Reducing sensor interference in a medical device
11751952 · 2023-09-12
Assignee
Inventors
- Eric Franciscus Johannes Claessens (Helmond, NL)
- Jan Harm de Boer (Nuenen, NL)
- Patrick Wilhelmus Van Kaam (Best, NL)
- Ioannis Pappous (Eindhoven, NL)
Cpc classification
A61B8/12
HUMAN NECESSITIES
A61B8/463
HUMAN NECESSITIES
A61N1/086
HUMAN NECESSITIES
A61B34/20
HUMAN NECESSITIES
A61B2560/0223
HUMAN NECESSITIES
A61N1/3718
HUMAN NECESSITIES
A61B2034/2063
HUMAN NECESSITIES
A61B5/7225
HUMAN NECESSITIES
A61B8/4483
HUMAN NECESSITIES
A61B5/02055
HUMAN NECESSITIES
A61B5/684
HUMAN NECESSITIES
A61B8/4245
HUMAN NECESSITIES
A61B8/5207
HUMAN NECESSITIES
International classification
A61B34/20
HUMAN NECESSITIES
A61B8/00
HUMAN NECESSITIES
Abstract
A medical sensing system (100) includes an elongate interventional device (101) and an adjustable capacitance circuit (102). The elongate interventional device (101) includes a sensor (103) having a capacitance (C.sub.ss). The elongate interventional device (101) also includes a first electrical conductor (104) and a second electrical conductor (105). The first electrical conductor (104) and the second electrical conductor (105) are in electrical contact with the sensor (103) and extend along the elongate interventional device (101). The elongate interventional device (101) also includes i) an electrically conductive shield (106) that overlaps the electrical conductors (104, 105) and/or ii) an electrically conductive shaft (107). The adjustable capacitance circuit (102) provides an adjustable capacitance (C.sub.Adj1, C.sub.Adj2) between at least one of the electrical conductors (104, 105) and i) the electrically conductive shield (106) that overlaps the electrical conductors (104, 105) and/or ii) the electrically conductive shaft (107).
Claims
1. A medical sensing system comprising: an elongate interventional device comprising: a sensor having a capacitance, the sensor disposed on the elongate interventional device; a first electrical conductor and a second electrical conductor in electrical contact with the sensor, extending along the elongate interventional device, and configured to provide electrical signals corresponding to signals detected by the sensor; and at least one of an electrically conductive shield overlapping both the first electrical conductor and the second electrical conductor or an electrically conductive shaft, wherein the first electrical conductor and the second electrical conductor each have a stray capacitance to at least one of the electrically conductive shield or to the electrically conductive shaft; and an adjustable capacitance circuit configured to: measure a difference in the stray capacitance between each of the first electrical conductor and the second electrical conductor and at least one of the electrically conductive shield or the electrically conductive shaft, and control an adjustable capacitance, between at least one of the first electrical conductor or the second electrical conductor and at least one of the electrically conductive shield or the electrically conductive shaft, based on the measured difference in stray capacitance.
2. The medical sensing system according to claim 1, wherein the adjustable capacitance circuit is further configured to control the adjustable capacitance such that a substantially equal total capacitance is provided between each of the first electrical conductor and the second electrical conductor and at least one of the electrically conductive shield or electrically conductive shaft.
3. The medical sensing system according to claim 1, wherein the adjustable capacitance circuit is further configured to: receive electrical signals indicative of interference signals detected on the first electrical conductor or on the second electrical conductor; and control the adjustable capacitance based on the detected interference signals.
4. The medical sensing system according to claim 1, wherein the adjustable capacitance circuit comprises a varactor diode.
5. The medical sensing system according to claim 1, further comprising: a differential amplifier in electrical communication with each of the first electrical conductor and the second electrical conductor, the differential amplifier configured to provide an output signal corresponding to an amplified difference between an electrical signal on the first electrical conductor and an electrical signal on the second electrical conductor.
6. The medical sensing system according to claim 1, wherein the elongate interventional device comprises both the electrically conductive shield and the electrically conductive shaft, and the electrically conductive shield is electrically connected to the electrically conductive shaft.
