “good” to “serious”, the patient transfer apparatus may change the destination and transfer the patient to the ICU instead of a scanner room.
[0098]
[0099] In step 114, a priority information is provided for triggering a control requirement for an access to a common facility within the healthcare facility such that when the patient transfer apparatus arrives at the common facility, the patient transfer apparatus is given a priority access to the common facility.
[0100] In step 116, the priority information is provided for determining a relative right of way for two or more patient transfer apparatuses. The priority information may refer to the right of the patient transfer apparatus to proceed with precedence over others in a particular situation or place within the healthcare facility. The priority of routing may be required when a patient condition is or is becoming serious and thus the patient transfer apparatus carrying that patient has the right of way. The priority of routing may also be required to use common block points, e.g. the usage of lifts, corridors.
[0101] In step 118, a first relative right of way of the patient transfer apparatus is determined, according to the priority information, when another patient transfer apparatus is encountered.
[0102] In step 120, the patient transfer apparatus is controlled to move according to the first relative right of way.
[0103] In step 122, the priority information is updated in response to the evaluated patient condition, if the evaluated patient condition meets the predefined criterion, e.g. a downgrade of patient condition.
[0104] In step 124, a second relative right of way of the patient transfer apparatus is determined, according to the updated priority information, when another patient transfer apparatus is encountered.
[0105] In step 126, the patient transfer apparatus is controlled to move according to the second relative right of way. The second relative right of way is different from the first relative right of way.
[0106]
[0107] In step 128, a scan schedule is provided to trigger a movement of the patient transfer apparatus. The scan schedule may determine when the next patient is due. The scan schedule may comprise the availability of a scanner, scan type, scan duration, modality type and/or scheduling of scan slot.
[0108] In step 130, the routing information is determined based on the provided scan schedule. For example, the right route, time of movement and approach, can be estimated for determining the routing information and/or priority information, based on the scan schedule, e.g. the availability of the scanner, the type of scan and modality.
[0109] In step 132, the patient transfer apparatus is controlled to move on a first guided path according to the determined routing information. For example, the first guide path will lead the patient transfer apparatus to a MRI scanner room.
[0110] In step 134, the scan schedule is updated in response to the evaluated patient condition, if the evaluated patient condition meets the predefined criterion. For example, in case of a downgrade of the patient condition, the scan schedule may change, e.g. transferring the patient immediately to an ICU and rearranging the MRI scan.
[0111] In step 136, the routing information and/or the priority information is updated in response to the updated scan schedule. For example, in case of a downgrade of the patient condition, the routing information is updated such that the patient will be transfer to an ICU instead of an MRI scanner.
[0112] In step 138, the patient transfer apparatus is controlled to move on a second guided path according to the updated routing information and/or the updated priority information during the transit of the patient transfer apparatus.
[0113] Accordingly, the system, which may be an autonomous system, may be aware the availability of the scanner, scan duration, transfer time and scheduling of scans slots during autonomous movement.
[0114]
[0115] In step 140, a local routing information of the patient transfer apparatus is obtained during transit. The local routing information may comprise position information of the patient transfer apparatus, traffic conditions of the surroundings of the patient transfer apparatus, etc.
[0116] In step 142, the scan schedule of the patient is updated based on the local routing information of the patient transfer apparatus.
[0117] This may advantageously allow a dynamic change in the scan schedule based on a change in clinical pathways in addition to the patient condition.
[0118] As a further option, in step 144, the routing information may be visualized as a road map to assist a user with a manual decision.
[0119] In another exemplary embodiment of the present invention, a computer program or a computer program element is provided that is characterized by being adapted to execute the method steps of the method according to one of the preceding embodiments, on an appropriate system.
[0120] The computer program element might therefore be stored on a computer unit, which might also be part of an embodiment of the present invention. This computing unit may be adapted to perform or induce a performing of the steps of the method described above. Moreover, it may be adapted to operate the components of the above-described apparatus. The computing unit can be adapted to operate automatically and/or to execute the orders of a user. A computer program may be loaded into a working memory of a data processor. The data processor may thus be equipped to carry out the method of the invention.
[0121] This exemplary embodiment of the invention covers both, a computer program that right from the beginning uses the invention and a computer program that by means of an up-date turns an existing program into a program that uses the invention.
[0122] Further on, the computer program element might be able to provide all necessary steps to fulfil the procedure of an exemplary embodiment of the method as described above.
[0123] According to a further exemplary embodiment of the present invention, a computer readable medium, such as a CD-ROM, is presented wherein the computer readable medium has a computer program element stored on it which computer program element is described by the preceding section.
[0124] A computer program may be stored and/or distributed on a suitable medium, such as an optical storage medium or a solid-state medium supplied together with or as part of other hardware, but may also be distributed in other forms, such as via the internet or other wired or wireless telecommunication systems.
[0125] However, the computer program may also be presented over a network like the World Wide Web and can be downloaded into the working memory of a data processor from such a network. According to a further exemplary embodiment of the present invention, a medium for making a computer program element available for downloading is provided, which computer program element is arranged to perform a method according to one of the previously described embodiments of the invention.
[0126] It has to be noted that embodiments of the invention are described with reference to different subject matters. In particular, some embodiments are described with reference to method type claims whereas other embodiments are described with reference to the system type claims. However, a person skilled in the art will gather from the above and the following description that, unless otherwise notified, in addition to any combination of features belonging to one type of subject matter also any combination between features relating to different subject matters is considered to be disclosed with this application. However, all features can be combined providing synergetic effects that are more than the simple summation of the features.
[0127] While the invention has been illustrated and described in detail in the drawings and foregoing description, such illustration and description are to be considered illustrative or exemplary and not restrictive. The invention is not limited to the disclosed embodiments. Other variations to the disclosed embodiments can be understood and effected by those skilled in the art in practicing a claimed invention, from a study of the drawings, the disclosure, and the dependent claims.
[0128] In the claims, the word “comprising” does not exclude other elements or steps, and the indefinite article “a” or “an” does not exclude a plurality. A single processor or other unit may fulfil the functions of several items re-cited in the claims. The mere fact that certain measures are re-cited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage. Any reference signs in the claims should not be construed as limiting the scope.