7. The medical sensing system according to claim 1, wherein the sensor is configured to detect ultrasound signals.
8. The medical sensing system according to claim 1, further comprising: a console or an electrical connector, wherein the adjustable capacitance circuit is disposed in the console or the electrical connector; and an electrical cable configured to connect the adjustable capacitance circuit to the first electrical conductor, to the second electrical conductor, and to at least one of the electrically conductive shield or the electrically conductive shaft.
9. The medical sensing system according to claim 1, wherein the sensor is an ultrasound sensor, and the system further comprising: a beamforming ultrasound imaging probe configured to generate an ultrasound field; an image reconstruction processor configured to provide a reconstructed ultrasound image corresponding to the ultrasound field of the beamforming ultrasound imaging probe; and a position determination processor configured to: compute a position of the ultrasound sensor of the interventional device relative to the ultrasound field based on ultrasound signals transmitted between the beamforming ultrasound imaging probe and the ultrasound sensor, and to provide an icon in the reconstructed ultrasound image based on the computed position of the ultrasound sensor.
10. A method for reducing interference of electrical signals, the method comprising: providing an interventional device that includes: a sensor disposed on an elongate interventional device and having a capacitance, a first electrical conductor and a second electrical conductor in electrical contact with the sensor, the first electrical conductor and the second electrical conductor extending along the elongate interventional device and configured to provide electrical signals corresponding to signals detected by the sensor, and at least one of an electrically conductive shield overlapping both the first electrical conductor and a second electrical conductor or an electrically conductive shaft, wherein the first electrical conductor and the second electrical conductor each have a stray capacitance to at least one of the electrically conductive shield or to the electrically conductive shaft; measuring a difference in stray capacitance between each of the first electrical conductor and the second electrical conductor and at least one of the electrically conductive shield or the electrically conductive shaft; and adjusting a capacitance, between at least one of the first electrical conductor or the second electrical conductor and at least one of the electrically conductive shield or the electrically conductive shaft, based on the measured difference in stray capacitance.
11. The method according to claim 10, further comprising: receiving signals indicative of detected interference on at least one of the first electrical conductor or the second electrical conductor; and adjusting the capacitance based on the received signals.
12. A non-transitory computer readable medium having stored thereon instructions which when executed on a processor, cause the processor to: detect an interventional device that includes: a sensor disposed on an elongate interventional device and having a capacitance, and a first electrical conductor and a second electrical conductor in electrical contact with the sensor, the first electrical conductor and the second electrical conductor extending along the elongate interventional device and configured to provide electrical signals corresponding to signals detected by the sensor, and at least one of an electrically conductive shield overlapping both the first electrical conductor and a second electrical conductor or an electrically conductive shaft, wherein the first electrical conductor and the second electrical conductor each have a stray capacitance to at least one of the electrically conductive shield or to the electrically conductive shaft; measure a difference in stray capacitance between each of the first electrical conductor and the second electrical conductor and at least one of the electrically conductive shield or the electrically conductive shaft; and adjust a capacitance, between at least one of the first electrical conductor or the second electrical conductor and at least one of the electrically conductive shield or the electrically conductive shaft, based on the measured stray capacitance.
13. The non-transitory computer readable medium according to claim 12, further comprising instructions that, when executed by the processor, further cause the processor to: receive signals indicative of detected interference on at least one of the first electrical conductor or the second electrical conductor; and adjust the capacitance based on the received signals.
14. The non-transitory computer readable medium according to claim 12, further comprising instructions that, when executed by the processor, further cause the processor to output a signal corresponding to an amplified difference between an electrical signal on the first electrical conductor and an electrical signal on the second electrical conductor.
15. The non-transitory computer readable medium according to claim 12, wherein the sensor is an ultrasound sensor and the non-transitory computer readable medium further comprising instructions that, when executed by the processor, further cause the processor to: communicate with an ultrasound imaging probe configured to generate an ultrasound field, the computer readable medium further comprising instructions that, when executed by the processor, further cause the processor to: reconstruct an ultrasound image corresponding to the ultrasound field of the beamforming ultrasound imaging probe; and compute a position of the ultrasound sensor of the interventional device relative to the ultrasound field based on ultrasound signals transmitted between the beamforming ultrasound imaging probe and the ultrasound sensor, and to provide an icon in the reconstructed ultrasound image based on the computed position of the ultrasound sensor.
16. The method according to claim 10, further comprising: receiving signals indicative of detected interference on at least one of the first electrical conductor or the second electrical conductor; and adjusting the capacitance based on the received signals.
17. The method according to claim 10, further comprising outputting a signal corresponding to an amplified difference between an electrical signal on the first electrical conductor and an electrical signal on the second electrical conductor.
18. The method according to claim 10, wherein the sensor is an ultrasound sensor; and the method further comprising: communicating with an ultrasound imaging probe configured to generate an ultrasound field; reconstructing an ultrasound image corresponding to the ultrasound field of the beamforming ultrasound imaging probe; and computing a position of the ultrasound sensor of the interventional device relative to the ultrasound field based on ultrasound signals transmitted between the beamforming ultrasound imaging probe and the ultrasound sensor, and to provide an icon in the reconstructed ultrasound image based on the computed position of the ultrasound sensor.
Description
BRIEF DESCRIPTION OF THE FIGURES
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
DETAILED DESCRIPTION OF THE INVENTION
(11) In order to illustrate the principles of the present invention a medical sensing system is described with particular reference to an exemplary position tracking application in which an ultrasound sensor disposed on a medical needle is used to track a position of the interventional device respective the ultrasound field of a beamforming ultrasound imaging probe.
(12) It is however to be appreciated that the invention finds application in the medical sensing field in general. The use of a sensor other than an ultrasound sensor is thus also contemplated, including the use of sensors of pressure, temperature, fluid flow, optical radiation, sound, or electrical signals. The sensing of physical parameters in applications such as blood flow sensing and thermometry is contemplated. Moreover, the use of interventional devices other than a medical needle is contemplated, including without limitation a catheter, a guidewire, a biopsy device, a pacemaker lead, an intravenous line or a surgical tool in general. The interventional device may be used in a wide variety or medical procedures, for example from routine needle insertion for regional anesthesia, to biopsies and percutaneous ablation of cancer, and in more advanced interventional procedures.
(13) Thereto,
(14) In the embodiment illustrated in
(15) Electrically conductive shield 106 in
(16) Various adjustable capacitances may be used to provide adjustable capacitance C.sub.Adj1 illustrated in
(17) In one exemplary implementation,
(18)
(19) Adjustable capacitance C.sub.Adj1 may have any suitable value, and may include a fixed component and a variable component as indicated in Equation 1. In some implementations C.sub.Adj1 may provide a value of a few picofarads or a few tens or hundreds of pico farads or a few nano farads or a few tens or hundreds of nano farads.
(20) Adjustable capacitance circuit 102 in
(21) Thus, in a variation of the implementation of
(22) In another example implementation,
(23) It is also contemplated that the invention may be used with interventional devices having an electrically conductive shaft 107. Many interventional devices including medical needles, guidewires and so forth include such an electrically conductive shaft 107. EMI may alternatively or additionally couple to electrically conductive shaft 107, and subsequently couple to electrical conductors 104, 105 in differing amounts, thereby giving rise to different amounts of EMI on each electrical conductor as described above. With reference to
(24) In a variation, not illustrated, of the implementation of
(25) In another variation of the medical sensing system of
(26) Combinations of the aforementioned implementations of
(27) In order to provide optimal EMI reduction, C.sub.Adj1 and/or C.sub.Adj2 referred-to above may be adjusted in order to provide a similar, preferably the same, total capacitance between each electrical conductor 104, 105 and i) electrically conductive shield 106 that overlaps the electrical conductors 104, 105 and/or ii) electrically conductive shaft 107. This total capacitance comprises the combination of stray capacitance C.sub.S104/C.sub.S105, and its associated adjustable capacitance C.sub.Adj1/C.sub.Adj2. With reference to
(28) In some implementations it is contemplated to determine adjustable capacitance value C.sub.Adj1, C.sub.Adj2 during a calibration procedure, for example prior-to use, or when in-use, and during which the necessary capacitance value C.sub.Adj1, C.sub.Adj2 is e.g. adjusted or stored for later use. In other implementations the adjustment may be determined and made in-use, intermittently at predefined time intervals, or continuously, in order to accommodate temporal variations in stray capacitance or EMI coupling to electrical conductors 104, 105, for example due to bending of interventional device 101, and thereby improve the temporal EMI performance of the medical sensing system. Moreover, adjustable capacitance C.sub.Adj1, C.sub.Adj2 may alternatively be adjusted based on interference signals detected on each of electrical conductors 104, 105, or based on a measured difference between stray capacitances C.sub.S104 and C.sub.S105.
(29) In this regard,
(30) In this implementation the use of a differential amplifier that connects to electrical conductors 104, 105 inherently provides a signal corresponding to the difference in interference on these conductors. The output of the differential amplifier may then be suitably processed, for example by (bandpass) filtering the signal in order to distinguish interference from any desired sensor signal that may be present on these electrical conductors, and e.g. determining its average or root mean square value, such that it may be used to generate bias voltage V.sub.Bias to adjustable capacitance circuit 102 in
(31) In one implementation of the adjustable capacitance circuit 102 that does not use a differential amplifier, an analogue-to-digital converter may alternatively be used to directly convert the measured interference values on one or both of electrical conductors 104, 105 in order to generate bias voltage V.sub.Bias for adjustable capacitance circuit 102 in
(32) In so doing a reliable technique of reducing EMI is provided because it is based on the actual detected interference. As mentioned above, in some implementations it is contemplated to determine adjustable capacitance value C.sub.Adj1, C.sub.Adj2 during a calibration procedure, for example prior-to use, or when in-use, and during which the necessary capacitance value C.sub.Adj1, C.sub.Adj2 is e.g. adjusted or stored for later use. In other implementations the adjustment may be determined and made in-use, intermittently at predefined time intervals, or continuously.
(33) In another implementation, not illustrated, adjustable capacitance circuit 102 is configured to control adjustable capacitance C.sub.Adj1, C.sub.Adj2 based on a difference in stray capacitance, i.e. C.sub.S104, C.sub.S105, measured between each electrical conductor 104, 105 and i) electrically conductive shield 106 that overlaps electrical conductors 104, 105 and/or ii) electrically conductive shaft 107. Well-known capacitance measuring techniques may be used to determine the stray capacitances C.sub.S104, C.sub.S105. As with the measured interference, in some implementations it is contemplated to determine adjustable capacitance value C.sub.Adj1, C.sub.Adj2 during a calibration procedure, for example prior-to use, or when in-use, and during which the necessary capacitance value C.sub.Adj1, C.sub.Adj2 is e.g. adjusted or stored for later use. In other implementations the adjustment may be determined and made in-use, intermittently at predefined time intervals, or continuously.
(34) In one implementation, medical sensing system 100 includes a differential amplifier. Thereto,
(35) It is to be noted that the embodiments of
(36) In some implementations, elongate interventional device 101 includes both i) an electrically conductive shield 106 that overlaps the electrical conductors 104, 105 and ii) an electrically conductive shaft 107. Moreover, electrically conductive shield 106 may be electrically connected to electrically conductive shaft 107. Preferably this electrical connection is made via a conductive trace such as a wire and so forth. Connecting these two items together has been found to further reduce EMI to the electrical signals detected by electrical conductors 104, 105. Moreover, such a connection may reduce the complexity of the electrical shielding and provides for a more flexible interconnection between the medical sensing system and adjustable capacitance circuit 102 since only a single electrical conductor is required to shield the electrical signals between these two items.
(37) In this regard,
(38) One exemplary technique for disposing aforementioned sensor 103 on interventional device 101 is now illustrated with reference to
(39) Polymer layers 125, 126 in sensor strip 800 may be formed from a range of polymers including but not limited to polyethylene terephthalate, PET, polyimide, PI, or polyamide, PA. Moreover, polymer layers 125, 126 may include an adhesive coating, optionally a pressure sensitive adhesive coating, on one or both of their surfaces, these being illustrated as adhesive layers 127, 128, 128, 130 in
(40) In one specific implementation, sensor 103 is formed from a piezoelectric material. Various so-called hard or soft piezoelectric materials may be used. The piezoelectric material may for example be a polymer such as Polyvinylidene fluoride, i.e. PVDF, PVDF co-polymer such as polyvinylidene fluoride trifluoroethylene (P(VDF-TrFE)) layer, or PVDF ter-polymer such as P(VDF-TrFE-CTFE). Such PVDF materials are available as a layer that may be incorporated within polymer layers 125, 126. Such PVDF materials may for example detect ultrasound signals, sound, or pressure. Sensor 103 may for example be another type of ultrasound sensor such as a capacitive micromachined ultrasound transducer, i.e. a CMUT, or another type of sensor altogether.
(41) With reference to
W=π.Math.D.Math.Sin(α) Equation 1
wherein α is the acute angle defined above with respect to length direction 124, and D is the diameter of a circular cross section of elongate interventional device 101. By arranging that W exceeds the above value, consecutive turns of the spiral overlap one another. Likewise by arranging that W is less than this value a small gap may be provided between consecutive turns of the spiral.
(42) Medical sensing system 100 described above finds application in many areas in the medical field. One particular application is now described with reference to
(43) Together, units 1040, 1042, 1044, 1045 and 1046 form a conventional ultrasound imaging system. The units 1042, 1044, 1045 and 1046 are conventionally located in a console that is in wired or wireless communication with beamforming ultrasound imaging probe 1040. Some of units 1042, 1044, 1045 and 1046 may alternatively be incorporated within beamforming ultrasound imaging probe 1040 as for example in the Philips Lumify ultrasound imaging system. Beamforming ultrasound imaging probe 1040 generates ultrasound field 1041. In
(44) In-use the above-described conventional ultrasound imaging system is operated in the following way. An operator may plan an ultrasound procedure via imaging system interface 1045. Once an operating procedure is selected, imaging system interface 1045 triggers imaging system processor 1046 to execute application-specific programs that generate and interpret the signals transmitted to and detected by beamforming ultrasound imaging probe 1040. A memory, not shown, may be used to store such programs. The memory may for example store ultrasound beam control software that is configured to control the sequence of ultrasound signals transmitted by and/or received by beamforming ultrasound imaging probe 1040. Image reconstruction unit 1042 provides a reconstructed ultrasound image corresponding to ultrasound field 1041 of beamforming ultrasound imaging probe 1040. Image reconstruction unit 1042 thus provides an image corresponding to the image plane defined by ultrasound field 1041 and which intercepts region of interest ROI. The function of image reconstruction unit 1042 may alternatively be carried out by imaging system processor 1046. The image may subsequently be displayed on display 1044. The reconstructed image may for example be an ultrasound Brightness-mode “B-mode” image, otherwise known as a “2D mode” image, a “C-mode” image or a Doppler mode image, or indeed any ultrasound image.
(45) Also shown in
(46) In-use, a position of ultrasound sensor 103 is computed respective ultrasound field 1041 by position determination unit 1043 based on ultrasound signals transmitted between beamforming ultrasound imaging probe 1040 and ultrasound sensor 103. Ultrasound sensor 103 detects ultrasound signals corresponding to beams B.sub.1..k. Position determination unit 1043 identifies the position of ultrasound sensor 103 based on i) the amplitudes of the ultrasound signals corresponding to each beam B.sub.1..k that are detected by ultrasound sensor 103, and based on ii) the time delay, i.e. time of flight, between emission of each beam B.sub.1..k and its detection by ultrasound sensor 103. Position determination unit 1043 subsequently provides an icon in the reconstructed ultrasound image based on the computed position of ultrasound sensor 103. The icon may for example indicate the computed position of ultrasound sensor 103. The icon may optionally also indicate a range of positions within which a portion of the interventional device, e.g. its distal end, may lie. More specifically the position is computed by finding the best fit position of ultrasound sensor 103 respective ultrasound field 1041 based on the detected ultrasound signals.
(47) This may be illustrated as follows. When ultrasound sensor 103 is in the vicinity of ultrasound field 1041, ultrasound signals from the nearest of beams B.sub.1..k to the sensor will be detected with a relatively larger amplitude whereas more distant beams will be detected with relatively smaller amplitudes. Typically the beam that is detected with the largest amplitude is identified as the one that is closest to ultrasound sensor 103. This beam defines in-plane angle θ.sub.IPA between beamforming ultrasound imaging probe 1040 and ultrasound sensor 103. The corresponding range depends upon the time delay, i.e. the time of flight, between the emission of the largest-amplitude beam B.sub.1..k and its subsequent detection. The range may thus be determined by multiplying the time delay by the speed of ultrasound propagation. Thus, the range and corresponding in-plane angle θ.sub.IPA of the beam detected with the largest amplitude can be used to identify the best-fit position of ultrasound sensor 103 respective ultrasound field 1041.
(48) Whilst reference has been made above to a planar ultrasound imaging probe in the above it is to be appreciated that the exemplified beamforming ultrasound imaging probe 1040 is only one example of a beamforming ultrasound imaging probe in which elongate interventional device 101 may be used. Elongate interventional device 101 also finds application in ultrasound-based position determination systems that include other types of 2D or 3D beamforming ultrasound imaging probes. These may include for example a “TRUS” transrectal ultrasonography probe, an “IVUS” intravascular ultrasound probe, a “TEE” transesophageal probe, a “TTE” transthoracic probe, a “TNE” transnasal probe, an “ICE” intracardiac probe. Moreover, it is to be appreciated that elongate interventional device 101 also finds application in other ultrasound sensing applications in the medical field beyond position tracking.
(49) In accordance with some implementations an interference reduction method is provided for use in medical sensing system 100 that includes sensor 103 having capacitance C.sub.ss disposed on elongate interventional device 101, and first electrical conductor 104 and second electrical conductor 105, first electrical conductor 104 and second electrical conductor 105 being in electrical contact with sensor 103 and extending along elongate interventional device 101 for providing electrical signals corresponding to signals detected by sensor 103, and i) an electrically conductive shield 106 that overlaps electrical conductors 104, 105 and/or ii) an electrically conductive shaft 107 and in which first electrical conductor 104 and second electrical conductor 105 each have a stray capacitance C.sub.S104, C.sub.S105 to electrically conductive shield 106 and/or to electrically conductive shaft 107. The method comprises the steps of:
(50) adjusting a capacitance C.sub.Adj1, C.sub.Adj2 between at least one of the electrical conductors 104, 105 and i) the electrically conductive shield 106 that overlaps electrical conductors 104, 105 and/or ii) electrically conductive shaft 107, such that a magnitude of interference to the electrical signals on at least one of the electrical conductors 104, 105 is adjusted.
(51) Preferably the interference to the electrical signals on both of the electrical conductors 104, 105, is reduced.
(52) The method may further include the steps of:
(53) receiving signals indicative of detected interference on at least one of the electrical conductors 104, 105; and
(54) adjusting the capacitance C.sub.Adj1, C.sub.Adj2 based on the received signals.
(55) Again, preferably the capacitance C.sub.Adj1, C.sub.Adj2 is adjusted such that the interference to the electrical signals on both of the electrical conductors 104, 105, is reduced.
(56) This interference reduction method may for example be implemented by a processor that controls an analogue to digital converter for digitizing the electrical signals on electrical conductors 104, 105 and thus determining the detected interference, and which also controls the aforementioned adjustable capacitance circuit 102.
(57) Moreover, any of the method steps disclosed herein, particularly those described in relation to the processor of position determination unit 1043 in
(58) In summary, a medical sensing system has been provided that includes an elongate interventional device and an adjustable capacitance circuit. The elongate interventional device includes a sensor having a capacitance. The sensor is disposed on the elongate interventional device. The elongate interventional device also includes a first electrical conductor and a second electrical conductor, the first electrical conductor and the second electrical conductor being in electrical contact with the sensor and extending along the elongate interventional device for providing electrical signals corresponding to signals detected by the sensor. The elongate interventional device also includes i) an electrically conductive shield that overlaps the electrical conductors and/or ii) an electrically conductive shaft. The first electrical conductor and the second electrical conductor each have a stray capacitance to the electrically conductive shield and/or to the electrically conductive shaft. The adjustable capacitance circuit provides an adjustable capacitance between at least one of the electrical conductors and i) the electrically conductive shield that overlaps the electrical conductors and/or ii) the electrically conductive shaft.
(59) Various embodiments and options have been described in relation to the medical sensing system, and it is noted that the various embodiments may be combined to achieve further advantageous effects. In particular it is noted that any of the features described in relation to the medical sensing system disclosed may be implemented in the aforementioned method. Any reference signs in the claims should not be construed as limiting the scope of the invention.
(60) As used herein, the term “or” should be interpreted as a disjunctive “or.” Further, the term “or” and the term “and” when prefaced by the term “at least one of” or the term by “one or more of” should be interpreted as a disjunctive list such that, for example, a list of “at least one of A or B” or a list of “one or more of A and B” or a list of “A or B” should be interpreted to include either A or B, one of A and one of B, a combination of one or more of each of A and B; both A and B; or combinations of one or more of A and B, and such other combinations as relevant to the recited list or terms consistent with the corresponding description in the specification.